Rotavirus morbidity and mortality in children in Brazil

Objective. To study the epidemiology of rotavirus and estimate rotavirus- associated morbidity and mortality in children <= 5 years of age in Brazil in 2004 before introducing the rotavirus vaccine in Brazil`s National Immunization Program ( Programa Nacional de Imunizacoes, PNI). Methods. To estimate rotavirus morbidity, published studies ( 1999 - 2006) addressing incidence of acute diarrhea among children <= 5 years of age and frequency of rotavirus infection among children with diarrhea in Brazil were reviewed. Diarrhea episodes were divided into three categories of severity by level of care: mild cases requiring only home- based care; moderate cases requiring a visit to an outpatient healthcare facility; and severe cases requiring hospitalization. To estimate rotavirus mortality, information on the number of registered deaths from diarrhea in children <= 5 years of age was obtained from the Mortality Information System ( Sistema de Informacao, sobre Mortalidade, SIM) of Brazil`s public healthcare system ( Sistema Unico de Sa de, SUS) and the proportion of deaths due to rotavirus was calculated. Results. Rotavirus infections were estimated to cause 3 525 053 episodes of diarrhea, 655 853 visits to outpatient healthcare facilities, 92 453 hospitalizations, and 850 deaths of children <= 5 years of age each year in Brazil. Conclusion. Rotavirus infections are an important cause of child morbidity and mortality in Brazil.

Mucosal and systemic anti-GAG immunity induced by neonatal immunization with HIV LAMP/gag DNA vaccine in mice

Vaccines capable of inducing mucosal immunity in early postnatal life until adulthood, protecting early sexual initiation, should be considered as strategies to vaccination against HIV. The HIV-1 GAG protein as a chimera with the lysosome-associated membrane protein (LAMP/gag), encoded by a DNA vaccine, is targeted to the endosomal/lysosomal compartment that contains class II MHC molecules and has been shown to be immunogenic in adult mice. Assuming that one such strategy could help to overcome the immunological immaturity in the early postnatal period, we have evaluated the systemic and mucosal immunogenicity of LAMP/gag immunization in neonatal mice. Intranasal immunization with LAMP/gag vaccine induced higher levels of sIgA and IgG anti-GAG antibodies in intestinal washes than did the gag vaccine. The combination of ID injections and the IN protocol with the chimeric vaccine promoted the increase of Ab levels in sera. Both vaccines induced splenic IFN-gamma- secreting cells against GAG peptide pools, as well as in vivo cytotoxic T lymphocyte (CTL) function, and increased the percentage of CD8+ T cells to the immunodominant class I peptide in gut and spleen. However, only the chimeric vaccine was able to enhance Th1/Th2 cytokine secretion in response to class II GAG peptide and to enhance IL-4-secreting cells against GAG peptides and p24 protein stimuli. Long-lasting humoral and cellular responses were detected until adult age, following neonatal immunization with the chimeric vaccine. The LAMP/gag vaccination was able to induce potent GAG-specific T and B cell immune responses in early life which are essential to elicit sustained and long-lasting mucosal and systemic humoral response. (C) 2010 Elsevier GmbH. All rights reserved.

Differential Persistence of Transmitted HIV-1 Drug Resistance Mutation Classes

Methods. We studied participants with acute and/or early HIV infection and TDR in 2 cohorts (San Francisco, California, and Sao Paulo, Brazil). We followed baseline mutations longitudinally and compared replacement rates between mutation classes with use of a parametric proportional hazards model. Results. Among 75 individuals with 195 TDR mutations, M184V/I became undetectable markedly faster than did nonnucleoside reverse-transcriptase inhibitor (NNRTI) mutations (hazard ratio, 77.5; 95% confidence interval [CI], 14.7-408.2; P < .0001), while protease inhibitor and NNRTI replacement rates were similar. Higher plasma HIV-1 RNA level predicted faster mutation replacement, but this was not statistically significant (hazard ratio, 1.71 log(10) copies/mL; 95% CI, .90-3.25 log(10) copies/mL; P = .11). We found substantial person-to-person variability in mutation replacement rates not accounted for by viral load or mutation class (P < .0001). Conclusions. The rapid replacement of M184V/I mutations is consistent with known fitness costs. The long-term persistence of NNRTI and protease inhibitor mutations suggests a risk for person-to-person propagation. Host and/or viral factors not accounted for by viral load or mutation class are likely influencing mutation replacement and warrant further study.

A subunit vaccine based on biodegradable microspheres carrying rHsp65 protein and KLK protects BALB/c mice against tuberculosis infection

Of the hundreds of new tuberculosis ( TB) vaccine candidates some have therapeutic value in addition to their prophylactic properties. This is the case for the DNA vaccine encoding heat-shock protein 65 (DNAhsp65) from Mycobacterium leprae. However, there are concerns about the use of DNA vaccines in certain populations such as newborns and pregnant women. Thus, the optimization of vaccination strategies that circumvent this limitation is a priority. This study evaluated the efficacy of a single dose subunit vaccine based on recombinant Hsp65 protein against infection with M. tuberculosis H37Rv. The Hsp65 protein in this study was either associated or not with immunostimulants, and was encapsulated in biodegradable PLGA microspheres. Our results demonstrate that the protein was entrapped in microspheres of adequate diameter to be engulfed by phagocytes. Mice vaccinated with a single dose of Hsp65-microspheres or Hsp65 + CpG-microspheres developed both humoral and cellular-specific immune responses. However, they did not protect mice against challenge with M. tuberculosis. By contrast, Hsp65+KLK-microspheres induced specific immune responses that reduced bacilli loads and minimized lung parenchyma damage. These data suggest that a subunit vaccine based on recombinant protein Hsp65 is feasible.

Teleantagonism: A pharmacodynamic property of the primary nociceptive neuron

Previous work from our group showed that intrathecal (i.t.) administration of substances such as glutamate, NMDA, or PGE(2) induced sensitization of the primary nociceptive neuron (PNN hypernociception) that was inhibited by a distal intraplantar (i.pl.) injection of either morphine or dipyrone. This pharmacodynamic phenomenon is referred to in the present work as ""teleantagonism``. We previously observed that the antinociceptive effect of i.t. morphine could be blocked by injecting inhibitors of the NO signaling pathway in the paw (i.pl.), and this effect was used to explain the mechanism of opioid-induced peripheral analgesia by i.t. administration. The objective of the present investigation was to determine whether this teleantagonism phenomenon was specific to this biochemical pathway (NO) or was a general property of the PNNs. Teleantagonism was investigated by administering test substances to the two ends of the PNN (i.e., to distal and proximal terminals; i.pl. plus i.t. or i.t. plus i.pl. injections). We found teleantagonism when: (i) inhibitors of the NO signaling pathway were injected distally during the antinociception induced by opioid agonists; (ii) a nonselective COX inhibitor was tested against PNN sensitization by IL-1 beta; (iii) selective opioid-receptor antagonists tested against antinociception induced by corresponding selective agonists. Although the dorsal root ganglion seems to be an important site for drug interactions, the teleantagonism phenomenon suggests that, in PNNs, a local sensitization spreads to the entire cell and constitutes an intriguing and not yet completely understood pharmacodynamic property of this group of neurons.

Sodium nitrite downregulates vascular NADPH oxidase and exerts antihypertensive effects in hypertension

Dietary nitrite and nitrate are important sources of nitric oxide (NO). However, the use of nitrite as an antihypertensive drug may be limited by increased oxidative stress associated with hypertension. We evaluated the antihypertensive effects of sodium nitrite given in drinking water for 4 weeks in two-kidney one-clip (21(1 C) hypertensive rats and the effects induced by nitrite on NO bioavailability and oxidative stress. We found that, even under the increased oxidative stress conditions present in 2K1C hypertension, nitrite reduced systolic blood pressure in a dose-dependent manner. Whereas treatment with nitrite did not significantly change plasma nitrite concentrations in 2K1C rats, it increased plasma nitrate levels significantly. Surprisingly, nitrite treatment exerted antioxidant effects in both hypertensive and sham-normotensive control rats. A series of in vitro experiments was carried out to show that the antioxidant effects induced by nitrite do not involve direct antioxidant effects or xanthine oxidase activity inhibition. Conversely, nitrite decreased vascular NADPH oxidase activity. Taken together, our results show for the first time that nitrite has antihypertensive effects in 2K1C hypertensive rats, which may be due to its antioxidant properties resulting from vascular NADPH oxidase activity inhibition. (C) 2011 Elsevier Inc. All rights reserved.

Nossa V??rzea: cidadania e sustentabilidade na Amaz??nia brasileira

Em um novo modelo de gest??o compartilhada da Secretaria do Patrim??nio da Uni??o, a iniciativa faz parte do projeto Nossa V??rzea ??? regulariza????o fundi??ria em ??reas de v??rzeas ??? e est?? sendo desenvolvida pela SPU, por meio da Ger??ncia da Secretaria do Patrim??nio da Uni??o do Estado do Par?? (GRPU/PA). Tem como objetivo promover a regulariza????o fundi??ria de ocupa????es em terras p??blicas utilizando o Termo de Autoriza????o de Uso ??? instrumento legal inovador, que constitui o fundamento expressivo da a????o. Ao entregar o Termo ??s fam??lias de comunidades ribeirinhas, a Uni??o reconhece o direito ?? ocupa????o e possibilita a explora????o sustent??vel das ??reas de v??rzeas. Al??m disso, o instrumento representa para a fam??lia beneficiada um comprovante oficial de resid??ncia e uma garantia de acesso a aposentadoria, a recursos do Programa Nacional de Fortalecimento da Agricultura Familiar (Pronaf) e a outros programas sociais do Governo Federal. Desde a implanta????o do Programa, j?? foram beneficiadas cerca de 6.000 fam??lias ribeirinhas, principalmente as que residem no arquip??lago do Maraj??

Sistema de Monitoramento do Mercado de Terras (SMMT)

O Minist??rio do Desenvolvimento Agr??rio, por meio da Secretaria de Reordenamento Agr??rio, implementou o Programa Nacional de Cr??dito Fundi??rio (PNCF) com o objetivo de financiar a aquisi????o de terras a trabalhadores rurais sem-terra, jovens do meio rural, arrendat??rios, meeiros e posseiros. O Programa prev?? a concess??o de b??nus adicional de redu????o do pre??o da terra para os agricultores que negociarem a aquisi????o do im??vel abaixo de um pre??o de refer??ncia. O Sistema de Monitoramento do Mercado de Terras (SMMT) acompanha os neg??cios realizados pelo PNCF, visando obter valores de refer??ncia para os im??veis financiados pelo Programa, realizando tamb??m o c??lculo do b??nus adicional. O SMMT busca, dessa forma, incentivar a redu????o do pre??o da terra para os benefici??rios e para o governo, constituindo-se ferramenta de efici??ncia no gasto p??blico e de controle social

Sistema de controle de remanejamento e reserva t??cnica: siscort

O Sistema de Controle de Remanejamento e Reserva T??cnica (SISCORT) ?? uma tecnologia social in??dita na gest??o p??blica. ?? um inovador instrumento de gest??o no desenvolvimento de pol??ticas p??blicas voltadas para a melhoria da qualidade da educa????o. O SISCORT, por meio de suas consultas e cadastros dispon??veis, ?? ferramenta eficaz na concretiza????o das a????es propostas. Ele facilita, registra e controla o remanejamento dos livros adquiridos e distribu??dos em todas as escolas p??blicas de ensino fundamental, no ??mbito do maior programa do g??nero no mundo, o Programa Nacional do Livro Did??tico (PNLD). Acessando o SISCORT, no s??tio eletr??nico do FNDE, ?? poss??vel saber a quantidade de livros enviados para cada escola, por t??tulo, por s??rie e por componente curricular, permitindo que as escolas, ap??s informar o seu alunado real, saibam, automaticamente, se e onde h?? excesso ou escassez de livros, proporcionando mais transpar??ncia e maior controle social dos recursos p??blicos

Sistemas de informa????es para o licenciamento ambiental: exemplo de coopera????o interinstitucional para melhoria da gest??o ambiental

Em 1981, com a edi????o da Lei no 6938, foi criado o Sistema Nacional de Meio Ambiente (Sisnama), composto dos ??rg??os federais e estaduais respons??veis pela formula????o e implementa????o das pol??ticas de meio ambiente. No ??mbito federal, integram o Sisnama o Minist??rio do Meio Ambiente (MMA) e o Instituto Brasileiro de Meio Ambiente e Recursos Naturais (Ibama); nos estados s??o integrantes os ??rg??os estaduais de meio ambiente. O licenciamento ambiental de qualquer atividade econ??mica ?? obrigat??rio em todo o pa??s, mas somente seis desses ??rg??os ambientais estaduais possuem sistemas informatizados para acompanhamento da situa????o desses empreendimentos. Essa situa????o conduz a uma s??rie de problemas gerenciais e administrativos entre os empreendedores e o governo, entre o p??blico e o governo e entre os empreendedores e a sociedade. At?? mesmo o Minist??rio P??blico, ao requisitar informa????es sobre a situa????o de determinada atividade econ??mica, n??o recebe dados com a presteza e a confiabilidade necess??rias

Baixa de empresa web

Visando oferecer um servi??o inteligente, eficiente, ??gil e com maior qualidade ao contribuinte, a Diretoria de Arrecada????o do INSS disponibilizou, em conson??ncia com o Plano de A????o do Governo Eletr??nico e o Programa Nacional de Desburocratiza????o, o programa Baixa de Empresa Web, que viabiliza a emiss??o da certid??o de baixa para fins de registro ou arquivamento no ??rg??o pr??prio. Esse programa busca as informa????es contributivas da empresa e verifica a exist??ncia de restri????es ou impedimentos nos diversos bancos de dados do INSS, disponibilizando, em tempo real, o resultado do processamento. Os contribuintes podem acess??-lo pela Internet, no site da Previd??ncia Social (www.previdenciasocial.gov.br), e os servidores, pela Intranet

Aperfei??oamento e moderniza????o dos mecanismos de controle de projetos culturais

Tendo em conta a fragilidade dos mecanismos de controles existentes para acompanhamento dos projetos culturais beneficiados com incentivos fiscais, tornou-se necess??rio o aperfei??oamento e moderniza????o desses mecanismos, objetivando garantir ao Minist??rio da Cultura que os recursos captados estavam de fato sendo empregados nas ??reas de atua????o do Programa Nacional de Apoio ?? Cultura ??? PRONAC. As principais inova????es foram: exig??ncia por parte do MinC de capta????o m??nima para in??cio da execu????o do projeto; descentraliza????o da an??lise e acompanhamento dos projetos para todas as Secret??rias-fim do MinC; e cria????o de instrumentos para a fiscaliza????o / acompanhamento sistem??tico da execu????o dos projetos culturais incentivados, at?? ent??o inexistentes na Administra????o P??blica Federal.Ap??s a implanta????o da experi??ncia houve maior credibilidade dos incentivos fiscais junto ao mercado produtor; garantia de execu????o total dos projetos culturais com capta????o; condi????es para uma avalia????o global do desempenho do mecanismo "mecenato" do PRONAC; redu????o do tempo de an??lise dos projetos de 90 para 45 dias em m??dia, melhorando a qualidade dos servi??os prestados pelo MinC aos produtores culturais

A trajet??ria dos programas de transfer??ncia de renda no Brasil: o impacto da vari??vel federativa

Neste trabalho, analisa-se a trajet??ria dos programas de transfer??ncia de renda no sistema de prote????o social brasileiro, procurando demonstrar como algumas quest??es federativas t??m afetado decisivamente a sua implementa????o, desde as primeiras iniciativas subnacionais at?? a ado????o de programas nacionais com clara interface intergovernamental. O argumento central ?? que o modelo federativo influenciou diretamente o desenvolvimento dos programas de transfer??ncia de renda no Brasil, sendo determinante para o seu bom desempenho.

Gest??o do conhecimento em organiza????es p??blicas de sa??de no Brasil: diagn??stico de pr??ticas

As organiza????es p??blicas e privadas vivem diante de um cen??rio complexo, em que os fatores econ??micos e sociais de alcance mundial s??o respons??veis pela sua reestrutura????o. Nesse contexto, a Gest??o do Conhecimento (GC) se torna um valioso instrumento estrat??gico para a vida das pessoas e das organiza????es a que pertencem. A cria????o e a implanta????o de processos que gerem, armazenem, gerenciem e disseminem o conhecimento representam o mais novo desafio a ser enfrentado pelas organiza????es. O estudo realizado junto a Centros de Pesquisa Cl??nica (unidades vinculadas principalmente a Hospitais Universit??rios) e organiza????es p??blicas de sa??de integrantes do Programa Nacional de Gest??o P??blica e Desburocratiza????o (GESP??BLICA) tem como objetivo verificar como o tema GC est?? sendo tratado. O artigo identifica as pr??ticas de GC empregadas pelas organiza????es de sa??de abrangidas pelo estudo e sugere recomenda????es para uma dissemina????o mais eficaz do Modelo de Excel??ncia em Gest??o P??blica.

Transformando burocracias para financiar os mais pobres: a evolu????o do Pronaf Cr??dito Grupo B

Institui????es banc??rias tradicionalmente n??o oferecem servi??os financeiros, principalmente cr??dito produtivo, aos grupos de mais baixa renda. Considerando-se a rigidez do sistema financeiro em trabalhar com os mais pobres, o presente artigo descreve o processo de cria????o e aperfei??oamento de uma pol??tica p??blica de microcr??dito rural dentro do Programa Nacional de Fortalecimento da Agricultura Familiar (Pronaf). S??o apresentadas as motiva????es para altera????es no desenho da linha de cr??dito, assim como as mudan??as normativas, de fontes e de agentes operadores, efetuadas em cada ano-safra para tornar poss??vel superar os desafios apresentados pela burocracia do Sistema Nacional de Cr??dito Rural ??? SNCR. O texto apresenta ainda o impacto no n??mero de contrata????es resultante das diversas medidas tomadas. Finalmente, ?? feito um balan??o das principais li????es aprendidas assim como dos desafios atuais de maior qualifica????o do microcr??dito e integra????o com outras pol??ticas p??blicas.