La solución de controversias en los acuerdos regionales de América Latina con países desarrollados

Incluye Bibliografía

Estudio sobre las experiencias europeas con los instrumentos de evaluación de las políticas del mercado de trabajo

Incluye Bibliografía

Fallas de coordinación: desafíos de política para el federalismo fiscal ambiental argentino

Incluye Bibliografía

La dimensión espacial en las políticas de superación de la pobreza urbana

Incluye Bibliografía

Productividad del sector público, evaluación de la gestión del gasto público e indicadores de desempeño en Guatemala

Incluye Bibliografía

Las fallas del mercado de capitales

Incluye Bibliografía

Diez tesis sobre el conflicto social en América Latina

Incluye Bibliografía

Nuevas orientaciones para la gestión pública

Incluye Bibliografía

Monetarism, open-economy policies and the ideological crisis

Includes bibliography

The imperfections of the capital market

Includes bibliography

Guía metodológica: medición del gasto en protección ambiental del gobierno general

La medición del gasto en protección ambiental permite evaluar el desempeño, la eficacia y el impacto de políticas, planes, programas e instrumentos económicos de gestión ambiental. Sin embargo, para medir los progresos y realizar ajustes a las políticas ambientales es necesario que estas mediciones sean sistemáticas, continuas y estandarizadas. En América Latina y el Caribe existen experiencias de cálculo del gasto en protección ambiental del sector público, aunque la mayoría no ha perdurado en el tiempo. Las mayores dificultades en la medición de este gasto se asocian con la falta de uniformidad de conceptos y clasificaciones, la doble contabilidad y los escasos registros administrativos existentes. Para abordar los retos mencionados es necesario un marco ordenador, basado en estándares internacionales, que permita fortalecer las capacidades técnicas de los países y calcular el gasto en protección ambiental de manera regular. Por ello, la Comisión Económica para América Latina y el Caribe (CEPAL) y el Instituto Nacional de Estadística y Geografía (INEGI) de México han elaborado esta guía metodológica, con el fin de apoyar los esfuerzos de los países vinculados a la generación y difusión de estadísticas oficiales sobre el gasto en protección ambiental.

Hydroxyurea in the sickle cell anemia: toxicity and effectiveness

Objective: to evaluate the use of hydroxyurea with regard to effectiveness and toxicity in people with sickle cell anemia. Method: this is a retrospective descriptive study, developed with 57 medical records of patients with sickle cell anemia, treated at the University Hospital Center of Campo Grande (Mato Grosso do Sul, Brazil), from 1993 to 2005. Inclusion criteria: electrophoresis of hemoglobin in medical record; regular use of drugs, for an average of 196 weeks; dosage; and hematological analyses before starting treatment. Exclusion criteria: living with other hemoglobinopathies. The variables evaluated were: neutrophils count; platelets; leukocytes; hemoglobin; time using hydroxyurea; drug response to the optimal dosage; and number and type of episodes of hospitalization. The research protocol was approved by the Ethics Committee of Universidade Federal de Mato Grosso do Sul, under the Protocol 645. Results: of the 57 medical records, 3 cases were evaluated. Comparing the hematological values, according to Portaria 872, enacted on 11/12/2002, it was found that: cases A, B, and C present an use of hydroxyurea (500 mg/day) for four years, with an average of 196 weeks. Case A, female, decreased painful episodes and frequency of hospitalization, keeping hematological values with no toxicity. In Case B, female, there was one hospitalization due to pain crises and important hemolysis. It stood out, in case C, male, neutropenia with hematological values < 2,000/mm3 . Conclusion: in the cases analyzed, we observed a drop in the number of hospitalizations with the decrease in painful crises from three to one a year, and there was no toxicity with regard to the dosage and time using hydroxyurea, in all three cases. For more comprehensive results, one suggests further study on this therapy with significant samples of this clientele.

Medicamentos inadequados para idosos na estratégia da saúde da família

The ageing process can change the pharmacodynamics and pharmacokinetics parameters. Therefore, some medications are considered potentially inappropriate (PIM) for the elderly people, since they can increase the likelihood of occurrence of adverse drug events. The objectives are to estimate the frequency of use of PIM in the elderly people, with potentially hazardous drug interactions (PHDI) and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. A cross-sectional study was performed in a Health Family Strategy (region of Araraquara, SP), between January and February/2012. The medical records of patients aged ≥60 years, that use at least one drug, were consulted for identification of PIM, according to the Beers criteria. The MPI identified were classified considering the Anatomical Therapeutic Chemical Classification System (ATC) and the essentiality of the drug (safety, effectiveness, quality and cost parameters) The inclusion criteria were met by 358 elderly, being that 93 of them (26%) had taken at least one PIM. Of the 114 different drugs prescribed for elderly, ten were classified as PIM, of which four of them act on the central nervous system, four on cardiovascular system and two on the digestive tract. Seven MPI are essential medicines, belonging to national list of essential drugs (RENAME-2010). Fourteen drug interactions were identified, of which two are PHDI (fluoxetine/amitriptyline and digoxin/hydrochlorothiazide).After the PI, there was no change in medical prescriptions of patients with PIM use or with DI. Medical prescriptions of elderly attended in the Health Family Strategy show pharmacotherapeutic safety problems, of which may be responsible for health hazardous for this age group. Although the intervention carried out by letter had been ineffective for the adherence of doctors in prescribing safe alternatives, wide dissemination of the lists that contain PIM and PHDI is need, as well as the inclusion of safer equivalents in RENAME, in order to contribute for rational use of drugs.

Selección del tratamiento farmacológico en el estado de mal epiléptico en niños

The status epilepticus (SE) is characterized by a series of crises which occur without recovery of consciousness or a single seizure lasting more than 30 minutes and can damage the central nervous system and systemic. The duration and frequency of attacks are directly related to patient prognosis. Whether seizures occur often and are longer, increase the risk of neurological and systemic complications. Child population has a higher frequency of seizures and it is associated with a lower threshold of immature brain to trigger these episodes. Aim: To determine the safest drugs prescribed for children in SE, their doses and schedules. A bibliographic survey was performed in electronic databases. Methods: The scientific health descriptors used for search was: “status epilecticus” and “anticonvulsivants” and “child”. Results: This strategy identified 396 manuscripts, of whom four were considered eligible for the study, after the assessment by floating reading and criteria. Of these, two were randomized trials and two descriptive. The studies address the use of oral midazolam, rectal diazepam and intravenous lorazepam. Conclusions: All investigated drugs were effective in treat in status epilepticus. Lorazepam is highlight, since it has fewer secondary effects and, as an alternative to the intravenous, oral midazolam. However, there is a need for further studies to demonstrate the efficacy and safety in the use of drugs in children.

Democracia digital e redes sociais: Twitter como filtro de informação política

The internet, with its hypertext and multimedia features, can be a support for the dissemination of information in an attractive way, which may contribute to the strengthening of democracy. Recent innovation, social networks have been explored also as a resource to attract the interest of the broader public to information about public policies. This paper presents and discusses the results of an empirical study which assessed, through content analysis, the breadth and depth of information offered by the Sao Paulo state government and the federal government in texts accessed through Twitter to publicize purposes, lines of action and limits of public policy in the areas of welfare, health, education and environment . The results indicate that the information available tend to focus mainly on goals, resources and current actions of policies, whereas there can be found few data on planned features, relation between cost and effectiveness and user satisfaction.