Análisis económico de las vacunas 10-valente y 13-valente contra neumococo: revisión sistemática

Introducción: Las vacunas clásicamente han representado un método económico y eficaz para el control y prevención de múltiples enfermedades infecciosas. En los últimos años se han introducido nuevas vacunas contra neumococo a precios elevados, y los diferentes análisis económicos a nivel mundial de estas vacunas no muestran tendencias. El objetivo de este trabajo era resumir la evidencia existente a través de los diferentes estudios económicos evaluando las dos vacunas de segunda generación contra neumococo en la población a riesgo. Metodología: En este trabajo se realizo una revisión sistemática de la literatura en 8 bases de datos localizadas en diferentes partes del mundo y también que tuvieran literatura gris. Los artículos fueron inicialmente evaluados acorde a su titulo y resumen, posteriormente los elegidos se analizaron en su totalidad. Resultados: Se encontraron 404 artículos, de los cuales 20 fueron incluidos en el análisis final. Se encontró que la mayoría de los estudios se realizaron en áreas donde la enfermedad tiene una carga baja, como es Norte América y Europa, mientras que en los lugares del mundo donde la carga es mas alta, se realizaron pocos estudios. De igual manera se observo que la mayoría de los estudios mostraron por los menos ser costo efectivos respecto a la no vacunación, y en su totalidad las dos vacunas de segunda generación mostraron costo efectividad respecto a la vacunación con PCV-7. Los resultados de los estudios son muy heterogéneos, hasta dentro del mismo país, señalando la necesidad de guías para la conducción de este tipo de estudios. De igual manera, la mayoría de los estudios fueron financiados por farmacéuticas, mientras en un numero muy reducido por entes gubernamentales. Conclusiones: La mayoría de los estudios económicos sobre las vacunas de segunda generación contra neumococo han sido realizados en países con un alto índice de desarrollo económico y patrocinados por farmacéuticas. Dado que la mayoría de la carga de la enfermedad se encuentran en regiones con un menor nivel de desarrollo económico se deberían realizar mas en estas zonas. De igual manera, al ser la vacunación un asunto de salud publica y con un importante impacto económico los gobiernos deberían estar mas involucrados en los mismos.

Where's my mum?

Un niño se despierta en su cama y pregunta por su mamá. La busca en los cajones, en el armario, en el baño, en el frigorífico, en el piano, en el jardín, y buscando, buscando por la casa, la encuentra durmiendo en su habitación.

Nutrição parentérica em recém-nascidos prematuros

A nutrição parentérica é um importante aliado no crescimento e desenvolvimento de recém-nascidos prematuros. A nutrição parentérica consiste numa solução contendo nutrientes, como glicose, proteínas, lípidos, eletrólitos, vitaminas e oligoelementos, administrada por via endovenosa de modo a garantir um crescimento saudável do recém-nascido. O objetivo deste trabalho é abordar de uma forma discritiva a nutrição dos prematuros desde os seus componentes, as vias de administração, as suas indicações e contra-indicações até à manipulação propriamente dita destas soluções. Para finalizar é apresentado um caso clínico de um recém-nascido do Hospital São Francisco Xavier, evidenciando desta forma, todo o trabalho em contexto real, de farmacêuticos e técnicos hospitalares nesta área.

La facultad reglamentaria del Ejecutivo como instrumento de presidencialismo asentado en Ecuador (Otros Temas)

Existen diversas atribuciones constitucionales entregadas al Presidente de la República. La facultad de dictar los reglamentos a las leyes vigentes en el país es una de ellas, y es en donde centraremos un importante análisis, pues, esta potestad constitucional es la generadora de un espacio de acción del gobernante que ha generado cuestionamientos por su ejercicio extralimitado a la prescripción constitucional y la doctrina que al respecto se ha determinado. Es así como el Ejecutivo, al dictar reglamentos a las leyes del Ecuador, ha venido regulando situaciones diferentes a las que en ellas se encuentran prescritas, ejerciendo arbitrariamente su potestad. En consecuencia, la facultad reglamentaria asienta el presidencialismo marcado en Ecuador y debilita la necesaria existencia de pesos y contrapesos en el poder.

Features of the Atlantic diet and its healthiness: Theory and evidence from social science

In order to understand diets, why and how they change and can be influenced, it is important to understand how food choices are made. The has been the subject of, considerable study within many of the social science disciplines and the humanities. The paper draws on the theoretical and empirical work of psychologists, sociologists, economists, market researchers, anthropologists, geographers and historians to understand better the forces behind food choice, derive some general empirical messages from the literature, to shed light on food choice in a European context and to address the question of whether there is, or has been, a recognisably Atlantic diet. The paper proceeds to analyse the characteristics of the food consumption patterns in the Atlantic diet countries, examines whether their food consumption patterns are homogenous (i.e. similar across the countries of this group), whether they are specific (i.e. different from the ones in other country groups) and finally evaluates the nutritional composition of the Atlantic diet against the WHO/FAO recommendations for a healthy and wholesome diet.

BIRD FORAGING IN ANACARDIUM PATCHES IN CENTRAL BRAZILIAN FIRE BREAKS: RELATIONSHIP BETWEEN FLOCK SIZE AND PATCH SIZE

Fire management ran increase the biomass of some plant species at fire breaks in reserves of the Cerrado. For example, numerous and large patches of monkey-nuts (Anacardium humile, Anacardiaceae) provide abundant food resources for wildlife in the lower strata of savanna woodlands managed by fire. The objective of this study was to examine the exploitation of A. humile patches by birds in managed savanna woodlands (fire breaks) at Emas National Park, southwest Brazil. The relationship between flock size and the size of Anacardium patches were also investigated. Fire breaks were sampled in September and October 2006, when fruits and flowers were abundant. Ara ararauna was often recorded exploiting resources of Anacardium patches. This species and other psittacids (Amazona aestiva, Alipiopsittaca xanthops, and Diopsittaca nobilis) consumed seeds usually on the ground around fruiting patches. Members of Aratinga aurea flocks and Ramphastos toco consumed pseudo-fruits. Larger flocks detected were those of A. aurea and A. ararauna. Groups of A. ararauna that exploited larger patches tended to be larger than flocks that exploited smaller patches. This study suggests that intra- and interspecific interactions and characteristics of Anacardium patches and of the surrounding vegetation are involved in the feeding ecology of birds in the lower stratum of managed woodlands. Fruiting Anacardium patches attract numerous frugivorous birds to fire breaks at Emas National Park. Further research is needed to a better understanding of the influence of fire management on birds in the Cerrado. Accepted 31 July 2009.

Breeding of the Rufous-thighed Hawk (Accipiter erythronemius) in Argentina and Brazil

The Rufous-thighed, Hawk (Accipiter erythronemius) is a poorly-known, small raptor that dwells in forests and wooded savannas in south and eastern Brazil, Taraguay, eastern Bolivia, north and central Argentina, and Uruguay. We studied breeding biology and food habits of the Rufous-thighed Hawk from 1994 to 2007. We documented 14 breeding attempts recorded at nine nest sites in eight localities in Argentina and Brazil. Rufous-thighed Hawks were year-round residents at the study areas. The breeding season was c. 38 weeks long (June through March). Territorial behavior and courtship spanned for 22 weeks starting in mid June. Nest-building started in August. Nestlings were observed throughout December and into early January while fledglings were observed from late December through late March. Most nest sites were conifer plantations averaging 32.2 (SD = 10) years old, 12.6 ha (SD = 11.3) in size with trees averaging d 37.5 cm (SD = 13.5) of diameter at breast height. Nests were placed 20.2 m high (SD = 5.7), near the trunks of non-emergent conifers (Pinus sp. or Araucaria angustifolia). Nests were made of sticks, greater diameter averaging 48.8 cm (SD = 11.4), while nest depth averaged 23.3 cm (SD = 14). Prey items were birds (n = 49) ranging in size from c. 10 g [House Wren (Troglodytes, aedon)] to c. 140 g [White-tipped Dove (Leptotila verreauxi)]. Young started to chase birds at the age of 42-45 days in mid January. Adult males were primarily food providers but also aided in nest defense against other raptors. Females incubated, brooded, and fed young, and took leading roles in defense against humans. Rufous-thighed Hawks had unlined nests placed high in trees, and breeding season was markedly protracted.

CONSIDERATIONS ON THE REINTRODUCTION AND RECOVERY OF THE ALAGOAS CURASSOW MITU MITU (LINNAEUS, 1766) FROM EXTINCTION USING A POTENTIALLY HYBRID CAPTIVE STOCK

The Alagoas Curassow Mitu mitu is considered extinct in the wild. Since 1979, two females and a male caught in the wild have bred successfully in captivity, and, in 1990, hybridizations between M. mitu and Razor-billed Mitu M. tuberosum were performed. By June 2008, there were around 130 living birds in two different aviaries. We sequenced two regions of the mitochondrial DNA of both captive stocks of Alagoas Curassows. We unequivocally identified hybrids that have haplotype typical of M. tuberosum. However, unless the original studbook can be recovered there is no confident way to discriminate ""pure"" M. mitu birds for breeding and reintroduction purposes. Allied with morphological data gathered in an independent study, we suggest that conservation actions need to focus on specimens with diagnostic phenotypic characters of M. mitu, and avoid birds with mitochondria, genetic contribution of M. tuberosum. Although we have detected low levels of genetic variability among captive birds, the steady increase of the captive population suggests that inbreeding depression and hybridization are not a reproductive hindrance. Reintroduction of some of these potential hybrid birds in the original area of occurrence of the Alagoas Curassow may be the only hope to fill in the ecological niche left vacant. An educational program involving local communities to conserve future reintroduction of curassows and their restored habitat is highly recommended. Accepted 12 November 2009.

Adubação orgânica e mineral na produção, qualidade e composição química de sementes de abobrinha (Cucurbita pepo L. var. melopepo cv. Caserta)

Com o objetivo de estudar os efeitos da adubação sobre os componentes do rendimento, no potencial de produção, qualidade e composição química das sementes de C. pepo L variedade melopepo (Caserta) conduziu-se dois Estudos no Centro Agrícola Demonstrativo da Prefeitura de Porto Alegre/CAD, e no Laboratório de Análise de Sementes do Departamento de Plantas forrageiras e Agrometeorologia da Faculdade de Agronomia da Universidade Federal do Rio Grande do Sul (UFRGS) nos períodos de 2000/01 e 2002/03. No primeiro estudo utilizou-se dois tipos de adubação uma orgânica (cama de aviário- 386g/cova), e outra mineral (fórmula 5-20-20). No segundo estudo, os tratamentos constaram de:T1= testemunha, T2= adubação mineral, e 4 doses de cama de aviário: T3= 63g/cova, T4= 125 g/cova, T5= 187g/cova, T6= 250g/cova. O delineamento experimental foi o de blocos casualizados com 4 e 3 repetições no primeiro e segundo estudos, respectivamente. Foram determinados: número de flores/planta, número de frutos/planta, peso médio de frutos, peso de sementes/fruto, número de sementes/fruto, peso de 1000 sementes, rendimento de sementes/área, germinação, emergência em campo, teste de frio, condutividade elétrica, comprimento de plântula, composição centesimal (Cinza, PB, EE, FB, ENN, NDT, EB, MO), macronutrientes (N, P, K, Ca, MG, S) e micronutrientes (Cu, Zn, Fe, Mn, Na, B). No primeiro estudo, tanto a adubação mineral como a adubação orgânica não afetaram os componentes do rendimento, o rendimento/área, a qualidade e a composição química de sementes. No segundo estudo, a aplicação de cama de aviário aumentou o rendimento de sementes de abobrinha e os teores de nitrogênio e ferro nas sementes, porém não afetou a qualidade. A dose de cama de aviário que proporcionou o melhor resultado foi de 250g/cova (3,12 t/ha).

Degradação in situ da matéria seca e da fração fibrosa do capim marandu obtido por diferentes métodos de amostragem, no período seco do ano

Este trabalho foi realizado na Faculdade de Ciências Agrárias Veterinárias - Unesp - Jaboticabal e foi conduzido, com o objetivo de avaliar a influência do método de amostragem do pasto sobre a degradabilidade in situ da matéria seca e da fração fibrosa de capim Marandu, colhido no período seco dos anos de 2003 e 2005. O experimento foi instalado em delineamento de blocos casualizados com parcela subdividida, com três repetições, representadas pelos piquetes amostrados. Nas parcelas, foram avaliados cinco métodos de amostragens de forragem (método do quadrado metálico; método de avaliação através de extrusa de bovino da raça Nelore; método de avaliação por meio de extrusa de bovino Cruzado (Red Angus x Nelore); método de avaliação por meio do pastejo, simulando bovino da raça Nelore; método de avaliação por meio do pastejo, simulando bovino Cruzado (Red Angus x Nelore) e as subparcelas foram constituídas pelos anos de amostragem, 2003 e 2005. Foram determinadas as frações da cinética ruminal: solúvel A; insolúvel potencialmente degradável B; taxa de degradação Kd; degradação potencial (DP) e fração não degradável C da MS e degradação potencial (DP), fração não degradável C e taxa de degradação Kd da FDN e da FDA. de acordo com os resultados obtidos, observou-se que o método do quadrado metálico subestimou as características da degradação do capim. Os métodos do pastejo simulado se assemelharam muito ao das extrusas, no entanto, a prática do simulador é que assegurou a amostragem eficiente, conforme foi constatado pelos dados obtidos no ano de 2003 e 2005.

Population structure and effects of inbreeding on milk yield and quality of Murrah buffaloes

To provide data for conservation, selection, and expansion programs of buffalo herds, this study evaluated the history of a population of Murrah buffaloes based on population structure and the effect of inbreeding on accumulated 305-d milk yield (MY), fat yield (FY), protein yield (PY), mozzarella production (MProd), and somatic cell score (SCS). The usefulness of including the individual inbreeding coefficient (F) or individual increase in inbreeding coefficient (Delta F) in the model to describe inbreeding depression was evaluated. Pedigree information from 8,054 animals born between 1976 and 2008 and 4,497 lactation records obtained from 12 herds were used. The realized effective population size was 40.10 +/- 1.27, and the mean F of the entire population was 2.14%. The ratio between the number of founders and ancestors demonstrated the existence of a bottleneck in the pedigree of this population, which may contribute to a reduction of genetic diversity. The effect of F on MY, FY, PY, MProd, and SCS was -1.005 kg, -0.299 kg, -0.246 kg, -1.201 kg, and -0.002 units, and the effect of Delta F transformed to equivalent F (%) for a mean of 2.57 equivalent generations was -4.287 kg, -0.581 kg, -0.383 kg, -2.001 kg, and -0.007 units, respectively. The inbreeding depression observed may have important economic repercussions for production systems. The Delta F can be considered the better of the two indicators of inbreeding depression due to its properties that prevent underestimation of this effect. A designed mating system to avoid inbreeding may be applied to this population to maintain genetic diversity.

Frugivory and habitat use by fruit-eating birds in a fragmented landscape of southeast Brazil

To investigate the movement of seeds transported by fruit-eating birds in an agricultural, fragmented landscape of the Atlantic forest of southeast Brazil, I asked which bird species are the main seed dispersers in such environment, and how they use the available habitats (small forest fragments, forest thickets, live fences, isolated trees, and active pastures) where they are most likely to drop the seeds they swallow the relative importance of fruit-eating birds as seed vectors was evaluated based on the number of fruit species eaten, the number of visits, and visitation rate to fruiting plants. Habitat use was accessed by recording the habitats where birds were seen or heard during walks conducted throughout the study area. Sixteen plant species were observed during 308.3 plant-hours. Forty-one bird species were observed eating fruits in a total of 830 visits to fruiting plants. Sayaca Tanagers (Thraupis sayaca) and Pale-breasted Thrushes (Turdus leucomelas) ate the greatest number of fruit species, were the most frequent plant visitors in terms of number and rate of visits, and had a broad range of habitat use. These two species and the Rusty-margined Guan (Penelope superciliaris), which is able to swallow large fruits with large seeds that smaller bird species cannot cat, likely have a great contribution to the movement of seeds throughout this highly degraded landscape.