Doenças tropicais negligenciadas: uma nova era de desafios e oportunidades

In an article recently published in Química Nova, entitled "Chemistry Without Borders" ("Química Sem Fronteiras") [Pinto, A. C.; Zucco, C.; Galembeck, F.; Andrade, J. B.; Vieira, P. C. Quim. Nova 2012, 35, 2092], the authors highlighted the important aspects of science and technology with special emphasis on the field of Chemistry and its contributions toward a more prosperous Brazil of future. As a second step in that direction, this article extends the discussion of a key issue for the country in the framework of the chemistry community through the so called position papers in strategic areas. This document is a part of the contribution of the Brazilian Chemical Society to the World Science Forum to be held in Rio de Janeiro in November 2013. In this context, the present paper provides a brief discussion on neglected tropical diseases (NTDs) with emphasis on the current challenges and opportunities towards the development and evolution of the field. NTDs leads to illness, long-term disability or death, and has severe social, economic and psychological consequences for millions of men, women, and children worldwide. In most cases, the available treatments are inadequate and extremely limited in terms of efficacy and safety, leading to an urgent demand for new drugs. In addition to the traditional challenges involved in any drug discovery process, it is widely recognized that there is an innovation gap and a lack of investment for research and development (R&D) in the area of NTDs. In the last few decades, methods toward combating, eradication, prevention, and treatment of NTDs have been repeatedly emphasized in the major international agendas. Developments in these strategies and alliances have continued to have an essential impact, particularly in the area of drug discovery, both in Brazil and globally and should be encouraged and supported. Several examples of international activities dedicated to the reduction of the devastating global impact of NTDs can be provided. Despite the beneficial developments in the past 30 years, NTDs continue to devastate poor communities in remote and vulnerable areas, in large part, due to market failures and public policies. Recent studies have shown that among 756 new drugs approved between 2000 and 2011, only four new chemical entities (NCEs) were identified for the treatment of malaria, while none were developed against NTDs or tuberculosis. Furthermore, only 1.4% of approximately 150,000 clinical trials were registered for neglected diseases, with a smaller number of trials for NCEs. Establishment and strengthening of global strategies involving the triad "government-academia-industry" is fundamental to the success in R&D of new drugs for NTDs. National and international public-private initiatives that aim to create, encourage, and invest in R&D projects have been implemented and therefore are of utmost importance to successfully integrate Brazil into this new paradigm. It is essential to lay the foundation for mechanisms that will intensify investments in infrastructure, training, and qualification of personnel with an ultimate strategic vision that foresees continuity. Our research group has made significant contributions to the development of this field with the goal of forging new frontiers while tackling both current and future challenges that include indispensable elements such as innovation and integration.

L’exemption de paiement des soins associée à la supervision et à la formation au Burkina Faso : les effets sur la prescription de médicaments

L’accès financier limité aux soins de santé a suscité l’instauration de politiques sanitaires de subvention des soins en Afrique. Au Burkina Faso, une ONG, en complémentarité avec la politique sanitaire nationale subventionne à 100% depuis septembre 2008 les soins et les médicaments pour les enfants de moins de cinq ans dans le district sanitaire de Dori. L’intervention regroupe formation du personnel soignant, supervisions et suppression de paiement des soins et des médicaments. L’objectif de l’étude est d’analyser l’effet de cette intervention sur l’adéquation des prescriptions médicales. Neuf centres de santé ont été pris en compte. Au total 14956 ordonnances d’enfants de moins de cinq ans ciblés par l’intervention ont été sélectionnées par échantillonnage systématique à partir des registres de consultation un an avant et un an après l’instauration de l’intervention. Quatorze prescripteurs ont été interviewés. Les prescriptions ont été analysées par comparaison au référentiel de l’OMS ainsi qu’au référentiel national. Le discours des prescripteurs a été analysé en vue de comprendre leur perception de leur changement de pratiques depuis de début de la subvention. L’intervention a eu pour effet de diminuer l’utilisation des injections (Rapport de cote (RC) =0,28; p<0,005) dans le cas des infections respiratoires aiguës (IRA). Elle a entraîné une diminution de l’utilisation inappropriée des antibiotiques dans les cas de paludisme seul (RC=0,48; p<0,0005). Le nombre moyen de médicaments par ordonnance a également diminué de 14% dans les cas d’IRA (p<0,0005). Les prescripteurs ont affirmé pour la plupart que leurs pratiques se sont soit maintenues soit améliorées. L’intervention a entrainé une amélioration de l’adéquation des prescriptions médicales dans certains cas.

Description des valeurs éthiques dans la politique de lutte contre le paludisme en Côte d’Ivoire

À l’instar de nombreux pays en développement, la prévention et la prise en charge du paludisme présente occupent une place centrale dans les politiques publiques en Côte d’ivoire. En vue de fournir des outils d’aide à la décision aux acteurs politiques, plusieurs études sur l’évaluation de l’efficacité et des coûts des programmes sont régulièrement engagées. Toutefois, très peu d’études se sont penchées sur les dimensions éthiques de ces programmes. En conséquence, nous avons choisi d’explorer dans une perspective éthique les programmes de prévention et de prise en charge du paludisme en Côte d’Ivoire à travers une analyse documentaire descriptive. La méthode qualitative fut retenue à cet effet. Ce mémoire vise à démontrer que la lutte contre le paludisme est une entreprise qui intègre des valeurs éthiques implicites notamment de solidarité et de promotion de la vie en santé. En outre, des mesures particulières notamment de gratuité d’accès aux services de prévention et de prise en charge sont prévues dans le but de prendre en compte les populations vulnérables face au paludisme. Le chapitre d’analyse nous permettra de montrer comment ces dispositions présentent des limites en ce qui concerne l’équité. Enfin, nous allons démontrer que ces dispositions spécifiques sont susceptibles in fine de générer voir d’accentuer les risques d’inégalités sociales.

L’efficacité contestée du recours aux agents de santé communautaires pour la prise en charge du paludisme : évaluation du programme burkinabé dans les districts de Kaya et de Zorgho

Contexte. Le paludisme provoque annuellement le décès d’environ 25 000 enfants de moins de cinq ans au Burkina Faso. Afin d’améliorer un accès rapide à des traitements efficaces, les autorités burkinabées ont introduit en 2010 la prise en charge du paludisme par les agents de santé communautaires (ASC). Alors que son efficacité a été démontrée dans des études contrôlées, très peu d’études ont évalué cette stratégie implantée dans des conditions naturelles et à l’échelle nationale. Objectif. L’objectif central de cette thèse est d’évaluer, dans des conditions réelles d’implantation, les effets du programme burkinabé de prise en charge communautaire du paludisme sur le recours aux soins des enfants fébriles. Les objectifs spécifiques sont : (1) de sonder les perceptions des ASC à l’égard du programme et explorer les facteurs contextuels susceptibles d’affecter leur performance ; (2) d’estimer le recours aux ASC par les enfants fébriles et identifier ses déterminants ; (3) de mesurer, auprès des enfants fébriles, le changement des pratiques de recours aux soins induit par l’introduction d’une intervention concomitante – la gratuité des soins dans les centres de santé. Méthodes. L’étude a été conduite dans deux districts sanitaires similaires, Kaya et Zorgho. Le devis d’évaluation combine des volets qualitatifs et quantitatifs. Des entrevues ont été menées avec tous les ASC de la zone à l’étude (N=27). Des enquêtes ont été répétées annuellement entre 2011 et 2013 auprès de 3002 ménages sélectionnés aléatoirement. Les pratiques de recours aux soins de tous les enfants de moins de cinq ans ayant connu un récent épisode de maladie ont été étudiées (N2011=707 ; N2012=787 ; N2013=831). Résultats. Les résultats montrent que le recours aux ASC est très modeste en comparaison de précédentes études réalisées dans des milieux contrôlés. Des obstacles liés à l’implantation du programme de prise en charge communautaire du paludisme ont été identifiés ainsi qu’un défaut de faisabilité dans les milieux urbains. Enfin, l’efficacité du programme communautaire a été négativement affectée par l’introduction de la gratuité dans les centres de santé. Conclusion. La prise en charge communautaire du paludisme rencontre au Burkina Faso des obstacles importants de faisabilité et d’implantation qui compromettent son efficacité potentielle pour réduire la mortalité infantile. Le manque de coordination entre le programme et des interventions locales concomitantes peut générer des effets néfastes et inattendus.

Reservas internacionais ótimas de um país: um estudo do caso brasileiro

O objetivo deste trabalho analisar acumulação de reservas internacionais por parte de países como Brasil, que acumulam reservas na tentativa de se proteger de crises externas bem como diminuir tal probabilidade. Desejamos analisar determinação do nível ótimo de reservas. Apresentaremos um breve histórico da literatura sobre acumulação de reservas. No estudo do Brasil, discutiremos nível ótimo de reservas internacionais brasileiras usando modelo de buffer stock, partir de uma abordagem de séries temporais, diferindo de trabalhos anteriores usando dados cross-section.

Índia e crescimento: modelos tradicionais e impacto da filosofia hindu

A Índia, com sua notável expansão econômica, cultura e filosofia milenares, é o tema desse trabalho, com dois objetivos: exemplificar diversos aspectos teóricos ligados ao crescimento econômico e aprofundar o estudo de um aspecto institucional pouco difundido na literatura, os impactos das filosofias religiosas. A princípio, são analisadas as reformas econômicas realizadas após a crise do balanço de pagamentos ocorrida em 1991. Diversos estudos teóricos são citados ao longo do texto para contextualizar o efeito das reformas no potencial de crescimento. O setor externo é analisado com profundidade, seguido pela desregulamentação no setor privado, principalmente na atividade industrial e no controle de preços. Estes dois setores foram conjuntamente responsáveis pelo grande salto de produtividade na economia (descrito pelos impactos na produtividade total dos fatores). Alguns aspectos de política monetária e fiscal também são analisados, mas com menor ênfase, visto que as reformas e resultados nesses setores são limitados. A seguir, apresenta-se análise sobre a filosofia Hindu, predominante no país. Introduz-se o tema com breve descrição dos aspectos filosóficos, para seguir com avaliação dos impactos econômicos resultantes. Max Weber e Amartya Sen contradizem-se sobre o sinal do impacto: Weber suportando que a magia hindu impediria o racionalismo; Sen argumentando que o próprio hinduísmo tem histórico de racionalismo heterodoxo, de contestação e criação. Para disseminar dúvidas apresenta-se um modelo econométrico, com base em convergência condicional: impactos diretos e indiretos não se mostram significantes. Levanta-se um debate e um alento a alguns países: um histórico institucional bastante desalentador ao desenvolvimento, baseado em uma filosofia religiosa controversa de nuances pós-vida, pode ser superado com algumas corretas reformas na economia.

O Instituto da Ouvidoria como ferramenta para a melhoria da gestão pública : experiência do METROREC e DETRAN-PE

Diante do crescimento do número de ouvidorias dentro das instituições brasileiras e em particular, nas empresas públicas, a pesquisa realizada abordou as relações entre a sociedade e o Estado, destacando, como tema central, o instituto da ouvidoria como ferramenta para melhoria da gestão pública. A pesquisa investigou as ouvidorias do DETRAN-PE e do METROREC ressaltando o tratamento dado às manifestações do cidadão. Os resultados dos estudos, baseados na revisão da literatura sobre o instituto da ouvidoria, envolvendo conceitos, objetivos e um modelo conceitual sobre ouvidoria, apontam caminhos de participação social e indicam que há ações implementadas decorrentes, gerando benefícios para a sociedade e para as instituições. A análise de elementos como o histórico de criação de suas ouvidorias, a estrutura de funcionamento, formas de atuações e indicadores no tratamento das demandas, permitiu realizar comparações sobre o desempenho das ouvidorias nessas duas organizações. O presente trabalho também fez observações sobre alguns aspectos de dissonância encontrados entre o modelo conceitual do instituto da ouvidoria e as ouvidorias pesquisadas, havendo a necessidade de reflexão sobre suas práticas institucionais vigentes. O estudo possibilitou um panorama sobre o instituto da ouvidoria nas instituições DETRAN-PE e METROREC, observando suas interações com os atores sociais, aproximando a gestão pública de uma vertente mais social, mediante a efetiva participação do cidadão, colocando o instituto da ouvidoria a serviço da sociedade e da instituição, como ferramenta para a melhoria da gestão pública.

Estratégias internacionais da fruticultura do RN: o caso finobrasa processo e evolução

The present inquiry has as main objective to understand the process of formation of the international strategies of the exporting companies of fruits of the RN through the theory of the resource dependence. Aiming at to clarify as the companies they can carry through the process of internationalization through this theory had been study the behavior and economic theories of the process of internationalization of companies. Amongst the economic theories they are distinguished the eclectic paradigm of Dunning (1958), Vernon (1669) through the theory of the cycle of the product and Bucley and Casson (1979) with the theory of the international operations. In the mannering boarding they had been investigated the school of Upsala through Johanson and Valnhe (1977) with the concept of the increasing of the markets and in the distance psychic starts and the interaction of the purchaser-salesman of Hallen and Wiedersheim-Paul (1979). In this perspective it observes main the occured changes in the organization in function of this process, following the rules observed by the gradual ingression in the international market, having as base ways of entrances in the external market used by these companies, in view of the frist phase that the company presents of businesses. Ahead of you analyze of these theories the study searches to analyze the convergence of the concepts proclaimed for the theory of the dependence of resources (PFEFFER; SALANCIK, 1978). and strategies of internationalization of the companies. The research is characterized as qualitative case study which adopts and exploratory and analytical type, retrospective matrix. The adopted strategy is of case study and the unit of analysis consisting of the Finobrasa, pertaining company to the Vicunha Group. The main method of collection of data was halfstructuralized interview allied the documentary research that together had presented an empirical perspective of the internationalization process. The analysis and quarrel of the results understand the description and the interpretation of the one of the information through the technique of analyzes of content. Initially the historical of the exportation of fruits of the Rio Grande do Norte with the focus in the region Açu/Mossoró is presented and after that the information of the Finobrasa are presented as base of the study. The main events are identified that had constituted the phases of the strategical model of the company. It was observed that the dimensions most excellent amongst those proclaimed by the School of Uppsala had been the learning, staffs and the step-starts is sufficiently gifts in the reality of the company, as well as the aspects of strategical alliances since the consolidated relationship of the Vicunha Group create a more solid trajectory in the international market allied the conditions created windows of marked . One understands, therefore, that the investigated process still has base the theoretical theories of the internationalization strategies corroborating for the theoretical convergence of the rules proclaimed for the theory of the dependence of resources.

Nego veio é um sofrer : uma etnografia da subalternidade e do subalterno numa irmandade do Rosário

The object of this work is a fellowship of São Sebastião e Nossa Senhora do Rosário in the city of Jardim do Seridó (RN), that is, a black catholic fellowship on the sertão potiguar. The devotion to Nossa Senhora do Rosário, in colonial Brazil, organizes itself through black catholic men as fellowships. They blossomed in Brazil until the abolition, getting support from the Catholic church, from owners of slaves and from the population in general − unlike others afro-Brazilian religious expression. Today, these fellowships remain active, against the sentimental pessimism of the folklore studies, and they also have a highlight position in the calendar of many cities in Brazil, and in particular in Seridó. The research s foothold is the apparent valorization of the fellowship by the local elite, attitude that hides asymmetric relationships between the group of negros do Rosário and the local authorities, having as its consequence that the members occupy a subaltern position inside their own fellowship. This subalternity take place, mainly, in the public area, where the negros do Rosário cannot represent themselves neither political nor discursively. To discuss this idea, it s done a brief historical of these catholic institutions as well as a description of the relationship between the negros do Rosário and the elites of the city. Then, the phenomenon is analyzed as folklore and/or religion , under the perspective of many agents that participate in this process. In other moment, it is going to be presented how the group formulates their own representation of the history, of the devotional forms and of their own political-religious experiences. In this sense, an ethnography of the subalternity is understood as an analysis of the process that leads the negros do Rosário to become a subaltern group. It s also outlined the perception that the group has of its own position, through an ethnography essay of the subaltern subject. The research, focused in the group of Rosário, was done between August 2010 and January 2012 and includes other agents (like treasurers, priests and intellectuals). Besides that, as a methodological complement, there are documental research, photography, as well as shoots of the party days and public presentation

Atividade antiplasmódica e toxicológica de plantas medicinais usadas popularmente no Brasil : uma abordagem etnobotânica

Malaria is a disease of global distribution, recognized by governments around the world as a serious public health problem, affecting more than 109 countries and territories and endangering more than 3.3 billion people. The economic costs of this disease are also relevant: the African continent itself has malaria-related costs of about $ 12 billion annually. Nowadays, in addition to chloroquine, Plasmodium falciparum is resistant to many drugs used in the treatment of malaria, such as amodiaquine, mefloquine, quinine and sulfadoxine-pyrimethamine; resistance of Plasmodium vivax to treatments, although less studied, is also reported. Nature, in general, is responsible for the production of most known organic substances, and the plant kingdom is responsible for the most of the chemical diversity known and reported in the literature. Most medicinal plants commercialized in Brazil, however, are of exotic origin, which makes the search for endemic medicinal plants, besides a patent necessity, a fascinating subject of academic research and development. This study aimed to: (i) verify the antimalarial activity of ethanolic and hydroalcoholic extracts of Boerhavia paniculata Rich. And acetonic extract of Clethra scabra Pers. in Swiss albino mice infected by Plasmodium berghei NK65, (ii) observe possible combined effects between the course of infection by P. berghei NK65 and administration of these extracts in Swiss albino mice, and (iii) conduct a preliminary study of the acute toxicity of these extracts in Swiss albino mice. All extracts notable pharmacological activities - with parasite infections inhibitions ranging from 22% to 54%.These characteristics suggest that the activities are relevant, although comparatively lower than the activity displayed by the positive control group (always above 90%). The general framework of survival analysis demonstrates an overall reduction in survival times for all groups. Necroscopy has not pointed no change in color, shape, size and/or consistency in the evaluated organs - the only exception was the livers of rats submitted to treatment to hydroalcoholic extracts: these organs have been presented in a slightly congestive aspect with mass increasing roughly 28% higher than the other two groups and a p-value of 0.0365. The 250 mg/Kg ethanolic group has been pointed out by the Dunn s post test, as the only class with simultaneous inequalities (p<0.05) between positive and negative control groups. The extracts, notably ethanol extract, have, in fact, a vestigial antimalarial activity, although well below from the ones perceived to chloroquine-treated groups; nevertheless, the survival times of the animals fed with the extracts do not rise by presence of such therapy. Both the toxicopharmacological studies of the synergism between the clinical course of malaria and administration of extracts and the isolated evaluation of toxicity allow us to affirm the absence of toxicity of the extracts at the level of CNS and ANS, as well as their non-influence on food and water consumption patterns, until dosages of 500 mg/Kg. Necroscopic analysis leads us to deduct a possible hepatotoxic effect of hydroalcoholic extract at dosages of 500 mg/Kg, and an innocuous tissue activity of the ethanol extract, in the same dosage. We propose a continuation of the studies of these extracts, with protocol modifications capable of addressing more clearly and objectively their pharmacological and toxicological aspects

Os filhos evangélicos do novo caldeirão do diabo: a conversão religiosa na penitenciária de alcaçuz

The theme of the research is inserted at a field of intersection between the Sociology of Religion and Sociology of Violence, having as the general objective study the sociological meaning of the conversion of prisoners that lives at the biggest prison (Prison of Alcaçuz) of Rio Grande do Norte to the evangelical churches. The research is justified, because Brazil shelter the fourth greater arrested population arrested of the world, with projections indicating that it can turn the greatest in 2034. Besides, this study about religious conversion of prisoners to the Social Sciences is too important, because is a theme little developed in Brazil and deserves attention, one time that as the arrested people as the evangelicals are in expansion in our country. Starting from the precedent observations, we guide ourselves by the following problematic of research: the religious practice in Alcaçuz presents a mere instrumental perspective, where the actions of prisoners converted was on purpose oriented to conquest material or symbolic privileges; or purely religious, where seek a moral renovation? To develop the work, the scientific methodology adopted was exploratory and explanatory, using the Goffman´s theory about total institutions and presentation of self, and Blumer´s doctrine relating to Symbolic Interacionism and the Story life method, besides considerations about evangelical religion. Having this theoretical basis, was accomplished the Field research, when were made interviews and applied questionnaires to 11 Jailer Agents, 31 prisoners, Director and Vice-Dictor (in November, 2011), the coordinator of social projects of the prison and the coordinator of evangelization at the prisons in Rio Grande do Norte. As results, it was seeing in Alcaçuz that the prisoners can be separated in two groups: the one of Pavilions and other one of the Medical Section. The Pavilions are branded for managerial and structural problems, where are found idle prisoners in collective cells and with a historical of escaping attempts, mutinies and murders. The Medical Section has some individual cells or destined for two people, besides few collective also, and the prisoners work and have a more disciplined behavior, there isn t escapes or rebellions and that, for these reasons end for have more confidence from the Administration. About the presence of evangelical prisoners, most are at Medical Section, where exist a specific place to the cults (what doesn t at Pavilions). At the end, the conclusion is that the prisoner that says himself evangelical in Alcaçuz, although can be seeing with distrust about your real conversion, he gets win a trust vote and until the opposite being demonstrated in other words, that he is not hiding himself behind the bible to divert the vigilance of Direction and practice disciplinary faults without make any suspicions, is treated with more respect and has more opportunities live at Medical Section; have work, that most of times is paid and guarantee the homologation of your payment of penalty with work, besides other benefits, diminishing his time in jail

Nas sombras da família coelho: a dinâmica de uma dominação política

As one of the most important cities in the state of Pernambuco, Petrolina is settled in the Pernabucanian backwoods, a place that still holds its own traditions and manners. Petrolina s economy is mainly based on primary activities. It s politics is run by Family groups which preserve themselves and remain in power, using the clientelism, which could be said as a give and get practice. That means that the suffrage is a currency to exchange benefits. The present study analyses facts occurred in the political history of the Coelho s Family, which still dominates the local Politics. They persist as heirs of the old system of Coronelism that is maintaining their power structuring a political machine, which is able to make them unbeatable for over fifty years. Despite of a family internal division, it benefits all of them, directly or indirectly. Based on empirical observation, we set a brief historical of the Coelho s family facts, in order to demonstrate the range of their power through the ancestry, which is to say we ve described the local political labyrinths. Our metodological choices were driven by the comprehensive sociology, through the Weberian ideal types, in order to find the answers for the historical, social and political conformation of the facts, in consonance with the reality. According to that, we ve studied the Coelho s political trajectory from 1968 to 2012, considering the election periods. Commonplace: where a new generation becomes active subjects on a new apprenticeship, moral and intellectual. After all, they are all family heirs

Avaliação dos níveis de proteína C-reativa ultra-sensível em pacientes com periodontite crônica severa generalizada e sem periodontite

INTRODUCTION: The high sensitivity C-reactive protein (hsCRP) constitutes an inflammatory mediator used as predictor of cardiovascular risk that comes being researched as indicative relation factor between cardiovascular and periodontal diseases. PROPOSITION: To compare serumals levels of C-reactive protein between patients with and without generalized severe chronic periodontitis. METHODOLOGY: A seccional study was realized using a sample with 62 patients, being 31 participants carriers of periodontal diseases (Group I) and 31 without periodontal diseases (Group II), grouped to the pairs by age and sex. As inclusion criterio were selected patients with diagnosis of generalized severe chronic periodontitis, being preculeds, individuals which presented systemic disease, recent infection history, historical of CVA or stroke, smokers, pregnants and lactants. The research consisted of two stages, a clinc and other biochemist. The clinical stage is constituted of periodontal examination and the biochemist stage, of the peripheral blood collection for determination hsCRP levels and a hemogram to inquire any panel which could suggest infectious and/or inflammatory process. RESULTS: Periodontal disease group presented a average of 0,36mg/dL, while the group without disease presented 0,17 mg/dL, do not existing significant difference statistically between the averages (p = 0,061). The cardiovascular risk for the group I was classified high for 27,6% of participants and low for 72,4% of them. In the group II, 6,45% presented high risk e 93,5% low risk, being this significant relation statistically gotten for Fisher s Test (p = 0,042) presenting OR = 5,33; IC = 95% (1,02 27,4). The independets variables reseacred do not presented significant association statistically with the levels of hsCRP. CONCLUSION: The study indicated that despite of carriers patients of periodontal diseases do not present differents serumals levels of hsCRP from the other group, the periodontal disease was considered as risk factor for hsCRP plasmatic levels elevation

O impacto dos custos não-gerenciáveis na determinação das tarifas de energia elétrica: um estudo nas companhias distribuidoras do nordeste que tiveram revisão tarifária nos exercícios de 2003 e 2004

This work presents results derived from a study related to impact on non-controllable costs in the determination of energy taxes. This is done analyzing tax review practiced by concessionaries responsible for the distribution of electrical energy located in the Northeastern Region of Brazil, between 2003 and 2004. This Region was chosen as a study area due to the researcher s expectation in congregating companies that deliver services to markets that have similar social-economical profiles. A brief explanation related to the restructuring of the electrical sector in Brazil is presented, pointing out that there was privatization of the great majority of these companies. The study also points out the definition of regulating rules in service delivery process. The components of taxes that are practiced by these companies aimed at final consumers, as well as the market as a whole and the revision process that is executed by Agência Nacional de Energia Elétrica ANEEL for the definition of these taxes are demonstrated in the research. A brief historical of the concessionaires that were focus of the research is presented, totaling five companies. Some data used by ANEEL in the tax review process was analyzed as well as data on components of approved taxes. It is concluded that as a media 47, 49% of the components of taxes in the researched companies correspond to the non-controllable costs. These is done considering previous classification by ANEEL in the tax review process. Although, if it is considered that these companies since 2006, by the means of participation in energy auctions are able to negotiate energy prices for their own needs, it is concluded that these concession contracts guarantee the delivery of the service to the costumer in the total tribute. The percentage of non-controllable costs is 16, 27% average of the tax. This means, amongst other information, that the government has a great deal of responsibility in the formation of price practiced by these companies and its target markets

Avaliação da incidência da deficiência de Glicose-6-Fosfato Desidrogenase (G6PD) e perfil hematológico em indivíduos de uma região de Rondônia

O estudo compreendeu a avaliação da deficiência de Glicose-6-Fosfato Desidrogenase (G6PD) e perfil hematológico em 122 indivíduos (69 homens e 53 mulheres), com idade variando entre 3 a 84 anos, selecionados conforme a aceitação em participação no estudo, residentes na área urbana e rural do município de Porto Velho, Rondônia, Brasil, no período de julho de 2003 a agosto de 2004. A análise foi realizada utilizando-se o método da glicose NaNO2, e hemograma completo. Foram detectados quatro indivíduos do sexo masculino com deficiência da G6PD, sendo 5,8% entre os homens e 3,3% do total analisado. Dos indivíduos com deficiência da G6PD nenhum apresentava malária, através de diagnóstico realizado pela gota espessa corado pelo Giemsa. Entre os homens, 19 (27,5%) apresentaram malária, sendo 15 por Plasmodium vivax e quatro por Plasmodium falciparum; 48 (69,5%) apresentaram valores de hemoglobina abaixo de 14,0 g/dl, e 26 (37,6%) apresentaram valores eritrocitários abaixo do 4,5 milhões/mm³. Entre as mulheres apenas duas (3,7%) apresentaram malária por Plasmodium vivax; 24 (45,2%) apresentaram valores de hemoglobina abaixo de 12,0 g/dl, e 12 (22,6%) apresentaram massa eritrocitária abaixo de 4,0 milhões/mm³. A eosinofilia esteve presente em 47 (68,1%) dos homens e em 34 (64,1%) das mulheres. A incidência de deficiência da G6PD foi significativa na população masculina que procurou assistência médica devido a sintomas febris. Considerando que a primaquina é utilizada para o tratamento da malária vivax e falciparum, o risco de ocorrência de hemólise intravascular grave entre os indivíduos é significante. O teste utilizado é muito simples e de baixo custo e sugerimos a adoção desta metodologia na rotina dos laboratórios de atendimento público em áreas endêmicas de malária.