Prevalência de infecção pelo T. cruzi em doadores de sangue nos hemocentros coordenadores do Brasil em 2007

Objetivo: conhecer a prevalência de Trypanosoma cruzi entre os doadores de sangue, analisar a organização da rede de hemoterapia e as normas de segurança do sangue para transfusão no Brasil no ano de 2007. Métodos: estudo descritivo utilizando-se os Regulamentos Técnicos para hemoterapia definidos pela Agência Nacional de Vigilância Sanitária (Anvisa) e o questionário aplicado aos Hemocentros Coordenadores (HC) do Brasil. Resultados: responderam 84% dos hemocentros, onde doaram sangue 3.251.361 indivíduos, sendo 1.192 (0,04%) excluídos na triagem clínica por risco presumido para doença de Chagas; foram realizadas 2.726.668 sorologias; 5.432 (0,20%) foram reagentes para Trypanosoma cruzi e 3.065 (0,11%) inconclusivas. Conclusão: a falta de resposta dos Estados de Pernambuco, Bahia, Paraíba, Goiás e Rondônia constituiu limitação ao estudo; entretanto, os resultados obtidos sugerem baixa prevalência de Trypanosoma cruzi entre os doadores de sangue e indicam o cumprimento dos procedimentos para a segurança do sangue definidos pela Anvisa.

Effects of Aedes aegypti salivary components on dendritic cell and lymphocyte biology

Abstract Background Saliva is a key element of interaction between hematophagous mosquitoes and their vertebrate hosts. In addition to allowing a successful blood meal by neutralizing or delaying hemostatic responses, the salivary cocktail is also able to modulate the effector mechanisms of host immune responses facilitating, in turn, the transmission of several types of microorganisms. Understanding how the mosquito uses its salivary components to circumvent host immunity might help to clarify the mechanisms of transmission of such pathogens and disease establishment. Methods Flow cytometry was used to evaluate if increasing concentrations of A. aegypti salivary gland extract (SGE) affects bone marrow-derived DC differentiation and maturation. Lymphocyte proliferation in the presence of SGE was estimated by a colorimetric assay. Western blot and Annexin V staining assays were used to assess apoptosis in these cells. Naïve and memory cells from mosquito-bite exposed mice or OVA-immunized mice and their respective controls were analyzed by flow cytometry. Results Concentration-response curves were employed to evaluate A. aegypti SGE effects on DC and lymphocyte biology. DCs differentiation from bone marrow precursors, their maturation and function were not directly affected by A. aegypti SGE (concentrations ranging from 2.5 to 40 μg/mL). On the other hand, lymphocytes were very sensitive to the salivary components and died in the presence of A. aegypti SGE, even at concentrations as low as 0.1 μg/mL. In addition, A. aegypti SGE was shown to induce apoptosis in all lymphocyte populations evaluated (CD4+ and CD8+ T cells, and B cells) through a mechanism involving caspase-3 and caspase-8, but not Bim. By using different approaches to generate memory cells, we were able to verify that these cells are resistant to SGE effects. Conclusion Our results show that lymphocytes, and not DCs, are the primary target of A. aegypti salivary components. In the presence of A. aegypti SGE, naïve lymphocyte populations die by apoptosis in a caspase-3- and caspase-8-dependent pathway, while memory cells are selectively more resistant to its effects. The present work contributes to elucidate the activities of A. aegypti salivary molecules on the antigen presenting cell-lymphocyte axis and in the biology of these cells.

On the monitoring of surface displacement in connection with volcano reactivation in Tenerife, Canary Islands, using space techniques

Geodetic volcano monitoring in Tenerife has mainly focused on the Las Cañadas Caldera, where a geodetic micronetwork and a levelling profile are located. A sensitivity test of this geodetic network showed that it should be extended to cover the whole island for volcano monitoring purposes. Furthermore, InSAR allowed detecting two unexpected movements that were beyond the scope of the traditional geodetic network. These two facts prompted us to design and observe a GPS network covering the whole of Tenerife that was monitored in August 2000. The results obtained were accurate to one centimetre, and confirm one of the deformations, although they were not definitive enough to confirm the second one. Furthermore, new cases of possible subsidence have been detected in areas where InSAR could not be used to measure deformation due to low coherence. A first modelling attempt has been made using a very simple model and its results seem to indicate that the deformation observed and the groundwater level variation in the island may be related. Future observations will be necessary for further validation and to study the time evolution of the displacements, carry out interpretation work using different types of data (gravity, gases, etc) and develop models that represent the island more closely. The results obtained are important because they might affect the geodetic volcano monitoring on the island, which will only be really useful if it is capable of distinguishing between displacements that might be linked to volcanic activity and those produced by other causes. One important result in this work is that a new geodetic monitoring system based on two complementary techniques, InSAR and GPS, has been set up on Tenerife island. This the first time that the whole surface of any of the volcanic Canary Islands has been covered with a single network for this purpose. This research has displayed the need for further similar studies in the Canary Islands, at least on the islands which pose a greater risk of volcanic reactivation, such as Lanzarote and La Palma, where InSAR techniques have been used already.

Proposta de avaliação de práticas sustentáveis nas operações de serviço em instituições de ensino superior da Rede Federal de Educação Profissional, Científica e Tecnológica

Higher Education Institutions (HEIs) have an extremely important social role, they are responsible for the place where they work and to form citizens who contribute to a fair and cooperative society. Universities can engage with sustainable development in planning, management, education, research, operations, community services, procurement of materials, transportation and infrastructure; this research seeks to analyze the sustainability practices in service operations in the Higher Education Institutions of the Federal Network of Professional, Scientific and Technological Education in Brazil through the development and application of a model called the Sustainability Assessment for Higher Technological Education (SAHTE). To achieve the proposed goal, a systematic survey of the scientific literature on sustainability assessment models in higher education institutions was conducted, making it possible to identify the characteristics and features of existing models. The model was applied through multiple case studies. The proposal compares the sustainability performance of service operations among individual institutions using a common methodology. It presents five areas to be evaluated in the HEI: Governance and Policies, People, Food, Water and Energy, and Waste and Environment, with a total of 134 questions. The need for greater support from the senior management of institutions to formulate and implement policies on sustainable development was identified when the lack of policies on sustainability in service operations was found; initiatives tend to be isolated. The participation of students and teachers in studies on the daily operations of the campus can be expanded and more widespread. The model seeks to evaluate sustainable practices in the service operations of the Brazilian Federal Network of Professional, Scientific and Technological Education; studies related to the evaluation of teaching sustainability are absent and the applicability of the model in private institutions and other countries is needed. The results obtained with the application of the SAHTE model are useful for the preparation and development of policies on sustainable development, especially in the service operations of the surveyed HEI. The results can sensitize staff and students, who can reflect on their roles in the HEI, as well as the community and suppliers.

Modernization and new services of the Brazilian active control network

The Brazilian Network for Continuous Monitoring of GNSS - RBMC is a national network of continuously operating reference GNSS stations. Since its establishment in December of 1996, it has been playing an essential role for the maintenance and user access of the fundamental geodetic frame in the country. In order to provide better services for RBMC, the Brazilian Institute of Geography and Statistics - IBGE and the National Institute of Colonization and Land Reform - INCRA are both partners involved in the National Geospatial Framework Project - PIGN. This paper provides an overview of the recent modernization phases the RBMC network has undergone highlighting its future steps. These steps involve the installation of new equipment, provide real time data from a group of core stations and compute real-time DGPS corrections, based on CDGPS (The real-time Canada-Wide DGPS Service) (The Real-Time Canada-Wide DGPS Service. http://www.cdgps.com/ 2009a). In addition to this, a post-mission Precise Point Positioning (PPP) service has been established based on the current Geodetic Survey Division of NRCan (CSRS-PPP) service. This service is operational since April 2009 and is in large use in the country. All activities mentioned before are based on a cooperation signed at the end of 2004 with the University of New Brunswick, supported by the Canadian International Development Agency and the Brazilian Cooperation Agency. The Geodetic Survey Division of NRCan is also participating in this modernization effort under the same project. This infrastructure of 66 GNSS stations, the real time, post processing services and the potentiality of providing Wide Area DGPS corrections in the future show that the RBMC system is comparable to those available in USA and Europe. © Springer-Verlag Berlin Heidelberg 2012.

Perinatal factors associated with early deaths of preterm infants born in Brazilian Network on Neonatal Research centers

Objective: To evaluate perinatal factors associated with early neonatal death in preterm infants with birth weights (BW) of 400-1,500 g.Methods: A multicenter prospective cohort study of all infants with BW of 400-1,500 g and 23-33 weeks of gestational age (GA), without malformations, who were born alive at eight public university tertiary hospitals in Brazil between June of 2004 and May of 2005. Infants who died within their first 6 days of life were compared with those who did not regarding maternal and neonatal characteristics and morbidity during the first 72 hours of life. Variables associated with the early deaths were identified by stepwise logistic regression.Results: A total of 579 live births met the inclusion criteria. Early deaths occurred in 92 (16%) cases, varying between centers from 5 to 31%, and these differences persisted after controlling for newborn illness severity and mortality risk score (SNAPPE-II). According to the multivariate analysis, the following factors were associated with early intrahospital neonatal deaths: gestational age of 23-27 weeks (odds ratio - OR = 5.0; 95%CI 2.7-9.4), absence of maternal hypertension (OR = 1.9; 95%CI 1.0-3.7), 5th minute Apgar 0-6 (OR = 2.8; 95%CI 1.4-5.4), presence of respiratory distress syndrome (OR = 3.1; 95%CI 1.4-6.6), and network center of birth.Conclusion: Important perinatal factors that are associated with early neonatal deaths in very low birth weight preterm infants can be modified by interventions such as improving fetal vitality at birth and reducing the incidence and severity of respiratory distress syndrome. The heterogeneity of early neonatal rates across the different centers studied indicates that best clinical practices should be identified and disseminated throughout the country.

Brazilian network for the surveillance of maternal potentially life threatening morbidity and maternal near-miss and a multidimensional evaluation of their long term consequences

Background. It has been suggested that the study of women who survive life-threatening complications related to pregnancy (maternal near-miss cases) may represent a practical alternative to surveillance of maternal morbidity/mortality since the number of cases is higher and the woman herself is able to provide information on the difficulties she faced and the long-term repercussions of the event. These repercussions, which may include sexual dysfunction, postpartum depression and posttraumatic stress disorder, may persist for prolonged periods of time, affecting women's quality of life and resulting in adverse effects to them and their babies. Objective. The aims of the present study are to create a nationwide network of scientific cooperation to carry out surveillance and estimate the frequency of maternal near-miss cases, to perform a multicenter investigation into the quality of care for women with severe complications of pregnancy, and to carry out a multidimensional evaluation of these women up to six months. Methods/Design. This project has two components: a multicenter, cross-sectional study to be implemented in 27 referral obstetric units in different geographical regions of Brazil, and a concurrent cohort study of multidimensional analysis. Over 12 months, investigators will perform prospective surveillance to identify all maternal complications. The population of the cross-sectional component will consist of all women surviving potentially life-threatening conditions (severe maternal complications) or life-threatening conditions (the maternal near miss criteria) and maternal deaths according to the new WHO definition and criteria. Data analysis will be performed in case subgroups according to the moment of occurrence and determining cause. Frequencies of near-miss and other severe maternal morbidity and the association between organ dysfunction and maternal death will be estimated. A proportion of cases identified in the cross-sectional study will comprise the cohort of women for the multidimensional analysis. Various aspects of the lives of women surviving severe maternal complications will be evaluated 3 and 6 months after the event and compared to a group of women who suffered no severe complications in pregnancy. Previously validated questionnaires will be used in the interviews to assess reproductive function, posttraumatic stress, functional capacity, quality of life, sexual function, postpartum depression and infant development. © 2009 Cecatti et al.

Using the Analytic Network Process to evaluate the relation between Reverse Logistics and corporate performance in Brazilian companies

Reverse Logistics activities are practiced by most Brazilian companies. However, a relevant problem is to identify how different Reverse Logistics programs can affect corporate performance indicators. Analytic Network Process is one of the analytical tools, which can be used to handle a multi-criteria decision-making problem and it is the only one that can capture the interdependencies between the criteria under consideration. This method was adopted here to study the influence of Reverse Logistics practices in corporate performance. Preliminary results indicated that the method can be used, reaching a result compatible to the reality of the Brazilian companies.

Scientific collaboration network among Brazilian universities: an analysis in Dentistry area

This paper analyses the scientific collaboration network formed by the Brazilian universities that investigate in dentistry area. The constructed network is based on the published documents in the Scopus (Elsevier) database covering a period of 10 (ten) years. It is used social network analysis as the best methodological approach to visualize the capacity for collaboration, dissemination and transmission of new knowledge among universities. Cohesion and density of the collaboration network is analyzed, as well as the centrality of the universities as key-actors and the occurrence of subgroups within the network. Data were analyzed using the software UCINET and NetDraw. The number of documents published by each university was used as an indicator of its scientific production.

Late-Onset Sepsis in very Low Birth Weight Infants: A Brazilian Neonatal Research Network Study

Background: Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.Aim: To determine the incidence, risk factors and etiology of LOS.Methods: LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days.Results: Of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. The majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation.Conclusion: LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU.

Severity of Brazilian sickle cell disease patients: severity scores and feasibility of the Bayesian network model use

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Brazilian psychiatric brain bank: a new contribution tool to network studies

There is an urgent need for expanding the number of brain banks serving psychiatric research. We describe here the Psychiatric Disorders arm of the Brain Bank of the Brazilian Aging Brain Study Group (Psy-BBBABSG), which is focused in bipolar disorder (BD) and obsessive compulsive disorder (OCD). Our protocol was designed to minimize limitations faced by previous initiatives, and to enable design-based neurostereological analyses. The Psy-BBBABSG first milestone is the collection of 10 brains each of BD and OCD patients, and matched controls. The brains are sourced from a population-based autopsy service. The clinical and psychiatric assessments were done by an expert team including psychiatrists, through an informant. One hemisphere was perfused-fixed to render an optimal fixation for conducting neurostereological studies. The other hemisphere was comprehensively dissected and frozen for molecular studies. In 20 months, we collected 36 brains. A final report was completed for 14 cases: 3 BDs, 4 major depressive disorders, 1 substance use disorder, 1 mood disorder NOS, 3 obsessive compulsive spectrum symptoms, 1 OCD and 1 schizophrenia. The majority were male (64%), and the average age at death was 67.2 +/- 9.0 years. The average postmortem interval was 16 h. Three matched controls were collected. The pilot stage confirmed that the protocols are well fitted to reach our goals. Our unique autopsy source makes possible to collect a fairly number of high quality cases in a short time. Such a collection offers an additional to the international research community to advance the understanding on neuropsychiatric diseases.

The viewpoint of health professionals on the role of basic units in the healthcare network of the Brazilian Unified Health System

In the process of creation of the Unified Health System (SUS) as a universal policy seeking to ensure comprehensive care, unscheduled assistance in primary healthcare units (UBS) is an unresolved challenge. The scope of this paper is to analyze the viewpoint of health professionals on the role of primary healthcare units in meeting this demand. It is a transversal study of qualitative data obtained through questionnaires and interviews with 106 medical practitioners from 6 emergency medical services and 190 professionals from 30 units. They explained why people seek emergency care for occurrences pertaining to primary care. The content analysis technique with thematic categories was used for data analysis. Lack of resources and problems with primary health unit work processes (50.8%) were the reasons most frequently cited by emergency care physicians to explain this inadequate demand. Only 33.3% of the health unit professionals agreed that these occurrences should be attended in the primary healthcare services. The limited viewpoint of the role of health services on the unscheduled care, particularly among primary care professionals, possibly leads to restrictive practices for access by the population.