Medicação de alto custo para portador de sofrimento psíquico: Um estudo preliminar dos custos

The present work aims to raise the costs of high-cost drugs used to treat patients of Refractory Schizophrenia in ambulatory unit. The study was carried out in the Psychosocial Support Center, which treated 33 patients with these medications, during the period of June, 2005 to May, 2006. Data analysis disclosed that the mostly used drugs to treat the carriers of Refractory Schizophrenia were: clozapina and risperidona. It was observed that the treatment with olanzapina is more expensive than that with risperidona. The study concluded that the analysis of the consumption and costs of drugs of high cost is necessary to subside better management of the expenses and new investments in the service. Moreover, the necessity of more studies in the area was also identified to contribute with the control of costs.

Towards intelligent manufacturing

This article describes the application of an Artificial Intelligence Planner in a robotized assembly cell that can be integrated to a Flexible Manufacturing System. The objective is to allow different products to be automatically assembled in a single production line with no pre-established assembly plans. The planner function is to generate action plans to the robot, in real time, from two input information: the initial state (disposition of parts of the product in line) and the final state (configuration of the assembled product). Copyright © 2007 IFAC.

Petri nets teaching in the Mechatronics Engineering course

The current solutions implanted in the majority of manufacturing systems controlled by PLCs were developed through the language of programming known as ladder. Such a language, easily learned and handled, shows to be efficient whenever the system to be implanted does not demand greater complexity of analyses. Bigger systems, presenting characteristics in which resource compartments, parallelism and synchronizing among processes are more frequent, demand the adoption of solutions differentiation. This article presents a teaching experience and practical application of Petri nets in a Mechatronics Engineering graduation course. Copyright © 2007 IFAC.

An efficient methodological approach in the didatic of automation applied to integrated manufacturing

This work presents challenges and solutions for the teaching and learning of automation applied to integrated manufacturing by means of a methodological approach based on techniques, tools and industrial equipment directly applicable in the industry. The approach was implemented in a control and automation engineering course divided into expositive and laboratory classes. Since the success of the approach is mainly from the practical activities, the article focus more on activities developed in laboratory than theorical classes. Copyright © 2007 IFAC.

Avaliação de desempenho do microaspersor amanco em bancada de testes

The need for a rational use of water and supply of food for a growing world population have led to the development of research in the area of irrigation systems. Thus, some irrigation systems which join efficiency with low cost of material have been developed. Although some technical characteristics are provided by the manufacturers, tests are required to verify functioning of the system and uniformity of water distribution. Continuous research on uniformity, characteristics of the materials and design of water distribution systems is essential for system improvement. Therefore, the objective of this work was to evaluate the CV (manufacturer's coefficient of variation) of Amanco microsprinkler (1.0 mm light green nipple) using bench testing in the laboratory of Irrigation at UNESP - FCA campus of Botucatu-SP. Twenty-five microsprinklers in a sequential design were used in the tests. Three flow systems were tested as follows: a Coil system based on serial connected pipes; a Lateral system, the most common system in which secondary lines are fed by a main line; and a Mesh system used in the urban water supply. The results showed that 4.17% CVf met the production standards and the Lateral and Mesh systems were similar regarding outflow using bench testing. The Mesh system presented the highest mean value of outflow and the lowest range of variation.

Prevention of hypertension in patients with pre-hypertension: Protocol for the PREVER-prevention trial

Background: Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage.Methods: This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution.Discussion: The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.Trial Registration: Clinical Trials NCT00970931. © 2011 Fuchs et al; licensee BioMed Central Ltd.

Topical use of fluorides for caries control

Since the early findings on the protective effects of fluoride present in drinking water upon caries incidence and prevalence, intensive research has been conducted in order to determine the benefits, safety, as well as the cost-effectiveness of other modalities of fluoride delivery. The present chapter reviews the various forms of topical fluoride use - professionally and self-applied - with special emphasis on clinical efficacy and possible side effects. The most widely used forms of fluoride delivery have been subject of several systematic reviews, providing strong evidence supporting the use of dentifrices, gels, varnishes and mouth rinses for the control of caries progression. Dentifrices with fluoride concentrations of 1,000 ppm and above have been shown to be clinically effective in caries prevention when compared to a placebo treatment, but the evidence regarding formulations with 450-550 ppm is still subject of debate. Therefore, the recommendation for low-fluoride dentifrice use must take into account both risks and benefits. The evidence for the combined use of two modalities of fluoride application in comparison to a single modality is still inconsistent, implying that more studies with adequate methodology are needed to determine the real benefits of each method. Considering the currently available evidence and risk-benefit aspects, it seems justifiable to recommend the use of fluoridated dentifrices to individuals of all ages, and additional fluoride therapy should also be targeted towards individuals at high caries risk. © 2011 S. Karger AG, Basel.

Hunger and malnutrition in the countries of the Association of Caribbean States (ACS)

Includes bibliography

Military expenditure and development in Latin America

Includes bibliography

Expert opinion as an instrument for assessing investment in primary education

Includes bibliography

Evaluation of reusable cardboard box designs: Biomechanical and perceptual aspects

Reusable cardboard boxes can be ergonomically designed for internal transportation of dry products in industrial settings. In this study we compared the effects of handling a regular commercial box and two cardboard prototypes on upper limb postures through the evaluation of movements, myoelectrical activity, perceived grip acceptability and capacity for reuse. The ergonomic designs provided a more acceptable grip, safer wrist and elbow movements and lower wrist extensors and biceps activity. Biomechanical disadvantages were observed only for one of the prototypes when handling to high surface. The prototypes were durable and suitable for extensive reuse (more than 2000 handlings) in internal industrial transportation. Despite being slightly more expensive than regular cardboard, the prototypes showed good cost-benefit considering their high durability. Relevance to industry: Cardboard boxes can be efficiently redesigned for allowing safer upper limb movements and lower muscle workload in manual materials handling. New designs can also be extensively reused for internal industrial transportation with good cost-benefit. © 2012 Elsevier B.V.

Systematic review of randomized controlled trials of new anticoagulants for venous thromboembolism prophylaxis in major orthopedic surgeries, compared with enoxaparin

Background: In the past 10 years, new anticoagulants (NACs) have been studied for venous thromboembolism (VTE) prophylaxis. Objective: To evaluate the risk/benefit profile of NACs versus enoxaparin for VTE prophylaxis in major orthopedic surgery. Methods: A systematic review of double-blind randomized phase III studies was performed. The search strategy was run from 2000 to 2011 in the main medical electronic databases in any language. Independent extraction of articles was performed by 2 authors using predefined data fields, including study quality indicators. Results: Fifteen published clinical trials evaluating fondaparinux, rivaroxaban, dabigatran, and apixaban were included. Primary efficacy (any deep vein thrombosis [DVT], nonfatal pulmonary embolism, or all-cause mortality) favored fondaparinux (relative risk [RR] 0.50; 95% CI, 0.39, 0.63) and rivaroxaban (RR, 0.50; 95% CI, 0.34, 0.73) over enoxaparin, although significant heterogeneity was observed in both series. The primary efficacy of dabigatran at 220 mg, apixaban, and bemiparin were similar, with RRs of 1.02 (95% CI, 0.86, 1.20), 0.63 (95% CI, 0.39, 1.01), and 0.87 (95% CI, 0.65, 1.17), respectively. The primary efficacy of dabigatran at 150 mg (RR, 1.20; 95% CI, 1.03, 1.41), was inferior to enoxaparin. The incidence of proximal DVT favored apixaban (RR, 0.45; 95% CI, 0.27, 0.75) only. Rivaroxaban (RR, 0.45; 95% CI, 0.27, 0,77) and apixaban (RR, 0.38; 95% CI, 0.16, 0.90) produced significantly lower frequencies of symptomatic DVT. The incidence of major VTE favored rivaroxaban (RR, 0.44; 95% CI, 0.25, 0.81), only. Bleeding risk was similar for all NACs, except fondaparinux (RR, 1.27; 95% CI, 1.04, 1.55), which exhibited a significantly higher any-bleeding risk compared with enoxaparin, and apixaban (RR, 0.88; 95% CI, 0.79, 0.99), which was associated with a reduced risk of any bleeding. Alanine amino transferase was significantly lower with 220 mg of dabigatran, (RR, 0.67; 95% CI, 0.79, 0.99) than with enoxaparin. Conclusions: NACs can be considered alternatives to conventional thromboprophylaxis regimens in patients undergoing elective major orthopedic surgery, depending on clinical characteristics and cost-effectiveness. The knowledge of some differences concerning efficacy or safety profile, pointed out in this systematic review, along with the respective limitations, may be useful in clinical practice. © 2013 Elsevier Inc. All rights reserved.

Sustainable production of biologically active molecules of marine based origin

The marine environment offers both economic and scientific potential which are relatively untapped from a biotechnological point of view. These environments whilst harsh are ironically fragile and dependent on a harmonious life form balance. Exploitation of natural resources by exhaustive wild harvesting has obvious negative environmental consequences. From a European industry perspective marine organisms are a largely underutilised resource. This is not due to lack of interest but due to a lack of choice the industry faces for cost competitive, sustainable and environmentally conscientious product alternatives. Knowledge of the biotechnological potential of marine organisms together with the development of sustainable systems for their cultivation, processing and utilisation are essential. In 2010, the European Commission recognised this need and funded a collaborative RTD/SME project under the Framework 7-Knowledge Based Bio-Economy (KBBE) Theme 2 Programme 'Sustainable culture of marine microorganisms, algae and/or invertebrates for high value added products'. The scope of that project entitled 'Sustainable Production of Biologically Active Molecules of Marine Based Origin' (BAMMBO) is outlined. Although the Union is a global leader in many technologies, it faces increasing competition from traditional rivals and emerging economies alike and must therefore improve its innovation performance. For this reason innovation is placed at the heart of a European Horizon 2020 Strategy wherein the challenge is to connect economic performance to eco performance. This article provides a synopsis of the research activities of the BAMMBO project as they fit within the wider scope of sustainable environmentally conscientious marine resource exploitation for high-value biomolecules. © 2013 Elsevier B.V.

Efeitos do treinamento resistido concêntrico versus excêntrico sobre parâmetros clínicos e funcionais

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)