852 resultados para Healthcare utilization


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Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

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Peritoneal dialysis (PD), although classically described and utilized in the treatment of patients with end-stage renal disease, can also be utilized in the acute setting in different clinical situations. Recent studies showed that, in patients with acute renal failure, it is possible to obtain reasonable dialysis doses with adequate metabolic and etectrolytic control and tow incidence of complications by utilizing continuous PD through a cycler at high volume. In patients with congestive heart failure without end-stage renal disease, PD is capable of promoting clinical improvement with slow removal of liquids, becoming an attractive alternative for situations of rapidly or slowly worsening cardiac function. In patients submitted to chronic hemodialysis but who have vascular access difficulties, PD can also be utilized as a bridge, thereby avoiding the use of central venous catheters, which can be associated with infectious complications such as bacterial endocarditis. New studies must be realized showing other indications for PD.

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The motility of Spirillum volutans was used for monitoring the toxicity of effluents of a cellulose and paper industry. Results indicated that there was no correlation between organic content and the toxic effects of the residues in the effluents. The effluents from the chlorination step and from the sludge ponds presented the highest toxicity. on the other hand, the final effluent from the biological treatment basin had no toxic agent. This bioassay showed to be a simple and reliable technique that can be used for adequately monitoring the toxicity of effluents.

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Whereas genome sequencing defines the genetic potential of an organism, transcript sequencing defines the utilization of this potential and links the genome with most areas of biology. To exploit the information within the human genome in the fight against cancer, we have deposited some two million expressed sequence tags (ESTs) from human tumors and their corresponding normal tissues in the public databases. The data currently define approximate to23,500 genes, of which only approximate to1,250 are still represented only by ESTs. Examination of the EST coverage of known cancer-related (CR) genes reveals that <1% do not have corresponding ESTs, indicating that the representation of genes associated with commonly studied tumors is high. The careful recording of the origin of all ESTs we have produced has enabled detailed definition of where the genes they represent are expressed in the human body. More than 100,000 ESTs are available for seven tissues, indicating a surprising variability of gene usage that has led to the discovery of a significant number of genes with restricted expression, and that may thus be therapeutically useful. The ESTs also reveal novel nonsynonymous germline variants (although the one-pass nature of the data necessitates careful validation) and many alternatively spliced transcripts. Although widely exploited by the scientific community, vindicating our totally open source policy, the EST data generated still provide extensive information that remains to be systematically explored, and that may further facilitate progress toward both the understanding and treatment of human cancers.

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The aim of the current study was to evaluate a population of Menippe nodiffons in a reef of sabellariid worms, Phragmatopoma lapidosa, with regard to recruitment, population structure and sex ratio. Sampling was carried out each other month from September 1994 up to and including July 1995, on the rocky shores of the Tenorio beach, São Paulo, Brazil. It resulted in 183 individuals, whose average carapace width in this biotope was 9.1 +/- 5.6 m. The animals were grouped in nine size classes and the frequency distribution showed that 80% occupied the three first classes. This means that the polychaete worm colonies are of great importance for the establishment of individuals in the first juvenile stages.

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Epiphytes constitute a great part of the vegetation biomass in Neotropical forests, offering a large variety of resources to birds. Despite their structural and ecological importance, few studies investigated the use of epiphytes by birds in the Neotropical region. We studied the bird species that exploit vascular epiphytes (and hemi-epiphytes) in an Atlantic forest site in southeastern Brazil. The resources exploited, seasonal variation in the use of epiphytes, the frequency of foraging and selectivity in epiphytes, and the relationship between the use of epiphytes and the participation in mixed-species bird flocks were investigated. After 360 h of observations along trails crossing the forest, 24 bird species (12 families) were recorded in a total of 74 events of epiphyte exploitation. Thamnophilidae (four species), Trochiliclae, Thraupidae and Furnariidae (three species) were the richest bird families in our sample, while Furnariidae and Dendrocolaptidae were the more frequently recorded families. Plants in the Bromeliaceae and Araceae families were the most abundant and more frequently exploited epiphytes. Nectar, water, nest material and invertebrates were the most frequently exploited resources, mainly from Bromeliaceae. None of the species for which we had enough data revealed to be a frequent user of epiphytes for foraging or selective to any epiphyte group. The White-eyed Foliage-gleaner (Automolus leucophthalmus; Furnariidae), a common participant of understory mixed-species flocks, exploited epiphytes more frequently when associated with mixed-species flocks. The utilization of epiphytes was opportunistic for most of the bird species recorded and occurred throughout the year with no seasonal variation.

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Governmental programmes should be developed to collect and analyse data on healthcare associated infections (HAIs). This study describes the healthcare setting and both the implementation and preliminary results of the Programme for Surveillance of Healthcare Associated Infections in the State of São Paulo (PSHAISP), Brazil, from 2004 to 2006. Characterisation of the healthcare settings was carried out using a national database. The PSHAISP was implemented using components for acute care hospitals (ACH) or long term care facilities (LTCF). The components for surveillance in ACHs were surgical unit, intensive care unit and high risk nursery. The infections included in the surveillance were surgical site infection in clean surgery, pneumonia, urinary tract infection and device-associated bloodstream infections. Regarding the LTCF component, pneumonia, scabies and gastroenteritis in all inpatients were reported. In the first year of the programme there were 457 participating healthcare settings, representing 51.1% of the hospitals registered in the national database. Data obtained in this study are the initial results and have already been used for education in both surveillance and the prevention of HAI. The results of the PSHAISP show that it is feasible to collect data from a large number of hospitals. This will assist the State of São Paulo in assessing the impact of interventions and in resource allocation. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

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The burden of disease is borne by those who suffer as patients but also by society at large, including health service providers. That burden is felt most severely in parts of the world where there is no infrastructure, or foreseeable prospects of any, to change the status quo without external support. Poverty, disease and inequality pervade all the activities of daily living in low-income regions and are inextricably linked. External interventions may not be the most appropriate way to impact on this positively in all circumstances, but targeted programmes to build social capital, within and by countries, are more likely to be sustainable. By these means, basic oral healthcare, underpinned by the primary healthcare approach, can be delivered to more equitably address needs and demands. Education is fundamental to building knowledge-based economies but is often lacking in such regions even at primary and secondary level. Provision of private education at tertiary level may also introduce its own inequities. Access to distance learning and community-based practice opens opportunities and is more likely to encourage graduates to work in similar areas. Recruitment of faculty from minority groups provides role models for students from similar backgrounds but all faculty staff must be involved in supporting and mentoring students from marginalized groups to ensure their retention. The developed world has to act responsibly in two crucial areas: first, not to exacerbate the shortage of skilled educators and healthcare workers in emerging economies by recruiting their staff; second, they must offer educational opportunities at an economic rate. Governments need to lead on developing initiatives to attract, support and retain a competent workforce.

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This study evaluates the effect of subgingival irrigation with a 1% chlorhexidine collagen gel in periodontal pockets as an adjunct procedure to scaling and root planing (SRP). Thirty-seven sites with probing depth (PD) of 5-7 mm and BANA positive in 6 patients with chronic periodontal disease were selected. Sites were assigned to different treatment groups consisting of SRP only (group 1), SRP + irrigation with collagen gel (group 2), or SRP + irrigation with collagen gel containing 1% chlorhexidine (group 3). Subgingival irrigation was performed after initial SRP and at 7, 14 and 21 days. Clinical measurements including PD, plaque index (PI), gingival index (GI), gingival recession (GI), bleeding on probing (BOP) and clinical attachment level (CAL) were performed at the selected sites at baseline, 60 and 90 days and the BANA test was performed on plaque samples from the same sites at baseline and 90 days. There was an improvement in clinical parameters in all groups with a significantly greater decrease in GI and bleeding in the chlorhexidine group. There was a greater reduction of BANA positive sites in groups 2 and 3. The authors concluded that 1% chlorhexidine collagen gel is a promising adjunct to SRP in the treatment of adult periodontitis.

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Using molecular markers, this work compares the genetic diversity in Colletotrichum gloeosporioides infecting species of the tropical forage legume Stylosanthes at the center of origin in Brazil and Colombia with that of Australia, China, and India, where Srylosanthes spp. have been introduced for commercial use. There was extensive diversity in the pathogen population from Brazil, Colombia, China, and India. The Australian pathogen population was least diverse probably due to its geographical isolation and effective quarantine. The extensive diversity in China and India means that threats from exotic pathogen races to Stylosanthes pastures can potentially come from countries outside the South American center of origin. In Brazil and India, both with native Stylosanthes populations, a high level of genetic differentiation in the pathogen population was associated with sites where native or naturalized host population was widely distributed. There was limited genetic diversity at germplasm evaluation sites, with a large proportion of isolates having identical haplotypes. This contrasts recent pathogenicity results for 78 of the Brazilian isolates that show hot spots of complex races are more common around research stations where host germplasm are tested, but few are found at sites containing wild host populations. For a pathogen in which the same races arise convergently from different genetic backgrounds, this study highlights the importance of using both virulence and selectively neutral markers to understand pathogen population structure.

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The objective of this study was to determine models for ME requirements for broiler breeder pullets using the factorial method. The influence of the temperature on maintenance ME requirements was determined by experiments conducted in three environmental rooms with temperature kept constant at 15, 22, and 30°C, using the comparative slaughter technique. The energy requirements for weight gain were determined based on the body energy content and efficiency of energy utilization for weight gain. Two ME requirement models for each age were developed using the coefficients for maintenance and weight gain. The models for 3 to 8 wk were ME = W 0.75 (186.52 - 1.94T) + 2.47WG, and ME = W 0.75 (174 - 1.88T) + 2.83WG; for 9 to 14 wk, ME = W 0.75 (186.52 - 1.94T) + 2.69WG, and ME = W 0.75 (174 - 1.88T) + 2.50WG; and 15 to 20 wk, ME = W 0.75 (186.52 - 1.94T) + 2.76WG, and ME = W 0.75 (174 - 1.88T) + 3.24WG. In these equations, W is BW (kg), T is temperature (°C), and WG is daily weight gain (g). These models were compared to the breeder's recommendations in a feeding trial from 5 to 20 wk of age. Models 1 and 2 provided energy intakes that promoted BW smaller than the breeder's recommendation. However, all breeder pullets had weights above the standard recommendation. Model 2 gave the smallest ME intake and BW close to the standard recommendation and provided the best prediction of ME requirements.