Eqüidade e provisão de serviços públicos odontológicos no estado do Paraná

OBJETIVO: Analisar a associação entre indicadores socioeconômicos, de provisão de serviços públicos odontológicos e de alocação de recursos financeiros em saúde, e identificar se o sentido das associações ocorre em favor da eqüidade vertical. MÉTODOS: Foi realizado um estudo transversal de abordagem ecológica, com dados do Ministério da Saúde referentes a 399 municípios do estado do Paraná, no período de 1998 a 2005. A condição socioeconômica foi aferida por meio do Índice de Desenvolvimento Humano dos municípios, além de indicadores de renda, educação e saneamento básico, os quais foram obtidos nas bases de dados do Instituto Brasileiro de Geografia e Estatística. Os dados foram submetidos a testes estatísticos não-paramétricos: coeficiente de correlação de Spearman, Friedman e Mann-Whitney. RESULTADOS: Houve tendência redistributiva dos recursos federais transferidos aos municípios para o custeio da atenção básica, intensificada a partir do lançamento da Estratégia Saúde da Família. Observou-se expansão das ações de saúde bucal no período analisado, bem como tendência pró-eqüidade na oferta e utilização dos serviços odontológicos em atenção básica. CONCLUSÕES: Houve tendência redistributiva, ou pró-eqüidade, na provisão de serviços odontológicos no estado do Paraná, com maior provisão per capita de recursos ou serviços para municípios com piores indicadores socioeconômicos. Esta tendência se mostrou compatível com as diretrizes programáticas recentes do Ministério da Saúde.

Influência da renda sobre as despesas com alimentação fora do domicílio, no Brasil, 2002-2003

Objetivou-se descrever e avaliar a influência da renda sobre a participação da alimentação fora do domicílio no Brasil. Utilizaram-se dados coletados pela Pesquisa de Orçamentos Familiares realizada em 2002/2003 (POF 2002/2003), pelo Instituto Brasileiro de Geografia e Estatística. Analisaram-se os registros dos gastos com aquisições de alimentos e bebidas consumidos fora do domicílio. A associação entre a participação da alimentação fora do domicílio e a renda, ajustada para atributos sócio-demográficos, foi estudada por meio de modelos de regressão utilizados para estimação de coeficientes de elasticidade-renda. A alimentação fora do domicílio representou 21% do total dos gastos com alimentação; destaque-se que o incremento de 10% na renda aumentaria em 3% a participação da alimentação fora do domicílio. O efeito da renda sobre a participação da alimentação fora, ainda que sempre positivo, diminui conforme elevação da renda, sendo alto nos domicílios com renda inferior a R$68,70 per capita/mês. Há influência da renda nos gastos com alimentação fora do domicílio, assim a evolução favorável da renda resultará em aumento dessa forma de se alimentar.

Resgate histórico do controle do tabagismo na Faculdade de Saúde Pública da Universidade de São Paulo: relato de uma experiência

A ação da Faculdade de Saúde Pública da Universidade de São Paulo na luta contra o tabagismo teve início em 1975, quando a instituição participou da III Conferência Mundial de Fumo e Saúde, realizada em New York (EUA). Depois de três décadas de trabalho ininterrupto, ela recebeu, em 2008, da Secretaria de Estado da Saúde de São Paulo, o selo prata de certificação de ambiente livre do tabaco. Nesse espaço de tempo, ao lado de um trabalho educativo, realizado corpo a corpo com docentes, funcionários e alunos, foram realizadas pesquisas, treinamentos e desenvolvido toda uma programação orientada pelo Ministério da Saúde / Instituto Nacional do Câncer. Foram também produzidas inúmeras monografias de mestrado, teses de doutorado e de livre docência, tendo como tema o tabagismo do ponto de vista educativo, social, médico e sanitário. Este artigo pretendeu fazer o relato dessa trajetória

Influence of metallic nanoparticles on electric-dipole and magnetic-dipole transitions of Eu(3+) doped germanate glasses

Luminescence properties of Eu(3+) doped germanate glasses containing either silver or gold nanoparticles (NPs) were investigated for excitation at 405 nm. Enhanced emissions and luminescence quenching of the Eu(3+) transitions in the range from 570 to 720 nm were observed for samples having various concentrations of metallic NPs. Electric-dipole and magnetic-dipole transitions that originate from the Eu(3+) level (5)D(0) exhibit large enhancement due to the presence of the metallic NPs. The results suggest that the magnetic response of rare-earth doped metal-dielectric composites at optical frequencies can be as strong as their electric response due to the confinement of the optical magnetic field. (C) 2010 American Institute of Physics. [doi:10.1063/1.3431347]

IL-17 Produced during Trypanosoma cruzi Infection Plays a Central Role in Regulating Parasite-Induced Myocarditis

Background: Chagas disease is a neglected disease caused by the intracellular parasite Trypanosoma cruzi. Around 30% of the infected patients develop chronic cardiomyopathy or megasyndromes, which are high-cost morbid conditions. Immune response against myocardial self-antigens and exacerbated Th1 cytokine production has been associated with the pathogenesis of the disease. As IL-17 is involved in the pathogenesis of several autoimmune, inflammatory and infectious diseases, we investigated its role during the infection with T. cruzi. Methodology/Principal Findings: First, we detected significant amounts of CD4, CD8 and NK cells producing IL-17 after incubating live parasites with spleen cells from normal BALB/c mice. IL-17 is also produced in vivo by CD4(+), CD8(+) and NK cells from BALB/c mice on the early acute phase of infection. Treatment of infected mice with anti-mouse IL-17 mAb resulted in increased myocarditis, premature mortality, and decreased parasite load in the heart. IL-17 neutralization resulted in increased production of IL-12, IFN-gamma and TNF-alpha and enhanced specific type 1 chemokine and chemokine receptors expression. Moreover, the results showed that IL-17 regulates T-bet, ROR gamma t and STAT-3 expression in the heart, showing that IL-17 controls the differentiation of Th1 cells in infected mice. Conclusion/Significance: These results show that IL-17 controls the resistance to T. cruzi infection in mice regulating the Th1 cells differentiation, cytokine and chemokine production and control parasite-induced myocarditis, regulating the influx of inflammatory cells to the heart tissue. Correlations between the levels of IL-17, the extent of myocardial destruction, and the evolution of cardiac disease could identify a clinical marker of disease progression and may help in the design of alternative therapies for the control of chronic morbidity of chagasic patients.

Gender Differences in Life Expectancy and Disability-Free Life Expectancy Among Older Adults in Sao Paulo, Brazil

Background: Research on life expectancy has demonstrated the negative impact of disability on the health of older adults and its differential effects on women as evidenced by their higher disabled life expectancy (DLE). The goal of the present study was to investigate gender differences in total life expectancy (TLE), disability-free life expectancy (DFLE), and DLE; examine gender differences on personal care assistance among older adults in Sao Paulo, Brazil; and discuss the implications for public policies. Methods: The sample was drawn from two waves (2000, 2006) of the dataset of Salud, Bienestar, y Envejecimiento, a large longitudinal study conducted in Sao Paulo (n = 2,143). The study assessed disability using the activities of daily living (ADL). The interpolation of Markov Chain method was used to estimate gender differences in TLE, DLE, and DFLE. Findings: TLE at age 60 years was approximately 5 years longer for women than men. Women aged 60 years were expected to live 28% of their remaining lives twice the percentage for men with at least one ADL disability. These women also lived more years (M = 0.71, SE = 0.42) with three or more ADL disabilities than men (M = 0.82, SE = 0.16). In terms of personal care assistance, women received more years of assistance than men. Conclusion: Among older adults in Sao Paulo, women lived longer lives but experienced a higher and more severe disability burden than men. In addition, although women received more years of personal assistance than men, women experienced more unmet care assistance needs. Copyright (C) 2011 by the Jacobs Institute of Women`s Health. Published by Elsevier. Inc.

Acute Streptococcus agalactiae endocarditis: Outcomes of early surgical treatment

The incidence of Streptococcus agalactiae is widely recognized as increasing in nonpregnant adults. This report describes a retrospective case series of S. agalactiae endocarditis at the Heart Institute of Sao Paulo, Brazil, between 2000 and 2006. Early diagnosis and valve surgery seem to have contributed to improved patient outcomes. (Heart Lung (R) 2010;39:331-334.)

Characterization of tree-rings of Pinus caribaea var. hondurensis Barr. et Golf. trees by X ray densitometry

This work aimed to determining the anatomical structure of wood, through methodology of histology and X-ray densitometry, of resin-tapped and not resin-tapped Pinus caribaea var. hondurensis trees samples, of three diameter classes. Pine trees, in forest plantation established in 1969, in the Ecological Experimental Station of Itirapina, from the Forestry Institute of Sao Paulo State, were measured and stratified into three classes of trunk diameter. The pine trees were resin-tapped since 2004, with the opening of two simultaneous and opposing panels. Sixty samples of pine wood trees were extracted from the tree trunk through a non-destructive method and in the laboratory. Tree rings were determined in the laboratory and wood apparent density by X-ray densitometry. The test results showed that: (i) false tree rings occur in the early wood and late wood of the tree rings due to climate change; (ii) the X-ray densitometry allowed the demarcation of the tree rings limits; (iii) the wood apparent density average was significantly different between the trees in high class diameter and in the medium-low class; (iv) the wood characteristics from the resin-tapped and non resin-tapped faces did not show significant differences.

A recombinant vaccine based on domain II of Plasmodium vivax Apical Membrane Antigen 1 induces high antibody titres in mice

The Apical Membrane Antigen 1 (AMA-1) is considered a promising candidate for development of a malaria vaccine against asexual stages of Plasmodium. We recently identified domain II (DII) of Plasmodium vivax AMA-1 (PvAMA-1) as a highly immunogenic region recognised by IgG antibodies present in many individuals during patent infection with P. vivax. The present study was designed to evaluate the immunogenic properties of a bacterial recombinant protein containing PvAMA-1 DII. To accomplish this, the recombinant protein was administered to mice in the presence of each of the following six adjuvants: Complete/Incomplete Freund`s Adjuvant (CFA/IFA), aluminium hydroxide (Alum), Quil A, QS21 saponin, CpG-ODN 1826 and TiterMax. We found that recombinant DII was highly immunogenic in BALB/c mice when administered in the presence of any of the tested adjuvants. Importantly, we show that DII-specific antibodies recognised the native AMA-1 protein expressed on the surface of P. vivax merozoites isolated from the blood of infected patients. These results demonstrate that a recombinant protein containing PvAMA-1 DII is immunogenic when administered in different adjuvant formulations, and indicate that this region of the AMA-1 protein should continue to be evaluated as part of a subunit vaccine against vivax malaria. (C) 2010 Elsevier Ltd. All rights reserved.

Methylmercury and inorganic mercury determination in blood by using liquid chromatography with inductively coupled plasma mass spectrometry and a fast sample preparation procedure

Despite the necessity to differentiate chemical species of mercury in clinical specimens, there area limited number of methods for this purpose. Then, this paper describes a simple method for the determination of methylmercury and inorganic mercury in blood by using liquid chromatography with inductively coupled mass spectrometry (LC-ICP-MS) and a fast sample preparation procedure. Prior to analysis, blood (250 mu L) is accurately weighed into 15-mL conical tubes. Then, an extractant solution containing mercaptoethanol, L-cysteine and HCI was added to the samples following sonication for 15 min. Quantitative mercury extraction was achieved with the proposed procedure. Separation of mercury species was accomplished in less than 5 min on a C18 reverse-phase column with a mobile phase containing 0.05% (v/v) mercaptoethanol, 0.4% (m/v) L-cysteine, 0.06 mol L(-1) ammonium acetate and 5% (v/v) methanol. The method detection limits were found to be 0.25 mu g L(-1) and 0.1 mu Lg L(-1) for inorganic mercury and methylmercury, respectively. Method accuracy is traceable to Standard Reference Material (SRM) 966 Toxic Metals in Bovine Blood from the National Institute of Standards and Technology (NIST). The proposed method was also applied to the speciation of mercury in blood samples collected from fish-eating communities and from rats exposed to thimerosal. With the proposed method there is a considerable reduction of the time of sample preparation prior to speciation of Hg by LC-ICP-MS. Finally, after the application of the proposed method, we demonstrated an interesting in vivo ethylmercury conversion to inorganic mercury. (C) 2009 Elsevier B.V. All rights reserved.

Determination of total and inorganic mercury in whole blood by cold vapor inductively coupled plasma mass spectrometry (CV ICP-MS) with alkaline sample preparation

A simple method with a fast sample preparation procedure for total and inorganic mercury determinations in blood samples is proposed based on flow injection cold vapor inductively coupled plasma mass spectrometry (FI-CVICP-MS). Aliquots of whole blood (500 mL) are diluted 1 + 1 v/v with 10.0% v/v tetramethylammonium hydroxide (TMAH) solution, incubated for 3 h at room temperature and then further diluted 1 + 4 v/v with 2.0% v/v HCl. The inorganic Hg was released by online addition of L-cysteine and then reduced to elemental Hg by SnCl(2). On the other hand, total mercury was determined by on-line addition of KMnO(4) and then reduced to elemental Hg by NaBH(4). Samples were calibrated against matrix-matching. The method detection limit was found to be 0.80 mu g L(-1) and 0.08 mu g L(-1) for inorganic and total mercury, respectively. Sample throughput is 20 samples h(-1). The method accuracy is traceable to Standard Reference Material (SRM) 966 Toxic Metals in Bovine Blood from the National Institute of Standards and Technology (NIST). For additional validation purposes, human whole blood samples were analyzed by the proposed method and by an established CV AAS method, with no statistical difference between the two techniques at 95% confidence level on applying the t-test.

Mercury speciation in whole blood by gas chromatography coupled to ICP-MS with a fast microwave-assisted sample preparation procedure

A simple and fast method is described for simultaneous determination of methylmercury (MeHg), ethylmercury (Et-Hg) and inorganic mercury (Ino-Hg) in blood samples by using capillary gas chromatography-inductively coupled plasma mass spectrometry (GC-ICP-MS) after derivatization and alkaline digestion. Closed-vessel microwave assisted digestion conditions with tetramethylammonium hydroxide (TMAH) have been optimized. Derivatization by using ethylation and propylation procedures have also been evaluated and compared. The absolute detection limits (using a 1 mu L injection) obtained by GC-ICP-MS with ethylation were 40 fg for MeHg and Ino-Hg, respectively, and with propylation were 50, 20 and 50 fg for MeHg, Et-Hg and Ino-Hg, respectively. Method accuracy is traceable to Standard Reference Material (SRM) 966 Toxic Metals in Bovine Blood from the National Institute of Standards and Technology (NIST). Additional validation is provided based on the comparison of results obtained for mercury speciation in blood samples with the proposed procedure and with a previously reported LC-ICP-MS method. With the new proposed procedure no tedious clean-up steps are required and a considerable improvement of the time of analysis was achieved compared to other methods using GC separation.

Effects of memory load and distraction on performance and event-related slow potentials in a visuospatial working memory task

Brain electrical activity related to working memory was recorded at 15 scalp electrodes during a visuospatial delayed response task. Participants (N = 18) touched the remembered position of a target on a computer screen after either a 1 or 8 sec delay. These memory trials were compared to sensory trials in which the target remained present throughout the delay and response periods. Distracter stimuli identical to the target were briefly presented during the delay on 30% of trials. Responses were less accurate in memory than sensory trials, especially after the long delay. During the delay slow potentials developed that were significantly more negative in memory than sensory trials. The difference between memory and sensory trials was greater at anterior than posterior electrodes. On trials with distracters, the slow potentials generated by memory trials showed further enhancement of negativity whereas there were minimal effects on accuracy of performance. The results provide evidence that engagement of visuospatial working memory generates slow wave negativity with a timing and distribution consistent with frontal activation. Enhanced brain activity associated with working memory is required to maintain performance in the presence of distraction. © 1997 by the Massachusetts Institute of Technology

Controllability of Volterra-Fredholm type systems in Banach spaces

We show the results in Chalishajar [Controllability of mixed Volterra-Fredholm-type integro-differential systems in Banach space, J. Franklin Inst. 344(1) (2007) 12-21] and Chang and Chalishajar [Controllability of mixed Volterra-Fredholm type integro-differential systems in Banach space, J. Franklin Inst., doi:10.1016/j. jfranklin.2008.02.002] are only valid for ordinary differential control systems. As a result the examples provided cannot be recovered as applications of the abstract results. (C) 2008 The Franklin Institute. Published by Elsevier Ltd. All rights reserved.

Fast-convergent iterative scheme for filtering velocity signals and finding Kolmogorov scales

The present fundamental knowledge of fluid turbulence has been established primarily from hot- and cold-wire measurements. Unfortunately, however, these measurements necessarily suffer from contamination by noise since no certain method has previously been available to optimally filter noise from the measured signals. This limitation has impeded our progress of understanding turbulence profoundly. We address this limitation by presenting a simple, fast-convergent iterative scheme to digitally filter signals optimally and find Kolmogorov scales definitely. The great efficacy of the scheme is demonstrated by its application to the instantaneous velocity measured in a turbulent jet.