Avaliação da estrutura organizacional da assistência ambulatorial em HIV/Aids no Brasil

OBJETIVO: No contexto de acesso universal à terapia antiretroviral, os resultados do Programa de Aids dependem da qualidade do cuidado prestado. O objetivo do estudo foi avaliar a qualidade do cuidado dos serviços ambulatoriais que assistem pacientes de Aids. MÉTODOS: Estudo realizado em sete Estados brasileiros, em 2001 e 2002. Foi avaliada a qualidade do atendimento a pacientes com Aids quanto à disponibilidade de recursos e a organização do trabalho de assistência. Um questionário com 112 questões estruturadas abordando esses aspectos, foi enviado a 336 serviços. RESULTADOS: A taxa de resposta foi de 95,8% (322). Os indicadores de disponibilidade de recursos mostram uma adequação maior do que os indicadores de organização do trabalho. Não faltam antiretrovirais em 95,5% dos serviços, os exames de CD4 e Carga Viral estão disponíveis em quantidade adequada em 59 e 41% dos serviços, respectivamente. em 90,4% dos serviços há pelo menos um profissional não médico (psicólogo, enfermeiro ou assistente social). Quanto à organização, 80% não agendavam consulta médica com hora marcada; 40,4% agendavam mais que 10 consultas médicas por período; 17% não possuíam gerentes exclusivos na assistência e 68,6% não realizavam reuniões sistemáticas de trabalho com a equipe. CONCLUSÕES: Os resultados apontam que além de garantir a distribuição mais homogênea de recursos, o programa precisa investir no treinamento e disseminação do manejo do cuidado, conforme evidenciado nos resultados da organização de trabalho.

Ovarian follicle diameter at timed insemination and estrous response influence likelihood of ovulation and pregnancy after estrous synchronization with progesterone or progestin-based protocols in suckled Bos indicus cows

The objectives of the present study were to evaluate factors associated with estrous synchronization responses and pregnancy per insemination (P/AI) in Bos indicus beef cows submitted to progesterone-based fixed-time artificial insemination (FTAI) protocols. A total of 2388 cows (1869 Nellore and 519 crossbred Nellore x Angus) from 10 commercial farms were evaluated to determine the relationships among breed, body condition score (BCS) on the first day of the FTAI protocol, the occurrence of estrus between progesterone device removal and FTAI and diameter of largest ovarian follicle (LF) at FTAI on estrous synchronization responses and P/AI. Cows (n=412 primiparous; 1976 multiparous) received an intravaginal device containing progesterone or an ear implant containing norgestomet (a progestin), and an injection of estradiol at the beginning of the estrous synchronization protocol. Body condition was scored using a 1-5 scale on the first day of the FTAI protocol and at 30-60 days postpartum. Females received 300IU of equine chorionic gonadotropin (eCG) and PGF(2 alpha) on the day the progesterone device/implant was removed and were inseminated 48-60h later. At insemination, cows (n=2388) were submitted to an ultrasonographic exam to determine the diameter of the LF. Follicles were classified into four categories based on mean and standard deviation (SD) of the LF (LF1 = two SD below the mean; LF2 = mean minus one SD; LF3 = mean plus one SD; LF4 = two SD above the mean). Ovulation rate was determined in a subset of cows (n=813) by three consecutive ultrasonographic exams: (1) at time of progesterone device/implant removal, (2) at time of FTAI and (3) 48 h after FTAI. Ovulation was defined as the disappearance of a large follicle (>= 8.0 mm) that was previously recorded. Estrus was determined in a subset of the cows (n = 445) by the activation of a detection of estrous patch placed on the tail head on the day of progesterone device/implant removal. Pregnancy was diagnosed 30 days after FTAI. Pregnancy was influenced (P = 0.001) by follicle diameter [LF1 = 27.5% (81/295), LF2 = 46.6% (328/705), LF3 = 57.9% (647/1118), LF4 = 63.3% (171/270)] and the occurrence of estrus [estrus = 67.7% (174/257) and no estrus = 36.2% (68/188)]. Follicle diameter at FTAI influenced ovulation rate [LF1 = 42.5% (34/80), LF2 = 73.9% (161/218), LF3 = 95.8% (407/425), LF4 = 97.8% (88/90)], the occurrence of estrus [LF1 = 54.8% (51/93), LF2 = 33.6% (43/128), LF3 = 68.9% (126/183), LF4 = 90.2% (37/41)] and P/AI among cows that had ovulations [LF1 =32.4% (11/34), LF2 = 50.3% (81/161), LF3 = 60.0% (244/407), LF4 = 68.2% (60/88)]. Improving estrous responses between progesterone device withdrawal and FTAI and increasing the diameter of the LF at FTAI may be important aspects to achieve improved estrous synchronization responses and P/AI following progesterone/progestin and estradiol based FTAI protocols in suckled Bos indicus cows. (C) 2010 Elsevier B.V. All rights reserved.

Validation of a Leishmania infantum ELISA rapid test for serological diagnosis of Leishmania chagasi in dogs

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Psychiatric disorders and psychiatric consultation in a general hospital: A case- control study

Introduction: Psychiatric consultation (PC) has been considered an efficient tool to develop research, to track and to give assistance benefiting patients, health professionals and the institution. However, it has not been much used in Brazil. Although 30 to 50% of general hospital (GH) inpatients may present a psychiatric disorder, only 1 to 12% of them are referred to assessment. The aims of this study were: to assess mental disorders in a GH; to identify which of these patients are sent to psychiatric care; to verify alleged reasons for referral to psychiatric consultation, and to examine the relationship between PC and psychiatric learning (during medical school and residence). Methods: A case-control patient study was conducted (47 cases and 94 controls) to analyze in detail the following variables: socio-demographic; clinical; degree of information (about the disease and diagnostic/therapeutic procedures), and relationship between patient and health team. Psychiatric diagnoses were made according to the ICD- 10 criteria. The Self Report Questionnaire (SRQ), the CAGE and Brief Psychiatric Rating Scale (BPRS) were used as well as a specifically designed questionnaire to collect clinical and demographic data. Results: Behavioral alterations, either of elation or of depression, were the main for requesting a PC; 95.8% of the cases and 27.7% of the controls had a mental disorder. Organic mental disorders and alcohol-related disorders were the most frequent diagnoses in group I (cases), while anxiety, depressive and alcohol-related disorders were predominant in group II (controls). Control group patients were better informed and more able to establish an appropriate relationship with the health team than case patients. The logistic regression showed CAGE-positive patients having 12.85 times greater risk of being referred to PC, followed by unemployed patients (2.44 times more PC referrals). Discussion: The SRQ and CAGE were quite useful in the screening of possible patients and might be important for medical students to learn and use as generalists. Further research is needed to verify if and how the newly-established service will improve the diagnostic and treatment skills of our students.

Estudo biológico e morfométrico dos estádios ninfais de Rhodnius neglectus Lent, 1954 (Hemiptera, Reduviidae)

The following parameters of the biological cycle of the Rhodnius neglectus were determined under a temperature of 28°C and relative humidity of the air varying between 52-94%: a) average period of incubation: 13.67 days; b) rate of the eggs eclosion: 86.18%; c) average period of growth of the 1st, 2nd, 3rd, 4th, 5th instar nymphs: 18.91, 15.19, 21.38, 21.34, 30.43 days, respectively; d) percentage of death in the instar nymphs: 13.82, 18.26, 9.95, 8.78, 15.06% respectively; e) percentage of changes per instar nymphs: 86.18, 81.74, 90.05, 91.22, 84.94% respectively. The morphometric study with the stereoscopic microscope and Leica image analyses system, using the Qwin software, of the five instar nymphs showed that in the five instar nymphs a gradual growth of the head, thorax and abdomen occurs. In all the instars the abdomen is the largest segment. In the four first instars the head is larger than the thorax. In the fifth instar the head and the thorax present equivalent sizes.

Avaliação do kit TF-Test para o diagnóstico das infecções por parasitas gastrintestinais em ovinos

This study was performed to standardize parasite egg counting in feces of sheep by TF-Test, in addition to compare this test to the Gordon & Whitlock technique (G&W). Twenty-four lambs were artificially infected with Haemonchus contortus throughout 12 weeks. At the end of this time, faecal samples were taken and animals were slaughtered for worm identification and counting. G&W and TF-Test methods were carried out on each fecal sample. Both tests showed Haemonchus eggs in 95.8% of the samples (P>0.05). The correlation coefficients (r) between fecal egg counts (FEC) using G&W × Total Worm Count (TWC) were r=0.52 (not transformed data) and r=0.85 (transformed data); between FEC by TF-Test × TWC were r=0.51 (not transformed data) and r=0.87 (transformed data). Other 100 fecal samples were taken from naturally infected sheep. In these animals, the G&W and TF-Test methods showed 85% and 86% of fecal samples positive for Strongylidea eggs, respectively (P>0.05). Also in those animals, Eimeria oocysts were found in 33% of fecal samples by TF-Test, whereas in the G&W only 12% were positive (P<0.001). For Strongyloides spp., TF-Test showed 15% of positive fecal samples, whereas G&W showed 5% (P<0.05). In conclusion, both methods were efficient to diagnose gastrointestinal nematodes and TF-Test was superior to diagnose oocysts of Eimeria spp. and eggs of Strongyloides spp; conversely, Strongylidea eggs counting using TF-Test was underestimated.

Crystal and molecular structure of dinuclear palladium(II) complex containing nitrogen and phosphorus donor ligands, [Pd2(N3)4(PPh3)2(μ-ted)]

The dinuclear azido-palladium(II) complex [Pd2(N3)4(PPh3)2(μ-ted)], where PPh3 = triphenylphosphine and ted = triethylenediamine, was synthesized and characterized by single-crystal X-ray diffraction. The title compound was crystallized in a triclinic system, space group P1 with a = 11.5875(2)Å, b = 13.0817(3)Å, c = 15.2618(3)Å, α = 93.306(2)°, β =110.040(1)°, γ = 98.486(1)°, V = 2134.95(8)Å3, Z = 2. Each Pd(II) center displays a distorted squareplanar coordination environment formed by two N atoms from two trans terminally coordinated azido groups, one P atom from the phosphine and one N atom from the bridging ted ligand. 2008 © The Japan Society for Analytical Chemistry.

Opinião dos pais sobre a voz de seus filhos de 5 a 12 anos

Pós-graduação em Pediatria - FMB

Desenvolvimento e aplicação de métodos sorológicos e moleculares para o diagnóstico da doença de Newcastle em pombos comuns (Columba livia)

Pós-graduação em Microbiologia Agropecuária - FCAV

Hemerobiidae (Neuroptera) em Coffea arabica L. (Rubiaceae): diversidade, sazonalidade e associação com presas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Acidentes por centopéia notificados pelo "Centro de Informações Toxicológicas de Belém", num período de dois anos

Centopéias são animais invertebrados do filo dos artrópodes e da classe Chilopoda . Este trabalho objetiva estudar o perfil dos acidentes por centopéias notificados pelo "Centro de Informações Toxicológicas de Belém" (CIT-Belém). Foram estudados 76 protocolos registrados no período de março de 1998 a março de 2000. Corresponderam a 16,7% dos acidentes por animais peçonhentos, superados apenas pelo ofidismo (44,4%) e escorpionismo (20,5%). O local do acidente foi a residência em 86,8% dos casos. A faixa etária 20 - 49 anos foi a mais acometida (64,4 %) e 61,8 % dos casos registrados pertenciam ao sexo feminino. Membros superiores foram a parte do corpo mais acidentada (47,4%). Dor local ocorreu em 95,8 % dos pacientes e edema local leve em 52,1%. O tratamento foi predominantemente sintomático; 94,7% evoluíram para a cura e ignora-se a evolução nos outros 5,3 %. Sugere-se que o acidente por centopéia é benigno e doméstico e que tratamentos analgésicos são suficientes.

Citotoxidade de cimentos resinosos sobre célular obtidas da polpa de dentes humanos (HDPCs) e odontoblastóides (MDPC-23)

Pós-graduação em Reabilitação Oral - FOAR

A liquid-phase-blocking concanavalin A enzyme-linked immunosorbent assay for the detection of antibodies against Newcastle disease virus in serum of free-ranging pigeons

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Comparative evaluation of the DPP (R) CVL rapid test for canine serodiagnosis in area of visceral leishmaniasis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

ROCK1 as a novel prognostic marker in vulvar cancer

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)