Cost-effectiveness analysis of routine rotavirus vaccination in Brazil

Objective. The objective of this study was to conduct a cost-effectiveness analysis of a universal rotavirus vaccination program among children : 5 years of age in Brazil. Methods. Considering a hypothetical annual cohort of approximately 3 300 000 newborns followed over 5 years, a decision-tree model was constructed to examine the possible clinical and economic effects of rotavirus infection with and without routine vaccination of children. Probabilities and unit costs were derived from published research and national administrative data. The impact of different estimates for key parameters was studied using sensitivity analysis. The analysis was conducted from both healthcare system and societal perspectives. Results. The vaccination program was estimated to prevent approximately 1735 351 (54%) of the 3 210 361 cases of rotavirus gastroenteritis and 703 (75%) of 933 rotavirus-associated deaths during the 5-year period. At a vaccine price of 18.6 Brazilian reais (R$) per dose, this program would cost R$121 673 966 and would save R$38 536 514 in direct costs to the public healthcare system and R$71 778 377 in direct and indirect costs to society. The program was estimated to cost R$1 028 and R$1 713 per life-years saved (LYS)from the societal and healthcare system perspectives, respectively. Conclusions. Universal rotavirus vaccination was a cost-effective strategy for both perspectives. However, these findings are highly sensitive to diarrhea incidence rate, proportion of severe cases, vaccine coverage, and vaccine price.

Influence of thermal and mechanical cycling on the flexural strength of ceramics with titanium or gold alloy frameworks

Objectives. The aim of this study was to evaluate the effect of thermal and mechanical cycling alone or in combination, on the flexural strength of ceramic and metallic frameworks cast in gold alloy or titanium. Methods. Metallic frameworks (25 mm x 3 mm x 0.5 mm) (N = 96) cast in gold alloy or commercial pure titanium (Ti cp) were obtained using acrylic templates. They were airborne particle-abraded with 150 mu m aluminum oxide at the central area of the frameworks (8 mm x 3 mm). Bonding agent and opaque were applied on the particle-abraded surfaces and the corresponding ceramic for each metal was fired onto them. The thickness of the ceramic layer was standardized by positioning the frameworks in a metallic template (height: I mm). The specimens from each ceramic-metal combination (N = 96, n = 12 per group) were randomly assigned into four experimental fatigue conditions, namely water storage at 37 degrees C for 24 h (control group), thermal cycling (3000 cycles, between 4 and 55 degrees C, dwell time: 10 s), mechanical cycling (20,000 cycles under 10 N load, immersion in distilled water at 37 degrees C) and, thermal and mechanical cycling. A flexural strength test was performed in a universal testing machine (crosshead speed: 1.5 mm/min). Data were statistically analyzed using two-way ANOVA and Tukey`s test (alpha = 0.05). Results. The mean flexural strength values for the ceramic-gold alloy combination (55 +/- 7.2MPa) were significantly higher than those of the ceramic-Ti cp combination (32 +/- 6.7 MPa) regardless of the fatigue conditions performed (p < 0.05). Mechanical and thermo-mechanical fatigue decreased the flexural strength results significantly for both ceramic-gold alloy (52 +/- 6.6 and 53 +/- 5.6 MPa, respectively) and ceramic-Ti cp combinations (29 +/- 6.8 and 29 +/- 6.8 MPa, respectively) compared to the control group (58 +/- 7.8 and 39 SA MPa, for gold and Ti cp, respectively) (p < 0.05) (Tukey`s test). While ceramic-Ti cp combinations failed adhesively at the metal-opaque interface, gold alloy frameworks exhibited a residue of ceramic material on the surface in all experimental groups. Significance. Mechanical and thermo-mechanical fatigue conditions decreased the flexural strength values for both ceramic-gold alloy and ceramic-Ti cp combinations with the results being significantly lower for the latter in all experimental conditions. (C) 2007 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Disease-modifying properties of long-term lithium treatment for amnestic mild cognitive impairment: randomised controlled trial

Background Two recent clinical studies support the feasibility of trials to evaluate the disease-modifying properties of lithium in Alzheimer`s disease, although no benefits were obtained from short-term treatment. Aims To evaluate the effect of long-term lithium treatment on cognitive and biological outcomes in people with amnestic mild cognitive impairment (aMCI). Method Forty-five participants with aMCI were randomised to receive lithium (0.25-0.5mmol/l) (n=24) or placebo (n = 21) in a 12-month, double-blind trial. Primary outcome measures were the modification of cognitive and functional test scores, and concentrations of cerebrospinal fluid (CSF) biomarkers (amyloid-beta peptide (A beta(42)), total tau (T-tau), phosphorylated-tau) (P-tau). Trial registration: NCT01055392. Results Lithium treatment was associated with a significant decrease in CSF concentrations of P-tau (P=0.03) and better perform-ance on the cognitive subscale of the Alzheimer`s Disease Assessment Scale and in attention tasks. Overall tolerability of lithium was good and the adherence rate was 91%. Conclusions The present data support the notion that lithium has disease-modifying properties with potential clinical implications in the prevention of Alzheimer`s disease.

Carbon monoxide and nitric oxide modulate hyperosmolality-induced oxytocin secretion by the hypothalamus in vitro

OT (oxytocin) is secreted from the posterior pituitary gland, and its secretion has been shown to be modulated by NO (nitric oxide). In rats, OT secretion is also stimulated by hyperosmolarity of the extracellular fluid. Furthermore, NOS (nitric oxide synthase) is located in hypothalamic areas involved in fluid balance control. In the present study, we evaluated the role of the NOS/NO and HO (haem oxygenase)/CO (carbon monoxide) systems in the osmotic regulation of OT release from rat hypothalamus in vitro. We conducted experiments on hypothalamic fragments to determine the following: (i) whether NO donors and NOS inhibitors modulate OT release and (ii) whether the changes in OT response occur concurrently with changes in NOS or HO activity in the hypothalamus. Hyperosmotic stimulation induced a significant increase in OT release that was associated with a reduction in nitrite production. Osmotic stimulation of OT release was inhibited by NO donors. NOS inhibitors did not affect either basal or osmotically stimulated OT release. Blockade of HO inhibited both basal and osmotically stimulated OT release, and induced a marked increase in NOS activity. These results indicate the involvement of CO in the regulation of NOS activity. The present data demonstrate that hypothalamic OT release induced by osmotic stimuli is modulated, at least in part, by interactions between NO and CO.

Holt-Oram syndrome: novel TBX5 mutation and associated anomalous right coronary artery

The Holt-Oram syndrome was confirmed in an asymptomatic 36-year-old man by a novel TBX5-gene mutation (exon 8 acceptor splicing site, c.663-1G greater than A). Computed tomography showed an atrial septal defect and an anomalous right coronary artery crossing between the aorta and pulmonary arteries. Surgery corrected the septal defect and the initial segment of the anomalous vessel was unroofed and enlarged. Anomalous coronary arteries were not previously described in the Holt-Oram syndrome patients and should be added to the list of possible associated cardiac defects.

Detection of Bartonella spp. in neotropical felids and evaluation of risk factors and hematological abnormalities associated with infection

Although antibodies to Bartonella henselae have been described in all neotropical felid species, DNA has been detected in only one species, Leopard us wiedii. The aim of this study was to determine whether DNA of Bartonella spp. could be detected in blood of other captive neotropical felids and evaluate risk factors and hematological findings associated with infection. Blood samples were collected from 57 small felids, including 1 Leopard us geoffroyi, 17 L wiedii, 22 Leopardus tigrinus, 14 Leopardus pardalis, and 3 Puma yagouaroundi; 10 blood samples from Panthera onca were retrieved from blood banks. Complete blood counts were performed on blood samples from small felids, while all samples were evaluated by PCR. DNA extraction was confirmed by amplification of the cat GAPDH gene. Bartonella spp. were assessed by amplifying a fragment of their 16S-23S rRNA intergenic spacer region; PCR products were purified and sequenced. For the small neotropical felids, risk factors [origin (wild-caught or zoo-born), gender, felid species, and flea exposure) were evaluated using exact multiple logistic regression. Hematological findings (anemia, polycythemia/hyperproteinemia, leukocytosis and leukopenia) were tested for association with infection using Fisher`s exact test. The 635 bp product amplified from 10 samples (10/67 = 14.92%) was identified as B. henselae by sequencing. Small neotropical felid males were more likely to be positive than females (95% CI = 0.00-0.451, p = 0.0028), however other analyzed variables were not considered risk factors (p > 0.05). Hematological abnormalities were not associated with infection (p > 0.05). This is the first report documenting B. henselae detection by PCR in several species of neotropical felids. (C) 2009 Elsevier B.V. All rights reserved.

Effects of sperm concentration and straw volume on motion characteristics and plasma, acrosomal, and mitochondrial membranes of equine cryopreserved spermatozoa

The advantages of using cryopreserved semen in equine reproduction are well known. During cryopreservationl spermatozoa undergo many changes that lead to a decrease in fertility. There is no agreement on the ideal sperm dose and concentration to maximize fertility rates. Thus, the objectives of this experiment were to evaluate sperm motion by computer-assisted analysis (CASA), sperm membrane integrity and function with fluorescence probes of cryopreserved sperm at three concentrations: 100 (C100), 200 (C200) and 400 x 10(6) sperm/mL (C400), and two straw volumes (0.50 and 0.25 mL). There was no interaction between sperm concentration and storage volume (P > .05). Sperm motion characteristics were influenced by concentration (C100 > C200 > C400; P < .05). Curvilinear velocity (VCL) in 0.25-mL straws had higher average values (P < .05). Membrane integrity and function were not changed by straw volume (P > .05). However, sperm concentration changed the percentage of cells with intact plasma membrane (C100 > C200 > C400; P < .05) and the percentage of cells with high mitochondrial membrane potential (C100 = C200; P > .05 and C400 < C100 and C200; P < .05). According to this experiment, the best freeing method was that involving 100 x 10(6) sperm/mL, regardless of straw volume.

Understanding the impact of divalent cation substitution on hydroxyapatite: An in vitro multiparametric study on biocompatibility

Hydroxyapatite (HA), a stable and biocompatible material for bone tissue therapy, may present a variable stoichiometry and accept a large number of cationic substitutions. Such substitutions may modify the chemical activity of HA surface, with possible impact on biocompatibility. In this work, we assessed the effects of calcium substitution with diverse divalent cations (Pb(2+), Sr(2+), Co(2+), Zn(2+), Fe(2+), Cu(2+), or Mg(2+)) on the biological behavior of HA. Physicochemical analyses revealed that apatite characteristics related to crystallinity and calcium dissolution/uptake rates are very sensitive to the nature of cationic substitution. Cytocompatibility was evaluated by mitochondrial activity, membrane integrity, cell density, proapoptotic potential, and adhesion tests. With the exception of Zn-HA, all the substituted HAs induced some level of apoptosis. The highest apoptosis levels were observed for Mg-HA and Co-HA. Cu-HA was the only material to impair simultaneously mitochondrial activity, membrane integrity, and cell density. The highest relative cell densities after exposure to the modified HAs were observed for Mg-HA and Zn-HA, while Co-HA significantly improved cell adhesion onto HA surface. These results show that changes on surface dissolution caused by cationic substitution, as well as the increase of metal species released to biological media, were the main responsible factors related to alterations on HA biocompatibility. (C) 2011 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 98A: 351-358, 2011.

The role of handouts, note-taking and overhead transparencies in veterinary science lectures

Objective To study student and staff views of the role and use of handouts, note-taking and overhead transparencies in veterinary science lectures at the University of Queensland Methods The Nominal Group Technique was used to help develop a questionnaire, which was completed by 351 students (a response rate of 84%) and 35 staff (76%) from the 5 years of the veterinary course. The data were analysed using the SAS statistical computer package. Results Staff and students held different views as to the frequency with which handouts should be used, their educational value, and whether they should be complete or partial. Fewer students than staff agreed that handouts discourage further reading in a subject. Almost all staff and students saw the central functions of note-taking to be provision of notes for subsequent revision and encoding information given by the lecturer. More students than staff however, considered that note-taking in lectures interferes with understanding. Staff and students held similar views as to the uses of overheads in lectures. Interestingly however, more staff than students agreed that overheads often contain too much information. Conclusion Both students and staff saw the central role of note-taking as providing a set of good notes for revision. Generally students preferred that this information be provided in the form of partial or complete handouts, while staff preferred students to take notes and to read outside lectures. Surprisingly, more staff than students felt that overhead transparencies often contained too much information. Note-taking, handouts and overhead transparencies need to be linked in a coherent educational strategy to promote effective learning.

Lectures and other types of teaching

A questionnaire on lectures was completed by 351 students (84% response) and 35 staff (76% response) from all five years of the veterinary course at the University of Queensland. Staff and students in all five years offered limited support for a reduction in the number of lectures in the course and the majority supported a reduction in the number of lectures in the clinical years. Students in the clinical years only and appropriate staff agreed that the number of lectures in fifth year should be reduced but were divided as to whether lectures in fifth year should be abolished. There was limited support for replacement of some lectures by computer assisted learning (CAL) programs, but strong support for replacement of some lectures by subject-based problem based learning (PBL) and strong support for more self-directed learning by students. Staff and students strongly supported the inclusion of more clinical problem solving in lectures in the clinical years and wanted these lectures to be more interactive. There was little support for lectures in the clinical years to be of the same type as in the preclinical years.

Sex- and race-related differences in cross-sectional geometry and bone density of the femoral mid-shaft in older adults

Background : Femoral shaft fracture incidence increases in older adults and is associated with low-energy trauma. Apart from bone density, the distribution and size of bone contributes to its strength. Aim : To examine if bone geometry and density of the femoral mid-shaft in older adults differs by sex and race, we studied 197 White women, 225 Black women, 242 White men, and 148 Black men aged 70-79 years participating in the Health, Aging, and Body Composition study; a prospective cohort study in the USA. A secondary purpose of the study was to examine the association of site-specific muscle and fat to bone geometry and density. Subjects and methods : Subjects were community-dwelling and reported no difficulty walking one-quarter of a mile or climbing stairs. Mid-femoral volumetric bone mineral density (vBMD, mg cm -3 ), total area (TA), cortical area (CA), medullary area (MA), cross-sectional moments of inertia (CSMI: I x , I y , J ), and muscle and fat areas (cm 2 ) were determined by computed tomography (CT; GE CT-9800, 10 mm slice thickness). Results : vBMD was greater in men than women with no difference by race ( p < 0.001). Bone areas and area moments of inertia were also greater in men than women ( p < 0.001), with Black women having higher values than White women for TA and CA. Standardizing geometric parameters for body size differences by dividing by powers of femur length did not negate the sex difference for TA and MA. Significant differences ( p < 0.05) among the four groups also remained for I x and J . Mid-thigh muscle area was an independent contributor to TA in all groups (Std beta = 0.181-0.351, p < 0.05) as well as CA in women (Std beta = 0.246-0.254, p < 0.01) and CSMI in White women (Std beta = 0.175-0.185, p < 0.05). Further, muscle area was a significant contributor to vBMD in Black women. Conclusion : These results indicate that bone geometry and density of the femoral diaphysis differs primarily by sex, rather than race, in older well-functioning adults. In addition, site-specific muscle area appears to have a potential contributory role to bone geometry parameters, especially in women.

Sistema Ponto Focal: gerenciamento eletr??nico de informa????es sobre exig??ncias t??cnicas

O Inmetro ?? o ponto focal para o Acordo sobre Barreiras T??cnicas ao Com??rcio (TBT), como representante do Brasil na Organiza????o Mundial do Com??rcio (OMC). O exerc??cio dessa atividade propiciou ac??mulo de informa????es sobre exig??ncias t??cnicas, necess??rias para inser????o dos produtos industriais brasileiros nos mercados externos. A otimiza????o do uso dessas informa????es demandou o desenvolvimento de um sistema de gest??o de informa????o. Para tanto, desenvolveu-se o Sistema Ponto Focal, que ?? uma ferramenta de dissemina????o personalizada e proativa de informa????es sobre barreiras t??cnicas ??s exporta????es para o setor empresarial. Trata-se de um instrumento que auxilia o exportador no aprimoramento cont??nuo da qualidade e competitividade do produto brasileiro no mundo globalizado

Educa????o a dist??ncia: o estado da arte e o futuro necess??rio

Este artigo analisa alguns desafios que cercam a ado????o da Educa????o a Dist??ncia por institui????es de ensino, unidades de forma????o e qualifica????o profissional e de educa????o corporativa. Al??m disto, ?? sugerida uma agenda de pesquisa sobre EAD. O artigo trata do papel da EAD na educa????o continuada de adultos e na amplia????o do acesso ?? aprendizagem, em fun????o da possibilidade de intera????es ass??ncronas, mediadas por tecnologias da informa????o e comunica????o. Uma an??lise da situa????o EAD no Brasil mostra um grande crescimento da modalidade. Observa-se que ainda s??o raras as pesquisas sobre EAD no servi??o p??blico. H?? informa????es sugerindo que, em ??rg??os p??blicos com pr??ticas institucionalizadas de EAD, a modalidade representa uma valiosa e eficaz estrat??gia de inclus??o de pessoas em atividades de ensino-aprendizagem. S??o analisados alguns importantes desafios ligados ?? implementa????o e ao desenho de cursos a dist??ncia, e, al??m disto, ?? apresentada uma agenda de pesquisas para a ??rea.

Acordo amaz??nico de ci??ncia, tecnologia e inova????o em sa??de: uma experi??ncia de integra????o regional

O presente artigo incorpora a experi??ncia de integra????o regional amaz??nica sob a ??gide do Acordo Amaz??nico de Ci??ncia, Tecnologia e Inova????o em Sa??de. Reconhecendo a import??ncia estrat??gica dessa regi??o detentora de inestim??veis patrim??nios em s??cio e biodiversidades, o Governo Federal declara, em 2003, a Amaz??nia uma prioridade para o combate ??s desigualdades e ao desenvolvimento socioecon??mico, articulando, desde ent??o, f??runs com minist??rios e institui????es regionais, embasados no Programa de Desenvolvimento Sustent??vel da Amaz??nia. Com o objetivo de implementar a????es para produ????o de saber cient??fico voltado ?? realidade local e para a integra????o da pesquisa b??sica e aplicada, ensino e tecnologia, incentiva-se a coopera????o com outras institui????es afins regionais, nacionais e internacionais. Uma dessas a????es resultou, em 2004, na formaliza????o do Acordo Multilateral de Coopera????o T??cnico-Cient??fica em Sa??de das Institui????es da Amaz??nia, cuja proposta baseia-se na constitui????o de uma rede de pesquisa, forma????o de recursos humanos, coopera????o t??cnica com gestores do SUS e coopera????o internacional em sa??de, objetivando desenvolver atividades de investiga????o conjunta para conhecer as realidades s??cios sanit??rias e epidemiol??gicas da regi??o e implementar respostas do sistema de sa??de e de ci??ncia, tecnologia e inova????o.

Non-volant tetrapods from Reserva Biológica de Duas Bocas, State of Espírito Santo, Southeastern Brazil

A Reserva Biológica de Duas Bocas (2.190 ha) é um dos maiores remanescentes de Mata Atlântica do Estado do Espírito Santo, Sudeste do Brasil. Nós amostramos tetrápodes não voadores nessa área entre maio de 2007 e abril de 2008, utilizando armadilhas de queda, armadilhas de isca, armadilhas fotográficas e buscas oportunísticas diurnas e noturnas. Além disso, nós compilamos registros de vertebrados não voadores ocorrentes nesta área disponíveis na literatura e através de espécimes em museus. Nós documentamos 52 espécies de anfíbios, 24 espécies de répteis não voadores e 39 espécies de mamíferos não voadores. Do total de 115 espécies, 47 configuram novos registros para a área e seis outras espécies tiveram sua distribuição geográfica ampliada com os resultados do presente estudo. Além disso, apresentamos o registro de predação da perereca Hypsiboas faber pela serpente Chironius bicarinatus. Cinco das espécies registradas são listadas como ameaçadas no Estado do Espírito Santo e muitas outras possuem estado de conservação incerto. A Reserva Biológica de Duas Bocas é um importante refúgio de vida selvagem, principalmente quando consideramos a expansão de áreas urbanas no seu entorno.