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[SciELO Preprints] - EVOLUTION OF POLICIES RELATED TO CHILD CARE WITHIN THE SCOPE OF PRIMARY HEALTH CARE (PHC) IN BRAZIL
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Lima, Acácia Mayra Pereira de Santos, Helena Paula Guerra dos Luz, Leandro Alves da Flores-Quispe, Maria del Pilar Martufi, Valentina Anjos, Eduarda Ferreira dos Oliveira, Cátia Falcão, Ila Ortelan, Naiá Rocha, Aline dos Santos Aquino, Rosana Vieira-Meyer, Anya P G F Ichihara, Maria Yury Barreto, Maurício Lima Pinto Junior, Elzo Pereira

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Publication date: 2022-08-08

Abstract: En Pt

Introdução: As políticas públicas são essenciais para reduzir a morbimortalidade infantil. Este estudo descreve a evolução das políticas relacionadas à atenção à criança no âmbito da Atenção Primária à Saúde (APS) no Brasil, implementadas desde a criação do Sistema Único de Saúde (SUS). Metodologia: Revisão narrativa da literatura com base nos principais marcos regulatórios com influência direta ou indireta na Atenção à Saúde da Criança (ACS) na APS, publicados entre 1990 e 2017. Resultados: Foram analisados 31 documentos oficiais, organizados em uma linha do tempo e classificados em três categorias: I) Normas do SUS e da APS; II) diretrizes para os serviços de saúde materno-infantil no âmbito da APS; e, III) políticas intersetoriais. Conclusão:A evolução das políticas de CSC no Brasil é marcada por uma série de conquistas em prol da ampliação dos direitos sociais e da garantia do direito à saúde que ampliou o acesso aos serviços de saúde e contribuiu para a melhoria das condições de vida e de vida das crianças. No entanto, as desigualdades sociais e os desafios no acesso e qualidade da atenção na APS são persistentes, com retrocessos causados pela implementação de medidas de austeridade desde 2016.

Introdução: Políticas públicas são fundamentais para a redução da morbimortalidade na infância. O presente estudo descreve uma evolução política relacionada à Atenção Primária à Saúde da Criança no âmbito da Atenção Primária Saúde (APS) no Brasil, desde a criação do Sistema Único de Saúde (SUS). Metodologia: Revisão narrativa da literatura com base nos principais marcos normativos com influência na Atenção à Saúde da Criança no âmbito da APS, publicados entre 1990 e 2017. Resultados: Foram analisados 31 documentos oficiais, distribuídos numa linha do tempo, classificados em: I) normatização do SUS e da APS; II) orientação aos serviços de saúde materno-infantil no âmbito da APS e III) políticas intersetoriais. Conclusão: A evolução das políticas pensadas no Brasil está marcada para serviços e como soluções da série de direitos sociais e como possibilidades de vistas da vida. Porém, além das desigualdades sociais, desafios no acesso e na qualidade do cuidado na APS se fazem persistentes, com retrocessos são persistentes agravados com a capacidade de trabalhar1 em medidas de austeridade curso desde 206.

https://doi.org/10.1590/SciELOPreprints.4524

Consenso chileno para la atención integral de niños y adultos con fibrosis quística
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Boza C., María Lina

; Melo T., Joel

; Barja Y., Salesa

; Codner D., Ethel

; Gomolan G., Patricio

; Hernández M., Rubén

; Astorga F., Luis

; Barrientos I., Hortensia

; Bozzo H., Rodrigo

; Calderón R., Mauricio

; Cáceres V., Jeanette

; Chávez C., Eduardo

; Contreras E., Ilse

; Henríquez Y., María Teresita

; Fielbaum C., Oscar

; Jakubson S., Leticia

; Jara H., Beatriz

; Jorquera P., Pablo

; Kogan A., Ricardo

; Lezana S., Viviana

; Meyer P., Rodolfo

; Moraga M., Francisco

; Moscoso G., Gustavo

; Navarro D., Elizabeth

; Orellana F., María de los Ángeles

; Parra O., Genoveva

; Pavez A., Daniela

; Pérez O., María Eugenia

; Pinochet N., María José

; Puppo G., Homero

; Quintanilla A., Ana Isabella

; Repetto L., Gabriela

; Slaibe C., Lisset

; Soto B., Julio

; Vega M., Adriana

; Wong L., Carolina

Revista chilena de enfermedades respiratorias

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dec 2020, Volume 36 N. 4 Pages 268 - 333

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Cystic Fibrosis (CF) is the most frequent hereditary disease in whites, with a reserved prognosis. Since 2003, Chile began a comprehensive National Cystic Fibrosis Program, directed by the Respiratory Health Unit of the Ministry of Health. To date, the main results of the Program record a significantly longer survival (average 27 years) and a significant reduction in the age of diagnosis of patients admitted from 2006 onwards. Access to Chilean Explicit Health Guarantees, the implementation of neonatal screening in some regions of the country, the organization and setting up of CF-trained teams of various specialties, has contributed to improving results. Although the main manifestations are of the respiratory and digestive system, the multisystemic nature of CF makes it necessary to know the different aspects involved in its management, in order to optimize the results of the treatment and the resources invested, both in the public and private sectors. This document is a review and an update on the main aspects of the diagnosis, monitoring and treatment of the respiratory and non-respiratory manifestations of CF.

Resumen La Fibrosis Quística (FQ) es la enfermedad hereditaria de pronóstico reservado más frecuente en raza blanca. Desde el año 2003, Chile inicia un Programa Nacional de Fibrosis Quística, de carácter integral, dirigido por la Unidad de Salud Respiratoria del Ministerio de Salud. Hasta la fecha, los principales resultados del Programa registran una significativa mayor sobrevida (promedio 27 años) y una significativa reducción en la edad de diagnóstico de los pacientes ingresados desde 2006 en adelante. El acceso a la canasta GES (Garantías Explícitas en Salud), la implementación del tamizaje neonatal en algunas regiones del país, la organización y la constitución de equipos entrenados en FQ de diversas especialidades, ha contribuido a mejorar los resultados. Si bien las principales manifestaciones son del aparato respiratorio y digestivo, el carácter multisistémico de la FQ obliga a conocer los distintos aspectos involucrados en su manejo, a fin de optimizar los resultados del tratamiento y los recursos invertidos, tanto en el sector público como privado. Este documento es una revisión y actualización sobre los principales aspectos del diagnóstico, seguimiento y tratamiento de las manifestaciones respiratorias y no respiratorias de la FQ.

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In vitro sensitivity of Corynespora cassiicola isolated from soybean to fungicides and field chemical control of target spot
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Teramoto, Adriana

; Meyer, Maurício Conrado

; Suassuna, Nelson Dias

; Cunha, Marcos Gomes da

Summa Phytopathologica

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dec 2017, Volume 43 N. 4 Pages 281 - 289

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A mancha-alvo da soja (Corynespora cassiicola) tornou-se uma importante doença na maioria das regiões produtoras de soja no Brasil. A sensibilidade de 34 isolados de Corynespora cassiicola a 11 fungicidas foi avaliada pela inibição do crescimento micelial (boscalida, carbendazim, ciproconazol, fluopiram, fluxapiroxada, protioconazol e tiofanato-metílico) ou inibição da germinação de esporos (azoxistrobina, picoxistrobina, piraclostrobina e trifloxistrobina). Além disso, a eficácia de cinco fungicidas para controlar mancha-alvo foi testada em quatro ensaios no campo, conduzidos durante três safras: 2011/2012, 2012/2013 e 2013/2014. Os isolados do fungo foram coletados de plantas de soja em diversas regiões produtoras de soja do Brasil. A concentração efetiva para inibir o crescimento micelial ou a germinação dos esporos em 50% (EC50), para cada fungicida, foi calculada para todos os isolados. Fluxapiroxada e protioconazol proporcionaram as maiores inibições de crescimento micelial do patógeno e piraclostrobina a menor porcentagem de germinação de esporos, com os menores valores de EC50. Nos ensaios de campo, ciproconazol e carbendazim apresentaram percentuais de controle de mancha-alvo variando de 26% a 29%. Por outro lado, fluxapiroxada e protioconazol preveniram a epidemia da doença na ordem de 45% e 55%, respectivamente. No geral, a eficácia dos fungicidas no campo refletiu as médias de sensibilidade in vitro. Foi detectada ampla redução da sensibilidade aos benzimidazóis (MBC) indicando que esse grupo de fungicidas não deve ser mais usado no controle de mancha-alvo. Houve uma correlação negativa e significativa (-0,265) entre severidade da doença e produção da soja. O patógeno mostrou variabilidade na sensibilidade aos grupos fungicidas carboxamidas (SDHI), triazóis (DMI) e estrobilurinas (QoI), o que demonstra alto risco de seleção para resistência.

ABSTRACT Soybean target spot (Corynespora cassiicola) has become an important disease in most soybean growing regions in Brazil. The sensitivity of 34 isolates of C. cassiicola to 11 fungicides was evaluated based on mycelial growth inhibition (boscalid, carbendazim, cyproconazole, fluopyram, fluxapyroxad, prothioconazole and thiophanate-methyl) or spore germination inhibition (azoxystrobin, picoxystrobin, pyraclostrobin and trifloxystrobin). In addition, the efficacy of five fungicides to control target spot was tested in four field trials carried out during three crop seasons: 2011/2012, 2012/2013 and 2013/2014. Fungal isolates were collected from soybean plants in several soybean growing areas in Brazil. The effective concentration of each fungicide to inhibit fungal growth or spore germination by 50% (EC50) was calculated for all isolates. Fluxapyroxad and prothioconazole provided the greatest mycelial growth inhibition and pyraclostrobin led to the lowest spore germination percentage, with the lowest EC50 values. At field experiments, cyproconazole and carbendazim showed target spot control ranging from 26% to 29%. On the other hand, fluxapyroxad and prothioconazole prevented an epidemic of the disease by 45% to 55%, respectively. In general, the efficacy of fungicides in the field reflected the in vitro sensitivity averages. Large sensitivity reduction was detected to benzimidazoles (MBC), indicating that this group of fungicides should no longer be used for target spot control. There was a negative and significant correlation (-0.265) between target spot severity and soybean yield. The pathogen showed variability in sensitivity to the fungicide groups carboxamides (SDHI), triazoles (DMI) and strobilurins (QoI), which denotes a high risk of selection for resistance.

https://doi.org/10.1590/0100-5405/2195 2186 downloads

Asian soybean rust in Brazil: past, present, and future
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Godoy, Cláudia Vieira

; Seixas, Claudine Dinali Santos

; Soares, Rafael Moreira

; Marcelino-Guimarães, Franscismar Correa

; Meyer, Maurício Conrado

; Costamilan, Leila Maria

Pesquisa Agropecuária Brasileira

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may 2016, Volume 51 N. 5 Pages 407 - 421

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo: A ferrugem-asiática da soja, causada pelo fungo Phakopsora pachyrhizi, é a doença mais severa da cultura e pode causar perdas de produtividade de até 90%. A doença foi relatada pela primeira vez no Brasil em 2001. Epidemias da doença são comuns no País, onde o fungo pode sobreviver durante todo o ano. Medidas regulatórias para reduzir o inóculo entre safras e evitar a semeadura tardia de soja têm sido adotadas para manejar a doença. O controle da doença tem se baseado principalmente no controle químico, mas uma menor sensibilidade do fungo aos fungicidas tem sido relatada no Brasil. Genes de resistência têm sido mapeados e incorporados às cultivares. Por causa da redução da eficiência dos fungicidas, a adoção de medidas integradas para o controle da doença será importante para a sustentabilidade da cultura. Este artigo de revisão apresenta as principais mudanças no sistema de produção da soja causadas pela introdução do fungo no Brasil, as medidas de controle atualmente usadas para evitar perdas, e as novas tendências que, juntas com estratégias biotecnológicas, podem melhorar o manejo da doença no futuro.

Abstract: Asian soybean rust, caused by the fungus Phakopsora pachyrhizi, is the most severe disease of the crop and can cause yield losses of up to 90%. The disease was first reported in Brazil in 2001. Epidemics of the disease are common in the country, where the fungus can survive year-round. Regulatory measures to reduce the inoculum between seasons and avoid late-season soybean have been adopted to manage the disease. Disease control has relied mainly on chemical control, but a lower sensibility of the fungus to fungicides has been reported in Brazil. Major-resistance genes have been mapped and incorporated into the cultivars. With the reduced efficacy of the fungicides, the adoption of integrated measures to control the disease will be important for the sustainability of the crop. This review presents the main changes in the soybean crop system caused by the introduction of the fungus in Brazil, the current management strategies adopted to avoid losses, and the new trends that, together with biotechnological strategies, can improve management in the future.

https://doi.org/10.1590/S0100-204X2016000500002 9304 downloads

Métodos de inoculação de Sclerotinia sclerotiorum para triagem de cultivares de soja resistentes ao mofo-branco
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Garcia, Riccely Ávila

; Meyer, Maurício Conrado

; Ávila, Kássia Aparecida Garcia Barbosa

; Cunha, Marcos Gomes da

Pesquisa Agropecuária Brasileira

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aug 2015, Volume 50 N. 8 Pages 726 - 729

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo:O objetivo deste trabalho foi avaliar a eficiência e a praticidade de métodos de inoculação de Sclerotinia sclerotiorum, para uso na seleção de cultivares de soja resistentes ao mofo-branco. Avaliaram-se quatro métodos de inoculação, em plantas no estádio fenológico V3/V4. Aos três e sete dias após a inoculação, mediu-se o comprimento da lesão na haste das plantas. As cultivares de soja BRS 8460RR, BRSGO Ipameri e P98Y11 apresentaram as menores lesões. O método de inoculação por meio de ponteira no pecíolo é o mais eficiente e mais prático para avaliar a resistência ao mofo-branco em soja.

Abstract:The objective of this work was to evaluate the efficacy and usefulness of methods of Sclerotinia sclerotiorum inoculation for screening soybean cultivars resistant to white mold. Four inoculation methods were evaluated in plants at the V3/V4 phenological stages. Stem lesion length was measured three and seven days after inoculation. The soybean cultivars BRS 8460RR, BRSGO Ipameri, and P98Y11 had the smallest stem lesions. The inoculation method with pipette tip on the petiole is the most effective and practical to evaluate soybean resistance to white mold.

https://doi.org/10.1590/S0100-204X2015000800011 2907 downloads

Percepción del clima educacional en el pregrado de la carrera de cinesiología (UCSC-Chile)
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Hechenleitner, Marcela

; Flores, Guillermo

; Bittner, Verónica

; Nocetti, Alejandra

; Meyer, Andrea

; Alarcón, Mauricio

; Lermanda, Claudio

FEM: Revista de la Fundación Educación Médica

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aug 2015, Volume 18 N. 4 Pages 261 - 267

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

Introduction. At present there is enough evidence to establish that affective, attitudinal and physical variables influence learning. Given this, there is interest now in studying the educational climate and move towards the development of proposals for improvement. In this context, a descriptive study on educational climate was developed through the application of the Spanish version of the Dundee Ready Educational Enviromenment (DREEM) in Kinesiology students of the first three years, Universidad Católica de la Santísima Concepción, Chile. Subjects and methods. A sample equivalent to 142 students was constructed. Evolving statistical analysis of data supported by the SPSS 19 program that show high internal consistency, measured by Cronbach’s alpha (0.91). Results and conclusions. The results show a positive appreciation of Educational Climate, emphasizing the perception of teachers as a key factor of this. It was also established that there is no significant relationship between educational climate and sex or appropriateness of the student. Finally, we observed a decrease in the perception of educational climate as students advance in their career, being considered in this relevant interventions needed in the area of professional training.

Introducción. En la actualidad hay suficiente evidencia para establecer que las variables afectivas, actitudinales y físicas influyen en el aprendizaje. Dado lo anterior, existe interés por estudiar el clima educacional y avanzar hacia el desarrollo de propuestas para su mejora. En este contexto, se desarrolló un estudio descriptivo sobre clima educacional a través de la aplicación de la encuesta Dundee Ready Educational Enviromenment (DREEM) en su versión en español, a los tres primeros años de la carrera de cinesiología de la Universidad Católica de la Santísima Concepción, Chile. Sujetos y métodos. Se seleccionó una muestra de 142 estudiantes. Se realizó un análisis estadístico de los datos apoyados en el programa SPSS v. 19, que permitió evidenciar una alta consistencia interna medida a través del alfa de Cronbach (0,91). Resultados y conclusiones. Los resultados muestran una apreciación positiva del clima educacional, destacando la percepción sobre los profesores como factor clave. Además, se estableció que no existe relación significativa entre clima educacional y sexo o procedencia del estudiante. Finalmente, se observa una disminución de la percepción del clima educacional a medida que los alumnos avanzan en su carrera, siendo esto relevante de considerar en intervenciones necesarias en el área de la formación profesional

https://doi.org/10.4321/S2014-98322015000500007 439 downloads

Cell therapy in the treatment of bronchiolitis obliterans in a murine model
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Espinel, Julio de Oliveira

; Uribe, Carolina

; Meyer, Fabíola Schons

; Bringheti, Rafael

; Kulczynski, Jane Ulbricht

; Saueressig, Maurício Guidi

Revista do Colégio Brasileiro de Cirurgiões

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jun 2015, Volume 42 N. 3 Pages 181 - 188

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

<sec><title>OBJETIVO:</title> avaliar a importância das células-tronco derivadas de tecido adiposo na redução do processo inflamatório no enxerto em modelo murino de transplante traqueal heterotópico alogênico.</sec><sec><title>MÉTODOS:</title> foi realizado alotransplante traqueal heterotópico em bolsa dorsal subcutânea e injetado 5x105 células-tronco mesenquimais, derivadas de tecido adiposo, sistemicamente. Os animais foram distribuídos em dois grupos, conforme o tempo de sacrifício: T7 e T21. Procedida a análise em HE e morfometria digital.</sec><sec><title>RESULTADOS:</title> Os T7 tratados com terapia celular apresentaram mediana de área obstruída do enxerto de 0 contra 0,54 dos controles (p=0,635). Os T21 tratados apresentaram mediana de área obstruída da luz do enxerto de 0,25 nos tratados e 0 nos controles (p=0,041).</sec><sec><title>CONCLUSÃO:</title>A terapia celular injetada sistemicamente em modelo experimental murino de bronquiolite obliterante não reduziu a gravidade do processo inflamatório no aloenxerto de forma estatisticamente significativa em sete dias; de modo contrário, em 21 dias, aumentou o processo inflamatório no aloenxerto.</sec>

<sec><title>OBJECTIVE:</title> To evaluate the importance of stem cells derived from adipose tissue in reducing graft inflammation in a murine model of allogeneic heterotopic tracheal transplant.</sec><sec><title>METHODS:</title> We performed a heterotopic tracheal allografting in dorsal subcutaneous pouch and systemically injected 5x105 mesenchymal stem cells derived from adipose tissue. The animals were divided into two groups according to the time of sacrifice: T7 and T21. We also carried out histological analysis and digital morphometry.</sec><sec><title>RESULTS:</title> The T7 animals treated with cell therapy had median obstructed graft area of 0 versus 0.54 of controls (p = 0.635). The treated T21 subjects had median obstructed graft area of 0.25 versus 0 in controls (p = 0.041).</sec><sec><title>CONCLUSION:</title> The systemically injected cell therapy in experimental murine model of bronchiolitis obliterans did not reduce the severity of the allograft inflammation in a statistically significant way in seven days; Conversely, in 21 days, it increased the allograft inflammatory process.</sec>

https://doi.org/10.1590/0100-69912015003010 15806 downloads

Reação de cultivares de soja à Corynespora cassiicola
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Teramoto, Adriana

; Machado, Tariane A.

; Santos, Lucas M. dos

; Volf, Marcelo R.

; Meyer, Maurício C.

; Cunha, Marcos G. da

Tropical Plant Pathology

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feb 2013, Volume 38 N. 1 Pages 68 - 71

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O fungo Corynespora cassiicola, agente causal da mancha-alvo em soja, tem ocorrido com frequência na região Centro-Oeste do Brasil e pode, sob condições de alta temperatura e alta umidade, causar sérios danos à cultura. O uso de cultivares resistentes ao patógeno é recomendado, porém são poucas as disponíveis no mercado. Este trabalho foi realizado visando avaliar a reação de doze cultivares comerciais de soja inoculados com C. cassiicola, em casa de vegetação e no campo. A severidade foi avaliada utilizando escala diagramática de severidade da mancha-alvo. As cultivares menos suscetíveis ao patógeno na casa de vegetação foram BRSGO 7960 e BRS Sambaíba e as mais suscetíveis foram BMX Potência RR e M-SOY 7908 RR. No campo, as cultivares menos suscetíveis foram M-SOY 8866, M-SOY 7908 RR e BMX Potência RR e as mais suscetíveis foram BRSGO 8360 e BRS Tracajá.

The fungus Corynespora cassiicola, the causal agent of soybean target spot, frequently occurs in the Brazilian midwestern region. Under favorable climate conditions it can cause serious damage to this crop. The use of resistant cultivars is recommended although there are only a few available in the market. This investigation was carried out to evaluate the reaction of twelve soybean commercial cultivars to C. cassiicola. Severity was evaluated using a diagrammatic scale of target spot. The less susceptible cultivars in greenhouse were BRSGO 7960 and BRS Sambaíba and the most susceptible were BMX Potencia RR and M-SOY 7908 RR. In the field, the less susceptible cultivars were M-SOY 8866, M-SOY 7908 RR and BMX Potência RR and the most susceptible were BRSGO 8360 and BRS Tracajá.

4219 downloads Cited 1 time in SciELO

Laringectomia de resgate: utilização do retalho miocutâneo de peitoral maior na prevenção de fístula faringocutânea
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Sousa, Alexandre Andrade

; Castro, Sebastião Maurício de Oliveira

; Porcaro-Salles, José Maria

; Soares, João Marcos Arantes

; Moraes, Gustavo Meyer de

; Carvalho, Jomar Rezende

; Silva, Guilherme Souza

Brazilian Journal of Otorhinolaryngology

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aug 2012, Volume 78 N. 4 Pages 103 - 107

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Laringectomias de resgate estão associadas a altas taxas de complicações pós-operatórias. O uso de retalhos na reconstrução do trânsito faríngeo poderia reduzir a incidência destas complicações. OBJETIVO: Avaliar a utilidade do retalho miocutâneo de músculo peitoral maior na prevenção da fístula salivar no pós-operatório de laringectomia total de resgate. MÉTODO: Estudo retrospectivo, realizado de abril/2006 a maio/2011, com 31 pacientes portadores de CCE de laringe recidivado, tratados previamente com quimiorradioterapia ou radioterapia isolada, submetidos à laringectomia de resgate. Destes 31 pacientes, a reconstrução da faringe foi realizada com utilização do retalho miocutâneo de músculo peitoral maior em 19 (61%) casos, enquanto o fechamento primário ocorreu em 12 pacientes (39%). RESULTADOS: Foi observada taxa de fistula salivar em (16%) dos pacientes em que se utilizou o retalho e 58% nos pacientes submetidos a fechamento primário da faringe (p < 0,02). Não foi observada diferença estatisticamente significativa entre os grupos em relação ao tempo médio de aparecimento de fistula e reintrodução da dieta por via oral, bem como tempo de uso de cateter nasoentérico para alimentação. CONCLUSÃO: O retalho miocutâneo do músculo peitoral maior mostrou-se como opção capaz de reduzir incidência de fistula salivar em laringectomias de resgate.

Salvage laryngectomy in patients treated with organ preservation protocols is associated with high rates of postoperative complications. The use of non-irradiated tissue flaps in pharyngeal reconstruction could reduce the incidence of these complications. OBJECTIVE: This study aims to evaluate the usefulness of the pectoralis major myocutaneous flap in preventing salivary fistulae during the postoperative period of salvage total laryngectomy (TL). MATERIALS AND METHOD: This retrospective study enrolled 31 patients operated between April of 2006 and May of 2011. All patients had advanced cancer at the time of the salvage procedure and had been treated with chemoradiotherapy or radiotherapy alone. Pharyngeal reconstruction was performed using pectoralis major myocutaneous flap in 19 cases (61%); primary wound closure occurred in 12 patients (39%). RESULTS: Salivary fistulae occurred in 16% of the patients who received the flap and in 58% of the patients with primary closure of the pharynx (p < 0.02). No statistically significant differences were noted between the groups with respect to the mean time for fistula formation, reintroduction of an oral diet, or use of a nasoenteric tube for feeding. CONCLUSION: The pectoralis major myocutaneous flap was found to reduce the incidence of salivary fistulae in salvage laryngectomy procedures.

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10.

Crecimiento económico en el sector agropecuario-silvícola a nivel nacional y regional en el período 1996 - 2008
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Valderas, Ramón

; Meyer, Mauricio

; González, Rodrigo

Idesia (Arica)

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aug 2011, Volume 29 N. 2 Pages 119 - 129

Abstract: En Es | Text: En Es | PDF: En | PDF: Es

ABSTRACT The agricultural-forestry sector has shown a positive momentum in recent decades, both in volume production and in export diversification and gross internal product (GIP). In spite of the overall results, there are those who suggest that it is necessary to disaggregate the national economic agricultural - forestry sector into regional and sub-sector scales in terms of primary production. This includes the claim that in some regions crop agriculture is decreasing and the growth of the sector is concentrated in few regions of central Chile. The study concludes that currently the agricultural subsector (crops), forestry, livestock and fruit growing account for 15.9 %, 18.5%, 24.8% and 40.7%, respectively, of the gross internal product (GIP) of the sector. This reveals a declining share of the agriculture subsector on the basis of the GIP parameter. The Regions with faster increase in their GIP participation include the Fifth, Sixth, Seventh and Metropolitan Region. First, Second, Eleventh and Twelfth Regions remain without improvement.

RESUMEN El sector agropecuario-silvícola ha demostrado un dinamismo positivo en las últimas décadas tanto en volumen, producción como en la diversificación de exportaciones y en el producto interno bruto (PIB). Existen, a pesar de los resultados globales nacionales, otras opiniones que estiman necesario darle atención a la desagregación del sector agropecuario silvícola a niveles regionales y subsectoriales en su característica de producción primaria. Se plantea la afirmación de que la participación subsectorial y regional es decreciente en agricultura y que el crecimiento del sector aumenta su concentración y participación en algunas regiones del centro del país. En el estudio se concluye que actualmente los subsectores agricultura (cultivos), silvicultura, ganadería y fruticultura participan en un 16%, 18%, 24,8% y 40,7 % respectivamente en el valor agregado del sector. Esto revela una disminución de la participación del subsector agricultura sobre la base de este parámetro. Respecto de las regiones, las que crecen a mayor velocidad en la participación son la Quinta, la Sexta y la Séptima y Región Metropolitana. Las regiones Primera, Segunda, Undécima y Duodécima son las que experimentan un estancamiento.

5450 downloads

11.

Immune and inflammatory responses to Leishmania amazonensis isolated from different clinical forms of human leishmaniasis in CBA mice
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Souza, Valderes L de

; Veras, Patrícia ST

; Welby-Borges, Marcus

; Silva, Tânia MC

; Leite, Bruna R

; Ferraro, Rodrigo B

; Meyer-Fernandes, José R

; Barral, Aldina

; Costa, Jackson Mauricio Lopes

; Freitas, Luiz AR de

Memórias do Instituto Oswaldo Cruz

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feb 2011, Volume 106 N. 1 Pages 23 - 31

Abstract: En | Text: En | PDF: En

Leishmania amazonensis causes different diseases depending on the host and parasitic virulence factors. In this study, CBA mice were infected with L. amazonensis isolates from patients with localized (Ba125), diffuse cutaneous (Ba276) or visceral leishmaniasis (Ba109). Mice infected with Ba125 and Ba276 progressed rapidly and lesions displayed an infiltrate rich in parasitized macrophages and were necrotic and ulcerated. Ba109 induced smaller lesions and a mixed inflammatory infiltrate without necrosis or ulceration. Ba109 induced an insidious disease with lower parasite load in CBA mice, similar to human disease. Levels of IFN-γ, IL-4 and IL-10 did not differ among the groups. Because all groups were unable to control the infection, expression of IL-4 associated with low production of IFN-γ in the early phase of infection may account for susceptibility, but others factors may contribute to the differences observed in inflammatory responses and infection progression. Evaluation of some parasitic virulence factors revealed that Ba276 exhibits higher ecto-ADPase and 5'-nucleotidase activities compared to the Ba109 and Ba125 strains. Both Ba276 and Ba125 had higher arginase activity in comparison to Ba109. Finally, these data suggest that the differences in enzyme activities among parasites can account for differences in host inflammatory responses and infection progression.

3132 downloads

12.

Pneumonia necrosante em crianças submetidas à toracoscopia por empiema pleural: incidência, tratamento e evolução clínica
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Macedo, Maurício

; Meyer, Karine Furtado

; Oliveira, Tatiana Cristina Miranda

Jornal Brasileiro de Pneumologia

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jun 2010, Volume 36 N. 3 Pages 301 - 305

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

OBJETIVO: Analisar a incidência de pneumonia necrosante (PN) em crianças submetidas a toracoscopia e comparar pacientes com e sem PN em relação às diferentes apresentações e evolução clínica. MÉTODOS: Estudo retrospectivo de crianças portadoras de empiema e submetidas a toracoscopia. A toracoscopia foi realizada em pacientes não submetidos a drenagem torácica prévia e evidência de derrame septado ou pneumotórax, assim como naqueles submetidos previamente a drenagem torácica e pneumotórax persistente ou febre e secreção purulenta. Baseado na presença de PN durante a toracoscopia, os pacientes foram divididos em dois grupos: com PN e sem PN. RESULTADOS: Participaram do estudo 52 pacientes. Dos 24 pacientes com PN, 19 (79%) foram submetidos a drenagem torácica anterior à toracoscopia, 11 (46%) apresentaram pneumotórax, e 16 (67%) evoluíram com fístula broncopleural. Neste grupo, as medianas do tempo de drenagem e de hospitalização foram, respectivamente, 18 e 19 dias. Dos 28 pacientes sem PN, 10 (36%) foram submetidos a drenagem torácica anterior à toracoscopia, 9 (32%) apresentaram pneumotórax, e 5 (18%) evoluíram com fístula broncopleural. Neste grupo, as medianas do tempo médio de drenagem e de hospitalização foram, respectivamente, 6 e 10 dias. CONCLUSÕES: A PN deve ser suspeitada na presença de pneumotórax. A toracoscopia precoce pode ser uma opção terapêutica de grande valor na PN da infância, pois acelera a recuperação quando comparada ao tratamento médico isolado e evita ressecções pulmonares extensas da toracotomia tardia.

OBJECTIVE: To assess the incidence of necrotizing pneumonia (NP) in children submitted to thoracoscopy, comparing patients with and without NP in terms of the presentation and clinical evolution. METHODS: A retrospective study of children with pleural empyema submitted to thoracoscopy. Thoracoscopy was performed in patients not previously submitted to thoracic drainage and in whom there was evidence of loculated effusion or pneumothorax, as well as in those previously submitted to thoracic drainage and in whom there was persistent pneumothorax or fever with purulent discharge. On the basis of the thoracoscopy findings, patients were distributed into two groups: those with NP (NP group) and those without (no-NP group). RESULTS: The study sample comprised 52 patients. Of the 24 patients with NP, 19 (79%) had undergone thoracic drainage prior to thoracoscopy, 11 (46%) presented with pneumothorax, and 16 (67%) developed bronchopleural fistula. In the NP group, the median drainage time and the median length of hospital stay were 18 and 19 days, respectively. Of the 28 patients without NP, 10 (36%) had undergone thoracic drainage prior to thoracoscopy, 9 (32%) presented pneumothorax, and 5 (18%) developed bronchopleural fistula. In the no-NP group, the median drainage time and the median length of hospital stay were 6 and 10 days, respectively. CONCLUSIONS: Pneumothorax should raise the suspicion of NP. Early thoracoscopy can be a valuable treatment option for NP in children because it hastens recovery in comparison with the medical treatment alone and avoids extensive late thoracotomy lung resections.

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13.

Corantes vitais em cromovitrectomia
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Dib, Eduardo

; Rodrigues, Eduardo Büchelle

; Maia, Maurício

; Meyer, Carsten H.

; Penha, Fernando Marcondes

; Furlani, Bruno de Albuquerque

; Costa, Elaine de Paula Fiod

; Farah, Michel Eid

Arquivos Brasileiros de Oftalmologia

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dec 2009, Volume 72 N. 6 Pages 845 - 850

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

O objetivo do artigo é apresentar os dados atuais da aplicação de corantes vitais durante cirurgia vitreorretiniana, "cromovitrectomia", bem como uma revisão da literatura atual sobre o assunto no tocante às técnicas de aplicação, indicações e complicações em cromovitrectomia. Um grande número de publicações tem abordado o perfil tóxico da indocianina verde na cromovitrectomia. Dados experimentais mostram uma toxicidade dose-dependente da mesma em várias populações de células retinianas. Novas gerações de corantes incluem: azul tripan, azul patente, acetato de triancinolona, infracianina verde, fluoresceína sódica, azul de bromofenol, acetato de fluorometolona e azul brilhante. Novos instrumentos podem permitir um corar seletivo de estruturas durante a vitrectomia. Este artigo mostra que o campo da cromovitrectomia está em plena expansão de pesquisas. Os corantes de primeira linha são a indocianina verde, infracianina verde e o azul brilhante. Azul patente, azul de bromofenol e azul tripan surgem como novos adjuvantes para melhor observação da membrana epirretiniana. Demais corantes que surgiram merecem maior investigação.

The aim of this article is to present the current data with regard to the application of vital dyes during vitreoretinal surgery, "chromovitrectomy", as well as to overview the current literature regarding the properties of dyes, techniques of application, indications and complications in chromovitrectomy. A large body of published research has recently addressed the toxicity profile of indocyanine green for chromovitrectomy. Experimental data demonstrate dose-dependent toxicity of indocyanine green to various retinal cells. Newer generation vital dyes for chromovitrectomy include trypan blue, patent blue, triamcinolone acetonide, infracyanine green, sodium fluorescein, bromophenol blue, fluorometholone acetate and brilliant blue. Novel instruments may enable a selective painting of preretinal tissues during chromovitrectomy. This review suggests that the field of chromovitrectomy represents an expanding area of research. The first line agents for internal limiting membrane staining in chromovitrectomy are indocyanine green, infracyanine green, and brilliant blue. Patent blue, bromophenol blue and trypan blue arose as outstanding biostains for visualization of epiretinal membranes. Novel dyes available for chromovitrectomy deserve further investigation.

10703 downloads

14.

The prevalence of thyroid dysfunction in elderly cardiology patients with mild excessive iodine intake in the urban area of São Paulo
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Duarte, Glaucia C.

; Tomimori, Eduardo K.

; Camargo, Rosalinda Y. A.

; Rubio, Ileana G.S.

; Wajngarten, Mauricio

; Rodrigues, Amanda G.

; Knobel, Meyer

; Medeiros-Neto, Geraldo

Clinics

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feb 2009, Volume 64 N. 2 Pages 135 - 142

Abstract: En | Text: En | PDF: En

OBJECTIVES: To evaluate the prevalence of thyroid dysfunction in elderly cardiac patients in an outpatient setting. SUBJECTS AND METHODS: A total of 399 consecutive patients (268 women, age range 60-92 years) who were followed at Heart Institute were evaluated for thyroid dysfunction with serum free T4, TSH, anti-Peroxidase antibodies, urinary iodine excretion measurements and thyroid ultrasound. RESULTS: Hyperthyroidism (overt and subclinical) was present in 29 patients (6.5%), whereas hypothyroidism (overt and subclinical) was found in 32 individuals (8.1%). Cysts were detected in 11 patients (2.8%), single nodules were detected in 102 (25.6%), and multinodular goiters were detected in 34 (8.5%). Hashimoto's thyroiditis was present in 16.8% patients, most of whom were women (83.6%). The serum TSH increased with age and was significantly higher (p= <0.01) in patients, compared to the normal control group. No significant differences in serum TSH and free T4 values were observed when patients with atrial fibrillation (AF) where compared with those without arrhythmia. The median urinary iodine levels were 210 µg/L (40-856 µg/L), and iodine levels were higher in men than in women (p<0.01). Excessive iodine intake (urinary iodine >300 µg/L) was observed in one-third of patients (30.8%). CONCLUSIONS: Elderly patients have a higher prevalence of both hypo- and hyperthyroidism as well as thyroid nodules when compared with the general population. About one-third of the older patients had elevated urinary secretion of iodine and a higher prevalence of chronic Hashimoto's thyroiditis. It is recommended that ultrasonographic studies, tests for thyroid function and autoimmunity should be evaluated in elderly patients.

3324 downloads

15.

Primary endemic Cryptococcosis gattii by molecular type VGII in the state of Pará, Brazil
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Santos, Wallace Raimundo A dos

; Meyer, Wieland

; Wanke, Bodo

; Costa, Solange PS Evangelista

; Trilles, Luciana

; Nascimento, Jose Luiz M

; Medeiros, Rita

; Morales, Bernardina Pernarrieta

; Bezerra, Claudia de Carvalho Falci

; Macêdo, Regina Célia Lima de

; Ferreira, Silvana O

; Barbosa, Gláucia Gonçalves

; Perez, Mauricio A

; Nishikawa, Marília Martins

; Lazéra, Márcia dos Santos

Memórias do Instituto Oswaldo Cruz

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dec 2008, Volume 103 N. 8 Pages 813 - 818

Abstract: En | Text: En | PDF: En

In order to study the infectious agents causing human disseminated cryptococcosis in the state of Pará, North Brazil, 56 isolates of Cryptococcusspp. (54 isolated from cerebral spinal fluid and two from blood cultures) from 43 cases diagnosed between 2003-2007 were analysed. The species were determined through morphological and physiological tests and genotypes were determined by URA5-RFLP and PCR-fingerprinting (wild-type phage M13). The following species and genotypes were identified: Cryptococcus neoformans VNI (28/56, 50%), Cryptococcus gattii VGII (25/56, 44.64%) and C. gattii VGI (3/56, 5.26%). The genotype VNI occurred in 12 out of 14 HIV-positive adults, whereas the genotype VGII occurred in 11 out of 21 HIV-negative adults (p < 0.02, OR = 6.6 IC95% 0.98-56.0). All patients less than 12 years old were HIV negative and six cases were caused by the VGII genotype, one by the VGI and one by VNI. Therefore, endemic primary mycosis in HIV-negative individuals, including an unexpectedly high number of children, caused by the VGII genotype deserves further study and suggests the need for surveillance on cryptococcal infection in the state of Pará, Eastern Amazon.

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