RESUMO Objetivo Analisar o Programa Saúde da Família, substituído pela Estratégia Saúde da Família em 2011, considerando os indicadores de saúde e as doenças classificadas como sensíveis à Atenção Primária. Métodos Trata-se de estudo descritivo, analítico e documental, realizado na Região Metropolitana de São Paulo, no período de 2002 a 2007. Foram analisados dados fornecidos pelo Observatório de Saúde da Região Metropolitana de São Paulo. Após a coleta, calcularam-se, com base na correlação de Pearson e por meio do software SPSS, versão 17.0, as associações entre os dados. Resultados Foram usados 30 dos 31 indicadores de saúde de 24 dos 39 municípios pesquisados. Foram analisados 720 (100%) indicadores de saúde sensíveis à Atenção Primária na Região Metropolitana de São Paulo. Conclusão Foram baixos os percentuais de melhoras e pioras, ou, ainda, os dados não foram apresentados. A maioria permaneceu estável.

ABSTRACT Objective To analyze the Family Health Program replaced by the Family Health Strategy in 2011, based on health indicators and diseases classified as primary care sensitive. Methods This was a descriptive, analytical and documental study carried out in the Metropolitan Region of São Paulo between 2002 and 2007. We analyzed data from Health observatory for the Metropolitan Region of São Paulo. Pearson’s correlation and the Statistical Package for the Social Sciences software version 17.0 were used to calculate data associations. Results We used 30 of the 31 health indicators of 24 from the 39 studied municipalities. A total of 720 (100%) health primary care sensitive indicators were analyzed in the Metropolitan Region of São Paulo. Conclusion Percentages of improvements and worsening were low. In addition, some data were not presented. The majority of indicators remained stable.

Abstract Background: It has long been established that obesity plays a positive role against osteoporosis (OP) and low-impact fractures (Fx). However, more recent data has shown higher fracture risk in obese individuals. The aim of this study was to investigate the association between BMI, particularly obesity, OP and low-impact Fx in Brazilian women, as well as to evaluate the SAPORI (Sao Paulo Osteoporosis Risk Index) tool performance to identify low BMD according BMI category. Methods: A total of 6182 women aged over 40 years were included in this cross-sectional analysis using data from two large Brazilian studies. All participants performed hip and spine bone mineral density (BMD) measurements and answered a detailed questionnaire about the presence of clinical risk factors (CRFs) related to low BMD and risk fractures. The World Health Organization (WHO) criteria were used to define obesity. Results: Age-adjusted osteoporosis prevalence was 20.8, 33.6, 47 and 67.1% in obese, overweight, normal and underweight category, respectively. Obesity was present in 29,6% (1.830 women) in the study population and the likelihood of osteoporosis and low-impact Fx compared to a normal BMI in this subgroup was of 0.24 (95% CI 0.20– 0.28; p < 0.001) and of 1.68 (95% CI 1.35–2.11; p < 0.001), respectively. However, the hip Fx likelihood was lower in obese compared with non-obese women (OR = 0.44; 95% CI 0.20–0.97). Using an originally validated cut-off, the SAPORI tool sensitivity was significantly hampered in overweight and obese women although the accuracy had remained suitable because of increasing in specificity. Conclusions: The osteoporosis prevalence reduced as BMI increased and obesity was associated with low-impact Fx, regardless of the BMD measurements. Moreover, the SAPORI performance was impaired in obese women.

OBJETIVO: Analisar o nível de conhecimento sobre fibromialgia em uma amostra incluindo pacientes, familiares e profissionais de vários estados do Brasil. MÉTODOS: Análise dos resultados de 362 adultos que acessaram o site do Grupo de Apoio à Fibromialgia (www.unifesp.br/grupos/fibromialgia) e responderam a um questionário eletrônico de conhecimento sobre a síndrome. As respostas foram avaliadas em relação a idade, sexo, nível de escolaridade e tipo de interesse no Grupo. RESULTADOS: 92% eram mulheres e 62% haviam completado o ensino superior. O pior resultado foi no domínio "proteção articular e conservação de energia", seguido pelo domínio "conhecimento sobre medicação". O melhor resultado ocorreu no domínio "exercícios para fibromialgia". Houve diferença significativa entre os gêneros, sendo as mulheres responsáveis por um porcentual maior de acertos. O gênero feminino foi responsável por um resultado estatisticamente superior em cinco análises estatísticas (quatro perguntas e um domínio). CONCLUSÕES: O estudo sugere a necessidade de um planejamento estratégico para ações educativas sobre fibromialgia no Brasil

OBJECTIVE: To assess knowledge on fibromyalgia in a sample of patients, their families, and professionals interested on the theme from some Brazilian states. METHODS: Analysis of the results of an electronic fibromyalgia knowledge questionnaire completed by 362 adults who had access to the the support group for fibromyalgia site (www.unifesp.br/grupos/fibromialgia). The answers were grouped according to age, sex, years of schooling, and type of interest in the condition. RESULTS: 92% of the responders were women and 62% had higher educational level. The worst results were observed in the "joint protection and energy conservation" domain, followed by the "medication in fibromyalgia" domain. The best results were recorded in the "exercises in fibromyalgia" domain. The answers differed significantly between sexes, and women achieved a higher percentage of correct answers. The female sex accounted for a statistically superior result in five statistical analyses (four questions and one domain). CONCLUSIONS: The study suggests the need for a strategic planning for an educational approach to fibromyalgia in Brazil

Aggregatibacter actinomycetemcomitans is associated with periodontal disease, especially localized aggressive periodontitis, produces a potent leukotoxin and its distribution is influenced by ethnic characteristics of the population. Objective: Using culture and polymerase chain reaction (PCR) techniques, this study evaluated the occurrence of this microorganism and the distribution of leukotoxic strains isolated from Indians belonging to the Umutima Reservation, Mato Grosso, Brazil. MATERIAL AND METHODS: Forty-eight native Brazilians with gingivitis and 38 with chronic periodontitis, belonging to Umutina, Paresi, Bororo, Bakairi, Kayabi, Irantxe, Nambikwara and Terena ethnicities, were studied. Subgingival, supragingival and saliva samples of each patient were collected and transferred to VMGA III medium and to ultra pure Milli Q water. Bacteria were grown on TSBV agar and incubated in anaerobiosis (90% N2 + 10% CO2) at 37ºC for 72 h. The presence of the ltx promoter was determined by PCR, and a 530 bp deletion in the promoter was evaluated by using specific primers. RESULTS: A. actinomycetemcomitans was isolated from 8.33% of saliva, supragingival and subgingival samples from patients with gingivitis and from 18.42% of saliva and supragingival biofilm, and 26.32% subgingival biofilm from patients with chronic periodontitis. By PCR, the bacterial DNA was detected in 8.33% of saliva, supragingival and subgingival biofilms from patients with gingivitis and from 23.68% of saliva, 28.95% supragingival biofilm and 34.21% subgingival biofilm from patients with periodontitis. All strains were grouped as non-JP2 clones based on the absence of deletion in the leukotoxin promoter. Differences among the microbial and clinical parameters in patients were analyzed by using the Mann-Whitney, Chi-square or Fisher's exact tests. CONCLUSIONS: The present results suggest that A. actinomycetemcomitans can be related to the attachment loss in this population, but the presence of minimally leukotoxic strains, as well as its role in the pathogenesis of the periodontitis in these native Brazilians need to be further investigated.