Caracterização do uso de alendronato de sódio no tratamento de osteoporose por clínicos da rede privada de duas cidades do interior de São Paulo / Survey of the use of sodium alendronate in osteoporosis treatment by physicians in the private health system in two towns in São Paulo

O estudo mostrou como os clínicos da rede privada de Amparo e Pedreira, no interior do estado de São Paulo, utilizam o alendronato de sódio como recurso terapêutico na osteoporose. Esta enfermidade é de alta prevalência na população idosa, sendo tratada por médicos de diferentes especialidades. Este estudo, do tipo observacional, transversal e descritivo, foi realizado pormeio de entrevistas com 32 médicos para obtenção de dados sobre indicação, forma de utilização, seguimento de tratamento, medidas não farmacológicas e referencial teórico utilizado pelos entrevistados. Os resultadosmostraram que há concordância com o preconizado em consensos e guias terapêuticos em relação à indicação,doses recomendadas e medidas não farmacológicas, porém, foram verificadas falhas no seguimento dotratamento e na orientação dada ao paciente para a administração correta do medicamento, além de descrição imprecisa de fontes de informação. Concluiu-se que a atualização científica em fontes referenciais (ensaios randomizados controlados, metanálises) é indispensável para ajudar os clínicos na promoção do uso racional do alendronato de sódio no tratamento de osteoporose.

This is a study of how physicians working in the private health system in the towns of Amparo and Pedreira (upstate São Paulo, 75 miles away from the State capital) use sodium alendronate in the treatment of osteoporosis. This disease is highly prevalent in the elderly population and is treated by consultant clinicians/various specialities. The paper describes an observational, cross-sectional study that was carried out by interviewing 32 clinicians to evaluate: indication, usage, follow-up and evaluation of treatment, non pharmacological measures and source of information used by interviewees. The results show that clinical practice is in conformity with what is recommended in clinical guidelines and the general consensus, concerning indication, doses, and nonpharmacological measures. However, some faults were found in the course of treatment and in the advice given to the patients on how to take the drug, as well as imprecise descriptions of the sources of information by the doctors interviewed. It is concluded that constant scientific updating based on sources of reference (Randomized Controlled Trial, Meta- Analysis) is an indispensable aid to these clinicians in promoting the rational use of sodium alendronate inthe treatment of osteoporosis.

The association of genetic markers and malaria infection in the Brazilian Western Amazonian region

Almost all individuals (182) belonging to an Amazonian riverine population (Portuchuelo, RO, Brazil) were investigated for ascertaining data on epidemiological aspects of malaria. Thirteen genetic blood polymorphisms were investigated (ABO, MNSs, Rh, Kell, and Duffy systems, haptoglobins, hemoglobins, and the enzymes glucose-6-phosphate dehydrogenase, glyoxalase, phosphoglucomutase, carbonic anhydrase, red cell acid phosphatase, and esterase D). The results indicated that the Duffy system is associated with susceptibility to malaria, as observed in other endemic areas. Moreover, suggestions also arose indicating that the EsD and Rh loci may be significantly associated with resistance to malaria. If statistical type II errors and sample stratification could be ruled out, hypotheses on the existence of a causal mechanism or an unknown closely linked locus involved in susceptibility to malaria infection may explain the present findings

A rural community in a Brazilian Western Amazonian region: some demographic and epidemiological patterns

Some demographic and epidemiological patterns of the rural population of Monte Negro, locality situated in the State of Rondônia (Brazil), Western Amazonia, are described based on a sample of 924 randomly selected individuals, approximately 10 percent of the whole population. The main features of this sample are (1) the illiteracy rates in the parental generation were 23 percent for fathers and 20 percent for mothers. Among children, this figure dropped to 6 percent; (2) housing in Monte Negro is characterized by being constructed with wood (92 percent), and also a floor (75 percent). Nevertheless, only 32 percent of these houses had electric energy; (3) the mean ages for the parental generation were 41.9 for males and 36.3 for females. These values for the offspring generation were 12.2 and 10.5, respectively; (4) the sex-ratio of the offspring generation was 1.32;(5) the bioassay of kinship was estimated as .033 for this long range migrant population; (6) the prevalence of some macrophage dependent infectious disease was conspicuously high; (7) the reported number of malarial episodes among males and females was statistically different, suggesting that malaria may be, in part, a "professional" disease; (8) the prevalence of serum-positive reactions against B-hepatitis is distressing. It has a strong age dependence and reaches 74 percent among adult males. Conversely, signs of active infection (AgHbs) rises to 16 percent among children

Production of monoclonal antibodies against Schistosoma mansoni and a trypanosomatid: a methodological report.

Anticorpos monoclonais foram produzidos contra dois diferentes organismos: o tripanosomatideo Herpetomonas muscarum muscarum e Schistosoma mansoni. Verificou-se que a obtencao desses anticorpos depende de variaveis como esquemas de imunizacao, origem e peso molecular do polietilenoglicol, lotes de soro fetal bovino, feederlayers de macrofagos, linhagens de celulas e condicoes de cultura de celulas mielomatosas de camundongo. Aplicando um protocolo aqui descrito, foram obtidos 35 anticorpos monoclonais estaveis contra H.m.muscarum e 10 contra S. mansoni. Com relacao ao tripanosomatideo, um esquema de intervalos menores entre as imunizacoes resultou em anticorpos da classe IgM; ao contrario, intervalos mais longos resultaram em anticorpos predominantemente da classe IgG. Com S. mansoni, infeccoes mais ou menos longas produziram igualmente anticorpos predominantemente da classe IgG.Padroes diferentes de reacao foram observados atraves de imunofluorescencia indireta: alguns anticorpos mostraram predominancia de reacao contra o flagelo do tripanosomatideo. Os anticorpos monoclonais anti-S. mansoni reagiram contra o tegumento ou contra o tubo digestivo em cortes de vermes adultos. A importancia biologica dos dois tipos de anticorpos esta agora sendo investigada