Peri-implant health after supportive mucositis therapy is associated with increased levels of FGF-2

Abstract This study aimed to analyze Fibroblast Growth Factor-2 (FGF-2) levels in the peri-implant crevicular fluid throughout supportive mucositis therapy. Twenty-six participants with Branemark protocol prosthesis were divided into two groups: the control group, characterized by healthy peri-implants, and the mucositis group, presenting a diagnosis of peri-implant mucositis. All participants underwent clinical examination, radiographic analysis, prosthesis removal, and non-invasive peri-implant therapy (mechanical debridement associated with chlorhexidine 0.12%) during a period of 36 days divided into three intervals. Peri-implant crevicular fluid samples were collected at each interval in order to analyze FGF-2 levels by immuno-enzymatic assay. The control and mucositis groups showed difference in keratinized mucosa. The smaller the range of keratinized mucosa the higher susceptibility of peri-implant mucositis. Throughout the treatment intervals, participants were diagnosed in different groups indicating whether or not the non-invasive therapy was able to treat peri-implant mucositis. There was a significant difference of FGF-2 levels between groups, with the higher FGF-2 levels in the control group (p=0.01). After supportive therapy, the mucositis group showed significantly increased FGF-2 levels (p<0.01) compared to initial levels. After 36 days of supportive therapy, there was a reduction of peri-implant mucositis from 70% to 23%. Clinical and laboratory outcomes showed a clear correlation since FGF-2 levels increased after 36 days. It was concluded that the therapy protocol was effective and promoted a regenerative reaction and FGF-2 can be considered a future target for peri-implant mucositis understanding.

Resumo Este estudo teve como objetivo analisar os níveis de FGF-2 no fluido crevicular peri-implantar durante a terapia de suporte da mucosite. Vinte e seis participantes com prótese protocolo Branemark foram divididos em dois grupos: o grupo controle, caracterizado por saúde peri-implanter, e o grupo mucosite, apresentando diagnóstico de mucosite peri-implantar. Todos os participantes foram submetidos a exame clínico, análise radiográfica, retirada da prótese e terapia não invasiva peri-implantar (debridamento mecânico associado à clorexidina 0,12%) durante um período de 36 dias, dividido em três intervalos. Amostras de fluido crevicular peri-implantar foram coletadas em cada intervalo para análise dos níveis de FGF-2, por ensaio imunoenzimático. Os grupos controle e mucosite não apresentaram diferença nos parâmetros clínicos, exceto para mucosa queratinizada. Ao longo dos intervalos de tratamento, os participantes foram diagnosticados em diferentes grupos, indicando se a terapia não invasiva era ou não capaz de tratar a mucosite peri-implantar. Houve diferença significativa dos níveis de FGF-2 entre os grupos, sendo os níveis de FGF-2 maiores no grupo controle (p = 0.01). Após a terapia de suporte, o grupo com mucosite apresentou níveis de FGF-2 significativamente aumentados (p <0.01) em comparação aos níveis iniciais. Após 36 dias de terapia de suporte, houve redução da mucosite peri-implantar de 70% para 23%. Os resultados clínicos e laboratoriais mostraram uma correlação clara, uma vez que os níveis de FGF-2 aumentaram após 36 dias. O protocolo de terapia foi eficaz e promoveu uma reação regenerativa. O FGF-2 pode ser considerado um alvo futuro para o tratamento da mucosite peri-implantar.

Profound Hypothermia Provides Neuroprotection Following Hypothermic Circulatory Arrest: Ultrastructural Observations.

Objective: To assess whether cooling to 10°C can reduce neurological injury during 75 minutes of hypothermic circulatory arrest (HCA) compared to cooling to 18°C. Methods: Twelve domestic swine were used for this prospective blind randomized study. The animals were divided into 2 groups: Group A (n=6) underwent hypothermic circulatory arrest at 18oC for 75 min, and Group B (n=6) underwent hypothermic circulatory arrest at 10oC for 75 min. At the end of the experiment, the brains were removed and immersed in paraformaldehyde. All brains were dissected in the sagital plane. Tissue blocks from the left hemisphere were cut to encompass the sensory neocortex. Results: The selected area was identified with a dissecting microscope. Samples were examined in a blind fashion using electron microscope. Two investigators were instructed to find 10 representative neurons and analyze electron micrographs of these neurons for evidence of nuclear and cytoplasmic changes. Similarly, each investigator was instructed to examine the perinuclear neuronal mitochondria for abnormalities in mitochondrial distribution. Significant differences were observed between the 2 groups in mitochondria and rough endoplasmic reticulum (RER). In 5 of the 6 animals treated with 18oC HCA, neurons had slightly dilated RER, Golgi apparatus and mitochondria. In all 6 animals treated with 10oC HCA, the structure of the cytoplasmic organelles was intact, with no apparent dilatation (p=0.015). Conclusion: This study adds further support that hypothermia at 10oC exerts better cellular protection than hypothermia at 18oC, as evidenced by these electron microscopy findings.

Anti-inflammatory effects of methanolic extract of green algae Caulerpa mexicana in a murine model of ulcerative colitis

Abstract Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, are characterized by chronic and relapsed gut inflammation. Caulerpa mexicana is a type of green marine algae that can be found in tropical areas, such as the Brazilian Coastland. These macrophytes exhibit in vitro and in vivo anti-inflammatory properties such as the ability to reduce both cell migration to different sites and edema formation induced by chemical irritants. The aim of this study was to examine the effect of the C. mexicana methanolic extract on the treatment of colitis induced by dextran sodium sulfate. Acute experimental colitis was induced in BALB/c mice by treatment with 3% dextran sodium sulfate orally for 14 days. During this 14-day period, C. mexicana methanolic extract (2 mg/kg/day) was given intravenously on alternate days. Treatment with the methanolic extract significantly attenuated body weight loss and severe clinical symptoms. This was associated with a remarkable amelioration of colonic architecture disruption and a significant reduction in pro-inflammatory cytokine production. These results suggest that the anti-inflammatory action of C. mexicana methanolic extract on colorectal sites may be a useful therapeutic approach for inflammatory bowel diseases.

Molecular characterization of CTX-M type Extended Spectrum Beta Lactamase producing E. coli isolated from humans and the environment.

Purpose: Escherichia coli is a common pathogen causing community- and hospital-acquired infections. The infections caused by the Extended Spectrum Beta Lactamase (ESBL) enzymes-producing E. coli hinder antibiotic treatment. Materials and Methods: Plasmid DNA samples were subjected to PCR specifi c for TEM, SHV and CTX-M genes obtained from 110 E. coli strains isolated from hospitalized patients, healthy individuals and environment in Vellore, South India. Results: Among the 110 isolates tested, 21.8% were positive for TEM and 2.7% positive for SHV and 91.8% positive for CTX-M. The proportion of CTX-M positive E. coli was not statistically different between the study groups. Nineteen of 20 strains were CTX-M-15 type and the other was CTX-M-14 type. The phylogenetic analysis of 19 strains clustered with the pandemic CTX-M-15-ST131 strain, indicating this as an evolving global problem for antibiotic therapy. The geomapping of samples indicated ‘hotspot’ areas of healthy individuals, patients and the environmental samples. Conclusion: The spatial presentation of GIS mapping allowed identifi cation of clustering among patients and healthy individuals and contaminated environmental points.

Cryptosporidial Diarrhoea in Children at a Paediatric Hospital in Accra, Ghana.

Background: Diarrhoeal diseases are common among children in developing countries, and are caused by several aetiological agents including Cryptosporidium sp. Several species of this parasite exist which may belong to either anthroponotic or zoonotic forms. With recent application of molecular tools, species involved in human transmission in any locality and sources of infection can now be determined. Aim: We screened children with acute diarrhoea at a paediatric hospital in Accra, Ghana for enteric parasites to determine frequency of cryptosporidial diarrhoea. Cryptosporidium isolates were then characterized by molecular methods to determine the genetic species in transmission. Methodology: A total of 365 diarrhoeic children of age ≤ 5 years were used in this cross-sectional study. Stool samples were collected and tested for enteric parasites by microscopy and ELISA. Cryptosporidium isolates were subsequently genotyped by PCR-RFLP and confirmed by sequencing of the 18S rRNA gene. Demographic and clinical data were obtained by a structured questionnaire and data analysed for possible association with cryptosporidial diarrhoea. Results: Enteric parasites detected were Cryptosporidium sp. (22.2%), G. lamblia (5.8%) and E. histolytica (0.8%). Neither gender nor breastfeeding habits, presence of domestic animals, source of children’s food, seasons (dry or rainy) appeared to be associated with infection of Cryptosporidium sp. However, age of children, source of drinking water, and education level of mother seems to have association with infection of the parasite. Genotyping results show that C. parvum is the only species involved in transmission. Conclusion: Cryptosporidium parvum is the commonest enteric parasite causing diarrhoea among children with acute diarrhoea. Children ≤ 3 years and those who drank sachet water were most affected. A carefully planned health education among illiterate mothers and improved sanitary conditions could reduce rate of infections. Further sub-genotyping of C. parvum is needed to determine whether source of infection is zoonotic or anthroponotic.

Adenosine Triphosphatase Activities of Zea Mays and Vigna unguiculata Exposed to Different Crude Oil Fractions.

This study was carried out to investigate the activities of some adenosine triphosphatases (ATPases) in the radicle of maize and cowpea grown in soils contaminated with crude oil and its fractions. Total ATPase, Ca2+ ATPase, Na+/K+ ATPase and Mg2+ ATPase activities were evaluated. Cowpea and maize seeds were planted in polythene bags containing 500g of sandy loam soil each. The soils used had no known history of crude oil contamination and the study was carried out in the Department of Biochemistry, University of Benin garden and laboratory. A total of 660 bags were used in the study. Of these, 60 bags were used for planting maize and cowpea (30 bags for each plant) in soils not contaminated, which served as controls for the plants and another 60 bags with soils from Ubeji (a crude oil contaminated site in, Delta State, Nigeria) was planted maize or cowpea (30 for each plant). The remaining 540 bags had soils that were contaminated with 2%, 5%, or 10% whole crude oil or its water soluble or water insoluble fraction, and in it were planted either maize or cowpea and they served as the test groups. The experiment lasted for a period of one month. Seedlings in 10 bags from each group of 30 bags were harvested after 7, 14, or 21 days post germination and the activities of ATPases were determined. The data obtained were subjected to descriptive statistic of variance analysis. In a general sense, contamination of soils with crude oil or its fractions or in Ubeji significantly increased (P<.01) the activities of total ATPase, Ca2+-, Mg2+-, and Na+/K+- ATPases of cowpea compared with the uncontaminated control. In maize the effect of crude oil was mixed however Mg2+- ATPases was consistently reduced with crude oil contamination. The study indicated that crude oil and its fraction affects the activities of adenosine triphosphatases in ways which are species related.

Transformações recentes da indústria farmacêutica: um exame da experiência mundial e brasileira no século XXI / Recent changes in the pharmaceutical industry: a survey of worldwide and Brazilian experience in the 21st century

O artigo discute as características e tendências da indústria farmacêutica mundial e brasileira no século XXI, suas transformações e tendências setoriais, e seus atores. Foram utilizadas a pesquisa qualitativa e a técnica de análise documental, que permitiram verificar que, no início do século XX, a indústria farmacêutica mundial apresentava estrutura homogênea e oferta reduzida de seus produtos. Após a Segunda Guerra Mundial, houve fortalecimento da produção de medicamentos baseados na síntese química e diversificação da oferta e demanda por medicamentos. O mercado farmacêutico passou da competição mais ampla para uma de caráter oligopólico. Nos anos 1990, o portfólio dessas indústrias ampliou-se para áreas de saúde animal, produtos de higiene/cuidado pessoal e de nutrição/dietética. Na década de 2000, a indústria farmacêutica mundial intensificou esse processo, e devido à expiração das patentes dos medicamentos, se concentrou no segmento dos genéricos, adquirindo empresas nos mercados emergentes. O setor farmacêutico brasileiro seguiu os moldes da indústria farmacêutica mundial e passou a investir na produção de medicamentos genéricos, fitoterápicos e no avanço dos biotecnológicos, com o apoio financeiro público do BNDES. Esse contexto continua a exigir avanços na inovação em saúde, e reclama da regulação sanitária o enfrentamento dos desafios advindos dessa grande transformação. Cabe destacar os desafios relativos aos custos dos medicamentos e de seus fortes impactos sobre os sistemas de saúde, em especial aqueles de caráter mais inclusivo...

This article discusses the characteristics and trends of the global and Brazilian pharmaceutical industry in the 21st century, its transformations and industry trends, and its actors. Qualitative research and the technique of document analysis allowed us to check that in early 20th century, the global pharmaceutical industry was characterized by homogeneous structure and reduced supply of products. After the Second World War, there was strengthening of the production of medicines based on chemical synthesis and diversification of supply and demand for drugs. The pharmaceutical market has shifted from broader competition for one of oligopolistic character. In the 1990s, these industries' portfolio expanded to areas of animal health, hygiene / personal care and nutrition / dietetics. In the 2000s, the global pharmaceutical industry intensified this process, and due to the expiration of patents on medicines, focused on the generic segment, acquiring companies in emerging markets. The Brazilian pharmaceutical industry followed the lines of the global pharmaceutical industry and started to invest in the production of generic medicines, herbal and advancement of biotechnology, with public financial support of the BNDES. This context continues to demand advances in health innovation, and demands of the health regulation to face the challenges arising from this great transformation. It is worth mentioning the challenges relating to costs of drugs and their strong impact on health systems, particularly those of more inclusive character...

Incidence of extended spectrum beta lactamase producing Escherichia coli among patients, healthy individuals and in the environment.

We investigated the faecal carriage of extended spectrum β‑lactamases (ESBL) producing Escherichia coli in different groups of human subjects and in the environment. A total of 363 E. coli strains were isolated from stool samples of patients (n = 77), healthy subjects (n = 170) and from different environmental samples (n = 116). A total of 124 ESBL producing E. coli strains were isolated in this study. The frequency of ESBL producing E. coli was found to be highest (60.3%) among the strains isolated from patients, followed by healthy individuals (38%) and the environment (10.5%). The environment was observed to have a very low number of ESBL producing E. coli.

Relação entre qualidade do sono e funções cognitivas em pacientes com doença de Parkinson / Relación entre la calidad del sueño y función cognitiva en pacientes con la enfermedad de Parkinson / Relationship between quality of sleep and cognitive function in patients with Parkinsons disease

Descrever as características clínicas e demográficas de pacientes com Doença de Parkinson, bem como verificar a relação entre a qualidade do sono e as funções cognitivas. Trata-se de um estudo descritivo-analítico de corte transversal em que foram avaliados episódios de depressão, ansiedade, estado geral e progressão da doença, sonolência, qualidade do sono e funções cognitivas de 24 pacientes com Doença de Parkinson sem demência. Analisando os resultados do teste de memória tardia e a as alterações do sono, encontrou-se correlação do tipo inversa e moderada. O componente latência do sono teve uma correlação inversa e moderada com a memória, e também com a função visuoespacial. Outras relações também foram observadas como entre a qualidade subjetiva do sono e a função visuoespacial, a latência do sono e o resultado global do SCOPA-COG, e entre a duração do sono e a atenção. Todas essas correlações foram inversas e de caráter fraco. Esse estudo sugere que os déficits cognitivos leves, na ausência de demência, foram relacionados com qualidade ruim do sono.

Describir las características clínicas de pacientes con la enfermedad de Parkinson, así como la relación entre la calidad del sueño y las funciones cognitivas. Se realizó un estudio descriptivo-analítico de corte transversal que evaluó: los episodios de depresión, ansiedad, estado de salud general, progresión de la enfermedad, sueño, calidad del sueño y funciones cognitivas de 24 pacientes con enfermedad de Parkinson sin demencia. Se observó una relación inversa de tipo moderada entre la memoria tardía y trastornos del sueño. El componente de la latencia del sueño tuvo una correlación inversa moderada con la memoria, y con la función visuoespacial. También se observaron otras relaciones entre la calidad subjetiva del sueño y la función visuoespacial, la latencia del sueño y el resultado global de la SCOPA-COG, y entre la duración del sueño y la atención. Se observó que estas correlaciones fueron inversas y de carácter débil. Este estudio sugiere que los déficits cognitivos leves en ausencia de demencia se relacionaron con la mala calidad del sueño.

Here, we describe the clinical characteristics of patients with Parkinson's disease, as well as study the relationship between sleep quality and cognitive functions. This is a descriptive-analytical cross-sectional study in which we evaluate episodes of depression and anxiety, as well as the state of general health, disease progression, sleepiness, sleep quality and cognitive functions of 24 patients with Parkinson's disease without dementia. We found a moderate inverse correlation between memory and sleep disturbances, and a moderate inverse correlation of memory and visuospatial function. We also observed other associations between subjective sleep quality and visuospatial function, sleep latency and the overall result of the SCOPA-COG, and between sleep duration and attention; all of these correlations were inverse and weak. This study suggests that mild cognitive deficits in the absence of dementia are associated with poor sleep quality.

Effects of temperature, salinity and irradiance on carposporeling development of Hidropuntia caudata (Gracilariales, Rhodophyta)

The success of seaweed cultivation depends on the scientific control of the tolerance limits and the optimal physiological conditions that affect the spore germination and the early development of algal species. In order to establish cultivation techniques for spores of Hidropuntia caudata (J. Agardh) Gurgel & Fredericq, the effects of irradiance, salinity, and temperature on the carpospore germination and carposporeling development were evaluated under laboratory conditions. Five photon flux densities (PFD, from 18 to 200 µmol photons m-2s-1), six salinity values (from 7 to 55 psu), and four temperatures (from 20 ºC to 35 ºC) were investigated. The level of irradiance caused significant differences in the growth, in the following order: 200±5 > 100±5 ~= 62.5±2.5 > 30±1.5 > 18±1 µmol of photons m-2s-1, but they did not inhibit the carposporeling development. Maximum growth occurred under 35 psu, while at 15 psu the formation of carposporeling erect axis was limited. The optimal temperature for growth was 25 ºC, while at 35 ºC the spores died. These results show the importance of previous knowledge on the tolerance limits and optimal conditions for sporeling development of H. caudata for the implementation of an aquaculture program.

A regulação em saúde no Brasil: um breve exame das décadas de 1999 a 2008 / Health regulation in Brazil: a brief survey of the decade from 1999 to 2008

Este artigo discute a experiência brasileira de regulação em saúde no período de 1999 a 2008. Buscou-se compreender as interfaces do processo de regulação em saúde no Brasil, sobretudo com o setor farmacêutico, identificando, historicamente, os atores e contextos referentes a esse processo. A pesquisa baseou-se na revisão bibliográfica e no levantamento das resoluções da diretoria colegiada da Agência Nacional de Vigilância Sanitária. Esse levantamento permitiu identificar a concentração dessas resoluções nas subáreas: medicamentos, recursos humanos e alimentos. No tocante à subárea medicamentos, a concentração se deu em três descritores: registro de medicamentos, boas práticas e substâncias sujeitas a controle especial. Além de fazer uma síntese histórica da evolução da vigilância sanitária brasileira, o artigo focalizou os aspectos regulatórios da Agência Nacional de Vigilância Sanitária e sua relação com a indústria farmacêutica. Portanto, o texto pautou-se pela pretensão de dar resposta à seguinte questão: será que a experiência de regulação da Agência Nacional de Vigilância Sanitária está apta a enfrentar o cenário adverso gerado pela nova crise mundial, especialmente no que se refere ao setor farmacêutico? A principal conclusão do trabalho é de que, apesar dos muitos desafios a serem superados pela Agência Nacional de Vigilância Sanitária no Brasil contemporâneo, a experiência de regulação avançou bastante nesta década. Uma conclusão adicional é que esses avanços constituíram, para o setor farmacêutico, uma proteção face ao quadro adverso gerado pela crise mundial.

This paper discusses the Brazilian experience of health regulation from 1999 to 2008. It aims to understand the interfaces of the regulatory process in health in Brazil, particularly the pharmaceutical industry, seeking to identify, historically, the actors and contexts relating to the proceedings. The research was based on literature review and survey of the resolutions of the Board of the National Health Surveillance Agency. This survey identified the concentration of these resolutions in the following areas: drugs, human resources and food. Regarding drugs, emphasis was placed in three key words: drug registration, practices and substances subject to special control. In addition to a brief history of the evolution of Brazilian health surveillance, this paper focused on the regulatory aspects of the National Health Surveillance Agency and its relationship with the pharmaceutical industry. Therefore, the text was guided by the desire to answer the following question: is the experience of regulation of the National Health Surveillance Agency able to cope with the adverse scenario created by the world crisis, especially with regard to the pharmaceutical industry? The main conclusion of this study is that despite the many challenges to be overcome by the National Sanitary Surveillance Agency in Brazil today, the experience of regulation has made good progress in this decade. A further finding is that these developments were, for the pharmaceutical industry, a protection against the adverse situation created by the global crisis.

Flavonóides de Piper carniconnectivum C. DC Piperaceae / Flavonoids from Piper carniconnectivum C. DC (Piperaceae)

Os flavonóides 5,3’,4’-triidroxi-7-metoxiflavona, 5,3’-diidroxi-7-4’-dimetoxiflavona, 5,4’-diidroxi-7-metoxiflavona e uma mistura de esteróides (β-sitosterol e estigmasterol) foram isoladas das partes aιreas de Piper carniconnectivumC.DC, Piperaceae. As estruturas desses compostos foram estabelecidas por análises espectroscópicas de UV, IV e RMN de ¹H e 13C, incluindo técnicas uni e bidimensionais.

The flavonoids 5,3’,4’-trihydroxy-7-methoxyflavone, 5,3’-dihydroxy-7-4’-dimethoxyflavone, 5,4’-dihydroxy-7-methoxyflavone and steroids mixture (β-sitosterol and stigmasterol) were isolated from the dried aerials parts of Piper carniconnectivumC.DC. Their structures were established by spectroscopic analyses (UV, IV and ¹H, 13C NMR, including 1D and 2D NMR).

Renal parenchyma thickness: a rapid estimation of renal function on computed tomography

Purpose: To define the relationship between renal parenchyma thickness (RPT) on computed tomography and renal function on nuclear renography in chronically obstructed renal units (ORUs) and to define a minimal thickness ratio associated with adequate function. Materials and Methods: Twenty-eight consecutive patients undergoing both nuclear renography and CT during a six-month period between 2004 and 2006 were included. All patients that had a diagnosis of unilateral obstruction were included for analysis. RPT was measured in the following manner: The parenchyma thickness at three discrete levels of each kidney was measured using calipers on a CT workstation. The mean of these three measurements was defined as RPT. The renal parenchyma thickness ratio of the ORUs and non-obstructed renal unit (NORUs) was calculated and this was compared to the observed function on Mag-3 lasix Renogram. Results: A total of 28 patients were evaluated. Mean parenchyma thickness was 1.82 cm and 2.25 cm in the ORUs and NORUs, respectively. The mean relative renal function of ORUs was 39 percent. Linear regression analysis comparing renogram function to RPT ratio revealed a correlation coefficient of 0.48 (p < 0.001). The linear regression equation was computed as Renal Function = 0.48 + 0.80 * RPT ratio. A thickness ratio of 0.68 correlated with 20 percent renal function. Conclusion: RPT on computed tomography appears to be a powerful predictor of relative renal function in ORUs. Assessment of RPT is a useful and readily available clinical tool for surgical decision making (renal salvage therapy versus nephrectomy) in patients with ORUs.

Cuidados de longa duração para idosos: um novo risco para os sistemas de seguridade social / Texto para Discussão (TD) 1371: Cuidados de longa duração para idosos: um novo risco para os sistemas de seguridade social

Analisa o processo de envelhecimento populacional e o surgimento da demanda por cuidados de longa duração no âmbito dos sistemas de seguridade social. Ressalta as experiências de três países desenvolvidos, com processos de envelhecimento já bastante avançados: Alemanha, Dinamarca e Estados Unidos. Aborda a legislação de proteção aos idosos brasileiros. Analisa a situação dos idosos, tanto em termos socioeconômicos e familiares quanto ao atendimento pretendido pelas políticas sociais vigentes.

Os marcos legais das políticas de medicamentos no Brasil contemporâneo (1990-2006) / The legal landmarks of the drugs policies in contemporary Brazil (1990-2006)

O presente trabalho tem como objeto o processo de reorientação da assistência farmacêutica levada a termo no Brasil a partir da Lei 8.080 de 1990. Essa lei é o primeiro marco legal de um processo que gerou distintas legislações relativas à assistência farmacêutica no âmbito do SUS. O objetivo principal do trabalho foi levantar, sistematizar e nalisar os principais documentos e propostas que promoveram a reorientação da assistência farmacêutica desde 1990 até o presente. O foco do trabalho foi a elaboração, em 1998, da Política Nacional de Medicamentos (PNM), seus antecedentes Central de Medicamentos – (CEME) – Decreto 68.806/71 e a Lei 6.360/76 relativa às ações de vigilância sanitária, bem como a crescente edição de legislações voltadas para a sua efetiva implantação: a criação da Agência Nacional de Vigilância Sanitária – (ANVISA) (1999); a Lei 9.787, conhecida como a Lei dos Genéricos (1999), e a Política Nacional de Assistência Farmacêutica (2004). O trabalho apresenta uma periodização da trajetória das políticas de medicamentos no Brasil contemporâneo e procura assinalar algumas das características desse processo. Entre essas características figura o caráter abrangente dessas legislações, bem como a insuficiente articulação entre estas no sentido de promover a consolidação de uma nova cultura de medicamentos no país. Este trabalho não se limitou a construir uma visão retrospectiva do processo de reorientação da assistência farmacêutica em curso no Brasil contemporâneo, mas procurou buscar alguns elementos para a formação de uma visão prospectiva - na qual estudos avaliativos ganham importância estratégica – das ações no campo da assistência farmacêutica.

The present work focuses on the process of the reorientation of pharmaceutical assistance introduced in Brazil with Law 8,080 of 1990. This law is the first legal landmark of a process that created distinct legal provisions concerning pharmaceutical assistance in the setting of SUS (the Unified National Health System). The main purpose of the study was identifying, systematizing and analyzing the principal documents and proposals that promoted the reorientation of pharmaceutical assistance from 1990 to today. The focus of the work was the elaboration, in 1998, of the National Drug Policy, its antecedents Central for Drugs - (CEME) - Decree 68,806/71 and Law 6,360/76 relative to public health surveillance activities, as well as the increasing number of legislative provisions focused on its effective implementation: establishment: the creation of the National Health Surveillance Agency - (ANVISA) (1999); Law 9,787, known as the Generic Drug Law (1999) and the National Pharmaceutical Assistance Policy (2004). The study presents a timeline of the trajectory of drug policy in Brazil today and seeks to highlight some of the characteristics of this process. Among these characteristics there is the all-inclusive nature of these pieces of legislation as well as the insufficient coordination between them that would promote the consolidation of a new medication culture in the country. This work was not limited to a retrospective view of the reorientation process of pharmaceutical assistance in practice today in Brazil, but it tried to find some elements for the formation of a prospective vision, in which evaluation studies become an important strategy in the policies of pharmaceutical assistance.

Identification of conserved regulatory elements in mammalian promoter regions: a case study using the PCK1 promoter / 基因组蛋白质组与生物信息学报·英文版

A systematic phylogenetic footprinting approach was performed to identify conserved transcription factor binding sites (TFBSs) in mammalian promoter regions using human, mouse and rat sequence alignments. We found that the score distributions of most binding site models did not follow the Gaussian distribution required by many statistical methods. Therefore, we performed an empirical test to establish the optimal threshold for each model. We gauged our computational predictions by comparing with previously known TFBSs in the PCK1 gene promoter of the cytosolic isoform of phosphoenolpyruvate carboxykinase, and achieved a sensitivity of 75% and a specificity of approximately 32%. Almost all known sites overlapped with predicted sites, and several new putative TFBSs were also identified. We validated a predicted SP1 binding site in the control of PCK1 transcription using gel shift and reporter assays. Finally, we applied our computational approach to the prediction of putative TFBSs within the promoter regions of all available RefSeq genes. Our full set of TFBS predictions is freely available at http://bfgl.anri.barc.usda.gov/tfbsConsSites.

Pre hospital issues in acute myocardial infarction.

OBJECTIVES: Time is of prime importance in the management of acute myocardial infarction (AMI). Time to hospital admission should be minimised for maximum thrombolytic benefit. The present paper has evaluated some socio-demographic factors influencing pre hospital delay. METHODS: This prospective observational study of 1,072 patients with AMI admitted to 14 hospitals in South India was done over one year. Socio-demographic factors viz. time of symptom onset, place of residence, type of transportation to hospital, distance travelled, as well as clinical and treatment details were recorded. Hospitals were grouped based on their location into metropolitan and town hospitals. RESULTS: Males predominated (85%) and had AMI at a younger age than females. Most patients (74%) travelled less than 30 km to a hospital. The mean distance travelled to a town hospital was longer than that to a metropolitan hospital (24.2 km vs 21 km; p < 0.0001); however there was no significant difference in the type of transportation or time taken to reach either of the hospitals. Majority (79%) of patients arrived at a hospital within the thrombolytic window of 12 hours (mean time = 11 hours). The occurrence of a previous MI had no influence on time taken to hospital arrival, questioning the role of symptom education as an interventional strategy to reduce pre hospital delay. Patients older than 70 years and females in towns with symptom onset during the day (6 am to 6 pm) took a longer time to reach hospital. CONCLUSION: Community facilities do not affect pre hospital delay. Interventions should focus on reducing decision time to call for help and the role of symptom education needs further evaluation.

Horizontes do mundo da experiência: uma alternativa pós-cartesiana ao inconsciente freudiano / World horizons: a post-Cartesian alternative to the Freudian unconscious

Começando com a crítica às hipóteses cartesianas do isolamento da mente que saturaram a visão freudiana de inconsciente, este artigo propõe a idéia da multiplicação dos mundos vivenciais contextualizados e de seus horizontes limitadores como uma alternativa pós-cartesiana ao inconsciente freudiano. Para ilustrar essa contextualização, reexamina-se um exemplo dramático de inconsciência esclarecido durante a análise conduzida por um dos autores, há quase 30 anos, a partir da perspectiva de um sistema intersubjetivo

Food security among preschool children.

A cross-sectional study of preschool children from 450 families from a residential colony of 'D' class hospital employees was undertaken to study food security & associated variables. Food security was established from (a) 24 hours recall method with 1 day weighment and (b) monthly food purchase inventory for cereals and pulses. Relationship between food secure status and variables of interest was studied from Chi-square value and odds ratio. Only 42.6% households and 54% preschool children from these households were calorically secure. Insecurity was the highest in 48-59 months age group. Per capital income, increasing birth order, family size, household size, less years of schooling of the mother, less than 4 meals per day and pulse insufficiency at home were associated with food insecurity. Per capita income ensures food availability at home. Family size and household size probably ensure distribution. Mother's education, frequent feeds more than four, ensure that it reaches the preschool children.