Eventos adversos en la terapia farmacológica de la enfermedad inflamatoria intestinal / Adverse events associated with the treatment of inflammatory bowel disease

Background: The purpose of inflammatory bowel disease (IBD) treatment is to achieve resolution of symptoms and remission of disease with a minimum of adverse events (AE). Aim: To report AE of different prescriptions used for the treatment of IBD. Material and Methods: Analysis of a registry of patients with IBD held at a private clinic from 1976 to 2013. All used medications, the occurrence and severity of AE were recorded. Results: The records of 346 patients aged 16 to 86 years, 74% with ulcerative colitis, were analyzed. The most commonly type of medications prescribed were 5-aminosalicylates (5-ASAs) in 329 patients (92%), followed by adrenal steroids in 218 (61%). Forty nine AE were recorded in the same number of patents (14%). These were more common in patients with Crohn disease (n = 19, 21%). An univariate analysis, demonstrated that extra-intestinal manifestations, hospitalizations secondary to IBD crisis, requirement of surgery and treatment with steroids, immunosuppressants or biologic agents were significantly associated with the presence of AE. AEs were more common with immunosuppressants, followed by 5-ASAs and steroids. Discontinuation of therapy was required in 79, 100 and 43% of patients taking these medications, respectively. Twenty percent of AEs were severe. Leukopenia and pancytopenia along with alopecia were the most common AEs attributable to azathioprine. Conclusions: The occurrence of AEs in patients with IBD is uncommon. Even inmunosuppressants or biologic agents have a low rate of AE and most of them mild.

As bases da reformulação da presença digital da Sociedade Brasileira de Cirurgia Plástica / A basis for a reformulation of the digital presence of the Brazilian Association of Plastic Surgery

INTRODUÇÃO: Com o crescimento exponencial da internet, observou-se o grande potencial da rede como ferramenta eficaz no provimento de informações e acesso difundido. Desenvolver portais que respondam as necessidades informacionais de seus associados e usuários configuram uma preocupação das sociedades de classe. O objetivo deste estudo foi reavaliar a estrutura do portal da Sociedade Brasileira de Cirurgia Plástica, além da necessidade de implementação de uma nova dinâmica de interação de seus associados e usuários. MÉTODO: Realizou-se pesquisa qualitativa com seus associados e formadores de opinião previamente selecionados. RESULTADOS: As considerações mais frequentes foram: aporte de melhor conteúdo científico, necessidade de atualização do portal, divulgação de pesquisas, acesso a periódicos e instrumento de treinamento e/ou aperfeiçoamento. CONCLUSÃO: Essa pesquisa possibilitou a modernização do portal da Sociedade Brasileira de Cirurgia Plástica, além de definir diretrizes de sua presença contínua nas redes sociais.

INTRODUCTION: The exponential growth of the Internet has revealed its great potential as an effective tool for providers to access information. The development of websites that meet associates' and other users' needs to be informed is a concern of professional associations. This study aimed to assess the structure of the SBCP website and the need to implement a new dynamic interaction between associates and other users. METHOD: A qualitative study was conducted by surveying previously selected associates and opinion makers. RESULTS: The most common considerations were as follows: (1) the need to improve scientific content, (2) update the website, (3) disseminate research, (4) access journals, and (5) training and/or development of tools. CONCLUSION: This study promoted the modernization of the SBCP website and defined guidelines for its ongoing presence in social networks.

El Estado fomenta el regreso de los investigadores argentinos / State encouragement of repatriaton of argentine scientific researchers

Pone en conocimiento las actividades y resultados del programa de vinculación de científicos argentinos en el exterior, Programa Raíces, así como su importancia política en el marco de las políticas de recursos humanos del Ministerio de Ciencia, Tecnología e Innovación Productiva de la Argentina.

Ecuador define sus prioridades de investigación en salud / Ecuador defines its health research priorities

La construcción de una agenda de prioridades de investigación es una herramienta esencial para acrecentar la capacidad de investigación científica y tecnológica, y el resultado de procesos sistemáticos dirigidos a jerarquizar, seleccionar y organizar problemáticas que pueden ser resueltas por métodos científicos.

Financiamiento público de la investigación en salud en cinco países de América Latina / Public financing of health research in five Latin American countries

OBJETIVOS: Describir los subsistemas públicos de los Sistemas Nacionales de Investigación en Salud (SNIS) en cinco países de América Latina (Argentina, Bolivia, Chile, Paraguay y Uruguay), con énfasis en los tipos de arreglos institucionales que se observan en cada país para promover, desarrollar y sostener sus SNIS, así como en los mecanismos explícitos o implícitos de priorización de proyectos de investigación en salud. MÉTODOS: Se identificó a los organismos responsables de manejar los recursos públicos destinados a financiar proyectos de investigación en salud en los cinco países estudiados. Luego se analizaron los tipos de proyectos que fueron financiados -utilizando una matriz por área y objeto de estudio-, ciertas características de los investigadores principales y los montos asignados entre 2002 y 2006. RESULTADOS: Solamente los países con mayores recursos o con redes de investigadores más desarrolladas poseen estructuras formales de asignación de fondos, con convocatorias periódicas y reglas estables, y ninguno cuenta con mecanismos explícitos e integrales de priorización para la investigación en salud. A su vez, las prioridades de investigación en salud presentan diferencias importantes entre países. En este sentido, es notorio que ciertos problemas, como "nutrición y medio ambiente" o "violencia y accidentes", reciban escasa atención en la mayoría de los países, al igual que varios temas de salud pública en algunos otros. Contrariamente, la investigación referida a "ciencias básicas" absorbe hasta un tercio de los recursos totales para investigación. CONCLUSIONES: Surgen numerosos interrogantes acerca de la capacidad de estos países para adaptar y generar nuevos conocimientos, y de la casi inexistente investigación sobre condicionantes sociales, económicos y culturales o sobre servicios y sistemas de salud, de alto impacto en grupos con acceso limitado al cuidado de la salud. Es necesario establecer explícitamente las prioridades en la agenda de investigación en salud, en consenso con las partes interesadas, así como incorporar mecanismos de monitoreo y seguimiento por temas y áreas de estudio del financiamiento de la investigación en este campo.

OBJECTIVES: Describe the public subsystems of the national health research systems (SNIS) in five Latin American countries (Argentina, Bolivia, Chile, Paraguay, and Uruguay), emphasizing the types of institutional arrangements in place in each country to promote, develop, and sustain their SNIS, as well as explicit or implicit mechanisms for prioritizing health research projects. METHODS: The bodies responsible for managing the public resources allocated to finance health research projects in the five countries studied were identified. The types of projects financed were then analyzed-using a matrix constructed by area and object of study-, certain characteristics of the principal investigators, and the sums allocated between 2002 and 2006. RESULTS: Only the countries with greater resources or better developed networks of investigators have formal structures for allocating funds with regular calls for proposals and fixed rules. None of them has explicit comprehensive mechanisms for prioritizing health research. Moreover, the health research priorities in the countries vary widely. In this regard, it is significant that problems such as "nutrition and the environment" or "violence and accidents" receive little attention in most countries. The same holds true for a number of public health issues in some countries. In contrast, the research in the "hard sciences" absorbs up to one-third of the total resources for research. CONCLUSIONS: Many questions arise about the ability of these countries to adapt and generate new knowledge, as well as the nearly nonexistent research on social, economic, and cultural determinants, or on health services and systems that have a high impact on groups with limited access to health care. Explicit priorities should be set with stakeholders for the health research agenda, and mechanisms should be adopted for monitoring and following up health research financing by subject and area of study.

Regulación de las experiencias con nuevos fármacos y obtención de recursos para la docencia y la investigación en un hospital público / Regulating academical industrial research relationchip: clinical investigators and the pharmaceutical industry

Vista la creciente participación de profesionales de hospitales públicos como investigadores contratados para realizar tareas patrocinadas por la industria, utilizando las instalaciones, el equipamiento y los pacientes del hospital, las instituciones deben regular y supervisar esta tarea, a fin de asegurar que los proyectos de investigación concuerden con los legítimos intereses de los pacientes, del hosital y de la comunidad que lo sostiene. La Institución debe también recibir compensación económica por estas actividades, siendo conveniente que estos recursos se vuelquen a necesidades vinculadas a la actividad docente y a proyectos de investigación huérfanos de apoyo, paliando así el problema de la tradicional escasez de recursos para estos fines en nuestro medio.

Academic trajectories of dental researchers receiving CNPq's productivity grants

The present study analyzed the profile of dental researchers receiving grants related to their productivity in research from the Brazilian National Research and Development Council (CNPq). Data collection was carried out in March 2008, using the Brazilian database for curriculum vitae (Lattes Format). There were 144 researchers registered in the database and linked to 25 institutions. These researchers published a total of 12,997 full-text articles, 6,927 of which were published in the last 5 years. Category 1 grant holders (n=77) were responsible for 53.5 percent of this production; Category 2 grant holders (n=65) were responsible for 45.1 percent; Senior grant holders (n=2) were responsible for 1.4 percent. Regarding institutional affiliation, 90.3 percent of the research grants holders develop activities at public institutions and 9.7 percent develop activities in private institutions. Furthermore, 84.0 percent of the researchers are linked to institutions located in the southeast region of Brazil and 75.0 percent of the researchers perform their activities in the state of São Paulo. This study performed a mapping of the distribution of CNPq researchers, revealing a concentration in the southeast region of the country, especially in the state of São Paulo. The findings of the present study also demonstrate the important contribution of grant holders to the scientific production in dentistry in Brazil.

Este estudo teve como objetivo verificar o perfil dos pesquisadores de Odontologia, bolsistas de produtividade em pesquisa, do Conselho Nacional de Desenvolvimento e Pesquisa (CNPq). A coleta dos dados foi realizada em março de 2008, a partir da base de dados do curriculum vitae (Plataforma Lattes). Observou-se que estavam registrados 144 pesquisadores vinculados a 25 instituições brasileiras de ensino e pesquisa. Esses pesquisadores publicaram um total de 12.997 artigos completos, sendo 6.927 produzidos nos últimos 5 anos. Os bolsistas da categoria 1 (n=77) foram responsáveis por 53,5 por cento dessa produção, os da categoria 2 (n=65) por 45,1 por cento e os bolsistas seniores (n=2) por 1,4 por cento. Em relação ao vínculo institucional, 90,3 por cento dos pesquisadores bolsistas desenvolvem suas atividades em instituições públicas e 9,7 por cento em instituições privadas. Observou-se ainda que 84,0 por cento dos pesquisadores estão vinculados a instituições localizadas na região sudeste do Brasil, sendo que do total dos pesquisadores, 75,0 por cento atuam no Estado de São Paulo. Este estudo demonstrou a importante contribuição dos bolsistas para a produção científica da área. Ademais, possibilitou o mapeamento da distribuição desses pesquisadores, evidenciando a concentração dos mesmos na região sudeste do país, especialmente no Estado de São Paulo.

Assessment of scientific programs: a necessary procedure for Brazilian scientific policy - the Young Investigator Program of the State of São Paulo Research Foundation

Programs of Science and Technology research have grown significantly in Brazil over the last decades. Until the 1980s the so-called undirected programs, without specific goals and requiring only scientific merit, prevailed. The few programs with defined goals in this period were never objectively assessed. The same situation occurred in developed countries. In the early 1990s, the assessment of programs supported by public funding became mandatory in US and some European countries. In Brazil, program assessment has so far not been implemented yet. The Fundação de Amparo à Pesquisa no Estado de São Paulo (FAPESP) (Brazilian funding agency) Young Investigator (YI) Program is in its eleventh year, with approximately eight hundred projects awarded. Although it is free-demand based as concerns areas of knowledge, it has specific goals : (1) conceding grants to YI in view of the balance between funding, merit and real needs so as to enable satisfactory working conditions in the short term, (2) providing priority for institutions with a less extensive background in research, (3) granting a special fellowship to YI with no employment connection and (4) introduction of new research fronts in centers with a sound research background. This assessment provided evidence for the achievement of first three goals. The fourth one is still pending on additional data requiring survey assessment. Actions in this direction are recommended.

Programas de Ciência e Tecnologia cresceram significativamente no Brasil nas últimas décadas. Até a década de 80 os assim chamados programas não dirigidos, sem metas específicas e requerendo apenas mérito científico prevaleciam. Os poucos programas com metas definidas neste período não foram jamais objetivamente avaliados. A mesma situação ocorria nos países desenvolvidos. No início da década de 90, a avaliação de programas dependentes de recursos públicos tornou-se mandatória nos Estados Unidos e em alguns países europeus. No Brasil a avaliação de programas não foi até agora implementada. O programa de Jovem Pesquisador (JP) da FAPESP está em seu décimo primeiro ano, com a concessão de aproximadamente 800 projetos. Embora não seja dirigido em termos de áreas específicas de conhecimento, ele tem metas específicas: (1) conceder auxílios a JP tendo em vista um balanço entre fundos, mérito e reais necessidades para permitir condições satisfatórias de trabalho dentro de um curto período, (2) conceder prioridade à instituições menos consolidadas em pesquisa, (3) conceder bolsa especial a JP sem vínculo empregatício à instituição e (4) introduzir novas frentes de pesquisa em centros cientificamente bem consolidados. A presente avaliação forneceu evidências de que as três primeiras metas foram alcançadas.A quarta está ainda pendente de dados adicionais que requerem avaliação por enquete. São sugeridas ações nesta direção.

A Comparison of Smoking Control Strategies in Korea and the United States / 간호학회지

The purpose of this study was to compare smoking control strategies between Korea and the United States. Korea and other developing countries may learn from the experience of the United States in dealing with the growing epidemic of cigarettes. In particular, smoking control objectives, structures, laws and regulations, funds, programs and activities, research, and surveillance systems were compared. The comparison was conducted at the federal, states/provincial, and county levels of the two countries. The data were collected through various governmental websites, contact with people directly, and a literature review. Based on the comparison, seven recommendations for smoking control strategies were made primarily for Korea.

Review of North-South and South-South cooperation and conditions necessary to sustain research capability in developing countries.

The paper extracted pertinent aspects of 21 years (1981-2001) of scientific cooperation among Zimbabwe's Blair Research Laboratory (BRL), the Biomedical Research and Training Institute (BRTI), and the Danish Bilharziasis Laboratory (DBL). DBL supported the building of research capacity at BRL through PhD-level training and short courses on research training organized by BRTI. The BRL-BRTI-DBL cooperation involved institutional support, scientific training, joint research programmes, and technology transfer, and forms a basis for the discussion of North-South and South-South collaboration in this paper. As the collaboration matured, DBL researchers began cooperating with their counterparts at BRL in internationally funded research programmes and partnerships based on mutual interests and responsibilities. Several research projects were formulated under co-principal investigators from the two institutions and later extended to other European and US institutions. An impressive outturn (18 PhDs) of postgraduate students undertaking field-based PhD work was accomplished from 1990 to 2001. As the socioeconomic situation in Zimbabwe deteriorated from 1999, significant attrition of senior scientists began to affect some of BRL's core functions in support of the Ministry of Health's programmes. In solidarity with BRL, DBL and BRTI jointly implemented a management-strengthening project to reduce deterioration of research productivity by retaining mid-level research managers. BRTI, able to respond rapidly to research needs in the Southern Africa Development Community (SADC), is not in competition with national research institutions and universities. An advisory committee of SADC stakeholders sets its priorities. The framework for South-South cooperation is research training to facilitate national scientists to attract resources from local and international funding agencies. It has established a National Institutes of Health-accredited ethical review board that provides ethical assurance for BRTI and non-BRTI-administered projects. Over the last eight years, BRTI has established regional and international legitimacy, and many funding agencies accept the role of the organization in 'Third Country Training for South-South Cooperation'. The article concludes by identifying essential conditions for sustaining research capability at BRL and similar institutions in developing countries. In rolling out a new ethos for research, great expectation is placed on the success of the New Partnership for Africa Development.

Programa especial para investigación y adiestramiento en enfermedades tropicales (TDR) / Special programme in research and training in tropical diseases

A description of the six tropical diseases involved in the programme and the achierement of research goals are evaluated. The author points out the important accomplishment of these aims in the impact in the malaria and filiariasis control, in the elimination of leprosy and the future erradication of Chagas disease in the Americas. At the same time the relevance of the manpower training were imphasized in the strenghtening on the research infrastructure of the member countries

Práctica de la investigación en la Facultad de Ciencias Médicas en 1994-1995 / Research practice in the medical school in 1994-1995

En el estudio de la práctica de la investigación en la Facultad de Ciencias Médicas durante los años de 1994 al 95, se pretendió, identificar los aspectos demográficos y la labor del personal docente en general; determinar el nivel de capacitación; y las demandas en está e identificar la producción científica y su publicación a nivel nacional e internacional. Con el diseño de un estudio descriptivo transversal, se distribuyó un cuestionario (de auto administración) a los Docentes de la Facultad de Ciencias Médicas en los años de 1994 y 1995; se esperaba una respuesta del 100 por ciento de Docentes, (282 al momento del estudio) de respuesta. Entre los datos que resaltan en el nivel de formación donde el 64 por ciento (108/170) de los docentes, tienen una especialidad, la mayoría en el área clínica; y 16 por ciento (27/120) el grado de maestría. El 75 por ciento (127/170) de los respondentes han recibido cursos sobre metodología e investigación sin embargo el 99 por ciento (168/170) indicó la necesidad de que se realicen cursos de capacitación en procesamiento y análisis computarizados de datos. El 71 por ciento (120/170) dijo haber realizado algún trabajo de investigación, actividad que es esporádica en 77 por ciento de ellos (92/120); con pocas posibilidades de asistencia financiera 32 por ciento (39/120) han publicado sus investigaciones, 48 por ciento (19/39) como autor principal y 33 por ciento (13/39) en revistas internacionales. En los datos ponen una voz de alerta para que la UNAH retome las investigaciones como una de sus funciones o ejes prioritarias

From molecular biology to biotechnology: the role of markets and institutions in the Brazilian scenario

Biotechnology owes a great deal to molecular biology. Even so, scientific discoveries are just a partial, although very important, component of modern biotechnology. To generate products and processes basic research needs integration with other fields, like process technologies, which are essential for large-scale production, or plant and animal breeding for dissemination of valuable genes identified through molecular markers. Moreover, several different agents must interact for the transformation of science into technological innovation: research centers, companies, government departments, financing organizations. The demand for biotechnologies in Brazilian agriculture serves here as a "case study". Technological trajectories and opportunities for inverstment are identifield in segments where biotechnology is relevant for competitiveness. The country's institutional framework for supporting research and development (R&D) activites related to commercial biotechnology is analyzed focusing the PADCT experience.

El concepto y la práctica de la salud internacional en el Programa Takemi / The concept and practice of International healtah in the Takemi Program

El Programa Takemi en Salud Internacional se fundó en la Escuela de Salud Pública de Harvard en 1983 como un programa de investigación y capacitación al más alto nivel, dirigido a profesionales de la salud a mitad de su carrera e interesados en la distribución de recursos para la salud, particularmente en los países en desarrollo. Este ensayo describe los orígenes del Programa Takemi y presenta siete principios que subyacen en el concepto y la práctica de la salud internacional en él. Los principios son: énfasis en la investigación, orientación de las políticas, perspectiva interdisciplinaria, respeto mutuo, libertad individual, espíritu comunitario y desarrollo de la capacidad individual. Las implicaciones más generales de estos principios se proponen para los actuales esfuerzos por redefinir el concepto de salud internacional

The Takemi Program in International Health was established at the Harvard School of Public Health in 1983 as a research and advanced training program for mid-career health professionals concerned with the allocation of resources for health, especially in developing countries. This essay describes the origins of the Takemi Program and presents seven principles that underlie the concept and practice of international health in the Takemi Program. The principles are: research emphasis, policy orientation, interdisciplinary perspective; mutual respect, individual freedom, community spirit, and individual capacity building. The broader implications of these principles are suggested for current efforts to redefine the concept of international health.