Autonomic denervation, myocardial hypoperfusion and fibrosis may predict ventricular arrhythmia in the early stages of Chagas cardiomyopathy.

BACKGROUND: Sudden cardiac death (SCD) can be the first clinical event of Chagas heart disease (CHD). However, current guidelines contain no clear recommendation for early cardioverter-defibrillator implantation. Using imaging modalities, we evaluated associations among autonomic denervation, myocardial hypoperfusion, fibrosis and ventricular arrhythmia in CHD. METHODS AND RESULTS: Twenty-nine patients with CHD and preserved left ventricular function underwent 123I-metaiodobenzylguanidine (MIBG) scintigraphy, 99mTc-methoxyisobutylisonitrile (MIBI) myocardial perfusion and cardiac magnetic resonance imaging (MRI). They were divided into arrhythmic (≥ 6 ventricular premature complexes/h and/or non-sustained ventricular tachycardia on 24-hour Holter, n = 15) and non-arrhythmic (< 6 ventricular premature complexes/h and no ventricular tachycardia; n = 14) groups. The arrhythmic group had higher denervation scores from MIBG imaging (23.2 ± 18.7 vs 5.6 ± 4.9; P < .01), hypoperfusion scores from MIBI SPECT (4.7 ± 6.8 vs 0.29 ± 0.6: P = .02), innervation/perfusion mismatch scores (18.5 ± 17.5 vs 5.4 ± 4.8; P = .01) and fibrosis by late gadolinium enhancement on MRI (14.3% ± 13.5% vs 4.0% ± 2.9%; P = .04) than the non-arrhythmic group. CONCLUSION: These imaging parameters were associated with ventricular arrhythmia in early CHD and may enable risk stratification and the implementation of primary preventive strategies for SCD.

Antileishmanial activity and insights into the mechanisms of action of symmetric Au(I) benzyl and aryl-N-heterocyclic carbenes.

Leishmania amazonensis and L. braziliensis are the main etiological agents of the American Tegumentary Leishmaniasis (ATL). Taking into account the limited effectiveness and high toxicity of the current drug arsenal to treat ATL, novel options are urgently needed. Inspired by the fact that gold-based compounds are promising candidates for antileishmanial drugs, we studied the biological action of a systematic series of six (1)-(6) symmetric Au(I) benzyl and aryl-N-heterocyclic carbenes. All compounds were active at low micromolar concentrations with 50% effective concentrations ranging from 1.57 to 8.30 µM against Leishmania promastigotes. The mesityl derivative (3) proved to be the best candidate from this series, with a selectivity index ~13 against both species. The results suggest an effect of the steric and electronic parameters of the N-substituent in the activity. Intracellular infections were drastically reduced after 24h of (2)-(5) incubation in terms of infection rate and amastigote burden. Further investigations showed that our compounds induced significant parasites' morphological alterations and membrane permeability. Also, (3) and (6) were able to reduce the residual activity of three Leishmania recombinant cysteine proteases, known as possible targets for Au(I) complexes. Our promising results open the possibility of exploring gold complexes as leishmanicidal molecules to be further screened in in vivo models of infection.

Semysinthetic biflavonoid Morelloflavone-7,4',7″,3‴,4‴-penta-O-butanoyl is a more potent inhibitor of Proprotein Convertases Subtilisin/Kexin PC1/3 than Kex2 and Furin.

BACKGROUND: Garcinia brasiliensis is a species native to the Amazon forest. The white mucilaginous pulp is used in folk medicine as a wound healing agent and for peptic ulcer, urinary, and tumor disease treatments. The activity of the proprotein convertases (PCs) Subtilisin/Kex is associated with the development of viral, bacterial and fungal infections, osteoporosis, hyperglycemia, atherosclerosis, cardiovascular, neurodegenerative and neoplastic diseases. METHODS: Morelloflavone (BF1) and semisynthetic biflavonoid (BF2, 3 and 4) from Garcinia brasiliensis were tested as inhibitor of PCs Kex2, PC1/3 and Furin, and determined IC50, Ki, human proinflammatory cytokines secretion in Caco-2 cells, mechanism of inhibition, and performed molecular docking studies. RESULTS: Biflavonoids were more effective in the inhibition of neuroendocrine PC1/3 than mammalian Furin and fungal Kex2. BF1 presented a mixed inhibition mechanism for Kex2 and PC1, and competitive inhibition for Furin. BF4 has no good interaction with Kex2 and Furin since carboxypropyl groups results in steric hindrance to ligand-protein interactions. Carboxypropyl groups of BF4 promote steric hindrance with Kex2 and Furin, but effective in the affinity of PC1/3. BF4 was more efficient at inhibiting PCl/3 (IC50 = 1.13 µM and Ki = 0,59 µM, simple linear competitive mechanism of inhibition) than Kex2, Furin. Also, our results strongly suggested that BF4 also inhibits the endogenous cellular PC1/3 activity in Caco-2 cells, since PC1/3 inhibition by BF4 causes a large increase in IL-8 and IL-1ß secretion in Caco-2 cells. CONCLUSIONS: BF4 is a potent and selective inhibitor of PC1/3. GENERAL SIGNIFICANCE: BF4 is the best candidate for further clinical studies on inhibition of PC1/3.

Cysteine proteases as potential targets for anti-trypanosomatid drug discovery.

Leishmaniasis and trypanosomiasis are endemic neglected disease in South America and Africa and considered a significant public health problem, mainly in poor communities. The limitations of the current available therapeutic options, including the lack of specificity, relatively high toxicity, and the drug resistance acquiring, drive the constant search for new targets and therapeutic options. Advances in knowledge of parasite biology have revealed essential enzymes involved in the replication, survival, and pathogenicity of Leishmania and Trypanosoma species. In this scenario, cysteine proteases have drawn the attention of researchers and they are being proposed as promising targets for drug discovery of antiprotozoal drugs. In this systematic review, we will provide an update on drug discovery strategies targeting the cysteine proteases as potential targets for chemotherapy against protozoal neglected diseases.

Epidemiological profile of women with breast cancer in a public hospital in the Federal District of Brazil

Introduction: In Brazil, for the 2020­2022 triennium, the estimated incidence of breast cancer in women was 66,280/year. It is the most incident type of cancer in all Brazilian regions. Several risk factors are associated with the probable etiology of breast cancer, though the complexity of the disease makes it difficult to define its main cause. Objective: To investigate the prevalence of factors associated with breast cancer in an outpatient population at a public hospital in the Federal District, and to verify the epidemiological profile of this population to compare the data obtained with data published in the literature. Method: This is a descriptive crosssectional study, with 115 participants diagnosed with breast cancer undergoing treatment in a highly complex unit of oncology care in the Federal District between July and October 2020. Data collection was done through a questionnaire. The electronic medical record was consulted to complement the data. Results: The majority of women were brown, married, with an average age of 52. Hormone therapy was reported by 73.9%, early menarche by only 33.9% and late menopause by 25.2%. Most had children before the age of 30 and more than 80% breastfed. A family history of breast cancer was present in 30.4% of the sample. The consumption of alcoholic beverages was reported by more than half of the women, but the use of cigarettes was denied by the majority. The practice of some physical activity before the diagnosis of cancer was reported by 69.6%. Most were overweight or had some degree of obesity. Nonspecial invasive carcinoma was the most common type. Conclusions: This study showed that the main factors present in the sample were: advanced age, alcohol consumption, use of hormone therapy and overweight.

Associations between Cardiac Magnetic Resonance T1 Mapping Parameters and Ventricular Arrhythmia in Patients with Chagas Disease.

Chronic Chagas disease can progress to myocardial involvement with intense fibrosis, which may predispose patients to sudden cardiac death through ventricular arrhythmia. The associations of myocardial fibrosis detected by cardiac magnetic resonance (CMR) parameters with non-sustained ventricular tachycardia (NSVT) were evaluated. This cross-sectional study included patients in early stages of Chagas disease (n = 47) and a control group (n = 15). Patients underwent cardiac evaluation, including CMR examination. Myocardial fibrosis assessment by CMR with measurement of late gadolinium enhancement (LGE), native T1, and extracellular volume (ECV) was performed. There was an increase in myocardial fibrosis CMR parameters and ventricular arrhythmias among different stages of Chagas disease, combined with a decrease in the left ventricular ejection fraction (LVEF) by CMR and also in the right ventricular systolic function by S' wave on tissue Doppler. Fibrosis mass and ECV were associated with the Rassi score, ventricular extrasystole, and E/e' ratio in a logistic regression model adjusted for age and gender. The ECV maintained an association with the presence of NSVT, even after adjustments for fibrosis mass and LVEF assessed by CMR. The receiver-operating characteristic area under the curve for global ECV (0.85; 95% CI: 0.71-0.99) and NSVT was greater than that for fibrosis mass (0.75; 95% CI: 0.54-0.96), although this difference was not statistically significant. Extracellular volume could be an early marker of increased risk of ventricular arrhythmia in Chagas disease, presenting an independent association with NSVT in the initial stages of chronic Chagas cardiomyopathy, even after adjustment for fibrosis mass and LVEF.

Case Report: Malignant Ventricular Arrhythmias Mimicking Acute Coronary Syndrome in Chagas Disease.

Chronic Chagas heart disease has different clinical manifestations including arrhythmias, heart failure, and stroke. Chest pain is one of the most common symptoms and when associated with changes in the electrocardiogram, such as T-wave changes, electrically inactive areas, and segmental wall motion abnormalities, may lead to a misdiagnosis of acute coronary syndrome (ACS). Here, we describe two patients with Chagas heart disease and syncope due to sustained ventricular tachycardia who were misdiagnosed with ACS, and discuss the role of novel imaging modalities in the differential diagnosis and risk stratification.

Prevalence of colonisation by group B streptococcus in pregnant patients in Taguatinga, Federal District, Brazil: a cross-sectional study.

PROPOSE: Group B streptococcus is responsible for severe infections in neonates resulting from vertical transmission from pregnant women colonized in the anal, perineal or vaginal regions. The identification of colonized patients and use of intrapartum prophylaxis may reduce the risk of neonatal infection. METHODS: A cross-sectional study of pregnant women of gestational age between 35 and 37 weeks was conducted. Material was collected from patients for laboratory identification of group B streptococcus. Epidemiological data, including weight, height, body mass index, antibiotic use during pregnancy, pathologies during pregnancy (diabetes, hypertensive diseases, and hypothyroidism), twinning, and others, were also collected from patients. RESULTS: The sample consisted of 501 pregnant women, and the prevalence of group B streptococcus was 14%. The mean age was 29 years, and the mean BMI was 30.7. During pregnancy, 204 patients had some type of infection, and 201 used antibiotics. Ninety-five patients were diagnosed with gestational diabetes mellitus and 74 with some type of hypertensive disease. CONCLUSIONS: The prevalence of group B streptococcus observed did not differ from that observed in other studies. None of the factors studied can be considered as risk or protective factors for maternal colonization by group B streptococcus.

Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease / Relação entre o Escore de Cálcio e a Cintilografia Miocárdica no Diagnóstico da Doença Coronariana

Abstract Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy.

Resumo Metade dos pacientes com doença arterial coronariana apresenta, como primeiro sintoma, morte súbita ou infarto agudo, tornando o diagnóstico precoce fundamental. A cintilografia de perfusão miocárdica é utilizada, com frequência, na avaliação desses pacientes, porém, não detecta a doença sem restrição de fluxo, expõe o paciente a uma maior radiação e seu custo é alto. Por outro lado, com menor exposição radiológica, o escore de cálcio se correlaciona diretamente com a presença e a extensão da aterosclerose coronariana e, também, com o risco de eventos cardiovasculares. Apesar do escore de cálcio ser um método estabelecido e comprovado para a estratificação de pacientes assintomáticos, sua utilização ainda é reduzida nesse contexto uma vez que as diretrizes atuais são contraditórias em relação a sua utilização na doença sintomática. Essa revisão tem como objetivo identificar, nos pacientes em investigação para doença arterial coronariana, as principais evidências em relação ao uso do escore de cálcio associado à avaliação funcional com a cintilografia.

Relationship between Calcium Score and Myocardial Scintigraphy in the Diagnosis of Coronary Disease.

Half the patients with coronary artery disease present with sudden death - or acute infarction as first symptom, making early diagnosis pivotal. Myocardial perfusion scintigraphy is frequently used in the assessment of these patients, but it does not detect the disease without flow restriction, exposes the patient to high levels of radiation and is costly. On the other hand, with less radiological exposure, calcium score is directly correlated to the presence and extension of coronary atherosclerosis, and also to the risk of cardiovascular events. Even though calcium score is a tried-and-true method for stratification of asymptomatic patients, its use is still reduced in this context, since current guidelines are contradictory to its use on symptomatic diseases. The aim of this review is to identify, on patients under investigation for coronary artery disease, the main evidence of the use of calcium score associated with functional evaluation and scintigraphy.

Análise crítica do diagnóstico, tratamento e seguimento de pacientes com câncer de mama acompanhadas em serviço de Mastologia do Distrito Federal / Critical analysis of the diagnosis, treatment and follow-up of patients with breast cancer accompanied in a Mastology service of the Distrito Federal

Objetivo: Analisar o diagnóstico, tratamento e seguimento de pacientes com câncer de mama do Serviço de Mastologia do Hospital Regional de Taguatinga (HRT) e verificar a adequação às recomendações preconizadas e os aspectos epidemiológicos da população estudada. Métodos: Estudo observacional transversal realizado no período de 01 de janeiro de 2009 a 31 de dezembro de 2011. Coleta de dados em livros de registro de cirurgias, revisão de prontuários e entrevista. Análise estatística pelo programa IBM/SPSS v.18.0. Resultados: Das 201 pacientes com suspeição para câncer de mama, 116 permaneceram na amostra. 74% tiveram tempo de espera menor do que 30 dias para a primeira consulta no HRT. O resultado anatomopatológico com menos de 30 dias foi para 57%. A espera para tratamento complementar menor do que 30 dias foi para 38%, 41% entre 30 e 60 dias e 21% maior do que 60 dias. O intervalo entre as consultas foi de 3 e 6 meses para 66,4%. 35% das biópsias foram realizadas em serviço particular, e 7,89%, em serviço público. 69,44% das pacientes com câncer de mama tiveram acesso ao estudo imuno-histoquímico. 47,2% das pacientes com câncer de mama tiveram suporte de equipe multidisciplinar. 27,8% fizeram reconstrução mamária. 83,33% das pacientes com câncer de mama amamentaram. 58,3% não apresentavam história familiar positiva para câncer de mama. O tipo histológico mais frequente foi o carcinoma ductal invasivo (88,9%). Conclusão: Este trabalho se presta como instrumento gerador de mudanças em políticas públicas para estruturação de serviços prestadores de assistência às pacientes com câncer de mama a fim de impactar o prognóstico e a sobrevida.

Objective: To analyze the diagnosis, treatment and follow-up of patients with breast cancer of the Mastology service from Hospital Regional de Taguatinga (HRT) and check the adequacy to the recommendations and the epidemiological aspects of the study population. Methods: Cross-sectional observational study conducted in the period of 01/01/2009 to 31/12/2011. Data collection in books of record of surgeries, review of medical records and interview. Statistical analysis by the program IBM/SPSS v. 18.0. Results: Between 201 patients with suspicion for breast cancer, 116 remained in the sample. 74% had waiting time less than 30 days for the first consultation in HRT. The result of pathologic with less than 30 days was 57%. The waiting for additional treatment less than 30 days was 38%, 41% between 30 and 60 days and 21% greater than 60 days. The interval between the medical consultations was 66.4% between 3 and 6 months. 35% of biopsies were performed in particular service and 7.89%, public service. 69.44% of patients with breast cancer have had access to immunohistochemical study. 47.2% of patients with breast cancer have had support of the multidisciplinary team. 27.8% have had the breast reconstruction. 83.33% of patients with breast cancer breastfed. 58.3% hadn't a positive family history for breast cancer. The most common histological type was invasive ductal carcinoma (88.9%). Conclusion: This work aims to provoke changes in public policies for structuring services providers of assistance to patients with breast cancer to impact in terms of prognosis and survival.

Análise crítica do diagnóstico, tratamento e seguimento de pacientes com Câncer de Mama acompanhadas em serviço de Mastologia do Distrito Federal / Critical analysis of the diagnosis, treatment and follow-up of patients withbreast cancer accompanied in a Mastology service of the Distrito Federal

Objetivo: Analisar o diagnóstico, tratamento e seguimento de pacientes com câncer de mama do serviço de Mastologia do Hospital Regional de Taguatinga (HRT) e verificar a adequação às recomendações preconizadas e os aspectos epidemiológicos da população estudada. Métodos: Estudo observacional transversal realizado no período de 01/01/2009 a 31/12/2011. Coleta de dados em livros de registro de cirurgias, revisão de prontuários e entrevista. Análise estatística pelo programa IBM/SPSS v.18.0. Resultados: Das 201 pacientes com suspeição para câncer de mama, 116 permaneceram na amostra. 74% tiveram tempo de espera menor de 30 dias para a primeira consulta no HRT. O resultado de anatomopatológico com menos de 30 dias foi para 57%. A espera para tratamento complementar menor de 30 dias foi para 38%, 41% entre 30 e 60 dias e 21% maior que 60 dias. O intervalo entre as consultas foi de 3 e 6 meses para 66,4%. 35% das biópsias foram realizadas em serviço particular e 7,89%, público. 69,44% das pacientes com Câncer de mama tiveram acesso ao estudo imunohistoquímico. 47,2% das pacientes com Câncer de mama tiveram suporte de equipe multidisciplinar. 27,8% fizeram reconstrução mamária. 83,33% das pacientes com Câncer de mama amamentaram. 58,3% não apresentavam História Familiar positiva para Câncer de mama. O tipo histológico mais frequente foi o Carcinoma Ductal Invasivo (88,9%). Conclusão: Esse trabalho se presta como instrumento gerador de mudanças em políticas públicas para estruturação de serviços prestadores de assistência às pacientes com Câncer de mama a fim de impactar o prognóstico e a sobrevida.

Objective: To analyze the diagnosis, treatment and follow-up of patients with breast cancer of the Mastology service from Hospital Regional de Taguatinga - HRT and check the adequacy to the recommendations and the epidemiological aspects of the study population. Methods: Cross-sectional Observational study conducted in the period of 01/01/2009 to 31 /12/2011 . Data Collection in books of record of surgeries, review of medical records and interview. Statistical Analysis by the program IBM/SPSS v. 18.0. Results: Between 201 patients with suspicion for breast cancer, 116 remained in the sample. 74% had waiting time less than 30 days for the first consultation in HRT. The result of pathologic with less than 30 days was 57%. The waiting for additional treatment less than 30 days was 38 %, 41% between 30 and 60 days and 21% greater than 60 days. The interval between the medical consultations was 66.4 % between 3 and 6 months. 35% of biopsies were performed in particular service and 7.89%, public. 69.44% of patients with breast cancer have had access to immunohistochemical study. 47.2% of patients with breast cancer have had support of the multidisciplinary team. 27.8% have had the breast reconstruction. 83.33% of patients with breast cancer breastfed. 58.3% hadn?t a positive family history for breast cancer. The most common histological type was Invasive Ductal Carcinoma (88.9%). Conclusions: This work aims to provoke changes in public policies for structuring services providers of assistance to patients with breast cancer to impact in terms of prognosis and survival.

Influência da mobilização precoce na força muscular periférica e respiratória em pacientes críticos / Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients

OBJETIVO: Avaliar os efeitos de um protocolo de mobilização precoce na musculatura periférica e respiratória de pacientes críticos. MÉTODOS: Ensaio clínico, controlado e randomizado realizado em 59 pacientes de ambos os gêneros, em ventilação mecânica. Os pacientes foram divididos em grupo fisioterapia convencional - grupo controle, n=14, que realizou a fisioterapia do setor, e grupo mobilização precoce, n=14, que recebeu um protocolo sistemático de mobilização precoce. A força muscular periférica foi avaliada por meio do Medical Research Council e a força muscular respiratória (dada por pressão inspiratória máxima e pressão expiratória máxima) foi mensurada pelo manovacuômetro com uma válvula unidirecional. A mobilização precoce sistemática foi realizada em cinco níveis. RESULTADOS: Para os valores de pressão inspiratória máxima e do Medical Research Council, foram encontrados ganhos significativos no grupo mobilização precoce. Entretanto, a pressão expiratória máxima e o tempo de ventilação mecânica (dias), tempo de internamento na unidade de terapia intensiva (dias), e tempo de internamento hospitalar (dias) não apresentaram significância estatística. CONCLUSÃO: Houve ganho da força muscular inspiratória e periférica para a população estudada quando submetida a um protocolo de mobilização precoce e sistematizado.

OBJECTIVE:To evaluate the effects of an early mobilization protocol on respiratory and peripheral muscles in critically ill patients. METHODS: A randomized controlled clinical trial was conducted with 59 male and female patients on mechanical ventilation. The patients were divided into a conventional physical therapy group (control group, n=14) that received the sector's standard physical therapy program and an early mobilization group (n=14) that received a systematic early mobilization protocol. Peripheral muscle strength was assessed with the Medical Research Council score, and respiratory muscle strength (determined by the maximal inspiratory and expiratory pressures) was measured using a vacuum manometer with a unidirectional valve. Systematic early mobilization was performed on five levels. RESULTS: Significant increases were observed for values for maximal inspiratory pressure and the Medical Research Council score in the early mobilization group. However, no statistically significant improvement was observed for maximal expiratory pressure or MV duration (days), length of stay in the intensive care unit (days), and length of hospital stay (days). CONCLUSION: The early mobilization group showed gains in inspiratory and peripheral muscle strength.

Influence of early mobilization on respiratory and peripheral muscle strength in critically ill patients. / Influência da mobilização precoce na força muscular periférica e respiratória em pacientes críticos.

OBJECTIVE: To evaluate the effects of an early mobilization protocol on respiratory and peripheral muscles in critically ill patients. METHODS: A randomized controlled clinical trial was conducted with 59 male and female patients on mechanical ventilation. The patients were divided into a conventional physical therapy group (control group, n=14) that received the sector's standard physical therapy program and an early mobilization group (n=14) that received a systematic early mobilization protocol. Peripheral muscle strength was assessed with the Medical Research Council score, and respiratory muscle strength (determined by the maximal inspiratory and expiratory pressures) was measured using a vacuum manometer with a unidirectional valve. Systematic early mobilization was performed on five levels. RESULTS: Significant increases were observed for values for maximal inspiratory pressure and the Medical Research Council score in the early mobilization group. However, no statistically significant improvement was observed for maximal expiratory pressure or MV duration (days), length of stay in the intensive care unit (days), and length of hospital stay (days). CONCLUSION: The early mobilization group showed gains in inspiratory and peripheral muscle strength.

Medicamentos anti-hipertensivos na gestação e puerpério / Antihypertensive medications in pregnancy and puerperium

A toxemia gravídica é uma doença multissistêmica, que ocorre principalmente no final da gravidez, caracterizada por manifestações clínicascomo hipertensão, edema e proteinúria. É a complicação médica maiscomum da gravidez e a principal causa de morbimortlidade materna eperinatal. O objetivo deste artigo é rever os principais aspectos concernentesao uso de agentes antihipertensivosna gravidez e puerpério. Osdados foram coletados no Pubmed e Bireme, período de 2006 a 2010utilizando-se os descritores “anti-hipertensivo e gravidez” e “antihypertensive and pregnancy”. O conhecimento da hipertensão durante a gestação e sua terapêutica está em evolução; a busca por medicações quepossam proteger a mãe dos perigos agudos e garantir um recém nascidosaudável deve ser o foco. Faltam evidências sobre a melhor terapia aser adotada, período de início, duração e resultados. Apesar do avançofarmacológico, ainda não há fármacos totalmente isentos de comprometimentopara a mãe e ao concepto.

Pregnancy toxemia is a multisystemic disease, which occurs mainly atthe end of pregnancy, characterized by clinical manifestations such ashypertension, edema and proteinuria. It is the most commonly occurredmedical complication in pregnancies and the main cause for perinataland maternal morbimortalities. The purpose of this article is to reviewthe main aspects concerning the use of antihypertensive agents duringpregnancy and puerperium. The data has been collected from Pubmedand Bireme, from 2006 to 2010 using the words “anti-hipertensivo egravidez” and “antihypertensive and pregnancy”. The knowledge regardinghypertension during pregnancy and its therapy is evolving; the searchfor medication that could protect the mother from acute dangers and to ensure a healthy newborn must be the focus. Evidence is still lacking regarding the best therapy, beginning period, duration and results. In spite of the pharmacological advances, there are still no drugs completely exempt of compromises to the mother and the conceptus.

Aging and food source effects on mandibular stylets teeth wear of phytophagous stink bug (Heteroptera: Pentatomidae)

Studies were conducted to test the effect of age and food sources on wear of the mandibular teeth of the phytophagous pentatomid, Euschistus heros (F.). The total length (µm) of the area bearing the mandibular teeth, the length of the 1st tooth, and the height of the 2nd tooth for teneral (< 1 day-old) adults were significantly greater than that of adults fed on natural [green bean, Phaseolus vulgaris pods, raw shelled peanuts, Arachis hypogaea, and mature soybean, Glycine max seeds] for 30 or 60 days. Adults fed on artificial dry diet showed, in general, similar results to those of teneral adults. Force (Newtons) required penetrating the natural foods was significantly greater than that required penetrating the artificial diet. The greater hardness of the natural foods caused increased mandibular serration wear.

Uso de medicamentos em atenção básica na Secretaria de Estado de Saúde–DF / Medication use in primary care at the health system of the Federal District in Brazil

Nos últimos anos o gasto farmacêutico vem se tornando uma ameaça à sustentabilidade dos sistemas públicos de saúde em muitos países. O uso irracional de medicamentos induz ao desperdício, gera desigualdades de acesso e pode modifi car, de forma negativa, a qualidade de vida das pessoas.

Over the last years the pharmaceutical expenditure has become a menace to the sustainability of health public systems in several countries. The irrational use of medication induces waste, generates access inequalities e may modify, in a negative way, population’s quality of life.

Aging and food source effects on mandibular stylets teeth wear of phytophagous stink bug (Heteroptera: Pentatomidae).

Studies were conducted to test the effect of age and food sources on wear of the mandibular teeth of the phytophagous pentatomid, Euschistus heros (F.). The total length (µm) of the area bearing the mandibular teeth, the length of the 1st tooth, and the height of the 2nd tooth for teneral (< 1 day-old) adults were significantly greater than that of adults fed on natural [green bean, Phaseolus vulgaris pods, raw shelled peanuts, Arachis hypogaea, and mature soybean, Glycine max seeds] for 30 or 60 days. Adults fed on artificial dry diet showed, in general, similar results to those of teneral adults. Force (Newtons) required penetrating the natural foods was significantly greater than that required penetrating the artificial diet. The greater hardness of the natural foods caused increased mandibular serration wear.

Condicionalidades em saúde e alocação orçamentária no programa Bolsa Família / Health condicionalities and budget allocation in Family Welfare Funding

A associação entre renda, saúde e desigualdades, vem sendo estudada há bastante tempo. Atualmente, tem se destacado o enfoque dos Determinantes Sociais de Saúde, que se baseia no pressuposto de que as condições de vida e trabalho dos indivíduos e de grupos da população estão relacionadas com sua situação de saúde. O objetivo desse artigo foi comparar a alocação orçamentária do programa Bolsa Família, que estabelece condicionalidades de competência da área da saúde, com os programas Atenção Social Básica, Atenção Básica em Saúde e Assistência Ambulatorial e Hospitalar Especializada, de responsabilidade dos Ministérios da Saúde e do Desenvolvimento Social. Foi abrangido o período 2006/2009 e os dados se originam do Plano Plurianaual 2008/2011 e do Anexo I da Lei 11.768/2008. Concluiu-se que, dentre os quatro programas, o Programa Bolsa Família teve a menor alocação orçamentária, nos quatro anos considerados.

The connection between income, health and inequalities has been studied for quite some time and, these days, it is highlighted in the Public Health area by the approach of the Social Determinants of Health, which study covers those relations based on the assumption that life and work conditions of individuals and population groups are related to their health status. This article has compared one of the aspects of income transference program, Bolsa Família (Family Welfare Funding), parting from the criteria of budget allocation percentage and follow-up of the circumstances related to health to the programs of Social Basic Attention, Health Primary Care, Ambulatory and Hospital Care, supported by the Health Ministry and Social Development Ministry. It was considered the years from 2006 to 2009. The investigation was made in databases from Brazilian government. Four different programs were evaluated and the Bolsa Família has lowest cost in studied years.