Peptidomics of Zebrafish Brain in a 6-OHDA-Induced Neurodegeneration Model.

Bioactive peptides such as neuropeptides and peptide hormones are largely understood in their involvement in a variety of physiologic systems. In addition to the neuropeptides produced and processed by the classic secretory pathway, intracellular peptides (InPeps) have shown biological activity in studies involving different organisms. A model that has become attractive in many research fields is the zebrafish (Danio rerio), which has allowed correlating behavioral responses or physiological processes with underlying molecular pathways or signaling cascades, improving the understanding of homeostasis mechanisms of the central nervous system, as well as pathological processes such as neurodegenerative diseases. Here, we provide a detailed description of the protocol of treatment with 6-OHDA, which mimics some features of Parkinson's Disease, as well as the validation of the treatment by evaluation of the locomotor activity and the protocol of peptide extraction followed by isotopic labeling to peptide relative quantitation by mass spectrometry.

Artificial intelligence applied to analyzes during the pandemic: COVID-19 beds occupancy in the state of Rio Grande do Norte, Brazil.

The COVID-19 pandemic is already considered one of the biggest global health crises. In Rio Grande do Norte, a Brazilian state, the RegulaRN platform was the health information system used to regulate beds for patients with COVID-19. This article explored machine learning and deep learning techniques with RegulaRN data in order to identify the best models and parameters to predict the outcome of a hospitalized patient. A total of 25,366 bed regulations for COVID-19 patients were analyzed. The data analyzed comes from the RegulaRN Platform database from April 2020 to August 2022. From these data, the nine most pertinent characteristics were selected from the twenty available, and blank or inconclusive data were excluded. This was followed by the following steps: data pre-processing, database balancing, training, and test. The results showed better performance in terms of accuracy (84.01%), precision (79.57%), and F1-score (81.00%) for the Multilayer Perceptron model with Stochastic Gradient Descent optimizer. The best results for recall (84.67%), specificity (84.67%), and ROC-AUC (91.6%) were achieved by Root Mean Squared Propagation. This study compared different computational methods of machine and deep learning whose objective was to classify bed regulation data for patients with COVID-19 from the RegulaRN Platform. The results have made it possible to identify the best model to help health professionals during the process of regulating beds for patients with COVID-19. The scientific findings of this article demonstrate that the computational methods used applied through a digital health solution, can assist in the decision-making of medical regulators and government institutions in situations of public health crisis.

Retrospective Study of 57 Patients Submitted to Dorsal Root Entry Zone Lesioning by Radiofrequency for Brachial Plexus Avulsion Pain.

BACKGROUND: Dorsal root entry zone (DREZ) lesioning may be used to treat neuropathic pain in patients with traumatic brachial plexus injuries. The clinical outcome after surgery is variable in the medical literature. We aimed to report the surgical outcome after DREZ lesioning by radiofrequency and to analyze prognostic factors such as the presence of a spinal cord injury identified before surgery. METHODS: We conducted a retrospective study that included 57 patients who had experienced traumatic brachial plexus injuries and exhibited neuropathic pain that did not respond to conservative treatment methods. They were submitted to DREZ lesioning. We defined the inclusion and exclusion criteria, collected sociodemographic and clinical characteristics, and identified and classified spinal cord lesions based on magnetic resonance imaging. We applied statistical tests to evaluate the association between pain intensity after surgery and the radiological profile and sociodemographic characteristics. RESULTS: Immediately after surgery, the pain outcome was considered good or excellent in 50 patients (89.28%). At the last follow-up, it was good or excellent in 39 patients (68.43%). There was no association (P > 0.05) between the pain outcome and the variables analyzed (time interval between trauma and DREZ lesioning, presence of spinal cord injury, age, the number of avulsed roots, and the type of pain). CONCLUSIONS: DREZ lesioning using radiofrequency represents a significant therapeutic approach for managing neuropathic pain after a traumatic brachial plexus injury. Importantly, we found that the presence of a spinal cord injury is not associated with the surgical outcome.

Ultrasonography findings in knee osteoarthritis: a prospective observational cross-sectional study of 100 patients.

Worldwide, knee osteoarthritis (KOA) accounts for 2.2% of total years lived with disability. There is a low correlation between joint tissue damage and pain intensity. Periarticular structures may be involved and cannot be identified in X-rays. To describe the main ultrasonography (USG) changes in symptomatic patients with primary KOA; to correlate the number of USG findings with KOA severity assessed by Kellgren and Lawrence (K&L) radiological scores, with pain intensity measured by a visual analogue scale (VAS) and with functioning scores assessed with the Timed up and go test (TUG) and Western Ontario and McMaster Universities (WOMAC) questionnaire. 100 patients with primary symptomatic KOA were assessed with X-ray and USG. Quantitative and qualitative analyses were evaluated in a systematic manner. The most frequent findings were joint effusion, pes anserinus bursitis, quadriceps tendon enthesopathy, popliteal cyst, iliotibial band tendinitis and patellar tendinitis. Pearson's correlation analysis demonstrated a significant moderate positive association between VAS scores and the number of USG findings (r = 0.36; p < 0.0001). The number of USG findings was different between K&L grades I and III (p = 0.041), I and IV (p < 0.001), and II and IV (p = 0.001, analysis of variance with Bonferroni correction). There was significant association between number of USG findings and TUG (r = 0.18; p = 0.014) and WOMAC scores for pain (r = 0.16; p < 0.029) and physical function domains (r = 0.16; p < 0.028). The most frequent USG finding was joint effusion. Periarticular structures should be explored as potential sources of pain and disability.

Acesso borboleta para tratamento cirúrgico de fratura de osso frontal: relato de caso / Butterfly wing-type of incision for surgical treatment of front bone fracture: case report

Quando comparado aos demais ossos da face, o osso frontal é raramente acometido por fraturas, sendo essa menor ocorrência relacionada à sua maior resistência. Nosso estudo relata um caso clínico de paciente do gênero masculino, 27 anos, vítima de acidente motociclístico, encaminhado ao Hospital da Restauração - Governador Paulo Guerra com fraturas complexas do terço superior e médio da face. Dessa forma, o objetivo deste estudo é demonstrar a resolução cirúrgica dessas fraturas de face, por meio da utilização do acesso supraciliar com incisão em "asa de borboleta" e infraorbital possibilitando a redução e fixação. Todas as abordagens cirúrgicas para redução do osso frontal têm como objetivo promover respostas estéticas, restaurar a função e prevenir complicações cirúrgicas, não dependendo apenas da gravidade da fratura, mas também, do paciente e da preferência do cirurgião. O acesso supraciliar em "asa de borboleta" é feito a partir de uma incisão linear na região da glabela, com extensões laterais para as sobrancelhas. Dessa maneira ele garante boa visualização e exposição do campo operatório com acesso direto e simples. Por fim, o acesso borboleta mostrou-se uma boa opção de abordagem para fraturas da parede anterior do osso frontal, apesar de demonstrar desvantagem estética na ponte nasal segundo a literatura, no presente caso essa filosofia não é compartilhada, já que a "camuflagem" da incisão linear na ruga nasal mostrou-se esteticamente satisfatória... (AU)

Comparative Analysis of the Proteomic Profile of the Dental Pulp in Different Conditions. A Pilot Study.

This study aimed to quantitatively compare the difference in protein expression in the progression of pulp pathogenesis, as well as to describe the biological functions of proteins identified in pulp tissue. Samples were obtained from six patients treated at the Araçatuba School of Dentistry and were divided into three groups: normal pulp - from teeth extracted for orthodontic indication; inflamed pulp and necrotic pulp - from patients diagnosed with irreversible pulpitis and chronic apical periodontitis, respectively. After previous proteomic preparation, dental pulp samples were processed for label-free quantitative proteomic analysis in a nanoACQUITY UPLC-Xevo QTof MS system. The difference in expression between the groups was calculated using the Protein Lynx Global Service software using the Monte Carlo algorithm. A total of 465 human proteins were identified in all groups. The most expressed proteins in the inflamed pulp group in relation to the normal pulp group were hemoglobin, peroxiredoxins and immunoglobulins, whereas the less expressed were the tubulins. Expression levels of albumins, immunoglobulins and alpha-2-macroglobulin were higher in the necrotic pulp group than in the inflamed pulp group. As for the qualitative analysis, the most prevalent protein functions in the normal pulp group were metabolic and energetic pathways; in the inflamed pulp group: cellular communication and signal transduction; and regulation and repair of DNA/RNA, while in the necrotic pulp group proteins were associated with the immune response. Thus, proteomic analysis showed quantitative and qualitative differences in protein expression in different types of pulp conditions.

Comparative analysis of the proteomic profile of the dental pulp in different conditions. a pilot study

Abstract This study aimed to quantitatively compare the difference in protein expression in the progression of pulp pathogenesis, as well as to describe the biological functions of proteins identified in pulp tissue. Samples were obtained from six patients treated at the Araçatuba School of Dentistry and were divided into three groups: normal pulp - from teeth extracted for orthodontic indication; inflamed pulp and necrotic pulp - from patients diagnosed with irreversible pulpitis and chronic apical periodontitis, respectively. After previous proteomic preparation, dental pulp samples were processed for label-free quantitative proteomic analysis in a nanoACQUITY UPLC-Xevo QTof MS system. The difference in expression between the groups was calculated using the Protein Lynx Global Service software using the Monte Carlo algorithm. A total of 465 human proteins were identified in all groups. The most expressed proteins in the inflamed pulp group in relation to the normal pulp group were hemoglobin, peroxiredoxins and immunoglobulins, whereas the less expressed were the tubulins. Expression levels of albumins, immunoglobulins and alpha-2-macroglobulin were higher in the necrotic pulp group than in the inflamed pulp group. As for the qualitative analysis, the most prevalent protein functions in the normal pulp group were metabolic and energetic pathways; in the inflamed pulp group: cellular communication and signal transduction; and regulation and repair of DNA/RNA, while in the necrotic pulp group proteins were associated with the immune response. Thus, proteomic analysis showed quantitative and qualitative differences in protein expression in different types of pulp conditions.

Resumo Este estudo teve como objetivo comparar quantitativamente a diferença da expressão de proteínas na progressão da patogênese pulpar, bem como descrever as funções biológicas das proteínas identificadas no tecido pulpar. As amostras foram obtidas de seis pacientes atendidos na Faculdade de Odontologia de Araçatuba e divididas em três grupos: polpa normal - dentes extraídos por indicação ortodôntica; polpa inflamada e polpa necrótica - pacientes diagnosticados com pulpite irreversível e periodontite apical crônica, respectivamente. Após o preparo proteômico prévio, as amostras de polpa dentária foram processadas para análise proteômica quantitativa livre de marcadores em um sistema nanoACQUITY UPLC-Xevo QTof MS. A diferença de expressão entre os grupos foi calculada usando o software Protein Lynx Global Service através do algoritmo de Monte Carlo. Um total de 465 proteínas humanas foram identificadas em todos os grupos. As proteínas mais expressas no grupo polpa inflamada em relação ao grupo polpa normal foram hemoglobinas, peroxirredoxinas e imunoglobulinas, enquanto as menos expressas foram as tubulinas. Os níveis de expressão de albuminas, imunoglobulinas e alfa-2-macroglobulina foram maiores no grupo polpa necrótica do que no grupo de polpa inflamada. Quanto à análise qualitativa, as funções proteicas mais prevalentes no grupo polpa normal foram vias metabólicas e energéticas; no grupo polpa inflamada: comunicação celular e transdução de sinal; e regulação e reparo de DNA / RNA, enquanto no grupo polpa necrótica as proteínas foram associadas à resposta imune. Assim, a análise proteômica mostrou diferenças quantitativas e qualitativas na expressão de proteínas em diferentes tipos de condições pulpares.

Effects of strength training based on velocity versus traditional training on muscle mass, neuromuscular activation, and indicators of maximal power and strength in girls soccer players

This study examines the effects of two strength training (ST) programs, one based on mean propulsive velocity (MPV) and another under the traditional method, the % one-repetition maximum (1RM), on neuromuscular performance and muscle composition in girls who play soccer. Fifty players with an average age of 13.6 ± 1.2 years participated in the study and were randomly assigned into three groups: a maximal execution velocity training group (VG, n = 15), a maximal strength group (RMG, n = 13), and a control group (CG, n = 18). The study was developed for a period of twelve weeks during regular team training to prepare for the season. The VG and RMG groups performed additional strength or muscle power training three times a week, including movements of full squat and pedaling on a cycle ergometer. The two types of training groups and the control group exhibited significant gains. However, the greatest increases were achieved with VG training, with significant increases (p < 0.000) in maximal strength, (p < 0.000) squat power, (p < 0.000) velocity over 30 m, (p < 0.000) cycle ergometer power, and (p < 0.008) lower limb muscle mass. Statistically significant differences were observed between VG and RMG in countermovement jump (CMJ) (p < 0.008) and squat power (p < 0.01) tests, between VG and CG in CMJ (p < 0.01), squat power (p < 0.000), and maximal squat strength (p < 0.000), and between RMG and CG in maximal squat strength (p < 0.000) only. These findings might indicate that high-velocity ST can be performed simultaneously with regular training to improve the explosive actions of soccer players

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Perfil proteômico de bactérias presentes em canais radiculares de dentes com periodontite apical sintomática ou assintomática / Proteomic profile of bacteria present in root canals of teeth with symptomatic or asymptomatic apical periodontitis

As infecções endodônticas são causadas por uma comunidade multiespécie de bactérias. Com os métodos de identificação microbiológica e quantificação de endotoxinas, é difícil inferir a fisiologia, a função e a patogenicidade microbiana. Assim, a análise proteômica é uma técnica que pode revolucionar o estudo da patogênese das infecções endodônticas. O presente estudo tem por objetivo analisar o perfil proteômico de infecções endodônticas relacionadas a dentes com periodontite apical sintomática ou assintomática utilizando cromatografia líquida associada à espectrometria de Massas. A análise deste perfil proteômico visa a proporcionar a compreensão dos aspectos ecológicos e patogênicos do comportamento de comunidades bacterianas endodônticas através da identificação de proteínas expressas no referido ambiente no momento da coleta e a determinação da função dessas proteínas. Foram coletadas amostras de 18 pacientes encaminhados para tratamento de canal radicular ou tratamento de emergência na Faculdade de Odontologia de Araçatuba FOA ­ UNESP. Foram incluídos dentes com infecção endodôntica primária, sintomáticos ou assintomáticos. A identificação dos peptídeos foi feita num sistema nanoACQUITY UPLC-Xevo QTof MS system (Waters), a identificação das proteínas foi obtida utilizando o software Protein Lynx Global Server (PLGS) versão 3.0, utilizando o banco de dados de proteínas UniProtKB. A diferença de expressão entre os grupos foi obtida através do mesmo software, considerando-se p<0,05 para as proteínas subreguladas e 1-p>0,95 para as proteínas suprareguladas. Foram identificados um total de 2181 números de acessos entre fragmentos, isoformas e proteínas completas humana e 51 proteínas bacterianas e ambas foram classificadas quanto a sua função biológica, em relação às proteínas exclusivas de cada grupo, 347 proteínas foram identificadas no grupo sintomático. As funções biológicas mais prevalentes foram comunicação celular e transdução de sinais, seguidas pela resposta imune, observou-se diversas proteínas exclusivamente expressas no grupo sintomático, indicando a influência direta da periodontite sintomática na resposta do hospedeiro(AU)

Endodontic infections are caused by a multispecies community of bacteria. With microbiological identification methods and endotoxin quantification, it is difficult to infer physiology, function and microbial pathogenicity. Thus, proteomic analysis is a technique that can revolutionize the study of the pathogenesis of endodontic infections. The present study aims to analyze the proteomic profile of endodontic infections related to teeth with symptomatic or asymptomatic apical periodontitis using liquid chromatography associated with mass spectrometry. The analysis of this proteomic profile aims to provide an understanding of the ecological and pathogenic aspects of the behavior of endodontic bacterial communities by identifying proteins expressed in the said environment at the time of collection and determining the function of these proteins. Samples were collected from 18 patients referred for root canal treatment or emergency treatment at the School of Dentistry of Araçatuba FOA - UNESP. Teeth with primary endodontic infection, symptomatic or asymptomatic were included. The identification of peptides was made in a nanoACQUITY UPLC-Xevo QTof MS system (Waters) system, the identification of proteins was obtained using protein lynx global server (PLGS) software version 3.0, using the UniProtKB protein database. The difference in expression between the groups was obtained through the same software, considering p<0.05 for subregulated proteins and 1-p>0.95 for the superregulated proteins. A total of 2,181 access numbers were identified between human fragments, isoforms and complete proteins and 51 bacterial proteins, and both were classified as their biological function, in relation to the exclusive proteins of each group, 347 proteins were identified in the symptomatic group. The most prevalent biological functions were cellular communication and signal transduction, followed by the immune response, and several proteins were observed exclusively expressed in the symptomatic group, indicating the direct influence of symptomatic periodontitis on the host response(AU)

Fluoride varnishes containing sodium trimetaphosphate reduce enamel demineralization in vitro.

OBJECTIVE: This study evaluated the effects of fluoride varnishes containing sodium trimetaphosphate (TMP) on bovine enamel demineralization in vitro. MATERIAL AND METHODS: Enamel bovine discs were randomly assigned into six groups (n = 20/group): placebo, 2.5% NaF, 2.5% NaF/5% TMP, 5% NaF, 5% NaF/5% TMP, and a commercial formulation (Duraphat, 5% NaF). Varnishes were applied on all enamel discs and kept for 6 h. Loosely and firmly bound fluoride formed on/in enamel after treatment were analyzed in 10 discs from each group. The other 10 discs were subjected to a pH-cycling regimen for 7 days, and analyzed for surface (SH) and cross-sectional hardness (ΔKHN), as well as for loosely and firmly bound fluoride in/on enamel. Data were analyzed by analysis of variance (ANOVA) followed by Student-Newman-Keuls' test (p < .05). RESULTS: The lowest SH change and ΔKHN were observed for the 5%NaF/5%TMP varnish, which was significantly different from all the other groups. Both fluoridated varnishes containing TMP promoted significantly lower SH change and ΔKHN when compared with their counterparts without TMP. Loosely and firmly bound fluoride was significantly lower in groups treated with varnishes containing TMP. CONCLUSION: TMP and fluoride added to varnishes have a synergistic effect against enamel demineralization in vitro.

[Abdominal re-operations: Prevalence in elective and emergency surgery]. / Reintervenciones abdominales: prevalencia en cirugías electivas y urgencias.

BACKGROUND: The word «re-laparotomy¼ defines the surgical procedure in which the abdominal cavity is re-explored to resolve the complications of the disease or initial surgery. OBJECTIVE: To determine the prevalence of abdominal re-operations in patients undergoing elective and emergency surgery in the General Hospital of Matamoros. MATERIAL AND METHODS: A retrospective, observational, longitudinal study was conducted by reviewing the medical records of patients with a re-operation from January 2014 to January 2015, statistically analysing the variables: Age, sex, type of surgery, complications, and postoperative course. RESULTS: A total of 21 re-operated patients were found, the majority of whom were women (52.38%). The cases were more common in ages between 70 and 79 years old, in both sexes. Almost two-thirds (61.91%) of re-operations were after an emergency surgery. The residual abscess (23.8%) and evisceration (23.8%) were the most frequent indications for re-intervention. There were postoperative complications in 23.8%, with wound dehiscence (60%) being the most frequent. There was an 85.6% survival rate after the re-intervention. CONCLUSIONS: The study showed a low incidence of re-interventions and a low mortality. There is evidence of major occurrence of abdominal re-interventions in advanced ages, in female patients, and emergency surgery.

Influence of the Amount of Dentifrice and Fluoride Concentrations on Salivary Fluoride Levels in Children.

PURPOSE: This study evaluated fluoride (F) concentrations in saliva of children after brushing with dentifrices containing different F concentrations (zero, 550, and 1,100 ppm F) in different quantities (full bristles, transversal technique, and pea-sized). METHODS: Eight- to 10-year-old volunteers (N=24) were randomly assigned into nine experimental groups (dentifrice type versus amounts) following a double-blind, crossover protocol. After a one-week washout period (use of placebo toothpaste), stimulated saliva was collected prior to toothbrushing (baseline) and at five, 15, 30, 60, and 120 minutes after toothbrushing with one of the possible combinations. Centrifuged saliva was used for F analysis after buffering with TISAB III. Data were submitted to repeated-measures ANOVA followed by Student-Newman-Keuls' test (P<0.05). RESULTS: Salivary F peaked at five minutes after brushing, decreasing exponentially afterward. A clear dose-response relationship was seen between F concentration/amount of dentifrice applied and the mean area under the curve (AUC) of salivary F concentrations (P<0.001). The low-fluoride toothpaste applied using transversal technique or full bristles led to a significantly higher AUC than the conventional toothpaste using a pea-sized amount. CONCLUSIONS: Brushing with a low-fluoride toothpaste applied using the transversal technique delivers more fluoride to saliva compared to a conventional toothpaste in a pea-sized amount.

Fiocruz as an actor in Brazilian foreign relations in the context of the Community of Portuguese-Speaking Countries: an untold story.

Brazilian foreign policy paradigms and changes in the global scenario since the Cold War created conditions for stronger ties between Brazil and Portuguese-speaking African countries. Recently, Brazil took the lead in regional integration processes and in South-South cooperation initiatives. These strategies and Fiocruz's acknowledged technical expertise resulted in its direct involvement in Brazilian foreign public health policy in the Community of Portuguese-Speaking Countries. Fiocruz developed cooperation projects in various areas, sharing its know-how and best practices in the most critical fields in partner countries, consolidating "public health framework cooperation" and contributing to diversifying Brazil's partners and promoting Brazil as a global actor.

Fiocruz as an actor in Brazilian foreign relations in the context of the Community of Portuguese-Speaking Countries: an untold story / A Fiocruz como ator da política externa brasileira no contexto da Comunidade dos Países de Língua Portuguesa: uma história revelada

Brazilian foreign policy paradigms and changes in the global scenario since the Cold War created conditions for stronger ties between Brazil and Portuguese-speaking African countries. Recently, Brazil took the lead in regional integration processes and in South-South cooperation initiatives. These strategies and Fiocruz's acknowledged technical expertise resulted in its direct involvement in Brazilian foreign public health policy in the Community of Portuguese-Speaking Countries. Fiocruz developed cooperation projects in various areas, sharing its know-how and best practices in the most critical fields in partner countries, consolidating "public health framework cooperation" and contributing to diversifying Brazil's partners and promoting Brazil as a global actor.

Os paradigmas da política externa brasileira e as mudanças no cenário global desde a Guerra Fria criaram as condições para aproximação do Brasil com os países africanos de língua portuguesa. Recentemente, o Brasil tomou a liderança nos processos de integração regional e nas iniciativas de cooperação Sul-Sul. Essas estratégias e a reconhecida expertise técnica da Fiocruz abriram espaço para o envolvimento direto da instituição na política externa do Brasil com a Comunidade de Países de Língua Portuguesa na área da saúde. A Fiocruz desenvolveu projetos de cooperação em áreas diversas, compartilhando seu know-how e melhores práticas em áreas prioritárias dos países parceiros, consolidando a "cooperação estruturante em saúde" e contribuindo para a diversificação de parceiros do país e promovendo o Brasil como ator global.

A Fiocruz como ator da política externa brasileira no contexto da Comunidade dos Países de Língua Portuguesa / Fiocruz as an actor in Brazilian foreign relations in the context of the Community of Portuguese-Speaking Countries: an untold story

Os paradigmas da política externa brasileira e as mudanças no cenário global desde a Guerra Fria criaram as condições para aproximação do Brasil com os países africanos de língua portuguesa. Recentemente, o Brasil tomou a liderança nos processos de integração regional e nas iniciativas de cooperação Sul-Sul. Essas estratégias e a reconhecida expertise técnica da Fiocruz abriram espaço para o envolvimento direto da instituição na política externa do Brasil com a Comunidade de Países de Língua Portuguesa na área da saúde. A Fiocruz desenvolveu projetos de cooperação em áreas diversas, compartilhando seu know-how e melhores práticas em áreas prioritárias dos países parceiros, consolidando a “cooperação estruturante em saúde” e contribuindo para a diversificação de parceiros do país e promovendo o Brasil como ator global. (AU)

Governança de novas dimensões de segurança internacional: Doenças infecciosas emergentes / Governance of new dimensions of international security: Emerging infectious diseases

Esse estudo objetiva compreender de que forma se estrutura a governança de uma nova dimensão de segurança internacional: as doenças infecciosas emergentes (DIEs). Inicialmente, discute-se como o tema das doenças infecciosas ­ em geral ­ tem sido apresentado pela literatura acadêmica especializada como novos riscos à segurança internacional. A partir desse escrutínio, foi possível organizar as contribuições de diversos autores sobre o tema, propondo cinco abordagens diferentes da relação entre doenças infecciosas e segurança internacional. A partir disso, averígua-se a maneira mais adequada para compreender a governança das DIEs com a análise das teorias de governança nos campos das Relações Internacionais e da "saúde global". Nesse contexto, e com essas ferramentas, mapeiam-se os atores e dispositivos internacionais que caracterizam a governança das doenças infecciosas, e, posteriormente a das DIEs. Do ponto de vista metodológico, essa dissertação adota o modelo analítico de Young (1999) e Fidler (2002) para analisar a principal peça jurídica desse regime, o Regulamento Sanitário Internacional, examinando sua evolução entre versões de 1969 e 2005 em seus componentes substantivos, processuais e de implementação. Essa análise inova ao apresentar, de um ângulo original, o desenvolvimento da governança internacional das DIEs nas últimas décadas.

This study aims to understand how is developed the governance of a new dimension of international security: emerging infectious diseases (EIDs). At first, we discuss how the topic of infectious disease - in general - have been presented by the academic literature as new risk to international security. From this analysis, it was possible to organize the contributions of various authors on the subject by proposing five different approaches to the relationship between infectious diseases and international security. After that, this study investigates the most appropriate way to understand the governance of EIDs analyzing theories of governance in the fields of International Relations and "global health." In this sense, and adopting these tools, it was possible to map actors and international devices that are involved in the governance of infectious diseases, and later in the EID. Methodologically, this dissertation adopts the analytical model of Young (1999) and Fidler (2002) to analyze the centerpiece of this regime, the International Health Regulations, tracing its development between its 1969 and 2005 versions. This analysis innovates for it presents, from an original point of view, the development of international governance of EIDs in recent decades.

Características clínicas de los pacientes con tratamiento para la osteoporosis en un centro de Atención Primaria: ¿a quién tratamos en nuestras consultas? / Clinical characteristics of patients under treatment for osteoporosis in a Primary Care Centre. Who do we treat?

ObjetivosConocer las características demográficas y clínicas de los pacientes con tratamiento para la osteoporosis; identificar los factores de riesgo y de fractura y valorar la indicación del tratamiento.DiseñoEstudio descriptivo de una serie de casos.EmplazamientoCentro de Atención Primaria de la Comunidad de Madrid.ParticipantesDoscientos dieciséis pacientes con algún tratamiento para la osteoporosis durante el año 2007.Mediciones principalesVariables sociodemográficas, factores de riesgo para osteoporosis, riesgo de caídas e información relacionada con la prescripción y el tratamiento. Para valorar la indicación de tratamiento nos basamos en las recomendaciones de las principales guías clínicas.ResultadosLa mayoría de las pacientes eran mujeres caucásicas con edad media de 66,1 años (DE: 12,2). El 39,3% tiene registrado un antecedente personal de fractura y en un 16,1% existe la fractura como antecedente familiar. El 73,1% de las historias no tiene ninguna referencia a la densitometría ósea. La existencia de factores de riesgo no está reflejada en un altísimo porcentaje de historias clínicas. Solo el 51,8% cumplía criterios para iniciar tratamiento. El 44% de los tratamientos se inician en Atención Primaria.ConclusionesCasi el 50% de los tratamientos no están correctamente indicados y en un alto porcentaje de las historias no se registran correctamente los factores de riesgo. Debemos mejorar la calidad de nuestras historias clínicas(AU)

ObjectivesTo find out the clinical and demographic features of patients in treatment for osteoporosis, look for risk factors for osteoporosis and bone fractures, and assess whether treatment is indicated.DesignDescriptive study of a series of cases.LocationPrimary Care Centre, Madrid.Participants216 patients on treatment for osteoporosis during 2007.Principal measuresSociodemographic variables, osteoporosis risk factors, risk of falling, prescription and treatment related information. To evaluate if treatment is indicated we have used principal medical guidelines.ResultsMost of our patients were Caucasian women with a mean age of 66.14 years. A total of 39.5% had suffered an osteoporotic fracture and 16.12% had family history of osteoporotic fracture. The majority of our registers,73.15%, do not report information on Dual-Energy X-ray Absorptiometry (DEXA), and 73.13% do not make any reference to bone mineral density. Risk factors are not recorded in most of the clinical histories. Only 51.85% of the treatments were well indicated, and 44% of them began at a primary health care centre.ConclusionsNearly 50% of treatments are not well indicated and a high percentage of our clinical histories do not record risk factors correctly. We should improve our clinical histories, as we are responsible for identifying, studying, evaluating, treating and controlling the progress of osteoporosis(AU)

[Clinical characteristics of patients under treatment for osteoporosis in a Primary Care Centre. Who do we treat?]. / Características clínicas de los pacientes con tratamiento para la osteoporosis en un centro de Atención Primaria: ¿a quién tratamos en nuestras consultas?

OBJECTIVES: To find out the clinical and demographic features of patients in treatment for osteoporosis, look for risk factors for osteoporosis and bone fractures, and assess whether treatment is indicated. DESIGN: Descriptive study of a series of cases. LOCATION: Primary Care Centre, Madrid. PARTICIPANTS: 216 patients on treatment for osteoporosis during 2007. PRINCIPAL MEASURES: Sociodemographic variables, osteoporosis risk factors, risk of falling, prescription and treatment related information. To evaluate if treatment is indicated we have used principal medical guidelines. RESULTS: Most of our patients were Caucasian women with a mean age of 66.14 years. A total of 39.5% had suffered an osteoporotic fracture and 16.12% had family history of osteoporotic fracture. The majority of our registers,73.15%, do not report information on Dual-Energy X-ray Absorptiometry (DEXA), and 73.13% do not make any reference to bone mineral density. Risk factors are not recorded in most of the clinical histories. Only 51.85% of the treatments were well indicated, and 44% of them began at a primary health care centre. CONCLUSIONS: Nearly 50% of treatments are not well indicated and a high percentage of our clinical histories do not record risk factors correctly. We should improve our clinical histories, as we are responsible for identifying, studying, evaluating, treating and controlling the progress of osteoporosis.

Evaluación de las indicaciones de tranfusión de sangre y derivados en pacientes transfundidos en el Instituto Nacional de Salud del Perú, durante el periodo de Septiembre a Noviembre del 2009 / Evaluation of indications for transfusion of blood and blood products transfused in patients at the National Institute of Health of Peru, during the period from September to November 2009

Es importante conocer si las indicaciones de las transfusiones sanguíneas y derivados son justificadas, ya que se trata de un acto médico, y como tal, cada indicación a transfundir debe sustentarse en estudios necesarios y criterios objetivos que demuestren que el paciente transfundido obtendrá un real beneficio sobre la patología a tratar. Se realizó un estudio transversal prospectivo en el que se incluyeron pacientes entre 2 meses y 18 años de edad hospitalizados en el Instituto de Salud del Niño, durante el periodo de septiembre a noviembre del 2009, con él objetivo de evaluar las indicaciones de transfusión de sangre y derivados, según la Guía de Transfusiones Sanguíneas de la Organización Mundial de la Salud, y verificar la indicación de la transfusión, y la justificación según los datos clínicos y de laboratorio. Se evaluaron 300 indicaciones de transfusiones sanguíneas y derivados, identificándose que el 58,2 por ciento de indicaciones fueron adecuadas según la Guía de Transfusiones Sanguíneas de la OMS, y un 41,8 por ciento fueron indicaciones inadecuadas. De la muestra total, se identifico que la indicación de transfusión, más frecuente, fueron los trastornos hemorrágicos y de la coagulación (31,1 por ciento), y el producto sanguíneo transfundido con mayor frecuencia fue el Paquete Globular (52,7 por ciento), este mismo, a su vez, fue el elemento con mayor porcentaje de indicación inadecuada de transfusión (66 por ciento). Con este estudio se pudo concluir que la mayoría de las indicaciones para transfundir sangre y sus derivados son adecuadas según la Guía De Transfusiones Sanguíneas de la OMS, sin embargo, existe un alto porcentaje (41.8 por ciento) de pacientes transfundidos con inadecuada indicación. Los trastornos hemorrágicos y de la coagulación es la indicación más frecuente de transfusión y el producto sanguíneo más transfundido es el Paquete Globular, el mismo que es indicado inadecuadamente en mayor porcentaje...