Prevalence and predictors of nonadherence to hemodialysis.

BACKGROUND: The prevalence of nonadherence to dialysis (NAD) presents a wide variation, depending on the parameters used and demographic regions studied. This study aimed to assess the prevalence and predictors of NAD of patients with chronic kidney disease undergoing hemodialysis (HD). MATERIALS AND METHODS: This was a cross-sectional study with 255 adult patients receiving HD for >3 months. Skipping a session per month, shortening a session for at least 10 min, phosphorus >7.5 mg/dl, potassium >6.0 mmol/l and interdialytic weight gain (IDWG) >5.7% of body weight were indicative of NAD. The association of sociodemographic and clinical variables with NAD was assessed using logistic regression. RESULTS: Mean age was 50 ± 13.1 years, 62.7% were male, 85.5% were of African descent and 62% were married. The prevalence rates of NAD were: 49% of shortening sessions, 18% of hyperkalemia, 12% of hyperphosphatemia, 9% of IDWG >5.7% of dry weight and 8% of skipping HD. Independent predictors of NAD were: age ≤50 years, not being married, living alone, living in Salvador, attending dialysis without a companion, ethnic African descent, Kt/V <1.3 and residual diuresis <100 ml/day. CONCLUSION: NAD is frequent and distinct sociodemographic and clinical variables predict different parameters.

An analysis of the 1978 African swine fever outbreak in Brazil and its eradication.

The aim of this paper is to evaluate the African swine fever (ASF) outbreak that began in 1978 in Paracambi municipality, Rio de Janeiro State, Brazil, and the steps taken by the Brazilian authorities to eradicate the disease. The presence of ASF in the country was confirmed by isolating the virus, and its pathogenicity was certified by the laboratory of the Plum Island Disease Center, New York, United States. Even before the laboratory results became available, the Brazilian Agriculture Ministry declared an Animal Health Emergency, in which the official Veterinary Services adopted rapid control measures to restrain and eradicate the disease. These control measures contributed to the reorganisation of the national swine industry and stimulated the use of high-technology production techniques, as well as an improvement in herd health consciousness. All this contributed to Brazil becoming the largest meat exporter in the world.

Adherence rate to inhaled corticosteroids and their impact on asthma control.

BACKGROUND: Poor asthma control is associated to high morbidity. The objective of this study was to assess the association between adherence rates to beclomethasone dipropionate (BDP) and the degree of asthma control. METHODS: A cohort concurrent study was carried out for 12 months with 122 asthmatic patients, aged 3-12 years, randomly selected in a pediatric pulmonology outpatient clinic, who received BDP free of charge. Adherence rates were verified by pharmacy records. Clinical control was assessed through a scoring system comprised four variables (nocturnal and morning symptoms, limitation of physical activities and exacerbations). Total score was 16 points. Patients whose score was below or equal to two were considered controlled (group 1), and patients whose score was above or equal to three were considered uncontrolled (group 2). For patients able to perform spirometry, we considered as controlled the patients with forced expiratory volume in 1 s (FEV(1)) equal to or above 80% of the predicted value, and as uncontrolled the patients with FEV(1) below 80%. RESULTS: Fewer than half (40.3% maximum) of the 122 patients maintained asthma control. Median adherence rate of groups 1 and 2 were 85.5% and 33.8%, (P < 0.001) in the 4th month, 90.0% and 48.0% (P < 0.001) in the 8th month and 84.4% and 47.0% in the 12th month (P < 0.001), respectively. CONCLUSION: In all periods, there were statistically significant differences in adherence rates for maintaining or not maintaining the asthma control. Optimal asthma control entailed adherence rate higher than 80%. Strategies for reducing asthma morbidity should include a regular monitoring of adherence to inhaled steroids.

[Relations between official and private veterinary services in epidemiology and the control of contagious diseases]. / Relación entre los servicios veterinarios del sector oficial y privado en epidemiología y control de enfermedades contagiosas.

Growing budget restrictions in many countries have meant that official Veterinary Services cannot assume responsibility for any new activities. The natural reaction is to turn to private veterinary services to provide the support needed to strengthen the control and surveillance of priority diseases and thereby support the development of the livestock sector and the establishment of safe international trade. In this context, official Veterinary Services must work together with private veterinarians, delegating various technical animal health activities, so that they may focus their efforts on those tasks that cannot be delegated: standardisation, control, auditing, general system co-ordination, epidemiological surveillance, etc., as well as organising veterinary policy in order to make best use of budget resources. For these relations to be efficient, a dynamic, two-way epidemiological information mechanism must be created, whereby private veterinarians periodically keep governments informed, on the basis of an agreed methodology. Moreover, the official Veterinary Services must systematically transmit information on List A and B diseases of the OIE (World organisation for animal health), and perform detailed analyses of epidemiologically significant events. The article proposes the establishment of relations between public and private veterinary services as a way in which to provide the livestock sector with the health and hygiene conditions that are necessary for effective disease control, which in turn provides greater security for international trade and increased consumer protection.

[Combating foot and mouth disease in Brazil: private sector participation]. / La lutte contre la fièvre aphteuse au Brésil: la participation du secteur privé.

The fact that cattle herds in Brazil are in such good health and that the meat on the domestic and international markets is safe and of high quality is largely due to the campaign to combat foot and mouth disease and to the improvements that this campaign has made in the organisation of the Brazilian bovine production industry. Launched in 1965, the campaign set itself ambitious objectives, but thanks to the direct participation of producer organisations it received the necessary support and funding. The results are reflected in the growing number of states--fifteen to date--that are internationally recognised as free from foot and mouth disease with vaccination. Thanks to the active participation of producers and of the entire production chain in foot and mouth disease eradication efforts, Brazil has risen to become a leading player in the international beef trade.

Atividade antinociceptiva do extrato etanólico do fruto de Solanum acanthodes Hook.f. em camundongos

Solallum acanthodes. popularmente conhecido como "jurubeba", foi estudada com o objetivo de avaliar suas propriedades antinocicept i vas nos modelos de nociccpção induzida pela I'ormalina e glutamato. Para isto foi utilizado o extrato elanólico dos frutos (EES) da planta. Os resultados apresentaram altos níveis de significância, demonstrando o potencial analgésico de S. acanthodes.

Solanum acanthodes, popularly known as "jurubcba", was studied with the objective to evaluatc its antinocíccptivc propcrties In lhe models aI' fonnalin-induced nociceptive and glutamate. For this lhe cthanolic extract of lhe fruits (E.ES) of the plant was used. The results had prescnlcd high lcvcls 01' significance, demonstrating lhe analgesic potcntial of S. acanthodes.

Six-month isoniazid-rifampin treatment for pulmonary tuberculosis in children.

One hundred and seventeen children with pulmonary tuberculosis underwent treatment with a 6-month daily regimen of rifampin (15 mg/kg/day) and isoniazid (10 mg/kg/day). The criteria for the diagnosis of pulmonary tuberculosis were (1) clinical symptoms and signs in 93 children (79%), (2) history of direct contact with an adult with tuberculosis in 106 children (91%), (3) tuberculin reaction of 5 mm or more, without previous bacillus Calmette-Guérin (BCG), in 45 children (38%), (4) suggestive radiologic alterations in all patients, and (5) positive bacteriology or histology in four patients (3%). The treatment was completed by 97 children (83%). The mean weight gain during therapy was 2,145 g. There was an excellent clinicoradiologic response to the treatment, and improvement in chest roentgenograms was observed in all patients at the end of therapy. No relapses occurred among the patients followed for an average of 21.4 months. This study indicates that the treatment of primary pulmonary tuberculosis in children with a combination of rifampin and isoniazid daily for 6 months is efficacious and does not result in any relapse.

Estudo retrospectivo de asmáticos crônicos em serviço de pneumologia / Retrospective study of chronic asthmatics in Pneumology Services

Foram analisados, retrospectivamente, dois grupos de asmáticos: grupo A (50 pacientes) e grupo B (17 pacientes) classificados de acordo com a utilizaçäo ou näo de corticóides, por tempo prolongado, durante o controle ambulatorial. Observou-se que os pacientes do grupo B (uso de corticóide) eram os mais gravemente acometidos, de acordo com a avaliaçäo dos seguintes parâmetros: internamentos mais freqüentes, acompanhamento ambulatorial por período mais longo e necessidade de maior número de medicamentos para controle adequado. O número relativamente alto (25 por cento) de pacientes, utilizando corticóide no controle ambulatorial, ressalta a necessidade de procedimentos mais objetivos, como monitorizaçäo de drogas e avaliaçäo periódica da funçäo pulmonar, dentre outros, como forma de diminuir este índice