Acesso a medicamentos pelo Sistema Único de Saúde e equidade: inquéritos de base populacional em São Paulo, Brasil

: Introduction: Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.: Introdução: Desde 2003, o acesso da população a medicamentos tem aumentado no Brasil e particularmente em São Paulo. O estudo visou analisar o acesso a medicamentos obtidos do setor público e as desigualdades socioeconômicas nesse acesso em 2003 e em 2008. Método: Os dados são provenientes dos inquéritos domiciliares de saúde ISA-Capital, realizados na cidade de São Paulo em 2003 e em 2008. Foi feita Regressão Logística para analisar os fatores associados ao acesso a medicamentos. A análise das desigualdades no acesso a medicamentos foi feita a partir da Curva de Concentração e Índice de Concentração. Adicionalmente, as diferenças entre os anos de 2003 e 2008 com relação às características socioeconômicas e ao acesso a medicamentos foram estudadas. Resultados: O acesso a medicamentos foi 89,55% em 2003 e 92,99% em 2008. O acesso a medicamentos pelo setor público aumentou de 26,40% em 2003 para 48,55% em 2008 e foi maior na população com menor poder aquisitivo, porém houve mudança no índice de concentração entre 2003 e 2008. Conclusões: Os achados indicam a expansão da clientela do Sistema Único de Saúde na cobertura de medicamentos, com a entrada da população com maior poder aquisitivo no setor público. O acesso continua maior na população com menor poder aquisitivo, o que sugere que o SUS tenta a equidade na provisão de medicamentos. Entretanto, a cobertura universal para gastos com medicamentos essenciais e a equidade no acesso a medicamentos pelo setor público ainda são desafios para o SUS.191263

Acesso A Medicamentos Pelo Sistema Único De Saúde E Equidade: Inquéritos De Base Populacional Em São Paulo, Brasil

Since 2003, the access to medication has been increasing in Brazil and particularly in São Paulo. The present study aimed to analyze the access to medication obtained in the public sector and the socioeconomic differences in this access in 2003 and 2008. Also, we explored the difference in access to medication from 2003 to 2008. Method: Data were obtained from two cross-sectional population-based household surveys from São Paulo, Brazil (ISA-Capital 2003 and ISA-Capital 2008). Concentration curve and concentration index were calculated to analyze the associations between socioeconomic factors and access to medication in the public sector. Additionally, the differences between 2003 and 2008 regarding socioeconomic characteristics and access to medication were studied. Results: Access to medication was 89.55% in 2003 and 92.99% in 2008, and the proportion of access to medication did not change in the period. Access in the public sector increased from 26.40% in 2003 to 48.55% in 2008 and there was a decrease in the concentration index between 2003 and 2008 in access to medication in the public sector. Conclusions: The findings indicate an expansion of Brazilian Unified Health System (Sistema Único de Saúde ) users, with the inclusion of people of higher socioeconomic position in the public sector. As the SUS gives more support to people of lower socioeconomic position in terms of medication provision, the SUS tends to equity. Nevertheless, universal coverage for medication and equity in access to medication in the public sector are still challenges for the Brazilian public health system.191263

Giz de cera com pigmento natural sob a temática da sustentabilidade

O objetivo deste trabalho foi preparar gizes de cera de abelha contendo pigmentos inorgânicos naturais a partir de terras de modo a apresentar um material com apelo sustentável. Sabe-se da importância de propostas que contribuam ao desenvolvimento da sustentabilidade nos diversos setores e da abordagem da transdisciplinaridade. Fato este que, envolve a capacidade de questionamentos multidirecionais concomitante aos assuntos ambientais. Os gizes coloridos com pigmentos naturais apresentaram consistência dura e homogênea, a presença de uma ponta na barra do giz ajudou no detalhamento das pinturas, na qualidade da capacidade de transferência do pigmento para o papel e não houve diferença na qualidade da coloração e textura, quando comparado ao produto comercial. Desta forma, a proposta deste giz demonstrou uma perspectiva socioambiental e pedagógico, enfatizando um olhar mais atual e preocupado com as questões ambientais.&nbsp

Evaluation of eficacity of a bait with lufenuron 3% to control Ceratitis capitata Wied. in Terceira island, Azores

The main goal of this survey was to evaluate the effectiveness of a new method to control Mediterranean fruit fly, Ceratitis capitata Wied. (Diptera: Tephritidae), which could be less hazard for the human health and for the environment. This method uses baits with 3% of lufenuron. For this survey, 1056 of baits were installed covering an area of 44 ha in the North Island of Terceira. The experiment has started in 2009 and lasted for 3 years. The results are contradictory about its effectiveness. Between 2009 and 2010, there was a decrease of C. capitata male populations, while between 2010 and 2011 there was a high increase of C. capitata male populations, overcoming 2009 capture values. There are differences of the attack influence of males in areas with baits and without them. The number of captured males was much higher than of the females

Uso, Acesso E Equidade Nos Serviços De Saúde Em São Paulo, Brasil

The study analyzed how socioeconomic factors are associated with seeking, access, use, and quality of health care services in São Paulo, Brazil. Data were obtained from two household health surveys in São Paulo. We used logistic regression to analyze associations between socioeconomic factors and seeking, access, use, and quality of health care services. Access to health care services was high among those who sought it (94.91% in 2003 and 94.98% in 2008). The proportion of access to and use of health care services did not change significantly from 2003 to 2008. Use of services in the public sector was more frequent in lower socioeconomic groups. There were some socioeconomic differences in seeking health care and resolution of health problems. The study showed almost universal access to health care services, but the results suggest problems in quality of services and differences in quality experienced by lower socioeconomic groups, who mostly use the Brazilian Unified National Health System (SUS).33

Characterization of an animal model of severe sepsis associated with respiratory dysfunction

PURPOSE: Pathophysiological studies in humans regarding sepsis are difficult to perform due to ethical and methodological concerns. In this context, animal models of sepsis can be useful to better understand this condition and to test therapeutic strategies. The purpose of this study was to characterize a feasible and clinically relevant model of sepsis in pigs that could be useful for testing different therapeutic interventions. METHODS: 5 White Large pigs were anesthetized, arterial and pulmonary catheters were introduced, and sepsis was induced by fecal peritonitis. Several biochemical indicators of organ dysfunction and infectious parameters were measured. The pigs were monitored until death, when fragments of organs were removed for pathology. Three animals without peritonitis served as controls and were sacrificed 24 hours after surgery without developing significant changes in organ function. RESULTS: Septic pigs survived 17 hours on average (range, 16-18 h), and Escherichia coli was recovered from blood cultures. They developed a significant decrease in left ventricular work and a nonsignificant reduction in mixed venous oxygen saturation. Respiratory dysfunction was characterized by a decrease in the PaO2/FiO2 ratio and respiratory compliance. Pathology of the lungs revealed areas of pulmonary collapse, hemorrhage, pulmonary congestion, and discrete neutrophil infiltrate. CONCLUSIONS: Fecal peritonitis in pigs is a clinically relevant model of sepsis associated with acute lung injury without direct pulmonary insult. This model may prove to be useful for studying pathogenic aspects of secondary lung injury as well as for validating ventilatory or pharmacologic interventions.PROPOSTA: Estudos sobre sepse envolvendo sua fisiopatologia são difíceis de serem realizados devido a razões éticas e metodológicas. Neste sentido, modelos animais criam oportunidades de estudos para entender a fisiopatologia e testar estratégias terapêuticas. O objetivo deste estudo foi criar um modelo relevante de choque séptico em porcos para testar e entender diferentes intervenções. MÉTODOS: 5 porcos da raça "White Large" foram anestesiados e monitorizados com uma linha arterial e um cateter de artéria pulmonar. Uma peritonite fecal foi induzida através de laparotomia. Marcadores de disfunções orgânicas e infecciosos foram mensurados. Todos porcos evoluíram até a morte e amostras de órgãos foram coletadas para exame anátomo patológico. Três animais controles com o mesmo preparo cirúrgico e sem peritonite foram sacrificados após 24 horas de evolução, sem desenvolver mudanças significativas nas funções orgânicas. RESULTADOS: Os animais séptico sobreviveram na média 17 horas (16 - 18h), e Escherichia coli foi cultivada nas amostras de sangue. Os animais sépticos evoluíram com redução do trabalho de ventrículo esquerdo. A disfunção respiratória foi caracterizada por uma redução na relação PaO2/FiO2 e na complacência respiratória. A anatomia patológica dos pulmões revelou colapso pulmonar, hemorragia, congestão e infiltrado neutrofílico. CONCLUSÕES: A peritonite fecal em porcos é um modelo de choque séptico clinicamente relevante e associada a uma lesão pulmonar sem um insulto direto. Este é um modelo que pode ser utilizado para estudar aspectos fisiopatológicos das lesões pulmonares secundárias, assim como para estudar intervenções ventilatórias ou farmacológicas

Evaluation of damage caused by the olive fruit fly Bactrocera (Daculus) oleae in Terceira Island, Azores

In the Azores archipelago, the olive tree only occurs in 2 Islands, Terceira and Pico. The olive fruit fly, Bactrocera oleae (Gmelin) is the key pest for this crop on the Island of Terceira, by causing important damage. Monitoring of B. oleae adults showed the occurrence of 2 population peaks, one of greater intensity in October and another of lesser intensity, in August. For the assessment of the damage caused by B. oleae, were held, in 2010, samplings of olives in 2 orchards, one with a high number of treatments and the other without any treatment. The intensity of attack in the olives, in the orchard with treatments was just 1% and in the orchard without treatments, was 66% of the olives

TRINIBACULUM ALTIPARANAE SP. N. UNA NUEVA ESPECIE DE DACTYLOGYRIDO (MONOGENEA) DE ASTYANAX ALTIPARANAE (OSTEICHTHYES: CHARACIDAE) EN EL RÍO PEIXE, SUDESTE DE BRASIL

This article describes a new species –Trinibaculum altiparanae sp. n. –found in the gills of the Astyanax altiparanae Garutti & Britski, 2000. Fish were collected from the Peixe River in the municipality of Anhembi, State of São Paulo, Brazil, in March 2010. This paper describes the third species of the genus Trinibaculum. This new species is characterized by having an accessory structure that does not articulate with the male copulatory organ (MCO). This accessory structure has a basally bifid, well-curved distal end, tapered with a terminal flabellate piece. The male copulatory organ is a simple tube with less than one ring coiled counterclockwise; two similar curved dorsal bars; a ventral bar with concave ends and a posterior projection, a dorsal anchor with a truncated deep root and a slightly curved shaft, a ventral anchor with a curved shaft and differently shaped and sized hooks. Those features distinguish the new species from the two other species previously described in this genus: Trinibaculum braziliensis Kritsky, Thatcher & Kayton, 1980 was found parasitizing Brycon melanopterus (Cope, 1872) and Trinibaculum rotundus Karling, Lopes, Takemoto & Pavanelli, 2011 was found parasitizing Schizodon borellii (Boulenger, 1900).Una nueva especie - Trinibaculum altiparanae sp. n. - se describe de las branquias de Astyanax altiparanae Garutti & Britski, 2000. Los peces fueron recolectados en el río Peixe en el municipio de Anhembi, São Paulo, Brasil, en marzo del 2010. Esta es la tercera especie del género Trinibaculum que se describe. La nueva especie se caracteriza por tener una pieza accesoria no articulada al órgano masculino copulador (COM), basalmente bífida y curva, el extremo distal cónico con una pieza terminal flabelada. El órgano copulador masculino es un tubo simple y envuelto con menos de una vuelta en dirección hacia la izquierda; barras dorsales similares y curvadas; una barra ventral con extremo cóncavo y con proyección posterior; raíz del áncora dorsal profunda y truncada y suavemente curvada; áncora ventral curvada y ganchos con diferente forma y tamaño, que difiere de las otras dos especies previamente descritas en este género: Trinibaculum braziliensis Kritsky, Thatcher & Kayton, 1980 que parasita a Brycon melanopterus (Cope, 1872) y Trinibaculum rotundus Karling, Lopes, Takemoto & Pavanelli, 2011 que parasita Schizodon borellii (Boulenger, 1900)

Comparison between two shock wave regimens using frequencies of 60 and 90 impulses per minute for urinary stones

PURPOSE: Two different regimens of SWL delivery for treating urinary stones were compared. METHODS: Patients with urinary stones were randomly divided into two groups, one of which received 3000 shocks at a rate of 60 impulses per minute and the other of which received 4000 shocks at 90 impulses per minute. Success was defined as stone-free status or the detection of residual fragments of less than or equal to 3 mm three months after treatment. Partial fragmentation was considered to have occurred if a significant reduction in the stone burden was observed but residual fragments of 3mm or greater remained. RESULTS: A total of 143 procedures were performed with 3000 impulses at a rate of 60 impulses per minute, and 156 procedures were performed with 4000 impulses at 90 impulses per minute. The stone-free rate was 53.1% for patients treated with the first regimen and 54.8% for those treated with the second one (p = 0.603). The stone-free rate for stones smaller than 10 mm was 60% for patients treated with 60 impulses per minute and 58.6% for those treated with 90 impulses per minute. For stones bigger than 10 mm, stone-free rates were 34.2% and 45.7%, respectively (p = 0.483). Complications occurred in 2.3% of patients treated with 60 impulses per minute and 3.3% of patients treated with 90 impulses per minute. CONCLUSION: No significant differences in the stone-free and complication rates were observed by reducing the total number of impulses from 4000 to 3000 and the frequency from 90 to 60 impulses per minute