The utilization of primary care and emergency services in the SUS of Belo Horizonte : health problems, procedures and choice of services

Avalia-se o uso das unidades básicas e de urgências do Sistema Único de Saúde (SUS) de Belo Horizonte (BH). Objetivos: identificar o principal problema de saúde que o cidadão leva à Unidade de Pronto- atendimento (UPA) e à Unidade Básica de Saúde (UBS), considerando as especificidades dos níveis de atenção; caracterizar os principais procedimentos de atenção básica e de média complexidade utiliza- dos nesses serviços, comparativamente. Pesquisa do tipo survey, com aplicação direta de questionário fechado a 997 entrevistados, distribuídos em 10 UBSs e 7 UPAs. A demanda que chega aos serviços investigados é por consultas médicas e por procedimentos de enfermagem, motivada por afecções leves, passíveis de atendimento na atenção básica. Os usuários vão à UBS por ser um serviço próximo da residência, de rápido atendimento e de fácil deslocamento, caracterizando boa oferta e capilaridade da Saúde da Família. Verificou-se duplicidade na utilização dos serviços, o que contribui para outras investigações.The use of the Primary Care and Emergency Units of Sistema Único de Saúde (SUS – Brazilian National Health System) was evaluated in the city of Belo Horizonte (Southeastern Brazil). Objectives: to identify the main health problem that the citizen takes to the Emergency Unit and to the Primary Care Unit, considering the specificities of the health care levels; to characterize the main primary level and second level procedures that are used in these services, comparatively. This is a survey in which a closed questionnaire was administered to 997 interviewees from 10 Primary Care Units and 7 Emergency Units. The demand that arrives at the investigated services is for medical consultations and nursing procedures, motivated by minor affections which can be assisted in the Primary Care Unit. Users go to the Primary Care Unit because it is a service that is close to their homes and provides quick assistance, characterizing good offer and capillarity of the Family Health Program. Duplicity in services utilization was verified, which contributes to further investigations

COVID-Inconfidentes - SARS-CoV-2 seroprevalence in two Brazilian urban areas during the pandemic first wave: study protocol and initial results

Background: A population study is an important tool that can be used to understand the actual epidemiological scenario of the Covid-19 in different territories, identify its magnitude, understand its transmission dynamics, and its demographic, geographical, and social distribution. Objective: The aim of this study was to determine the prevalence and dynamics of SARS-CoV-2 infection in the population of two Brazilian cities during the pandemic first wave and subsequent socioeconomic and health effects. Materials & methods: This paper described the methodological procedures adopted and the prevalence of the SARS-CoV-2 infection in the population. A household survey was conducted between October and December 2020, in two historic cities of Brazil's mining region. Anti-SARS-CoV-2 antibody was detected using the Wondfo® rapid test. The face-to-face interview consisted of administration of a questionnaire containing registration data, sociodemographic and economic variables, living habits, general health condition, mental health, sleep habits, and eating and nutrition. Results: We evaluated 1,762 residents, of which 764 (43.4%) were in Mariana and 998 (56.6%) in Ouro Preto. For both cities, 51.9% of the interviewees were female, with a predominance of the age range 35 to 59 years old (47.2%). The prevalence of the SARS-CoV-2 infection was 5.5% in all cities, 6.2% in Ouro Preto, and 4.7% in Mariana. The prevalence was similar between cities (P>0.05). Conclusion: The study was effective in verifying the seroprevalence of infection by the virus and its findings will enable further analyses of the health conditions of the population related to social isolation and the risk of infection with SARS-CoV-2

Compliance of indoor air quality during sleep with legislation and guidelines: a case study of Lisbon dwellings

E2Sleep Project 711030-IPL/2017/E2SLEEP/ESTeSL.This study aimed to provide a comprehensive characterization of the indoor air quality during the sleeping period of 10 couples at Lisbon dwellings, using a multi-pollutant approach, and to understand how the compliance with legislation and guidelines was to assure good indoor air quality. The assessment of indoor air quality was conducted in the cold season using real-time monitors during the sleeping period for comfort parameters (temperature and relative humidity) and air pollutants (carbon dioxide - CO2, carbon monoxide - CO, formaldehyde - CH2O, total volatile organic compounds - VOCs, and particulate matter - PM2.5 and PM10), together with an active sampling of bioaerosols (fungi and bacteria) before and after the sleeping period. Lower compliance (less than 50% of the cases) with the Portuguese legislation was found for temperature, CO2 (3440 ± 1610 mg m-3), VOCs (1.79 ± 0.99 mg m-3), and both bioaerosol types. In 70% of the cases, PM2.5 (15.3 ± 9.1 μg m-3) exceeded the WHO guideline of 10 μg m-3. All bedrooms presented air change rates above the recommended minimum value of 0.7 h-1, highlighting that a good indoor air quality during sleep is not guaranteed.info:eu-repo/semantics/publishedVersio

A utilização dos serviços de atenção básica e de urgência no sus de belo horizonte: problema de saúde, procedimentos e escolha dos serviços The utilization of primary care and emergency services in the sus of belo horizonte: health problems, procedures and choice of services

Avalia-se o uso das unidades básicas e de urgências do Sistema Único de Saúde (SUS) de Belo Horizonte (BH). Objetivos: identificar o principal problema de saúde que o cidadão leva à Unidade de Pronto-atendimento (UPA) e à Unidade Básica de Saúde (UBS), considerando as especificidades dos níveis de atenção; caracterizar os principais procedimentos de atenção básica e de média complexidade utilizados nesses serviços, comparativamente. Pesquisa do tipo survey, com aplicação direta de questionário fechado a 997 entrevistados, distribuídos em 10 UBSs e 7 UPAs. A demanda que chega aos serviços investigados é por consultas médicas e por procedimentos de enfermagem, motivada por afecções leves, passíveis de atendimento na atenção básica. Os usuários vão à UBS por ser um serviço próximo da residência, de rápido atendimento e de fácil deslocamento, caracterizando boa oferta e capilaridade da Saúde da Família. Verificou-se duplicidade na utilização dos serviços, o que contribui para outras investigações.<br>The use of the Primary Care and Emergency Units of Sistema Único de Saúde (SUS - Brazilian National Health System) was evaluated in the city of Belo Horizonte (Southeastern Brazil). Objectives: to identify the main health problem that the citizen takes to the Emergency Unit and to the Primary Care Unit, considering the specificities of the health care levels; to characterize the main primary level and second level procedures that are used in these services, comparatively. This is a survey in which a closed questionnaire was administered to 997 interviewees from 10 Primary Care Units and 7 Emergency Units. The demand that arrives at the investigated services is for medical consultations and nursing procedures, motivated by minor affections which can be assisted in the Primary Care Unit. Users go to the Primary Care Unit because it is a service that is close to their homes and provides quick assistance, characterizing good offer and capillarity of the Family Health Program. Duplicity in services utilization was verified, which contributes to further investigations

Selection strategy of phage-displayed immunogens based on an in vitro evaluation of the Th1 response of PBMCs and their potential use as a vaccine against Leishmania infantum infection

Abstract Background The development of a vaccine for the prevention of visceral leishmaniasis (VL) still represents a significant unmet medical need. A human vaccine can be found if one takes into consideration that many people living in endemic areas of disease are infected but do not develop active VL, including those subjects with subclinical or asymptomatic infection. Methods In this study, a phage display was used to select phage-exposed peptides that were specific to immunoglobulin G (IgG) antibodies from asymptomatic and symptomatic VL patients, separating them from non-infected subjects. Phage clones presenting valid peptide sequences were selected and used as stimuli of peripheral blood mononuclear cells (PBMCs) obtained from both patients’ groups and controls. Those with higher interferon-gamma (IFN-γ)/interleukin (IL)-10 ratios were further selected for vaccination tests. Results Among 17 evaluated clones, two were selected, B1 and D11, and used to immunize BALB/c mice in an attempt to further validate their in vivo protective efficacy against Leishmania infantum infection. Both clones induced partial protection against the parasite challenge, which was evidenced by the reduction of parasitism in the evaluated organs, a process mediated by a specific T helper (Th)1 immune response. Conclusions To the best of our knowledge, this study is the first to use a rational strategy based on in vitro stimulation of human PBMCs with selected phage-displayed clones to obtain new immunogens against VL

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Clinical Effect of Early vs Late Amyloid Positron Emission Tomography in Memory Clinic Patients

International audienceImportance Amyloid positron emission tomography (PET) allows the direct assessment of amyloid deposition, one of the main hallmarks of Alzheimer disease. However, this technique is currently not widely reimbursed because of the lack of appropriately designed studies demonstrating its clinical effect. Objective To assess the clinical effect of amyloid PET in memory clinic patients. Design, Setting, and Participants The AMYPAD-DPMS is a prospective randomized clinical trial in 8 European memory clinics. Participants were allocated (using a minimization method) to 3 study groups based on the performance of amyloid PET: arm 1, early in the diagnostic workup (within 1 month); arm 2, late in the diagnostic workup (after a mean [SD] 8 [2] months); or arm 3, if and when the managing physician chose. Participants were patients with subjective cognitive decline plus (SCD+; SCD plus clinical features increasing the likelihood of preclinical Alzheimer disease), mild cognitive impairment (MCI), or dementia; they were assessed at baseline and after 3 months. Recruitment took place between April 16, 2018, and October 30, 2020. Data analysis was performed from July 2022 to January 2023. Intervention Amyloid PET. Main Outcome and Measure The main outcome was the difference between arm 1 and arm 2 in the proportion of participants receiving an etiological diagnosis with a very high confidence (ie, ≥90% on a 50%-100% visual numeric scale) after 3 months. Results A total of 844 participants were screened, and 840 were enrolled (291 in arm 1, 271 in arm 2, 278 in arm 3). Baseline and 3-month visit data were available for 272 participants in arm 1 and 260 in arm 2 (median [IQR] age: 71 [65-77] and 71 [65-77] years; 150/272 male [55%] and 135/260 male [52%]; 122/272 female [45%] and 125/260 female [48%]; median [IQR] education: 12 [10-15] and 13 [10-16] years, respectively). After 3 months, 109 of 272 participants (40%) in arm 1 had a diagnosis with very high confidence vs 30 of 260 (11%) in arm 2 ( P &amp;lt; .001). This was consistent across cognitive stages (SCD+: 25/84 [30%] vs 5/78 [6%]; P &amp;lt; .001; MCI: 45/108 [42%] vs 9/102 [9%]; P &amp;lt; .001; dementia: 39/80 [49%] vs 16/80 [20%]; P &amp;lt; .001). Conclusion and Relevance In this study, early amyloid PET allowed memory clinic patients to receive an etiological diagnosis with very high confidence after only 3 months compared with patients who had not undergone amyloid PET. These findings support the implementation of amyloid PET early in the diagnostic workup of memory clinic patients. Trial Registration EudraCT Number: 2017-002527-2