Avaliação epidemiológica da hanseníase e dos serviços responsáveis por seu atendimento em Ribeirão Preto - SP no ano de 1992

A partir de dados registrados na planilha epidemiológica de hanseníase, instituída pelo Ministério da Saúde, sobre os casos atendidos no Município de Ribeirão Preto-S.P., buscou-se traçar um perfil epidemiológico da hanseníase, no ano de 1992, e avaliar a eficácia dos serviços responsáveis pela assistência aos hansenianos. Encontrou-se um coeficiente de prevalência de 1,72/1000 habitantes, pouco abaixo do coeficiente nacional de 1992 (1,78/1000 habitantes), e superior àquele preconizado pela O.M.S. para definir áreas de baixa prevalência (0,2/1000 habitantes). A maioria dos casos (65,4%) era de formas multibacilares, e o esquema terapêutico predominante foi o DNDS (apesar das recomendações do Ministério da Saúde). Detectou-se, também, que cerca da metade dos pacientes não recebeu avaliação de incapacidades durante o ano, havendo 60% dos pacientes com incapacidades de graus II e III, entre os que saíram do programa por alta, por cura e foram avaliados quanto a incapacidades, apesar do comparecimento dos pacientes ter sido satisfatório. Com base em tais resultados inquietantes, os autores propõem a descentralização do atendimento para as Unidades Básicas de Saúde, aproximando o serviço à comunidade. Encaminhamentos a serviços de nível secundário e terciário seriam feitos apenas para determinação diagnóstica mais apurada, e na ocorrência de complicações. Grupos terapêuticos com orientação multiprofissional e multidisciplinar deveriam ser formados para discutir o estigma e formas de reintegrar, socialmente, os pacientes.Analysis of governmental data collected in health services of Ribeirão Preto City in 1992 was made with the purpose of evaluate the leprosy epidemiology and the efficacy of leprosy health services. It was found a prevalence of 1,72 /1000 habitants, that was lower than the brazilian national prevalence in 1992 (1,78 /1000 habitants), and higher than the W.H.O. definition for low prevalence areas (0,2 /1000 habitants). The majority of patients (65,4%) was multibacillary leprosy, and the predominant therapeutics was monoquimiotherapy (despite the W.H.O. recomendations); there was satisfactory patient attendance, but approximately the half of the patients had not evaluations of their disabilities in the year, and 60% of them had sequelae. The proposition is to centralize the assistance in Basic Health Care Facilities, approximating the service to community; the participation of medical specialists and more advanced technology would be employed only to improve the diagnosis or in complications in the course of the treatment. The therapy would be applied in groups of patients, in search for social reintegration and health education

Associação do polimorfismo de nucleotídeo único rs7903146 no locus do TCF7L2 com diabetes tipo 2 em indivíduos brasileiros

OBJECTIVE:To investigate the association of the T allele of the single nucleotide polymorphism (SNP) rs7903146 of TCF7L2 with the occurrence of T2D in a sample of subjects followed up at the Brasilia University Hospital. SUBJECTS AND METHODS: The SNP rs7903146 of TCF7L2 was genotyped by allele-specific PCR in 113 patients with known T2D and in 139 non-diabetic controls in Brasilia, Brazil. RESULTS:We found that the T allele of the SNP rs7903146 of TCF7L2 was significantly associated with T2D risk (odds ratio of 3.92 for genotype TT in the recessive genetic model, p = 0.004 and 1.5 for T allele, p = 0.032). CONCLUSION:These results reinforce previous findings on the consistent association of this genetic factor and the risk of T2D in populations of diverse ethnic backgrounds. Arq Bras Endocrinol Metab. 2012;56(8):479-84OBJETIVO: Investigar a associação do alelo T do polimorfismo de nucleotídeo único (SNP) rs7903146 do TCF7L2 com a ocorrência de DM2 em uma amostra de indivíduos acompanhados no Hospital Universitário de Brasília. SUJEITOS E MÉTODOS: O SNP 7903146 do TCF7L2 foi genotipado por PCR alelo-específica em 113 pacientes portadores de DM2 e em 139 controles não diabéticos em Brasília, Brasil. RESULTADOS: Foi observada associação significativa do alelo T do SNP rs7903146 do TCF7L2 com a ocorrência de DM2 (razão de chances de 3,92 para o genótipo TT utilizando o modelo genético recessivo, p = 0,003; e de 1,5 para o alelo T, p = 0,032). CONCLUSÃO: Esse resultado reforça os achados prévios de associação consistente desse fator genético com o risco de diabetes em populações de origens étnicas diversas. Arq Bras Endocrinol Metab. 2012;56(8):479-8

Evaluation of the presence of arabinogalactan proteins and pectins during Quercus suber male gametogenesis

Supplementary data are available online at www.aob.oxford journals.org and consist of the following. Figure S1: Quercus suber predicted AG peptide sequences. Table S1: Gene-specific primers used in qRT-PCR analysis.Quercus suber (cork oak) is a dominant tree of the Fagaceae in forests of the south-west Iberian Peninsula. It is monoecious with a long progamic phase that provides a comprehensive system for comparative studies in development and sexual reproduction. In this study the distribution of arabinogalactan protein (AGPs) and pectin epitopes in anthers of Q. suber was assessed to map these hydroxyproline-rich glycoproteins and the galacturonate-rich acidic polysaccharides during pollen development. Methods Immunolocalization in male flowers was performed with a set of monoclonal antibodies directed against the carbohydrate moiety that recognizes AGPs and pectins. To identify AGP genes involved in cork oak male flower development, a search was conducted for annotated AGP genes in the available transcriptome data of the Cork Oak EST Consortium database (www.corkoakdb.org).This work was funded by FEDER funds through the Operational Competitiveness Programme – COMPETE and by National Funds through FCT – Fundac¸a˜o para a Cieˆncia e a Tecnologia under the project FCOMP-01-0124-FEDER019461 (PTDC/AGR-GPL/118508/2010). R.S. was supported by funding from FCT with a PhD grant (ref. SFRH/BD/84365/ 2012).info:eu-repo/semantics/publishedVersio

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

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)