ESTUDO DE UTILIZAÇÃO DE ANTIBIÓTICOS NAS UNIDADES BÁSICAS DO MUNICÍPIO DE MOREILÂNDIA-PE

Os atuais dados da Organização Mundial da Saúde (OMS) mostram que 50% das prescrições de antibióticos são inapropriadas, e informa ainda que dois terços dos antibióticos usados pela população são consumidos sem a prescrição médica. A implantação da RDC 20/2011 no Brasil é uma das medidas para tentar evitar o uso irracional. A presente pesquisa teve como objetivo avaliar o uso de antibióticos pelos pacientes que utilizam o serviço das Unidades Básicas de Saúde de Moreilândia – PE. Tratou-se de um estudo transversal, descritivo de abordagem quantitativa no qual foi aplicado um questionário com perguntas objetivas e subjetivas. O período da pesquisa ocorreu de junho a setembro de 2020. Os entrevistados (n=100) foram na sua maioria do sexo feminino (72%), solteiro (53%) e que afirmou ter concluído o ensino fundamental (58%). Os antibióticos mais utilizados foram: amoxicilina, azitromicina e cefalexina. Dos entrevistados 49,5% fizeram uso de antibióticos sem prescrição de profissional legalmente habilitado e 56% não souberam responder o que é um medicamento antibiótico. Constatou-se o uso inapropriado de antibióticos para tratamento de doenças como gripe, dor de cabeça, acne, verme, dentre outras. Os resultados revelam que o desconhecimento da população da cidade de Moreilândia-PE acerca dos riscos da utilização abusiva de antimicrobianos está relacionado à falta de orientação. Há uma grande e errônea facilidade, de acesso da população aos medicamentos antibióticos, levando em consideração que grande parte dos entrevistados tiveram acesso aos medicamentos sem receita médica. Fatores estes, que contribuem diretamente para o surgimento da resistência bacteriana

Lineamientos de política pública de salud bucal de Medellín 2013-2022: referentes, objetivos y estrategias para avanzar en la garantía del derecho a la salud bucal

La Secretaría de Salud de Medellín, lideró la formulación de la Política Pública de Salud Bucal para la ciudad de Medellín-PPSB-. El presente documento describe el proceso de formulación de la Política Pública de Salud Bucal, sus antecedentes y sus principales referentes; sintetiza el producto colectivo logrado respecto a los principios, ejes de acción, objetivos y estrategias de la PPSB, que los actores han construido de manera progresiva, basados en los análisis de situación de salud y en múltiples talleres de deliberación y concertación de criterios técnicos y análisis de viabilidad realizados en el proceso de formulación. También fueron construidas unasmetas e indicadores durante el proceso, con una proyección a diez años y alcances parciales a corto y mediano plazo (dos y cuatro años respectivamente), que constituyen un importante insumo para que el ente rector y los actores institucionales y sociales definan las proyecciones políticas y económicas acordes a los momentos de la planeación sectorial, institucional y de la ciudad. Esa será una de las principales acciones para emprender en el corto plazo

Assessing Dietary Branched-Chain Amino Acids to Achieve Linear Programming Goals through Model Extrapolation and Empirical Research

Renewed interest, especially in the United States, has sparked in assessing branched-chain amino acid interactions in practical diets for broilers. Indeed, as L-valine enters formulation bird nitrogen excesses are reduced as diet protein falls to the new first limiting amino acid (e.g., isoleucine, arginine, or tryptophan). For a United States based example, the result is less oilseeds and more gains, which typically result in increased inclusions in corn or corn by-products, coupled with a concomitant increase in dietary leucine. The proceedings outline the foundations of the branched-chain amino acid early research, antagonism studies, and a meta-analysis conducted on publications with Cobb and Ross birds from 2000 to present. Results indicate that branched-chain amino acid interactions can occur in broilers fed on practical diets, and that responses vary by strain

Dependent seniors garment design

This paper is part of a PhD research in Textile Engineering at University of Minho and aims to establish an ergonomic pattern design methodology to be used in the construction of garments for elderly women, aged 65 and over, dependent of care. The research was developed with a close contact with four institutions involved in supporting this aged population, located in the cities of Guimaraes (Portugal) and Teresina (Brazil). These clothes should be adequate to their anthropometrics and their special needs, in accordance with important functional factors for the dependency of their caregiver, such as: care for the caregiver and comfort for the user. Questions regarding the functional properties of the materials, the pattern design process, trimmings and the assembling process of the garments are specially considered in the desired comfort levels, in order to provide an adequate handling by facilitating the dressing and undressing tasks, but also to assure the user the needed comfort in all its variables.This work is supported by FEDER funds through the Competitive Factors Operational Program (COMPETE) POCI-01-0145-FEDER-007136 and by national funds through Portuguese Foundation for Science and Technology (FCT), under the project UID/CTM/000264 financed by Science Without Borders/CAPEs.info:eu-repo/semantics/publishedVersio

A tumor DNA complex aberration index is an independent predictor of survival in breast and ovarian cancer

Complex focal chromosomal rearrangements in cancer genomes, also called "firestorms", can be scored from DNA copy number data. The complex arm-wise aberration index (CAAI) is a score that captures DNA copy number alterations that appear as focal complex events in tumors, and has potential prognostic value in breast cancer. This study aimed to validate this DNA-based prognostic index in breast cancer and test for the first time its potential prognostic value in ovarian cancer. Copy number alteration (CNA) data from 1950 breast carcinomas (METABRIC cohort) and 508 high-grade serous ovarian carcinomas (TCGA dataset) were analyzed. Cases were classified as CAAI positive if at least one complex focal event was scored. Complex alterations were frequently localized on chromosome 8p (n = 159), 17q (n = 176) and 11q (n = 251). CAAI events on 11q were most frequent in estrogen receptor positive (ER+) cases and on 17q in estrogen receptor negative (ER) cases. We found only a modest correlation between CAAI and the overall rate of genomic instability (GII) and number of breakpoints (r = 0.27 and r = 0.42, p <0.001). Breast cancer specific survival (BCSS), overall survival (OS) and ovarian cancer progression free survival (PUS) were used as clinical end points in Cox proportional hazard model survival analyses. CAAI positive breast cancers (43%) had higher mortality: hazard ratio (HR) of 1.94 (95%CI, 1.62-2.32) for BCSS, and of 1.49 (95%CI, 1.30-1.71) for OS. Representations of the 70-gene and the 21-gene predictors were compared with CAAI in multivariable models and CAAI was independently significant with a Cox adjusted HR of 1.56 (95%CI, 1.23-1.99) for ER+ and 1.55 (95%CI, 1.11-2.18) for ER disease. None of the expression-based predictors were prognostic in the ER subset. We found that a model including CAM and the two expression-based prognostic signatures outperformed a model including the 21-gene and 70-gene signatures but excluding CAAL Inclusion of CAAI in the clinical prognostication tool PREDICT significantly improved its performance. CAAI positive ovarian cancers (52%) also had worse prognosis: HRs of 1.3 (95%CI, 1.1-1.7) for PFS and 1.3 (95%CI, 1.1-1.6) for OS. This study validates CAM as an independent predictor of survival in both ER+ and ER breast cancer and reveals a significant prognostic value for CAAI in high-grade serous ovarian cancer. (C) 2014 The Authors. Published by Elsevier B.V. on behalf of Federation of European Biochemical Societies. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).Publisher PDFPeer reviewe

Landscape of somatic mutations in 560 breast cancer whole-genome sequences.

We analysed whole-genome sequences of 560 breast cancers to advance understanding of the driver mutations conferring clonal advantage and the mutational processes generating somatic mutations. We found that 93 protein-coding cancer genes carried probable driver mutations. Some non-coding regions exhibited high mutation frequencies, but most have distinctive structural features probably causing elevated mutation rates and do not contain driver mutations. Mutational signature analysis was extended to genome rearrangements and revealed twelve base substitution and six rearrangement signatures. Three rearrangement signatures, characterized by tandem duplications or deletions, appear associated with defective homologous-recombination-based DNA repair: one with deficient BRCA1 function, another with deficient BRCA1 or BRCA2 function, the cause of the third is unknown. This analysis of all classes of somatic mutation across exons, introns and intergenic regions highlights the repertoire of cancer genes and mutational processes operating, and progresses towards a comprehensive account of the somatic genetic basis of breast cancer

A tumor DNA complex aberration index is an independent predictor of survival in breast and ovarian cancer.

Complex focal chromosomal rearrangements in cancer genomes, also called "firestorms", can be scored from DNA copy number data. The complex arm-wise aberration index (CAAI) is a score that captures DNA copy number alterations that appear as focal complex events in tumors, and has potential prognostic value in breast cancer. This study aimed to validate this DNA-based prognostic index in breast cancer and test for the first time its potential prognostic value in ovarian cancer. Copy number alteration (CNA) data from 1950 breast carcinomas (METABRIC cohort) and 508 high-grade serous ovarian carcinomas (TCGA dataset) were analyzed. Cases were classified as CAAI positive if at least one complex focal event was scored. Complex alterations were frequently localized on chromosome 8p (n = 159), 17q (n = 176) and 11q (n = 251). CAAI events on 11q were most frequent in estrogen receptor positive (ER+) cases and on 17q in estrogen receptor negative (ER-) cases. We found only a modest correlation between CAAI and the overall rate of genomic instability (GII) and number of breakpoints (r = 0.27 and r = 0.42, p < 0.001). Breast cancer specific survival (BCSS), overall survival (OS) and ovarian cancer progression free survival (PFS) were used as clinical end points in Cox proportional hazard model survival analyses. CAAI positive breast cancers (43%) had higher mortality: hazard ratio (HR) of 1.94 (95%CI, 1.62-2.32) for BCSS, and of 1.49 (95%CI, 1.30-1.71) for OS. Representations of the 70-gene and the 21-gene predictors were compared with CAAI in multivariable models and CAAI was independently significant with a Cox adjusted HR of 1.56 (95%CI, 1.23-1.99) for ER+ and 1.55 (95%CI, 1.11-2.18) for ER- disease. None of the expression-based predictors were prognostic in the ER- subset. We found that a model including CAAI and the two expression-based prognostic signatures outperformed a model including the 21-gene and 70-gene signatures but excluding CAAI. Inclusion of CAAI in the clinical prognostication tool PREDICT significantly improved its performance. CAAI positive ovarian cancers (52%) also had worse prognosis: HRs of 1.3 (95%CI, 1.1-1.7) for PFS and 1.3 (95%CI, 1.1-1.6) for OS. This study validates CAAI as an independent predictor of survival in both ER+ and ER- breast cancer and reveals a significant prognostic value for CAAI in high-grade serous ovarian cancer