Ordinance 3992/2017: challenges and advances for resource management in the Brazilian Unified Health System (SUS)

To advance in order to overcome the challenge of enabling greater autonomy in the use of financial resources in the Unified Health System (SUS), system managers agreed that transfers from the Union to other federated entities will be carried out through a financial investment account and a costing account. Over the past few years, states and municipalities managed more than 34,000 bank accounts dedicated to the Union’s on-lendings, in which balance exceeded R$8 billion. However, from 2018, Ordinance 3,992/2017 unequivocally separated the budget flow from the financial flow, and the fund-to-fund transfers started to be carried out in only 11,190 bank accounts. Since then, managers have had financial autonomy in the management of financial resources received from the Union, if in accordance

Porous titanium for biomedical applications : an experimental study on rabbits

Objective: The aim of this study was to carry out an in vivo assessment of bone ingrowth in two different types of porous titanium -the first being completely porous, and the second with a porous surface and dense nucleus, manufactured by powder metallurgy- and to evaluate their mechanical properties. Study design: Ten scaffolds from each group were submitted to metallographic analysis and compression tests. Next, two scaffolds of each type were inserted into 14 rabbits, which were sacrificed 8 weeks after surgery. The samples were submitted for histological examination. Results: Metallographic analysis revealed interconnected pores, and the average interconnected pore diameter was about 360 mm, with 36% total porosity. The totally porous titanium samples and the titanium samples with porous surface and dense nucleus showed an average compressive strength of 16.19 MPa and 69.27 MPa, respectively. After 8 weeks, the animals showed bone ingrowth, even into the most internal pores. Conclusions: The pore morphology was effective in permitting bone ingrowth in both groups. Titanium scaffolds with a porous surface and dense nucleus showed the best mechanical properties and most adequate interface

Relationship between mood states, heart rate variability and creatine kinase of Brazilian para-athletes

The main purpose of this study was to check any relationship between mood states heart rate, variability (HRV) and creatine kinase (CK) of Brazilian para-athletes. Were evaluated 12 athletes, members of the Brazilian Team of Para-Athletics. In order to evaluate the autonomic response the HRV of athletes was determined at rest, by collecting the R-R intervals within 10 min. It was also collected blood samples to analyze the total CK, and the Brums scale was applied to know the mood states of the athletes, being calculated the six mood states (tension, depression, anger, fatigue, confusion and vigor). Analysis of the data was performed by Spearman correlation. The main results indicated a relationship between the parasympathetic modulation and the Vigor of the athletes (r = 0.50 to 0.53; p<0.05). The CK was not related with any marker. In conclusion: There was a relationship between the parasympathetic modulation of HRV and the Vigor, which is good for the performance.Objetivo deste estudo foi investigar a relação entre os estados de humor, a variabilidade da frequência cardíaca (VFC) e creatina quinase (CK) de para-atletas brasileiros. Foram avaliados 12 atletas, integrantes da Seleção Brasileira de Para-Atletismo. Para avaliar a resposta autonômica foi determinada a VFC em repouso, coletando os intervalos R-R em 10 min. Foram coletadas também amostras de sangue para analisar a CK total e para conhecer os estados de humor dos atletas, foi utilizado a Escala de Brums, sendo calculados os seis estados de humor (tensão, depressão, raiva, fadiga, confusão e vigor). A análise dos dados foi realizada pela correlação de Sperman. Os principais resultados demonstraram relação entre a modulação parassimpática e o Vigor dos atletas (r = 0,50 a 0,53; p<0,05). A CK não se relacionou com nenhum marcador. Conclui-se que houve relação entre a modulação parassimpática da VFC e o Vigor, o que é positivo para o rendimento na competição.Universidade Nove de JulhoUniversidade São Judas TadeuUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Evaluation of opening pattern and bone neoformation at median palatal suture area in patients submitted to surgically assisted rapid maxillary expansion (SARME) through cone beam computed tomography

AbstractSurgically assisted rapid maxillary expansion (SARME) is the treatment of choice to adult patients even with severe transversal maxillary discrepancies. However, the adequate retention period to achieve the bone remodeling, thus assuring treatment stability, is controversial.Objective To evaluate the opening pattern and bone neoformation process at the midpalatal suture in patients submitted to surgically assisted (SARME) through cone beam computed tomography (CBCT).Material and Methods Fourteen patients were submitted to SARME through subtotal Le Fort I osteotomy. Both the opening pattern and the mean bone density at midpalatal suture area to evaluate bone formation were assessed pre- and post-operatively (15, 60 and 180 days) through CBCT.Results Type I opening pattern (from anterior to posterior nasal spine) occurred in 12 subjects while type II opening pattern (from anterior nasal spine to transverse palatine suture) occurred in 2 individuals. The 180-day postoperative mean (PO 180) of bone density value was 49.9% of the preoperative mean (Pre) value.Conclusions The opening pattern of midpalatal suture is more related to patients’ age (23.9 years in type I and 33.5 years in type II) and surgical technique. It was not possible to observe complete bone formation at midpalatal suture area at the ending of the retention period studied (180 days)

Yield performance of okra under potassium fertilization and number of plants per hole

The okra is a vegetable that responds to mineral nutrition and the plant population, with increased production. The work was carried out at the Federal University of Paraíba, in Areia-PB, with the objective of evaluating the influence of K2O doses and number of plants per pit on the yield and quality of okra, cultivating Santa Cruz, in an experimental block design randomized, with treatments distributed in a 6 x 2 factorial scheme, with six K2O doses (0, 50, 100, 150, 200 and 250 kg ha-1), and one and two plants per pit, in four replications. The values ​​for the average mass of fruits, 16 and 18 g were reached as a function of K2O doses, with one and two plants per pit, respectively. The highest numbers of fruits per plant in okra were 45 and 56, at doses of 123.7 and 184 kg ha-1 of K2O, respectively for one and two plants per pit, and the highest fruit production per plant was 584.2 g, with two plants per pit and 250 kg ha-1 of K2O. The total fruit yield was 42.13 t ha-1, in the treatment with two plants per pit and 100 kg ha-1 of K2O, and the doses of 122.5 and 115 kg ha-1 of K2O were responsible for the higher productivity of commercial fruits in okra, 25.6 and 29.2 t ha-1, respectively, with one and two plants per pit, and the leaf K content was influenced only by K2O doses. Keywords: Abelmoschus esculentus; mineral fertilizers; plant densit

Bronquiolite aguda como condição sensível a atenção primária, em uma cidade no sul do brasil

The bronchiolitis , que often occurs in young infants , with predominance In the winter months . And Sensitive Primary Health Care (PHC ) by decree No. 221 of 17 April 2008 of the Ministry of Health , however occupies hum large contingent hospital . OS was observed hospitalization rates related to bronchiolitis in Age of Children 0-9 years , no period 2012/2013 , in Pelotas , assessing the Quality of Primary and ITS effects on Admission Process. -If Found que were 323 hospitalizations , being 174 in 2012 and 149 in 2013. More prevalent age group was in Children under 1 year ( 83.59 % ) , after 1-4 years ( 15.17% ) , and 5 -9 year (1.23 % ) . The Health and selflimited and and preventable BY simple hygiene measures it is possible to infer that the number of hospitalizations for bronchiolitis may be related to the lack of effective actions Prevention nos PHC servicesA Bronquiolite, que ocorre frequentemente em lactentes jovens, com predomínio nos meses de inverno. É sensível a atenção primária à Saúde (APS) pela portaria nº 221 do dia 17 de abril de 2008 do Ministério da Saúde, porém ocupa um grande contingente hospitalar. Se observou os índices de internação hospitalar referentes à bronquiolite em crianças de faixa etária de 0-9 anos, no período de 2012/2013, em Pelotas, avaliando a qualidade da atenção básica e seus efeitos no processo de internação. Constatou-se que ocorreram 323 internações, sendo 174 em 2012 e 149 em 2013. A faixa etária mais prevalente foi em crianças menores de 1 ano (83,59%), após 1-4 anos (15,17%), e 5-9 anos (1,23%). A doença é autolimitada e é prevenível por medidas simples de higiene, é possível depreender que o número de hospitalizações por bronquiolite pode estar relacionada à carência de ações de prevenção efetivas nos serviços de APS

Estado nutricional de crianças com cardiopatias congênitas

OBJECTIVE: to characterize nutritional status and variables that predict nutritional changes in children with congenital heart disease. METHOD: a cross-sectional study undertaken in two health institutions between January and June 2009, using a questionnaire with questions about nutrition, applied to 132 children under two years of age who had congenital heart disease. Children who had additional serious illnesses were excluded. RESULT: the predominant percentile values and Z scores were concentrated within the range of normal levels. The Z scores, however, presented negative variations with a deviation to the left. In the analysis of predictive factors, the occurrence of immediate and acute malnutrition was related to a decrease in skinfold thickness (decrease in subscapular skinfold thickness, while immediate malnutrition was related to a high Apgar score. Chronic malnutrition was related to female children with higher ages. CONCLUSION: it is evidenced that it is necessary to carry out nutritional strategies which improve prognosis, so as to widen the nursing care directed at these children.OBJETIVO: caracterizar el estado nutricional y verificar variables que predicen alteraciones nutricionales en niños portadoras de cardiopatías. MÉTODO: estudio transversal realizado en dos instituciones de salud de enero a junio de 2009, utilizando formulario con cuestiones nutricionales. Se seleccionaron 132 niños menores de dos años y presentando cardiopatía congénita, excluyéndose aquéllas con otras enfermedades graves. RESULTADO: los valores de percentiles y scores Z predominantes se concentraron dentro de la banda de normalidad. Mientras, los valores de scores Z presentaron variaciones negativas con desvío para la izquierda. En el análisis de factores predictores, la ocurrencia de desnutrición inmediata y aguda estuvo relacionada a la disminución del pliegue cutáneo subescapular, la desnutrición inmediata se relacionó al elevado score de Apgar. La desnutrición crónica se refirió a los niños del sexo femenino con edades mayores. CONCLUSIÓN: se evidencia la necesidad de realizar estrategias nutricionales que posibiliten mejor pronóstico, en la tentativa de ampliar las atenciones de enfermería dirigidos a estos niños.OBJETIVO: caracterizar o estado nutricional e verificar variáveis que predizem alterações nutricionais em crianças portadoras de cardiopatias. MÉTODO: trata-se de estudo transversal, realizado em duas instituições de saúde, de janeiro a junho de 2009, utilizando formulário com questões nutricionais. Selecionaram-se 132 crianças menores de dois anos e que apresentavam cardiopatia congênita, excluindo-se aquelas com outras doenças graves. RESULTADO: os valores de percentis e escores Z predominantes concentraram-se dentro da faixa de normalidade. Entretanto, os valores de escores Z apresentaram variações negativas com desvio para a esquerda. Na análise de fatores preditores, a ocorrência de desnutrição imediata e aguda esteve relacionada à diminuição da prega cutânea subescapular, a desnutrição imediata relacionou-se ao elevado escore de Apgar. A desnutrição crônica referiu-se às crianças do sexo feminino com idademaior. CONCLUSÃO: evidencia-se a necessidade de realizar estratégias nutricionais que possibilitem melhor prognóstico, na tentativa de ampliar os cuidados de enfermagem direcionados a essas crianças

Sedimentary Patterns and Spatial Distributions of Heavy Minerals along the Continental Shelf in the Espírito Santo State, Brazil

Heavy minerals can be used as tools to better understand sedimentary patterns across continental shelves, in addition to their economic importance, where they form marine placers. This study investigates the spatial distributions of heavy minerals in sand deposits along the three different morpho-sedimentary compartments (i.e., Paleovalley Shelf, Doce river Shelf, and Abrolhos Shelf) of the Espírito Santo Continental Shelf, which presents distinct sedimentary regimes. A mineralogical characterization of 180 surface sediment samples allowed to identify fifteen different heavy mineral species across the study area, with a predominance of ilmenite. The qualitative characterization shows similar heavy mineral patterns among the three compartments, while their mineral proportion (quantitative analysis) is heterogeneous. Also, the supply and accommodation regimes do not responsible by influence the heavy mineral assemblages and sediment maturity. However, there is a significant relationship between supply regime (delta sedimentation) and higher average abundances of each heavy mineral species. With results found here is possible to affirm that marine placers are closely related to Holocene sedimentation.