Evolução na utilização e nos gastos de uma operadora de saúde

Brazil’s aging population and the rising number of people reliant upon the country’s supplementary healthcare system have elicited the concern of public and private managers regarding the increase in healthcare costs. In this paper, the costs per gender, per type of medical expenses and per age group of a major Brazilian self-managed healthcare provider between 2007 and 2013 were analyzed. This healthcare provider is of interest because, besides portraying a single condition of revenue growth restricted to the existing contributors, it also replicates the demographic profile expected for Brazil in 2050, when approximately one-third of its population will be over 60 years of age. The analyses confirm the current literature as they show an increase in healthcare plan usage by the elderly and the difference between admission rates by gender. They also reveal an increase in average length of stay in hospital and the increase in medical costs far above inflation, especially for materials and medicines. It is hoped that this study will help scholars and others interested in comparisons of medical expense trends, especially by age and sex, and that it encourages further collaboration on the sustainability of health insurance providers in Brazil

Assessment of Electrochemical and Mechanical Behavior of Hot-Extruded Powders and As-Cast Samples of Al-Ni Alloys

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)The cellular or dendritic morphologies of the Al-rich matrix as well as the morphology, size, and distribution of the intermetallic particles can affect not only the electrochemical corrosion resistance but also the mechanical strength of Al-Ni alloys. The aim of this work is to analyze the effects of two different powder size (d) ranges (d<45 mu m; 106 mu m<d<180 mu m) of Al-Ni alloy samples prepared by nitrogen gas atomization followed by compaction and hot extrusion consolidation, on the microstructure, corrosion behavior and mechanical properties. The corresponding characteristics and properties of directionally solidified Al-Ni alloy samples (as cast) are also examined. Electrochemical impedance spectroscopy (EIS), potentiodynamic polarization techniques and an equivalent circuit analysis were used to evaluate the electrochemical behavior in a 0.5 M NaCl solution at room temperature. It was found that finer microstructure arrays are associated with better electrochemical behavior. This was shown to be intimately associated with fragmented or globular Al3Ni intermetallic particles, which detached from the eutectic mixture reducing the cathode area and interfering in the corrosion action. A combined plot of corrosion and mechanical properties as a function of a representative microstructural parameter is proposed, permitting an appropriate combination of these properties to be designed based on the alloy microstructure.71099469971FAEPEX-UNICAMPConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

High prevalence of HTLV-1 and 2 viruses in pregnant women in São Luis, state of Maranhão, Brazil

INTRODUCTION: Human T cell lymphotropic virus type 1 (HTLV-1) is endemic in the Caribbean, Japan, South America and regions of Africa. HTLV-2 is present in Native American populations and associated with IV drug use in Europe and North America. In Brazil, it is estimated that 1.5 million people are infected with HTLV-1/2. The study objective was to determine HTLV-1/2 prevalence in pregnant women in the prenatal care from three public services in São Luis, State of Maranhão, Brazil, and to counsel seropositive women to reduce viral transmission. METHODS: A cross-sectional study was conducted from February to December 2008; women with age of 18 to 45 years, with low risk for sexually transmitted disease (STD) were invited to participate. Blood samples were collected in filter paper, and HTLV-1/2 immunoenzymatic test (ELISA) was performed as a screening test. Women with reactive results were submitted to peripheral venous blood collection for ELISA repetition, followed by Western blot (WB) and real-time PCR to confirm and discriminate the infection between virus types 1 and 2. RESULTS: Of the 2,044 women tested, seven (0.3%) were ELISA reactive and confirmed positive (four were HTLV-1, and three were HTLV-2). All positive women were oriented not to breastfeed their newborns. CONCLUSIONS: This study showed that the virus is present in high prevalence in that population. Further studies covering other segments of the population are necessary to better characterize the presence of HTLV-1/2 in Maranhão and to elicit measures to prevent its spread