Óbitos e internações por tuberculose não notificados no município do Rio de Janeiro

OBJETIVO: Analisar a subnotificação de óbitos e internações por tuberculose no Sistema de Informação de Agravos de Notificação (Sinan). MÉTODOS: Foram selecionados os óbitos do Sistema de Informação sobre Mortalidade (SIM) com tuberculose como causa básica ou associada e as internações do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS) com causa principal ou secundária tuberculose de residentes no município do Rio de Janeiro em 2004. Foi realizada associação probabilística das bases de dados do SIM e SIH-SUS com a do Sinan, referentes aos anos de 2002 a 2004. RESULTADOS: Dos 542 óbitos por tuberculose no período, 234 (43,2%) não foram registrados no Sinan nos dois anos anteriores. Das 1.079 internações, 238 (22,1%) não foram notificadas. Foram relacionados às internações 71 óbitos: 47 ocorreram durante a internação por tuberculose, 24 após a internação. Sete não foram notificados no Sinan. Os idosos tiveram 1,6 vez (IC95% 1,074;2,516) a chance de não notificação dos mais jovens, e pessoas com nível superior ou mais escolaridade tiveram 3,6 vezes a chance (IC95% 1,384;11,022) daqueles com nenhum ano de estudo de não serem notificadas. Os menores de 15 anos tiveram 4,8 vezes a chance (IC95% 2,757;8,452) de não notificação daqueles entre 15 e 59 anos. Algumas divisões regionais de saúde apresentaram percentual de óbitos não notificados acima de 50% e esse percentual variou entre 37,8% e 12,7% para internações. CONCLUSÕES: Os dados sugerem problemas na detecção de casos e apontam barreiras de acesso ao tratamento oportuno e adequado e falhas na qualidade do sistema de informação, com diferenças entre as regiões do município.OBJETIVO: Analizar la subnotificación de óbitos e internaciones por tuberculosis en el Sistema de Información de Agravios de Notificación (Sinan). MÉTODOS: Se seleccionaron los óbitos del Sistema de Información sobre Mortalidad (SIM) con causa básica o asociada a tuberculosis y las internaciones del Sistema de Informaciones Hospitalarias del Sistema Único de Salud con causa principal o secundaria tuberculosis de residentes en el municipio de Rio de Janeiro (Sureste de Brasil) en 2004. Se realizó asociación probabilística de las bases de datos del SIM y SIH-SUS con la del Sinan, referentes a los años de 2002 a 2004. RESULTADOS: De los 542 óbitos por tuberculosis en el período, 234 (43,2%) no fueron registrados en el Sinan en los dos años anteriores. De las 1.079 internaciones, 238 (22,1%) no fueron notificadas. Se relacionaron a las internaciones 71 óbitos: 47 durante la internación por tuberculosis, 24 posterior a la internación. Siete no fueron notificados en el Sinan. Los ancianos presentaron 1,6 veces (IC 95% 1,074;2,516) la probabilidad de no notificación con relación a los más jóvenes, y personas con nivel superior o más de escolaridad presentaron 3,6 veces la probabilidad (IC 95% 1,384;11,022) de no ser notificados con relación a los que no tenían ningún año de estudio. Los menores de 15 años reflejaron 4,8 veces la probabilidad (IC 95% 2,757;8,452) de no notificación con respecto a los que tenían de 15 a 59 años. Algunas divisiones regionales de salud presentaron porcentaje de óbitos no notificados por encima del 50% y ese porcentaje varió entre 37,8% a 12,7% para internaciones. CONCLUSIONES: Los datos sugieren problemas en la detección de casos y apuntan barreras de acceso al tratamiento oportuno y adecuado y fallas en la calidad del sistema de información, con diferencias entre las regiones del municipio.OBJECTIVE: To analyze underreporting of deaths and hospital admissions from tuberculosis to the Information System for Notifiable Diseases (SINAN). METHODS: Cases with tuberculosis as basic or associated cause of death were selected from the Brazilian Mortality Information System (SIM) and hospital admissions for tuberculosis as main or secondary cause from the Hospital Information System of the Brazilian Unified Health System (SIH-SUS), for residents in the municipality of Rio de Janeiro in 2004. Probabilistic record linkage was carried out between the SIM and SIH-SUS databases and the SINAN for the years 2002 to 2004. RESULTS: Out of the 542 deaths from tuberculosis in the period, 234 (43.2%) were not registered in the SINAN for the two previous years. As for the 1,079 admissions, 238 (22.1%) failed to be notified. Seventy-one deaths were related to these admissions: 47 were registered out of the SIH-SUS by death, 24 occurred after discharge and seven remained unnotified in the SINAN. The elderly were 1.6 times (95%CI 1.074;2.516) less likely to be notified than younger patients, and those with at least a college education were 3.6 times (95%CI 1.384;11.022) less likely to be notified than those with no formal education. Patients under 15 were 4.8 times (95%CI 2.757;8.452) less likely to be notified than those aged between 15 and 59 years. Some regional health administration divisions showed a percentage of unnotified deaths of over 50% and this percentage ranged from 37.8% to 12.7% for hospital admissions. CONCLUSIONS: The data suggest problems in the detection of cases and point to obstacles in adequate and timely treatment, as well as to quality flaws in the information system, with differences among regions in the municipality

Adult-Young Ratio, a Major Factor Regulating Social Behaviour of Young: A Horse Study

Adults play an important role in regulating the social behaviour of young individuals. However, a few pioneer studies suggest that, more than the mere presence of adults, their proportions in social groups affect the social development of young. Here, we hypothesized that aggression rates and social cohesion were correlated to adult-young ratios. Our biological model was naturally-formed groups of Przewalski horses, Equus f. przewalskii, varying in composition.We investigated the social interactions and spatial relationships of 12 one- and two-year-old Przewalski horses belonging to five families with adult-young ratios (AYR) ranging from 0.67 to 1.33. We found striking variations of aggression rates and spatial relationships related to the adult-young ratio: the lower this ratio, the more the young were aggressive, the more young and adults segregated and the tighter the young bonded to other young.This is the first study demonstrating a correlation between adult-young ratios and aggression rates and social cohesion of young individuals in a naturalistic setting. The increase of aggression and the emergence of social segregation in groups with lower proportions of adults could reflect a related decrease of the influence of adults as regulators of the behaviour of young. This social regulation has both theoretical and practical implications for understanding the modalities of the influence of adults during ontogeny and for recommending optimal settings, as for instance, for schooling or animal group management

Structural basis for Mep2 ammonium transceptor activation by phosphorylation

Mep2 proteins are fungal transceptors that play an important role as ammonium sensors in fungal development. Mep2 activity is tightly regulated by phosphorylation, but how this is achieved at the molecular level is not clear. Here we report X-ray crystal structures of the Mep2 orthologues from Saccharomyces cerevisiae and Candida albicans and show that under nitrogen-sufficient conditions the transporters are not phosphorylated and present in closed, inactive conformations. Relative to the open bacterial ammonium transporters, non-phosphorylated Mep2 exhibits shifts in cytoplasmic loops and the C-terminal region (CTR) to occlude the cytoplasmic exit of the channel and to interact with His2 of the twin-His motif. The phosphorylation site in the CTR is solvent accessible and located in a negatively charged pocket ∼30 Å away from the channel exit. The crystal structure of phosphorylation-mimicking Mep2 variants from C. albicans show large conformational changes in a conserved and functionally important region of the CTR. The results allow us to propose a model for regulation of eukaryotic ammonium transport by phosphorylation

Adding value to under-utilised Irish fish roe: a physico-chemical and sensory comparison of cured Irish pollock (Pollachius pollachius) roe with commercial mullet (Mugil cephalus) and cod (Gadus morhua) products

peer reviewedIrish marine fish roe is generally discarded at sea or processed as low value-added fishmeal and not utilised as nutritious seafood ingredients. Locally sourced pollock roes were salted, air-dried (Mediterranean-style) and compared to similar commercial mullet and cod products for: weight; moisture content; pH; instrumental texture and colour; and sensory attributes. Raw pollock roes averaged 105 g (n = 25). Roes lost on average 3.1% moisture (w/w) after a 2-h salting period and 48.8% weight reduction was observed after an average 105 h air-drying time. The moisture content of pollock was not significantly different to commercial products. Average pH for pollock, mullet and cod products was 5.9, 5.4 and 5.7, respectively (P < 0.05). Pollock and mullet had similar hardness, but cod was significantly harder than both, when measured instrumentally. Total colour difference (ΔE*) between the surface of pollock and cod, and that of pollock and mullet was 7.5 and 3.0, respectively. Sensory assessment of sliced and powdered products, using 9-point hedonic and 5-point just-about-right (JAR) scales, was conducted with 38 consumers. Pollock received the highest scores for overall liking and intention to purchase compared to commercial mullet and cod products, averaging 5.6, 5.6 and 4.9, respectively, for sliced roe products, and 6.3, 5.3 and 6.1 for powdered products. Penalty analysis of JAR showed “overall liking” was impacted by the flavour being “too fishy”. In conclusion, pollock had similar characteristics and acceptable sensory attributes compared to commercial products presenting opportunities to expand the range of value-added roe products (e.g., trout, salmon) available, while also contributing to waste reduction

Additive QTLs on three chromosomes control flowering time in woodland strawberry (Fragaria vesca L.)

Flowering time is an important trait that affects survival, reproduction and yield in both wild and cultivated plants. Therefore, many studies have focused on the identification of flowering time quantitative trait locus (QTLs) in different crops, and molecular control of this trait has been extensively investigated in model species. Here we report the mapping of QTLs for flowering time and vegetative traits in a large woodland strawberry mapping population that was phenotyped both under field conditions and in a greenhouse after flower induction in the field. The greenhouse experiment revealed additive QTLs in three linkage groups (LG), two on both LG4 and LG7, and one on LG6 that explain about half of the flowering time variance in the population. Three of the QTLs were newly identified in this study, and one co-localized with the previously characterized FvTFL1 gene. An additional strong QTL corresponding to previously mapped PFRU was detected in both field and greenhouse experiments indicating that gene(s) in this locus can control the timing of flowering in different environments in addition to the duration of flowering and axillary bud differentiation to runners and branch crowns. Several putative flowering time genes were identified in these QTL regions that await functional validation. Our results indicate that a few major QTLs may control flowering time and axillary bud differentiation in strawberries. We suggest that the identification of causal genes in the diploid strawberry may enable fine tuning of flowering time and vegetative growth in the closely related octoploid cultivated strawberry.Peer reviewe

Long non-coding RNAs: spatial amplifiers that control nuclear structure and gene expression

Over the past decade, it has become clear that mammalian genomes encode thousands of long non-coding RNAs (lncRNAs), many of which are now implicated in diverse biological processes. Recent work studying the molecular mechanisms of several key examples — including Xist, which orchestrates X chromosome inactivation — has provided new insights into how lncRNAs can control cellular functions by acting in the nucleus. Here we discuss emerging mechanistic insights into how lncRNAs can regulate gene expression by coordinating regulatory proteins, localizing to target loci and shaping three-dimensional (3D) nuclear organization. We explore these principles to highlight biological challenges in gene regulation, in which lncRNAs are well-suited to perform roles that cannot be carried out by DNA elements or protein regulators alone, such as acting as spatial amplifiers of regulatory signals in the nucleus

Immune neuroendocrine phenotypes in Coturnix coturnix: Do avian species show LEWIS/FISCHER-like profiles?

Immunoneuroendocrinology studies have identified conserved communicational paths in birds and mammals, e.g. the Hypothalamus-Pituitary-Adrenal axis with anti-inflammatory activity mediated by glucocorticoids. Immune neuroendocrine phenotypes (INPs) have been proposed for mammals implying the categorization of a population in subgroups underlying divergent immune-neuroendocrine interactions. These phenotypes were studied in the context of the LEWIS/FISCHER paradigm (rats expressing high or low pro-inflammatory profiles, respectively). Although avian species have some common immunological mechanisms with mammals, they have also evolved some distinct strategies and, until now, it has not been studied whether birds may also share with mammals similar INPs. Based on corticosterone levels we determined the existence of two divergent groups in Coturnix coturnix that also differed in other immune-neuroendocrine responses. Quail with lowest corticosterone showed higher lymphoproliferative and antibody responses, interferon-γ and interleukin-1β mRNA expression levels and lower frequencies of leukocyte subpopulations distribution and interleukin-13 levels, than their higher corticosterone counterparts. Results suggest the existence of INPs in birds, comparable to mammalian LEWIS/FISCHER profiles, where basal corticosterone also underlies responses of comparable variables associated to the phenotypes. Concluding, INP may not be a mammalian distinct feature, leading to discuss whether these profiles represent a parallel phenomenon evolved in birds and mammals, or a common feature inherited from a reptilian ancestor millions of years ago

Hand osteoarthritis: clinical phenotypes, molecular mechanisms and disease management

Osteoarthritis (OA) is a highly prevalent condition and the hand is the most commonly affected site. Patients with hand OA frequently report symptoms of pain, functional limitations, and frustration in undertaking everyday activities. The condition presents clinically with changes to the bone, ligaments, cartilage and synovial tissue, which can be observed using radiography, ultrasonography or MRI. Hand OA is a heterogeneous disorder and is considered to be multifactorial in aetiology. This review provides an overview of the epidemiology, presentation and burden of hand OA, including an update on hand OA imaging (including the development of novel techniques), disease mechanisms and management. In particular, areas for which new evidence has substantially changed the way we understand, consider and treat hand OA are highlighted. For example, genetic studies, clinical trials and careful prospective imaging studies from the past 5 years are beginning to provide insights into the pathogenesis of hand OA that might uncover new therapeutic targets in disease