EFICÁCIA MOSQUICIDA DE UMA ASSOCIAÇÃO “POUR-ON” CONTENDO CLORPIRIFÓS 50% e CIPERMETRINA 20%, NO CONTROLE DA MOSCA DOS CHIFRES (Haematobia irritans) EM BOVINOS NATURALMENTE INFESTADOS

A mosca-dos-chifres (Haematobia irritans) é um pequeno ectoparasita díptero hematófago que parasita o bovino, causando prejuízos econômicos estimados em 3,24 bilhões de dólares, determinados principalmente pela espoliação e o incomodo ao animal que acarretam perda de peso e diminuição da produção leiteira dentre outros aspectos da produção. O estudo, aprovado pela Comissão de Ética no uso de Animais do Instituto de Veterinária da UFRRJ (CEUA Nº 4515061217), objetivou avaliar a eficácia da associação a base de clorpirifós e cipermetrina, contra H. irritans em bovinos naturalmente infestados. Foram utilizados 30 bovinos mestiços e o ranqueamento foi feito com base nas médias das contagens do número total de moscas, em ambos os lados do animal, realizadas nos dias D-3 e D-1. Os animais selecionados foram divididos em dois grupos, Grupo Controle (GC) e Grupo Tratado (GT), contendo em cada um, 15 animais. No dia D0, a associação do medicamento foi administrada por via tópica nos animais do GT em dose única de 5 litros por pulverização com auxílio de uma bomba costal. Os animais foram contidos em brete e tratados individualmente. O efeito contra H. irritans foi avaliado por meio de contagens do número de moscas vivas contidos em ambos os lados dos animais nos dias experimentais D+1, D+3, D+7, D+14, D+21, D+28, D+35 e D+42. Diferenças estatísticas significativas (p≤0,05) foram verificadas nas médias das contagens de moscas em todos os dias após tratamento dos animais. Os resultados das médias aritméticas de contagens de moscas foram os seguintes para o grupo controle (GC): 95,20 (D+1),  74,07 (D+3),  100,80 (D+7),  79,07 (D+14),  65,53 (D+21),  75,47 (D+28),  92,87  (D+35),  76,93 (D+42); e para o grupo tratado (GT): 0,53 (D+1), 0,40 (D+3), 1,27 (D+7), 4,27 (D+14), 11,80 (D+21), 16,67 (D+28), 29,47 (D+35), 40,07 (D+42). A eficácia observada por dia experimental foi de: 99,4% (D+1), 99,46% (D+3), 98,74% (D+7), 94,60% (D+14), 81,99% (D+21), 77,92% (D+28), 68,27% (D+35) e 47,92% (D+42). Através dos resultados da contagem de H. irritans pôde-se observar antes do tratamento variações de 34 a 114 moscas nos animais. Os resultados demostraram que a associação à base de clorpirifós 50% e cipermetrina 20%, empregada por pulverização, foi efetiva para o tratamento de bovinos naturalmente infestados por H. irritans, apresentando níveis de eficácia acima de 80% por até 21 dias após tratamento

Relação entre níveis de hemoglobina, concentração de retinol sérico e estado nutricional em crianças de 6 a 59 meses do Estado da Paraíba

OBJETIVO: Analisar a relação entre os níveis de hemoglobina, concentração de retinol sérico e estado nutricional em crianças de 6 a 59 meses de idade do estado da Paraíba. MÉTODOS: Corte transversal, de base populacional, envolvendo 1.108 crianças de 6 a 59 meses de idade, de ambos os sexos, do Estado da Paraíba. As concentrações de hemoglobina foram analisadas em sangue venoso por meio decontador automático, e as de retinol sérico por cromatografia líquida de alta resolução. Para a avaliação do estado nutricional energético-proteico, foram utilizados peso e estatura pelos índices: peso/idade, estatura/idade e peso/estatura em escores-Z. As proporções foram comparadas pelo teste do Qui-quadrado de Pearson e teste exato de Fisher, e a associação entre as concentrações de hemoglobina e de retinolemia e o estado nutricional, pelo modelo de regressão de Poisson. RESULTADOS: Observou-se prevalência de 36,5% (IC95%=33,7-39,3) de anemia (Hb<11,0 g/dL), 21,4% (IC95%=17,3-22,2) de hipovitaminose A (<0,70µmol/L), 7,3% (IC95%=5,8-8,8)) de desnutrição crônica (estatura/idade<-2), 1,3% (IC95%=0,6-2,0) de desnutrição global (peso/idade<-2), e 2,3% (IC95%=1,4-3,2) de desnutrição aguda (estatura/idade<-2). Na análise multivariada, observou-se associação direta entre anemia e retinolemia inadequada, assim como entre anemia e desnutrição crônica. CONCLUSÃO: A elevada prevalência da anemia e da hipovitaminose A impõe a adoção de medidas efetivas de prevenção e controle. A associação entre as carências nutricionais demonstrou que uma melhoria na retinolemia bem como no estado nutricional tende a reduzir a anemia no contexto estudado

Teses sobre hepatites na Faculdade de Medicina da Universidade Federal do Rio de Janeiro, 1837-2000 Theses on hepatitis at the Faculdade de Medicina of the Universidade Federal do Rio de Janeiro, 1837-2000

Apresenta inventário das teses sobre hepatites da Faculdade de Medicina da Universidade Federal do Rio de Janeiro entre 1837 e 2000. A análise indica potencialidades e limites para discussão do quadro evolutivo do conhecimento científico no Brasil sobre esses agravos. As teses também são discutidas à luz de seus referenciais científicos e das mudanças tecnológicas e sociais que as influenciaram. Identificam-se e categorizam-se os marcos do ensino médico e do conhecimento sobre as hepatites, considerando que as teses revelam, no mínimo, o estado da arte de seu objeto. O estudo permitiu explorar as bases em que os saberes científicos sobre as hepatites foram construídos e indicar possibilidades de pesquisas na reconstrução do conhecimento científico de outros agravos.<br>An inventory of the theses on hepatitis of the Faculdade de Medicina of the Universidade Federal do Rio de Janeiro between 1837 and 2000 is presented. The analysis indicates the potential and limits for discussion of the evolutionary framework of scientific knowledge on these health problems in Brazil. The theories are also discussed in light of their scientific reference points and the technological and social changes that influenced them. The landmarks in medical education and knowledge about hepatitis are identified and categorized, considering that the theses reveal at the very least the state of the art on the subject. The study makes it possible to explore the foundations upon which the scientific knowledge on hepatitis were built and indicate possibilities for research in the reconstruction of scientific knowledge of other health problems

I Diretriz Latino-Americana para avaliação e conduta na insuficiência cardíaca descompensada I Latin American Guidelines for the assessment and management of decompensated heart failure

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Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research