Meningomyeloradiculitis as an Unusual Presentation of Neuroborreliosis in Childhood

We report a pediatric case of Lyme neuroborreliosis-associated meningomyeloradiculitis with atypical manifestations and negative initial cerebrospinal fluid borrelial antibodies. Transverse myelitis and painful radiculoneuritis have rarely been described in pediatric neuroborreliosis. Clinical manifestations are wide ranging and nonspecific, and the serologic diagnosis is often delayed in the acute phase.info:eu-repo/semantics/publishedVersio

Implantação da política de materiais

O compromisso assumido pelo Grupo Hospitalar Conceição-GHC de oferecer atenção integral a saúde da população do Estado do Rio Grande do Sul, honrando os princípios preconizados pelo SISTEMA ÚNICO DE SAÚDE - SUS, exigiu o desenvolvimento de ações que buscassem a racionalização dos recursos orçamentários/financeiros alocados, assegurando, desta maneira, o atendimento da gigantesca demanda que aporta à estas instituições. A nova política de materiais partiu da necessidade constatada ainda em 1997, de reduzir a fragilidade dos controles existentes nas áreas de aquisição guarda e distribuição de materiais em geral, cujos gastos mensais representavam o segundo maior item de despesa no atendimento do paciente. A ação iniciou com um diagnóstico do almoxarifado, onde foram observados os índices de cobertura, movimentação e de acuracidade dos estoques existentes. As metas definidas, como a redução de 30% dos estoques, a implantação dos pontos mínimo e máximo de reposição, e a implantação do Sistema "Registro de Preços" permitiu a redução dos estoques em 33%, considerando a data da implantação. Nesta área também foi implantado o sistema de mensuração da inflação interna, utilizando-se os índices de Laspeyres Paache, como mecanismo de avaliação de desempenho. Na área de compras, adotou-se instrumentos que permitiram a comparação do preço proposto em contratos novos com os preços praticados em contratos anteriores para produtos de mesma natureza. A medida resultou na economia de R$3.530.773,26 no período de 1998 e a previsão de R$ 143.191,86 para o período de 1999. Quanto a distribuição de materiais aos Serviços consumidores, adotou-se o Sistema Kanban que resultou na redução de 9,84% do consumo de materiais médicos e medicamentosNúmero de páginas: 7 p.InovaçãoIniciativa premiada no 4º Concurso Inovação na Gestão Pública Federal sob responsabilidade de Delson Luiz MartiniAções premiadas no 4º Concurso Inovação na Gestão Pública Federal - Prêmio Hélio Beltrão – 2000Área temática: melhoria dos processos de trabalh

Delays in access to care for abortion-related complications: the experience of women in Northeast Brazil.

Around 18 million unsafe abortions occur in low and middle-income countries and are associated with numerous adverse consequences to women's health. The time taken by women with complications to reach facilities where they can receive appropriate post-abortion care can influence the risk of death and the extent of further complications. All women aged 18+ admitted for abortion complications to public-sector hospitals in three capital cities in the Northeastern Brazil between August-December 2010 were interviewed; medical records were extracted (N = 2,804). Nearly all women (94%) went straight to a health facility, mainly to a hospital (76.6%); the rest had various care-seeking paths, with a quarter visiting 3+ hospitals. Women waited 10 hours on average before deciding to seek care. 29% reported difficulties in starting to seek care, including facing challenges in organizing childcare, a companion or transport (17%) and fear/stigma (11%); a few did not initially recognize they needed care (0.4%). The median time taken to arrive at the ultimate facility was 36 hours. Over a quarter of women reported experiencing difficulties being admitted to a hospital, including long waits (15%), only being attended after pregnant women (8.9%) and waiting for a bed (7.4%). Almost all women (90%) arrived in good condition, but those with longer delays were more likely to have (mild or severe) complications. In Brazil, where access to induced abortion is restricted, women face numerous difficulties receiving post-abortion care, which contribute to delay and influence the severity of post-abortion complications

Scenario of the spread of the invasive species Zaprionus indianus Gupta, 1970 (Diptera, Drosophilidae) in Brazil

Zaprionus indianus was first recorded in Brazil in 1999 and rapidly spread throughout the country. We have obtained data on esterase loci polymorphisms (Est2 and Est3), and analyzed them, using Landscape Shape Interpolation and the Monmonier Maximum Difference Algorithm to discover how regional invasion occurred. Hence, it was apparent that Z. indianus, after first arriving in São Paulo state, spread throughout the country, probably together with the transportation of commercial fruits by way of the two main Brazilian freeways, BR 153, to the south and the surrounding countryside, and the BR 116 along the coast and throughout the north-east

Primary B-Cell Deficiencies Reveal a Link between Human IL-17-Producing CD4 T-Cell Homeostasis and B-Cell Differentiation

IL-17 is a pro-inflammatory cytokine implicated in autoimmune and inflammatory conditions. The development/survival of IL-17-producing CD4 T cells (Th17) share critical cues with B-cell differentiation and the circulating follicular T helper subset was recently shown to be enriched in Th17 cells able to help B-cell differentiation. We investigated a putative link between Th17-cell homeostasis and B cells by studying the Th17-cell compartment in primary B-cell immunodeficiencies. Common Variable Immunodeficiency Disorders (CVID), defined by defects in B-cell differentiation into plasma and memory B cells, are frequently associated with autoimmune and inflammatory manifestations but we found no relationship between these and Th17-cell frequency. In fact, CVID patients showed a decrease in Th17-cell frequency in parallel with the expansion of activated non-differentiated B cells (CD21lowCD38low). Moreover, Congenital Agammaglobulinemia patients, lacking B cells due to impaired early B-cell development, had a severe reduction of circulating Th17 cells. Finally, we found a direct correlation in healthy individuals between circulating Th17-cell frequency and both switched-memory B cells and serum BAFF levels, a crucial cytokine for B-cell survival. Overall, our data support a relationship between Th17-cell homeostasis and B-cell maturation, with implications for the understanding of the pathogenesis of inflammatory/autoimmune diseases and the physiology of B-cell depleting therapies