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

Effects of Rio de Janeiro Ar Livre program on the autonomy of octogenarian elderly women

With the increase in life expectancy, it is important to acknowledge the impact of health promotion programs on the elderly. The aimed of this study was to evaluate the influence of the Rio de Janeiro Ar Livre physical program on the functional autonomy of octogenarian elderly women´s. To this end, elderly women´s from 19 Rio de Janeiro Ar Livre program gyms were selected for the experimental group (EG) (n=23; 82.57±3.78 years), and for the Control Group (CG) (n=17; 82.88±2.23 years) from the attending cohabitation houses of the City of Rio de Janeiro. To access the functional autonomy was used Rikli and Jones (1999) protocol in two times separated by (28 weeks). It was observed in the EG a significant (p=0.010) increase in Upper limbs' strength test (13.00±3.41 to 15.09±3.60 times, pre and post innervation, respectively) and a significant (p=0.002) increase in 2 minutes Step test in the CG (36.59±15.00 to 47.24±10.96 times, pre and post, respectively). However, any significant differences between groups were observed in all variables analysed. Based in the present data we can conclude that the training program was only effective in the promotions of the functional strength of the upper limbs and to maintain the functional autonomy of octogenarian elderly women

Regionalização para o cultivo do feijão no Rio Grande do Sul com base na interação genótipo x ambiente¹.

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Combinações entre cultivares, ambientes, preparo e cobertura do solo em características agronômicas de alface.

Objetivou-se identificar combinações entre cultivares, ambientes de cultivo e preparo e cobertura de solo capazes de melhorar o desempenho agronômico e aumentar a produtividade da cultura da alface em cultivo orgânico. A pesquisa foi conduzida na Universidade Federal do Acre, utilizando o delineamento experimental de blocos casualizados, com parcelas subdivididas para cada experimento (campo e casa de vegetação), com quatro repetições. Em cada experimento, três cultivares de alface (Simpson, Marisa e Vera), constituindo as sub-parcelas, foram sorteadas nas parcelas, representadas por quatro preparos e cobertura do solo (encanteiramento com cobertura de palha de arroz, polietileno prateado, solo descoberto e plantio direto). A produtividade comercial de alface foi de 12,3 t ha-1 em cultivo protegido e de 7,9 t ha-1 em campo. O cultivo protegido promoveu melhor desenvolvimento das plantas, caracterizado por maior massa da matéria fresca e seca da parte aérea, massa da matéria fresca comercial e melhor classificação comercial, além de promover bom desempenho agronômico e maior produtividade em qualquer um dos preparos de solo. As cultivares Simpson e Marisa apresentaram massa da matéria seca da parte aérea semelhante e superior à ‘Vera’, porém, o crescimento do caule da ‘Simpson’ foi elevado, caracterizando pendoamento precoce, fato que reduz sua qualidade comercial. As cultivares Marisa e Vera não alongaram o caule indicando serem tolerantes às condições ambientais de Rio Branco. A cobertura do solo com casca de arroz ou plástico prateado contribuiu para minimizar os efeitos climáticos prejudiciais ao cultivo da alface em campo. O plantio direto orgânico não diferiu do plantio em canteiro descoberto

Alcoholism and Strongyloides stercoralis: Daily Ethanol Ingestion Has a Positive Correlation with the Frequency of Strongyloides Larvae in the Stools

It has been reported that Strongyloides stercoralis infection is more prevalent in chronic alcoholic patients than in non alcoholics living in the same country. In a retrospective study on the prevalence of S. stercoralis infection in a large sample of alcoholic patients, we demonstrate that this prevalence is significantly higher than in non-alcoholic patients admitted at the same hospital. Moreover, the frequency of the parasite was in close relationship with the daily amount of ingested ethanol, even in the absence of liver cirrhosis, reinforcing the idea that chronic alcoholism is associated with increased susceptibility to Strongyloides infection. Beside the bad hygiene profile of alcoholic patients, which explains high risk for acquisition of the parasite, the high prevalence of S. stercoralis in alcoholics may be in relationship with other effects of ethanol on the intestinal motility, steroid metabolism and immune system, which could enhance the chance of autoinfection and the survival and fecundity of females in duodenum. In this way, the number of larvae in the stools is higher in alcoholic patients, increasing the chance of a positive result in a stool examination by sedimentation method

Conservation and divergence within the clathrin interactome of <i>Trypanosoma cruzi</i>

Trypanosomatids are parasitic protozoa with a significant burden on human health. African and American trypanosomes are causative agents of Nagana and Chagas disease respectively, and speciated about 300 million years ago. These parasites have highly distinct life cycles, pathologies, transmission strategies and surface proteomes, being dominated by the variant surface glycoprotein (African) or mucins (American) respectively. In African trypanosomes clathrin-mediated trafficking is responsible for endocytosis and post-Golgi transport, with several mechanistic aspects distinct from higher organisms. Using clathrin light chain (TcCLC) and EpsinR (TcEpsinR) as affinity handles, we identified candidate clathrin-associated proteins (CAPs) in Trypanosoma cruzi; the cohort includes orthologs of many proteins known to mediate vesicle trafficking, but significantly not the AP-2 adaptor complex. Several trypanosome-specific proteins common with African trypanosomes, were also identified. Fluorescence microscopy revealed localisations for TcEpsinR, TcCLC and TcCHC at the posterior region of trypomastigote cells, coincident with the flagellar pocket and Golgi apparatus. These data provide the first systematic analysis of clathrin-mediated trafficking in T. cruzi, allowing comparison between protein cohorts and other trypanosomes and also suggest that clathrin trafficking in at least some life stages of T. cruzi may be AP-2-independent

Factors associated with delayed diagnosis of tuberculosis in hospitalized patients in a high TB and HIV burden setting: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The most essential components of TB control are early diagnosis and adequate treatment. Delay in the diagnosis and treatment of tuberculosis may result in more extensive disease and more complications, increase severity of the disease and is associated with higher risk of mortality. The purpose of this study was to identify factors associated with delayed diagnosis of TB in hospitalized patients.</p> <p>Methods</p> <p>We conducted a cross-sectional study in a general, tertiary care, university-affiliated hospital. Adult patients with TB that were hospitalized were identified retrospectively, and risk factors for delayed diagnosis were collected.</p> <p>Results</p> <p>The median delay until diagnosis was 6 days (IQR: 2-12 days). One hundred and sixty six (54.4%) patients were diagnosed ≤ 6 days, and 139 (45.6%) > 6 days after admission. The main factors associated with diagnostic delay (> 6 days) were extra-pulmonary TB and negative sputum smear.</p> <p>Conclusions</p> <p>Although hospitalization permits a rapid management of the patient and favors a faster diagnosis, we found an unacceptable time delay before the diagnosis of pulmonary TB was made. Future studies should focus on attempt to explain the reasons of diagnostic retard in the patients with the characteristics related to delay in this study.</p

A Rapid and Sensitive Method for Measuring NAcetylglucosaminidase Activity in Cultured Cells

A rapid and sensitive method to quantitatively assess N-acetylglucosaminidase (NAG) activity in cultured cells is highly desirable for both basic research and clinical studies. NAG activity is deficient in cells from patients with Mucopolysaccharidosis type IIIB (MPS IIIB) due to mutations in NAGLU, the gene that encodes NAG. Currently available techniques for measuring NAG activity in patient-derived cell lines include chromogenic and fluorogenic assays and provide a biochemical method for the diagnosis of MPS IIIB. However, standard protocols require large amounts of cells, cell disruption by sonication or freeze-thawing, and normalization to the cellular protein content, resulting in an error-prone procedure that is material- and time-consuming and that produces highly variable results. Here we report a new procedure for measuring NAG activity in cultured cells. This procedure is based on the use of the fluorogenic NAG substrate, 4- Methylumbelliferyl-2-acetamido-2-deoxy-alpha-D-glucopyranoside (MUG), in a one-step cell assay that does not require cell disruption or post-assay normalization and that employs a low number of cells in 96-well plate format. We show that the NAG one-step cell assay greatly discriminates between wild-type and MPS IIIB patient-derived fibroblasts, thus providing a rapid method for the detection of deficiencies in NAG activity. We also show that the assay is sensitive to changes in NAG activity due to increases in NAGLU expression achieved by either overexpressing the transcription factor EB (TFEB), a master regulator of lysosomal function, or by inducing TFEB activation chemically. Because of its small format, rapidity, sensitivity and reproducibility, the NAG one-step cell assay is suitable for multiple procedures, including the high-throughput screening of chemical libraries to identify modulators of NAG expression, folding and activity, and the investigation of candidate molecules and constructs for applications in enzyme replacement therapy, gene therapy, and combination therapies