Longe dos partidos e perto da federação: uma avaliação dos gastos municipais na saúde pública

The institutionalization of SUS made the municipalities important players in the public health policy. Thus, it was expected that the amount of resources allocated to public health would be determinate in some measure by the political party preferences. Given these political and institutional contexts, we analyzed the importance of the political party policies at the municipality level as a determinant of the expenditure on public health, as well was other conventional determinants of the expenditures on public health (region, per capita income, GDP, etc). Applying some econometric techniques (quantile regressions and econometric decomposition), we found that the parties’ political preferences have minor influence on the allocation of resources in public health. We conclude that the constitutional regulation (Constitutional Emend 29 or EC29) seems to be a more important determinant to explain the allocation of resources in the period 2002-2006 than the supposed political preferences announced by parties.SUS, health economics, Brazil

Biodiversidade, população e economia: uma região de mata atlântica [Biodiversity, Population, and Economy: a region of atlantic forest]

biodiversity; Minas Gerais; Rio Doce; mata atlântica; atlantic forest; sustainable development; conservation; natural resources; environment; environmental economics

Desenvolvimento financeiro e crescimento econômico no Brasil (1995-2004)

Este trabalho tem por objetivo analisar empiricamente a relação entre desenvolvimento financeiro e crescimento econômico para as Unidades Federativas do Brasil. Para tanto, realizou-se um exercício econométrico com o auxílio da técnica de regressão quantílica, o que permitiu um mapeamento mais completo do impacto gerado pelas medidas de desenvolvimento financeiro utilizadas sobre a variável resposta (PIB estadual). As evidências encontradas sugerem uma relação positiva entre desenvolvimento do sistema financeiro e crescimento econômico

Epiisopilosine alkaloid has activity against schistosoma mansoni in mice without acute toxicity

CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPSchistosomiasis is a disease caused by parasites of the genus Schistosoma, currently affecting more than 200 million people. Among the various species of this parasite that infect humans, S. mansoni is the most common. Pharmacological treatment is limited135119CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPCONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP404134/2012-22014/02282-76, 2016/18023-5, 2016/22488-3The authors are grateful to Phytobios Pesquisa Desenvolvimento e Inovação LTDA.,company of the Centroflora Group, for its support during the realization of this research. SMA is grateful to Conselho Nacional de Desenvolvimento Científico e Tecnológico

ST-Elevation myocardial infarction network: systematization in 205 cases reduced clinical events in the public health care system

BACKGROUND: The major cause of death in the city of São Paulo (SP) is cardiac events. At its periphery, in-hospital mortality in acute myocardial infarction is estimated to range between 15% and 20% due to difficulties inherent in large metropoles. OBJECTIVE:To describe in-hospital mortality in ST-segment elevation acute myocardial infarction (STEMI) of patients admitted via ambulance or peripheral hospitals, which are part of a structured training network (STEMI Network). METHODS: Health care teams of four emergency services (Ermelino Matarazzo, Campo Limpo, Tatuapé and Saboya) of the periphery of the city of São Paulo and advanced ambulances of the Emergency Mobile Health Care Service (abbreviation in Portuguese, SAMU) were trained to use tenecteplase or to refer for primary angioplasty. A central office for electrocardiogram reading was used. After thrombolysis, the patient was sent to a tertiary reference hospital to undergo cardiac catheterization immediately (in case of failed thrombolysis) or in 6 to 24 hours, if the patient was stable. Quantitative and qualitative variables were assessed by use of uni- and multivariate analysis. RESULTS: From January 2010 to June 2011, 205 consecutive patients used the STEMI Network, and the findings were as follows: 87 anterior wall infarctions; 11 left bundle-branch blocks; 14 complete atrioventricular blocks; and 14 resuscitations after initial cardiorespiratory arrest. In-hospital mortality was 6.8% (14 patients), most of which due to cardiogenic shock, one hemorrhagic cerebrovascular accident, and one bleeding. CONCLUSION: The organization in the public health care system of a network for the treatment of STEMI, involving diagnosis, reperfusion, immediate transfer, and tertiary reference hospital, resulted in immediate improvement of STEMI outcomes.FUNDAMENTO: A principal causa de óbitos na cidade de São Paulo (SP) é por eventos cardíacos. Em hospitais periféricos de São Paulo estima-se a mortalidade hospitalar no infarto agudo entre 15% e 20%, pelas dificuldades existentes. OBJETIVO: Descrever a mortalidade intra-hospitalar do Infarto Agudo do Miocárdio com Supradesnivelamento de ST (IAMCSST) de pacientes admitidos via ambulância ou hospitais periféricos, como resultado da organização de uma estruturada rede de treinamento. MÉTODOS: Equipes de quatro prontos-socorros (Ermelino Matarazzo, Campo Limpo, Tatuapé e Saboya) e das ambulâncias avançadas do Serviço de Atendimento Móvel de Urgência (Samu) foram treinadas para uso de tenecteplase (TNK) ou para encaminhamento para angioplastia primária. Uma central de leitura de eletrocardiogramas foi usada quando necessário. Após uso de trombolítico, um hospital terciário recebia o paciente que era submetido a cinecoronariografia imediata (trombólise sem sucesso) ou entre 6 e 24 h, caso estável. Variáveis quantitativas, qualitativas foram avaliadas em análise uni e multivariável. RESULTADOS: De janeiro 2010 a junho 2011, 205 pacientes consecutivos utilizaram a rede de atendimento, ocorrendo 87 infartos de parede anterior, 11 bloqueios de ramo esquerdo, 14 bloqueios atrioventricular total, e em 14 houve reanimação pós-parada cardiorrespiratória inicial. A mortalidade intra-hospitalar foi de 6,8% (14 casos), a maioria por choque cardiogênico, um por acidente vascular encefálico hemorrágico e um por sangramento. CONCLUSÃO: A organização em instituições públicas de uma rede de tratamento, envolvendo diagnóstico, reperfusão, transporte imediato e hospital de retaguarda resultou em melhora imediata dos resultados de IAMCSST.Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)Serviço de Atendimento Móvel de UrgênciaPrefeitura Municipal de São Paulo Secretaria de SaúdeHospital Municipal Prof. Dr. Alípio Correa NettoUNIFESP, EPMSciEL

Effects of isokinetic eccentric training on knee extensor and flexor torque and on gait of individuals with long term ACL reconstruction: A controlled clinical trial

Abstract-This study investigated the effects of the isokinetic eccentric training (IET) on the knee extensor and flexor torque and kinematic gait parameters in individuals with ACL reconstruction. Sixteen men with ACL reconstructed (ACLr) whose torque and the gait were evaluated, before and after 12 weeks of IET, was compared to a control group (14 individuals). Student t, MANOVA and ANOVA tests were performed with 5% of significance. The training increased the isometric, concentric at 30 and 120º/s (p < .05) and eccentric at 30º/s (p < .01) extensor torque on the affected limb (AL), and eccentric at 30 and 120º/s (p < .01), on the non-affected limb (NAL). In the flexors, there was an increase on the torque: isometric, concentric at 30º/s and eccentric at 30 and 120º/s (p < .01) in AL and in eccentric at 30 (p < .05) and 120º/s (p < .01) in NAL. With respect to the angular and spatio-temporal variables gait, there was no difference between pre-and post-training in LCAr group. Compared to control group, the cycle time, in two members, was lower in LCAr group, and stride length and cadence were higher in the AL of the LCAr (p < .05). Moreover, the knee flexion-extension angles (minimum and maximum) remained lower in LCAr, pre-and post-training (p < .01). The torque gain associated with eccentric isokinetic training did not affect the kinematic parameters of gait in patients undergoing ACL reconstruction. Keywords: gait, exercise, muscle strength, movement, anterior cruciate ligament reconstruction Resumo-"Efeitos do treinamento isocinético excêntrico de extensores de joelho e torque flexor na marcha de indivíduos com reconstrução do LCA: Um ensaio clínico controlado." Este estudo investigou os efeitos do treinamento isocinético excêntrico (TIE) sobre o torque extensor e flexor do joelho e parâmetros cinemáticos da marcha de indivíduos com reconstrução do LCA. Dezesseis homens com LCA reconstruído (LCAr), foram avaliados quanto ao torque e marcha, antes e após 12 semanas de TIE e comparados com um grupo controle (14 indivíduos). Testes t Student, MANOVA e ANOVA foram realizados com 5% de significância. O treinamento aumentou o torque extensor isométrico, concêntrico a 30 e 120º/s (p < 0,05) e excêntrico a 30º/s (p < 0,01) no membro afetado (MA), e excêntrico a 30 e 120º/s (p < 0,01), no membro não afetado (MNA). Nos flexores, houve um aumento no torque: isométrico, concêntrico a 30º/s e excêntrico a 30 e 120º/s (p < 0,01) no MA, e excêntrico a 30 (p < 0,05) e 120º/s (p < 0,01) no MNA. Com relação às variáveis espaço-temporais e angulares da marcha, não houve diferença entre as avaliações pré e pós-treino no grupo LCAr. Comparado ao controle, a duração do ciclo, nos dois membros, foi menor no LCAr, e comprimento da passada e cadência foram maiores no MA do grupo LCAr (p < 0,05). Além disso, os ângulos (mínimo e máximo) de flexão-extensão do joelho permaneceram menores no LCAr, pré e pós-treino (p < 0,01). O ganho de torque associado ao treinamento isocinético excêntrico não modificou os parâmetros cinemáticos da marcha nos indivíduos submetidos à reconstrução do LCA. Palavras-chave: marcha, exercício, força muscular, movimento, reconstrução do ligamento cruzado anterior H.H. Santos, C.O. Sousa, J.A. Barela, A.M.F. Barela & T.F. Salvini Motriz, Rio Claro, v.20 n.4, p. 431-441, Oct./Dec. 2014 432 Resumen-"Efectos del entrenamiento excéntrico isocinético en extensor de la rodilla y el par flexor y sobre la marcha de las personas con reconstrucción ACL: Un ensayo clínico controlado." Este estudio investigó los efectos del entrenamiento isocinético excéntrico (EIE) en el torque del extensor y del flexor de la rodilla y parámetros cinemáticos de la marcha de personas con la reconstrucción del LCA. Dieciséis hombres con LCA reconstruido (LCAr), fueron evaluados para el par y la marcha antes y después de 12 semanas de EIE y se compararon con un grupo control (14 personas). Prueba t Student, ANOVA y MANOVA se realizaron con 5 % de significación. La formación aumentó extensor torque isométrico, concéntrico 30 y 120°/s (p < 0,05) y la excéntrica 30°/s (p < 0,01) en el miembro afectado (MA), y la excéntrica 30 y 120°/s (p < 0,01) en el miembro no afectado (MNA). Flexor, hubo un aumento en el par motor: isométrica , concéntrica 30°/s excéntrica 30 y 120°/s (p < 0,01) en MA, excéntrico y 30 (p < 0,05 ) y 120°/ s (p < 0,01) en el MNA. Con respecto a las variables angulares y espacio-temporal de andar, no hubo diferencia entre pre y post-entrenamiento en grupo LCAr. En comparación con el grupo control, el tiempo de ciclo, em los dos miembros, fue menor en LCAr, y la longitud del paso y cadencia fueron mayores en el LCAr del MA (p < 0,05). Por otra parte, los ángulos de flexión-extensión de la rodilla (mínimo y máximo) se mantuvieron bajos en LCAr, pre y post-entrenamiento (p < 0,01). El aumento del torque asociado con el entrenamiento isocinético excéntrico no afectó los parámetros cinemáticos de la marcha en las personas sometidas a la reconstrucción del LCA

Brazilian network for HIV Drug Resistance Surveillance (HIV-BresNet): a survey of treatment-naive individuals

Introduction: In Brazil, more than 487,450 individuals are currently undergoing antiretroviral treatment. In order to monitor the transmission of drug-resistant strains and HIV subtype distribution in the country, this work aimed to estimate its prevalence and to characterize the nationwide pretreatment drug resistance in individuals recently diagnosed with HIV between 2013 and 2015. Methods: The HIV threshold survey methodology (HIV-THS, WHO) targeting antiretroviral-naive individuals with recent HIV diagnosis was utilized, and subjects were selected from 51 highly populated cities in all five Brazilian macroregions. The HIV pol genotypic test was performed by genomic sequencing. Results: We analysed samples from 1568 antiretroviral-naive individuals recently diagnosed with HIV, and the overall transmitted drug resistance (TDR) prevalence was 9.5% (150 sequences). The regional prevalence of resistance according to Brazilian geographical regions was 9.4% in the northeast, 11.2% in the southeast, 6.8% in the central region, 10.2% in the north and 8.8% in the south. The inhibitor-specific TDR prevalence was 3.6% for nucleoside reverse transcriptase inhibitors (NRTIs), 5.8% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 1.6% for protease inhibitors (PIs)1.0% of individuals presented resistance to more than one class of inhibitors. Overall, subtype B was more prevalent in every region except for the southern, where subtype C prevails. Conclusions: To the best of our knowledge, this is the first TDR study conducted in Brazil with nationwide representative sampling. The TDR prevalence revealed a moderate rate in the five Brazilian geographical regions, although some cities presented higher TDR prevalence rates, reaching 14% in Sao Paulo, for example. These results further illustrate the importance of surveillance studies for designing future strategies in primary antiretroviral therapy, aiming to mitigate TDR, as well as for predicting future trends in other regions of the globe where mass antiretroviral (ARV) treatment was implemented.Brazilian Ministry of HealthUniv Fed Rio de Janeiro, Lab Virol Mol, Dept Genet IB, Rio De Janeiro, RJ, BrazilFdn Med Trop Amazonas, Manaus, Amazonas, BrazilLAPI Univ Fed Bahia, Hosp Univ Prof Edgar Santos, Lab Pesquisa, Salvador, BA, BrazilLab Cent Saude Publ Ceara Lacen CE, Fortaleza, Ceara, BrazilLab Cent Saude Publ Dist Fed, Setor Grandes Areas Norte SGAN 601, Brasilia, DF, BrazilUniv Fed Minas Gerais UFMG, Fac Med, Lab Imunol & Biol Mol DIP, Belo Horizonte, MG, BrazilLab Cent Saude Publ Mato Grosso Sul, Campo Grande, MS, BrazilLab Cent Saude Publ Pernambuco, Recife, PE, BrazilLab Municipal Curitiba, Curitiba, PR, BrazilFiocruz MS, Lab AIDS & Imunol Mol, Dept Imunol, Rio De Janeiro, RJ, BrazilUniv Fed Rio de Janeiro, Hosp Univ Clementino Fraga Filho, Lab Carga Viral, Rio de Janeiro, RJ, BrazilInst Biol Exercito, Rio De Janeiro, RJ, BrazilLab Cent Saude Publ Rio Grande Sul, Porto Alegre, RS, BrazilLab Hosp Nossa Senhora Conceicao, Porto Alegre, RS, BrazilLab Cent Saude Publ Santa Catarina, Florianopolis, SC, BrazilUNESP, Lab Biol Mol Hemocentro Botucatu, Fac Med, Botucatu, SP, BrazilUniv Estadual Campinas, Lab Pesquisa AIDS, Hosp Clin, Campinas, SP, BrazilInst Adolfo Lutz Sao Jose do Rio Preto, Lab Biol Mol, Sao Jose Do Rio Preto, SP, BrazilUniv Fed Sao Paulo UNIFESP, Escola Paulista Med, Lab Retrovirol, Sao Paulo, SP, BrazilInst Adolfo Lutz Cent, Lab Retrovirus, Ctr Virol, Nucleo Doencas Sanguineas & Sexuais, Sao Paulo, SP, BrazilMinist Saude, Dept Vigilancia Prevencao & Controle DST AIDS & H, Setor Adm Fed Sul SAFS 02, Secretaria Vigilancia Saude, Brasilia, DF, BrazilUniv Brasilia, Programa Pos Grad Saude Colet, Fac Med, Fac Ciencias Saude, Brasilia, DF, BrazilUniv Sao Paulo, Fac Med, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Escola Paulista Med, Lab Retrovirol, Sao Paulo, SP, BrazilBMH: TC 298/12Web of Scienc

Low frequency of TERT promoter mutations in gastrointestinal stromal tumors (GISTs).

Somatic mutations in the promoter region of telomerase reverse transcriptase (TERT) gene, mainly at positions c. − 124 and c. − 146 bp, are frequent in several human cancers; yet its presence in gastrointestinal stromal tumor (GIST) has not been reported to date. Herein, we searched for the presence and clinicopathological association of TERT promoter mutations in genomic DNA from 130 bona fide GISTs. We found TERT promoter mutations in 3.8% (5/130) of GISTs. The c. − 124C4T mutation was the most common event, present in 2.3% (3/130), and the c. − 146C4T mutation in 1.5% (2/130) of GISTs. No significant association was observed between TERT promoter mutation and patient’s clinicopathological features. The present study establishes the low frequency (4%) of TERT promoter mutations in GISTs. Further studies are required to confirm our findings and to elucidate the hypothetical biological and clinical impact of TERT promoter mutation in GIST pathogenesis.This project was partially supported by Barretos Cancer Hospital internal research funds (PAIP) and CNPq Universal Grant (476192/2013-7) to RMR. NCC is a recipient of an FAPESP Doctoral Fellowship (2013/25787-3). Further funding from the project ‘Microenvironment, metabolism and cancer’ that was partially supported by Programa Operacional Regional do Norte (ON.2—O Novo Norte) under the Quadro de Referência Estratégico Nacional (QREN) and the Fundo Europeu de Desenvolvimento Regional (FEDER). IPATIMUP is an Associate Laboratory of the Portuguese Ministry of Science, Technology and Higher Education that is partially supported by the FCT

Predicting the Proteins of Angomonas deanei, Strigomonas culicis and Their Respective Endosymbionts Reveals New Aspects of the Trypanosomatidae Family

Endosymbiont-bearing trypanosomatids have been considered excellent models for the study of cell evolution because the host protozoan co-evolves with an intracellular bacterium in a mutualistic relationship. Such protozoa inhabit a single invertebrate host during their entire life cycle and exhibit special characteristics that group them in a particular phylogenetic cluster of the Trypanosomatidae family, thus classified as monoxenics. in an effort to better understand such symbiotic association, we used DNA pyrosequencing and a reference-guided assembly to generate reads that predicted 16,960 and 12,162 open reading frames (ORFs) in two symbiont-bearing trypanosomatids, Angomonas deanei (previously named as Crithidia deanei) and Strigomonas culicis (first known as Blastocrithidia culicis), respectively. Identification of each ORF was based primarily on TriTrypDB using tblastn, and each ORF was confirmed by employing getorf from EMBOSS and Newbler 2.6 when necessary. the monoxenic organisms revealed conserved housekeeping functions when compared to other trypanosomatids, especially compared with Leishmania major. However, major differences were found in ORFs corresponding to the cytoskeleton, the kinetoplast, and the paraflagellar structure. the monoxenic organisms also contain a large number of genes for cytosolic calpain-like and surface gp63 metalloproteases and a reduced number of compartmentalized cysteine proteases in comparison to other TriTryp organisms, reflecting adaptations to the presence of the symbiont. the assembled bacterial endosymbiont sequences exhibit a high A+T content with a total of 787 and 769 ORFs for the Angomonas deanei and Strigomonas culicis endosymbionts, respectively, and indicate that these organisms hold a common ancestor related to the Alcaligenaceae family. Importantly, both symbionts contain enzymes that complement essential host cell biosynthetic pathways, such as those for amino acid, lipid and purine/pyrimidine metabolism. These findings increase our understanding of the intricate symbiotic relationship between the bacterium and the trypanosomatid host and provide clues to better understand eukaryotic cell evolution.Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)ERC AdG SISYPHEUniv Fed Rio de Janeiro, Inst Biofis Carlos Chagas Filho, Lab Ultraestrutura Celular Hertha Meyer, BR-21941 Rio de Janeiro, BrazilUniv Fed Rio de Janeiro, Inst Biofis Carlos Chagas Filho, Lab Metab Macromol Firmino Torres de Castro, BR-21941 Rio de Janeiro, BrazilLab Bioinformat, Lab Nacl Computacao Cient, Rio de Janeiro, BrazilINRIA Grenoble Rhone Alpes, BAMBOO Team, Villeurbanne, FranceUniv Lyon 1, CNRS, UMR5558, Lab Biometrie & Biol Evolut, F-69622 Villeurbanne, FranceUniv Estadual Campinas, Inst Biol, Dept Genet Evolucao & Bioagentes, São Paulo, BrazilUniv São Paulo, Fac Ciencias Farmaceut Ribeirao Preto, Dept Ciencias Farmaceut, São Paulo, BrazilLab Nacl Ciencia & Tecnol Bioetano, São Paulo, BrazilUniv Fed Minas Gerais, Inst Ciencias Biol, Dept Bioquim & Imunol, Belo Horizonte, MG, BrazilUniv Fed Goias, Inst Ciencias Biol, Mol Biol Lab, Goiania, Go, BrazilFundacao Oswaldo Cruz, Inst Carlos Chagas, Lab Biol Mol Tripanossomatideos, Curitiba, Parana, BrazilFundacao Oswaldo Cruz, Inst Carlos Chagas, Lab Genom Func, Curitiba, Parana, BrazilUniv Estadual Campinas, Ctr Pluridisciplinar Pesquisas Quim Biol & Agr, São Paulo, BrazilUniv Fed Minas Gerais, Inst Ciencias Biol, Dept Parasitol, Belo Horizonte, MG, BrazilUniv Fed Santa Catarina, Dept Microbiol Imunol & Parasitol, Ctr Ciencias Biol, Lab Protozool & Bioinformat, Florianopolis, SC, BrazilUniv Fed Vicosa, Dept Bioquim & Biol Mol, Ctr Ciencias Biol & Saude, Vicosa, MG, BrazilInst Butantan, Lab Especial Ciclo Celular, São Paulo, BrazilUniv São Paulo, Dept Biol, Fac Filosofia Ciencias & Letras Ribeirao Preto, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, São Paulo, BrazilUniversidade Federal de São Paulo, Escola Paulista Med, Dept Microbiol Imunol & Parasitol, São Paulo, BrazilWeb of Scienc