Saúde Brasil 2011 : uma análise da situação de saúde e a vigilância da saúde da mulher

Introdução: No Brasil, ocorrem cerca de 3 milhões de nascimentos ao ano, sendo grande parte deles por meio de cesarianas. Entender como se distribui esse procedimento no País é relevante para a reflexão sobre o papel das políticas públicas nesse contexto. Objetivos: a) Descrever: magnitude e tendência da taxa de cesáreas*1 no País; morbimortalidade materna e neonatal associada a tipo de parto; e características dos hospitais; b) analisar o preenchimento das variáveis da nova versão da Declaração de Nascido Vivo (DNV) que permitirão monitoramento das indicações de cesárea; c) descrever as respostas institucionais para o enfrentamento do problema. Métodos: Estudo descritivo de série histórica da taxa de cesarianas, no País e macrorregiões, segundo características sociodemográficas, morbimortalidade e tipo de provedor, com fonte em bancos de dados oficiais. Analisou-se a completitude de variáveis da versão da DNV de 2010 para monitoramento das indicações de cirurgia. Foram pesquisados documentos oficiais, visando identificar iniciativas para qualificar a atenção a partos e nascimentos e reduzir cesarianas desnecessárias. Resultados: A taxa de cesarianas foi de 32%, em 1994, e de 52%, em 2010, sendo menor no Norte e Nordeste. Mulheres submetidas a cesáreas tiveram 3,5 vezes mais probabilidade de morrer (entre 1992–2010) e 5 vezes mais de ter infecção puerperal (entre 2000–2011) que as de parto normal. No período, a proporção de prematuros se elevou, mais nas cesáreas (7,8%, sendo 6,4% nos partos normais em 2010). Em 2010, hospitais não públicos apresentaram taxas maiores (63,6%) e maior aumento no período de 2006 a 2010 (14,0%); para os públicos, as taxas foram de 47,8% (federais), de 39,6% (estaduais) e de 34,0% (municipais). Conclusão: A cesariana é frequente e sua proporção ascende no País, sendo muito elevada no setor de Saúde Suplementar. Para reverter essa tendência, serão necessárias várias medidas, incluindo a qualificação da informação para monitorar a efetividade das medidas propostas

Exact SO(8) Symmetry in the Weakly-Interacting Two-Leg Ladder

A perturbative renormalization group analysis of interacting electrons on a two-leg ladder reveals that at half-filling any weakly repulsive system scales onto an exactly soluble Gross-Neveu model with a hidden SO(8) symmetry. The half-filled ground state is a Mott insulator with short-range d-wave pair correlations. We extract the exact energies, degeneracies, and quantum numbers of *all* the low energy excited multiplets. One energy (mass) m octets contains Cooper pair, magnon, and density-wave excitations, two more octets contain single-particle excitations, and a mass \sqrt{3}m antisymmetric tensor contains 28 "bound states". Exact single-particle and spin gaps are found for the lightly-doped (d-wave paired one-dimension Bose fluid) system. We also determine the four other robust phases occuring at half-filling for partially attractive interactions. All 5 phases have distinct SO(8) symmetries, but share S.C. Zhang's SO(5) as a common subgroup.Comment: RevTex, 35 pages with 15 figure

Evidence of multiple paternity and cooperative parental care in the so called monogamous silver arowana Osteoglossum bicirrhosum (Osteoglossiformes: Osteoglossidae)

Monogamy is rare in fishes and is usually associated with elaborate parental care. When parental care is present in fishes, it is usually the male that is responsible, and it is believed that there is a relationship between the high energetic investment and the certainty of paternity (except in the case of sneaker males). Osteoglossum bicirrhosum is considered a monogamous fish, and has particular behavioral traits that permit the study of mating systems and parental care, such as male mouthbrooding. We investigated the genetic relationships of males with the broods found in their oral cavities in Osteoglossum samples collected in a natural environment in the lower Purus river basin, Amazonas, Brazil. Fourteen broods were analyzed for parentage (268 young and 14 adult males) using eight microsatellite loci. The results indicate that eleven broods show a monogamous system. In one brood, however, approximately 50% of the young were genetically compatible with being offspring of another male, and in another two broods, none of the subsampled young were compatible with the genotypes of the brooding male. The result of this first brood may be explained by the extra-parental contribution of a sneaker male, whereas cooperative parental care may explain the result in the other two broods

High levels of T lymphocyte activation in Leishmania-HIV-1 co-infected individuals despite low HIV viral load

<p>Abstract</p> <p>Background</p> <p>Concomitant infections may influence HIV progression by causing chronic activation leading to decline in T-cell function. In the Americas, visceral (AVL) and tegumentary leishmaniasis (ATL) have emerged as important opportunistic infections in HIV-AIDS patients and both of those diseases have been implicated as potentially important co-factors in disease progression. We investigated whether leishmaniasis increases lymphocyte activation in HIV-1 co-infected patients. This might contribute to impaired cellular immune function.</p> <p>Methods</p> <p>To address this issue we analyzed CD4⁺T absolute counts and the proportion of CD8⁺T cells expressing CD38 in <it>Leishmania</it>/HIV co-infected patients that recovered after anti-leishmanial therapy.</p> <p>Results</p> <p>We found that, despite clinical remission of leishmaniasis, AVL co-infected patients presented a more severe immunossupression as suggested by CD4⁺T cell counts under 200 cells/mm³, differing from ATL/HIV-AIDS cases that tends to show higher lymphocytes levels (over 350 cells/mm³). Furthermore, five out of nine, AVL/HIV-AIDS presented low CD4⁺T cell counts in spite of low or undetectable viral load. Expression of CD38 on CD8⁺T lymphocytes was significantly higher in AVL or ATL/HIV-AIDS cases compared to HIV/AIDS patients without leishmaniasis or healthy subjects.</p> <p>Conclusions</p> <p><it>Leishmania </it>infection can increase the degree of immune system activation in individuals concomitantly infected with HIV. In addition, AVL/HIV-AIDS patients can present low CD4⁺T cell counts and higher proportion of activated T lymphocytes even when HIV viral load is suppressed under HAART. This fact can cause a misinterpretation of these laboratorial markers in co-infected patients.</p

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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