Saúde, direito de todos e dever do estado: impacto financeiro na assistência farmacêutica em um componente especializado / Health, everyone'srightandthestate'sduty: financial impactonpharmaceuticalcare in a specialized componente

     O direito à saúde é um direito adquirido, com apoio na Constituição Federal, e que desse modo o acesso aos medicamentos de alto custo é apenas um dos aspectos dessa garantia constitucional, o qual insere-se nesse debate como um fator relevante dos direitos fundamentais, e cuja intervenção do Poder Judiciário torna-se imprescindível, no sentido de garantir o atendimento dos serviços de saúde e consequentemente a sobrevivência para muitas pessoas, bem como, de tornar efetivo do princípio da dignidade humana. O objetivo do presente trabalho consiste em dissertar sobre os medicamentos de alto custo fornecidos pelo SUS, além de  mostrar como a saúde pública do país evoluiu ao passar do tempo. Para isso usou-se as bases de dados Scientific Eletronic Library Online (SCIELO), Literatura Latino Americana, Caribe em Ciências da Saúde (LILACS), WebSites e  Portal de Pesquisa da Biblioteca Virtual em Saúde (BVS) aplicando-se os descritores: componente especializado, medicamentos e assistência farmacêutica, com artigos nas línguas inglesa, espanhola, portuguesa e corte temporal  entre os anos de 2010 e 2021. Os resultados apresentaram as Principais Patologias, Medicamentos de Alto Custo do Componente Especializado da Assistência Farmacêutica eosProtocolos Clínicos e Diretrizes Terapêuticas, Classificação Internacional de Doenças (CID) e suas respectivas legislações. Através do estudo constatou-se que a implementação dos princípios da integralidade e universalidade do SUS apesar de limitações quanto aos seus cumprimentos buscam ser atendidos, e fornecer medicamentos de alto custo é fundamental  e a assistência farmacêutica utiliza-se de um nicho de conhecimentos técnicospara assistir ao paciente em suas necessidades de tratamento e cuidado, sendo, entretanto, atividade de caráter multiprofissional e multidisciplinar.O direito à saúde é um direito adquirido, com apoio na Constituição Federal, e que desse modo o acesso aos medicamentos de alto custo é apenas um dos aspectos dessa garantia constitucional, o qual insere-se nesse debate como um fator relevante dos direitos fundamentais, e cuja intervenção do Poder Judiciário torna-se imprescindível, no sentido de garantir o atendimento dos serviços de saúde e consequentemente a sobrevivência para muitas pessoas, bem como, de tornar efetivo do princípio da dignidade humana. O objetivo do presente trabalho consiste em dissertar sobre os medicamentos de alto custo fornecidos pelo SUS, além de  mostrar como a saúde pública do país evoluiu ao passar do tempo. Para isso usou-se as bases de dados Scientific Eletronic Library Online (SCIELO), Literatura Latino Americana, Caribe em Ciências da Saúde (LILACS), WebSites e  Portal de Pesquisa da Biblioteca Virtual em Saúde (BVS) aplicando-se os descritores: componente especializado, medicamentos e assistência farmacêutica, com artigos nas línguas inglesa, espanhola, portuguesa e corte temporal  entre os anos de 2010 e 2021. Os resultados apresentaram as Principais Patologias, Medicamentos de Alto Custo do Componente Especializado da Assistência Farmacêutica eosProtocolos Clínicos e Diretrizes Terapêuticas, Classificação Internacional de Doenças (CID) e suas respectivas legislações. Através do estudo constatou-se que a implementação dos princípios da integralidade e universalidade do SUS apesar de limitações quanto aos seus cumprimentos buscam ser atendidos, e fornecer medicamentos de alto custo é fundamental  e a assistência farmacêutica utiliza-se de um nicho de conhecimentos técnicospara assistir ao paciente em suas necessidades de tratamento e cuidado, sendo, entretanto, atividade de caráter multiprofissional e multidisciplinar.

Molecular epidemiological investigation of Mayaro virus in febrile patients from Goiania City, 2017-2018.

Mayaro virus (MAYV) has historically been associated with sylvatic transmission; however, urban outbreaks have been reported in Brazil, including cases of co-detection with dengue virus (DENV). Therefore, we performed a molecular survey to investigate MAYV circulation and cocirculation with DENV within Goiania, a major city in Central-West Brazil. Among 375 subjects with arbovirus-like symptoms, 259 were positive for DENV and 26 for MAYV. Of these, 17 were coinfected with DENV-2, suggesting co-transmission of the viruses. The most common complaints at the time of inclusion were myalgia, headache, fever, arthralgia, retro-orbital pain, and skin rash. No specific symptoms were associated with MAYV when either detected alone or co-detected with DENV, compared to that when DENV was detected alone. Most MAYV-infected subjects were women with no recent travel history to rural/sylvatic areas. Phylogenetic reconstruction indicated that the MAYV identified in this study is closely related with a lineage observed in Peru, belonging to genotype D. Our results corroborate the growing circulation of MAYV in urban environments in Brazil and reinforce the need to implement laboratory diagnosis in the Unified Health System, considering that the clinical manifestations of Mayaro fever are similar to those of other arboviruses, particularly dengue. Furthermore, most cases occurred in association with DENV-2. Further phylogenetic studies are needed to evaluate MAYV, which has not been widely examined

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

Longer-term effectiveness of a heterologous coronavirus disease 2019 (COVID-19) vaccine booster in healthcare workers in Brazil

Abstract Objective: To compare the long-term vaccine effectiveness between those receiving viral vector [Oxford-AstraZeneca (ChAdOx1)] or inactivated viral (CoronaVac) primary series (2 doses) and those who received an mRNA booster (Pfizer/BioNTech) (the third dose) among healthcare workers (HCWs). Methods: We conducted a retrospective cohort study among HCWs (aged ≥18 years) in Brazil from January 2021 to July 2022. To assess the variation in the effectiveness of booster dose over time, we estimated the effectiveness rate by taking the log risk ratio as a function of time. Results: Of 14,532 HCWs, coronavirus disease 2019 (COVID-19) was confirmed in 56.3% of HCWs receiving 2 doses of CoronaVac vaccine versus 23.2% of HCWs receiving 2 doses of CoronaVac vaccine with mRNA booster (P < .001), and 37.1% of HCWs receiving 2 doses of ChAdOx1 vaccine versus 22.7% among HCWs receiving 2 doses of ChAdOx1 vaccine with mRNA booster (P < .001). The highest vaccine effectiveness with mRNA booster was observed 30 days after vaccination: 91% for the CoronaVac vaccine group and 97% for the ChAdOx1 vaccine group. Vacine effectiveness declined to 55% and 67%, respectively, at 180 days. Of 430 samples screened for mutations, 49.5% were SARS-CoV-2 delta variants and 34.2% were SARS-CoV-2 omicron variants. Conclusions: Heterologous COVID-19 vaccines were effective for up to 180 days in preventing COVID-19 in the SARS-CoV-2 delta and omicron variant eras, which suggests the need for a second booster

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple organism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region's vulnerability to environmental change. 15%–18% of the most neglected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lost

Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences

The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & Nemésio 2007; Donegan 2008, 2009; Nemésio 2009a–b; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on 18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based researchers who signed it in the short time span from 20 September to 6 October 2016

Climate seasonality limits leaf carbon assimilation and wood productivity in tropical forests

The seasonal climate drivers of the carbon cycle in tropical forests remain poorly known, although these forests account for more carbon assimilation and storage than any other terrestrial ecosystem. Based on a unique combination of seasonal pan-tropical data sets from 89 experimental sites (68 include aboveground wood productivity measurements and 35 litter productivity measurements), their associated canopy photosynthetic capacity (enhanced vegetation index, EVI) and climate, we ask how carbon assimilation and aboveground allocation are related to climate seasonality in tropical forests and how they interact in the seasonal carbon cycle. We found that canopy photosynthetic capacity seasonality responds positively to precipitation when rainfall is  < 2000 mm yr⁻¹ (water-limited forests) and to radiation otherwise (light-limited forests). On the other hand, independent of climate limitations, wood productivity and litterfall are driven by seasonal variation in precipitation and evapotranspiration, respectively. Consequently, light-limited forests present an asynchronism between canopy photosynthetic capacity and wood productivity. First-order control by precipitation likely indicates a decrease in tropical forest productivity in a drier climate in water-limited forest, and in current light-limited forest with future rainfall  < 2000 mm yr⁻¹

Balanco energético consolidado MRH 152 : tabuleiros de Valença

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