Analysis of access to hypertensive and diabetic drugs in the Family Health Strategy, State of Pernambuco, Brazil

OBJECTIVE: To evaluate the access to drugs for hypertension and diabetes and the direct cost of buying them among users of the Family Health Strategy (FHS) in the state of Pernambuco, Brazil. METHODS: Population-based, cross-sectional study of a systematic random sample of 785 patients with hypertension and 823 patients with diabetes mellitus who were registered in 208 randomly selected FHS teams in 35 municipalities of the state of Pernambuco. The selected municipalities were classified into three levels with probability proportional to municipality size (LS, large-sized; MS, medium-sized; SS, small-sized). To verify differences between the cities, we used the χ2 test. RESULTS: Pharmacological treatment was used by 91.2% patients with hypertension whereas 85.6% patients with diabetes mellitus used oral antidiabetic drugs (OADs), and 15.4% used insulin. The FHS team itself provided antihypertensive medications to 69.0% patients with hypertension, OADs to 75.0% patients with diabetes mellitus, and insulin treatment to 65.4%. The 36.9% patients with hypertension and 29.8% with diabetes mellitus that had to buy all or part of their medications reported median monthly cost of R$18.30, R$ 14.00, and R$ 27.61 for antihypertensive drugs, OADs, and insulin, respectively

Reproductive biology of Cattleya eldorado, a species of Orchidaceae from the Amazonian white sand campinas

The orchid plants are highly prized for their lush exotic flowers. It is the largest plant family with more than 24000 species, which indicates a high diversity of forms and adaptations to different environments, including the capacity to attract, deceive and manipulate visitors involved in cross-pollination. Cattleya eldorado occurs in areas of white sand campinas, a typical vegetation type of the Amazon region, which is under strong anthropogenic pressure. This work's main objectives to know the biological processes of C. eldorado providing subsidies to maintain and manage it in its natural habitat. This study was conducted from 2000 to 2006 in the Campina Biological Reserve, during its flowering period. C. eldorado is an epiphytic orchid species that has the melittophyly syndrome and is adapted to its pollinator, the bee Eulaema mocsaryi recognizing their flowers by smell and by visual stimuli, through their color and reflection of ultraviolet light. C. eldorado is self-compatible, even if it requires a pollinating agent for the transfer of the pollinarium until its deposition in the stigmatic cavity of the flower.", 'enAs Orchidaceae são muito apreciadas por suas flores exóticas e exuberantes. É a maior família de plantas apresentando mais de 24000 espécies, o que denota uma alta diversidade de formas e adaptações a diferentes ambientes, como também para atração, engano e manipulação de visitantes na realização da polinização cruzada. Cattleya eldorado ocorre em áreas de campinas, que são formações vegetais típicas da região amazônica, que se encontram sob forte ação antrópica. Este trabalho tem como um de seus principais objetivos conhecer parte dos processos biológicos de C. eldorado fornecendo subsídios para conservá-la e manejá-la em seu habitat natural. Este estudo foi desenvolvido na Reserva Biológica de Campina, de 2000 a 2006, durante a sua floração. C. eldorado é uma espécie epifítica que apresenta a síndrome de melitofilia, estando adaptada ao seu polinizador, a abelha Eulaema mocsaryi, que reconhece suas flores pelo odor e pelo estímulo visual através de sua coloração e reflexão de luz ultravioleta. C. eldorado é uma espécie autocompatível, embora necessite de um agente polinizador para a transferência do polinário até sua deposição na cavidade estigmática da flor

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true