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Copy-number variants (CNVs) play a substantial role in the molecular pathogenesis of hereditary disease and cancer, as well as in normal human interindividual variation. However, they are still rather difficult to identify in mainstream sequencing projects, especially involving exome sequencing, because they often occur in DNA regions that are not targeted for analysis. To overcome this problem, we developed OFF-PEAK, a user-friendly CNV detection tool that builds on a denoising approach and the use of "off-target" DNA reads, which are usually discarded by sequencing pipelines. We benchmarked OFF-PEAK on data from targeted sequencing of 96 cancer samples, as well as 130 exomes of individuals with inherited retinal disease from three different populations. For both sets of data, OFF-PEAK demonstrated excellent performance (>95% sensitivity and >80% specificity vs. experimental validation) in detecting CNVs from in silico data alone, indicating its immediate applicability to molecular diagnosis and genetic research.
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Algoritmos , Neoplasias , Humanos , Sequenciamento de Nucleotídeos em Larga Escala , Análise de Sequência de DNA , Exoma , Variações do Número de Cópias de DNA/genética , Neoplasias/genéticaRESUMO
OBJECTIVE: The aim of this study was to compare the effectiveness of a combined intervention of manual therapy and exercise (MET) versus usual care (UC), on disability, pain intensity and global perceived recovery, in patients with non-specific chronic neck pain (CNP). DESIGN: Randomized controlled trial. SETTING: Outpatient care units. SUBJECTS: Sixty-four non-specific CNP patients were randomly allocated to MET (n = 32) or UC (n = 32) groups. INTERVENTIONS: Participants in the MET group received 12 sessions of mobilization and exercise, whereas the UC group received 15 sessions of usual care in physiotherapy. MAIN MEASURES: The primary outcome was disability (Neck Disability Index). The secondary outcomes were pain intensity (Numeric Pain Rating Scale) and global perceived recovery (Patient Global Impression Change). Patients were assessed at baseline, three weeks, six weeks (end of treatment) and at a three-month follow-up. RESULTS: Fifty-eight participants completed the study. No significant between-group difference was observed on disability and pain intensity at baseline. A significant between-group difference was observed on disability at three-week, six-week and three-month follow-up (median (P25-P75): 6 (3.25-9.81) vs. 15.5 (11.28-20.75); P < 0.001), favouring the MET group. Regarding pain intensity, a significant between-group difference was observed at six-week and three-month follow-up (median (P25-P75): 2 (1-2.51) vs. 5 (3.33-6); P < 0.001), with superiority of effect in MET group. Concerning the global perceived recovery, a significant between-group difference was observed only at the three-month follow-up (P = 0.001), favouring the MET group. CONCLUSION: This study's findings suggest that a combination of manual therapy and exercise is more effective than usual care on disability, pain intensity and global perceived recovery.
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Dor Crônica/terapia , Terapia por Exercício , Manipulações Musculoesqueléticas , Cervicalgia/terapia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Prospectivos , Método Simples-Cego , Resultado do TratamentoRESUMO
Bullous lupus erythematosus is a rare clinical form of lupus. The diagnosis is challenging and involves the exclusion of other subepidermal bullous dermatoses. We present a 21-year-old woman with erythematosus, polycyclic plaques with vesiculobullae along the periphery, creating an erythema gyratum repens-like pattern on acral regions. The cutaneous biopsy, analytical, and autoimmune studies support the diagnosis of systemic lupus erythematosus. Dapsone and glucocorticosteroids were given with prompt resolution of the lesions within two weeks. To our knowledge this is the first case of bullous lupus erythematosus with this atypical acral presentation.
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Dermatoses do Pé/diagnóstico , Dermatoses da Mão/diagnóstico , Dermatoses da Perna/diagnóstico , Lúpus Eritematoso Sistêmico/diagnóstico , Dermatopatias Vesiculobolhosas/diagnóstico , Anti-Infecciosos/uso terapêutico , Dapsona/uso terapêutico , Eritema , Feminino , Dermatoses do Pé/tratamento farmacológico , Dermatoses do Pé/etiologia , Dermatoses do Pé/patologia , Glucocorticoides/uso terapêutico , Dermatoses da Mão/tratamento farmacológico , Dermatoses da Mão/etiologia , Dermatoses da Mão/patologia , Humanos , Dermatoses da Perna/tratamento farmacológico , Dermatoses da Perna/etiologia , Dermatoses da Perna/patologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/imunologia , Lúpus Eritematoso Sistêmico/patologia , Dermatopatias Vesiculobolhosas/tratamento farmacológico , Dermatopatias Vesiculobolhosas/etiologia , Dermatopatias Vesiculobolhosas/patologia , Adulto JovemRESUMO
Aspergillus fumigatus azole resistance has emerged as a global health problem. We evaluated the in vitro antifungal susceptibility of 221 clinical A. fumigatus isolates according to CLSI guidelines. Sixty-one isolates exhibiting MICs at the epidemiological cutoff value (ECV) for itraconazole or above the ECV for any triazole were checked for CYP51A mutations. No mutations were documented, even for the isolates (1.8%) with high voriconazole MICs, indicating that triazoles may be used safely to treat aspergillosis in Brazil.
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Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergillus fumigatus/efeitos dos fármacos , Farmacorresistência Fúngica/genética , Infecções Fúngicas Invasivas/tratamento farmacológico , Itraconazol/uso terapêutico , Voriconazol/uso terapêutico , Aspergillus fumigatus/isolamento & purificação , Brasil , Humanos , Testes de Sensibilidade Microbiana , Estudos RetrospectivosRESUMO
This article examines discoveries, inventions, and innovations related to penicillin by sampling activities to solve technological problems which can be traced by the distribution of scientific articles, government reports, innovations, and patents between 1929 and 1945, and proposes reflection on the importance of scientific progress for national security. The analysis highlights the technological trajectory and outcomes in the area of intellectual property, considering US policy implemented to catalyze innovation and provide institutional conditions to meet national defense needs as an important factor, although this did not necessarily imply a unique solution in other contexts.
A partir de pesquisa sobre a descoberta, a invenção e a inovação relacionadas à penicilina, por amostra de atividades de resolução de problemas tecnológicos rastreada pela distribuição, no período de 1929 a 1945, de trabalhos científicos, relatórios de governo, inovações e patentes, o artigo propõe uma reflexão sobre a importância do progresso científico para a segurança nacional. A análise destaca a trajetória tecnológica e os resultados na área de propriedade intelectual, considerando um fator importante a política implementada nos EUA para catalisar processos de inovação e oferecer condições institucionais para atender às demandas de defesa nacional, o que não significa necessariamente unicidade de solução em outros contextos.
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Patentes como Assunto , Penicilinas , História do Século XX , Patentes como Assunto/história , Penicilinas/história , Antibacterianos/história , Humanos , BrasilRESUMO
Duplication of the distal 1q and 4p segments are both characterized by the presence of intellectual disability/neurodevelopmental delay and dysmorphisms. Here, we describe a male with a complex chromosome rearrangement (CCR) presenting with overlapping clinical findings between these 2 syndromes. In order to better characterize this CCR, classical karyotyping, FISH, and chromosomal microarray analysis were performed on material from the patient and his parents, which revealed an unbalanced karyotype with duplications at 1q41q43 and 4p15.2p14 in the proband. The rearrangements, which were derived from a maternal balanced karyotype, included an insertion of a segment from the long to the short arm of chromosome 1, a balanced translocation involving chromosomes 14 and 18, and an insertion of a segment from the short arm of chromosome 4 into the derived chromosome 14. This study aimed to better define the clinical history and prognosis of a patient with this rare category of chromosomal aberration. Our results suggest that the frequency of CCR in the general population may be underestimated; when balanced, they may not have a phenotypic effect. Moreover, they emphasize the need for cytogenetic techniques complementary to chromosomal microarray for proper genetic counseling.
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As a central and prominent structure of the face, the nose has particular aesthetic and functional importance and constitutes a true reconstructive challenge. Subcutaneous transposition flaps are rarely used in this region, but the surgical technique can be modified for the use of a simple flap with good aesthetic results, thereby gaining a prominent place in the range of options available for nasal ala reconstruction. We present a unique case report of a modified subcutaneous pedicle transposition flap for nasal ala defect reconstruction, showing that this flap can be applied on this area with good aesthetic results and a simple technique.
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Nariz/cirurgia , Rinoplastia/métodos , Retalhos Cirúrgicos , Idoso de 80 Anos ou mais , Feminino , Humanos , Tela Subcutânea/transplanteRESUMO
BACKGROUND: Pyoderma gangrenosum (PG) is a rare and difficult-to-diagnose disease that often associates with inflammatory bowel disease. CASE: We present a case of a 57-year-old female with ulcerative colitis receiving 5-ASA who presented with rapidly progressive ulcers in the right foot and on the inside of the thigh, extending from the left large vaginal lip to the perianal area, compatible with PG. She was initially treated with corticosteroids with no response. After multidisciplinary consultation, it was decided to initiate in-fliximab 5 mg/kg, and to perform ileostomy for fecal diversion and negative-pressure wound therapy. The patient presented with marked improvement of the lesions, being discharged after 2 months and demonstrating almost complete resolution of the lesions within 4 months. CONCLUSION: Due to the rarity of PG, there is no evidence of the optimal management. The role of surgery is controversial as PG lesions can demonstrate pathergy and theoretically could worsen with surgical intervention. In this case it was decided based on the extent of the lesions and the experience in other septic/ulcerative perianal conditions.
INTRODUÇÃO: O pioderma gangrenoso (PG) é uma doença rara e de difícil diagnóstico, que frequentemente se associa à doença inflamatória intestinal. CASO: Apresentamos um caso de uma mulher de 57 anos de idade com colite ulcerosa sob 5-ASA que recorreu ao serviço de urgência pelo aparecimento de úlceras rapidamente progressivas no pé direito e no interior da coxa, estendendo-se desde o grande lábio vaginal esquerdo até à área perianal, compatível com PG. A doente foi inicialmente tratada com corticosteroides, sem resposta. Após consulta multidisciplinar, optou-se por iniciar o infliximab 5 mg/kg, realizar ileostomia para desvio fecal e iniciar terapia de vácuo com pressão negativa. A doente apresentou melhoria marcada das lesões tendo tido alta após 2 meses e demonstrando resolução quase completa das lesões aos 4 meses. CONCLUSÃO: Devido à raridade do PG, não há evidências de qual a abordagem ideal. O papel da cirurgia é controverso, pois as lesões do PG podem demonstrar patergiae teoricamente poderiam piorar com a intervenção cirúrgica. Neste caso, a opção cirúrgica foi tomada com base na extensão das lesões e na experiência em outras condições perianais sépticas/ulcerativas.
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Although sanitation problems seem to have been resolved, every day thousands of children around the world die of diseases caused by the lack of it. Nevertheless, sanitation remains virtually invisible in the Brazilian health sector agenda. The objective of this study is to investigate the importance given to this topic by researchers from the public health field. The relevance of the subject was mapped out in CNPq's research groups, Brazilian scientific journals, and public health graduate programs. The results showed that few of these programs addressed the topic of sanitation. As a consequence, few public health research groups study and publish about sanitation in the journals assessed. The potential factors that could be behind the limited interest in sanitation shown by the public health academic community are discussed.
Milhares de crianças no mundo ainda morrem por doenças causadas pela falta de saneamento. Entretanto, o saneamento segue quase invisível na agenda da saúde brasileira. O objetivo deste estudo é investigar a relevância dada ao tema pelos pesquisadores do campo da saúde coletiva. Para isso mapeou-se a presença do tema nos grupos de pesquisa do CNPq, nos periódicos científicos nacionais e nos programas de pós-graduação em saúde coletiva. Os resultados mostraram que poucos desses programas abordam o tema. Assim, poucos grupos de pesquisa em saúde coletiva estudam e publicam sobre saneamento nos periódicos avaliados. Fatores que poderiam estar associados à aparente baixa relevância dada ao tema pela comunidade acadêmica da saúde coletiva são discutidos.
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INTRODUCTION: Erythematotelangiectatic rosacea is a common condition in Caucasians. The most frequently used lasers to treat this condition are pulsed dye laser (PDL) and neodymium:yttrium-aluminum-garnet laser (Nd:YAG). This study compares the treatment efficacy of purpuragenic PDL with that of sequential emission of 595 nm PDL and 1,064 nm Nd:YAG (multiplexed PDL/Nd:YAG). METHODS: We performed a prospective, randomized, and controlled split-face study. Both cheeks were treated, with side randomization to receive treatment with PDL or multiplexed PDL/Nd:YAG. Efficacy was evaluated by spectrophotometric measurement, visual photograph evaluation, the Dermatology Quality of Life Index questionnaire, and a post-treatment questionnaire. RESULTS: Twenty-seven patients completed the study. Treatment was associated with a statistically significant improvement in quality of life (p < 0.001). PDL and multiplexed PDL/Nd:YAG modalities significantly reduced the erythema index (EI; p < 0.05). When comparing the degree of EI reduction, no differences were observed between the two treatment modalities. PDL was associated with a higher degree of pain and a higher percentage of purpura. Multiplexed PDL/Nd:YAG modality was associated with fewer side effects and greater global satisfaction, and 96.3% of the patients would recommend this treatment to a friend. CONCLUSIONS: Both laser modalities are efficacious in the treatment of erythematotelangiectatic rosacea. The multiplexed PDL/Nd:YAG modality was preferred by the patients.
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Dermatoses Faciais/radioterapia , Lasers de Corante/uso terapêutico , Lasers de Estado Sólido/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Satisfação do Paciente/estatística & dados numéricos , Rosácea/radioterapia , Método Duplo-Cego , Estética , Dermatoses Faciais/patologia , Dermatoses Faciais/fisiopatologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Qualidade de Vida , Medição de Risco , Rosácea/patologia , Rosácea/fisiopatologia , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Resumo A partir de pesquisa sobre a descoberta, a invenção e a inovação relacionadas à penicilina, por amostra de atividades de resolução de problemas tecnológicos rastreada pela distribuição, no período de 1929 a 1945, de trabalhos científicos, relatórios de governo, inovações e patentes, o artigo propõe uma reflexão sobre a importância do progresso científico para a segurança nacional. A análise destaca a trajetória tecnológica e os resultados na área de propriedade intelectual, considerando um fator importante a política implementada nos EUA para catalisar processos de inovação e oferecer condições institucionais para atender às demandas de defesa nacional, o que não significa necessariamente unicidade de solução em outros contextos.
Abstract This article examines discoveries, inventions, and innovations related to penicillin by sampling activities to solve technological problems which can be traced by the distribution of scientific articles, government reports, innovations, and patents between 1929 and 1945, and proposes reflection on the importance of scientific progress for national security. The analysis highlights the technological trajectory and outcomes in the area of intellectual property, considering US policy implemented to catalyze innovation and provide institutional conditions to meet national defense needs as an important factor, although this did not necessarily imply a unique solution in other contexts.
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BACKGROUND: Daylight photodynamic therapy (PDT) has been reported as having similar efficacy to conventional photodynamic therapy in actinic keratosis treatment. METHODS: 25 patients with actinic keratosis of the scalp and/or face were submitted to a daylight photodynamic therapy session. Adverse reactions were evaluated after one week and efficacy after 3 months. Confocal Microscopy was performed in 6 patients, before and one week after the treatment. Our aim was to compare our results with others studies and analyse the changes occurring in the epidermis and upper dermis with confocal microscopy. RESULTS: 76% of the patients were male. The mean age was 74.2 years. In 51.7% of patients the treatment site was the scalp. Mean cure rate at 3 months was 74%. Aesthetic results were excellent in all patients and only one patient reported mild pain during the 2 h exposure. Confocal Microscopy showed a normalization of the honeycomb pattern in all of the patients. CONCLUSIONS: This therapy has similar results to conventional photodynamic therapy and stands out for less discomfort, fewer adverse effects and better cost-effectiveness. Using confocal microscopy it's possible to in vivo demonstrate the efficacy of this method, with normalization of the honeycomb pattern in the epidermis following succcessful PDT.
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Ácido Aminolevulínico/uso terapêutico , Ceratose Actínica/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Luz Solar , Idoso , Idoso de 80 Anos ou mais , Face , Feminino , Humanos , Masculino , Microscopia Confocal , Couro Cabeludo , Índice de Gravidade de DoençaRESUMO
Cutaneous manifestations of tuberculosis (TB) are rare, particularly from an exogenous source. Involvement of the nail apparatus is extremely rare and has only previously been reported as a secondary involvement. We report the case of a 76-year-old female patient referred to our department with onychodystrophy with purulent drainage of the first left finger, which had developed during the preceding year. She had no previous traumatic history and had received treatment with multiple cycles of oral antibiotics and antimycotics, with no clinical improvement. Physical examination showed paronychia and onychodystrophy of the entire nail plate. Biopsy evaluation revealed epithelioid granulomas with central foci of necrosis, and laboratory cultures were positive for Mycobacterium tuberculosiscomplex. Chest computed tomography excluded primary pulmonary TB. X-ray of the left hand revealed the presence of dactylitis on the distal phalanx. Based on these findings, the patient was treated with rifampicin, isoniazid, pyrazinamide, and ethambutol for 2 months and with rifampicin and isoniazid for 7 months, resulting in complete resolution of the lesions. Cutaneous TB is a diagnostic challenge, particularly in rare cases such as involvement of the nail apparatus. It should be considered as a diagnostic hypothesis in cases of painless paronychia with refractory purulent drainage and associated onychodystrophy.
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Introdução: Este texto identifica e analisa matérias jornalísticas que abordaram o consumo de alimentos durante a pandemia, no contexto da crise econômica e do desmonte das políticas públicas de segurança alimentar no país. Objetivo: O objetivo geral do trabalho é analisar o conteúdo das matérias que abordaram o tema para perceber que mensagens elas transmitiam a respeito do agravamento da insegurança alimentar no contexto da crise econômica e do aumento do preço dos alimentos. Método: Para efetuar a análise do conteúdo, foram selecionadas 15 matérias nos sites de dois jornais, a saber, Extra e G1, do Grupo Globo S.A., publicadas entre 2020 e 2021, auge da pandemia. Resultados: Os resultados obtidos mostraram que, via de regra, a cobertura jornalística abordou o aumento do preço dos alimentos e dos custos na cadeia de suprimentos como uma realidade dada às vezes, da natureza e não como resultante de um processo construído politica e socialmente a partir das decisões políticas dos nossos dirigentes. Com isso, os verdadeiros responsáveis pela crise e pelo desmonte das políticas de segurança alimentar seguiram invisíveis e, portanto, protegidos da opinião pública. Discussão: O estudo examina de forma crítica o papel da mídia na produção de mensagens que perpetuam narrativas que ocultam os responsáveis pelos problemas coletivos da população e mostra, a partir da trajetória do setor, as decisões políticas que nos levaram de volta ao mapa da fome. Por fim, destaca a importância de reativar o CONSEA como órgão consultivo fundamental no combate à insegurança alimentar. (AU)
Introduction: This text identifies and analyzes journalistic articles that addressed food consumption during the pandemic, in the context of the economic crisis and the dismantling of public food security policies in the country. Objective: The general objective of the work is to analyze the content of the articles that addressed the theme to understand what messages they transmitted regarding the worsening of food insecurity in the context of the economic crisis and the increase in food prices. Method: To perform the content analysis, 15 articles were selected on the websites of two newspapers, namely, Extra and G1, from Grupo Globo S.A., published between 2020 and 2021, the height of pandemic. Results: The results showed, mostly, that journalistic coverage addressed the increase in food prices and costs in the supply chain as a given reality sometimes, of nature and not as a result of a political and social process, based on the political decisions of our leaders. As a result, those truly responsible for the crisis and the dismantling of food security policies were not properly identified or held accountable for their actions. Discussion: The study critically examines the role of the media in producing messages that perpetuate narratives that hide those responsible for the collective problems of the population and shows, based on the trajectory of the sector, the political decisions that led us back to the hunger map. Finally, it highlights the importance of reactivating the CONSEA as fundamental advisory body in the fight against food insecurity. (AU)
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This case study describes a 37-year-old Caucasian male with pruritic papules and plaques-some with central erosion-on the arms, neck, and trunk that appeared after chemotherapy with FOLFOX (folinic acid, fluorouacil, and oxiliplatin) for colon cancer. A histological examination showed features of neutrophilic eccrine hidradenitis. To the best of our knowledge, this is the first reported case of neutrophilic eccrine hidradenitis due to FOLFOX.
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Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias do Colo/tratamento farmacológico , Hidradenite/induzido quimicamente , Hidradenite/diagnóstico , Adulto , Fluoruracila/uso terapêutico , Hidradenite/terapia , Humanos , Leucovorina/uso terapêutico , Masculino , Compostos Organoplatínicos/uso terapêuticoRESUMO
RESUMO Este texto tem o propósito de mostrar que as novas alterações na regulação dos serviços ligados à água são o efeito, em escala nacional, de uma transformação estrutural recente na dinâmica de acumulação capitalista mundial. O objetivo é situar os leitores do campo da saúde no processo de financeirização que avança no setor do saneamento no Brasil e ameaça o direito ao acesso. Para tanto, pretende-se mostrar, a partir da perspectiva da geografia crítica e da ecologia política, como a nova lei do saneamento aprovada durante a pandemia e a proposta de criação de um mercado de águas no Brasil vão ao encontro do movimento das elites internacionais que, diante das crises cíclicas do setor produtivo, buscam nos bens comuns e na natureza novas oportunidades de lucro. Discutem-se, também, o papel do Estado nesse processo e os efeitos mapeados pela literatura que investiga esse assunto.
ABSTRACT This paper aims to show that the recent changes in the framework of water-related services represent, on a national scale, the effect of a recent structural change in the dynamics of global capitalism. The purpose is to clarify readers in the field of health on the process of financialization that is taking place in the sanitation sector in Brazil, which threatens public health. Therefore, we intend to show, from the perspective of the critical geography theory, how the new sanitation framework and the creation of a water market in Brazil meet the interests of the international elites who, in the face of cyclical crises in the productive field, seek for opportunities to profit from common goods and nature. It also discusses the role of the State in this entire process and the likely effects that have already been pointed out by the literature on the subject.
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Resumo Este artigo descreve e analisa a participação do Instituto de Tecnologia em Fármacos (Farmanguinhos) na produção local de medicamentos antirretrovirais no Brasil. São também apresentadas as mudanças no padrão de provimento, a situação das parcerias para o desenvolvimento produtivo e a posição dos produtores nacionais para esses medicamentos. As estratégias metodológicas foram revisão bibliográfica, análise de documentos oficiais e dados fornecidos por Farmanguinhos e pelo Departamento de Condições Crônicas e Infecções Sexualmente Transmissíveis do Ministério da Saúde, via Lei de Acesso à Informação. Este artigo mostra que o estabelecimento das parcerias abriu novas perspectivas para o desenvolvimento da política de oferta pública de antirretrovirais para as pessoas vivendo com HIV, por contribuir para a sustentabilidade das despesas financeiras do Ministério da Saúde com medicamentos. Farmanguinhos é o laboratório público que fornece mais quantidades e recebe os maiores valores provenientes do fornecimento desses produtos ao Ministério da Saúde. Embora os medicamentos importados preponderem largamente em quantidade e valores pagos pelo Ministério da Saúde, Farmanguinhos permanece sendo um provedor fundamental na produção local de antirretrovirais. Apesar dos problemas verificados nas Parcerias, os ganhos nas competências tecnológicas na produção de antirretrovirais podem ampliar o horizonte tecnológico e produtivo do laboratório.
Abstract This article describes and analyses the part played by the Instituto de Tecnologia em Fármacos (Farmanguinhos) in local production of antiretroviral medicines in Brazil, as well as changes in the pattern of supply, the status of related Production Development Partnerships and the position of Brazilian producers of these medicines. The methodological strategies used were literature review and analysis of official documents and data provided by Farmanguinhos and by the Ministry of Health's Department of Chronic Conditions and Sexually Transmitted Infections, via the Information Access Law. This article shows that, by contributing to the sustainability of Ministry of Health expenditure on medicines, these partnerships have opened new prospects for developing the policy of public supply of antiretrovirals for people living with HIV. Farmanguinhos is the public laboratory that supplies the largest quantities of these products to the Ministry of Health and receives the largest revenues from supplying them. Although the imported medicines supplied to the Ministry of Health account for much larger quantities and revenues, Farmanguinhos continues to be a fundamentally important supplier of locally produced antiretrovirals. Despite the problems found in establishing the partnerships, the gains in antiretroviral production technology competences can broaden the laboratory's technological and production horizons.
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Humanos , Infecções Sexualmente Transmissíveis , HIV , Antirretrovirais/provisão & distribuição , Indústria Farmacêutica , Política Nacional de Medicamentos , Acesso a Medicamentos Essenciais e Tecnologias em Saúde , Sistema Único de Saúde , BrasilRESUMO
This article demonstrates that the position of dominance enjoyed by state sanitation companies dictates the public policy decision-making process for sanitation in Brazil. These companies' hegemony is explained here through the analysis of a path that generated political and economic incentives that have permitted its consolidation over time. Through the content analysis of the legislation proposed for the sector and the material produced by the stakeholders involved in the approval of new regulations for the sector in 2007, the study identifies the main sources of incentive introduced by the adoption of the National Sanitation Plan, which explain certain structural features of the current sanitation policy and its strong capacity to withstand the innovations proposed under democratic rule.
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Dissidências e Disputas/história , Governo/história , Política Pública/história , Saneamento/história , Brasil , Regulamentação Governamental/história , História do Século XX , História do Século XXI , Sistemas Políticos/história , Privatização/história , Privatização/legislação & jurisprudência , Política Pública/legislação & jurisprudência , Saneamento/legislação & jurisprudênciaRESUMO
Introduction: It is well known that adequate hygiene is important for health. Even though this topic has drawn the attention of the media, little or no scientific investigation has been done. Methods: We performed a comparative questionnaire-based cross-sectional study in three groups: patients attending a dermatology outpatient clinic, patients attending an internal medicine consultation, and community members. Results: We analyzed a total of 446 questionnaires (249 from dermatology patients, 98 from internal medicine patients, and 99 from the community group). The three groups did not differ statistically in sex and age (p=0.070). The patients from the dermatology department had a higher education level. The number of weekly baths did not differ among the three groups (p=0.417). Hair hygiene did not differ between the three groups. The dermatology and internal medicine groups washed their hands more frequently than the community group (p=0.028). Conclusions: Comparing our results to the limited data available, we find that the population surveyed has better hygiene habits than those previously reported. We believe that hygiene habits should be discussed during office visits.
Assuntos
Hábitos , Higiene , Adulto , Idoso , Instituições de Assistência Ambulatorial , Estudos Transversais , Dermatologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Medicina Interna , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
RESUMO Este artigo analisou a produção científica brasileira do campo das ciências da saúde que incorpora questões de gênero aos estudos sobre a pandemia da Covid-19. A busca pelas publicações foi realizada nas bases bibliográficas da área da saúde; seus resultados foram categorizados em eixos temáticos e, em seguida, analisados. Busca-se não apenas caracterizar como a assimetria de gênero é tratada no campo das ciências da saúde, mas também apreender as repercussões da pandemia apontadas sobre a saúde das mulheres. Elas sofreram duramente com aumento do desemprego, da sobrecarga doméstica, da violência pelos parceiros, dos transtornos emocionais e de sua qualidade de vida mostrando que as ações políticas para o enfrentamento da pandemia, quando não pensadas sob as lentes das desigualdades de gênero, são potencialmente produtoras de maiores vulnerabilidades para grupos já vulneráveis antes da crise sanitária, como é o caso das mulheres, especialmente quando negras, pobres e idosas. Isso inclui a devida qualificação profissional da rede de assistência básica e dos profissionais de saúde no que tange à abordagem de gênero, como notou a literatura aqui revisada.
ABSTRACT This paper analyzes the Brazilian scientific production in health sciences, which incorporates gender issues into the COVID-19 pandemic studies. We searched for publications in the bibliographic health databases; their results were categorized into thematic axes and then analyzed. Our work does not only aim to characterize how gender asymmetry is addressed in health sciences but also acknowledges the repercussions of the pandemic pointed out on women's health. Women suffered severely from increased unemployment, domestic overload, partner violence, emotional disorders, and their quality of life, showing that political actions to fight the pandemic, when not inspected through the lens of gender inequalities, potentially prompt more significant vulnerabilities for groups already vulnerable before the health crisis, such as women, notably when racialized and poor, which also includes proper professional qualification of the primary care network and health professionals with regards to gender approaches, as noted in the literature reviewed.