Do national health priorities align with Global Burden of Disease estimates on disease burden? An analysis of national health plans and official governmental websites.

OBJECTIVE: To investigate the alignment of national health priorities with a country's burden of disease as measured by disability-adjusted life years (DALYs). METHODS: We identified priorities in national health plans and the 20 most burdensome conditions measured by DALYs from the 2017 Global Burden of Disease Study. We computed point-biserial correlations (rpb) between DALYs and being nominated as a health priority and the pooled proportion (95% confidence intervals [CIs]) of the 20 most burdensome conditions nominated as a priority across countries. RESULTS: We identified national health plans and official governmental websites in 145 countries. There was little to no correlation (rpb = 0.06, 95% CI: 0.02 to 0.09) between national DALY data and whether a condition was nominated as a health priority. The pooled proportion of the 20 most burdensome conditions nominated as priorities across countries was 46%. HIV/AIDS had the greatest number of nominations as a national health priority (62 countries) as well as the greatest match with the burden of disease (among the top 20 most burdensome conditions in 51 [82%] countries). Low back pain, headache disorders and congenital birth defects had the lowest proportion of nominations as health priorities in countries where they were in the top 20 most burdensome conditions (6%, 6% and 11%, respectively). CONCLUSION: Globally, there were low correlations between national health priorities and GBD estimates on disease burden. Failing to prioritise health priorities according to burden may mean that insufficient resources have been directed to improve health outcomes for people with those health conditions.

Cytogenetic characterization of species of the family Heptapteridae (Teleostei: Siluriformes) from the Cuiabá and Ivaí River Basins, Brazil.

We cytogenetically characterized three species of Heptapteridae (Pimelodella sp, Pimelodella taenioptera, and Imparfinis schubarti) by investigating the distribution of constitutive heterochromatin and nucleolar organizer regions by silver nitrate impregnation (Ag-NOR) and fluorescence in situ hybridization. Pimelodella sp showed had a diploid number (2n) = 46 chromosomes, 26m + 10sm + 10st, and FN = 92; P. taenioptera, 2n = 52 chromosomes, 26m + 22sm + 4st, and FN = 104; and I. schubarti, 2n = 58 chromosomes, 28m + 28sm + 2st, and FN = 116. The two Pimelodella species had Ag-NORs sites on the submetacentric pair 14, located on the short arm in terminal position. In I. schubarti, the Ag-NORs sites were in an interstitial position on the long arm of the metacentric pair 1. C-banding revealed that Pimelodella sp contained a small amount of constitutive heterochroma-tin, whereas P. taenioptera contained a higher number of heterochromatic regions, in the pericentromeric, interstitial, and telomeric positions. I. schubarti had markers in centromeric and telomeric regions of a few chromosomes, and a large pericentromeric block on pair 1. Fluorochrome chromomycin A3 (CMA3) staining revealed positive signals on pair 14 in both Pimelodella species. Treatment with 4ꞌ,6-diamidino- 2-phenylindole (DAPI) revealed no markings in P. taenioptera, but an interstitial marking on the long arm of pair 14 in Pimelodella sp. In I. schubarti, positive signals of CMA3 were detected in the first pair, but negative signals were detected for DAPI staining. These results con-tribute to the karyotypic description of the less-studied species in the Brazilian Midwest.

Avaliação histológica da infecção crônica pelo vírus da Hepatite C

A Hepatite C (HCV) é uma infecção prevalente em todo o mundo e, atualmente, é a principal causa de indicação de transplante hepático. A biópsia hepática é uma ferramenta importante na avaliação desta infecção, uma vez que a maioria dos pacientes é assintomática e as enzimas hepáticas nem sempre se correlacionam com lesão histológica. A presença de fibrose hepática tem sido relacionada a maior morbimortalidade. O objetivo deste estudo foi avaliar as alterações hepáticas observadas à biópsia hepática em pacientes assintomáticos portadores de infecção crônica pelo HCV

Relato de 7 casos de pacientes portadores de Hepatite B em acompanhamento no Ambulatório de Hepatologia do Hospital do Servidor Público Municipal

Vários estudos têm demonstrado a preocupação em relação ao HBV devido a sua evolução para formas crônicas e o aparecimento de hepatocarcinoma. Hoje temos um novo arsenal de medicamentos para diminuir a carga viral dos portadores HBV quando em atividade replicativa, sendo a carga viral extremamente importante, num futuro próximo os genótipos também orientarão para o prognóstico

Insuficiência hepática aguda: etiologia e evolução clínica

A Insuficiência Hepática Aguda é uma condição grave associada à coagulopatia e alteração mental em pacientes sem doença hepática prévia. Pode ser causada por diversos agentes, tais como, vírus, auto-imunidade e drogas. A Hepatite Aguda B pode se apresentar sob a forma de doença grave e a indicação de transplante hepático deve ser considerada