POF-based biosensors for cortisol detection in seawater as a tool for aquaculture systems.

A surface plasmon resonance (SPR) phenomenon implemented via D-shaped polymer optical fiber (POF) is exploited to realize cortisol biosensors. In this work, two immonosensors are designed and developed for the qualitative as well as quantitative measurement of cortisol in artificial and real samples. The performances of the POF-based biosensors in cortisol recognition are achieved using different functionalization protocols to make the same antibody receptor layer over the SPR surface via cysteamine and lipoic acid, achieving a limit of detection (LOD) of 0.8 pg/mL and 0.2 pg/mL, respectively. More specifically, the use of cysteamine or lipoic acid changes the distance between the receptor layer and the SPR surface, improving the sensitivity at low concentrations of about one order of magnitude in the configuration based on lipoic acid. The LODs of both cortisol biosensors are achieved well competitively with other sensor systems but without the need for amplification or sample treatments. In order to obtain the selectivity tests, cholesterol and testosterone were used as interfering substances. Moreover, tests in simulated seawater were performed for the same cortisol concentration range achieved in buffer solution to assess the immunosensor response to the complex matrix. Finally, the developed cortisol biosensor was used in a real seawater sample to estimate the cortisol concentration value. The gold standard method has confirmed the estimated cortisol concentration value in real seawater samples. Liquid-liquid extraction was implemented to maximize the response of cortisol in liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) analysis.

Diagnostic Methods for Helicobacter pylori.

Helicobacter pylori infection is a significant global health concern. It cannot be diagnosed based solely on the patient's medical history and symptoms, and laboratory and imaging tests are often required to confirm the diagnosis. Both noninvasive and invasive methods are available for diagnosing H. pylori infection, including conventional and advanced detection techniques. It is not uncommon for patients to present with false-negative results due to the use of inadequate investigation methodologies, which prevents the adoption of appropriate clinical management. Thus, an analysis of the literature regarding the methods of diagnosis of H. pylori, with its advantages and disadvantages, is necessary. Publications in specialized scientific journals will undoubtedly contribute to facilitating access by professionals interested in the topic providing greater knowledge and potentially clinically useful guidance. In this review, the authors have sought to analyze and summarize the invasive and noninvasive methods, their applications, limitations, and the conditions that affect the sensitivity of the tests used for diagnosing H. pylori, an essential step for the successful treatment of this infection. It is essential to treat all patients infected with H. pylori. This represents a significant change in the approach, as the treatment was recommended previously only for patients showing symptoms of infection. Therefore, it is crucial to understand the limitations of traditional diagnostic methods and help raise awareness among healthcare professionals about the latest advances in diagnosing this important bacterium.

New infections by SARS-CoV-2 variants of concern after natural infections and post-vaccination in Rio de Janeiro, Brazil.

After a one-year rollout of the pandemic caused by SARS-CoV-2, the continuous dissemination of the virus has generated a number of variants with increased transmissibility and infectivity, called variants of concern (VOC), which now predominate worldwide. Concerns about the susceptibility of humans that have already been infected before or those already vaccinated to infection by VOC rise among scientists and clinicians. Herein, we assessed the prevalence of different VOC among recent infections at the Brazilian National Cancer Institute (Rio de Janeiro, Brazil). By using a Sanger-based sequencing approach targeting the viral S gene to identify VOC, we have analyzed 72 recent infections. The overall prevalence of VOC was 97%. Among the subjects analyzed, six had been vaccinated with the ChAdOx1-S/nCoV-19 (n = 4; one with two doses and three with one dose) or the CoronaVac (n = 2; both with 2 doses) vaccine, while five subjects represented reinfection cases, being two of them also part of the vaccinated group (each one with one vaccine type). All vaccinated and re-infected subjects carried VOC irrespective of the vaccine type taken, the number of doses taken, IgG titers or being previously infected during the first wave of the Brazilian pandemic. Importantly, all six vaccinees only had mild symptoms. We present here several examples of how natural infections or vaccination may not be fully capable of conferring sterilizing immunity against VOC.

Preparation and characterization of leukocyte- and platelet-rich fibrin membrane derived from cats' blood.

Autologous platelet concentrates have been used in regenerative medicine in humans due to the abundance of growth factors, but there are only a few reports in small animals. This study aimed to prepare and characterize a leukocyte and platelet-rich fibrin membrane (L-PRF) produced with blood obtained from cats. Thirteen client-owned healthy adult Maine Coon cats were enrolled. The blood samples were collected and centrifuged at 650g for 12 min using a centrifuge specifically designed for this application. The L-PRF clot was removed from the tube and red blood cell base layer was separated, leaving buffy coat intact. After this, L-PRF clot was compressed by specialized metal plate for 30-60 s, and L-PRF membrane was obtained. Light microscopy examination of the membranes showed three distinct layers: white part, buffy coat, and red part. Immunohistochemical analysis demonstrated expression of vascular endothelial growth factor and platelet derived growth factor. The scanning electron microscopy showed that three-dimensional architecture of fibrin network was more compact in the area near the buffy coat. In conclusion, the method used allowed the characterization of the L-PRF membrane composition, which presented cell types and fibrin network architecture similar to those described in the human species.

Cancer inpatients with COVID-19: A report from the Brazilian National Cancer Institute.

OBJECTIVE: This study aimed to describe the demographic and clinical characteristics of cancer inpatients with COVID-19 exploring clinical outcomes. METHODS: A retrospective search in the electronic medical records of cancer inpatients admitted to the Brazilian National Cancer Institute from April 30, 2020 to May 26, 2020 granted identification of 181 patients with COVID-19 confirmed by RT-PCR. RESULTS: The mean age was 55.3 years (SD ± 21.1). Comorbidities were present in 110 (60.8%) cases. The most prevalent solid tumors were breast (40 [22.1%]), gastrointestinal (24 [13.3%]), and gynecological (22 [12.2%]). Among hematological malignancies, lymphoma (20 [11%]) and leukemia (10 [5.5%]) predominated. Metastatic disease accounted for 90 (49.7%) cases. In total, 63 (34.8%) had recently received cytotoxic chemotherapy. The most common complications were respiratory failure (70 [38.7%]), septic shock (40 [22.1%]) and acute kidney injury (33 [18.2%]). A total of 60 (33.1%) patients died due to COVID-19 complications. For solid tumors, the COVID-19-specific mortality rate was 37.7% (52 out of 138 patients) and for hematological malignancies, 23.5% (8 out of 34). According to the univariate analysis COVID-19-specific mortality was significantly associated with age over 75 years (P = .002), metastatic cancer (p <0.001), two or more sites of metastases (P < .001), the presence of lung (P < .001) or bone metastases (P = .001), non-curative treatment or best supportive care intent (P < .001), higher C-reactive protein levels (P = .002), admission due to COVID-19 (P = .009), and antibiotics use (P = .02). After multivariate analysis, cases with admission due to symptoms of COVID-19 (P = .027) and with two or more metastatic sites (P < .001) showed a higher risk of COVID-19-specific death. CONCLUSION: This is the first Brazilian cohort of cancer patients with COVID-19. The rates of complications and COVID-19-specific death were significantly high.

Eumicetoma e actinomicetoma: uma breve revisão da literatura / Eumycetoma and actinomycetoma: a brief review of the literature

Micetoma é uma infecção que acomete o tecido subcutâneo após a inoculação de microrganismos na pele em locais de pequenos traumas. Caracteriza-se pela ocorrência de tumoração, associada à formação de fistulas e à drenagem de grãos. Trata-se de um grupo de infecções subcutâneas de difícil tratamento com epidemiologia bem definida, acometendo preferencialmente trabalhadores rurais do gênero masculino. Os agentes causadores podem ser fungos ou bactérias. Este artigo propõe-se à revisão dos dados recentes da epidemiologia e tratamento dessas infecções.

Assistive technologies for improving the oral hygiene of leprosy patients residing in a former leprosy colony in Betim, Minas Gerais, Brazil.

BACKGROUND: This study deals with management of a group of elderly patients with a history of leprosy and hand deformities by a multidisciplinary team of dentists and occupational therapists. Assistive technology devices have been developed to allow such patients to obtain independence in oral self-care and can be a cost-effective approach to improving oral care in this population. The objective of this study was to describe the development of assistive devices to facilitate daily oral hygiene in older people with enduring leprosy-related impairments. METHODOLOGY: Case study realized among elders with a history of leprosy residents in a former isolation colony in Betim, Minas Gerais, Brazil. The elders were evaluated for dependence on others for denture hygiene and mouthwash using the Daily Oral Hygiene Activity Index (ADOH). Those deemed partially or completely dependent on others were eligible for an intervention based on assistive technology. We adopted a personalized approach to each case, taking into account medical history, physical impairment and living environment. Six months after the intervention, the participants were assessed again using the ADOH and an unstructured interview about use of the devices. PRINCIPAL FINDINGS: Assistive devices for denture hygiene and mouthwash were developed for 16 elders. These devices facilitated oral hygiene in most patients and there was no worsening in any of the cases. Patients' report suggested they were satisfied with the devices provided. CONCLUSIONS: This study demonstrated that assistive devices can facilitate oral hygiene activities in leprosy patients. It also reinforces the importance of using a multidisciplinary team for the rehabilitation of these patients.

Aumento horizontal de rebordo utilizando osso xenógeno, L-PRF e membrana D-PTFE com reforço de titânio / Horizontal alveolar ridge augmentation using xenogeneic bone, L-PRF and titanium-reinforced d-PTFE barrier

O objetivo deste trabalho é descrever uma técnica cirúrgica de regeneração óssea guiada (ROG) para aumento horizontal de rebordo, na qual foram utilizados membrana de PTFE associado ao L-PRF e enxerto ósseo particulado, em conjunto com o I-PRF. A ROG tem como finalidade recuperar as estruturas ósseas perdidas após a remodelação tecidual decorrente de exodontias. A utilização de membranas de d-PTFE permite a manutenção do espaço para a maturação do enxerto ósseo. O L-PRF atua como fonte de fatores de crescimento e leucócitos, estimulando simultaneamente, e de forma sincronizada, a neoformação óssea e a maturação do tecido gengival. A técnica descrita é mais uma alternativa disponível como opção para reconstrução de rebordos alveolares atróficos.

The aim of this article is to describe a surgical technique of guided bone regeneration (GBR) for horizontal alveolar ridge augmentation in which PTFE barriers are used in association with L-PRF and particulated bone graft associated to I-PRF. The objective of GBR is reconstructing missed bone structures after tissue remodelling due to teeth removal. The use of d-PTFE barrier allows space maintenance for bone graft maturation. L-PRF acts as source of growth factor and leukocytes stimulating synchronized and simultaneous bone neoformation and gingival tissue maturation. The described technique is another available alternative as an option to restore atrophic alveolar ridge.

Spatially distributed potential of landfill biogas production and electric power generation in Brazil.

Due to the relatively low investment, operation costs, and technical requirements, landfills are still the most widespread alternative for final disposal of municipal solid waste (MSW). The biogas produced in the landfill, a renewable energy source, may be an important alternative for electric power generation. Brazil has a significant number of operating landfills, which receive the most part of the collected MSW. However, the country has only 17 landfill biogas power plants (LBPPs), resulting in about 122 MW of capacity. The United Kingdom, for instance, which is about 3 times smaller than Brazil in population, has 442 LBPPs (corresponding to 1051 MW of capacity). This fact highlights a considerable unexplored potential of landfill biogas in Brazil. It is also important to estimate this potential throughout the country to provide information for the government, researchers and companies in decision making, planning and formulation of public policies regarding this use of landfill biogas. Therefore, this study aims at estimating the spatially distributed potential of landfill biogas production that can be used for electric power generation in Brazil from 2015 to 2045, considering two scenarios: (i) operating sanitary landfills and (ii) hypothetical scenario of Territorial Arrangements (TA) comprising every Brazilian city, considering one landfill per TA. The total installed capacity estimated in 2018 for scenario 1 is about 523 MW and 87% of this number are related to LBPPs bigger than 1 MW. In this same year, the total installed capacity estimated for scenario 2 is 768 MW and 95% of this number are related to LBPPs bigger than 1 MW. These results emphasize that Brazil has a considerable unexplored potential of landfill biogas and the importance of municipal consortiums for MSW management.

Advanced predictive methods for wine age prediction: Part I - A comparison study of single-block regression approaches based on variable selection, penalized regression, latent variables and tree-based ensemble methods.

In this paper we test and compare advanced predictive approaches for estimating wine age in the context of the production of a high quality fortified wine - Madeira Wine. We consider four different data sets, namely, volatile, polyphenols, organic acids and the UV-vis spectra. Each one of these data sets contain chemical information of a different nature and present diverse data structures, namely a different dimensionality, level of collinearity and degree of sparsity. These different aspects may imply the use of different modelling approaches in order to better explore the data set's information content, namely their predictive potential for wine age. This happens to be so, because different regression methods have different prior assumptions regarding the predictors, response variable(s) and the data generating mechanism, which may or may not find good adherence to the case study under analysis. In order to cover a wide range of modelling domains, we have incorporated in this work methods belonging to four very distinct classes of approaches that cover most applications found in practice: linear regression with variable selection, penalized regression, latent variables regression and tree-based ensemble methods. We have also developed a rigorous comparison framework based on a double Monte Carlo cross-validation scheme, in order to perform the relative assessment of the performance of the various methods. Upon comparison, models built using the polyphenols and volatile composition data sets led to better wine age predictions, showing lower errors under testing conditions. Furthermore, the results obtained for the polyphenols data set suggest a more sparse structure that can be further explored in order to reduce the number of measured variables. In terms of regression methods, tree-based methods, and boosted regression trees in particular, presented the best results for the polyphenols, volatile and the organic acid data sets, suggesting a possible presence of a nonlinear relationship between predictors and response. Regarding the UV-vis data set, penalized regression methods (ridge regression, LASSO and elastic nets) presented the best results, albeit methods such as partial least squares (PLS) or principal component regression (PCR) are often the practitioners' preferred choice.

What is the effect on cardiovascular events of reducing hyperuricemia with allopurinol? An evidence-based review.

INTRODUCTION: High levels of uric acid (UA) have been associated with cardiovascular (CV) disease, but its role as an independent risk factor is the subject of debate. Treating hyperuricemia may be useful in reducing CV risk. OBJECTIVE: To review the evidence on the effect of treatment with allopurinol in patients with hyperuricemia on reducing CV events. METHODS: We searched medical databases for randomized controlled trials (RCT), cohort studies (CS) and case-control studies (CCS), meta-analyses, systematic reviews and guidelines, published between January 2002 and December 2013 in Portuguese and English. Level of evidence (LE) and strength of recommendation were graded according to the definitions used by the European Society of Cardiology. RESULTS: Out of 46 articles, one RCT, three CS and one CCS were included. In the RCT, treatment with allopurinol decreased CV events in patients with moderate chronic renal failure by 71% compared to controls (LE B). In one CS, patients treated with high doses had a greater reduction in CV events compared to low doses (LE B). The other two CS, in patients with heart failure (HF), found similar benefits in patients treated with high doses of allopurinol (LE B). In the CCS, in patients with HF and a history of gout, treatment with allopurinol reduced HF admission and all-cause mortality (LE B). DISCUSSION AND CONCLUSIONS: Prolonged treatment with high doses of allopurinol may be associated with a reduction in morbidity and mortality in high CV risk populations (class of recommendation IIa). More studies evaluating the effect of therapy with allopurinol in reducing CV events in patients with and without risk are needed.

Multivariate optimization of an analytical method for the analysis of dog and cat foods by ICP OES.

Experimental design methodology was used to optimize an analytical method for determination of the mineral element composition (Al, Ca, Cd, Cr, Cu, Ba, Fe, K, Mg, Mn, P, S, Sr and Zn) of dog and cat foods. Two-level full factorial design was applied to define the optimal proportions of the reagents used for microwave-assisted sample digestion (2.0 mol L(-1) HNO3 and 6% m/v H2O2). A three-level factorial design for two variables was used to optimize the operational conditions of the inductively coupled plasma optical emission spectrometer, employed for analysis of the extracts. A radiofrequency power of 1.2 kW and a nebulizer argon flow of 1.0 L min(-1) were selected. The limits of quantification (LOQ) were between 0.03 µg g(-1) (Cr, 267.716 nm) and 87 µg g(-1) (Ca, 373.690 nm). The trueness of the optimized method was evaluated by analysis of five certified reference materials (CRMs): wheat flour (NIST 1567a), bovine liver (NIST 1577), peach leaves (NIST 1547), oyster tissue (NIST 1566b), and fish protein (DORM-3). The recovery values obtained for the CRMs were between 80 ± 4% (Cr) and 117 ± 5% (Cd), with relative standard deviations (RSDs) better than 5%, demonstrating that the proposed method offered good trueness and precision. Ten samples of pet food (five each of cat and dog food) were acquired at supermarkets in Aracaju city (Sergipe State, Brazil). Concentrations in the dog food ranged between 7.1 mg kg(-1) (Ba) and 2.7 g kg(-1) (Ca), while for cat food the values were between 3.7 mg kg(-1) (Ba) and 3.0 g kg(-1) (Ca). The concentrations of Ca, K, Mg, P, Cu, Fe, Mn, and Zn in the food were compared with the guidelines of the United States' Association of American Feed Control Officials (AAFCO) and the Brazilian Ministry of Agriculture, Livestock, and Food Supply (Ministério da Agricultura, Pecuária e Abastecimento-MAPA).

Um estudo sobre o perfil dos empregados com deficiência em uma organização / A study on the profile of disabled employees in an organization

Baseado na premissa de que todo processo inclusivo, seja este educacional, social ou laboral, precisa partir de uma apropriação do contexto sociocultural dos diferentes atores envolvidos - no caso desta pesquisa: empregadores, pessoas com deficiência e empresa, o presente estudo tem como objetivo identificar o perfil dos empregados com deficiência em uma organização de grande porte do ramo da alimentação. Procuramos discutir o contexto social no qual os trabalhadores com deficiência estão inseridos através de um recorte quantitativo dos resultados de uma pesquisa desenvolvida sobre o processo de inclusão em uma organização. O estudo foi desenvolvido por meio dos documentos disponibilizados pela empresa, bem como de documentos nacionais. Os resultados revelam uma cartografia das pessoas com deficiência inseridas na organização através de informações sobre escolaridade, idade, salário, funções e tipos de deficiência, comparando-os aos dados nacionais disponíveis sobre as pessoas com deficiência. Por fim, discutimos alguns resultados obtidos com o estudo. Em que pese a importância das políticas públicas, propomos uma reflexão acerca de mecanismos como o Benefício da Prestação Continuada (BPC), para o favorecimento desta relação entre trabalho e deficiência. Entendemos, finalmente, que é urgente educar e qualificar as pessoas com deficiência, mas não é suficiente, pois também são necessárias ações estruturantes da sociedade para o sucesso do processo de inclusão.

based on the premise that all inclusive processes, be they educational, social or occupational, require an appropriation of the sociocultural context of the different actors involved - in the case of this research: employers, disabled people and company, the aim of this study is to identify the profile of employees with disabilities in a large food industry company. We attempted to discuss the social context in which workers with disabilities are part of the work force by looking at a sample of the quantitative results of a survey conducted on the inclusion process in an organization. Documents provided by the company were analyzed, as were national policies. The results revealed a cartography of people with disabilities included in the organization based on data on education, age, salary, duties and types of disabilities, which were then compared to national data on people with disabilities. We discussed some results obtained during the study. Despite the importance of public policies, we propose a reflection on mechanisms such as the Benefício da Prestação Continuada (BPC) for encouraging positive relations between work and disability. Finally, we believe that promoting education and skills for people with disabled people is essential, though not sufficient. Society must also provide for structured actions in order to assure success in the process of inclusion.

Academia da terceira idade da Santa Casa da Misericórdia de Angra do Heroísmo: caracterização do modelo de formação / Elderly Academy of Santa Casa da Misericórdia de Angra do Heroísmo

Percecionar e caracterizar o paradigma de formação da Academia da Terceira Idade da Santa Casa da Misericórdia de Angra do Heroísmo, é o principal foco da presente dissertação, no âmbito do Mestrado em Gerontologia Social. O envelhecimento é vivenciado de forma cada vez menos "formatada" ou padronizada, sendo cada vez mais heterogéneo e protagonizado por seniores mais autónomos, ativos e com maior formação escolar/académica. Esta realidade traduz-se em opções diferenciadas de ocupação e de vivência do próprio envelhecimento, podendo-se destacar a educação/formação dos seniores como uma resposta em crescente expansão e constante revisão e adaptação para um público que continua a investir no seu desenvolvimento através da aprendizagem ao longo da vida. Neste contexto, procurou-se conhecer a perceção de formadores e alunos seniores da referida Academia acerca da formação nesta preconizada, bem como tentar perceber os seus efeitos nos participantes e ainda recolher sugestões de intervenção. Para este efeito, e recorrendo a um estudo qualitativo, optou-se por recolher os dados através de dois grupos de focagem com formadores de seniores e três grupos de focagem de alunos seniores, organizados por distintos grupos de habilitações literárias. Podemos concluir que as motivações de formadores e alunos para adesão à Academia, de um modo geral, se concretizam positivamente com a experiência que vivenciam e, sobretudo, que a formação desenvolvida vai ao encontro das características dos alunos seniores, respeitando os seus ritmos, competências e interesses, através da aplicação de conteúdos práticos e úteis aos mesmos, seguindo metodologias de formação práticas, dinâmicas e adaptadas, isto é numa linha predominantemente direcionada para a prática da gerontagogia.

To perceive and characterize the paradigm of education from the Elderly Academy of Santa Casa da Misericórdia de Angra do Heroísmo city, is the initial focus of this writing essay, as part of the social gerontology masters degree. The aging process has experienced in such a way that is increasing less and less formatted or standardized and more heterogeneous and featuring senior citizens that are becoming more and more autonomous, active and productive with more accessible education and training. This fact is reflected by different occupation alternatives and experiencing their own aging, being able to highlight the education/training of these seniors as a response to a growing expansion and constant revision to a huge public that still invests on its further development throughout lifelong learning. In this context, we attempted to know the level of perception between teachers and senior students of this Academy as well as to understand the effects and benefits on its participants and also obtain intervention comments or suggestions. For this purpose, using a qualitative study, we chose to collect data through two focus groups with senior trainers and three focus groups of senior students, these groups were organized by different educational qualifications. We can conclude the teachers and students motivation to join the Academy, generally is realized by a positive experience witnessed, and especially that the developed training meets the characteristics of senior students, respecting their rhythms, skills and interest, by applying practical and useful contents to the same followed training methodologies practice, dynamic and adapted, predominantly directed to the practice of gerontagogy.

O processo decisório subsidiado por informações de custos / The health decision-making process subsidized by cost information / El proceso decisorio en la salud subsidiado por informaciones de costos

As empresas enfrentam diariamente problemas para tomar decisões, que ameaçam diretamente a continuidade de seus negócios. Uma análisede decisões compreende a utilização de diferentes conceitos e técnicas de modelagem e síntese, visando a uma melhor qualidade no processo decisório. O objetivo desta pesquisa foi o de analisar a relevância das informações de custos no processo decisório empresarial. Foi realizada uma pesquisa em uma Clínica de diagnósticos cardiológicos. Quanto aos fins, tratou-se de uma pesquisa descritiva, e, quanto aos meios de investigação, foram realizadas pesquisa de campo, pesquisa documental e pesquisa bibliográfica. A clínica em estudo confrontou-se com uma decisão importante sobre a proposta do hospital para elevar o repasse das receitas advindas da prestação de serviços de 20% para 35% e cobrar taxa de utilização do espaço físico. Objetivando decidir sobre aceitar ou não a nova proposta do hospital, foi elaborada uma análise mais detalhada dos fluxos operacionais e respectivos custos envolvidos. No caso da mão de obra dos médicos, a remuneração era realizada por um valor fixo para um plantão de 6 horas, mais o valor por exame, quando ultrapassava ovalor fixo. Observou-se que essa forma de remuneração onerava o custo dos exames realizados. Também se verificou, para o grupo dos médicos, uma taxa de ociosidade de 79,73%, motivado pela obrigatoriedade de manter um corpo clínico de plantão para atender a todos os chamados do hospital. A clínica encontrava-se em uma situação de prejuízo. Se aceitasse a nova proposta do hospital, essa situação ficaria agravada, elevando os prejuízos e exigindo a realização de cerca de 3.265 exames, correspondendo a um aumento de 147,35% no atendimento, para atingir o ponto de equilíbrio. As informações decustos foram relevantes, contribuindo para antever uma situação que seria pior caso aceitasse a proposta do hospital, cumprindo, assim, a primeira fasedo processo decisório e colaborando para...

Companies daily face decision-making problems that directly threaten their business continuity. A decision analysis comprises using differentsummary and modeling concepts and techniques towards a better quality in the decision-making process. This research aimed at analyzing the relevance of the cost information in the entrepreneurial decision-making process. A research was carried out in a Diagnostic Cardiology Clinic. It referred to a descriptive research as to the purposes, and field, document and bibliographical researches were conducted as to the means of investigation. The studiedClinic faced an important decision about the hospital’s proposal to increase the transfer of the revenues arising from the provision of services from 20% to 35% and charge a usage fee of the physical space. To decide whether to accept or not the new hospital’s proposal, a thorough analysis of the operating flows and the respective costs involved was made. In the case of the labor of physicians, the remuneration was paid by means of a fixed amount for a 6-hour shift plus the sum per medical examination, when the fixed amount exceeded. It was observed that this form of remuneration burdened the costs of the medical examinations made. Moreover, for the group of physicians, a 79,73% idleness rate was verified owing to the compulsoriness of keeping amedical staff on duty to answer all the hospital’s calls. The Clinic was in a situation of loss. If it accepted the new hospital’s proposal, this situation would become worse by increasing the losses and requiring about 3,265 medical examinations to be made, corresponding to a 147,35% rise in medical services, to achieve the break-even point. The cost information was relevant by contributing to foresee a situation that would be worse if the hospital’s proposal was accepted, thus complying with the first phase of the decision-making process and collaborating on the start of the following phase, that is, creating...

Las empresas enfrentan diariamente problemas de decisión que amenazan directamente la continuidad de sus negocios. Un análisis de decisionescomprende la utilización de diferentes conceptos y técnicas de modelado y síntesis, teniendo en vista una mejor calidad en el proceso decisorio. El objetivo de esta investigación fue el de analizar la relevancia de las informaciones de costos en el proceso decisorio empresarial. Fue realizada una investigación en una Clínica de diagnósticos cardiológicos. En cuanto a los fines, se trató de una investigación descriptiva y en cuanto a los medios de investigaciónfue realizada una investigación de campo, investigación documental e investigación bibliográfica. La clínica en estudio se confrontó con una decisión importante sobre la propuesta del hospital para elevar el repase de los ingresos provenientes de la prestación de servicios del 20% al 35% y cobrar tasa de utilización del espacio físico. Con el objeto de decidir sobre aceptar o no la nueva propuesta del hospital fue elaborado un análisis más detallado de los flujos operativos y respectivos costos involucrados. En el caso de la mano de obra de los médicos, la remuneración era realizada por un valor fijo para unturno de 6 horas más el valor por examen, cuando sobrepasaba el valor fijo. Se observó que esta forma de remuneración cargaba el costo de los exámenes realizados. También se verificó para el grupo de los médicos, una tasa de ociosidad del 79,73%, motivado por la obligatoriedad de mantener un cuerpo clínico de turno para atender a todos los llamados del hospital. La Clínica se encontraba en una situación de perjuicio. Si aceptaba la nueva propuesta delhospital, esa situación quedaría agravada elevando los perjuicios y exigiendo la realización de cerca de 3.265 exámenes, correspondiendo a un aumento del 147,35% en la atención para lograr el punto de equilibrio. Las informaciones de costos fueron relevantes contribuyendo para antever una situación...

Risk factors for renal scarring in children and adolescents with lower urinary tract dysfunction.

Risk factors for renal scarring in children with lower urinary tract dysfunction (LUTD) were evaluated. The medical records of 120 patients were assessed concerning gender, presence of vesicoureteric reflux (VUR), bladder capacity, detrusor overactivity, residual urine, febrile urinary tract infection (UTI), bacteriuria, constipation, detrusor sphincter incoordination (DSI), high detrusor pressure at maximal cystometric capacity (PMCC), low compliance, and thickness and trabeculation of the bladder wall. Renal scarring was diagnosed by (99m)technetium-dimercaptosuccinic acid renal scan (DMSA). Renal scarring was detected in 38 patients (31%). VUR, UTI, decreased bladder capacity, urinary residue, and trabeculated and thick bladder wall were associated with scarring at univariate analysis. Multivariate analysis showed VUR (P < 0.0001) as the independent risk factor for renal scarring. Thickness of the bladder wall was a marginal risk factor (P = 0.07). Although UTI was not a risk factor, it was associated with VUR (P = 0.03). In our analysis, VUR was the main risk factor; however, renal scarring was probably due to multifactorial causes, as VUR was associated with UTI.

Um estudo sobre as necessidades de capital de giro em instituições hospitalares / A Study on the Needs for Working Capital in Hospital Institutions

O objetivo deste estudo exploratório e descritivo foi o de investigar como as empresas do segmento da saúde têm financiado suas necessidades de capital de giro. Inicialmente foi realizada uma pesquisa bibliográfica, seguida de uma pesquisa documental com a coleta de demonstrações financeiras dos anos de 2000 e 2001 de empresas do segmento da saúde, publicados em jornais de grande circulação. O universo da pesquisa foi constituído de empresas do segmento de saúde com fins lucrativos cujo objetivo era a prestação de serviços médicos hospitalares. Foram coletados dados de treze empresas. O tratamento dos dados coletados foi realizado em três etapas: 1) Cálculo dos capitais de giro (circulante) líquido (CCL) e dos índices de liquidez; 2) Reclassificação das contas do Balanço Patrimonial, conforme o modelo de Fleuriet; 3) Cálculo das variáveis NCG, NTFP e ST. Constatou-se: a) que a maior parte das empresas analisadas tinham capacidade para saldar suas dívidas de curto prazo; b) que os passivos operacionais financiavam todos os ativos operacionais; c) que as necessidades de capital de giro não estavam sendo financiadas por recursos financeiros de curto prazo. Devido ao universo de treze empresas, as conclusões ficaram limitadas diante da realidade de que o ciclo operacional destas empresas é muito diferente das demais. Porém este trabalho tem sua importância por apresentar as ferramentas disponíveis para auxiliar na gestão mais eficiente do capital de giro.

Estudo experimental do efeito dos clareadores dentais sobre úlceras induzidas com NaoH na mucosa bucal de ratos / The experimental study tooth-whitening agents effect on ulcers induced with naoh on the oral mucous of mice

Objetivo: Verificar as alterações microscópicas decorrentes da aplicação tópica dos dentrifícios clareadores e dos geis clareadores contendo peróxido de carbamida e carbopol nas concentrações 10 porcento, 16 porcento e 35 porcento, em úlceras no dorso da língua de rato. Método: Foram utilizadas 150 Rattus norvegicus albinus machos com idade de 45 a 50 dias e peso corporal de 250g a 350g, alimentados com ração e água ad libitum. Os mesmos foram divididos em 6 grupos com tratamentos diferenciados e com datas de morte de 2,7,14,21,42 dias. Os grupos de tratamento foram os de gel clareador 10 porcento, 16 porcento, 35 porcento: WHITENESS; o dentrificio clareador 1: COLGATE BICARBONATO DE SÓDIO & PERÓXIDO; dentrificio clareador 2: CONFIDENT, e o Grupo Controle tratado com água destilada. Na mucosa que reveste o dorso da língua de cada animal, na porção mais anterior foram induzidas as lesões ulceradas, por meio da aplicação diária de hidróxido de sódio (NaOH) a 40 porcento, por 7 dias. Após constatada a presença da úlcera foi iniciada a aplicação tópica dos produtos clareadores e a água destilada no grupo controle. Resultados: As úlceras tratadas com os géis clareadores estavam presentes ainda no sétimo dia, porém as tratadas com os dentifrícios clareadores, principalmente o CONFIDENT, persistiam por mais tempo, eram maiores e com o fundo esbranqueçado, havendo maior número de mortes entre os ratos tratados com o CONFIDENT. Conclusão: Pacientes portadores de aftas e outros tipos de úlceras devam ser aletardos sobre o risco de aumentar o período de cicatrização e de ter uma infecção sucundária, quando estiveram utilizando os produtos odontológicos clareadores

Um estudo de caso sobre a metodologia de custeio adotada pela Unidade de Nutrição e Dietética de um hospital / Cost-management methodology of a hospital nutrition and diet unit: a case study

Este artigo apresenta um estudo de caso realizado numa instituição hospitalar, com a finalidade de analisar o método de custeio adotado pela Unidade de Nutrição e Dietética. A Unidadade de Nutrição e Dietética adota o método de custeio ponderado, onde são atribuídos pesos às diferentes refeições dependendo da importância (ou onerosidade) delas. Comparativamente, aplicou-se o método de custeio por absorção. Analisando-se os resultados, percebeu-se uma grande distorção entre os dois métodos. Concluiu-se que as distorções ocorreram em função dos graus de subjetividade quanto à atribuição de pesos, no método de custeio por absorção. Diante dos resultados obtidos, foi sugerido que a instituição adote um método de custeio que mensure com maior exatidão o custo, como, por exemplo, metodologia de custeio baseado em atividades - ABC (Activity Based Costing).

Dietary and reproductive determinants of plasma organochlorine levels in pregnant women in Rio de Janeiro.

Organochlorine (OC) plasma levels and their dietary and reproductive determinants were investigated in 64 pregnant women from Rio de Janeiro, Brazil. Prenatal exposure of newborns was evaluated in a subset of these women in which umbilical cord blood was analyzed. To assess the influence of dietary factors on OC levels, a semiquantitative food frequency questionnaire was completed by participants. Nondietary determinants were investigated through a general questionnaire that addressed reproductive history, lifestyle, and social-demographic characteristics. Both women and their newborns had detectable but low levels of OCs. The most frequently detected compound was p,p'-DDE, the main metabolite of p,p'-DDT. This compound was found in 97% of the women who participated in the study and in 67% of the umbilical cord blood samples, with levels ranging from 0.161 to 8.03ppb and from 0.320 to 1.06ppb, respectively. Among the OCs detected, only p,p'-DDE showed any correlation with dietary and nondietary factors. There was a positive correlation between maternal p,p'-DDE and the consumption of fish (Pearson r=0.38,P=0.002) and chicken (Pearson r=0.26, P=0.042). The correlation between pork consumption and p,p'-DDE exhibited an inverse relationship (Pearson r=-0.25,P=0.052). Parity was the only nondietary factor that showed a significant correlation (Pearson r=-0.36,P=0.004). The main determinants of p,p'-DDE levels in this group of women were fish consumption and parity, together explaining 28% of the variance (P<001), in a multivariate model.