RESUMEN

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.

Asunto(s)

Infecciones por Helicobacter , Helicobacter pylori , Humanos , Infecciones por Helicobacter/diagnóstico , Sensibilidad y Especificidad , Pruebas Respiratorias/métodos

RESUMEN

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.

Asunto(s)

Vacunas contra la COVID-19/administración & dosificación , COVID-19/inmunología , COVID-19/virología , SARS-CoV-2/aislamiento & purificación , Glicoproteína de la Espiga del Coronavirus/genética , Brasil/epidemiología , COVID-19/diagnóstico , COVID-19/epidemiología , Humanos , Pandemias , Filogenia , SARS-CoV-2/clasificación , SARS-CoV-2/genética , Vacunación

RESUMEN

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.

Asunto(s)

Fibrina Rica en Plaquetas , Animales , Plaquetas , Gatos , Fibrina , Humanos , Leucocitos , Factor A de Crecimiento Endotelial Vascular

RESUMEN

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.

Asunto(s)

Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pacientes Internos/estadística & datos numéricos , Neoplasias/epidemiología , Pandemias , Neumonía Viral/epidemiología , Academias e Institutos/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Brasil/epidemiología , COVID-19 , Instituciones Oncológicas/estadística & datos numéricos , Causas de Muerte , Niño , Preescolar , Comorbilidad , Diabetes Mellitus/epidemiología , Susceptibilidad a Enfermedades , Femenino , Mortalidad Hospitalaria , Humanos , Hipertensión/epidemiología , Huésped Inmunocomprometido , Lactante , Masculino , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico , Estudios Retrospectivos , SARS-CoV-2 , Adulto Joven

RESUMEN

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.

Asunto(s)

Terapéutica , Actinomicosis , Diagnóstico , Micetoma , Fístula

RESUMEN

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.

Asunto(s)

Colonias de Leprosos , Lepra/rehabilitación , Higiene Bucal/instrumentación , Autocuidado/instrumentación , Dispositivos de Autoayuda/economía , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Brasil , Análisis Costo-Beneficio , Dentaduras , Estudios de Factibilidad , Femenino , Humanos , Lepra/complicaciones , Masculino , Higiene Bucal/economía , Higiene Bucal/métodos , Grupo de Atención al Paciente , Autocuidado/economía , Autocuidado/métodos

RESUMEN

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.

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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.

Asunto(s)

Humanos , Masculino , Persona de Mediana Edad , Aumento de la Cresta Alveolar , Materiales Biocompatibles , Huesos , Regeneración Ósea , Trasplante Óseo/métodos , Xenoinjertos

RESUMEN

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.

Asunto(s)

Biocombustibles , Eliminación de Residuos , Instalaciones de Eliminación de Residuos , Brasil , Ciudades , Reino Unido

RESUMEN

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).

Asunto(s)

Dieta/veterinaria , Análisis de los Alimentos/métodos , Animales , Gatos , Perros , Análisis de los Alimentos/normas , Metales/análisis , Metales/normas , Mascotas , Fósforo/análisis , Fósforo/normas , Estándares de Referencia , Azufre/análisis , Azufre/normas

RESUMEN

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.

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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.

RESUMEN

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...

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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...

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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...

Asunto(s)

Humanos , Honorarios y Precios , Economía y Organizaciones para la Atención de la Salud , Gestor de Salud , Instituciones de Salud

RESUMEN

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.

Asunto(s)

Cicatriz/diagnóstico por imagen , Cicatriz/epidemiología , Enfermedades Urológicas/diagnóstico por imagen , Enfermedades Urológicas/epidemiología , Niño , Preescolar , Adaptabilidad , Femenino , Humanos , Masculino , Análisis Multivariante , Cintigrafía , Estudios Retrospectivos , Factores de Riesgo , Ácido Dimercaptosuccínico de Tecnecio Tc 99m , Ultrasonografía , Vejiga Urinaria/diagnóstico por imagen , Vejiga Urinaria Neurogénica/diagnóstico por imagen , Vejiga Urinaria Neurogénica/epidemiología , Vejiga Urinaria Hiperactiva/diagnóstico por imagen , Vejiga Urinaria Hiperactiva/epidemiología , Infecciones Urinarias/diagnóstico por imagen , Infecciones Urinarias/epidemiología , Urodinámica , Reflujo Vesicoureteral/diagnóstico por imagen , Reflujo Vesicoureteral/epidemiología

RESUMEN

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.

Asunto(s)

Financiación de la Atención de la Salud , Administración Hospitalaria , Organización y Administración , Costos de Hospital

RESUMEN

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

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Objective: To come out the microscopy alterations that can happen by the topic applications of the following toothpastes: ® COLGATE BICARBONATO DE SODIO & PEROXIDO and CONFIDENT®, and the whitening gels containing carbamide peroxide and carbopol with the concentrations: 10%, 16% and ® 35% WHITENESS , in ulcer in the oral mucous of mouse. Method: The study used 150 Rattus norvegicus albinus, Wistar, 45 to 50 day-old male rats with an average weight of 250 to 300 grams. The animals were divided in 6 groups. They were called: 2-day group, 7-day group, 14-day group, 21-day group and 42-day group. The control groups did not receive any kind of treatment and the experimental groups were treated with the whitening gels containing carbamide peroxide and carbopol. To induce the ulcers with NaOH to 40%, for 7 days in tongue the rats. After 48 hours we carried out a clinical assessment of the ulcers wound and noticed continuous lesions in all the animals. The treatment with whitening gels containing carbamide peroxide and carbopol. was used in the experimental groups. Results: The ulcers treated with the whitening gels were still present on the seventh day, although the ones treated with the ® toothpastes, mainly CONFIDENT , persisted for a long time, they were bigger and with white bottom. We watched out either, a significant death mice number, the ones treated with ® CONFIDENT . Conclusion: Patients who have recurrent aphthous or another types of ulcers might be advised about the risk of increasing the repair tissue period and the risk of secondary infection, while they were using the tooth-whitening agents.

Asunto(s)

Animales , Ratas , Blanqueamiento de Dientes/métodos , Dentífricos/química , Estomatitis Aftosa/diagnóstico , Úlceras Bucales/diagnóstico , Dentífricos/uso terapéutico , Estadísticas no Paramétricas

RESUMEN

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).

Asunto(s)

Administración Financiera de Hospitales/métodos , Servicio de Alimentación en Hospital

RESUMEN

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.

Asunto(s)

Dieta , Contaminantes Ambientales/sangre , Insecticidas/sangre , Exposición Materna/estadística & datos numéricos , Adulto , Animales , Brasil/epidemiología , Estudios Transversales , Diclorodifenil Dicloroetileno/sangre , Femenino , Sangre Fetal/química , Contaminación de Alimentos , Humanos , Exposición Materna/efectos adversos , Carne , Embarazo , Reproducción , Encuestas y Cuestionarios

RESUMEN

Em detrimento do crescimento vertiginoso do setor de assistência médica, é notório que muitas instituições desconhecem a sua estrutura de custos. Com o advento gradual do Managed Care, inicia-se dentro das relações entre os financiadores, usualmente planos de saúde e os prestadores de serviços (hospitais, clínicas, grupo de médicos) o compartilhamento de riscos. Este sistema procura introduzir controles sobre a prática médica, com a finalidade de alterar o comportamento habitual de aumento da utilização dos serviços e dos custos, como no caso do modelo de remuneração Fee-for-service, que reembolsa conforme o gasto. A transferência do risco financeiro para o sistema de prestação por pacote (preço global) ou por capitation (remuneração antecipada de uma população referenciada), o que vem levando estas instituições a se preocuparem com a composição de seus custos, bem como a conhecer a demanda de pacientes. Assim a contabilidade de custos irá desempenhar um papel relevante para determinação da estrutura de custos, além de envolver o corpo clínico na determinação do custo por procedimento, como estabelecimento de protocolos. É possível então que estas instituições atinjam a lucratividade, medida consistente de eficácia de uma empresa.

Asunto(s)

Costos de Hospital , Administración Hospitalaria/métodos , Planes de Sistemas de Salud

RESUMEN

A Síndrome da Imunodeficiência Adquirida (AIDS) é uma doença de origem infecciosa, viral, que atinge o sistema imunológico do portador. É transmíssivel através de sangue, secreçöes humanas contaminadas e do contato profissional com sangue contaminado. A Odontologia e outras profissöes da área da saúde, quando se depararam com os primeiros casos de AIDS e outras doenças infecciosas, tiveram que reavaliar os métodos de controle de infecçäo e disponibilizá-los a todos os pacientes. Além das mudanças técnicas na questäo da biossegurança, o odontólogo se depara com o aspecto ético e legal quando a vítima do vírus HIV é o próprio cirurgiäo-dentista e näo o seu paciente. Junto com o impasse ético de revelar ou näo a seu paciente seu estado de saúde, o profissional cria uma espectativa de retorno ou perda da clientela devido a sua condiçäo de soropositividade. Baseado na possibilidade de o cirurgiäo-dentista ser portador do vírus HIV, foi desenvolvida uma pesquisa questionando 89 profissionais, na situaçäo de infectados, se contariam ou näo a seus pacientes sua condiçäo e sobre sua espectativa de retorno dos pacientes após a revelaçäo. Entrevistaram-se também 100 pessoas, na condiçäo de pacientes, questionando se fariam ou näo o tratamento com o cirurgiäo-dentista soropositivo para o HIV. Foi observado que a reaçäo do paciente é contraditória à espectativa do cirurgiäo-dentista quanto ao retorno de sua clientela ao consultório. A maioria dos profissionais entrevistados näo contaria aos seus pacientes a sua condiçäo de soropositividade para o HIV, sendo tal atitude amparada por lei

Asunto(s)

Síndrome de Inmunodeficiencia Adquirida , Enfermedades Transmisibles , Relaciones Dentista-Paciente , Legislación en Odontología