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O objetivo do estudo foi analisar a reposta hematológica de ciclistas após uma competição de nível nacional. Participaram 20 atletas (35 ± 7,90 anos, 1,75 ± 0,06m de estatura, 18,71 ± 4,12% de gordura, VO2 máx de 57,90 ± 6,80 ml/kg/min, 345 ± 50,90W, 202 ± 6,77 bpm de frequência cardíaca máxima), que passaram por duas coletas de sangue, monitoramento do peso corporal e da ingesta de água. Após a competição foi verificada queda no peso corporal (78,20 ± 9,10 para 76,70 ± 9,20 kg, p= 0,0001) com consumo médio de 620 ± 532,20 ml de água, e aumento significativo (p = 0,0001) na concentração de eritrócitos (5,28 ± 0,44 para 6 ± 0,41 milhões/mm3), de hemoglobina (15,80 ± 1 para 17,70 ± 0,95 g/%), de plaquetas (211.950 ± 42.488,20 para 285.050 ± 47.097,20 un/mm3) e hematócrito(47 ± 2,97 para 54 ± 2,79%). Foi verificada forte correlação (r > 0,7) entre o hematócrito como nível de eritrócitos e de hemoglobina. Concluiu-se que existe aumento na quantidade dos componentes hematológicos em ciclistas após competição, com fraca correlação com a ingesta voluntária de água,peso corporal e nível do volume máximo de oxigênio...

The aim of the study was to analyze the hematologic response of cyclists after a nationwide competition evel. Participated in 20 athletes (35 ± 7,90 years old, 1,75 ± 0,06m of height, 18,71 ± 4,12% of body fat, VO2max 57,90 ± 6,80 ml/kg/min, 345 ± 50,90W, 202 ± 6,77bpm of maximum heart rate), which underwent two blood samples, monitoring of body weight and water intake. After the competition was observed decrease in body weight (78,20 ± 9,10 to 76,70 ± 9,20 kg, p = 0,0001) with an average consumption of 620 ± 532,20 mL of water, and a significant increase (p = 0,0001) in the concentration of erythrocytes (5,28 ± 0,44 6 ± 0,41 million/mm3), hemoglobin (15,80 ± 1 to 17,70 ± 0,95 g/%), the platelets (211.950 ± 42.488,2 to 285.050 ± 47.097,2 un/mm3) and hematocrit (47 ± 2,97 to 54 ±2,79%). Strong correlation (r > 0.7) between hematocrit with erythrocytes level and hemoglobin was observed. It was concluded that there is an increase in the number of hematological components of cyclists after competition with weak correlation with the water intake, body weight and the maximum volume of oxygen level...

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OBJECTIVE: To identify and analyze the characteristics of consultations provided by the Unified Health System (SUS) to Brazilians living abroad in the cities of Ponta Porã, Coronel Sapucaia, Paranhos, and Sete Quedas, located on the border of the state of Mato Grosso do Sul and Paraguay. METHODS. Data were collected during a 30-day period using a form filled out for each consultation provided. All the SUS facilities in the four cities were studied (14 primary family health care units, four primary health care units, five hospitals and four laboratories). Semi-structured interviews were also performed with key informants (city health secretaries, health care unit managers, and city health council representatives). RESULTS: The highest demand from Brazilians living abroad was related to primary health care services: 11.9% of the primary family health care consultations in Coronel Sapucaia, 1.1% in Sete Quedas, 3.5% in Paranhos, and 3.5% in Ponta Porã. In primary health care units, the percent of consultations to non-resident Brazilian citizens was 21.1%, 43.8%, 14.7%, and 2.3%, respectively. The interviews supported the perception that a major number of Brazilians living abroad seek health care in public services of Brazilian border cities. CONCLUSIONS: Despite the considerable number of Brazilians living abroad who seek health care provided by SUS in Brazil, this demand is not taken into consideration in the planning of services and may have an impact on the quality of the health care provided.

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OBJETIVO: Identificar e analisar as características dos atendimentos realizados no Sistema Único de Saúde (SUS) a brasileiros residentes no exterior em Ponta Porã, Coronel Sapucaia, Paranhos e Sete Quedas, municípios fronteiriços de Mato Grosso do Sul com o Paraguai. MÉTODOS: Os dados foram colhidos durante 30 dias através de um formulário para cada atendimento efetuado. Foram estudados todos os serviços de saúde do SUS disponíveis nos quatro municípios (14 unidades básicas de saúde da família, quatro unidades básicas de saúde, cinco hospitais e quatro laboratórios). Também foram realizadas entrevistas semiestruturadas com informantes-chave (secretários de saúde, gerentes das unidades de saúde e representantes do conselho municipal de saúde). RESULTADOS: Constatou-se que a maior demanda de atendimentos a brasileiros não residentes no País foi nos serviços de atenção básica: 11,9 por cento nas unidades básicas de saúde da família de Coronel Sapucaia, 1,1 por cento nas de Sete Quedas, 3,5 por cento em Paranhos e 3,5 por cento em Ponta Porã. Nas unidades básicas de saúde, o percentual foi de 21,1, 43,8, 14,7 e 2,3 por cento, respectivamente. As entrevistas confirmaram a percepção de que existe um número importante de brasileiros que moram no exterior recebendo atenção pelo SUS nessas cidades. CONCLUSÕES: Uma proporção considerável de brasileiros não residentes no País busca atendimento pelo SUS nos municípios brasileiros. Entretanto, essa demanda não é considerada no planejamento dos serviços e pode causar impacto na qualidade da atenção prestada.

OBJECTIVE: To identify and analyze the characteristics of consultations provided by the Unified Health System (SUS) to Brazilians living abroad in the cities of Ponta Porã, Coronel Sapucaia, Paranhos, and Sete Quedas, located on the border of the state of Mato Grosso do Sul and Paraguay. METHODS. Data were collected during a 30-day period using a form filled out for each consultation provided. All the SUS facilities in the four cities were studied (14 primary family health care units, four primary health care units, five hospitals and four laboratories). Semi-structured interviews were also performed with key informants (city health secretaries, health care unit managers, and city health council representatives). RESULTS: The highest demand from Brazilians living abroad was related to primary health care services: 11.9 percent of the primary family health care consultations in Coronel Sapucaia, 1.1 percent in Sete Quedas, 3.5 percent in Paranhos, and 3.5 percent in Ponta Porã. In primary health care units, the percent of consultations to non-resident Brazilian citizens was 21.1 percent, 43.8 percent, 14.7 percent, and 2.3 percent, respectively. The interviews supported the perception that a major number of Brazilians living abroad seek health care in public services of Brazilian border cities. CONCLUSIONS: Despite the considerable number of Brazilians living abroad who seek health care provided by SUS in Brazil, this demand is not taken into consideration in the planning of services and may have an impact on the quality of the health care provided.

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In Brazil, sophisticated techniques currently employed for diagnosis of visceral leishmaniasis, such as polymerase chain reaction-based assays, are only available in major research centers, whereas conventional methods are still used in many areas where the disease occurs. In the state of Mato Grosso do Sul, in the country's Center-West Region, visceral leishmaniasis has recently emerged in many cities, and duration of the disease, from the onset of symptoms to diagnosis, has been short. Considering that results of diagnostic tests may depend on the phase of the disease, we compared direct examination of bone marrow aspirates (BMAs), BMA culture, and serology by Indirect Immunofluorescence Antibody Test (IFAT) for diagnosis in children, according to time of evolution (< or = 30 days or > 30 days) and to spleen size (< or = 5 cm or > 5 cm) at admission. Duration of the illness did not interfere with test positivity: direct smear examination and IFAT were positive in more than 80% of patients, as was culture in around 60%. Results of positive microscopy, however, where predominant in patients with larger spleens. Thanks to the association of traditional techniques, only a few patients had to begin a treatment trial without confirming the diagnosis. Conventional methods for diagnosis of visceral leishmaniasis are still indispensable in our region, and training professionals in basic techniques should be incremented. The highest sensitivity in laboratory diagnosis among the cases investigated was that obtained with a combination of BMA direct examination and IFAT, nearing 100%.

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In Brazil, sophisticated techniques currently employed for diagnosis of visceral leishmaniasis, such as polymerase chain reaction-based assays, are only available in major research centers, whereas conventional methods are still used in many areas where the disease occurs. In the state of Mato Grosso do Sul, in the country's Center-West Region, visceral leishmaniasis has recently emerged in many cities, and duration of the disease, from the onset of symptoms to diagnosis, has been short. Considering that results of diagnostic tests may depend on the phase of the disease, we compared direct examination of bone marrow aspirates (BMAs), BMA culture, and serology by Indirect Immunofluorescence Antibody Test (IFAT) for diagnosis in children, according to time of evolution (< 30 days or >30 days) and to spleen size (< 5 cm or > 5 cm) at admission. Duration of the illness did not interfere with test positivity: direct smear examination and IFAT were positive in more than 80 percent of patients, as was culture in around 60 percent. Results of positive microscopy, however, where predominant in patients with larger spleens. Thanks to the association of traditional techniques, only a few patients had to begin a treatment trial without confirming the diagnosis. Conventional methods for diagnosis of visceral leishmaniasis are still indispensable in our region, and training professionals in basic techniques should be incremented. The highest sensitivity in laboratory diagnosis among the cases investigated was that obtained with a combination of BMA direct examination and IFAT, nearing 100 percent.

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