Paulo Sérgio Carneiro Miranda

Fragmentos da história da atenção à saúde para usuários de álcool e outras drogas no Brasil: da Justiça à Saúde Pública

The purpose of this article is to identify, factors that could be associated to the establishment of the countrys health policy for users of alcohol and other drugs in 2003. It makes particular use of semi-structured interviews, as well as a study of the literature and documents. The article shows that the Brazilian States approach to alcohol and drugs emerged in the early 20th century with the creation of a legal and institutional apparatus designed to control the sale and use of drugs, justified by the need to assure public security and public health. This apparatus permitted the development of healthcare practices for drug users based on the penalties it proposed. The article concludes that even though the rationales behind legal and public health measures do not always coincide, some of the practices that emerged in the legal sphere did help provide the conditions needed for the creation of a health policy for alcohol and drug users in Brazil in 2003.

Serviço substitutivo e hospital psiquiátrico: convivência e luta

This paper summarizes a dissertation which was part of the requirement for the attainment of the degree of Master in Public Health at the Medical School of the Universidade Federal de Minas Gerais (UFMG). In this investigation, the impasses in the psychiatric reform in Brazil were analysed. Based on the evidences of progress both in the offer of services and in the pertaining legislation as well as on the difficulties faced in the effort to surmount the mental hospital, five hypotheses were built to study the relationship between the two modes of treatment: the alternative service and the psychiatric hospital. This paper deals with the fifth hypothesis, which posits a peaceful coexistence of the two services in the future. The investigation demonstrated that this condition has not happened until now, and the solution for the stalemates aforementioned involves the enhancement of the reform movement, political decisions and the definitions shaped by patients and their families.

Validation of four AIDS-case definitions in HIV-infected intravenous drug users in Barcelona, Spain

The objective of the study is to assess the sensitivity and specificity of four epidemiological AIDS-Case Definitions (CDC-87, CDC-93, Europe-93 and Revised Caracas) in HIV-infected intravenous drug users (IDU). The authors carried out a cross-sectional study with 136 IDUs, HIV-infected from a Men Penitentiary Center and from a drug addiction treatment center of Barcelona, Spain, between October/93 and April/94. A protocol, including demographic, clinical and laboratory variables was used by one doctor and the laboratory tests were done in the same institution. After that, the patients were classified in the four Epidemiological AIDS-Case Definitions used by this study. As gold standard we used the CD4 Cell Count (out point 200 or 14% CD4+). The number of AIDS cases varied between 31 and 84 according to the type of AIDS definition. The CDC-93 AIDS definition implied an increase of 170.9% in the number of cases in relation to CDC-87 AIDS-Case Definition. The sensitivities of the CDC-87, CDC-93, Europe-93 and Revised Caracas Epidemiological AIDS - Case Definitions were 34.2, 88.6, 45.6 and 56.9% while the specificities were 93.0, 75.4, 75.4 and 77.2%, respectively. The positive predictive values were between 72.0% (Europe-93) and 87.1% (CDC-87) and the negative predictive values were between 50.0% (Europe-93) and 82.7% (CDC-93). The authors concluded: the sensitivity and specificity of Caracas Revised Epidemiological AIDS-Case Definition was better than Europe-93 AIDS Case Definition. So this Definition can be very useful in countries and situations where the CD4 Cell Count is not available for technical or economical reasons.

Avaliação da inserção precoce de estudantes universitários em serviços de saúde

The authors evaluated the actions of Nursery School students in health services as a Teaching-Learning Method. Fifty-three students of the first year of Nursery School studying epidemiology were put in seventeen health Centers of Divinopolis Health System during five months, one time by week, to learning the discipline. The researchers concluded that when the actions and limits of the student practices are clearly defined never the university students use in Health Services will be a mistake.

Evaluación del ingreso de estudiantes universitários en los services de salud

The authors evaluated the actions of Nursery School students in health services as a Teaching-Learning Method. Fifty-three students of the first year of Nursery School studying epidemiology were put in seventeen health Centers of Divinopolis Health System during five months, one time by week, to learning the discipline. The researchers concluded that when the actions and limits of the student practices are clearly defined never the university students use in Health Services will be a mistake.

Evaluation of the ingression of university students in health services

The authors evaluated the actions of Nursery School students in health services as a Teaching-Learning Method. Fifty-three students of the first year of Nursery School studying epidemiology were put in seventeen health Centers of Divinopolis Health System during five months, one time by week, to learning the discipline. The researchers concluded that when the actions and limits of the student practices are clearly defined never the university students use in Health Services will be a mistake.