Sebastião Loureiro

Cost-effectiveness analysis of a state funded programme for control of severe asthma

BackgroundAsthma is one of the most common chronic diseases and a major economical burden to families and health systems. Whereas efficacy of current therapeutical options has been clearly established, cost-effectiveness analysis of public health interventions for asthma control are scarce.Methods81 patients with severe asthma (12–75 years) joining a programme in a reference clinic providing free asthma medication were asked retrospectively about costs and events in the previous 12 months. During 12 months after joining the programme, information on direct and indirect costs, asthma control by lung function, symptoms and quality of life were collected. The information obtained was used to estimate cost-effectiveness of the intervention as compared to usual public health asthma management. Sensitivity analysis was conducted.Results64 patients concluded the study. During the 12-months follow-up within the programme, patients had 5 fewer days of hospitalization and 68 fewer visits to emergency/non scheduled medical visits per year, on average. Asthma control scores improved by 50% and quality of life by 74%. The annual saving in public resources was US

Epidemiologia da leishmaniose tegumentar americana e suas relações com a lavoura e o garimpo, em localidade do Estado da Bahia (Brasil)

387 per patient. Family annual income increased US

A proteomic approach to identify proteins from Trichuris trichiura extract with immunomodulatory effects.

512, and family costs were reduced by US

O efeito da infecção pelo Schistosoma mansoni sobre a morbidade de crianças do Estado da Bahia, Brasil: II Análise ao nível individual

733.ConclusionA programme for control of severe asthma in a developing country can reduce morbidity, improve quality of life and save resources from the health system and patients families.

De novo assembly and characterization of the Trichuris trichiura adult worm transcriptome using Ion Torrent sequencing

Realizou-se um estudo sobre a associacao entre infeccao leishmaniotica e a ocupacao dos individuos em Lencois-Bahia (Brasil). Foram utilizados um questionario com variaveis biologicas, sociais e economicas e o teste de Montenegro. Houve captura de flebotomineos em locais peri e intra-domiciliares. Encontrou-se maior prevalencia da infeccao no grupo ocupacional de lavradores/garimpeiros em comparacao as demais ocupacoes. Explica-se esse resultado em razao da dupla exposicao dos lavradores/garimpeiros a leishmaniose tegumentar americana, em sua area de moradia e local de trabalho.This study was carried out in the city of Lencois, State of Bahia, with the objective of verifying the association between leishmaniasis infection and occupation. A Montenegro test and a questionnaire including biological and socio-economic variables were applied to the study group. Sandflies were captured in and around dwellings. The higher-than-average prevalence of leishmaniasis observed among agricultural workers and prospectors is explained by the double exposure to the infection-both at home and at work.

Formação médica na UFSB: I. Bacharelado interdisciplinar em saúde noprimeiro ciclo

Infections with Trichuris trichiura and other trichurid nematodes have been reported to display protective effects against atopy, allergic and autoimmune diseases. The aims of the present study were to investigate the immunomodulatory properties of T. trichiura adult worm extract (TtE) and its fractions (TtEFs) on the production of cytokines by peripheral blood mononuclear cells and to identify their proteinaceous components. Fourteen TtEFs were obtained by ion exchange chromatography and tested for effects on cytokine production by peripheral blood mononuclear cells. The molecular constituents of the six most active fractions were evaluated using nano‐LC/mass spectrometry. The homology between T. trichiura and the related nematode Trichinella spiralis was used to identify 12 proteins in TtEFs. Among those identified, fructose biphosphate aldolase, a homologue of macrophage migration inhibitory factor and heat‐shock protein 70 may contribute to the immunomodulatory effects of TtEFs. The identification of such proteins could lead to the development of novel drugs for the therapy of allergic and other inflammatory diseases.

Survey on hospital care and hospitalar morbidity in the county of Salvador, Bahia - Brazil

This investigation was carried out in 10 small towns of the State of Bahia (Northeastern Brazil). The objective was to study the correlations between the prevalences of liver and spleen enlargment in different areas and the prevalence and intensity of Schistosoma mansoni infection in the same areas. Our conclusions are that: a) schistosomiasis mansoni morbidity (prevalences of hepatomegaly and splenomegaly) was directly correlated to the prevalence and intensity of infection; b) the intensity of infection of a community is a good indicator of morbidity and explain the morbidity variation between areas better than the prevalence of infection; c) the prevalence of splenomegaly and the mean size of the liver in the mid-sternal line appear to be good indicators of the S. mansoni prevalence and intensity of infection in a community. Our conclusions raised the possibility of construction of definitive regressions equations between indicators of morbidity and indicators of infection, so that the value of one could be used to predict the other.

The Dissemination of Local Health Innovations: Political Economy Issues in Brazil

Infection with helminthic parasites, including the soil-transmitted helminth Trichuris trichiura (human whipworm), has been shown to modulate host immune responses and, consequently, to have an impact on the development and manifestation of chronic human inflammatory diseases. De novo derivation of helminth proteomes from sequencing of transcriptomes will provide valuable data to aid identification of parasite proteins that could be evaluated as potential immunotherapeutic molecules in near future. Herein, we characterized the transcriptome of the adult stage of the human whipworm T. trichiura, using next-generation sequencing technology and a de novo assembly strategy. Nearly 17.6 million high-quality clean reads were assembled into 6414 contiguous sequences, with an N50 of 1606bp. In total, 5673 protein-encoding sequences were confidentially identified in the T. trichiura adult worm transcriptome; of these, 1013 sequences represent potential newly discovered proteins for the species, most of which presenting orthologs already annotated in the related species T. suis. A number of transcripts representing probable novel non-coding transcripts for the species T. trichiura were also identified. Among the most abundant transcripts, we found sequences that code for proteins involved in lipid transport, such as vitellogenins, and several chitin-binding proteins. Through a cross-species expression analysis of gene orthologs shared by T. trichiura and the closely related parasites T. suis and T. muris it was possible to find twenty-six protein-encoding genes that are consistently highly expressed in the adult stages of the three helminth species. Additionally, twenty transcripts could be identified that code for proteins previously detected by mass spectrometry analysis of protein fractions of the whipworm somatic extract that present immunomodulatory activities. Five of these transcripts were amongst the most highly expressed protein-encoding sequences in the T. trichiura adult worm. Besides, orthologs of proteins demonstrated to have potent immunomodulatory properties in related parasitic helminths were also predicted from the T. trichiura de novo assembled transcriptome.

Access and equity in use of diagnostic imaging in Brazil: a longitudinal ecological study

Esta serie de artigos aborda diretrizes, estrutura curricular e estrategias pedagogicas de um novo modelo de curso de Medicina proposto pela Universidade Federal do Sul da Bahia (UFSB). Este artigo inicial apresentao Bacharelado Interdisciplinar em Saude como primeiro ciclo para a formacao medica. Em primeiro lugar, avaliam-se resultados de uma prospeccao de modelos avancados de formacao medica no cenario internacional e o potencial de sua aplicacao a realidade da educacao medica brasileira. Em segundo lugar, descrevem-se a estrutura e o funcionamento do Bacharelado Interdisciplinar como formacao geral em Artes, Saude, Humanidades e Ciencias. Em terceiro lugar, discute-se o BI-Saude como formacao especifica, com especial atencao para o conceito de Area de Concentracao, que pode funcionar como etapa propedeutica para o curso medico em regime de ciclos. Finalmente, avalia-se a formacao em Saude no primeiro ciclo como oportunidade de uma escolha vocacional mais madura, aprendizagem para o trabalho em equipe, atualizacao cientifica e pratica, uso consciente e critico de tecnologias de cuidado em saude, com base em valores eticos, politicos e humanisticos.

Uma análise exploratória dos programas de controle da tuberculose da Bahia e Goiás à luz da teoria dos custos de transação

Para suprir a deficiencia de dados sobre a disponibilidade e a efetiva utilizacao de leitos hospitalares, bem como sobre a morbidade hospitalar em nosso meio, procedeu-se a um censo hospitalar no municipio do Salvador, Bahia - Brasil. Em uma data escolhida ao acaso aplicou-se um questionario pre-codificado a todos Hospitais e Servicos de Urgencia, ou a quaisquer outras entidades que mantivessem leitos hospitalares na area urbana de Salvador. Os questionarios foram analisados e com base nos dados obtidos discutiu-se: disponibilidade de leitos e sua efetiva utilizacao; distribuicao dos leitos entre as varias especialidades; servicos auxiliares ou complementares e sua adequacao as necessidades; caracteristicas das pessoas internadas; formas de pagamento da assistencia hospitalar; morbidade hospitalar. Conclui-se que estudos desta natureza fornecem valiosos dados para o Planejamento de Saude recomendando sua realizacao em maior escala.