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Introdução: As pneumoconioses correspondem a um grupo de doenças causadas pela inalação e acúmulo de poeira nos pulmões relacionado ao ambiente de trabalho. No âmbito mundial, o número de casos desta patologia aumentou em 66,0% de 1990 a 2017. Objetivo: Descrever dados epidemiológicos notificados e relacionados ao acometimento dos trabalhadores por pneumoconioses, no período de 2017 a 2019, no estado de São Paulo. Métodos: Trata-se de um estudo descritivo que aborda informações sociodemográficas e profissionais dos casos de pneumoconioses notificados no estado entre 2017 a 2019. Os dados foram coletados no Sistema de Informação de Agravos de Notificação. Resultados: Houve 721 notificações de pneumoconiose, com uma média de 240 casos/ano. A doença foi mais frequente em homens de 50 a 64 anos. Quanto à situação no mercado de trabalho, 73,6% dos casos ocorreram em trabalhadores registrados. A ocupação mais frequente foi servente de obras; já o ramo de atividade econômica foi o de fabricação de artefatos de concreto, cimento, fibrocimento, gesso e estuque. Entre os agentes causadores, o asbesto predominou (77,3%), seguido da sílica e da poeira mista. A maioria dos tratamentos ocorreu em regime ambulatorial, mas foram os hospitais e Centros de Referência em Saúde do Trabalhador os maiores notificadores. Considerando os Grupos de Vigilância Epidemiológica de São Paulo, observou-se o predomínio de Santo André, região com 480 notificações no período estudado. Conclusão: São necessários esforços na conscientização da importância da notificação para a construção e implantação de linha de cuidado que contemple as peculiaridades desta grave doença ocupacional.

Made available in DSpace on 2020-12-10T20:00:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2020-05-15 Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) BACKGROUND Toll-like receptor-2 (TLR2) is responsible for recognizing Helicobacter pylori (H. pylori) and activating the immune response. Polymorphisms in TLR2 may modulate gastric carcinogenesis. AIM To evaluate whether the TLR2 19216T/C (rs3804099) and TLR2 -196 to -174 ins/del (rs111200466) polymorphisms contribute to gastric carcinogenesis in the Brazilian population, and to determine the influence of both polymorphisms and H. pylori infection on TLR2 mRNA expression. METHODS DNA was extracted from 854 peripheral blood leukocyte or gastric tissue samples [202 gastric cancer (GC), 269 chronic gastritis (CG), and 383 control/healthy (C)] and genotyped by allele-specific PCR or restriction fragment length polymorphism (RFLP)-PCR. Quantitative polymerase chain reaction by TaqMan(R) assay was used to quantify TLR2 mRNA levels in fresh gastric tissues (48 GC, 36 CG, and 14 C). RESULTS Regarding the TLR2 -196 to -174 polymorphism, the ins/del and del/del genotypes were associated with a higher risk of GC by comparison with the C in all of the analyzed inheritance models (codominant, dominant, recessive, overdominant and log-additive; P < 0.0001). Similarly, an increased risk was observed when comparing the GC and CG groups [codominant (P < 0.0001), dominant (P < 0.0001), recessive (P = 0.0260), overdominant (P < 0.0001) and log-additive (P < 0.0001)]. In contrast, TLR2 19216T/C was associated with a protective effect in the GC group compared to the C group [dominant (P = 0.0420) and log-additive (P = 0.0300)]. Regarding the association of polymorphisms with H. pylori infection, individuals infected with H. pylori and harboring the TLR2 -196 to -174 ins/del polymorphism had an increased risk of gastric carcinogenesis [codominant (P = 0.0120), dominant (P = 0.0051), overdominant (P = 0.0240) and log-additive (P = 0.0030)], while TLR2 19216T/C was associated with a protective effect [codominant (P = 0.0039), dominant (P < 0.0001), overdominant (P = 0.0097) and log-additive (P = 0.0021)]. TLR2 mRNA levels were significantly increased in the GC group (median RQ = 6.95) compared to the CG group (RQ = 0.84, P < 0.0001) and to the normal mucosa group (RQ = 1.0). In addition, both H. pylori infection (P < 0.0001) and the presence of the polymorphic TLR2 -196 to -174del (P = 0.0010) and TLR2 19216 C (P = 0.0004) alleles influenced TLR2 mRNA expression. CONCLUSION The TLR2 -196 to -174 ins/del and TLR2 19216 T/C polymorphisms are strongly associated with GC. TLR2 mRNA expression levels are upregulated in neoplastic tissues and influenced by both the presence of H. pylori and variant genotypes. Univ Sagrado Coracao, Dept Grad Level Res, BR-17011970 Bauru, SP, Brazil Sao Jose do Rio Preto Sch Med, Dept Mol Biol, BR-15090000 Sao Jose Do Rio Preto, SP, Brazil Sao Paulo State Univ, Dept Biol, Rua Cristovao Colombo 2265, BR-15054000 Sao Jose Do Rio Preto, SP, Brazil Sao Paulo State Univ, Dept Biol, Rua Cristovao Colombo 2265, BR-15054000 Sao Jose Do Rio Preto, SP, Brazil FAPESP: 2013/14022-6 FAPESP: 2014/177161

The effects of magnesium (Mg) supplementation on vascular function have been evaluated in some randomized controlled trials (RCT) but their results are conflicting. A systematic review and meta-analysis were conducted to summarize the effects of oral Mg supplementation on vascular function in RCT. The databases MEDLINE (PubMed), Embase, Web of Science and Cochrane Library were accessed from inception to May 27, 2019. Intergroup differences (treatment vs. control group) related to changes in flow-mediated dilation (FMD) and pulse wave velocity (PWV), expressed as mean and standard deviation, were used to evaluate the effect of Mg supplementation on these outcomes. The results of the meta-analysis were expressed using a random-effects model. The heterogeneity between studies was evaluated using the I2 statistic. The oral supplementation of Mg had no significant effect on FMD (mean difference 2.13; 95% CI − 0.56, 4.82; p = 0.12) and PWV (mean difference − 0.54, 95% CI − 1.45, 0.36, p = 0.24). Heterogeneity for both outcomes (FMD and PWV) was high (I2 = 99%, p

Summary Background & aims Evidence suggests that gut microbiota is a potential factor in the pathophysiology of both obesity and related metabolic disorders. While individual randomized controlled trials (RCTs) have evaluated the effects of probiotics on adiposity and cardiovascular disease (CVD) risk factors in subjects with overweight and obesity, the results are inconsistent. Thus, this systematic review and meta-analysis aimed to evaluate the effects of probiotic supplementation on body weight, body adiposity and CVD risk markers in overweight and obese subjects. Methods A systematic search for RCTs published up to December 2020 was conducted in MEDLINE (via PubMed), EMBASE, Scopus and LILACS. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Results Twenty-six RCTs (n = 1720) were included. Data pooling showed a significant effect of probiotics in reducing body weight (MD:-0.70 kg; 95%CI:-1.04,-0.35 kg; P Conclusions The present meta-analysis suggests that probiotics consumption may be helpful for improving body weight, body adiposity and some CVD risk markers in individuals with overweight and obesity. The review was registered on PROSPERO (International prospective register of systematic reviews): CRD42020183136.

Resumo Fundamento: Diversos índices antropométricos têm sido propostos para determinar a associação entre excesso de peso e fatores de risco cardiovascular. Objetivo: Avaliar a relação entre adiposidade corporal e reatividade microvascular em pacientes hipertensos sob terapia anti-hipertensiva. Métodos: Pacientes hipertensos tratados de 40 a 70 anos foram submetidos à avaliação de índices antropométricos: conicidade (IC), adiposidade corporal (IAC), adiposidade visceral (IAV) e relação cintura-estatura (RCE). Os participantes foram divididos pelos tercis de percentual de gordura (%G) obtido pela bioimpedância elétrica (BIA) e submetidos a teste de reatividade microvascular (laser speckle contrast image), medida da velocidade da onda de pulso (VOP). O valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: A variação da área sob a curva (ASC) da perfusão cutânea foi inferior no tercil superior (97 ± 57% vs. 67 ± 36%; p = 0,027). O %G apresentou correlação significativa com RCE (r = 0,77; p < 0,001), IAV (r = 0,41; p = 0,018), IC (r = 0,60; p < 0,001) e IAC (r = 0,65; p < 0,001) nos homens e somente com RCE (r = 0,55; p < 0,001) e IAC (r = 0,60; p < 0,001) nas mulheres. Na regressão linear, a ASC mostrou associação independente com o %G (β =–3,15; p = 0,04) nas mulheres e com a glicemia (β = –1,15; p = 0,02) nos homens. Não houve diferença nas medidas de VOP. Conclusão: Os índices antropométricos de obesidade foram mais associados ao %G nos homens. A maior adiposidade corporal foi relacionada com menor reatividade microvascular, o que foi mais evidente nas mulheres. Não houve diferença na rigidez arterial, o que pode ter sido influenciado pelo tratamento anti-hipertensivo. Abstract Background: Several anthropometric indexes have been proposed to determine the association between overweight and cardiovascular risk factors. Objective: To evaluate the relationship between body adiposity and microvascular reactivity in hypertensive patients under antihypertensive therapy. Methods: Treated hypertensive patients aged 40 to 70 were submitted to evaluation of anthropometric indexes: conicity (CI), body adiposity (BAI), visceral adiposity (VAI) and waist-to-height ratio (WHtR). Participants were divided by the terciles of fat percentage (%F) obtained by bioelectrical impedance. The patients underwent microvascular reactivity test (Laser Speckle Contrast Image) and pulse wave velocity (PWV) measurement. The p value

Endothelial dysfunction is a surrogate marker of cardiovascular risk. Resveratrol is known to improve endothelial function in animals, however, clinical trials are limited. We hypothesized that the acute trans-resveratrol supplementation improves endothelial function in treated hypertensive patients with endothelial dysfunction. Twenty-four hypertensive patients between 45 and 65 years-old with baseline endothelial dysfunction were enrolled in a randomized, cross-over, double-blind, placebo-controlled trial. Individuals received either a single dose of trans-resveratrol (300 mg) or placebo and were crossed-over after a one-week washout period. Blood pressure (BP) measurements, aortic systolic blood pressure (SBP) and brachial flow-mediated dilation (FMD) were performed before and 1.5 hours after the intervention. FMD was significantly increased in women (4.2 ± 0.5 vs 7.1 ± 1.3%, p = 0.026) but not in men (4.4 ± 0.9 vs 4.9 ± 0.8%, p = 0.588) in the trans-resveratrol group. There was no statistical difference between baseline and final values of brachial BP and also no changes in aortic SBP. Patients with higher low-density lipoprotein (LDL) cholesterol had better FMD response to trans-resveratrol than patients with lower LDL cholesterol (7.4 ± 1.2 vs 4.3 ± 1.0%, p = 0.004). Our study demonstrated that the acute supplementation of trans-resveratrol promoted an improvement in endothelial function, especially in women and those with higher LDL-cholesterol, despite no changes in BP. List of Abbreviation: Aix: augmentation index; AP: augmentation pressure; BP: blood pressure; BMI: body Mass Index; CVD: cardiovascular disease; FMD: flow-mediated dilation; FRS: Framingham Risk Score; HDL: high-density lipoprotein; LDL: low-density lipoprotein; NO: nitric oxide; SPSS: Statistical Package for Social Sciences; ROS: reactive oxygen species; SBP: systolic blood pressure; TG: triglycerides.

Objective: To determine the prevalence of bruxism, associating it with mouth breathing in preschool children in Florianopolis, Brazil. Material and Methods: Clinical examination and questions to parents/guardians of 429 children aged 2-5 were conducted. The clinical examination was performed by three calibrated examiners to register the presence of tooth wear on incisors and molars. The questions were related to sleep bruxism (teeth grinding) and mouth breathing. For determinate diagnosis, were “possible” bruxism by the American Academy of Sleep Medicine and “probable” bruxism, whereas the Item Response Theory was employed for mouth breathing. To determine the associations, a Chi-square test and Fisher exact test with a standard error of 5% and 95% interval confidence were applied. Results: The clinical examination revealed bruxism in 8.2%, whereas the parental report revealed bruxism in 17.2%. When clinical examination was associated with the parent’s report, bruxism was present in 2.1%. Among the non-clinical variables, the most prevalent changes included: child presenting a regular stuffy nose (19.6%), followed by child is always open-mouthed (16.1%). A significant statistical association between bruxism and age was obtained (p 0.05). Conclusion: Bruxism was prevalent for children aged 4-5 and bruxism had no association with mouth breathing.

The aim of this study was to analyze the sociodemographic factors associated with cesarean section in adult women with conditions favorable for normal delivery and to identify the groups most likely to undergo this surgery in the state of Santa Catarina (SC). A case control study with microdata from the Sistema de Informação de Nascidos Vivos on 7,065 women for 2016 in SC. A relationship between cesarean section and sociodemographic variables was analyzed by logistic regression where we calculated the Adjusted Odds Ratio (AOR), confidence interval and p-value. The probability of cesarean section for each group of women (called "interaction") was also calculated. Among women with more favorable conditions for normal childbirth, the prevalence of cesarean section was 41.1%. Lower chance of cesarean section was found for women without partners (AOR: 0.79 [0.71-0.87]), up to 8 years of schooling (AOR: 0.56 [0.47-0.66]), with up to 2 prenatal visits (AOR: 0.46 [0.23-0.90]). The most likely group of women (51.4% [49.3-53.4]) to undergo cesarean section are women who perform 7 to 15 prenatal visits and have 12 or more years of schooling. A cesarean section occurs with women who have greater access to education and prenatal care and those who have partners, even though the aspects favor normal childbirth, suggesting that this does not seem to be a decision only by women.

A Encefalopatia Crônica Não Progressiva (ECNP) é um grupo de desordens do desenvolvimento motor e da postura, decorrente de distúrbio não progressivo ocorrido no Sistema Nervoso Central. Gera dificuldades na aquisição de padrões neuropsicomotores e na realização das atividades cotidianas. A órtese abdutora de polegar pode contribuir para a evolução da função manual, favorecendo o desempenho adequado em todas as áreas de ocupação humana. O objetivo desta pesquisa foi avaliar o efeito do uso da órtese abdutora de polegar em neoprene com faixa para supinação em uma criança com ECNP espástica associado à intervenção da Terapia Ocupacional. Trata-se de um estudo de caso, de caráter quali-quantitativo, com uma criança de 2 anos com diagnóstico de ECNP. Aplicou-se o instrumento de avaliação Physician Rating Scale para membros superiores, antes e após o tratamento com o uso das órteses. Os atendimentos foram realizados uma vez por semana, com duração de 20/25 minutos durante 3 meses, e as órteses utilizadas 4 vezes por semana, por 4 horas ininterruptas. Houve evolução nos aspectos físicos e funcionais. Em Membro Superior Esquerdo (MSE) a evolução da funcionalidade foi significativa em relação ao Membro Superior Direito (MSD), sendo observada apenas evolução nos aspectos físicos e qualitativos. A órtese abdutora de polegar em neoprene com faixa para supinação contribui na evolução da função manual de crianças com ECNP.

The Falls Efficacy Scale-International (FES-I) is a highly reliable instrument to assess fear of falling among older population. This study aimed to develop a European Portuguese version of the FES-I (FES-I(P)) and analyse its psychometric properties in terms of internal consistency, test-retest reliability, concurrent and convergent validity. A cross-sectional study was conducted. Data collection integrated a socio-demographic questionnaire which included falls history and presence/absence of fear of falling, the Activities-specific Balance Confidence Scale (ABC), the Hospital Anxiety and Depression Scale (HADS), the Timed Up and Go (TUG) and the Five Times Sit to Stand Test (FTSST). Descriptive and inferential statistical analyses were performed. A total of 100 Portuguese community-dwelling older people (74.27±8.7years old) have participated in the study. From these, 82 have participated in the reliability study. The FES-I(P) had excellent internal consistency (α=0,978) and test-retest reliability (ICC2,1=0,999). A significant negative correlation was found between the FES-I(P) and the ABC (rs=-0.85; p

Objective: This parallel, randomized, examiner-blind clinical trial aimed to evaluate the efficacy of two different toothbrushes (manual and sonic) on plaque control in adolescents. Material and Methods: This study enrolled 56 volunteers, randomly allocated to two different groups: group A (n = 28) for the manual toothbrush (Curaprox 5460 Ultra Soft®) and group B (n = 28) for the sonic toothbrush (Edel White®). Mean age was 17.2 ± 1.1 years. A calibrated periodontist performed a periodontal evaluation to assess the presence of plaque with the Turesky Modification of the Quigley Hein Plaque Index (PI) and the gingival inflammation with the Silness & Löe Gingival Index (GI). Adolescents received instructions about the mechanical control of plaque at baseline (T0), with a reexamination after 3 months (T1) and 6 months (T2). Non-parametric Mann Whitney test was used to compare the differences between the two toothbrush groups and the Friedman test was used for the comparisons between times. Results: There has been PI reduction concerning the study times (T0, T1 and T2, p0.05). As for GI there has been no significant difference between the groups and between the study times (p>0.05). Conclusion: Both toothbrushes were efficient in the control of supragingival plaque (visible biofilm).

Price bundling is one of the most important pricing strategies in the hospitality industry. This paper aims to investigate the specific importance of mixed-joint bundling strategy in hotels' profitability. Data was gathered through an ad hoc questionnaire, administrated in three and five-star hotels'. Univariate and bivariate techniques were performed to eventually identify statistical differences. The results show statistical differences between bundling with two services and bundling with more than two services included. Bundling strategy with restaurant service included is more attractive to customers in the hospitality industry. With these findings, managers can structure effective but different bundling solutions for both 3 and 5 stars hotels.

O presente artigo analisou alterações na percepção corporal e medo do reganho de peso em 10 pacientes submetidos à cirurgia bariátrica de Fobi-Capella (Bypass Gástrico em Y de Roux) há no mínimo quatro anos, que tiveram reganho de pelo menos 20% do peso perdido. Foi utilizado um roteiro de entrevista semiestruturada sobre: dados demográficos, hábitos alimentares, mudanças no estilo de vida e comportamentais, imagem corporal, preconceitos vivenciados e reaquisição de peso. As entrevistas foram gravadas, transcritas e submetidas à análise de conteúdo. Observou-se que o reganho de peso ocorreu de modo desapercebido pelo paciente, até que tenha sido sinalizado socialmente; o emagrecimento excessivo foi mal avaliado pelos pares; observou-se medo acentuado, por parte dos operados bariátricos, de voltar à obesidade mórbida; os participantes relataram alterações nas relações afetivas; a percepção da imagem corporal oscilou e era infiel à aparência externa.

Introduction: In Brazil, hantavirus cardiopulmonary syndrome (HCPS) has a high lethality rate that varies by region. This study aimed to identify the risk factors associated with fatal hantavirosis. Methods: This study was a case-control study that included all laboratory confirmed cases of hantavirosis. The cases were stratified by the different Brazilian regions using data from the Notifiable Diseases Information System. “Cases” were patients who progressed to death, whereas “controls” were patients who were cured. The odds ratio (OR) and the adjusted OR were calculated. Results: Overall, 158 cases and 281 controls were included in this study. In the Midwest region, the cases were 60% less likely to present with flank pain, and the time between the beginning of symptoms and death was shorter than the time between the beginning of symptoms and a cure. In the Southeast region, the cases were 60% less likely to present with thrombocytopenia or reside in rural areas compared to those who progressed to a cure. Additionally, the cases sought medical assistance, notification and investigation more quickly than the controls. In the Southern region, the cases that died were 70% less likely to be male compared to the controls. Conclusions: HCPS manifests with nonspecific symptoms, and there are few published studies related to the condition, so determining a patient's therapeutic strategy is difficult. This study presents findings from different Brazilian regions and highlights the need for further investigations to improve comprehension about regional risk factors associated with hantavirosis and to reduce morbimortality.

Based on results of two intervention projects with professionals working with drug users in Sorocaba, São Paulo, the article discusses the possibilities of health promotion in the field of mental health, understood as a form of resistance to the regulatory powers of official policies. The projects proved to be promising for the construction of autonomy of these workers. The guiding principles of humanized care in health care and respect for human rights of drug users proved to be important tools for these interventions as were university extramural activities.

Protein malnutrition (PM) is a major public health problem in developing countries, affecting the inflammatory response and increasing susceptibility to opportunistic infections. For this reason, an adequate nutritional intervention can improve the quality of life of patients. Glutamine (GLN) is a nonessential amino acid, but can be considered "conditionally essential" for macrophage function in stress situations, in which it plays a role in the improvement of the inflammatory response. Concerning this issue, in the current study, it was of interest to evaluate some biological aspects of peritoneal cells from a protein malnutrition (PM) mouse model challenged with lipopolysaccharide (LPS) and treated intravenously with GLN. Two-month-old male Balb/c mice were subjected to a low-protein diet (2 % protein) and stimulated intravenously with LPS 1 h prior to the injection of 0.75 mg/kg GLN. Malnourished animals showed a reduced number of total peritoneal cells. Malnourished animals stimulated with LPS or LPS plus GLN did not show differences in peritoneal cell counts; however, the control group showed increased cellularity after LPS stimulus, which was reversed after GLN injection. Further, in the animals from both groups stimulated with LPS, GLN decreased the circulating levels of TNF-α and the levels of TNF-α produced by peritoneal cells; additionally, GLN decreased the IL-10 circulating levels in the malnourished animals stimulated with LPS. In addition, peritoneal cells of the control and malnourished groups stimulated with LPS showed a negative modulation of the NFkB signaling pathway after GLN injection. In conclusion, this study shows that GLN has the capacity to reduce TNF-α synthesis as well as to act as a negative regulator of NFkB phosphorylation, leading to a positive outcome in the control of TNF-α production.

Objective To compare the emotional aspects of children with and without constipation. Methodology Some emotional aspects were studied in children with and without constipation. A nonstructured interview was performed with the mothers regarding the emotional aspects of their children. The children were asked to tell a story based on the observation of a board from the thematic children apperception test. This is a qualitative study using the technique of constant comparison. Results In the interview with the mothers of constipated children. Conclusion In the children with constipation a higher prevalence of some emotional aspects was observed.

The present study analyzed the (ICHD I-1988) and (ICHD II-2004) diagnostic criteria in children and adolescents. Our population consisted of 496 patients of the Headache Outpatient Ward for Children and Adolescents retrospectively studied from 1992 to 2002. Individuals were classified according to three diagnostic groups: Intuitive Clinical Diagnosis (Gold Standard), ICHD I-1988 and ICHD II-2004. They were statistically compared using the variables: Sensitivity (S), Specificity (Sp), Positive Predictive Value (PPV), Negative Predictive Value (NPV). When ICHD I-1988 was used, the sensitivity of migraine without and with aura was 21% and 27%, respectively, whereas in ICHD II-2004 it changed to 53% and 71% without affecting specificity. As a conclusion, the current classification criteria (ICHD II-2004) showed greater sensitivity and high specificity for migraine than ICHD I-1988, although it improved migraine diagnosis in children and adolescents, the sensitivity remains poor.

Background: High salt intake has been associated with structural and functional vascular changes.1 Objective: To correlate urinary sodium excretion with endothelial function and arterial stiffness in non-diabetic hypertensive patients. Methods: Cross-sectional study with non-diabetic hypertensive patients, both genders, aged 45–65 years, submitted to office blood pressure measurement, 24-hour urine sampling, carotid-femoral pulse wave velocity (PWV; Complior Analysis), central hemodynamic parameters by applanation tonometry (SphygmoCor) and microvascular reactivity by Laser Speckle Contrast Analysis (Pericam PSI)2. Results: Patients (n = 18) were divided according to the urinary sodium excretion (UrNa) median: group 1 (UrNa

OBJETIVO: estimar as chances de adoecimento por coqueluche segundo número de doses de vacinas Pertussis administradas e idade, no Brasil. MÉTODOS: estudo de caso-controle utilizando dados do Sistema de Informação de Agravos de Notificação (Sinan) no período 2007-2011; considerou-se como casos aqueles notificados com coqueluche confirmada, e como controles, aqueles descartados; foram calculadas as odds ratio (OR) e respectivos intervalos de confiança de 95% (IC95%). RESULTADOS: foram incluídos 5.389 casos e 10.689 controles; entre 7-12 meses de idade, a chance de adoecimento foi maior com 1 dose administrada [OR:2,1(IC95%:1,3-3,4)], comparativamente às 3 doses esperadas; entre 1-3 anos, essa chance foi maior sem reforço vacinal [OR 1 dose: 2,4 (IC95%:1,6-3,8); OR 2 doses:3,6 (IC95%:2,2-6,1); OR 3 doses:1,6 (IC:1,3-2,2); OR 0 dose:2,8 (IC95%:1,7-4,8)], quando este era esperado; entre 7-15 anos, foi maior com 1 reforço [OR:1,6 (IC95%:1,2-2,3)], quando 2 eram esperados. CONCLUSÃO: o esquema vacinal incompleto aumenta as chances de adoecimento por coqueluche em todas as idades estudadas. OBJECTIVE: estimate the likelihood of pertussis according to number of vaccine doses received and age. METHODS: Case-control study using 2007-2011 SINAN data. "Cases" were considered to be confirmed reported pertussis cases. "Controls" were the discarded cases. RESULTS: 5,389 cases and 10,689 controls were included. In those aged 7-12 months, cases were twice as likely [OR:2.1 (95%CI:1.3-3.4)] when only 1 instead of 3 doses had been administered. In 1-3 year-olds, likelihood was greater in those not having boosters (1 booster expected) [OR 1 dose: 2.4 (95%CI:1.6-3.8); OR 2 doses: 3.6 (95%CI:2.2-6.1); OR 3 doses: 1.6 (95%CI:1.3-2.2); OR 0 dose: 2.8 (95%CI:1.7-4.8)]. In 7-15 year-olds, cases were 60% more likely in those having had 1 booster instead of 2 [OR:1.6 (95%CI:1.2-2.3)]. CONCLUSION: incomplete immunization increases likelihood of contracting pertussis in all age groups studied, mainly 7-15 years.

O objetivo deste artigo foi analisar a etapa da importação que integra o controle sanitário das substâncias psicotrópicas realizado pela área de portos, aeroportos e fronteiras da Agência Nacional de Vigilância Sanitária. Aqui, entenderam-se como substâncias psicotrópicas os insumos farmacêuticos ativos constantes da lista B1 da Portaria nº 344/98 e que necessitam da anuência da Anvisa para serem importados. Este estudo utilizou o método de entrevistas semiestruturadas com informantes-chave e observação participante. Os dados foram coletados e sistematizados por meio de análise de conteúdo, modalidade temática. Os resultados apontaram um controle bastante complexo que envolve um intenso processo burocrático. Os principais pontos críticos do processo identificados foram: a precariedade do sistema de informação; a carência em recursos humanos; a deficiência de apoio laboratorial e de infraestrutura dos recintos alfandegados. A página eletrônica da Anvisa e a legislação mostraram-se como pontos fortes, embora necessitem de aprimoramentos. Percebeu-se que, apesar do avanço, várias ações ainda precisam ser feitas para que o país tenha um sistema de controle sanitário eficiente sobre essas importações. The purpose of this work is to analyze the process of importation, that is a part of the sanitary control of psychotropic substances, made by Brazilian National Health Surveillance Agency's ports, airports and borders. For this work, psychotropic substances are defined as active pharmaceutical raw materials present in the list B1 of Portaria nº 344/98; which need Anvisa's permission to be imported. For this purpose we used semistructured interviews with key informers and participant observation. The information were collected and systematized through the content analysis, thematic modality. The results show a very complex control which involves an intense bureaucratic process. The main identified critical points of the process were: the information system precariousness; the absence of human resources; deficiency of laboratorial support and infra-structure at customs. Anvisa's web page and the specific law are strong points of the process, but still needing improvements. We understood that despite of the progress made, there are many things to do for giving the country an efficient health control system to the importation of these substances.

Hypomyelination with atrophy of the basal ganglia and cerebellum (H-ABC) is a rare disease that has been recently described. It must be remembered as a possible etiology of leukoencephalopathies in children. We describe a typical case of H-ABC in a 11-month-old boy. He presents with global development delay, oral dyskinesia, and global dystonia and spasticity. Magnetic resonance imaging disclosed typical features of H-ABC and clinical laboratory tests were all negative. A slow neurological deterioration has been detected with worsening of involuntary movements.