Dimensions of Access to Antihypertensive Medications in Ceilandia,Distrito Federal,Brazil

Access can be understood as the sum of a number of elements of the interface between patients and the health care system. This study took a comprehensive approach to the dimensions of access to medications, employing indicators to evaluate the dimensions of access to antihypertensive medications in Ceilandia, DF, Brazil. This was a cross-sectional epidemiological study, administering questionnaires during home visits. The survey covered epidemiological and socioeconomic profiles, behavioral habits and the dimensions of access to antihypertensive medications comprising physical, financial, and geographic availability and accept ability according to the hypertensive population of Ceilandia. The total sample comprised 400 individuals and the hypertensive subset numbered 140 (35%). Indicators of physical availability of medications revealed that users found it difficult to acquire their drugs on almost one third of occasions and in some cases were unable to access any of these products. The greatest barriers to access were reported by users of pharmacies belonging to the Brazilian National Health Service (SUS) and on the “People’s Pharmacies” network. More than one third of the hypertensive sample spent their own money on medications they could not find at these pharmacies. The majority of the hypertensive subsets were overweight/obese, a minority engaged in physical activity and 40% were smokers/ex-smokers. More women reduced their salt intake. Men had higher incomes, educational level, and socioeconomic status. Failure to keep the public health care system supplied has prejudiced access to essential medications for hypertension treatment, transferring the costs onto users. This population has lifestyle habits that increase the risk of exacerbation of hypertension. These results reveal a need for effective public policies to ensure access to antihypertensive medications and involve users of the health care system in changing their habits and behaviors in order to achieve adequate and lasting control of systemic arterial hypertension.

CRISPR/Cas9-Targeted Knockout of Rice Susceptibility Genes OsDjA2 and OsERF104 Reveals Alternative Sources of Resistance to Pyricularia oryzae

Rice genes OsDjA2 and OsERF104,encoding a chaperone protein and an APETELA2/ethylene-responsive factor,respectively,are strongly induced in a compatible interaction with blast fungus,and also have function in plant susceptibility validated through gene silencing.Here,we reported the CRISPR/Cas9 knockout of OsDjA2 and OsERF104 genes resulting in considerable improvement of blast resistance.A total of 15 OsDjA2(62.5%)and 17 OsERF104(70.8%)T_(0)transformed lines were identified from 24 regenerated plants for each target and used in downstream experiments.Phenotyping of homozygous T1 mutant lines revealed not only a significant decrease in the number of blast lesions but also a reduction in the percentage of diseased leaf area,compared with the infected control plants.Our results supported CRISPR/Cas9-mediated target mutation in rice susceptibility genes as a potential and alternative breeding strategy for building resistance to blast disease.

Civic and Social Applications to Support Public Policies on Health

The discussion with emphasis on social control is expressed in new guidelines for its effectiveness through normative instruments and the legal creation of institutional spaces that guarantee the participation of organized civil society in the direct supervision of the executive in the three spheres of government.Social participation for the strengthening of public health in Brazil has undergone complex processes of change,which have resulted in an increasingly qualified,deliberative,independent,and representative social control system.However,policy makers need to identify new technologies and carefully analyze their potential before they begin to exert their breaking power in the economy and society.Mobility and unlimited connectivity deserve special attention from the public power for the ability to achieve the digital inclusion of the citizen through smartphones.This requires a transformation of the governance structure into a platform that is based on the tripod transparency,participation,and collaboration,which relies on the Internet,social networks and connectivity.

Sister Mary Joseph's nodule and port-site metastasis in abdominal cancers

Sister Mary Joseph nodule(SMJn)or umbilical metastasis was first named by Henry Hamilton Bailey in 1949,and port-site metastasis(PSM)is a novel concern.1,2 The nurse Sister Mary Joseph had noticed umbilical nodules prior to surgery in patients with abdominal cancer,and reported this clinical observation to the Mayo Clinic direction.Since then,the ominous SMJn has been scarcely reported in association with tumors of the stomach,pancreas,colon,rectum,ovary,uterus,and cholangiocarcinoma.1,3-12 The estimated incidence of SMJn is 1%-3%in the general population with malignancy and is often related to gastrointestinal(35%-65%)or genitourinary tumors(12%-35%).3,5 Metastatic routes are peritoneal,bloodborne,lymphatic,along an embryonic structure like the round or falciform ligament,and by the laparoscopic direct implantation.5,7,11 SMJn is usually violaceous to the reddish-brown lesion with up to 5 cm(Fig.1),10,11 but it can be mimicked by endometriosis,fibroma,keloid,abscess,cyst,or hernia.

Neuropsychological and Physical Trajectories in Neurotypical and High-cognitive Performing Older Adults

The maintenance of high cognitive performance in old age has increasingly become a public health interest due to associations between cognition,well-being,longevity,and autonomy.The objective of the research is to investigate cognitive,physical,and psychological trajectories of neurotypical older adults(NOAs)and high performing older adults(HPOAs).An exploratory study to investigate 21 NOAs and six HPOAs(mean age 71,SD=±3.59),followed up for one year.The older adults were submitted to physical fitness,quality of life,anxiety,depression,RAVLT,ACE-R,and Stroop tests,being assessed at three moments:baseline,six months after the cognitive(MEMO)or stimulation(Stimullus)interventions,and six months after the multimodal interventions,which could be physical or psychopedagogical interventions(health education lectures).Nonparametric statistical tests(Mann-Whitney and Wilcoxon)were performed with p≤0.05.The results demonstrated that the cognitive measures were good predictors of cognitive performance and we observed positive correlations between cognitive and mood measures.The older adults with high performance had a lower prevalence of depressive symptoms.There were gains in global cognitive performance,mood,and in physical fitness variables associated with multimodal interventions,evident in the neurotypical group.

Antibiofilm and immunomodulatory resorbable nanofibrous filing for dental pulp regenerative procedures

Multifunctional scaffolds with host defense peptides designed for regenerative endodontics are desirable nanobiotechnological tools for dentistry.Here,different scaffolds were tested for use during the pulp revascularization process,including poly(vinyl alcohol)-PVA hydrogels or resins,collagen hydrogels and poly(vinyl alcohol)PVA/Chitosan(PVA/CS)nanofibers.Based on time to degradation(21 days),nanofibers were chosen to be incorporated with ciprofloxacin and IDR-1002(each at 50 mg/g).Nanofibers containing ciprofloxacin and IDR-1002 had anti-biofilm activity against Enterococcus faecalis,Staphylococcus aureus and a multispecies oral biofilm,besides anti-inflammatory activities.The in vivo subcutaneous tissue response to tooth fragments filled with nanofibers demonstrated a pulp-like tissue formation,when compared to empty teeth fragments.Thus,we designed a strong antimicrobial,immunomodulatory and regenerative candidate for pulp revascularization and regeneration procedures.

Alternative Method to Evaluate Performance Improvement Rate in Athletics Middle Distance Events

Purpose The aims of this study were to propose an alternative method to assess an optimal performance improvement rate(PIR)that would be used as a tool for coaches and elite athletes willing to reach their personal best,mainly those seeking for national,continental or even world record(WR)in middle-distance events.We further compared the improvement rate of women vs.men of the top-10 ranked athletes in the IAAF running these middle-distance events Method The top 10 athletes in the IAAF ranking of 800 m,1500 m,and 3000 m events for each sex were assessed for their history of race times before achieving their personal record(PR).The difference between PR(‘actual’season)and the best race time in the last season was defined as the 1st season improvement rate(1-SIR),whereas the average improvement rate in the last and preceding seasons was the multi-season improvement rate(M-SIR).1-SIR and M-SIR were calculated for each athlete.Result There were sex differences in the 1500 m with a large effect size(d=−0.746)in 1-SIR(P=0.001)and very large(d=−2.249)in M-SIR(P=0.001).Women improved more than men before the PR/WR achievements in the 800 m and 1500 m events(P=0.001)and had similar improvement rates before performing PR/WR in 3000 m events(P=0.533).Conclusion Women improve more before PR/WR achievement in 800 m and 1500 m races.However,in the 3000 m men and women have similar improvement rates in previous seasons before the PR/WR achievement.