Abstract This study analyzed the influence of strong and moderate El Niño-Southern Oscillation (ENSO) events on the seasonal and interannual variabilities of the sea surface temperature (SST) in the Western Equatorial Atlantic (WEA) Ocean and how the precipitation over the state of Maranhão, in Brazil, responds to the zonal teleconnection. To evaluate the ENSO magnitude and phase in the four Niño regions (1+2, 3, 3.4, and 4), the SODA 3.3.1 oceanic reanalysis database for the period from 1980 to 2015 was used. Our results showed that the La Niña phase with moderate magnitude was the most predominant among the 70 events analyzed, with Niño 3.4 presenting the highest number (20) of ENSO events (both positive and negative phases). At lag = 0, we found that significant negative correlations prevailed between the WEA SST anomalies and ENSO index, with the region of Niño 3.4 showing the most significant correlations (r = −0.25). The whole events of El Niño and La Niña were, respectively, accompanied by a cooling and a heating of up to −0.6°C or +0.8°C in the WEA Ocean. The WEA SST anomalies during El Niño and La Niña events have, respectively, reduced and increased the precipitation in Maranhão around ± 100 mm in a quarter. Strong El Niño events influence a greater precipitation deficit in Maranhão than moderate El Niño events. Moderate La Niña events have more pronounced influence on the precipitation over Maranhão than strong La Niña events do, especially on the negative anomalies. Our results showed that the central, northern, and eastern tip sectors of the state are the most affected by this zonal teleconnection. We concluded that ENSO’s significant influences on the WEA SST seasonal variability, added to the performance of the Atlantic Meridional Mode (Soares, 2019), determine the quality of the rainy season (March–April–May) in the state of Maranhão. NiñoSouthern Southern (ENSO (SST (WEA Brazil teleconnection 1+2, 12 1 2 (1+2 3 34 4 4, , 4) 331 3.3. 198 201 used 7 3. 20 (20 both phases. phases . phases) 0 index r −0.25. 025 −0.25 25 −0.25) were respectively 06C C 6 08C 8 10 quarter do central northern ENSOs s variability Soares, Soares (Soares 2019, 2019 2019) March–April–May MarchAprilMay March April May (March–April–May 1+2 (1+ 33 3.3 19 (2 02 −0.2 1+ (1 ( −0. −0 −

Abstract This text proposes the analysis of a questionnaire carried out with the participation of military police officers (PMs) from 23 states in Brazil at the beginning of the covid-19 pandemic. We observed how general aspects of the health crisis impacted and led PMs to review their protocols and how social rearrangements caused by the pandemic affected policing. The research shows that covid-19 created conditions for officers to manifest vulnerabilities such as insufficient equipment, lack of investment in general, fragility on institutional assistance to police mental health and, finally, lack of social and professional recognition. (PMs 2 covid19 covid 19 covid-1 policing equipment finally recognition covid1 1 covid-

Resumo Este texto propõe a análise de um questionário realizado com a participação de policiais militares (PMs) de 23 estados do Brasil no início da pandemia da covid-19. Observamos como aspectos gerais na crise sanitária impactaram e levaram PMs a rever seus protocolos e como rearranjos sociais causados pela pandemia afetaram o policiamento. A pesquisa mostra que a covid-19 criou condições para que os policiais manifestassem vulnerabilidades como insuficiência de equipamentos, ausência de investimentos em geral, fragilidade na assistência institucional à saúde mental do policial e, por fim, falta de reconhecimento social e profissional. (PMs 2 covid19. covid19 covid 19. 19 policiamento covid-1 equipamentos geral fim profissional covid1 1 covid-

ABSTRACT: The term rickets refers to insufficient or retarded mineralization of the osteoide matrix. X-linked hypophosphatemic (XLH) rickets is a rare genetic disorder characterized by biochemical changes in bone mineralization due to inactivation of the phosphate regulating gene and primary defect of the osteoblasts. The aim of this article was to report a clinical case of XLH, its oral manifestations, periapical changes and dental management. A 31-year old woman female patient was referred to the school of dentistry with pain and sensitivity in the teeth. She had a childhood history of rickets, hypophosphatemia and alteration in Vitamin D. In the oral exam, enamel hypoplasia, microdontia, fistula, caries and periapical lesions and periodontal disease were diagnosed. The radiographic and tomographic exams exhibited the presence of periapical lesions involving various teeth with radiolucent images, suggestive of granuloma or periapical cysts. The treatme nt prioritized the urgency of eliminating pain and removing the foci of infection. Endodontic treatment began in the teeth that had fistula or periapical lesions and in parallel, oral hygiene guidance was provided and periodontal treatment was performed. There was an improvement in the clinical condition with reduction in inflammation and mobility of the teeth. Dentists and health professionals must evaluate the patient as a whole, considering the relations between systemic and oral health. Knowledge of systemic diseases associated with rickets and their characteristics is essential for making a correct oral diagnosis and planning the dental treatment.

RESUMEN: El término raquitismo se refiere a la mineralización insuficiente o retardada de la matriz osteoide. El raquitismo hipofosfatémico ligado al cromosoma X (XLH) es un trastorno genético caracterizado por cambios bioquímicos en la mineralización ósea debido a la inactivación del gen regulador del fosfato y al defecto primario de los osteoblastos. El objetivo de este artículo fue reportar un caso clínico de XLH, sus manifestaciones orales, cambios periapicales y manejo dental. La paciente, una mujer de 31 años, acudió a la Clínica de Semiología de la UFPR con dolor y sensibilidad en varios dientes. Tenía antecedentes infantiles de raquitismo, hipofosfatemia y alteración de la vitamina D. En el examen oral se diagnosticó hipoplasia del esmalte, microdoontia, fístula, caries y lesiones periapicales y enfermedad periodontal. Los exámenes radiográficos y tomográficos mostraron la presencia de lesiones periapicales en varios dientes con imágenes radiolúcidas, sugestivas de granuloma o quistes periapicales. El tratamiento priorizó la urgencia de eliminar el dolor y remover los focos de infección. Se inició tratamiento de endodoncia en los dientes que presentaban fístula o lesiones periapicales y paralelamente se brindó orientación de higiene oral y se realizó tratamiento periodontal. Hubo una mejoría en la condición clínica con reducción de la inflamación y movilidad de los dientes. Los odontólogos y profesionales de la salud deben evaluar al paciente como un todo, teniendo en cuenta las relaciones entre salud sistémica y oral. El conocimiento de las enfermedades sistémicas asociadas al raquitismo y sus características es fundamental para realizar un correcto diagnóstico oral y planificar el tratamiento odontológico.

Resumo O objetivo desta pesquisa foi caracterizar a distribuição dos nutrientes dissolvidos em seis estações de amostragem no estuário do rio Anil (ERA) e caracterizar o sedimento de fundo. A área de estudo é influenciada por um clima tropical e regime macromarés semidiurnas. A amostragem das águas superficiais e sedimentos foi realizada no canal principal em seis estações de amostragem distribuídas ao longo do estuário no período chuvoso (09 de maio) e seco (05 de outubro) durante a primavera. Variáveis físicas foram coletadas com o auxílio de uma sonda multiparâmetro HANNA HI-8424 (temperatura da água, salinidade, pH, oxigênio dissolvido e turbidez) e sonda YSI CTD (condutividade, temperatura e profundidade). Uma draga van Veen foi usada para a coleta de sedimentos de fundo do canal principal. Os resultados sedimentológicos foram heterogêneos. O tamanho do grão variou de areia muito fina a média. Os nutrientes dissolvidos no ERA tinham fontes diferentes dependendo do período sazonal. Insumos continentais e fluviais, evidenciados pelos valores de salinidade, governaram a distribuição dos nutrientes no período chuvoso (janeiro a junho), enquanto as concentrações dos nutrientes foram relacionadas à reciclagem da matéria orgânica no estuário na estação seca (julho a dezembro). A presença de areia no canal principal indica que os sedimentos disponíveis no ERA estão expostos a uma hidrodinâmica intensa. A distribuição dos nutrientes e o tamanho do grão revelaram a ocorrência de diferentes fontes no estuário de acordo com o regime de chuvas e a intensa hidrodinâmica das correntes de maré (macromarés semidiurnas).

Abstract The objective of this research was to characterize the distribution of dissolved nutrients at six sampling stations in the estuary of the Anil River (ARE) and characterize the bottom sediment. The study area is influenced by a tropical climate and semidiurnal macrotidal regime. Sampling of the surface water and sediment was performed in the main channel at six sampling stations distributed along the estuary in the rainy period (May 9th) and dry period (October 5th) during the spring. Physical variables were collected with the aid of a HANNA HI-8424 multi-parameter probe (water temperature, salinity, pH, dissolved oxygen, and turbidity) and YSI CTD (conductivity, temperature, and depth) probe. A van Veen dredge was used for the collection of bottom sediment from the main channel. The sedimentological results were heterogeneous. Grain size ranged from very fine to medium sand. Dissolved nutrients in the ARE had different sources depending on the season. Continental and fluvial inputs, evidenced by salinity values, governed the distribution of nutrients in the rainy period (January to June), whereas nutrient concentrations were related to the recycling of organic material in the estuary in the dry season (July to December). The considerable presence of sand in the main channel indicates that the sediments available in ARE are exposed to intense hydrodynamics. The distribution of nutrients and the grain size revealed the occurrence of different sources in the estuary according to the rainfall regime and the intense hydrodynamics of tidal currents (semidiurnal macrotidal).

Resumo A circulação do novo coronavírus é um acontecimento sanitário nas dimensões do fenômeno dantesco que se constituiu a Gripe Espanhola, porém, agravado pela globalização. A escolha deste objeto de estudo se impôs em função da preocupação mundial com a covid-19, e pela percepção de que há indagações persistentes e insuficiência de análises que explicitem a intrínseca relação entre o processo saúde-doença e as dimensões políticas, econômicas e sociais a ele associados. A tese defendida é de que o enfrentamento insensato e descoordenado da epidemia no Brasil traria reflexos no número de casos e óbitos. Trata-se de estudo exploratório, apoiado no referencial teórico da hermenêutica crítica, desenvolvido com base na análise de documentos e dados, que tem como objetivo analisar o perfil epidemiológico da covid-19 e, a partir desta análise, discutir as políticas econômicas, sociais e sanitárias adotadas no Brasil diante do quadro pandêmico. Conclui-se que a insensatez política, econômica, social e sanitária na aplicação de políticas públicas, bem como a descoordenação do governo federal do Brasil no enfrentamento da pandemia da covid-19 trouxe como reflexo o aumento exponencial do número de casos e de óbitos pela doença, principalmente em populações mais pobres e vulneráveis.

Abstract The circulation of the new coronavirus is a health event in the dimensions of the Dantesque phenomenon that constituted the Spanish Flu, but aggravated by the fact that we live in an interconnected world. The choice of this object of study was imposed due to the worldwide concern with the covid-19, and the perception that there are persistent questions and insufficient analyses that explain the intrinsic relationship between the health-disease process and the political, economic and social dimensions associated with it. We defend that the foolish and uncoordinated confrontation of the epidemic in Brazil would have affected the number of cases and deaths. This is an exploratory study, supported by the theoretical framework of critical hermeneutics, developed based on the analysis of documents and data, which aims at analyzing the epidemiological profile of Covid-19 and to discuss economic, social policies and sanitary measures adopted in Brazil in the face of the pandemic situation. We concluded that the political, economic, social and sanitary folly in the application of public policies combined with the lack of coordination of the federal government of Brazil in confronting the covid-19 pandemic reflected in the exponential increase in the number of cases and deaths, especially among the poorest and most vulnerable populations.

Resumo A circulação do novo coronavírus é um acontecimento sanitário nas dimensões do fenômeno dantesco que se constituiu a Gripe Espanhola, porém, agravado pela globalização. A escolha deste objeto de estudo se impôs em função da preocupação mundial com a covid-19, e pela percepção de que há indagações persistentes e insuficiência de análises que explicitem a intrínseca relação entre o processo saúde-doença e as dimensões políticas, econômicas e sociais a ele associados. A tese defendida é de que o enfrentamento insensato e descoordenado da epidemia no Brasil traria reflexos no número de casos e óbitos. Trata-se de estudo exploratório, apoiado no referencial teórico da hermenêutica crítica, desenvolvido com base na análise de documentos e dados, que tem como objetivo analisar o perfil epidemiológico da covid-19 e, a partir desta análise, discutir as políticas econômicas, sociais e sanitárias adotadas no Brasil diante do quadro pandêmico. Conclui-se que a insensatez política, econômica, social e sanitária na aplicação de políticas públicas, bem como a descoordenação do governo federal do Brasil no enfrentamento da pandemia da covid-19 trouxe como reflexo o aumento exponencial do número de casos e de óbitos pela doença, principalmente em populações mais pobres e vulneráveis.

Abstract The circulation of the new coronavirus is a health event in the dimensions of the Dantesque phenomenon that constituted the Spanish Flu, but aggravated by the fact that we live in an interconnected world. The choice of this object of study was imposed due to the worldwide concern with the covid-19, and the perception that there are persistent questions and insufficient analyses that explain the intrinsic relationship between the health-disease process and the political, economic and social dimensions associated with it. We defend that the foolish and uncoordinated confrontation of the epidemic in Brazil would have affected the number of cases and deaths. This is an exploratory study, supported by the theoretical framework of critical hermeneutics, developed based on the analysis of documents and data, which aims at analyzing the epidemiological profile of Covid-19 and to discuss economic, social policies and sanitary measures adopted in Brazil in the face of the pandemic situation. We concluded that the political, economic, social and sanitary folly in the application of public policies combined with the lack of coordination of the federal government of Brazil in confronting the covid-19 pandemic reflected in the exponential increase in the number of cases and deaths, especially among the poorest and most vulnerable populations.

Hydroxyapatite (HA) nanopowders are attracting interest for surface application to ceramic biomaterials. In this study, we developed innovative and new viable synthesis routes of calcium phosphate nanopowders from the natural calcium carbonate of chicken eggshells. Following the four routes, alternative co-precipitation, vacuum process, brushite, and calcination, we obtained the HA samples, which were then characterized by different methods. The X-ray diffraction /Rietveld method showed the HA phases, monetite and brushite crystallinity with greater symmetry, and nanoscale. Transmission electron microscopy showed the morphology of nanoparticles functionalized nanoparticles smaller than 100 nm in routes A, B and D, and Fourier-transform infrared spectrophotometry and Raman spectroscopy identified the classic chemical groups of calcium phosphates by four routes mainly groups (PO4)3- and (CO3-). Scanning electron microscopy analysis revealed a good surface topography to future cell biointeraction in A, B and D routes, and thermogravimetric analysis showed the mass loss profile inherent to each synthesis route with slot at 200 °C. Hence, the eggshell HA and brushite and the specific monetite nanoparticles with different morphology can be prepared from the four new possible and viable routes using different methods.

O estudo visa traçar um panorama das causas da evasão na educação a distância, discutindo os (contra)pontos e jogando luzes ao problema. Embora existam muitos estudos e discursos afinados sobre as causas da evasão, percebemos um distanciamento por parte das instituições formadoras em relação aos problemas da evasão, o que gera uma diminuição ou isenção de responsabilidades, tendo em vista a tendência em atribuir suas causas a dimensões psicológicas do estudante ou a (in)comunicabilidade entre os sujeitos participantes ou ainda às (des)continuidades ordenadas normativamente. O esforço dessa pesquisa consiste em dar visibilidade ao conjunto de dissertações e teses produzidas sobre a evasão na EaD. Trata-se de mapear na Biblioteca Digital Brasileira de Teses e Dissertações estas produções com os descritores Evasão EaD, por meio de uma busca avançada, considerando o período de publicação de 2007 a 2017. Acerca dessa temática, obtivemos setenta e dois resultados, dos quais fizeram parte do corpus investigativo de produção de dados sessenta e oito trabalhos. Compreende-se que apesar da EaD ser avaliada como um modelo de gestão propício às demandas sociais ela recebe forte influência de interesses de mercado, o que exige reavaliações constantes para um processo efetivo de (re)construção de conhecimentos e metodologias, contribuindo, também, para a diminuição dos índices da evasão (tensão inclusão/exclusão) na EaD. O estudo pontuou vários fatores comuns à evasão, apresentando contrapontos, no sentido de utilizar meios tradicionais de forma virtualizada, e propostas de melhoria nos processos via EaD, considerando os limites de estudar a distância, a necessidade de não confundir flexibilidade com facilidade para avaliação dos estudantes.

The study aims to outline the causes of avoidance in distance education, discussing the (Counter) points and throwing light on the problem. Although there are many studies and refined discourses on the causes of evasion, we perceive a distancing by training institutions from the problems of evasion, which leads to a decrease or lack of responsibility, given the tendency to attribute their causes to psychological dimensions of the student or the (in) communicability between the subjects involved or even the normatively ordered (dis) continuities. The effort of this research consists in giving visibility to the set of dissertations and theses produced on the evasion in the EaD. It is a question of mapping these productions with the descriptors Evasion EaD in the Brazilian Digital Library of Theses and Dissertations, by means of an advanced search, considering the period of publication from 2007 to 2017. About this theme, we obtained seventy-two results, of which sixty-eight papers were part of the investigative corpus of data production. It is understood that although EaD is evaluated as a management model conducive to social demands, it is strongly influenced by market interests, which requires constant re-evaluations for an effective process of (re) construction of knowledge and methodologies, to reduce the rates of evasion (inclusion / exclusion strain) in the EaD. The study pointed out several common factors to avoidance, presenting counterpoints in the sense of using traditional means in a virtualized way, and proposals for improvement in processes via distance learning, considering the limits of studying distance, the need not to confuse flexibility with ease for evaluation of students.

RESUMO A malária é uma doença de distribuição tropical, sendo endêmica em mais de 90 países, responsável por cerca de 212 milhões de casos reportados ao redor do mundo em 2016. As estratégias de erradicação dessa doença são ineficazes até o presente, sem medidas de prevenção específica, como vacinas. Atualmente, o arsenal terapêutico existente é limitado e vem se tornando ineficaz frente à expansão de plasmódios resistentes a artemisinina, evidenciando a necessidade de estudos que viabilizem o desenvolvimento de novos compostos contra a doença. Nesse contexto, estudamos o óleo essencial obtido de rizomas de Cyperus articulatus (VOCA), uma espécie vegetal comumente encontrada na região amazônica, utilizada popularmente como alternativa terapêutica para o tratamento de malária. Visamos confirmar o potencial antimalárico da planta através de testes in vitro e in vivo. Utilizamos cepas de Plasmodium falciparum W2 (cloroquina-resistente) e 3D7 (cloroquina-sensível) cultivadas em hemácias e expostas ao VOCA em microplacas de 96 poços. A atividade antimalárica in vivo foi testada em camundongos da linhagem BALB/c infectados com aproximadamente 106 eritrócitos parasitados por Plasmodium berghei. O VOCA apresentou alto potencial antimalárico (IC50 < 10 µg ml-1) frente às duas cepas de P. falciparum testadas (IC50=1,21 µg ml-1 para W2 e 2,3 µg ml-1 para 3D7). Além disso, houve redução significativa da parasitemia induzida por P. Berghei em camundongos tratados com EOAC, e também observamos diminuição da anemia, uma sintomatologia provocada pela infecção. Nossos resultados confirmam o potencial antimalárico do óleo essencial de Cyperus articulatus.

ABSTRACT Malaria is a disease of global tropical distribution, being endemic in more than 90 countries and responsible for about 212 million cases worldwide in 2016. To date, the strategies used to eradicate this disease have been ineffective, without specific preventive measures such as vaccines. Currently, the existing therapeutic arsenal is limited and has become ineffective against the expansion of artemisinin-resistant Plasmodium, demonstrating the need for studies that would allow the development of new compounds against this disease. In this context, we studied the volatile oil obtained from rhizomes of Cyperus articulatus (VOCA), a plant species commonly found in the Amazon region and popularly used as a therapeutic alternative for the treatment of malaria, in order to confirm its potential as an antimalarial agent by in vitro and in vivo assays. We cultured Plasmodium falciparum W2 (chloroquine-resistant) and 3D7 (chloroquine-sensitive) strains in erythrocytes and exposed them to VOCA at different concentrations in 96-well microplates. In vivo antimalarial activity was tested in BALB/c mice inoculated with approximately 106 erythrocytes infected with Plasmodium berghei. VOCA showed a high antimalarial potential against the two P. falciparum strains, with IC50 = 1.21 μg mL-1 for W2 and 2.30 μg mL-1 for 3D7. VOCA also significantly reduced the parasitemia and anemia induced by P. berghei in mice. Our results confirmed the antimalarial potential of the volatile oil of Cyperus articulatus.

Abstract We assessed the effect of a new coating material based on resin-modified glass-ionomer with calcium (Ca) in inhibiting the demineralization of underlying and adjacent areas surrounding caries-like lesions in enamel. The measures used were surface hardness (SH) and cross-sectional hardness (CSH). Thirty-six bovine enamel specimens (3 × 6 × 2 mm) were randomly allocated into three groups (n = 12): No treatment (NT); resin-modified glass-ionomer with Ca (Clinpro XT Varnish, 3M ESPE) (CL), and fluoride varnish (Duraphat, Colgate) (DU). The specimens were subjected to alternated immersions in demineralizing (6 h) and remineralizing solutions (18 h) for 7 days. SH measurements were conducted at standard distances of 150, 300, and 450 µm from the treatment area. CSH evaluated the mean hardness profile over the depth of the enamel surface and at standard distances from the materials. The energy-dispersive X-ray spectroscopy analysis was conducted to evaluate the demineralization bands created on the sublayer by % of calcium (Ca), phosphorus (P), and fluoride (F). Ca/P weight ratio was also calculated. Based on SH and CSH measurements, there was no difference between groups at the distances 150 µm (p = 0.882), 300 µm (p = 0.995), and 450 µm (p = 0.998). Up to 50 µm depth (at 150 µm from the treatment area), CL showed better performance than DU ( p< 0.05). NT presented higher loss of Ca and P than CL and DU (p < 0.05). There was no significant difference in the % of F ion among the three groups. The new coating material was similar to F varnish in attenuating enamel demineralization.

RESUMO OBJETIVO Analisar a alocação de recursos financeiros no Sistema Único de Saúde (SUS) no estado de São Paulo por nível de atenção, região de saúde, fonte de recursos e ente federado. MÉTODOS Trata-se de estudo exploratório circunscrito ao exercício de 2014. Os dados extraídos do Sistema de Informações sobre Orçamentos Públicos em Saúde estão apresentados em valores absolutos, relativos e per capita . RESULTADOS Em 2014 observou-se um gasto público com saúde de R$52,1 bi, sendo 58,0% relativos ao gasto dos municípios e 42,0% relativos ao gasto do governo do estado. O gasto regional per capita variou de R$561,75 a R$824,85. Já o gasto per capita com atenção primária à saúde, que representou 37,5% do gasto total dos municípios, foi menor na região da Grande São Paulo e maior em Araçatuba. A região de Campinas apresentou o maior gasto per capita com atenção de média e alta complexidade, enquanto Presidente Prudente teve o menor. O maior percentual regional da receita corrente líquida gasto com saúde foi verificado em Registro, e o menor na Grande São Paulo. CONCLUSÕES O paradigma de financiamento do setor da saúde em São Paulo revelou que o gasto com a atenção primária, nível eleito pela política de saúde como estratégico porque dele dependem a coordenação e o cuidado integral à saúde nas redes de atenção, não recebeu prioridade em relação ao gasto com a média e a alta complexidade, expondo as iniquidades nas regiões do estado.

ABSTRACT OBJECTIVE To analyze the allocation of financial resources in the Brazilian Unified Health System (SUS) in the state of São Paulo by level of care, health region, source of funds and level of government. METHODS This is an exploratory study based on 2014 data extracted from the Public Health Budget Database, presented in absolute terms, relative terms and per capita . RESULTS In 2014, R$52.1 bi were spent on public health, 58.0% having corresponded to the expenditures of the municipalities and 42.0% to those of the state government. Regional per capita spending varied from R$561.75 to R$824.85. As for the per capita spending on primary health care, which represented 37.5% of the municipalities’ total expenditure, the lowest value was found in the city of São Paulo and the highest, in Araçatuba. Campinas had the highest per capita expenditure on medium and high complexity care, while Presidente Prudente had the lowest. The highest regional percentage of the current net revenue spent on health was verified in Registro, and the lowest, in the city of São Paulo. CONCLUSIONS The paradigm of the health sector’s financing in São Paulo revealed that the expenditure on primary health care, level elected by health policy as strategic because it depends on coordination and integral health care in the attention networks, was not considered a priority in relation to the expenditure with the medium and high complexity, exposing the iniquities in the state’s regions.

RESUMO OBJETIVO Analisar a alocação de recursos financeiros no Sistema Único de Saúde (SUS) no estado de São Paulo por nível de atenção, região de saúde, fonte de recursos e ente federado. MÉTODOS Trata-se de estudo exploratório circunscrito ao exercício de 2014. Os dados extraídos do Sistema de Informações sobre Orçamentos Públicos em Saúde estão apresentados em valores absolutos, relativos e per capita . RESULTADOS Em 2014 observou-se um gasto público com saúde de R$52,1 bi, sendo 58,0% relativos ao gasto dos municípios e 42,0% relativos ao gasto do governo do estado. O gasto regional per capita variou de R$561,75 a R$824,85. Já o gasto per capita com atenção primária à saúde, que representou 37,5% do gasto total dos municípios, foi menor na região da Grande São Paulo e maior em Araçatuba. A região de Campinas apresentou o maior gasto per capita com atenção de média e alta complexidade, enquanto Presidente Prudente teve o menor. O maior percentual regional da receita corrente líquida gasto com saúde foi verificado em Registro, e o menor na Grande São Paulo. CONCLUSÕES O paradigma de financiamento do setor da saúde em São Paulo revelou que o gasto com a atenção primária, nível eleito pela política de saúde como estratégico porque dele dependem a coordenação e o cuidado integral à saúde nas redes de atenção, não recebeu prioridade em relação ao gasto com a média e a alta complexidade, expondo as iniquidades nas regiões do estado.

ABSTRACT OBJECTIVE To analyze the allocation of financial resources in the Brazilian Unified Health System (SUS) in the state of São Paulo by level of care, health region, source of funds and level of government. METHODS This is an exploratory study based on 2014 data extracted from the Public Health Budget Database, presented in absolute terms, relative terms and per capita . RESULTS In 2014, R$52.1 bi were spent on public health, 58.0% having corresponded to the expenditures of the municipalities and 42.0% to those of the state government. Regional per capita spending varied from R$561.75 to R$824.85. As for the per capita spending on primary health care, which represented 37.5% of the municipalities’ total expenditure, the lowest value was found in the city of São Paulo and the highest, in Araçatuba. Campinas had the highest per capita expenditure on medium and high complexity care, while Presidente Prudente had the lowest. The highest regional percentage of the current net revenue spent on health was verified in Registro, and the lowest, in the city of São Paulo. CONCLUSIONS The paradigm of the health sector’s financing in São Paulo revealed that the expenditure on primary health care, level elected by health policy as strategic because it depends on coordination and integral health care in the attention networks, was not considered a priority in relation to the expenditure with the medium and high complexity, exposing the iniquities in the state’s regions.

ABSTRACT Background: The selection of compatible human leukocyte antigen platelets has been associated with improved platelet increments. Therefore, an effective strategy would be the selection of donors who are genetically compatible according to the human leukocyte antigen system. Nonetheless, this is costly as it concerns a highly polymorphic system, which requires a large bank of genotyped donors. Methods: This study evaluated the feasibility of virtual crossmatching using EpVix software, which simplifies the identification of compatible donors or donors with acceptable incompatibilities. Results: Forty-three oncohematological patients were evaluated, in 96 platelet transfusion episodes with 16.3% of the patients being found to be refractory to platelet transfusions. Eight alloimmunized, multitransfused patients were selected to evaluate human leukocyte antigen compatibility against a bank of 336 platelet donors. At least partially compatible donors were found for all patients. The number of compatible donors was found to be inversely proportional to the human leukocyte antigen-panel reactive antibody score of each patient. It was noted that five patients with scores of 15% or less had at least 190 compatible donors; four fully compatible donors were found for two other patients with scores greater than 80% and only one patient (score of 93%) did not have a fully compatible donor. However, for this last patient, 40 donors were partially compatible according to the software. Conclusion: The results showed the effectiveness of the use of the EpVix tool to identify potential platelet donors for multitransfused and/or alloimmunized patients, even with a small number of human leukocyte antigen genotyped donors available.