Resumo A bartonelose é uma zoonose transmitida por vetores, com distribuição mundial, que infecta várias espécies de mamíferos. Apesar dos estudos conduzidos no Brasil, informações sobre Bartonella em cães são escassas. Portanto, foi realizado um estudo retrospectivo para investigar a exposição a Bartonella sp. em cães cães, utilizando-se o ensaio de imunofluorescência indireta (IFA). Trezentas e trinta e cinco amostras de soro de cães, previamente testadas para patógenos transmitidos pelos vetores, Toxoplasma gondii e Neospora caninum foram avaliadas quanto à presença de anticorpos IgG contra Bartonella sp. Todos os cães eram oriundos da região metropolitana de Ribeirão Preto, Nordeste do Estado de São Paulo. Vinte e oito amostras (8,3%) foram positivas para Bartonella sp. no ponto de corte de 64. Entre as 28 amostras positivas, 16 (57,1%) também foram positivas para Ehrlichia canis, 12 (42,8%) para Babesia vogeli, cinco (17,8%) para T. gondii e três (10,7%) para L. infantum e N. caninum. Os resultados demonstraram que os cães amostrados foram expostos a Bartonella sp. Como os animais eram de proprietários particulares, nossos achados demonstram que as pessoas também podem ter sido expostas a Bartonella sp. São necessários estudos para avaliar se a infecção por B. canis ou E. canis constitui fator de risco para infecção por Bartonella em cães.

Abstract Bartonellosis is a vector-borne zoonotic disease with worldwide distribution that infect a broad spectrum of mammalian species. Despite the recent studies carried out in Brazil, information regarding Bartonella in dogs are scarce. Therefore, we performed a retrospective study to investigate the exposure to Bartonella sp. in dogs by indirect immunofluorescence assay (IFA). Three hundred and thirty-five archived serum samples from dogs previously tested for vector-borne pathogens, Toxoplasma gondii, and Neospora caninum were screened for the presence of IgG antibodies to Bartonella sp. All dogs originated from the Metropolitan region of Ribeirão Preto, northeast of the State of São Paulo. Twenty-eight samples (8.3%) were positive for Bartonella sp. at the cut-off of 64. Among the 28 seropositive samples for Bartonella sp., 16 (57.1%) were also seropositive for Ehrlichia canis, 12 (42.8%) for Babesia vogeli, five (17.8%) for T. gondii and three (10.7%) for L. infantum and N. caninum. Our results demonstrated that dogs sampled were exposed to Bartonella sp. Since all the animals sampled in the present study were from private owners, our findings demonstrate that these people may also be exposed to Bartonella sp. Further studies designed to assess whether the infection by other arthropod-borne pathogens such as B. vogeli and E. canis are risk factors for Bartonella infection are needed.

Abstract Purpose To evaluate different concentrations of ciprofloxacin to prevent infection after open fracture contaminated with S. aureus in rats using absorbable local delivery system. Methods Fifty-two Wistar rats were assigned to six groups. After 4 weeks, all animals underwent 99mTc-ceftizoxima scintigraphy evaluation, callus formation measurement and histological analysis. ANOVA, t-Student and Kruskal Wallis were used for quantitative variables statistical analysis, whereas qui square and exact Fisher were used for qualitative variables. Results Treatment using 25% and 50% of ciprofloxacin incorporated at the fracture fixation device were effective in preventing bone infection compared to control group (p<0.05). Chitosan were not effective in preventing bone infection when used alone compared to control group (p>0.05). Histological findings demonstrated bone-healing delay with 50% of ciprofloxacin. No difference in callus formation were observed (p>0.05). Conclusion Local delivery treatment for contaminated open fracture using chitosan with ciprofloxacin is effective above 25%.

Resumo Toxoplasma gondii e Neospora caninum são parasitas protozoários intracelulares do philo Aplicomplexa que afetam uma vasta gama de espécies animais, causando sérias doenças e levando a perdas econômicas, dependendo da espécie envolvida. O papel das aves na manutenção e transmissão destes coccídios tem sido estudado por anos, já que eles são potenciais fontes de infecção para outros animais e humanos. O objetivo deste estudo foi avaliar a exposição do Ganso-do-Orinoco (Neochen jubata) a T. gondii e N. caninum por meio de técnicas sorológicas. Entre os anos de 2010 e 2013, 41 Gansos-do-Orinoco de vida livre foram capturados no Vale do Rio Araguaia, Brasil. A presença e titulação de anticorpos IgY para ambos os coccídios foi obtida utilizando-se a Reação de Imunofluorescência Indireta (RIFI). Enquanto a presença de anticorpos IgY para N. caninum foi detectada em 5 aves, com titulação 20, anticorpos para T. gondii foram encontrados em 35 aves, com títulos variando de 20 a 640. Considerando que a carne do Ganso-do-Orinoco é uma fonte de alimento para a população da área estudada, a ave pode representar uma importante fonte de infecção de T. gondii para humanos. Devido ao seu comportamento migratório, esta espécie assume grande importância na dispersão de ambos os parasitas. Estudos moleculares são necessários a fim de caracterizar genotipicamente os isolados de T. gondii que ocorrem nesta espécie de ave.

Abstract Toxoplasma gondii and Neospora caninum are Apicomplexan intracellular protozoan parasites that affect numerous animal species, thus leading to severe diseases and economic losses, depending on the vertebrate species involved. The role of the avian species in maintaining and transmission of these coccidia has been studied for several years as they tend to serve as a potential source of infection for mammals and humans. The present study aimed to assess the serological exposure of Orinoco goose (Neochen jubata) to T. gondii and N. caninum. Between 2010 and 2013, 41 free-ranging Orinoco geese were captured in the Araguaia River, Brazil. The presence and titration of IgY antibodies to both coccidia were assayed via indirect immunofluorescent antibody test (IFAT). While IgY antibodies for N. caninum were present in 5 animals, with titers of 20, the antibodies for T. gondii were found in 35 animals, with titers ranging from 20 to 640. Considering that the Orinoco goose’s meat is consumed by the local population in the studied area, it may represent an important source of T. gondii infection for humans. Due to its migratory behavior, this goose may play a pivotal role in the natural dispersion of both parasites. Furthermore, molecular studies are required for genotyping the isolates of T. gondii that occurs in this avian species.

RESUMO: Este artigo pretende socializar algumas práticas educativas desenvolvidas na Escola Municipal de Educação Integral (EEI) Dr. João Alves dos Santos, localizada na região norte da cidade de Campinas, São Paulo. Pretende também apresentar considerações a respeito do conceito de Educação Integral na perspectiva da formação humana, buscando refletir sobre suas políticas de implementação. Interessa-nos olhar para as necessidades dos estudantes e dos educadores, provocando reflexões e narrativas que mobilizam o jeito de ver/fazer o trabalho educativo.

ABSTRACT: This article intends to socialize some educational practices developed in the Municipal School of Full-time Education (Escola Municipal de Educação Integral - EEI Dr. João Alves dos Santos), located in the northern region of the city of Campinas, São Paulo, Brazil. It also intends to raise discussions about the concept of full-time education in the perspective of human formation, seeking to reflect on its implementation. We are interested in looking at the needs of students and educators, provoking reflections and narratives that mobilize the way to see/do the educational work.

Resumo A toxoplasmose é uma importante zoonose para mulheres grávidas e pessoas imunossuprimidas. Os suínos também são infectados por este patógeno; e a carne crua ou malcozida é uma importante fonte de infecção para o ser humano. O objetivo do presente trabalho foi avaliar a taxa de exposição suína à T. gondii no município de Mossoró, Rio Grande do Norte e identificar associações com possíveis fatores de risco. Amostras de sangue foram coletadas em tubos sem anticoagulante e o soro foi separado de 412 porcos e analisadas pelo ensaio de imunofluorescência. Dentre as 412 amostras de soro, 40,7% foram positivas para T. gondii. Os títulos para o anticorpo IgG foram 64 (56 amostras); 128 (32); 256 (37); 512 (23); 1024 (14); 2048 (5) e 4046 (1). A soropotividade para T. gondii foi relacionada (p-valor < 0,05) aos seguintes fatores: gênero feminino, sistema de criação de semi-confinamento, uso de água de poço, animais vermifugados, presença de gatos, cabras, ovelhas, ratos e urubus na fazenda e carcaças deixadas à céu aberto. Em contrapartida, a soropositividade não foi relacionada (p-valor < 0,05) à idade dos suínos, tipo de instalações ou alimentação com restos de comida humana. As adoções de medidas preventivas são necessárias na propriedade estudada, objetivando diminuir a ingestão de oocistos esporulados pelos animais.

Abstract Toxoplasmosis is an important zoonosis for pregnant women and immunosuppressed people. The pig population also becomes infected by this pathogen, and undercooked or raw meat is an important source of infection for humans. The aims of the present study were to evaluate the rate of exposure of pigs to T. gondii in the municipality of Mossoró, Rio Grande do Norte and seek to identify associations with possible risk factors. Blood samples were collected from 412 pigs and were analyzed using the immunofluorescence assay. Among these 412 serum samples, 40.7% were seropositive for T. gondii. The IgG antibody titers were 64 (56 specimens), 128 (32), 256 (37), 512 (23), 1024 (14), 2048 (5) and 4046 (1). Seropositivity for T. gondii was found to be related (p-value < 0.05) to the following factors: female gender, semi-confined rearing system, use of well water, dewormed animals, presence of cats, goats, sheep, mice and vultures on the farm and carcasses left on the ground. In contrast, seropositivity was not related (p-value < 0.05) to the age of the pigs, type of facility or feeding with human food remains. Preventive measures need to be adopted on the farms studied here, with the aim of decreasing the animals’ intake of sporulated oocysts.

Resumo O gene msp4 de A. marginale é unicodon, estável e pouco heterogêneo, sendo considerado como um marcador útil para caracterização filogeográfica desta bactéria. Este trabalho teve como objetivo analisar a filogeografia de A. marginale com base no gene msp4 em bovinos de corte do Pantanal Brasileiro, comparativamente a outra regiões do mundo. Alíquotas de sangue foram colhidas de 400 bovinos (200 vacas e 200 bezerros) em cinco propriedades de cria e recria extensiva. Como resultado, 56,75% (227/400) mostraram-se positivas para A. marginale pela qPCR para o gene msp1β e destas, 8,37% (19/227) amostras foram positivas na PCR convencional para o gene msp4. Na análise de distância Network, 14 sequências do Pantanal brasileiro foram agrupadas em um único grupo com as da Thailândia, Índia, Espanha, Colômbia, Paraná (Brasil), México, Portugal, Argentina, China, Venezuela, Austrália, Italia e Minas Gerais (Brasil). Dentre 68 sequências do Brasil e do mundo, constatou-se a presença de 15 genótipos, sendo o genótipo número um (#1) o mais distribuído. As sequências msp4 de A. marginale detectadas em bovinos de corte no Pantanal brasileiro apresentaram baixo polimorfismo com formação de dois genogrupos filogeneticamente relacionados àqueles encontrados em ruminantes de países das América do Sul e Central, Europa e Ásia.

Abstract The msp4 gene of A. marginale is unicodon, stable and mostly homogeneous, being considered as a useful marker for phylogeographic characterization of this bacterium. The objective of this work was to analyze the phylogeography of A. marginale based on the msp4 gene in beef cattle from the Brazilian Pantanal, compared to those found in other regions worldwide. The blood samples investigated were collected from 400 animals (200 cows and 200 calves) reared in five extensive breeding farms in this region. The results indicated that of the evaluated samples, 56.75% (227/400) were positive for A. marginale based on the msp1β gene by quantitatitve PCR (qPCR), while 8.37% (19/227) were positive for the msp4 gene in the conventional PCR. In the Network distance analysis, 14 sequences from the Brazilian Pantanal were grouped into a single group with those from Thailand, India, Spain, Colombia, Parana (Brazil), Mexico, Portugal, Argentina, China, Venezuela, Australia, Italy and Minas Gerais (Brazil). Among 68 sequences from Brazil and the world, 15 genotypes were present while genotype number one (#1) was the most distributed worldwide. Both Splitstree and network analyses showed that the A. marginale msp4 sequences detected in beef cattle from the Brazilian Pantanal showed low polymorphism, with the formation of one genogroup phylogenetically related to those found in ruminants from South and Central America, Europe, and Asia.

Resumo Recentemente, a importância de roedores selvagens na manutenção de agentes Anaplasmataceae no ambiente tem sido investigada, haja visto o papel que tais mamíferos podem desempenhar como reservatórios para os patógenos e como hospedeiros para estágios imaturos dos carrapatos vetores. O presente estudo objetivou investigar a ocorrência de Ehrlichia sp. e Anaplasma sp. em 24 cotias (Dasyprocta azarae) capturadas na Reserva Ambiental de Itapiracó, em São Luís, Maranhão, nordeste do Brazil, utilizando métodos moleculares. Quatro animais (16,7%) mostraram-se positivos nos ensaios de nested PCR para Ehrlichia spp. baseados no gene 16S rRNA gene. Na análise filogenética baseda no gene 16S rRNA e utilizando o método de Máxima Verossimilhança e modelo evolutivo GTRGAMMA+I, os genótipos de Ehrlichia sp. detectados em cotias mostraram-se filogeneticamente relacionados às sequências de E. canis e outros genótipos relacionados a E. canis detectados previamente em animais selvagens no Brasil. O presente trabalho mostrou a primeira detecção molecular de Ehrlichia sp. em cotias no Brasil.

Abstract Recently, the importance of wild-living rodents for maintenance of pathogens of the family Anaplasmataceae in the environment was investigated. These mammals play a role as reservoirs for these pathogens and act as hosts for the immature stages of tick vectors. The aim of the present study was to investigate the prevalence of Ehrlichia sp. and Anaplasma sp. in 24 specimens of Azara’s agouti (Dasyprocta azarae) that had been trapped in the Itapiracó Environmental Reserve, in São Luís, Maranhão, northeastern Brazil, using molecular methods. Four animals (16.7%) were positive for Ehrlichia spp. in nested PCR assays based on the 16S rRNA gene. In a phylogenetic analysis based on the 16S rRNA gene, using the maximum likelihood method and the GTRGAMMA+I evolutionary model, Ehrlichia sp. genotypes detected in Azara’s agoutis were found to be closely related to E. canis and to genotypes relating to E. canis that had previously been detected in free-living animals in Brazil. The present work showed the first molecular detection of Ehrlichia sp. in Azara’s agoutis in Brazil.

RESUMO: O suprimento sanguíneo da glândula mamária é extremamente importante, uma vez que é um fator crucial para o desenvolvimento do tecido mamário. Assim, a necessidade de registro dos parâmetros de fluxo sanguíneo arterial é evidente. O objetivo do estudo foi descrever e avaliar as principais características hemodinâmicas da artéria mamária de cordeiras submetidas a diferentes taxas de crescimento, usando o ultrassom Doppler. Dois grupos experimentais, A e B, (n=10) de cordeiras da raça Bergamácia brasileira foram mantidas sob as mesmas condições de manejo e instalações. O estudo foi dividido em diferentes fases, sendo: Fase 1, de 90 dias de idade até o início da puberdade; Fase 2, desde a puberdade até 1 ano de idade. Durante a fase 1, dietas específicas foram formuladas para cada grupo experimental, a fim de obter duas médias diferentes de ganho de peso diário: 150g, para o tratamento A, e 250g, para o tratamento B. Durante a Fase 2, não houve diferença na dieta oferecida para os dois grupos. A cada 14 dias, todos os animais foram pesados e determinado o escore de condição corporal. A cada 60 dias, exames de ultrassom (Doppler) da artéria mamária foram realizados a fim de calcular os índices de resistência e pulsatilidade. As cordeiras do tratamento B registrou maior ganho de peso e escore de condição corporal (P<0,05). No entanto, não houve diferença para os índices de resistência e pulsatilidade entre os tratamentos (P>0,05). Os valores hemodinâmicos permaneceram constantes, independente da dieta ou o desenvolvimento do corpo apresentada pelos animais. Assim, os dados obtidos são informações valiosas sobre o desenvolvimento da raça a que se refere.

ABSTRACT: Blood supply of mammary gland is extremely important, since it is a crucial factor in the mammary tissue development. The objective of this study was to describe and assess main mammary artery hemodynamic characteristics of lambs with two growth rates, using Doppler ultrasound. Two experimental groups, A and B, (n=10) of female Brazilian Bergamasca lambs were kept under the same management conditions and facilities. There were two phases: Phase 1, from 90 days of age until onset of puberty; Phase 2, from puberty until 1 year of age. During phase 1, a specific diet was formulated to each experimental group to obtain two different average daily gains: 150g, for treatment A, and 250g, for treatment B. During phase 2, there was no difference on the diet offered to both groups. Every 14 days, all animals were weighed and their body condition score was evaluated. Every 60 days, ultrasound exams (Doppler) of mammary artery were performed to obtain resistance and pulsatility indexes. Treatment B lambs showed higher weight gain and higher body condition score (P<0.05). However, for resistance and pulsatility indexes, there was no difference between treatments (P>0.05). Hemodynamic values remained constant, independent of diet or body development presented by the animals. Obtained data is valuable information on Bergamasca ewe lambs development.

Abstract Background Current diagnostic methods and imaging techniques are not able to differentiate septic and aseptic inflammation. Thus, reliable methods are sought to provide this distinction and scintigraphic imaging is an interesting option, since it is based on physiological changes. In this context, radiolabeled antimicrobial peptides have been investigated as they accumulate in infectious sites instead of aseptic inflammation. The peptide LyeTx I, from the venom of Lycosa erythrognatha, has potent antimicrobial activity. Therefore, this study aimed to synthesize LyeTx I derivatives with the chelating compound HYNIC, to evaluate their antimicrobial activity and to radiolabel them with 99mTc. Methods Two LyeTx I derivatives, HYNIC-LyeTx I (N-terminal modification) and LyeTx I-K-HYNIC (C-terminal modification), were synthesized by Fmoc strategy and purified by RP-HPLC. The purified products were assessed by RP-HPLC and MALDI-ToF-MS analysis. Microbiological assays were performed against S. aureus (ATCC® 6538) and E. coli (ATCC® 10536) in liquid medium to calculate the MIC. The radiolabeling procedure of LyeTx I-K-HYNIC with 99mTc was performed in the presence of co-ligands (tricine and EDDA) and reducing agent (SnCl2. 2H2O), and standardized taking into account the amount of peptide, reducing agent, pH and heating. Radiochemical purity analysis was performed by thin-layer chromatography on silica gel strips and the radiolabeled compound was assessed by RP-HPLC and radioactivity measurement of the collected fractions. Data were analyzed by ANOVA, followed by Tukey test (p-values < 0.05). Results Both LyeTx I derivatives were suitably synthesized and purified, as shown by RP-HPLC and MALDI-ToF-MS analysis. The microbiological test showed that HYNIC-LyeTx I (N-terminal modification) did not inhibit bacterial growth, whereas LyeTx I-K-HYNIC (C-terminal modification) showed a MIC of 5.05 μmol.L−1 (S. aureus) and 10.10 μmol.L−1 (E. coli). Thus, only the latter was radiolabeled with 99mTc. The radiochemical purity analysis of LyeTx I-K-HYNIC-99mTc showed that the optimal radiolabeling conditions (10 μg of LyeTx I-K-HYNIC; 250 μg of SnCl2. 2H2O; pH = 7; heating for 15 min) yielded a radiochemical purity of 87 ± 1 % (n= 3). However, RP-HPLC data suggested 99mTc transchelation from LyeTx I-K-HYNIC to the co-ligands (tricine and EDDA). Conclusions The binding of HYNIC to the N-terminal portion of LyeTx I seems to affect its activity against bacteria. Nevertheless, the radiolabeling of the C-terminal derivative, LyeTx I-K-HYNIC, must be better investigated to optimize the radiolabeled compound, in order to use it as a specific imaging agent to distinguish septic and aseptic inflammation.

Leishmaniasis is one of the six major tropical diseases targeted by the World Health Organization. It is a life-threatening disease of medical, social and economic importance in endemic areas. No vaccine is yet available for human use, and chemotherapy presents several problems. Pentavalent antimonials have been the drugs of choice to treat the disease for more than six decades; however, they exhibit high toxicity and are not indicated for children, for pregnant or breastfeeding women or for chronically ill patients. Amphotericin B (AmpB) is a second-line drug, and although it has been increasingly used to treat visceral leishmaniasis (VL), its clinical use has been hampered due to its high toxicity. This review focuses on the development and in vivo usage of new delivery systems for AmpB that aim to decrease its toxicity without altering its therapeutic efficacy. These new formulations, when adjusted with regard to their production costs, may be considered new drug delivery systems that promise to improve the treatment of leishmaniasis, by reducing the side effects and the number of doses while permitting a satisfactory cost-benefit ratio.

The objective of this study was to characterize the clonal profile, virulence factors and antimicrobial resistance, particularly oxacillin resistance, of Staphylococcus aureus isolated from sheep milk. Milk samples were collected from all teats for the California Mastitis Test (CMT), somatic cell count, identification of S. aureus, investigation in these strains of genes encoding toxins (sea, seb, sec, sed, tst), biofilm (icaA, icaC, icaD, bap), leukocidin (luk-PV) oxacillin resistance by mecA gene detection and susceptibility testing (12 antibiotics). Messenger RNA expression was evaluated by RT-PCR in isolates carrying toxin and biofilm genes. Biofilm formation was also evaluated phenotypically by adherence to polystyrene plates. The clonal profile of S. aureus was investigated by pulsed-field gel electrophoresis. A total of 473 milk samples were collected from 242 animals on three farms and 20 S. aureus strains were isolated and none carried the mecA gene. The two sec gene-positive isolates and the isolates carrying the tst and luk-PV genes were positive by RT-PCR. Staphylococcus aureus isolated from the three flocks studied showed high susceptibility to the drugs tested and none was biofilm producer, indicating that biofilm formation was not a virulence factor causing infection by these strains. The typing of 17 S. aureus isolates revealed the presence of a common clone on the three farms studied, and the presence and expression of the sec and tst genes in one strain of this clone suggest the possible acquisition of virulence genes by this clone, a fact that is important for animal health and food hygiene.

OBJETIVO Estimar taxas de não adesão em intervenções com estratégias de telemedicina para tratamento de dependência química. MÉTODOS Foi realizada revisão sistemática de ensaios clínicos randomizados com diferentes métodos terapêuticos de dependência química que incluíam telemedicina. Foram consultadas as bases de dados PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase e Clinical Trials e a plataforma Google Scholar no período de 18/4/2012 a 21/6/2012. Para avaliar a qualidade dos estudos, utilizou-se a escala Grading of Recommendations Assessment, Development and Evaluation . Os critérios avaliados foram: adequada sequência da geração de dados, ocultação da alocação, cegamento, descrição das perdas e exclusões e análises por intenção de tratar. Foram selecionados 274 estudos, dos quais 20 foram analisados. RESULTADOS As taxas de não adesão variaram entre 15,0% e 70,0%. As intervenções avaliadas possuíam no mínimo três meses de intervenção e, embora todos utilizassem a telemedicina como apoio, os métodos de tratamentos foram diferentes. Em relação à qualidade dos estudos, os valores também variaram entre muito baixa qualidade e alta qualidade. Os estudos com qualidade alta demonstraram maiores taxas de adesão, bem como aqueles que utilizaram mais de uma técnica de intervenção e tempo limitado de tratamento. Estudos com monousuários apontaram maiores taxas de adesão que estudos com poliusuários. CONCLUSÕES As taxas de não adesão a tratamentos para usuários de substâncias psicoativas por meio de telemedicina apresentaram consideráveis diferenças, dependendo do país, método da intervenção, tempo de seguimento e substâncias utilizadas. O uso de mais de uma técnica de intervenção, tempo curto de tratamento e o tipo de substância utilizada pelos pacientes parecem facilitar a adesão.

OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.

OBJETIVO Estimar taxas de não adesão em intervenções com estratégias de telemedicina para tratamento de dependência química. MÉTODOS Foi realizada revisão sistemática de ensaios clínicos randomizados com diferentes métodos terapêuticos de dependência química que incluíam telemedicina. Foram consultadas as bases de dados PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase e Clinical Trials e a plataforma Google Scholar no período de 18/4/2012 a 21/6/2012. Para avaliar a qualidade dos estudos, utilizou-se a escala Grading of Recommendations Assessment, Development and Evaluation . Os critérios avaliados foram: adequada sequência da geração de dados, ocultação da alocação, cegamento, descrição das perdas e exclusões e análises por intenção de tratar. Foram selecionados 274 estudos, dos quais 20 foram analisados. RESULTADOS As taxas de não adesão variaram entre 15,0% e 70,0%. As intervenções avaliadas possuíam no mínimo três meses de intervenção e, embora todos utilizassem a telemedicina como apoio, os métodos de tratamentos foram diferentes. Em relação à qualidade dos estudos, os valores também variaram entre muito baixa qualidade e alta qualidade. Os estudos com qualidade alta demonstraram maiores taxas de adesão, bem como aqueles que utilizaram mais de uma técnica de intervenção e tempo limitado de tratamento. Estudos com monousuários apontaram maiores taxas de adesão que estudos com poliusuários. CONCLUSÕES As taxas de não adesão a tratamentos para usuários de substâncias psicoativas por meio de telemedicina apresentaram consideráveis diferenças, dependendo do país, método da intervenção, tempo de seguimento e substâncias utilizadas. O uso de mais de uma técnica de intervenção, tempo curto de tratamento e o tipo de substância utilizada pelos pacientes parecem facilitar a adesão.

OBJECTIVE To estimate rates of non-adherence to telemedicine strategies aimed at treating drug addiction. METHODS A systematic review was conducted of randomized controlled trials investigating different telemedicine treatment methods for drug addiction. The following databases were consulted between May 18, 2012 and June 21, 2012: PubMed, PsycINFO, SciELO, Wiley (The Cochrane Library), Embase, Clinical trials and Google Scholar. The Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the quality of the studies. The criteria evaluated were: appropriate sequence of data generation, allocation concealment, blinding, description of losses and exclusions and analysis by intention to treat. There were 274 studies selected, of which 20 were analyzed. RESULTS Non-adherence rates varied between 15.0% and 70.0%. The interventions evaluated were of at least three months duration and, although they all used telemedicine as support, treatment methods differed. Regarding the quality of the studies, the values also varied from very poor to high quality. High quality studies showed better adherence rates, as did those using more than one technique of intervention and a limited treatment time. Mono-user studies showed better adherence rates than poly-user studies. CONCLUSIONS Rates of non-adherence to treatment involving telemedicine on the part of users of psycho-active substances differed considerably, depending on the country, the intervention method, follow-up time and substances used. Using more than one technique of intervention, short duration of treatment and the type of substance used by patients appear to facilitate adherence.

Background: The Brief Motivational Intervention (BMI) is an effective treatment for alcohol misuse but has not been adequately tested for use in helplines for alcoholics. The main objective of this study was to evaluate the efficacy of a telephone-based BMI for Brazilians seeking help with alcohol use cessation. Methods: A randomized, controlled trial was performed with Brazilian subjects. Participants were randomly assigned to either the minimal intervention group (i.e., given reference materials) or the BMI group. Alcohol abstinence was evaluated in a 6-month follow-up telephone counseling session. The analysis was based on the intention to treat (ITT). Results: Of the 5,896 drug users who called the helpline, 700 (12%) used alcohol, 637 of whom enrolled in this study. At 6-month follow-up, 70% of the BMI group had stopped consuming alcohol compared to 41% in the control group (odds ratio = 1.5; 95% confidence interval = 1.2-1.9; p = 0.001). Conclusions: A helpline-based BMI helps alcohol users achieve abstinence.

Qualidade de vida está relacionada a um dos desejos humanos básicos, que é viver bem e se sentir bem. O objetivo deste estudo foi avaliar a qualidade de vida dos usuários de substâncias psicoativas e familiares, em comparação aos não-usuários, analisados por estratos socioeconômicos. Foi realizado um estudo transversal com usuários de substâncias psicoativas, parentes e outras pessoas que chamaram o Serviço de Informação e Orientação sobre o abuso de drogas (VIVAVOZ). A coleta de dados ocorreu entre novembro de 2009 e dezembro de 2010. Foram coletados dados de usuários, parentes e não-usuários, incluindo as características socioeconômicas e dados sobre consumo de substâncias, quando apropriado, além disso, foi administrado o questionário WHOQOL-BREF. Responderam ao WHOQOL-Bref 347 pessoas, 138 (70%) usuários de álcool , 76 (39%) maconha, 111 (57%) tabaco, 78 (40%) de cocaína e 70 (36%) crack. Os controles tiveram escores maiores de qualidade de vida, que os familiares de usuários e usuários em todas as áreas do questionário (p < 0,05). Usuários de substâncias psicoativas tiveram escores mais baixos em quase todos os domínios e escore geral do WHOQOL-Bref em comparação com a amostra de não usuários de drogas. Estes resultados refletem baixa qualidade de vida dos pacientes e seus familiares.

Quality of life is related to one of the basic human desires, which is to live well and feel good. The scope of this study was to evaluate the quality of life of psychoactive substance users and relatives, compared to non-users, analyzed by socioeconomic strata. A cross-sectional study with users of psychoactive substances, relatives, and other individuals who called the Information and Orientation Service regarding drug abuse. Data collection took place between November 2009 and December 2010. Data was collected from users, relatives, and non-users, including socioeconomic characteristics and data regarding substance consumption when appropriate. In addition to this the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was given to 347 individuals. Among the 138 users (70%) used alcohol, 76 (39%), marijuana, 111 (57%) tobacco, 78 (40%) cocaine and 70 (36%) crack. Control subjects had higher, scores than the relatives of users and users in all areas of the questionnaire (p < 0.05). Psychoactive substance users scored lower in almost all domains and overall score in the WHOQOL-BREF questionnaire in comparison with the sample of non-drug users. These findings reflect poor quality of life of patients and their relatives.