Resumo A 16ª Conferência Nacional de Saúde demonstrou o interesse do controle social em intervir sobre as políticas públicas a fim de garantir o direito às tecnologias de saúde. O projeto Integra - Integração das Políticas de Vigilância em Saúde, Assistência Farmacêutica, Ciência, Tecnologia e Inovação em Saúde -, nasce da parceria entre o Conselho Nacional de Saúde, a Escola Nacional dos Farmacêuticos e a Fundação Oswaldo Cruz (Fiocruz), com apoio da Organização Pan-Americana de Saúde (OPAS) com objetivo de fortalecimento da participação e engajamento social na temática e a integração das políticas e práticas de saúde em diferentes setores da sociedade (movimentos sociais, controle social e profissionais de saúde), tendo as diversas etapas relacionadas ao acesso aos medicamentos (pesquisa, incorporação, produção nacional e serviços) como mote principal, no cenário da pandemia de COVID-19. Oferta-se, neste projeto, capacitação para grupos de lideranças nas regiões de saúde e atividades de grande abrangência nacional e política. Espera-se alcançar o estabelecimento de uma rede intersetorial, integrada de lideranças capazes de atuar colaborativamente para a defesa do desenvolvimento da ciência, das políticas públicas, da soberania nacional e do controle social da saúde.

Abstract The 16th National Health Conference illustrated the interest of health councils to intervene in public policies in order to guarantee the right to health technologies. The INTEGRA project (Integration of policies for Health Surveillance, Pharmaceutical Care, Science, Technology, and Innovation in Health) is a partnership among the National Health Council, the National School of Pharmacists, and the Oswaldo Cruz Foundation (Fiocruz), with support from the Pan American Health Organization (PAHO), with the goal of strengthening participation and social engagement in the theme, as well as the integration of health policies and practices within different sectors of society (social movements, health councils, and health professionals), with the various stages related to the access to medicines (research, incorporation, national production, and services) being the main theme in the context of the COVID-19 pandemic. It seeks to offer training for leadership groups in the health regions and activities with a broad national and political scope, and it hopes to establish an intersectorial and integrated network of leaders capable of acting collaboratively to defend the development of science, public policies, national sovereignty, and social control of health.

Resumo A 16ª Conferência Nacional de Saúde demonstrou o interesse do controle social em intervir sobre as políticas públicas a fim de garantir o direito às tecnologias de saúde. O projeto Integra - Integração das Políticas de Vigilância em Saúde, Assistência Farmacêutica, Ciência, Tecnologia e Inovação em Saúde -, nasce da parceria entre o Conselho Nacional de Saúde, a Escola Nacional dos Farmacêuticos e a Fundação Oswaldo Cruz (Fiocruz), com apoio da Organização Pan-Americana de Saúde (OPAS) com objetivo de fortalecimento da participação e engajamento social na temática e a integração das políticas e práticas de saúde em diferentes setores da sociedade (movimentos sociais, controle social e profissionais de saúde), tendo as diversas etapas relacionadas ao acesso aos medicamentos (pesquisa, incorporação, produção nacional e serviços) como mote principal, no cenário da pandemia de COVID-19. Oferta-se, neste projeto, capacitação para grupos de lideranças nas regiões de saúde e atividades de grande abrangência nacional e política. Espera-se alcançar o estabelecimento de uma rede intersetorial, integrada de lideranças capazes de atuar colaborativamente para a defesa do desenvolvimento da ciência, das políticas públicas, da soberania nacional e do controle social da saúde.

Abstract The 16th National Health Conference illustrated the interest of health councils to intervene in public policies in order to guarantee the right to health technologies. The INTEGRA project (Integration of policies for Health Surveillance, Pharmaceutical Care, Science, Technology, and Innovation in Health) is a partnership among the National Health Council, the National School of Pharmacists, and the Oswaldo Cruz Foundation (Fiocruz), with support from the Pan American Health Organization (PAHO), with the goal of strengthening participation and social engagement in the theme, as well as the integration of health policies and practices within different sectors of society (social movements, health councils, and health professionals), with the various stages related to the access to medicines (research, incorporation, national production, and services) being the main theme in the context of the COVID-19 pandemic. It seeks to offer training for leadership groups in the health regions and activities with a broad national and political scope, and it hopes to establish an intersectorial and integrated network of leaders capable of acting collaboratively to defend the development of science, public policies, national sovereignty, and social control of health.

ABSTRACT BACKGROUND: COVID-19 infection has high transmissibility and several measures have been adopted for controlling its dissemination. OBJECTIVE: To identify and summarize the evidence from Cochrane systematic reviews (SRs) regarding measures for controlling the dissemination of COVID-19 infection. DESIGN AND SETTING: This review of Cochrane SRs was carried out in the Division of Vascular and Endovascular Surgery and in the Division of Emergency Medicine and Evidence-Based Medicine of Universidade Federal de São Paulo, Brazil. METHODS: A comprehensive search in the Cochrane Database of Systematic Reviews retrieved all Cochrane SRs directly related to measures for controlling COVID-19 dissemination. The main characteristics and results of all the SRs included were summarized and discussed. RESULTS: Three Cochrane SRs were included in the qualitative synthesis. These evaluated population-based and individual measures for controlling the dissemination of COVID-19. CONCLUSION: Low-certainty evidence shows that quarantine for people exposed to confirmed or suspected COVID-19 cases prevented 44% to 81% of incident cases and 31% to 63% of deaths, compared with situations of no measures. Moreover, the sooner the quarantine measures were implemented, the greater the cost savings were. High-confidence evidence showed that clear communication about infection control and prevention guidelines was vital for successful implementation. Low-certainty evidence showed that healthcare professionals with long gowns were less exposed to contamination than were those using coveralls. In addition, coveralls were more difficult to doff. Further SRs on controlling the dissemination of COVID-19 infection are desirable.

ABSTRACT Leaf-cutting ants are the main pests in forest plantations. The most commonly used chemical control for the ants is toxic bait. However, the active ingredients in these baits have been restricted by forest certification organizations, justifying the search for new active compounds to control these insects. Thus, this work aimed to evaluate the formicidal activity of alkaloid fractions from the roots, stems, branches and leaves of Psychotria hastisepala and Psychotria leiocarpa (Rubiaceae) against Atta sexdens Forel, 1908 (Hymenoptera: Formicidae). The alkaloid fractions were obtained from the crude methanolic extracts of P. hastisepala and P. leiocarpa by the acid-base extraction method employing liquid-liquid partitions. The fractions, previously solubilized in propanone, were applied topically to the pronotum of worker ants. Bioassays were conducted in a completely randomized design, with six replicates of each treatment and 10 ants per replicate. Insect survival was assessed daily for 21 days. The median lethal time was estimated by Weibull models. The root fractions from P. hastisepala presented the highest toxicity, followed by those from the branches, stems and leaves. Among fractions from P. hastisepala roots, the most toxic were a fraction that apparently is rich in lipophilic compounds and nonbasic alkaloids and a fraction that is likely rich in quaternary benzophenanthridine alkaloids, protopine alkaloids and tertiary bases. Psychotria leiocarpa fractions were not toxic to this insect. Psychotria hastisepala is potentially useful for the development of new products for A. sexdens control.

Resumo O Pleno do Conselho Nacional de Saúde (CNS) aprovou a Resolução nº 568/2017 que convoca a 16ª Conferência Nacional de Saúde, a ser realizada no ano de 2019 e deliberou pela realização de atividades temáticas, em oito áreas, incluindo Assistência Farmacêutica e Ciência e Tecnologia. Uma parceria do CNS com a Fiocruz e a Escola Nacional dos Farmacêuticos propôs a realização do 8º Simpósio Nacional de Ciência e Tecnologia e Assistência Farmacêutica, antecedido por dez encontros regionais preparatórios para o simpósio em todo o país. O objetivo deste artigo é apresentar e analisar os resultados dessa primeira etapa de encontros. Foi desenvolvida uma metodologia participativa para os encontros que inclui a apresentação de situações-problema em forma de “casos” com narrativas reais, fictícias ou adaptadas da realidade. Debates em grupos e construção de propostas, compilação e ponderação, com discussão geral completaram os encontros. As 150 propostas oriundas de cinco encontros foram lidas por cada membro da equipe de análise e pré-categorizado. Esses encontros reuniram 238 participantes. Quatro categorias foram definidas: Saúde como direito; Consolidação dos princípios do SUS; Financiamento adequado e suficiente para o SUS; Democracia participativa.

Abstract The Plenary of the National Health Council (CNS) approved the Resolution 568/2017, convening the 16th National Health Conference to be held in 2019 and decided to promote thematic activities in eight areas, including Pharmaceutical Policy and Science and Technology. CNS partnership with FIOCRUZ and the National School of Pharmacists proposed the 8th National Symposium on Science and Technology and Pharmaceutical Policy, preceded by ten regional preparatory meetings for the symposium throughout the country. The purpose of this article is to present and analyze the results of the first stage of meetings. A participatory methodology was developed for the meetings that included the presentation of problem situations reported in the form of “cases” built by real narratives, fictitious or adapted from reality. Debates in groups and proposals construction, compilation and weighting, with general discussion completed the meetings. The set of 150 proposals from the 5 meetings was read individually by each of the members of the analysis team and pre-categorized. The 5 meetings had a total of 238 participants. Four categories were defined: Health as a right; Consolidation of SUS principles; Adequate and sufficient financing for SUS; Participatory democracy.

Resumo O Pleno do Conselho Nacional de Saúde (CNS) aprovou a Resolução nº 568/2017 que convoca a 16ª Conferência Nacional de Saúde, a ser realizada no ano de 2019 e deliberou pela realização de atividades temáticas, em oito áreas, incluindo Assistência Farmacêutica e Ciência e Tecnologia. Uma parceria do CNS com a Fiocruz e a Escola Nacional dos Farmacêuticos propôs a realização do 8º Simpósio Nacional de Ciência e Tecnologia e Assistência Farmacêutica, antecedido por dez encontros regionais preparatórios para o simpósio em todo o país. O objetivo deste artigo é apresentar e analisar os resultados dessa primeira etapa de encontros. Foi desenvolvida uma metodologia participativa para os encontros que inclui a apresentação de situações-problema em forma de “casos” com narrativas reais, fictícias ou adaptadas da realidade. Debates em grupos e construção de propostas, compilação e ponderação, com discussão geral completaram os encontros. As 150 propostas oriundas de cinco encontros foram lidas por cada membro da equipe de análise e pré-categorizado. Esses encontros reuniram 238 participantes. Quatro categorias foram definidas: Saúde como direito; Consolidação dos princípios do SUS; Financiamento adequado e suficiente para o SUS; Democracia participativa.

Abstract The Plenary of the National Health Council (CNS) approved the Resolution 568/2017, convening the 16th National Health Conference to be held in 2019 and decided to promote thematic activities in eight areas, including Pharmaceutical Policy and Science and Technology. CNS partnership with FIOCRUZ and the National School of Pharmacists proposed the 8th National Symposium on Science and Technology and Pharmaceutical Policy, preceded by ten regional preparatory meetings for the symposium throughout the country. The purpose of this article is to present and analyze the results of the first stage of meetings. A participatory methodology was developed for the meetings that included the presentation of problem situations reported in the form of “cases” built by real narratives, fictitious or adapted from reality. Debates in groups and proposals construction, compilation and weighting, with general discussion completed the meetings. The set of 150 proposals from the 5 meetings was read individually by each of the members of the analysis team and pre-categorized. The 5 meetings had a total of 238 participants. Four categories were defined: Health as a right; Consolidation of SUS principles; Adequate and sufficient financing for SUS; Participatory democracy.

Human papillomavirus (HPV) infections are strongly associated with the development of cervical intraepithelial neoplasias and invasive cervical cancer. Polymorphisms in cytokine-encoding genes and behavioural cofactors could play an important role in protecting an individual against viral infections and cancer. Here, we investigated whether IL-6 -174 G>C, IL-8 +396 G>T, and TGF-β1 +869 G>C and +915 G>C polymorphisms were associated with susceptibility to HPV infection in women from north-east (Pernambuco) Brazil. We analysed 108 healthy uninfected women (HC) and 108 HPV-positive women with cervical lesions. Genetic polymorphisms were assessed using Sanger sequencing and polymerase chain reaction-restriction fragment length polymorphism. Comparison of the distribution of the genotypic and allelic frequencies of the IL-18 +396 T>G polymorphism between HPV infected woman an uninfected controls showed that the GG genotype and G allele were both more frequent in the HC group, and were associated with protection from HPV infection (p = 0.0015; OR = 0.29 CI95% = 0.13-0.61; p = 0.0005; OR = 0.45 CI95% 0.29-0.7, respectively). Individuals from the control group could have previously had HPV infection that was spontaneously eliminated; however, it was undetectable at the time of sample collection. Based on our findings, we hypothesize that the IL-8 +396 G>T polymorphism could interfere with susceptibility to HPV infection, by modulating the ability of immune system to fight the virus.

ABSTRACT Introduction: Minimal residual disease is an important independent prognostic factor that can identify poor responders among patients with acute lymphoblastic leukemia. Objective: The aim of this study was to analyze minimal residual disease using immunoglobulin (Ig) and T-cell receptor (TCR) gene rearrangements by conventional polymerase chain reaction followed by homo-heteroduplex analysis and to compare this with real-time polymerase chain reaction at the end of the induction period in children with acute lymphoblastic leukemia. Methods: Seventy-four patients diagnosed with acute lymphoblastic leukemia were enrolled. Minimal residual disease was evaluated by qualitative polymerase chain reaction in 57 and by both tests in 44. The Kaplan-Meier and multivariate Cox methods and the log-rank test were used for statistical analysis. Results: Nine patients (15.8%) were positive for minimal residual disease by qualitative polymerase chain reaction and 11 (25%) by real-time polymerase chain reaction considering a cut-off point of 1 × 10−3 for precursor B-cell acute lymphoblastic leukemia and 1 × 10−2 for T-cell acute lymphoblastic leukemia. Using the qualitative method, the 3.5-year leukemia- free survival was significantly higher in children negative for minimal residual disease compared to those with positive results (84.1% ± 5.6% versus 41.7% ± 17.3%, respectively; p-value = 0.004). There was no significant association between leukemia-free survival and minimal residual disease by real-time polymerase chain reaction. Minimal residual disease by qualitative polymerase chain reaction was the only variable significantly correlated to leukemia-free survival. Conclusion: Given the difficulties in the implementation of minimal residual disease monitoring by real-time polymerase chain reaction in most treatment centers in Brazil, the qualitative polymerase chain reaction strategy may be a cost-effective alternative.

Este artigo apresenta a distribuição do apoio matricial (AM) no Brasil, identificando relações entre as atividades de AM e a certificação do PMAQ-AB. Utilizaram-se dois modelos de regressão logística múltipla. As atividades de AM na Atenção Básica são significativas mas desiguais, com altos graus de AM em lugares desenvolvidos. Existe associação positiva entre o grau de apoio e o resultado obtido na certificação. Elevados graus de AM correspondem a 89%, 80%, 89% e 63% de chances de as equipes obterem uma melhor certificação na atenção à mulher, criança, hipertensão e diabetes e saúde mental, respectivamente. O AM tem ajudado a melhorar a qualidade da Atenção Básica no Brasil.

This article aims to present the distribution of matrix support (MS) in Brazil and identify relations between MS activities and PMAQ-AB certification results. Two multiple logistic regression models were run. MS activities in primary care are significant, although uneven. There is a positive association between the level of support and result obtained in certification. High degrees of MS correspond to the probabilities of 89%, 80%, 89% and 63% that teams obtain better certification on attention to woman, child, hypertension and diabetes, and to mental health, respectively. MS has progressively helped to improve primary care in Brazil.

Este artigo apresenta a distribuição do apoio matricial (AM) no Brasil, identificando relações entre as atividades de AM e a certificação do PMAQ-AB. Utilizaram-se dois modelos de regressão logística múltipla. As atividades de AM na Atenção Básica são significativas mas desiguais, com altos graus de AM em lugares desenvolvidos. Existe associação positiva entre o grau de apoio e o resultado obtido na certificação. Elevados graus de AM correspondem a 89%, 80%, 89% e 63% de chances de as equipes obterem uma melhor certificação na atenção à mulher, criança, hipertensão e diabetes e saúde mental, respectivamente. O AM tem ajudado a melhorar a qualidade da Atenção Básica no Brasil.

This article aims to present the distribution of matrix support (MS) in Brazil and identify relations between MS activities and PMAQ-AB certification results. Two multiple logistic regression models were run. MS activities in primary care are significant, although uneven. There is a positive association between the level of support and result obtained in certification. High degrees of MS correspond to the probabilities of 89%, 80%, 89% and 63% that teams obtain better certification on attention to woman, child, hypertension and diabetes, and to mental health, respectively. MS has progressively helped to improve primary care in Brazil.

OBJETIVOS: Avaliar o efeito da semente de linhaça no crematócrito do leite de ratas e crescimento corporal dos filhotes durante a lactação. MÉTODOS: Utilizou-se 22 ratas Lister Hooded divididas em dois grupos: controle (GC, n = 11), que recebeu ração caseína com 17% de proteína; e linhaça (GL, n = 11), que recebeu ração com 25% de linhaça acrescida de 14% de caseína, totalizando 17% de proteína. Controlou-se o consumo de ração das ratas por gaiola individual, número de crias, e avaliou-se o crematócrito do leite materno e variação ponderal dos filhotes até idade de desmame. RESULTADOS: O GL foi semelhante ao GC no consumo de ração das ratas (GL = 76,46±31,87 g; GC = 76,7±33,36 g; p = 0,9613) e equivalente ao GC no número de crias (GL = 4,94±2,34; GC = 5,5±3,19; p = 0,435). O mesmo foi verificado no teor de gordura do leite materno (GL = 18,4±4,76; GC = 15,3±6,03; p = 0,204) e valor energético total (GL = 212,92±46,4; GC = 181,1±60; p = 0,1964). O GL assemelhou-se ao GC tanto no peso corporal dos filhotes ao desmame (GL = 37±6,96 g; GC = 32,6±7,5 g; p = 0,1817) quanto na evolução ponderal (GL = 31,8±7,0 g; GC = 27,7±7,5 g; p = 0,2104). CONCLUSÃO: Um total de 25% de linhaça promoveu um crescimento adequado aos filhotes.

OBJECTIVES: To assess the effect of flaxseed on rat milk creamatocrit and its contribution to offspring weight gain during lactation. METHODS: The study was conducted with 22 Lister Hooded rats divided into two groups: Control Group (CG, n = 11), which received a casein-based diet with 17% protein, and Flaxseed Group (FG, n = 11), which received a 25% flaxseed diet supplemented with 14% casein, totaling 17% protein. Food consumption was controlled per individual cage and litter size. Maternal milk creamatocrit and offspring weight variation until weaning age were also evaluated. RESULTS: FG was similar to CG concerning food intake (FG = 76.46±31.87 g; CG = 76.7±33.36 g; p = 0.9613) and equivalent to CG concerning litter size (FG = 4.94±2.34; CG = 5.5±3.19; p = 0.435). The same was found for milk fat content (FG = 18.4±4.76; CG = 15.3±6.03; p = 0.204) and total energy value (FG = 212.92±46.4; CG = 181.1±60; p = 0.1964). FG was similar to CG both in offspring body weight at weaning (FG = 37±6.96 g; CG = 32.6±7.5 g; p = 0.1817) and in weight gain (FG = 31.8±7.0 g; CG = 27.7±7.5 g; p = 0.2104). CONCLUSION: A total of 25% flaxseed promoted an adequate offspring growth.