The changing process of health care services affects the University Hospitals (UH) in a particular manner. This paper aims to analyse the challenges and future perspectives of the Brazilian UH. In order to do so, only the UH affiliated to the Brazilian Federal Teaching Institutions were analysed. There is a substantial heterogeneity amongst UH in Brazil, in terms of size and organizational structure as well as in the type of health care provided. Brazilian UH represent core elements of two State policies: Education and Health. Consequently, the existing tensions between these two policies, to some extent, often reflect on the UH. Also, the UH must frequently address challenges that go beyond their purpose. Organizational sustainability remains a crucial issue to the UH. This concept entails effective financial and management skills, outcomes monitoring and evaluation mechanisms, and accountability. UH in Brazil have two main roles: providing health care and integrating the National Health System. From a future perspective, the UH shall be conceived from a much broader perspective than that of institutions that only provide health care. The future of Brazilian UH relies on their capacity to provide effective support to the State Health and Education policies.
Objective: To evaluate serum levels of different biomarkers associated with cardiovascular disease in patients with bipolar disorder (BD). Patients were prospectively evaluated in two separate instances: during acute mania and after remission of manic symptoms. All measurements were compared with those of healthy controls. Methods: The study included 30 patients with BD and 30 healthy controls, matched for gender and age. Biochemical parameters evaluated included homocysteine (Hcy), folic acid, vitamin B12, ferritin, creatine kinase (CK) and C-reactive protein (CRP). Results: Hcy levels were significantly higher in the BD patients, both during mania and after achieving euthymia. When Hcy was adjusted for body mass index, there was no significant difference between patients and controls. Ferritin was the only marker that showed a significant decrease during mania when compared to both euthymic patients and controls. There were no significant differences for folate, vitamin B12, CK and CRP. Conclusions: These findings do not show an association between alterations of markers of cardiovascular risk during manic episodes. Further studies are necessary to determine factors and mechanisms associated with cardiovascular risk in patients with BD.
Efeito da suplementação com diferentes níveis de selênio orgânico e inorgânico na produção e na composição do leite e no sangue de vacas em lactação RESUMO Avaliaram-se o efeito da suplementação de selênio, na dieta ofertada aos animais, sobre a concentração do mineral no sangue e no leite e as alterações nas características físico-químicas, contagem de células somáticas (CCS) e produção de leite. O experimento durou 63 dias, dos quais os primeiros 21 foram pré-experimental. Foram utilizadas 32 vacas em lactação da raça Jersey, as quais apresentavam, ao início, peso corporal de 402,5+58,4kg, escore de condição corporal de 3,19+0,31, produção de leite de 10,4+2,1kg e número de dias em lactação de 141,4+69,3. Os tratamentos foram: sem suplementação (grupo-controle); com suplementação de selênio inorgânico 0,3 (dieta-padrão + 0,3mg selenito de sódio/kg de concentrado -SI0,3); com suplementação com selênio orgânico 0,3 (dieta-padrão + 0,3mg seleniometionina/kg de concentrado -SO0,3) e com suplementação de selênio orgânico 0,6 (dieta-padrão + 0,6mg seleniometionina/kg de concentrado -SO0,6). As quantidades totais de selênio das dietas foram, respectivamente, 2,38; 4,18; 4,18 e 5,98mg/dia para os tratamentos controle, SI0,3, SO0,3 e SO0,6. O delineamento experimental foi o completamente ao acaso. O número de dias em lactação e os valores obtidos no início do experimento foram usados como covariáveis. Foram realizadas avaliações da produção de leite, do peso, da condição corporal, da composição do leite e do sangue nos dias 0, 14, 28 e 42 do período experimental. Entre os tratamentos, não foram detectadas alterações quanto à produção de leite, peso, condição corporal, características físico-químicas e microbiológicas do leite, e perfil bioquímico do sangue, exceto em relação à concentração de selênio no sangue entre o tratamento-controle e os tratamentos suplementados. Não houve diferenças quanto aos teores de selênio no sangue entre as fontes de selênio e as doses. Os teores de selênio no sangue evoluíram distintamente durante o experimento conforme a dose e a fonte. A suplementação com selênio não alterou os demais componentes do leite e do sangue.Palavras-chave: bovino de leite, levedura, selenometionina, selenito de sódio 38, 4.18, 4.18, and 5.98mg/cow, respectively, for control, SI0.3, SO0.3, and SO0.6 ABSTRACT The effects of the dietary supplementation with selenium were evaluated on the concentration of the mineral in blood and milk, as well as changes in milk yield, physical and chemical characteristics, and somatic cells count (SCC
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