Search

Starting in the late 1980s, many Latin American countries began social sector reforms to alleviate poverty, reduce socioeconomic inequalities, improve health outcomes, and provide financial risk protection. In particular, starting in the 1990s, reforms aimed at strengthening health systems to reduce inequalities in health access and outcomes focused on expansion of universal health coverage, especially for poor citizens. In Latin America, health-system reforms have produced a distinct approach to universal health coverage, underpinned by the principles of equity, solidarity, and collective action to overcome social inequalities. In most of the countries studied, government financing enabled the introduction of supply-side interventions to expand insurance coverage for uninsured citizens--with defined and enlarged benefits packages--and to scale up delivery of health services. Countries such as Brazil and Cuba introduced tax-financed universal health systems. These changes were combined with demand-side interventions aimed at alleviating poverty (targeting many social determinants of health) and improving access of the most disadvantaged populations. Hence, the distinguishing features of health-system strengthening for universal health coverage and lessons from the Latin American experience are relevant for countries advancing universal health coverage., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Objective: to compare the effects of low intensity laser therapy on in vitro bacterial growth and in vivo in infected wounds, and to analyze the effectiveness of the AsGa Laser technology in in vivo wound infections., Methods: in vitro: Staphylococcus aureus were incubated on blood agar plates, half of them being irradiated with 904 nm wavelength laser and dose of 3J/cm² daily for seven days. In vivo: 32 male Wistar rats were divided into control group (uninfected) and Experimental Group (Infected). Half of the animals had their wounds irradiated., Results: in vitro: there was no statistically significant variation between the experimental groups as for the source plates and the derived ones (p>0.05). In vivo: there was a significant increase in the deposition of type I and III collagen in the wounds of the infected and irradiated animals when assessed on the fourth day of the experiment (p=0.034)., Conclusion: low-intensity Laser Therapy applied with a wavelength of 904 nm and dose 3J/cm² did not alter the in vitro growth of S. aureus in experimental groups; in vivo, however, it showed significant increase in the deposition of type I and III collagen in the wound of infected and irradiated animals on the fourth day of the experiment.

Two types of monofilament polypropylene meshes of markedly different construction, configuration and pore size were compared and used to repair full-thickness muscle defects in the abdominal wall of 22 mongrel dogs to assess their biocompatibility with host tissues. The defects were repaired with Prolene (Ethicon) woven mesh (pore size = 164 x 96 microns) and with an experimental, extruded mesh called T mesh (pore size = 3 mm x 4 mm). On the 30th postoperative day, the animals were sacrificed, and the segments of the abdominal wall containing the implanted meshes were excised. Although the Prolene mesh had greater tensile strength before implantation, 30 days after implantation, the T mesh showed similar tensile strength to Prolene mesh. The collagen densitometry showed a significant increase of total and mature collagen type I deposition in the T mesh. This suggests that the increased mature collagen type I deposition significantly increases the tensile strength of the reinforced mesh tissue and that the larger pore in the T mesh contributed to this finding by allowing increasing fibber orientation within the pores as a result of in vivo tension.

Although many efforts have been put forth, fecal incontinence of colostomates is still an unsolved problem. Among the techniques available to improve continence, the use of electromagnetic/mechanical power has not been explored. Our work looks at the characteristics needed by the components of an artificial sphincter where the power of sphincteric muscles is substituted with electromagnetic/mechanical power, and the mechanical absence of muscles is replaced by a plastic band. Experimental work was done with isolated colon of 26 mongrel dogs, and all of them became continent by an intraluminal gas pressure over 80 mm Hg when a final perimeter between 3.7 and 4.7 cm was reached. No macroscopic lesions were noted on the guts' surface beneath the plastic band. The largest band displacement was 4.2 cm, and the traction force was under 50 N.