Effect of meteorological factors on first episode and recurrence of primary spontaneous pneumothorax

SUMMARY OBJECTIVE: In this study, we evaluated the clinical characteristics and seasonal distribution of patients with primary spontaneous pneumothorax and examined the relationships between meteorological factors and pneumothorax development overall and in terms of first episode and recurrence. METHODS: The hospital records of 168 pneumothorax patients treated in our clinic between January 2016 and December 2020 were reviewed retrospectively. A cluster was defined as two or more patients with pneumothorax presenting within three consecutive days. Meteorological factors were compared between days with and without pneumothorax patients. This comparison was based on meteorological data from the day of symptom onset (D), the day before symptom onset (D1), and the difference between those days (D-D1). Meteorological data from the index day (D) were also compared between patients with first episode and recurrence of pneumothorax. RESULTS: The study included 149 (88.7%) men and 19 (11.3%) women. The mean age was 25.02±6.97 (range, 17-35; median, 26) years. Of note, 73 (43.4%) patients underwent surgery. The highest number of patients presented in November (n=19, 11.3%). In terms of season, most presentations occurred in autumn. Humidity was significantly lower on recurrence days compared with first episode (p=0.041). CONCLUSION: Our results indicated that meteorological factors (i.e., atmospheric pressure, humidity, wind speed, temperature, and precipitation) were not associated with pneumothorax development. By comparing the patients with first episode and recurrence, the humidity was significantly lower in the recurrence group.

Are smoking, environmental pollution, and weather conditions risk factors for COVID-19? / Tabagismo, poluição ambiental e condições climáticas são fatores de risco para COVID-19?

ABSTRACT Coronavirus disease 2019 (COVID-19), caused by the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is probably systemic, has a major respiratory component, and is transmitted by person-to-person contact, via airborne droplets or aerosols. In the respiratory tract, the virus begins to replicate within cells, after which the host starts shedding the virus. The individuals recognized as being at risk for an unfavorable COVID-19 outcome are those > 60 years of age, those with chronic diseases such as diabetes mellitus, those with hypertension, and those with chronic lung diseases, as well as those using chemotherapy, corticosteroids, or biological agents. Some studies have suggested that infection with SARS-CoV-2 is associated with other risk factors, such as smoking, external environmental pollution, and certain climatic conditions. The purpose of this narrative review was to perform a critical assessment of the relationship between COVID-19 and these potential risk factors.

RESUMO A doença denominada COVID-19, causada pelo vírus altamente contagioso denominado SARS-CoV-2, é uma doença provavelmente sistêmica com importante componente respiratório e é transmitida pelo contato com uma pessoa infectada por meio de gotículas e/ou aerossóis. Após atingir o trato respiratório, o vírus inicia a multiplicação intracelular e, a seguir, sua semeadura. Os grupos de risco reconhecidos para uma evolução desfavorável são indivíduos com idade > 60 anos, portadores de doenças crônicas, como diabetes mellitus, hipertensão arterial sistêmica e/ou doenças pulmonares crônicas, assim como aqueles em uso de quimioterápicos, corticosteroides ou imunobiológicos. Alguns estudos mostram uma possível associação do SARS-CoV-2 com outros fatores de risco, como tabagismo, poluição ambiental externa e determinadas condições climáticas. O objetivo desta revisão narrativa foi avaliar criticamente a relação entre COVID-19 e esses possíveis fatores de risco.

Variabilidade climática e internações por doenças diarreicas infecciosas em um município da Amazônia Ocidental brasileira / Climate variability and hospitalizations due to infectious diarrheal diseases in a municipality of the Western Brazilian Amazon Region

Resumo A morbimortalidade por doenças diarreicas infecciosas ainda representa um grave problema de saúde no Brasil e está altamente relacionada a fatores como condições climáticas, ambientais e de vida da população. O objetivo deste estudo foi analisar a associação das taxas de internações por doenças diarreicas infecciosas na população do município de Rio Branco/AC com a precipitação, o nível do rio, a umidade e a temperatura, entre os anos de 2000 e 2013. Os dados foram extraídos do Sistema de Informações Hospitalares do SUS, do Instituto Nacional de Meteorologia e da Agência Nacional das Águas. Foram ajustados modelos múltiplos de regressão de Poisson e binomial negativa. Os resultados mostram que existe uma associação positiva entre as internações por doenças diarreicas infecciosas e o nível do Rio Acre (RT:1,07; IC95%:1,04 a 1,1); houve um decréscimo de 14% nestas taxas de internações entre os anos de 2000 e 2013 (RT:0,86; IC95%:0,85 a 0,87); o grupo mais vulnerável pertence à faixa etária de menores de 1 ano de vida. Este estudo mostrou a vulnerabilidade de uma cidade na Amazônia quanto à variabilidade climática e a respectiva influência epidemiológica na incidência de internações por doenças diarreicas infecciosas.

Abstract Morbimortality due to infectious diarrheal diseases still is a serious health issue in Brazil and is highly related to factors such as weather, environment, and people's life conditions. This study aimed to analyze the relationship between hospitalization rates due to infectious diarrheal diseases among the population of the municipality of Rio Branco (AC), Brazil and precipitation, river level, humidity and temperature between 2000 and 2013. Data were retrieved from the Hospital Information System of the SUS (Unified Health System), the National Institute of Meteorology and the National Water Agency. Multiple Poisson and negative binomial regression models were adjusted. Results showed that there is a positive association between hospitalization due to infectious diarrheal diseases and the level of the Acre river (RR: 1.07; CI 95%: 1.04 to 1.1); these hospitalization rates fell 14% between 2000 and 2013 (RR: 0.86; CI 95%: 0.85 to 0.87). The most vulnerable group was the age group of less than 1 year of age. This study showed the vulnerability of an Amazonian city to climate variability and its respective epidemiological influence on the incidence of hospitalizations due to infectious diarrheal diseases.

Evolução de crianças asmáticas com tratamento homeopático / Evolution in asthmatic children through homeopatic treatment

Estudando 43 crianças asmáticas, atendidas no ambulatório de asma da Associação Paulista de Homeopatia, pudemos observar boa evolução na intensidade e no número de crises com o tratamento, bem como constatar a importância dos fatores físicos e climáticos na etiologia asmática e na busca do remédio adequado. (AU)

The aim of the present paper is to describe the results of a study on the progression of 43 cases of asthmatic children subjected to homeopathic treatment at the asthma outpatient clinic, São Paulo Homeopathic Medical Association, from march to December 1985. Improvement in the intensity and frequency of attacks was observed. The results further demonstrate, based on the preset statistical criteria, the relevance of investigating mental, physical and climate-related factors. (AU)

Association between weather seasonality and blood parameters in riverine populations of the Brazilian Amazon / Relação da sazonalidade climática com parâmetros sanguíneos de ribeirinhos residentes na Amazônia brasileira

Abstract Objective: To analyze the seasonality of blood parameters related to iron homeostasis, inflammation, and allergy in two riverine populations from the Brazilian Amazon. Methods: This was a cross-sectional study of 120 children and adolescents of school age, living in riverine communities of Porto Velho, Rondonia, Brazil, describing the hematocrit, hemoglobin, ferritin, serum iron, total white blood cell count, lymphocytes, eosinophils, C-reactive protein, and immunoglobulin E levels in the dry and rainy seasons. The chi-squared test and the prevalence ratio were used for the comparison of proportions and mean analysis using paired Student's t-test. Results: Hemoglobin (13.3 g/dL) and hematocrit (40.9%) showed higher average values in the dry season. Anemia prevalence was approximately 4% and 12% in the dry and rainy seasons, respectively. Serum iron was lower in the dry season, with a mean of 68.7 mcg/dL. The prevalence of iron deficiency was 25.8% in the dry season and 9.2% in the rainy season. Serum ferritin did not show abnormal values in both seasons; however, the mean values were higher in the dry season (48.5 ng/mL). The parameters of eosinophils, lymphocytes, global leukocyte count, C-reactive protein and immunoglobulin E showed no seasonal differences. C-reactive protein and immunoglobulin E showed abnormal values in approximately 7% and 60% of the examinations, respectively. Conclusion: Hematological parameters of the red cell series and blood iron homeostasis had seasonal variation, which coincided with the dry season in the region, in which an increase in atmospheric pollutants derived from fires is observed.

Resumo Objetivo: Analisar a sazonalidade climática de parâmetros sanguíneos relacionados à homeostase do ferro, inflamação e alergia em duas populações ribeirinhas da Amazônia brasileira. Método: Fez-se um estudo transversal em 120 crianças e adolescentes em idade escolar, residentes em comunidades ribeirinhas de Porto Velho, Rondônia. Foram analisados hematócrito, hemoglobina, ferritina, ferro sérico, leucometria global, linfócitos, eosinófilos, proteína C-reativa e imunoglobulina E nas estações seca e chuvosa. Usaram-se o teste do qui-quadrado e a razão de prevalência para a comparação das proporções, além do teste t de Student pareado para a análise de médias. Resultados: Hemoglobina (13,3 g/dL) e hematócrito (40,9%) apresentaram maiores valores médios no período de seca. A prevalência de anemia foi de 4% e 12% na seca e na chuva, respectivamente. O ferro sérico foi menor no período de seca com média de 68,7 mcg/dL. A prevalência de deficiência de ferro foi em média 25,8% na seca e 9,2% na chuva. A concentração sérica de ferritina não apresentou valores alterados em ambos os períodos, no entanto os valores médios apresentaram-se mais elevados na seca (48,5 ng/mL). Os parâmetros dos eosinófilos, linfócitos, leucometria global, proteína C-reativa e imunoglobulina E não apresentaram diferenças sazonais. A proteína C-reativa e a imunoglobulina E apresentaram valores alterados em 7% e 60% dos exames feitos, respectivamente. Conclusão: Os parâmetros hematológicos da série vermelha e a homeostasia ferro sanguíneo apresentaram variação sazonal, que coincide com o período de seca na região, no qual se observa aumento dos poluentes atmosféricos derivados das queimadas.

Effects of changes in micro-weather conditions on structural features, total protein and carbohydrate content in leaves of the Atlantic rain forest tree golden trumpet (Tabebuia chrysotricha) / Efeito de alterações nas condições micro-climáticas sobre características estruturais, e proteína e carboidratos histoquimicamente marcados, de folhas da árvore da floresta Atlântica ipê amarelo

Abstract Golden trumpet, Tabebuia chrysotricha, is a native tree from the Brazilian Atlantic rain forest, with a broad latitudinal distribution. In this study, we investigated the potential effects of short-term changes in micro-weather conditions on structural features, and total protein and carbohydrate content of golden trumpet leaves, using structural and histochemical approaches. Leaves were harvested in four different micro-weather conditions: 1. Afternoon, after a hot, sunny day; 2. at dawn, after a previously hot, sunny day; 3. at noon, of a hot, sunny day; and 4. at noon, of a cold, cloudy day. Leaflets exposed to low light irradiance showed flattened chloroplasts, uniformly distributed within the cells, throughout the palisade parenchyma. Conversely, leaflets exposed to high light irradiance presented flattened and rounded chloroplasts, in the upper and lower palisade parenchyma cells, respectively. The strongest protein staining was found for leaves harvested at the coldest period, whereas the weakest protein staining was found for leaves harvested after a hot, sunny day. The largest and most numerous starch grains were found for leaves harvested in the afternoon, after a hot, sunny day. Conversely, the smallest and less numerous starch grains were found for leaves harvested at dawn. Analysis of the data reported herein suggests that the leaflet responses to transient changes in micro-weather conditions are likely to contribute to the golden trumpet successful establishment in the broad latitudinal distribution in which the species is found.

Resumo Ipê amarelo é uma árvore nativa da floresta Atlântica brasileira, encontrada em uma ampla distribuição latitudinal. Neste estudo, nós investigamos os efeitos potenciais de alterações de curto prazo nas condições micro-climáticas sobre características estruturais, proteína e carboidratos histoquimicamente marcados, de folhas de ipê amarelo, usando estratégias de análise estrutural e histoquímicas. As folhas foram marcadas em quatro condições microclimáticas distintas: 1. Tarde, após um dia quente e ensolarado; 2. Amanhecer, após um dia quente e ensolarado; 3. Ao meio-dia, de um dia quente e ensolarado; e 4. Ao meio-dia, de um dia frio e nublado. Folíolos expostos à baixa irradiância luminosa apresentaram cloroplastos achatados, uniformemente distribuídos no interior das células, por todo o parênquima paliçádico, enquanto que folíolos expostos à alta irradiância apresentaram cloroplastos achatados e arredondados, nas células superiores e inferiores do parênquima paliçádico, respectivamente. A marcação mais intensa para proteína foi observada para folhas coletadas no momento mais frio de coleta, enquanto que a marcação mais fraca foi observada para folhas coletadas após um dia quente e ensolarado. Os grãos de amido maiores e mais numerosos foram observados em folhas coletadas durante a tarde de dia quente e ensolarado, enquanto que os menores e menos numerosos grãos de amido foram observados em folhas coletadas ao amanhecer.

Effects of climatic and social factors on dengue incidence in Mexican municipalities in the state of Veracruz / Efectos de factores climáticos y sociales en la incidencia de dengue en municipios mexicanos en el estado de Veracruz

Abstract: Objective: To assess links between the social variables and longer-term El Niño-Southern Oscillation (ENSO) related weather conditions as they relate to the week-to-week changes in dengue incidence at a regional level. Materials and methods: We collected data from 10 municipalities of the Olmeca region in México, over a 10 year period (January 1995 to December 2005). Negative binomial models with distributed lags were adjusted to look for associations between changes in the weekly incidence rate of dengue fever and climate variability. Results: Our results show that it takes approximately six weeks for sea surface temperatures (SST -34) to affect dengue incidence adjusted by weather and social variables. Conclusion: Such models could be used as early as two months in advance to provide information to decision makers about potential epidemics. Elucidating the effect of climatic variability and social variables, could assist in the development of accurate early warning systems for epidemics like dengue, Chikungunya and Zika.

Resumen: Objetivo: Evaluar los vínculos entre las variables sociales y las condiciones climáticas de largo plazo relacionadas con El Niño-oscilación del sur (ENOS) y con los cambios semanales en la incidencia del dengue a nivel regional. Material y métodos: Los datos fueron recolectados en diez municipios de la región Olmeca, México, durante un periodo de 10 años (enero de 1995 a diciembre de 2005). Se ajustaron modelos binomial negativo con rezagos distribuidos para evaluar las asociaciones entre los cambios en la tasa de incidencia semanal de dengue y la variabilidad climática. Resultados: Se requieren aproximadamente seis semanas para observar un efecto del incremento de la temperatura de la superficie marina (TSM -34) sobre la incidencia de dengue, ajustando por variables de tiempo y variables sociales. Conclusiones: Estos modelos se pueden usar con dos meses de antelación para proveer de información a tomadores de decisión sobre potenciales epidemias. Elucidar el efecto de la variabilidad climática en conjunto con las variables sociales puede favorecer el desarrollo de los sistemas de alerta temprana ante epidemias como dengue, Chikungunya y Zika.

Flutuação populacional e estimativa do número de gerações de Anastrepha fraterculus (Diptera: Tephritidae) em pomar de macieira em Caçador, Santa Catarina, Brasil / Population fluctuation and estimate of generations number of Anastrepha fraterculus (Diptera: Tephritidae) in apple orchard in Caçador, Santa Catarina, Brazil

Este estudo teve como objetivos avaliar a flutuação populacional e estimar o número de gerações por ano de Anastrepha fraterculus (Diptera: Tephritidae), com base nas variáveis meteorológicas de Caçador, Santa Catarina, Brasil. O estudo foi conduzido em pomar orgânico de macieira, de outubro de 2009 a abril de 2012. O número de moscas-das-frutas foi aferido semanalmente, com quatro armadilhas do tipo McPhail iscadas com Torula®. A associação entre o número de adultos capturados e as variáveis meteorológicas (temperaturas máxima, mínima e média, precipitação pluviométrica e umidade relativa do ar) foi feita pelo coeficiente de correlação de Pearson (p < 0,05). Para o período de entressafra (maio a setembro), os valores médios diários das variáveis meteorológicas foram calculados pelos testes F ou de Kruskal-Wallis (p < 0,05). O número de gerações/ano foi estimado utilizando-se os dados de temperatura mínima de 2009 até 2012, constante térmica e temperatura basal estabelecidos para A. fraterculus. Verificou-se que a mosca-das-frutas sul-americana ocorreu de novembro a abril, com picos populacionais em janeiro ou fevereiro. Apenas na safra 2010/2011 houve correlação entre o número médio de adultos capturados e as temperaturas máxima, média e mínima. Estimou-se que podem ocorrer em torno de oito gerações de A. fraterculus por ano em Caçador, Santa Catarina.(AU)

This study aimed to evaluated the population fluctuation and estimate the number of Anastrepha fraterculus (Diptera: Tephritidae) generations per year, based on meteorological variables in Caçador, SC, Brazil. The work was carried out in an organic apple orchard from October/2009 to April/2012. The fruit flies numbers were weekly recorded with four McPhail traps baited with Torula®. The association between the number of adults captured and meteorological variables (maximum, average and minimum temperatures, rainfall and relative humidity) was calculated using Pearson's correlation coefficient (p < 0.05). In off-season crop (May to September), the daily average of the meteorological variables were evaluated calculated by F or Kruskal-Wallis tests (p < 0.05). The number of generations per year was estimated based on minimum temperature from 2009 to 2012, thermal constant and basal temperature, established for A. fraterculus. The South American fruit fly occurred from November to April, with population peaks in January or February. We observed, only in 2010/2011 crop season, correlation between average number of adults captured and maximum, average and minimum temperatures. It was estimated that may occur about eight A. fraterculus generations per year in Caçador, Santa Catarina.(AU)

Flutuação populacional e estimativa do número de gerações de Anastrepha fraterculus (Diptera: Tephritidae) em pomar de macieira em Caçador, Santa Catarina, Brasil / Population fluctuation and estimate of generations number of Anastrepha fraterculus (Diptera: Tephritidae) in apple orchard in Caçador, Santa Catarina, Brazil

This study aimed to evaluated the population fluctuation and estimate the number of Anastrepha fraterculus (Diptera: Tephritidae) generations per year, based on meteorological variables in Caçador, SC, Brazil. The work was carried out in an organic apple orchard from October/2009 to April/2012. The fruit flies numbers were weekly recorded with four McPhail traps baited with Torula®. The association between the number of adults captured and meteorological variables (maximum, average and minimum temperatures, rainfall and relative humidity) was calculated using Pearsons correlation coefficient (p 0.05). In off-season crop (May to September), the daily average of the meteorological variables were evaluated calculated by F or Kruskal-Wallis tests (p 0.05). The number of generations per year was estimated based on minimum temperature from 2009 to 2012, thermal constant and basal temperature, established for A. fraterculus. The South American fruit fly occurred from November to April, with population peaks in January or February. We observed, only in 2010/2011 crop season, correlation between average number of adults captured and maximum, average and minimum temperatures. It was estimated that may occur about eight A. fraterculus generations per year in Caçador, Santa Catarina.

Este estudo teve como objetivos avaliar a flutuação populacional e estimar o número de gerações por ano de Anastrepha fraterculus (Diptera: Tephritidae), com base nas variáveis meteorológicas de Caçador, Santa Catarina, Brasil. O estudo foi conduzido em pomar orgânico de macieira, de outubro de 2009 a abril de 2012. O número de moscas-das-frutas foi aferido semanalmente, com quatro armadilhas do tipo McPhail iscadas com Torula®. A associação entre o número de adultos capturados e as variáveis meteorológicas (temperaturas máxima, mínima e média, precipitação pluviométrica e umidade relativa do ar) foi feita pelo coeficiente de correlação de Pearson (p 0,05). Para o período de entressafra (maio a setembro), os valores médios diários das variáveis meteorológicas foram calculados pelos testes F ou de Kruskal-Wallis (p 0,05). O número de gerações/ano foi estimado utilizando-se os dados de temperatura mínima de 2009 até 2012, constante térmica e temperatura basal estabelecidos para A. fraterculus. Verificou-se que a mosca-das-frutas sul-americana ocorreu de novembro a abril, com picos populacionais em janeiro ou fevereiro. Apenas na safra 2010/2011 houve correlação entre o número médio de adultos capturados e as temperaturas máxima, média e mínima. Estimou-se que podem ocorrer em torno de oito gerações de A. fraterculus por ano em Caçador, Santa Catarina.

Changes in abundance and composition of a Caribbean coral reef zooplankton community after 25 years / Cambios en abundancia y composición de una comunidad de zooplancton arrecifal en el Caribe 25 años después

Abstract:Coral reef zooplankton represents a key community in coral ecosystems, as they are involved in trophic and biogeochemical dynamics, and recruitment processes. Zooplankton abundance, composition and biomass were surveyed at six stations within the coral reef at Cahuita National Park, Limon, Costa Rica, in order to compare with the only previous study conducted during 1984. Samples were collected monthly (September 2010-August 2011). Seston biomass (0.49-85.87 mg/m3) and total abundance (1 145-112 422 ind./ m3) fluctuated among the months and the stations. Higher values of these two variables were found in the rainiest months (November 2010 and May 2011). A total of 38 taxa were identified, of which calanoid copepods abundance dominated year round (66 %), followed by appendicularians (12 %). Zooplankton mean abundance in this survey resulted 20 times higher (13 184 ± 4 104 ind./m3) than in 1984 (645 ± 84 ind./m3). Copepods and appendicularians were the groups that differed the most, relative to the 1984 study, resulting in 63 and 170 times more abundant overall, respectively. An increase in terrestrial runoff and nutrient input during the past 30 years could explain these differences. High abundances of zooplankton may constitute an important food source for coral reef organisms in Cahuita ecosystem. In addition, zooplankton abundances here reported for Cahuita are among the worldwide highest coral reef zooplankton abundances, and further trophic models can help elucidate its role in coral reef resilience in the Caribbean Coast of Central America.

ResumenEl grupo de zooplancton representa una comunidad clave en los arrecifes de coral. Está involucrado en dinámicas tróficas y biogeoquímicas, y en procesos de reclutamiento. La abundancia, composición y biomasa del zooplancton fueron estudiadas en seis estaciones dentro del arrecife coralino del Parque Nacional Cahuita, para compararlas con el único estudio realizado durante 1984. Las muestras se recolectaron mensualmente (Septiembre 2010-Agosto 2011). La biomasa del seston (0.49-85.87 mg/m3) y la abundancia total (1 145-112 422 ind./m3) fluctuaron entre meses y estaciones. Los valores más altos se encontraron durante los meses más lluviosos (Noviembre 2010 y Mayo 2011). Treinta y ocho taxones fueron identificados, copépodos calanoidos (66 %) y apendicularias (12 %) dominaron la abundancia durante todo el año. La abundancia promedio en este estudio fue 20 veces más alta (13 184 ± 4 104 ind./m3) que en 1984 (645 ± 84 ind./m3). Copépodos y apendicularias fueron los grupos con mayor discrepancia con respecto al estudio de 1984. Un aumento en la descarga de nutrientes de origen terrestre, podría explicar estas grandes diferencias. Abundancias tan altas de zooplancton podrían constituir una importante fuente de alimento para los organismos del arrecife en Cahuita. Las abundancias aquí reportadas colocan al arrecife de Cahuita entre los arrecifes de coral con mayor abundancia de zooplancton en el mundo y estudios futuros en redes tróficas podrían elucidar el papel de esta comunidad en procesos de resiliencia en los arrecifes del Caribe centroamericano.

Air pollution and respiratory diseases: ecological time series / Poluição do ar e doenças respiratórias: estudo ecológico de série temporal

ABSTRACT CONTEXT AND OBJECTIVE: Exposure to air pollutants is one of the factors responsible for hospitalizations due to respiratory diseases. The objective here was to estimate the effect of exposure to particulate matter (such as PM2.5) on hospitalizations due to certain respiratory diseases among residents in Volta Redonda (RJ). DESIGN AND SETTING: Ecological time series study using data from Volta Redonda (RJ). METHODS: Data on hospital admissions among residents of Volta Redonda (RJ), between January 1, 2012, and December 31, 2012, due to pneumonia, acute bronchitis, bronchiolitis and asthma, were analyzed. Daily data on PM2.5 concentrations were estimated through the CCATT-BRAMS model. The generalized additive Poisson regression model was used, taking the daily number of hospitalizations to be the dependent variable and the PM2.5 concentration to be the independent variable, with adjustment for temperature, relative humidity, seasonality and day of the week, and using lags of zero to seven days. Excess hospitalization and its cost were calculated in accordance with increases in PM2.5 concentration of 5 µg/m3. RESULTS: There were 752 hospitalizations in 2012; the average concentration of PM2.5 was 17.2 µg/m3; the effects of exposure were significant at lag 2 (RR = 1.017), lag 5 (RR = 1.022) and lag 7 (RR = 1,020). A decrease in PM2.5 concentration of 5 µg/m3 could reduce admissions by up to 76 cases, with a decrease in spending of R$ 84,000 a year. CONCLUSION: The findings from this study provide support for implementing public health policies in this municipality, which is an important steelmaking center.

RESUMO CONTEXTO E OBJETIVO: A exposição aos poluentes do ar é um dos fatores responsáveis por internações por doenças respiratórias; o objetivo foi estimar o efeito da exposição a material particulado (como PM2,5) sobre as hospitalizações devido a certas doenças respiratórias em moradores de Volta Redonda (RJ). TIPO DE ESTUDO E LOCAL: Estudo ecológico de séries temporais utilizando dados de Volta Redonda (RJ). MÉTODOS: Foram analisados dados de internação hospitalar, entre 1 de janeiro de 2012 e 31 de dezembro de 2012, devida a pneumonia, bronquite aguda, bronquiolite e asma, em residentes em Volta Redonda (RJ), e dados diários das concentrações de PM2,5 obtidos a partir do modelo CCATT-BRAMS. Utilizou-se o modelo aditivo generalizado de regressão de Poisson, sendo o número diário de internações a variável dependente e a concentração PM2,5 a variável independente, ajustado para temperatura, umidade relativa, sazonalidade e dia da semana e defasagens entre zero e sete dias. Excesso de internação hospitalar e seu custo, de acordo com o aumento de 5 ug/m3 na concentração de PM2,5, foram calculados. RESULTADOS: Ocorreram 752 internações em 2012; a concentração média de PM2,5 foi de 17,2 ug/m3; os efeitos da exposição foram significativos em lag 2 (RR = 1,017), lag 5 (RR = 1,022) e lag 7 (RR = 1,020). A redução em 5 ug/m3 na concentração de PM2,5 poderia reduzir até 76 casos as internações com diminuição nos gastos de R$ 84 mil/ano. CONCLUSÃO: Os achados deste estudo fornecem subsídios para implantar políticas públicas de saúde neste município, que é importante polo siderúrgico.

Cuantificación económica de los beneficios en salud asociados a la reducción de la contaminación por MP10 en Concepción Metropolitano, Chile / Health and economic benefits of reducing 10 µm particulate matter (PM10) in Metropolitan Area of Concepción, Chile

Background: Several international studies show the effects of PM10 pollution on health but specific analyses for many cities in Chile are lacking. Aim: To relate PM10 concentrations to effects with population health and quantify the economic benefits of its reduction in Concepción Metropolitan Area. Material and Methods: Poisson regression and generalized additive models were used to analyze the short-term effects of PM10 on mortality and morbidity, controlling for lags, seasonal, trend and weather variables. The damage function method to determine the economic impact of pollution reduction was used. Results: The selected concentration-response (C-R) coefficients showed that PM10 concentrations had effects on hospital admissions with a two days lag for respiratory diseases in children under 15 years of age and with a one day lag for asthma in patients over 64 years. The effects on premature mortality had a six days lag. The decrease in 1 µg/m³ of PM10 concentration would generate benefits ranging from 1,025.8 to 32,490.9 million of Chilean pesos per year, with a confidence level of 95%, according the estimation based on concentration-response coefficients and their economic cost. Conclusions: Reduction of PM10 would have important health and economic benefits.

Weather parameters and nosocomial bloodstream infection: a case-referent study / Parâmetros meteorológicos e infecção hospitalar de corrente sanguínea: estudo caso-referência

OBJECTIVE To evaluate if temperature and humidity influenced the etiology of bloodstream infections in a hospital from 2005 to 2010. METHODS The study had a case-referent design. Individual cases of bloodstream infections caused by specific groups or pathogens were compared with several references. In the first analysis, average temperature and humidity values for the seven days preceding collection of blood cultures were compared with an overall “seven-days moving average” for the study period. The second analysis included only patients with bloodstream infections. Several logistic regression models were used to compare different pathogens and groups with respect to the immediate weather parameters, adjusting for demographics, time, and unit of admission. RESULTS Higher temperatures and humidity were related to the recovery of bacteria as a whole (versus fungi) and of gram-negative bacilli. In the multivariable models, temperature was positively associated with the recovery of gram-negative bacilli (OR = 1.14; 95%CI 1.10;1.19) or Acinetobacter baumannii (OR = 1.26; 95%CI 1.16;1.37), even after adjustment for demographic and admission data. An inverse association was identified for humidity. CONCLUSIONS The study documented the impact of temperature and humidity on the incidence and etiology of bloodstream infections. The results correspond with those from ecological studies, indicating a higher incidence of gram-negative bacilli during warm seasons. These findings should guide policies directed at preventing and controlling healthcare-associated infections. .

OBJETIVO Avaliar se temperatura e umidade influenciam a etiologia das infecções na corrente sanguínea em hospital, no período de 2005 a 2010. MÉTODOS O estudo teve delineamento caso-referência. Casos individuais de infecções de corrente sanguínea por patógenos ou grupos de interesse foram comparados com diferentes referências. Na primeira etapa, valores médios de temperatura e umidade, para os sete dias que precederam a coleta de culturas de sangue, foram comparados com a “média-móvel de ordem 7” para todos os dias do período do estudo. A segunda etapa incluiu somente os casos com culturas positivas. Foram realizadas análises por regressão logística para avaliar a influência dos parâmetros meteorológicos imediatos sobre a etiologia dessas infecções, ajustando os resultados para dados demográficos, tempo e unidade de internação. RESULTADOS Temperatura e umidade mais elevadas foram associadas às infecções de corrente sanguínea causadas por bactérias como um todo (versus fungos) e por bacilos Gram-negativos. Nos modelos multivariados, a temperatura foi positivamente associada com o isolamento nas culturas de bacilos Gram-negativos (OR = 1,14; IC95% 1,10;1,19) ou A. baumannii (OR = 1,26; IC95% 1,16;1,37), mesmo após ajuste para dados demográficos e de internação. Associação inversa foi identificada por umidade. CONCLUSÕES O estudo documentou o impacto de temperatura e umidade sobre incidência e etiologia de infecções da corrente sanguínea. Os resultados são coerentes com os relatados em estudos ecológicos, apontando para maior incidência de bacilos Gram-negativos durante as estações quentes. Esses achados devem orientar as estratégias direcionadas à prevenção e controle de infecções relacionadas à assistência à saúde. .

Hand-foot-and-muuth disease epidemiological staus and relationship with meteorrological variables in guangzhou, southern China, 2008-2012 / Situação epidemiológica e a relação com variáveis meteorológicas da HFMD em Guangzhou, sul da China, 2008-2012

Hand-foot-and-mouth disease (HFMD) is becoming one of the extremely common airborne and contact transmission diseases in Guangzhou, southern China, leading public health authorities to be concerned about its increased incidence. In this study, it was used an ecological study plus the negative binomial regression to identify the epidemic status of HFMD and its relationship with meteorological variables. During 2008-2012, a total of 173,524 HFMD confirmed cases were reported, 12 cases of death, yielding a fatality rate of 0.69 per 10,000. The annual incidence rates from 2008 to 2012 were 60.56, 132.44, 311.40, 402.76, and 468.59 (per 100,000), respectively, showing a rapid increasing trend. Each 1 °C rise in temperature corresponded to an increase of 9.47% (95% CI 9.36% to 9.58%) in the weekly number of HFMD cases, while a one hPa rise in atmospheric pressure corresponded to a decrease in the number of cases by 7.53% (95% CI -7.60% to -7.45%). Similarly, each one percent rise in relative humidity corresponded to an increase of 1.48% or 3.3%, and a one meter per hour rise in wind speed corresponded to an increase of 2.18% or 4.57%, in the weekly number of HFMD cases, depending on the variables considered in the model. These findings revealed that epidemic status of HFMD in Guangzhou is characterized by high morbidity but low fatality. Weather factors had a significant influence on the incidence of HFMD.

A doença de mão-pé-e-boca (HFMD) está se tornando doença extremamente comum transmitida pelo ar e contato em Guangzhou, sul da China, levando preocupação às autoridades de saúde pública acerca da sua incidência aumentada. Neste estudo foi usada parte ecológica e regressão binomial negativa para identificar o status epidêmico da HFMD e sua relação com variáveis meteorológicas. Durante 2008-2012 um total de 173.524 casos confirmados de HFMD foram apresentados, 12 com morte, elevando o índice de fatalidade a 0,69 por 10.000. As incidências anuais de 2008 a 2010 foram 60,56, 132,44, 311,40, 402,76 e 468,59 por 100.000, respectivamente, mostrando tendência de rápido aumento. Cada 1 °C de aumento da temperatura correspondeu a aumento de 9,47% (95% CI 9,36% a 9,58%) no número semanal de casos de HFMD, enquanto a 1 hPa de aumento da pressão atmosférica correspondeu a decréscimo no número de casos de 7,53% (95% CI - 7,60% a - 7,45%). De maneira semelhante cada aumento de 1% na humidade relativa correspondeu a aumento de 1,48% ou 3,3% e a um aumento de 1 metro por hora na velocidade do vento correspondeu a um aumento de 2,18% ou 4,57%, no número de casos semanais de HFMD, dependendo das variáveis consideradas no modelo. Estes achados revelaram que o status epidêmico do HFMD em Guangzhou é caracterizado por alta morbidade, mas baixa fatalidade. Fatores referentes ao tempo tiveram influência significante na incidência do HFMD.

Phlebotomine fauna, natural infection rate and feeding habits of Lutzomyia cruzi in Jaciara, state of Mato Grosso, Brazil

Visceral leishmaniasis (VL) in Brazil is transmitted by the phlebotomine Lutzomyia longipalpis and in some midwestern regions by Lutzomyia cruzi. Studies of the phlebotomine fauna, feeding habits and natural infection rate by Leishmania contribute to increased understanding of the epidemiological chain of leishmaniases and their vectorial capacity. Collections were performed in Jaciara, state of Mato Grosso from 2010-2013, during which time 2,011 phlebotomines (23 species) were captured (68.70% Lu. cruzi and 20.52% Lutzomyia whitmani). Lu. cruzi females were identified by observing the shapes of the cibarium (a portion of the mouthpart) and spermatheca, from which samples were obtained for polymerase chain reaction to determine the rates of natural infection. Engorged phlebotomines were assessed to identify the blood-meal host by ELISA. A moderate correlation was discovered between the number of Lu. cruzi and the temperature and the minimum rate of infection was 6.10%. Twenty-two females were reactive to the antisera of bird (28%), dog (3.30%) and skunk (1.60%). We conclude that Lu. cruzi and Lu. whitmani have adapted to the urban environment in this region and that Lu. cruzi is the most likely vector of VL in Jaciara. Moreover, maintenance of Leishmania in the environment is likely aided by the presence of birds and domestic and synanthropic animals.

A time series analysis of meteorological factors and hospital outpatient admissions for cardiovascular disease in the Northern district of Guizhou Province, China

Findings on the effects of weather on health, especially the effects of ambient temperature on overall morbidity, remain inconsistent. We conducted a time series study to examine the acute effects of meteorological factors (mainly air temperature) on daily hospital outpatient admissions for cardiovascular disease (CVD) in Zunyi City, China, from January 1, 2007 to November 30, 2009. We used the generalized additive model with penalized splines to analyze hospital outpatient admissions, climatic parameters, and covariate data. Results show that, in Zunyi, air temperature was associated with hospital outpatient admission for CVD. When air temperature was less than 10°C, hospital outpatient admissions for CVD increased 1.07-fold with each increase of 1°C, and when air temperature was more than 10°C, an increase in air temperature by 1°C was associated with a 0.99-fold decrease in hospital outpatient admissions for CVD over the previous year. Our analyses provided statistically significant evidence that in China meteorological factors have adverse effects on the health of the general population. Further research with consistent methodology is needed to clarify the magnitude of these effects and to show which populations and individuals are vulnerable.

Phytoplankton variability in Lake Fraijanes, Costa Rica, in response to local weather variation

Phytoplankton species show a variety in morphology which is the result of adaptations to pelagic life including responses to fluctuations in water column dynamics driven by weather conditions. This has been reported in the oceans and in Northern temperate lakes. In order to observe whether tropical freshwater phytoplankton responds to seasonal variation in weather, the weekly variation in temperature of the water column and phytoplankton composition was studied in Lake Fraijanes, Costa Rica, a shallow (6.2m) lake at 1 640m above sea level. A chain of data loggers for temperature was placed in the deepest point in the lake to register temperature every hour at four different depths, and phytoplankton samples were retrieved every week for a year. Additional monthly samples for nutrients were taken at two depths. Notwithstanding its shallowness, the lake developed a thermal gradient which kept the water column stratified for several months during dry season. Whole lake overturns occurred during cold spells with intense precipitation. Phytoplankton changed throughout the year mainly through a shift in dominant taxa. From September to February the lake was frequently mixed by rain storms and windy weather. At this time, phytoplankton was dominated by Chlorococcal green algae. From March to June, the lake was stratified and warmer. Phytoplankton became dominated by Cyanobateria, mainly colonial Chroococcales. The rainy season started again in May 2009. During June and July the lake started to mix intermittently during rain events and phytoplankton showed a brief increase in the contribution of Chlorococcales. These changes fitted well to a general model of phytoplankton succession based on functional groups identified according to their morphology and adaptations.

Variabilidad del fitoplancton en el lago Fraijanes, Costa Rica, en respuesta a la variación local del clima. Las especies del fitoplancton muestran una variada morfología que es el resultado de su adaptación a la vida pelágica la cual incluye respuestas a las fluctuaciones en la dinámica de la columna de agua inducida por las condiciones del tiempo atmosférico. Esto ha sido reportado para el océano y lagos de zonas templadas. Con el fin de observar si el fitoplancton de lagos tropicales responde de la misma manera a los cambios estacionales se estudió la variación semanal de la temperatura del agua y la composición del fitoplancton en el lago Fraijanes, Costa Rica, un lago somero (6.2m de profundidad) localizado a 1 640m sobre el nivel del mar. Se colocó una cadena de registradores automáticos de temperatura en el punto más profundo del lago programados para tomar una lectura cada hora a cuatro profundidades y se tomaron muestras superficiales del fitoplancton cada semana por un periodo de un año. Adicionalmente se tomaron muestras mensuales para la determinación de nutrientes a dos profundidades. A pesar de su poca profundidad, el lago desarrolló un gradiente térmico que mantuvo la columna de agua estratificada por varios meses durante la estación seca. Los eventos de mezcla total ocurrieron durante episodios fríos y de lluvia intensa. El fitoplancton cambió a través del año principalmente por cambios en los táxones dominantes. De septiembre a febrero el lago se mezcló frecuentemente por la lluvia y el viento. En este periodo el fitoplancton estuvo dominado por algas verdes Chloroccocales. De marzo a junio el lago estuvo estratificado y cálido. El fitoplancton pasó a ser dominado por Cyanobacteria principalmente Chroococcales. La estación lluviosa inició de nuevo en mayo 2009. Durante junio y julio el lago se mezcló intermitentemente y el fitoplancton mostró breves episodios en los cuales las algas verdes aumentaron de nuevo. Estos cambios se ajustan bien al modelo general de sucesión del fitoplancton basado en grupos funcionales definidos de acuerdo a su morfología y adaptaciones.

Epidemiological aspects of influenza A related to climatic conditions during and after a pandemic period in the city of Salvador, northeastern Brazil

During the influenza pandemic of 2009, the A(H1N1)pdm09, A/H3N2 seasonal and influenza B viruses were observed to be co-circulating with other respiratory viruses. To observe the epidemiological pattern of the influenza virus between May 2009-August 2011, 467 nasopharyngeal aspirates were collected from children less than five years of age in the city of Salvador. In addition, data on weather conditions were obtained. Indirect immunofluorescence, real-time transcription reverse polymerase chain reaction (RT-PCR), and sequencing assays were performed for influenza virus detection. Of all 467 samples, 34 (7%) specimens were positive for influenza A and of these, viral characterisation identified Flu A/H3N2 in 25/34 (74%) and A(H1N1)pdm09 in 9/34 (26%). Influenza B accounted for a small proportion (0.8%) and the other respiratory viruses for 27.2% (127/467). No deaths were registered and no pattern of seasonality or expected climatic conditions could be established. These observations are important for predicting the evolution of epidemics and in implementing future anti-pandemic measures.