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1.
Braz. j. biol ; 84: e257402, 2024. tab, graf
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1355856

RESUMO

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.


Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/epidemiologia , Estações do Ano , Brasil/epidemiologia , Incidência , Modelos Estatísticos
2.
Chemosphere ; 311(Pt 1): 136872, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36252898

RESUMO

A risk assessment and a source apportionment of the particulate- and gas-phase PAHs were conducted in a high vehicular traffic and industrialized region in southeastern Brazil. Higher concentrations of PAHs were found during summer, being likely driven by the contributions of PAHs in the vapor phase caused by fire outbreaks during this period. Isomer ratio diagnostic and Principal Component Analysis (PCA) identified four potential sources in the region, in which the Positive Matrix Factorization (PMF) model confirmed and apportioned as gasoline-related (31.8%), diesel-related (25.1%), biomass burning (23.4%), and mixed sources (19.6%). The overall cancer risk had a tolerable value, with ∑CR = 4.6 × 10-5, being ingestion the major via of exposure (64% of the ∑CR), followed by dermal contact (33% of the ∑CR) and inhalation (3%). Mixed sources contributed up to 45% of the overall cancer risk (∑CR), followed by gasoline-related (up to 35%), diesel-related (up to 15%), and biomass burning (up to 10%). The risk assessment for individual PAH species allowed identifying higher CR associated with BaP, DBA, BbF, BaA, and BkF, species associated with gasoline-related and industrial sources. Higher risks were associated with PM2.5-bound PAHs exposure, mainly via ingestion and dermal contact, highlighting the need for measures of mitigation and control of PM2.5 in the region.


Assuntos
Poluentes Atmosféricos , Neoplasias , Hidrocarbonetos Policíclicos Aromáticos , Humanos , Hidrocarbonetos Policíclicos Aromáticos/análise , Gasolina/análise , Monitoramento Ambiental , Brasil/epidemiologia , Carvão Mineral/análise , Poeira/análise , Medição de Risco , Poluentes Atmosféricos/análise , Material Particulado/análise , China
3.
Acta Trop ; 237: 106704, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36257456

RESUMO

Leishmaniasis represents a major neglected public health problem and the control measures have not been successful in Brazil. Recent studies have shown leishmaniasis importance to Brazilian border zones which reinforces the need to investigate its spread in those regions. This study aimed to analyze epidemiologic profile and its spatial distribution or aggregation process in both tegumentary and visceral leishmaniasis in the Brazilian border strip from 2009 to 2017. This is an ecological study of the epidemiological profile and spatial patterns encompassing municipalities in the Brazilian border strip. The presence of spatial autocorrelation and determination of priority areas for disease control were performed using global (Moran I) and local (LISA) Moran spatial techniques. The annual mean coefficients of tegumentary and visceral leishmaniasis were 29.8 and 0.6 by 100,000 inhabitants in the border strip, respectively. The indigenous population rates of leishmaniasis in the border zone appears to be higher than in the rest of the country (cutaneous changed from 33.2% to 6.6% and visceral rising from 1.0% to 17.5%) in the period. The most affected municipalities were located in the North and Central arches of the border zone. The results can subsidize the development of more targeted and effective strategies that can contribute to the surveillance and control of leishmaniasis in border zones, as the provision of epidemiological and spatial data on the disease. For better control of the disease, we recommend and emphasize the need to integrate public health policies of neighboring countries.


Assuntos
Leishmaniose Visceral , Leishmaniose , Humanos , Leishmaniose Visceral/epidemiologia , Leishmaniose Visceral/prevenção & controle , Brasil/epidemiologia , Leishmaniose/epidemiologia , Leishmaniose/prevenção & controle , Análise Espacial , Saúde Pública , Incidência
4.
Acta Trop ; 237: 106740, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36332674

RESUMO

THE FAMILY TRICHECHIDAE (ORDER SIRENIA) COMPRISES THREE SPECIES: African (Trichechus senegalenses), West Indian (T. manatus), WIM)], and the Amazonian manatees (T. inunguis, AMM). Whereas WIM inhabits both riverine and coastal systems in the western Atlantic, AMM is the only exclusively freshwater sirenian, endemic to the Amazon River Basin. The study of infectious agents is essential to species conservation, especially considering that both species are classified as Vulnerable by the IUCN Red List and as Endangered by the Brazilian Red List. The current knowledge about viral agents in sirenians is scarce. Herpesviruses and adenovirus are DNA viruses able to infect and cause disease in a wide range of hosts. Herein, we used panPCR protocols to survey herpesvirus and adenovirus in blood samples of wild WIM (n = 23) and AMM (n = 26) under human care in Brazil. Herpesvirus DNA was detected in one juvenile female WIM (1/23; 4.3%; 95% CI -4.7 - 13.3) from Ceará state and in four AMM (two juvenile females, a juvenile male, and an adult female; 4/26; 15.4%; 95% CI 0.5 - 30.3) from Amazonas state. The two different gammaherpesvirus DNA polymerase sequence types identified (one per species, a sequence type in a WIM and another one in three AMM) were highly similar (99% nucleotide identity) to Trichechid herpesvirus 1, reported in West Indian manatees of Florida (USA), and 100% identical when translated into amino acids. A herpesviral glycoprotein B sequence was identified in two AMM. None of the samples was positive to adenovirus. To the authors' knowledge, this is the first herpesvirus detection in manatees from South America, expanding the herpesvirus geographical range, and the first in WIM and AMM worldwide. Our findings suggest (i) that West Indian and Amazonian manatees are possibly the natural hosts of the detected herpesvirus, and (ii) coevolution of that gammaherpesvirus with Trichechus. Future studies are necessary to characterize the obtained virus and elucidate potential pathological effects (if any) in these species.


Assuntos
Herpesviridae , Trichechus inunguis , Trichechus manatus , Animais , Humanos , Feminino , Masculino , Trichechus inunguis/genética , Brasil/epidemiologia , Adenoviridae/genética , Trichechus , Herpesviridae/genética
5.
Acta Trop ; 237: 106742, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36334845

RESUMO

Bartonella henselae is a zoonotic pathogen responsible for causing Cat Scratch Disease (CSD) and other clinical manifestations in humans. Domestic cats are the main reservoirs of this Bartonella species. Previous studies have suggested that certain genotypes of B. henselae seem to be more associated with human infections. The present study aimed to genotype B. henselae isolates from domestic cats' blood samples in the state of Goiás, midwestern Brazil. The association of quantitative real-time PCR (qPCR) based on the nuoG gene from Bartonella spp. of blood samples, before and after incubation in pre-enrichment liquid medium (BAPGM) and isolation on chocolate agar, showed a positivity frequency of 42% (42/100) for Bartonella spp. Twelve B. henselae isolates obtained on agar chocolate from six cats' blood samples (two isolates from each animal) were characterized by Multi-locus Sequencing Typing (MLST) and revealed to belong to Sequence Types ST1 and ST5. One of the cats (1/6) presented both STs, demonstrating that domestic cats can be coinfected with different variants of B. henselae. The STs detected in this study are distributed worldwide and have already been detected in humans with clinical manifestations of bartonellosis. This is the first report of the zoonotic variants ST1 and ST5 of B. henselae in domestic cats from Brazil.


Assuntos
Infecções por Bartonella , Bartonella henselae , Bartonella , Doenças do Gato , Coinfecção , Gatos , Animais , Humanos , Bartonella henselae/genética , Tipagem de Sequências Multilocus , Ágar , Brasil/epidemiologia , Infecções por Bartonella/epidemiologia , Infecções por Bartonella/veterinária , Bartonella/genética , Doenças do Gato/epidemiologia , DNA Bacteriano/genética
6.
Acta Trop ; 237: 106697, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36162457

RESUMO

This study aimed to determine the occurrence of hemoplasmas and tick-borne pathogens (TBP) (Theileria equi, Babesia caballi, and Ehrlichia sp.) in horses and ticks' salivary glands, and determine the factors associated with exposure/infection in a rural settlement in southern Brazil. Blood samples from 22 horses were screened for anti-T. equi and anti-Ehrlichia sp. antibodies by an indirect fluorescent antibody test (IFAT) assays. Samples were also tested by PCR assays for T. equi and B. caballi (18S rRNA and rap-1 genes, respectively), hemoplasmas (16S rRNA gene), and Ehrlichia sp. (dsb gene). Ticks were removed from the animals (inspection) and the environment (flannel trawling and dry ice traps), and morphologically identified. Additionally, salivary glands DNA was extracted from 28 adult ticks infesting the animals and four nymphs from the environment, and further screened for Ehrlichia sp. and hemotropic Mycoplasma sp. Anti-T. equi and anti-Ehrlichia sp. antibodies were detected in 40.91% (nine/22; 95% CI: 23.26-61.27) and 31.81% (seven/22; 95% CI: 16.36-52.68) horses, respectively. Theileria equi, B. caballi, and hemotropic Mycoplasma sp. DNA was detected in 59.09% (13/22), 4.55% (one/22), and 50% (11/22) horses, respectively. All horses tested negative in the PCR for Ehrlichia sp. All sequences showed ≥99% identity with multiple T. equi, B. caballi, and Mycoplasma ovis sequences deposited in GenBank database. Adult ticks were identified as Dermacentor nitens (44/47; 93.62%) and Rhipicephalus microplus (three/47; 6.38%). Ticks' salivary glands were negative for Ehrlichia sp., while 39.29% from adults (11/28) and 50% from nymphs (two/four) from the environment were positive for hemotropic Mycoplasma sp. This is the first report of M. ovis infection in horses from Brazil and the first detection of hemoplasma DNA in salivary glands of D. nitens and R. microplus ticks. Further studies are needed to elucidate the vector competence of ticks to transmit hemoplasmas.


Assuntos
Babesiose , Doenças dos Cavalos , Mycoplasma , Theileria , Theileriose , Carrapatos , Animais , Ovinos , Cavalos , Bovinos , Babesiose/epidemiologia , RNA Ribossômico 16S/genética , Brasil/epidemiologia , Doenças dos Cavalos/diagnóstico , Doenças dos Cavalos/epidemiologia , Theileria/genética , Mycoplasma/genética , Ehrlichia/genética , Theileriose/epidemiologia
7.
J Affect Disord ; 320: 48-56, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36162679

RESUMO

BACKGROUND: The association between vegetarianism and depression is still unclear. We aimed to investigate the association between a meatless diet and the presence of depressive episodes among adults. METHODS: A cross-sectional analysis was performed with baseline data from the ELSA-Brasil cohort, which included 14,216 Brazilians aged 35 to 74 years. A meatless diet was defined from in a validated food frequency questionnaire. The Clinical Interview Schedule-Revised (CIS-R) instrument was used to assess depressive episodes. The association between meatless diet and presence of depressive episodes was expressed as a prevalence ratio (PR), determined by Poisson regression adjusted for potentially confounding and/or mediating variables: sociodemographic parameters, smoking, alcohol intake, physical activity, several clinical variables, self-assessed health status, body mass index, micronutrient intake, protein, food processing level, daily energy intake, and changes in diet in the preceding 6 months. RESULTS: We found a positive association between the prevalence of depressive episodes and a meatless diet. Meat non-consumers experienced approximately twice the frequency of depressive episodes of meat consumers, PRs ranging from 2.05 (95%CI 1.00-4.18) in the crude model to 2.37 (95%CI 1.24-4.51) in the fully adjusted model. LIMITATIONS: The cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS: Depressive episodes are more prevalent in individuals who do not eat meat, independently of socioeconomic and lifestyle factors. Nutrient deficiencies do not explain this association. The nature of the association remains unclear, and longitudinal data are needed to clarify causal relationship.


Assuntos
Depressão , Dieta , Humanos , Adulto , Estudos Transversais , Brasil/epidemiologia , Estudos Longitudinais , Prevalência , Depressão/epidemiologia , Depressão/etiologia
8.
Arch Gerontol Geriatr ; 104: 104823, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36179459

RESUMO

OBJECTIVE: This study aimed to assess the longitudinal predictions between glycated hemoglobin A1c (HbA1c) and physical performance scores in different epidemiological contexts of aging. MATERIAL AND METHODS: Longitudinal data of 1,337 older people from three countries (Canada, Brazil and Colombia) of the International Mobility in Aging Study (IMIAS) were used to assess the relationship between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Linear Mixed Models grouped by sex and adjusted by Age, Study site, Chronic Conditions, Anthropometric Measures, and Inflammatory Level were used to estimate the influence of HbA1c and covariates on SPPB scores. RESULTS: At the IMIAS baseline, Latin American (LA) cities had higher HbA1c averages compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ± 1.49; 6,56 ± 1.70 respectively). SPPB scores were significantly lower in LA cities, and older people in Natal had lower SPPB averages in men (9.67 ± 2.38; p-value < 0.05) and women (8.52 ± 2.33; p-value <0.05). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (ß = -0.25, 95% CI: -0.39 to -0.12, p-value = 0.02) but not in women. CONCLUSION: High HbA1c levels at baseline were longitudinally associated in older adults from different countries, and this association was observed only in men and not in women. This study highlights a possible influence of gender on this relationship.


Assuntos
Envelhecimento , Desempenho Físico Funcional , Masculino , Humanos , Feminino , Idoso , Hemoglobina A Glicada , Canadá/epidemiologia , Brasil/epidemiologia , Estudos Longitudinais
9.
Acta Trop ; 237: 106707, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36195183

RESUMO

Since the first case of visceral leishmaniasis (VL) recorded in Brazil, in 1913, referring to a patient from Boa Esperança, state of Mato Grosso, Central-West region, epidemics have been observed, with intensified expansion and urbanization from 1980. For a better understanding of the factors associated with VL in the Brazilian Central-West region, the present study aimed to carry out a systematic review on aspects related to the occurrence of VL in this region, which includes the states of Goiás, Mato Grosso, Mato Grosso do Sul and the Distrito Federal. Three thousand and nineteen studies were evaluated, of which twenty published between the years of 2002 and 2020 were included in this systematic review. In the states of Central-West region, it was possible to verify the occurrence of VL related to epidemiological characteristics that included: climatic variables (temperature and precipitation); socioeconomic factors (male gender; age group from zero to 14 years old; deaths from 40 years old, with emphasis from the 60 years and residents of the urban area); urban infrastructure vulnerability indicators (areas with environmental degradation, occupied by low-income population, with precarious hygienic-sanitary conditions; anthropic disturbances and population agglomerations; densely vegetated and vacant lots containing rubble and material decaying organic matter); presence of the vector (Lutzomyia longipalpis and Lu. cruzi), dogs and other animals; in addition to the migratory process. Studies related to regional aspects of VL epidemiology can help in the adoption of strategies for better effectiveness in its control.


Assuntos
Leishmaniose Visceral , Psychodidae , Humanos , Masculino , Cães , Animais , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Leishmaniose Visceral/veterinária , Brasil/epidemiologia , Insetos Vetores , Temperatura
10.
Addict Behav ; 137: 107522, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36242996

RESUMO

OBJECTIVE: To investigate the mechanisms of the #Tamojunto2.0 program that mediated the prevention of lifetime alcohol and drug use, including drug knowledge, behavioral beliefs, attitudes, decision-making skills, and refusal skills. METHODS: A cluster-randomized controlled trial was conducted in 73 public middle schools in three Brazilian cities. The sample included 5208 students (49.4 % girls; Mage = 13.2 years). The intervention group attended twelve #Tamojunto2.0 lessons conducted by their previously trained teachers. The control group did not receive any intervention. Data were collected pre-intervention and at the 9-months follow-up. We performed multiple mediation models (for the whole sample, users, and non-users) with a post-estimation adjustment to standard errors to account for nesting. We analyzed all available mediators simultaneously according to each drug: alcohol, binge drinking, tobacco, marijuana, and inhalant lifetime use. To handle missing data, we used the "full-information maximum-likelihood" paradigm. RESULTS: Outcomes in the whole sample and among non-users showed that #Tamojunto2.0 indirectly prevented lifetime alcohol use and binge drinking by increasing negative and non-positive alcohol beliefs. Only the direct effect on decreasing lifetime alcohol consumption was statistically significant. However, an indirect increase in binge drinking was observed through knowledge about alcohol, but the direct effect was not statistically significant. No effects were reported for marijuana, tobacco, or inhalants. Among users, no statistically significant effects were found for alcohol or drug use. CONCLUSIONS: The results suggest that the #Tamojunto2.0 program was only effective in delaying alcohol consumption via increasing negative and non-positive alcohol beliefs. It seems that mediating mechanisms vary depending on contextual characteristics, differences in socializing among adolescents, features of the educational systems, psychosocial conditions, or, fidelity issues of program implementation.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas , Cannabis , Alucinógenos , Transtornos Relacionados ao Uso de Substâncias , Feminino , Adolescente , Humanos , Masculino , Brasil/epidemiologia , Consumo Excessivo de Bebidas Alcoólicas/prevenção & controle , Serviços de Saúde Escolar , Consumo de Bebidas Alcoólicas/prevenção & controle , Instituições Acadêmicas , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
11.
Environ Pollut ; 302: 119070, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35231538

RESUMO

Long-term exposure to PM2.5 has been linked to lung cancer incidence and mortality, but limited evidence existed for other cancers. This study aimed to assess the association between PM2.5 on cancer specific mortality. An ecological study based on the cancer mortality data collected from 5,565 Brazilian cities during 2010-2018 using a difference-in-differences approach with quasi-Poisson regression, was applied to examine PM2.5-cancer mortality associations. Globally gridded annual average surface PM2.5 concentration was extracted and linked with the residential municipality of participants in this study. Sex, age stratified and exposure-response estimations were also conducted. Totalling 1,768,668 adult cancer deaths records of about 208 million population living across 5,565 municipalities were included in this study. The average PM2.5 concentration was 7.63 µg/m3 (standard deviation 3.32) with range from 2.95 µg/m3 to 28.5 µg/m3. With each 10 µg/m3 increase in three-year-average (current year and previous two years) concentrations of PM2.5, the relative risks (RR) of cancer mortality were 1.16 (95% confidence interval [CI]: 1.11-1.20) for all-site cancers. The PM2.5 exposure was significantly associated with several cancer-specific mortalities including oral, nasopharynx, oesophagus, and stomach, colon rectum, liver, gallbladder, larynx, lung, bone, skin, female breast, cervix, prostate, brain and leukaemia. No safe level of PM2.5 exposure was observed in the exposure-response curve for all types of cancer. In conclusion, with nationwide cancer death records in Brazil, we found that long-term exposure to ambient PM2.5 increased risks of mortality for many cancer types. Even low level PM2.5 concentrations had significant impacts on cancer mortality.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Neoplasias Pulmonares , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Brasil/epidemiologia , Exposição Ambiental , Feminino , Humanos , Masculino , Mortalidade , Material Particulado/análise
12.
J. Health Biol. Sci. (Online) ; 10(1): 1-6, 01/jan./2022.
Artigo em Português | LILACS | ID: biblio-1366907

RESUMO

Objetivos: estabelecer diagnóstico diferencial das demências em ambulatório de geriatria no Distrito Federal, calculando-se sua prevalência por meio de exame clínico e avaliação multifuncional. Método: estudo longitudinal, retrospectivo, com amostra de pessoas com 60 anos ou mais residentes no Distrito Federal-Brasil, com déficit cognitivo caracterizado por Transtorno Neurocognitivo (TNC) Maior (demência), cadastradas durante os anos de 2010 a 2018. A coleta de dados foi realizada em prontuários para selecionar e avaliar o perfil do idoso com diagnóstico de TNC seguida de avaliação geriátrica ampla e avaliação multifuncional. A análise de dados foi realizada com o cálculo da prevalência, estatística descritiva e índice V de Cramer. Resultados: 158 indivíduos conseguiram concluir todas as avalições. 52,5% possuem de 80 a 89 anos, 62,5% são mulheres e 62,7% caucasianos, 50,6% viúvos e 47,5% analfabetos. A prevalência inicial de Doença de Alzheimer (DA) foi de 45,6%, reduzindo-se para 35,4% após um período de acompanhamento e a demência vascular (DV) foi de 34,2%, inicialmente, e 45,6% ao final. Utilizou-se o Coeficiente V de Cramer, em que se encontrou uma relação fraca de fatores de risco com os diagnósticos das demências apresentados. Conclusão: DV foi a mais prevalente na área estudada. Entende-se ser a maior frequência de DA esteja relacionada à avaliação superficial uma vez que esse tipo de demência é mundialmente mais frequente


Objetivos: estabelecer diagnóstico diferencial das demências em ambulatório de geriatria no Distrito Federal, calculando-se sua prevalência por meio de exame clínico e avaliação multifuncional. Método: estudo longitudinal, retrospectivo, com amostra de pessoas com 60 anos ou mais residentes no Distrito Federal-Brasil, com déficit cognitivo caracterizado por Transtorno Neurocognitivo (TNC) Maior (demência), cadastradas durante os anos de 2010 a 2018. A coleta de dados foi realizada em prontuários para selecionar e avaliar o perfil do idoso com diagnóstico de TNC seguida de avaliação geriátrica ampla e avaliação multifuncional. A análise de dados foi realizada com o cálculo da prevalência, estatística descritiva e índice V de Cramer. Resultados: 158 indivíduos conseguiram concluir todas as avalições. 52,5% possuem de 80 a 89 anos, 62,5% são mulheres e 62,7% caucasianos, 50,6% viúvos e 47,5% analfabetos. A prevalência inicial de Doença de Alzheimer (DA) foi de 45,6%, reduzindo-se para 35,4% após um período de acompanhamento e a demência vascular (DV) foi de 34,2%, inicialmente, e 45,6% ao final. Utilizou-se o Coeficiente V de Cramer, em que se encontrou uma relação fraca de fatores de risco com os diagnósticos das demências apresentados. Conclusão: DV foi a mais prevalente na área estudada. Entende-se ser a maior frequência de DA esteja relacionada à avaliação superficial uma vez que esse tipo de demência é mundialmente mais frequente


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Avaliação Geriátrica/métodos , Demência/diagnóstico , Demência/epidemiologia , Brasil/epidemiologia , Demência Vascular/diagnóstico , Demência Vascular/epidemiologia , Prevalência , Estudos Retrospectivos , Fatores de Risco , Estudos Longitudinais , Diagnóstico Diferencial , Estudos Ecológicos , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/epidemiologia , Testes de Estado Mental e Demência
13.
Rev. urug. enferm ; 17(2): 1-14, dic. 2022.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1391902

RESUMO

Objetivo: Avaliar as características das internações de recém-nascidos em uma unidade de terapia intensiva neonatal do extremo sul do Brasil durante um curto período de tempo. Método: Estudo observacional, com 85 neonatos, por dados secundários de pacientes internados na Unidade de Terapia Intensiva Neonatal, nos meses de maio de 2020 a outubro de 2020. Resultados: A prevalência das internações foi do sexo masculino, com diagnóstico de prematuridade, que pesavam entre 1500g e 2499g, não receberam leite materno na primeira hora de vida, receberam visitas dos pais, colo e leite materno durante a internação. As mães tinham mais de 6 consultas de pré-natal e os bebês nasceram de cesárea. Conclusão: O atendimento prestado de forma holística, baseado na ciência e maneira humanizada aos recém-nascidos e aos pais, pode reduzir a mortalidade infantil, trazer maior segurança aos pais e confi ança na equipe assistencial, além de evitar complicações futuras no desenvolvimento infantil.


Objetivo: Evaluar las características de las hospitalizaciones de recién nacidos en una unidad de cuidados intensivos neonatales en el extremo sur de Brasil durante un corto período de tiempo. Método: Estudio observacional, con 85 neonatos, con base en datos secundarios de pacientes hospitalizados en la Unidad de Cuidados Intensivos Neonatales, de mayo de 2020 a octubre de 2020. Resultados: La prevalencia de hospitalizaciones fue del sexo masculino, con diagnóstico de prematuridad, que pesaron entre 1500g y 2499g, no recibió leche materna en la primera hora de vida, recibió visitas de los padres, regazo y leche materna durante la hospitalización. Las madres tuvieron más de 6 consultas prenatales y los bebés nacieron por cesárea. Conclusión: La atención brindada de forma holística, basada en la ciencia y de forma humanizada a los recién nacidos y a los padres, puede reducir la mortalidad infantil, brindar mayor seguridad a los padres y confi anza en el equipo de atención, además de prevenir futuras complicaciones en el desarrollo del niño.


Objective: To evaluate the characteristics of hospitalizations of newborns in a neonatal intensive care unit in the extreme south of Brazil during a short period of time. Method: Observational study, with 85 neonates, based on secondary data from patients hospitalized in the Neonatal Intensive Care Unit, from May 2020 to October 2020. Results: The prevalence of hospitalizations was male, with a diagnosis of prematurity, who weighed between 1500g and 2499g, did not receive breast milk in the fi rst hour of life, received visits from parents, lap and breast milk during hospitalization. The mothers had more than 6 prenatal consultations and the babies were born by cesarean section. Conclusion: The care provided in a holistic way, based on science and in a humanized way to newborns and parents, can reduce infant mortality, bring greater security to parents and confidence in the care team, in addition to preventing future complications in child development.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Criança , Adolescente , Adulto , Adulto Jovem , Qualidade da Assistência à Saúde , Unidades de Terapia Intensiva Neonatal , COVID-19/epidemiologia , Hospitalização , Fatores Socioeconômicos , Fatores de Tempo , Brasil/epidemiologia , Mortalidade Infantil , Estudos Retrospectivos , Estudos Longitudinais , Humanização da Assistência , Saúde Holística
14.
PLoS One ; 17(11): e0276960, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36327238

RESUMO

BACKGROUND: Atopic dermatitis (AD) primarily affects the pediatric population, which is highly colonized by S. aureus. However, little is known about the genetic features of this microorganism and other staphylococcal species that colonize AD patients. OBJECTIVE: This study aimed to characterize Staphylococcus spp. isolated from the nares and skin (with and without lesion) of 30 AD and 12 non-AD Brazilian children. METHODS: Skin and nasal swabs were cultured onto mannitol salt agar, and bacterial colonies were counted and identified by matrix assisted laser desorption ionization time of flight mass spectrometry and polymerase chain reaction (PCR). Antimicrobial susceptibility was evaluated by phenotypic and genotypic tests. In S. aureus isolates, Panton-Valentine leukocidin genes were detected by PCR, and their clonality was assessed by pulsed-field gel electrophoresis and multilocus sequence typing. RESULTS: S. aureus was more prevalent in the nares (P = 0.005) and lesional skin (P = 0.0002) of children with AD, while S. hominis was more frequent in the skin of non-AD children (P < 0.0001). All children in the study, except one from each group, were colonized by methicillin-resistant coagulase-negative Staphylococcus and 24% by methicillin-resistant S. aureus. Despite the great clonal diversity of S. aureus (18 sequence types identified), most AD children (74.1%) were colonized by the same genotype in both niches. CONCLUSION: High colonization by polyclonal S. aureus isolates was found among children with AD, while S. hominis was more frequent among non-AD children. The high prevalence of methicillin-resistant staphylococcal isolates highlights the importance of continued surveillance, especially when considering empiric antibiotic therapy for the treatment of skin infections in these patients.


Assuntos
Dermatite Atópica , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Humanos , Criança , Staphylococcus aureus/genética , Meticilina , Resistência a Meticilina , Dermatite Atópica/epidemiologia , Brasil/epidemiologia , Testes de Sensibilidade Microbiana , Infecções Estafilocócicas/microbiologia , Staphylococcus
15.
Clinics (Sao Paulo) ; 77: 100127, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36327641

RESUMO

PURPOSE: The authors aim to carry out an investigation on the impact of cervical oncogenic Human Papillomavirus (HPV) detection in pregnant adolescents, to clarify the prevalence and risk factors, considering the importance and lack of data on this topic in Brazil. METHODS: A cross-sectional study was conducted with adolescents receiving prenatal care in a tertiary hospital in São Paulo, Brazil, with routine Pap smear and oncogenic HPV detection test in the uterine cervix. The authors sought to associate the results of these tests with demographic and obstetric variables. RESULTS: A total of 303 pregnant adolescents whose mean age was 15.30 ± 1.22 years comprised the study subjects. The frequency of high-risk HPV cervical detection was 50.50%. Multivariate analysis revealed that a large number of partners in their lifetime (OR = 1.27) and having a religion (OR = 2.05) were risk factors for cervical detection of oncogenic HPV, while schooling appeared as a protective factor (OR = 0.85). There was an association between this detection and colpocytological alterations, reaching almost 30% of patients, but without association with obstetric and neonatal outcomes. CONCLUSION: The prevalence found is one of the highest in Brazil and worldwide. A greater number of partners during their lifetime and having religion were detected as possible factors associated with cervical HPV detection. Detection of cervical HPV-DNA did not influence obstetric and neonatal outcomes. The findings of this study reinforce the need to implement educational measures capable of modifying the incidence of sexually transmitted infections in this population and capable of promoting adherence to HPV vaccination programs.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Gravidez , Recém-Nascido , Humanos , Adolescente , Papillomaviridae/genética , Teste de Papanicolaou , Prevalência , Estudos Transversais , Brasil/epidemiologia , Fatores de Risco , Esfregaço Vaginal
16.
Sci Rep ; 12(1): 18629, 2022 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-36329109

RESUMO

Several studies have demonstrated the cost-effectiveness of genetic testing for surveillance and treatment of carriers of germline pathogenic variants associated with hereditary breast/ovarian cancer syndrome (HBOC). In Brazil, seventy percent of the population is assisted by the public Unified Health System (SUS), where genetic testing is still unavailable. And few studies were performed regarding the prevalence of HBOC pathogenic variants in this context. Here, we estimated the prevalence of germline pathogenic variants in BRCA1, BRCA2 and TP53 genes in Brazilian patients suspected of HBOC and referred to public healthcare service. Predictive power of risk prediction models for detecting mutation carriers was also evaluated. We found that 41 out of 257 tested patients (15.9%) were carriers of pathogenic variants in the analyzed genes. Most frequent pathogenic variant was the founder Brazilian mutation TP53 c.1010G > A (p.Arg337His), adding to the accumulated evidence that supports inclusion of TP53 in routine testing of Brazilian HBOC patients. Surprisingly, BRCA1 c.5266dupC (p.Gln1756fs), a frequently reported pathogenic variant in Brazilian HBOC patients, was not observed. Regarding the use of predictive models, we found that familial history of cancer might be used to improve selection or prioritization of patients for genetic testing, especially in a context of limited resources.


Assuntos
Neoplasias da Mama , Síndromes Neoplásicas Hereditárias , Neoplasias Ovarianas , Feminino , Humanos , Brasil/epidemiologia , Prevalência , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/diagnóstico , Predisposição Genética para Doença , Proteína BRCA2/genética , Proteína BRCA1/genética , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama/diagnóstico , Carcinoma Epitelial do Ovário , Atenção à Saúde , Mutação em Linhagem Germinativa , Proteína Supressora de Tumor p53/genética
17.
Allergol Immunopathol (Madr) ; 50(6): 10-16, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36335440

RESUMO

Our objective was to describe the serum vitamin D concentrations of children and adolescents with food allergy (FA) and to verify the association between the number of food allergens involved, length of sun exposure, and nutritional status. Through a cross-sectional study, 79 patients with FA, from ages 2 to 15 years, were assessed and followed up in a reference outpatient clinic, in Sao Paulo, Brazil. Clinical and biochemical data were collected for analysis of 25(OH)D, calcium, phosphorus, phosphatase, parathyroid hormone (PTH), and high-sensitivity C-reactive protein (hs-CRP). The cut-off point used for vitamin D deficiency was 25(OH)D ≤ 20 ng/mL. Vitamin D deficiency was detected in 45.6% of patients with a median age of 6.9 years (Interquartile range [IQR] 4.7; 10.2). The median serum 25(OH)D concentration was 21.1 ng/mL (IQR 17.8; 26.0). Multivariate linear regression was performed considering serum vitamin D level as a dependent variable. Allergy to multiple foods (inverse) and length of sun exposure (direct), but not nutritional status, were independently associated with serum 25(OH)D levels (P = 0.034 and P = 0.014, respectively). Patients with cow's milk allergy also showed lower vitamin D concentrations in comparison with other FA (19.1 ng/mL [IQR 16.6; 24.4] vs 22.2 ng/mL [IQR 18.1; 27.1] [P = 0.056]). Vitamin D deficiency affected about half of individuals with FA. Multiple food allergy was associated with lower vitamin D concentrations, reinforcing the importance of monitoring vitamin D status in patients with FA.


Assuntos
Hipersensibilidade a Leite , Deficiência de Vitamina D , Bovinos , Feminino , Animais , Alérgenos , Luz Solar , Estudos Transversais , Brasil/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D , Vitaminas
18.
Ren Fail ; 44(1): 1660-1668, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36326657

RESUMO

BACKGROUND: Acute kidney injury (AKI) is a worldwide public health problem and is often treated by non-nephrologists. The objective of this study was to evaluate the knowledge of non-nephrologists, undergraduate medical students and health professionals regarding AKI. METHODS: An unsupervised and closed-response electronic questionnaire was sent to sixth-year medical students and non-nephrologist health professionals working in the city of São Paulo, Brazil. RESULTS: A total of 424 responses were returned from 650 invitations (40.1% males, 39.2% physicians, 34.0% senior medical students or resident physicians, 16.3% nurses and 10.6% pharmacists). The knowledge of medical students and health professionals about the prevalence and lethality of AKI in hospitals ranged from 40.8% to 59.2%. The most recognized susceptibilities and risk factors for AKI were sepsis/septic shock (95.0%) and diabetes mellitus (91.3%); the less-recognized susceptibilities and risk factors were exposure to gadolinium-based contrast (23.3%) and chronic liver disease (55.7%). The study participants' rate of knowledge regarding the diagnosis of AKI was 50.9-73.6%, and their rate of knowledge regarding the criteria of increased serum creatinine and reduced urine volume was 52.6%. The most-recognized nephrotoxic medications were vancomycin (82.3%) and diclofenac (80.4%), and the least-recognized were acyclovir (34.0%) and cotrimoxazole (30.4%). The indications for emergency renal replacement therapy that were recognized by the study respondents were metabolic acidosis (82.3%), uremic syndrome (81.6%), hyperkalemia unresponsive to clinical treatment (78.1%) and acute pulmonary edema (71.6%). CONCLUSION: The study showed knowledge gaps that can impact patient care and can be used to guide professional training programs.


Assuntos
Injúria Renal Aguda , Estudantes de Medicina , Masculino , Humanos , Feminino , Estudos Transversais , Brasil/epidemiologia , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/terapia , Terapia de Substituição Renal
19.
Rev Assoc Med Bras (1992) ; 68(10): 1389-1393, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36417641

RESUMO

OBJECTIVE: Leprosy is a disabling infectious disease caused by Mycobacterium leprae. This study aimed to investigate the prevalence of leprosy among household contacts of leprosy patients. METHODS: This study is a serological survey in household contacts of leprosy patients who had been treated or were undergoing treatment in the city of Presidente Prudente, São Paulo, Brazil, from 2006-2016, using clinical examination and screening for anti- Phenolic glycolipid-I antibodies with Mycobacterium leprae-flow serology. RESULTS: A total of 263 index cases of leprosy were identified during the study period. Of these, 53 were approached, and among their household contacts, 108 were examined. The ML-flow test was positive in 2 (1.85%) individuals, but clinical examination revealed no signs or symptoms of leprosy in them. Therefore, they were considered to have a subclinical infection. Leprosy was not confirmed in any household contacts. In this study, a lower percentage of household contacts, when compared to that in the literature, had a positive Mycobacterium leprae-flow test result. CONCLUSION: The use of Mycobacterium leprae-flow should be encouraged during the follow-up of at-risk populations, such as the household contacts of leprosy patients.


Assuntos
Antígenos de Bactérias , Hanseníase , Humanos , Estudos Soroepidemiológicos , Brasil/epidemiologia , Mycobacterium leprae , Hanseníase/epidemiologia , Hanseníase/diagnóstico
20.
PLoS One ; 17(11): e0276977, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36417347

RESUMO

OBJECTIVE: The aim was to analyze the spatial association and relative risk (RR) of leprosy cases diagnosed in southern Brazil and in the Argentinean province of Misiones during 2010 to 2016. METHODS: This ecological-type epidemiological study analyzed data from the Health Ministries of both countries. The analysis included frequency measures, spatial autocorrelation, RR cluster analysis and map construction. RESULTS: A hyperendemic occurrence was identified in all study regions, in the state of Paraná 71.2% of the municipalities were hyperendemic and in Misiones, Argentina 41.2%. The GI* statistical analysis showed clusters of high incidence rates in the state of Paraná and low-risk clusters in much of the state of Rio Grande do Sul, both in Brazil. The analysis indicated an area with RR equal to 3.87 - (p < .0001) when considering the entire territory and an RR of 2.80 - (p < .0001) excluding the state of Paraná, with the number of departments of Misiones, Argentina included in the risk clusters increasing significantly. CONCLUSIONS: The findings indicate a high probability of similar illness in adjacent areas, according to their relative position in space, as the occurrence of the disease is influenced by neighboring clusters.


Assuntos
Hanseníase , Mariposas , Animais , Brasil/epidemiologia , Argentina/epidemiologia , Hanseníase/epidemiologia , Análise Espacial
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