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1.
BMC Public Health ; 20(1): 477, 2020 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-32276612

RESUMEN

BACKGROUND: Chronic venous disease (CVD) and disability are worldwide problems and have significant socioeconomic implications. This study aims to analyze the time trends and social security burden of temporary work disability due to CVD in Brazil. METHODS: An ecological time series study using the Brazilian Social Security System database was performed from 2005 to 2014. Data from all benefits granted to workers with temporary disability due to CVD were analyzed. The cases were identified using diagnosis codes I83-I83.9 of the International Classification of Diseases 10th Revision (ICD-10). The time trend analyses were performed by the Joinpoint Regression Model, with sex, age, regions, income, and category of affiliation as variables. Crude and age-standardized rates were calculated. RESULTS: A total of 429,438 benefits were granted for temporary work disability due to CVD from 2005 to 2014, with a growing trend and an age-standardized annual percent change (APC) of 3.4 (95% CI: 2.6-4.2) (p < 0.05). Social security expense increased 3.5-fold, and the number of days in benefit doubled from 2005 to 2014. In total, 27,017,818 working days were lost. The average duration of benefits was 55.3 days. The majority of workers were women (68.2%) (p < 0.001), between 30 and 59 years old, employed, had a monthly income ≤2 minimum wages (MW) (83.2%), and lived in the regions southeast (53.6%) and south (29.3%). Significantly higher APCs were observed for women than for men (APC: 4.9, 95% CI: 4.0-5.7 versus APC: 1.2, 95% CI: 0.1-2.4). All regions in Brazil had a significant growing trend, except in the north. No significant growth was observed in the age group of 60-69 years. A decreasing trend was observed in workers with monthly incomes above 2 MW (p < 0.05). CONCLUSIONS: Temporary work disability due to CVD and social security burden showed increasing trends with millions of working days lost, particularly among women and low-income workers. Preventing disability is challenging, and public policies are needed to reduce the social and economic impact of disability. Therefore, measures for promoting health at the workplace should be encouraged.


Asunto(s)
Personas con Discapacidad/estadística & datos numéricos , Seguridad Social/economía , Enfermedades Vasculares/economía , Enfermedades Vasculares/epidemiología , Adolescente , Adulto , Anciano , Brasil/epidemiología , Enfermedad Crónica , Bases de Datos Factuales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Tiempo , Adulto Joven
2.
J Infect Dis ; 220(11): 1797-1801, 2019 10 22.
Artículo en Inglés | MEDLINE | ID: mdl-31352487

RESUMEN

Congenital Zika syndrome (CZS) is a cluster of malformation, and the mechanisms that lead it are still unclear. Using hypothesis-driven candidate genes and their function in viral infections, single-nucleotide polymorphisms (SNPs) were genotyped by quantitative polymerase chain reaction in a sample population from Sergipe State, Brazil. This study shows that rs3775291 SNP at Toll-like receptor 3, which triggers type I interferon antiviral responses in mothers infected by Zika virus during pregnancy, is associated with CZS occurrence (odds ratio [OR], 2.19; 95% confidence interval [CI], 1.158-4.148). Moreover, rs1799964 SNP at tumor necrosis factor-α gene in CZS babies is associated with severe microcephaly (OR, 2.63; 95% CI, 1.13-6.21).


Asunto(s)
Genotipo , Microcefalia/genética , Receptor Toll-Like 3/genética , Factor de Necrosis Tumoral alfa/genética , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/genética , Adolescente , Adulto , Brasil , Femenino , Técnicas de Genotipaje , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Polimorfismo de Nucleótido Simple , Reacción en Cadena en Tiempo Real de la Polimerasa , Adulto Joven
3.
Emerg Infect Dis ; 25(11): 2088-2092, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31625841

RESUMEN

Through whole-genome sequencing analysis, we identified non-Leishmania parasites isolated from a man with a fatal visceral leishmaniasis-like illness in Brazil. The parasites infected mice and reproduced the patient's clinical manifestations. Molecular epidemiologic studies are needed to ascertain whether a new infectious disease is emerging that can be confused with leishmaniasis.


Asunto(s)
Infecciones por Euglenozoos/epidemiología , Infecciones por Euglenozoos/parasitología , Trypanosomatina/genética , Anciano , Animales , Brasil/epidemiología , ADN Espaciador Ribosómico , Genes de Helminto , Humanos , Leishmaniasis Visceral/epidemiología , Leishmaniasis Visceral/parasitología , Masculino , Ratones , Filogenia , Trypanosomatina/clasificación
4.
Br J Clin Pharmacol ; 80(5): 1160-8, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25940755

RESUMEN

AIMS: The aim of the present study was to investigate the impact of human visceral leishmaniasis (VL) and curative chemotherapy on the activity of cytochrome P450 (CYP) 3A, CYP2C9 and CYP2C19 in patients from an endemic region in Brazil. METHODS: Adult patients with parasitologically confirmed VL were given a CYP phenotyping cocktail, comprising midazolam, omeprazole and losartan, immediately before (Study phase 1), 2-3 days (phase 2) and 3-6 months (phase 3) after curative VL chemotherapy. CYP activity was assessed by the apparent clearance of midazolam (CYP3A), omeprazole/5-hydroxyomeprazol ratio in plasma (CYP2C19) and losartan/E3174 ratio in urine (CYP2C9). RESULTS: Mean values (95% confidence interval) in phases 1, 2 and 3 were, respectively: log apparent midazolam clearance, 1.21 (1.10-1.31), 1.45 (1.32-1.57) and 1.35 (1.26-1.44) ml min(-1) kg(-1) ; omeprazole/5-hydroxyomeprazole ratio, 0.78 (0.61-0.94), 0.45 (0.27-0.63) and 0.37 (0.20-0.55); losartan/E3174 ratio, 0.66 (0.39-0.92), 0.35 (0.20-0.50) and 0.35 (0.16-0.53). Analysis of variance revealed significant differences in CYP3A (P = 0.018) and CYP2C19 (P = 0.008), but not CYP2C9 (P = 0.11) phenotypic activity, across the three study phases. CONCLUSION: The phenotypic activities of CYP3A4 and CYP2C19 were significantly reduced during acute VL compared with post-chemotherapy. We propose that increased plasma concentrations of proinflammatory cytokines during active disease account for the suppression of CYP activity. The failure to detect significant changes in CYP2C9 activity in the overall cohort may reflect differential effects of the inflammatory process on the expression of CYP isoforms, although the possibility of insufficient statistical power cannot be dismissed.


Asunto(s)
Sistema Enzimático del Citocromo P-450/metabolismo , Leishmaniasis Visceral/tratamiento farmacológico , Leishmaniasis Visceral/enzimología , Losartán/farmacocinética , Midazolam/farmacocinética , Omeprazol/farmacocinética , Adolescente , Adulto , Brasil , Citocromo P-450 CYP2C19/metabolismo , Citocromo P-450 CYP2C9/metabolismo , Citocromo P-450 CYP3A/metabolismo , Femenino , Humanos , Losartán/orina , Masculino , Midazolam/sangre , Persona de Mediana Edad , Omeprazol/sangre , Adulto Joven
5.
Diagnostics (Basel) ; 13(22)2023 Nov 17.
Artículo en Inglés | MEDLINE | ID: mdl-37998606

RESUMEN

This study focuses on developing accurate immunoassays for diagnosing Chagas disease (CD), a challenging task due to antigenic similarities between Trypanosoma cruzi and other parasites, leading to cross-reactivity. To address this challenge, chimeric recombinant T. cruzi antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) were synthesized to enhance specificity and reduce cross-reactivity in tests. While these antigens showed minimal cross-reactivity with leishmaniasis, their performance with other trypanosomatid infections was unclear. This study aimed to assess the diagnostic potential of these IBMP antigens for detecting CD in patients with Crithidia sp. LVH-60A, a parasite linked to visceral leishmaniasis-like symptoms in Brazil. This study involved seven Crithidia sp. LVH-60A patients and three Leishmania infantum patients. The results indicated that these IBMP antigens displayed 100% sensitivity, with specificity ranging from 87.5% to 100%, and accuracy values between 90% and 100%. No cross-reactivity was observed with Crithidia sp. LVH-60A, and only one L. infantum-positive sample showed limited cross-reactivity with IBMP-8.1. This study suggests that IBMP antigens offer promising diagnostic performance, with minimal cross-reactivity in regions where T. cruzi and other trypanosomatids are prevalent. However, further research with a larger number of Crithidia sp. LVH-60A-positive samples is needed to comprehensively evaluate antigen cross-reactivity.

6.
J Nerv Ment Dis ; 196(11): 852-5, 2008 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19008738

RESUMEN

Our study evaluated the relationship between positive affect (PA) and negative affect (NA) traits on the development of posttraumatic stress symptoms (PTSS) among peacekeepers. A longitudinal study with 138 army personnel deployed to a peacekeeping mission in Haiti was conducted. An instrument for measuring PA and NA traits was used before deployment. PTSS, indexed by posttraumatic stress disorder Checklist--Military Version (PCL-M) and frequency of stressful situations were measured after return. Regression analysis showed that both NA and number of stressful situations contributed toward increasing PCL-M scores (Adjusted R = 0.25; p < 0.001). We also found that NA traits interact with intensively stressful situations enhancing the occurrence of PTSS (Adjusted R = 0.32; p < 0.001). These findings suggest that NA traits are an important predictor for PTSS among peacekeepers and also worsen the consequences of being exposed to stressful situations.


Asunto(s)
Síntomas Afectivos/diagnóstico , Trastornos de Combate/diagnóstico , Personal Militar/psicología , Trastornos por Estrés Postraumático/diagnóstico , Naciones Unidas , Voluntarios/psicología , Adulto , Síntomas Afectivos/epidemiología , Síntomas Afectivos/psicología , Brasil , Carácter , Trastornos de Combate/epidemiología , Trastornos de Combate/psicología , Estudios Transversales , Haití , Humanos , Estudios Longitudinales , Masculino , Inventario de Personalidad/estadística & datos numéricos , Estudios Prospectivos , Psicometría , Factores de Riesgo , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Voluntarios/estadística & datos numéricos , Adulto Joven
7.
Dent J (Basel) ; 6(4)2018 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-30360395

RESUMEN

The aim of this study was to investigate the association of stress and anxiety with the expectation, perception and memory of dental pain among schoolchildren. A follow-up study involving 46 children aged 9 to 12 years was conducted in a public school in the city of Petropolis (RJ), Brazil. Demographic characteristics, stress (children's stress scale), and state and trait anxiety (state⁻trait anxiety inventory) were recorded before a dental procedure to restore the occlusal surface of a permanent first molar under local anaesthetic. Dental pain was assessed using the faces pain scale before (dental pain expectation), immediately after (dental pain perception) and six weeks after (memory of dental pain) the dental procedure. Dental pain expectation scores were significantly higher than dental pain perception, independent of the levels of stress, state anxiety and trait anxiety. Children with high scores of stress (OR 1.05 95%CI 1.02⁻1.09), state anxiety (OR 1.15 95%CI 1.05⁻1.27) and trait anxiety (OR 1.18 95%CI 1.07⁻1.30) were more likely to report greater scores of dental pain expectation. Children anticipated more dental pain than what was actually perceived after the dental restoration. Children with greater levels of stress and anxiety have a distorted evaluation of expected dental pain before the dental procedure.

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