RESUMO
AIM: Chemically disparate toxic organic and/or inorganic molecules produced by anthropogenic activities often hinder the bioremediation process. This research was conducted to understand the capacity of Streptomyces sp. MC1 to remove chemically disparate toxics such as Cr(VI) or phenanthrene. METHODS AND RESULTS: Genomic, metabolic modeling and proteomic approaches were used in this study. Our results demonstrated that Streptomyces sp. MC1 has the genetic determinants to remove Cr(VI) or degrade phenanthrene. Proteomics showed that these genetic determinants were expressed. Metabolic versatility of the strain was confirmed by two metabolic models in complex and minimal media. Interestingly, our results also suggested a connection between the degradation of phenanthrene and synthesis of specialized metabolites. CONCLUSIONS: Streptomyces sp. MC1 has the genetic and physiological potential to remove Cr(VI) or degrade phenanthrene SIGNIFICANCE AND IMPACT OF STUDY: The probability of a microorganism to survive in the presence of different contaminants depends on its genetic potential and the ability to express it. The genetic and proteomic profiles obtained for Streptomyces sp. MC1 can be recommended as model and predict if other Streptomyces strains can be used in bioremediation processes. Our work also hypothesized that intermediates of the phenanthrene degradation serve as precursors for the specialized metabolism.
Assuntos
Cromo/metabolismo , Fenantrenos/metabolismo , Streptomyces/genética , Streptomyces/metabolismo , Biodegradação Ambiental , Genômica , ProteômicaRESUMO
Water buffaloes (Bubalus bubalis) are quite well adapted to climatic conditions in the Amazon, and in this biome, they are noted for the considerable amount of meat and milk they produce and how hard they are able to work. Because of a lack of research dedicated to improving the rearing of buffaloes in the Amazon, the objective of this study was to genetically characterize the Murrah and Mediterranean breeds, as well as a mixed-breed population, based on polymorphisms in the diacylglycerol O-acyltransferase 1 gene (DGAT1), and associate the genotypes with milk production. By using the polymerase chain reaction-single-strand conformation polymorphism technique, the alleles A (0.79), B (0.20), and D (0.01) were found in the Murrah breed. In the Mediterranean and mixed-breed buffaloes, we found alleles A (0.69) and (0.77) and B (0.31) and (0.23), respectively. The Murrah breed had the genotypes AA (0.63), AB (0.29), BB (0.05), and AD (0.03), and the Mediterranean and mixed-breed buffaloes had the genotypes AA (0.44) and (0.61), AB (0.50) and (0.31), and BB (0.06) and (0.08), respectively. For the Murrah, Mediterranean, and mixed-breed buffaloes, respectively, the expected heterozygosity values were 0.34, 0.43, and 0.35, the inbreeding coefficients were 0.78, -0.15, and 0.17, and the Hardy-Weinberg probabilities were 0.70, 0.67, and 0.52. The genotypes evaluated did not have an effect on milk production; however, the single nucleotide polymorphisms can be used in studies on genetic variability.
Assuntos
Búfalos/genética , Diacilglicerol O-Aciltransferase/genética , Variação Genética , Alelos , Animais , Diacilglicerol O-Aciltransferase/metabolismo , Genótipo , Leite/metabolismo , Polimorfismo de Nucleotídeo Único/genéticaRESUMO
The organochlorine insecticide γ-hexachlorocyclohexane (γ-HCH, lindane) and its non-insecticidal α- and ß-isomers continue to pose serious environmental and health concerns, although their use has been restricted or completely banned for decades. In this study we report the first evidence of the growth ability of a Streptomyces strain in a mineral salt medium containing high doses of α- and ß-HCH (16.6 mg l(-1)) as a carbon source. Degradation of HCH isomers by Streptomyces sp. M7 was investigated after 1, 4, and 7 days of incubation, determining chloride ion release, and residues in the supernatants by GC with µECD detection. The results show that both the α- and ß-HCH isomers were effectively metabolized by Streptomyces sp. M7, with 80 and 78 % degradation respectively, after 7 days of incubation. Moreover, pentachlorocyclohexenes and tetrachlorocyclohexenes were detected as metabolites. In addition, the formation of possible persistent compounds such as chlorobenzenes and chlorophenols were studied by GC-MS, while no phenolic compounds were detected. In conclusion, we have demonstrated for the first time that Streptomyces sp. M7 can degrade α- and ß-isomers individually or combined with γ-HCH and could be considered as a potential agent for bioremediation of environments contaminated by organochlorine isomers.
Assuntos
Hexaclorocicloexano/química , Hexaclorocicloexano/metabolismo , Poluentes do Solo/química , Poluentes do Solo/metabolismo , Streptomyces/metabolismo , Anaerobiose , Biodegradação Ambiental , Inseticidas/química , Inseticidas/metabolismo , IsomerismoRESUMO
Cereus jamacaru DC. occurs in the central-eastern region of Brazil and is among the best-known cacti in the country. Its phytochemical properties and fruits hold great significance to the local communities. We examined published ethnobotanical studies regarding C. jamacaru (mandacaru) undertaken between 2000 to 2024, to better understand its traditional uses and relationships with human communities in Brazil. The literature review was carried out by consulting the databases Google Scholar (166 articles), Scopus (1 article) and Web of Science (2 articles), and followed the PRISMA 2020 protocol. A total of 169 articles were identified, of which 45 were deemed relevant. The most frequent uses of C. jamacaru include medicinal (cited in 32 articles), human consumption as a non-conventional food (22), and forage (18). C. jamacaru is often cited to treat health conditions such as kidney problems, flu and inflammations, but it's also used for construction and crafts. Our results highlight the diverse and vital uses of C. jamacaru for human communities. Furthermore, we demonstrate the pattern of knowledge production regarding the ethnobotany of this species and the challenges for its conservation and the preservation of associated traditional knowledge.
Assuntos
Cactaceae , Etnobotânica , Brasil , Humanos , Cactaceae/classificação , Cactaceae/químicaRESUMO
We evaluated the phenology and reproductive phenological diversity of three sympatric species of Miconia in a gallery forest in the Chapada Diamantina mountains, Bahia, Brazil. The reproductive phenophases (bud, flower, immature fruit, and mature fruit) of M. alborufescens (N=38), M. holosericea (N=46), and M. prasina (N=44) were evaluated monthly, between June/2008 and June/2015. The Fournier index was used to assess the intensities of the reproductive phenophases; synchrony and seasonality were analyzed using circular statistics and the Rayleigh (Z) test. The Frideman and Wilcoxon tests were used to verify interannual variations in phenological patterns. Reproductive phenological diversity was measured by calculating the Shannon-Wiener index; ANOVA tested possible differences in the means of diversity among the different years. The reproductive phenophases of the studied Miconia species occurred sequentially (M. alborufescens, then M. holoserica, followed by M. prasina), in the transition between the dry and rainy seasons, with little overlap between them. In general, the species showed seasonal and synchronic phenological patterns, with some variations that coincided with El Niño and/or La Niña events, e.g., demonstrating changes in the periodicity, synchrony, and intensity of their phenophases. The intensity of fruiting, for example, showed increases during La Niña years. Reproductive phenological diversity appears to respond to climate changes resulting from El Niño events and periods of prolonged drought, with high Shannon-Wiener index values. The results also suggest that the effects of global climatic phenomena (El Niño and La Niña) that alter regional climatic seasonality can also cause variations in the reproductive phenological rhythms of the Miconia species studied.
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Melastomataceae , Floresta Úmida , Estações do Ano , Florestas , Chuva , El Niño Oscilação SulRESUMO
Ateleia glazioveana Baill. is a pioneer, rustic and can be used for forest recovery. This work aimed to study the process of physiological maturation of this species. The research was carried out in the city of Alegre - ES, the trees were identified in the floral anthesis and accompanied during the filling of the fruits and development of the seeds until the complete maturation. The fruits were harvested at the following stages 7, 14, 21, 28, 35 and 42 days after anthesis, and characterized according to: morphometry, moisture, fresh and dry mass of fruits and seeds, germination, germination speed index, shoot and root length and dry mass of seedlings. The regression equations were adjusted for the main characteristics analyzed as a function of the harvest period. The point of physiological maturity of timbó occurred at 42 days after anthesis.
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Fabaceae , Sementes , Germinação/fisiologia , Plântula , FrutasRESUMO
INTRODUCTION: Fibrogenesis markers, such as alpha-actin (AA), CD163 (macrophages), and E-cadherin, have been studied as chronic kidney allograft injury (CAI) predictors, a major cause of allograft failure. OBJECTIVE: Investigate the value of these markers in predicting CAI and initiation of dialysis. MATERIALS AND METHODS: Retrospective analysis of 26 kidney allograft biopsies (from 22 patients with CAI) during 2 years, evaluating intensity and percentage of marked cells on glomeruli and tubulointerstitial compartment. At the time of the biopsy, patients were 45.5 ± 15.8 years and 4.2 years after transplant, and they had a mean glomerular filtration rate (GFR) of 25.8 ± 9.9 mL/min. From an average of 8.5 glomeruli per biopsy, there was ≤25% sclerosis in 17 cases, 26% to 50% in 5, and >50% in 4. Interstitial fibrosis or tubular atrophy affected ≤25% of cortical area in 14 cases, 26% to 50% in 8, and >50% in 2. Twelve patients started dialysis 5.8 ± 4.7 years after transplant, with an average GFR 20.9 mL/min at the time of the biopsy. RESULTS: There was a higher intensity and percentage of CD163-marked cells in the tubulointerstitial compartment in advanced interstitial fibrosis. We found an association between intensity of AA in the tubulointerstitial compartment and initiation of dialysis (P = .003) and a negative correlation between intensity of E-cadherin loss and GFR (r = -0.56, P = .012). CONCLUSIONS: In our study, intensity of tubulointerstitial AA was shown to be a predictor of initiation of dialysis, and E-cadherin loss intensity was associated to CAI progression. However, prospective and larger studies are needed to evaluate the predictive value of these markers.
Assuntos
Aloenxertos/química , Sobrevivência de Enxerto/fisiologia , Nefropatias/fisiopatologia , Transplante de Rim/efeitos adversos , Complicações Pós-Operatórias/fisiopatologia , Actinas/análise , Adulto , Aloenxertos/fisiopatologia , Antígenos CD , Biomarcadores/análise , Biópsia/métodos , Caderinas/análise , Progressão da Doença , Feminino , Fibrose , Taxa de Filtração Glomerular , Humanos , Rim/química , Rim/fisiopatologia , Nefropatias/etiologia , Nefropatias/terapia , Glomérulos Renais/química , Glomérulos Renais/fisiopatologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia , Diálise Renal , Estudos RetrospectivosRESUMO
BACKGROUND: Polyomavirus nephropathy (BKVN) is an important cause of chronic allograft dysfunction (CAD). Recipient determinants (male sex, white race, and older age), deceased donation, high-dose immunosuppression, diabetes, delayed graft function (DGF), cytomegalovirus infection, and acute rejection (AR) are risk factors. Reducing immunosuppression is the best strategy in BKVN. The objective of our study was to evaluate CAD progression after therapeutic strategies in BKVN and risk factors for graft loss (GL). METHODS: Retrospective analysis of 23 biopsies, from patients with CAD and histological evidence of BKVN, conducted over a period of 10 years. Glomerular filtration rate was <30 mL/min in 16 patients at the time of the BKVN diagnosis. RESULTS: BKVN was histologically diagnosed in 23 recipients (19 men, 4 women). All patients were white, with age of 51.2 ± 12.1 years (6 patients, age >60 years), and 22 had a deceased donor. Diabetes affected 4 patients, DGF occurred in 3, cytomegalovirus infection in 2, and AR in 15. All patients were medicated with calcineurin inhibitors (CNI) (95.7% tacrolimus) and corticoids, and 16 also received an antimetabolite. One year after antimetabolite reduction/discontinuation and/or CNI reduction/switching and/or antiviral agents, graft function was decreased in 11 patients, increased/stabilized in 10, and unknown in 2. GL occurred in 9 patients. Older age (hazard ratio, 1.76; 95% confidence interval, 0.94-3.28) and DGF (hazard ratio, 2.60; 95% confidence interval, 0.54-12.64) were the main risk factors for GL. The lower GFR at the time of the BKVN diagnosis was associated with an increased risk of initiation of dialysis. CONCLUSIONS: GL occurred in 39.1% of patients with BKVN and DGF; older age and lower GFR at the time of diagnosis were important risk factors. Early diagnosis of BKVN is essential to prevent GL.
Assuntos
Inibidores de Calcineurina/efeitos adversos , Terapia de Imunossupressão/efeitos adversos , Nefropatias/virologia , Transplante de Rim/efeitos adversos , Infecções por Polyomavirus/complicações , Complicações Pós-Operatórias/virologia , Adulto , Aloenxertos/virologia , Vírus BK , Função Retardada do Enxerto/virologia , Progressão da Doença , Feminino , Taxa de Filtração Glomerular , Sobrevivência de Enxerto , Humanos , Masculino , Pessoa de Meia-Idade , Polyomavirus , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Risco , Tacrolimo/efeitos adversos , Fatores de TempoRESUMO
The objective of this study was to determine factors affecting phenotypic characteristics related to milk production and reproductive efficiency of dairy buffalo. Phenotypic records of 2,459 Murrah, Mediterranean and crossbred buffaloes from the Embrapa Eastern Amazônia herd, from 1969 to 2013 were used. Traits included: total milk production during lactation (TMP), milk production corrected for 305 days (P305); cow weight at calving (CW), fat milk percentage (F), age at first calving (AFC), calving interval (CI), calf birth weight (BW), as well as lactation (LP) and service periods (SP). Most traits were affected by genetic group as well as year and season or interaction between them. Genetic group affected F, CI, SP and CW. Very young and older cows showed poorer production traits. There was interaction between season and year for F, CI and CW. Correlations traits were generally medium to low. The principal component analysis showed that higher fat milk percentage was associated with higher percentage of Murrah breed, longer lactation period and older cows. Phenotypic characteristics in buffaloes reared in the Brazilian Amazon were significantly affected by genetic and management factors. This information can be used to help build sustainable production systems for the region and guide farmer decisions.(AU)
O objetivo deste estudo foi determinar os fatores que afetam as características fenotípicas relacionadas à produção de leite e a eficiência reprodutiva de búfalas leiteiras. Foram utilizados os registros fenotípicos de 2.459 búfalas das raças Murrah, Mediterrâneo e seus cruzamentos do rebanho da Embrapa Amazônia Oriental, de 1969 a 2013. As características incluídas foram: produção total de leite durante a lactação (PTL), produção de leite corrigida para 305 dias (P305), peso da búfala ao parto (PV), percentual de gordura do leite (G), idade ao primeiro parto (IPP), intervalo entre partos (IP), peso do bezerro ao nascimento (PN), assim como os períodos de lactação (PL) e de serviço (PS). A maioria das características foi afetada pelo grupo genético, bem como pelo ano e pela estação ou pela interação entre eles. O grupo genético afetou o G, IP, PS e PV. Búfalas muito jovens e mais velhas mostraram características de produção mais baixas. Houve interação entre estação e o ano para G, IP e PV. As correlações entre as características foram geralmente de médias a baixas. A análise de componentes principais mostrou que a maior porcentagem de gordura no leite foi associada com a maior porcentagem de sangue Murrah, com o maior período de lactação e com búfalas mais velhas. As características fenotípicas das búfalas criadas na Amazônia brasileira foram significativamente afetadas por fatores genéticos e de manejo. Essas informações podem ser usadas para ajudar a construir sistemas de produção sustentáveis para a região e orientar as decisões dos produtores.(AU)
Assuntos
Animais , Feminino , Fenótipo , Búfalos/genética , LeiteRESUMO
With the aim of describing the structure and process by which prenatal care is provided at the primary health care level in the city of Pelotas in southern Brazil, a descriptive cross-sectional study was conducted. All 31 urban health care facilities were visited and their structure analyzed. A total of 839 prenatal records from mothers who delivered in the six months prior to the beginning of the study were reviewed. The structure as a whole was classified as poor (only 70% of standard parameters were present), mainly due to deficiencies in the physical plant. Process assessment showed low coverage (53%) and an average of 5.3 visits. Only 37% of patient records showed adequate results (Kessner Index). Adding laboratory test results and routine procedures as complementary criteria, 31% and 5% of the records scored as adequate, respectively. In summary, overall quality of prenatal care provided at the primary health care level in Pelotas is poor. Mechanisms to increase staff adherence to both procedures and program logistics need to be developed.
Assuntos
Atenção à Saúde/organização & administração , Cuidado Pré-Natal/organização & administração , Atenção Primária à Saúde/organização & administração , Qualidade da Assistência à Saúde , Adolescente , Adulto , Estudos Transversais , Feminino , Hospitalização , Humanos , Auditoria Médica , GravidezRESUMO
This study deals with adherence to tuberculosis treatment among men and women as well as the disease's links and consequences vis-à-vis life styles and treatment outcomes. The ethnographic study was a component of the Tuberculosis Epidemiological Control Project in the city of Pelotas and aimed to identify the reasons patients failed to complete treatment. Direct ethnographic observations and semi-structured interviews were used. Use of the term "adherence" is justified by the concern for extending to other fundamental factors in addition to the patient's own individual responsibility. This approach fostered an understanding of views towards disease, social dynamics among the various protagonists involved in the disease process, and treatment. Some of the factors considered in adherence to treatment were: socio-demographic characteristics, cultural factors, popular beliefs, the cost-benefit relationship, physical and chemical aspects of the drugs, the physician-patient relationship, and level of family participation in treatment.
Assuntos
Cooperação do Paciente , Recusa do Paciente ao Tratamento/psicologia , Tuberculose Pulmonar/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brasil , Efeitos Psicossociais da Doença , Características Culturais , Relações Familiares , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente/psicologia , Relações Médico-Paciente , Fatores Socioeconômicos , Tuberculose Pulmonar/psicologiaRESUMO
OBJECTIVE: The objective was determine the use of health services by the adult population in Pelotas, RS, Brazil. METHODS: A cross-sectional study was made on the basis of a population sample. One thousand six hundred and fifty-seven persons we interviewed during the months of March and June, 1992. A percentage of 9.7 of the sample was lost. RESULTS: Two dependents variables. One the type of service as determined by type of payment. The other the number of medical visits made during the previous year. The type of service was seen to be associated with the following social variables: social class, level of schooling and place of residence. The frequency of medical visits was associated with sex, risk factors and reasons for the visit. CONCLUSION: It was concluded that choice of the type of service depends more heavily in social class than other variables associated with the severity of the disease in question.
Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Serviços Urbanos de Saúde/estatística & dados numéricos , Adulto , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Classe SocialRESUMO
OBJECTIVE: The characterization of diabetic patients seen at a primary health care clinic. METHODS: The case notes of 3,024 families were searched by means of a cross-sectional study for patients 30 to 75 years of age with a diagnosis of diabetes mellitus who had had a medical consultation during the previous five years. These patients were interviewed at their homes and were asked to come to the health center for physical examination and a plasma glucose test using glucosylated hemoglobin (GH). RESULTS: The prevalence of diabetes was 4%. The typical diabetic patient was a white women, > or = 50 years of age, from a family with a monthly income < or = 3 minimum wages. Compliance with GH was observed in 70% of the patients. Diet therapy was followed by less than one third of the patients and only one fifth were engaged in regular exercise. Nearly 70% were undergoing drug therapy (oral hypoglicemic agents or insulin); of these, only 15% used insulin. Most of the patients (66%) who agreed to have the GH test showed normal or fair glucose blood levels. CONCLUSIONS: Great efforts should be made by health teams to enhance diabetic patient education in order to promote compliance with recommendations regarding diet and exercise.
Assuntos
Diabetes Mellitus/diagnóstico , Diabetes Mellitus/terapia , Adulto , Idoso , Brasil , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Atenção Primária à Saúde , Avaliação de Processos em Cuidados de SaúdeRESUMO
INTRODUCTION: A medical audit on the prenatal care program in the Vila Municipal Health Center, Pelotas, RS, Brazil, was described with the purpose of verifying the aspects of the medical process and improving the program's effectiveness. METHODS: Data from prenatal specific records were collected. Pregnant women with delivery due date in 1997 and in the first semester of 1998 were included in the study. Women registered in the program when they were 4-month pregnant and who had had at least 5 visits were also enrolled. Bivariate analysis was used to detect health care indicators. RESULTS: A total of 73 pregnant women were registered in the program in 1997 and 75 in 1998. In 1997, the average number of medical visits was 5.2, while in 1998 this average was 6.2. The difference between the means was statistically significant (p<0.05). Some medical process indicators were analysed to verify the quality of the care. CONCLUSION: The use of the epidemiological method to organize health services was discussed. This type of study requires few resources and time and it can provide guidelines to health service actions.
Assuntos
Auditoria Médica/normas , Cuidado Pré-Natal/normas , Avaliação de Programas e Projetos de Saúde , Adolescente , Adulto , Brasil , Feminino , Instalações de Saúde , Humanos , Gravidez , Indicadores de Qualidade em Assistência à SaúdeRESUMO
This article describes an evaluation method that involves the health team. This method is fast and cheap. The major objective is the use of the health team to improve the health attention quality. This method gives information about children inscription, consults.
RESUMO
The objective of this study was to evaluate genetic aspects related to production and reproductive efficiency of Murrah and Mediterranean buffaloes and their crosses. A ranking of bulls from Embrapa Eastern Amazonia was also composed to guide assisted mating. Birth records of 2,322 Murrah, Mediterranean, and crossbred buffaloes from the Embrapa Eastern Amazon herd, from 1953 to 2013, as well as information on production and reproductive traits were used. Genetic analyzes were performed in the WOMBAT software using the animal model with two-trait analysis. While heritability (h2) for total milk production (TMP) and fat milk percentage (F) were generally high, for reproductive traits h2 tended to be low. Genetic correlations for TMP with the other traits were low and negative, except for TMP with calving interval (CI) and service period (SP) in the Mediterranean breed and with age at first calving (AFC) and SP in crossbred, which were positive and high. Bull 1001 had high predicted transmitting ability (PTA) for TMP, so it should transmit a greater volume of milk to his offspring, although it had a lower PTA for F. There was sufficient variability within the herd to work with genetic management for both production and reproductive efficiency.(AU)
O objetivo deste estudo foi avaliar os aspectos genéticos relacionados à produção e à eficiência reprodutiva de búfalas das raças Murrah, Mediterrâneo e suas cruzas. Uma classificação de touros da Embrapa Amazônia Oriental também foi composta para orientar os cruzamentos assistidos. Foram utilizados 2.322 registros de nascimento de búfalas das raças Murrah, Mediterrâneo e cruzadas do rebanho da Embrapa Amazônia Oriental, de 1953 a 2013, bem como características produtivas e reprodutivas. As análises genéticas foram realizadas pelo software Wombat, utilizando-se o modelo animal com análise de duas características. Enquanto a herdabilidade (h 2 ) para a produção total de leite (PTL) e para a porcentagem de gordura (G) foi alta, para as características reprodutivas a h 2 tendeu a ser baixa. As correlações genéticas da PTL com as demais características foram baixas e negativas, exceto para a PTL com intervalo entre partos (IP) e período de serviço (PS) na raça Mediterrâneo e com idade ao primeiro parto (IPP) e PS nas cruzadas, que foram positivas e altas. O touro 1001 apresentou alta capacidade de transmissão predita (CTP) para a PTL, então deve transmitir um maior volume de leite para seus descendentes, embora com um menor conteúdo transmissível de CTP para G. Portanto, existe variabilidade suficiente dentro do rebanho para trabalhar com o manejo genético para a produção e a eficiência reprodutiva.(AU)
Assuntos
Animais , Cruzamento/estatística & dados numéricos , Búfalos/genética , Técnicas Reprodutivas/veterinária , Correlação de DadosAssuntos
Anestesia Obstétrica , Cesárea , Feto/efeitos dos fármacos , Ketamina , Tiopental , Avaliação de Medicamentos , Feminino , Humanos , Recém-Nascido , Troca Materno-Fetal , GravidezRESUMO
In 1995, cervical cancer was the fourth most important cause of death among women in the state of Rio Grande do Sul, Brazil. There are no available studies on Pap smear examination coverage in Pelotas, which is the largest city in the southern part of Rio Grande do Sul. Accordingly, in 1992 a population-based, cross-sectional study was carried out among 20 to 69 year-old women residing in urban areas of the city. The objectives of the study were to ascertain any Pap smear testing in the 3 years prior to the study, to determine the coverage of cervical cancer screening, and to identify any factors associated with the performance of Pap tests in Pelotas. Social class was chosen as the determining variable. To categorize social class, two classifications were used: Bronfman's classification and the classification used by the Brazilian Association of Market Research Institutes. Among the 934 women interviewed, 606 (65%) had had a Pap smear test in the 3 years before the study. The multivariate analysis revealed significant differences regarding performance of such tests in terms of social class, age, and frequency of medical consultations per year. No significant differences were found in terms of education, type of health service used, or hospitalizations during the year prior to the study. This study reveals that coverage of cervical cancer screening for women between 20 and 69 years of age in Pelotas is higher than the coverage found in other parts of the country or even of the world. However, for women in lower social classes, coverage was found to be between 52 and 56%. These data can contribute to the development of measures aimed at increasing cervical cancer screening among specific sectors of the population.
Assuntos
Teste de Papanicolaou , Esfregaço Vaginal , Adulto , Idoso , Brasil , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Classe Social , Neoplasias do Colo do Útero/prevenção & controleRESUMO
OBJECTIVE: To evaluate the role of central adiposity, as evaluated by the measurement of waist circumference (WC), as an independent risk factor for hypertension and type 2 diabetes mellitus in the setting of a developing country. DESIGN: Population-based, cross-sectional study. SETTING: A medium-sized town in southern Brazil. PARTICIPANTS: One thousand and ninety-five non-pregnant women, 20 to 69 years old, recruited by cluster random sampling between 1999 and 2000. Their mean WC was 85.3 cm (standard deviation 13.9 cm) and 23.3% (n=255) were obese (body mass index >30 kg m(-2)). The prevalence of hypertension and diabetes was 25.6% (n=280) and 6.2% (n=68), respectively. RESULTS: The risks of hypertension and diabetes were directly related to WC measurement. Women with WC>80 cm had increased risk of hypertension (odds ratio (OR)=6.2, P<0.001). The association remained significant (OR=1.04 per cm increase in WC, P=0.02) after adjusting for confounders. The effect of WC on diabetes was modified by age. The effect was stronger in women younger than 40 years old (OR=12.7, P=0.016) than in those over 40 years old (OR=2.8, P=0.013). In the multivariate analysis, the odds ratio was 5.7 (P=0.12) in those under 40 years old and 2.8 (P=0.008) in older women. CONCLUSIONS: Waist circumference is an independent determinant for hypertension and diabetes in women in this population. The stronger association between WC and diabetes in younger women suggests that the validity of this indicator to assess abdominal adiposity is age-specific. Further studies should validate the usefulness of WC measurement in different age groups.