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1.
Ethn Health ; 26(8): 1261-1274, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-31072126

RESUMEN

Objective: To relate the socio-demographic profile with access to health services of the population living in environmentally degraded areas in an estuary region.Study design: A sectional field study of 8819 people, evaluating three contaminated areas of São Vicente.Methods: Households were divided by studied area. A structured and pre-tested questionnaire was applied to obtain the data. A probabilistic sample was used. The prevalence of each of the outcomes of interest by area was calculated. To verify the existence of an association between the outcomes of interest and other variables (qualitative), by area, a descriptive analysis and to compare percentages and a comparison test was used between two proportions, a Chi-square test and/or a Fisher's exact test and a Kruska-wallis and Dunn multiple comparison were used as well. The significance level was 5%.Results: Most residents (94%) reported the use of public health services at least once a year (p < 0.001), mainly through the Basic Health Units (BHU) (p < 0.001). Most of the studied population (65%) did not have private health insurance and their schooling was basically restricted to primary education (p < 0.001). The predominant family income (70%) in the three areas was between one and five minimum wages (p < 0.001), with a higher incidence of people receiving one to three minimum wages at the time. The demand for health services was not associated with education or income.Conclusion: The population of the regions analysed heavily rely on the Unified Health System - SUS, but there was no association between income and frequency of health services and there was also no association between education and use of health services.


Asunto(s)
Estuarios , Servicios de Salud , Brasil/epidemiología , Humanos , Renta , Prevalencia
2.
J Occup Environ Med ; 62(10): e593-e597, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32826546

RESUMEN

OBJECTIVES: To describe the strategies to monitor and expand access to care for a health system workers in the first 2 months of the COVID-19 epidemic in Brazil. METHODS: Description of the implemented strategy based on the guidelines developed to address the surveillance and care of a large health system's workforce in the COVID-19 epidemic. RESULTS: During phase 1, the surveillance strategy focused on monitoring suspected cases among employees. In phase 2, surveillance was restricted to employees with confirmed COVID-19, aiming at monitoring of symptoms and following hospitalizations. Access to care was expanded. A total of 1089 employees were diagnosed with COVID-19, 89 required hospitalizations and none had died. CONCLUSION: The strategies adopted were promptly implemented and could be adapted to the changing epidemic dynamics, allowing low rates of adverse outcomes in this high-risk population.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Atención a la Salud/organización & administración , Personal de Salud/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Salud Laboral , Pandemias/prevención & control , Neumonía Viral/prevención & control , Adulto , Brasil/epidemiología , COVID-19 , Infecciones por Coronavirus/epidemiología , Estudios Transversales , Femenino , Humanos , Control de Infecciones/organización & administración , Masculino , Persona de Mediana Edad , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Sistema de Registros , Medición de Riesgo , Recursos Humanos/organización & administración
3.
Rev Bras Epidemiol ; 20(2): 189-199, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28832843

RESUMEN

INTRODUCTION:: Birth weight is an important indicator of several conditions that manifest earlier (as fetal and neonatal mortality and morbidity, inhibited growth and cognitive development) and later in life such as chronic diseases. Air pollution has been associated with adverse pregnancy outcomes. OBJECTIVE:: Retrospective cohort study investigated the association between low birth weight (LBW) and maternal exposure to air pollutants in Volta Redonda city, Rio de Janeiro, Brazil, from 2003 to 2006. METHODS:: Birth data was obtained from Brazilian Information System. Exposure information (O3, PM10, temperature and humidity) was provided by Governmental Air Quality Monitoring System. Linear and Logistic models, adjusted for sex, type of pregnancy, prenatal care, place of birth, maternal age, parity, education, congenital anomalies and weather variables were employed. RESULTS:: Low birth weight (LBW) represented 9.1% of all newborns (13,660). For an interquartile range increase in PM10 it was found OR2 ndTrimester = 1.06 (95%CI 1.02 - 1.10), OR3 rdTrimester = 1.06 (95%CI 1.02 - 1.10) and, in O3 it was found OR2 ndTrimester = 1.03 (95%CI 1.01 - 1.04), OR3 rdTrimester = 1.03 (95%CI 1.02 - 1.04). The dose-response relationship and a reduction in birth weight of 31.11 g (95%CI -56.64 - -5.58) was observed in the third trimester of pregnancy due to an interquartile increase of O3. CONCLUSION:: This study suggests that exposures to PM10 and O3, even being below the Brazilian air quality standards, contribute to risks of low birth weight.


Asunto(s)
Contaminación del Aire/efectos adversos , Recién Nacido de Bajo Peso , Exposición Materna/efectos adversos , Adolescente , Adulto , Brasil , Estudios de Cohortes , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Estudios Retrospectivos , Salud Urbana , Adulto Joven
4.
Environ Sci Pollut Res Int ; 22(19): 14950-9, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26002366

RESUMEN

This study aims to compare pregnancy outcomes in four contaminated areas to those observed in a non-contaminated area of similar socioeconomic status. A cross-sectional study was carried out. A structured and pre-tested questionnaire was administered to population-based samples of 788-920 families in each of the five studied areas. The exposure assessment used was an ecological measure. Using logistic regression, odds of several pregnancies outcomes (pregnancy occurrence, miscarriage, stillbirth, prematurity, low birth weight, congenital malformation, and multiple births) were estimated after adjustment for potential confounders such as socioeconomic, demographic, and substance abuse factors. We adopted a statistical significance level of 5 %. In three of the four exposed areas, pregnancy occurrence was reduced in comparison to the control area (Area 2, odds ratio (OR) = 0.68, 95 % CI = 0.54-0.86; Area 3, OR = 0.76, 95 % CI = 0.60-0.97; Area 4, OR = 0.71, 95 % CI = 0.56-0.90). Also, a significantly increased odds of miscarriage for living in Area 3 (OR = 1.83, 95 % CI = 1.07-3.12) was found. The other pregnancy outcomes were not significantly elevated in the exposed areas. In conclusion, this study shows evidence of reduced pregnancy occurrence and increased miscarriage occurrence in some of the contaminated areas, compared to the control area.


Asunto(s)
Contaminantes Ambientales/toxicidad , Resultado del Embarazo , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Recién Nacido , Modelos Logísticos , Persona de Mediana Edad , Oportunidad Relativa , Embarazo , Adulto Joven
5.
Rev. bras. epidemiol ; 20(2): 189-199, Abr.-Jun. 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-898592

RESUMEN

ABSTRACT: Introduction: Birth weight is an important indicator of several conditions that manifest earlier (as fetal and neonatal mortality and morbidity, inhibited growth and cognitive development) and later in life such as chronic diseases. Air pollution has been associated with adverse pregnancy outcomes. Objective: Retrospective cohort study investigated the association between low birth weight (LBW) and maternal exposure to air pollutants in Volta Redonda city, Rio de Janeiro, Brazil, from 2003 to 2006. Methods: Birth data was obtained from Brazilian Information System. Exposure information (O3, PM10, temperature and humidity) was provided by Governmental Air Quality Monitoring System. Linear and Logistic models, adjusted for sex, type of pregnancy, prenatal care, place of birth, maternal age, parity, education, congenital anomalies and weather variables were employed. Results: Low birth weight (LBW) represented 9.1% of all newborns (13,660). For an interquartile range increase in PM10 it was found OR2 ndTrimester = 1.06 (95%CI 1.02 - 1.10), OR3 rdTrimester = 1.06 (95%CI 1.02 - 1.10) and, in O3 it was found OR2 ndTrimester = 1.03 (95%CI 1.01 - 1.04), OR3 rdTrimester = 1.03 (95%CI 1.02 - 1.04). The dose-response relationship and a reduction in birth weight of 31.11 g (95%CI -56.64 - -5.58) was observed in the third trimester of pregnancy due to an interquartile increase of O3. Conclusion: This study suggests that exposures to PM10 and O3, even being below the Brazilian air quality standards, contribute to risks of low birth weight.


RESUMO: Introdução: O peso de nascimento é considerado como um indicador importante de várias condições que se manifestam mais cedo (como mortalidade fetal e neonatal e morbidade, inibição do crescimento e desenvolvimento cognitivo) e mais tarde na vida, tais como as doenças crônicas. A poluição atmosférica tem sido associada a efeitos adversos da gestação. Objetivo: Estudo de coorte histórica que associa o baixo peso ao nascer (BPN) e a exposição materna aos poluentes do ar em Volta Redonda, Rio de Janeiro, Brasil, entre 2003 e 2006. Metodologia: Dados sobre nascidos vivos foram obtidos no sistema de informação Brasileiro, e os de exposição (O3, PM10, temperatura e umidade) na rede pública de monitoramento do ar. Foram utilizados modelos lineares e logísticos, ajustados por sexo, tipo de gravidez, assistência pré-natal, local de nascimento, idade materna, paridade, educação, anomalias congênitas e variáveis meteorológicas. Resultados: A prevalência de BPN foi de 9,1% sobre 13.660 nascimentos. Para o aumento de um interquartil no nível de PM10 (OR2 ºtrimestre = 1,06; IC95% 1,02 - 1,10; OR3 ºtrimestre = 1,06; IC95% 1,02 - 1,10) e no nível de O3 (OR2 ºtrimestre = 1,03; IC95% 1,01 - 1,04; OR3 ºtrimestre = 1,03; IC95% 1,02 - 1,04). Observou-se uma relação dose-resposta e uma redução do peso ao nascer de 31,11 g (95%IC -56,64 - -5,58) no terceiro trimestre da gravidez devido ao aumento de um interquartil de O3. Conclusão: Este estudo sugere que exposições ao PM10 e O3, mesmo abaixo de padrões de qualidade do ar, contribuem para os riscos de BPN.


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Adolescente , Adulto , Adulto Joven , Recién Nacido de Bajo Peso , Exposición Materna/efectos adversos , Contaminación del Aire/efectos adversos , Brasil , Salud Urbana , Estudios Retrospectivos , Estudios de Cohortes
6.
Rev Bras Epidemiol ; 14(4): 598-608, 2011 Dec.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-22218659

RESUMEN

OBJECTIVE: Estimate and compare prevalence of events related to pregnancy (pregnancy, low birth weight, premature delivery, spontaneous abortion, stillbirth, congenital malformation, and multiple births) in populations exposed and non-exposed to environmental contaminants in Santos and São Vicente Estuary. METHODS: This study was part of a large project financed by CNPq, which aimed to estimate health effects associated with environmental area, contaminants exposure among individuals of the Baixada Santista region. This cross-sectional study evaluated two neighborhoods of São Vicente near a contaminated area, and one neighborhood of Bertioga, the control area. A structured and previously tested questionnaire was applied at 236 households in São Vicente and 251 households in Bertioga in order to obtain the data. The chi-square test or Fisher's exact test were used to evaluate associations between area and qualitative variables; Student's t test or two proportion comparison test were used to evaluate differences between variables; and a significance level of 5% adopted. RESULTS: There was significant association between living in Bertioga (p = 0.01) and number of pregnancies in the past five years. In São Vicente, 64 (28.3%) childbearing age women became pregnant whereas in Bertioga there where 109 (38.8%). There were no statistical significant associations between living in any area and others pregnancy outcomes evaluated. CONCLUSION: Although no significant association was found, prevalence of low birth weight, preterm delivery and spontaneous abortion and prevalent odds ratio were higher in contaminated area. This study's evidence of a reduced number of pregnancies in contaminated area strengthens the need for additional more in-depth studies in Santos and São Vicente Estuary.


Asunto(s)
Contaminación Ambiental/efectos adversos , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Adolescente , Adulto , Brasil , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Prevalencia , Adulto Joven
7.
Rev. bras. epidemiol ; 14(4): 598-608, dez. 2011. ilus, tab
Artículo en Portugués | LILACS | ID: lil-611302

RESUMEN

OBJETIVO: Estimar e comparar a prevalência dos eventos relacionados à gravidez (engravidar, baixo peso de nascimento, parto prematuro, aborto espontâneo, natimortalidade, malformações congênitas e gemelaridade) em populações exposta e não-exposta aos contaminantes ambientais na região do estuário de Santos e São Vicente. MÉTODOS: O estudo fez parte de um amplo projeto financiado pelo CNPq, que teve como objetivo estimar os efeitos à saúde associados à exposição aos contaminantes ambientais entre os moradores da Baixada Santista. O estudo transversal avaliou dois bairros do município de São Vicente, próximos a uma área contaminada, e um bairro no município de Bertioga, área controle. Para a obtenção dos dados foi aplicado um questionário estruturado e pré-testado em 236 domicílios em São Vicente e 251 domicílios em Bertioga. Para avaliar associações entre a área e as variáveis qualitativas utilizouse o teste qui-quadrado ou teste exato de Fisher; para avaliar as diferenças entre as variáveis, o teste t de Student ou o teste de comparação de duas proporções, e adotado nível de significância de 5 por cento. RESULTADOS: Houve associação significativa entre morar em Bertioga (p = 0,01) e o número de gestações ocorridas nos últimos cinco anos. Em São Vicente, 64 (28,3 por cento) mulheres em idade fértil engravidaram, enquanto em Bertioga foram 109 (38,8 por cento). Não houve associações estatísticas significativas nas áreas com os demais desfechos da gravidez avaliados. CONCLUSÕES: As prevalências e as razões de chances prevalentes de baixo peso ao nascer, nascimentos prematuros e abortos espontâneos foram maiores nas áreas contaminadas, sem associações significativas. A evidência do estudo de diminuição do número de gestações na área contaminada reforça a necessidade de aprofundamento de estudos na região do estuário de Santos e São Vicente.


OBJECTIVE: Estimate and compare prevalence of events related to pregnancy (pregnancy, low birth weight, premature delivery, spontaneous abortion, stillbirth, congenital malformation, and multiple births) in populations exposed and non-exposed to environmental contaminants in Santos and São Vicente Estuary. METHODS: This study was part of a large project financed by CNPq, which aimed to estimate health effects associated with environmental area, contaminants exposure among individuals of the Baixada Santista region. This cross-sectional study evaluated two neighborhoods of São Vicente near a contaminated area, and one neighborhood of Bertioga, the control area. A structured and previously tested questionnaire was applied at 236 households in São Vicente and 251 households in Bertioga in order to obtain the data. The chi-square test or Fisher's exact test were used to evaluate associations between area and qualitative variables; Student's t test or two proportion comparison test were used to evaluate differences between variables; and a significance level of 5 percent adopted. RESULTS: There was significant association between living in Bertioga (p = 0.01) and number of pregnancies in the past five years. In São Vicente, 64 (28.3 percent) childbearing age women became pregnant whereas in Bertioga there where 109 (38.8 percent). There were no statistical significant associations between living in any area and others pregnancy outcomes evaluated. CONCLUSION: Although no significant association was found, prevalence of low birth weight, preterm delivery and spontaneous abortion and prevalent odds ratio were higher in contaminated area. This study's evidence of a reduced number of pregnancies in contaminated area strengthens the need for additional more in-depth studies in Santos and São Vicente Estuary.


Asunto(s)
Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Adulto Joven , Contaminación Ambiental/efectos adversos , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo/epidemiología , Brasil , Estudios Transversales , Prevalencia
8.
São Paulo; s.n; 2012. [167] p. ilus, tab, graf.
Tesis en Portugués | LILACS | ID: lil-655455

RESUMEN

Introdução: O Estuário de Santos e São Vicente está contaminado com metais pesados, compostos organoclorados, dioxinas e furanos. Estudos epidemiológicos evidenciam que fetos são mais susceptíveis às substâncias tóxicas que adultos. Este trabalho avaliou a ocorrência de eventos relacionados à gestação em áreas contaminadas e não contaminada na região estuarina. Métodos: Estudo transversal onde foram analisados dados do SINASC entre 2003 e 2007 nos municípios de São Vicente, Guarujá, Cubatão e Bertioga. Foram calculadas as taxas bruta de natalidade e de fecundidade total por ano e os riscos de nascimento prematuro, baixo peso de nascimento, nascimento múltiplo e presença de anormalidade congênita no período, por município. Um questionário estruturado e pré-testado foi aplicado em uma amostra de base populacional (820 famílias) em cinco áreas da região, quatro dessas em áreas contaminadas e uma (controle) sem contaminação conhecida. Foram calculados os riscos de ocorrência de mulheres em idade fértil que engravidaram, aborto, parto prematuro, baixo peso ao nascer, natimorto, malformação congênita e nascimento múltiplo. Os dados de aborto e ocorrência de gestação foram georreferenciados na área 3, São Vicente continental. Utilizou-se o teste do qui-quadrado de Pearson ou teste exato de Fisher investigando associações entre as áreas e as variáveis qualitativas. O odds ratio (OR) e os intervalos de confiança de 95 por cento foram calculados por regressão logística de acordo com as áreas, ajustados para fatores de confusão (socioeconômicos, demográficos e de hábitos das mulheres). Nível de significância foi de 5 por cento. Resultados: As taxas de natalidade e fecundidade diminuíram no período em todos os municípios, predominantemente em Bertioga. Existe risco significativamente maior (p=0,00) de ocorrência de baixo peso de nascimento em São Vicente (OR=2,25; 1,93 2,62), no Guarujá (OR=2,14; 1,80 2,56) e em Cubatão (OR=2,06; 1,75 2,43), que em Bertioga, controlado pela idade...


Background: Santos and São Vicente Estuary is contaminated with heavy metals, organochlorines compounds, dioxins and furans. Epidemiological studies show that fetuses are more susceptible to toxic chemicals than adults. This study evaluated occurrence of pregnancy events in contaminated and non-contaminated areas in estuarine region. Methods: This cross-sectional study analyzed SINASC data from 2003 to 2007 in São Vicente, Guarujá, Cubatão and Bertioga cities. Crude birth and total fertility rates per year, and risks of preterm birth, low birth weight, multiple birth and congenital abnormality in the period were calculated by city. A pre-tested and structured questionnaire was applied in a population-based sample (820 families each) in five areas. Four of these areas are in contaminated regions and one (control) has no known environmental contamination. Risks of childbearing age women who became pregnant, abortion, premature birth, low birth weight, stillbirth, congenital malformation and multiple birth were calculated. Data of abortion and pregnancy occurrence were georeferenced in area 3, continental part of São Vicente city. Pearsons chi-square test or Fishers exact test were used to investigate associations between areas and qualitative variables. Odds ratio and 95 percent confidence intervals were calculated by logistic regression according to the area, adjusted for confounding factors (socioeconomic, demographic and women habits). The statistical significance level was set at 5 percent. Results: Birth and fertility rates declined over the years in all cities, predominantly in Bertioga. There were significant higher risks (p<0.01) of low birth weight in São Vicente (OR=2.25, 1.93 2.62), Guarujá (OR=2,14, 1.80 2.56) and Cubatão (OR=2.06, 1.75 2.43), compared to Bertioga, controlling for maternal age, marital status, maternal education, prenatal, and congenital abnormalities. Risk of preterm birth was also significantly higher (p<0.01) in São Vicente (OR=2.24, 1.89...


Asunto(s)
Humanos , Femenino , Embarazo , Aborto , Anomalías Congénitas , Contaminación Ambiental , Recién Nacido de Bajo Peso , Recien Nacido Prematuro , Embarazo
9.
Rev. Inst. Adolfo Lutz ; 67(1): 59-63, jan.-abr. 2008. ilus, tab
Artículo en Portugués | LILACS, SES-SP, SESSP-CTDPROD, SES-SP, SESSP-IALPROD, SES-SP | ID: lil-500697

RESUMEN

Em virtude das lesões granulomatosas em animais e humanos aparentemente demonstrarem as mesmas alterações histológicas, poucas dados existem sobre as alterações patobioquímicas relacionadas aos carboidratos expressos pelos tecidos parasitados pelo S. mansoni. Neste trabalho, os resultados indicam que todas as lectinas testadas evidenciaram padrões de marcação diferenciados no tegumento do ovo do parasita e no granuloma periovular. A lectina WGA (Wheat germ agglutinin) apresentou uma intensa marcação do sistema ovo-granuloma (SOG) na esquistossomose experimental, enquanto que nas amostras teciduais humanas a WGA, LTA (Lotus tetragonolobus agglutinin) e PNA (Peanut agglutinin) marcaramapenas o ovo de S. mansoni. A lectina UEA-I (Ulex europaeus agglutinin) marcou de forma incipiente e inespecífica o SOG; por outro lado, a LTA marcou preferencialmente os anéis de fibrose do granuloma hepático em humanos. Houve intensa marcação da WGA no SOG e no ovo de S. mansoni, enquanto que a PNA marcou apenas o ovo do parasita, o qual indica a presença de resíduos de n-acetil-glucosamina e galactose, respectivamente. As lectinas WGA, PNA e Con A (Concanavalin agglutinin) falharam na distinção de tipos celulares encontrados no granuloma tanto experimental como humano. Conclui-se que a análise histoquímica com o uso de lectinas é uma ferramenta útil na investigação de alterações bioquímicas específicas que caracterizam a esquistossomose humana e experimental.


Asunto(s)
Carbohidratos , Esquistosomiasis , Fosfatidilcolinas , Granuloma
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