Mortality by colon, lung, esophagus, prostate, cervix and breast cancers in Brazilian capitals, 2000-2015: a multilevel analysis.

This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.

Mortality by colon, lung, esophagus, prostate, cervix and breast cancers in Brazilian capitals, 2000-2015: a multilevel analysis / Mortalidade por câncer de cólon, pulmão, esôfago, próstata, colo do útero e mama nas capitais brasileiras, 2000-2015: uma análise multinível

Abstract This study aimed to analyze the role of period, geographic and socio demographic factors in cancer-related mortality by prostate, breast, cervix, colon, lung and esophagus cancer in Brazilians capitals (2000-2015). Ecological study using data of Brazilian Mortality Information. Multilevel Poisson models were used to estimate the adjusted risk of cancer mortality. Mortality rate levels were higher in males for colon, lung and esophageal cancers. Mortality rates were highest in the older. Our results showed an increased risk of colon cancer mortality in both sexes from 2000 to 2015, which was also evidenced for breast and lung cancers in women. In both genders, the highest mortality risk for lung and esophageal cancers was observed in Southern capitals. Midwestern, Southern and Southeastern capitals showed the highest mortality risk for colon cancer both for males and females. Colon cancer mortality rate increased for both genders, while breast and lung cancers mortality increased only for women. The North region showed the lowest mortality rate for breast, cervical, colon and esophageal cancers. The Midwest and Northeast regions showed the highest mortality rates for prostate cancer.

Resumo Este estudo teve como objetivo analisar o papel de fatores temporais, geográficos e sociodemográficos na mortalidade por câncer de próstata, mama, colo do útero, cólon, pulmão e esôfago nas capitais brasileiras (2000-2015). Estudo ecológico utilizando informações brasileiras de mortalidade. Modelos de Poisson multinível foram usados ​​para estimar o risco ajustado de mortalidade por câncer. Os níveis de mortalidade foram maiores em homens para câncer de cólon, pulmão e esôfago. As taxas de mortalidade foram mais altas nos idosos. Nossos resultados mostraram risco aumentado de mortalidade por câncer de cólon em ambos os sexos de 2000 a 2015, o que também foi evidenciado para câncer de mama e de pulmão em mulheres. Em ambos os sexos, o maior risco de mortalidade para câncer de pulmão e esôfago foi observado nas capitais do Sul. As capitais do Centro-Oeste, Sul e Sudeste apresentaram o maior risco de mortalidade por câncer de cólon tanto para homens quanto para mulheres. A taxa de mortalidade por câncer de cólon aumentou para ambos os sexos, enquanto a mortalidade por câncer de mama e de pulmão aumentou apenas para as mulheres. A região Norte apresentou a menor taxa de mortalidade por câncer de mama, colo do útero, cólon e esôfago. As regiões Centro-Oeste e Nordeste apresentaram as maiores taxas de mortalidade por câncer de próstata.

"On-Demand" Antimicrobial Photodynamic Activity through Supramolecular Photosensitizers Built with Rose Bengal and (p-Vinylbenzyl)triethylammomium Polycation Derivatives.

The antimicrobial photodynamic activity (aPDA) in fungal and bacterial strains of supramolecular adducts formed between the anionic photosensitizer (PS) Rose Bengal (RB2-) and aromatic polycations derived from (p-vinylbenzyl)triethylammonium chloride was evaluated. Stable supramolecular adducts with dissociation constants Kd ≈ 5 µM showed photosensitizing properties suitable for generating singlet oxygen (ΦΔ = 0.5 ± 0.1) with the added advantage of improving the photostability of the xanthenic dye. However, the aPDA of both free and supramolecular RB2- was highly dependent on the type of microorganism treated, indicating the importance of specific interactions between the different cell wall structures of the microbe and the PSs. Indeed, in the case of Gram-positive Staphylococcus aureus, the aPDA of molecular and supramolecular PSs was highly effective. Instead, in the case of Gram-negative Escherichia coli, only the RB2-:polycation adducts showed aPDA, while RB2- alone was inefficient, but in the case of Candida tropicalis, the opposite behavior was observed. Therefore, the present results indicate the potential of supramolecular chemistry to obtain aPDA à la carte depending on the target microbe and the PS properties.

"In the middle of the crossfire": considerations about the armed violence impacts in Primary Health Care in the city of Rio de Janeiro. / "No meio do fogo cruzado": reflexões sobre os impactos da violência armada na Atenção Primária em Saúde no município do Rio de Janeiro.

The paper addresses the impacts of armed violence, based on Primary Health Care, in a neighborhood in the city of Rio de Janeiro, Brazil. This is a qualitative exploratory study developed in two services aiming to identify the main types of violence, their impacts and the strategies used to cope with the phenomenon. The production of information included data collection in the service records, conducting semi-structured interviews, focus groups and feedback seminar. Armed violence, among all expressions of violence, was identified as one of the major concerns of healthcare professionals and users of services, due to its intense occurrence and the severity of its consequences on health. Its impact on strategies to cope with the violence and the difficulty in making the phenomenon visible are highlighted. It is considered that this type of violence, prevalent in the black territories of the city, is legitimized by structural racism, being the public security policy - based on the ideal of war on drugs and on the military confrontation with armed groups that operate in the retail trade of illicit drugs - expressions of state racism and necropolitics.

O artigo aborda os impactos da violência armada, a partir da Atenção Primária em Saúde, em um bairro do município do Rio de Janeiro, Brasil. Trata-se de estudo qualitativo exploratório desenvolvido em dois serviços com o objetivo de identificar os principais tipos de violência, seus impactos e as estratégias utilizadas para enfrentamento do fenômeno. A produção de informações incluiu coleta de dados nos registros dos serviços, realização de entrevistas semi-estruturadas, grupos focais e seminário de devolutiva. A violência armada, dentre todas as expressões de violência, foi identificada como uma das maiores preocupações de profissionais de saúde e usuários dos serviços, em função de sua intensa ocorrência e gravidade de suas consequências sob a saúde. Destaca-se seu impacto nas estratégias de enfrentamento à violência e a dificuldade em visibilizar o fenômeno. Considera-se que esse tipo de violência, predominante nos territórios negros da cidade, é legitimada pelo racismo estrutural, sendo a política pública de segurança ­ baseada no ideário de guerra às drogas e no enfrentamento bélico com grupos armados que atuam no comércio varejista de drogas ilícitas ­ expressões do racismo de estado e da necropolítica.

Photosensitization With Supramolecular Arrays for Enhanced Antimicrobial Photodynamic Treatments.

Microbial infections represent a silent threat to health that has worsened in recent decades due to microbial resistance to multiple drugs, preventing the fight against infectious diseases. Therefore, the current postantibiotic era forces the search for new microbial control strategies. In this regard, antimicrobial photodynamic therapy (aPDT) using supramolecular arrays with photosensitizing capabilities showed successful emerging applications. This exciting field makes it possible to combine applied aspects of molecular photochemistry and supramolecular chemistry, together with the development of nano- and biomaterials for the design of multifunctional or "smart" supramolecular photosensitizers (SPS). This minireview aims to collect the concepts of the photosensitization process and supramolecular chemistry applied to the development of efficient applications of aPDT, with a brief discussion of the most recent literature in the field.

"No meio do fogo cruzado": reflexões sobre os impactos da violência armada na Atenção Primária em Saúde no município do Rio de Janeiro / "In the middle of the crossfire": considerations about the armed violence impacts in Primary Health Care in the city of Rio de Janeiro

Resumo O artigo aborda os impactos da violência armada, a partir da Atenção Primária em Saúde, em um bairro do município do Rio de Janeiro, Brasil. Trata-se de estudo qualitativo exploratório desenvolvido em dois serviços com o objetivo de identificar os principais tipos de violência, seus impactos e as estratégias utilizadas para enfrentamento do fenômeno. A produção de informações incluiu coleta de dados nos registros dos serviços, realização de entrevistas semi-estruturadas, grupos focais e seminário de devolutiva. A violência armada, dentre todas as expressões de violência, foi identificada como uma das maiores preocupações de profissionais de saúde e usuários dos serviços, em função de sua intensa ocorrência e gravidade de suas consequências sob a saúde. Destaca-se seu impacto nas estratégias de enfrentamento à violência e a dificuldade em visibilizar o fenômeno. Considera-se que esse tipo de violência, predominante nos territórios negros da cidade, é legitimada pelo racismo estrutural, sendo a política pública de segurança - baseada no ideário de guerra às drogas e no enfrentamento bélico com grupos armados que atuam no comércio varejista de drogas ilícitas - expressões do racismo de estado e da necropolítica.

Abstract The paper addresses the impacts of armed violence, based on Primary Health Care, in a neighborhood in the city of Rio de Janeiro, Brazil. This is a qualitative exploratory study developed in two services aiming to identify the main types of violence, their impacts and the strategies used to cope with the phenomenon. The production of information included data collection in the service records, conducting semi-structured interviews, focus groups and feedback seminar. Armed violence, among all expressions of violence, was identified as one of the major concerns of healthcare professionals and users of services, due to its intense occurrence and the severity of its consequences on health. Its impact on strategies to cope with the violence and the difficulty in making the phenomenon visible are highlighted. It is considered that this type of violence, prevalent in the black territories of the city, is legitimized by structural racism, being the public security policy - based on the ideal of war on drugs and on the military confrontation with armed groups that operate in the retail trade of illicit drugs - expressions of state racism and necropolitics.

The Effect of Continuous Low-Intensity Exposure to Electromagnetic Fields from Radio Base Stations to Cancer Mortality in Brazil.

BACKGROUND: this study aims to estimate the rate of death by cancer as a result of Radio Base Station (RBS) radiofrequency exposure, especially for breast, cervix, lung, and esophagus cancers. METHODS: we collected information on the number of deaths by cancer, gender, age group, gross domestic product per capita, death year, and the amount of exposure over a lifetime. We investigated all cancer types and some specific types (breast, cervix, lung, and esophagus cancers). RESULTS: in capitals where RBS radiofrequency exposure was higher than 2000/antennas-year, the average mortality rate was 112/100,000 for all cancers. The adjusted analysis showed that, the higher the exposure to RBS radiofrequency, the higher cancer mortality was. The highest adjusted risk was observed for cervix cancer (rate ratio = 2.18). The spatial analysis showed that the highest RBS radiofrequency exposure was observed in a city in southern Brazil that also showed the highest mortality rate for all types of cancer and specifically for lung and breast cancer. CONCLUSION: the balance of our results indicates that exposure to radiofrequency electromagnetic fields from RBS increases the rate of death for all types of cancer.

Gigantomastia gravídica / Gestational gigantomastia

Presentamos dos casos clínicos de mujeres jóvenes (38 y 25 años) con gigantomastia gravídica que presentaban mastalgia, alteraciones de la postura y disminución de la calidad de vida, una de ellas incluso se complicó con necrosis cutánea e infección. El tratamiento fue quirúrgico, las técnicas utilizadas fueron elegidas según las características anatómicas y el estado clínico de las pacientes: técnica de Thorek para el primer caso y mastectomía bilateral en el segundo.

We present two clinical cases of young women (38 and 25 years old) with gravidic gigantomastia who presented with mastalgia, posture alterations and decreased quality of life, one of which was even complicated by cutaneous necrosis and infection. The treatment was surgical, the techniques used were chosen according to the anatomical characteristics and the clinical status of the patients: Thorek technique for the first case and bilateral mastectomy in the second.

Cáncer de mama en varón / Male breast cancer

El cáncer de mama en el hombre es una patología infrecuente, representan menos del 1 % de los cánceres de mama diagnosticados, por lo cual la información científica disponible se limita a casos aislados. Presentamos el caso de un paciente de 53 años que acude a consulta por tumoración en mama izquierda de 2 años de evolución, no doloroso, que alcanza 6 cm. Los estudios de imágenes solicitados informan que se trata de un quiste complejo. Por la alta sospecha de tratarse de una patología neoplásica maligna se realiza mastectomía cuyo resultado de anatomía patológica confirma un carcinoma intraquistico de 65 mm con componente infiltrante de 4 mm. En el vaciamiento ganglionar no se identifican metástasis. En la literatura se cita como el subtipo más representativo el carcinoma ductal infiltrante. Se siguen los mismos criterios diagnósticos y terapéuticos que en la patología mamaria femenina.

Breast cancer in men is an uncommon pathology, representing less than 1 % of diagnosed breast cancers, so the available scientific information is limited to isolated cases. We present the case of a 53-year-old patient who comes to a consultation for a tumor in the left breast of 2 years of evolution, not painful, that reaches 6 cm. The requested imaging studies report that it is a complex cyst. Due to the high suspicion of being a malignant neoplastic pathology, a mastectomy is performed whose pathological anatomy confirms a 65 mm intracystic carcinoma with a 4 mm infiltrating component. In lymph node emptying, no metastases are identified. In the literature the infiltrating ductal carcinoma is cited as the most representative subtype. The same diagnostic and therapeutic criteria as in female breast pathology are followed.

Empowering Citizens through Perceptual Sensing of Urban Environmental and Health Data Following a Participative Citizen Science Approach.

The growth of the urban population together with a high concentration of air pollution have important health impacts on citizens who are exposed to them, causing serious risks of the development and evolution of different chronic diseases. This paper presents the design and development of a novel participatory citizen science-based application and data ecosystem model. These developments are imperative and scientifically designed to gather and process perceptual sensing of urban, environmental, and health data. This data acquisition approach allows citizens to gather and generate environment- and health-related data through mobile devices. The sum of all citizens' data will continuously enrich and increase the volumes of data coming from the city sensors and sources across geographical locations. These scientifically generated data, coupled with data from the city sensors and sources, will enable specialized predictive analytic solutions to empower citizens with urban, environmental, and health recommendations, while enabling new data-driven policies. Although it is difficult for citizens to relate their personal behaviour to large-scale problems such as climate change, pollution, or public health, the developed ecosystem provides the necessary tools to enable a greener and healthier lifestyle, improve quality of life, and contribute towards a more sustainable local environment.

The role of heparan sulfates in protein aggregation and their potential impact on neurodegeneration.

Neurodegenerative disorders, such as Alzheimer's, Parkinson's, and prion diseases, are directly linked to the formation and accumulation of protein aggregates in the brain. These aggregates, principally made of proteins or peptides that clamp together after acquisition of ß-folded structures, also contain heparan sulfates. Several lines of evidence suggest that heparan sulfates centrally participate in the protein aggregation process. In vitro, they trigger misfolding, oligomerization, and fibrillation of amyloidogenic proteins, such as Aß, tau, α-synuclein, prion protein, etc. They participate in the stabilization of protein aggregates, protect them from proteolysis, and act as cell-surface receptors for the cellular uptake of proteopathic seeds during their spreading. This review focuses attention on the importance of heparan sulfates in protein aggregation in brain disorders including Alzheimer's, Parkinson's, and prion diseases. The presence of these sulfated polysaccharides in protein inclusions in vivo and their capacity to trigger protein aggregation in vitro strongly suggest that they might play critical roles in the neurodegenerative process. Further advances in glyco-neurobiology will improve our understanding of the molecular and cellular mechanisms leading to protein aggregation and neurodegeneration.

Exploiting the therapeutic potential of ready-to-use drugs: Repurposing antibiotics against amyloid aggregation in neurodegenerative diseases.

Neurodegenerative diseases are chronic and progressive disorders that affect specific regions of the brain, causing gradual disability and suffering that results in a complete inability of patients to perform daily functions. Amyloid aggregation of specific proteins is the most common biological event that is responsible for neuronal death and neurodegeneration in various neurodegenerative diseases. Therapeutic agents capable of interfering with the abnormal aggregation are required, but traditional drug discovery has fallen short. The exploration of new uses for approved drugs provides a useful alternative to fill the gap between the increasing incidence of neurodegenerative diseases and the long-term assessment of classical drug discovery technologies. Drug re-profiling is currently the quickest possible transition from bench to bedside. In this way, experimental evidence shows that some antibiotic compounds exert neuroprotective action through anti-aggregating activity on disease-associated proteins. The finding that many antibiotics can cross the blood-brain barrier and have been used for several decades without serious toxic effects makes them excellent candidates for therapeutic switching towards neurological disorders. The present review is, to our knowledge, the first extensive evaluation and analysis of the anti-amyloidogenic effect of different antibiotics on well-known disease-associated proteins. In addition, we propose a common structural signature derived from the antiaggregant antibiotic molecules that could be relevant to rational drug discovery.

Heparán sulfatos, amiloidosis y neurodegeneración / Heparan sulphates, amyloidosis and neurodegeneration

Introducción. Numerosos trastornos neurodegenerativos se han asociado directamente a la acumulación de fibras amiloides. Estas fibras están formadas por proteínas o péptidos con conformaciones alteradas y que se agregan in vivo en asociación con polisacáridos de tipo heparán sulfatos. Objetivos. Examinar los conceptos más recientes sobre la biología de los heparán sulfatos y su papel en la agregación del péptido Abeta, de la proteína tau, de la alfa-sinucleína y de los priones, y analizar sus implicaciones en trastornos neurodegenerativos como las enfermedades de Alzheimer y de Parkinson y las enfermedades priónicas. Desarrollo. In vitro, los heparán sulfatos han desempeñado un papel importante en el proceso de oligomerización y fibrilación de proteínas o péptidos amiloidógenos, en la estabilización de estos cuerpos y su resistencia a la proteólisis, participando así en la formación de una gran variedad de fibras amiloides. Los heparán sulfatos se han relacionado también con el proceso de internalización de fibras proamiloides durante el proceso de propagación intercelular (spreading) considerado como central en la evolución de las proteinopatías, cuyo mejor ejemplo es la enfermedad de Alzheimer. Conclusión. Este trabajo sugiere que las estructuras finas de los heparán sulfatos, sus localizaciones celulares y tisulares, así como sus concentraciones locales, pueden regular los procesos de amiloidosis. Avances en la comprensión de esta área de la gliconeurobiología permitirán mejorar la comprensión de los mecanismos celulares y moleculares del proceso neurodegenerativo (AU)

Introduction. A number of neurodegenerative disorders have been linked directly to the accumulation of amyloid fibres. These fibres are made up of proteins or peptides with altered structures and which join together in vivo in association with heparan sulphate-type polysaccharides. AIMS. To examine the most recent concepts in the biology of heparan sulphates and their role in the aggregation of the peptide Abeta, of tau protein, of alpha-synuclein and of prions. The study also seeks to analyse their implications in neurodegenerative disorders such as Alzheimers and Parkinson’s disease and prion diseases. Development. In vitro, heparan sulphates have played an important role in the process of oligomerisation and fibrillation of amyloidogenic proteins or peptides, in the stabilisation of these bodies and their resistance to proteolysis, thereby participating in the formation of a wide range of amyloid fibres. Heparan sulphates have also been related to the internalisation of pro-amyloid fibres during the process of intercellular propagation (spreading), which is considered to be crucial in the development of proteinopathies, the best example of which is Alzheimers disease. Conclusion This study suggests that the fine structures of heparan sulphates, their localisation in cells and tissues, together with their local concentration, may regulate the amyloidosis processes. The advances made in the understanding of this area of glyconeurobiology will make it possible to improve the understanding of the cell and molecular mechanisms underlying the neurodegenerative process (AU)

Lessons learned from protein aggregation: toward technological and biomedical applications.

The close relationship between protein aggregation and neurodegenerative diseases has been the driving force behind the renewed interest in a field where biophysics, neurobiology and nanotechnology converge in the study of the aggregate state. On one hand, knowledge of the molecular principles that govern the processes of protein aggregation has a direct impact on the design of new drugs for high-incidence pathologies that currently can only be treated palliatively. On the other hand, exploiting the benefits of protein aggregation in the design of new nanomaterials could have a strong impact on biotechnology. Here we review the contributions of our research group on novel neuroprotective strategies developed using a purely biophysical approach. First, we examine how doxycycline, a well-known and innocuous antibiotic, can reshape α-synuclein oligomers into non-toxic high-molecular-weight species with decreased ability to destabilize biological membranes, affect cell viability and form additional toxic species. This mechanism can be exploited to diminish the toxicity of α-synuclein oligomers in Parkinson's disease. Second, we discuss a novel function in proteostasis for extracellular glyceraldehyde 3-phosphate dehydrogenase (GAPDH) in combination with a specific glycosaminoglycan (GAG) present in the extracellular matrix. GAPDH, by changing its quaternary structure from a tetramer to protofibrillar assembly, can kidnap toxic species of α-synuclein, and thereby interfere with the spreading of the disease. Finally, we review a brighter side of protein aggregation, that of exploiting the physicochemical advantages of amyloid aggregates as nanomaterials. For this, we designed a new generation of insoluble biocatalysts based on the binding of photo-immobilized enzymes onto hybrid protein:GAG amyloid nanofibrils. These new nanomaterials can be easily functionalized by attaching different enzymes through dityrosine covalent bonds.

Efeitos auditivos do ruído e dificuldades de comunicação em um grupamento de radiopatrulha aérea / Auditory effects and communication disorders in an aerial patrol group / Efectos auditivos y dificultades de comunicación en un grupamento de radiopatrulha aérea

Introdução: O ruído pode ocasionar problemas auditivos e não auditivos em trabalhadores. Objetivo: estudar os efeitos auditivos e as dificuldades de comunicação em militares de um grupamento de radiopatrulha aérea. Método: estudo observacional, do tipo transversal de inquérito. A amostra foi de 50 policiais militares com média de idade de 39 e tempo de trabalho de 16,7 anos. Os procedimentos incluíram anamnese, questionário, inspeção visual do meato acústico externo e avaliação audiométrica. Resultados: 96% dos policiais acham o ambiente de trabalho muito ruidoso e citam os rádios controle (aéreo e terrestre) e as outras aeronaves como as principais fontes. As principais queixas foram: estresse (46%), dificuldade de comunicação (40%), falta de atenção (32%), incômodo (28%), zumbido (32%), sensação de plenitude auricular (26%) e intolerância a sons intensos (32%). As audiometrias tonais indicaram 35 militares classificados como Normal (70%), oito como sugestivos de PAIR (16%) e sete (14%) como Outras Causas. Houve associação estatística entre "O ruído do ambiente dificulta a comunicação com os outros?" e as variáveis: ruído de outras aeronaves, estresse, incômodo, falta de atenção, irritabilidade, zumbido e eficiência no trabalho. A análise de regressão logística indicou que quando o indivíduo relata incômodo, a chance de ele ter dificuldade para se comunicar com os outros é 21 vezes (IC 3,87 - 113,88). Conclusão: os militares consideram o ambiente de trabalho ruidoso e apresentam alta ocorrência de queixas de saúde. A dificuldade para se comunicar foi estatisticamente associada ao ruído no ambiente de trabalho e a diversos efeitos na saúde.

Introduction: noise exposure can cause auditory and non-auditory effects. Objective: To study auditory effects and communication disorders among aerial patrol group. Method: observational, crosssectional study with 50 police officers with a mean age of 39 years and a mean working time of 16.7 years. Procedures include anamnesis, questionnaire, visual inspection of the external auditory canal and audiometric assessment. Results: 96% of the police believe that the working environment is noisy and cite radio control (air and ground) and other aircraft as the main sources. The main complaints were: stress (46%), communication disorders (40%), lack of attention (32%), annoyance (28%), tinnitus (32%), full hearing (26%) and discomfort for high levels (32%). The audiometry showed 35 soldiers classified as normal hearing (70%), eight as suggestive of noise induced hearing loss (16%) and seven (14%) with other causes. There was a statistical association between "Difficulty of communication with others" and the variables: noise from other aircraft, stress, annoyance, lack of attention, discomfort, tinnitus and work efficiency. In logistic regression analysis, individual reports of discomfort, the chance that had difficulty of communication with others is 21 times (CI 3.87 to 113.88). Conclusion: The military believes that the work environment is noisy and has high incidences of health problems. The difficulty of communication was statistically associated with noise and various effects on health.

Introducción: El ruido puede traer efectos auditivos y no auditivos Objetivo: Estudiar los efectos auditivos y las dificultades de comunicación en un grupamento de radiopatrulha aérea. Método: estudio observacional y transversal con 50 agentes de policía con una edad media de 39 y un tiempo medio de trabajo de 16,7 años. Los procedimientos incluyen anamnesis, cuestionario, la inspección visual del conducto auditivo externo y la evaluación audiométrica. Resultados: El 96% de la policía creen que el ambiente de trabajo es ruidoso y citan el control de radio (aire y tierra) y otras aeronaves como las principales fuentes. Las principales quejas son: estrés (46%), dificultades de comunicación (40%), la falta de atención (32%), molestia (28%), zumbido (32%), el oído está lleno (26%) y la intolerancia sonidos intensos (32%). La audiometría mostró 35 militares clasificados como normales (70%), ocho como sugerente de pérdida de audición inducida por ruido (16%) y siete (14%) con otras causas. Hubo una asociación estadística entre "El ruido ambiental dificulta la comunicación con los demás" y las variables: ruido de otras aeronaves, estrés, molestia, falta de atención, irritabilidad, tinnitus y eficiencia en el trabajo. Análisis de regresión logística indicó que cuando los informes individuales de molestia, la oportunidad que tenía dificultades para comunicarse con los demás es 21 veces (IC 3,87 a 113,88). Conclusión: Los militares creen que el ambiente de trabajo es ruidoso y tienen altas incidencias de problemas de salud. La dificultad de comunicación se asoció estadísticamente con el ruido y diversos efectos sobre la salud.

O impacto da internet na interação entre pacientes: novos cenários em saúde / The impact of internet on patients interaction: new scenarios in health / El impacto de la internet em la interacción entre pacientes: nuevos escenarios em la salud

O artigo apresenta novas formas de atuação de grupos de pacientes durante as últimas décadas. Pacientes e/ou seus familiares fazem circular o conhecimento adquirido pela experiência com a doença em grupos de apoio, associações de pacientes e movimentos ativistas. Como resultado destas associações, surgem novos cenários na área da Saúde, como a incorporação das demandas do paciente nas políticas públicas de cuidado em saúde e a colaboração em esforços de pesquisa. O objetivo deste artigo é analisar, por meio de revisão de literatura, o papel da internet na constituição deste novo agente na área da saúde. Ele aborda igualmente um novo fenômeno, tornado possível com o advento da internet: a promoção de pesquisas por pacientes sem a participação do pesquisador especialista. Para nos auxiliar na análise destes cenários em saúde, nos servimos do conceito de biopoder.

The paper presents the new role played by patient groups over the last decades. Through the use of support groups, patient associations and activist movements, patients and/or their relatives share knowledge that has been acquired about specific illness. New scenarios arise in the field of Health derived from such associative forms, such as patients’ demands being incorporated into health care public policy as well as collaboration with research efforts. The present paper aims, using literature review, to analyze the role played by the internet in the constitution of this new actor in the field of health. It also addresses a new phenomenon, made possible by the Internet: the promotion of research by patients without the participation of expert researchers. The concept of biopower is employed as a framework to analyze these new health scenarios.

El artículo presenta nuevas formas de actuación de grupos de pacientes durante las últimas décadas. Pacientes y/o familiares hacen circular el conocimiento adquirido a partir de sus experiencias con la enfermedad en grupos de apoyo, asociaciones de pacientes y movimientos activistas. Como resultado de tales asociaciones, surgen nuevos escenarios en el área de Salud, como la incorporación de las demandas de los pacientes en políticas públicas de cuidado para la salud y la colaboración de los mismos con la investigación científica. El objetivo de este artículo es analizar, por medio de una revisión bibliográfica, el papel de internet en la constitución de este nuevo agente en el cuidado de la salud. El mismo aborda, igualmente, un nuevo fenómeno que se ha hecho posible gracias a internet: la promoción de la investigación por los pacientes sin la participación de investigadores expertos. Para un mejor análisis de estos escenarios de salud, nos valemos del concepto de biopoder.

Edema agudo hemorrágico del lactante / Acute hemorrhagic edema of infancy

Se presenta un caso de edema agudo hemorrágico de la infancia, en un lactante de 13 meses de edad, que tiene como substrato anatomopatológico una vasculitis leucocitoclástica. Las dos principales características son una erupción equimótica y un edema inflamatorio de cara y miembros. A pesar de la aparente gravedad de las lesiones cutáneas, el cuadro clínico presenta una evolución benigna con tendencia a la resolución espontánea.

Let's sense beforehand the case of a breast-fed baby of 13 months of age with manifestations of sharp hemorrhagic edema of the infancy, which takes a vasculitis leucocitoclastica as a substrate anatomopatológico. Both principal characteristics are an eruption equimótica and an inflammatory edema of face and members. In spite of the apparent gravity of the cutaneous injuries, the clinical picture presents a benign evolution with trend to the spontaneous resolution.

Incorporación de la Perspectiva de Género en los Programas Prioritarios de Salud: El Caso de Prevención y Control de la Diabetes Mellitus en México

En México, la diabetes mellitus se ha mostrado como una enfermedad que genera más demanda de atención y por la que mueren más mujeres, siendo la primera causa de muerte de mujeres desde el año 2000, y de hombres desde el año 2004. Esta experiencia inició en 2005 con los objetivos de documentar la existencia de inequidades de género asociadas a la mortalidad por diabetes en México; incorporar la perspectiva de género en el Programa de Prevención y Atención a la Diabetes, específicamente en el componente de prevención de la enfermedad y promoción de la salud; elaborar materiales impresos y audiovisuales de apoyo para el autocuidado de la salud, diseñados con perspectiva de género; difundir y promover medidas de autocuidado de la salud con perspectiva de género a través de la actividad física, para prevenir y combatir el sobrepeso y la obesidad. En esta experiencia aprendimos que es fundamental el trabajo colaborativo con las autoridades responsables de los programas de salud para lograr incorporar la perspectiva de igualdad de género en salud.