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1.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-LISBR1.1-46985

RESUMEN

Diante do relato de casos da doença respiratória na China, o Ministério da Saúde iniciou o monitoramento desse evento desde o dia 03 de janeiro e com a evolução da situação de saúde na China instalou no dia 22/01/2020, um Centro de Operações de Emergência (COE-nCoV) para monitorar a situação da Infecção Humana pelo novo coronavírus, e coordenar as ações de preparação da resposta de saúde brasileira a uma eventual situação de emergência no Brasil.


Asunto(s)
Coronavirus , Brasil/epidemiología , Centro de Operaciones de Emergencia
2.
Rio de Janeiro; SES/RJ; 28 jan. 2020. 4 p. (Nota Técnica-SVS/SES-RJ, 01).
Monografía en Portugués | LILACS, CONASS, SES-RJ | ID: biblio-1048858

RESUMEN

Os Coronavírus (CoV) compõem uma grande família de vírus, conhecidos desde meados da década de 1960. Podem causar desde um resfriado comum até síndromes respiratórias graves, como a síndrome respiratória aguda grave (SARS - Severe Acute Respiratory Syndrome) e a síndrome respiratória do Oriente Médio (MERS - Middle East Respiratory Syndrome). Os casos agora identificados estão relacionados a uma nova variante do Coronavírus, denominada 2019-nCoV, até então não identificada em humanos.


Asunto(s)
Humanos , Infecciones por Coronavirus/epidemiología , Betacoronavirus , Brasil/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control
3.
Braz Oral Res ; 33: e102, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939495

RESUMEN

The objective of this study was to evaluate the association between social inequality indicators and oral health conditions in an adult population. This prospective cohort study assessed a probabilistic sampling of adults (aged 20-64 years) living in Piracicaba, São Paulo, Brazil. Oral examinations were performed in 2011 and 2015, conducted at home, and used the decay-missing-filled (DMFT) index of permanent teeth, the Community Periodontal Index (CPI), and the visible biofilm criterion. A questionnaire was administered to determine demographic and socioeconomic aspects and dental services used, and collect oral health-related quality of life (OHRQoL) data. Social inequality indicators were evaluated according to social class (high, middle or low) and type of dental service used (public, health insurance or private), and compared with oral health conditions (visible biofilm, DMFT and incidence of tooth loss, periodontal pockets and bleeding, and OHRQoL), evaluated between 2011 and 2015. Analysis using chi-squared or Fisher tests (p < 0.05) and Cochran's Q test was conducted separately for each category analyzed between 2011 and 2015 (p < 0.05). A total of 143 adults who participated in an earlier study were examined after four years of follow-up. Although the occurrence of oral disease did not decrease over the study period (4 years), there was a reduction in inequality among lower social classes in regard to presence of tooth decay and oral health impact on self-perceived quality of life between 2011 and 2015 (p < 0.05). These results suggest that the Brazilian National Oral Health Policy has achieved its principles, especially that of greater equity.


Asunto(s)
Disparidades en Atención de Salud/estadística & datos numéricos , Salud Bucal/estadística & datos numéricos , Adulto , Brasil/epidemiología , Índice CPO , Femenino , Humanos , Seguro de Salud/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Índice Periodontal , Estudios Prospectivos , Calidad de Vida , Autoimagen , Clase Social , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
4.
Braz Oral Res ; 33: e119, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939499

RESUMEN

The aim of this study was to assess the occurrence of erosive tooth wear (ETW) among 15-19-year-old South Brazilian adolescents, regarding prevalence, extent, severity, intraoral distribution, and sociodemographic risk indicators. A population-based cross-sectional survey was conducted in Santa Maria, southern Brazil, and included a representative sample of 15-19-year-old adolescents. Data collection included the application of a questionnaire and a clinical examination. A questionnaire was sent to the parents/legal guardians of the selected students, containing questions on demographic information, socioeconomic characteristics, and living conditions. After tooth cleaning and drying, all erupted permanent teeth were clinically assessed by two calibrated examiners, and classified according to the Basic Erosive Wear Examination (BEWE). The association between explanatory variables and the outcomes (ETW prevalence and extent) was assessed using Poisson regression models (both unadjusted and adjusted). A total of 1,197 adolescents were included in the study (participation rate of 72.3%). The overall prevalence of ETW was 57%. Severe ETW affected 16% of the sample. Overall, this adolescent population presented 13.3 affected surfaces, and 8.34 affected teeth. In the risk assessment analysis, gender, skin color, socioeconomic status, and family income were significantly associated with ETW. Boys, white adolescents, and those with higher socioeconomic status were more affected by ETW. This population-based cross-sectional study revealed that the prevalence of ETW was high, and that it was associated with sociodemographic variables in this South Brazilian population of adolescents.


Asunto(s)
Erosión de los Dientes/epidemiología , Adolescente , Distribución por Edad , Brasil/epidemiología , Estudios Transversales , Femenino , Humanos , Masculino , Prevalencia , Análisis de Regresión , Factores de Riesgo , Índice de Severidad de la Enfermedad , Distribución por Sexo , Factores Sexuales , Factores Socioeconómicos , Encuestas y Cuestionarios
5.
Braz Oral Res ; 33: e122, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31939501

RESUMEN

The distribution of harms to health varies spatially determined by the socioeconomic conditions of the environment. This research aimed to assess the spatial distribution of dental caries in 12-year-old children and their correlation with socioeconomic indicators in Brazilian states. The sample of this ecological study comprised all the 26 Brazilian states and the Federal District. Thematic and correlation maps were constructed in order to assess the spatial dependency, as well as the correlation between dental caries and socioeconomic factors. The results showed that the states with the worst DMFT indexes were located in the north and northeast, showing spatial autocorrelation. These regions also had the worst results for the following variables: poverty, illiteracy, education, and income. The bivariate analysis showed that household income and education level had negative spatial correlation with the DMFT index, while illiteracy and poverty rates showed positive correlation. Despite advances in the decline of DMFT index in recent years, there is still an inequity in the distribution of the caries disease.


Asunto(s)
Índice CPO , Caries Dental/epidemiología , Disparidades en el Estado de Salud , Brasil/epidemiología , Niño , Composición Familiar , Femenino , Geografía , Humanos , Masculino , Pobreza , Factores Socioeconómicos
6.
Clin Biochem ; 75: 7-14, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31678428

RESUMEN

Cardiovascular diseases are among the main causes of mortality worldwide, and dyslipidemia is a principal factor risk. Hence the study of biochemical markers is necessary for early diagnosis. OBJECTIVES: Evaluate biomarkers to diagnose the risks of cardiovascular diseases in healthy Brazilian and African young adults. DESIGN & METHODS: Weight, height, waist circumference, percentage of body fat and systemic blood pressure were measured; and fasting blood samples were taken for biochemical analysis. Triglycerides, total cholesterol, HDL-c, and apolipoproteins A-I and B were measured on automated equipment using commercially available kits, in addition to the tests of antioxidant capacity of HDL and the enzymatic activity of Paraoxonase 1. RESULTS: After statistical analysis, it was found that BMI, WC, fat (%), triglycerides, ApoB/ApoA-I ratio and Vmax were higher in Brazilians, while HDL-c, ApoA-I, Lag Time, Vmax and PON1 activity were higher in Africans. In Brazilians, the ApoB/ApoA-I ratio was related to obesity factors and lipid profile, but in Africans it was related only to lipids. The antioxidant capacity of HDL and PON1 activity was better in Africans. Through independence testing, we observed an association with moderate risk of myocardial infarction with gender in Africans. In the binary logistic regression analysis, it was found that men in general - and particularly African men - have higher risk of myocardial infarction than women; Odds Ratio 2144 (CI95%: 1343-3424) and 2281 (CI95%: 1082-4811), respectively. CONCLUSIONS: The anthropometric and biochemical parameters of Brazilians, especially men, predispose them to greater risks of cardiovascular diseases.


Asunto(s)
Apolipoproteína A-I/sangre , Arildialquilfosfatasa/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , HDL-Colesterol/sangre , Adolescente , Angola/epidemiología , Biomarcadores/sangre , Índice de Masa Corporal , Peso Corporal , Brasil/epidemiología , Enfermedades Cardiovasculares/sangre , Femenino , Guinea Bissau/epidemiología , Humanos , Masculino , Factores de Riesgo , Estudiantes , Adulto Joven
7.
World Neurosurg ; 133: e115-e120, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31550545

RESUMEN

OBJECTIVE: Pilocytic astrocytoma (PA) is rare in adults comprising 5.1% of the primary central nervous system tumors. The aim is to describe the first Brazilian series of adult patients with PA and compare its features with the available literature. METHODS: We retrospectively review all patients 18 years or older with PA from our institution's database from 1991 to 2018. We analyzed information regarding clinical presentation, location, imaging features, extent of resection, adjuvant treatments, and follow-up. RESULTS: Twenty-three patients with PA were analyzed: 60.9% male; median age 26 years. The most frequent symptoms were headache (34.8%) and seizure (26.1%). Temporal and parietal lobes were the most common locations, 21.7% each. All patients underwent a surgical procedure, gross total resection in 40.9%, subtotal resection in 22.7%, and biopsy in 27.3%. Adjuvant treatment with radiotherapy was performed in 2 patients. Only 4 patients had disease progression, 2 after gross total resection and 2 after subtotal resection. They were all alive and without evidence of new progression at the last follow-up (October 2018). Median overall survival was not reached after a median follow-up time of 88.9 months. CONCLUSIONS: This is the first Brazilian series regarding adults with PA, and our patients had a favorable outcome as reported in recent literature reviews. The tumor's prevalence reduces within older patients and supratentorial lesions are more frequent, especially on the temporal lobe. There was no significant relationship between location and progression, although according to the literature the extent of resection remains the most important prognostic factor.


Asunto(s)
Astrocitoma/cirugía , Neoplasias Encefálicas/cirugía , Adolescente , Adulto , Astrocitoma/complicaciones , Astrocitoma/epidemiología , Astrocitoma/radioterapia , Neoplasias Encefálicas/complicaciones , Neoplasias Encefálicas/epidemiología , Neoplasias Encefálicas/radioterapia , Brasil/epidemiología , Terapia Combinada , Irradiación Craneana , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Cefalea/etiología , Humanos , Masculino , Persona de Mediana Edad , Radioterapia Ayuvante , Estudios Retrospectivos , Convulsiones/etiología , Resultado del Tratamiento , Adulto Joven
8.
Oral Dis ; 26(1): 43-52, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31605560

RESUMEN

OBJECTIVES: The aim of this study was to investigate the prevalence of oral sarcomas from geographic regions of Brazil. MATERIALS AND METHODS: A cross-sectional study was conducted on biopsies obtained from January 2007 to December 2016 at twelve Brazilian oral and maxillofacial pathology centres. Gender, age, evolution time, clinical aspects, tumour location, tumour size at diagnosis, radiographic aspects and histopathological diagnosis were evaluated. Data were analysed using descriptive statistical methods. RESULTS: From 176,537, a total of 200 (0.11%) oral sarcomas were reported, and the most prevalent were osteosarcomas (74 cases; 37%) and Kaposi's sarcomas (52 cases; 26%). Males were more affected than females at a mean age of 32.2 years old (range of 3-87 years). The most common symptoms were swelling¸ localised pain and bleeding at a mean evolution time of 5.14 months (range <1-156 months). The lesions were mostly observed in the mandible (90 cases; 45%), with a mean tumour size of 3.4 cm (range of 0.3-15 cm). Radiographically, the lesions presented a radiolucent aspect showing cortical bone destruction and ill-defined limits. CONCLUSIONS: Oral sarcomas are rare lesions with more than 50 described subtypes. Osteosarcomas and Kaposi's sarcomas were the main sarcomas of the oral cavity in Brazil.


Asunto(s)
Neoplasias de la Boca/epidemiología , Sarcoma/epidemiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Biopsia , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteosarcoma/epidemiología , Estudios Retrospectivos , Sarcoma de Kaposi/epidemiología , Adulto Joven
9.
J Appl Oral Sci ; 28: e20190067, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31778444

RESUMEN

OBJECTIVES: This study approaches the history of reclassifications and redefinitions around the odontogenic keratocyst (OK), as proposed by the World Health Organization (WHO), and aims to understand the impact of those changes on the prevalence and epidemiology of odontogenic tumors (OTs). METHODOLOGY: Cases of OTs diagnosed in an Oral Pathology service between January 1996 and December 2016 were reviewed. Demographic data of patients such as age, gender and site of lesions were retrieved from their respective records. RESULTS: Within the studied period, 7,805 microscopic reports were elaborated and 200 (2.56%) of these were diagnosed as OTs. Out of these 200, between 1996 and 2005, prior to the 2005 WHO classification, there were 41 (20.5%) OTs cases, being odontoma the most frequent (23; 56.09%), followed by ameloblastoma (8; 19.51%) and myxoma (03; 7.31%). Between 2006 and 2016, after the previous 2005 WHO classification there were 159 (79.5%) OTs, being odontogenic keratocystic tumor (KCOT) the most frequent (68; 42.76%), followed by odontoma (39; 24.52%) and ameloblastoma (21; 13.20%). CONCLUSIONS: As of today, the most recent WHO classification to be followed brings KCOT back to the cyst category, which will impact on the prevalence and epidemiology of OTs; thus, this study was able to identify a considerable increase (287.80%) in the prevalence of OTs when the 2005 WHO classification was utilized. Despite being an important academic exercise, classifying odontogenic lesions and determining whether to place the odontogenic keratocyst in a cyst or tumor category is crucial to establish the correct diagnosis and treatment to follow, whether by oral medicine or oral surgery specialist, or by the general practitioner.


Asunto(s)
Tumores Odontogénicos/clasificación , Organización Mundial de la Salud , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Tumores Odontogénicos/diagnóstico , Tumores Odontogénicos/epidemiología , Prevalencia , Adulto Joven
10.
Pathogens ; 9: 25, 2020. tab, ilus
Artículo en Inglés | Sec. Est. Saúde SP, SESSP-IIERPROD, Sec. Est. Saúde SP | ID: biblio-1048132

RESUMEN

BACKGROUND: Despite its relatively low incidence of associated diseases, Human T-cell Leukemia Virus-1 (HTLV-1) infection was reported to carry a significant risk of mortality in several endemic areas. HTLV-1-associated diseases, adult T-cell leukemia/lymphoma (ATLL) and HTLV-1-associated myelopathy/tropical spastic paraperesis (HAM/TSP), as well as frequent coinfections with human immunodeficiency virus (HIV), hepatitis C virus (HCV), and Strongyloides stercoralis were associated to increased morbidity and mortality of HTLV-1 infection. OBJECTIVE: To determine the mortality rate and its associated variables from an open cohort started in July 1997 at the HTLV Clinic, Emilio Ribas Institute (IIER), a major infectious disease hospital in São Paulo, Brazil. METHODS: Since inception up to September 2018, we admitted 727 HTLV-1-infected individuals, with a rate of 30-50 new admissions per year. All patient data, including clinical and laboratory data, were regularly updated throughout the 21-year period, using a dedicated REDCap database. The Ethical Board of IIER approved the protocol. RESULTS: During 21 years of clinical care to people living with HTLV-1 in the São Paulo region, we recruited 479 asymptomatic HTLV-1-infected individuals and 248 HAM/TSP patients, of which 632 remained under active follow-up. During a total of 3800 person-years of follow-up (maximum follow-up 21.5 years, mean follow-up 6.0 years), 27 individuals died (median age of 51.5 years), of which 12 were asymptomatic, one ATLL patient and 14 HAM/TSP patients. HAM/TSP diagnosis (but neither age nor gender) was a significant predictor of increased mortality by univariate and multivariate (hazard ratio (HR) 5.03, 95% CI [1.96-12.91], p = 0.001) Cox regression models. Coinfection with HIV/HCV was an independent predictor of increased mortality (HR 15.08; 95% CI [5.50-41.32]; p < 0.001), with AIDS-related infections as a more frequent cause of death in asymptomatics (6/13; p = 0.033). HIV/HCV-negative fatal HAM/TSP cases were all female, with urinary tract infection and decubitus ulcer-associated sepsis as the main cause of death (8/14, p = 0.002). CONCLUSIONS: All-cause mortality among people living with HTLV-1 in São Paulo differs between asymptomatic (2.9%) and HAM/TSP patients (7.3%), independent of age and gender. We observe a dichotomy in fatal cases, with HAM/TSP and HIV/HCV coinfection as independent risk factors for death. Our findings reveal an urgent need for public health actions, as the major causes of death, infections secondary to decubitus ulcers, and immune deficiency syndrome (AIDS)-related infections, can be targeted by preventive measures


Asunto(s)
Brasil/epidemiología , Virus Linfotrópico T Tipo 1 Humano , Paraparesia Espástica Tropical
11.
Forensic Sci Int ; 306: 110002, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31864775

RESUMEN

Designer drugs or new psychoactive substances (NPS) are a heterogeneous group of substances obtained through the modification of chemical structure of some natural products or drugs. NPS illegally commercialized in blotter papers mimicking the most common form of LSD consumption, with a great variability of colours and symbols, have largely increased worldwide, including in Brazil, becoming an important emerging public health issue. In this study, we have evaluated the presence and profile of NPS in blotters seized in the State of Santa Catarina, Brazil, over the period of 2011 to 2017. The state government criminal forensics staff has performed gas chromatography-mass spectrometer (GC-MS) analyses in order to determine the chemical composition of the blotters. During the evaluated period, there was a considerable increase in the seizing of blotters events, from 87 in 2011, to 301 in 2016 and reaching 277 in 2017. There was also an increase in the number of blotters seized per event. Interestingly, while in 2011, 100% of blotters contained LSD, this number decreased to 0,1% in 2014, and achieved 17,6% in 2017, when up to 25 different substances were detected in blotters seized. Drugs such as DOx, NBOMe, fentanyl, mescaline derivatives, triptamines, cathinones, and synthetic cannabinoids were detected and became the major substances found in blotters. In some cases, more than one substance was found in the same blotter, characterizing a new mixture scenario. The presence of several new psychoactive substances in blotters is a reality in forensic toxicology. In Brazil, it might be related to the fact that most of these substances were not considered illegal by Brazilian legislation by the time they emerged.


Asunto(s)
Drogas Diseñadas/análisis , Papel , Psicotrópicos/análisis , Brasil/epidemiología , Cromatografía de Gases y Espectrometría de Masas , Humanos , Dietilamida del Ácido Lisérgico/análisis , Estudios Retrospectivos , Trastornos Relacionados con Sustancias/epidemiología
12.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 12: 257-262, jan.-dez. 2020. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1047911

RESUMEN

Objetivo: identificar o perfil epidemiológico dos usuários atendidos em ação de saúde na Baixada Litorânea do Rio de Janeiro. Método: trata-se de um estudo descritivo, retrospectivo, exploratório de natureza quantitativa que utilizou como delineamento a pesquisa documental por meio da análise de dados secundários. Resultados: foram avaliados 746 registros, com prevalência do sexo feminino (69,7%), idade entre 20 e 29 anos (41,6%), ensino superior incompleto (63,9%) e estado civil solteiro (69,4%). O sexo masculino apresentou uma média mais elevada de níveis pressóricos quando comparado com as mulheres. Evidenciou-se que com o avançar da idade e baixa escolaridade, maiores são os níveis de pressão arterial e glicêmicos. Conclusão: estudos que ampliam o conhecimento sobre o perfil epidemiológico de uma população representam uma ferramenta importante para subsidiar o cuidado em saúde


Objective: to reveal the epidemiological profile of the users met in health action in the Coastal Lowlands of Rio de Janeiro. Method: this is a descriptive study, retrospective, exploratory quantitative in nature used as documentary research design through the analysis of secondary data. Results: 746 records were evaluated, with female prevalence (69.7%), age between 20 and 29 years (41.6%), incomplete higher education (63.9%) and marital status single (69.4%). Males showed an average blood pressure higher when compared with the female. It was evidenced that with advancing age and lower educational level, the greater the blood pressure and blood glucose levels. Conclusion: it is considered that studies about the knowledge of the epidemiological profile of a population becomes an important tool to support health actions


Objetivo: identificar el perfil epidemiológico de los usuarios se reunieron en la acción sanitaria en las tierras bajas costeras de Río de Janeiro. Método: se trata de un estudio descriptivo, retrospectivo, utilizado cuantitativo en naturaleza exploratoria como diseño de investigación documental a través del análisis de datos secundarios. Resultados: se evaluaron registros de 746, con predominio femenino (69.7%), edad entre 20 y 29 años (41.6%), educación superior incompleta (63.9%) y el estado civil solo (69,4%). Los varones mostraron mayor los niveles de presión arterial media en comparación con las mujeres. Se evidenció que con el avance de edad y menor nivel educativo, mayor será los niveles de glucosa en sangre y presión arterial. Conclusión: estudios que amplían el conocimiento sobre el perfil epidemiológico de una población representan una herramienta importante para apoyar la atención de la salud


Asunto(s)
Humanos , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedad Crónica/epidemiología , Estudios Retrospectivos , Enfermedades no Transmisibles/epidemiología , Factores Socioeconómicos , Perfil de Salud , Brasil/epidemiología , Diabetes Mellitus , Hipertensión
13.
Einstein (Sao Paulo) ; 18: eAO4739, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31553355

RESUMEN

OBJECTIVE: To use magnetic resonance imaging to assess the prevalence of foot and ankle ligament injuries and fractures associated with ankle sprain and not diagnosed by x-ray. METHODS: We included 180 consecutive patients with a history of ankle sprain, assessed at a primary care service in a 12-month period. Magnetic resonance imaging findings were recorded and described. RESULTS: Approximately 92% of patients had some type of injury shown on the magnetic resonance imaging. We found 379 ligament injuries, 9 osteochondral injuries, 19 tendinous injuries and 51 fractures. Only 14 magnetic resonance imaging tests (7.8%) did not show any sort of injury. We observed a positive relation between injuries of the lateral complex, syndesmosis and medial ligaments. However, there was a negative correlation between ankle ligament injuries and midfoot injuries. CONCLUSION: There was a high rate of injuries secondary to ankle sprains. We found correlation between lateral ligament injuries and syndesmosis and deltoid injuries. We did not observe a relation between deltoid and syndesmosis injuries or between lateral ligamentous and subtalar injuries. Similarly, no relation was found between ankle and midfoot injuries.


Asunto(s)
Traumatismos del Tobillo/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Adolescente , Adulto , Anciano , Traumatismos del Tobillo/diagnóstico por imagen , Brasil/epidemiología , Cartílago Articular/lesiones , Niño , Femenino , Humanos , Ligamentos Laterales del Tobillo/lesiones , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Prevalencia , Adulto Joven
14.
Acta Trop ; 201: 105183, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31542372

RESUMEN

Leptospirosis is a zoonotic disease caused by the pathogenic helical spirochetes, Leptospira. Symptoms include sudden-onset fever, severe headaches, muscle pain, nausea and chills. Leptospirosis is endemic in developing countries such as Malaysia, India, Sri Lanka, and Brazil where thousands of cases are reported annually. The disease risk factors include the high population of reservoirs, environmental factors, recreational factors, and occupational factors. To end the endemicity of leptospirosis, these factors need to be tackled. The management of leptospirosis needs to be refined. Early diagnosis remains a challenge due to a lack of clinical suspicion among physicians, its non-specific symptoms and a limited availability of rapid point-of-care diagnostic tests. The purpose of this review is to provide insight into the status of leptospirosis in developing countries focusing on the risk factors and to propose methods for the improved management of the disease.


Asunto(s)
Leptospirosis/epidemiología , Animales , Brasil/epidemiología , Países en Desarrollo , Humanos , India/epidemiología , Leptospirosis/prevención & control , Malasia/epidemiología , Masculino , Sri Lanka/epidemiología , Zoonosis
15.
Acta Trop ; 201: 105188, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31545949

RESUMEN

Triatoma petrocchiae is the newly member of the Triatoma brasiliensis species complex. This species overlaps with T. brasiliensis in geographic and ecotypic occupation in the sylvatic habitat because both inhabit rocky outcrops in the semi-arid portion of Brazilian northeast. In this region T. brasiliensis is the most important Chagas disease vector because it constantly colonizes domiciles. In contrast, T. petrocchiae is rarely found in peri or intradomiciliary habitats - reason why little is known about this species. Therefore, Here, we present information for the first time on. the T. petrocchiae ecotopes, genetic diversity, Trypanosoma cruzi prevalence/genotyping in comparison to T. brasiliensis. We found T. brasilensis (N = 223) and T. petrocchiae (N = 69) in co-habitation in rocky outcrops in three Districts of Paraíba and Rio Grande do Norte states. Forty-tree T. petrocchiae insects of eleven sampling spots (composing three geographic populations) were genotyped for the mitochondrial Cyt B gene and little geographic structure was observed. Tajima's D test suggested that species is evolving toward a mutation-drift equilibrium in our collection range. Sylvatic T. petrocchiae had 4% (3/68) of infected insects by T. cruzi, whereas T. brasiliensis had 26% (59/223). Fluorescent Fragment Length Barcoding demonstrated that all three T. petrocchiae harbored TcI whereas T. brasiliensis had TcI, but also TcIII, TcII/TcVI and T. rangeli genotype A, sometimes under mixed infections. None of infected T. petrocchiae were carrying mixed infections. However, this result should be confirmed using a larger pool of infected bugs. We here presented the first documentation of T. rangeli infecting T. brasiliensis. The finding of infected T. petrocchiae calls for constant vector monitoring because the epidemiologic scenario is dynamic and sylvatic vectors are progressively found in adaptation to anthropic environments.


Asunto(s)
Enfermedad de Chagas/transmisión , Insectos Vectores/parasitología , Simpatría , Triatoma/parasitología , Trypanosoma cruzi/genética , Animales , Brasil/epidemiología , Enfermedad de Chagas/epidemiología , Ecosistema , Variación Genética , Genotipo , Epidemiología Molecular , Prevalencia
16.
Rev Saude Publica ; 53: 105, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31826174

RESUMEN

OBJECTIVE: To evaluate the factors associated with tooth loss in adults from the position and number of teeth lost in the dental arches. METHODS: This is a cross-sectional, population-based study with adults participating in the epidemiological survey of oral health of São Paulo in 2015. The outcome of the study was tooth loss, assessed by the proposed classification, namely: I) lost up to 12 back teeth; II) lost up to 12 teeth (including front teeth); and III) lost more than 12 teeth. A four-block analysis was conducted, supported by a conceptual theoretical model adapted for tooth loss. For the multinomial logistic regression, "individuals who did not lose teeth due to caries or periodontal disease" was used as reference (p < 0.05). RESULTS: Of 6,051 adults evaluated, 25.3% (n = 1,530) were classified in category I, 32.7% (n = 1,977) in II, 9.4% (n = 568) in III, and 1.9% (n = 117) were edentulous. Lower income and schooling, the perception of need for treatment and the last appointment motivated by routine, pain or extraction were associated with tooth loss, regardless of the classification. The negative evaluation of the dental service was associated with individuals who lost up to 12 teeth, both front and back. The presence of women and periodontal pocket were associated with tooth loss of up to 12 teeth, including front, and more than 12 teeth. Caries were associated with adults who lost up to 12 teeth, including front teeth. CONCLUSION: The proposed classification allowed the identification of differences between the associated factors. Thus, the need to consider such classification in future studies is evident.


Asunto(s)
Pérdida de Diente/epidemiología , Adulto , Factores de Edad , Brasil/epidemiología , Estudios Transversales , Caries Dental/epidemiología , Caries Dental/fisiopatología , Femenino , Humanos , Masculino , Salud Bucal , Enfermedades Periodontales/clasificación , Bolsa Periodontal/epidemiología , Bolsa Periodontal/fisiopatología , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos , Pérdida de Diente/etiología
17.
Rev Saude Publica ; 53: 108, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31826175

RESUMEN

OBJECTIVE: To evaluate the association of school failure among Brazilian adolescents with social conditions and aspects of oral health through hierarchical analysis. METHODS: A state-wide survey of 5,558 adolescents from the state of São Paulo, Brazil, inquired about the sociodemographic and social capital of participants by using a structured questionnaire. Trained and calibrated professionals performed intraoral examinations and interviews in the households. Questions about the access to dentist, reason for and frequency of using dental services, toothache episodes and impact of oral conditions on daily activities (OIDP) were applied. Oral examinations evaluated caries experience, tooth losses, periodontal problems, presence of open bite, and maxillary and mandibular overjet. School failure was estimated according to the teenagers' years of schooling. The independent variables were grouped into three blocks: sociodemographic and economic characteristics, social capital and oral health aspects. The multiple hierarchical logistic regression model was used to identify the factors associated with school failure. RESULTS: Of the total sample, information about schooling of 5,162 adolescents was obtained, of whom 29.6% presented school failure. We found that adolescents over the age of 16 years who did not declare themselves as white, female, with feelings of insecurity, unhappiness, with toothache, caries, tooth losses, affected by dentofacial and/or periodontal changes, were more likely to fail at school. CONCLUSION: Oral disorders and social factors were associated with school failure in adolescents. A successful school trajectory was a strong determinant of health, therefore actions between the educational and health sectors must be developed for adolescents, especially those with this profile.


Asunto(s)
Fracaso Escolar , Evaluación Educacional , Salud Bucal/estadística & datos numéricos , Adolescente , Adulto , Brasil/epidemiología , Estudios Transversales , Caries Dental , Encuestas de Salud Bucal , Femenino , Humanos , Masculino , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios , Pérdida de Diente , Adulto Joven
18.
J Glob Health ; 9(2): 020432, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31788230

RESUMEN

Background: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality worldwide, but it mainly affects women from low- and middle-income countries. Despite being a treatable condition, the high number of maternal deaths resulting from PPH is outstanding for at least 25 years. Late diagnosis and difficulties in identifying women who will develop severe postpartum bleeding can, in part, explain the high incidence of PPH. Over the past few years, researchers have focused on identifying a simple, accessible and low-cost diagnostic tool that could be applied to avoid maternal deaths. In particular, it has been suggested that vital signs and shock index (SI) could be useful. The objective of this study was to evaluate whether vital signs are correlated with the percentage of body blood volume (BBVp) lost after vaginal delivery. Methods: A prospective cohort study was performed at the Women's Hospital of UNICAMP, Brazil. The inclusion criteria were women delivering vaginally who did not suffer from hypertension, hyper- or hypothyroidism, cardiac disease, infections or coagulopathy. Blood loss was measured over 24 hours using a calibrated drape and by weighing compresses, gauzes and pads. Vital signs were measured up to 24 hours after delivery. We evaluated the BBVp lost, and generated a Receiver operating characteristics (ROC) curve with area under the curve (AUC) analysis to determine the cut-off values for vital signs to determine the likelihood of postpartum bleeding above the 90th percentile within 24 hours of delivery. Results: A total of 270 women were included. The mean blood loss within 24 hours of vaginal delivery was 570.66 ± 360.04 mL. In the first 40 minutes, 73% of the total blood loss over the 24-hour period had occurred, and within 2 hours, 91% of women had bled 90% of the total blood loss. Changes in SI and heart rate (HR) were statistically significant in predicting postpartum bleeding (P ≤ 0.05). Higher values for likelihood ratio (LR) to identify BBVp loss above the 90th percentile within 2 hours were a SI above 1.04 at 41-60 minutes after birth (LR = +11.84) and a HR above 105.2 bpm at 21-40 minutes after birth (LR = +4.96). Both measures showed high specificity but low sensitivity. Conclusion: Values of SI and HR are statistically significant in predicting postpartum bleeding with high specificity but low sensitivity. The cut-off points were 1.04 for SI and 105 bpm for HR.


Asunto(s)
Pérdida de Sangre Quirúrgica/fisiopatología , Parto Obstétrico/efectos adversos , Frecuencia Cardíaca/fisiología , Hemorragia Posparto/epidemiología , Índices de Gravedad del Trauma , Adulto , Volumen Sanguíneo , Brasil/epidemiología , Femenino , Humanos , Incidencia , Mortalidad Materna , Valor Predictivo de las Pruebas , Embarazo , Estudios Prospectivos , Índice de Severidad de la Enfermedad , Signos Vitales
19.
BMC Infect Dis ; 19(1): 1021, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31791261

RESUMEN

BACKGROUND: Currently, norovirus (NoV) is associated with one-fifth of all acute gastroenteritis (AGE) cases worldwide. The NoV GII.17_2014 variant has been associated with gastroenteritis outbreaks in several Asian countries, replacing the previously dominant Sydney 2012 variant. There is limited data about circulation of this new strain in Brazil. This study aimed to describe the phylogenetic and evolutionary characteristics of the GII.17_2014 strains in the Northern region of Brazil. METHODS: NoV was detected by enzyme immunoassay (EIA) in 645 stool samples of AGE cases that were reported in Pará and Amazonas states during 2015-2016. All positive samples were tested for NoV GI and GII by reverse transcription polymerase chain reaction (RT-PCR) and the amplicons were subjected to genome sequencing. The GII.17-positive samples were retested by PCR using different sets of designed primers, which target a highly conserved capsid gene region. Next, the amplicons were sequenced and phylogenetically analyzed using Bayesian inferences. RESULTS: Of the 645 samples tested, 208 (32.2%) tested were positive for NoV by EIA, among which 95 (45.7%) were genotyped. Among the genotyped samples, 12 (12.6%) were characterized as GII.17_2014 with the first case detected in November 2015 (1/30, 3.3%) and the others in 2016 (11/65, 16.9%). All strains found in our study were clustered in clade D (epidemic strain). The uncorrelated log-normal model estimations calculated the rate of evolution for GII-17 strains as 1.95 × 10- 3 (1.28 × 10- 3-2.63 × 10- 3). In total, 36 nucleotide changes were observed after analyzing the VP1 sequence, among which 28 occurred in the P2 region. CONCLUSIONS: These data demonstrate the evolutionary dynamics in NoV GII.17_2014 strains, which indicated high mutation rates with nucleotide substitutions and indels that are related to the elevated levels of antigenic diversity. This partly explains the increase in viral prevalence.


Asunto(s)
Infecciones por Caliciviridae/virología , Evolución Molecular , Gastroenteritis/virología , Tipificación Molecular , Norovirus/clasificación , Norovirus/genética , Brasil/epidemiología , Infecciones por Caliciviridae/epidemiología , Proteínas de la Cápside/genética , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/virología , Brotes de Enfermedades , Epidemias , Heces/virología , Gastroenteritis/epidemiología , Genotipo , Humanos , Tipificación Molecular/métodos , Filogenia , Prevalencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Virología/métodos
20.
Rev Bras Epidemiol ; 22Suppl 3(Suppl 3): e190010.supl.3, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31800849

RESUMEN

INTRODUCTION: Brazil presented a high proportion of ill-defined causes of death (IDCD) in 2000, compromising accurate cause-of-death analysis. OBJECTIVE: To analyze specific underlying causes for deaths originally assigned as IDCD in the Mortality Information System (SIM - Sistema de Informação sobre Mortalidade), after investigation activities implemented in country between 2006 and 2017. METHOD: For all IDCD identified in the SIM, municipal health professionals collected information about the final disease obtained from hospital records, autopsies, forms of family health teams, and home investigation. Specific causes among reclassified IDCD after investigation were evaluated according to age groups and four calendar periods. RESULTS: Proportions of IDCD reassigned to other causes after review increased over time, reaching 30.1% in 2017. From a total of 257,367 IDCD reclassified in 2006-2017, neonatal-related conditions, injury, ischemic heart disease and stroke were the leading causes detected in the age groups 0-9 years, 10-29 years, 30-69 years, 70 years and over, respectively. DISCUSSION: The similarity and plausibility of cause-specific proportions derived from the reclassification of IDCD by age group over time indicate the accuracy of the investigation data. CONCLUSION: High proportions of IDCD reassigned to more informative causes after review indicate the success of this approach to correct misclassification in the SIM, an initiative that should be maintained. Training physicians on death certification along with better quality of medical care and access to health services would lead to further improvement.


Asunto(s)
Causas de Muerte , Recolección de Datos/métodos , Sistemas de Información/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Factores de Edad , Anciano , Autopsia/estadística & datos numéricos , Brasil/epidemiología , Niño , Preescolar , Certificado de Defunción , Femenino , Humanos , Lactante , Entrevistas como Asunto/estadística & datos numéricos , Masculino , Registros Médicos/estadística & datos numéricos , Persona de Mediana Edad , Factores de Tiempo , Adulto Joven
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