Ecologia política: una lectura de cambios que promueve la educación ambiental no formal en Santiago de Cali -Colombia / Political ecology: a reading of changes promoted by nonformal environmental education in Santiago de Cali -Colombia / Ecologia política: uma leitura da mudança promovendo a educação ambiental não formal em Santiago de Cali -Colombia

RESUMEN Ante la presión antropogénica sobre el medio ambiente, es preponderante el rol de la educación ambiental para generar cambios que resignifiquen la relación ser humano-naturaleza en los territórios. Esta investigación cualitativa hermenêutica tuvo un enfoque descriptivo explicativo y en ella se estudiaron cambios culturales y socioambientales promovidos por procesos específicos de educación ambiental no formal realizados en Santiago de Cali - Colombia acerca de conservación de bienes ambientales y servicios ecosistémicos, embellecimiento del entorno, soberania alimentaria y preservación de la biodiversidad. Se identificaron indicadores de educación ambiental potenciales para valorar los cambios promovidos, se definieron indicadores específicos indagando experiencias, percepciones y motivaciones de actores sociales participantes y se contrastó su correspondencia desde la ecologia política y el pensamiento ambiental crítico. Se encontró que la definición de indicadores de educación ambiental presenta retos considerables y que, si bien los procesos educativos posibilitaron una mejor comprensión de las problemáticas medioambientales, los cambios culturales y socioambientales promovidos dependen de dinâmicas socioeconómicas, prácticas éticas, culturales y del ejercicio del poder político.

ABSTRACT In the face of anthropogenic pressure on the environment, the role of environmental education to generate changes that redefine the human-nature relationship in the territories is preponderant. This qualitative hermeneutic research had a descriptive explanatory approach and studied cultural and socio-environmental changes promoted by specific non-formal environmental education processes carried out in Santiago de Cali - Colombia regarding the conservation of environmental goods and ecosystem services, beautification of the environment, food sovereignty and preservation of biodiversity Potential environmental education indicators were identified to assess the changes promoted, specific indicators were defined by investigating experiences, perceptions and motivations of participating social actors and their correspondence was contrasted from political ecology and critical environmental thinking. It was found that the definition of environmental education indicators presents considerable challenges and that, although the educational processes enabled a better understanding of environmental issues, the cultural and socio-environmental changes promoted depend on socioeconomic dynamics, ethical and cultural practices and the exercise of political power.

RESUMO Diante da pressão antropogênica sobre o meio ambiente, o papel da educação ambiental na geração de mudanças que redefinem a relação homem-natureza nos territórios é preponderante. Esta pesquisa hermenêutica qualitativa teve uma abordagem explicativa descritiva e estudou as mudanças culturais e socioambientais promovidas por processos específicos de educação ambiental não-formal realizados em Santiago de Cali - Colombia sobre a conservação dos bens e serviços ambientais, o embelezamento do meio ambiente, a soberania alimentar e a preservação da biodiversidade. Indicadores potenciais de educação ambiental foram identificados para avaliar as mudanças promovidas, indicadores específicos foram definidos através de pesquisas sobre as experiências, percepções e motivações dos atores sociais participantes e sua correspondência foi contrastada a partir da perspectiva da ecologia politica e do pensamento ambiental crítico. Verificou-se que a definição de indicadores de educação ambiental apresenta desafios consideráveis e que, embora os processos educacionais tenham levado a uma melhor compreensão das questões ambientais, as mudanças culturais e socioambientais promovidas dependem da dinâmica socioeconòmica, das práticas éticas e culturais e do exercicio do poder politico.

Epidemiological and molecular profile of blood donors infected with HTLV-1/2 in the state of Pará, northern Brazil.

BACKGROUND: The Human T-lymphotropic virus (HTLV) is a retrovirus of the genus Deltaretrovirus, which belongs to the family Retroviridae. The most important types are HTLV-1 and HTLV-2. It is estimated that between five and 10 million individuals are infected with HTLV-1, worldwide. Studies in the state of Pará indicate that it has the third highest prevalence of HTLV infections of any Brazilian state. The present study describes the epidemiological, serological, and molecular profile of blood donors from the state of Pará that were classified as unfit due to infection by HTLV-1 and 2. METHODS: The present study is based on a descriptive, retrospective, and cross-sectional review of the epidemiological, serological, and molecular data on blood donations, between January 2015 and December 2019. The data were obtained from the blood bank system and were digitalized to form a database in the Statistical Package for Social Sciences program, version 20. Descriptive statistics were used to determine the absolute and relative frequencies of the qualitative variables. For the quantitative variables, the mean, standard deviation, and minimum and maximum values were calculated. A p < 0.05 significance level was adopted for all analyses. RESULTS: A total of 632 samples were analyzed, of which 496 (78%) had no detectable proviral DNA and 136 (22%) had detectable HTLV. The HTLV-1 was detected in most (78%; 106/136) of these samples, while only 30 (22%) were detected for HTLV-2. The HTLV proviral DNA was detected primarily in females (69.1%), with a mean age of 40 years, with the highest frequencies of detection being recorded in single individuals (66.2%), first-time donors (74.3%), and individuals that had graduated high school (44.1%). The molecular confirmation of HTLV showed that three-quarters (78%) of the serologically reactive individuals were negative for either types 1 or 2, so the epidemiological profile of these individuals was significantly different from their detectable profile. CONCLUSIONS: The HTLV is neglected in Brazil; there is thus a clear need for further research in the area of regional hemotherapy and hematology services, in order to contribute to the definition of regional infection profiles, that will be fundamental to the development of effective prophylactic practices for the prevention of the infection and the dissemination of knowledge on the dangers of HTLV in the community.

Prevalence, incidence and residual risk of transfusion-transmitted HBV infection before and after the implementation of HBV-NAT in northern Brazil.

BACKGROUND: Nucleic acid testing (NAT) for virus detection during blood screening has helped to prevent transfusion-transmitted infections worldwide. In northern Brazil, NAT was implemented in 2012 for HIV and HCV and more recently, in January 2015, the screening for HBV was included and currently used concomitant with serological tests (HBsAg and anti-HBc). This study aims to evaluate the prevalence and the incidence of HBV infection among voluntary blood donors at ten regional blood centers of HEMOPA Foundation in Pará state and to compare the residual risk of transfusion-transmitted HBV infection before and after the Brazilian HBV-NAT implementation. METHODS: The prevalence (restricted to first time donors- FT) and seroconversion rate (restricted to repeat donors- RP) of HBV were calculated based on rates of confirmed positive samples. Residual risk was based on the incidence and window period (WP) model described by Schreiber and coauthors. Logistic and Poisson regression were used in the statistical analysis by SPSS v20.0. A p value <0.05 was considered statistically significant. RESULTS: HBV prevalence in the periods before and after the implementation of HBV-NAT were 247 and 251 per 100,000 donations, respectively. Seroconversion rates were 114 and 122 per 100,000 donations in the two periods, respectively. The residual risk (RR) for HBV decreased significantly in the posterior period to the HBV-NAT implementation, when compared to RR before implementation, with a reduction of 1:144,92 to 1:294,11 donations (p <0,001). CONCLUSIONS: The RR to HBV decreased after the implementation of HBV-NAT, increasing significantly the transfusional security in the North region of Brazil at HEMOPA Foundation.

Characterization of hepatitis B virus infection in illicit drug users in the Marajó Archipelago, northern Brazil.

South America is considered to have a low prevalence of hepatitis B virus (HBV) infection, although areas with a relatively high prevalence have been identified in northern Brazil. Few epidemiological studies of populations at risk of HBV infection are available for this region. Given this, in the present study, we investigated the prevalence of HBV and the factors associated with infection among illicit drug users (DUs) in the Marajó Archipelago, northern Brazil. In this cross-sectional study, we collected samples and epidemiological information from DUs in 11 municipalities of the Marajó Archipelago. The diagnosis was established by ELISA and real-time PCR; and genotyping was done by multiplex real-time PCR. Statistical modeling was based on simple and multiple logistical regressions with the Hosmer-Lemeshow test. The mean age of the 466 DUs was 28.4 years, and most were male. The most-consumed illicit drugs were crack cocaine and marijuana. In all, 171 DUs were exposed to HBV, with genotypes A, D and F being identified. The factors associated with higher frequencies of HBV infection were (i) male gender, (ii) age above 35 years, (iii) anti-HIV positivity, (iv) tattoos, (v) the use of injected drugs, (vi) the use of illicit drugs for more than 3 years, (vii) sexual relations without protection, (viii) sexual relations with another DU, and (ix) more than 10 sexual partners in the past 24 months. In summary, this study provides important insights into the dynamics of HBV infection among DUs in the Marajó Archipelago. We hope that these findings will contribute to the development of strategies, actions and public health policies aimed at preventing and controlling this viral infection more effectively.

Espesor medio intimal carotídeo en niños escolares y su relación con factores de riesgo cardiovascular / Carotid intima-media thickness in school children and its relationship with cardiovascular risk factors

Objetivo: Determinar la relación entre los factores de riesgo cardiovascular y el espesor medio intimal carotídeo en una población de escolares de la ciudad de Bogotá. Método: Estudio descriptivo de corte transversal, al que fueron invitados todos los estudiantes de dos colegios seleccionados por conveniencia. La muestra correspondió a 94 escolares (57 niñas y 37 niños) de 13 ± 1,54 años. Se tomaron medidas antropométricas, presión arterial y medición ecográfica del espesor medio-intimal carotídeo. El análisis de datos se llevó a cabo mediante estadística descriptiva, en tanto que el análisis univariado y bivariado se hizo a través de tablas de distribución de frecuencias y tablas de contingencia para variables cualitativas y medidas descriptivas de tendencia central y de variabilidad para variables cuantitativas. Resultados: Del total de la población, el 34,79% presentó exceso de peso según el índice de masa corporal, el 28,8% registró exceso de grasa corporal, el 46% tuvo cifras tensionales elevadas de donde el 36,8% correspondió a prehipertensión arterial y 9,2% a hipertensión arterial estadio 1. El promedio del espesor de la arteria carótida fue de 0,3163 ± 0,040 mm. Se encontró asociación directa entre el espesor medio intimal carotídeo y la presión arterial diastólica (r = 0,193). Existe asociación lineal directa entre el porcentaje de grasa y la presión arterial diastólica (r = 0,283). Conclusión: En este estudio se encontró una relación entre el espesor medio intimal carotídeo y la presión arterial diastólica. No se evidenció relación estadística entre el espesor medio intimal carotídeo y la obesidad o el exceso de grasa corporal. Es importantísimo continuar con este tipo de estudios en la población colombiana con el fin de prevenir, desde etapas tempranas de la vida, la aparición de factores de riesgo cerebro-cardiovascular.

Objetive: To determine the relationship between cardiovascular risk factors and carotid intima-media thickness in a school children population of the city of Bogotá. Methods: Cross-sectional descriptive study including all students at the selected schools of the convenience sample. The sample gathered 94 pupils (57 girls and 37 boys) of ages 13 ± 1.54. Anthropometric measurements, blood pressure and ultrasound measurement of carotid intima-media thickness were conducted. Data analysis was carried out by means of descriptive statistics, in so far the univariate and bivariate analysis was made with frequency distribution and contingency tables for qualitative variables and descriptive measures of central tendency and variability for quantitative variables. Results: Out of the total population, 34.79% showed excess weight according to the body mass index, 28.8% registered excess body fat, 46% had high blood pressure, of which 36.8% corresponded to early arterial hypertension and 9.2% to stage I hypertension. Average carotid intima-media thickness was 0.3163 ± 0.040 mm. A direct association was found between the carotid intima-media thickness and diastolic pressure (r = 0.193). There is a direct lineal association between the percentage of body fat and diastolic pressure (r = 0.283). Conclusion: The present study found a direct association between the carotid intima-media thickness and diastolic pressure. No statistically significant evidence was found to relate carotid intima-media thickness and obesity or excess body fat. It is very important to continue this type of study in Colombian population in order to prevent, from early stages in life, the occurrence of cerebro-cardiovascular risk factors.

Predicción de la dinámica temporal de egresos hospitalarios por obesidad en niños y jóvenes en Estados Unidos / Prediction of the temporal dynamic of hospital discharges for obesity in children and youth in the united states

The prevalence of overweight in children worldwide is rising in developing countries. Diseases associated with childhood overweight as asthma, sleep apnea and diabetes mellitus, the latter being the most common among children and adolescents, imply another problem: the high cost to health, which has been analyzed by the National Center for Health Statistics in USA. The objective of this research was study mathematically the dynamics of the percentage of hospital discharges for overweight and obese patients between 6-17 years of age in the United States in order to predict the percentage of hospital discharges for obesity in the year 1999 in the context of probabilistic random walk, specifically from a total space of probability for analyzing the probabilistic behavior of increases and decreases, from the years between 1983 and 1998, in the United States. The predicted range for 1999 was 1,17%, which was then compared with data from the National Center for Health, which reported a 1,15%, achievinga 98,01% prediction. It was established a physical and mathematical order underlying the dynamics of hospital discharges rate for obesity in children, making predictions on its trajectory.

La prevalencia de sobrepeso en niños a nivel mundial tiende al incremento especialmente en países en vía de desarrollo. Enfermedades asociadas al sobrepeso infantil como asma, apnea del sueño y diabetes mellitus, siendo esta última la más frecuente en niños y adolescentes, implican otra problemática como es el alto costo en salud, el cual ha sido analizado por el Centro Nacional de Estadísticas de la Salud en los Estados Unidos. El objetivo de esta investigación fue estudiar matemáticamente la dinámica del porcentaje de altas hospitalarias por sobrepeso y obesidad de pacientes de 6 a 17 años de edad en los Estados Unidos con el fin de predecir el porcentaje de altas hospitalarias por obesidad en Estados Unidos para el año 1999, en el contexto de la caminata al azar probabilista, específicamente a partir de un espacio total de probabilidades que permite analizar el comportamiento probabilista de aumentos y disminuciones, a partir de los años comprendidos entre 1983 y 1998, en Estados Unidos. El rango predicho para el año 1999 fue de 1,17%, valor que fue posteriormente comparado con los datos del NCHS, que reportó un 1,15%, logrando una predicción del 98,01%. Se estableció un orden físico y matemático subyacente a la dinámica del porcentaje de altas hospitalarias por obesidad en niños, logrando realizar predicciones en su trayectoria.

Evaluación de la aplicación de las guías de hipertensión y diabetes en un programa de crónicos / Hypertension and diabetes guidelines evaluation and application in a chronic disease program / Avaliação da implementação das guias de hipertensão e diabetes em um programa de pacientes crônicos

Introducción: La Hipertensión arterial (HTA) y la Diabetes Mellitus (DM) hacen parte de las enfermedades crónicas no trasmisibles (ECNT) y ocupan las primeras causas de morbimortalidad a nivel mundial y nacional. Por tal razón es importante el control de estas enfermedades para prevenir la progresión de las coomorbilidades, con un impacto directo en la calidad de vida y en los costos de atención del paciente, por esto es importante evaluar la correcta aplicación de las guías de HTA y DM en los programas de prevención y control de las ECNT. Metodología: Se realizó un estudio descriptivo transversal por medio de un muestreo aleatorio estratificado. Para evaluar el control de los pacientes según la aplicación de las guías de Hipertensión y Diabetes en una población de usuarios inscritos en los programas de promoción y prevención de una Entidad Adaptada al Sistema, en la ciudad de Bogotá. Resultados: Se obtuvo una población de 425 pacientes hipertensos y de 279 diabéticos con un nivel de confianza de 95% y una precisión del 80%. Se encontró en el programa de hipertensos un cumplimiento de la guía del 67,8% y un control de la enfermedad del 60%. De los pacientes diabéticos evaluados se encontró un cumplimiento de la guía del 62,8% y un control de la patología menor al 1% y un aceptable control del 51%. Conclusión: Con el porcentaje de cumplimiento encontrado en la aplicación de las guías se está logrando un control en el programa de hipertensión de acuerdo a lo esperado, sin embargo en el programa de pacientes diabéticos se encuentra un bajo control. Por tal razón es imperativo mejorar la aplicación de las guías de manejo de estas patologías y así impactar en el control de la enfermedad y la calidad de vida de los pacientes.

Introduction: The hypertension and Mellitus diabetes are two of the highly risky diseases that are not contagious and are the first causes of mortality in an international and national level. For this reason is important to control these diseases to prevent the progression of the illnesses, with a direct impact in the life style and in the costs of the services for the patients, because of this is important to evaluate the right use of the HTA and DM guides in the prevention and control programs of the ECNT. Methodology: A transversal descriptive study was run by a random stratified sampling. To evaluate the control of the patients according to the application of the HTA and DM guides in a group of users of the promotion and prevention programs of a medical services institution in Bogota. Results: A group of 425 Hypertension patients and 279 diabetic patients was obtain; with a trusting level of 95% and a precision level of 80%. In the hypertension program was found a fulfillment of the guide of 67.75% and a 60% of the disease control. About the diabetic patients that were evaluated was found a fulfillment of the guide of 62.75%, less of 1% pathology control and an acceptable control of 51%. Conclusions: With the application guide percentage is being achieved the control in the hypertension program according to what was expected, but in the program of diabetic patients was found an underachieve. For this reason a better application of the guides is needed for the control of these diseases and because of this an impact in the illness control and life style of the patients.

Introdução: A hipertensão arterial (HTA) e a Diabetes mellitus (DM) fazem parte das doenças crônicas não transmissíveis (DCNT), sendo causas primarias de morbimortalidade no nível mundial e nacional. Além disso, é importante o controle destas doenças com o fim de prevenir a progressão das comorbilidades, com um impacto direito na qualidade de vida e nos custos da atenção dos doentes. Pelo anterior, é importante avaliar a correta implementação das Guias de HTA e DM nos programas de prevenção e controle das DCNT. Metodologia: Foi feito um estudo descritivo, transversal, aleatório estratificado, com o fim de avaliar o controle dos pacientes crônicos segundo a implementação das Guias de HTA e DM em uma população de usuários inscritos nos programas de promoção e prevenção de uma entidade adaptada ao sistema, na cidade de Bogotá. Resultados: Obteve-se uma população de 425 pacientes com HTA e de 279 com DM, com um nível de confiança de 95% e uma precisão de 80%. A implementação da Guia foi de 67,8% nos pacientes com HTA, com 60% de controle da doença. Nos pacientes com DM, a implementação da guia foi de 62,8%, controle da doença menor de 1% e controle aceitável de 51%. Conclusão: Segundo a porcentagem obtida da implementação das Guias, está-se logrando um controle no programa de HTA, embora no programa de pacientes com DM existe um baixo controle. É por isso que é importante melhorar a implementação das guias destas doenças, com o fim de impactar no controle da doença mesma e a qualidade de vida dos pacientes.

Epidemiological aspects of HCV infection in non-injecting drug users in the Brazilian state of Pará, eastern Amazon.

BACKGROUND: Currently, sharing of drug paraphernalia is the main form of HCV transmission worldwide. In South America, consistent findings indicate that shared sniffing equipment is an important factor in the spread of HCV among non-injecting drug users. Epidemiological data on the status of HCV infection in illicit drug users in the Amazon region are scarce, although reports of clinical cases of hepatitis or pathologies associated with HCV infection in other population groups are numerous. Thereby, this study investigated the prevalence, genotype frequency, and epidemiological factors associated with HCV infection in non-injecting drug users in the state of Pará, eastern Amazon. RESULTS: During 2008-2011, 300 non-injecting drug users attending drug-treatment centers participated in this study. Most non-injecting drug users were male (63.7%). The mean age was 32.5 years. The non-injecting drugs most consumed were: cannabis (15.6%), cocaine paste (21.3%), and oxi cocaine (25.7%). Tobacco (60.9%) and alcohol (79.4%) were also commonly consumed. One hundred six (35.1%; CI 95%: 29.8 - 41.1) non-injecting drug users presented anti-HCV antibodies by EIA. The HCV-RNA prevalence was 28.0% (95% CI: 20.6 - 35.8). Genotypes 1 (76.9%) and 3 (23.1%) of HCV have been identified. A multivariate analysis demonstrated that HCV infection was independently associated with the following factors: "age (≥ 35 years)", "tattoos", "use of a needle or syringe sterilized at home", "shared use of drug paraphernalia", "uses drugs for more than 5 years", and "use of drugs everyday". CONCLUSIONS: This study revealed a high prevalence of HCV infection in non-injecting drug users, and most infections are occasioned by genotype 1. Likely, HCV transmission is associated with the tattoos, the use of needle or syringe sterilized at home by people over the age of 35 years, and sharing, time and frequency of use of non-injecting drugs. These findings should serve as an incentive for the establishment of a program of Hepatitis C prevention and control by the local public-health authorities in order to develop effective policies and strategies for contain the spread of HCV infection.

Caminata al aza predictiva de la dinámica de oesidad: predicciones de obesidaad y sobrepeso en la población infantil de Colombia y de variación peso/talla y peso/edad en México / Predictive ranomm walk of obesity dynamic and redictions of obesity and overwweight in children from Colombia and weight/height and weight/age variation in Mexico / Caminhada prvisõões preditivos dinâmicas aleatórias de obesiade e sobrepesoo e obesidade em crianças na Colômbia e variação de peso / estatura e peso / idade noMééxico

La obesidad y el sobrepeso constituyen problemas de salud pública tanto a nivel mundial como en América Latina. La teoría de la probabilidad y la caminata al azar probabilista han sido base para el desarrollo de predicciones de la dinámica de diferentes epidemias. En este trabajo se estudió el crecimiento de la obesidad en cuatro países con base en la caminata al azar, para confirmar la capacidad de la metodología para describir y predecir esta dinámica específica, y se desarrollaron simulaciones de variables asociadas al estudio de sobrepeso y obesidad en Colombia y México, proyectando una predicción al 2015. Se estudiaron tasas de obesidad de Estados Unidos, Finlandia, Australia e Inglaterra desde 1982 a 1996, en analogía con una caminata al azar probabilista, evaluando su capacidad predictiva para el año 1997. Posteriormente se desarrollaron simulaciones de la dinámica de sobrepeso y obesidad en Colombia con base en reportes reales de los años 2005 y 2010 de acuerdo con el índice de masa corporal (IMC), así como simulaciones de la dinámica de peso/talla y peso/edad en la población mexicana de menores de 0 a 5 años, dividida en cuatro regiones, con base en los reportes de 1999 y 2006, proyectándolas hasta el 2015, con base en la caminata al azar. El análisis de la dinámica de crecimiento de la obesidad con base en la caminata al azar, permite predecir cuando los índices van a permanecer estables o cuando van a subir en Estados Unidos, Finlandia, Australia e Inglaterra, logrando predicciones con un porcentaje de efectividad igual o superior al 97,85% para 1997. Las simulaciones obtenidas para México y Colombia predicen un comportamiento probable hasta el 2015, encontrando que en 2015 en Colombia las prevalencias de obesidad para niños de 0 a 9 años oscilarán entre 4,2 y 11,2, y de sobrepeso para niños entre 10 y 17 años entre 12,9 y 19,4. También se encontraron valores predictivos entre 0,1 y 7,7 para el 2015 en México en niños de 0 a 5 años, respecto a la variable de peso/talla, mientras que respecto a peso/ edad se encontraron entre 0,2 y 11,89. Se evidenció que la metodología utilizada es útil para el estudio de diferentes variables asociadas a la dinámica de obesidad y sobrepeso y sirve como base para el desarrollo de predicciones de utilidad en la toma de decisiones de salud pública.

Obesity and overweight are public health problems both globally and in Latin America. The theory of probability and probabilistic random walk have been the basis for developing predictions of the dynamics of different epidemics. In this work, the growth of obesity in four countries is studied based on the random walk, to confirm the ability of the methodology to describe and predict this specific dynamics. Besides, simulations were developed to study variables associated with overweight and obesity in Colombia and Mexico, projecting a possible prediction to 2015. We studied obesity rates in the United States, Finland, Australia and England from 1982 to 1996 in analogy with a probabilistic random walk, assessing its predictive ability for 1997.Subsequently, dynamics simulations of overweight and obesity in Colombia were developed based on actual reports of 2005 and 2010, as well as simulations of the dynamics of weight/age and weight/ height in the Mexican population younger than 0-5 years, divided into four regions, based on the reports of 1999 and 2006. All the simulations were projected to 2015, based on the random walk. The analysis of the dynamics of the obesity rates based on random walk predicts if rates will remain stable or if they will go up in the United States, Finland, Australia and England, making predictions with an effectiveness rate equal to or higher than 97.85% in 1997. The simulations obtained for Mexico and Colombia predict a probable behavior until 2015 both with a regular growth and with the random walk. It was found that in 2015 in Colombia the prevalence of obesity for children aged 0 to 9 years will range between 4.2 and 11.2, and overweight in children between 10 and 17 years will range between 12.9 and 19.4. Predictive values between 0.1 and 7.7 were also found in Mexico for 2015 in children aged 0-5 years relating to the variable weight/height, while regarding weight/age values ranging between 0.2 and 11.89 were found. It was evident that the methodology is useful for the study of different variables associated with overweight and obesity dynamics and serve as a basis for developing predictions useful in making public health decisions.

A obesidade e o sobrepeso constituem problemas de saúde pública tanto a nível mundial quanto na América Latina. A teoria da probabilidade e a caminhada ao acaso probabilista têm sido base para o desenvolvimento de predições da dinâmica de diferentes epidemias. Em este trabalho se estudou o crescimento da obesidade em quatro países com base na caminhada ao acaso para confirmar a capacidade da metodologia para descrever e predizer esta dinâmica específica, e se desenvolveram simulações de variáveis associadas ao estudo de sobrepeso e obesidade na Colômbia e no México, projetando uma predição a 2015. Estudaram-se taxas de obesidade dos Estados Unidos, da Finlândia, da Austrália e da Inglaterra desde 1982 até 1996 em analogia com uma caminhada ao acaso probabilista, avaliando sua capacidade preditiva para o ano 1997. Posteriormente se desenvolveram simulações da dinâmica de sobrepeso e obesidade na Colômbia com base em reportes reais dos anos 2005 e 2010 de acordo ao índice de massa corporal (IMC), assim como simulações da dinâmica de peso/tamanho e peso/idade na população mexicana de menores de 0 a 5 anos, dividida em quatro regiões, com base nos reportes de 1999 e 2006, projetando-as até 2015, com base na caminhada ao acaso. Análise da dinâmica de crescimento da obesidade com base na caminhada ao acaso permite predizer quando os índices vão permanecer estáveis ou quando vão subir Nos Estados Unidos, na Finlândia, na Austrália e na Inglaterra, logrando predições com uma percentagem de efetividade igual ou superior ao 97,85% para 1997. As simulações obtidas para o México e a Colômbia predizem um comportamento provávelaté 2015, encontrando que em 2015 na Colômbia as prevalências de obesidade para crianças de 0 a 9 anos oscilarão entre 4,2 e 11,2, e de sobrepeso para crianças entre 10 e 17 anos entre 12,9 e 19,4. Também se encontraram valores preditivos entre 0,1 e 7,7 para 2015 no México em crianças de 0 a 5 anos, respeito à variável de peso/tamanho, por enquanto com respeito a peso/ idade se encontraram entre 0,2 e 11,89. Evidenciou-se que a metodologia utilizada é útil para o estudo de diferentes variáveis associadas à dinâmica de obesidade e sobrepeso e serve como base para o desenvolvimento de predições de utilidade na toma de decisões de saúde pública.

Epidemiological aspects of HCV infection in HIV-infected individuals in Piauí State, Northeast Brazil.

In this study, the prevalence, genotypic frequency, and risk factors for HCV infection in 768 patients infected with HIV were determined. Fifty-two (6.77 %) HIV-positive individuals had anti-HCV antibodies and 26 (3.39 %) had HCV-RNA. Genotyping results indicated that all RT-PCR samples from patients infected with HCV belonged to genotype 1. Multivariate analysis revealed an association of HIV-HCV coinfection with drug use and having received blood transfusions before 1994. The relatively low prevalence of HCV infection in the HIV-positive population in that region may be a consequence of the small number of drug users in the sample, despite a strong association between HCV infection and drug use.

Effectiveness of agricultural interventions that aim to improve nutritional status of children: systematic review.

OBJECTIVE: To assess the effectiveness of agricultural interventions in improving the nutritional status of children in developing countries. DESIGN: Systematic review. DATA SOURCES: Published and unpublished reports (after 1990) in English identified by searching 10 databases (Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Jolis, PubMed, Web of Science, and World Bank), websites, previous systematic reviews, and reference lists and by contacting experts. STUDY SELECTION: Included studies assessed effects of agricultural interventions aiming at improving the nutritional status of children (bio-fortification, home gardens, small scale fisheries and aquaculture, dairy development, and animal husbandry and poultry development). Only studies that used a valid counterfactual analysis were included. Before/after studies and participants/non-participants comparisons affected by selection bias were excluded. Data analysis Results were analysed for four intermediate outcomes (programme participation, income, dietary diversity, and micronutrient intake) and one final outcome (prevalence of under-nutrition). Analysis was by summary tables of mean effects and by meta-analysis (for vitamin A absorption). RESULTS: The review included 23 studies, mostly evaluating home garden interventions. The studies reviewed did not report participation rates or the characteristics of participants in programmes. The interventions had a positive effect on the production of the agricultural goods promoted, but not on households' total income. The interventions were successful in promoting the consumption of food rich in protein and micronutrients, but the effect on the overall diet of poor people remains unclear. No evidence was found of an effect on the absorption of iron, but some evidence exists of a positive effect on absorption of vitamin A. Very little evidence was found of a positive effect on the prevalence of stunting, wasting, and underweight among children aged under 5. CONCLUSIONS: The question posed by the review cannot be answered with any level of confidence. The data available show a poor effect of these interventions on nutritional status, but methodological weaknesses of the studies cast serious doubts on the validity of these results. More rigorous and better designed studies are needed, as well as the establishment of agreed quality standards to guide researchers in this important area.

Enfermedad de Castleman. Reporte de 14 casos de 1990-2002 en el Hospital Dr. Rafael Angel Calderón Guardia dos con presentación inusual y revisión de literatura / Diseases of Castleman. Report of 14 cases of 1999-2002 in Hospital Dr. Rafael Angel Calderón Guardia

La enfermedad de Castleman (hamartoma linfoideo, linfoma, gigante benigno, hiperplasia angiofolicular de los nódulos linfáticos) es un transtorno linfoproliferativo raro, de curso usualmente benigno de etiología desconocida y pobremente entendido. Resulta de un crecimiento no regulado del tejido linfático y puede manifestarse clínicamente en 2 formas, localizada y diseminada o multicéntrica, con 3 variantes histopatológicas, vascular hialino, plasmocelular y mixto o transicional. Usualmente la forma vascular hialina tiene una evolución clínica benigna manifestada solamente por adenopatías en el cambio, la forma plasmocelular o mixta puede manifestar alteraciones físicas y de laboratorio, tales como fiebre, pérdida de peso, anemia e hiperglobulinemia. Las 2 últimas condiciones clínicas pueden resultar en transformación maligna similar al linfoma de Hodgkin. Revisamos la base de datos del Servicio de Patología de nuestro hospital y encontramos 14 casos reportados desde enero de 1990 hasta enero del 2002, 2 mostraron presentación inusual. Descriptores: Enfermedad de Castleman, trastorno linfoproliferativo, comportamiento clínico.

Accumulation of fumonisins B1 and B2 in freshly harvested Brazilian commercial maize at three locations during two nonconsecutive seasons.

Fifty-six Brazilian commercial maize cultivars were examined for FB1 and FB2 accumulation after two non-consecutive growing seasons. During the 94/95 growing season 35 cultivars were planted at three locations in the state of São Paulo, Brazil. All samples (total of 105) were contaminated (0.10 micro/g-6.58 microg/g FB1 and 0.04 microg/g-2.15 microg/g FB2). During the 97/98 growing season, 8 of the cultivars used during 94/95 and 21 others were replanted at the same locations. All 87 samples were contaminated (1.15 microg/g-43.80 microg/g FB1 and 0.08 microg/g-11.65 microg/g FB2). One cultivar accumulated significantly less fumonisins in all locations during both growing seasons, indicating that some degree of selection may be possible even in climates that favor F. moniliforme (verticillioides) infection of maize. The presence of water surplus in soil from kernel maturity to harvest correlated with concentrations of FB1 in the grain for the 8 cultivars planted during both seasons at three locations. Observed trends indicated that water excesses and deficits from silking to harvest increased fumonisin levels. The difference in the incidence of FB1, FB2, and FB1 + FB2 was significant between growing seasons, planting locations and between cultivars. Neither the level of hybridization, nor the type of endosperm, nor the length of the vegetative cycle showed any effect on the FB1 contamination.

Fumonisins in corn cultivars in the state of Säo Paulo

Twenty three samples, belonging to 19 corn cultivars with sistinct types of germoplasms, endosperm and lenght of vegetative cycle, were analyzed for fumonisins B(1) and B(2). The cultivars were grown in experimental fields in three locations (Votuporanga, Ribeirão Preto and Capão Bonito) within th State of São Paulo, Brazil, during the 97/98 crop. All samples were contaminated with fumonisins with concentrations ranging from 1.63(micro)g/g to 25.69(micro)g/g with average of 5.61(micro)g/g for FB(1) and from 0.38(micro)g/g to 8.60(micro)g/g with an average of 1.86(micro)g/g for FB(2). In terms of fumonisins, these high levels put the corn cultivated in São Paulo among the most contaminated in the world reported to date

Fumonisins in corn cultivars in the state of São Paulo

Twenty three samples, belonging to 19 corn cultivars with distinct types of germoplasms, endosperm and length of vegetative cycle, were analyzed for fumonisins B1 and B2. The cultivars were grown in experimental fields in three locations (Votuporanga, Ribeirão Preto and Capão Bonito) within the State of São Paulo, Brazil, during the 97/98 crop. All samples were contaminated with fumonisins with concentrations ranging from 1.63 µg/g to 25.69 µg/g with an average of 5.61 µg/g for FB1 and from 0.38 µg/g to 8.60 µg/g with an average of 1.86 µg/g for FB2. In terms of fumonisins, these high levels put the corn cultivated in São Paulo among the most contaminated in the world reported to date.

Vinte e três amostras, representando 19 cultivares de milho com diferentes tipos de germoplasma, de endosperma e ciclo vegetativo, foram avaliadas quanto ao teor de fumonisinas em três Estações Experimentais do Instituto Agronômico (Capão Bonito, Ribeirão Preto e Votuporanga) em São Paulo, Brasil, durante a safra de 97/98. Todos os cultivares analisados estavam contaminados com fumonisinas em níveis que variaram de 1.63 µg/g a 25.69 µg/g e uma média de 5.61 µg/g FB1 e de 0.38 µg/g a 8.60 µg/g e uma média de 1.86 µg/g FB2. Estes níveis tão elevados colocam o milho cultivado no Estado de São Paulo entre os mais contaminados do mundo em termos de fumonisinas.