[Infant mortality rate and social disparity at Recife, the metropolis of the North-East of Brazil]. / Taux de mortalité infantile et disparités sociales à Recife, métropole du Nord-Est du Brésil.

We analyzed differences in infant mortality between areas of Recife, a city in the North East of Brazil, analyzing the relationship between living conditions and the risk of death. We compared infant mortality coefficients for 1995 with indicators of living conditions and collected data for the 770 infant deaths and the 27,965 live births. Neighborhoods were ranked according to the quality of living conditions and were grouped into four clusters. The infant, neonatal and postneonatal mortality coefficients were 27.53, 18.84 and 8.69 per 1,000 live births respectively. Lower quality living conditions were associated with higher coefficients. The main causes of infant deaths were perinatal disorders, the coefficient of which was 14.95 per 1,000 live births, followed by congenital malformations, gastroenteritis and bronchopneumonia. With the exception of congenital malformations, the coefficients of all these causes of death increased as living conditions worsened. These inequalities are generally obscured by the presentation of means for the city as a whole.

Liver failure and death after exposure to microcystins at a hemodialysis center in Brazil.

BACKGROUND: Hemodialysis is a common but potentially hazardous procedure. From February 17 to 20, 1996, 116 of 130 patients (89 percent) at a dialysis center (dialysis center A) in Caruaru, Brazil, had visual disturbances, nausea, and vomiting associated with hemodialysis. By March 24, 26 of the patients had died of acute liver failure. METHODS: A case patient was defined as any patient undergoing dialysis at dialysis center A or Caruaru's other dialysis center (dialysis center B) during February 1996 who had acute liver failure. To determine the risk factors for and the source of the outbreak, we conducted a cohort study of the 130 patients at dialysis center A and the 47 patients at dialysis center B, reviewed the centers' water supplies, and collected water, patients' serum, and postmortem liver tissue for microcystin assays. RESULTS: One hundred one patients (all at dialysis center A) met the case definition, and 50 died. Affected patients who died were older than those who survived (median age, 47 vs. 35 years, P<0.001). Furthermore, all 17 patients undergoing dialysis on the Tuesday-, Thursday-, and Saturday-night schedule became ill, and 13 of them (76 percent) died. Both centers received water from a nearby reservoir. However, the water supplied to dialysis center B was treated, filtered, and chlorinated, whereas the water supplied to dialysis center A was not. Microcystins produced by cyanobacteria were detected in water from the reservoir and from dialysis center A and in serum and liver tissue of case patients. CONCLUSIONS: Water used for hemodialysis can contain toxic materials, and its quality should therefore be carefully monitored.

[Antinomies and epistemological "sutures" between the socio-biological and the collective-individual characteristics within the field of social epidemiology]. / Antinomias e "suturas" epistemológicas entre biológico-social e individual-coletivo no âmbito da epidemiologia social.

The complexity of the epidemiological object has provoked discussion of the elements that have constituted it over time sometimes assuming the form of antinomies. By using as substract fundamental texts, the formulation and the proposal for a solution of the antinomies between the social-biological and the collective-individual are been analysed. The validity of the theoretical wasy ahead indicated by the epidemiological discourse for the solution of the conflict of "laws" that surround this object are been criticized. The concept of the individual in Marx and Heller is been used to contribute to the "suturing" of the three strata of reality: the universal, the particular and the singular.

[Rethinking the challenges of Ulysses and Faust: health, the individual and history]. / Repensando os desafios de Ulisses a Fausto: a sa de, o indiv duo e a hist ria.

Concentrating on two historical synecdoches, Ulysses and Faust, this article takes up the etymology of the Latin term salute as a unit lying somewhere between "existential needs" and "especially human needs", leading to the challenge of satisfying the need for "conservation of life" and at the same time to "surpass it, go beyond it". Both meanings are present in Ulysses attitude of not succumbing to the siren s melody and in Faust s desire to rise above everyday life. Some aspects of the Marxist conception of the philosophy of history and Althusser s Structuralist Marxism are criticized. Also, in light of Marxist-Hellerian theory, the article analyzes the hypothesis that the target of the final reports of the VIII National Health Conference was "particular man" and not the individual, since health is treated only as "an existential need", and does not envisage the generic human. As a theoretical challenge, the text, in search of the unfolding individual, finally recommends the construction of "epistemological sutures" between nature and society, everyday life and universality, and the young and old Marx.