Demographic profile of sylvatic yellow fever in Brazil from 1973 to 2008.

BACKGROUND: Yellow fever is an acute, frequently fatal, febrile arbovirosis that in Brazil occurs only in the sylvatic form. Sylvatic yellow fever (SYF) appears in sporadic outbreaks over a large area of Brazil. In this paper, we analyze the demographic profile of 831 SYF cases that occurred between 1973 and 2008, to determine which segments of the exposed population are at greater risk. METHODS: Data were statistically analyzed and were also geo-referenced in order to observe their spatial pattern. The basic reproductive number of infections, R0, was estimated by the ratio between average life expectancy and the average age of the cases. RESULTS: SYF cases showed a modal profile of young male adults, approximately 30 years of age, living in rural areas of the states of Pará, Goiás, Maranhão and Minas Gerais, who were unvaccinated or whose vaccination was out of date. The disease showed a high mortality rate (51%, 421/831) among the notified cases, with death occurring on around the seventh day of illness for most patients. The R0 for SYF was estimated at approximately 2.4. CONCLUSION: The results of this study suggest that lack of vaccination coverage is a major risk factor for SYF, and that the groups most at risk are migrant laborers, farm workers and tourists.

H3N2 homeopathic influenza virus solution modifies cellular and biochemical aspects of MDCK and J774G8 cell lines.

BACKGROUND: Influenza viruses cause highly contagious acute respiratory illnesses with significant mortality, especially among young children, elderly people, and individuals with serious medical conditions. This encourages the development of new treatments for human flu. Biotherapies are diluted solutions prepared from biological products compounded following homeopathic procedures. OBJECTIVES: To develop a biotherapy prepared from the infectious influenza A virus (A/Aichi/2/68 H3N2) and to verify its in vitro response. METHODS: The ultradiluted influenza virus solution was prepared in the homeopathic dilution 30dH, it was termed Influenzinum RC. The cellular alterations induced by this preparation were analyzed by optical and electron microscopy, MTT and neutral red assays. Glycolytic metabolism (PFK-1) was studied by spectrophotometric assay. Additionally, the production of tumor necrosis factor-α (TNF-α) by J774.G8 macrophage cells was quantified by ELISA before and after infection with H3N2 influenza virus and treatment. RESULTS: Influenzinum RC did not cause cytotoxic effects but induced morphological alterations in Madin-Darby canine kidney (MDCK) cells. After 30 days, a significant increase (p < 0.05) in mitosis rate was detected compared to control. MDCK mitochondrial activity was changed after treatment for 10 and 30 days. Treatment significantly diminished (p < 0.05) PFK-1 activity. TNF-α in biotherapy-stimulated J774.G8 macrophages indicated a significant (p < 0.05) increase in this cytokine when the cell supernatant was analyzed. CONCLUSION: Influenzinum RC altered cellular and biochemical features of MDCK and J774G8 cells.

Epidemiological aspects of acquired immunodeficiency syndrome in older Brazilians: a comparative approach.

OBJECTIVES: To compare epidemiological aspects of young (15 to 49 years old) and older (more than 50 years old) AIDS patients. METHODS: We analyzed 511,633 AIDS cases notified to the Brazilian Ministry of Health in the period of 1980-2008 looking at sex, age ranges, educational level and exposure category. Patients were divided into three age groups: under 15, from 15 to 49 and over 50 years old. Using a comparative approach, we analyzed data with regard to category of exposure, education (expressed in years of schooling), and sex ratio among younger (15-49) and older adults (over 50 years old). Time series data were log-transformed and normalized, and the temporal trend was evaluated. RESULTS: AIDS incidence is increasing among people over 50 years old in Brazil, with those older than 50 being responsible for 9.64 % of AIDS cases. There was no significant difference between educational level and gender (p = 0.468), but there was a significant difference in exposure category with a lower proportion of injecting drug users amongst the older group. CONCLUSION: Based on this analysis over the last 10 years, the percentage of AIDS cases has increased almost three times among people over 50 years old when compared with the 15-49 year-old group. Our findings suggest that public campaigns have to be specially targeted to the older segment of the population, aiming at heterosexual transmission.

Epidemiological aspects of acquired immunodeficiency syndrome in older Brazilians: a comparative approach

OBJECTIVES: To compare epidemiological aspects of young (15 to 49 years old) and older (more than 50 years old) AIDS patients. METHODS: We analyzed 511,633 AIDS cases notified to the Brazilian Ministry of Health in the period of 1980-2008 looking at sex, age ranges, educational level and exposure category. Patients were divided into three age groups: under 15, from 15 to 49 and over 50 years old. Using a comparative approach, we analyzed data with regard to category of exposure, education (expressed in years of schooling), and sex ratio among younger (15-49) and older adults (over 50 years old). Time series data were log-transformed and normalized, and the temporal trend was evaluated. RESULTS: AIDS incidence is increasing among people over 50 years old in Brazil, with those older than 50 being responsible for 9.64 percent of AIDS cases. There was no significant difference between educational level and gender (p = 0.468), but there was a significant difference in exposure category with a lower proportion of injecting drug users amongst the older group. CONCLUSION: Based on this analysis over the last 10 years, the percentage of AIDS cases has increased almost three times among people over 50 years old when compared with the 15-49 year-old group. Our findings suggest that public campaigns have to be specially targeted to the older segment of the population, aiming at heterosexual transmission.

Dynamic behavior of sylvatic yellow fever in Brazil (1954-2008) / Comportamento dinâmico da febre amarela silvestre no Brasil (1954-2008)

INTRODUCTION: Sylvatic yellow fever (SYF) is enzootic in Brazil, causing periodic outbreaks in humans living near forest borders or in rural areas. In this study, the cycling patterns of this arbovirosis were analyzed. METHODS: Spectral Fourier analysis was used to capture the periodicity patterns of SYF in time series. RESULTS: SYF outbreaks have not increased in frequency, only in the number of cases. There are two dominant cycles in SYF outbreaks, a seven year cycle for the central-western region and a 14 year cycle for the northern region. Most of the variance was concentrated in the central-western region and dominated the entire endemic region. CONCLUSIONS: The seven year cycle is predominant in the endemic region of the disease due the greater contribution of variance in the central-western region; however, it was possible identify a 14 cycle that governs SYF outbreaks in the northern region. No periodicities were identified for the remaining geographical regions.

INTRODUÇÃO: A febre amarela silvestre (FAS) é enzoótica no Brasil, causando surtos periódicos em humanos que vivem próximos às áreas florestais ou em áreas rurais. Neste estudo, foram analisados os padrões de periodicidade desta arbovirose. MÉTODOS: Utilizamos a análise espectral de Fourier para capturar os padrões de periodicidades da FAS em séries temporais. RESULTADOS: Os surtos de FAS aparentemente não aumentaram em frequência, mas em número de casos. Há dois ciclos dominantes na FAS, um de sete anos predominando na região centro-oeste, e um de 14 anos predominando na região norte. A maior parte da variância concentrou-se na região centro-oeste e dominava toda região endêmica. CONCLUSÕES: O ciclo de sete anos é predominante para a região endêmica da doença devido a maior contribuição da variância do centro-oeste. No entanto, foi possível identificar um ciclo de 14 que rege a FAS na região norte. Não foram detectadas periodicidades nas demais regiões geográficas.

Dynamic behavior of sylvatic yellow fever in Brazil (1954-2008).

INTRODUCTION: Sylvatic yellow fever (SYF) is enzootic in Brazil, causing periodic outbreaks in humans living near forest borders or in rural areas. In this study, the cycling patterns of this arbovirosis were analyzed. METHODS: Spectral Fourier analysis was used to capture the periodicity patterns of SYF in time series. RESULTS: SYF outbreaks have not increased in frequency, only in the number of cases. There are two dominant cycles in SYF outbreaks, a seven year cycle for the central-western region and a 14 year cycle for the northern region. Most of the variance was concentrated in the central-western region and dominated the entire endemic region. CONCLUSIONS: The seven year cycle is predominant in the endemic region of the disease due the greater contribution of variance in the central-western region; however, it was possible identify a 14 cycle that governs SYF outbreaks in the northern region. No periodicities were identified for the remaining geographical regions.

Susceptibility of a continuous murine cell line (GRX) to viral infection / Suscetibilidade de uma linhagem celular murina contínua (GRX) à infecção viral

The ability of a murine cell line (GRX) to support viral replication was evaluated. GRX cell cultures were infected with different DNA or RNA viruses. It was observed that the GRX cell line is susceptible to the replication of Herpes simplex virus types 1 and 2 (HSV-1 and HSV-2), Mayaro virus (MAY), Sindbis virus (SIN), and West equine encephalitis virus (WEE), and can beused as substrate for viral replication studies. Viral replication induced cytopathic effect (CPE) 24-48 h post-infection. The 2.4 5.4 GRX cells yielded infectious virus titers between 10 TCID (Tissue Culture Infectious Dose50) /25 µL and 10 5.4 and 10 TCID50 /25 µL in the first viral passage. These results demonstrate that GRX cells efficiently sustain viral replication and there fore can be used as a valuable tool in the virology laboratory.

Este estudo avaliou a capacidade de uma linhagem celular murina (GRX) de realizar a replicação viral. Culturas de células GRX foram infectadas com diferentes vírus DNA e RNA. Foi observado que a linhagem celular GRX é suscetível à replicação dos vírus Herpes simplex tipos 1 e 2 (HSV-1 e HSV-2), Mayaro (MAY), Sindbis (SIN) e vírus da encefalite equina do oeste (WEE) e pode ser utilizada como suporte para estudos sobre replicação viral. A replicação viral induziu o efeito 2.4 citopático 24 a 48 h pós-infecção. As células GRX produziram titulações de vírus infecciosos entre 10 TCID50 (dose 50 5.4 infecciosa de cultura de tecido )/25 µL e 10, 5.4 TCID50 /25 µL na primeira passagem viral. Esses resultados demonstram que as células GRX sustentam, de forma eficiente, a replicação viral e, portanto, podem ser utilizadas como uma ferramenta valiosa para estudos laboratoriais sobre virologia.

A influência do gênero e da escolaridade no diagnóstico de demência / The influence of gender and educational level on the diagnosis of dementia

Um problema no diagnóstico das demências é a ausência de informação prévia sobre o nível cognitivo dos pacientes, anterior às manifestações atuais. A análise das discrepâncias nos testes cognitivos torna-se assim uma referência para o diagnóstico. A relação entre gênero, nível de escolaridade, experiência profissional e resultados da avaliação neuropsicológica foi analisada a partir de prontuários clínicos de pacientes idosos. A amostra masculina de nível superior apresentou médias significativamente menores nas subescalas de execução em relação às verbais. Apesar do nível de escolaridade e da atividade intelectual ocultarem a perda de performance nos quadros demenciais, a análise das discrepâncias evidencia as quedas de rendimento. Na amostra feminina, com menor nível de escolaridade, embora os resultados mostrassem deficiência cognitiva, não ocorreram diferenças significativas entre os subtestes verbais e de execução. A análise da covariância indicou que o nível de escolaridade, e não o gênero, foi o fator responsável pela diferença.(AU)

A major problem with the early diagnosis of dementia is the lack of prior information about the cognitive level of patients before the current expression of the symptoms. The analysis of discrepancies in cognitive tests has become a reference for driving the diagnosis. Based on neuropsychological assessments of dementia in elderly patients, the present study analyzed the relationship between gender, level of education and professional experience. The WAIS-III, Rey auditory verbal learning, Folstein and Zülliger tests were employed. Results indicated that male subjects with higher education presented lower scores in the performance subtest when compared to the verbal subtest. Although educational status and intellectual activity had a tendency to mask the loss of performance in dementia disorder, the evaluation of the discrepancies indicated a reduction in efficiency. In the sample of females, with lower levels of schooling, although the results indicated a tendency towards cognitive impairment, no differences between verbal and performance subtests were detected. A covariance analysis indicated that the level of education was the variable responsible for this difference, and not gender.(AU)

A influência do gênero e da escolaridade no diagnóstico de demência / The influence of gender and educational level on the diagnosis of dementia

Um problema no diagnóstico das demências é a ausência de informação prévia sobre o nível cognitivo dos pacientes, anterior às manifestações atuais. A análise das discrepâncias nos testes cognitivos torna-se assim uma referência para o diagnóstico. A relação entre gênero, nível de escolaridade, experiência profissional e resultados da avaliação neuropsicológica foi analisada a partir de prontuários clínicos de pacientes idosos. A amostra masculina de nível superior apresentou médias significativamente menores nas subescalas de execução em relação às verbais. Apesar do nível de escolaridade e da atividade intelectual ocultarem a perda de performance nos quadros demenciais, a análise das discrepâncias evidencia as quedas de rendimento. Na amostra feminina, com menor nível de escolaridade, embora os resultados mostrassem deficiência cognitiva, não ocorreram diferenças significativas entre os subtestes verbais e de execução. A análise da covariância indicou que o nível de escolaridade, e não o gênero, foi o fator responsável pela diferença.

A major problem with the early diagnosis of dementia is the lack of prior information about the cognitive level of patients before the current expression of the symptoms. The analysis of discrepancies in cognitive tests has become a reference for driving the diagnosis. Based on neuropsychological assessments of dementia in elderly patients, the present study analyzed the relationship between gender, level of education and professional experience. The WAIS-III, Rey auditory verbal learning, Folstein and Zülliger tests were employed. Results indicated that male subjects with higher education presented lower scores in the performance subtest when compared to the verbal subtest. Although educational status and intellectual activity had a tendency to mask the loss of performance in dementia disorder, the evaluation of the discrepancies indicated a reduction in efficiency. In the sample of females, with lower levels of schooling, although the results indicated a tendency towards cognitive impairment, no differences between verbal and performance subtests were detected. A covariance analysis indicated that the level of education was the variable responsible for this difference, and not gender.

Avaliação dos fatores de risco de sintomas depressivos em população deDiabéticos da rede pública municipal de saúde de Taubaté SP / Assessment of depressive simptoms risk factors in diabetes mellitus population in the city of Taubaté São Paulo public primary care center

Este artigo tem como objetivo analisar fatores de risco biológicos história pregressa de doença grave e fatores psicossociais, para Transtornos Depressivos em estudo transversal com amostra de pacientes com diabete melito da rede de atenção primária à saúdeda Prefeitura de Taubaté SP. Participaram da pesquisa 192 pacientes de um programa deatenção primária de diabetes da cidade de Taubaté SP. O grupo controle foi constituído de oitenta e quatro 84 voluntários sem história de transtornos depressivos e ou diabetes. Foramutilizadas escalas de Beck para Depressão e questionário de fatores psicosociais amplamenteutilizado na literatura. Os riscos associados aos fatores foram analisados por regressão logísticabinária e a análise. Foi utilizado o software Minitab 4.0. Encontraram-se dois tipos de riscos:riscos de estresse biológico, no qual a presença de diabetes e história pregressa de doença grave estressores biológicos considerados em nosso experimento constituíram os únicos riscos para depressão na amostra examinada; e riscos psicossociais, nos quais a presençade filhos e escolaridade tiveram uma participação significativa entre os fatores de risco paradepressão na população com diabetes. Concluiu-se que a presença de diabetes e históriapregressa de doença grave, bem como a presença de filhos e escolaridade foram os fatores derisco encontrados.

The purpose of this study was to investigate the biological and psycho social riskfactors to depressive disturbances in a sample of patients with diabetes mellitus in the city ofTaubaté s São Paulo public primary care center. One hundred-ninety two patients underdiabetes mellitus treatment on the public primary care center had the psycho social statusassessed through interview and the Beck s scale for depression. Eighty four patients with nosuch pathology were used as control. Techniques of logistic regression were used to measurebiological and psycho social stress agents. The statistical analysis was conducted by using theMinitab 4.0 software. Diabetes mellitus in association with other severe pathologies is a riskfactor for depression in adults. The vulnerability to depression condition is increased in femalepatients with diabetes mellitus.

[Climate and dengue epidemics in State of Rio de Janeiro]. / Clima e epidemias de dengue no Estado do Rio de Janeiro.

Temperatures in the city of Rio de Janeiro in the first quarter of the year over the period 1986-2003, especially the minimum, were significantly higher in the years in which dengue epidemics started in the city. There was no significant relationship with total rainfall for the same quarter of the year, but epidemics were more frequent in the years in which the volume of rain during the summer was small (less than 200 mm).

Clima e epidemias de dengue no Estado do Rio de Janeiro / Climate and dengue epidemics in State of Rio de Janeiro

As temperaturas dos primeiros trimestres do período de 1986-2003, especialmente as mínimas, mostraram-se significativamente mais altas nos anos em que as epidemias de dengue tiveram início na Cidade do Rio de Janeiro. Não houve relação significativa com o total das precipitações pluviométricas para os mesmos trimestres, contudo, as epidemias foram mais freqüentes nos anos em que o volume de chuvas no verão foi pequeno (abaixo de 200mm).

Temperatures in the city of Rio de Janeiro in the first quarter of the year over the period 1986-2003, especially the minimum, were significantly higher in the years in which dengue epidemics started in the city. There was no significant relationship with total rainfall for the same quarter of the year, but epidemics were more frequent in the years in which the volume of rain during the summer was small (less than 200mm).

Mortalidade por transtornos mentais e comportamentais e a reforma psiquiátrica no Brasil contemporâneo - II: elementos para um debate / Death from mental and behavioral disturbances and psychiatric reform in contemporary Brazil - II: elements for a debate

O aumento da mortalidade na categoria dos transtornos mentais e comportamentais - face à redução progressiva das internações hospitalares promovida pela reforma psiquiátrica em curso - tem aquecido o debate entre os proponentes da reforma e parte da comunidade psiquiátrica brasileira. Neste artigo, analisa-se os argumentos dos reformistas.(AU)

El incremento de la mortalidad en la categoría desordenes mentales y del comportamiento - concerniente a la reducción progresiva de camas psiquiátricas - tiene acalorado la discusión entre los que proponen la reforma y parte de la comunidad psiquiátrica brasileña. En este artículo se analizan los argumentos de los reformistas.(AU)

L'augmentation de la mortalité dans la catégorie des désordres mentaux et comportementaux - face à la réduction progressive des lits psychiatriques préconisée par la réforme psychiatrique en cours - a attisé le débat entre les réformistes et une partie de la communauté psychiatrique brésilienne. Cet article analyse les arguments des réformistes.(AU)

The rising death rate in the category of mental and behavioral disorders - related to the progressive reduction in the number of psychiatric beds - is bringing new elements to the discussion between reformists and some sectors of the Brazilian psychiatric community. In this paper, the arguments of the reformists are analyzed.(AU)

Mortalidade por transtornos mentais e comportamentais e a reforma psiquiátrica no Brasil contemporâneo - II: elementos para um debate / Mortalidad por trastornos mentales y de comportamiento y la reforma psiquiátrica en el Brasil contemporáneo - II: elementos para un debate / Mortalité par désordres mentaux et comportementaux et la réforme psychiatrique au Brésil contemporain - II: eléments pour un débat / Death from mental and behavioral disturbances and psychiatric reform in contemporary Brazil - II: elements for a debate

O aumento da mortalidade na categoria dos transtornos mentais e comportamentais - face à redução progressiva das internações hospitalares promovida pela reforma psiquiátrica em curso - tem aquecido o debate entre os proponentes da reforma e parte da comunidade psiquiátrica brasileira. Neste artigo, analisa-se os argumentos dos reformistas.

El incremento de la mortalidad en la categoría desordenes mentales y del comportamiento - concerniente a la reducción progresiva de camas psiquiátricas - tiene acalorado la discusión entre los que proponen la reforma y parte de la comunidad psiquiátrica brasileña. En este artículo se analizan los argumentos de los reformistas.

L'augmentation de la mortalité dans la catégorie des désordres mentaux et comportementaux - face à la réduction progressive des lits psychiatriques préconisée par la réforme psychiatrique en cours - a attisé le débat entre les réformistes et une partie de la communauté psychiatrique brésilienne. Cet article analyse les arguments des réformistes.

The rising death rate in the category of mental and behavioral disorders - related to the progressive reduction in the number of psychiatric beds - is bringing new elements to the discussion between reformists and some sectors of the Brazilian psychiatric community. In this paper, the arguments of the reformists are analyzed.

Mortalidade por transtornos mentais e comportamentais e a reforma psiquiátrica no Brasil contemporâneo / Death resulting from mental and behavioral disorders, and psychiatric reform in contemporary Brazil

A mortalidade por transtornos mentais e comportamentais têm aumentado no Brasil com a redução progressiva das internações hospitalares. A reforma psiquiátrica do governo aparentemente está contribuindo para este cenário preocupante, com sua política de desospitalização.(AU)

La mortalidad por trastornos mentales y del comportamiento ha aumentado en Brasil con la reducción gradual de las internaciones hospitalarias. La reforma psiquiátrica del gobierno aparentemente, está contribuyendo para ese escenario preocupante con su política de deshospitalización.(AU)

La mortalité par trouble mental et comportemental a augmenté au Brésil avec la réduction progressive des hospitalisations. La réforme psychiatrique du gouvernement contribue apparemment à ce cadre inquiétant, avec sa politique de deshospitalisation.(AU)

Death due to mental and behavioral disorders has increased in Brazil with the gradual reduction in the numbers of hospitalized mental patients. The federal government's psychiatric reform, based largely on closing down mental hospitals, is apparently contributing to this phenomenon.(AU)

Mortalidade por transtornos mentais e comportamentais e a reforma psiquiátrica no Brasil contemporâneo / Mortalidad por los trastornos mentales y del comportamiento y la reforma psiquiátrica en el Brasil contemporáneo / La mortalité par trouble mental et comportemental et la réforme psychiatrique au Brésil contemporain / Death resulting from mental and behavioral disorders, and psychiatric reform in contemporary Brazil

A mortalidade por transtornos mentais e comportamentais têm aumentado no Brasil com a redução progressiva das internações hospitalares. A reforma psiquiátrica do governo aparentemente está contribuindo para este cenário preocupante, com sua política de desospitalização.

La mortalidad por trastornos mentales y del comportamiento ha aumentado en Brasil con la reducción gradual de las internaciones hospitalarias. La reforma psiquiátrica del gobierno aparentemente, está contribuyendo para ese escenario preocupante con su política de deshospitalización.

La mortalité par trouble mental et comportemental a augmenté au Brésil avec la réduction progressive des hospitalisations. La réforme psychiatrique du gouvernement contribue apparemment à ce cadre inquiétant, avec sa politique de deshospitalisation.

Death due to mental and behavioral disorders has increased in Brazil with the gradual reduction in the numbers of hospitalized mental patients. The federal government's psychiatric reform, based largely on closing down mental hospitals, is apparently contributing to this phenomenon.