Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 481
Filtrar
3.
Diabetes Res Clin Pract ; 166: 108301, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32623036

RESUMO

AIMS: The present observational study aims to describe political actions in place to combat COVID-19 in the South and Central America region (SACA) while protecting individuals with diabetes. METHODS: A survey with 12 questions was shared with all IDF-SACA member organizations, in 18 countries. A descriptive analysis was performed and a multivariate cluster analysis technique pam (partitioning around medoids) was applied. RESULTS: Two groups of countries were identified. The first group, mostly countries with stricter measures to contain the spread of the virus, reported more difficulties (limitations in accessing basic or health needs) and fears (concerns regarding the impact of the pandemic); whereas most of the second group consisted of countries with less restrictive measures, and reported fewer difficulties. Only 37% responded that a policy was put into place to protect individuals with diabetes, either delivering their medicines and supplies at home (16%) or providing them at once enough for 2-3 months (21%). All respondents reported that one of the main fear was to "be infected and not to receive adequate treatment" and/or "getting infected if going to the hospital or medical appointments". CONCLUSION: Most of the SACA countries failed to implement timely measures to protect individuals with diabetes, which may severely impact individuals, health systems and economies.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Infecções por Coronavirus/psicologia , Complicações do Diabetes , Diabetes Mellitus/fisiopatologia , Pneumonia Viral/complicações , Pneumonia Viral/psicologia , América Central/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Diabetes Mellitus/terapia , Diabetes Mellitus/virologia , Humanos , Pandemias , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , América do Sul/epidemiologia , Inquéritos e Questionários
5.
Thorax ; 75(9): 798-800, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32467338

RESUMO

Global incidence and temporal trends of asbestosis are rarely explored. Using the detailed information on asbestosis from the Global Burden of Disease (GBD) 2017, we described the age-standardised incidence rate (ASIR) and its average annual percentage change. A Joinpoint Regression model was applied to identify varying temporal trends over time. Although the use of asbestos has been completely banned in many countries, the ASIR of asbestosis increased globally from 1990 to 2017. Furthermore, the most pronounced increases in ASIR of asbestosis were detected in high-income North America and Australasia. These findings indicate that efforts to change the asbestos regulation policy are urgently needed.


Assuntos
Asbestose/epidemiologia , Carga Global da Doença/tendências , África/epidemiologia , Ásia/epidemiologia , Região do Caribe/epidemiologia , América Central/epidemiologia , Europa (Continente)/epidemiologia , Humanos , Incidência , América do Norte/epidemiologia , Oceania/epidemiologia , América do Sul/epidemiologia
8.
Rev Med Suisse ; 16(683): 412-416, 2020 Feb 26.
Artigo em Francês | MEDLINE | ID: mdl-32129019

RESUMO

Over the last decades, an increasing number of cases of chronic and end-stage kidney disease has been observed in Central America and Asia. This kidney disease mainly affects young farmers without classic renal risk factors. The clinical presentation includes a progressive decrease of the glomerular filtration rate, minimal proteinuria and the presence of tubulo-interstitial nephritis at renal biopsy. A close link with global warming is suspected for this disease, called (according to its location) meso-american nephropathy, Sri Lanka nephropathy or chronic kidney disease of unknown etiology. Others have suggested that intake of water contaminated with pesticides may be responsible. This article provides an overview of this new kidney disease. Measures to prevent acute kidney injury during heat waves in Switzerland are also discussed.


Assuntos
Aquecimento Global , Nefropatias/epidemiologia , Nefropatias/etiologia , Rim/patologia , Rim/fisiopatologia , América Central/epidemiologia , Humanos , Nefropatias/prevenção & controle , Falência Renal Crônica/epidemiologia , Falência Renal Crônica/etiologia , Falência Renal Crônica/prevenção & controle , Sri Lanka/epidemiologia , Suíça/epidemiologia
9.
J Am Heart Assoc ; 9(4): e013903, 2020 02 18.
Artigo em Inglês | MEDLINE | ID: mdl-32063111

RESUMO

Background Reports on sex differences in stroke outcome and risk factors are scarce in Latin America. Our objective was to analyze clinical and prognostic differences according to sex among participants in the LASE (Latin American Stroke Registry). Methods and Results Nineteen centers across Central and South America compiled data on demographics, vascular risk factors, clinical stroke description, ancillary tests, and functional outcomes at short-term follow-up of patients included from January 2012 to January 2017. For the present study, all these variables were analyzed according to sex at hospital discharge. We included 4788 patients with a median in-hospital stay of 8 days (interquartile range, 5-8); 2677 were male (median age, 66 years) and 2111 female (median age, 60 years). Ischemic stroke occurred in 4293: 3686 as cerebral infarction (77%) and 607 as transient ischemic attack cases (12.7%); 495 patients (10.3%) corresponded to intracerebral hemorrhage. Poor functional outcome (modified Rankin scale, 3-6) was present in 1662 (34.7%) patients and 38.2% of women (P<0.001). Mortality was present in 6.8% of the registry, with 7.8% in women compared with 6.0% in men (P=0.01). Death and poor functional outcome for all-type stroke showed a higher risk in female patients (hazard ratio, 1.3, P=0.03; and hazard ratio, 1.1, P=0.001, respectively). Conclusions A worse functional outcome and higher mortality rates occurred in women compared with men in the LASE, confirming sex differences issues at short-term follow-up.


Assuntos
Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Acidente Vascular Cerebral/terapia , Idoso , Idoso de 80 Anos ou mais , América Central/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recuperação de Função Fisiológica , Sistema de Registros , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , América do Sul/epidemiologia , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/mortalidade , Fatores de Tempo , Resultado do Tratamento
10.
Antonie Van Leeuwenhoek ; 113(5): 593-604, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31902009

RESUMO

Paracoccidiodomycosis (PCM) is a systemic mycosis caused by the fungus Paracoccidioides brasiliensis and Paracoccidioides lutzii. The disease requires long and complicated treatment. The aim of this review is to address the fungal virulence factors that could be the target of the development of new drugs for PCM treatment. Virulence factors favoring the process of fungal infection and pathogenicity are considered as a microbial attribute associated with host susceptibility. P. brasiliensis has some known virulence factors which are 43 kDa glycoprotein (gp 43) which is an important fungal antigen, 70 kDa glycoprotein (gp 70), the carbohydrates constituting the fungal cell wall α-1,3, glucan and ß-1,3-glucan, cell adhesion molecules and the presence of melanin pigments. The discovery and development of drugs that interact with these factors, such as inhibitors of ß-1,3-glucan, reduced synthesis of gp 43, inhibitors of melanin production, is of great importance for the treatment of PCM. The study of virulence factors favors the understanding of pathogen-host relationships, aiming to evaluate the possibility of developing new therapeutic targets and mechanisms that these molecules play in the infectious process, favoring the design of a more specific treatment for this disease.


Assuntos
Paracoccidioides , Paracoccidioidomicose , Fatores de Virulência/metabolismo , Animais , Antifúngicos/uso terapêutico , Parede Celular/metabolismo , América Central/epidemiologia , Proteínas Fúngicas/metabolismo , Glucanos/metabolismo , Glicoproteínas/metabolismo , Interações Hospedeiro-Patógeno , Humanos , Melaninas/metabolismo , Paracoccidioides/efeitos dos fármacos , Paracoccidioides/isolamento & purificação , Paracoccidioides/metabolismo , Paracoccidioides/patogenicidade , Paracoccidioidomicose/epidemiologia , Paracoccidioidomicose/metabolismo , Paracoccidioidomicose/patologia , Paracoccidioidomicose/terapia , Prevalência , América do Sul/epidemiologia
11.
Acta Trop ; 204: 105329, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31904346

RESUMO

The phylogeny of the Triatoma dimidiata complex has been widely assessed with different genetic and morphological data, which has allowed to reach the consensus that the complex consists of at least three taxonomic units. However, these taxonomic units seem to have a distribution related to geography throughout Mesoamerica, with different groupings depending on the source of information used. In the present study, we aimed to determine if there is a common biogeographical, genetic and phenetic distribution pattern among the T. dimidiata species in Mesoamerica and if this pattern is related to ecological and geological variability of the region. We found that panbiogeographical analysis showed three generalized tracks that coincide with genetic/phenetic data which showed a general pattern of distribution in two big clusters to the north and south of Mesoamerica. We also found that these clusters were significantly related to geological tectonic plates and ecotypes. We conclude that the geological history may be a plausible explanation for the greater differentiation observed in the T. dimidiata complex, but that the current ecological characteristics of the morphotectonic units or ecotypes may be responsible for the additional variation observed and therefore differential control strategies for each cluster considering geological history and ecotype should be used. Further, more detailed biogeographical and landscape genetic analyses are necessary with the goal to elucidate T. dimidiata differentiation related with ecological and geological variables in the region and the possible epidemiological and evolutionary consequences.


Assuntos
Doença de Chagas/parasitologia , Filogenia , Triatoma/genética , Animais , América Central/epidemiologia , Doença de Chagas/epidemiologia , Colômbia/epidemiologia , Triatoma/fisiologia
12.
Transbound Emerg Dis ; 67(1): 377-387, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31529612

RESUMO

Parvoviruses in the genera Bocaparvovirus (HBoV), Erythroparvovirus (B19) and Tetraparvovirus (PARV4) are the only autonomous parvoviruses known to be associated with human and non-human primates based on studies and clinical cases in humans worldwide and non-human primates in Asia and Africa. Here, the presence of these agents with pathogenic potential was assessed by PCR in blood and faeces from 55 howler monkeys, 112 white-face monkeys, 3 squirrel monkeys and 127 spider monkeys in Costa Rica and El Salvador. Overall, 3.7% (11/297) of the monkeys had HboV DNA, 0.67% (2/297) had B19 DNA, and 14.1% (42/297) had PARV4 DNA, representing the first detection of these viruses in New World Primates (NWP). Sex was significantly associated with the presence of HBoV, males having greater risk up to nine times compared with females. Captivity was associated with increased prevalence for PARV4 and when all viruses were analysed together. This study provides compelling molecular evidence of parvoviruses in NWPs and underscores the importance of future research aimed at understanding how these viruses behave in natural environments of the Neotropics and what variables may favour their presence and transmission.


Assuntos
Haplorrinos/virologia , Infecções por Parvoviridae/veterinária , Parvovirinae/isolamento & purificação , Primatas/virologia , Animais , Bocavirus/genética , Bocavirus/isolamento & purificação , América Central/epidemiologia , Fezes/virologia , Feminino , Humanos , Masculino , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Parvovirinae/genética , Reação em Cadeia da Polimerase/veterinária , Prevalência
13.
J Med Entomol ; 56(6): 1448-1455, 2019 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-31549719

RESUMO

The introduction of West Nile virus (WNV) to North America in 1999 and its subsequent rapid spread across the Americas demonstrated the potential impact of arboviral introductions to new regions, and this was reinforced by the subsequent introductions of chikungunya and Zika viruses. Extensive studies of host-pathogen-vector-environment interactions over the past two decades have illuminated many aspects of the ecology and evolution of WNV and other arboviruses, including the potential for pathogen adaptation to hosts and vectors, the influence of climate, land use and host immunity on transmission ecology, and the difficulty in preventing the establishment of a zoonotic pathogen with abundant wildlife reservoirs. Here, we focus on outstanding questions concerning the introduction, spread, and establishment of WNV in the Americas, and what it can teach us about the future of arboviral introductions. Key gaps in our knowledge include the following: viral adaptation and coevolution of hosts, vectors and the virus; the mechanisms and species involved in the large-scale spatial spread of WNV; how weather modulates WNV transmission; the drivers of large-scale variation in enzootic transmission; the ecology of WNV transmission in Latin America; and the relative roles of each component of host-virus-vector interactions in spatial and temporal variation in WNV transmission. Integrative studies that examine multiple factors and mechanisms simultaneously are needed to advance our knowledge of mechanisms driving transmission.


Assuntos
Febre do Nilo Ocidental , Vírus do Nilo Ocidental , Zoonoses , Adaptação Biológica , Animais , América Central/epidemiologia , Interações Hospedeiro-Patógeno , Humanos , América do Norte/epidemiologia , América do Sul/epidemiologia , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/transmissão , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/patogenicidade , Vírus do Nilo Ocidental/fisiologia , Zoonoses/epidemiologia , Zoonoses/transmissão , Zoonoses/virologia
14.
Gynecol Oncol ; 154(3): 608-615, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31303255

RESUMO

OBJECTIVE: Ovarian germ cell tumors (OGCT) are the primary ovarian malignancy affecting girls and young women. Globally, incidence rates and trends for OGCTs have not been compared in the literature and their etiology is not well described. Comparisons of incidence globally could inform etiologic hypotheses. The aim of this analysis was to evaluate geographic variation in OGCT incidence and to identify trends in incidence rates. METHODS: Data were extracted from Cancer Incidence in 5 Continents (CI5) from 1988 to 2012. Rates of OGCT in women and girls were calculated for ages 0-9, 10-19, and 20-39 years and standardized to the 2000-2025 average world population. Data were aggregated within subregions corresponding to the United Nations Statistics Division (UNSD) geoscheme. Incidence rates were compared in subregions and average annual percent change (AAPC) was estimated using Poisson regression. RESULTS: Overall, the highest incidence rates were observed in 10-19-year-olds. Incidence was generally the highest in Eastern Asia, Central America and North America. While incidence was variable by geographic region, less variation was observed in 0-9-year-olds as compared to adolescents and young adults. Significant increases in incidence were seen in some regions (Eastern Asia, Oceania, Western Europe, Southern Europe, and North America) and in countries with a high or very high human development index for one or more age groups. CONCLUSIONS: Evaluating 25 years of OGCT incidence data, the highest incidence rates and largest increases in incidence were seen in Eastern Asia. Future studies should focus on etiologic features that may account for geographic variation and increases in incidence of OGCT.


Assuntos
Neoplasias Embrionárias de Células Germinativas/epidemiologia , Neoplasias Ovarianas/epidemiologia , Adolescente , Adulto , Fatores Etários , América Central/epidemiologia , Europa (Continente)/epidemiologia , Extremo Oriente/epidemiologia , Feminino , Saúde Global , Humanos , Incidência , Estados Unidos/epidemiologia , Organização Mundial da Saúde , Adulto Jovem
15.
Workplace Health Saf ; 67(9): 481-490, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31179873

RESUMO

For the past two decades, agricultural workers in regions of Central America have reported an epidemic of chronic kidney disease of undetermined etiology (CKDu) that is not associated with established risk factors of chronic kidney disease. Several hypotheses have emerged, but the etiology of CKDu remains elusive and controversial. The aim of this literature review was to describe the potential risk factors of CKDu in Mesoamerica and implications for the U.S. agricultural worker population. PubMed and CINAHL databases were searched for articles published between 2000 and 2018 that examined CKDu in Mesoamerica; 29 original studies were included in this review. CKDu is a multifactorial disease that is often asymptomatic with hallmark characteristics of elevated serum creatinine and blood urea nitrogen (BUN), low glomerular filtration rate, electrolyte abnormalities, and non-nephrotic proteinuria. Reducing the global prevalence of CKDu will require more robust studies on causal mechanisms and on interventions that can reduce morbidity and mortality in vulnerable populations.


Assuntos
Fazendeiros , Doenças Profissionais/epidemiologia , Insuficiência Renal Crônica/epidemiologia , América Central/epidemiologia , Feminino , Humanos , Masculino , Doenças Profissionais/etiologia , Insuficiência Renal Crônica/etiologia , Fatores de Risco
16.
BMC Cancer ; 19(1): 545, 2019 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-31174492

RESUMO

BACKGROUND: Geospatial technology has facilitated the discovery of disease distributions and etiology and helped target prevention programs. Globally, gastric cancer is the leading infection-associated cancer, and third leading cause of cancer mortality worldwide, with marked geographic variation. Central and South America have a significant burden, particularly in the mountainous regions. In the context of an ongoing population-based case-control study in Central America, our aim was to examine the spatial epidemiology of gastric cancer subtypes and H. pylori virulence factors. METHODS: Patients diagnosed with gastric cancer from 2002 to 2013 in western Honduras were identified in the prospective gastric cancer registry at the principal district hospital. Diagnosis was based on endoscopy and confirmatory histopathology. Geospatial methods were applied using the ArcGIS v10.3.1 and SaTScan v9.4.2 platforms to examine regional distributions of the gastric cancer histologic subtypes (Lauren classification), and the H. pylori CagA virulence factor. Getis-Ord-Gi hot spot and Discrete Poisson SaTScan statistics, respectively, were used to explore spatial clustering at the village level (30-50 rural households), with standardization by each village's population. H. pylori and CagA serologic status was determined using the novel H. pylori multiplex assay (DKFZ, Germany). RESULTS: Three hundred seventy-eight incident cases met the inclusion criteria (mean age 63.7, male 66.3%). Areas of higher gastric cancer incidence were identified. Significant spatial clustering of diffuse histology adenocarcinoma was revealed both by the Getis-Ord-GI* hot spot analysis (P-value < 0.0015; range 0.00003-0.0014; 99%CI), and by the SaTScan statistic (P-value < 0.006; range 0.0026-0.0054). The intestinal subtype was randomly distributed. H. pylori CagA had significant spatial clustering only in association with the diffuse histology cancer hot spot (Getis-Ord-Gi* P value ≤0.001; range 0.0001-0.0010; SaTScan statistic P value 0.0085). In the diffuse gastric cancer hot spot, the lowest age quartile range was 21-46 years, significantly lower than the intestinal cancers (P = 0.024). CONCLUSIONS: Geospatial methods have identified a significant cluster of incident diffuse type adenocarcinoma cases in rural Central America, suggest of a germline genetic association. Further genomic and geospatial analyses to identify potential spatial patterns of genetic, bacterial, and environmental risk factors may be informative.


Assuntos
Saúde da População Rural , Neoplasias Gástricas/epidemiologia , Idoso , Estudos de Casos e Controles , América Central/epidemiologia , Suscetibilidade a Doenças , Feminino , Geografia , Infecções por Helicobacter/complicações , Infecções por Helicobacter/microbiologia , Helicobacter pylori , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Análise Espacial , Neoplasias Gástricas/etiologia , Neoplasias Gástricas/patologia
18.
Semin Nephrol ; 39(3): 244-255, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31054623

RESUMO

Chronic kidney disease increasingly is being recognized as an important global public health problem. Interindividual susceptibility to kidney disease is high and likely is dependent on risk modulation through genetics, fetal and early childhood development, environmental circumstances, and comorbidities. Traditionally, the chronic kidney disease burden has been ascribed largely to hypertension and diabetes. Increasingly, evidence is accumulating that nontraditional risk factors may predominate in some regions and populations, contributing to epidemics of kidney disease. Such nontraditional risk factors include environmental exposures, traditional medicines, fetal and maternal factors, infections, kidney stones, and acute kidney injury. Genetic factors may predispose patients to chronic kidney disease in some populations. Chronic kidney disease of unknown origin has its epicenters in Central America and South Asia. Such clustering of CKD may represent either genetic or environmentally driven kidney disease, or combinations of both. Developmental conditions impacting kidney development often are related to poverty and structural factors that persist throughout life. In this article, we explore the possibilities that genetic and developmental factors may be important contributors to the epidemics in these regions and suggest that optimization of factors impacting kidney development hold promise to reduce the risk of kidney disease in future generations.


Assuntos
Epidemias , Desenvolvimento Fetal , Rim/embriologia , Efeitos Tardios da Exposição Pré-Natal , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/genética , Pressão Sanguínea , América Central/epidemiologia , Feminino , Interação Gene-Ambiente , Predisposição Genética para Doença , Humanos , Rim/fisiopatologia , Saúde Materna , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Sri Lanka/epidemiologia
19.
Semin Nephrol ; 39(3): 263-271, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31054625

RESUMO

Mesoamerican endemic nephropathy is a type of chronic kidney disease of unknown origin, present in pockets of high prevalence along the Pacific Ocean coast of the Mesoamerican region, from southwest Mexico to Costa Rica. The disease is common in young adult men, most often yet not exclusively from agricultural communities, and with a high mortality rate. Kidney biopsy specimens show primarily tubular atrophy and interstitial fibrosis with some glomerular changes attributed to ischemia. Exposure to agrochemicals, heavy metals or metalloids, intense physical activity under heat stress with dehydration, infections, among other possible causes have been hypothesized as the culprit of the disease. Hypokalemia and hyperuricemia are frequent clinical features. Early diagnosis is key to initiate timely treatment and slow down the progression to end-stage kidney disease. At present, our knowledge about the magnitude of the disease burden imposed by Mesoamerican endemic nephropathy is clearly incomplete and its cause has not been determined. There is a need to implement epidemiologic and mechanistic research projects as well as formal chronic kidney disease and end-stage kidney disease registries in the Mesoamerican region to better understand the real extent of the epidemic, delimit risk populations, and to construct sound public health policy decisions.


Assuntos
Nefropatias/epidemiologia , Nefropatias/etiologia , Agroquímicos/efeitos adversos , América Central/epidemiologia , Desidratação/complicações , Geografia , Humanos , Nefropatias/diagnóstico , Nefropatias/patologia , Falência Renal Crônica/etiologia , Falência Renal Crônica/terapia , Metais Pesados/efeitos adversos , México/epidemiologia , Fatores de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA