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1.
Epidemiol Infect ; 149: e94, 2021 04 13.
Artigo em Inglês | MEDLINE | ID: mdl-33845928

RESUMO

The global outbreak of coronavirus disease 2019 (COVID-19) is greatly threatening the public health in the world. We reconstructed global transmissions and potential demographic expansions of severe acute respiratory syndrome coronavirus 2 based on genomic information. We found that intercontinental transmissions were rare in January and early February but drastically increased since late February. After world-wide implements of travel restrictions, the transmission frequencies decreased to a low level in April. We identified a total of 88 potential demographic expansions over the world based on the star-radiative networks and 75 of them were found in Europe and North America. The expansion numbers peaked in March and quickly dropped since April. These findings are highly concordant with epidemic reports and modelling results and highlight the significance of quarantine validity on the global spread of COVID-19. Our analyses indicate that the travel restrictions and social distancing measures are effective in containing the spread of COVID-19.


Assuntos
/epidemiologia , Genoma Viral , Política Pública , Viagem , África/epidemiologia , Ásia/epidemiologia , Austrália/epidemiologia , /virologia , Controle de Doenças Transmissíveis , Europa (Continente)/epidemiologia , Genômica , Humanos , Internacionalidade , América do Norte/epidemiologia , Filogenia , América do Sul/epidemiologia
2.
PLoS One ; 16(3): e0237294, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33780470

RESUMO

The coronavirus disease 2019 (COVID-19) outbreak in North, Central, and South America has become the epicenter of the current pandemic. We have suggested previously that the infection rate of this virus might be lower in people living at high altitude (over 2,500 m) compared to that in the lowlands. Based on data from official sources, we performed a new epidemiological analysis of the development of the pandemic in 23 countries on the American continent as of May 23, 2020. Our results confirm our previous finding, further showing that the incidence of COVID-19 on the American continent decreases significantly starting at 1,000 m above sea level (masl). Moreover, epidemiological modeling indicates that the virus transmission rate is lower in the highlands (>1,000 masl) than in the lowlands (<1,000 masl). Finally, evaluating the differences in the recovery percentage of patients, the death-to-case ratio, and the theoretical fraction of undiagnosed cases, we found that the severity of COVID-19 is also decreased above 1,000 m. We conclude that the impact of the COVID-19 decreases significantly with altitude.


Assuntos
Altitude , /patologia , /epidemiologia , /virologia , América Central/epidemiologia , Humanos , Incidência , América do Norte/epidemiologia , Índice de Gravidade de Doença , América do Sul/epidemiologia
4.
Lancet Child Adolesc Health ; 5(4): 245-255, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33545071

RESUMO

BACKGROUND: Tobacco use is a leading preventable cause of morbidity and mortality worldwide. Little is known about recent prevalence and trends in tobacco use among adolescents globally. We aimed to assess the recent global prevalence of tobacco use in young adolescents and the secular trends in prevalence between 1999 and 2018. METHODS: We used the most recent Global Youth Tobacco Surveys data on adolescents aged 13-15 years from 143 countries or territories that had done at least one survey between Jan 1, 2010, and Dec 31, 2018, to assess the recent prevalence of tobacco use; and data from 140 countries that had done two or more surveys between Jan 1, 1999, and Dec 31, 2018, to assess the trends in the prevalence of tobacco use. FINDINGS: 530 234 adolescents were included from the 143 countries that had done at least one survey between 2010 and 2018. 1 192 312 adolescents were included from the 140 countries that had done two or more surveys between 1999 and 2018. The most recent global prevalence of cigarette smoking was 11·3% (95% CI 10·3-12·3) in boys and 6·1% (5·6-6·6) in girls, based on cigarette smoking on at least 1 day during the past 30 days, 6·0% (5·5-6·6) and 2·6% (2·4-2·9) based on smoking on at least 3 days, and 4·2% (3·8-4·6) and 1·6% (1·4-1·8) based on smoking on at least 6 days. The most recent prevalence of the use of tobacco products other than cigarettes (eg, chewing tobacco, snuff, dip, cigars, cigarillos, pipe, electronic cigarettes) on at least 1 day during the past 30 days was 11·2% (9·9-12·6) in boys and 7·0% (6·4-7·7) in girls. The most recent prevalence of any tobacco use on at least 1 day during the past 30 days was 17·9% (16·1-19·6) in boys and 11·5% (10·5-12·4) in girls. The prevalence of cigarette smoking on at least 1 day during the past 30 days decreased between the first and last surveys in 80 (57·1%) of 140 countries, was unchanged in 39 countries (27·9%), and increased in 21 countries (15·0%). However, the prevalence of the use of tobacco products other than cigarettes was unchanged or increased in 81 (59·1%) of 137 countries. INTERPRETATION: The global prevalence of tobacco use among adolescents aged 13-15 years was substantial. Although the prevalence of cigarette smoking decreased over time in the majority of countries, the prevalence of the use of other tobacco products increased or did not change in the majority of countries during the past two decades. These findings re-emphasise the need to strengthen tobacco control efforts among young adolescents globally. FUNDING: Shandong University.


Assuntos
Fumar Cigarros/epidemiologia , Uso de Tabaco/epidemiologia , Tabaco sem Fumaça , Adolescente , África/epidemiologia , Ásia/epidemiologia , América Central/epidemiologia , Fumar Cigarros/tendências , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , América do Norte/epidemiologia , Prevalência , Distribuição por Sexo , América do Sul/epidemiologia , Fumar Tabaco/epidemiologia , Fumar Tabaco/tendências , Uso de Tabaco/tendências
5.
J Med Microbiol ; 70(2)2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33416465

RESUMO

Cholera is a severe diarrhoeal disease that spreads rapidly and affects millions of people each year, resulting in tens of thousands of deaths. The disease is caused by Vibrio cholerae O1 and is characterized by watery diarrhoea that can be lethal if not properly treated. Cholera had not been reported in South America from the late 1800s until 1991, when it was introduced in Peru, wreaking havoc in one of the biggest epidemics reported to date. Within a year, the disease had spread to most of the Latin American region, resulting in millions of cases and thousands of deaths in all affected countries. Despite its aggressive entry, cholera virtually disappeared from the continent after 1999. The progression of the entire epidemic was well documented, making it an ideal model to understand cholera dynamics. In this review, we highlight how the synergy of socioeconomic, political and ecological factors led to the emergence, rapid spread and eventual disappearance of cholera in Latin America. We discuss how measures implemented during the cholera epidemic drastically changed its course and continental dynamics. Finally, we synthesize our findings and highlight potential lessons that can be learned for efficient and standardized cholera management programmes during future outbreaks in non-endemic areas.


Assuntos
Cólera/epidemiologia , Controle de Doenças Transmissíveis/métodos , Vibrio cholerae O1/isolamento & purificação , Cólera/patologia , Mudança Climática , Epidemias , Humanos , América Latina/epidemiologia , Política , Fatores Socioeconômicos , América do Sul/epidemiologia , Vibrio cholerae O1/imunologia
6.
Sci Total Environ ; 763: 144365, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33360513

RESUMO

The propagation of the COVID-19 pandemic worldwide has been alarming in the last months. According to recommendations of the World Health Organization (WHO), the use of face masks is essential for slowing down the transmission rate of COVID-19 in human beings. This pandemic has generated a substantial increase in the use, as well as in the production, of face masks and other elements (gloves, face protectors, protective suits, safety shoes) manufactured with polymeric materials, including antiviral textiles most of which will end as microplastic pools. Focusing on South America, the use and mismanagement of this type of personal protective equipment (PPE) represents an environmental problem. Added to this issue are the increase in the use of single-use plastic, and the reduction of plastic recycling due to the curfew generated by the pandemic, further aggravating plastic pollution on coasts and beaches. Recently, researchers have developed antiviral polymeric textile technology composed of Ag and Cu nanoparticles for PPE to reduce the contagion and spread of COVID-19. Antiviral polymeric textile wastes could also have long-term negative repercussions on aquatic environments, as they are an important emerging class of contaminants. For this reason, this work provides reflections and perspectives on how the COVID-19 pandemic can aggravate plastic pollution on beaches and coastal environments, consequently increasing the damage to marine species in the coming years. In addition, the potential impact of the pandemic on waste management systems is discussed here, as well as future research directions to improve integrated coastal management strategies.


Assuntos
Antivirais , Humanos , Pandemias , Plásticos , América do Sul/epidemiologia , Têxteis
7.
PLoS Negl Trop Dis ; 14(12): e0009015, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33370305

RESUMO

Trypanosoma rangeli is a non-pathogenic protozoan parasite that infects mammals, including humans, in Chagas disease-endemic areas of South and Central America. The parasite is transmitted to a mammalian host when an infected triatomine injects metacyclic trypomastigotes into the host's skin during a bloodmeal. Infected mammals behave as parasite reservoirs for several months and despite intensive research, some major aspects of T. rangeli-vertebrate interactions are still poorly understood. In particular, many questions still remain unanswered, e.g. parasite survival and development inside vertebrates, as no parasite multiplication sites have yet been identified. The present study used an insect bite transmission strategy to investigate whether the vector inoculation spot in the skin behave as a parasite-replication site. Histological data from the skin identified extracellular parasites in the dermis and hypodermis of infected mice in the first 24 hours post-infection, as well as the presence of inflammatory infiltrates in a period of up to 7 days. However, qPCR analyses demonstrated that T. rangeli is eliminated from the skin after 7 days of infection despite being still consistently found on circulating blood and secondary lymphoid tissues for up to 30 days post-infection. Interestingly, significant numbers of parasites were found in the spleen and mesenteric lymph nodes of infected mice during different periods of infection and steady basal numbers of flagellates are maintained in the host's bloodstream, which might behave as a transmission source to insect vectors. The presence of parasites in the spleen was confirmed by fluorescent photomicrography of free and cell-associated T. rangeli forms. Altogether our results suggest that this organ could possibly behave as a T. rangeli maintenance hotspot in vertebrates.


Assuntos
Doença de Chagas/transmissão , Linfonodos/parasitologia , Pele/parasitologia , Baço/parasitologia , Trypanosoma rangeli/isolamento & purificação , Animais , América Central/epidemiologia , Doença de Chagas/epidemiologia , Modelos Animais de Doenças , Interações Hospedeiro-Parasita , Humanos , Mordeduras e Picadas de Insetos/parasitologia , Insetos Vetores/parasitologia , Camundongos , Rhodnius/parasitologia , Sepse/parasitologia , América do Sul/epidemiologia
8.
PLoS One ; 15(12): e0244177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33373384

RESUMO

This paper reports the results of a Bayesian analysis on large-scale empirical data to assess the effectiveness of eleven types of COVID-control policies that have been implemented at various levels of intensity in 40 countries and U.S. states since the onset of the pandemic. The analysis estimates the marginal impact of each type and level of policy as implemented in concert with other policies. The purpose is to provide policymakers and the general public with an estimate of the relative effectiveness of various COVID-control strategies. We find that a set of widely implemented core policies reduces the spread of virus but not by enough to contain the pandemic except in a few highly compliant jurisdictions. The core policies include the cancellation of public events, restriction of gatherings to fewer than 100 people, recommendation to stay at home, recommended restrictions on internal movement, implementation of a partial international travel ban, and coordination of information campaigns. For the median jurisdiction, these policies reduce growth rate in new infections from an estimated 270% per week to approximately 49% per week, but this impact is insufficient to prevent eventual transmission throughout the population because containment occurs only when a jurisdiction reduces growth in COVID infection to below zero. Most jurisdictions must also implement additional policies, each of which has the potential to reduce weekly COVID growth rate by 10 percentage points or more. The slate of these additional high-impact policies includes targeted or full workplace closings for all but essential workers, stay-at-home requirements, and targeted school closures.


Assuntos
/epidemiologia , Controle de Infecções/legislação & jurisprudência , Teorema de Bayes , Europa (Continente)/epidemiologia , Política de Saúde , Humanos , México/epidemiologia , Pandemias/prevenção & controle , América do Sul/epidemiologia , Estados Unidos/epidemiologia
9.
Front Immunol ; 11: 2008, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33013857

RESUMO

Coronavirus disease (COVID-19), caused by the virus SARS-CoV-2, is already responsible for more than 4.3 million confirmed cases and 295,000 deaths worldwide as of May 15, 2020. Ongoing efforts to control the pandemic include the development of peptide-based vaccines and diagnostic tests. In these approaches, HLA allelic diversity plays a crucial role. Despite its importance, current knowledge of HLA allele frequencies in South America is very limited. In this study, we have performed a literature review of datasets reporting HLA frequencies of South American populations, available in scientific literature and/or in the Allele Frequency Net Database. This allowed us to enrich the current scenario with more than 12.8 million data points. As a result, we are presenting updated HLA allelic frequencies based on country, including 91 alleles that were previously thought to have frequencies either under 5% or of an unknown value. Using alleles with an updated frequency of at least ≥5% in any South American country, we predicted epitopes in SARS-CoV-2 proteins using NetMHCpan (I and II) and MHC flurry. Then, the best predicted epitopes (class-I and -II) were selected based on their binding to South American alleles (Coverage Score). Class II predicted epitopes were also filtered based on their three-dimensional exposure. We obtained 14 class-I and four class-II candidate epitopes with experimental evidence (reported in the Immune Epitope Database and Analysis Resource), having good coverage scores for South America. Additionally, we are presenting 13 HLA-I and 30 HLA-II novel candidate epitopes without experimental evidence, including 16 class-II candidates in highly exposed conserved areas of the NTD and RBD regions of the Spike protein. These novel candidates have even better coverage scores for South America than those with experimental evidence. Finally, we show that recent similar studies presenting candidate epitopes also predicted some of our candidates but discarded them in the selection process, resulting in candidates with suboptimal coverage for South America. In conclusion, the candidate epitopes presented provide valuable information for the development of epitope-based strategies against SARS-CoV-2, such as peptide vaccines and diagnostic tests. Additionally, the updated HLA allelic frequencies provide a better representation of South America and may impact different immunogenetic studies.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Epitopos de Linfócito T/imunologia , Frequência do Gene , Antígenos HLA/genética , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Proteínas do Envelope Viral/imunologia , Alelos , Sequência de Aminoácidos , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Variação Genética , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , América do Sul/epidemiologia , Vacinas de Subunidades/imunologia , Vacinas Virais/imunologia
10.
PLoS Negl Trop Dis ; 14(10): e0008686, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33119616

RESUMO

As the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic continues to expand, healthcare resources globally have been spread thin. Now, the disease is rapidly spreading across South America, with deadly consequences in areas with already weakened public health systems. The Amazon region is particularly susceptible to the widespread devastation from Coronavirus disease 2019 (COVID-19) because of its immunologically fragile native Amerindian inhabitants and epidemiologic vulnerabilities. Herein, we discuss the current situation and potential impact of COVID-19 in the Amazon region and how further spread of the epidemic wave could prove devastating for many Amerindian people living in the Amazon rainforest.


Assuntos
Infecções por Coronavirus/etnologia , Índios Sul-Americanos , Pneumonia Viral/etnologia , Betacoronavirus , Infecções por Coronavirus/mortalidade , Humanos , Pandemias , Pneumonia Viral/mortalidade , Floresta Úmida , América do Sul/epidemiologia
11.
J Frailty Aging ; 9(4): 197-213, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32996556

RESUMO

OBJECTIVES: The present study aimed at investigating the prevalence of prefrailty and frailty in South American older adults according to the setting and region. DESIGN: A literature search combining the terms "frailty", "South America" or a specific country name was performed on PubMed, EMBASE, Lilacs, and Scielo to retrieve articles published in English, Portuguese or Spanish on or before August 2019. PARTICIPANTS: Older adults aged 60+ years from any setting classified as frail according to a validated scale were included in the study. MEASUREMENTS: Frailty assessment by a validated scale. RESULTS: One-hundred eighteen reports (98 performed from Brazil, seven from Chile, five from Peru, four from Colombia, two from Ecuador, one from Argentina, and one from Venezuela) were included in the study. The mean prevalence of prefrailty in South America was 46.8% (50.7% in older in-patients, 47.6% in the community, and 29.8% in nursing-home residents). The mean prevalence of frailty in South America was 21.7% (55.8% in nursing-home residents, 39.1% in hospitalized older adults, and 23.0% in the community). CONCLUSIONS: Prefrailty and frailty are highly prevalent in South American older adults, with rates higher than those reported in Europe and Asia. In the community, almost one-in-two is prefrail and one-in-five is frail, while hospitalized persons and nursing-home residents are more frequently affected. These findings indicate the need for immediate attention to avoid frailty progression toward negative health outcomes. Our findings also highlight the need for specific guidelines for the management of frailty in South America.


Assuntos
Fragilidade/epidemiologia , Humanos , Estudos Observacionais como Assunto , Prevalência , América do Sul/epidemiologia
12.
J Community Health ; 45(6): 1270-1282, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32918645

RESUMO

OBJECTIVES: The main aim of this study was to find the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death. METHODS: Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify relevant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-effects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures. Cochrane chi-square test statistic Q, [Formula: see text], and [Formula: see text] tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested. RESULTS: In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortality among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46-21.30), p < 0.001. Highest mortality was found in Europe [PR 26.85%, 95% CI (19.41-34.29), p < 0.001] followed by North America [PR 21.47%, 95% CI (16.27-26.68), p < 0.001] and Asia [PR 14.83%, 95% CI (12.46- 17.21), p < 0.001]. An significant association were found between mortality among COVID-19 infected patients and older age (> 65 years vs. < 65 years) [RR 3.59, 95% CI (1.87-6.90), p < 0.001], gender (male vs. female) [RR 1.63, 95% CI (1.43-1.87), p < 0.001], ICU admitted patients [RR 3.72, 95% CI (2.70-5.13), p < 0.001], obesity [RR 2.18, 95% CI (1.10-4.34), p < 0.05], hypertension [RR 2.08,95% CI (1.79-2.43) p < 0.001], diabetes [RR 1.87, 95% CI (1.23-2.84), p < 0.001], cardiovascular disease [RR 2.51, 95% CI (1.20-5.26), p < 0.05], and cancer [RR 2.31, 95% CI (1.80-2.97), p < 0.001]. In addition, significant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease. CONCLUSION: This meta-analysis revealed that the mortality rate among COVID-19 patients was highest in the European region and older age, gender, ICU patients, patients with comorbidity had a high risk for case fatality. Those findings would help the health care providers to reduce the mortality rate and combat this pandemic to save lives using limited resources.


Assuntos
Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Prevalência , Adulto , Idoso , Idoso de 80 Anos ou mais , Ásia/epidemiologia , Betacoronavirus , Comorbidade , Bases de Dados Factuais , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Oriente Médio/epidemiologia , América do Norte/epidemiologia , Pandemias , Fatores de Risco , América do Sul/epidemiologia
13.
Rev Prat ; 70(3): 312-316, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32877067

RESUMO

Yellow fever is still a current threat? Yellow fever is a mosquito-borne disease. Africa is the major endemic zone, although there have been epidemics of concern in South America in the last 3 years, especially in Brazil. The virus causes a febrile hepatitis, which can lead to hemorrhagic complications and death. Diagnosis is based on non-specific serological tests. There is no curative treatment. Prevention relies on protection against mosquito bites and on vaccination with a live attenuated vaccine. WHO recommends only one dose of vaccine but data from the literature about life-long protection are divergent on that point, and travel medicine French authorities still recommend a second dose in most at-risk situations.


Assuntos
Vacina contra Febre Amarela , Febre Amarela , África/epidemiologia , Animais , América do Sul/epidemiologia , Medicina de Viagem , Febre Amarela/epidemiologia , Febre Amarela/prevenção & controle
14.
Lancet ; 396(10254): 830-838, 2020 09 19.
Artigo em Inglês | MEDLINE | ID: mdl-32877651

RESUMO

BACKGROUND: Angina might persist or reoccur despite successful revascularisation with percutaneous coronary intervention (PCI) and antianginal therapy. Additionally, PCI in stable patients has not been shown to improve survival compared with optimal medical therapy. Trimetazidine is an antianginal agent that improves energy metabolism of the ischaemic myocardium and might improve outcomes and symptoms of patients who recently had a PCI. In this study, we aimed to assess the long-term potential benefits and safety of trimetazidine added to standard evidence-based medical treatment in patients who had a recent successful PCI. METHODS: We did a randomised, double-blind, placebo-controlled, event-driven trial of trimetazidine added to standard background therapy in patients who had undergone successful PCI at 365 centres in 27 countries across Europe, South America, Asia, and north Africa. Eligible patients were aged 21-85 years and had had either elective PCI for stable angina or urgent PCI for unstable angina or non-ST segment elevation myocardial infarction less than 30 days before randomisation. Patients were randomly assigned by an interactive web response system to oral trimetazidine 35 mg modified-release twice daily or matching placebo. Participants, study investigators, and all study staff were masked to treatment allocation. The primary efficacy endpoint was a composite of cardiac death; hospital admission for a cardiac event; recurrence or persistence of angina requiring an addition, switch, or increase of the dose of at least one antianginal drug; or recurrence or persistence of angina requiring a coronary angiography. Efficacy analyses were done according to the intention-to-treat principle. Safety was assessed in all patients who had at least one dose of study drug. This study is registered with the EU Clinical Trials Register (EudraCT 2010-022134-89). FINDINGS: From Sept 17, 2014, to June 15, 2016, 6007 patients were enrolled and randomly assigned to receive either trimetazidine (n=2998) or placebo (n=3009). After a median follow-up of 47·5 months (IQR 42·3-53·3), incidence of primary endpoint events was not significantly different between the trimetazidine group (700 [23·3%] patients) and the placebo group (714 [23·7%]; hazard ratio 0·98 [95% CI 0·88-1·09], p=0·73). When analysed individually, there were no significant differences in the incidence of the components of the primary endpoint between the treatment groups. Similar results were obtained when patients were categorised according to whether they had an elective or urgent PCI. 1219 (40·9%) of 2983 patients in the trimetazidine group and 1230 (41·1%) of 2990 patients in the placebo group had serious treatment-emergent adverse events. Frequencies of adverse events of interest were similar between the groups. INTERPRETATION: Our results show that the routine use of oral trimetazidine 35 mg twice daily over several years in patients receiving optimal medical therapy, after successful PCI, does not influence the recurrence of angina or the outcome; these findings should be taken into account when considering the place of trimetazidine in clinical practice. However, the long-term prescription of this treatment does not appear to be associated with any statistically significant safety concerns in the population studied. FUNDING: Servier.


Assuntos
Infarto do Miocárdio sem Supradesnível do Segmento ST/terapia , Intervenção Coronária Percutânea/métodos , Trimetazidina/efeitos adversos , Vasodilatadores/efeitos adversos , Administração Oral , África do Norte/epidemiologia , Idoso , Angina Estável/terapia , Angina Instável/terapia , Ásia/epidemiologia , Estudos de Casos e Controles , Angiografia Coronária/métodos , Angiografia Coronária/estatística & dados numéricos , Morte , Europa (Continente)/epidemiologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea/tendências , Placebos/administração & dosagem , Recidiva , Segurança , América do Sul/epidemiologia , Resultado do Tratamento , Trimetazidina/administração & dosagem , Trimetazidina/uso terapêutico , Vasodilatadores/administração & dosagem , Vasodilatadores/uso terapêutico
15.
Parasitol Res ; 119(10): 3125-3143, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32803332

RESUMO

Pediculosis by Pediculus humanus capitis is still an important health issue in school-age students worldwide. Although pediculicidal agents effectively kill head lice, the re-infestation rate is still high. This study was conducted to provide a summary of evidence about the prevalence of pediculosis capitis among school-age students worldwide. Different databases including MEDLINE/PubMed, Scopus, and Web of Science were searched for publications related to pediculosis capitis in school-age students from 1977 to 2020. All peer-reviewed original research articles describing pediculosis capitis among school-age students were included. Statistical heterogeneity of the different years among studies was assessed using the standard chi squared and I2 tests. Due to the significant heterogeneity, a random effect model was adopted to estimate the pooled, continent, and gender-specific prevalence of pediculosis. Two hundred and one papers met the inclusion criteria of this review and entered into the meta-analysis including 1,218,351 individuals. Through a random effect model, the prevalence of pediculosis capitis among school students was estimated as 19% (CI 95% = 0.18-0.20%, I2 = 99.89%). The prevalence of pediculosis capitis among boys was 7% (CI 95% = 0.05-0.10) compared to 19% (CI 95% = 0.15-0.24) in girls. The highest prevalence was in Central and South America (33%, CI 95% = 0.22-0.44, I2 = 99.81%) and the lowest was in Europe (5%, CI 95% = 4-6, I2 = 99.28%). Relatively high pediculosis capitis prevalence among school-age students observed in this study emphasizes the need for implementing screening and prophylaxis tailored to the local context.


Assuntos
Infestações por Piolhos/epidemiologia , Pediculus/crescimento & desenvolvimento , Estudantes/estatística & dados numéricos , Adolescente , Animais , Criança , Europa (Continente)/epidemiologia , Feminino , Humanos , Infestações por Piolhos/tratamento farmacológico , Masculino , Programas de Rastreamento , Prevalência , Saúde Pública , Instituições Acadêmicas , América do Sul/epidemiologia
16.
Int J Equity Health ; 19(1): 131, 2020 08 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746851

RESUMO

BACKGROUND: Disabled people are particularly exposed to the risks of COVID-19, as well as to the measures taken to address it, and their impact. The aim of the study was to examine the disability-inclusiveness of government responses to COVID-19 in four South American Countries: Argentina, Brazil, Chile, and Peru. METHODS: We conducted documentary research, using framework analysis to analyse reports, legislation, decrees, and other official documents that communicated measures taken in response to the pandemic, published from February 1st until May 22nd, 2020. We included documents reporting measures that affected disabled people either directly (measures specifically designed for disabled people) or indirectly (measures for the general population). We developed an analytical framework based on recommendations for disability-inclusive response to COVID-19 published by the Economic Commission for Latin America and the Carribean, the World Health Organisation, and other international organisations. RESULTS: We analysed 72 documents. The findings highlight that while some positive measures were taken, the needs of disabled people were not fully considered. Several countries published recommendations for a disability-inclusive response to COVID-19, without ensuring their translation to practice. All countries took at least some steps to ensure access to financial support, health, and education for disabled people, but at the same time they also implemented policies that had a detrimental impact on disabled people. The populations that are most exposed to the impacts of COVID-19, including disabled people living in institutional care, were protected in several cases only by recommendations rather by legislation. CONCLUSIONS: This study illustrates how the official government responses taken by four countries in the region - while positive, in several aspects - do not fully address the needs of disabled people, thus further disadvantaging them. In order to ensure response to COVID - 19 is disability inclusive, it is necessary to translate recommendations to practice, consider disabled people both in mainstream policy and in disability-specific measures, and focus on the long-term reconstruction phase.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoas com Deficiência , Governo , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Políticas , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia , América do Sul/epidemiologia
17.
Arterioscler Thromb Vasc Biol ; 40(10): 2508-2515, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32757650

RESUMO

OBJECTIVE: Characterize homozygous familial hypercholesterolemia (HoFH) individuals from Iberoamerica. Approach and Results: In a cross-sectional retrospective evaluation 134 individuals with a HoFH phenotype, 71 adults (age 39.3±15.8 years, 38.0% males), and 63 children (age 8.8±4.0 years, 50.8% males) were studied. Genetic characterization was available in 129 (96%). The majority (91%) were true homozygotes (true HoFH, n=79, 43.0% children, 46.8% males) or compound heterozygotes (compound heterozygous familial hypercholesterolemia, n=39, 51.3% children, 46.2% males) with putative pathogenic variants in the LDLR. True HoFH due to LDLR variants had higher total (P=0.015) and LDL (low-density lipoprotein)-cholesterol (P=0.008) compared with compound heterozygous familial hypercholesterolemia. Children with true HoFH (n=34) tended to be diagnosed earlier (P=0.051) and had a greater frequency of xanthomas (P=0.016) than those with compound heterozygous familial hypercholesterolemia (n=20). Previous major cardiovascular events were present in 25 (48%) of 52 children (missing information in 2 cases), and in 43 (67%) of 64 adults with LDLR variants. Children who are true HoFH had higher frequency of major cardiovascular events (P=0.02), coronary heart (P=0.013), and aortic/supra-aortic valve diseases (P=0.022) than compound heterozygous familial hypercholesterolemia. In adults, no differences were observed in major cardiovascular events according to type of LDLR variant. From 118 subjects with LDLR variants, 76 (64%) had 2 likely pathogenic or pathogenic variants. In 89 subjects with 2 LDLR variants, those with at least one null allele were younger (P=0.003) and had a greater frequency of major cardiovascular events (P=0.038) occurring at an earlier age (P=0.001). CONCLUSIONS: There was a high frequency of cardiovascular disease even in children. Phenotype and cardiovascular complications were heterogeneous and associated with the type of molecular defect.


Assuntos
Doenças Cardiovasculares/epidemiologia , LDL-Colesterol/sangue , Homozigoto , Hiperlipoproteinemia Tipo II/genética , Mutação , Proteínas Adaptadoras de Transdução de Sinal/genética , Adolescente , Adulto , Fatores Etários , Apolipoproteína B-100/genética , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Criança , Pré-Escolar , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Predisposição Genética para Doença , Humanos , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Fenótipo , Pró-Proteína Convertase 9/genética , Receptores de LDL/genética , Estudos Retrospectivos , Fatores de Risco , América do Sul/epidemiologia , Adulto Jovem
19.
BMC Public Health ; 20(1): 937, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32611321

RESUMO

BACKGROUND: The study aimed to investigate the associations between physical partner violence victimization (IPV) and/or sexual violence victimization and various health risk behaviours and mental health in university students in 25 countries. METHODS: Using a cross-sectional study design, 18,335 university students with a median age of 20 years from 25 countries in Africa, the Americas and Asia, replied to self-reported measures of interpersonal violence, health compromising behaviours, mental health measures and protective factors. RESULTS: In adjusted logistic regression analysis, physical IPV and/or sexual violence victimization was associated, among men and/or among women, with sexual risk behaviours (multiple sexual partners, alcohol use in the context of sex, diagnosed with HIV and pregnancy), violence related behaviour (in a physical fight and carrying a weapon), poor mental health (depression, loneliness, post-traumatic stress disorder, sleeping problem and short sleep), addictive behaviour (binge drinking, tobacco and drug use), and other health risk behaviour (skipping breakfast and frequent salt intake). CONCLUSIONS: We found evidence that physical IPV and/or sexual violence victimization among female and/or male university students was associated with 4 of 5 sexual risk behaviours, 2 violence related behaviours, 5 of 5 poor mental health indicators, 3 of 3 addictive behaviours and 2 of 7 other health risk behaviours.


Assuntos
Vítimas de Crime/psicologia , Comportamentos de Risco à Saúde , Violência por Parceiro Íntimo/psicologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Delitos Sexuais/psicologia , Estudantes/psicologia , Adulto , África/epidemiologia , Ásia/epidemiologia , Vítimas de Crime/estatística & dados numéricos , Estudos Transversais , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Gravidez , Fatores de Risco , Autorrelato , Delitos Sexuais/estatística & dados numéricos , América do Sul/epidemiologia , Estudantes/estatística & dados numéricos , Universidades , Índias Ocidentais/epidemiologia , Adulto Jovem
20.
Eur J Clin Invest ; 50(10): e13364, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32725884

RESUMO

BACKGROUND: COVID-19 is currently the most urgent threat to public health in the world. The aim of this study is to provide an overview of the first cases of COVID-19 to make further improvements in health policies and prevention measurements in response to the outbreak of COVID-19. METHODS: We performed a search in PubMed, the CNKI (China National Knowledge Infrastructure), Web of Science and the WHO database of publications on COVID-19 for peer-reviewed papers from 1 December 2019 to 9 July 2020. We analysed the demographics, epidemiological characteristics, clinical features, signs and symptoms of the disease at the onset. RESULTS: We identified the first cases of COVID-19 in 16 different countries/regions from Asia, Europe, North America and South America. Of these 16 cases, 8 (50.0%) were male, with a mean of age 43.38 ± 15.19 years. All the cases had a history of travel or exposure. Twelve cases (75.0%) occurred in January, eight patients were Chinese, two patients were international students in Wuhan, one patient had a history of travelling in Wuhan, and one patient was in contact with Chinese patient. The longest hospital stay was 24 days (1 patient), and the shortest was 5 days (1 patient). The usual hospital stay was 9 days (4 patients). CONCLUSION: Understanding the epidemiological characteristics, clinical characteristics, and diagnosis and treatment of the first patients in various countries are of great significance for the identification, prevention and control of COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Tempo de Internação/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Viagem , Adulto , Distribuição por Idade , Idoso , Ásia/epidemiologia , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/fisiopatologia , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , América do Norte/epidemiologia , Pandemias , Pneumonia Viral/fisiopatologia , Distribuição por Sexo , América do Sul/epidemiologia , Doença Relacionada a Viagens , Adulto Jovem
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