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1.
Braz. j. biol ; 84: e257402, 2024. tab, graf
Artigo em Inglês | MEDLINE, LILACS, VETINDEX | ID: biblio-1355856

RESUMO

Abstract Visceral leishmaniasis (VL) is an infectious disease predominant in countries located in the tropics. The prediction of occurrence of infectious diseases through epidemiologic modeling has revealed to be an important tool in the understanding of its occurrence dynamic. The objective of this study was to develop a forecasting model for the incidence of VL in Maranhão using the Seasonal Autoregressive Integrated Moving Average model (SARIMA). We collected monthly data regarding VL cases from the National Disease Notification System (SINAN) corresponding to the period between 2001 and 2018. The Box-Jenkins method was applied in order to adjust a SARIMA prediction model for VL general incidence and by sex (male or female) for the period between January 2019 and December 2013. For 216 months of this time series, 10,431 cases of VL were notified in Maranhão, with an average of 579 cases per year. With regard to age range, there was a higher incidence among the pediatric public (0 to 14 years of age). There was a predominance in male cases, 6437 (61.71%). The Box-Pierce test figures for overall, male and female genders supported by the results of the Ljung-Box test suggest that the autocorrelations of residual values act as white noise. Regarding monthly occurrences in general and by gender, the SARIMA models (2,0,0) (2,0,0), (0,1,1) (0,1,1) and (0,1,1) (2, 0, 0) were the ones that mostly adjusted to the data respectively. The model SARIMA has proven to be an adequate tool for predicting and analyzing the trends in VL incidence in Maranhão. The time variation determination and its prediction are decisive in providing guidance in health measure intervention.


Resumo A leishmaniose visceral (LV) é uma doença de natureza infecciosa, predominante em países de zonas tropicais. A predição de ocorrência de doenças infecciosas através da modelagem epidemiológica tem se revelado uma importante ferramenta no entendimento de sua dinâmica de ocorrência. O objetivo deste estudo foi desenvolver um modelo de previsão da incidência da LV no Maranhão usando o modelo de Média Móvel Integrada Autocorrelacionada Sazonal (SARIMA). Foram coletados os dados mensais de casos de LV através do Sistema de Informação de Agravos de Notificação (SINAN) correspondentes ao período de 2001 a 2018. O método de Box-Jenkins foi aplicado para ajustar um modelo de predição SARIMA para incidência geral e por sexo (masculino e feminino) de LV para o período de janeiro de 2019 a dezembro de 2023. Durante o período de 216 meses dessa série temporal, foram registrados 10.431 casos de LV no Maranhão, com uma média de 579 casos por ano. Em relação à faixa etária, houve maior registro no público pediátrico (0 a 14 anos). Houve predominância do sexo masculino, com 6437 casos (61,71%). Os valores do teste de Box-Pierce para incidência geral, sexo masculino e feminino reforçados pelos resultados do teste Ljung-Box sugerem que as autocorrelações de resíduos apresentam um comportamento de ruído branco. Para incidência mensal geral e por sexo masculino e feminino, os modelos SARIMA (2,0,0) (2,0,0), (0,1,1) (0,1,1) e (0,1,1) (2, 0, 0) foram os que mais se ajustaram aos dados, respectivamente. O modelo SARIMA se mostrou uma ferramenta adequada de previsão e análise da tendência de incidência da LV no Maranhão. A determinação da variação temporal e sua predição são determinantes no norteamento de medidas de intervenção em saúde.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Leishmaniose Visceral/diagnóstico , Leishmaniose Visceral/epidemiologia , Estações do Ano , Brasil/epidemiologia , Incidência , Modelos Estatísticos
2.
Environ Pollut ; 302: 119070, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35231538

RESUMO

Long-term exposure to PM2.5 has been linked to lung cancer incidence and mortality, but limited evidence existed for other cancers. This study aimed to assess the association between PM2.5 on cancer specific mortality. An ecological study based on the cancer mortality data collected from 5,565 Brazilian cities during 2010-2018 using a difference-in-differences approach with quasi-Poisson regression, was applied to examine PM2.5-cancer mortality associations. Globally gridded annual average surface PM2.5 concentration was extracted and linked with the residential municipality of participants in this study. Sex, age stratified and exposure-response estimations were also conducted. Totalling 1,768,668 adult cancer deaths records of about 208 million population living across 5,565 municipalities were included in this study. The average PM2.5 concentration was 7.63 µg/m3 (standard deviation 3.32) with range from 2.95 µg/m3 to 28.5 µg/m3. With each 10 µg/m3 increase in three-year-average (current year and previous two years) concentrations of PM2.5, the relative risks (RR) of cancer mortality were 1.16 (95% confidence interval [CI]: 1.11-1.20) for all-site cancers. The PM2.5 exposure was significantly associated with several cancer-specific mortalities including oral, nasopharynx, oesophagus, and stomach, colon rectum, liver, gallbladder, larynx, lung, bone, skin, female breast, cervix, prostate, brain and leukaemia. No safe level of PM2.5 exposure was observed in the exposure-response curve for all types of cancer. In conclusion, with nationwide cancer death records in Brazil, we found that long-term exposure to ambient PM2.5 increased risks of mortality for many cancer types. Even low level PM2.5 concentrations had significant impacts on cancer mortality.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Neoplasias Pulmonares , Adulto , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Brasil/epidemiologia , Exposição Ambiental , Feminino , Humanos , Masculino , Mortalidade , Material Particulado/análise
4.
Multimedia | Recursos Multimídia | ID: multimedia-9688

RESUMO

Observa-se no contexto atual, um aumento nas prevalências de insegurança alimentar e nutricional (IAN), o que indica um maior número de famílias brasileiras sem acesso regular e permanente a uma alimentação de qualidade e em quantidade suficiente, sendo essa situação diretamente relacionada com a ocorrência da má nutrição. Considerando a complexidade dos determinantes da saúde e da segurança alimentar e nutricional (SAN), as consequências da desnutrição, e, considerando ainda a importância do diagnóstico e da vigilância alimentar e nutricional, é imprescindível que se consiga avançar na qualificação e organização do cuidado no âmbito da APS, bem como fortalecer o apoio a gestores e profissionais de saúde para o desenvolvimento de estratégias intersetoriais capazes de atuar na garantia da SAN e da saúde. A desnutrição é um problema de saúde pública que acomete a população brasileira, especialmente pessoas de maior vulnerabilidade social e biológica. De acordo com os dados do Sistema de Vigilância Alimentar e Nutricional (Sisvan), em 2020, 14,2% das gestantes apresentaram baixo peso para a idade gestacional, 6,1% das crianças menores de 5 anos estavam com magreza acentuada ou magreza e 13,0% delas com baixa estatura para a idade. O cenário é preocupante, tendo em vista as consequências da desnutrição a curto e longo prazo. A desnutrição associa-se a maior mortalidade e morbidade, é um fator de risco para infecções, como doenças diarreicas e respiratórias, e contribui para um inadequado crescimento e desenvolvimento na primeira infância. Entre os múltiplos fatores para a prevenção da desnutrição, a alimentação adequada e saudável é essencial para garantir o pleno crescimento e desenvolvimento, com destaque para os primeiros mil dias de vida, que englobam o período gestacional e os primeiros dois anos de vida da criança. Uma alimentação em quantidade ou qualidade insuficiente nessas fases da vida associa-se à múltipla carga de má nutrição, caracterizada pela coexistência de desnutrição, excesso de peso e carências nutricionais, como a anemia e a deficiência de vitamina A.


Assuntos
Política Nutricional , Segurança Alimentar/estatística & dados numéricos , Comportamento Alimentar , COVID-19/epidemiologia , Dieta Saudável , Desnutrição/prevenção & controle , Desnutrição/epidemiologia , Insegurança Alimentar , Programas e Políticas de Nutrição e Alimentação , Saúde da Criança , Alimentos Industrializados , Guias Alimentares , Atenção Primária à Saúde , Promoção da Saúde , Sistemas Locais de Saúde , Brasil/epidemiologia , México/epidemiologia
5.
Malar J ; 21(1): 157, 2022 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-35641976

RESUMO

BACKGROUND: In Brazil, malaria is caused mainly by the Plasmodium vivax and Plasmodium falciparum species. Its transmission occurs in endemic and non-endemic areas. Malaria geography in Brazil has retracted and is now concentrated in the North region. The Brazilian Amazon region accounts for 99% of Brazil's cases. Brazil's extra-Amazon region has a high frequency of imported cases and in 2019 presented a mortality rate 123 times higher than the Amazon region. Extra-Amazon cases present risks of reintroduction. This study aims to characterize the epidemiological scenario for malaria in the extra-Amazon region of Brazil from 2011 to 2020 with a two-year forecast. METHODS: Time-series study with description of malaria cases and deaths registered in Brazilian extra-Amazon region from 2011 to 2020. Public data from the Notifiable Diseases Information System (Sinan) and the Mortality Information System (SIM) were used. Descriptive analysis, incidence, and notification rates were calculated. Flow charts analysed the flux between Places of Probable Infection (PI) and places of notification. The prediction model utilized a multiplicative Holt-winters model for trend and seasonality components. RESULTS: A total of 6849 cases were registered. Cases were predominantly white males with 9 to 11 years of education, mostly between 30 and 39 years old. Imported cases accounted for 78.9% of cases. Most frequent occupations for imported cases are related to travelling and tourism activities. Among autochthonous cases, there is a higher frequency of agriculture and domestic economic activities. In the period there were 118 deaths due to malaria, of which 34.7% were caused by P. falciparum infections and 48.3% were not specified. The most intense flows of imported cases are from Amazonas and Rondônia to São Paulo, Rio de Janeiro, and Paraná. The prediction estimates around 611 cases for each of the following two years. CONCLUSION: The time series allows a vast epidemiological visualization with a short-term prediction analysis that supports public health planning. Government actions need to be better directed in the extra-Amazon region so the objective of eliminating malaria in Brazil is achieved. Carrying out quality assessments for information systems and qualifying personnel is advisable. Malaria outside the Amazon region is mainly due to imported cases and delay in diagnosis is associated with a higher fatality rate. Better strategies to diagnose and treat suspected cases can lead to lower risk of deaths and local outbreaks that will be important for achieving malaria elimination in Brazil.


Assuntos
Malária Falciparum , Malária Vivax , Malária , Adulto , Brasil/epidemiologia , Humanos , Malária/epidemiologia , Malária Falciparum/epidemiologia , Malária Vivax/diagnóstico , Masculino , Fatores de Tempo , Estados Unidos
6.
Front Cell Infect Microbiol ; 12: 894297, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35646737

RESUMO

Sporotrichosis has been expanding throughout the Brazilian territory in recent years. New outbreaks have emerged, and consequently, the sporotrichosis agents, mainly Sporothrix brasiliensis, should remain in the environment somehow. Therefore, the aim of this study was to investigate the presence of Sporothrix spp. in the environment from an area of ​​the Rio de Janeiro state, Brazil, with recurrent cases of human and animal sporotrichosis. Abandoned demolition timber wood samples were collected in the garden of a house where the cases of human and feline sporotrichosis have occurred in the last 10 years. The environmental survey revealed a Sporothrix spp. colony from the serial dilution cultures of one abandoned demolition wood sample. In addition, a fungal strain isolated from a cat with skin lesions that lived in the house was also included in the study. The species-specific PCR, and calmodulin partial sequencing identified the environmental and cat isolates as S. brasiliensis. Furthermore, the phylogenetic analysis performed with the partial sequences of internal transcribed spacer region and constitutive genes (calmodulin, ß-tubulin, and chitin synthase) showed high similarity between environmental and cat isolates from the same geographic region. Moreover, the antifungal susceptibility test revealed that the minimal inhibitory concentration of itraconazole from the environment isolate was lower than the cat isolate, while amphotericin B and terbinafine were similar. Our results show that S. brasiliensis is able to maintain itself in the environmental material for years. With this, we corroborate that the eco-epidemiology of sporotrichosis is not well understood, and despite the major occurrence of S. brasiliensis in Brazil, it is rarely isolated from the environment.


Assuntos
Sporothrix , Esporotricose , Animais , Brasil/epidemiologia , Calmodulina/genética , Gatos , Filogenia , Sporothrix/genética , Esporotricose/epidemiologia , Esporotricose/microbiologia , Esporotricose/veterinária
7.
Front Public Health ; 10: 869684, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35707054

RESUMO

This study aimed to evaluate the association between the years of work of food handlers in the foodservice and excess weight among Brazilian low-income food handlers. A total of 559 food handlers from all Brazilian regions were characterized using a questionnaire. Weight and height were measured to estimate the Body Mass Index and classify the individuals. The association between food handlers' years of work in the foodservice, anthropometric status, and other variables (gender, age group, educational level, participation in a government program and per capita income at home and energetic consumption) were performed using Pearson's chi-square test (p < 0.05). Multinomial logistic regression analyses were performed (p < 0.05) as well as sensitivity tests using the outcome continuously and transformed, excluding underweight individuals, in a multivariate linear regression model. Most of the sample was female (63.1%), aged between 21 and 40 years old (63.5%), and 53.3% had studied up to complete elementary school. Almost 41% of the food handlers had less than half the minimum wage per capita income. Of the evaluated individuals, 59.9% presented excess weight. There was an association with family per capita income (Odds Ratio - OR: 1.73; Confidence interval - CI95%: 1.09-2.75); handlers whose per capita income was ≤0.5 minimum wage had a 73% higher chance of obesity than those with higher income. Working in foodservive ≥3 years increased the chance of being overweight by 96% compared to those who work for <3 years (OR: 1.96; CI95%: 1.11-3.49). No significant association was found between the years of work of food handlers in the foodservice and obesity. Since work-related factors may contribute to the high prevalence of excess weight, including working in a food handling environment, the government and employers should consider workplace interventions. These would guide the food handlers in avoiding high rates of excess weight and their consequences on public health. Excess weight is an important driver of costs in the workplace associated with absenteeism, job change, and diseases. More studies are necessary to clarify the relationship between the factors related to work and the anthropometric status of food handlers since excess weight is multifactorial.


Assuntos
Sobrepeso , Restaurantes , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Adulto Jovem
8.
Acta Odontol Latinoam ; 35(1): 45-50, 2022 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-35700541

RESUMO

Cyberchondria is a psychopathological behavior that affects people who compulsively consult the internet, by searching the symptoms of different pathologies from which they believe they are suffering, and when influenced by what they read, are sure they have some of these diseases. The aim of this study was to assess the cyberchondria level and associated factors among Brazilian and Portuguese dentists. A total 597 Brazilian and Portuguese dentists participated in this cross-sectional study. They were contacted via WhatsApp and asked to complete an online questionnaire on the Google Forms platform, from January 17 to 31, 2021, during the COVID-19 pandemic. Sociodemographic information was collected and cyberchondria was measured using the Portuguese language version of the Cyberchondria Severity Scale. Binary logistic regression models were used to estimate the unadjusted and adjusted Odds Ratio (OR) and corresponding 95% confidence interval (CI) for theassociationofcyberchondria and covariates. Each covariate was individually included in the regression model, and the unadjusted OR (95% CI) was estimated. Most participants were Brazilian (62.8%), women (75.5%), married (60.5%) and with children (55.6%). Average age was 42.1 years (+ 12.5). In the final model, it was found that with each increase of one year in age, the chance of a high level of cyberchondria decreased (OR=0.97; 95% CI 0.95-0.98). Brazilian dentists were 1.85 times more likely (95% CI 1.25-2.75) to have a high level of cyberchondria than Portuguese dentists. Women were 1.62 times more likely (95% CI 1.07-2.44) to have a high level of cyberchondria than men. It was concluded that young age, Brazilian nationality, and female gender favored the high level of cyberchondria among the participants in this sample during COVID-19 pandemic.


A cibercondria é um comportamento psicopatológico que atinge as pessoas que consultam compulsivamente a internet, pesquisando os sintomas das diferentes patologias de que acreditam estar sofrendo e, quando influenciadas pelo que leem, têm a certeza de possuir alguma dessas doenças. O objetivo deste estudo foi avaliar o nível de cibercondria e fatores associados entre dentistas brasileiros e portugueses. Participaram deste estudo transversal 597 dentistas brasileiros e portugueses. Eles foram contatados via WhatsApp e solicitados a preencher um questionário online na plataforma do Google Forms, no período de 17 a 31 de janeiro de 2021, durante a pandemia de COVID-19. Informações sociodemográficas foram coletadas e a cibercondria foi mensurada através da versão em língua portuguesa da Cyberchondria Severity Scale. Modelos de regressão logística binária foram usados para estimar a Odds Ratio (OR) não ajustada e ajustada e o intervalo de confiança(IC)de 95%correspondente para a associação de cibercondria e covariáveis. Cada covariável foi incluída individualmente no modelo de regressão, e o OR não ajustado (IC 95%) foi estimado. A maioria dos participantes eram brasileiros (62,8%), mulheres (75,5%), casados (60,5%) e com filhos (55,6%). A média de idade foi de 42,1 anos (+ 12,5). No modelo final, verificou-se que a cada aumento de um ano de vida, a chance de um nível elevado de cibercondria diminuía (OR = 0,97; IC95% 0,95-0,98). Os dentistas brasileiros tiveram 1,85 vezes mais probabilidade (IC95% 1,25-2,75) de apresentar alto índice de cibercondria quando comparados aos portugueses. As mulheres tinham 1,62 vezes mais probabilidade (IC 95% 1,07-2,44) de ter um alto nível de cibercondria em comparação com os homens. Concluiu-se que a idade mais jovem, a nacionalidade brasileira e o sexo feminino favoreceram o alto índice de cibercondria entre os participantes desta amostra durante a pandemia COVID-19.


Assuntos
COVID-19 , Adulto , Brasil/epidemiologia , COVID-19/epidemiologia , Criança , Estudos Transversais , Odontólogos , Feminino , Humanos , Internet , Idioma , Masculino , Pandemias , Portugal/epidemiologia , Inquéritos e Questionários
9.
PLoS One ; 17(6): e0269997, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709075

RESUMO

A rapid and accurate diagnosis is a crucial strategy for containing the coronavirus disease (COVID-19) pandemic. Considering the obstacles to upscaling the use of RT-qPCR, rapid tests based on antigen detection (Ag-RDT) have become an alternative to enhance mass testing, reducing the time for a prompt diagnosis and virus spreading. However, the performances of several commercially available Ag-RDTs have not yet been evaluated in several countries. Here, we evaluate the performance of eight Ag-RDTs available in Brazil to diagnose COVID-19. Patients admitted to tertiary hospitals with moderate or mild COVID-19 symptoms and presenting risk factors for severe disease were included. The tests were performed using a masked protocol, strictly following the manufacturer's recommendations and were compared with RT-qPCR. The overall sensitivity of the tests ranged from 9.8 to 81.1%, and specificity greater than 83% was observed for all the evaluated tests. Overall, slight or fair agreement was observed between Ag-RDTs and RT-PCR, except for the Ag-RDT COVID-19 (Acro Biotech), in which moderate agreement was observed. Lower sensitivity of Ag-RDTs was observed for patients with cycle threshold > 25, indicating that the sensitivity was directly affected by viral load, whereas the effect of the disease duration was unclear. Despite the lower sensitivity of Ag-RDTs compared with RT-qPCR, its easy fulfillment and promptness still justify its use, even at hospital admission. However, the main advantage of Ag-RDTs seems to be the possibility of increasing access to the diagnosis of COVID-19 in patients with a high viral load, allowing immediate clinical management and reduction of infectivity and community transmission.


Assuntos
COVID-19 , Antígenos Virais/análise , Brasil/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , Teste para COVID-19 , Humanos , Pandemias , Sensibilidade e Especificidade
10.
PLoS One ; 17(6): e0269318, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709187

RESUMO

BACKGROUND: In early 2020, the COVID-19 pandemic paralyzed the world and exposed the fragility of health systems in the face of mass illness. Health professionals became protagonists, fulfilling their mission at the risk of physical and mental illness. The study aimed to evaluate absenteeism indirectly related to SARS-CoV-2 infection in a large population of health care professionals. METHODS: An observational longitudinal repeated measures study was performed, including workers linked to 40 public university hospitals in Brazil. All causes of absenteeism were analyzed, focusing on those not directly attributed to COVID-19. Results for the same population were compared over two equivalent time intervals: prepandemic and during the pandemic. FINDINGS: A total of 32,691 workers were included in the study, with health professionals comprising 82.5% of the sample. Comparison of the periods before and during the pandemic showed a 26.6% reduction in work absence for all causes, except for COVID-19 and mental health-related absence. Concerning work absence related to mental health, the odds ratio was 39.0% higher during the pandemic. At the onset of the pandemic, there was an increase in absenteeism (all causes), followed by a progressive reduction until the end of the observation period. INTERPRETATION: Work absence related to mental illness among health care professionals increased during the COVID-19 pandemic, highlighting the need for health care managers to prioritize and implement support strategies to minimize absenteeism.


Assuntos
COVID-19 , Brasil/epidemiologia , COVID-19/epidemiologia , Pessoal de Saúde/psicologia , Hospitais Universitários , Humanos , Saúde Mental , Pandemias , SARS-CoV-2
11.
PLoS One ; 17(6): e0270107, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709233

RESUMO

The purpose of this research was to identify risk factors that were independently related to the maintenance of a swallowing dysfunction in patients affected by critical COVID-19. We conducted a prospective observational cohort study of critical patients with COVID-19, who were admitted to a COVID-19 dedicated intensive care unit (ICU) and required prolonged orotracheal intubation (≥48 hours). Demographic and clinical data were collected at ICU admission and/or at hospital discharge or in-hospital death. Swallowing data was based on The Functional Oral Intake Scale (FOIS) and was collected at two distinct moments: initial swallowing assessment and at patient outcome. Patients were divided into two groups according to their FOIS level assigned on the last swallowing assessment: in-hospital resolved dysphagia-patients with FOIS levels 6 and 7; non-resolved dysphagia at hospital outcome-patients with FOIS levels 1 to 5. Nine hundred and twenty patients were included in our study. Results of the multivariate logistic regression model for the prediction of non-resolved dysphagia at hospital outcome in critical COVID-19 patients. indicated that increasing age (p = 0.002), severity at admission (p = 0.015), body mass index (p = 0.008), use of neuromuscular blockers (p = 0.028), presence of neurologic diseases (p = 0.038), presence of Diabetes Mellitus (p = 0.043) and lower FOIS levels on the initial swallowing assessment (p<0.001) were associated with higher chances of presenting dysphagia at hospital outcome. Critical patients with COVID-19 may experience post-acute COVID-19 dysphagia, indicating the need to prepare for the care/rehabilitation of these patients.


Assuntos
COVID-19 , Transtornos de Deglutição , Brasil/epidemiologia , COVID-19/complicações , COVID-19/epidemiologia , Transtornos de Deglutição/epidemiologia , Transtornos de Deglutição/etiologia , Surtos de Doenças , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Estudos Prospectivos
12.
PLoS One ; 17(6): e0269703, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35709301

RESUMO

BACKGROUND: Sickle cell disease (SCD) may cause several impacts to patients and the whole society. About 4% of the population has the sickle cell trait in Brazil, and 60,000 to 100,000 have SCD. However, despite recognizing the significant burden of disease, little is known about SCD costs. OBJECTIVE: To estimate SCD societal costs based on disease burden modelling, under Brazilian societal perspective. METHODS: A disease burden model was built considering the societal perspective and a one-year time horizon, including direct medical and indirect costs (morbidity and mortality). The sum of life lost and disability years was considered to estimate disability-adjusted life years (DALYs). Data from a public database (DATASUS) and the prevalence obtained from literature or medical experts were used to define complications prevalence and duration. Costs were defined using data from the Brazilian public healthcare system table of procedures and medications (SIGTAP) and the human capital method. RESULTS: Annual SCD cost was 413,639,180 USD. Indirect cost accounted for the majority of burden (70.1% of the total; 290,158,365 USD vs 123,480,816 USD). Standard of care and chronic complications were the main source of direct costs among adults, while acute conditions were the main source among children. Vaso-occlusive crisis represented the complication with the highest total cost per year in both populations, 11,400,410 USD among adults and 11,510,960 USD among children. CONCLUSIONS: SCD management may impose an important economic burden on Brazilian society that may reach more than 400 million USD per year.


Assuntos
Anemia Falciforme , Custos de Cuidados de Saúde , Adulto , Anemia Falciforme/epidemiologia , Brasil/epidemiologia , Criança , Efeitos Psicossociais da Doença , Estresse Financeiro , Humanos
13.
Front Cell Infect Microbiol ; 12: 893501, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35694546

RESUMO

The zoonotic transmission of sporotrichosis due to Sporothrix brasiliensis occurs largely in Rio de Janeiro state, Brazil since the 1990´s. Most patients infected with S. brasiliensis respond well to itraconazole or terbinafine. However, a few patients have a slow response or do not respond to the treatment and develop a chronic infection. The aim of this study was to analyze strains of S. brasiliensis against five different drugs to determine minimal inhibitory concentration distributions, to identify non-wild type strains to any drug evaluated and the clinical aspects of infections caused by them. This study evaluated 100 Sporothrix spp. strains obtained from 1999 to 2018 from the Evandro Chagas National Institute of Infectious Diseases, Fiocruz, which were identified through a polymerase chain reaction using specific primers for species identification. Two-fold serial dilutions of stock solutions of amphotericin B, itraconazole, posaconazole, ketoconazole and terbinafine prepared in dimethyl sulfoxide were performed to obtain working concentrations of antifungal drugs ranging from 0.015 to 8.0 mg/L. The broth microdilution reference method was performed according the M38-A2 CLSI guideline. All strains were identified as S. brasiliensis and thirteen were classified as non-wild type, two of them against different drugs. Non-wild type strains were identified throughout the entire study period. Patients infected by non-wild type strains presented prolonged treatment times, needed increased antifungal doses than those described in the literature and one of them presented a permanent sequel. In addition, three of them, with immunosuppression, died from sporotrichosis. Despite the broad use of antifungal drugs in hyperendemic areas of sporotrichosis, an emergence of non-wild type strains did not occur. The results of in vitro antifungal susceptibility tests should guide sporotrichosis therapy, especially in immunosuppressed patients.


Assuntos
Sporothrix , Esporotricose , Antifúngicos/farmacologia , Antifúngicos/uso terapêutico , Brasil/epidemiologia , Humanos , Itraconazol/farmacologia , Itraconazol/uso terapêutico , Testes de Sensibilidade Microbiana , Sporothrix/genética , Esporotricose/tratamento farmacológico , Esporotricose/epidemiologia , Esporotricose/microbiologia , Terbinafina/uso terapêutico
14.
PLoS Genet ; 18(6): e1010174, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35653335

RESUMO

Non-typhoidal Salmonella enterica is a common cause of diarrhoeal disease; in humans, consumption of contaminated poultry meat is believed to be a major source. Brazil is the world's largest exporter of chicken meat globally, and previous studies have indicated the introduction of Salmonella serovars through imported food products from Brazil. Here we provide an in-depth genomic characterisation and evolutionary analysis to investigate the most prevalent serovars and antimicrobial resistance (AMR) in Brazilian chickens and assess the impact to public health of products contaminated with S. enterica imported into the United Kingdom from Brazil. To do so, we examine 183 Salmonella genomes from chickens in Brazil and 357 genomes from humans, domestic poultry and imported Brazilian poultry products isolated in the United Kingdom. S. enterica serovars Heidelberg and Minnesota were the most prevalent serovars in Brazil and in meat products imported from Brazil into the UK. We extended our analysis to include 1,259 publicly available Salmonella Heidelberg and Salmonella Minnesota genomes for context. The Brazil genomes form clades distinct from global isolates, with temporal analysis suggesting emergence of these Salmonella Heidelberg and Salmonella Minnesota clades in the early 2000s, around the time of the 2003 introduction of the Enteritidis vaccine in Brazilian poultry. Analysis showed genomes within the Salmonella Heidelberg and Salmonella Minnesota clades shared resistance to sulphonamides, tetracyclines and beta-lactams conferred by sul2, tetA and blaCMY-2 genes, not widely observed in other co-circulating serovars despite similar selection pressures. The sul2 and tetA genes were concomitantly carried on IncC plasmids, whereas blaCMY-2 was either co-located with the sul2 and tetA genes on IncC plasmids or independently on IncI1 plasmids. Long-term surveillance data collected in the UK showed no increase in the incidence of Salmonella Heidelberg or Salmonella Minnesota in human cases of clinical disease in the UK following the increase of these two serovars in Brazilian poultry. In addition, almost all of the small number of UK-derived genomes which cluster with the Brazilian poultry-derived sequences could either be attributed to human cases with a recent history of foreign travel or were from imported Brazilian food products. These findings indicate that even should Salmonella from imported Brazilian poultry products reach UK consumers, they are very unlikely to be causing disease. No evidence of the Brazilian strains of Salmonella Heidelberg or Salmonella Minnesota were observed in UK domestic chickens. These findings suggest that introduction of the Salmonella Enteritidis vaccine, in addition to increasing antimicrobial use, could have resulted in replacement of salmonellae in Brazilian poultry flocks with serovars that are more drug resistant, but less associated with disease in humans in the UK. The plasmids conferring resistance to beta-lactams, sulphonamides and tetracyclines likely conferred a competitive advantage to the Salmonella Minnesota and Salmonella Heidelberg serovars in this setting of high antimicrobial use, but the apparent lack of transfer to other serovars present in the same setting suggests barriers to horizontal gene transfer that could be exploited in intervention strategies to reduce AMR. The insights obtained reinforce the importance of One Health genomic surveillance.


Assuntos
Salmonella enterica , Animais , Antibacterianos/farmacologia , Brasil/epidemiologia , Galinhas , Farmacorresistência Bacteriana/genética , Aves Domésticas , Saúde Pública , Salmonella , Salmonella enterica/genética , Sulfonamidas , Tetraciclinas , beta-Lactamas
15.
PLoS Negl Trop Dis ; 16(6): e0010441, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35679262

RESUMO

Chikungunya, a mosquito-borne disease, is a growing threat in Brazil, where over 640,000 cases have been reported since 2017. However, there are often long delays between diagnoses of chikungunya cases and their entry in the national monitoring system, leaving policymakers without the up-to-date case count statistics they need. In contrast, weekly data on Google searches for chikungunya is available with no delay. Here, we analyse whether Google search data can help improve rapid estimates of chikungunya case counts in Rio de Janeiro, Brazil. We build on a Bayesian approach suitable for data that is subject to long and varied delays, and find that including Google search data reduces both model error and uncertainty. These improvements are largest during epidemics, which are particularly important periods for policymakers. Including Google search data in chikungunya surveillance systems may therefore help policymakers respond to future epidemics more quickly.


Assuntos
Febre de Chikungunya , Vírus Chikungunya , Animais , Teorema de Bayes , Brasil/epidemiologia , Febre de Chikungunya/epidemiologia , Incidência , Ferramenta de Busca
16.
J Surg Oncol ; 126(1): 10-19, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35689574

RESUMO

BACKGROUND: Risk-reducing operations are an important part of the management of hereditary predisposition to cancer. In selected cases, they can considerably reduce the morbidity and mortality associated with cancer in this population. OBJECTIVES: The Brazilian Society of Surgical Oncology (BSSO) developed this guideline to establish national benchmarks for cancer risk-reducing operations. METHODS: The guideline was prepared from May to December 2021 by a multidisciplinary team of experts to discuss the surgical management of cancer predisposition syndromes. Fourteen questions were defined and assigned to expert groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments, classified the level of evidence, and voted on the recommendations. RESULTS: For all questions including risk-reduction bilateral salpingo-oophorectomy, hysterectomy, and mastectomy, major agreement was achieved by the participants, always using accessible alternatives. CONCLUSION: This and its accompanying article represent the first guideline in cancer risk reduction surgery developed by the BSSO, and it should serve as an important reference for the management of families with cancer predisposition.


Assuntos
Neoplasias da Mama , Ginecologia , Neoplasias Ovarianas , Oncologia Cirúrgica , Brasil/epidemiologia , Neoplasias da Mama/genética , Neoplasias da Mama/prevenção & controle , Neoplasias da Mama/cirurgia , Feminino , Humanos , Mastectomia , Neoplasias Ovarianas/cirurgia
17.
J Surg Oncol ; 126(1): 28-36, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35689577

RESUMO

The management of colorectal cancer liver metastasis (CRLM) has become complex because of the increasing availability of medical, radiological, and surgical treatment options applied either alone or in combination. However, resection remains the only evidence-based curative therapy. These Brazilian Society of Surgical Oncology surgical standards are intended to guide clinicians in the decision-making process for modern surgical management of CRLM within a multidisciplinary team in an evidence-based framework, focusing on resectable disease.


Assuntos
Neoplasias Colorretais , Neoplasias Hepáticas , Oncologia Cirúrgica , Brasil/epidemiologia , Neoplasias Colorretais/patologia , Hepatectomia , Humanos , Neoplasias Hepáticas/secundário
18.
J Surg Oncol ; 126(1): 20-27, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35689578

RESUMO

BACKGROUND: Risk-reducing operations are an important part of the management of hereditary predisposition to cancer. In selected cases, they can considerably reduce the morbidity and mortality associated with cancer in this population. OBJECTIVES: The Brazilian Society of Surgical Oncology (BSSO) developed this guideline to establish national benchmarks for cancer risk-reducing operations. METHODS: The guideline was prepared from May to December 2021 by a multidisciplinary team of experts to discuss the surgical management of cancer predisposition syndromes. Eleven questions were defined and assigned to expert groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments, classified the level of evidence, and voted on the recommendations. RESULTS: For all questions including risk-reducing colectomy, gastrectomy, and thyroidectomy, a major agreement was achieved by the participants, always using accessible alternatives. CONCLUSION: This and its accompanying article represent the first guideline in cancer risk reduction surgery developed by the BSSO and it should serve as an important reference for the management of families with cancer predisposition.


Assuntos
Neoplasias , Oncologia Cirúrgica , Brasil/epidemiologia , Humanos , Glândula Tireoide
19.
J Surg Oncol ; 126(1): 168-174, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35689580

RESUMO

BACKGROUND AND OBJECTIVES: Incidence of pancreatic neuroendocrine tumors (pNETS) seems to be rising over the years, with many cases incidentally diagnosed. Surgery and active surveillance are current treatment modalities for small pNETS. We review our institutional series and compare outcomes for small asymptomatic and nonfunctioning tumors. METHODS: This retrospective cohort study included patients with 2 cm or less and well differentiated pNETS at a single Brazilian Cancer Center. From 2002 to 2020, patients received active surveillance or surgery as a treatment strategy. Short and long-term results were compared. RESULTS: Sixty-four patients were included, 41 in surgical strategy and 23 in the active surveillance approach. Baseline group characteristics were comparable. More patients on active surveillance underwent abdominal magnetic resonance imaging (MRI) and had tumors located in the pancreatic head (41% vs. 17%, p = 0.038). Minimally invasive procedure was chosen in 80.1% of the surgical patients. No patient died after surgery. Median follow-up period was 38.6 and 46.4 months for active surveillance and surgery cohorts, respectively. No difference in disease progression rate was observed. CONCLUSION: Both approaches seem to be safe for small pNETs. Long-term outcome and quality of life should be considered when discussing such options with patients.


Assuntos
Tumores Neuroectodérmicos Primitivos , Tumores Neuroendócrinos , Neoplasias Pancreáticas , Brasil/epidemiologia , Estudos de Coortes , Humanos , Tumores Neuroendócrinos/patologia , Pancreatectomia/métodos , Neoplasias Pancreáticas/patologia , Qualidade de Vida , Estudos Retrospectivos , Conduta Expectante
20.
Cad Saude Publica ; 38(5): e00022421, 2022.
Artigo em Português, Inglês | MEDLINE | ID: mdl-35703596

RESUMO

This study aimed to analyze factors associated with delay in specialized treatment after diagnosis of cervical cancer in the State of Bahia, Brazil. This was a cross-sectional hospital-based study of women treated in accredited units in the Hospital-Based Cancer Registry (HBCR) system in the State of Bahia from 2008 to 2017. A descriptive analysis and logistic regression were performed with backward stepwise modeling to estimate crude and adjusted prevalence ratios (PR), defining statistical significance as p ≤ 0.05 in Pearson's chi-square test. We analyzed 9,184 cases, and 65% had delayed treatment (time between diagnosis and first treatment > 60 days). Delayed treatment was more prevalent among women 65 years or older (PR = 1.30; 95%CI: 1.21-1.39), with no schooling (PR = 1.24; 95%CI: 1.15-1.33), and in advanced stages (PR = 1.17; 95%CI: 1.13-1.21). Most of the cases analyzed had delayed treatment, more prevalent among older women, with less schooling, and advanced tumor stages, highlighting the need to expand access to cancer treatment services in Bahia state, especially for these groups in worse conditions.


Este estudo teve o objetivo de analisar os fatores associados ao tratamento especializado em tempo inoportuno após diagnóstico do câncer do colo do útero no Estado da Bahia, Brasil. Trata-se de um estudo de base hospitalar, de corte transversal, realizado com mulheres tratadas em unidades credenciadas ao sistema de Registro Hospitalar de Câncer (RHC) do Estado da Bahia, no período de 2008 a 2017. Foi realizada análise descritiva e regressão logística, construída na modelagem stepwise backward, para estimar as razões de prevalência (RP) bruta e ajustada, sendo consideradas estatisticamente significantes aquelas com o valor de p ≤ 0,05 pelo teste qui-quadrado de Pearson. Foram analisados 9.184 casos, destes, 65% tiveram tratamento em tempo inoportuno (tempo transcorrido entre o diagnóstico e o primeiro tratamento > 60 dias). A prevalência de tratamento em tempo inoportuno apresentou valores mais elevados entre mulheres com 65 anos ou mais (RP = 1,30; IC95%: 1,21-1,39), nenhuma escolaridade (RP = 1,24; IC95%: 1,15-1,33) e estadiamento avançado (RP = 1,17; IC95%: 1,13-1,21). Na maioria dos casos analisados, houve tratamento em tempo inoportuno, com maior prevalência entre as mulheres com mais idade, menor escolaridade e estadiamento clínico do tumor avançado, evidenciando a necessidade de ampliação do acesso aos serviços de tratamento oncológico no Estado da Bahia, em especial para estes grupos que apresentaram pior situação.


El objetivo de este estudio fue analizar los factores asociados al tratamiento especializado en un tiempo inadecuado, tras el diagnóstico del cáncer de cuello de útero en el estado da Bahía, Brasil. Se trata de un estudio con base hospitalaria, de corte transversal, realizado con mujeres tratadas en unidades acreditadas en el sistema de Registro Hospitalario de Cáncer (RHC) del estado de Bahía, en el período de 2008 a 2017. Se realizó un análisis descriptivo y regresión logística, construida en el modelado stepwise backward, para estimar las razones de prevalencia (RP) bruta y ajustada, siendo consideradas estadísticamente significativas aquellas con el valor de p ≤ 0,05, mediante el test chi-cuadrado de Pearson. Todos los análisis fueron procesados en el programa Stata versión 16.0. Se analizaron 9.184 casos, de estos, un 65% tuvieron tratamiento en un tiempo inadecuado (tiempo transcurrido entre el diagnóstico y el primer tratamiento > 60 días). La prevalencia de tratamiento en tiempo inoportuno presentó valores más elevados entre mujeres con 65 años o más (RP = 1,30; IC95%: 1,21-1,39), ninguna escolaridad (RP = 1,24; IC95%: 1,15-1,33) y estadio avanzado (RP = 1,17; IC95%: 1,13-1,21). En la mayoría de los casos analizados, hubo tratamiento en un tiempo inadecuado, con mayor prevalencia entre las mujeres con más edad, menor escolaridad y estadio clínico del tumor avanzado, evidenciando la necesidad de una ampliación del acceso a los servicios de tratamiento oncológico en el estado de Bahía, en especial para estos grupos que presentaron peor situación.


Assuntos
Neoplasias do Colo do Útero , Idoso , Brasil/epidemiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Prevalência , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/terapia
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