RESUMO
Dengue is an ongoing health risk for Peace Corps Volunteers (PCVs) working in the tropics. On May 2019, the Peace Corps Office of Health Services notified the Centers for Disease Control and Prevention (CDC) of a dengue outbreak among PCVs in Timor-Leste. The purpose of this investigation was to identify the clinical, demographic, and epidemiological characteristics of PCVs with dengue and recommend dengue preventive measures. To identify PCVs with dengue and describe disease severity, the medical records of PCVs reporting fever during September 2018-June 2019 were reviewed. To identify factors associated with dengue virus (DENV) infection, we administered a questionnaire on demographics, travel history, and mosquito avoidance behaviors and collected blood specimens to detect the anti-DENV IgM antibody to diagnose recent infection. Of 35 PCVs in-country, 11 (31%) tested positive for dengue (NS1, IgM, PCR), eight requiring hospitalization and medical evacuation. Among 27 (77%) PCVs who participated in the investigation, all reported having been recently bitten by mosquitoes and 56% reported being bitten most often at home; only 16 (59%) reported having screens on bedroom windows. Nearly all (93%) PCVs reported using a bed net every night; fewer (70%) reported using mosquito repellent at least once a day. No behaviors were significantly associated with DENV infection. Raising awareness of dengue risk among PCVs and continuing to encourage mosquito avoidance behavior to prevent dengue is critical. Access to and use of measures to avoid mosquito bites should be improved or implemented. Peace Corps medical officers should continue to receive an annual refresher training on dengue clinical management.
Assuntos
Dengue/epidemiologia , Peace Corps/estatística & dados numéricos , Voluntários/estatística & dados numéricos , Adulto , Idoso , Animais , Culicidae/virologia , Dengue/transmissão , Surtos de Doenças , Feminino , Humanos , Imunoglobulina M/sangue , Mordeduras e Picadas de Insetos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários , Timor-Leste/epidemiologia , Viagem , Estados Unidos , Adulto JovemRESUMO
Tobacco use among adolescents is a global problem of public health importance. This study examined the profile of differences and similarities in adolescent tobacco use, and the role of parental monitoring activities among adolescents in three island nations of varying economic status: Cook Islands, Curaçao, and East Timor. Using nationally representative data we conducted regression modeling to determine the effect of four types of parental monitoring activities on tobacco use. Within a recall period of 30 days prior to being surveyed, 29.7% of students in East Timor, 21.6% in Cook Islands, and 13.1% in Curaçao reported having smoked cigarettes and/or used tobacco in other forms during 1 or more days during the preceding 30 days. Lower rates of parental monitoring as measured by four variables (parental understanding of problems and worries; knowing about how free time was being spent; going over things without approval; and checking to see if homework was done) were associated with higher percentages of adolescent tobacco use. Taken together the results underscore the need for increased parental involvement in programs which are designed to reduce tobacco use among adolescents.
Assuntos
Modelos Estatísticos , Relações Pais-Filho , Fumar , Uso de Tabaco , Adolescente , Curaçao/epidemiologia , Feminino , Humanos , Masculino , Poder Familiar , Polinésia/epidemiologia , Análise de Regressão , Fumar/epidemiologia , Inquéritos e Questionários , Timor-Leste/epidemiologia , Uso de Tabaco/epidemiologiaRESUMO
OBJECTIVE: To explore whether the climate has played a role in the COVID-19 outbreak, we compared virus lethality in countries closer to the Equator with others. Lethality in European territories and in territories of some nations with a non-temperate climate was also compared. MATERIALS AND METHODS: Lethality was calculated as the rate of deaths in a determinate moment from the outbreak of the pandemic out of the total of identified positives for COVID-19 in a given area/nation, based on the COVID-John Hopkins University website. Lethality of countries located within the 5th parallels North/South on 6 April and 6 May 2020, was compared with that of all the other countries. Lethality in the European areas of The Netherlands, France and the United Kingdom was also compared to the territories of the same nations in areas with a non-temperate climate. RESULTS: A lower lethality rate of COVID-19 was found in Equatorial countries both on April 6 (OR=0.72 CI 95% 0.66-0.80) and on May 6 (OR=0.48, CI 95% 0.47-0.51), with a strengthening over time of the protective effect. A trend of higher risk in European vs. non-temperate areas was found on April 6, but a clear difference was evident one month later: France (OR=0.13, CI 95% 0.10-0.18), The Netherlands (OR=0.5, CI 95% 0.3-0.9) and the UK (OR=0.2, CI 95% 0.01-0.51). This result does not seem to be totally related to the differences in age distribution of different sites. CONCLUSIONS: The study does not seem to exclude that the lethality of COVID-19 may be climate sensitive. Future studies will have to confirm these clues, due to potential confounding factors, such as pollution, population age, and exposure to malaria.
Assuntos
Clima , Infecções por Coronavirus/mortalidade , Pneumonia Viral/mortalidade , Estações do Ano , Tempo (Meteorologia) , Betacoronavirus , Brunei/epidemiologia , Burundi/epidemiologia , COVID-19 , Congo/epidemiologia , Infecções por Coronavirus/epidemiologia , Equador/epidemiologia , Guiné Equatorial/epidemiologia , Europa (Continente) , França/epidemiologia , Gabão/epidemiologia , Humanos , Ilhas do Oceano Índico/epidemiologia , Indonésia/epidemiologia , Quênia/epidemiologia , Malásia/epidemiologia , Melanesia/epidemiologia , Micronésia/epidemiologia , Países Baixos/epidemiologia , Pandemias , Papua Nova Guiné/epidemiologia , Pneumonia Viral/epidemiologia , Ruanda/epidemiologia , SARS-CoV-2 , Samoa/epidemiologia , São Tomé e Príncipe/epidemiologia , Seicheles/epidemiologia , Singapura/epidemiologia , Somália/epidemiologia , Timor-Leste/epidemiologia , Clima Tropical , Uganda/epidemiologia , Reino Unido/epidemiologiaAssuntos
Acessibilidade aos Serviços de Saúde , Disparidades em Assistência à Saúde/etnologia , Segurança do Paciente , Migrantes , Adulto , Idoso , Angola/etnologia , Brasil/etnologia , Cabo Verde/etnologia , Feminino , Grupos Focais , Guiné-Bissau/etnologia , Humanos , Idioma , Londres , Masculino , Pessoa de Meia-Idade , Moçambique/etnologia , Portugal/etnologia , São Tomé e Príncipe/etnologia , Timor-Leste/etnologiaRESUMO
Dengue transmission has been known in East Timor since 2005, but the country is not equipped with an Aedes aegypti mosquito monitoring and control program. This study aimed to evaluate the baited ovitrap as a possible tool to monitor the arbovirus vector Dengue (DENV), Chikungunya (CHIKV) and Zika (ZIKV) and was conducted in the city of Dili, capital of East-Timor, between epidemiological weeks 32 (02/08) and 48 (02/12) of 2016. In total, 70 ovitraps were installed in residences scattered throughout fifteen streets of four Administrative Posts (districts) of the city. The following entomological indicators were used: Ovitrap Positivity Index (OPI), Vector Density Index (VDI), and Egg Density Index (EDI). A total of 158.904 eggs were collected during the experiment. The OPI showed that 98-100% of traps contained Aedes spp. in all areas of the study. The EDI and OPI indicators were positively and significantly correlated with the temperature. The two- and three-week lag for rainfall indicated a significant positive correlation for VDI and EDI. Therefore, the ovitrap is a tool that can integrate the actions of an Aedes spp. monitoring and control program in East-Timor.
A dengue ocorre no Timor-Leste desde 2005, porém não existe um programa de monitoramento e controle do "Aedes aegypti". O objetivo deste estudo foi de avaliar a armadilha ovitrampa iscada com atraente natural como uma possível ferramenta para monitorar o vetor das arboviroses: Dengue (DENV), Chikungunya (CHIKV) e Zika (ZIKV). O estudo foi realizado na cidade de Dili, capital do Timor-Leste, entre as semanas epidemiológicas 32 (02/08) a 48 (02/12) de 2016. Foram instaladas 70 armadilhas Ovitrampa, em residências de 15 sucos (ruas), de quatro Postos Administrativos (bairros) da cidade. Para as analises dos dados utilizou-se os indicadores entomológicos: Índice de Positividade de Ovitrampa (IPO), Índice de Densidade Vetorial (IDV) e Índice de Densidade de Ovos (IDO). Durante o experimento foram coletados 158.904 ovos de Aedes spp.. O IPO demonstrou que todas as áreas tiveram 98% a 100% de armadilhas contendo ovos de Aedes spp.. Os indicadores IDO e IPO apresentaram correlações positivas e significativa com a temperatura. A defasagem de duas e três semanas para precipitação indicou correlação positiva significativa para IDV e IDO. Portanto, a armadilha ovitrampa é uma ferramenta que pode integrar as ações de um programa de monitoramento e controle de Aedes spp. no Timor-Leste.
Assuntos
Aedes/virologia , Controle de Mosquitos/métodos , Mosquitos Vetores/virologia , Aedes/fisiologia , Animais , Febre de Chikungunya/prevenção & controle , Febre de Chikungunya/transmissão , Vírus Chikungunya/isolamento & purificação , Dengue/prevenção & controle , Dengue/transmissão , Vírus da Dengue/isolamento & purificação , Feminino , Humanos , Oviposição , Timor-Leste , Zika virus/isolamento & purificação , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissãoRESUMO
Resumo A dengue ocorre no Timor-Leste desde 2005, porém não existe um programa de monitoramento e controle do "Aedes aegypti". O objetivo deste estudo foi de avaliar a armadilha ovitrampa iscada com atraente natural como uma possível ferramenta para monitorar o vetor das arboviroses: Dengue (DENV), Chikungunya (CHIKV) e Zika (ZIKV). O estudo foi realizado na cidade de Dili, capital do Timor-Leste, entre as semanas epidemiológicas 32 (02/08) a 48 (02/12) de 2016. Foram instaladas 70 armadilhas Ovitrampa, em residências de 15 sucos (ruas), de quatro Postos Administrativos (bairros) da cidade. Para as analises dos dados utilizou-se os indicadores entomológicos: Índice de Positividade de Ovitrampa (IPO), Índice de Densidade Vetorial (IDV) e Índice de Densidade de Ovos (IDO). Durante o experimento foram coletados 158.904 ovos de Aedes spp.. O IPO demonstrou que todas as áreas tiveram 98% a 100% de armadilhas contendo ovos de Aedes spp.. Os indicadores IDO e IPO apresentaram correlações positivas e significativa com a temperatura. A defasagem de duas e três semanas para precipitação indicou correlação positiva significativa para IDV e IDO. Portanto, a armadilha ovitrampa é uma ferramenta que pode integrar as ações de um programa de monitoramento e controle de Aedes spp. no Timor-Leste.
Assuntos
Humanos , Animais , Feminino , Controle de Mosquitos/métodos , Aedes/virologia , Mosquitos Vetores/virologia , Oviposição , Vírus Chikungunya/isolamento & purificação , Aedes/fisiologia , Dengue/prevenção & controle , Dengue/transmissão , Vírus da Dengue/isolamento & purificação , Timor-Leste , Febre de Chikungunya/prevenção & controle , Febre de Chikungunya/transmissão , Zika virus/isolamento & purificação , Infecção por Zika virus/prevenção & controle , Infecção por Zika virus/transmissãoRESUMO
Dramatic shifts are occurring in the size, shape and skill of rural health workforces in Pacific island countries (PICs) due to an unprecedented convergence of political agreement, policy commitment, donor support and technical assistance. In particular, the impact of "medical internationalism" is being felt across the Pacific region, with new doctors returning home in far greater numbers than ever before, the majority having graduated from medical schools in Cuba, China and other countries outside the region, in addition to the more typical numbers graduating and returning home from the region's main medical schools in Fiji and Papua New Guinea. With an agreed regional vision of "Healthy Islands" across the Pacific, the main objective of expanding overseas training opportunities for Pacific island medical students has been to correct the widespread centralization and maldistribution of the medical workforce in PICs and improve health access and quality of care in rural areas by deploying the new graduates to outer-island facilities. However, the return of these new graduates in several PICs has demonstrated that additional training is required to equip them with the knowledge and skills necessary to practice safely and sustainably in unsupervised settings. Thus, the development of specific postgraduate programmes has been urgently needed to provide pathways to vocational training and specialization in rural medicine appropriate to the Pacific region. Rocketship Pacific Ltd. (Rocketship) is an international health charity, based in Australia, dedicated to improving health in Pacific island countries through stronger primary care. Rocketship's particular focus to date has been on education and capacity-building for doctors and nurses working in rural communities and outer-island facilities. Since 2015, Rocketship has been working in partnership with the Ministries of Health and other key partners in Solomon Islands, Timor-Leste, Tonga and Vanuatu to design and deliver postgraduate training programmes in the core generalist disciplines family, community and rural hospital medicine. To date, this has resulted in new postgraduate Family Medicine courses being established in Timor-Leste and Tonga; a rural medical workforce support programme being delivered in Vanuatu; and a new Postgraduate Diploma in Rural Generalist Medicine being designed in Solomon Islands. These new programmes, as well as other notable initiatives elsewhere in the Pacific such as the Master of Medicine (Rural) programme in Papua New Guinea, the Diploma and Master of Family Medicine programme in Fiji and the Cook Islands Fellowship in General Practice, are transforming the health workforce in PICs with the potential to benefit island people across the "Blue Continent." This paper describes the establishment of new postgraduate training programmes in family, community and rural hospital medicine in Timor-Leste, Tonga, Solomon Islands and Vanuatu from the perspective of Rocketship, the non-profit organization engaged by each country's Ministry of Health (or equivalent) to provide expert technical assistance with their initiative.
Assuntos
Mão de Obra em Saúde , População Rural , Austrália , China , Cuba , Fiji , Humanos , Melanesia , Ilhas do Pacífico , Papua Nova Guiné , Polinésia , Saúde da População Rural , Timor-Leste , Tonga , Vanuatu , Recursos HumanosAssuntos
Atenção à Saúde/história , Mortalidade Materna/tendências , Atenção Primária à Saúde/organização & administração , Cuba , Atenção à Saúde/estatística & dados numéricos , Surtos de Doenças/estatística & dados numéricos , Feminino , Acessibilidade aos Serviços de Saúde/normas , História do Século XX , História do Século XXI , Humanos , Expectativa de Vida/tendências , Gravidez , Atenção Primária à Saúde/estatística & dados numéricos , Timor-Leste/epidemiologiaRESUMO
BACKGROUND: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic development patterns that differ from that of Portugal. OBJECTIVE: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and 2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI). METHODS: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed international standards for death certification, through information systems on vital statistics and mortality surveillance, surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational attainment and total fertility rate) were estimated for each country. A p-value <0.05 was considered significant. RESULTS: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for CVD among all PSC are hypertension and dietary factors. CONCLUSION: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those countries.
Assuntos
Doenças Cardiovasculares/mortalidade , Carga Global da Doença/estatística & dados numéricos , Angola/epidemiologia , Brasil/epidemiologia , Cabo Verde/epidemiologia , Causas de Morte , Guiné Equatorial/epidemiologia , Feminino , Guiné-Bissau/epidemiologia , Humanos , Expectativa de Vida , Masculino , Morbidade , Moçambique/epidemiologia , Portugal/epidemiologia , Fatores de Risco , São Tomé e Príncipe/epidemiologia , Fatores Socioeconômicos , Fatores de Tempo , Timor-Leste/epidemiologiaRESUMO
Abstract Background: Portuguese-speaking countries (PSC) share the influence of the Portuguese culture but have socioeconomic development patterns that differ from that of Portugal. Objective: To describe trends in cardiovascular disease (CVD) morbidity and mortality in the PSC between 1990 and 2016, stratified by sex, and their association with the respective sociodemographic indexes (SDI). Methods: This study used the Global Burden of Disease (GBD) 2016 data and methodology. Data collection followed international standards for death certification, through information systems on vital statistics and mortality surveillance, surveys, and hospital registries. Techniques were used to standardize causes of death by the direct method, as were corrections for underreporting of deaths and garbage codes. To determine the number of deaths due to each cause, the CODEm (Cause of Death Ensemble Model) algorithm was applied. Disability-adjusted life years (DALYs) and SDI (income per capita, educational attainment and total fertility rate) were estimated for each country. A p-value <0.05 was considered significant. Results: There are large differences, mainly related to socioeconomic conditions, in the relative impact of CVD burden in PSC. Among CVD, ischemic heart disease was the leading cause of death in all PSC in 2016, except for Mozambique and Sao Tome and Principe, where cerebrovascular diseases have supplanted it. The most relevant attributable risk factors for CVD among all PSC are hypertension and dietary factors. Conclusion: Collaboration among PSC may allow successful experiences in combating CVD to be shared between those countries.
Resumo Fundamento: Os países de língua portuguesa (PLP) partilham a influência da cultura portuguesa com desenvolvimento socioeconômico diverso de Portugal. Objetivo: Descrever as tendências de morbidade e mortalidade por doenças cardiovasculares (DCV) nos PLP, entre 1990 e 2016, estratificadas por sexo, e sua associação com os respectivos índices sociodemográficos (SDI). Métodos: O estudo utilizou dados e metodologia do Global Burden of Disease (GBD) 2016. As informações seguiram padrões internacionais de certificação de óbito, através de sistemas de informação sobre estatísticas vitais e vigilância da mortalidade, pesquisas e registros hospitalares. Empregaram-se técnicas para padronização das causas de morte pelo método direto, e correções para sub-registro dos óbitos e garbage codes. Para determinar o número de mortes por cada causa, aplicou-se o algoritmo CODEm (Modelagem Agrupada de Causas de Morte). Estimaram-se os anos saudáveis de vida perdidos (DALYs) e o SDI (renda per capita, nível de escolaridade e taxa de fertilidade total) para cada país. Resultados: Existem grandes diferenças na importância relativa da carga de DCV nos PLP relacionadas principalmente às condições socioeconômicas. Entre as DCV, a doença isquêmica do coração foi a principal causa de morte nos PLP em 2016, com exceção de Moçambique e São Tomé e Príncipe, onde as doenças cerebrovasculares a suplantaram. Os fatores de risco atribuíveis mais relevantes para as DCV entre os PLP foram a hipertensão arterial e os fatores dietéticos. Um valor de p < 0,05 foi considerado significativo. Conclusão: A colaboração entre os PLP poderá permitir que experiências exitosas no combate às DCV sejam compartilhadas entre esses países.
Assuntos
Humanos , Masculino , Feminino , Doenças Cardiovasculares/mortalidade , Carga Global da Doença/estatística & dados numéricos , Portugal/epidemiologia , Fatores Socioeconômicos , Fatores de Tempo , Brasil/epidemiologia , Fatores de Risco , Expectativa de Vida , Morbidade , Causas de Morte , Guiné Equatorial/epidemiologia , Timor-Leste/epidemiologia , Cabo Verde/epidemiologia , São Tomé e Príncipe/epidemiologia , Guiné-Bissau/epidemiologia , Angola/epidemiologia , Moçambique/epidemiologiaRESUMO
Se realizó un estudio observacional y analítico, de casos y controles, pareados por sexo y edad, de 126 pacientes ingresados en la sala de aislamiento del Hospital Nacional Guido Valadares, en Dili, Timor Oriental, durante el año 2015, con vistas a determinar los factores de riesgo asociados a la tuberculosis pulmonar en ellos. El grupo de casos, de 42 integrantes, incluyó a los recién diagnosticados con tuberculosis y a los que presentaron recaída, fallo terapéutico, resistencia a múltiples fármacos, así como padecimiento previo de la afección con secuelas (bronquiectasias concomitantes con infección, hemoptisis); en tanto, el grupo de controles lo conformaron 84 pacientes con entidades respiratorias no tuberculosas. De las variables analizadas, la presencia de alcoholismo, la desnutrición, el contacto íntimo con pacientes cuya baciloscopia dio positiva y el ser recluso o ex-recluso, fueron los factores de riesgo de mayor asociación causal y estadística en el contagio de la enfermedad y constituyeron los resultados más relevantes de esta (AU)
An observational, analytic and cases-controls study of 126 patients paired by sex and age, admitted to the isolation room of Guido Valadares National Hospital, in Dili, East Timor, was carried out during 2015, aimed at determining the risk factors associated with lung tuberculosis in them. The cases group with 42 members, included those recently diagnosed with tuberculosis and those that presented relapse, therapeutic failure, resistance to multiple drugs, as well as previous suffering of the disorder with sequelae (concomitant bronchiectasis with infection, hemoptysis); as long as, the control group was conformed by 84 patients with non tuberculous breathing entities. Of the analyzed variables, the presence of alcoholism, malnutrition, intimate contact with patients whose baciloscopia was positive and being prisoner or former-prisoner, were the risk factors of more causal and statistical association in the infection of the disease and constituted the most outstanding results in this investigation(AU)
Assuntos
Humanos , Masculino , Feminino , Tuberculose Pulmonar , Mycobacterium tuberculosis , Timor-Leste , Fatores de Risco , Estudo ObservacionalRESUMO
Se realizó un estudio observacional y analítico, de casos y controles, pareados por sexo y edad, de 126 pacientes ingresados en la sala de aislamiento del Hospital Nacional Guido Valadares, en Dili, Timor Oriental, durante el año 2015, con vistas a determinar los factores de riesgo asociados a la tuberculosis pulmonar en ellos. El grupo de casos, de 42 integrantes, incluyó a los recién diagnosticados con tuberculosis y a los que presentaron recaída, fallo terapéutico, resistencia a múltiples fármacos, así como padecimiento previo de la afección con secuelas (bronquiectasias concomitantes con infección, hemoptisis); en tanto, el grupo de controles lo conformaron 84 pacientes con entidades respiratorias no tuberculosas. De las variables analizadas, la presencia de alcoholismo, la desnutrición, el contacto íntimo con pacientes cuya baciloscopia dio positiva y el ser recluso o ex-recluso, fueron los factores de riesgo de mayor asociación causal y estadística en el contagio de la enfermedad y constituyeron los resultados más relevantes de esta investigación
An observational, analytic and cases-controls study of 126 patients paired by sex and age, admitted to the isolation room of Guido Valadares National Hospital, in Dili, East Timor, was carried out during 2015, aimed at determining the risk factors associated with lung tuberculosis in them. The cases group with 42 members, included those recently diagnosed with tuberculosis and those that presented relapse, therapeutic failure, resistance to multiple drugs, as well as previous suffering of the disorder with sequelae (concomitant bronchiectasis with infection, hemoptysis); as long as, the control group was conformed by 84 patients with non tuberculous breathing entities. Of the analyzed variables, the presence of alcoholism, malnutrition, intimate contact with patients whose baciloscopia was positive and being prisoner or former-prisoner, were the risk factors of more causal and statistical association in the infection of the disease and constituted the most outstanding results in this investigation
Assuntos
Humanos , Masculino , Feminino , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/epidemiologia , Mycobacterium tuberculosis , Estudos de Casos e Controles , Fatores de Risco , Timor-Leste , Estudo ObservacionalRESUMO
Se presentó un caso intervenido en el servicio de Urología del Hospital Nacional Guido Valadares de Timor Oriental, con diagnóstico de retención completa de orina, insuficiencia renal aguda obstructiva posrrenal, hidronefrosis bilateral y estenosis uretral e hipospadia, con el objetivo de demostrar el uso de la mucosa prepucial para las hipospadias que concomitan con estenosis uretral. La conducta quirúrgica consistió en una uretroplastia con mucosa prepucial. Se logró la reconstrucción total de la uretra afectada, con buenos resultados finales estéticos y funcionales. El uso de la mucosa oral fue de gran utilidad en el manejo del paciente(AU)
A case was presented in the Department of Urology of Guido Valadares National Hospital in East Timor, diagnosed with complete retention of urine, post renal, obstructive and acute renal failure, bilateral hydronephrosis and urethral stricture and hypospadias, in order to demonstrate the use of prepucial mucosa for hypospadias that concomitan with urethral stricture. The surgical treatment consisted urethroplasty with preputial mucosa. Total reconstruction of the affected urethra was done with good aesthetic and functional outcomes. The use of oral mucosa was very useful in patient management(AU)
Foi apresentado um caso no Departamento de Urologia do Hospital Nacional Guido Valadares de Timor Oriental, com diagnóstico de retenção urinária completa, insuficiência renal aguda obstrutiva pós-renal, hidronefrose bilateral e estenose e hipospádia uretral, para demonstrar a utilização da mucosa prepucial para hipospádia que coincide com estenose uretral. O procedimento cirúrgico consistiu em uma uretroplastia com mucosa prepucial. A reconstrução total da uretra afetada foi alcançada, com bons resultados estéticos e funcionais finais. O uso da mucosa oral foi muito útil no manejo do paciente(AU)
Assuntos
Humanos , Masculino , Estreitamento Uretral/diagnóstico , Hipospadia/diagnóstico , Hipospadia/cirurgia , Timor-LesteRESUMO
Se presentó un caso intervenido en el servicio de Urología del Hospital Nacional "Guido Valadares" de Timor Oriental, con diagnóstico de retención completa de orina, insuficiencia renal aguda obstructiva posrrenal, hidronefrosis bilateral y estenosis uretral e hipospadia, con el objetivo de demostrar el uso de la mucosa prepucial para las hipospadias que concomitan con estenosis uretral. La conducta quirúrgica consistió en una uretroplastia con mucosa prepucial. Se logró la reconstrucción total de la uretra afectada, con buenos resultados finales estéticos y funcionales. El uso de la mucosa oral fue de gran utilidad en el manejo del paciente(AU)
A case was presented in the Department of Urology of Guido Valadares National Hospital in East Timor, diagnosed with complete retention of urine, post renal, obstructive and acute renal failure, bilateral hydronephrosis and urethral stricture and hypospadias, in order to demonstrate the use of prepucial mucosa for hypospadias that concomitan with urethral stricture. The surgical treatment consisted urethroplasty with preputial mucosa. Total reconstruction of the affected urethra was done with good aesthetic and functional outcomes. The use of oral mucosa was very useful in patient management(AU)
Foi apresentado um caso no Departamento de Urologia do Hospital Nacional "Guido Valadares" de Timor Oriental, com diagnóstico de retenção urinária completa, insuficiência renal aguda obstrutiva pós-renal, hidronefrose bilateral e estenose e hipospádia uretral, para demonstrar a utilização da mucosa prepucial para hipospádia que coincide com estenose uretral. O procedimento cirúrgico consistiu em uma uretroplastia com mucosa prepucial. A reconstrução total da uretra afetada foi alcançada, com bons resultados estéticos e funcionais finais. O uso da mucosa oral foi muito útil no manejo do paciente(AU)
Assuntos
Humanos , Masculino , Estreitamento Uretral/diagnóstico , Hipospadia/cirurgia , Hipospadia/diagnóstico , Timor-LesteAssuntos
Hipertensão , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde , África Austral , Brasil , Cabo Verde , Feminino , Guiné-Bissau , Humanos , Hipertensão/classificação , Hipertensão/diagnóstico , Hipertensão/terapia , Masculino , Portugal , Gravidez , Medição de Risco , Fatores de Risco , Timor-LesteAssuntos
Erradicação de Doenças/organização & administração , Malária/prevenção & controle , África/epidemiologia , Butão/epidemiologia , América Central/epidemiologia , China/epidemiologia , Equador/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia , Malária/epidemiologia , Malásia/epidemiologia , México/epidemiologia , Nepal/epidemiologia , Paraguai/epidemiologia , República da Coreia/epidemiologia , Arábia Saudita/epidemiologia , Suriname/epidemiologia , Timor-Leste/epidemiologiaRESUMO
Em finais do século XVIII a Coroa portuguesa implementou um sistema regular de colecta de dados demográficos nos seus domínios ultramarinos. A partir do modelo definido, cada governador deveria enviar anualmente o numeramento da sua jurisdição. O Arquivo Histórico Ultramarino, em Lisboa, conserva mais de um milhar de tabelas estatísticas provenientes desde o Brasil até Macau. Esta documentação abre importantes horizontes para a história demográfica, social e colonial, apesar de relativamente negligenciada por historiadores e demógrafos. A partir destas fontes o projecto estuda a demografia e os processos estatísticos na construção do império português entre 1776 e 1875. Adiante discutimos o contexto desta investigação, com ênfase nas características da informação, variáveis e suas potencialidades, bem como uma agenda de investigação.
By the end of the 18th century, the Portuguese Crown implemented a system for the gathering of demographic data in its overseas domains. In accordance with the model defined, each governor was to send a population count for the area under his jurisdiction annually. At the Arquivo Histórico Ultramarino, in Lisbon, there are over a thousand "population tables" from Brazil to Macao. This documentation significantly broadens horizons for demographic, social and colonial history, despite having been relatively neglected by historians and demographers. These sources allow for the study of demography and statistical processes during the construction of the Portuguese Empire between 1776 and 1875. The context of this research, with an emphasis on the particular characteristics of the
A finales del siglo XVIII la Corona portuguesa puso en marcha un sistema regulado de recolección de datos demográficos en sus territorios ultramarinos. A partir del modelo establecido, cada gobernador debía enviar anualmente la numeración de su jurisdicción. El Archivo Histórico Ultramarino, en Lisboa, conserva más de un millar de tablas estadísticas que provienen de lugares como Brasil o Macao. Esta documentación abre importantes horizontes para la historia demográfica, social y colonial, pese a la escasa atención que han mostrado historiadores y demógrafos por ella. Con base en estas fuentes, el proyecto estudia la demografía y los procesos estadísticos en la construcción del imperio portugués entre 1776 y 1875. Analiza además el contexto de esta investigación, con énfasis en las características de la información, las variables y su potencial, junto con un plan de investigación.
Assuntos
Portugal , Características da População , Demografia , Censos , Historiografia , Brasil , Registros , Colonialismo , Mapa , História do Século XVIII , Timor-Leste , Escravização , Angola , MoçambiqueRESUMO
BACKGROUND: Molecular-based surveys have indicated that Ancylostoma ceylanicum, a zoonotic hookworm, is likely the second most prevalent hookworm species infecting humans in Asia. Most current PCR-based diagnostic options for the detection of Ancylostoma species target the Internal Transcribed Spacer (ITS) regions of the ribosomal gene cluster. These regions possess a considerable degree of conservation among the species of this genus and this conservation can lead to the misidentification of infecting species or require additional labor for accurate species-level determination. We have developed a novel, real-time PCR-based assay for the sensitive and species-specific detection of A. ceylanicum that targets a non-coding, highly repetitive genomic DNA element. Comparative testing of this PCR assay with an assay that targets ITS sequences was conducted on field-collected samples from Argentina and Timor-Leste to provide further evidence of the sensitivity and species-specificity of this assay. METHODS/PRINCIPAL FINDINGS: A previously described platform for the design of primers/probe targeting non-coding highly repetitive regions was used for the development of this novel assay. The assay's limits of detection (sensitivity) and cross-reactivity with other soil-transmitted helminth species (specificity) were assessed with real-time PCR experiments. The assay was successfully used to identify infections caused by A. ceylanicum that were previously only identified to the genus level as Ancylostoma spp. when analyzed using other published primer-probe pairings. Further proof of sensitive, species-specific detection was provided using a published, semi-nested restriction fragment length polymorphism-PCR assay that differentiates between Ancylostoma species. CONCLUSIONS/SIGNIFICANCE: Due to the close proximity of people and domestic/wild animals in many regions of the world, the potential for zoonotic infections is substantial. Sensitive tools enabling the screening for different soil-transmitted helminth infections are essential to the success of mass deworming efforts and facilitate the appropriate interpretation of data. This study describes a novel, species-specific, real-time PCR-based assay for the detection of A. ceylanicum that will help to address the need for such tools in integrated STH deworming programs. TRIAL REGISTRATION: ANZCTR.org.au ACTRN12614000680662.
Assuntos
Ancylostoma/isolamento & purificação , Ancilostomíase/diagnóstico , Fezes/parasitologia , Reação em Cadeia da Polimerase em Tempo Real/métodos , Ancylostoma/classificação , Animais , Argentina , DNA de Helmintos/isolamento & purificação , Humanos , Filogenia , Polimorfismo de Fragmento de Restrição , Ensaios Clínicos Controlados Aleatórios como Assunto , Especificidade da Espécie , Timor-Leste , Zoonoses/parasitologiaRESUMO
Se realizó un estudio observacional, de corte transversal, de 83 gestantes con enfermedad hipertensiva gravídica, residentes en el subdistrito Venilale, de Timor Oriental, desde mayo de 2012 hasta igual mes de 2013, con vistas a caracterizarles según variables clinicoepidemiológicas de interés. En la serie se halló una prevalencia de la enfermedad de 29,1 por ciento del total de mujeres en edad fértil. Entre los resultados principales predominaron las familias grandes (60,2 por ciento) y ampliadas (68,7 por ciento), según tamaño y ontogénesis, respectivamente. Como factores de riesgo se identificaron: la edad materna menor de 20 años, la nuliparidad, el bajo peso materno y las condiciones socioeconómicas regulares; asimismo, la preeclampsia no agravada resultó ser la más frecuente. La prevalencia de dicha enfermedad estuvo asociada a factores sociales y epidemiológicos bien definidos(AU)
An observational, cross-sectional study, of 83 pregnant women with gestational hipertensive disease, residents in the Venilale subdistrict, in Timor Oriental was carried out, from May, 2012 to the same month in 2013, aimed at characterizing them according to clinical epidemiological variables of interest. In the series a prevalence of 29.1 percent of the disease in the total of women in fertility age was found. Among the main results the numerous (60.2 percent) and enlarged families (68.7 percent) prevailed, according to size and ontogenesis, respectively. As risk factors were identified: the maternal age younger than 20 years, nonparity, maternal low weight and regular socioeconomic conditions; also, the non worsened pre-eclampsia was the most frequent. The prevalence of this disease was associated to very defined social and epidemiological factors(AU)