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Bastos R, Silva SA. Adipose perforator flaps without skin donor site: "in between" single scar approach for reconstruction of small peripheral breast defects after lumpectomy. J Plast Reconstr Aesthet Surg 2024; 91:363-371. [PMID: 38447506 DOI: 10.1016/j.bjps.2024.01.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 01/01/2024] [Accepted: 01/29/2024] [Indexed: 03/08/2024]
Abstract
In breast conserving surgery, the reconstruction of defects in small breasts where volume displacement techniques are not feasible can be challenging. In contrast, patients with bigger breasts may not wish to undergo major breast remodeling surgery or breast symmetrization procedures. In such cases, volume replacement techniques can be beneficial, but these leave additional scars and are time consuming. The authors propose an "in between" single scar approach to perform both lumpectomy and reconstruction of small peripheral breast tumors. This approach reduces morbidity and operating time compared with standard volume replacement techniques. The tumors are resected from below, guided by wire, using an incision in the lateral breast crease or inframammary fold, depending on their location. The same incision is used to raise an adipose or adipofascial flap based on perimammary perforators, lateral thoracic artery perforator flap (LTAP), lateral intercostal artery perforator flap (LICAP), or anterior intercostal artery perforator flaps (AICAP) flaps, without skin donor site. Between March and November 2022, eight patients underwent this procedure. In four cases LICAP flap was used; in three-AICAP flap was chosen; and in one-LTAP perforator flap was used. Clear surgical margins were achieved in all cases. The average follow-up time was 9.9 months, during which no local recurrences were detected. All flaps survived. Two patients experienced seromas at the donor site, and an organized hematoma was also reported. This approach represents a viable alternative to volume displacement techniques or no reconstruction for small peripheral lumpectomy defects.
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Affiliation(s)
- R Bastos
- Plastic and Reconstructive Surgery Department, Hospital da Luz Lisboa, Avenida Lusíada, 100, 1500-650 Lisboa, and Breast Unit, Hospital de Beatriz Ângelo, Avenida Carlos Teixeira, 3, 2674-514 Loures, Portugal.
| | - S A Silva
- Breast Unit and Surgery Department, Hospital de Beatriz Ângelo, Hospital da Luz Torres de Lisboa, Rua Tomás da Fonseca, Edifícios B, D, E F, 1600-209 Lisboa, Portugal
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de Mello E Silva JF, de Jesus Silva N, Carrilho TRB, Jesus Pinto ED, Rocha AS, Pedroso J, Silva SA, Spaniol AM, da Costa Santin de Andrade R, Bortolini GA, Paixão E, Kac G, de Cássia Ribeiro-Silva R, Barreto ML. Identifying biologically implausible values in big longitudinal data: an example applied to child growth data from the Brazilian food and nutrition surveillance system. BMC Med Res Methodol 2024; 24:38. [PMID: 38360575 PMCID: PMC10868032 DOI: 10.1186/s12874-024-02161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
BACKGROUND Several strategies for identifying biologically implausible values in longitudinal anthropometric data have recently been proposed, but the suitability of these strategies for large population datasets needs to be better understood. This study evaluated the impact of removing population outliers and the additional value of identifying and removing longitudinal outliers on the trajectories of length/height and weight and on the prevalence of child growth indicators in a large longitudinal dataset of child growth data. METHODS Length/height and weight measurements of children aged 0 to 59 months from the Brazilian Food and Nutrition Surveillance System were analyzed. Population outliers were identified using z-scores from the World Health Organization (WHO) growth charts. After identifying and removing population outliers, residuals from linear mixed-effects models were used to flag longitudinal outliers. The following cutoffs for residuals were tested to flag those: -3/+3, -4/+4, -5/+5, -6/+6. The selected child growth indicators included length/height-for-age z-scores and weight-for-age z-scores, classified according to the WHO charts. RESULTS The dataset included 50,154,738 records from 10,775,496 children. Boys and girls had 5.74% and 5.31% of length/height and 5.19% and 4.74% of weight values flagged as population outliers, respectively. After removing those, the percentage of longitudinal outliers varied from 0.02% (<-6/>+6) to 1.47% (<-3/>+3) for length/height and from 0.07 to 1.44% for weight in boys. In girls, the percentage of longitudinal outliers varied from 0.01 to 1.50% for length/height and from 0.08 to 1.45% for weight. The initial removal of population outliers played the most substantial role in the growth trajectories as it was the first step in the cleaning process, while the additional removal of longitudinal outliers had lower influence on those, regardless of the cutoff adopted. The prevalence of the selected indicators were also affected by both population and longitudinal (to a lesser extent) outliers. CONCLUSIONS Although both population and longitudinal outliers can detect biologically implausible values in child growth data, removing population outliers seemed more relevant in this large administrative dataset, especially in calculating summary statistics. However, both types of outliers need to be identified and removed for the proper evaluation of trajectories.
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Affiliation(s)
| | - Natanael de Jesus Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- ISGlobal, Hospital Clínic. Universitat de Barcelona, Barcelona, Spain
| | - Thaís Rangel Bousquet Carrilho
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Elizabete de Jesus Pinto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Federal University of Recôncavo da Bahia, Santo Antônio de Jesus, BA, Brazil
| | - Aline Santos Rocha
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | - Jéssica Pedroso
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | - Sara Araújo Silva
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | - Ana Maria Spaniol
- Food and Nutrition Coordinating Unit, Ministry of Health, Brasília, DF, Brazil
| | | | | | - Enny Paixão
- London School of Hygiene & Tropical Medicine, London, UK
| | - Gilberto Kac
- Nutritional Epidemiology Observatory, Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil.
- School of Nutrition, Federal University of Bahia, Av. Araújo Pinho, nº 32, Canela, Salvador, Bahia, CEP: 40.110-150, BA, Brazil.
| | - Maurício L Barreto
- Centre for Data and Knowledge Integration for Health, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
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Silva NDJ, Silva JFDME, Carrilho TRB, Pinto EDJ, de Andrade RDCS, Silva SA, Pedroso J, Spaniol AM, Bortolini GA, Fagundes A, Nilson EAF, Fiaccone RL, Kac G, Barreto ML, Ribeiro-Silva RDC. Quality of child anthropometric data from SISVAN, Brazil, 2008-2017. Rev Saude Publica 2023; 57:62. [PMID: 37878848 PMCID: PMC10519688 DOI: 10.11606/s1518-8787.2023057004655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 12/19/2022] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To evaluate the quality of anthropometric data of children recorded in the Food and Nutrition Surveillance System (SISVAN) from 2008 to 2017. METHOD Descriptive study on the quality of anthropometric data of children under five years of age admitted in primary care services of the Unified Health System, from the individual databases of SISVAN. Data quality was annually assessed using the indicators: coverage, completeness, sex ratio, age distribution, weight and height digit preference, implausible z-score values, standard deviation, and normality of z-scores. RESULTS In total, 73,745,023 records and 29,852,480 children were identified. Coverage increased from 17.7% in 2008 to 45.4% in 2017. Completeness of birth date, weight, and height corresponded to almost 100% in all years. The sex ratio was balanced and approximately similar to the expected ratio, ranging from 0.8 to 1. The age distribution revealed higher percentages of registrations from the ages of two to four years until mid-2015. A preference for terminal digits "zero" and "five" was identified among weight and height records. The percentages of implausible z-scores exceeded 1% for all anthropometric indices, with values decreasing from 2014 onwards. A high dispersion of z-scores, including standard deviations between 1.2 and 1.6, was identified mainly in the indices including height and in the records of children under two years of age and residents in the North, Northeast, and Midwest regions. The distribution of z-scores was symmetric for all indices and platykurtic for height/age and weight/age. CONCLUSIONS The quality of SISVAN anthropometric data for children under five years of age has improved substantially between 2008 and 2017. Some indicators require attention, particularly for height measurements, whose quality was lower especially among groups more vulnerable to nutritional problems.
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Affiliation(s)
- Natanael de Jesus Silva
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universitat de BarcelonaInstituto de Salud Global de BarcelonaBarcelonaEspaña Universitat de Barcelona. Instituto de Salud Global de Barcelona. Barcelona, España.
| | - Juliana Freitas de Mello e Silva
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
| | - Thaís Rangel Bousquet Carrilho
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroObservatório de Epidemiologia NutricionalRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Observatório de Epidemiologia Nutricional. Rio de Janeiro, RJ, Brasil.
| | - Elizabete de Jesus Pinto
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal do Recôncavo da BahiaSanto Antônio de JesusBABrasil Universidade Federal do Recôncavo da Bahia. Santo Antônio de Jesus, BA, Brasil.
| | - Rafaella da Costa Santin de Andrade
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Sara Araújo Silva
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Jéssica Pedroso
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Ana Maria Spaniol
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Gisele Ane Bortolini
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Andhressa Fagundes
- Universidade Federal de SergipeDepartamento de NutriçãoSão CristóvãSEBrasil Universidade Federal de Sergipe. Departamento de Nutrição. São Cristóvão, SE, Brasil.
| | - Eduardo Augusto Fernandes Nilson
- Ministério da SaúdeCoordenação-Geral de Alimentação e NutriçãoBrasíliaDFBrasil Ministério da Saúde. Coordenação-Geral de Alimentação e Nutrição. Brasília, DF, Brasil.
| | - Rosemeire Leovigildo Fiaccone
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal da BahiaInstituto de Matemática e EstatísticaSalvadorBABrasil Universidade Federal da Bahia. Instituto de Matemática e Estatística. Salvador, BA, Brasil.
| | - Gilberto Kac
- Universidade Federal do Rio de JaneiroInstituto de Nutrição Josué de CastroObservatório de Epidemiologia NutricionalRio de JaneiroRJBrasil Universidade Federal do Rio de Janeiro. Instituto de Nutrição Josué de Castro. Observatório de Epidemiologia Nutricional. Rio de Janeiro, RJ, Brasil.
| | - Maurício Lima Barreto
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasil Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
| | - Rita de Cássia Ribeiro-Silva
- Fundação Oswaldo CruzInstituto Gonçalo MonizCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasil Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
- Universidade Federal da BahiaEscola de NutriçãoSalvadorBABrasil Universidade Federal da Bahia. Escola de Nutrição. Salvador, BA, Brasil.
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Ribeiro-Silva RDC, Silva NDJ, Felisbino-Mendes MS, Falcão IR, de Andrade RDCS, Silva SA, Nilson EAF, Spaniol AM, Fiaccone RL, Paixão E, Ichihara MYT, Velasquez-Melendez G, Barreto ML. Time trends and social inequalities in child malnutrition: nationwide estimates from Brazil's food and nutrition surveillance system, 2009-2017. Public Health Nutr 2021; 25:1-11. [PMID: 34915949 PMCID: PMC9991727 DOI: 10.1017/s1368980021004882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 11/11/2021] [Accepted: 12/14/2021] [Indexed: 12/27/2022]
Abstract
OBJECTIVE In Brazil, national estimates of childhood malnutrition have not been updated since 2006. The use of health information systems is an important complementary data source for analysing time trends on health and nutrition. This study aimed to examine temporal trends and socio-demographic inequalities in the prevalence of malnutrition in children attending primary health care services between 2009 and 2017. DESIGN Time trends study based on data from Brazil's Food and Nutrition Surveillance System. Malnutrition prevalence (stunting, wasting, overweight and double burden) was annually estimated by socio-demographic variables. Prais-Winsten regression models were used to analyse time trends. Annual percent change (APC) and 95 % CI were calculated. SETTING Primary health care services, Brazil. PARTICIPANTS Children under 5 years old. RESULTS In total, 15,239,753 children were included. An increase in the prevalence of overweight (APC = 3·4 %; P = 0·015) and a decline in the prevalence of wasting (-6·2 %; P = 0·002) were observed. The prevalence of stunting (-3·2 %, P = 0·359) and double burden (-1·4 %, P = 0·630) had discrete and non-significant reductions. Despite the significant reduction in the prevalence of undernutrition among children in the most vulnerable subgroups (black, conditional cash transfer's recipients and residents of poorest and less developed areas), high prevalence of stunting and wasting persist alongside a disproportionate increase in the prevalence of overweight in these groups. CONCLUSIONS The observed pattern in stunting (high and persistent prevalence) and increase in overweight elucidate setbacks in advances already observed in previous periods and stresses the need for social and political strategies to address multiple forms of malnutrition.
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Affiliation(s)
- Rita de Cássia Ribeiro-Silva
- School of Nutrition, Federal University of Bahia, Av. Araújo Pinho, nº 32, Canela, CEP 40.110-150, Salvador, BA, Brazil
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Natanael de Jesus Silva
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | - Mariana Santos Felisbino-Mendes
- Department of Maternal and Child Nursing and Public Health, Nursing School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ila Rocha Falcão
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
| | | | - Sara Araújo Silva
- General-Coordination Office for Food and Nutrition Policy, Ministry of Health, Brasília, DF, Brazil
| | | | - Ana Maria Spaniol
- General-Coordination Office for Food and Nutrition Policy, Ministry of Health, Brasília, DF, Brazil
| | - Rosemeire Leovigildo Fiaccone
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Mathematics and Statistics, Federal University of Bahia, Salvador, BA, Brazil
| | - Enny Paixão
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Gustavo Velasquez-Melendez
- Department of Maternal and Child Nursing and Public Health, Nursing School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maurício Lima Barreto
- Center for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, BA, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, BA, Brazil
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Silva SA, do Carmo AS, Carvalho KMB. Lifestyle patterns associated with common mental disorders in Brazilian adolescents: Results of the Study of Cardiovascular Risks in Adolescents (ERICA). PLoS One 2021; 16:e0261261. [PMID: 34905559 PMCID: PMC8670696 DOI: 10.1371/journal.pone.0261261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/28/2021] [Indexed: 11/19/2022] Open
Abstract
The association between lifestyle factors and mental health has been evaluated in isolation; however, there has been a lack of information about lifestyle patterns and Common Mental Disorders (CMD) in adolescents. Therefore, the present study aims to assess the association between sets of lifestyle patterns and the occurrence of CMD in Brazilian adolescents evaluated in a national school-based cross-sectional survey. The outcome variable considered was presence of CMD. Lifestyle patterns were identified from the Principal Component Analysis. Consumption of foods, water and alcoholic beverages, sleep, physical activity, and smoking were used to identify patterns as explanatory variables. Sociodemographic characteristics, administrative dependence of the school and, nutritional status, were considered adjustment factors in the regression model. A total of 70,427 adolescents were evaluated. The principal component analysis identified three lifestyle patterns: high consumption of ultra-processed foods and low consumption of unprocessed or minimally processed foods (pattern 1); high consumption of alcoholic beverages and tobacco in the last 30 days (pattern 2); and high consumption of water and high level of physical activity (pattern 3). In the adjusted model, in patterns 1 and 2, the third tertile presented greater chance of CMD (OR 1.68; CI 95% 1.51-1.87 and OR 1.38; CI 95% 1.19-1.60, respectively). In pattern 3, the second (OR 0.88; CI 95% 0.80-0.96) and the third (OR 0.80; CI 95% 0.72-0.88) tertiles presented lower chances of CMD among the adolescents evaluated. Therefore, we suggest that health-promoting practices aimed at adolescents include multiple behaviors, with the objective of ensuring physical, mental, and social well-being.
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Affiliation(s)
- Sara Araújo Silva
- Faculty of Health Sciences, Graduate Program in Human Nutrition, University of Brasilia, Brasilia, Brazil
- Department of Nutrition, Unieuro University Center, Brasilia, Brazil
- Ministry of Health, Brasilia, Brazil
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Nilson EAF, Spaniol AM, Santin RDC, Silva SA. Estratégias para redução do consumo de nutrientes críticos para a saúde: o caso do sódio. CAD SAUDE PUBLICA 2021; 37Suppl 1:e00145520. [DOI: 10.1590/0102-311x00145520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/04/2020] [Indexed: 11/22/2022] Open
Abstract
Doenças crônicas não transmissíveis correspondem à principal causa de morte no mundo e têm a alimentação inadequada como um de seus principais fatores de risco modificáveis, destacando-se o consumo excessivo de sódio e sua associação com doenças cardiovasculares, mediadas pela pressão arterial. Este estudo avaliou o impacto de diferentes cenários de políticas para a redução do consumo de sódio com base em alimentos processados e ultraprocessados na prevenção de mortes por desfechos cardiovasculares na população adulta no Brasil. Foram utilizados dados secundários, de relatórios e bases públicas do Sistema Único de Saúde e de inquéritos populacionais. Foram analisados os impactos, até 2027, de três cenários: manutenção das atuais metas voluntárias, e dois cenários mandatórios, considerando as menores metas nas Américas e as menores metas mundiais. Para a análise das mortes prevenidas ou adiadas com base no consumo de sódio em tais cenários foi utilizado o Preventable Risk Integrated ModEl (PRIME). Em 2027, mais de 72 mil mortes seriam atribuíveis ao excesso de sódio e as metas voluntárias resultariam na prevenção ou adiamento de até 4.001 (intervalos de 95% de incerteza - II95%: 1.611-6.563) mortes, e os cenários mandatórios resultariam na prevenção de 9.704 (II95%: 3.955-15.665) e 15.561 (II95%: 6.350-25.096) mortes por doenças cardiovasculares, considerando as menores metas regionais e internacionais, respectivamente. Os achados sugerem que a manutenção de metas voluntárias tem impacto limitado quando comparada a cenários possíveis e mais restritivos de redução do teor de sódio em alimentos processados e ultraprocessados, e reforçam a necessidade de adoção de medidas com maior efetividade no país.
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Silva SA, Silva SU, Ronca DB, Gonçalves VSS, Dutra ES, Carvalho KMB. Common mental disorders prevalence in adolescents: A systematic review and meta-analyses. PLoS One 2020; 15:e0232007. [PMID: 32324835 PMCID: PMC7179924 DOI: 10.1371/journal.pone.0232007] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 04/06/2020] [Indexed: 11/19/2022] Open
Abstract
An increasing number of original studies suggest the relevance of assessing mental health; however, there has been a lack of knowledge about the magnitude of Common Mental Disorders (CMD) in adolescents worldwide. This study aimed to estimate the prevalence of CMD in adolescents, from the General Health Questionnaire (GHQ-12). Only studies composed by adolescents (10 to 19 years old) that evaluated the CMD prevalence according to the GHQ-12 were considered. The studies were searched in Medline, Embase, Scopus, Web of Science, Lilacs, Adolec, Google Scholar, PsycINFO and Proquest. In addition, the reference lists of relevant reports were screened to identify potentially eligible articles. Studies were selected by independent reviewers, who also extracted data and assessed risk of bias. Meta-analyses were performed to summarize the prevalence of CMD and estimate heterogeneity across studies. A total of 43 studies were included. Among studies that adopted the cut-off point of 3, the prevalence of CMD was 31.0% (CI 95% 28.0-34.0; I2 = 97.5%) and was more prevalent among girls. In studies that used the cut-off point of 4, the prevalence of CMD was 25.0% (CI 95% 19.0-32.0; I2 = 99.8%). Global prevalence of CMD in adolescents was 25.0% and 31.0%, using the GHQ cut-off point of 4 and 3, respectively. These results point to the need to include mental health as an important component of health in adolescence and to the need to include CMD screening as a first step in the prevention and control of mental disorders.
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Affiliation(s)
- Sara Araújo Silva
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
| | - Simoni Urbano Silva
- Graduate Program in Collective Health, University of Brasilia, Federal District, Brasilia, Brazil
| | - Débora Barbosa Ronca
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
| | | | - Eliane Said Dutra
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
| | - Kênia Mara Baiocchi Carvalho
- Graduate Program in Human Nutrition, University of Brasilia, Federal District, Brasilia, Brazil
- Graduate Program in Collective Health, University of Brasilia, Federal District, Brasilia, Brazil
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Gonçalves VSS, Silva SA, Andrade RCSD, Spaniol AM, Nilson EAF, Moura IFD. Food intake and underweight markers in children under 6 months old monitored via the Food and Nutrition Surveillance System, Brazil, 2015. Epidemiol Serv Saude 2019; 28:e2018358. [PMID: 31291439 DOI: 10.5123/s1679-49742019000200012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 04/19/2019] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to investigate the frequency of exclusive breastfeeding, early introduction of other foods and association with prevalence of low weight in Brazilian children. METHODS we analyzed records of children under 6 months of age held on the Food and Nutrition Surveillance System for the year 2015; associations were investigated through Poisson Regression. RESULTS we found prevalence of 56.1% (95%CI 55.3;56.8) for exclusive breastfeeding, 8.1% (95%CI 7.7;8.5) for low weight for age, and 5.7% (95%CI 5.3;6.7) for low BMI for age; water or teas and infant formulas were the earliest foods introduced; underweight prevalence was lower (PR=0.73 - 95%CI 0.61;0.87) as was prevalence of low BMI (PR=0.69 - 95%CI 0.56;0.85) among exclusively breastfed infants; infant formula intake was associated with low weight (PR=1.35 - 95%CI 1.15;1.58). CONCLUSION the importance of exclusive breastfeeding for adequate growth in the first 6 months of life was reinforced.
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Affiliation(s)
| | - Sara Araújo Silva
- Ministério da Saúde, Secretaria de Atenção à Saúde, Brasília, DF, Brasil
| | | | - Ana Maria Spaniol
- Ministério da Saúde, Secretaria de Atenção à Saúde, Brasília, DF, Brasil
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Abstract
Castor bean (Ricinus communis L.) is a tropical plant of great commercial interest and a potential source of biodiesel. The development of genetically improved cultivars with high amounts of oil in the seeds and low ricin toxicity is crucial to increase the productivity of this crop. The use of TRAP (target region amplification polymorphism) markers to develop elite lineages and study genetic divergence is fundamental to advance the genetic improvement of this species. The goal of this study was to evaluate the genetic divergence among 40 elite lineages of R. communis, which belong to the NBIO-UFRB Genetic Improvement Program, using TRAP markers involved in the biosynthesis of oil and ricin. Total DNA was extracted and quantified from the leaf tissue of the castor bean plants, and 70 TRAP combinations (fixed and arbitrary primers) were used to genotype the 40 lineages. Of the 580 fragments amplified, 335 were polymorphic (58%). The genetic dissimilarity among the lineages was calculated by the Jaccard dissimilarity index using the UPGMA grouping method. A dendrogram was generated, and four groups formed, showing divergence among the elite lineages that favors selection. The TRAP molecular markers were efficient at characterizing the genetic variability among the lineages and, because TRAP markers are functional markers involved in the biosynthesis of oil and ricin, they are important when studying the association between a marker and a candidate gene.
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Affiliation(s)
- K S Simões
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - S A Silva
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - E L Machado
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - M S Silva
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
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10
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Abstract
The objective of this article was to develop TRAP (target region amplification polymorphism) primers for castor bean, with the goal of making functional markers available for genetic studies about the species. To do this, oligonucleotides were designed based on ESTs, obtained from the NCBI (National Center for Biotechnology Information) databank, which code enzymes involved in metabolic routes of fatty acid synthesis, ricin synthesis, and resistance to castor bean pathogens. The forward primers were designed with the help of the Primer3 software and, for the reverse, six arbitrary primers were used. To standardize the amplification reactions, the following criteria were used to select the primers: sizes between 18 and 20 bp, guanine/cytosine (GC) in the range of 40 to 60%, and average annealing temperature between 55° and 62°C. The design quality of the primers was verified using the Net Primer application. Fifty-six primers were designed, which had an average GC percentage of 53.2%. A total of 336 combinations were obtained using the 56 fixed and 6 arbitrary primers. Based on polymerase chain reaction, 330 combinations (89%) presented good amplification patterns for the genomic DNA of castor bean. The size of the fragments amplified varied between 50 and 2072 bp. The TRAP primers designed and validated in this study are the first for castor bean and represent a significant increase in the molecular markers for this species.
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Affiliation(s)
- K S Simões
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - S A Silva
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - E L Machado
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - H S Brasileiro
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
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11
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Pestana-Caldas CN, Silva SA, Machado EL, de Souza DR, Cerqueira-Pereira EC, Silva MS. Genetic divergence through joint analysis of morphoagronomic and molecular characters in accessions of Jatropha curcas. Genet Mol Res 2016; 15:gmr8385. [PMID: 27808356 DOI: 10.4238/gmr.15048385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aim of this study was to investigate the genetic divergence between accessions of Jatropha curcas through joint analysis of morphoagronomic and molecular characters. To this end, we investigated 11 morphoagronomic characters and performed molecular genotyping, using 23 inter-simple sequence repeat (ISSR) primers in 46 accessions of J. curcas. We calculated the contribution of each character on divergence using analysis of variance. The grouping among accessions was performed using the Ward-MLM (modified location model) method, using morphoagronomic and molecular data, whereas the cophenetic correlation was obtained based on Gower's algorithm. There were significant differences in all growth-related characteristics: number of primary and secondary branches per plant, plant height, and stem diameter. For characters related to grain production, differences were found for number of fruit clusters per plant and number of inflorescence clusters per plant and average number of seeds per fruit. The greatest phenotypic variation was found in plant height (59.67- 222.33 cm), whereas the smallest variation was found in average number of seeds per fruit (0-2.90), followed by the number of fruit clusters per plant (0-8.67). In total, 94 polymorphic ISSR fragments were obtained. The genotypic grouping identified six groups, indicating that there is genetic divergence among the accessions. The most promising crossings for future hybridization were identified among accessions UFRB60 and UFVJC45, and UFRB61 and UFVJC18. In conclusion, the joint analysis of morphoagronomic characters and ISSR markers is an efficient method to assess the genetic divergence in J. curcas.
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Affiliation(s)
- C N Pestana-Caldas
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias, Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - S A Silva
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias, Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - E L Machado
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias, Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - D R de Souza
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias, Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - E C Cerqueira-Pereira
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias, Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
| | - M S Silva
- Núcleo de Melhoramento Genético e Biotecnologia, Centro de Ciências Agrárias, Ambientais e Biológicas, Universidade Federal do Recôncavo da Bahia, Cruz das Almas, BA, Brasil
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Caldeira C, Freitas JCBR, Gimenes I, Silva SA, Cabello P, Presgrave OAF. Normal temperature variation in New Zealand white rabbits during restraint for preliminary pyrogen test. Pharmeur Bio Sci Notes 2014; 2014:118-123. [PMID: 25655248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The in vivo pyrogen test is the main toxicological assay used in the quality control of injectable products, especially immunobiologicals. Pharmacopoeias state that, before the main test, a preliminary test must be conducted on all animals, and must follow the same conditions as the main test. The aim of this study was to determine the normal temperature variation in New Zealand white rabbits during restraint and propose a limit value for considering an animal as suitable for testing. Results of the temperature variation in 4,689 rabbits during preliminary tests were obtained from the routine database of the Pharmacology and Toxicology Department of the National Institute of Quality Control in Health (INCQS/FIOCRUZ), Brazil. From these preliminary tests, 3,364 rabbits were considered suitable for testing according to the Brazilian Pharmacopoeia criteria (temperature variation < 0.5 °C). Results showed that about 92 per cent of the rabbits presented a normal individual temperature variation equal to or below 0.30 °C. Animals presenting a temperature variation close to the fever temperature must not be included in the main test, since they can be stressed or sick. Consequently, the temperature variation of 0.30 °C could be adopted by pharmacopoeias as a limit temperature to be considered in the preliminary test to determine which animals can be used in the main rabbit pyrogen test. Animals can be pre-tested until presenting this safe variation, in order to ensure they are healthy and minimise interference in the result.
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Affiliation(s)
- C Caldeira
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz; Departamento de Farmacologia e Toxicologia, INCQS/FIOCRUZ, Avenida Brasil, 4365, Manguinhos, 21045-900, Rio de Janeiro, RJ, Brazil,
| | - J C B R Freitas
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - I Gimenes
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - S A Silva
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - P Cabello
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - O A F Presgrave
- Instituto Nacional de Controle de Qualidade em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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13
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Bernardes SF, Silva SA, Carvalho H, Costa M, Pereira S. Is it a (fe)male pain? Portuguese nurses' and laypeople's gendered representations of common pains. Eur J Pain 2013; 18:530-9. [PMID: 24002778 DOI: 10.1002/j.1532-2149.2013.00387.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND Although many studies have explored gender role expectations of pain behaviours in different cultures, only a few authors have tried to explore whether certain pains are more associated with the typical man or woman. Hence, this study aimed at exploring, among Portuguese laypeople and nurses, patterns of common pains more strongly associated with the typical man or woman, and their relationship with health-care training and personal pain experiences. METHODS A total of 68 nurses (76% women) and 55 laypeople (62% women) were asked to identify, through free association, the most frequent common pains that people in general associate with the typical man and woman, respectively, and also to report their personal past pain experiences. A content analysis was used to categorize and quantify participants' responses. A multiple correspondence analysis was performed to identify gendered patterns of common pains, followed by a cluster analysis to classify participants according to their endorsed patterns. RESULTS Findings showed that while 'back and musculoskeletal pains' was the only pattern associated with the typical man, more differentiated patterns of pains were associated with the typical woman, namely (1) headaches; (2) abdominal, back and musculoskeletal pains; and (3) pains due to hormonal cycles, labour/puerperium and from the urinary/reproductive system. These representations were shared by laypeople and nurses and were only significantly associated with personal experiences of pains from the urinary/reproductive system. CONCLUSIONS This study identified different gendered patterns of common pains, which may have important implications for (wo)men's pain experiences and how these are interpreted by others.
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Affiliation(s)
- S F Bernardes
- Instituto Universitário de Lisboa (ISCTE-IUL), Lisbon, Portugal; Centro de Investigação e Intervenção Social (Cis-IUL), Lisbon, Portugal
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Brasileiro BP, Silva SA, Souza DR, Santos PA, Oliveira RS, Lyra DH. Genetic diversity and selection gain in the physic nut (Jatropha curcas). Genet Mol Res 2013; 12:2341-50. [PMID: 23315871 DOI: 10.4238/2013.january.4.12] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The use of efficient breeding methods depends on knowledge of genetic control of traits to be improved. We estimated genetic parameters, selection gain, and genetic diversity in physic nut half-sib families, in order to provide information for breeding programs of this important biofuel species. The progeny test included 20 half-sib families in 4 blocks and 10 plants per plot. The mean progeny heritability values were: 50% for number of bunches, 47% for number of fruits, 35% for number of seeds, 6% for stem diameter, 26% for number of primary branches, 14% for number of secondary branches, 66% for plant height, and 25% for survival of the plants, demonstrating good potential for early selection in plant height, number of branches, and number of fruits per plant. In the analysis of genetic diversity, genotypes were divided into 4 groups. Genotypes 18, 19, 20, and 8 clustered together and presented the highest means for the vegetative and production. Lower means were observed in the 17, 12, 13, and 9 genotypes from the same group. We detected genetic variability in this population, with high heritability estimates and accuracy, demonstrating the possibility of obtaining genetic gains for vegetative characters and production at 24 months after planting.
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Affiliation(s)
- B P Brasileiro
- Departamento de Estatística, Universidade Federal de Viçosa, Viçosa, MG, Brasil.
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15
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Malta DC, Oliveira MRD, Moura ECD, Silva SA, Zouain CS, Santos FPD, Morais Neto OLD, Penna GDO. [Prevalence of risk health behavior among members of private health insurance plans: results from the 2008 national telephone survey Vigitel, Brazil]. Cien Saude Colet 2011; 16:2011-22. [PMID: 21519689 DOI: 10.1590/s1413-81232011000300035] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2010] [Accepted: 07/15/2010] [Indexed: 11/21/2022] Open
Abstract
This article aims at estimating the prevalence of adults engaging in protective and risk health behaviors among members of private health insurance plans. It was used a random sample of individuals over the age of 18 living in the Brazilian state capitals collected on 28,640 telephone interviews in 2008. The results showed that among males there was a high prevalence of the following risk factors: tobacco, overweight, low fruit and vegetable consumption, high meat with fat consumption and alcohol drinking. Among females we found a high prevalence of high blood pressure, diabetes, dyslipidemia and osteoporosis. Men were generally more physically active and women consumed more fruit and vegetables. As more educated males were lower was the prevalence of tobacco, high blood pressure, but also a higher prevalence of overweight, consumption of meat with fat, dyslipidemia and lower number of yearly check-ups done. For females, tobacco smoking, overweight, obesity, decreasing with schooling, and consumption of fruit and vegetables, physical activity, mammography and PAP test, increased with schooling. The health insurance user population constitutes about 26% of Brazilian people and the current study aims to accumulate evidence for health promotion actions by this public.
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Affiliation(s)
- Deborah Carvalho Malta
- Coordenação Geral de Vigilância de Doenças e Agravos Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde, Brasília, DF, 70070-600, Brazil.
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Glenzer SH, MacGowan BJ, Meezan NB, Adams PA, Alfonso JB, Alger ET, Alherz Z, Alvarez LF, Alvarez SS, Amick PV, Andersson KS, Andrews SD, Antonini GJ, Arnold PA, Atkinson DP, Auyang L, Azevedo SG, Balaoing BNM, Baltz JA, Barbosa F, Bardsley GW, Barker DA, Barnes AI, Baron A, Beeler RG, Beeman BV, Belk LR, Bell JC, Bell PM, Berger RL, Bergonia MA, Bernardez LJ, Berzins LV, Bettenhausen RC, Bezerides L, Bhandarkar SD, Bishop CL, Bond EJ, Bopp DR, Borgman JA, Bower JR, Bowers GA, Bowers MW, Boyle DT, Bradley DK, Bragg JL, Braucht J, Brinkerhoff DL, Browning DF, Brunton GK, Burkhart SC, Burns SR, Burns KE, Burr B, Burrows LM, Butlin RK, Cahayag NJ, Callahan DA, Cardinale PS, Carey RW, Carlson JW, Casey AD, Castro C, Celeste JR, Chakicherla AY, Chambers FW, Chan C, Chandrasekaran H, Chang C, Chapman RF, Charron K, Chen Y, Christensen MJ, Churby AJ, Clancy TJ, Cline BD, Clowdus LC, Cocherell DG, Coffield FE, Cohen SJ, Costa RL, Cox JR, Curnow GM, Dailey MJ, Danforth PM, Darbee R, Datte PS, Davis JA, Deis GA, Demaret RD, Dewald EL, Di Nicola P, Di Nicola JM, Divol L, Dixit S, Dobson DB, Doppner T, Driscoll JD, Dugorepec J, Duncan JJ, Dupuy PC, Dzenitis EG, Eckart MJ, Edson SL, Edwards GJ, Edwards MJ, Edwards OD, Edwards PW, Ellefson JC, Ellerbee CH, Erbert GV, Estes CM, Fabyan WJ, Fallejo RN, Fedorov M, Felker B, Fink JT, Finney MD, Finnie LF, Fischer MJ, Fisher JM, Fishler BT, Florio JW, Forsman A, Foxworthy CB, Franks RM, Frazier T, Frieder G, Fung T, Gawinski GN, Gibson CR, Giraldez E, Glenn SM, Golick BP, Gonzales H, Gonzales SA, Gonzalez MJ, Griffin KL, Grippen J, Gross SM, Gschweng PH, Gururangan G, Gu K, Haan SW, Hahn SR, Haid BJ, Hamblen JE, Hammel BA, Hamza AV, Hardy DL, Hart DR, Hartley RG, Haynam CA, Heestand GM, Hermann MR, Hermes GL, Hey DS, Hibbard RL, Hicks DG, Hinkel DE, Hipple DL, Hitchcock JD, Hodtwalker DL, Holder JP, Hollis JD, Holtmeier GM, Huber SR, Huey AW, Hulsey DN, Hunter SL, Huppler TR, Hutton MS, Izumi N, Jackson JL, Jackson MA, Jancaitis KS, Jedlovec DR, Johnson B, Johnson MC, Johnson T, Johnston MP, Jones OS, Kalantar DH, Kamperschroer JH, Kauffman RL, Keating GA, Kegelmeyer LM, Kenitzer SL, Kimbrough JR, King K, Kirkwood RK, Klingmann JL, Knittel KM, Kohut TR, Koka KG, Kramer SW, Krammen JE, Krauter KG, Krauter GW, Krieger EK, Kroll JJ, La Fortune KN, Lagin LJ, Lakamsani VK, Landen OL, Lane SW, Langdon AB, Langer SH, Lao N, Larson DW, Latray D, Lau GT, Le Pape S, Lechleiter BL, Lee Y, Lee TL, Li J, Liebman JA, Lindl JD, Locke SF, Loey HK, London RA, Lopez FJ, Lord DM, Lowe-Webb RR, Lown JG, Ludwigsen AP, Lum NW, Lyons RR, Ma T, MacKinnon AJ, Magat MD, Maloy DT, Malsbury TN, Markham G, Marquez RM, Marsh AA, Marshall CD, Marshall SR, Maslennikov IL, Mathisen DG, Mauger GJ, Mauvais MY, McBride JA, McCarville T, McCloud JB, McGrew A, McHale B, MacPhee AG, Meeker JF, Merill JS, Mertens EP, Michel PA, Miller MG, Mills T, Milovich JL, Miramontes R, Montesanti RC, Montoya MM, Moody J, Moody JD, Moreno KA, Morris J, Morriston KM, Nelson JR, Neto M, Neumann JD, Ng E, Ngo QM, Olejniczak BL, Olson RE, Orsi NL, Owens MW, Padilla EH, Pannell TM, Parham TG, Patterson RW, Pavel G, Prasad RR, Pendlton D, Penko FA, Pepmeier BL, Petersen DE, Phillips TW, Pigg D, Piston KW, Pletcher KD, Powell CL, Radousky HB, Raimondi BS, Ralph JE, Rampke RL, Reed RK, Reid WA, Rekow VV, Reynolds JL, Rhodes JJ, Richardson MJ, Rinnert RJ, Riordan BP, Rivenes AS, Rivera AT, Roberts CJ, Robinson JA, Robinson RB, Robison SR, Rodriguez OR, Rogers SP, Rosen MD, Ross GF, Runkel M, Runtal AS, Sacks RA, Sailors SF, Salmon JT, Salmonson JD, Saunders RL, Schaffer JR, Schindler TM, Schmitt MJ, Schneider MB, Segraves KS, Shaw MJ, Sheldrick ME, Shelton RT, Shiflett MK, Shiromizu SJ, Shor M, Silva LL, Silva SA, Skulina KM, Smauley DA, Smith BE, Smith LK, Solomon AL, Sommer S, Soto JG, Spafford NI, Speck DE, Springer PT, Stadermann M, Stanley F, Stone TG, Stout EA, Stratton PL, Strausser RJ, Suter LJ, Sweet W, Swisher MF, Tappero JD, Tassano JB, Taylor JS, Tekle EA, Thai C, Thomas CA, Thomas A, Throop AL, Tietbohl GL, Tillman JM, Town RPJ, Townsend SL, Tribbey KL, Trummer D, Truong J, Vaher J, Valadez M, Van Arsdall P, Van Prooyen AJ, Vergel de Dios EO, Vergino MD, Vernon SP, Vickers JL, Villanueva GT, Vitalich MA, Vonhof SA, Wade FE, Wallace RJ, Warren CT, Warrick AL, Watkins J, Weaver S, Wegner PJ, Weingart MA, Wen J, White KS, Whitman PK, Widmann K, Widmayer CC, Wilhelmsen K, Williams EA, Williams WH, Willis L, Wilson EF, Wilson BA, Witte MC, Work K, Yang PS, Young BK, Youngblood KP, Zacharias RA, Zaleski T, Zapata PG, Zhang H, Zielinski JS, Kline JL, Kyrala GA, Niemann C, Kilkenny JD, Nikroo A, Van Wonterghem BM, Atherton LJ, Moses EI. Demonstration of ignition radiation temperatures in indirect-drive inertial confinement fusion hohlraums. Phys Rev Lett 2011; 106:085004. [PMID: 21405580 DOI: 10.1103/physrevlett.106.085004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Indexed: 05/30/2023]
Abstract
We demonstrate the hohlraum radiation temperature and symmetry required for ignition-scale inertial confinement fusion capsule implosions. Cryogenic gas-filled hohlraums with 2.2 mm-diameter capsules are heated with unprecedented laser energies of 1.2 MJ delivered by 192 ultraviolet laser beams on the National Ignition Facility. Laser backscatter measurements show that these hohlraums absorb 87% to 91% of the incident laser power resulting in peak radiation temperatures of T(RAD)=300 eV and a symmetric implosion to a 100 μm diameter hot core.
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Affiliation(s)
- S H Glenzer
- Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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Malta DC, Moura EC, Silva SA, Oliveira PPVD, Silva VLDCE. Prevalence of smoking among adults residing in the Federal District of Brasília and in the state capitals of Brazil, 2008. J Bras Pneumol 2010; 36:75-83. [PMID: 20209311 DOI: 10.1590/s1806-37132010000100013] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 10/15/2009] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the prevalence of smoking in the adult population of Brazil, in order to propose recommendations for the reduction of tobacco use. METHODS This was a population-based, cross-sectional study including a sample composed of residents (> 18 years of age) of the capital cities of 26 Brazilian states and in the Federal District of Brasília, Brazil. For the determination of sample size, a 95% confidence interval and a 2% sample error were defined. The participants were selected and interviewed by means of the Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (VIGITEL, Telephone-based System for the Surveillance of Risk and Protective Factors for Chronic Diseases).The proportion of smokers and the number of cigarettes smoked per day were estimated and stratified according to sociodemographic variables. In addition, the male/female ratio was estimated for the prevalence of smoking. RESULTS The prevalence of smoking was 16.1% (20.5% among males and 12.4% among females). The proportion of adults that reported smoking > 20 cigarettes a day was 4.9%, being greater in males (6.5% vs. 3.6%). The prevalence of smoking was greater among individuals with a lower level of education (< 8 years of schooling). The number of cigarettes smoked per day by males was approximately the double that smoked by females. CONCLUSIONS The VIGITEL estimates indicate a reduction in the prevalence of smoking, which was, however, still greater among males than among females. The VIGITEL has been fundamental to monitoring smoking, as well as to informing decisions regarding public policies for health promotion and the prevention of chronic nontransmissible diseases.
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Affiliation(s)
- Deborah Carvalho Malta
- National Coordinator of Noncommunicable Diseases Sector of Department of Health Surveillance, Brazilian National Ministry of Health, Brasília, Brazil.
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Curtis TP, Mara DD, Silva SA. Influence of pH, Oxygen, and Humic Substances on Ability of Sunlight To Damage Fecal Coliforms in Waste Stabilization Pond Water. Appl Environ Microbiol 2010; 58:1335-43. [PMID: 16348698 PMCID: PMC195595 DOI: 10.1128/aem.58.4.1335-1343.1992] [Citation(s) in RCA: 183] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Simple beaker experiments established that light damages fecal coliforms in waste stabilization ponds by an oxygen-mediated exogenous photosensitization. Wavelengths of up to 700 nm were able to damage bacteria. The ability of wavelengths of >425 nm to damage fecal coliforms was dependent on the presence of dissolved sensitizers. The sensitizers were ubiquitous in raw sewage, unaffected by sewage treatment, not derivatives of bacteriochlorophyll or chlorophyll, absorbed well in UV light, and had a slight yellowish color; they are therefore believed to be humic substances. The ability of light to damage fecal coliforms was highly sensitive to, and completely dependent on, oxygen. Scavengers of H(2)O(2) and singlet oxygen could protect the bacteria from the effects of sunlight, but scavengers of hydroxyl radicals and superoxides could not. Light-mediated damage of fecal coliforms was highly sensitive to elevated pH values, which also enabled light with wavelengths of >425 nm (in the presence of the sensitizer) to damage the bacteria. We conclude that humic substances, pH, and dissolved oxygen are important variables in the process by which light damages microorganisms in this and other environments and that these variables should be considered in future research on, and models of, the effects of light.
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Affiliation(s)
- T P Curtis
- Department of Civil Engineering, University of Leeds, Leeds, LS2 9JT, United Kingdom, and Estacao Experimental de Tratamentos Biologicos de Esgotos Sanitarios, Universidade Federal da Paraiba, Campina Grande, Paraiba 58100, Brazil
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19
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Abstract
OBJETIVO: Avaliar associação entre excesso de peso e consumo de feijão em adultos. MÉTODOS: O estudo constou de indivíduos adultos (>18 anos), moradores em Belém (PA), em 2005. A amostragem foi realizada por sorteio de residências com telefone fixo e de um morador adulto de cada casa sorteada. A variável desfecho foi excesso de peso, a variável explanatória consumo de feijão e as variáveis de controle foram idade, escolaridade e situação conjugal, além de atividade física no lazer e hábitos alimentares de risco. A análise dos dados foi feita pelo teste do qui-quadrado e por regressão logística. RESULTADOS: Foram avaliados 2 352 indivíduos (39,8% do sexo masculino). O excesso de peso atingiu mais os homens, 49,3%, do que as mulheres, 34,0% (p<0,001). A prevalência de excesso de peso apresentou associação direta com idade em ambos os sexos e com escolaridade para homens, para as mulheres a associação com a escolaridade foi inversa. A variável referente ao consumo alimentar que melhor se associou com excesso de peso foi o consumo de feijão. Após ajuste para as demais variáveis, o risco de excesso de peso foi cerca de 1,4 vez maior para os homens que consomem feijão menos do que cinco vezes na semana, porém o inverso para as mulheres. CONCLUSÃO: Os resultados indicam a necessidade de estudos mais controlados para melhor entendimento da associação entre consumo de feijão e excesso de peso.
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20
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Laval CB, de Andrade ALSS, Pimenta FC, de Andrade JG, de Oliveira RM, Silva SA, de Lima EC, Fabio JL, Casagrande ST, Brandileone MCC. Serotypes of carriage and invasive isolates of Streptococcus pneumoniae in Brazilian children in the era of pneumococcal vaccines. Clin Microbiol Infect 2006; 12:50-5. [PMID: 16460546 DOI: 10.1111/j.1469-0691.2005.01304.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Nasopharyngeal carriage of Streptococcus pneumoniae is a key factor in the development of invasive disease and the spread of resistant strains within the community. A single nasopharyngeal swab was obtained from 648 unvaccinated children aged <5 years, either healthy or with acute respiratory tract infection or meningitis, during the winters of 2000 and 2001. The overall pneumococcal carriage rate was 35.8% (95% CI 32.1-39.6). The pneumococcal serotypes found most frequently in the nasopharynx were 14, 6B, 6A, 19F, 10A, 23F and 18C, which included five of the seven serotypes in the currently licensed seven-valent conjugate vaccine (PCV7); serotypes 4 and 9V were less common. Serotypes 1 and 5 were isolated rarely from the nasopharynx. A comparison of 222 nasopharyngeal isolates with 125 invasive isolates, matched for age and time to the carrier isolates, showed a similar prevalence of penicillin non-susceptible pneumococci (PNSp) (19.8% and 19.2%, respectively). PNSp serotypes were similar (6B, 14, 19F, 19 A, 23B and 23F) for carriage and invasive disease isolates. The coverage of PCV7 for carriage isolates (52.2%) and invasive isolates (62.4%) did not differ significantly (p 0.06); similarly, there was no significant difference in PCV7 coverage for carriage isolates (34.5%) and invasive isolates (28.2%) of PNSp. These data suggest that PCV7 has the potential to reduce pneumococcal carriage and the number of carriers of PNSp belonging to vaccine serotypes.
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Affiliation(s)
- C B Laval
- Communicable Disease Surveillance, Secretariat of Health of the Municipality of Goiânia, Brazil
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21
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Rangel F, Rey H, Rocha R, Bittencourt M, Bernardo E, Silva S, Dohmann H, Gouvea E, Esporcatte R. Crit Care 2005; 9:P33. [DOI: 10.1186/cc3577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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22
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Pearson HW, Silva Athayde ST, Athayde GB, Silva SA. Implications for physical design: The effect of depth on the performance of waste stabilization ponds. Water Sci Technol 2005; 51:69-74. [PMID: 16114665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Studies on experimental primary facultative ponds showed that varying the depth from 1.25 m to 2.3 m had no effect on the rates of BOD removal. In contrast k values for FC removal rates were higher in the shallower (1.25 m) facultative ponds. The risk of odour release via H2S production was higher in the 2.2 m ponds than the 1.25 m ponds and NH3 removal was much better in the 1.25 m facultative ponds. A comparison of the efficiency of shallow 5-pond series (1.0 m and 0.61 m deep) with a 2.2 m deep series showed that the shallow systems were more efficient at FC removal, but the deeper series actually saved land area for the same FC final effluent quality under tropical conditions. However, efficient nutrient removal (N and P) only occurred in the shallow series and effluent standards for nutrient concentrations are unlikely to be met by 2.2 m deep 5-pond series in contrast to the norms for pathogen removal.
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Affiliation(s)
- H W Pearson
- LARHISA, Department of Engenharia Civil, Universidade Federal do Rio Grande Do Norte, Natal, RN. Brazil.
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23
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Dohmann H, Perin E, Silva S, Sousa A, Belém L, Rabichovisky A, Rangel F, Esporcatte R, Campos L, Dohmann H. Crit Care 2003; 7:P3. [DOI: 10.1186/cc2199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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24
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Dohmann H, Perin E, Sousa A, Silva S, Borojevic R, Rossi M, Carvalho L, Verney R, Mattos N, Dohmann H. Crit Care 2003; 7:P7. [DOI: 10.1186/cc2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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25
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Dohman H, Perin E, Sousa A, Silva S, Tinoco C, Esporcatte R, Rangel F, Campos L, Fernandes M, Dohmann H. Crit Care 2003; 7:P12. [DOI: 10.1186/cc2208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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26
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Silva S, Dohmann H, Perin E, Rutherford C, Sousa A, Souza P, Gonzales C, Falcão C, Feijó A, Dohmann H. Crit Care 2003; 7:P83. [DOI: 10.1186/cc2279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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27
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Dohmann H, Perin E, Sousa A, Silva S, Gonzáles C, Falcão C, Verney R, Belém L, Dohmann H. Crit Care 2003; 7:P2. [DOI: 10.1186/cc2198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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28
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de Andrade AL, Brandileone MC, Di Fabio JL, Oliveira RM, Silva SA, Baiocchi SS, Martelli CM. Haemophilus influenzae resistance in Latin America: systematic review of surveillance data. Microb Drug Resist 2002; 7:403-11. [PMID: 11822780 DOI: 10.1089/10766290152773419] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Haemophilus influenzae is a relevant cause of morbidity and mortality among children under 5 years of age in the developing world. In Latin America, H. influenzae type b (Hib) conjugate vaccine and surveillance of H. influenzae antimicrobial susceptibility have been implemented in recent years. We have undertaken a systematic review and a pooled analysis on H. influenzae antimicrobial resistance, including reports of 15 Latin America countries over a 10-year period (1990-2000). We have found that 450 (21.4%) of 2,100 invasive isolates were beta-lactamase producers compared to 145 (14.5%) of 998 isolates of noninvasive isolates (p < 0.05). Ampicillin resistance was detected among 783 (21.9%) of 3,577 invasive isolates compared to 111 (17.2%) of 646 noninvasive strains (p < 0.05). In contrast, 568 (41.9%) of 1,355 noninvasive strains were trimethoprim-sulfamethoxazole (TMP-SMX) resistance against 241 (26.9%) of 897 invasive ones (p < 0.05). Therefore, TMP-SMX resistance was more common in nonsterile fluids than in sterile fluids. Over time, rates of beta-lactamase-producing strains were stable in Brazil and Mexico, whereas rates of TMP-SMX resistance were increasing in Brazil. It is predictable that following the Hib immunization, Latin America countries will be faced with increased nontypeable H. influenzae infection. Although standing by the nontypeable H. influenzae vaccine, in this novel epidemiological scenario of post-Hib vaccination in Latin America settings there is a need to improve H. influenzae resistance monitoring to guide clinicians to choose efficacious antimicrobial therapy.
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Affiliation(s)
- A L de Andrade
- Institute of Tropical Pathology and Public Health, Federal University of Goias, Brazil.
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Silva SA, DE Castro JC, Da Silva TG, Da-Cunha EV, Barbosa-Filho JM, Da Silva MS. Krametosan, a new trinorlignan from the roots of Krameria tomentosa. Nat Prod Lett 2002; 15:323-9. [PMID: 11841116 DOI: 10.1080/10575630108041299] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A new phenylcoumarone type trinorlignan, krametosan (1), along with the known norlignans, ratanhiaphenol I (2) and 2-(2'-hydroxy-4',6'-dimethoxyphenyl)-5-(E)-propenylbenzofuran (3), the lignan conocarpan (4) and dinorlignan decurrenal (5), were isolated from the CHCl3 extract of the roots of Krameria tomentosa. The structure of these compounds were elucidated by the spectroscopic methods.
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Affiliation(s)
- S A Silva
- Laboratório de Tecnologia Farmacêutica, Universidade Federal da Paraiba, João Pessoa, Brazil
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Rodriguez Lopes CL, Bringel Martins RM, Araújo Teles S, Silva SA, Maggi PS, Tachibana Yoshida CF. [Seroepidemiological profile of hepatitis B infection in staff at hemodialysis units of Goiânia-Goiás, Central Brazil]. Rev Soc Bras Med Trop 2001; 34:543-8. [PMID: 11813061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
In order to investigate the hepatitis B virus (HBV) infection profile in hemodialysis staff (n = 152) of Goiânia,Goiás, blood samples were tested for detection of HBsAg, anti-HBs and anti-HBc markers. An overall HBV infection prevalence of 24.3% (CI 95%: 17.8 - 32) was found. Multivariate analysis of risk factors showed that length of employment, history of occupational exposure and nonuse of protective equipment were significantly associated with HBV seropositivity. Of 40 staff members who were susceptible to this infection, 20 agreed to participate in the vaccination program. After three vaccine doses (Euvax-B), 18 (90%) seroconverted to anti-HBs with titers >/= 10 IU/L. These data suggest the dialytic environmental as a possible source of occupational transmission of HBV, and emphasize the need to evaluate strategies of control and prevention to be followed in these units.
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Affiliation(s)
- C L Rodriguez Lopes
- Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO
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Neto OL, Barros MB, Martelli CM, Silva SA, Cavenaghi SM, Siqueira JB. [Differential patterns of neonatal and post-neonatal mortality rates in Goiânia, Brazil, 1992-1996: use of spatial analysis to identify high-risk areas]. CAD SAUDE PUBLICA 2001; 17:1241-50. [PMID: 11679898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
The aim of this study was to investigate the spatial pattern of neonatal and post-neonatal mortality in the city of Goiânia, Central Brazil. Analyses were based on linked birth and death certificates relating to 101,000 in-hospital live births from mothers residing in the city of Goiânia over the 1992-1996 period. Overall neonatal and post-neonatal mortality probabilities were calculated using the linked database. The empirical Bayes method was applied to smooth the estimated rates and minimize random fluctuation. Spatial units of analysis were 65 urban districts, corresponding to the urban planning sectors. The following exploratory spatial analyses were applied: "global" Moran's I statistic, local Moran LISA map, and Gi* local statistics. For both neonatal and post-neonatal mortality there was statistically significant spatial autocorrelation. Results of post-neonatal mortality showed a high-risk cluster located on the outskirts of the city. For the neonatal period, a heterogeneous mortality pattern was found with high-risk districts in all regions, including central areas.
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Affiliation(s)
- O L Neto
- Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, 74605-050, Brasil
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Carneiro MA, Martins RM, Teles SA, Silva SA, Lopes CL, Cardoso DD, Vanderborght BO, Yoshida CF. Hepatitis C prevalence and risk factors in hemodialysis patients in Central Brazil: a survey by polymerase chain reaction and serological methods. Mem Inst Oswaldo Cruz 2001; 96:765-9. [PMID: 11562698 DOI: 10.1590/s0074-02762001000600003] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
An hemodialysis population in Central Brazil was screened by polymerase chain reaction (PCR) and serological methods to assess the prevalence of hepatitis C virus (HCV) infection and to investigate associated risk factors. All hemodialysis patients (n=428) were interviewed in eight dialysis units in Goiânia city. Blood samples were collected and serum samples screened for anti-HCV antibodies by an enzyme-linked immunosorbent assay (ELISA). Positive samples were retested for confirmation with a line immunoassay (LIA). All samples were also tested for HCV RNA by the PCR. An overall prevalence of 46.7% (CI 95%: 42-51.5) was found, ranging from 20.7% (CI 95%: 8.8-38.1) to 90.4% (CI 95%: 79.9-96.4) depending on the dialysis unit. Of the 428 patients, 185 were found to be seropositive by ELISA, and 167 were confirmed positive by LIA, resulting in an anti-HCV prevalence of 39%. A total of 131 patients were HCV RNA-positive. HCV viremia was present in 63.5% of the anti-HCV-positive patients and in 10.3% of the anti-HCV-negative patients. Univariate analysis of risk factors showed that the number of previous blood transfusions, transfusion of blood before mandatory screening for anti-HCV, length of time on hemodialysis, and treatment in multiple units were associated with HCV positivity. However, multivariate analysis revealed that blood transfusion before screening for anti-HCV and length of time on hemodialysis were significantly associated with HCV infection in this population. These data suggest that nosocomial transmission may play a role in the spread of HCV in the dialysis units studied. In addition to anti-HCV screening, HCV RNA detection is necessary for the diagnosis of HCV infection in hemodialysis patients.
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Affiliation(s)
- M A Carneiro
- Laboratório de Virologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, 74605-050 Goiânia, GO, Brasil
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Porto A, Morgado J, Bitencourt M, Gomes R, Campos L, Fernandes M, Nogueira P, Silva S, Rey H, Dohmann H. Crit Care 2001; 5:P11. [DOI: 10.1186/cc1344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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34
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Martelli CM, Stefani MM, Gomes MK, Rebello PF, Peninni S, Narahashi K, Maroclo AL, Costa MB, Silva SA, Sacchetim SC, Nery JA, Salles AM, Gillis TP, Krahenbuhl JL, Andrade AL. Single lesion paucibacillary leprosy: baseline profile of the Brazilian Multicenter Cohort Study. Int J Lepr Other Mycobact Dis 2000; 68:247-57. [PMID: 11221086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In Brazil, there is little information about the clinical and epidemiological characteristics of paucibacillary, single skin lesion leprosy patients (SSL-PB). Only recently has the official notification system distinguished leprosy patients with a single lesion as a clinical entity, for whom the single-dose ROM (rifampin, ofloxacin and minocycline) regimen has been recommended. In this paper, we describe the baseline clinical features and the immunological background of a multicenter cohort of SSL-PB leprosy cases enrolled between December 1997-1998. Patients were recruited at health centers located in the following regions: Southeast = Rio de Janeiro; North = Amazon and Rondônia states and Center-West = Goiás state. Eligible cases were newly detected, untreated single-lesion leprosy patients without thickened nerve involvement, and were assessed by clinical, bacilloscopic and histopathological exams. The Mitsuda skin test and anti-PGL-I serology (ELISA) were also performed. Of the 299 SSL-PB leprosy patients, 259 (86.6%) fulfilled the criteria for single-dose ROM intervention. Our results showed that patients recruited from different sites had similar features, considering the clinical and immunological profiles. There was a predominance of adults (mean age 32.4; S.D. = 16.0), and a BCG scar was detected in 76.7% of the children (< or = 15 years old). Only 7 cases were diagnosed as the multibacillary type, representing less than 3% of the patients being misclassified. Our data indicate that in Brazil SSL-PB case ascertainment based on clinical and bacilloscopic criteria can be accurately defined under a routine control program; 75.0% of SSL-PB cases were Mitsuda positive (> or = 5 mm) and seropositivity for anti-PGL-I was detected in 17.3% of the patients. These data are compatible with effective cell-mediated immunity and low bacillary load, suggesting favorable clinical outcomes for most SSL-PB participants of this cohort.
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Affiliation(s)
- C M Martelli
- Universidade Federal de Goias, Instituto de Patologia Tropical e Saude Publica, Rua Delenda Rezende de Mello, S/N, Setor Universitario, Goiania/GO, Brazil.
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Martins LC, Paschoal IA, Von Nowakonski A, Silva SA, Costa FF, Ward LS. Nested-PCR using MPB64 fragment improves the diagnosis of pleural and meningeal tuberculosis. Rev Soc Bras Med Trop 2000; 33:253-7. [PMID: 10967593 DOI: 10.1590/s0037-86822000000300003] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fluids in which Mycobacterium tuberculosis are seldom found, such as pleural and cerebrospinal liquids, are good candidates to be studied using PCR techniques. We detail our experience with a PCR assay applied to pleural and cerebrospinal fluids using the primer MPB64. Seventy three specimens were analyzed: 30 pleural fluids (PF), 26 pleural biopsies (PB) and 17 cerebrospinal fluids (CSF). The gold standard for the diagnosis of tuberculous meningitis was the positive culture for M. tuberculosis in CSF. Tuberculous pleural effusion was diagnosed when cultures of PF and/or PB were positive for M. tuberculosis, or the PB histology showed granulomas. Our results, compared to the gold standards employed, showed a sensitivity of 70%, specificity of 88%, positive predictive value of 82% and negative predictive value of 80%. The high specificity of the MPB64 fragment while still retaining a good sensitivity makes it very well suited for pleural and cerebrospinal tuberculosis diagnosis.
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Ximenes RA, Martelli CM, Souza WV, Lapa TM, Albuquerque MD, Andrade AL, Morais Neto OL, Silva SA, Lima ML, Portugal JL. [Surveillance of endemic diseases in urban areas: the interface between census tract maps and morbidity data]. CAD SAUDE PUBLICA 1999; 15:53-61. [PMID: 10203446 DOI: 10.1590/s0102-311x1999000100006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In this article we discuss the methodological issues associated with the creation of a surveillance system for endemic diseases in urban areas based on analysis of populations at risk and on spatially referenced epidemiological indicators. We comment on the system's basic requirements, selection criteria for socioeconomic variables, and methodological steps to combine these variables so as to construct a census-based deprivation index. We also present the ways we solved some operational problems related to generation of digitized census tracts maps and linkage of morbidity data from different sources. This approach, spatial organization into account in surveillance of endemic diseases, exemplified here by tuberculosis and leprosy, allows for the interaction of several official data sets from census and health services in order to geographically discriminate inner-city risk strata. Criteria for constructing these risk strata were considered a useful tool for health planning and management activities for the control of endemic diseases in cities.
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Affiliation(s)
- R A Ximenes
- Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Av. Moraes Rego, s/n, Cidade Universitária, Recife, PE 50670-420, Brasil
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de Andrade AL, Zicker F, Rassi A, Rassi AG, Oliveira RM, Silva SA, de Andrade SS, Martelli CM. Early electrocardiographic abnormalities in Trypanosoma cruzi-seropositive children. Am J Trop Med Hyg 1998; 59:530-4. [PMID: 9790424 DOI: 10.4269/ajtmh.1998.59.530] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
As part of a major epidemiologic study on Chagas' disease, we compared the prevalence of electrocardiographic (ECG) abnormalities among 141 school children 7-12 years of age and seropositive for Trypanosoma cruzi, and 282 age-, sex-, and school-matched seronegative children in an endemic area in Brazil. The prevalence of ECG abnormalities was 11.3% among seropositive children and 3.5% among seronegative children (odds ratio = 3.5, 95% confidence interval [CI] = 1.5-8.4). The prevalence rate of ECG alterations was 10.7% for seropositive males versus 8.9% for seropositive females. Complete right bundle branch block (CRBBB), which is highly suggestive of Chagas' disease cardiopathy, was diagnosed in nine (6.4%) seropositive children and in only one (0.3%) seronegative child (odds ratio = 18.5, 95% CI = 2.3-146.5, attributable fraction = 58.3%). Five incident new cases of CRBBB were diagnosed after a 36-month follow-up of seropositive children who were enrolled in an independent clinical field trial. No case of frequent and/or multifocal ventricular premature beats was found in the cohort of children. The surprisingly high frequency of early ECG abnormalities, which indicates a rapid evolution from infection to disease, suggests the existence of endemic areas with a particular accelerated disease progression that was not described before. Under such conditions, a public health chemotherapy program focusing on the treatment of young seropositive children would be recommended.
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Affiliation(s)
- A L de Andrade
- Communicable Diseases Program, Pan American Health Organization, Washington, District of Columbia 20037, USA
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Abstract
Leprosy, a disease that used to be shrouded in darkness and fear, can now be cured thanks to a multidrug treatment schedule with rifampicin, clofazimine, and dapsone which has been in use since 1981. In 1991 the World Health Assembly, encouraged by the efficacy of this treatment regimen, established the goal of eliminating the disease as a public health problem globally and nationally by the year 2000. This goal, which calls for reducing disease prevalence to less than one case per 10,000 inhabitants, should not be confused with the goal of eradicating the disease, which implies a complete interruption of its transmission. Eliminating leprosy is an attainable goal which will depend on the forceful and massive use of the multidrug treatment regimen. This paper describes and discusses the various initiatives that have been launched in Latin America for the purpose of achieving this goal and the results obtained so far. It also explores the factors that impact on the feasibility of eradicating the disease.
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Affiliation(s)
- C Lombardi
- Departamento de Salud Colectiva, Universidad Federal de Goias Goiania, Brasil
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Teles SA, Martins RM, Silva SA, Gomes DM, Cardoso DD, Vanderborght BO, Yoshidà CF. Hepatitis B virus infection profile in central Brazilian hemodialysis population. Rev Inst Med Trop Sao Paulo 1998; 40:281-6. [PMID: 10030071 DOI: 10.1590/s0036-46651998000500003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Hepatitis B has proved to be a major health hazard in hemodialysis patients. In order to investigate the hepatitis B virus (HBV) infection profile in the hemodialysis population of Goiânia city--Central Brazil, all dialysis patients (N = 282) were studied. The prevalence of any HBV marker (HBsAg, anti-HBs, and anti-HBc) was 56.7% (95% CI: 51.1-62.7), ranging from 33.3% to 77.7% depending on dialysis unit. HBV-DNA was detected in 67.6% and 88.2% of the HBsAg-positive serum samples, in 91.3% and 100% of the HBsAg/HBeAg-positive samples, and in 18.2% and 63.6% of the HBsAg/anti-HBe-reactive sera by hybridization and PCR, respectively. The length of time on hemodialysis was significantly associated with HBV seropositivity. Only 10% of the patients reported received hepatitis B vaccination. The findings of a high HBV infection prevalence in this population and the increased risk for HBV infection on long-term hemodialysis suggest the environmental transmission, emphasizing the urgent need to evaluate strategies of control and prevention followed in these units.
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Affiliation(s)
- S A Teles
- Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Brasil
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40
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Oliveira EC, Stefani MM, Campos DE, Andrade AL, Silva SA, Rassi A, Luquetti AO. Trypanosoma cruzi stocks isolated from acute Chagas disease patients lead to lethal murine infection. Trans R Soc Trop Med Hyg 1997; 91:25-7. [PMID: 9093620 DOI: 10.1016/s0035-9203(97)90381-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Ten Trypanosoma cruzi stocks recently isolated from patients in acute and chronic phases of Chagas disease were inoculated to susceptible (A/Sn) mice. The mice were inoculated with 10(4) trypomastigotes intraperitoneally and monitored for parasitaemia and mortality for up to 300 d. The results demonstrated that (i) T. cruzi stocks isolated from patients in the acute phase killed animals, while stocks from patients in the chronic phase did not; (ii) survival curves differed statistically among mice infected with lethal stocks, and (iii) parasite burden did not affect the mortality rate of mice.
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Affiliation(s)
- E C Oliveira
- Departamento de Parasitologia, Universidade Federal de Goiás, Goiânia, Brazil
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41
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De Andrade AL, Zicker F, De Oliveira RM, Da Silva IG, Silva SA, De Andrade SS, Martelli CM. Evaluation of risk factors for house infestation by Triatoma infestans in Brazil. Am J Trop Med Hyg 1995; 53:443-7. [PMID: 7485701 DOI: 10.4269/ajtmh.1995.53.443] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
An active entomologic survey was conducted by a team of trained health workers in a rural area endemic for Chagas' disease in central Brazil. They used pyrethrum as a flushing agent and 4,232 houses were inspected for triatomine bugs both inside and in the immediate environs. Houses with Triatoma infestans or evidence of an established colony were identified and defined as infested houses (cases). The building and environmental characteristics of 161 randomly selected infested houses were compared with 161 matched, noninfested houses (controls) that were the shortest distance from the infested house. Domestic and peridomestic potential risk factors associated with house infestation by Triatoma infestans were assessed by logistic regression analysis. Incomplete house construction (odds ratio [OR] = 2.5, 95% confidence interval [CI] = 1.5-4.1) was confirmed as a risk factor related to the presence or evidence of Triatoma infestans in the dwellings. The study also disclosed a statistically significant association between the presence of rats (OR = 1.6, 95% CI = 1.1-2.6) and indoor crop storage (OR = 2.3, 95% CI = 1.1-5.2) and house infestation. Further experimental field studies using tagged rodents should be conducted to assess their epidemiologic role in the domestic chain of Trypanosoma cruzi transmission.
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Affiliation(s)
- A L De Andrade
- Instituto de Patologia Tropical e Saude Publica, Universidade Federal de Goias, Goiania, Goias, Brazil
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42
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Martelli CM, Moraes Neto OL, Andrade AL, Silva SA, Silva IM, Zicker F. Spatial patterns of leprosy in an urban area of central Brazil. Bull World Health Organ 1995; 73:315-9. [PMID: 7614663 PMCID: PMC2486659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Reported is the spatial variation of leprosy in an urban area of Brazil and its correlation with socioeconomic indicators. From November 1991 to October 1992 a total of 752 newly diagnosed leprosy patients who were attending all outpatient clinics in Goiânia city, central Brazil, were identified. A database o leprosy cases was set up linking patients' addresses to 64 urban districts. Leprosy cases were detected in 86% of the districts and three risk strata were identified. The highest-risk area for leprosy was in the outskirts of the city and detection rates increased on moving from more developed to poorer areas. The risk of detecting leprosy cases was 5.3-fold greater (95% CI: 3.8-7.4) in the outskirts of the town than in the central zone. Discussed are the methodological issues related to leprosy case ascertainment, completeness and reliability of information, and the interpretation of the spatial distribution of leprosy per unit area. Highlighted also are the lack of leprosy control activities in primary health care units and the usefulness of geographical analysis in planning health services.
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Affiliation(s)
- C M Martelli
- Departmamento de Saúde Coletiva, Universidade Federal de Goiás, Goiânia, Brazil
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43
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Mara DD, Pearson HW, Silva SA. Waste stabilization ponds. Bull Pan Am Health Organ 1994; 28:183-7. [PMID: 8069339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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44
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Ayres RM, Lee DL, Mara DD, Silva SA. The accumulation, distribution and viability of human parasitic nematode eggs in the sludge of a primary facultative waste stabilization pond. Trans R Soc Trop Med Hyg 1993; 87:256-8. [PMID: 8236383 DOI: 10.1016/0035-9203(93)90115-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Investigations into the enumeration, distribution and viability of nematode eggs in the sludge from a primary facultative waste stabilization pond showed that pond sludges are not nematologically safe for immediate land application. Up to 12% of Ascaris lumbricoides eggs were viable after the pond had been in operation for 2.5 years. Eggs were recovered from the sludge along the full length of the pond, although there were significant decreases in egg concentration and viability with increasing distance from the inlet.
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Affiliation(s)
- R M Ayres
- Department of Pure and Applied Biology, University of Leeds, UK
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Abstract
Characteristics and possible risk factors associated with Trypanosoma cruzi infection among blood donors were assessed within a routine screening programme in blood banks in an endemic area of Chagas disease. 6,172 voluntary blood donors were interviewed and tested for anti-T. cruzi antibodies by Haemagglutination and Complement Fixation tests in six blood banks in Goiânia-Central Brazil from October 1988 to April 1989. An overall prevalence of 2.3% for T. cruzi infection was obtained, being 3.3% for first-time blood donors and 1.9% for regular ones (p < 0.01). Considering this seropositivity among regular blood donors, selection of candidates relying only on the history of previous donation was found to be inadequate. The risk of infection increased inversely with the degrees of education and monthly income. There was a 9.2 risk of infection (95% CI 3.8-22.6) for those who had lived more than 21 years in an endemic area compared to subjects who had never lived in rural settings, after multivariate analysis. These informations may help to review the criteria of selection of donors in order to improve quality of blood products in endemic areas.
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Affiliation(s)
- C M Martelli
- Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Brasil
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46
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de Andrade JG, de Andrade AL, Araujo ES, Oliveira RM, Silva SA, Martelli CM, Zicker F. A randomized clinical trial with high dose of chloroquine for treatment of Plasmodium falciparum malaria in Brazil. Rev Inst Med Trop Sao Paulo 1992; 34:467-73. [PMID: 1342112 DOI: 10.1590/s0036-46651992000500015] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
This clinical trial compared parasitological efficacy, levels of in vivo resistance and side effects of oral chloroquine 25 mg/Kg and 50 mg/Kg in 3 days treatment in Plasmodium falciparum malaria with an extended followed-up of 30 days. The study enrolled 58 patients in the 25 mg/Kg group and 66 in the 50 mg/Kg group. All eligible subjects were over 14 years of age and came from Amazon Basin and Central Brazil during the period of August 1989 to April 1991. The cure rate in the 50 mg/Kg group was 89.4% on day 7 and 71.2% on day 14 compared to 44.8% and 24.1% in the 25 mg/Kg group. 74.1% of the patients in the 25 mg/Kg group and 48.4% of the patients in the 50 mg/Kg group had detectable parasitaemia at the day 30. However, there was a decrease of the geometric mean parasite density in both groups specially in the 50 mg/Kg group. There was 24.1% of RIII and 13.8% of RII in the 25 mg/Kg group. Side effects were found to be minimum in both groups. The present data support that there was a high level resistance to chloroquine in both groups, and the high dose regimen only delayed the development of resistance and its administration should not be recommended as first choice in malaria P. falciparum therapy in Brazil.
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Affiliation(s)
- J G de Andrade
- Departamento de Medicina Tropical, Instituto de Patologia Tropical e Saúde Pública/Universidade Federal de Goiás, Goiânia-GO, Brasil
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Rodrigues ML, Silva SA, Neto JC, de Andrade AL, Martelli CM, Zicker F. Protective effect of intradermal BCG against leprosy; a case-control study in central Brazil. Int J Lepr Other Mycobact Dis 1992; 60:335-9. [PMID: 1474274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
A case-control study was undertaken to evaluate the protective efficacy of intradermal BCG against leprosy in a high-endemic area of leprosy in central Brazil. Sixty-two cases and 186 controls were included in the study. Cases were all newly diagnosed leprosy patients under 16 years of age attending an outpatient health service, and all of them were schoolchildren. Three controls under 16 years old, frequency matched by sex and age group, were selected from schools geographically located in the area from which the cases came. The presence of BCG was negatively associated with leprosy, indicating a 5.3 risk of leprosy for those nonvaccinated and protective efficacy of 81%. Paucibacillary patients were more likely to have a BCG scar than multibacillary patients.
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Affiliation(s)
- M L Rodrigues
- Public Health Department, Universidade Federal de Goias, Brazil
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de Andrade AL, Zicker F, Luquetti AO, Oliveira RM, Silva SA, Souza JM, Martelli CM. Surveillance of Trypanosoma cruzi transmission by serological screening of schoolchildren. Bull World Health Organ 1992; 70:625-9. [PMID: 1464149 PMCID: PMC2393366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The seroprevalence of Trypanosoma cruzi infection among children is a sensitive indicator for assessing the effectiveness of programmes for control of Chagas disease. In this study we report the result of a cross-sectional serological survey carried out among schoolchildren living in a poor rural area in central Brazil. Eluates of blood collected on filter-paper were tested for anti-T. cruzi antibodies using immunofluorescence, haemagglutination, and enzyme-linked immunosorbent assays. The overall seroprevalence of T. cruzi infection was 7.9%, which compared with the findings of the national survey carried out in 1975-80 indicates that a twofold-to-threefold reduction in prevalence has occurred over the last 10 years. This is consistent with a reduction of transmission in the area, probably related to vector control efforts. Based on our results, the incidence of new cases was estimated to be 44 per annum in the study region. In rural areas with a scattered population, surveillance of T. cruzi transmission by serological screening of children at school entry is more practical and economical than entomological evaluation for assessing both the risk of transmission in the community and the efficacy of vector control measures. A sample size of around 1000 schoolchildren is sufficient to detect prevalences as low as 2%, and such an approach would be practical and applicable to most areas where Chagas disease is endemic.
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Affiliation(s)
- A L de Andrade
- Department of Community Health, Universidade Federal de Goiás, Goiânia, Brazil
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Abstract
Gastric submucosal tumors are relatively common. Using the current diagnostic techniques, however, differentiating these tumors from external gastric compression may sometimes be difficult. The nature of submucosal tumors, which may have therapeutic implications, may also be quite difficult to elucidate using current techniques, such as bore biopsy, high-frequency-wave scalpel biopsy, topical infusion of pure ethanol, and submucosography. We report a case of a sumucosal tumor of the gastric cardia and discuss the usefulness of endoscopic ultrasonography (EUS) in determining the internal structure of these tumors. After endoscopic ultrasonography, the tumor was diagnosed as a myoma of the gastric cardia, whose bulk had grown out the gastric cavity.
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Affiliation(s)
- S A Silva
- Second Department of Surgery, Chiba University School of Medicine, Japan
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50
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Silva SA. Acupuncture for the relief of pain of facial and dental origin. Anesth Prog 1989; 36:244-5. [PMID: 2490052 PMCID: PMC2190672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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