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Souza CDFD, Medronho RDA, Santos FGB, Magalhães MDAFM, Luna CF. Modelagem espacial da hanseníase no estado da Bahia, Brasil, (2001-2015) e determinantes sociais da saúde. Ciênc saúde coletiva 2020; 25:2915-2926. [DOI: 10.1590/1413-81232020258.21522018] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 11/26/2018] [Indexed: 12/19/2022] Open
Abstract
Resumo O trabalho analisa a distribuição espacial da hanseníase na Bahia e os determinantes sociais relacionados. Estudo ecológico com dados de hanseníase do período 2001-2015. Três indicadores epidemiológicos foram selecionados: coeficiente de detecção na população geral e em menores de 15 anos e a taxa de casos novos com grau II de incapacidade. Os indicadores foram suavizados pelo Modelo Bayesiano Empírico Local e aplicou-se estatística de Moran Global e Local. As variáveis independentes foram selecionadas a partir do Censo IBGE-2010. Regressões multivariadas foram empregadas, seguidas de regressão espacial. Observou-se distribuição heterogênea no estado, com concentração no eixo norte-oeste e região sul. Para o coeficiente de detecção geral, cinco variáveis compuseram o modelo: densidade demográfica, proporção da população urbana, renda per capita, proporção de extremamente pobres e domicílios com mais de três pessoas por dormitório. A proporção de analfabetismo compôs o modelo final para a taxa de grau II de incapacidade física. Não foram identificados determinantes da ocorrência da doença em menores de 15 anos. A modelagem utilizada contribuiu para demonstrar a heterogeneidade espacial e os determinantes sociais da doença na Bahia, colocando em evidência a complexidade do problema.
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Oliveira ALSD, Luna CF, Silva MGPD. [Homicides in Brazil in the last decade: an integrative review]. Cien Saude Colet 2020; 25:1925-1934. [PMID: 32402045 DOI: 10.1590/1413-81232020255.09932018] [Citation(s) in RCA: 2] [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] [Received: 08/10/2017] [Accepted: 09/14/2018] [Indexed: 11/22/2022] Open
Abstract
Homicide is the most serious form of violence with a negative impact on the population. It is broadly studied in the scientific field and disseminated in print and in the virtual media. The scope of this article is to locate papers in national and international journals, seeking the synthesis of knowledge and the incorporation of the applicability of the results of significant studies. It involved an integrative review of the SciELO, PubMed and LILACS databases of articles published between 2006 and 2016. The following key words were researched: Homicide and Brazil. The publications were selected by the title, abstract and methodology. For homicide and health studies in Brazil, 427 papers were found, of which 98 were selected. There were publications with emphasis on the national scenario, followed by the state of São Paulo and Pernambuco. The quantitative study was the most used, with collection of secondary data. The papers dealt with homicides in the population in general (48%), Femicide (14.3%) and Social Determinants (7.1%). The Brazilian scientific production on homicide and health is on the increase. It is important that researchers, analysts and editors turn their attention to the development of papers in this area, aiming to improve the quality of published articles.
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Lima SSD, Braga MC, Vanderlei LCDM, Luna CF, Frias PG. [Assessment of the impact of prenatal, childbirth, and neonatal care on avoidable neonatal deaths in Pernambuco State, Brazil: an adequacy study]. CAD SAUDE PUBLICA 2020; 36:e00039719. [PMID: 32130315 DOI: 10.1590/0102-311x00039719] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 08/14/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the impact of programs for prenatal, childbirth, and neonatal care (Mother Owl and Stork Network) on avoidable neonatal mortality in Pernambuco State, Brazil, using the adequacy approach. We analyzed the trend in avoidable neonatal mortality and the impact of these programs on avoidable neonatal mortality in four health regions in the state from 2000 to 2016. The Mortality Information System (SIM) and the Information System on Live Births (SINASC) and official documents were used as the data sources. Deaths were classified according to the Brazilian List of Avoidable Causes of Deaths Via Interventions by the Unified National Health System. Linear regression and joinpoint methods were used to analyze tendencies and identifying turning points in the neonatal mortality curves. There was a sharp drop in avoidable neonatal mortality in the state, especially in early neonatal mortality. Except for the I-Recife region, where there was a downturn in the mortality curves after implementation of the Stork Network, there was no association between the turning points in the curves and the periods with the programs' implementation in the regions. Other factors appear to have led to the improvement of these indicators, such as the expansion of the high-risk network. Strengthening this network can thus help reduce avoidable neonatal deaths, especially early deaths.
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Souza CDFD, Magalhães MAFM, Luna CF. Hanseníase e carência social: definição de áreas prioritárias em estado endêmico do Nordeste brasileiro. Rev bras epidemiol 2020; 23:e200007. [PMID: 32130396 DOI: 10.1590/1980-549720200007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 01/09/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Introdução: A hanseníase é uma doença que guarda estreita relação com as condições sociais e econômicas. O Brasil é o único país que ainda não alcançou a meta de eliminação da doença como problema de saúde pública. Objetivo: Este trabalho teve como objetivo analisar a associação entre a carência social dos municípios baianos e a detecção de casos novos de hanseníase na população, como instrumento para a definição de áreas prioritárias para intervenção. Metodologia: Trata-se de um estudo ecológico realizado no estado da Bahia, no período de 2001 a 2015. Variáveis analisadas: coeficiente de detecção casos novos, índice de carência social (ICS) e hanseníase em menores de 15 anos. O ICS foi construído com base em quatro variáveis: índice de performance socioeconômica, renda per capita, proporção de extremamente pobres e densidade domiciliar. Na análise espacial, foram utilizadas modelagem bayesiana empírica local e estatística de Moran global e local. Na análise estatística, foram empregados regressão multivariada, espacial e logística, cálculo do odds ratio e análise de variância. Resultados: A hanseníase apresentou distribuição heterogênea no estado, com concentração no eixo norte-oeste e sul. Dos municípios, 60,4% (n = 252) apresentaram muito baixa condição de vida. Observou-se associação entre as condições de vida e a detecção da hanseníase, com maiores coeficientes no grupo de município com melhor condição de vida (p < 0,001). Conclusão: As piores condições atuaram como um impeditivo ao diagnóstico, ao mesmo tempo que ampliaram o risco de adoecimento. As boas condições possuem efeito inverso.
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Gonçalves-Macedo L, Lacerda EM, Markman-Filho B, Lundgren FLC, Luna CF. Trends in morbidity and mortality from COPD in Brazil, 2000 to 2016. ACTA ACUST UNITED AC 2019; 45:e20180402. [PMID: 31778424 PMCID: PMC7447544 DOI: 10.1590/1806-3713/e20180402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/17/2019] [Indexed: 11/21/2022]
Abstract
Objective: To examine the trends in overall COPD mortality, as well as trends in in-hospital morbidity and mortality due to COPD, in Brazil, and to validate predictive models. Methods: This was a population-based study with a time-series analysis of cause-specific morbidity and mortality data for individuals ≥ 40 years of age, obtained from national health information systems for the 2000-2016 period. Morbidity and mortality rates, stratified by gender and age group, were calculated for the same period. We used regression analyses to examine the temporal trends and double exponential smoothing in our analysis of the predictive models for 2017. Results: Over the study period, COPD mortality rates trended downward in Brazil. For both genders, there was a downward trend in the southern, southeastern, and central-western regions. In-hospital morbidity rates declined in all regions, more so in the south and southeast. There were significant changes in the number of hospitalizations, length of hospital stay, and hospital expenses. The predictive models for 2017 showed error rates below 9% and were therefore validated. Conclusions: In Brazil, COPD age-adjusted mortality rates have declined in regions with higher socioeconomic indices, where there has been an even sharper decrease in all in-hospital morbidity and mortality variables. In addition to factors such as better treatment adherence and reduced smoking rates, socioeconomic factors appear to be involved in controlling COPD morbidity and mortality. The predictive models estimated here might also facilitate decision making and the planning of health policies aimed at treating COPD.
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Affiliation(s)
- Liana Gonçalves-Macedo
- . Serviço de Pneumologia, Hospital Otávio de Freitas, Secretaria de Saúde do Estado de Pernambuco, Recife (PE) Brasil
| | - Eliana Mattos Lacerda
- . Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Brivaldo Markman-Filho
- . Serviço de Cardiologia, Departamento de Clínica Médica, Universidade Federal de Pernambuco, Recife (PE) Brasil
| | | | - Carlos Feitosa Luna
- . Departamento de Estatística e Geoprocessamento, Fundação Oswaldo Cruz - Fiocruz - Recife (PE) Brasil
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Gonçalves de Albuquerque SDC, da Costa Oliveira CN, Vaitkevicius-Antão V, Silva AC, Luna CF, de Lorena VMB, de Paiva-Cavalcanti M. Study of association of the rs2275913 IL-17A single nucleotide polymorphism and susceptibility to cutaneous leishmaniasis caused by Leishmania braziliensis. Cytokine 2019; 123:154784. [PMID: 31344596 DOI: 10.1016/j.cyto.2019.154784] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 12/22/2018] [Revised: 05/23/2019] [Accepted: 07/16/2019] [Indexed: 12/14/2022]
Abstract
Cutaneous leishmaniasis (CL) caused by Leishmania braziliensis is the most spread clinical form of leishmaniasis in Brazil. However, only a few part of the people infected develop clinically perceptive disease, suggesting the influence of human genetic components in the CL pathogeny. The rs2275913 SNP is the nucleotide variant of the IL17A gene. The A allele is associated with a vast number of infectious and non-infectious diseases. Here, we investigated the association of the rs2275913 SNP (G/A) from IL-17A and two forms of susceptibility to CL in Brazil by case-control study. Furthermore, we evaluated the functional relevance of this SNP during the immune response of the host and analyzed its impact in the parasite elimination. Weak associations of A allele with susceptibility to L. braziliensis infection or to symptomatic CL were observed, and a tendency of A allele carriers to be more susceptible to infection and cutaneous disease. Functional analysis of the Th17 cell phenotypes revealed lower frequencies of CD4+ IL-17+ cells in samples of infected people with AA/AG genotypes. Furthermore, people carrying the A allele maintain higher parasite loads, reinforcing the genetic susceptibility findings. This study adds knowledge about the influence of a significant genetic variation on IL-17 promoter on CL pathogenesis, and may contribute to enhance the knowledge about the role of IL-17 in the L. braziliensis infections.
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Affiliation(s)
- Suênia da Cunha Gonçalves de Albuquerque
- Department of Microbiology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil; Central Laboratory of Public Health Dr Milton Bezerra de Sobral, Rua João Fernandes Vieira S/N, 50050-215 Recife, Pernambuco, Brazil
| | - Cíntia Nascimento da Costa Oliveira
- Department of Microbiology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil
| | - Victor Vaitkevicius-Antão
- Department of Microbiology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil
| | - Ana Carla Silva
- Department of Microbiology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil
| | - Carlos Feitosa Luna
- Department of Microbiology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil
| | - Virgínia Maria Barros de Lorena
- Department of Immunology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil
| | - Milena de Paiva-Cavalcanti
- Department of Microbiology, Aggeu Magalhães Institute, Oswaldo Cruz Foundation, Av. Prof. Moraes Rego S/N, 50670-420 Recife, Pernambuco, Brazil.
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Ayres CFJ, Guedes DRD, Paiva MHS, Morais-Sobral MC, Krokovsky L, Machado LC, Melo-Santos MAV, Crespo M, Oliveira CMF, Ribeiro RS, Cardoso OA, Menezes ALB, Laperrière-Jr RC, Luna CF, Oliveira ALS, Leal WS, Wallau GL. Zika virus detection, isolation and genome sequencing through Culicidae sampling during the epidemic in Vitória, Espírito Santo, Brazil. Parasit Vectors 2019; 12:220. [PMID: 31068218 PMCID: PMC6505216 DOI: 10.1186/s13071-019-3461-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 04/27/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Zika virus (ZIKV) has been isolated from many mosquito species in nature, but it is believed that the main vectors in urban environments are species of the genus Aedes. Here, we detected and isolated ZIKV in samples from Aedes aegypti, Aedes taeniorhynchus and Culex quinquefasciatus, collected during the Zika epidemic in Vitória, southeast Brazil. Using quantitative real-time polymerase chain reaction, ZIKV detection was performed in mosquito samples collected from February to April 2016. RESULTS Overall, six pools of mosquitoes were positive for ZIKV: four of Cx. quinquefasciatus, one of Ae. aegypti and one of Ae. taeniorhynchus. Their genomes were sequenced. CONCLUSIONS These results support and strengthen the hypothesis that other mosquito species can also be involved in ZIKV transmission.
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Affiliation(s)
| | | | - Marcelo Henrique Santos Paiva
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brasil.,Universidade Federal de Pernambuco, Caruaru, Brasil
| | | | - Larissa Krokovsky
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brasil
| | - Laís Ceschini Machado
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brasil
| | | | - Mônica Crespo
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brasil
| | | | - Ricardo Silva Ribeiro
- Núcleo de Vigilância em Saúde, Superintendência Regional de Saúde de Vitória, Cariacica, Brasil
| | - Orlei Amaral Cardoso
- Núcleo de Vigilância em Saúde, Superintendência Regional de Saúde de Vitória, Cariacica, Brasil
| | | | - Roberto Costa Laperrière-Jr
- Núcleo Especial de Vigilância Ambiental, Gerência Estratégica de Vigilância em Saúde, Secretaria de Estado da Saúde, Vitória, Brasil
| | - Carlos Feitosa Luna
- Núcleo de Estatística e Geoprocessamento (NEG), Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brazil
| | - André Luiz Sá Oliveira
- Núcleo de Estatística e Geoprocessamento (NEG), Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brazil
| | - Walter Soares Leal
- Department of Molecular and Cellular Biology, University of California, Davis, USA
| | - Gabriel Luz Wallau
- Departamento de Entomologia, Instituto Aggeu Magalhães (IAM), Fundação Oswaldo Cruz, Recife, Brasil
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Souza CDFD, Luna CF, Magalhães MDAFM. Transmissão da hanseníase na Bahia, 2001-2015: modelagem a partir de regressão por pontos de inflexão e estatística de varredura espacial*. Epidemiologia e Serviços de Saúde 2019; 28:e2018065. [DOI: 10.5123/s1679-49742019000100015] [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] [Received: 09/19/2018] [Accepted: 01/11/2019] [Indexed: 11/02/2022] Open
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de Souza CDF, Luna CF, Magalhães MDAFM. Spatial modeling of leprosy in the state of Bahia and its social determinants: a study of health inequities. An Bras Dermatol 2019; 94:182-191. [PMID: 31090823 PMCID: PMC6486086 DOI: 10.1590/abd1806-4841.20197554] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 01/22/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Leprosy is a neglected disease caused by Mycobacterium leprae. Brazil has the second largest number of cases in the world. OBJECTIVES To analyze the spatial distribution of leprosy in the state of BAHIA, Brazil, and the association between his occurrence and the synthetic indicators of municipal socioeconomic performance, social vulnerability and income inequality. METHODS An ecological study with secondary data obtained from the National System of Notifiable Diseases. Dependent variables: coefficient of detection in the general population and in the population under 15 years old and the rate of grade II of physical disability. Independent variables: Synthetic indicators of socioeconomic performance, social vulnerability and income inequality. RESULTS The highest coefficients of detection of new cases in the general population and in children under 15 years old are concentrated in the north-west axis and in the southern region of the state. On the other hand, the highest rates of degree II of physical incapacity are concentrated in the north, northeast and south regions. Only the Index of Social and Economic Performance(IPESE)-Economy and Finance composed the final regression model of the general detection coefficients and in children under 15 years old. The municipalities with the highest indexes had the highest detection coefficients, reflecting the capacity to diagnose new cases. STUDY LIMITATIONS The use of synthetic indicators is a limitation of the study. CONCLUSIONS Leprosy presents a heterogeneous spatial pattern in the state of BAHIA, and the IPESE-Economics and Finance indicator is the only one with explanatory potential of the disease.
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Affiliation(s)
- Carlos Dornels Freire de Souza
- Discipline of Collective Health, Curso de Medicina,
Universidade Federal de Alagoas, Arapiraca (AL), Brazil
- Instituto Aggeu Magalhães, Fundação
Oswaldo Cruz, Recife (PE), Brazil
| | - Carlos Feitosa Luna
- Instituto Aggeu Magalhães, Fundação
Oswaldo Cruz, Recife (PE), Brazil
- Program of Post-Graduation in Public Health,
Fundação Oswaldo Cruz, Recife (PE), Brazil
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Oliveira ALSD, Luna CF, Quinino LRDM, Magalhães MDAFM, Santana VCDM. Spatial analysis of intentional homicides in João Pessoa, Paraíba, Brazil, 2011-2016. Epidemiol Serv Saude 2019; 28:e2018184. [PMID: 30785574 DOI: 10.5123/s1679-49742019000100003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/01/2018] [Indexed: 11/02/2022] Open
Abstract
OBJECTIVE to describe spatial patterns of intentional homicides in João Pessoa, Paraíba, Brazil, 2011-2016. METHODS this was an ecological study using census tracts as units of analysis; the study used data on intentional homicides of victims living in João Pessoa obtained by cross-checking Mortality Information System SIM information with Public Security information; mortality coefficients were calculated for the whole period and its triennia and were later smoothed using the local empirical Bayesian method; spatial autocorrelation techniques were applied to the smoothed coefficients which were using Moran's spatial statistics. RESULTS significant spatial autocorrelation was detected for the period as a whole I=0.679, p=0.01, the 1st triennium I=0.508, p=0.01, and the 2nd triennium I=0.572, p=0.01; areas of greater risk were identified distributed among the western, northwestern, southeastern, and far south zones of the city, mainly in regions with low socioeconomic conditions; census tracts with low coefficients were located in areas of medium/high socioeconomic status. CONCLUSION homicides in João Pessoa were high in poor districts and these are priority areas for intervention.
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Affiliation(s)
| | - Carlos Feitosa Luna
- Fundação Instituto Oswaldo Cruz, Instituto Aggeu Magalhães, Recife, PE, Brasil
| | | | | | - Vinícius César de Moura Santana
- Secretaria de Estado de Segurança Pública e Defesa Social da Paraíba, Assessoria de Ações Estratégicas, João Pessoa, PB, Brasil
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da Silva JSF, Braga C, Duarte FM, Oliveira P, Feitosa Luna C, Marcondes M, Araújo J, Grilis MR, de Souza Melo PFA, Brandão E, Rocha A. Effectiveness of annual single doses of diethylcarbamazine citrate among bancroftian filariasis infected individuals in an endemic area under mass drug administration in Brazil. Pathog Glob Health 2018; 112:274-280. [PMID: 30111259 PMCID: PMC6225505 DOI: 10.1080/20477724.2018.1498821] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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] [Indexed: 10/28/2022] Open
Abstract
The Global Program to Eliminate Lymphatic Filariasis has achieved extraordinary success in reducing transmission and preventing morbidity through mass drug administration (MDA) to the population at-risk. Brazil is the only currently using diethylcarbamazine citrate (DEC) alone for MDA, so an assessment of its effectiveness is needed. We report the trends of filarial markers in a cohort of 175 individuals infected with Wuchereria bancrofti in areas that underwent MDA in the city of Olinda, Northeastern Brazil. The prospective study was conducted between 2007 and 2012 (corresponding to five annual MDA rounds). The quantification of microfilaraemia (QMFF) was assessed by filtration. Circulating filarial antigen (CFA) was detected through immunochromatographic point-of-care test (POCT-ICT) and Og4C3-ELISA whereas antifilarial antibody titres (IgG4) were assessed through Bm14 assay. The CFA and IgG4 titres were measured by Optical Density (OD). The main characteristics at baseline, MDA coverage and the trend of filarial infection markers during follow up were described. The trend of filarial markers in relation to time (years of MDA), sex and age were analysed through Generalized Estimating Equations (GEE) models. The models demonstrated a significant decrease in all markers during MDA. The probability of remaining positive by QMFF and POCT-ICT diminished 70% and 46%, respectively, after each MDA round. There was a significant annual drop in CFA (-0.290 OD) and IgG4 antibodies titres (-0.303 OD). This study provides evidence that MDA with DEC alone can be effective in the elimination of LF in Brazil.
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Affiliation(s)
- Jennifer S. F. da Silva
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | - Cynthia Braga
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | | | - Paula Oliveira
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | - Carlos Feitosa Luna
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | - Márcia Marcondes
- Municipal Health Secretariat of Recife, Recife, Pernambuco, Brazil
| | - Josué Araújo
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | - Maria Rosangela Grilis
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | | | - Eduardo Brandão
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
| | - Abraham Rocha
- Oswaldo Cruz Fundation, Aggeu Magalhães Institute, National Center of Lymphatic Filariasis, Recife, Pernambuco, Brazil
- Laboratory of the Hospital Otávio de Freitas, Recife, Pernambuco, Brazil
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Almeida RDS, Ramos AMDL, Luna CF, Pedrosa F, Donadi EA, Lucena-Silva N. Cytokines and soluble HLA-G levels in bone marrow stroma and their association with the survival rate of patients exhibiting childhood T-cell acute lymphoblastic leukemia. Cytokine 2018; 102:94-101. [DOI: 10.1016/j.cyto.2017.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 07/07/2017] [Accepted: 07/19/2017] [Indexed: 12/27/2022]
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Gonçalves-Macedo L, Lopes EP, Domingues ALC, Markman B, Mota VG, Luna CF. Schistosomiasis and hepatopulmonary syndrome: the role of concomitant liver cirrhosis. Mem Inst Oswaldo Cruz 2017; 112:469-473. [PMID: 28591307 PMCID: PMC5452483 DOI: 10.1590/0074-02760160383] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 03/13/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Hepatopulmonary syndrome (HPS) is defined as an oxygenation defect induced by intrapulmonary vasodilation in patients with liver disease or portal hypertension. It is investigated in patients with liver cirrhosis and less frequently in those with portal hypertension without liver cirrhosis, as may occur in hepatosplenic schistosomiasis (HSS). OBJECTIVES To investigate the prevalence of HPS in patients with HSS, and to determine whether the occurrence of HPS is influenced by concomitant cirrhosis. METHODS We evaluated patients with HSS with or without concomitant liver cirrhosis. All patients underwent laboratory testing, ultrasound, endoscopy, contrast echocardiography, and arterial blood gas analysis. FINDINGS Of the 121 patients with HSS, 64 were also diagnosed with liver cirrhosis. HPS was diagnosed in 42 patients (35%) and was more frequent among patients with concomitant liver cirrhosis than in those without cirrhosis (42% vs. 26%), but the difference was not significant (p = 0.069). HPS was more common in those with spider naevi, Child-Pugh classes B or C and high model for end stage liver disease (MELD) scores (p < 0.05 each). MAIN CONCLUSIONS The prevalence of HPS was 35% in this study. The occurrence of liver cirrhosis concomitantly with HSS may have influenced the frequency of patients presenting with HPS.
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Affiliation(s)
- Liana Gonçalves-Macedo
- Universidade Federal de Pernambuco, Programa de Pós-Graduação em Medicina Tropical, Recife, PE, Brasil
| | - Edmundo Pessoa Lopes
- Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Serviço de Gastroenterologia e Hepatologia, Recife, PE, Brasil
| | - Ana Lucia Coutinho Domingues
- Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Serviço de Gastroenterologia e Hepatologia, Recife, PE, Brasil
| | - Brivaldo Markman
- Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Serviço de Cardiologia e Ecocardiografia, Recife, PE, Brasil
| | - Vitor Gomes Mota
- Universidade Federal de Pernambuco, Departamento de Medicina Clínica, Serviço de Cardiologia e Ecocardiografia, Recife, PE, Brasil
| | - Carlos Feitosa Luna
- Fundação Oswaldo Cruz-Fiocruz, Laboratório de Métodos Quantitativos em Saúde, Recife, PE, Brasil
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Gonçalves-Macedo L, Domingues ALC, Lopes EP, Luna CF, Mota VG, Becker MMDC, Markman-Filho B. Pulmonary shunts in severe hepatosplenic schistosomiasis: Diagnosis by contrast echocardiography and their relationship with abdominal ultrasound findings. PLoS Negl Trop Dis 2017; 11:e0005417. [PMID: 28369056 PMCID: PMC5391128 DOI: 10.1371/journal.pntd.0005417] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 04/13/2017] [Accepted: 02/16/2017] [Indexed: 12/31/2022] Open
Abstract
Background Schistosomiasis is endemic to several parts of the world. Among the species that affect humans, Schistosoma mansoni is one of the most common causes of illness. In regions where schistosomiasis mansoni is endemic, reinfection is responsible for the emergence of hepatosplenic schistosomiasis (HSS) with portal hypertension in about 10% of infected individuals. Regardless of its etiology, portal hypertension may bring about the formation of arteriovenous fistulas and pulmonary vascular dilation, thus constituting a pulmonary shunt and its presence has been associated with the occurrence of neurological complications. The objective of this study was to identify pulmonary shunt using TTCE in patients with HSS and esophageal varices, and to compare the abdominal ultrasound and endoscopy findings among patients with and without pulmonary shunt. Methodology/Principal findings In this case series, a total of 461 patients with schistosomiasis mansoni were prospectively evaluated using abdominal ultrasound and endoscopy and 71 presented with HSS with esophageal varices. Fifty seven patients remained in the final analysis. The mean age of the patients was 55 ± 14 years, and 65% were female. Pulmonary shunts were observed in 19 (33.3%) patients. On comparing the groups with and without pulmonary shunt, no significant differences were observed in relation to the abdominal ultrasound and endoscopic findings. When comparing the two subgroups with pulmonary shunts (grade 1 vs grades 2 and 3), it was observed that the subgroup with shunt grades 2 and 3 presented with a significantly higher frequency of an enlarged splenic vein diameter (>0.9 cm), and an advanced pattern of periportal hepatic fibrosis (P = 0.041 and P = 0.005, respectively). None of the patients with pulmonary shunts had severe neurological complications. Conclusions/Significance Our findings suggest that in HSS with esophageal varices the pulmonary shunts may be present in higher grades and that in this condition it was associated with ultrasound findings compatible with advanced HSS. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. In the areas where schistosomiasis mansoni is endemic, around 10% of infected individuals develop hepatosplenic schistosomiasis (HSS) with portal hypertension. Portal hypertension may promotes an imbalance in the hepatic production of vasoactive substances, which may act on the lungs promoting the formation of arteriovenous fistulas and pulmonary vascular dilation, a condition that is called a pulmonary shunt. When the pulmonary shunt is of higher grades, small thrombus or septic emboli that would normally be filtered through the pulmonary capillaries reach the left heart and the systemic circulation, which can lead to neurological complications. We found pulmonary shunts in patients with HSS and esophageal varices and we also found that patients with higher grades of pulmonary shunts presented with a significantly higher frequency of advanced periportal fibrosis and an enlarged splenic vein diameter. No neurological complications were observed. Our findings suggest that pulmonary shunts may be present in patients with HSS and esophageal varices. The abdominal ultrasound findings compatible with advanced HSS could be used as screening to investigate pulmonary shunt.
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Affiliation(s)
- Liana Gonçalves-Macedo
- Graduate Program in Tropical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- * E-mail:
| | - Ana Lucia Coutinho Domingues
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Gastroenterology and Hepatology, Universidade Federal de Pernambuco, Recife, Brazil
| | - Edmundo Pessoa Lopes
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Gastroenterology and Hepatology, Universidade Federal de Pernambuco, Recife, Brazil
| | - Carlos Feitosa Luna
- Laboratory of Quantitative Health Methods, Fundação Oswaldo Cruz (Fiocruz), Recife, Brazil
| | - Vitor Gomes Mota
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Cardiology and Echocardiography, Universidade Federal de Pernambuco, Recife, Brazil
| | - Mônica Moraes de Chaves Becker
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Cardiology and Echocardiography, Universidade Federal de Pernambuco, Recife, Brazil
| | - Brivaldo Markman-Filho
- Department of Clinical Medicine, Universidade Federal de Pernambuco, Recife, Brazil
- Center for Cardiology and Echocardiography, Universidade Federal de Pernambuco, Recife, Brazil
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de Brito RDCCM, Lucena-Silva N, Torres LC, Luna CF, Correia JDB, da Silva GAP. The balance between the serum levels of IL-6 and IL-10 cytokines discriminates mild and severe acute pneumonia. BMC Pulm Med 2016; 16:170. [PMID: 27905908 PMCID: PMC5131553 DOI: 10.1186/s12890-016-0324-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/17/2016] [Indexed: 01/03/2023] Open
Abstract
Background To identify markers for earlier diagnosis of severe pneumonia, we assess the correlation between serum cytokine profile of children with different pneumonia severity. Methods In 25 hospitalized children, 7 with mild pneumonia and 18 with severe pneumonia, the serum concentration of 11 cytokines in three sampling times were dosed. Statistical analysis included parametric and non-parametric tests, Pearson correlation and ROC curve for cut-off definition of cytokines. Results At admission, IL-6 serum levels were high in mild or severe pneumonia, and was associated to vomiting (P = 0.019) in both groups; and also to dyspnea (P = 0.012) and white blood cell count (P = 0.045) in patients with severe pneumonia. IL-10 levels were also high in patients with pneumonia and were associated to lymphocytosis (P = 0.025). The ROC curve of the IL-6:IL-10 serum levels ratio discriminated severe pneumonia cases at admission, and persistence of infection in the third day of antibiotic therapy, with positive predictive values of 93% and 89%, respectively. Conclusions The balance between IL-6 and IL-10 serum levels showed to be a more discriminative marker for severity definition and evaluation of recovery in patients with pneumonia. Electronic supplementary material The online version of this article (doi:10.1186/s12890-016-0324-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rita de Cássia Coelho Moraes de Brito
- Institute of Integral Medicine Professor Fernando, Figueira (IMIP), Pediatrics, Rua Dona Benvinda de Farias 159, apt 1101, Boa Viagem, Recife, Pernambuco, Brazil.
| | - Norma Lucena-Silva
- Institute of Integral Medicine Professor Fernando Figueira (IMIP), Oncology and Aggeu Magalhães Research Center, Fiocruz-PE, Immunology, Recife, Brazil
| | - Leuridan Cavalcante Torres
- Institute of Integral Medicine Professor Fernando, Figueira, IMIP, Translational Medicine Laboratory, Recife, Brazil
| | | | - Jaílson de Barros Correia
- Institute of Integral Medicine Professor Fernando, Figueira, IMIP, Translational Medicine Laboratory, Recife, Brazil
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Santos Lima A, Carneiro Neves MM, Machado Gomes K, Miranda Guarines K, Luna CF, Silva Duarte R, Lapa Montenegro LM, Charifker Schindler H. First case report of infection by Mycobacterium wolinskyi after mammoplasty in Brazil. Infect Dis Rep 2013; 5:e12. [PMID: 24470962 PMCID: PMC3892610 DOI: 10.4081/idr.2013.e12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 09/09/2013] [Accepted: 09/28/2013] [Indexed: 11/30/2022] Open
Abstract
Mycobacterium wolinskyi is a rapidly growing mycobacterium, first described in 1999 as a member of the group Mycobacterium smegmatis (Mycobacterium smegmatis, Mycobacterium wolinskyi and Mycobacterium goodii). Only 19 case reports all over the world have been described on literature, none of them in Brazil. On this report, it is described one case of infection after a mammoplasty procedure performed in a private health service in the county of Recife, Pernambuco, Brazil, in 2009. The mycobacteria specie was identified using biochemical tests and sequencing the specific gene rpoB. To treat the infection by Mycobacterium wolinskyi it was necessary to combine antibiotics for a long period of time associated with surgical procedures of the breast abscesses.
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Affiliation(s)
- Andrea Santos Lima
- Department of Immunology, Aggeu Magalhães Center for Research/Fiocruz , Recif
| | | | - Karen Machado Gomes
- Institute of Microbiology, Federal University of Rio de Janeiro , Recif, Brazil
| | | | - Carlos Feitosa Luna
- Department of Public Health, Aggeu Magalhães Center for Research/Fiocruz , Recif, Brazil
| | - Rafael Silva Duarte
- Institute of Microbiology, Federal University of Rio de Janeiro , Recif, Brazil
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Silva VDL, Albuquerque MDFPMD, Cesse EÂP, Luna CF. Perfil de mortalidade do idoso: análise da evolução temporal em uma capital do Nordeste brasileiro de 1996 a 2007. Rev bras geriatr gerontol 2012. [DOI: 10.1590/s1809-98232012000300005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Este trabalho objetivou analisar a evolução temporal da mortalidade de idosos no município de Recife no período de 1996 a 2007. MÉTODOS: Realizou-se estudo de evolução temporal, com o universo de óbitos da população idosa (>60 anos). Os coeficientes de mortalidade foram calculados, padronizados por idade e sexo, pelo método direto para subgrupos etários, sexo, estado civil, causa básica de óbito, local de ocorrência e assistência médica na base de mil habitantes. Foram realizadas análises descritivas e análise de regressão linear. RESULTADOS: A mortalidade em idosos no Recife apresenta tendência de declínio na série analisada, com maiores coeficientes entre os idosos longevos (>80 anos). Os idosos homens apresentam maior mortalidade em relação às idosas, com tendência de diminuição dos coeficientes. Quanto ao estado civil, houve aumento da mortalidade entre idosos solteiros e separados judicialmente. A maioria dos óbitos ocorreu em hospitais e com assistência médica no momento do óbito. Foi observada tendência de decréscimo da mortalidade por doenças do aparelho circulatório, doenças infecciosas e parasitárias, doenças do aparelho digestivo e sinais e sintomas mal definidos e aumento da mortalidade por doenças do aparelho geniturinário. A evolução da mortalidade por neoplasias, doenças endócrinas, nutricionais e metabólicas, doenças do aparelho respiratório e causas externas não sofreu variações. CONCLUSÕES: A mortalidade do idoso recifense apresentou padrão semelhante à realidade nacional, destacando-se a tendência de redução dos coeficientes de mortalidade.
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Silva CC, Domingues AL, Lopes EP, Morais CN, Santos RB, Luna CF, Nader HB, Martins JR. Schistosomiasis mansoni: ultrasound-evaluated hepatic fibrosis and serum concentrations of hyaluronic acid. Ann Trop Med Parasitol 2011; 105:233-9. [PMID: 21801502 DOI: 10.1179/136485911x12987676649629] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Schistosomiasis mansoni is a fibrogenic liver disease that constitutes a major health problem in north-eastern Brazil. Although one common manifestation of the disease, periportal fibrosis (PPF), can be assessed by ultrasonography by well-trained physicians, the necessary equipment and personnel are not always readily available. Serum markers, including hyaluronic acid (HA), have been used as alternative means of measuring fibrosis. Recently serum concentrations of HA have been evaluated in 77 Brazilians (61 cases of schistosomiasis mansoni and 16 healthy controls) and compared against the ultrasound-evaluated PPF in the same subjects. The HA was measured using a non-competitive fluorescence-based assay, while the PPF was explored using a portable ultrasound scanner (SSD-500; Aloka, Tokyo) and graded, as patterns A-F, according to the World Health Organization's 'Niamey protocol'. In general, the serum concentrations of HA were found to be positively correlated with the severity of the PPF. The mean concentration of HA in the sera of the 16 controls was significantly lower than that recorded in the schistosomiasis cases who showed PPF of patterns D or E (P<0·001 for each). The cases who showed pattern-C PPF also had significantly less HA in their sera than the cases with PPF of patterns D or E (P<0·001 for each), and the cases with pattern-D fibrosis had significantly lower HA concentrations in their sera than the cases with PPF of pattern E (P<0·001). In an analysis based on a receiver-operating-characteristic (ROC) curve, an HA concentration of 20·2 μg/litre of serum was identified as a threshold that could be used to distinguish moderate cases of PPF (i.e. patterns C or D) from the more advanced cases (i.e. patterns E or F), with a sensitivity of 60% and specificity of 65%. In conclusion, it appears that serum concentrations of hyaluronic acid could be used as markers for periportal fibrosis in patients with schistosomiasis mansoni.
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Affiliation(s)
- C C Silva
- Universidade Federal de Pernambuco, Rua Irmã Maria Davi 154, Recife, PE, Brazil
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Luna CF, Brito AMD, Costa AM, Lapa TM, Flint JA, Marcynuk P. Impacto do uso da água de cisternas na ocorrência de episódios diarréicos na população rural do agreste central de Pernambuco, Brasil. Rev Bras Saude Mater Infant 2011. [DOI: 10.1590/s1519-38292011000300009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: avaliar o impacto do uso da água de cisternas na ocorrência de episódios diarréicos comparando o número e a duração de episódios entre moradores de domicílios com e sem cisternas, numa mesma área geográfica. MÉTODOS: estudo longitudinal prospectivo aninhado a um estudo de corte transversal com dois grupos de comparação (domicílios com e sem cisternas) realizado, em 21 municípios do Agreste Central de Pernambuco, em 2007. O período de coleta foi de 60 dias, e incluiu 1765 indivíduos. Para análise descritiva utilizou-se modelos mistos hierárquicos, Mann-Whitney e Kaplan-Meyer com nível de significância de 5%. RESULTADOS: entre os 949 indivíduos com cisternas, obteve-se uma redução no risco de ocorrência de episódios diarréicos de 73% quando comparados aos 816 indivíduos sem cisternas (RR=0,27; p<0.001). O número médio de episódios registrados nos residentes de domicílios sem cisternas foi de 0,48 (DP=1,17), contra 0,08 (DP=0,32) nos domicílios com cisternas(z=-10,26; p<0,001). A duração média dos episódios foi 1,5 vezes maior nos domicílios sem cisternas (χ²=8,99; p=0,003). CONCLUSÕES: os achados deste estudo destacam a importância do acesso à água potável na redução de doenças. A ocorrência de diarréia, bem como, seus indicadores de gravidade - número de episódios e duração da diarréia foram consistentemente maiores nos residentes de domicílios sem cisternas.
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Gouveia GC, Souza WVD, Luna CF, Szwarcwald CL, Souza Júnior PRBD. Satisfação dos usuários com a assistência de saúde no estado de Pernambuco, Brasil, 2005. Ciênc saúde coletiva 2011; 16:1849-61. [PMID: 21519674 DOI: 10.1590/s1413-81232011000300020] [Citation(s) in RCA: 6] [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] [Received: 10/08/2008] [Accepted: 12/15/2008] [Indexed: 11/22/2022] Open
Abstract
Pesquisar a satisfação dos usuários é tarefa fundamental para a gestão. Com o Projeto de Fortalecimento da Capacidade Avaliativa do Estado, a Secretaria de Saúde de Pernambuco identificou como demanda avaliar o desempenho do sistema de saúde no estado. O objetivo deste artigo é conhecer fatores associados à satisfação dos usuários do sistema de saúde pernambucano. Realizou-se estudo avaliativo a partir dos resultados obtidos num inquérito populacional com dados coletados em 2005 no estado de Pernambuco. A análise foi executada com emprego de métodos multivariados tendo a satisfação como variável dependente. Os principais aspectos analisados foram: qualidade dos profissionais, qualidade dos serviços de saúde e a resolutividade do sistema. As análises revelaram que o tempo de espera até o atendimento e a disponibilidade de medicamentos foram os fatores que geraram menores percentuais de satisfação dos usuários, o que leva a refletir se o acesso está de fato relacionado à oferta de serviços adequados às necessidades da população ou não e à política de assistência farmacêutica no estado. Concluindo, obteve-se um panorama mais completo sobre a forma como o sistema de saúde pernambucano tem respondido às expectativas de sua população na ótica dos usuários.
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Cesse EAP, Carvalho EFD, Souza WVD, Luna CF. [Mortality trends by the diabetes mellitus in Brazil: 1950 to 2000]. ACTA ACUST UNITED AC 2010; 53:760-6. [PMID: 19893920 DOI: 10.1590/s0004-27302009000600011] [Citation(s) in RCA: 5] [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: 09/06/2008] [Accepted: 06/15/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze mortality trend by diabetes mellitus in Brazilian capitals. METHODS It was analyzed mortality temporal trend by diabetes mellitus in Brazilian capitals, from the death data of the statistic directory of IBGE and the System of Mortality Information of the Ministry of Health, in the period from 1950 to 2000. RESULTS It was observed the growth of proportional mortality and the Standard Mortality Ratio by diabetes in most of the capitals. São Paulo (SP) outstood for presenting expressive and constant proportional mortalities along the series, particularly from 1960. As to the Standard Mortality Ratio in this capital, as well as in Belo Horizonte (MG), where it was noticed the oscillation of these indicators tending to decrease in the last years, it was not observed significant trends. CONCLUSIONS Mortality trend by diabetes is increasing in most of the capitals, with the exception of São Paulo and Belo Horizonte, which have shown different patterns from the other capitals.
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Affiliation(s)
- Eduarda Angela Pessoa Cesse
- Departamento de Saúde Coletiva, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
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Cesse EÂP, Carvalho EFD, Souza WVD, Luna CF. Tendência da mortalidade por doenças do aparelho circulatório no Brasil: 1950 a 2000. Arq Bras Cardiol 2009; 93:490-7. [DOI: 10.1590/s0066-782x2009001100009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Accepted: 09/01/2008] [Indexed: 11/22/2022] Open
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Cavalcanti YVN, Pereira VRA, Reis LC, Ramos ALG, Luna CF, Nascimento EJM, Lucena-Silva N. Evaluation of memory immune response to mycobacterium extract among household contact of tuberculosis cases. J Clin Lab Anal 2009; 23:57-62. [PMID: 19140213 DOI: 10.1002/jcla.20290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The human immune response to tuberculosis (TB) is especially mediated by T CD4(+)lymphocytes. However, more studies are needed in order to understand the exact role of each cytokine in the mechanisms for cures. In this article, our aim was to analyze the production of TNF-alpha, IL-10, and IFN-gamma in peripheral blood mononuclear cells (PBMCs) among the household contacts of common primary TB cases, with or without histories of active TB infection, who were negative to parasitological and HIV tests. In order to characterize the cytokine production, PBMCs from these groups were stimulated with whole-protein extract of M. tuberculosis (WPE) antigen (rAgTb) for 24 and 48 hr. The culture supernatants were collected and IFN-gamma, TNF-alpha, and IL-10 were assayed using capture ELISA. There were no statistical differences between primary TB cases and their household contacts with or without previous histories of lung TB. Our results suggest that T memory cells, T regulatory cells, and the Th1/Th2 dichotomy may be responsible for the results described in this article. Further studies are currently underway.
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Abstract
OBJECTIVE The increase in the number of AIDS cases among women has led to an increase in the maternal-infant transmission of human acquired immunodeficiency virus. Measures for the control of this type of transmission were implemented in Brazil in 1996. The aim of the present study was to analyze time trends in maternal-infant transmission of AIDS among Brazilian children. METHODS The present study included children born in Brazil between 1990 and 2001. We used the database of notified AIDS cases in children 13 years of age or younger between 1990 and 2004. Exponential regression models adjusted to the time series provided the annual variation rates and observed and expected values for the period. RESULTS We found a significant increasing trend for cases born prior to the year in which anti retroviral therapy was introduced, with an increase rate of about 12% (t<0.003) per year. Rates from different states ranged from 5.9% to 31%. The analysis of expected and observed cases for each of the country's five Regions showed a reduction in the number of cases among children born from 1997 onwards, with a progressive year-to-year reduction. The number of notified cases among children born in 2001 was less than 10% the number of expected cases. CONCLUSIONS The results obtained suggest a favorable response to the implementation of policies for the prevention of maternal-infant HIV transmission in Brazil, as observed in other parts of the world.
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Affiliation(s)
- Ana Maria de Brito
- Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brazil.
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Rothman A, Acherman RJ, Luna CF, Restrepo H. Enlarged left vitelline vein remnant as a cause of cyanosis after the Fontan procedure: resolution with an Amplatzer vascular plug. Pediatr Cardiol 2006; 27:381-4. [PMID: 16541221 DOI: 10.1007/s00246-005-1270-3] [Citation(s) in RCA: 8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A 6-year-old girl with heterotaxy and a functional single ventricle had persistent cyanosis 4 years after a fenestrated Fontan procedure. Cardiac catheterization revealed a large venous fistula from a left-sided hepatic vein to the coronary sinus, resulting in desaturation. The anomalous vein was occluded with an Amplatzer vascular plug.
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Affiliation(s)
- A Rothman
- Children's Heart Center and the Department of Pediatrics, University of Nevada School of Medicine, 3006 S. Maryland Parkway #690, Las Vegas, NV 89109, USA.
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de Lima MLC, Ximenes RADA, de Souza ER, Luna CF, de Albuquerque MDFPM. Análise espacial dos determinantes socioeconômicos dos homicídios no Estado de Pernambuco. Rev Saude Publica 2005; 39:176-82. [PMID: 15895135 DOI: 10.1590/s0034-89102005000200006] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [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: 11/21/2022] Open
Abstract
OBJETIVO: Investigar a associação entre variáveis socioeconômicas e taxas de homicídio, considerando a localização espacial dos indicadores. MÉTODOS: Utilizou-se o método de estudo ecológico. A variável dependente foi taxa de homicídio da população masculina de 15 a 49 anos, residente nos municípios do Estado de Pernambuco, em 1995 a 1998. As variáveis independentes referem-se a: índice de condições de vida, renda familiar per capita, desigualdade de Theil, índice de Gini, renda média do chefe de família, índice de pobreza, taxa de analfabetismo, densidade demográfica.Utilizou-se teste de correlação espacial determinado pelo Índice de Moran, regressão múltipla, Conditional Auto Regressive (CAR) e a função Loess, como modelo de detecção de tendência especial. RESULTADOS: Os indicadores taxa de analfabetismo e índice de pobreza explicaram 24,6% da variabilidade total das taxas de homicídio, cuja associação foi inversa. O índice de Moran revelou autocorrelação espacial entre os municípios. O modelo de regressão espacial que melhor se adequou ao estudo foi o CAR, que confirmou a associação entre índice de pobreza, analfabetismo e homicídio. CONCLUSÕES: A relação inversa observada entre os indicadores socioeconômicos e homicídios pode expressar determinado processo que propicia melhoria das condições de vida, e está atrelado predominantemente a condições geradoras de violência, como a do tráfico de drogas.
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Abstract
The management of cardiac arrhythmias has evolved rapidly over the past decade. This includes the development of more effective antiarrhythmic medications as well as catheter- and device-based therapies. Antiarrhythmic medications remain the primary treatment modality for most acute arrhythmias; however, the long term use of these medications may be accompanied by severe adverse effects. For this reason, antiarrhythmic medications are increasingly used in conjunction with other forms of therapy, such as catheter ablation or pacemaker implantation. Patients with congenital heart disease often have an increased propensity for cardiac arrhythmias due to both inherent conduction system abnormalities and impaired ventricular function. The purpose of this review is to examine the currently available antiarrhythmic drugs and assess their role in the treatment of arrhythmias in patients with congenital heart disease. It is important to emphasize that patients with congenital heart disease often have hemodynamic limitations and may be at an increased risk for developing adverse effects with antiarrhythmic agents. An awareness of the arrhythmias associated with congenital heart disease, the natural history of these arrhythmias, and the potential benefit of treatment with antiarrhythmic medications versus other forms of therapy provides a rational basis for therapy in this challenging population of patients.
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Affiliation(s)
- A S Batra
- Division of Cardiology, Childrens Hospital Los Angeles, University of Southern California, Los Angeles, California 90027, USA
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