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PubMed1995

[Eighty years of Japanese immigration in Brazil].

"Japanese emigration to Brazil started in 1908 with some eight hundred subsidized contract workers for coffee plantations. Hard conditions made many of them flee, and the paulista government suppressed subsidies for these projects; however, the Japanese emigration to Brazil kept on under Japanese subsidies from 1925 until 1934 when Brazil imposed immigration quotas unfavorable to Japanese immigration. International circumstances in the late 1930s and local prohibition on the use of the Japanese language in Brazil caused many immigrants to return to Japan between 1939-1941. Emigration to Brazil restarted as diplomatic relations between Japan and Brazil were reestablished in 1952 but decreased in the late 1960s. Subsequent economic evolution in both countries caused Japanese emigrants in Brazil and their [descendants] to initiate dekasegui [labor] migration from Brazil to Japan as from the late 1980s." (SUMMARY IN ENG)

Americas↗
PubMed1997

Introductory study of the once-a-month, injectable contraceptive Cyclofem in Brazil, Chile, Colombia, and Peru.

An introductory trial with the injectable contraceptive Cyclofem was carried out in Brazil, Chile, Colombia, and Peru, with participation by 3,183 women. Women were followed-up for up to 2 years of use and the data were evaluated by life table analysis. A total of 29,676 women-months were accumulated for up to 2 years. No pregnancies were observed in the 2 years. The discontinuation rates for amenorrhea in the first year ranged from 3.4 in Brazil to 8.1 in Colombia, and for menstrual disturbances from 5.1 in Chile to 9.2 in Brazil. The discontinuation rates for other medical reasons ranged from 7.8 in Brazil to 26.3 in Colombia, and for personal reasons from 17.2 in Chile to 23.5 in Brazil. Continuation rates ranged from 42.3 in Colombia to 52 in Chile. In the second year of observation the rates of discontinuation were lower than those observed in the first year, with the exception of personal reasons in Brazil, which were the same as those observed in the first year. Continuation rates ranged from 19.4 in Brazil to 36.8 in Chile. The comparison of reasons for discontinuation in selected clinics showed that the rate for amenorrhea in one clinic in Chile was more than three times that in others and in Peru was seven times more in one clinic than in another. Regarding menstrual disturbances, in Peru one clinic presented a rate three times higher than the others. The main reasons for discontinuation due to other medical reasons were headache and weight gain. In conclusion, Cyclofem presented a high contraceptive efficacy and an acceptable rate of continuation and discontinuation for up to 2 years in the four countries.

Adult↗
PubMed2003

Nephrology in Latin America, with special emphasis on Brazil.

Latin America constitutes a complex universe that shows extreme variation regarding socioeconomic and human development. Brazil is the largest and most populous Latin American country, and combines characteristics encountered in developed countries with problems typically associated with the poorest regions of the world. These disparities condition the profile of renal disease in Brazil, with glomerulonephritis still the leading cause of ESRD. Little is known about the epidemiology of renal disease in the Brazilian (or Latin American) native population, which is numerous in some Central and South American countries, but constitute a very small minority in Brazil. However, interesting information has been obtained from the Yanomamis, a tribe living in Northern Brazil and Southern Venezuela. Hypertension is virtually absent among these people, who ingest very little sodium, lending strong support to the concept that sodium retention, a "civilization" factor, plays a role in the pathogenesis of arterial hypertension. Despite Brazil's striking socioeconomic disparities, access to RRT is in principle accessible to all those in need of it. The dialysis units have been modernized in recent years, whereas the Government covers most expenses related to RRT. However, the prevalence of RRT in Brazil is currently approximately 320 per million population, less than one third as high as in the US, suggesting that ESRD may be underdiagnosed in the country. Much effort is still needed to limit the prevalence of renal disease and to improve the quality and the reach of RRT in Brazil and in Latin America.

Brazil↗
PubMed2002

Case studies in international tobacco surveillance: cigarette smuggling in Brazil.

OBJECTIVE: This article is the first in a series of international case studies developed by the American Cancer Society to illustrate use of publicly available surveillance data for regional tobacco control. DESIGN: A descriptive analysis of Brazil and Paraguay cigarette production and trade data from official sources. METHODS: Per capita cigarette consumption for Brazil and its neighbour was calculated from 1970 to 1998 using data on production, imports, and exports from NATIONS, the National Tobacco Information Online System. RESULTS: A 63% decrease was observed in the estimate of per capita consumption of cigarettes in Brazil between 1986 and 1998 (from 1913 cigarettes per person in 1986 to 714 cigarettes per person in 1998) and a 16-fold increase in Paraguay was observed during the same period (from 678 cigarettes per person in 1986 to 10 929 cigarettes per person in 1998). Following Brazil's 1999 passage of a 150% cigarette export tax, cigarette exports fell 89% and Brazil's estimated per capita consumption rose to 1990 levels (based on preliminary data). Per capita consumption in Paraguay also fell to 1990 levels. CONCLUSIONS: These trends coincide with local evidence that large volumes of cigarettes manufactured in Brazil for export to Paraguay are smuggled back and consumed as tax-free contraband in Brazil. It is hoped that this case study will draw wider public attention to the problems that smuggling presents for tobacco control, help identify other countries confronting similar issues, and stimulate effective interventions.

Brazil↗
PubMed1995

[The social geography of AIDS in Brazil].

The first of a series of papers concerning the evaluation of the dynamics of the AIDS epidemic in Brazil employing techniques of geographical analysis, is here presented. Results of research undertaken in the US (especially in New York City) are compared with those of a recent investigation carried out in the city of S.Paulo, Brazil (Grangeiro, 1994). In both, geographical patterns of socio-demographic variables correlate with different patterns of the spread of the AIDS epidemic through the transmission groups. Recent trends of the AIDS epidemic in Brazil: the displacement toward medium sized cities and expansion frontiers, increasing report of AIDS cases among the poor and underprivileged, changes in the pattern of transmission with proportional augmentation of heterosexual transmission and IDUs as transmission groups, are described and analysed. The geographical distribution of the AIDS cases registered between 1987-1993 in Brazil throughout the Brazilian States is evaluated by means of worksheets, maps, and non-parametric statistics. Results show that Gravimetric Centers (obtained by the use of the calculus spatial means) of AIDS in Brazil are situated within a triangle the sides of which are formed lines joining the three main metropolitan areas of the wealthiest region of Brazil--the southeast, i.e. São Paulo, Rio de Janeiro and Belo Horizonte. These especially S. Paulo, function as points of attraction for these Gravimetric Centers (GCs) towards the south as compared with the GCs of the general population calculated ia accordance with data from the 1980 and 1991 censuses. It is possible to observe a displacement of the GCs toward the northwest over this period in accordance with the migration patterns of the Brazilian population in general, though with a dynamic of its own. These changes in the geographical, socio-demographic and transmission group patterns show the complex nature of the epidemic in Brazil and pose additional difficulties for the development of prevention strategies.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Postweaning and feedlot growth and carcass characteristics of Angus-, gray Brahman-, Gir-, Indu-Brazil-, Nellore-, and red Brahman-sired F1 calves.

Postweaning, feedlot, and carcass data from crossbred calves sired by five Bos indicus breeds and one Bos taurus breed were evaluated. Data included records from F1 calves out of multiparous Hereford cows sired by Angus, Gray Brahman, Gir, Indu-Brazil, Nellore, and Red Brahman bulls. The Zebu crosses grew faster postweaning and were heavier and taller as yearlings than the Angus crosses (P < .05). Among the Zebu-sired calves, the Red and Gray Brahman crosses were faster gaining and were heavier at a year of age than the Gir, Indu-Brazil, and Nellore. The Nellore crosses were significantly taller than the Gray Brahman- and Gir-sired crosses; the Indu-Brazil and Red Brahman were intermediate. Angus crosses were lightest on and off feed but were not significantly different from Gir, and Red and Gray Brahman were heaviest (P < .05). The Nellore and Indu-Brazil were similar in initial weight, but Indu-Brazil calves were similar to Red and Gray Brahman for final weight. The Angus cross was more desirable (P < .05) in marbling score and quality grade although the Nellore crosses had the most desirable score and grade of the Zebu crosses. Gir crosses had higher skeletal maturity scores (P < .05) than Nellore, Gray Brahman, Indu-Brazil, and Angus crosses; Red Brahman crosses were intermediate Angus crosses had the lightest carcasses but not significantly lighter than the Indu-Brazil, Gir, or Nellore. Red Brahman-cross carcasses were heaviest and Gray Brahman-cross carcasses were intermediate.(ABSTRACT TRUNCATED AT 250 WORDS)

Aging↗
PubMed1993

Randomized comparative trial of three antivenoms in the treatment of envenoming by lance-headed vipers (Bothrops jararaca) in São Paulo, Brazil.

In São Paulo City, Brazil, 121 patients with moderately severe envenoming by Bothrops snakes (principally B. jararaca) were randomized for treatment with Brazilian polyspecific Bothrops antivenoms: Instituto Butantan (39 patients), Instituto Vital Brazil (41), Fundação Ezequiel Dias (FUNED) (41). The initial dose was four ampoules (40 ml) in 89 patients with less severe envenoming and eight ampoules (80 ml) in 32 patients with more severe envenoming. A second dose of four ampoules was required in 20 patients. Patients receiving the three antivenoms were comparable in all respects before treatment. There were no deaths. The majority showed rapid clinical improvement, resolution of local envenoming, cessation of bleeding and restoration of blood coagulability. No differences in the efficacy of the three antivenoms were revealed by clinical or laboratory observations, including measures of haematological, haemostatic and biochemical abnormalities. Twelve patients developed abscesses (Butantan 1, Vital Brazil 6, FUNED 5) and seven developed local necrosis (3,1,3). Of 88 patients followed up 20-30 days after the bite 33 (37.5%) still had symptoms or signs of local envenoming, especially swelling. Early (anaphylactic) reactions were unexpectedly frequent after all three antivenoms but were significantly more frequent with Butantan (87%) than with Vital Brazil (37%) or FUNED (56%) antivenoms (p < 0.001). A possible explanation was the higher total protein content and percentage immunoglobulin of Butantan antivenom. The doses of antivenom recommended in Brazil and used in this study may be unnecessarily high, resulting in an unacceptably high incidence of reactions. Results of the study should prompt a critical re-evaluation of antivenom production techniques and dosage recommendations in Brazil.

Adolescent↗
PubMed1997

Community screening for rheumatic disorder: cross cultural adaptation and screening characteristics of the COPCORD Core Questionnaire in Brazil, Chile, and Mexico. The PANLAR-COPCORD Working Group. Pan American League of Associations for Rheumatology. Community Oriented Programme for the Control of Rheumatic Disease.

OBJECTIVE: (1) To adapt the Community Oriented Programme for the Control of Rheumatic Disease (COPCORD) Core Questionnaire (CCQ) for use as a rheumatic disease screening instrument in Spanish and Portuguese communities in Brazil, Chile, and Mexico, including translation and back translation, and assessment of cross cultural equivalence and reliability. (2) To determine the screening characteristics of the CCQ, specifically the sensitivity and specificity of Spanish and Portuguese versions for detecting cases of rheumatic disorder compared with a full clinical examination by a rheumatologist. (3) To determine the number of clinical examinations that could be avoided in population studies by applying the CCQ followed by a clinical examination in positive CCQ screenees. METHODS: Translation and assessment of cross cultural equivalence were conducted by practising rheumatologists in Brazil, Chile, and Mexico using standardized methods. Back translation was done by an independent rheumatologist (Brazil), a radiologist (Chile), and a general physician (Mexico). Interviewer agreement was assessed in all sites in a convenience sample. Sensitivity and specificity were assessed by independently administering the CCQ and a full clinical examination to a sample of 200 persons aged 15 years or older, randomly selected from communities in Sao Paulo, Brazil (n = 200), Temuco, Chile (n = 200), and Mexico City, Mexico (n = 200). RESULTS: (1) Cross cultural equivalence and back translation of the modified questionnaire were satisfactory. Interviewer agreement was acceptable. (2) In groups from Brazil, Chile, and Mexico, respectively, the overall prevalence of rheumatic disease based on clinical examination was 33.3, 45.1, and 46.3%. The sensitivity and specificity of 2 definitions of a positive CCQ screening for the presence of rheumatic disorder were: Definition 1 (no trauma, present pain, tenderness, swelling or stiffness in bones, joints or muscles): sensitivity, 91.8, 96.0, 84.0; specificity, 70.0, 35.5, 61.0; Definition 2 (Definition 1 plus pain intensity > or = 4 and 11 point category rating scale): sensitivity, 66.2, 86.3, 42.7; specificity, 82.3, 41.9, 80.0. (3) In groups from Brazil, Chile, and Mexico, respectively, positive screening by Definition 1 followed by a clinical examination avoids 499, 213, and 403 clinical examination per 1000 respondents screened and yields an overall prevalence of rheumatic disorder of 30, 43, and 40%. The addition of pain intensity (Definition 2) increased the total number of examinations avoided, but reduced the prevalence estimate compared to Definition 1 (22.0, 39.0, and 20.0%). CONCLUSION: The CCQ appears promising as a screening tool to detect rheumatic disorder in Spanish and Portuguese speaking communities in a developing country. The findings suggest that the CCQ followed by a full clinical examination in positive respondents can provide an acceptable estimate of prevalence of rheumatic disorder. The total number of clinical examinations that must be administered in population based prevalence surveys can be reduced by using the CCQ, while maintaining satisfactory accuracy. Our findings need to be confirmed in further applications of the CCQ.

Adolescent↗
PubMed1997

[Accidents and acts of violence in Brazil: I--Analysis of mortality data].

External causes are an important cause of death in almost all countries. They are always the second or third in the mortality ranking, but their distribution according to type varies from country to country. Mortality due to external causes by type, gender and age, for Brazil as a whole and for state capitals specifically, is analysed. Mortality rates and the proportional mortality from 1977 to 1994 were calculated. The results showed that the number of deaths due to external causes has almost doubled from 1977 to 1994 and nowadays this is the second cause of death in Brazil. The mortality rate, in 1991, was 69.8 per 100,000 inhabitants and the highest increase was in the male rates. The male rates are almost 4.5 times greater than the female ones. The first cause of death among people from 5 to 39 years old is external causes, and the majority occur between 15 and 19 years of age (65% of the deaths by external causes). Besides the growth in itself it also seems that a shift of deaths to hower ages is occurring. Both mortality by traffic accidents and that by homicide have increased over the period from 1977 to 1994. Suicides have been stable and "other external causes" have increased slowly, especially due to falls and drowning. The mortality rates for external causes in state capitals are higher than the average for Brazil as a whole, except for some northeastern capitals. The rates for the capitals in the northern region are the highest in Brazil. In the northeastern region, only Recife, Maceió and Salvador have high rates. In the southeast, Vitória, Rio de Janeiro and S. Paulo have the highest rates in the country but Belo Horizonte's rates are declining. In the southern region all the capitals showed a growth in the rates as also in the capitals of the West-central region. The growth of mortality due to external causes type of external cause is different in these capitals. Suicide is not a public health problem in Brazil nor the state capitals. Traffic accidents are a major problem in Vitória, Goiânia, Macapá, the Distrito Federal and Curitiba. Homicides have increased greatly in Porto Velho, Rio Branco, Recife, S. Luís, Vitória, S. Paulo, Curitiba, Porto Alegre, Cuiabá and the Distrito Federal. The mortality due to external causes in Brazil has become a major public health problem, especially because of homicides. It is important to emphasize that the quality of the mortality data on external causes is not the same for all capitals, because it is a question very closely related to the quality of legal information.

Accidents↗
PubMed1998

Sensitization to the major allergen of Brazil nut is correlated with the clinical expression of allergy.

BACKGROUND: Only a few studies have investigated the clinical role of food allergens, especially the relationship between sensitization to a given allergen and occurrence of adverse reactions when eating the relevant food item. OBJECTIVE: This study evaluated the clinical role of the allergens of Brazil nut by comparing the patterns of IgE binding in sera from 11 patients with anaphylaxis after eating Brazil nuts with those from 10 subjects with no symptoms to this food item. Both groups had specific IgE to Brazil nut. METHODS: Allergens in the in-house extract of Brazil nut were identified by SDS-PAGE/immunoblotting, the major allergen was purified by HPLC, and its N-terminal sequence was determined by a protein sequencer. RESULTS: SDS-PAGE/immunoblotting detected a number of allergenic components with molecular weights ranging from 4 to 58 kd. All sera from symptomatic patients recognized a 9-kd allergen corresponding (as established by amino acid sequencing) to a 2S albumin already described as a major allergen of Brazil nut, whereas the other allergens each bound IgE from less than 50% of sera. No sera from asymptomatic subjects showed IgE binding to the 9-kd allergen, but they did recognize components from 25 to 58 kd, which are minor allergens. CONCLUSIONS: These findings indicate that the allergen underlying clinical reactions to Brazil nut is a 2S albumin of 9 kd and that in vitro reactivity to this allergen identifies subjects who react in vivo to ingestion of this food.

2S Albumins, Plant↗
PubMed2002

Country response to HIV/AIDS: national health accounts on HIV/AIDS in Brazil, Guatemala, Honduras, Mexico and Uruguay.

National expenditures on HIV/AIDS were estimated as summary indicators to assess the country's response to HIV/AIDS. The methodology is based on a matrix system describing the level and flow of health expenditures on HIV/AIDS: an adaptation of the National Health Accounts methods. The expenditures were classified by source (public, private, international), by the use of funds (prevention, care), by object, and by type of provider institution. The results are reported in US dollars using the official exchange rate for the year of estimation. For international comparisons monetary units were adjusted by the purchasing power parity (US dollars PPP). National HIV/AIDS total expenditures were: Guatemala US dollars PPP29.5 million, Uruguay US dollars PPP 32.5 million, Mexico US dollars PPP 257 million, and Brazil US dollars PPP 587.4 million during 1998, and Honduras US dollars PPP 33.9 million for 1999. The total HIV/AIDS expenditures per capita for 1998 were: Brazil US dollars 2.69, Mexico US dollars 1.25, Guatemala US dollars 1.08, Uruguay US dollars 6.63, and Honduras US dollars 3.6 for 1999. The 1998 distribution of the total HIV/AIDS expenditures in prevention and care were, respectively, Brazil 10 and 80%, Guatemala 15 and 70%, Mexico 29 and 66%, Uruguay 36 and 51%, and Honduras 28 and 65% for 1999. The share of total expenditures on antiretroviral drugs ranged from 52% in Guatemala to 75% in Brazil, even when the estimated coverage of antiretroviral therapy was close to 10% in Guatemala and universal in Brazil. The estimated flow from international sources per capita in 1998 was Uruguay US dollars 0.03, Brazil US dollars 0.24, Guatemala US dollars 0.11, Mexico US dollars 0.01, and Honduras US dollars 1.04 in 1999. The data allow international comparisons and provide critical information to improve equity and efficiency in the allocation of scarce resources. The National HIV/AIDS Accounts also constitute a powerful tool to describe the country's response to HIV/AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Rotavirus Infection in Brazil: Epidemiology, Immunity, and Potential Vaccination.

Worldwide, it is estimated that rotaviruses cause more than 125 million diarrheal episodes and nearly 1 million deaths per year among infants and young children. In Brazil, these agents have been associated with 13%-40% of cases of acute diarrhea affecting pediatric in-patients and outpatients. Longitudinal community-based studies involving children followed from birth to the age of three years, yielded an average of 0.3 rotavirus-related episodes of diarrhea per child per year. While seasonality of rotavirus infections is not evident in the more northern tropical areas, a peak incidence during the driest months (May to September) has been noted in Brazil's central and southern states. All four epidemiologically important rotavirus serotypes have been identified in Brazil, with Gl and G2 accounting for about two-thirds of typed strains. The recent characterization of G- and P- genotypes has demonstrated that predominant strains are essentially the same as those most commonly identified worldwide: taken together, P[S]G1 and P[4]G2 rotaviruses account for over 50% of genotyped strains. In addition, the occurrence of unusual types, such as P[8]G5, and mixed infections, have been reported in about 10% and 20% of diarrheal cases, respectively. Outbreaks of rotavirus diarrhea have been reported in both urban and remote communities, G2 type being reported to cause severe gastroenteritis among adults and children. Among Indian populations the clinical attack rate has approached 90%. Rotavirus group C has been associated with outbreaks of diarrhea in day-care centers, yielding clinical attack rates of nearly 50%. Seroprevalence studies in several regions in Brazil indicate that at least 70% of children aged 4-5 years have antibodies to rotavirus. It has also been demonstrated in longitudinal studies that heterotypic immune response in a primary infection may be an intrinsic property of the rotavirus strain. A tetravalent rhesus-human reassortant rotavirus vaccine (4 x 10,000 pfu/dose) has been evaluated in northern Brazil with the following main results: a) the vaccine was safe with only low-grade fever on days 3-5 in 2%-3% of vaccinees after the first dose; b) an IgA antibody response occurred in 58% of vaccinees and 33% of placebo recipients; and c) the overall vaccine efficacy was 35% (p = 0.03) against any rotavirus diarrhea for the 2-year study period, but reached 57% (p = 0.008) during the first year of follow-up. In view of findings indicating strain diversity throughout Brazil, a country-wild surveillance system is urgently needed to monitor circulating rotavirus strains.

Journal Article↗
PubMed2004

Geographic variation in Epstein-Barr virus-associated Burkitt's lymphoma in children from Brazil.

In developing countries, BL has a strong association with EBV infection during childhood. In South America, the data have shown an EBV association intermediate between that reported in the United States (30%) and that in equatorial Africa (95%). Early age at EBV infection and lower socioeconomic status have been related to increased EBV-associated BL in developing countries. In Brazil, there are not enough data on childhood BL related to EBV infection. Our aim was to evaluate the clinicopathologic features and EBV association of 44 children with NHL from the state of Rio de Janeiro, situated in the southeast of Brazil. EBV was detected using RNA in situ hybridization in 36 biopsy specimens. DNA from fresh tumor samples and from paraffin-embedded tissues of patients were analyzed by PCR, in which the first reaction included primers for an EBNA-2 common region while the nested reaction amplified the region discriminating between EBV types 1 and 2 in separate reactions. EBV was detected in 21 of 29 BLs (72%), and type 1 virus infected the majority of EBV-positive BLs (18/21). There was a trend for younger age in children with EBV-positive BL compared to EBV-negative BL (median age 4 compared to 6 years, respectively; p = 0.056). Our study confirmed that in the southeast of Brazil BL had an intermediate association with EBV. A higher rate of EBV-associated BL was described in the northeast of Brazil. These differences are probably related to regional socioeconomic status. In conclusion, our study suggests that early infection with EBV in the background of a low socioeconomic condition associated with other environmental factors could contribute to BL in Brazil.

Adolescent↗
PubMed1996

Rotavirus G and P types circulating in Brazil: characterization by RT-PCR, probe hybridization, and sequence analysis.

We used reverse transcription-polymerase chain reaction (RT-PCR) to determine the P and G genotypes of 130 culture-adapted rotavirus strains isolated from 181 fecal specimens of children under 5 years of age from 9 states and the Federal District of Brazil. The 4 genotypes found most commonly worldwide were also common in Brazil and P[8]G1 was the most prevalent (43%), followed by P[4]G2 (12%), P[8]G3 (6%), and P[8]G4 (6%). However, unusual types P[8]G5, P[6]G2, P[9]G1, P[9]G3, and mixed infections were responsible for 12% and 21% of the cases, respectively. Genotype G5 strains were detected in specimens collected in all 9 areas surveyed from all 4 regions of Brazil. The unusual strain diversity in Brazil suggests that when tetravalent rotavirus vaccines currently being developed are introduced into Brazil, laboratory surveillance will be essential to monitor protection against unusual strains, particularly those of genotype 5, as well as emergence of novel reassortants that may evolve from the large pool of children with mixed infections.

Antigens, Viral↗
PubMedDate not supplied

Pioneers of anti-venomous serotherapy: Dr Vital Brazil (1865-1950).

Dr Vital Brazil was a great humanitarian and pioneer of medical science. His main work arose from his concern with poisonous snakebite accidents to labourers working the land. Vital Brazil estimated that, at the beginning of this century, deaths due to crotaline snakebites in the State of São Paulo, Brazil, were nearly 3000 per year, representing a mortality rate of about 25%, the majority being due to bothropic envenomation. After reading a report of Calmette's anti-Naja serum, Vital Brazil raised monovalent serum against the venom of Bothrops jararaca and the venom of Crotalus durissus terrificus. In 1989 this led to the first demonstration of the specificity of anti-venomous serum and later, the first production of polyvalent serum for therapeutic use. As Director of the newly founded Institute Butantan in São Paulo, Vital Brazil was actively engaged in every aspect of serotherapeutic treatment. This included organizing a unique system of exchanging anti-ophidic serum for snakes as well as a wide-ranging teaching programme. His many outstanding contributions to the fields of immunology, public health, toxinology and herpetology required not only a very high level of observational, deductive and practical ability but also an unswerving vision and sense of duty; this was allied to great administrative skill and exceptional energy.

Antivenins↗
PubMed2002

Mental health of two communities of Japanese-Brazilians: a comparative study in Japan and in Brazil.

The aim of the present study was to assess the mental health status of Japanese-Brazilians living in Kiyoharadai, Japan and compare the findings with the Japanese-Brazilians living in Bauru, Brazil. A comparative community-based mental health survey was conducted from November 1997 to April 1999 on a randomly selected sample of Brazilians of Japanese descent living in Bauru, Brazil (n=213) and on the entire Brazilian community of Kiyoharadai, Utsunomiya, Japan (n=158), using the self-reporting questionnaire (SRQ-20). Analysis was done by chi2, Fisher and multiple logistic regression. Scores indicating probable cases of minor psychiatric disorders, were found in 3.2% of the community in Bauru city and 17.8% (OR=7.01) of the community in Kiyoharadai. The sociodemographic data indicated that those with high SRQ-20 scores were most likely to be female (OR=2.98), smokers (OR=2.76), and those whose former occupation was student when living in Brazil (OR=9.57). The mental health status of the Japanese-Brazilians living in Kiyoharadai, Japan is significantly worse than that of the community living in Bauru, Brazil, particularly among women, smokers and those who were students when living in Brazil. Further research concerning the mental health of this community is necessary and assistance provided.

Adult↗
PubMed2002

Molecular typing and antimicrobial susceptibility of vancomycin-resistant Enterococcus faecium in Brazil.

OBJECTIVES: To characterize vancomycin-resistant enterococci (VRE) isolates and to evaluate the mode of dissemination of this pathogen in Brazil. DESIGN: We collected 22 vancomycin-resistant Enterococcus faecium isolates from 6 medical centers in Sao Paulo, Brazil, and 1 isolate from a medical center in Curitiba, Brazil. PARTICIPANTS: All Brazilian hospitals that had identified vancomycin-resistant E. faecium up to the beginning of this study (late 1999) contributed isolates to the study. METHODS: The isolates were susceptibility tested using the broth microdilution method and the E-test. The presence of vancomycin resistance genes (vanA, vanB, vanC1, vanC2-3, and vanD) was evaluated by polymerase chain reaction; molecular typing was performed by pulsed-field gel electrophoresis (PFGE). RESULTS: The vanA gene was demonstrated in all vancomycin-resistant E. faecium, except for 1 isolate. None of the vancomycin resistance genes cited above was detected in the isolate from Curitiba, which was the first vancomycin-resistant E. faecium described in Brazil. All isolates were resistant to ampicillin and teicoplanin. The main clone remains susceptible to doxycycline and chloramphenicol, but intermediate to quinupristin-dalfopristin. PFGE analysis demonstrated 7 major PFGE patterns. A unique PFGE pattern with 4 subtypes was detected in 17 isolates from 4 different hospitals. CONCLUSION: The results of our study indicate the occurrence of intra- and interhospital dissemination of VRE in Sao Paulo, Brazil.

Brazil↗
PubMed2002

Trends of obesity and underweight in older children and adolescents in the United States, Brazil, China, and Russia.

BACKGROUND: Few studies have used the same references across countries to examine the trends of over- and underweight in older children and adolescents. OBJECTIVE: Using international references, we examined the trends of overweight and underweight in young persons aged 6-18 y from 4 countries. DESIGN: Nationally representative data from Brazil (1975 and 1997), Russia (1992 and 1998), and the United States (1971-1974 and 1988-1994) and nationwide survey data from China (1991 and 1997) were used. To define overweight, we used the sex- and age-specific body mass index cutoffs recommended by the International Obesity Task Force. The sex- and age-specific body mass index fifth percentile from the first US National Health and Nutrition Examination Survey was used to define underweight. RESULTS: The prevalence of overweight increased during the study periods in Brazil (from 4.1 to 13.9), China (from 6.4 to 7.7), and the United States (from 15.4 to 25.6); underweight decreased in Brazil (from 14.8 to 8.6), China (from 14.5 to 13.1), and the United States (from 5.1 to 3.3). In Russia, overweight decreased (from 15.6 to 9.0) and underweight increased (from 6.9 to 8.1). The annual rates of increase in the prevalence of overweight were 0.5% (Brazil), 0.2% (China), -1.1% (Russia), and 0.6% (United States). CONCLUSIONS: The burden of nutritional problems is shifting from energy imbalance deficiency to excess among older children and adolescents in Brazil and China. The variations across countries may relate to changes and differences in key environmental factors.

Adolescent↗