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At least 613 records · Page 34Linked to original sources
PubMed2000

Characterization of Leishmania sp. strains isolated from autochthonous cases of human cutaneous leishmaniasis in Santa Catarina State, southern Brazil.

Four Leishmania sp. samples were isolated from autochthonous human cases of American cutaneous leishmaniasis (ACL) in Santa Catarina State, southern Brazil. These strains were characterized using indirect immunofluorescence with a panel of Leishmania-specific monoclonal antibodies (MAbs), and by PCR amplification and hybridization assay of the mini-exon gene with group specific probes. The results obtained with the MAbs were in agreement with the genetic marker. Two isolates (MHOM/BR/89/JSC89-H1 and MHOM/BR/89/JSC89-H2) were identified as L. (Leishmania) amazonensis and two (MHOM/BR/96/LSC96-H3 and MHOM/BR/97/LSC97-H4) as L. (Viannia) braziliensis. The southernmost autochthonous cases of ACL in Brazil are due to two different Leishmania sp. species, confirming the spreading of ACL on the American continent.

Adolescent↗
PubMed2003

Cancer mortality among agricultural workers from Serrana Region, state of Rio de Janeiro, Brazil.

One of the proposed hypotheses to explain the higher incidence of specific-site cancers among agricultural workers is their higher exposure to pesticides. The role of pesticide exposure in morbidity and mortality profiles in Brazil is not well known. Therefore, in order to contribute to increase knowledge on this subject, an ecological analysis aiming to investigate cancer mortality among agricultural workers in an important agricultural area of the Rio de Janeiro State, Brazil, was performed. All causes of death for male workers 30-69 years old provided by the National Mortality Information System between 1979 and 1998 were evaluated. To estimate cancer mortality risks of selected sites, mortality odds ratio (MOR) was employed, and three reference populations were used. Higher mortality of esophagus, stomach, and larynx cancer in agricultural workers 50-69 years old was observed in the period from 1979 to 1988 and of esophagus and stomach cancer from 1989 to 1998. Agricultural workers 30-49 years old showed higher, but not statistically significant, mortality by stomach, esophagus, liver, testis, and prostate cancer, and soft-tissue sarcoma in the period of 1979-1988, and by testis and penis cancer, leukemia, and soft-tissue sarcoma in the period of 1989-1998. Despite the limitations of ecological approaches concerning causality ascertainment, we believe that this study raises questions of the possible role of pesticide exposure on the cancer mortality profile among Brazilian agricultural workers.

Adult↗
PubMed2002

Misoprostol use in obstetrics and gynecology in Brazil, Jamaica, and the United States.

OBJECTIVES: To investigate current clinical use of misoprostol for the treatment of a range of reproductive health indications by providers in Brazil, Jamaica, and the United States. METHODS: Using a 'snowball' sampling technique, we surveyed 228 gynecologists and obstetricians in Brazil (n=123), Jamaica (n=52), and the United States (n=53). RESULTS: Providers use misoprostol for labor induction (46%), postpartum hemorrhage (8%), intra-uterine fetal death (61%), cervical priming (21%), missed abortion (57%), and incomplete abortion (16%) as well as first and second trimester abortion induction (27% and 13%, respectively). CONCLUSIONS: There is considerable variation in the regimens used; moreover, the regimens commonly used in clinical practice often differ from those recommended in the medical literature. While misoprostol is an appealing alternative for many reproductive health indications in developing countries, the varied regimens and lack of registration raise critical medical and policy questions.

Brazil↗
PubMed2002

Domestic violence during pregnancy in Rio de Janeiro, Brazil.

OBJECTIVES: To estimate the prevalence and risk groups of domestic violence during pregnancy among public health care users in Rio de Janeiro, Brazil. The study focuses on violence perpetrated by both women and partners. METHOD: 526 women giving birth at term in public maternities from March to October 2000 were randomly selected and interviewers used the Revised Conflict Tactics Scales (CTS2). RESULTS: 33.8% [95% confidence interval (CI): 28.8-37.0%] of the respondents reported some form of physical violence and 16.5% (95% CI: 13.3-19.8%) referred to severe forms. A total of 78.3% (95% CI: 74.8-81.8%), 9.9% (95% CI: 7.5-12.7%) and 15.6% (95% CI: 12.6-18.9%) reported psychological aggression, sexual coercion and injuries, respectively. Physical violence mainly occurred among adolescent women with less schooling, who did not work outside the home, with fewer prenatal appointments, and with little social support. Families with more under-five children, alcohol and drug abuse, and low socio-economic status were also involved more frequently. CONCLUSION: High prevalence rates for various forms of domestic violence in Brazil suggest that the issue should be viewed as a major public health problem.

Adolescent↗
PubMedDate not supplied

Distribution of Plasmodium vivax variants (VK210, VK247 and P. vivax-like) in three endemic areas of the Amazon region of Brazil and their correlation with chloroquine treatment.

The present study evaluated the glass fibre membrane (GFM)-polymerase chain reaction (PCR)-enzyme-linked immunosorbent assay (ELISA) technique for genotyping the Plasmodium vivax variants, to verify the distribution of P. vivax variants (VK210, VK247 and P. vivax-like) in parts of Brazil and their correlation with levels of parasitaemia, previous malaria experience and clearance of parasitaemia linked to different treatment schedules. The samples were taken from individuals living in Macapá, Porto Velho and Belém, all of which are endemic areas of vivax malaria in the Amazon region of Brazil. Blood samples were collected on GFMs. The gene that codes for the circumsporozoite proteins of P. vivax variants was amplified by PCR and the amplified fragments were hybridized to variant-specific, digoxigenin-labelled oligonucleotide probes by ELISA. The GFM-PCR-ELISA technique was shown to be accurate for epidemiological surveys of the vivax complex. All variants were detected in all 3 areas, but only P. vivax VK210 was found as a single agent of infection, while the other 2 occurred as mixed infections. The P. vivax-like variant was found to be associated with low parasitaemia and VK210 with the highest parasitaemia levels; none of the P. vivax variants was linked with a previous malaria experience. In all cases parasitaemia clearance was identical regarding the type of treatment and consequently it is not possible to confirm the previously reported correlation between P. vivax genotype and response to chloroquine.

Animals↗
PubMedDate not supplied

Isolations of yellow fever virus from Haemagogus leucocelaenus in Rio Grande do Sul State, Brazil.

Following howling monkey (Alouatta caraya) deaths and yellow fever (YF) antigen detection by immunohistochemistry in the liver sample of a dead monkey in April and May 2001 in the municipalities of Garruchos and Santo Antônio das Missões, Rio Grande do Sul State, Brazil, epidemiological field investigations were initiated. Two strains of YF virus were isolated in suckling mice from 23 Haemagogus (Conopostegus) leucocelaenus Dyar & Shannon mosquitoes collected from the study sites. The YF virus was isolated from this species in the 1930s in Brazil and in the 1940s in Colombia. No human cases were reported during the current epizootic outbreak. The YF virus isolation and the absence of Hg. (Haemagogus) janthinomys Dyar from the area suggest that Hg. leucocelaenus may be a secondary YF vector and play an important role in the epidemiology of this disease in the Southern Cone.

Animals↗
PubMedDate not supplied

Occurrence of a community with high morbidity associated with Schistosoma mansoni infection regardless of low infection intensity in north-east Brazil.

To establish the relationship between schistosome-associated morbidity and infection intensity in northeast Brazil, a parasitological and ultrasonographical study was carried out on 484 inhabitants of 4 villages (I, II, III and IV) in São Lourenço da Mata, Pernambuco, Brazil, where schistosomiasis is endemic. Quantitative stool examination using Knight's method demonstrated a high prevalence and moderate intensity of Schistosoma mansoni infection, and also that the subjects in village IV had a significantly lower prevalence and intensity of infection than those of the other villages. By ultrasonography, periportal fibrosis (PPF) and splenomegaly were found in 52% of the 299 infected subjects and 66% of the 146 infected subjects aged over 16 years old, respectively; 32% and 31% of the 299 infected subjects had abnormally high values of total bile acid (TBA) and alkaline phosphatase (ALP) activity, respectively. Liver and spleen size, PPF, and serum level of TBA and ALP were not correlated with infection intensity. There was no significant difference in the morbidity assessed by liver and spleen size, PPF, and serum analysis between the subjects in village IV and the other villages. These findings suggest the occurrence of a community with high morbidity associated with schistosomiasis regardless of low infection intensity.

Adolescent↗
PubMed1997

Snakebite by the bushmaster (Lachesis muta) in Brazil: case report and review of the literature.

The bushmaster (Lachesis muta) of Central and South America, the world's longest pit viper, is capable of injecting a large dose of potent venom when it bites. A 28-year-old man, bitten by a 1.82 m long L. m. muta in Brazil, developed pain and oedema at the bite site, nausea, vomiting, diarrhoea and sweating. There was peripheral neutrophil leucocytosis and evidence of fibrinogen consumption with secondary activation of the fibrinolytic system. Two hours after the bite, eight ampoules of Instituto Butantan Lachesis antivenom was administered, and haemostasis was normal 24 hr later. A review of reports of 20 cases of bites in humans reliably attributed to this snake in Costa Rica, French Guiana, Brazil, Colombia and Venezuela confirms a syndrome of nausea, vomiting, abdominal colic, diarrhoea, sweating, hypotension, bradycardia and shock, possibly autopharmacological or autonomic in origin, not seen in victims of other American crotaline snakes. These, and other symptoms of bushmaster envenoming, are explained by haemorrhagic, coagulant and neurotoxic venom activities. The therapeutic efficacy of non-specific Bothrops/Crotalus polyvalent antivenoms in these cases has been unimpressive. For the treatment of bites by a snake which potentially injects a large dose (> 300 mg dry weight) of venom with a range of life-threatening activities, there is an urgent need to develop more potent specific antivenoms and to treat the dramatic and life-threatening cardiovascular symptoms.

Accidents, Occupational↗
PubMed1998

Comparative study of the venoms of three subspecies of Lachesis muta (bushmaster) from Brazil, Colombia and Costa Rica.

A comparative study was performed on the pharmacology and biochemistry of venoms from three subspecies of Lachesis muta (L. m. stenophrys, L. m. muta and L. m. rhombeata) from Brazil, Colombia and Costa Rica. All venoms induced lethal, hemorrhagic, edema-forming, myotoxic, coagulant and defibrinating effects, showing also proteolytic and indirect hemolytic activities. The venoms of L. m. stenophrys from Costa Rica and L. m. muta from Cascalheira, Brazil, had the highest lethal and hemorrhagic activities and the venom of L. m. rhombeata showed the highest coagulant activity, whereas no significant differences were observed in myotoxic and edema-forming activities at most of the time intervals studied. In addition, venoms showed similar electrophoretic patterns on SDS-polyacrylamide gel electrophoresis. In conclusion, despite quantitative differences in toxic and enzymatic activities, together with subtle variations in electrophoretic patterns, our results indicate that experimental envenomation by these venoms induce a qualitatively similar pathophysiological profile.

Animals↗
PubMed2000

Horse IgG isotypes and cross-neutralization of two snake antivenoms produced in Brazil and Costa Rica.

Horse IgG isotypes and cross-neutralization of two snake antivenoms produced in Brazil and Costa Rica. Toxicon 000-000. This work compared the specificity, ELISA titers and IgG subclass content of the polyvalent antivenom (anti-Bothrops asper, Crotalus durissus durissus and Lachesis muta stenophrys) of Instituto Clodomiro Picado (Costa Rica) and the bothropic antivenom (anti-Bothrops jararaca, B. jararacussu, B. moojeni, B. neuwiedi and B. alternatus) of Instituto Butantan (Brazil). The role of IgG(T) and IgGa subclasses in neutralization of some venom toxic activities and the cross neutralization of the antivenoms against B. jararaca and B. asper venoms were also evaluated. Both antivenoms were able to recognize B. asper and B. jararaca venoms by immunoblotting and presented similar antibody titers when assayed by ELISA. IgG(T) was highest, followed by IgGa, IgGb and IgGc. IgGa and IgG(T) isotypes isolated from both antivenoms by affinity chromatography were tested for neutralization of lethal, hemorrhagic, coagulant and phospholipase A2 activities of the homologous venoms. In both antivenoms, IgG(T) was the major isotype responsible for neutralization of all the tested activities, followed by IgGa. These results suggest that Instituto Butantan and Instituto Clodomiro Picado antivenoms have the same IgG profile and their neutralizing ability is due mostly to the IgG(T) isotype. Also, they neutralize lethality in mice induced by homologous and heterologous venoms, the bothropic antivenom of Instituto Butantan being more effective.

Animals↗
PubMed2003

Chlorinated pesticides and polychlorinated biphenyls in marine tucuxi dolphins (Sotalia fluviatilis) from the Cananéia estuary, southeastern Brazil.

The Cananéia estuary is an important biological area on the southeast coast of Brazil. In the past, it was impacted by both chlorinated pesticides and polychlorinated biphenyls (PCBs) due to its natural location. The marine tucuxi dolphin (Sotalia fluviatilis) is a top predator in this ecosystem and can be found year round in Cananéia estuarine waters that represent an important nursing area for the species. This work investigated chlorinated compounds in the blubber of nine individuals from the Cananéia estuary. Residue levels of DDTs (0.541-125 microg g(-1) lipid wt.) were the highest, followed by PCBs (0.2-9.22 microg g(-1) lipid wt.), mirex (0.014-0.312 microg g(-1) lipid wt.), chlordanes (0.001-0.047 microg g(-1) lipid wt.), HCHs (<0.003-0.044 microg g(-1) lipid wt.), and HCB (n.d.-0.024 microg g(-1) lipid wt.). The mean p,p'-DDE/Sigma DDT ratio was approximately 0.8 and is indicative of the former DDT application in the study area. PCB contamination is suggested to be associated with atmospheric transport and relative proximity to the Cubatão industrial complex-the most important along the Brazilian coast. Low levels of HCHs and HCB can be attributed to their high volatility in tropical environments. Concentrations of organochlorines in the blubber of marine tucuxis from the Cananéia estuary were lower than levels found in small cetacean species from developed countries, where the input of these compounds was considerably greater than in Brazil. At extremes, male dolphins can present DDT burden several orders of magnitude higher than females. Despite the high levels of total DDT found in males, the major detected compound was p,p'-DDE which is considered to be of low toxicity.

Adipose Tissue↗
PubMed2003

Incidence of erectile dysfunction in men 40 to 69 years old: results from a population-based cohort study in Brazil.

OBJECTIVES: To estimate the incidence of erectile dysfunction (ED) in Brazilian men 40 to 69 years old at study entry during an average 2-year follow-up and study the effect of age, socioeconomic status, and medical conditions on the risk of developing ED. METHODS: We analyzed data from a randomly sampled cohort of men living in Salvador, Bahia (Brazil), a racially diverse city with a population of 2.3 million. A total of 602 men completed the baseline interview in 1998 and 501 completed follow-up in 2000. The analysis sample consisted of 428 (83.4%) of 513 men without ED at baseline. The men were interviewed in person, using a standardized questionnaire, and ED was assessed by a single global self-rating question. RESULTS: The crude incidence rate for ED was 65.6 cases per 1000 person-years (95% confidence interval 49.6 to 85.2). The incidence rate increased with age and was 33.3, 53.7, and 189.5 cases per 1000 person-years for men 40 to 49, 50 to 59, and 60 to 69 years old, respectively. The age-adjusted risk of developing new-onset ED was higher for men with lower education, diabetes, hypertension, and benign prostatic hyperplasia. Population projections for men 40 to 69 years old suggest that approximately 68,600 new cases of ED in Bahia and 1,025,600 in Brazil would be expected annually. CONCLUSIONS: The incidence of ED in Brazilian men was 2.5-fold higher than that in the Massachusetts Male Aging Study (26/1000 person-years) and increased with age, lower education, diabetes, hypertension, and benign prostatic hyperplasia.

Adult↗
PubMed2002

Animal genetic resources in Brazil: result of five centuries of natural selection.

Brazil has various species of domestic animals, which developed from breeds brought by the Portuguese settlers soon after their discovery. For five centuries, these breeds have been subjected to natural selection in specific environments. Today, they present characteristics adapted to the specific Brazilian environmental conditions. These breeds developed in Brazil are known as "Crioulo," "local," or naturalized. From the beginning of the 20th century, some exotic breeds, selected in temperate regions, have begun to be imported. Although more productive, these breeds do not have adaptive traits, such as resistance to disease and parasites found in breeds considered to be "native." Even so, little by little, they replaced the native breeds, to such an extent that the latter are in danger of extinction. In 1983, to avoid the loss of this important genetic material, the National Research Center for Genetic Resources and Biotechnology (Cenargen) of the Brazilian Agricultural Research Corporation (Embrapa) decided to include conservation of animal genetic resources in its research program Conservation and Utilization of Genetic Resources. Until this time, they were only concerned with conservation of native plants. Conservation has been carried out by various research centers of Embrapa, universities, state research corporations, and private farmers, with a single coordinator at the national level, Cenargen. Specifically, conservation is being carried out by conservation nuclei, which are specific herds in which the animals are being conserved, situated in the habitats where the animals have been subjected to natural selection. This involves storage of semen and embryos from cattle, horses, buffaloes, donkeys, goats, sheep, and pigs. The Brazilian Animal Germplasm Bank is kept at Cenargen, which is responsible for the storage of semen and embryos of various breeds of domestic animals threatened with extinction, where almost 45,000 doses of semen and more than 200 embryos exist presently. An important challenge for this program is to make the different segments of society realize the importance of the conservation of animal genetic resources.

Adaptation, Physiological↗
PubMed2002

Access to antiretroviral drugs in Brazil.

Since 1996, the Brazilian Ministry of Health has guaranteed free and universal access to antiretroviral treatment for people living with HIV/AIDS. Implementation of this policy has had political, financial, and logistical challenges. I have investigated the history and context of antiretroviral policy in Brazil, the logistics of the drugs' distribution, and the government's strategies for acquisition of the drugs. Many antiretrovirals used in Brazil are produced domestically; the remainder, including some of the most expensive drugs, are purchased from abroad. Although the Brazilian policy of antiretroviral distribution has had notable success, it remains threatened by the high cost of acquisition of drugs, which has led to disputes with international pharmaceutical companies over prices and patents. Whether or not the Brazilian model of guaranteeing access to antiretroviral treatment for people living with HIV/AIDS can be applied in other countries or regions, much can be learnt from the country's experience.

Anti-HIV Agents↗
PubMed2002

Prevalence and underrecognition of dysthymia among psychiatric outpatients in São Paulo, Brazil.

BACKGROUND: Dysthymia is a highly prevalent disorder with rates varying from 3 to 6%. It is estimated that 7% of primary care and up to 36% of the psychiatric outpatients have this disorder. Dysthymia is characterized by a pattern of low intensity and long duration depression, leading to impairment in many aspects of the patient's life (work, family). However, it is a condition which is not frequently diagnosed, thereby remaining untreated and leading to chronification, risk of developing depression and substance abuse. Despite the well-known fact that dysthymia is underdiagnosed, there are no studies in Brazil regarding this problem. This paper presents a study on the prevalence of dysthymia in an outpatient psychiatric population in São Paulo, Brazil, identifying factors associated with the underdiagnosis of dysthymia. METHODS: Two raters carried out a study of 81 patients from a university outpatient clinic in São Paulo, using the SCID-I/P. The kappa coefficient was used to measure the inter-rater reliability for the dysthymia diagnosis. The SCID-I/P diagnosis was compared to consulting psychiatrist's diagnosis. Factors associated with underdiagnosis were identified. RESULTS AND CONCLUSIONS: 27% of the sample had SCID dysthymia. They presented more comorbidities than non-dysthymics. Only 27% of these SCID dysthymics were considered 'pure' dysthymics. Clinicians had identified only 37% of these SCID diagnosed cases as dysthymic. The main reason for missing diagnosis of dysthymia in this sample was axis I comorbidity. LIMITATION: As we did not investigate the presence of personality disorder, the impact of axis II on misdiagnosis of dysthymia could not be investigated in our sample.

Adult↗
PubMed1998

Demographic, clinical, and angiographic data of patients with Takayasu arteritis in Brazil.

We collected clinical, demographic, and angiographic data of Takayasu arteritis (TA) patients followed at Rheumatology Division of three Public University Centers (UNIFESP, USP, and UNICAMP) located in São Paulo State, Brazil. Clinical and demographic data were obtained from 73 patients (61 female; 50 white) The mean age at time of diagnosis was 27 y.o. and the mean follow-up time was 5 years. The following clinical features were observed along the evolution of these patients: absent or reduced pulses in upper limbs (85%), arterial bruit (64.5%), claudication of upper members (57%), headache (45%), hypertension (35.5%), dizziness (29%), cardiac bruit (29%), weight loss (27.5%), arthralgia or arthritis (26%), fever (24.5%) and claudication of lower limbs (20.5%). According to new angiographic classification of Takayasu arteritis performed in 28 patients followed at UNTFESP, with routine full aortography, 21% were classified as type I, 4% as type IIa, 4% as type III, 14% as type IV and 57% as type V. No patients had type IIb. Patients with Takayasu arteritis in São Paulo State Brazil showed female predominance and arterial involvement pattern similar to the one observed in Japan, with more than 20% classified as type I with exclusive involvement of the branches from the aortic arch.

Adolescent↗
PubMed2000

Decentralising the health sector: issues in Brazil.

The health sector in Brazil has undergone important changes, particularly with the development of the Unified Health System (SUS). Decentralisation is an important principle of SUS and advances have been made in transferring responsibilities and resources to the local government units, known as municipios. This article describes the changes introduced, focusing on the system of municipio classification and the funding mechanisms introduced through the basic operating rule (BOR) of 1996. The paper then moves on to analysing three key issues of decentralisation in Brazil that are related to the policy process, the system of decentralisation and the output of decentralisation. Firstly, the formal process by which decisions on health sector reform are made is discussed with particular attention being paid to the negotiated and relatively open policy space. Secondly, the role of the states is discussed within the decentralised system. Thirdly, the impact of decentralisation on equity is discussed with particular reference to the resourcing of the Municipal Health Funds. The article concludes by emphasising the political nature of health sector decentralisation and the need to develop the conditions for effectiveness in decentralisation programmes.

Brazil↗
PubMedDate not supplied

Sensorineural hearing loss among sickle cell disease patients from southern Brazil.

PURPOSE: A case-control study was done to confirm the higher prevalence of sensorineural hearing loss (SNHL) among sickle cell patients (HbSS) from southern Brazil. PATIENTS AND METHODS: Twenty-eight patients and 28 matched normal controls were studied. Besides complete anamneses and physical otolaryngological examination, all individuals had audiometric and tympanometric testings to determine the presence of SNHL or middle ear problems. The only significant difference between groups was the presence of a positive history of otologic symptoms (hearing loss, dizziness or tinnitus) and neurological sequelae in the HbSS patients. RESULTS: Six patients (21.4%) presented with SNHL compared with one control (3.6%) (Fisher's one-tailed P = .05; OR, 7.36 (95% CI, 0.82, 65.83). The average age of HbSS diagnosis was higher among the patients with SNHL (10 years +/- 8.3) than those without SNHL (5.43 years +/- 5.65), but this was not significant (analysis of variance P > .05). More patients 25 years and older on the examination date had SNHL than younger patients (Fisher's 2-tailed P < .05). Sixty-seven percent of the patients with SNHL had alterations in the acoustic reflex, and a surprising 27% of the patients without NSHL also presented with some elevation or an absence of acoustic reflex. CONCLUSIONS: These data indicate that patients with HbSS from southern Brazil are more predisposed to the development of sensorineural hearing problems than the general population.

Adolescent↗