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PubMed2001

Going like gangbusters: transnational tobacco companies "making a killing" in South America.

This article reports on the recent growth of transnational tobacco companies (TTCs) in South America. Although some scholarly attention has been directed toward such growth in Asia and eastern Europe, South America has also been targeted by the TTCs' aggressive expansionist practices in recent years. Fighting "Big Tobacco" is entirely different from combating most public health problems. Unlike cigarettes, most infectious diseases and maternal and child health problems never provide profits to transnational corporations and governments. Also, most public health problems (with alcohol being another notable exception) are not exacerbated by extensive advertising campaigns that promote the cause of the health problems. Supported by data gathered during three months of fieldwork in Ecuador, Peru, Chile, and Argentina in 1997, this article suggests that the TTCs' marketing strategies override cultural differences in the choices people make regarding smoking and health. Combining critical medical anthropology and public health, this article concludes that unless dramatic actions are taken, an avoidable outbreak of tobacco-related diseases will eventually reach epidemic proportions on the South American continent. It is also a "call to arms" for more medical anthropologists to investigate tobacco-related matters around the world.

Advertising↗
PubMed1985

Isolation of a Hantaan-related virus from Brazilian rats and serologic evidence of its widespread distribution in South America.

A serosurvey of domestic rats was conducted in several South American cities between September 1982 and March 1983 for evidence of hantavirus infection. Antibody-positive rats were found in Belem, São Paulo and Recife-Olinda, Brazil and in Buenos Aires, Argentina, with the highest antibody prevalence rate detected in Belem (30 positive of 54 tested, 56%). A virus isolated from tissues of a Rattus norvegicus captured in Belem, was shown to be antigenically similar to Girard Point viruses isolated from domestic rats captured in the United States and clearly distinct from prototype Hantaan virus, causative agent of Korean hemorrhagic fever in Asia. This represents the first isolation of a virus of the genus Hantavirus from South America and supports previous observations that indicate a widespread distribution of urban rat-associated hantaviruses. The abundance of domestic rats and their regionally high antibody rates suggest that risk of human hantavirus infection in some locations of South America may be significant.

Animals↗
PubMed1999

Molecular epidemiology of human T-cell leukemia virus type I (HTLV-1) Brazil: the predominant HTLV-1s in South America differ from HTLV-ls of Japan and Africa, as well as those of Japanese immigrants and their relatives in Brazil.

To better understand the origin of human T-cell leukemia virus type l (HTLV-l) in South America, we conducted a phylogenetic study on 27 new HTLV-ls in Brazil. These were obtained from Brazilians of various ethnic origins, such as Japanese immigrants, whites, blacks and mulattos. We amplified and sequenced proviral DNAs of a part of the long terminal repeats. Phylogenetic trees revealed that all but 6 of the new isolates were not only similar to each other but also similar to HTLV-ls of other South American countries, including those from Amerindians. However, the isolates differed from the HTLV-ls of Africa and Japan. The other six isolates were from Japanese immigrants and were phylogenetically almost identical to HTLV-ls in Japan but different from the majority of South American HTLV-ls, including the other new Brazilian HTLV-ls. These findings indicate that the recent introduction of HTLV-1 from Japan is limited to Japanese immigrants. In addition, the results do not support the prevailing hypothesis that HTLV-ls in South America were introduced by blacks who were brought from Africa as slaves. Rather, these results suggest that the majority of HTLV-1s prevailing in South America have spread from Amerindians, some of whom are likely to have possessed this human retrovirus from the beginning of their settlement in South America.

Adult↗
PubMed1999

Development in the treatment of burns in South America during the last decades.

The scientific approach toward the problems of burn treatment in South America started in the 1930's and was emphasized in the 1940's as a result of the positive influence of the Latin American Congresses of Plastic Surgery initiated in 1941. During the 1950's, as an appropriate answer to the problem, specialized burns facilities started to spread over the Latin American countries. Consequently, there was a progressive incorporation of very important advances such as a more adequate fluid replacement, early excision and grafting, enteral feeding, new topical antibacterial agents, a more appropriate approach for the prevention and treatment of infections, a better understanding of the smoke inhalation injury and better management of physical and psychological rehabilitation. Thus, during the past 25 years, burn care has dramatically evolved toward excellence. The Latin American Committee for Prevention and Care of Burns, created in 1964 was one important land-mark in the development of burn treatment in South America. The creation of Burn Associations in many South American countries was initiated in 1990, and culminated in 1991 when the Latin American Federation of Burn Associations was founded. These developments illustrate how the specialists in the South American countries have followed the tune of international progress. They constitute at this time, an important group of committed workers, not only to the treatment of burned patients but also to the scientific and academic side of this specialty.

Burn Units↗
PubMed2006

Phylogenetic analysis of foot-and-mouth disease virus type O re-emerging in free areas of South America.

The nucleotide sequences of the complete VP(1)-coding region of foot-and-mouth disease viruses (FMDV), type O, isolated during the recent emergencies of the disease in free areas of South America (Mato Grosso do Sul, Brazil, October 2005, and Corrientes, Argentina, February 2006), were determined. Also established were the complete VP(1)-coding sequences of viruses occurring in neighbouring locations between the years 2000 and 2003. A phylogenetic analysis was performed based on comparison with continental relevant field and vaccine strains, as well as with extra-continental representative viruses. The results show that the emergencies in Argentina and Brazil were caused by viruses presenting 93% genetic relatedness. Both variants are endogenous to South America, as they were placed within the Europe-South America topotype. When compared with the continental viruses available for the phylogenetic studies, they show the closest relationship with viruses responsible for previous emergencies in neighbouring free areas, or for sporadic outbreaks in the adjacent places with advanced eradication stages, presenting similarity values of at least 90% among them, and clustering together in a unique lineage. This lineage represents the only one sporadically appearing in the Southern Cone and differs from those including viruses presently circulating in the Andean region, reflecting the different livestock circuits and epidemiological scenarios.

Animals↗
PubMed2000

Genetic diversity, distribution, and serological features of hantavirus infection in five countries in South America.

Since 1995 when the first case of hantavirus pulmonary syndrome (HPS) was reported in Patagonia, there have been more than 400 cases of HPS reported in five countries in South America. The first case of HPS was associated with Andes (AND) virus. In this study, we report on the genetic diversity, geographical distribution, and serological features of hantavirus infection in six countries in South America based on 87 HPS cases from Argentina, Bolivia, Chile, Paraguay, and Uruguay. An early immunoglobulin M (IgM), IgA, and IgG humoral response was observed in almost all HPS cases. The IgM response appears to peak 1 or 2 days after the onset of symptoms. Peak IgG antibody titers occur mostly after the first week. Low IgG titers or the absence of IgG was associated with higher mortality rates. The IgA response peaks around day 15 and then rapidly decreases. The results of phylogenetic analysis based on partial M-fragment G1- and G2-encoding sequences showed that HPS cases from the five countries were infected with viruses related to AND or Laguna Negra (LN) virus. Within AND virus-infected persons, at least five major genetic lineages were found; one lineage was detected in Uruguayan and Argentinean cases from both sides of the Rio de la Plata river. Two Paraguayan patients were infected with a virus different from LN virus. According to the results of phylogenetic analyses, this virus probably belongs to a distinct lineage related more closely to the AND virus than to the LN virus, suggesting that there is probably an Oligoryzomys-borne viral variant circulating in Paraguay. These studies may contribute to a better understanding of hantavirus human infection in South America.

Adolescent↗
PubMed1996

Thalidomide, a current teratogen in South America.

Thalidomide, mainly used for the treatment of leprosy, is a current teratogen in South America, and it is reasonable to assume that at present this situation is affecting many births in underdeveloped countries. Moreover, the potential re-marketing of thalidomide for the treatment of a large variety of diseases may extend the problem to the developed world. When the drug is available, the control of its intake during early pregnancy is very difficult since most pregnancies are unintended. The ongoing occurrence of thalidomide embryopathy cases went undetected by the ECLAMC, due to several factors: (1) low populational coverage through this monitoring system; (2) pre-existence of the teratogen with its effects present in both baseline (expected) and monitored (observed) materials; and (3) lack of a defined phenotype to be monitored. Thus, if thalidomide re-enters the market throughout the world, due to the wide range of new applications, occurrence of phocomelia alone might not be sufficient to detect its effects. By a case-reference approach, the ECLAMC registered 34 thalidomide embryopathy cases born in South America after 1965 whose birthplaces correspond to endemic areas for leprosy. Phocomelia was found in five of eleven fully described cases. Thus, phocomelia alone is neither specific nor sufficient to serve as a suitable phenotype to survey the teratogenic effects of thalidomide. Therefore, a thalidomide-like phenotype, defined as any bilateral upper and/or lower limb reduction defect of the preaxial and/or phocomelia types, should be included in the routine surveillance of birth defects in all programmes.

Abnormalities, Drug-Induced↗
PubMed1996

Prophylaxis Failure Against Vivax Malaria in Guyana, South America.

Chloroquine-resistant Plasmodium vivax was originally reported in Papua, New Guinea by Reickman in 1989.1 In the same year, in Colombia, South America, Arias and Corredor2 reported relapses of 11 patients suffering from vivax malaria, following a chloroquine-primaquine regimen. Garavelli and Corti3 suggested chloroquine-resistant Plasmodium vivax may be present in Brazil following these therapeutic relapses. Further therapeutic failures in returned travelers from South America were reported by Moore et al (1994).4 We report vivax malaria in a group of expeditioners visiting Guyana who, whereas compliant with antimalarial chemoprophylaxis, developed clinical malaria, adding evidence to the presence of chloroquine-resistant Plasmodium vivax in South America. Raleigh International is a youth development charity that undertakes environmental and community projects around the world. These are usually in remote locations. Nine expeditions in countries such as Chile, Belize, Zimbabwe, Uganda, and Malaysia are organized annually. A project manager and a medical officer are placed at each site, along with approximately 10 venturers (age 17-25.) Participants are of all nationalities, but, at present, they are predominantly British.

Journal Article↗
PubMed1999

Cardiovascular risk factors in South America and the Caribbean.

Facing the conclusion of the twentieth century, cardiovascular disease (CVD) remains a major cause of morbidity and a leading contributor to mortality worldwide. Developing countries, including those in South America and the Caribbean, contribute substantially to the global burden of CVD. Indeed, 8 to 9 million deaths attributable to CVD (63% of world total) occurred in developing countries in 1990, compared to 5.3 million deaths in developed nations. Over the next 25 years, it is projected that there will be a rise in CVD mortality rates in the developing countries, linked not only to demographic changes (expansion and aging of the population), but also to progressive urbanization and lifestyle modifications. As such, the ratio of deaths from CVD to deaths from infectious disease is likely to triple during the next 20 years in South America and the Caribbean. The identification of major risk factors and the implementation of control strategies (eg, community education and target of high risk individuals) have contributed to the fall in CVD mortality rates observed in industrialized nations. Most countries of South America and the Caribbean lack an efficient health care system, and the medical and socio-economic consequences of the projected rise in CVD will further strain financial resources. Therefore, appropriate strategies based on knowledge extrapolated from research among other populations should be initiated. The agenda of any lifestyle-related disease control program should include the promotion of healthy diet, exercise, and should encourage decreasing tobacco and alcohol usage.

Adult↗
PubMed1995

Biochemical systematics and population genetic structure of Anopheles pseudopunctipennis, vector of malaria in Central and South America.

An electrophoretic survey of 42 populations of Anopheles pseudopunctipennis collected throughout its known geographic distribution was performed to clarify the taxonomic status of this important malaria vector species. The results indicated strong differences in the allele frequencies of three enzyme loci (glycerol dehydrogenase, 6-phosphogluconate dehydrogenase, and phosphoglucomutase) of the 33 loci analyzed. No fixed electromorphic differences separate the populations of An. pseudopunctipennis. The populations of An. pseudopunctipennis showed little genetic divergence, with Nei distances ranging from 0 to 0.079. A comparison of An. pseudopunctipennis data with either one of three other Anopheles species showed a high genetic distance of 0.335 with a closely related species, An. franciscanus; 0.997 with An. crucians, and 2.355 with An. (Nyssorhynchus) albimanus. Geographic populations of An. pseudopunctipennis were classified into three clusters; one cluster included populations collected in North America (United States and Mexico) and Guatemala, one cluster included populations from Belize and South America (Colombia, Ecuador, Peru, Chile, and Argentina); and one cluster was represented by populations from the Island of Grenada (type-locality of An. pseudopunctipennis). Based on our isozyme analyses, we defined these clusters as three geographic populations of An. pseudopunctipennis. Of the two mainland populations, one extends from the southern United States south through Mexico and Guatemala, and the other extends north from southern South America through Central America to Belize. These two geographic populations converge in southern Mexico and northern Central America. One part of the convergence zone was identified in the area of eastern Guatemala and southern Belize.

Alleles↗
PubMed2001

The World Survey of Cardiac Pacing and Cardioverter Defibrillators: calendar year 1997--Asian Pacific, Middle East, South America, and Canada.

A comprehensive cardiac pacing and ICD survey of the Asian Pacific region, Middle East, South America, and Canada was undertaken for calendar year 1997. Thirteen countries in the Asian Pacific region contributed to the survey. There were also two countries from the Middle East, three from South America, and Canada. Accurate numbers of new implants and replacements were obtained for cardiac pacemakers. In the Asian Pacific region, Japan with almost 20,000 implants, had the largest number of pacemaker implants, but Australia had the highest implant rate with 345 new implants per million population. However, Canada and Uruguay had higher new implant rates per million. The major indication for implantation of a cardiac pacemaker was high degree atrioventricular block. There was a high incidence of single chamber ventricular pacing in the developing countries of Asia. Only a few countries used substantial numbers of single lead VDD and AAIR pacing systems. Pacing leads were predominantly transvenous, bipolar, passive fixation, and steroid eluting. Active-fixation leads were also used in the atrium. With ICD use, Australia had the highest new implant rate per million population. The major indications were sudden death and ventricular arrhythmias. A group of enthusiastic survey coordinators has now been established. It is hoped to continue physician and country recruitment, particularly in the Middle East and South American regions to establish a fully global experience of cardiac pacing and ICD use.

Asia↗
PubMed2006

Effect of the interaction between high altitude and socioeconomic factors on birth weight in a large sample from South America.

Several studies of South American populations showed that altitude is associated with low birth weight and intrauterine growth retardation. Although some of them analyzed the altitude-birth weight association, only a few assessed the effect of the interaction between altitude and socioeconomic factors on birth weight. The purpose of this research is to evaluate such effects on birth weight, after adjustment for confounding factors. This observational descriptive study includes a sample of 37,022 live-born infants without congenital anomalies, weighing >or=500 g, from 75 South American maternity hospitals, during 1982-1999. Of the total sample, 1,187 infants were born in two South American cities located at more than 2,000-m altitude: La Paz, Bolivia (N = 974 at 3,600 m) and Bogota, Colombia (N = 274 at 2,600 m). Among the seven risk factors analyzed, altitude was the main predictor of birth weight (except for gestational age). After adjustment for the other risk factors, birth weight at cities located above 2,000 m showed a decrease of approximately 200 g. When comparing highest and lowest socioeconomic levels, birth weight also showed differences for levels of altitude analyzed (lowland, <2,000 m; middle land, 2,600 m; and highland, 3,600 m). Interaction between both factors showed no effect. High altitude seems to act independent of socioeconomic status in explaining birth weight reduction.

Altitude↗
PubMed1997

The origin of the dog-like borhyaenoid marsupials of South America.

Dog-like marsupials (superfamily Borhyaenoidea) were the largest predacious mammals during the Tertiary period in South America. They are critical to our understanding of marsupial origin, phylogeny and palaeobiogeography because they have been related to various marsupial lineages of several continents: didelphoids (mainly New World, but also Europe, Asia and Africa), pediomyid, stagodontids (North America), dasyuroids (Australia) and deltatheroidans (predominantly Asian). These relationships, based mainly on dental morphology, have been discussed and rejected several times. Here we report the discovery of exceptionally well preserved skulls and skeletons, referrable to the didelphoid Andinodelphys, which shed new light on the phylogenetic and palaeobiogeographic origin of dog-like marsupials. The skulls of Mayulestes (boryhyaenoid), Andinodelphys and Pucadelphys (didelphoids) from the early Palaeocene epoch of Bolivia are the oldest known for American marsupials. Comparison of their basicranial anatomy suggests that dog-like marsupials are closely related to an early didelphimorphian radiation in South America, rather than to Asiatic (deltatheroidan), North American (stagodontid), or Australian (dasyuroid) lineages.

Animals↗
PubMed2005

Prevalences, genotypes, and risk factors for HIV transmission in South America.

HIV cross-sectional studies were conducted among high-risk populations in 9 countries of South America. Enzyme-linked immunosorbent assay screening and Western blot confirmatory testing were performed, and env heteroduplex mobility assay genotyping and DNA sequencing were performed on a subset of HIV-positive subjects. HIV prevalences were highest among men who have sex with men (MSM; 2.0%-27.8%) and were found to be associated with multiple partners, noninjection drug use (non-IDU), and sexually transmitted infections (STIs). By comparison, much lower prevalences were noted among female commercial sex workers (FCSWs; 0%-6.3%) and were associated mainly with a prior IDU and STI history. Env subtype B predominated among MSM throughout the region (more than 90% of strains), whereas env subtype F predominated among FCSWs in Argentina and male commercial sex workers in Uruguay (more than 50% of strains). A renewed effort in controlling STIs, especially among MSM groups, could significantly lessen the impact of the HIV epidemic in South America.

Adult↗
PubMed2000

Emerging genetic diversity of HIV-1 in South America.

OBJECTIVE: Genotype determination and risk group analysis of HIV-1 infected individuals in selected regions of South America. DESIGN: Cross-sectional convenience sampling of HIV-1-positive individuals in Peru, Ecuador, Uruguay and Paraguay from March, 1994 through September, 1998. METHODS: HIV-1-positive subjects were identified through the national AIDS surveillance program in each country. A standardized questionnaire was used to obtain demographic, clinical and risk factor data on each study subject. Viral DNA was extracted from participants' peripheral blood mononuclear cells either directly or after co-cultivation. A nested PCR was used to obtain selected fragments of the envelope genes for genotyping by the heteroduplex mobility assay (HMA). A 600 bp sequence encompassing the V3 loop was sequenced from a selection of 23 of these samples for phylogenetic analysis and confirmation of HMA genotype. RESULTS: Among the 257 successfully genotyped HIV-1-positive samples, genotype B was found in 98.3% (228/232) of those obtained from subjects in Peru, Ecuador, and Paraguay. In contrast, 56% (14/25) of the samples from Uruguay were genotype F, and the remainder were genotype B. Genotype F was detected for the first time in Peru (2/224) and Paraguay (1/4), and genotype A for the first time in Peru (1/224). Phylogenetic analysis confirmed the genotype identified by HMA in the 23 samples sequenced. There was no detectable genetic clustering of HIV-1 within the different high-risk groups or geographic locations. CONCLUSIONS: These findings verify and extend the presence of several different HIV-1 genotypes in South America.

Amino Acid Sequence↗
PubMed2003

Circulating recombinant form CRF02_AG in South America.

With the objective of monitoring the distribution of HIV-1 subtypes and circulating recombinant forms (CRFs)in South America, population-based surveillance studies were performed in seven countries. Peripheral blood mononuclear cell, filter paper, fresh blood, and cocultivation samples were collected from HIV-positive patients from Colombia, Ecuador, Peru, Bolivia, Chile, Argentina, and Uruguay, during a 7-year period(1995-2001). DNA was prepared and HIV envelope subtypes were determined by heteroduplex mobility as-say and DNA sequencing from 1289 HIV-positive samples. While subtypes B and F were the most commonly observed subtypes, two CRF02_AG strains were detected, in Ecuador. This is the first report of the existence of this CRF in South America.

Adult↗
PubMed2005

Historical demography, selection, and coalescence of mitochondrial and nuclear (genes in Prochilodus species of northern South America.

Fishes of the genus Prochilodus are ecologically and commercially important, ubiquitous constituents of large river biota in South America. Recent ecologic and demographic studies indicate that these fishes exist in large, stable populations with adult census numbers exceeding one million individuals. Abundance data present a stark contrast to very low levels of genetic diversity (theta) and small effective population sizes (Ne) observed in a mitochondrial (mt) DNA dataset obtained for two species, Prochilodus mariae, and its putative sister taxon, Prochilodus rubrotaeniatus. Both species occupy major river drainages (Orinoco, Essequibo, and Negro) of northeastern South America. Disparity between expectations based on current abundance and life history information and observed genetic data in these lineages could result from historical demographic bottlenecks, or alternatively, natural selection (i.e., a mtDNA selective sweep). To ascertain underlying processes that affect mtDNA diversity in these species we compared theta and Ne estimates obtained from two, unlinked nuclear loci (calmodulin intron-4 and elongation factor-1alpha intron-6) using an approach based on coalescent theory. Genetic diversity and Ne estimated from mtDNA and nuclear sequences were uniformly low in P. rubrotaeniatus from the Rio Negro, suggesting that this population has encountered a historical bottleneck. For all P. mariae populations, theta and Ne based on nuclear sequences were comparable to expectations based on current adult census numbers and were significantly greater than mtDNA estimates, suggesting that a selective mtDNA sweep has occurred in this species. Comparative genetic analysis indicates that a suite of evolutionary processes involving historical demography and natural selection have influenced patterns of genetic variation and speciation in this important Neotropical fish group.

Animals↗
PubMed2003

The tobacco industry and secondhand smoke: lessons from Central and South America.

For more than 20 years the tobacco industry has considered secondhand smoke to be a threat to its viability. In this article, we describe why secondhand smoke is important to tobacco control and how the tobacco industry's "Latin Project" sought to prevent the creation of smoke-free workplaces and public places in Central and South America. Eliminating secondhand smoke exposure not only reduces the risk of cardiovascular and other diseases, but also creates an environment that substantially reduces smoking and cigarette consumption among smokers. The "Latin Project" was initiated in 1991 by Philip Morris and British American Tobacco and managed by the law firm Covington & Burling. The project assembled a network of well-placed physicians and scientists to divert the attention away from secondhand smoke toward other indoor air pollutants. As proven in Central and South America, the tobacco industry has manipulated the secondhand smoke issue in order to avoid the development of smoke-free environments. Sub-Saharan Africa, facing an epidemiologic transition similar to the one experienced by Central and South America, should be aware of tobacco industry tactics. Further delay in implementing smoke-free environments will only increase the burden of cardiovascular disease in both areas of the world.

Africa South of the Sahara↗