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[Professor Antonio Austregésilo. The pioneer of neurology and of the study of movement disorders in Brazil].

Professor Antonio Austregésilo was the pioneer of neurology in Brazil, creating the first neurologícal school, in Rio de Janeiro, of which he was the first professor. He was also the first to study the movement disorders in Brazil, publishing several works on this subject, primarily in "Revue Neurologique", and "L'Encephale", including a rival sign of Babinski and the first description of a posttraumatic dystonia.

Brazil↗

Neuronal ceroid lipofuscinoses: a clinical and morphological study of 17 patients from southern Brazil.

The neuronal ceroid lipofuscinoses (NCL) are a group of inherited progressive neurodegenerative disorders with presentation from infancy to adulthood. Three main childhood forms can be established on the basis of age of onset, clinical course, and ultrastructural morphology: infantile (INCL), late infantile (LINCL), and juvenile (JNCL). Several variant subtypes have been described. Genetic and biochemical analysis are helping to better understand, diagnose and classify these disorders. We report on clinical, neurophysiological, neuroradiological, and morphological data from 17 patients with different forms (infantile, late infantile, and juvenile ) of neuronal ceroid lipofuscinoses (NCL) evaluated at Hospital de Clínicas de Porto Alegre, Southern Brazil, during 6 years (1992-1997). Seven cases were infantile; 5 were late infantile; and 5 were juvenile NCL. Gender ratio was male:female, 11:6. Age at presentation varied from 2-24 months for INCL; 2,5 to 5 years for LINCL; and 4-10 years for the JNCL cases. Seizures (6 patients) and psychomotor retardation (1 patient) were the initial symptoms in the INCL group. All the patients in the group of LINCL had the usual findings. JNCL patients manifested different initial symptoms, although tending to follow a similar clinical picture within familial cases. Epidemiological data on the prevalence of NCLs in Brazil are not available, we expect this series of cases to contribute to further research in our population.

Adolescent↗

[Clinical and epidemiological aspects of neurocysticercosis in Brazil: a critical approach].

With the objective to show the characteristics of neurocysticercosis (NCC) in Brazil, was performed a critical analysis of national literature which showed a frequency of 1.5% in autopsies and 3.0% in clinical studies, corresponding to 0.3% of all admissions in general hospitals. In seroepidemiological studies the positivity of specific reactions was 2.3%. Brazilian patient with NCC presents a general clinical-epidemilogical profile (31-50 years old man, rural origin, complex partial epileptic crisis, increased protein levels or normal CSF, CT showing calcifications, constituting the inactive form of NCC), and a profile of severity (21-40 years old woman, urban origin, vascular headache and intracranial hypertension, typical CSF syndrome of NCC or alteration of two or more CSF parameters, CT showing vesicles and/or calcifications, constituting the active form of NCC). Although two localities from the state of S o Paulo have 72:100000 and 96:100000/habitants as prevalence coefficients, regional and national prevalences are very underestimated. Some aspects related to underestimation of NCC prevalence in Brazil are discussed.

Adolescent↗

Analysis of the prevalence of insomnia in the adult population of São José do Rio Preto, Brazil.

OBJECTIVE: To establish the prevalence of insomnia in the adult urban population of São José do Rio Preto, Brazil and correlate it with the demographic data. METHOD: We evaluated 1105 individuals in to guarantee an error margin of 3% and a confidence level of 95% using a structured questionnaire and following the DSM-IV and DSM-III-R criteria, in the period from January 10 to February 28 2001. RESULTS: We encountered a prevalence of 32% of insomnia, which was most commonly seen in women, single people, from the lower economical brackets, with a low level of schooling and it was less associated with younger adults (18-31 year-olds). CONCLUSION: Our findings indicate that the prevalence of insomnia in the adult population of São José do Rio Preto is comparable with other countries such as the USA and those of Europe and also with other cities in Brazil.

Adolescent↗

[Diagnosis of Alzheimer's disease in Brazil: diagnostic criteria and auxiliary tests. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology].

This panel had the objective of recommending evidence-based guidelines for the clinical diagnosis of Alzheimer's disease (AD) in Brazil. Guidelines from other countries and papers on the diagnosis of AD in Brazil were systematically evaluated in a thorough research of PUBMED and LILACS databases. The panel concluded that dementia diagnosis should be based on the DSM criteria and AD diagnosis, on the McKhann et al. criteria (NINCDS-ADRDA). The recommended auxiliary tests are: blood cell count, blood urea nitrogen, serum levels of creatinine, free-thyroxine, thyroid-stimulant hormone, albumin, hepatic enzymes, vitamin B12 and calcium, serological tests for syphilis and, for those aged less than 60 years, serological tests for HIV. Cerebrospinal fluid examination is recommended in special situations. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory and has the main objective of excluding other diseases. SPECT and EEG are optional diagnostic methods.

Academic Medical Centers↗

[Diagnosis of Alzheimer's disease in Brazil: cognitive and functional evaluation. Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology].

The educational and cultural heterogeneity of the Brazilian population leads to peculiar characteristics regarding the diagnosis of Alzheimer's disease (AD). This consensus had the objective of recommending evidence-based guidelines for the clinical diagnosis of AD in Brazil. Studies on the diagnosis of AD published in Brazil were systematically evaluated in a thorough research of PUBMED and LILACS databases. For global cognitive evaluation, the Mini-Mental State Examination was recommended; for memory evaluation: delayed recall subtest of CERAD or of objects presented as drawings; attention: trail-making or digit-span; language: Boston naming, naming test from ADAS-Cog or NEUROPSI; executive functions: verbal fluency or clock-drawing; conceptualization and abstraction: similarities from CAMDEX or NEUROPSI; construction: drawings from CERAD. For functional evaluation, IQCODE, or Pfeffer Questionnaire or Bayer Scale for Activities of Daily Living was recommended. The panel concluded that the combined use of cognitive and functional evaluation based on interview with informant is recommended.

Academic Medical Centers↗

[Social profile of the black population in Brazil: implications for the nursing profession].

The discussion about the inequality conditions in which black population lives in Brazil, has been disguised by today's economical conjuncture which apparently sets with no restrictions the white, black and mestizos in absolute destitution conditions. Considered unracist, entitled by 'Folha de Sao Paulo/Datafolha' as Kind Racist, Brazil has being instituting way of living among races whose discrimination is expressed by the lack of opportunity and access to consumption services. This way, the insertion of the black in Brazilian society after slavery abolition is our study object. This bibliographical discusses social indicators aiming at describing this population strategies in conquering a social space. This study shows up the difficulties faced by this populational group regarding to its insertions to the work market as determinant factor to its social rising. We have included black male and female as citizens which compose the labor force in Nursing.

Black or African American↗

[Psychiatric nursing production in Brazil, 1932-1993].

The present research aims at studying the psychiatric nursing bibliographical production in Brazil, from 1932 to 1993. Therefore, the authors searched national journals, annals of the Brazilian Nursing Congresses, Annals of the National Seminars on Nursing Research and Catalogues of the Brazilian Nursing Association--Center of Nursing Studies and Research. In addition, the authors selected publications of the following events: III Meeting of Researchs on Mental Health, II Meeting of Specialists on Psychiatric Nursing, Nursing Undergraduation Golden Jubilee and National Meeting of University Hospitals. After the conclusion of this study, discussions were based on the central themes of the texts as well as on historical development of Psychiatric Nursing in Brazil.

Bibliometrics↗

[The Brazilian Nurses Association and the development of nursing in Brazil--a path under construction].

Through the concept of memory by Walter Benjamin, the authors of the present study identify relevant facts of the Brazilian Association of Nursing (ABEn) that affected the development of nursing in Brazil. The investigation points out the participation of ABEn in the regulation of the nursing field, creation of Revista Brasileira de Enfermagem (Brazilian Journal of Nursing), promotion of the Congressos Brasileiros de Enfermagem (Brazilian Congresses of Nursing) and its importance on the political struggle for better health conditions in Brazil.

Brazil↗

[Quality of bacillus identification tests in the Federal District (Brazil)--a reliability testing].

In Brazil, one of the priorities in the fight against the tuberculosis is the evaluation of laboratories' performance through the quality control of baciloscopic tests. This study was meant to evaluate the reliability of the tests carried out by the Tuberculosis Control Program of the Federal District, Brazil. It is a descriptive study, made out of revised glass slides at the reference laboratory, from 1988 up to 1999. A double-blind comparison of the results of the smear readings obtained in the outskirts and central laboratories was made. The concordances/discrepancies were analyzed through Kappa and the Confidence Interval (CI). From a total of 62,487 glass slides, we evaluated 7,756 baciloscopic tests. The discrepancy results represented 1.9% of false-positive and 0.8% of false-negative. Until 1997, 66.5% of the positive baciloscopic tests had been revised, but when the quality control was implemented the results grew up to 90.1%. The Kappa obtained a very good reliability but didn't match with the CI results. The quality control will increase the reliability of the tuberculosis diagnose although the evaluation depends on the use of sensitive reproducing tests.

Brazil↗

[Socioeconomic aspects of subjects with imported malaria in the metropolitan area of São Paulo, Brazil. I. Characterization of the population and knowledge about the disease].

With a view to discovering the social and economic characteristics of people from endemic malarial areas of Brazil, 566 suspected malaria cases were studied at the S. Paulo City Metropolitan Region Malaria Laboratory. Data were obtained by means of the application of standardized questionnaires over the period from November 1986 to June 1987 to individuals with as history of transit to Brazil's endemic malarial region. Of the population studied, 345 (61.0%) lived in the endemic area; 479 (84.6%) were males, 513 (90.7%) were between 15 and 55 years old and 307 (54.2%) presented positive plasmodium haemoscopia. The analysis by educational level indicated that 486 (85.9%) had primary or secondary education; 109 (19.3%) worked in mineral extraction; 74 (13.2%) were farmers, and 46 (8.1%) were related to terrestrial transportation activities. With respect, to knowledge of the disease, 384 (67.8%) had at least 1 bout of malaria before and 491 (86.8%) associated the disease with the presence of the vector. Of the 221 residents in S. Paulo, 207 (93.7%), as well as 336 (97.4%) of those residing in the endemic area already know of the risks of infection prior to travelling through the area of transmission. The interval between the first symptoms and the seeking for medical care varied from 0 to 3 days in 386 cases (68.2%). The frequencies of the variables studied analysed according to the haemoscopic result and the place of residence, were statistically significant.

Brazil↗

[Mortality due to neoplasms in Brazil (1980/1983/1985): grouping by states, behavior and trends].

Mortality caused by neoplasms in Brazil was examined by means of official Ministry of Health data covering 26 of the Federal Units and 13 different tumoral sites and referring to the years 1980, 1983 and 1985. Both cluster analyses and those of principal components have shown heterogeneous behaviour as between the different regions of the country in relation to the 13 variants studied. The main discriminatory elements are the trachea/bronchus/lung malign neoplasms followed by those of stomach, pancreas, colon and larynx. Complementary analyses have demonstrated a tendency to an increase in the mortality rate due to prostate malign neoplasms (17.74%), followed by those of trachea/bronchus/lung (15.22%), breast (11.32%), pancreas (10.23%), colon (8.08%), uterine colon (6.45%) and larynx (6.36). There has been a decrease of the mortality due to benign neoplasms/carcinoma "in situ"/others (27.37%), malign rectus neoplasms of the sigmoid/anus (7.67%), stomach (5.31%), of other non-specific locations in the uterus (2.56%), of leukaemia (0.70%) and malign neoplasms of the oesophagus (0.44%). Maling neoplasms of the stomach have been the main cause of cancer mortality in Brazil accounting for 21.27% of the mean total, followed by of the malign neoplasms trachea/bronchus/lung (17.52% of the general average). The mortality rates by esophageal malign neoplasms in Rio Grande do Sul is stressed.

Brazil↗

[The distribution of Biomphalaria (Gastropoda, Planorbidae) in the states of Rio Grande do Sul and Santa Catarina, Brazil].

An analysis to determine new localities colonized by the intermediate snail hosts (B. straminea, B. tenagophila and B. tenagophila tenagophila) of Schistosoma mansoni from Rio Grande do Sul and Santa Catarina States (Brazil) was carried out. As regards the geographical distribution of the schistosomiasis vector, the possible extension of the endemic disease to Southernmost Brazil is commented on.

Animals↗

[Microhabitats of Aedes albopictus (Skuse) in the region of the Paraiba Valley, São Paulo State, Brazil].

The objective of this study was the determination of extent of the spatial distribution of Aedes albopictus in the Paraíba River Valley, State S. Paulo, Brazil. Thus, collections of larvae and pupae mosquitoes were carried out at six sites distributed along a transection with a 10-km extension. The target was the tree-holes but artificial containers were also used in this investigation. Aedes terrens and Ae. albopictus were the only species of genus Aedes present in the tree-holes mentioned. The segregation of seven species of the tree-hole community was undertaken in the light of macrohabitat and microhabitat features. Thus, the distribution of Ae. albopictus was found to cover the rural, rural-urban and urban zones, but the rural-urban held the preference. Ae. albopictus never present in the residual and primary forest. The favorable factor to infestation with Ae. albopictus in the Paraíba Valley seems to have been the large number of natural niches made vacant by human influence. The rain has been important in the production of larvae and pupae, but the rainfall period does not coincide with the maximum production on them. The tree-holes whose volume exceeded 600 ml were the most productive breeding places. The abundance of these two stages occurs in the summer and autumn. However, the highest peak was observed in the months of March and April. These seasonal variations were found to be common in both the bamboo trap and the artificial container. The temperature data suggest a limit of from 17 to 23 degrees C for the best development of larvae. In the light of this, the strain of Ae. albopictus studied seems to have originated in tropical Asia. Just as happened with Ae. aegypti it may become an important epidemiological vector for the dengue fever and provide links for yellow fever transmission in Brazil.

Aedes↗

[The model of state health policy and the system of medical assistance adopted in present-day Brazil].

A contribution to the analysis of the health reform presently occurring in Brazil is presented. The need to consolidate the theoretical background which supports the advances already achieved in order to understand recent events in the area is stressed. In this regard, the health reform is understood as a question transcending the mere administrative and managerial aspect of the health system, since it necessarily involves a redefinition of the concepts of health, disease and the medical practice adopted by the dominant mechanistic paradigm of medicine. The recent events which delineate the health system in Brazil are analysed and criticised in the light of this concern.

Animals↗

[Increasing risk of skin melanoma in Brazil].

The occurrence of cutaneous malignant melanoma in Brazil is analysed on the basis of available mortality data from the National Ministry of Health and from the incidence data of six Population-based Cancer Registries (Recife, Fortaleza, S. Paulo, Porto Alegre, Goiânia e Belém). The incidence in these State capitals has an intermediate pattern if compared to the world pictures. For Porto Alegre, the capital that had the highest rates, a comparison between the periods 1979-1982 and 1987 showed a proportional increases of 38% among males and 11% among females. The conclusion is reached that it is necessary to undertake studies in Brazil among fairskinned people from particular communities which may show a potentialized risk for the development of cutaneous melanoma in order to be able to define what kind of specific control actions should be developed.

Brazil↗

A case-control study on the association of hepatitis B virus infection and hepatocellular carcinoma in northeast Brazil.

Hepatitis B virus (HBV) serological markers were investigated in 40 incident cases of hepatocellular carcinoma (HCC) and in two age and sex matched control groups, comprising 40 patients with other cancers and 80 healthy individuals, resident in Bahia, Brazil. Serologic tests were done by radioimmunoassay. The study observed high proportion of seropositivity to HBsAg (42.5%) and of those presenting HBsAg or antiHBc (65.0%) among HCC cases, higher in men than women and in those aged 17 to 30 years old. HBsAg seropositivity among HCC patients was greater than in the control group with other cancers (7.5%) and in healthy controls (2.5%), corresponding to odds ratio estimates of 15.0 (95% CI 3.29, 68.30) and 33.0 (95% CI 9.13, 119.28), both statistically significant. HBeAg was not observed and antiHBe was present in 41.2% of cases, suggesting the absence of viral replication, possibly with viral DNA integration into the hepatocyte genome. The presence of cirrhosis was associated with HBsAg seropositivity among HCC cases. A history of chronic alcoholism is shown to be more frequently related to those cases with cirrhosis. This study highlights the relevant association between HCC and HBV in Northeast Brazil, particularly for young individuals, and the high risk of development of HCC for HBsAg carriers.

Adolescent↗

Geographical patterns of proportionate mortality for the most common causes of death in Brazil.

Mortality due to chronic diseases has been increasing in all regions of Brazil with corresponding decreases in mortality from infectious diseases. The geographical variation in proportionate mortality for chronic diseases for 17 Brazilian state capitals for the year 1985 and their association with socio-economic variables and infectious disease was studied. Calculations were made of correlation coefficients of proportionate mortality for adults of 30 years or above due to ischaemic heart disease, stroke and cancer of the lung, the breast and stomach with 3 socio-economic variables, race, and mortality due to infectious disease. Linear regression analysis included as independent variables the % of illiteracy, % of whites, % of houses with piped water, mean income, age group, sex, and % of deaths caused by infectious disease. The dependent variables were the % of deaths due to each one of the chronic diseases studied by age-sex group. Chronic diseases were an important cause of death in all regions of Brazil. Ischaemic heart diseases, stroke and malignant neoplasms accounted for more than 34% of the mortality in each of the 17 capitals studied. Proportionate cause-specific mortality varied markedly among state capitals. Ranges were 6.3-19.5% for ischaemic heart diseases, 8.3-25.4% for stroke, 2.3-10.4% for infections and 12.2-21.5% for malignant neoplasm. Infectious disease mortality had the highest (p < 0.001) correlation with all the four socio-economic variables studied and ischaemic heart disease showed the second highest correlation (p < 0.05). Higher socio-economic level was related to a lower % of infectious diseases and a higher % of ischaemic heart diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗