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PubMed1990

Bioethics: implications for medical practice and deontologic and legal standards in Brazil.

This article analyzes moral issues involving professional ethics in Brazil and provides appropriate up-to-date references to Brazil's Code of Deontology (1984), Code of Medical Ethics (1988), and civil and criminal codes. The analysis considers various trends that have emerged as a result of recent medical advances and discusses bioethical issues in the areas of family planning, abortion, medical research on human subjects, euthanasia, transplants, and professional confidentiality.

Bioethical Issues↗
PubMed1990

[Prevalence of arterial hypertension in Araraquara, Brazil].

PURPOSE: To study the prevalence of high blood pressure (HBP) in Araraquara, São Paulo, Brazil. PATIENTS AND METHODS: Cross sectional study: cluster equiprobabilistic sampling of 1.8% of the urban population aged 15-74 years, old (1.199 adults: 533 men and 66 women). For each subject, an interview was performed, with the fulfilling of a questionnaire; measures of blood pressure (BP, systolic and 2nd diastolic) as well as height and weight were taken. Criteria of definition for HBP were those of WHO (greater than or equal to 160/95). RESULTS: Systolic BP (mean +/- standard error) for men 137.6 +/- 0.8 mmHg, and for women 130.9 +/- 1.0 mmHg. Second diastolic BP for men 88.5 +/- 0.5 mmHg and for women 84.0 +/- 0.6 mmHg. Prevalence of definite HBP: 32.0% of men and 25.3% women (28.3% both sexes). Prevalence of borderline HBP; 18.7% of men and 12.0% of women (14.8% for both sexes). The greater part of hypertensives (68.3%) was of mild cases (less than 105 mmHg the second diastolic BP). CONCLUSION: It is the highest prevalence of HBP in Brazil described till now, and, therefore, an important public health problem.

Adolescent↗
PubMed1990

[Consanguinity marriages in Brazil].

This short review deals with the following problems: 1. frequencies of consanguineous marriages in Brazil; 2. their effects on precocious mortality (from abortions up to and including infant-juvenile mortality) and abnormalities among the survivors; 3. genetic counseling for consanguineous marriages; 4. reduction of the prenatal and post-natal damage in consequence of the abolition of the consanguineous marriages in Brazil.

Brazil↗
PubMed1990

[A behavioral dental science research concerning prevention of dental fear. A report on the surveys of dental fear in four countries Japan, Indonesia, Brazil and Argentina].

We conducted a behavioral scientific research from the point of view of dental fear prevention. This time, the writers carried out the surveys with the goal of understanding and making clear the realities concerning dental anxiety in the four countries: Japan, Indonesia, Brazil and Argentina. The subjects were 728 dental students from the four countries, and the surveys consisted of 25 multiple choice questions which were divided into three major areas. The first area consisted of preliminary questions such as chief complaints and treatment experiences, the second area dealt with the reactions and physical responses on receiving dental treatment and the third area was on the different levels of anxiety shown during treatment expressed through feelings and reactions. We concluded as follows: 1. In Japan, 77% of the subjects reported having at least a little fear and this percentage was higher than those of other countries (45-65%). But in all countries, 4-7% of subjects reported having extreme dental fear. 2. In Japan and Brazil, women reported the higher fear than men. In Indonesia and Argentina, these results were the opposite. 3. According to canonical correlation analysis, a significant correlation between the level of physical reactions and the degree of dental anxiety was found in all countries. 4. In the high fear group, dental anxiety increased by psychological stress before treatment and the expressions of physical reactions were stronger than in the low fear group.

Argentina↗
PubMed1990

A regional basic diet from northeast Brazil as a dietary model of experimental malnutrition.

The nutritional potentiality of the "Regional Basic Diet" (RBD) was assessed in albino rats. The diet, which was prepared according to data from food consumption surveys and was similar--in terms of quality and quantity--to those consumed by human populations in Northeast Brazil, was compared to a balanced diet (22% casein). The centesimal composition, aminogram, minerals content, NDpCal% and GCal%/PCal% ratio were determined. Vitamin contents were calculated from data in the literature. The RBD was shown to be imbalanced and poor in certain nutrients, mainly protein (7.8%). The growth curve of the RBD group was severely impaired; the naturally occurring sex-related differences in body weight were not detected. For fetuses and suckling pups, the weights of the liver and diaphragm paralleled body weight; brain weights were about 20% lower than those of controls, and its ratio was higher. RBD pregnant females presented, despite their higher food and energy intakes, lower weight gain as compared to the controls. During lactation food and energy intakes of RBD dams were lower than those of controls. The mortality rate among RBD pups was 24%. Our data indicate that RBD produces in the rat a type of malnutrition similar to that prevalent among children from Northeast Brazil, namely an association to nutritional dwarfism with some clinical signs of marasmus. RBD is considered to be a useful experimental model for studies on human malnutrition in countries where basic food patterns are similar to those in RBD-consuming regions.

Animals↗
PubMed1985

Masculinity, femininity, and homosexuality: on the anthropological interpretation of sexual meanings in Brazil.

This essay examines the anthropological interpretation of sexual meanings in Brazil as presented in the recent work of Peter Fry. Following Fry's lead, it places central emphasis on the study of male homosexuality and sexual ideology, suggesting that these cultural domains can be fully understood only when situated within the wider context of sexual meanings in Brazil. With this in mind, it traces the historical development of a series of analytically distinct, though practically interrelated, systems of sexual classification which structure the constitution of meaningful sexual identities in Brazilian life.

Anthropology↗
PubMedDate not supplied

[Hospital utilization in Brazil and effect of the measures to reduce hospitalizations].

The purpose of this paper is to discuss the increase and variation of hospital discharges in Brazil. In addition, the effects of recent governmental measures aiming at reducing the accelerated rate of use of in-patient facilities is discussed. A new case-based hospital reimbursement method, introduced late in 1983, was one of these measures, which seemed to have contributed to increase and not to decrease hospitalization. On the other hand, there has been a shift in hospital discharges from the private to the public sector. It is shown that there is a large difference in hospital workload between private and public institutions. While private hospitals in Brazil operate strongly in the specialties of internal medicine, public hospitals are treating more surgical patients. Consequently it seems that private hospitals are treating less complicated cases and public hospitals the most complicated ones.

Brazil↗
PubMed1989

[Hansen's disease in the northern region of Brazil--1986].

Some general facts about Hansen's Disease are presented: in the world, in the Americas, in 1986, with the purpose to focalize on the Northern Region of Brazil (Amazon Valley) where an attempt is made to specify, State, the clinical forms in the active registry, the respective coefficients of Prevalence, about the cases detected during the year, by clinical forms and the correspondent Coefficient of Incidence, the age range of less than 15 years, and above 15 years; and to analyze according to the township in the State of Amazonas in a series of 8 years, from 1979 to 1986, the registered cases under control and also without control, the new cases, by clinical form and Coefficient of Incidence, the positive cases among students in the capital and also in the country, and with more details, still by township and by Public Health Registry, in 1986, with the population, new cases, and Coefficient of Incidence, cases of the active registry, cases under control, Coefficient of Incidence, the relationship between patients/inhabitants, cases according to the decreasing intensity as far as the Prevalence and Health Department Regions: all this to give an idea, in detail, inclusive statistics, of the real position of Hansen's Disease in the Northern Region (Amazon Valley), with the highest figures of Prevalence and even of Incidence, in comparison with other Regions of the country, and to stress the grave situation of the endemic proportions of the disease, in Brazil in general and in that Regions, in particular.

Adolescent↗
PubMed1989

Public information about AIDS in Brazil, the Dominican Republic, Haiti, and Mexico.

Surveys of public knowledge and attitudes regarding AIDS have been conducted in Brazil, Haiti, Mexico, and the Dominican Republic. In Brazil two-thirds of the 5,000 survey subjects were aware of how HIV is transmitted, and 20% said they had changed their lifestyles or sexual practices to reduce their risk of infection. Of the 1,961 subjects surveyed in Mexico City, Mexico, 86% knew that AIDS was an infectious disease, and 52% believed condoms were an effective barrier against HIV. A 1987 survey in the Dominican Republic showed that awareness of AIDS, its modes of transmission, and preventive measures had improved since a similar survey conducted in 1985. In the Haitian survey in 1987, 24% to 68% of the respondents could identify high-risk groups, but there was some uncertainty about modes of transmission, the effectiveness of medical care, and the efficacy of measures to prevent HIV transmission.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

PGM3 polymorphism in human placenta samples from Bahia, Brazil.

PGM3 polymorphism was studied in 301 placenta samples from the Negroid population of Northeastern Brazil. The following gene frequencies were encountered: PGM3*1 = 0.545 and PGM3*2 = 0.455. They lie between European and African gene frequencies. The prevalent Black and White admixture of Northeastern Brazil populations fits well with the observed gene frequencies. Two samples exhibited variant electrophoretic patterns.

Black People↗
PubMedDate not supplied

[International agencies and the control of Hansen's disease in Brazil].

Main modes of international participation in hanseniasis control in Brazil, both public and private, are briefly described: public modes are established country to country or through Pan-american Health Organization; the others are essentially identified as "voluntary organizations". A descriptive assessment of this experience in Brazil follows. Considering our vast territory and a huge accumulated social debt, possible cooperative work is explored, adopting clear criteria (establishing priorities, planning and participative management), viewing basic actions as public attribuitions complemented by internacional organisms when necessary.

Brazil↗
PubMed1987

Evaluation of a program to overcome vitamin A and iron deficiencies in areas of poverty in Minas Gerais, Brazil.

Randon samples of children from both sexes from Belo Horizonte, the capital City, and from Turmalina, Jequitinhonha Valley, Minas Gerais, Brazil, were submitted to nutritional evaluation before and after the intervention "Program to Overcome Vitamin A and Iron Deficiencies in Areas of Poverty in Minas Gerais, Brazil". After the first examination, all the children received, with an interval of 180 days, a single oral dose of vitamin A, oral iron sulfate during 50 days, and 200 mg of Mebendazol/day for three days. Thirty days after ending administration of the third dose of medicine, the children were subjected to a new evaluation. In Belo Horizonte, the first evaluation revealed a high prevalence of deficient and low values of vitamin A in preschool children (21.5%) and school children (21.7%). A small prevalence of low hematocrit values was also observed in both groups. Deficient and low values of hemoglobin were found as well in 21.5% of preschool children and in 17.5% of school children. The second evaluation, practiced 30 days after the third dose of medicine, showed a small incidence of low vitamin A values (4.3% in preschool children and 2.9% in school children) and low hemoglobin values (6.5% in preschool children and 2.9% in school children). No deficient values of hemoglobin and vitamin A were observed. Concerning the hematocrit value, only one school child presented a low value at the second evaluation. On the other hand, in Jequitinhonha Valley, five cases of Bitot spot with conjunctival xerosis, two cases of corneal xerosis, and one case of keratomalacia were detected at the first examination. Thirty days after ending the third dose of medicine, only one corneal scar was observed. Only a small number of children with deficient and low levels of vitamin A and hemoglobin was found in the final evaluation (less than 8%), while this number was high at the first evaluation (above 38 and 12%, respectively). These results show the efficiency of the intervention Program in relation to hypovitaminosis A and iron anemia prevention. The Program is now being implemented by the Brazilian Ministry of Health.

Adolescent↗
PubMed1985

[An integrated program of occupational medicine: a proposal for medical schools in Brazil].

The article is animated essentially by a conviction of the feasibility and necessity of acting to improve the health of workers by making the most of the opportunities and instruments offered by the medical sciences. Following an account of the present status of occupational health/occupational medicine in Brazil, a description is given of the areas in which action could be taken in these fields in Brazil today, and the priorities in the areas of instruction, research and community services are identified, which are the proper province of the medical schools. The article then states the characteristics and policies of a Comprehensive Occupational Medicine Program as a practical alternative for new programs. This program should not necessarily become a new discipline or department in the medical school, but be conceived, implemented and administered as a system, that is, as an inter- or multidisciplinary network, and should hence have an advisory committee representing the departments in the school that participate in the program. To facilitate the establishment of this network, the article proposes setting up a central unit for the program and enumerates the functions it should have. Finally, a number of strategies for implementation of the program are proposed and some activities identified that could be set in motion in the short term.

Brazil↗
PubMed1985

An open, randomized, phase III clinical trial of mefloquine and of quinine plus sulfadoxine-pyrimethamine in the treatment of symptomatic falciparum malaria in Brazil.

The clinical and parasitological response of adult male patients to mefloquine and to a combination of quinine and sulfadoxine-pyrimethamine during the treatment of falciparum malaria was compared. These patients were from an area in Brazil where Plasmodium falciparum is showing increasing resistance to quinine and to sulfadoxine-pyrimethamine. The drugs were administered to 100 patients (50 in each group), based on a randomized study design.The rates of clearance of parasitaemia and fever were similar in both groups. However, the parasitological cure rate ("S" response) was 100% for mefloquine but only 92% for quinine plus sulfadoxine-pyrimethamine. Tolerance was good in both groups. The main side-effects (nausea, vomiting, abdominal pain, and dizziness) were mild, transient and required no specific treatment. Nausea and vomiting were more frequent in patients who received quinine plus sulfadoxine-pyrimethamine, while abdominal pain and loose stools or mild diarrhoea were more frequent in the mefloquine group. Tinnitus and hearing difficulty were observed following the administration of quinine plus sulfadoxine-pyrimethamine, but not after mefloquine treatment. Laboratory tests of various haematological and biochemical parameters were not adversely affected in either group after drug administration.It can be concluded that mefloquine, given in a single oral dose of 1000 mg, is highly effective, well tolerated, and safe for the treatment of falciparum malaria in adult males in Brazil.

Adolescent↗
PubMed1969

Seroepidemiological studies by indirect haemagglutination tests for malaria. Military recruit collections from Argentina, Brazil, Colombia, and the United States of America.

Seroepidemiological studies of 10 956 sera of military recruits from 4 countries in the Western Hemisphere suggest that the indirect haemagglutination test employing an antigen prepared from Plasmodium knowlesi adsorbed to human group O erythrocytes may be useful in epidemiological studies of malaria. Based on a titre of 1: 8, or higher, in a micro-titration of serum, the prevalence of serological reactors in the collection of sera from USA recruits was 0.9%, in the Argentina collection 4.6%, in the Brazil collection 20.8%, and in the Colombia collection 21.3%. In Brazil and Colombia the distribution of serological reactors correlated with the distribution of malaria as determined by active and passive surveillance. In Argentina, serological reactors were found in states where active and passive surveillance indicated that malaria had been eradicated years ago.

Brazil↗
PubMed1981

Plague in Brazil during two years of bacteriological and serological surveillance.

In north-east Brazil, where plague infection is endemic, bacteriological and serological methods were employed during a two-year period to determine accurately the occurrence of human infection and to define certain epidemiological features of both human and rodent infection. There were 67 confirmed cases of plague, predominantly among males and children. Most of these cases occurred in two inland rural plateaux of Ceara State. Clustering of cases in place and time was common, as was a history of contact with rats. Peak occurrence was in November 1978, during the warm, harvest time of year. Rodent surveillance resulted in isolation of Yersinia pestis from 33 animals, most of them from the field rodent, Zygodontomys pixuna, in the States of Pernambuco and Ceara. Our results indicate a decline in the number of human cases from previous years but show that several foci remain active and that serological testing, in addition to routine bacteriological testing, can assist workers in maintaining the surveillance of both human and rodent plague in Brazil.

Adolescent↗
PubMed1978

Community participation in health activities in an Amazon community of Brazil.

This article describes community participation in a comprehensive eight-year health program at Porto Nacional, a town in Brazils Amazon region. The authors discuss various techniques employed to encourage community participation, indicate methods used to resolve low-key conflicts in a positive manner, describe the major contributions made by community participation in this program, and present a number of conclusions considered applicable to other communities in this part of Brazil.

Brazil↗
PubMed1978

Fertility and land availability in rural Brazil.

Differences between the marital fertility of the agricultural frontier and that of the more settled rural areas of southern Brazil are analyzed in this paper. Fertility rates derived from 1970 census data appear to decrease as the degree of settlement increases, suggesting an experience parallel to the decline in U.S. rural fertility in the late nineteenth century, which Easterlin and others have attributed to increased scarcity of land for starting new farm households. Multivariate analysis of the Brazilian data shows parallels between the two situations but also reveals that the importance of literacy, child survival, and access to land is relatively greater than that of the availability of land for explaining fertility differentials in Brazil.

Adult↗