RESUMO
INTRODUCTION: Chagas disease (CD) is a disease caused by the protozoan flagellates of the Kinetoplastid order Trypanosoma cruzi. Approximately 8,000,000 people are infected worldwide, mainly in Latin America, causing disabilities and more than 10,000 deaths per year OBJECTIVE: This study aimed to describe the epidemiological panorama of CD in the Western Brazilian Amazon from 2007 to 2018. METHODS: In this ecological study, secondary data regarding the confirmed cases of T. cruzi infection in the states of Acre, Amazonas, Rondônia, and Roraima were collected from the Single Health System Notification Information System of the Department of Informatics of the Single Health System and were analyzed. The data were used to characterize the epidemiological profile of T. cruzi infection and to determine the frequency of infection in Western Amazonia. RESULTS: A total of 184 cases of CD were reported in Western Amazonia, and the highest number of cases was reported in the states of Amazonas and Acre. CONCLUSION: The epidemiological panorama of the Western Brazilian Amazon from 2007 to 2018 includes a greater number of cases of T. cruzi infection in men aged 20-39 years and those living in rural areas. Oral transmission was prevalent in the region during the study, and the highest number of cases was reported in the months of April and December. Epidemiological data are an important resource for understanding the dynamics of CD and the main aspects related to the health-disease process.
INTRODUÇÃO: A doença de Chagas (DC) é uma enfermidade causada pelo protozoário flagelado da ordem Kinetoplastida denominado Trypanosoma cruzi. Estima-se que oito milhões de pessoas estejam infectadas em todo o mundo, principalmente na América Latina, causando incapacidades e mais de dez mil mortes por ano. OBJETIVO: Descrever o panorama epidemiológico da doença de Chagas na Amazônia Ocidental brasileira no período de 2007 a 2018. MÉTODO: Trata-se de um estudo ecológico e com coleta e análise de dados referentes aos casos confirmados de infecção por T. cruzi nos estados do Acre, Amazonas, Rondônia e Roraima, por meio de fontes secundárias oriundos do Sistema de Informação de Agravos de Notificação do Sistema Único de Saúde (SINAN) do Departamento de Informática do Sistema Único de Saúde (DATASUS). Os dados foram utilizados para caracterizar o perfil epidemiológico dos infectados por T. cruzi e determinar a frequência da infecção na Amazônia Ocidental RESULTADOS: Houve a notificação de 184 casos de doença de Chagas na Amazônia Ocidental com mais registros nos estados do Amazonas e Acre. CONCLUSÃO: O panorama epidemiológico da Amazônia Ocidental Brasileira no período de 2007 a 2018, compreende uma maior quantidade de casos em indivíduos do sexo masculino, na faixa etária dos 20-39 anos, e provenientes de zona rural. A forma de contágio prevalente na região durante o estudo foi a oral e a maior sazonalidade compreendeu os meses de abril e dezembro. Dados epidemiológicos são um importante recurso para a compreensão da dinâmica da DC e os principais aspectos relacionados no processo saúde-doença.
Assuntos
Perfil de Saúde , Morbidade , Doença de Chagas , Doença de Chagas/epidemiologia , Sistemas de InformaçãoRESUMO
PURPOSE: The purpose of the study is to identify early vulnerabilities for psychiatric disorders among Brazilian elementary school children, controlling for familial and community adversities. METHODS: This is a cross-sectional study examining the association between child psychiatric disorders and potential early vulnerabilities (disability, low intellectual quotient, and negative dimensions of the temperament trait self-directedness (low resourcefulness, low purposefulness, low enlightened second nature), controlling for the potential confounders: familial and community adversities. SAMPLE: Four probabilistic samples of second-to-sixth grade students from public schools in four towns from different Brazilian regions (N = 1620). The following instruments were applied: the K-SADS-PL (to assess child/adolescent psychiatric disorders); the Ten-Question Screen (to measure child disability); three structured questions used as proxy of self-directedness; and the reduced version of the WISC-III to measure IQ. To evaluate familial/community adversities: Self-Report Questionnaire-SRQ-20 (to assess maternal/primary caretaker anxiety/depression); questions derived from structured questionnaires (to measure child abuse, marital physical violence, neighborhood violence); Brazilian Association of Research Companies questionnaire (to evaluate poverty/socioeconomic status). Trained psychologists interviewed mothers/primary caretakers and evaluated children/adolescents individually. RESULTS: A final logistic regression model showed that children/adolescents with low resourcefulness, low purposefulness, low enlightened second nature, lower IQ and disability were more likely to present any child psychiatric disorders. CONCLUSION: Early vulnerabilities such as low IQ, presence of disability, and dimensions of temperament were associated with psychiatric disorders among Brazilian elementary school children, after controlling for familial and ecological confounders. These early vulnerabilities should be considered in mental health prevention/intervention programs in low-middle-income countries like Brazil.
Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Transtornos Mentais/epidemiologia , Estudantes/psicologia , Adolescente , Ansiedade/psicologia , Brasil/epidemiologia , Criança , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Estudos Transversais , Depressão/psicologia , Feminino , Humanos , Modelos Logísticos , Masculino , Transtornos Mentais/psicologia , Mães , Pobreza , Prevalência , Características de Residência/estatística & dados numéricos , Instituições Acadêmicas , Classe Social , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Studies have demonstrated that phosphodiesterase 5 (PDE5) inhibition is associated with right ventricle (RV) functional improvement in patients with primary pulmonary hypertension. This study aims to demonstrate the immediate impact of Sildenafil, a PDE5 inhibitor, on RV function, measured by cardiovascular magnetic resonance (CMR), in patients with heart failure (HF). METHODS: We conducted a randomized double-blind controlled trial. INCLUSION CRITERIA: diagnosis of HF functional class I-III; left ventricle ejection fraction < 35%. Patients underwent CMR evaluation and were then equally randomly assigned to either 50 mg of Sildenafil or Placebo groups. One hour following drug administration, they were submitted to a second scan examination. RESULTS: 26 patients were recruited from a tertiary reference center in Brazil and 13 were allocated to each study group. The median age was 61.5 years (50-66.5 years). Except for the increase in RV fractional area change following the administration of sildenafil (Sildenafil [before vs. after]: 34.3 [25.2-43.6]% vs. 42.9 [28.5-46.7]%, p = 0.04; Placebo [before vs. after]: 28.1 [9.2-34.8]% vs. 29.2 [22.5-38.8]%, p = 0.86), there was no statistically significant change in parameters. There was no improvement in left ventricular parameters or in the fractional area change of the pulmonary artery. CONCLUSION: This study demonstrated that a single dose of Sildenafil did not significantly improve RV function as measured by the CMR. TRIAL REGISTRATION: ClinicalTrials.gov NCT01936350.
Assuntos
Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/fisiopatologia , Inibidores da Fosfodiesterase 5/uso terapêutico , Citrato de Sildenafila/uso terapêutico , Função Ventricular Direita/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Insuficiência Cardíaca/diagnóstico , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Inibidores da Fosfodiesterase 5/farmacologia , Citrato de Sildenafila/farmacologia , Resultado do Tratamento , Disfunção Ventricular Direita/tratamento farmacológico , Disfunção Ventricular Direita/fisiopatologia , Função Ventricular EsquerdaRESUMO
The important chemical and food properties conferred to P. angulata make it necessary to conduct studies in seed conservation. This study evaluated the effect of priming of P. angulata seed for varying periods and storage conditions. Lots of seeds were stored in a refrigerator and in ambient conditions for up to 24 months. Some of these seeds were primed before or after storage. The results show that there was variation in moisture content. The germination rate and germination rate index remained high in ambient conditions when primed up to 24 months.(AU)
As importantes propriedades alimentícias e químicas atribuídas a P. angulata fazem dela uma espécie de grande valor para estudos de conservação de sementes. Este trabalho objetivou avaliar o efeito do pré-condicionamento osmótico de sementes de P. angulata submetidas a diferentes condições e períodos de armazenamento. Lotes de sementes foram armazenados em condições de ambiente e refrigerador até 24 meses. Parte dessas sementes foram osmocondicionadas antes ou após o armazenamento. Os resultados apresentados mostram que houve variação no teor de umidade. As sementes mantiveram taxas de germinação e índice de velocidade de germinação elevadas em ambiente quando osmocondicionadas até 24 meses.(AU)
Assuntos
Physalis , Germinação , Longevidade , Osmose , Sementes/crescimento & desenvolvimentoRESUMO
The important chemical and food properties conferred to P. angulata make it necessary to conduct studies in seed conservation. This study evaluated the effect of priming of P. angulata seed for varying periods and storage conditions. Lots of seeds were stored in a refrigerator and in ambient conditions for up to 24 months. Some of these seeds were primed before or after storage. The results show that there was variation in moisture content. The germination rate and germination rate index remained high in ambient conditions when primed up to 24 months.
As importantes propriedades alimentícias e químicas atribuídas a P. angulata fazem dela uma espécie de grande valor para estudos de conservação de sementes. Este trabalho objetivou avaliar o efeito do pré-condicionamento osmótico de sementes de P. angulata submetidas a diferentes condições e períodos de armazenamento. Lotes de sementes foram armazenados em condições de ambiente e refrigerador até 24 meses. Parte dessas sementes foram osmocondicionadas antes ou após o armazenamento. Os resultados apresentados mostram que houve variação no teor de umidade. As sementes mantiveram taxas de germinação e índice de velocidade de germinação elevadas em ambiente quando osmocondicionadas até 24 meses.