RESUMO
Vanillin is the main component of natural vanilla extract and is responsible for its flavoring properties. Besides its well-known applications as an additive in food and cosmetics, it has also been reported that vanillin can inhibit fungi of clinical interest, such as Candida spp., Cryptococcus spp., Aspergillus spp., as well as dermatophytes. Thus, the present work approaches the synthesis of a series of vanillin derivatives with 1,2,3-triazole fragments and the evaluation of their antifungal activities against Candida albicans, Candida glabrata, Candida parapsilosis, Candida tropicalis, Cryptococcus neoformans, Cryptococcus gattii, Trichophyton rubrum, and Trichophyton interdigitale strains. Twenty-two vanillin derivatives were obtained, with yields in the range of 60%-91%, from copper(I)-catalyzed alkyne-azide cycloaddition (CuAAC) click reaction between two terminal alkynes prepared from vanillin and different benzyl azides. In general, the evaluated compounds showed moderate activity against the microorganisms tested, with minimum inhibitory concentration (MIC) values ranging from 32 to >512 µg mL-1 . Except for compound 3b against the C. gattii R265 strain, all vanillin derivatives showed fungicidal activity for the yeasts tested. The predicted physicochemical and ADMET (absorption, distribution, metabolism, excretion, and toxicity) properties for the compounds indicated favorable profiles for drug development. In addition, a four-dimensional structure-activity relationship (4D-SAR) analysis was carried out and provided useful insights concerning the structures of the compounds and their biological profile. Finally, molecular docking calculations showed that all compounds bind favorably at the lanosterol 14α-demethylase enzyme active site with binding energies ranging from -9.1 to -12.2 kcal/mol.
Assuntos
Fungicidas Industriais , Fungicidas Industriais/farmacologia , Simulação de Acoplamento Molecular , Relação Estrutura-Atividade , Antifúngicos/química , Triazóis/farmacologia , Testes de Sensibilidade MicrobianaRESUMO
BACKGROUND: Prenatal exposure to Zika virus has potential teratogenic effects, with a wide spectrum of clinical presentation referred to as congenital Zika syndrome. Data on survival among children with congenital Zika syndrome are limited. METHODS: In this population-based cohort study, we used linked, routinely collected data in Brazil, from January 2015 through December 2018, to estimate mortality among live-born children with congenital Zika syndrome as compared with those without the syndrome. Kaplan-Meier curves and survival models were assessed with adjustment for confounding and with stratification according to gestational age, birth weight, and status of being small for gestational age. RESULTS: A total of 11,481,215 live-born children were followed to 36 months of age. The mortality rate was 52.6 deaths (95% confidence interval [CI], 47.6 to 58.0) per 1000 person-years among live-born children with congenital Zika syndrome, as compared with 5.6 deaths (95% CI, 5.6 to 5.7) per 1000 person-years among those without the syndrome. The mortality rate ratio among live-born children with congenital Zika syndrome, as compared with those without the syndrome, was 11.3 (95% CI, 10.2 to 12.4). Among infants born before 32 weeks of gestation or with a birth weight of less than 1500 g, the risks of death were similar regardless of congenital Zika syndrome status. Among infants born at term, those with congenital Zika syndrome were 14.3 times (95% CI, 12.4 to 16.4) as likely to die as those without the syndrome (mortality rate, 38.4 vs. 2.7 deaths per 1000 person-years). Among infants with a birth weight of 2500 g or greater, those with congenital Zika syndrome were 12.9 times (95% CI, 10.9 to 15.3) as likely to die as those without the syndrome (mortality rate, 32.6 vs. 2.5 deaths per 1000 person-years). The burden of congenital anomalies, diseases of the nervous system, and infectious diseases as recorded causes of deaths was higher among live-born children with congenital Zika syndrome than among those without the syndrome. CONCLUSIONS: The risk of death was higher among live-born children with congenital Zika syndrome than among those without the syndrome and persisted throughout the first 3 years of life. (Funded by the Ministry of Health of Brazil and others.).
Assuntos
Mortalidade Infantil , Infecção por Zika virus/congênito , Infecção por Zika virus/mortalidade , Peso ao Nascer , Brasil/epidemiologia , Pré-Escolar , Estudos de Coortes , Feminino , Idade Gestacional , Humanos , Lactente , MasculinoRESUMO
Biological interactions play an important role in regulating and maintaining natural populations. Like most interactions, parasitism may be influenced by environmental conditions. Therefore, changes caused by human activity may drastically affect the equilibrium of the assemblages of parasitized organisms (hosts). Herein, we described the composition of hemoparasites of anurans from two distinct environments: forest and oil palm plantations. We identified the most frequent groups of blood parasites, and whether infections differ between habitats (forest and plantation) and between microhabitats (arboreal or terrestrial). We collected 128 anurans, of which 46 (36%) were parasitized by hemoparasites. The genus Trypanosoma spp. was found in 30% (n = 37/128) of the infected anurans in both habitats, recorded mostly in terrestrial anurans in oil palm plantations. Apicomplexa hemoprotozoans were also found in 13% (n=17/128) of the anurans, which mainly were terrestrial species collected in oil palm plantations. There was no difference in parasitism between the two assemblies and between the studied microhabitats. This is the first study that has analyzed the ecological relationship between anurans as hosts and their blood parasites, in a region under intense anthropic pressure, in the Brazilian Amazon.
Assuntos
Parasitos , Agricultura , Animais , Anuros , Ecossistema , Florestas , HumanosRESUMO
The indan-1,3-dione and its derivatives are important building blocks in organic synthesis and present important biological activities. Herein, the leishmanicidal and cytotoxicity evaluation of 16 2-arylidene indan-1,3-diones is described. The compounds were evaluated against the leukemia cell lines HL60 and Nalm6, and the most effective ones were 2-(4-nitrobenzylidene)-1H-indene-1,3(2H)-dione (4) and 4-[(1,3-dioxo-1H-inden-2(3H)-ylidene)methyl]benzonitrile (10), presenting IC50 values of around 30 µmol/L against Nalm6. The leishmanicidal activity was assessed on Leishmania amazonensis, with derivative 4 (IC50 = 16.6 µmol/L) being the most active. A four-dimensional quantitative structure-activity analysis (4D-QSAR) was applied to the indandione derivatives, through partial least-squares regression. The statistics presented by the regression models built with the selected field descriptors of Coulomb (C) and Lennard-Jones (L) nature, considering the activities against L. amazonensis, HL60, and Nalm6 leukemia cells, were, respectively, R2 = 0.88, 0.92, and 0.98; Q2 = 0.83, 0.88, and 0.97. The presence of positive Coulomb descriptors near the carbonyl groups indicates that these polar groups are related to the activities. Besides, the presence of positive Lennard-Jones descriptors close to substituents R3 or R1 indicates that bulky nonpolar substituents in these positions tend to increase the activities. This study provides useful insights into the mode of action of indandione derivatives for each biological activity involved.
Assuntos
Antineoplásicos/farmacologia , Antiprotozoários/farmacologia , Indanos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/química , Antiprotozoários/síntese química , Antiprotozoários/química , Linhagem Celular Tumoral , Células HL-60 , Humanos , Indanos/síntese química , Indanos/química , Concentração Inibidora 50 , Leishmania mexicana/efeitos dos fármacos , Leucemia/tratamento farmacológico , Relação Quantitativa Estrutura-AtividadeRESUMO
Purpose: The purpose of this study was to determine the prevalence and correlates of nonprescription hormone use among Brazilian trans women. Methods: This study is a cross-sectional survey of trans women in São Paulo, Brazil, recruited by respondent-driven sampling in 2017-2019. Results: Of 790 trans women, 36.8% were taking nonprescribed hormones. Nonprescribed hormone use was higher with younger age, lower education, homelessness, and using estrogen plus progesterone. Lower use was associated with accessing health care and having trans-specific health needs met. Conclusion: Marginalized Brazilian trans women exhibit high use of nonprescription hormones, which may have health consequences and requires further examination and research.
Assuntos
Hormônios/administração & dosagem , Medicamentos sem Prescrição/administração & dosagem , Pessoas Transgênero/estatística & dados numéricos , Adolescente , Adulto , Brasil , Estudos Transversais , Feminino , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
In this study, ent-kaurenoic acid derivatives were obtained by microbial transformation methodologies and tested against breast cancer cell lines (MCF-7). A multivariate quantitative-structure activity relationship (QSAR) analysis was performed taking into account both microbial transformation derivatives and other analogues previously reported in literature to give some insight into the main features behind the cytotoxic activity displayed by kaurane-type diterpenes against MCF-7â¯cells. The partial least square regression (PLS) method was employed in the training set and the best PLS model was built with a factor describing 69.92% of variance and three descriptors (logP, εHOMO and εHOMO-1) selected by the Ordered Predictors Selection (OPS) algorithm. The QSAR model provided reasonable regression (Q2â¯=â¯0.64, R2â¯=â¯0.72, SECâ¯=â¯0.29 and SEVâ¯=â¯0.33). The model was validated by leave-N-out cross-validation, y-randomization and external validation (R2predâ¯=â¯0.89 and SEPâ¯=â¯0.27). The selected descriptors indicated that the activity was mainly related to electronic parameters (HOMO and HOMO-1 molecular orbital energies), as well as to logP. These findings suggest that higher activity values are directly related with both higher logP and frontier orbital energy values. The positive relationship between these orbitals and the activity suggests that the ent-kaurenoic acid analogues interaction with the target involves charge displacement, which is entirely consistent with the literature. Based on these findings, three compounds were proposed and one of them was synthesized and tested. The experimental result confirmed the activity predicted by the model.
Assuntos
Antineoplásicos Fitogênicos/farmacologia , Neoplasias da Mama/tratamento farmacológico , Diterpenos/farmacologia , Antineoplásicos Fitogênicos/química , Antineoplásicos Fitogênicos/isolamento & purificação , Neoplasias da Mama/patologia , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Diterpenos/química , Diterpenos/isolamento & purificação , Ensaios de Seleção de Medicamentos Antitumorais , Fabaceae/química , Feminino , Humanos , Células MCF-7 , Relação Quantitativa Estrutura-Atividade , Teoria QuânticaRESUMO
BACKGROUND: Matrix metalloproteinases (MMP) are important enzymes in the tumor microenvironment associated with progression of cervical intraepithelial neoplasia (CIN) toward squamous cell carcinoma (SCC) of the cervix. However, the role of MMPs in the inflammatory process associated with Chlamydia trachomatis infection concomitant with the carcinogenic process driven by HPV has not yet been addressed. In the present study, we analyzed the state of the MMP-9-RECK axis in cervical carcinogenesis. METHODS: The levels of MMP-9 and RECK expression were analyzed by immunocytochemistry in liquid-based cytology samples from 136 women with high-grade cervical lesions (CIN2/CIN3) and cervical SCC diagnosed by LLETZ, and in 196 women without cervical neoplasia or CIN1. Real-time qPCR was performed to analyze expression of MMP-9 and RECK in 15 cervical samples. The presence of HPV-DNA and other genital pathogens was evaluated by PCR. RESULTS: We found a higher expression of MMP-9 [OR, 4.2; 95% confidence interval (CI), 2.2-7.8] and lower expression of RECK (OR, 0.4; 95% CI, 0.2-0.7) in women with CIN2/CIN3/SCC when compared with women from the control group (no neoplasia/CIN1). A statistically significant association was also found between MMP-9/RECK imbalance and infection by alpha-9 HPV and C. trachomatis. The prevalence of C. trachomatis infection was significantly higher in women with high-grade cervical disease (OR, 3.7; 95% CI, 1.3-11.3). CONCLUSIONS: MMP-9/RECK imbalance in cervical smears is significantly associated with high-grade cervical diseases and infection by alpha-9 HPV and C. trachomatis. IMPACT: MMP-9/RECK imbalance during cervical inflammation induced by C. trachomatis might play a role in HPV-mediated cervical carcinogenesis.
Assuntos
Infecções por Chlamydia/genética , Proteínas Ligadas por GPI/genética , Regulação Neoplásica da Expressão Gênica , Metaloproteinase 9 da Matriz/genética , Infecções por Papillomavirus/genética , Neoplasias do Colo do Útero/genética , Cervicite Uterina/genética , Adulto , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/virologia , Colo do Útero/metabolismo , Colo do Útero/patologia , Infecções por Chlamydia/metabolismo , Infecções por Chlamydia/patologia , Chlamydia trachomatis/genética , Estudos Transversais , DNA Bacteriano/genética , DNA de Neoplasias/genética , DNA Viral/genética , Feminino , Proteínas Ligadas por GPI/biossíntese , Regulação Bacteriana da Expressão Gênica , Genótipo , Papillomavirus Humano 16/genética , Humanos , Imuno-Histoquímica , Metaloproteinase 9 da Matriz/biossíntese , Teste de Papanicolaou , Infecções por Papillomavirus/metabolismo , Infecções por Papillomavirus/virologia , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Neoplasias do Colo do Útero/metabolismo , Neoplasias do Colo do Útero/virologia , Cervicite Uterina/metabolismo , Cervicite Uterina/microbiologia , Esfregaço VaginalRESUMO
The present study encompasses the species composition and ecological characteristics of the snake community in a Cerrado-Amazon transition zone in Midwest of Brazil (state of Mato Grosso). The data were collected during six excursions to the "Tanguro" (study area) by visual encounter survey, pitfall traps with drift fences and non-systematic sampling. We collected 194 specimens, distributed in 34 species, 26 genera, and eight families. The most abundant species were Crotalus durissus Linnaeus, 1758 (n = 50), Philodryas olfersii (Lichtenstein, 1823) (n = 15), Philodryas nattereri Steindachner, 1870 (n = 13), Xenodon rabdocephalus (Wied, 1824) (n = 12), Lachesis muta (Linnaeus, 1766) (n = 10) and Erythrolamprus almadensis (Wagler, 1824) (n = 10). The composition of species found here represents a combination of Cerrado and Amazonian savanna fauna.(AU)
Avaliamos neste estudo a composição de espécies, e características ecológicas de uma comunidade de serpentes em área de transição Cerrado-Amazônia, no Centro-Oeste do Brasil (Estado do Mato Grosso). Coletamos os dados durante seis expedições para "Tanguro" (área de estudo) através dos métodos de procura visual, armadilhas de interceptação e queda e encontros ocasionais. Registramos 194 espécimes, distribuídas em 34 espécies, 26 gêneros e oito famílias. As espécies mais abundantes foram Crotalus durissus Linnaeus, 1758 (n = 50), Philodryas olfersii (Lichtenstein, 1823) (n = 15), Philodryas nattereri Steindachner, 1870 (n = 13), Xenodon rabdocephalus (Wied, 1824) (n = 12), Lachesis muta (Linnaeus, 1766) (n = 10) e Erythrolamprus almadensis (Wagler, 1824) (n = 10). A composição de espécies encontrada representa uma combinação entre a fauna de Cerrado e Amazônica.(AU)
Assuntos
Animais , Serpentes , Ecossistema , Dinâmica Populacional , Floresta Úmida , PradariaRESUMO
The present study encompasses the species composition and ecological characteristics of the snake community in a Cerrado-Amazon transition zone in Midwest of Brazil (state of Mato Grosso). The data were collected during six excursions to the "Tanguro" (study area) by visual encounter survey, pitfall traps with drift fences and non-systematic sampling. We collected 194 specimens, distributed in 34 species, 26 genera, and eight families. The most abundant species were Crotalus durissus Linnaeus, 1758 (n = 50), Philodryas olfersii (Lichtenstein, 1823) (n = 15), Philodryas nattereri Steindachner, 1870 (n = 13), Xenodon rabdocephalus (Wied, 1824) (n = 12), Lachesis muta (Linnaeus, 1766) (n = 10) and Erythrolamprus almadensis (Wagler, 1824) (n = 10). The composition of species found here represents a combination of Cerrado and Amazonian savanna fauna.
Avaliamos neste estudo a composição de espécies, e características ecológicas de uma comunidade de serpentes em área de transição Cerrado-Amazônia, no Centro-Oeste do Brasil (Estado do Mato Grosso). Coletamos os dados durante seis expedições para "Tanguro" (área de estudo) através dos métodos de procura visual, armadilhas de interceptação e queda e encontros ocasionais. Registramos 194 espécimes, distribuídas em 34 espécies, 26 gêneros e oito famílias. As espécies mais abundantes foram Crotalus durissus Linnaeus, 1758 (n = 50), Philodryas olfersii (Lichtenstein, 1823) (n = 15), Philodryas nattereri Steindachner, 1870 (n = 13), Xenodon rabdocephalus (Wied, 1824) (n = 12), Lachesis muta (Linnaeus, 1766) (n = 10) e Erythrolamprus almadensis (Wagler, 1824) (n = 10). A composição de espécies encontrada representa uma combinação entre a fauna de Cerrado e Amazônica.
Assuntos
Animais , Ecossistema , Serpentes , Dinâmica Populacional , Floresta Úmida , PradariaRESUMO
BACKGROUND: Superoxide dismutase-2 (SOD2) is considered one of the most important antioxidant enzymes that regulate cellular redox state in normal and tumorigenic cells. Overexpression of this enzyme in lung, gastric, colorectal, breast cancer and cervical cancer malignant tumors has been observed. Its relationship with inguinal lymph node metastasis in penile cancer is unknown. METHODS: SOD2 protein expression levels were determined by immunohistochemistry in 125 usual type squamous cell carcinomas of the penis from a Brazilian cancer center. The casuistic has been characterized by means of descriptive statistics. An exploratory logistic regression has been proposed to evaluate the independent predictive factors of lymph node metastasis. RESULTS: SOD2 expression in more than 50% of cells was observed in 44.8% of primary penile carcinomas of the usual type. This expression pattern was associated with lymph node metastasis both in the uni and multivariate analysis. CONCLUSIONS: Our results indicate that SOD2 expression predicts regional lymph node metastasis. The potential clinical implication of this observation warrants further studies.
RESUMO
OBJECTIVE: This study aimed at evaluating whether human papillomavirus (HPV) groups and E6/E7 mRNA of HPV 16, 18, 31, 33, and 45 are prognostic of cervical intraepithelial neoplasia (CIN) 2 outcome in women with a cervical smear showing a low-grade squamous intraepithelial lesion (LSIL). METHODS: This cohort study included women with biopsy-confirmed CIN 2 who were followed up for 12 months, with cervical smear and colposcopy performed every three months. RESULTS: Women with a negative or low-risk HPV status showed 100% CIN 2 regression. The CIN 2 regression rates at the 12-month follow-up were 69.4% for women with alpha-9 HPV versus 91.7% for other HPV species or HPV-negative status (P < 0.05). For women with HPV 16, the CIN 2 regression rate at the 12-month follow-up was 61.4% versus 89.5% for other HPV types or HPV-negative status (P < 0.05). The CIN 2 regression rate was 68.3% for women who tested positive for HPV E6/E7 mRNA versus 82.0% for the negative results, but this difference was not statistically significant. CONCLUSIONS: The expectant management for women with biopsy-confirmed CIN 2 and previous cytological tests showing LSIL exhibited a very high rate of spontaneous regression. HPV 16 is associated with a higher CIN 2 progression rate than other HPV infections. HPV E6/E7 mRNA is not a prognostic marker of the CIN 2 clinical outcome, although this analysis cannot be considered conclusive. Given the small sample size, this study could be considered a pilot for future larger studies on the role of predictive markers of CIN 2 evolution.
RESUMO
OBJECTIVE: To evaluate Brazil's public health surveillance system (HSS), identifying its core capacities, shortcomings, and limitations in dealing with public health emergencies, within the context of the International Health Regulations (IHR 2005). METHODS: In 2008-2009 an evaluative cross-sectional study was conducted using semistructured questionnaires administered to key informants (municipal, state, and national government officials) to assess Brazilian HSS structure (legal framework and resources) and surveillance and response procedures vis-à-vis compliance with the IHR (2005) requirements for management of public health emergencies of national and international concern. Evaluation criteria included the capacity to detect, assess, notify, investigate, intervene, and communicate. Responses were analyzed separately by level of government (municipal health departments, state health departments, and national Ministry of Health). RESULTS: Overall, at all three levels of government, Brazil's HSS has a well-established legal framework (including the essential technical regulations) and the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. However, there are still some weaknesses at the state level, especially in land border areas and small towns. Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel. CONCLUSIONS: In general, the core capacities of Brazil's HSS are well established and fulfill most of the requisites listed in the IHR 2005 with respect to both structure and surveillance and response procedures, particularly at the national and state levels.
Assuntos
Vigilância em Saúde Pública , Brasil , Orçamentos/estatística & dados numéricos , Defesa Civil/economia , Defesa Civil/legislação & jurisprudência , Defesa Civil/normas , Doenças Transmissíveis Emergentes , Estudos Transversais , Surtos de Doenças , Órgãos Governamentais/economia , Órgãos Governamentais/legislação & jurisprudência , Órgãos Governamentais/organização & administração , Pesquisas sobre Atenção à Saúde , Recursos em Saúde/economia , Recursos em Saúde/estatística & dados numéricos , Humanos , Cooperação Internacional , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/legislação & jurisprudência , Programas Nacionais de Saúde/organização & administração , Gestão de Recursos Humanos , Política , Avaliação de Programas e Projetos de Saúde , Administração em Saúde Pública/economia , Administração em Saúde Pública/legislação & jurisprudência , Inquéritos e Questionários , Saúde da População Urbana , Organização Mundial da SaúdeRESUMO
OBJECTIVE: To evaluate Brazil's public health surveillance system (HSS), identifying its core capacities, shortcomings, and limitations in dealing with public health emergencies, within the context of the International Health Regulations (IHR 2005). METHODS: In 2008-2009 an evaluative cross-sectional study was conducted using semistructured questionnaires administered to key informants (municipal, state, and national government officials) to assess Brazilian HSS structure (legal framework and resources) and surveillance and response procedures vis-à-vis compliance with the IHR (2005) requirements for management of public health emergencies of national and international concern. Evaluation criteria included the capacity to detect, assess, notify, investigate, intervene, and communicate. Responses were analyzed separately by level of government (municipal health departments, state health departments, and national Ministry of Health). RESULTS: Overall, at all three levels of government, Brazil's HSS has a well-established legal framework (including the essential technical regulations) and the infrastructure, supplies, materials, and mechanisms required for liaison and coordination. However, there are still some weaknesses at the state level, especially in land border areas and small towns. Professionals in the field need to be more familiar with the IHR 2005 Annex 2 decision tool (designed to increase sensitivity and consistency in the notification process). At the state and municipal level, the capacity to detect, assess, and notify is better than the capacity to investigate, intervene, and communicate. Surveillance activities are conducted 24 hours a day, 7 days a week in 40.7% of states and 35.5% of municipalities. There are shortcomings in organizational activities and methods, and in the process of hiring and training personnel. CONCLUSIONS: In general, the core capacities of Brazil's HSS are well established and fulfill most of the requisites listed in the IHR 2005 with respect to both structure and surveillance and response procedures, particularly at the national and state levels.
OBJETIVO: Evaluar el sistema de vigilancia de salud pública del Brasil, identificando sus capacidades básicas, deficiencias y limitaciones para manejar emergencias de salud pública, dentro del contexto del Reglamento Sanitario Internacional (RSI 2005). MÉTODOS: En el período 2008-2009 se llevó a cabo un estudio transversal de evaluación utilizando cuestionarios semiestructurados administrados a informantes clave (funcionarios del gobierno municipal, estatal y nacional) a fin de evaluar la estructura del sistema de vigilancia de salud pública del Brasil (marco jurídico y recursos), y la vigilancia y los procedimientos de respuesta, con relación al cumplimiento de los requisitos del RSI 2005 para el manejo de emergencias de salud pública de importancia nacional e internacional. Los criterios de evaluación incluyeron la capacidad de detectar, evaluar, notificar, investigar, intervenir y comunicar. Las respuestas se analizaron por separado según el nivel gubernamental (departamentos de salud municipales y estatales y ministerio de salud nacional). RESULTADOS: En general, en los tres niveles del gobierno, el sistema de vigilancia de salud pública del Brasil tiene un marco jurídico bien establecido (incluidas las reglamentaciones técnicas esenciales) y la infraestructura, los suministros los materiales y los mecanismos requeridos para el enlace y la coordinación. Sin embargo, todavía hay algunos puntos débiles a nivel estatal, especialmente en las zonas fronterizas y los pueblos pequeños. Los profesionales de campo deben conocer más la herramienta de decisión del anexo 2 del RSI 2005 (diseñada para aumentar la sensibilidad y la consistencia del proceso de notificación). En el nivel estatal y municipal, la capacidad para detectar, evaluar y notificar es mejor que la capacidad para investigar, intervenir y comunicar. Las actividades de vigilancia se llevan a cabo 24 horas al día, 7 días a la semana, en 40,7% de los estados y 35,5% de los municipios. Existen deficiencias en las actividades de organización y los métodos, y en el proceso de contratación y capacitación del personal. CONCLUSIONES: En general, las capacidades básicas del sistema de vigilancia de salud pública del Brasil están bien establecidas y cumplen la mayoría de los requisitos enumerados en el RSI 2005, tanto con respecto a la estructura como a la vigilancia y los procedimientos de respuesta, en particular en los niveles nacional y estatal.
Assuntos
Humanos , Vigilância em Saúde Pública , Orçamentos/estatística & dados numéricos , Defesa Civil/economia , Defesa Civil/legislação & jurisprudência , Defesa Civil/normas , Doenças Transmissíveis Emergentes , Estudos Transversais , Órgãos Governamentais/economia , Órgãos Governamentais/legislação & jurisprudência , Órgãos Governamentais/organização & administração , Recursos em Saúde/economia , Recursos em Saúde/estatística & dados numéricos , Programas Nacionais de Saúde/legislação & jurisprudência , Programas Nacionais de Saúde/organização & administração , Política , Administração em Saúde Pública/economia , Administração em Saúde Pública/legislação & jurisprudência , Organização Mundial da SaúdeAssuntos
Regulamento Sanitário Internacional , Sistema de Vigilância em Saúde , Brasil , Regulamento Sanitário Internacional , Sistema de Vigilância em Saúde , Orçamentos , Defesa Civil , Política , Brasil , Vigilância em Saúde Pública , Doenças Transmissíveis Emergentes , Estudos Transversais , Surtos de Doenças , Órgãos Governamentais , Pesquisas sobre Atenção à Saúde , Recursos em Saúde , Cooperação Internacional , Programas Nacionais de Saúde , Gestão de Recursos Humanos , Avaliação de Programas e Projetos de Saúde , Administração em Saúde Pública , Inquéritos e Questionários , Saúde da População Urbana , Organização Mundial da SaúdeRESUMO
BACKGROUND: The success of HPV vaccination programs will require awareness regarding HPV associated diseases and the benefits of HPV vaccination for the general population. The aim of this study was to assess the level of awareness and knowledge of human papillomavirus (HPV) infection, cervical cancer prevention, vaccines, and factors associated with HPV awareness among young women after birth of the first child. METHODS: This analysis is part of a cross-sectional study carried out at Hospital Maternidade Leonor Mendes de Barros, a large public maternity hospital in Sao Paulo. Primiparous women (15-24 years) who gave birth in that maternity hospital were included. A questionnaire that included questions concerning knowledge of HPV, cervical cancer, and vaccines was applied. To estimate the association of HPV awareness with selected factors, prevalence ratios (PR) were estimated using a generalized linear model (GLM). RESULTS: Three hundred and one primiparous women were included; 37% of them reported that they "had ever heard about HPV", but only 19% and 7%, respectively, knew that HPV is a sexually transmitted infection (STI) and that it can cause cervical cancer. Seventy-four percent of interviewees mentioned the preventive character of vaccines and all participants affirmed that they would accept HPV vaccination after delivery. In the multivariate analysis, only increasing age (P for trend = 0.021) and previous STI (P < 0.001) were factors independently associated with HPV awareness ("had ever heard about HPV"). CONCLUSIONS: This survey indicated that knowledge about the association between HPV and cervical cancer among primiparous young women is low. Therefore, these young low-income primiparous women could benefit greatly from educational interventions to encourage primary and secondary cervical cancer prevention programs.
Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/uso terapêutico , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Fatores Etários , Brasil , Estudos Transversais , Feminino , Humanos , Análise Multivariada , Infecções por Papillomavirus/psicologia , Paridade , Infecções Sexualmente Transmissíveis/psicologia , Neoplasias do Colo do Útero/psicologia , Adulto JovemRESUMO
BACKGROUND: The physiopathology of dengue hemorrhagic fever (DHF), a severe form of Dengue Fever, is poorly understood. We are unable to identify patients likely to progress to DHF for closer monitoring and early intervention during epidemics, so most cases are sent home. This study explored whether patients with selected co-morbidities are at higher risk of developing DHF. METHODS: A matched case-control study was conducted in a dengue sero-positive population in two Brazilian cities. For each case of DHF, 7 sero-positive controls were selected. Cases and controls were interviewed and information collected on demographic and socio-economic status, reported co-morbidities (diabetes, hypertension, allergy) and use of medication. Conditional logistic regression was used to calculate the strength of the association between the co-morbidities and occurrence of DHF. RESULTS: 170 cases of DHF and 1,175 controls were included. Significant associations were found between DHF and white ethnicity (OR = 4.70; 2.17-10.20), high income (OR = 6.84; 4.09-11.43), high education (OR = 4.67; 2.35-9.27), reported diabetes (OR = 2.75; 1.12-6.73) and reported allergy treated with steroids (OR = 2.94; 1.01-8.54). Black individuals who reported being treated for hypertension had 13 times higher risk of DHF then black individuals reporting no hypertension. CONCLUSIONS: This is the first study to find an association between DHF and diabetes, allergy and hypertension. Given the high case fatality rate of DHF (1-5%), we believe that the evidence produced in this study, when confirmed in other studies, suggests that screening criteria might be used to identify adult patients at a greater risk of developing DHF with a recommendation that they remain under observation and monitoring in hospital.
Assuntos
Diabetes Mellitus/epidemiologia , Hipersensibilidade/epidemiologia , Dengue Grave/epidemiologia , Adolescente , Adulto , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Hipertensão , Modelos Logísticos , Masculino , Razão de Chances , Fatores de RiscoRESUMO
BACKGROUND: Early age at first delivery has been identified as a risk factor for high-risk HPV-type infection and cervical cancer development. METHODS: A cross-sectional study was carried out in a large public maternity hospital in São Paulo, Brazil. During June 2006 to February 2007, 301 women aged 15-24 years who gave birth to their first child were recruited between 43 and 60 days after delivery. Detection of HPV DNA in cervical specimens was performed using a standardised PCR protocol with PGMY09/11 primers. The association of selected factors with HPV infection was assessed by using a Generalised Linear Model. RESULTS: HPV DNA was detected in 58.5% (95% CI 52.7% to 64.0%) of the enrolled young women. The most common types of HPV found were: HPV16, HPV51, HPV52, HPV58 and HPV71. The overall prevalence of HPV types targeted by the HPV prophylactic vaccines was: HPV 16-12.0%, HPV 18- 2.3% and HPV 6 and 11 4.3%. In the multivariate analysis, only age (inversely, p for trend=0.02) and smoking habits were independently associated with HPV infection. CONCLUSIONS: The findings show that these young primiparous women had high cervical HPV prevalence, suggesting that this is a high-risk group for cervical cancer development. Nevertheless, 17.3% were positive for any of the four HPV types included in HPV vaccines (HPV6, 11, 16 or 18), with 13.3% positive for HPV 16 or 18 and only 1.0% having both vaccine related-oncogenic HPV types. Thus, young primiparous women could benefit from catch-up HPV vaccination programmes.
Assuntos
Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Paridade , Período Pós-Parto , Adolescente , Adulto , Alphapapillomavirus/genética , Brasil , Estudos Transversais , DNA Viral/genética , Feminino , Humanos , Idade Materna , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Pobreza , Gravidez , Prevalência , Fatores de Risco , Fatores de Tempo , Esfregaço Vaginal , Adulto JovemRESUMO
Lippia alba (Mill.) N. E. Brown (Verbenaceae), amplamente distribuída em todo o território brasileiro, é conhecida popularmente como erva cidreira e utilizada na medicina popular como analgésica, febrífuga, antiinflamatória, antigripal e nas afecções hepáticas. Extratos brutos foram preparados a partir de plantas cultivadas, de modo padronizado, em horta medicinal do Laboratório de Fitoterapia da Empresa Pernambucana de Pesquisa Agropecuária (IPA) para a verificação da atividade antimicrobiana, in vitro, pelo método de difusão em disco de papel. A concentração inibitória mínima (CIM) foi determinada para os extratos que exibiram melhores atividades. Os resultados obtidos mostraram que os extratos clorofórmico, acetônico e etanólico da raiz foram ativos frente a Staphylococcus aureus, Micrococcus luteus, Bacillus subtilis, Mycobacterium smegmatis, Candida albicans e Monilia sitophila e os extratos hexânicos, etanólicos e metanólicos das folhas inibiram S. aureus, M. luteus, B. subtilis, M. smegmatis e M. sitophila. A menor concentração inibitória (CIM = 31,2 µg/mL), foi obtida para o extrato clorofórmico da raiz frente a B. subtilis e M. luteus.
Lippia alba (Mill.) N. E. Brown (Verbenaceae), commonly known as "erva cidreira", is widely distributed throughout Brazil and is used in folk medicine as an analgesic, anti-inflammatory, cold remedy, as well as to reduce fevers and treat hepatic afflictions. Crude extracts of L. alba were prepared from plants cultivated in the medicinal garden of the Laboratório de Fitoterapia of the Empresa Pernambucana de Pesquisa Agropecuária (IPA), State of Pernambuco, Brazil, using standard techniques to test their in vitro antibacterial activity using the paper disk-diffusion method. The minimum inhibitory concentration (MIC) was determined for those extracts demonstrating the highest activity. The results demonstrated that the chloroform, acetone and ethanol extracts of root material were active against the growth of Staphylococcus aureus, Micrococcus luteus, Bacillus subtilis, Mycobacterium smegmatis, Candida albicans and Monilia sitophila, while the hexane, ethanol and methanol extracts of leaves inhibited the growth of S. aureus, M. luteus, B. subtilis, M. smegmatis and M. sitophila. The lowest inhibitory concentration (MIC = 31.2 µg/mL) was obtained with the chloroform root extract against B. subtilis and M. luteus.