Assuntos
Transplante de Fígado , Testes de Função Respiratória , Desmame do Respirador/métodos , Adulto , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Fluxo Expiratório Máximo , Oxigênio/sangue , Valor Preditivo dos Testes , Mecânica Respiratória , Volume de Ventilação Pulmonar , Fatores de TempoRESUMO
This review describes the authors' experience with 2,000 cases of benzene poisoning reported between 1983 and 1995 in Cubatão, an industrial section of São Paulo, Brazil, investigated through the integration of epidemiology and clinical research. Conflicting economic interests were reflected in disputes about medical criteria for evaluation of poisoned workers, about proper means of conducting workplace hygiene evaluations, about benzene exposure standards, and about compensation for chronic bone-marrow damage.
Assuntos
Benzeno/intoxicação , Surtos de Doenças/prevenção & controle , Doenças Hematológicas/induzido quimicamente , Doenças Profissionais/prevenção & controle , Exposição Ocupacional/prevenção & controle , Adulto , Brasil/epidemiologia , Doenças Hematológicas/epidemiologia , Doenças Hematológicas/prevenção & controle , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Neutropenia/induzido quimicamente , Neutropenia/epidemiologia , Neutropenia/prevenção & controle , Doenças Profissionais/epidemiologia , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/normas , Vigilância da População/métodos , AçoRESUMO
In order to assess the present situation of schistosomiasis in the Zona da Mata Sul, Pernambuco State, Brazil, a study was conducted in the following phases: origin, historical and temporal evolution, and basic determinants of this health/disease process; critical assessment of comprehensive intervention programs implemented by the State in the region since 1970; and a case study in 17 counties, representing 1,424 communities and 485,200 inhabitants, and Brazil's second most endemic region based on prevalence rates for schistosomiasis. Temporal series over a 14-year period were used to analyze results of intervention programs. Conclusions were: a) current positivity rates are higher than those observed in the early 1980s; b) the programs' strategy focused almost exclusively on mass treatment, thus allowing for reinfestation and occurrence of new cases; c) proposals such as the PCDEN (Program for Control of Endemic Diseases in the Northeast) aimed at decentralization to the municipal level in the 1990s were not effectively implemented, helping to leave this persistent endemic out of control.
Assuntos
Esquistossomose/epidemiologia , Brasil/epidemiologia , Estudos de Casos e Controles , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Humanos , Morbidade/tendências , Esquistossomose/prevenção & controleRESUMO
Seventy seven (68%) patients with mucosal leishmaniasis recorded during the period 1976-1986 in the region of Três Braços, Bahia were traced and re-evaluated clinically, diagnostically and therapeutically. Sixty-five patients were alive. The families of 12 dead patients were interviewed about probable cause of death. The 65 patients had a fresh clinical examination supplemented when necessary by a skilled ENT examination. All had a titre of circulating immunofluorescent antibodies estimated at the time. Eight patients with active mucosal lesions had triturated biopsies which were cultivated in NNN medium and inoculated in hamsters to attempt to recover Leishmania. The isolates were identified by monoclonal antibodies as Leishmania (Viannia) braziliensis. Fifty-six (86%) patients were judged clinically cured. Nine (13%) had active lesions. Of the 12 patients who died 5 (41%) had no signs of activity at death. Mucosal leishmaniasis was thought to be the direct cause of death in 3 patients. The field treatment programme at Três Braços has managed to clinically cure 61 patients (79%) during 17 years. Follow-up periods were a mean of 10 years (range 7-17).