RESUMO

OBJECTIVES: This study aimed to estimate the economic costs of excessive sodium consumption in terms of hospitalizations and outpatient procedures of medium and high complexity (OPMHC) for the Brazilian Unified Health System (SUS) and its states in 2019. STUDY DESIGN: Ecological study. METHOD: This study used population attributable fractions (PAFs) of excessive sodium consumption estimated by the Global Burden of Disease study based on the theoretical minimum risk exposure level (3 g of sodium per day), the average population consumption, and relative risks of sodium-outcome pairs. PAFs were applied to the total costs of hospitalizations and OPMHC paid by SUS for each outcome obtained from the Outpatient and Hospital Information Systems. The costs per 10,000 inhabitants in all the Brazilian states were calculated and converted into international dollars (Int$), considering the purchasing parity power in the year 2019. RESULTS: Excessive sodium consumption resulted in Int$ 98,882,386.36 (95% uncertainty interval: Int$ 3,398,343.53-312,065,319.80) in hospitalizations and OPMHC costs in Brazil in 2019. Males and the 55- to 69-year-old age group had the highest expenditures attributable to excessive sodium consumption. Cardiovascular diseases were the most significant contributors to the costs associated with the risk factor. Southern and southeastern states had the highest costs of diseases attributable to sodium. CONCLUSION: Excessive sodium consumption has a significant economic burden on SUS, particularly among men and more developed states. This underscores the inequalities in socio-economic factors and access to health services throughout the country. Economic analyses at the subnational level can provide evidence for public policy planning to define the most appropriate actions for the population's sociodemographic reality.

Assuntos

Assuntos

RESUMO

OBJECTIVE: The objective of this study was to describe non-communicable disease (NCD) mortality attributable to diets low in whole grains, fruits, and vegetables in Brazil in 2019. STUDY DESIGN: Ecological study. METHODS: Data from the Global Burden of Disease 2019 for adults aged ≥25 years of both sexes in Brazil and its 27 states were used to estimate the intake of fruits, vegetables, and whole grains; the NCD mortality attributable to these dietary risk factors; and the correlation between socio-demographic index (SDI), the age-standardised mortality rate (ASMR) per 100,000 population, and intake. RESULTS: The Brazilian population had suboptimal consumption of fruits, vegetables, and whole grains, and 62,439 NCD deaths were attributable to these three dietary risk factors in 2019. The highest ASMRs were found for diets low in whole grains (14.4, 95% uncertainty interval [95% UI]: 7.8-18.4), followed by diets low in vegetables (7.6, 95% UI: 4.8-10.3) and fruits (5.0, 95% UI: 3.2-7.0). A similar ranking was observed for all Brazilian states. The SDI was negatively correlated with ASMRs and was positively correlated with the investigated dietary risks. The population from the Northeast and North states presented the lowest SDI and the highest NCD ASMRs attributable to diets low in fruits, vegetables, and whole grains and consumed less of all three health foods. CONCLUSION: Diets low in fruits, vegetables, and mainly whole grains substantially contributed to NCD mortality in Brazil, especially in states with low SDI. Our findings support the need to target food interventions to reduce regional health inequalities within the country.

RESUMO

The presence and establishment of Culicidae in urban areas increase the transmissibility of tropical diseases, since some species can participate as vectors of pathogens. Thus, this study aimed to evaluate the indoor and outdoor abundance of immature and adult populations of Culicidae at the urban area of Porto Velho, Rondônia. Mosquitoes were captured using electric aspirators and ovitraps in September and December 2018 in 27 households spread over nine neighborhoods. A total of 2,342 specimens were collected, distributed among five species, of which Culex quinquefasciatus (Say, 1823), Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1894) were the most abundant. Considering the sum total obtained by both techniques, more mosquitoes were captured indoors than outdoors. However, the GLM estimates for the ovitrap technique showed that immature Ae. aegypti, Ae. albopictus and Cx. quinquefasciatus were significantly more abundant in the outdoors, on average. The opposite result was observed for electrical aspiration, in which Ae. aegypti and Cx. quinquefasciatus adults were more abundant indoors. The average number of winged Ae. albopictus showed no significant difference between indoors and outdoors. Our findings corroborate the data on the abundance and incidence of these three species in other regions of Brazil, highlighting the need for continuous surveillance due to their importance in disease transmission to humans. We also demonstrated that the ovitrap is a sensitive device to monitor Cx. quinquefasciatus larvae and wild species that occasionally frequent urban areas, and thus can be used for surveillance, especially when there are budgetary constraints. Therefore, we emphasize that the combination of techniques, in addition to identifying which species and which stage of development are more frequent inside and outside households, also allows for the implementation of specific and integrated control measures.

Assuntos

Assuntos

RESUMO

The presence and establishment of Culicidae in urban areas increase the transmissibility of tropical diseases, since some species can participate as vectors of pathogens. Thus, this study aimed to evaluate the indoor and outdoor abundance of immature and adult populations of Culicidae at the urban area of Porto Velho, Rondônia. Mosquitoes were captured using electric aspirators and ovitraps in September and December 2018 in 27 households spread over nine neighborhoods. A total of 2,342 specimens were collected, distributed among five species, of which Culex quinquefasciatus (Say, 1823), Aedes aegypti (Linnaeus, 1762) and Aedes albopictus (Skuse, 1894) were the most abundant. Considering the sum total obtained by both techniques, more mosquitoes were captured indoors than outdoors. However, the GLM estimates for the ovitrap technique showed that immature Ae. aegypti, Ae. albopictus and Cx. quinquefasciatus were significantly more abundant in the outdoors, on average. The opposite result was observed for electrical aspiration, in which Ae. aegypti and Cx. quinquefasciatus adults were more abundant indoors. The average number of winged Ae. albopictus showed no significant difference between indoors and outdoors. Our findings corroborate the data on the abundance and incidence of these three species in other regions of Brazil, highlighting the need for continuous surveillance due to their importance in disease transmission to humans. We also demonstrated that the ovitrap is a sensitive device to monitor Cx. quinquefasciatus larvae and wild species that occasionally frequent urban areas, and thus can be used for surveillance, especially when there are budgetary constraints. Therefore, we emphasize that the combination of techniques, in addition to identifying which species and which stage of development are more frequent inside and outside households, also allows for the implementation of specific and integrated control measures.

A presença e o estabelecimento de culicídeos na área urbana aumentam a transmissibilidade de doenças tropicais, pois algumas espécies podem participar como vetores de patógenos. Assim, este estudo teve como objetivo avaliar a abundância de populações imaturas e adultas de espécies de culicídeos em intradomicílio e peridomicílio, em localidades da área urbana de Porto Velho, Rondônia. Os mosquitos foram capturados com o uso de aspiradores elétricos e ovitrampas nos meses de setembro e dezembro de 2018 em 27 residências distribuídas por nove bairros. Coletaram-se 2.342 espécimes, distribuídos em cinco espécies, das quais Culex quinquefasciatus (Say, 1823), Aedes aegypti (Linnaeus, 1762) e Aedes albopictus (Skuse, 1894) foram as mais abundantes. Considerando o somatório obtido por ambas as técnicas, mais mosquitos foram capturados no intradomicílio que no peridomicílio. No entanto, as estimativas de GLM para a técnica de ovitrampa demonstraram que imaturos de Ae. aegypti, Ae. albopictus e Cx. quinquefasciatus foram significativamente mais abundantes em peridomicílio, em média. Resultado inverso foi observado para aspiração elétrica, no qual adultos de Ae. aegypti e Cx. quinquefasciatus foram mais abundantes em intradomicílio. O número médio de adultos de Ae. albopictus não apresentou diferença significativa entre intra e peridomicílio. Nossos achados corroboram os dados de abundância e ocorrência dessas três espécies em outras regiões do Brasil, evidenciando a necessidade de vigilância contínua devido à sua importância na transmissão de doenças aos seres humanos. Nós demonstramos também que a ovitrampa é uma técnica sensível para monitorar larvas de Cx. quinquefasciatus e espécies silvestres que ocasionalmente frequentam áreas urbanas, podendo assim, ser empregada para a vigilância, especialmente quando há restrições orçamentárias. Assim, ressaltamos que a combinação de técnicas, além de identificar quais espécies e qual fase de desenvolvimento são mais frequentes dentro e fora dos domicílios, permite também estabelecer a implementação de medidas de controle específicas e integradas.

Assuntos

RESUMO

This work, which is couched in the theoretical framework of Articulatory Phonology, deals with the influence of speech rate on the change/variation from antepenultimate stress words into penultimate stress words in Brazilian Portuguese. Both acoustic and articulatory (EMMA) studies were conducted. On the acoustic side, results show different patterns of post-stressed vowel reduction according to the word type. Some words reduced their medial post-stressed vowels more than their final post-stressed vowels, and others reduced their final post-stressed vowels more than their medial post-stressed vowels. On the articulatory side, results show that the coarticulation degree of the post-stressed consonants increases with speech rate. Also, with the use of a measure called proportional consonantal interval (PCI), it was found in measurements of articulation that such measure is influenced by the word type. Three different groups of words were found according to their PCI. These results show how dynamical aspects influenced by speech rate increase are related to the lexical process of change/variation from antepenultimate stress words into penultimate ones.

RESUMO

The medicinal plant Ocimum gratissimum L. (Labiatae) is widely encountered in the Northeast of Brasil where it is used to treat digestive problems. Its leaves have an essential oil (EOOG) content whose chemical composition varies according to the time of plant collection. We have compared the effects of the EOOG, collected at 08:00 a.m. (EOOG8) and at 12:00 a.m. (EOOG12), on the relaxation of guinea-pig isolated ileum. Both EOOG8 and EOOG12 (30-300 microg/ml) reversibly relaxed the spontaneous tonus of the guinea-pig ileum in a concentration-dependent manner, with similar IC50 values (49.3 and 23.8 microg/ml, respectively). The magnitude of the decrease in resting tonus was similar to that of the recognised smooth muscle relaxant papaverine. EOOG8 and EOOG12 relaxed 60 mM KCl-precontracted preparations similarly (38.33 +/- 9.91 microg/ml and 35.53 +/- 6.70), whereas a significantly more potent relaxant effect of EOOG12 compared to EOOG8 was observed when tissues were contracted using 10 microM acetylcholine (IC50 values of 69.55 +/- 4.93 and 128.16 +/- 15.70 microg/ml, respectively; p < 0.05). The principal constituents of the essential oil, eugenol and cineole, also relaxed KCl-precontracted preparations, although they were less potent than EOOG, suggesting that they alone were not responsible for EOOG-induced relaxations. Our results show that the essential oil extracted from the leaves of O. gratissimum L., collected at different time periods, exerts significant relaxant effects on isolated guinea-pig ileum which may underlie the therapeutic action of the plant.

Assuntos

Assuntos

Assuntos

RESUMO

We investigated the efficacy of danazol treatment in eight patients with HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP). Treatment with danazol yielded clinical improvement of urinary control and gait disturbances in 7 out of the 8 patients. The improvement was noted within 15 days of danazol administration. Analysis of factors of relevance to the clinical improvement with danazol showed that the beneficial response was preferentially found in females.

Assuntos

RESUMO

Recent studies of tropical spastic paraparesis have confirmed the existence of human T-cell leukemia virus type-1 (HTLV-I) in several tropical areas of the world. In order to determine the role of HTLV-I as an etiologic agent of myelopathies in Salvador, we conducted a clinical and serological study in 43 patients with non-traumatic and non-tumoral myelopathies. We found 9 patients with HTLV-I associated myelopathy (HAM) which points to a new endemic area of HAM.

PIP: Human T-lymphotropic virus type one (HTLV-I) exists in several tropical areas of the world and is associated with adult T-cell leukemia/lymphoma and tropical spastic paraparesis. HTLV-I associated myelopathy (HAM) has been described in southern Japan, the US, Colombia, and Central Africa. Several cases have also been identified and described in Brazil. The authors describe the first cases of HAM in Bahia based upon a clinical and serological study in 43 patients with non-traumatic and non-tumoral myelopathies. Sera and CSF of the 43 patients admitted to a general hospital in Salvador over the course of six months with chronic spastic paraparesis were tested for HTLV-I, of whom nine with progressive chronic spastic paraparesis had serum and CSF positive to HTLV-I. These patients were aged 18-56 years. Two were promiscuous and one of them had a blood transfusion eight months before symptoms. They had similar histories with progressive weakness, first in one leg and after in the other which was associated with paresthesias in varying degrees of intensity. None of the patients had sensory level, although all had vegetative disturbances which were characterized by bladder dysfunction, constipation, and impotence in men. These findings suggest the existence of a new area in which HAM is endemic.

Assuntos

RESUMO

Recentes estudos têm mostrado a presença de mielopatia associada a infecçäo por HTLV-I em muitas áreas tropicais do mundo. Com o objetivo de determinar o papel do HTLV-I como agente etiológico de mielopatias em Salvador, realizamos estudo clínico e sorológico em 43 pacientes com mielopatia de etiologia näo traumática e näo tumoral. Encontramos 9 pacientes com mielopatia associada a HTLV-I (HAM) o que sugere nova área endêmica de HAM

Assuntos