Sandfly fauna (Diptera: Psychodidae) in an urban area, Central-West of Brazil

ABSTRACT Biological and ecological relations among vectors and their pathogens are important to understand the epidemiology of vector-borne diseases. Camapuã is an endemic area for visceral and tegumentary leishmaniasis. The aim of this study was to characterize the sandfly fauna present in Camapuã , MS, Brazil. Sand flies were collected every fortnight from May 2014 to April 2015 using automatic light traps in the domicile and peridomicile of twelve neighborhoods and forest. The collected specimens were identified based on morphology according to the valid identification keys. In total, 2005 sandflies of five genera and nine species were collected. Nyssomyia whitmani and Lutzomyia cruzi were the most abundant species. Males were more abundant, with a male-to-female ratio of 2.14. The highest diversity was observed in peripheral neighborhood, with abundant plant cover. The peridomicile presented greater abundance of sandflies, with the predominance of Ny. whitmani . No significant correlation between the absolute frequencies of the most abundant species and the precipitation variable was observed; however, there was a predominance of Lu. cruzi in the rainy season. We observed a high frequency of sandflies in urban area, especially vector species. The presence of Nyssomyia whitmani and Lutzomyia cruzi indicate the necessity for health surveillance in the municipality. Additional method of collection such as sticky trap is also recommended for appropriate faunestic study

Prevalence of Urinary Incontinence in a Random Sample of the Urban Population of Pouso Alegre, Minas Gerais, Brazil Prevalencia de la incontinencia urinaria en muestra aleatoria de la población urbana de Pouso Alegre, Minas Gerais, Brasil Prevalência da incontinência urinária em amostra randomizada da população urbana de Pouso Alegre, Minas Gerais, Brasil

This study determines and analyzes the prevalence of Urinary Incontinence (UI) and its demographic and clinical predictors. This epidemiological and cross-sectional study was approved by the Research Ethics Committee of the University of São Paulo, Nursing School. The sample was randomly selected by cluster technique and included 519 individuals aged &#8805;18 years, living in 341 houses in urban areas. Data were analyzed through Chi-Square, Hosmer Lemeshow’s test and multivariate logistic regression (stepwise). Prevalence rates were standardized by gender and age. Of the 519 people composing the sample: 20.1% had UI, 32.9% were women and 6.2% were men. Longer duration of losses (OR = 29.3; p<0.001), diabetes mellitus (OR = 17.7; p<0.001), stroke (OR = 15.9; p<0.001), and cystocele (OR = 12.5; p <0.001) were the factors most strongly associated with UI. This study enabled the identification of UI epidemiology and can contribute to the development of public policies for its primary and secondary prevention and treatment, even if such measures are initially implemented at the city level.<br>El estudio tiene por objetivo conocer la prevalencia de la incontinencia urinaria (IU), de los factores de predicción demográficos y clínicos de la presencia de IU. Se trata de un estudio epidemiológico de corte transversal, aprobado por el Comité de Ética de la Escuela de Enfermería de la Universidad de Sao Paulo. Muestreo estratificado por conglomerado compuesto de 519 individuos con edad &#8805;18 años, residentes en 341 domicilios del área urbana, sorteados aleatoriamente. Las pruebas utilizadas fueron Chi-cuadrado, Hosmer Lemeshow y regresión logística multivariante (stepwise). Las prevalencias de IU fueron estandarizadas por sexo y edad, en una muestra de 519 personas, siendo 20,1 % en la población general - 32,9% eran mujeres y 6,2% hombres. Los factores más fuertemente asociados a la IU fueron: mayor tiempo de pérdidas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), accidente vascular encefálico (OR=15,9; p<0,001) y cistocele (OR=12,5; p<0,001). El estudio permitió conocer la epidemiologia de la IU y puede contribuir para el desarrollo de políticas públicas para su prevención primaria y secundaria, su tratamiento, inclusive considerando su inicio en el ámbito municipal.<br>Os objetivos deste trabalho foram conhecer a prevalência da incontinência urinária (IU), dos fatores demográficos e clínicos preditores da presença de IU. Estudo epidemiológico, corte transversal, aprovado pelo Comitê de Ética da Escola de Enfermagem da Universidade de São Paulo. A amostragem, estratificada por conglomerado, foi composta por 519 indivíduos com idade &#8805;18 anos, residentes em 341 domicílios da área urbana, sorteados aleatoriamente. Os testes utilizados foram qui-quadrado, Hosmer Lemeshow e regressão logística multivariada (stepwise). As prevalências foram padronizadas por sexo e idade, portanto, das 519 pessoas que compuseram a amostra, 20,1% dessas tinha IU numa população total; 32,9% eram mulheres e 6,2% homens. Maior tempo de perdas (OR=29,3; p<0,001), diabetes mellitus (OR=17,7; p<0,001), acidente vascular encefálico (OR=15,9; p<0,001) e cistocele (OR=12,5; p<0,001) foram os fatores mais fortemente associados à IU. O estudo permitiu conhecer a epidemiologia da IU e pode contribuir para o desenvolvimento de políticas públicas para a sua prevenção primária e secundária, seu tratamento, ainda que inicialmente em nível municipal

Trans* policy, politics and research: The UK and Portugal

This article explores law and social policy regarding trans* activism amongst trans* and non-binary social movements, and academic research addressing trans* in the UK and Portugal. In considering different possibilities for theorising gender diversity, this article positions a politics of difference and embodied citizenship as fruitful for synergising the issues under discussion. The authors consider recent law and policy shifts around gender recognition in each country and examine the gaps and the connections between policy developments, activism and research around trans*. Though each country has divergence in terms of the history of trans* activism and research, the article identifies significant similarities in the claims of activist groups in the UK and Portugal and the issues and questions under consideration in academic research on trans* and non-binary

Factors affecting clinical outcomes in the management of melioidosis in Singapore: a 16-year case series

Abstract Background Burkholderia pseudomallei is a gram negative bacteria that causes a spectrum of human diseases in the tropics. Although melioidosis is endemic in Southeast Asia, large clinical case series were rarely reported from metropolitan Singapore. Methods This is a retrospective study of 219 consecutive patients with culture proven infections due to Burkholderia pseudomallei between the years 2001 to 2016 managed in Singapore General Hospital (SGH). We aimed to review local patients’ characteristics and identify clinical factors associated with mortality and recurrent melioidosis. Results Culture proven melioidosis occurred in 219 patients, 83.1% were male with a mean age of 55.7 ± 14.3 years and 63.0% had diabetes mellitus. Most patients (71.7%) present within 4 weeks of symptom onset and the most common symptom was fever. The majority of patients had bacteremia (67.6%) and had infection involving the respiratory system (71.2%), presenting most frequently with multi-lobar pneumonia. Thirty-four (15.5%) deaths occurred during the initial hospitalisation with a median time from presentation to death of 6.0 days (interquartile range: 2.8–16.3). Twelve patients demised before the diagnosis of melioidosis was made. Univariate analysis identified patients with symptom duration of longer than 4 weeks, bacteremia, and disease requiring mechanical ventilation, inotropic support or temporary dialysis as factors that were significantly associated with mortality. Having bacteremia and disease requiring mechanical ventilation remained statistically significant factors in the multivariable analysis. Twenty-one (11.4%) patients developed at least 1 episode of culture proven recurrent infection, with 15 recurring within the first 12 months of their initial infection. Eight patients developed more than 1 episode of culture proven recurrent infection. Patients with multifocal infection were more likely to develop recurrent infection. Conclusion In metropolitan Singapore, melioidosis was associated with mortality in excess of 15%, where more than a third occurred before diagnosis. This study reminds local physicians that melioidosis is still a serious infection affecting local male diabetic patients and an important differential diagnosis in a patient presenting with severe multi-lobar pneumonia and septic shock. Recurrent infections occurred in 11.4% and the weight-based dosing of oral eradication antibiotics may improve the management of this disease locally