Utilizacion de medicamentos por la poblacion quilombola: pesquisa en el Suroeste de Bahia, Brasil

OBJETIVO Analizar el uso de medicamentos por la población quilombola. MÉTODOS Estudio transversal de base poblacional con 797 quilombolas adultas de Vitória da Conquista, Bahia, Brasil, en 2011. Se utilizó análisis de varianza para comparar los promedios de medicamentos por individuo según variables demográficas, socioeconómicas y de conductuales relacionados con la salud. Se estimaron las prevalencias, tasas de prevalencia y los respectivos intervalos de 95% de confianza. El análisis múltiple fue realizado por medio de regresión de Poisson con varianza robusta. RESULTADOS Los medicamentos más consumidos por la población fueron aquellos que actúan en los sistemas cardiovascular y nervioso. La prevalencia de uso de medicamentos fue de 41,9%, significativamente mayor en las mujeres (50,3%) que en los hombres (31,9%). Posterior al análisis ajustado, el uso de fármacos estuvo asociado al sexo femenino, edad de 60 años y más, nivel económico más alto, peor evaluación de la salud, mayor número de morbilidades auto-referidas y de consultas médicas. CONCLUSIONES Mujeres y ancianos deben ser los grupos de preferencia para el desarrollo de estrategias específicas que garanticen el uso racional de los medicamentos. Es necesaria la promoción de prescripción racional en el cotidiano de los servicios de salud.OBJECTIVE To characterize the medication use by the quilombola population. METHODS A population-based cross-sectional study was conducted with 797 adult quilombola in Vitória da Conquista, BA, Northeastern Brazil, in 2011. Analysis of variance was used to compare means of drugs by subject, according to demographic, socioeconomic and health-related behavior variables. Prevalence, prevalence ratios and their 95% confidence intervals were estimated. Multivariate analysis was carried out using Poisson regression with robust variance. RESULTS The most widely consumed drugs by the population were those for the cardiovascular and nervous systems. Prevalence of medication use was 41.9%, significantly higher among women (50.3%) than men (31.9%). After adjusted analysis, medication use was associated with being female gender, being aged 60 or older, higher economic level, worse self-rated health, greater number of self-reported diseases and number of medical appointments. CONCLUSIONS Strategies to improve rational drug use should preferentially focus on women and older adults. Thus, special attention should be given to promote rational prescription in everyday health services.OBJETIVO Analisar o uso de medicamentos pela população quilombola. MÉTODOS Estudo transversal de base populacional com 797 quilombolas adultos de Vitória da Conquista, BA, em 2011. Utilizou-se análise de variância para comparar as médias de medicamentos por indivíduo segundo variáveis demográficas, socioeconômicas e de comportamentos relacionados à saúde. Foram estimadas as prevalências, razões de prevalência e os respectivos intervalos de confiança de 95%. Análise múltipla foi conduzida por meio de regressão de Poisson com variância robusta. RESULTADOS Os medicamentos mais consumidos pela população foram aqueles que atuam nos sistemas cardiovascular e nervoso. A prevalência de uso de medicamentos foi de 41,9%, significativamente maior nas mulheres (50,3%) do que nos homens (31,9%). Após análise ajustada, o uso de fármacos foi associado a sexo feminino, idade de 60 anos e mais, nível econômico mais alto, pior avaliação da saúde, maior número de morbidades autorreferidas e de consultas médicas. CONCLUSÕES Mulheres e idosos deverão ser os grupos de preferência para o desenvolvimento de estratégias específicas que garantam o uso racional dos medicamentos. É necessária a promoção de prescrição racional no cotidiano dos serviços de saúde

Aspectos Epidemiológicos da AIDS/HIV no Brasil

Made available in DSpace on 2010-08-23T16:58:31Z (GMT). No. of bitstreams: 3 CASTILHO_Aspectos epidemiologicos_1993----.pdf: 5284409 bytes, checksum: eeefacd0153e5e5474cbf6fc3f185d94 (MD5) license.txt: 1842 bytes, checksum: ef77b793ae6d58d8bf02af1a4d73bd31 (MD5) CASTILHO_Aspectos epidemiologicos_1993----.pdf.txt: 11 bytes, checksum: b308b7fe5c1c2bbdc0cb686d451b84aa (MD5) Previous issue date: 1993Made available in DSpace on 2010-11-04T14:19:56Z (GMT). No. of bitstreams: 3 CASTILHO_Aspectos epidemiologicos_1993----.pdf.txt: 11 bytes, checksum: b308b7fe5c1c2bbdc0cb686d451b84aa (MD5) license.txt: 1842 bytes, checksum: ef77b793ae6d58d8bf02af1a4d73bd31 (MD5) CASTILHO_Aspectos epidemiologicos_1993----.pdf: 5284409 bytes, checksum: eeefacd0153e5e5474cbf6fc3f185d94 (MD5) Previous issue date: 1993Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, BrasilFundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Os autores apresentam uma descrição da evolução da epidemia da AIDS no Brasil, apontando as tendências temporais no que se refere aos grupos populacionais mais atingidos. Apresentam também comparações regionais bem como projeções da extensão da infecção pelo HIV e de casos de AIDS. Dentre as conclusões mais importantes destaca-se a preocupante disseminação do HIV na população heterossexual e entre os usuários de droga injetáveis, principalmente na região sudeste do país.A trend analysis of the AIDS epidemics in Brazil is presented, emphasizing temporal changes among the population groups most affected. Regional comparisons as well as protections of the extesion of HIV infection and AIDS cases are also reported. Amongst the most relevant conclusions the alarming increase of cases in heterosexual populations and intravenous drug users is emphasided, specially in the Southeast region

HIV infection among Female Partners of Seropositive Men in Brazil

The Rio de Janeiro Heterosexual Study Group includes Luiz A. Alves Lima from Santa Catarina Hematoiogic Center; Victor Berbara from National Institute of Medical Care; Solange Cavalcante from Evandro Chagas Hospital, Oswaldo Cruz Foundation; Valeria Gomes from Pedro Emesto Hospital, State University of Rio de Janeiro; Mariza Morgado from The Immunology Laboratory, Oswaldo Cruz Foundation; Eleonora Quinhões and Dario Signorini from Gaffree & Guinle University Hospital, University of Rio de Janeiro; Andrea Sereno from Federal University of Rio de Janeiro.Made available in DSpace on 2010-08-23T16:58:23Z (GMT). No. of bitstreams: 3 CASTILHO_HIV infection among female_1995.pdf: 3308169 bytes, checksum: 2d41961aae8014f4b8e3b0072ef94e1a (MD5) license.txt: 1842 bytes, checksum: d1c94afc8125b609539828876439f55c (MD5) CASTILHO_HIV infection among female_1995.pdf.txt: 5 bytes, checksum: cc9067c2ee470dc248b14b194209a34e (MD5) Previous issue date: 1995Made available in DSpace on 2010-11-04T14:19:40Z (GMT). No. of bitstreams: 3 CASTILHO_HIV infection among female_1995.pdf.txt: 5 bytes, checksum: cc9067c2ee470dc248b14b194209a34e (MD5) license.txt: 1842 bytes, checksum: d1c94afc8125b609539828876439f55c (MD5) CASTILHO_HIV infection among female_1995.pdf: 3308169 bytes, checksum: 2d41961aae8014f4b8e3b0072ef94e1a (MD5) Previous issue date: 1995Federal University of Minas Gerais. Department of Preventive and Social Medicine. Belo Horizonte, BH, Brazil.The Johns Hopkins University. School of Hygiene and Public Health. Department of Epidemiology. Baltimore, USA.Ministry of Health. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.Ministry of Health. Oswaldo Cruz Foundation. Rio de Janeiro, RJ, Brazil.A heterosexual partner study was carried out in Rio de Janeiro, Brazil, from August 1990 to Decembe: 1991. The main objectives were to determine the rate of male-to-female transmission of human Immunodeficiency virus (HIV) and to determine risk factors. Male index cases were recruited according to the following criteria: 1) confirmed HIV positivity, 2) 18 years old or older; 3) heterosexual contact within the past year. Only female partners who reported not to have other risk factors but to have had sexual contact with the Index case were invited to participate. Couples were interviewed for risk factors and had blood collected for laboratory studies. The overall prevalence of HIV infection was 45 percent among 204 female partners In the study. Using logistic regression, the authors found the following factors to be independently (p <0.05) associated with HIV infection: 1) anal sex (odds ratio (OR) = 3.74, 95% confidence interval (CI) 1.87-7.45); 2) condom use during vaginal sex sometimes (OR = 1.45,95% CI 1.07-1.96), rarely (OR = 2.10,95% CI 1.15-3.83), or never (OR = 3.04, 95% CI 1.23-7.50) as compared with always; 3) frequency of sexual contacts In the year prior to interview (100+) (OR = 2.00,95% CI1.03-3.91); and 4) oral contraceptive use (OR = 2.04, 95% CI 0:97-4.29). In addition to a borderline significance of oral contraceptive use, there was a strong suggestion of an interaction with history of sexually transmitted diseases

Análisis coste-efectividad de la adhesión inicial a la terapia antirretroviral entre individuos infectados por el VIH en Belo Horizonte,

Fundamento: En Brasil, los antirretrovirales (ARV) se distribuyen a los portadores de VIH de forma gratuita por el Sistema Único Salud. La adhesión al tratamiento es una de las principales variables la cual los servicios de salud pueden intervenir para aumentar la efectividad de la medicación. El objetivo del estudio es evaluar la relación coste-efectividad de la adhesión inicial a la terapia ARV e identificar factores que influencien los costes y la evolución global del paciente. Métodos: Estudio prospectivo con individuos infectados por VIH reclutados, después de la primera prescripción de ARV, en dos servicios públicos de referencia para el tratamiento del VIH/Sida Brasil. La no-adhesión fue definida como la utilización 200 cels/mm3 y ser adherente al tratamiento ARV.Conclusiones: Los resultados observados sostienen la terapia ARV como una intervención coste-efectiva. Sin embargo, la baja adhesión aumenta los riesgos de fallo terapéutico y de progresión de la enfermedad, que resultan en un impacto negativo sobre la relación coste-efectividad de la terapia ARV

Análisis coste-efectividad de la adhesión inicial a la terapia antirretroviral entre individuos infectados por el VIH en Belo Horizonte,

Fundamento: En Brasil, los antirretrovirales (ARV) se distribuyen a los portadores de VIH de forma gratuita por el Sistema Único Salud. La adhesión al tratamiento es una de las principales variables la cual los servicios de salud pueden intervenir para aumentar la efectividad de la medicación. El objetivo del estudio es evaluar la relación coste-efectividad de la adhesión inicial a la terapia ARV e identificar factores que influencien los costes y la evolución global del paciente. Métodos: Estudio prospectivo con individuos infectados por VIH reclutados, después de la primera prescripción de ARV, en dos servicios públicos de referencia para el tratamiento del VIH/Sida Brasil. La no-adhesión fue definida como la utilización <95% de cantidad prescrita durante los 3 días anteriores a la primera visita seguimiento. El ratio coste-efectividad se ha calculado para el grupo adherente y no-adherente. Se han empleado modelos de regresión lineal múltiple y logística binaria en el análisis univariante y multivariante. Resultados: Un 79,7% de los 197 participantes fue adherente tratamiento ARV y el ratio coste-efectividad obtenido para este grupo 2.667,66 euros) fue menor que el observado entre los no adherentes. El análisis multivariante (p<0,05) mostró que la adhesión a la terapia ARV y el uso de inhibidores de la proteasa en el tratamiento estaban asociados con mayor coste directo medio de la atención. La evolución global favorable estuvo asociada con estar asintomático, tener linfocitos TCD4+>200 cels/mm3 y ser adherente al tratamiento ARV.Conclusiones: Los resultados observados sostienen la terapia ARV como una intervención coste-efectiva. Sin embargo, la baja adhesión aumenta los riesgos de fallo terapéutico y de progresión de la enfermedad, que resultan en un impacto negativo sobre la relación coste-efectividad de la terapia ARV

Doença neurológica em pacientes infectados pelo HIV na era da terapia anti-retroviral altamente ativa: uma experiência brasileira

Submitted by Nuzia Santos ([email protected]) on 2013-06-06T17:45:30Z No. of bitstreams: 1 85.pdf: 74487 bytes, checksum: 9c3cb4beb82b73f014adfb591154936d (MD5)Made available in DSpace on 2013-06-06T17:45:30Z (GMT). No. of bitstreams: 1 85.pdf: 74487 bytes, checksum: 9c3cb4beb82b73f014adfb591154936d (MD5) Previous issue date: 2006Minas Gerais Hospital State Foundation. Hospital Eduardo de Menezes. Belo Horizonte, MG, BrazilFederal University of Minas Gerais. School of Medicine. Infectious Disease Service. Belo Horizonte, MG.Oswaldo Cruz Foundation. René Rachou Research Center. Belo Horizonte, MG, Brazil.Minas Gerais Hospital State Foundation . Hospital Eduardo de Menezes. Belo Horizonte, MG, Brazil.Federal University of Minas Gerais. School of Medicine. Department of Preventive and Social Medicine. Belo Horizonte, MG, BrazilOswaldo Cruz Foundation. René Rachou Research Center. Belo Horizonte, MG, Brazil.Com o objetivo de estudar as doenças neurológicas em pacientes HIV/AIDS e sua relação com a terapia anti-retroviral altamente ativa, foi realizado estudo transversal em hospital público de doenças infecciosas de Belo Horizonte, Brasil, no período de fevereiro de 1999 a março de 2000. Doença neurológica foi observada em 194 (46,5%) dos 417 indivíduos incluídos e um novo episódio de doença neurológica definidora de AIDS ocorreu em 23,7% pacientes. Toxoplasmose (42,3%), criptococose (12,9%) e tuberculose (10,8%) foram as principais causas de complicações neurológicas. A maioria dos pacientes estava em uso de terapia anti-retroviral altamente ativa (79,3%) e esses indivíduos apresentaram maiores contagens de linfócitos CD4 (p = 0,014) e maior freqüência de doença neurológica clinicamente estável, embora não tenha havido diferença no perfil etiológico das complicações neurológicas. As doenças neurológicas continuam sendo causas freqüentes de complicações da infecção pelo HIV/AIDS no Brasil, e a despeito da terapia anti-retroviral altamente ativa, as infecções são ainda a principal etiologia das doenças do sistema nervoso.To study characteristics of neurological disorders in HIV/AIDS patients and their relationship to highly active antiretroviral treatment, a cross-sectional study was conducted in an infectious disease public hospital in Belo Horizonte, Brazil, between February 1999 and March 2000. Of the 417 patients enrolled, neurological disease was observed in 194 (46.5%) and a new AIDS-defining neurological event developed in 23.7% of individuals. Toxoplasmosis (42.3%), cryptococcosis meningitis (12.9%) and tuberculosis (10.8%) were the most common causes of neurological complications. The majority (79.3%) of patients were on highly active antiretroviral treatment and these individuals using HAART showed higher CD4 cell counts (p = 0.014) and presented stable neurological disease (p= 0.0001), although no difference was found with respect to the profile of neurological complications. The neurological diseases continue to be a frequent complication of HIV/AIDS and infections are still its main causes in Brazil, even in the highly active antiretroviral treatment er

V3 region polymorphisms in HIV-1 from Brazil: prevalence of subtype B strains divergent from North American/European prototype and detection of subtype F

Made available in DSpace on 2010-08-23T16:58:21Z (GMT). No. of bitstreams: 3 Castilho_V3 Region Polymorphisms_1994---.pdf: 1916500 bytes, checksum: 7e8deb6f669635a58afc14adda9cda3b (MD5) license.txt: 1842 bytes, checksum: c6d856a4fff480a799b3afb2acbff224 (MD5) Castilho_V3 Region Polymorphisms_1994---.pdf.txt: 40521 bytes, checksum: ea16e4de18146e4b4dc61ac2d5afe743 (MD5) Previous issue date: 1994Made available in DSpace on 2010-11-04T14:19:42Z (GMT). No. of bitstreams: 3 Castilho_V3 Region Polymorphisms_1994---.pdf.txt: 40521 bytes, checksum: ea16e4de18146e4b4dc61ac2d5afe743 (MD5) license.txt: 1842 bytes, checksum: c6d856a4fff480a799b3afb2acbff224 (MD5) Castilho_V3 Region Polymorphisms_1994---.pdf: 1916500 bytes, checksum: 7e8deb6f669635a58afc14adda9cda3b (MD5) Previous issue date: 1994This work was partially supported by Grants ROI-HL-48367 and ROI-AI-32885 (NIH), by the NAID/PAHO/Brazilian Ministry of Health, and by the AIDS Programa da FIOCRUZ Brazilian Ministry of Health. 1.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Department of Immunology. Rio de Janeiro, RJ, Brazil.Instituto Adolfo Lutz. São Paulo, SP, Brazil.Stanford University. School of Medicine. Department of Microbiology and Immunology. Stanford, CA, USA.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Department of Immunology. Rio de Janeiro, RJ, Brazil.Instituto Adolfo Lutz. São Paulo, SP, Brazil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Oswaldo Cruz Institute. Rio de Janeiro, RJ, Brazil.Oswaldo Cruz Foundation. Gonçalo Muniz Institute. Salvador, BA, Brazil.Yiral and Rickettsial Disease Laboratory, California Department of Health Services. Berkeley, CaliforniaViral DNA sequences were determined over the V3 region of env from 28 infected individuals living in the high mV·l prevalence Brazilian cities of Rio de Janeiro and São Paulo. Twenty-six belonged to envelope sequence subtype B, prevalent in North America and Europe, and one was c1assifiedas subtype F, found recently in Brazil and in Romania (one appeared to be a B/F recombinant). Octameric sequences at the tip of the subtype B V3 loops were variable and distinct from those prevalent in North America and Europe. The GPGR motü, prevalent in North AmericanlEuropean strains, was found in only 8 (28.5%) sequences, whereas GWGR was found in 12 (43%) and novel sequences in 8 (28.5%). Brazilian subtype B sequences also diverged from the consensus North AmericanlEuropean strains over the remainder of the V3loop. These results suggest that Brazilian mv·l B strains may have important antigenic differences from prototype subtype B strains currently being evaluated for use in HIV vaccines. These results should be taken into account for future vaccine programs in Brazil

Tuberculosis patients co-infected with Mycobacterium bovis and Mycobacterium tuberculosis in an urban area of Brazil

In this cross-sectional study, mycobacteria specimens from 189 tuberculosis (TB) patients living in an urban area in Brazil were characterised from 2008-2010 using phenotypic and molecular speciation methods (pncA gene and oxyR pseudogene analysis). Of these samples, 174 isolates simultaneously grew on L&#246;wenstein-Jensen (LJ) and Stonebrink (SB)-containing media and presented phenotypic and molecular profiles of Mycobacterium tuberculosis, whereas 12 had molecular profiles of M. tuberculosis based on the DNA analysis of formalin-fixed paraffin wax-embedded tissue samples (paraffin blocks). One patient produced two sputum isolates, the first of which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, and the second of which only grew on SB media and presented phenotypic profiles of Mycobacterium bovis. One patient provided a bronchial lavage isolate, which simultaneously grew on LJ and SB media and presented phenotypic and molecular profiles of M. tuberculosis, but had molecular profiles of M. bovis from paraffin block DNA analysis, and one sample had molecular profiles of M. tuberculosis and M. bovis identified from two distinct paraffin blocks. Moreover, we found a low prevalence (1.6%) of M. bovis among these isolates, which suggests that local health service procedures likely underestimate its real frequency and that it deserves more attention from public health officials