A Ética do desenvolvimento e a proteção às condições de saúde The ethics of development and protection to health conditions

Neste artigo discute-se a influência do modelo de desenvolvimento brasileiro sobre o meio ambiente e a saúde da população, apontando suas características centrais e suas conseqüências, as denominadas eco-desigualdades. Relaciona-se dados que procuram ilustrar as relações entre desenvolvimento, meio ambiente e saúde. Considera-se que a crise econômica da última década, bem como a aproximação do Estado brasileiro ao modelo neo-liberal, dificultam acentuadamente os investimentos nos setores sociais e públicos, antevendo-se enormes prejuízos para a população, com a acentuação das desigualdades sociais no país. Enfatiza-se, por fim, a necessidade de uma nova ética nas relações entre os indivíduos, indivíduos e Estado e entre Nações.<br>This article discusses the influence of the Brazilian development model on the environment and on the population's health, focusing on the major characteristics as well as the consequences of this model - the so-called eco-inequalities. This paper presents data that attempt to illustrate the relationships between development, environment and health. The economic crisis of the last decade and the move to a neoliberal model by the Brazilian State are seen as factors that strongly hamper investments in the social and public sectors, promoting huge losses for the population and increased social inequalities in the country. Finally, emphasis is given to the need for a new ethics in the relationships among individuals, between individuals and State, and among Nations

Distribution of dengue vectors in neighborhoods with different urbanization types of Manaus, state of Amazonas, Brazil

Aedes aegypti   and Ae. albopictus are vectors of dengue viruses, which cause endemic disease in the city of Manaus, capital of the state of Amazonas, Brazil. More than 53 thousand cases have been registered in this city since the first epidemic in 1998. We evaluated the hypothesis that different ecological conditions result in different patterns of vector infestation in Manaus, by measuring the infestation level in four neighborhoods with different urbanization patterns, during the rainy (April), dry (August), and transitional (November) seasons. Ae. aegypti predominated throughout the study areas and sampling periods, representing 86% of all specimens collected in oviposition traps. High frequencies of houses positive for both species were observed in all studied sites, with Ae. aegypti present in more than 84% of the houses in all seasons. Ae. albopictus, on the other hand, showed more spatial and temporal variation in abundance. We found no association between infestation level and house traits. This study highlights the homogeneity of dengue vector distribution in Manaus

Canine Visceral Leishmaniasis in Rio de Janeiro, Brazil: clinical, parasitological, therapeutical and epidemiological findings (1977-1983)

Forty dogs from the periphery of the city of Rio de Janeiro were studied. All dogs where diagnosed as positive for leishmaniasis either parasitologically and/or serologically. Among them, 19 came from areas where only Visceral Leishmaniasis (VL) occurs (Realengo, Bangu, Senador Camará). Clinical signs of the disease were seen in 36.8% of the cases, including emaciation - 100%, lymphadenopathy and depilation - 85.7%. The other 21 dogs came from an area (Campo Grande) where both diseases (VL, and American Cutaneous Leishmaniasis - ACL) occur. Clinical signs of the disease, mainly cutaneous or mucocutaneous ulcers were seen in 76.2% of the cases. Leishmania parasites were found in 39 cases: 22% in viscera, 42.5% in viscera and normal skin and 35% in cutaneous or mucocutaneous ulcers. All the Leishmania stocks isolated from dogs which came from Realengo, Bangu, Senador Camará (VL area), and from Campo Grande (VL + ACL area) were characterized as L. donovani (except in one case) according to their schizodeme, zymodeme and serodeme. The only stock characterized as L. b. braziliensis, was isolated from the lymph node of a dog from Campo Grande with visceral disease and without skin lesions. Antimony therapy attempted in eight Leishmania donovani positive dogs was unsuccessful.<br>Durante inquéritos caninos realizados na periferia da cidade do Rio de Janeiro, foram estudados clínica e laboratorialmente 40 cães. Todos apresentavam diagnóstico parasitológico e/ou sorológico de leishmaniose. Dentre esses, 19 procediam de áreas de ocorrência de leishmaniose visceral (LV) - Realengo, Bangu e Senador Camará. Sinais clínicos sugestivos da infecção foram observados em 36,8% deles (incluindo emagrecimento - 100%, linfadenopatia e depilação - 85,7%). Outros 21 cães procediam da área de Campo Grande onde tanto a LV como a leishmaniose tegumentar americana (LTA) ocorrem. Sinais clínicos da infecção por Leishmania, principalmente ulcerações cutâneas e mucocutâneas, foram observadas em 76,2% deles. Em 39 cães foram encontrados leishmanias: 22% em vísceras, 42,5% em vísceras e pele normal e 35% um ulcerações cutâneas ou mucocutâneas. Todos os estoques de Leishmania isolados de cães provenientes das áreas de LV e da área de LV + LTA foram caracterizados como L. donovani (exceto em um caso) conforme seus esquisodemas, zimodemas e serodemas. O único estoque caracterizado como L. braziliensis brazilienzis foi isolado de linfonodo de um cão de Campo Grande, com leishmaniose visceral e sem alterações cutâneas. A tentativa de tratamento pelo antimonial em oito cães positivos para Leishmania donovani não reverteu o curso da doença e um deles apresentou intenso agravamento, morrendo em curto período

Neurological complications associated with emerging viruses in Brazil

Submitted by Fátima Lopes ([email protected]) on 2020-06-03T15:02:05Z No. of bitstreams: 1 NeurologicalComplications.pdf: 923126 bytes, checksum: 2769ef625c3549984b377b229767f8b9 (MD5)Approved for entry into archive by Fátima Lopes ([email protected]) on 2020-06-04T19:13:45Z (GMT) No. of bitstreams: 1 NeurologicalComplications.pdf: 923126 bytes, checksum: 2769ef625c3549984b377b229767f8b9 (MD5)Made available in DSpace on 2020-06-04T19:13:45Z (GMT). No. of bitstreams: 1 NeurologicalComplications.pdf: 923126 bytes, checksum: 2769ef625c3549984b377b229767f8b9 (MD5) Previous issue date: 2020Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.University of California Los Angeles. Institute of the Environment and Sustainability. Los Angeles, CA, USA.Fundação Oswaldo Cruz. Escola Politécnica de Saúde Joaquim Venâncio. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Universidade Federal Fluminense. Departamento de Neurologia. Niterói, RJ, Brasil.Universidade Federal Fluminense. Departamento de Neurologia. Niterói, RJ, Brasil.Universidade Federal do Piauí. Departamento de Ciência Política. Teresina, PI, Brasil.UCLA School of Medicine. Los Angeles, CA, USA.Universidade Federal Fluminense. Departamento de Neurologia. Niterói, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Endemias Samuel Pessoa. Rio de Janeiro, RJ, Brasil.Objective: To test the hypotheses that emerging viruses are associated with neurological hospitalizations and that statistical models can be used to predict neurological sequelae from viral infections. Methods: An ecological study was carried out to observe time trends in the number of hospitalizations with inflammatory polyneuropathy and Guillain-Barré syndrome (GBS) in the state of Rio de Janeiro from 1997 to 2017. Increases in GBS from month to month were assessed using a Farrington test. In addition, a cross-sectional study was conducted analyzing 50 adults hospitalized for inflammatory polyneuropathies from 2015 to 2017. The extent to which Zika virus symptoms explained GBS hospitalizations was evaluated using a calibration test. Results: There were significant increases (Farrington test, P<0.001) in the incidence of GBS following the introduction of influenza A/H1N1 in 2009, dengue virus type 4 in 2013, and Zika virus in 2015. Of 50 patients hospitalized, 14 (28.0%) were diagnosed with arboviruses, 9 (18.0%) with other viruses, and the remainder with other causes of such neuropathies. Statistical models based on cases of emerging viruses accurately predicted neurological sequelae, such as GBS. Conclusion: The introduction of novel viruses increases the incidence of inflammatory neuropathies

Prevalência da infecção pelo HIV em pacientes internados por tuberculose Prevalence of HIV infection in patients hospitalized due to tuberculosis

Objetivos: Verificar a prevalência da co-infecção tuberculose (TBC)/HIV e a capacidade da anamnese em detectar a infecção pelo HIV em pacientes internados por TBC. Local: Hospital Eduardo de Menezes, Belo Horizonte, MG, referência para TBC e SIDA. Material e métodos: Todos os pacientes internados com TBC na enfermaria de pneumologia foram avaliados prospectivamente no período de 1/1/1997 até 31/1/1998, com anamnese dirigida para fatores de risco para SIDA, TBC, tratamentos anteriores e abandonos de tratamento para TBC, e verificadas as formas clínicas de TBC. Foram excluídos pacientes com doenças marcadoras de SIDA com exceção da TBC, ou com sorologia anti-HIV realizada anteriormente. Foram realizadas sorologias anti-HIV (ELISA) e, quando positivas, confirmadas pelo teste Western-Blot. Os testes do qui-quadrado e de Fisher foram usados para análise estatística. Resultados: Sessenta e cinco pacientes avaliados foram divididos em grupo I (sorologia positiva para HIV, n = 6) e grupo II (sorologia negativa para HIV, n = 59). Não houve diferença significativa entre os dois grupos quanto a fatores de risco para SIDA, TBC, abandonos de tratamento ou tratamentos anteriores para TBC ou formas clínicas de TBC. Conclusões: Devido à alta prevalência da infecção pelo HIV (9,2%) no grupo estudado, estes achados reforçam as orientações do Consenso Brasileiro de Tuberculose no sentido de: 1) a anamnese não consegue detectar uma parcela significativa dos pacientes com co-infecção TBC/HIV; e: 2) a solicitação de sorologia anti-HIV deve ser feita de forma rotineira em todos os pacientes com TBC ativa.<br>Objectives: To verify the prevalence of tuberculosis (TB)/HIV co-infection and the ability of the clinical history to detect the HIV infection in TB inpatients. Setting: Eduardo de Menezes Hospital, reference for both TB and AIDS. Patients and methods: All patients admitted with TB in a pneumology ward were evaluated prospectively from 1/1/1997 to 1/31/1998. The clinical history was directed to the presence of risk factors for AIDS or TB, previous treatments or abandoned treatments for TB, and TB clinical forms. Patients with AIDS defining illnesses, except for TB, and with previous anti-HIV tests were excluded. All patients had an ELISA anti-HIV serology, and when positive, a Western-Blot test was performed to confirm the previous result. X-square test and Fisher test were used for statistical analysis. Results: Sixty-five patients were divided into group I (positive serology for HIV, n = 6) and group II (negative serology for HIV, n = 59). There were no statistical differences between the groups comparing the risk factors for AIDS and TB, previous treatments or abandoned treatments for TB, or TB clinical forms. Conclusions: The high prevalence of TB/HIV co-infection (9.2%) reinforces that: 1) the clinical history was not able to detect a significant number of patients with TB/HIV co-infection and that: 2) anti-HIV serology should be performed in all patients with active TB forms

Concordância na determinação da causa básica de óbito em menores de um ano na região metropolitana do Rio de Janeiro, 1986 Agreement as to the determination of the basic cause of death among children of under one year of age in Metropolitan Region of Rio de Janeiro, Brazil, 1986

No âmbito de um estudo sobre a qualidade do preenchimento da Declaração de Óbito, avaliou-se a concordância na determinação da causa básica da morte entre o médico que atestou o óbito e a equipe de médicos que avaliou informações do prontuário hospitalar. Estudou-se uma amostra de óbitos de menores de um ano ocorridos na Região Metropolitana do Rio de Janeiro, RJ (Brasil), de maio de 1986 a abril de 1987. Para os óbitos neonatais, as causas perinatais concentraram a maior parte dos óbitos e apesar das mudanças observadas, a composição entre os principais grupos não se alterou de modo importante. No interior do grupo de causas perinatais, conseguimos reduzir as causas classificadas de maneira genérica ou mal definidas em cerca de 50% com o preenchimento do novo atestado. Para os óbitos pós-neonatais, foram encontradas alterações significativas, em especial para os óbitos causados por pneumonia e desnutrição. Dado o grande inter-relacionamento observado entre as principais causas de morte neste grupo (pneumonia, diarréia, desnutrição), considerou-se que a apuração das causas múltiplas de morte daria uma idéia mais ampla e correta do processo que resultou na morte, permitindo uma visão mais globalizante da questão.<br>An evaluation was undertaken, during the assessment of the quality of the filling up of death certificates, with the purpose of evaluating the agreement, in the determination of the basic cause of death, between the physician who certified the death and a medical team which examined the information provided by hospital records. This survey included the analysis of a sample of deaths among children under one year of age which occurred in the Metropolitan Region of Rio de Janeiro (Brazil) in the period from May 1986 to April 1987. As regards neonatal deaths, the greatest concentration of causes of death is perinatal and, despite the changes that have been observed, the composition of the main groups of causes presented no significant alteration. However, within the perinatal group, those generically classified or poorly defined causes were reduced by about 50% and new certificates were made out. Among post-neonatal deaths, we found significant changes, particularly for deaths caused by pneumonia and malnutrition. Given the great interrelation observed among the major causes of death within this group (pneumonia, diarrhoea, malnutrition), it is believed that the investigation of multiple causes of death would provide a more accurate, overall notion of the process that led to death, thus allowing the formulation of a more comprehensive view