MORBIDITY AND MORTALITY DUE TO AIDS: A STUDY OF BURDEN OF DISEASE AT A MUNICIPAL LEVEL

Introduction: The purpose of measuring the burden of disease involves aggregating morbidity and mortality components into a single indicator, the disability-adjusted life year (DALY), to measure how much and how people live and suffer the impact of a disease. Objective: To estimate the global burden of disease due to AIDS in a municipality of southern Brazil. Methods: An ecological study was conducted in 2009 to examine the incidence and AIDS-related deaths among the population residing in the city of Tubarao, Santa Catarina State, Brazil. Data from the Mortality Information System in the National Health System was used to calculate the years of life lost (YLL) due to premature mortality. The calculation was based on the difference between a standardized life expectancy and age at death, with a discount rate of 3% per year. Data from the Information System for Notifiable Diseases were used to calculate the years lived with disability (YLD). The DALY was estimated by the sum of YLL and YLD. Indicator rates were estimated per 100,000 inhabitants, distributed by age and gender. Results: A total of 131 records were examined, and a 572.5 DALYs were estimated, which generated a rate of 593.1 DALYs/100,000 inhabitants. The rate among men amounted to 780.7 DALYs/100,000, whereas among women the rate was 417.1 DALYs/100,000. The most affected age groups were 30-44 years for men and 60-69 years for women. Conclusion: The burden of disease due to AIDS in the city of Tubarao was relatively high when considering the global trend. The mortality component accounted for more than 90% of the burden of disease.Introdução: A proposta de mensuração do impacto da doença implica a integração em um mesmo indicador, o DALY, de componentes de morbidade e mortalidade, para medir quanto e como as populações vivem e sofrem o impacto de determinada doença. Objetivo: Estimar o impacto da doença causada pela Aids em um município do sul do Brasil. Métodos: Foi desenvolvido um estudo ecológico envolvendo registros de incidência e de óbitos por Aids na população residente em Tubarão, SC, em 2009. Para cálculo do componente de mortalidade-YLL foram utilizados dados de mortalidade do Sistema de Informações de Mortalidade do Sistema Único de Saúde. Calculou-se pela diferença de uma expectativa de vida padronizada e a idade do óbito, aplicada uma taxa de desconto de 3% ao ano. Para cálculo do componente de morbidade-YLD foram utilizados dados do Sistema de Informação de Agravos de Notificação. O DALY foi estimado pela soma do YLL e YLD. Foram estimadas as taxas dos indicadores por 100 mil habitantes segundo sexo e faixa etária. Resultados: Foram analisados 131 registros e estimados 572,5 DALYs, o que gerou uma taxa de 593,1 DALYs/100 mil habitantes. No sexo masculino a taxa foi de 780,7 DALY/100 mil homens, já nas mulheres esta taxa correspondeu a 417,1 DALYs/100 mil mulheres. As faixas etárias mais acometidas foram de 30 a 44 anos no sexo masculino e de 60 a 69 anos no sexo feminino. Conclusão: O impacto da doença causada pela Aids no município de Tubarão mostrou-se elevado quando considerada a tendência global. O componente de mortalidade contribuiu com mais de 90% do indicador de impacto da doença

Lipohypertrophy and nutritional profile among people living with HIV in Southern Brazil

ABSTRACT: Introduction: People living with the human immunodeficiency virus (HIV) are generally overweight or have an altered body composition as compared to healthy individuals, showing a change in nutritional profile over time. Objective: The aim of the study was to characterize the nutritional status, estimate the prevalence of lipodystrophy, and examine the association between lipohypertrophy and lipid profile alterations, and other clinical data of HIV-infected individuals. Methods: This was a cross-sectional study on male and female subjects living with HIV, treated at a specialized outpatient clinic, aged 18 years old and over, whether using the antiretroviral therapy or not. Results: The sample consisted of 420 people with a mean age of 43.8 years (standard deviation 11.7). The length of time of the HIV infection averaged 74.6 months, and 91% of the respondents were on antiretroviral therapy. Lipodystrophy prevalence was 35.7%. Of these, 82 (54.7%) presented lipohypertrophy, 61 (40.7%) had lipoatrophy and 7 (4.6%) had a mixed syndrome. Female gender, body mass index, fat percentage, waist circumference and waist-hip ratio were positively associated with the presence of lipohypertrophy (p<0.001). High mean total cholesterol (p=0.015) and LDL fraction (p=0.028) also showed a statistically significant association with lipohypertrophy. The sampled participants had a nutritional profile compatible with overweight or obesity. No association was found between lipohypertrophy and ART and the therapy duration. Conclusion: Considering the consequences of overweight as a cause of various pathological conditions, preventive measures and interventions are highly recommended for this population

Meroanencephaly in an English Pointer Neonate

Background: Malformations are structural or functional abnormalities in the organs and structures present at birth. These conditions are rarely described in the newborns of dogs and can lead to their death. Meroanencephaly is a defect of the neural tube closure malformation. This study aims to characterize the clinical-pathological aspects of neonatal meroanencephaly since brain malformations are rare in newborn dogs.Case: A two-day-old English Pointer canine was sent for a necropsy. The newborn belonged to a litter of eight puppies, and only this one had macroscopic cranial alterations. Another puppy that died as a consequence of being trampled by the bitch was also necropsied. The newborn was alive for 48 h until death and presented apathy, crying, sucking reflex and opisthotonus. Macroscopic examination of the baby revealed flattening of the skull, with a slit at the site of bone symphysis fusion, and a slit in the skin of the parietal region, covered by thin, translucent meningeal tissue. The heads of the two animals were examined by radiography to identify the features of anencephaly in one of the animals by visualizing skull bone flattening. Upon removing the skin and exposing the cranial cavity, an irregular reddish mass was revealed, that corresponded microscopically to area cerebrovasculosa, composed of neurons, rudimentary glial tissue, vascular neoformations, as well as hemorrhagic areas.Discussion: Meroanencephaly is a type of anencephaly, a congenital malformation originating from abnormal neurulation, which results from the absence of neural fold fusion during neural tube formation. Live-born anencephalics have some brainstem-driven functions such as spontaneous breathing and some reflex responses, for instance, suction. Several genetic or teratogenic factors, such as viruses, radiation, drugs administered during pregnancy and other pathologies transmitted from bitch to fetus, can lead to this defect. The reports on anatomopathological findings and the presence of area cerebrovasculosa are rare

Burden of AIDS in a Brazilian State

Summary: Background: To estimate the burden of a disease implies the simultaneous quantification of the impact of early mortality and the health problems that affect the individual's quality of life, and this evaluation can be particularly important in a disease such as AIDS that has become a long-term disease. The purpose of this study was to determine the burden of disease due to AIDS in the Brazilian Southern State of Santa Catarina. Methods: An ecological designed study was performed using death and AIDS notifications data for 2009. The disability adjusted life years (DALYs) were estimated by the sum of years of life lost (YLL) and the years lived with disability (YLD). The YLL was estimated as the difference between the life expectancy from birth and the age at death with the application of a discount rate of 3% per year. The YLD was estimated as the product of the Burden of Disease Study's weight for AIDS of 0.167 and its average duration of 108 months in Brazil for the incident cases. The YLL, YLD and DALY rates were calculated per 100,000 inhabitants by sex and age groups. Results: There were 2034 notified cases and 689 deaths due to AIDS reported. There were 15,756.5 YLLs estimated, resulting in 257.5 YLLs/100,000 inhabitants, and 4554.1 YLDs were estimated, resulting in 74.4 YLDs/100,000 inhabitants. The DALY was estimated at 20,310.6, with a rate of 331.9 DALYs/100,000 inhabitants. The highest rates were observed in males in the age groups 30–44 and 45–59 years. Conclusions: The burden of AIDS was high and was observed mainly in adults, with a predominance in males. Keywords: Measurements in epidemiology, Acquired immunodeficiency syndrome, Basic indicators for health, Burden of diseas

Meroanencephaly in an English Pointer Neonate

Background: Malformations are structural or functional abnormalities in the organs and structures present at birth. These conditions are rarely described in the newborns of dogs and can lead to their death. Meroanencephaly is a defect of the neural tube closure malformation. This study aims to characterize the clinical-pathological aspects of neonatal meroanencephaly since brain malformations are rare in newborn dogs.Case: A two-day-old English Pointer canine was sent for a necropsy. The newborn belonged to a litter of eight puppies, and only this one had macroscopic cranial alterations. Another puppy that died as a consequence of being trampled by the bitch was also necropsied. The newborn was alive for 48 h until death and presented apathy, crying, sucking reflex and opisthotonus. Macroscopic examination of the baby revealed flattening of the skull, with a slit at the site of bone symphysis fusion, and a slit in the skin of the parietal region, covered by thin, translucent meningeal tissue. The heads of the two animals were examined by radiography to identify the features of anencephaly in one of the animals by visualizing skull bone flattening. Upon removing the skin and exposing the cranial cavity, an irregular reddish mass was revealed, that corresponded microscopically to area cerebrovasculosa, composed of neurons, rudimentary glial tissue, vascular neoformations, as well as hemorrhagic areas.Discussion: Meroanencephaly is a type of anencephaly, a congenital malformation originating from abnormal neurulation, which results from the absence of neural fold fusion during neural tube formation. Live-born anencephalics have some brainstem-driven functions such as spontaneous breathing and some reflex responses, for instance, suction. Several genetic or teratogenic factors, such as viruses, radiation, drugs administered during pregnancy and other pathologies transmitted from bitch to fetus, can lead to this defect. The reports on anatomopathological findings and the presence of area cerebrovasculosa are rare

O projecto Desenvolvimento de Competências de Coordenação Pedagógica da Universidade Nova de Lisboa

publishersversionpublishe

The national inventory of geosites in Portugal

During the last three years geoscientists of various institutions have developed a project aiming the setup of a geoconservation strategy in Portugal (Brilha, 2009). One of the main goals of the project was the establishment of an inventory of the most important Portuguese geosites, under the scientific point of view. In a near future, national authorities will consider this inventory as a technical support for the implementation of nature conservation policies and land-use strategies.Fundação para a Ciência e a Tecnologia (FCT) - PTDC/CTE-GEX76496672006 "Identification, characterisation and conservation of geological heritage : a geoconservation strategy for Portugal