Intimate partner homicide: victims and the dynamics of victim – perpetrator relationship

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Mortality associated factors in patients with acute pulmonary edema

Introduction: Risk factors related to acute pulmonary edema are still poorly described. However, they are determinant in the perspective of treatment. Methods: This is a retrospective, unicentric and observational study which aim was to evaluate factors related to mortality in patients with acute pulmonary edema. A total of 142 patients were included between January of 2,015 and 2,016. The following factors were evaluated: age, systolic and diastolic pressures, heart rate, creatinine, C-reactive protein, BNP, left ventricular ejection fraction, left ventricular diastolic diameter, troponin, left atrial diameter and pulmonary arterial systolic pressure.Statistical analysis: Evaluation of factors according to occurrence or not of death was performed through Q-square and T-test, being considered significant p <0.05. The complementary analysis of the factors was done by ROC curve to identify the sensitivity and specificity of the best cut-off point of risk factors as a probability of death discriminator.Results: About 49% of the patients were males and the mean age was 69 years. Hypertensive etiology was the most prevalent (42.3%) followed by valve disease (29.5%) and ischemia (14.8%). The in-hospital mortality rate was 15.5%. There were significant differences between patients who died or not, respectively, in the following factors: age (73.6 x 67.6, p = 0.024), C-reactive protein (64.9 mg/dL x 39.7 mg/dL, p = 0.042), troponin (7.41 ng/dL x 2.58 ng/dL, p = 0.007)and diastolic blood pressure (74.2 mmHg x 88.6 mmHg, p = 0.023). The areas under the ROC curve between risk and death factors were: age = 0.640; C-reactive protein = 0.640; Troponin = 0.660; Diastolic blood pressure = 0.318. Best cut-off points to discriminate the risk of death were: age = 67.5 (sensitivity of 72.7% and specificity of 54%), C-reactive protein = 21.5 mg/dL (sensitivity of 66.7% and specificity of 58%), troponin = 0.73 ng/dL (sensitivity of 63.6% and specificity of 65%) and diastolic blood pressure = 87.5 mmHg (sensitivity of 29.4% and specificity of 49%).Conclusion: Mortality in patients with acute pulmonary edema remains high. Age, C-reactive protein, troponin, and diastolic blood pressure were the factors related to mortality

Profile of American tegumentary leishmaniasis in transmission areas in the state of Minas Gerais, Brazil, from 2007 to 2017.

BACKGROUND: American tegumentary leishmaniasis (ATL) is a widespread anthropozoonosis caused by protozoa of the genus Leishmania and is considered a serious public health problem. The aim of this study was to provide a descriptive analysis of confirmed ATL cases and evaluate the spatial distribution of ATL in high-risk transmission areas from the state of Minas Gerais, Brazil. METHODS: An ecological, analytical, and retrospective study of the confirmed cases of ATL in Minas Gerais from 2007 to 2017 was conducted. To characterize these cases, multiple correspondence analysis and georeferencing of the ATL prevalence rates in the municipalities were conducted based on variables obtained at Sistema Nacional de Agravos de Notificação and Instituto Brasileiro de Geografia e Estatística databases. RESULTS: There were 13,025 confirmed cases of ATL from 74.4% (635) municipalities of Minas Gerais, corresponding to a prevalence rate of 66.5 cases for every 100,000 inhabitants. Males aged 20 to 59 years and individuals who attended elementary school were most affected with ATL. Multiple correspondence analysis presented an accumulated qui-squared value of 44.74%, proving that there was a relationship between the variables, including ethnicity, age, pregnancy status, zone of infection, and number of cases. CONCLUSION: We confirmed that ATL is endemic to Minas Gerais, and there is high risk of infection within the municipalities due to a high rate of parasite transmission. The occurrence of infection in children, pregnant women, and the indigenous population demonstrates the need for the government to expand social policies aimed at vulnerable groups

Mortality reduction with use of oral beta-blockers in patients with acute coronary syndrome

OBJECTIVES: Recent studies have revealed a relationship between beta-blocker use and worse prognosis in acute coronary syndrome, mainly due to a higher incidence of cardiogenic shock. However, the relevance of this relationship in the reperfusion era is unknown. The aim of this study was to analyze the outcomes of patients with acute coronary syndrome that started oral beta-blockers within the first 24 hours of hospital admission (group I) compared to patients who did not use oral beta-blockers in this timeframe (group II). METHODS: This was an observational, retrospective and multicentric study with 2,553 patients (2,212 in group I and 341 in group II). Data regarding demographic characteristics, coronary treatment and medication use in the hospital were obtained. The primary endpoint was in-hospital all-cause mortality. The groups were compared by ANOVA and the chi-square test. Multivariate analysis was conducted by logistic regression and results were considered significant when

Pathogenic Escherichia coli, Salmonella spp. and Campylobacter spp. in Two Natural Conservation Centers of Wildlife in Portugal: Genotypic and Phenotypic Characterization

This article belongs to the Section Food Microbiology.Human–wildlife coexistence may increase the potential risk of direct transmission of emergent or re-emergent zoonotic pathogens to humans. Intending to assess the occurrence of three important foodborne pathogens in wild animals of two wildlife conservation centers in Portugal, we investigated 132 fecal samples for the presence of Escherichia coli (Shiga toxin-producing E. coli (STEC) and non-STEC), Salmonella spp. and Campylobacter spp. A genotypic search for genes having virulence and antimicrobial resistance (AMR) was performed by means of PCR and Whole-Genome Sequencing (WGS) and phenotypic (serotyping and AMR profiles) characterization. Overall, 62 samples tested positive for at least one of these species: 27.3% for STEC, 11.4% for non-STEC, 3.0% for Salmonella spp. and 6.8% for Campylobacter spp. AMR was detected in four E. coli isolates and the only Campylobacter coli isolated in this study. WGS analysis revealed that 57.7% (30/52) of pathogenic E. coli integrated genetic clusters of highly closely related isolates (often involving different animal species), supporting the circulation and transmission of different pathogenic E. coli strains in the studied areas. These results support the idea that the health of humans, animals and ecosystems are interconnected, reinforcing the importance of a One Health approach to better monitor and control public health threats.This work was supported by funding from the European Union’s Horizon 2020 Research and Innovation Programme under grant agreement No 773830: One Health European Joint Pro- gramme, as part of the DiSCoVeR project (Discovering the sources of Salmonella, Campylobacter, VTEC and Antimicrobial Resistance). S.R., R.C. and V.M. were beneficiaries of fellowships from the same Programme on behalf of ADONIS (S.R.), FedAMR (R.C.) and BeOne (V.M) projects.info:eu-repo/semantics/publishedVersio

Intermediate levels of BNP were related with cardiology events in acute coronary syndromes?

Introdução: Diversos estudos na literatura têm relacionado valores elevados de peptídeo natriurético cerebral (BNP) com pior prognóstico em pacientes com síndrome coronária aguda (SCA). No entanto, valores entre 100 pg/mL e 400 pg/mL são considerados limítrofes e ainda questionados em relação à diagnóstico e ocorrência de eventos. Métodos: Trata-se de estudo retrospectivo observacional com objetivo de avaliar se o valor intermediário de BNP na admissão hospitalar é capaz de predizer prognóstico intrahospitalar. Os pacientes foram divididos em dois grupos: grupo I: BNP < 100 pg/mL; grupo II: 100 < BNP < 400 pg/mL. Foram incluídos 405 pacientes (235 no grupo I e 170 no grupo II) com SCA. Obtiveram-se dados referentes à comorbidades e medicações utilizadas. Análise estatística: O desfecho primário foi mortalidade por todas as causas. O desfecho secundário foi eventos combinados (choque cardiogênico, reinfarto, morte, acidente vascular cerebral e sangramento). A comparação entre grupos foi realizada através de Q-quadrado e ANOVA. A análise multivariada foi realizada por regressão logística, sendo considerado significativo p < 0,05. Resultados: Na comparação entre os grupos I e II, observaram-se diferenças em relação à prevalência de diabetes mellitus e angioplastia coronária prévia. Na análise multivariada, observaram-se diferenças significativas entre os grupos I e II em relação à ocorrência de choque cardiogênico (2,55% x 10,59%, OR = 4,09, p = 0,01), respectivamente. Conclusão: Valores intermediários de BNP não foram capazes de predizer mortalidade em pacientes com SCA. No entanto, observou-se uma maior incidência de choque cardiogênico.Introduction: Several studies in the literaturehave linked high levels of brain natriuretic peptide (BNP) withpoor prognosis in patients with acute coronary syndrome (ACS).However, values between 100 pg/ml and 400 pg/ml are consideredborderline and also questioned about the occurrence of events anddiagnosis. Methods: This is an observational retrospective studyto evaluate the BNP intermediate value at hospital admissioncan predict in-hospital prognosis. The patients were divided intotwo groups: Group I: BNP < 100 pg/ml; Group II: 100 < BNP <400 pg/mL. It included 405 patients (235 in group I and 170 ingroup II) with ACS. Data were obtained regarding comorbiditiesand medications used. Statistical analysis: The primary outcomewas mortality from all causes. The secondary endpoint wascombined events (cardiogenic shock, reinfarction, death, strokeand bleeding). The comparison between groups was performedusing Q-square test and ANOVA. Multivariate analysis wasperformed by logistic regression, considering significant p < 0.05.Results: Comparing the groups I and II, there were differences inthe prevalence of diabetes and previous coronary angioplasty. Inmultivariate analysis, there were significant differences betweengroups I and II in the occurrence of cardiogenic shock (2.55%vs. 10.59%, OR = 4.09, p = 0.01), respectively. Conclusion:Intermediate BNP values were not able to predict mortality inpatients with ACS. However, there was a higher incidence ofcardiogenic shock

PREVALÊNCIA DE PARASITOSES INTESTINAIS EM INDIVÍDUOS DO MUNICÍPIO DE PEDREIRAS – MARANHÃO

Intestines parasitosis are a big challenge to Brazil’s public health system. The prevalence of those diases may vary in different regions due to sanitary conditions, educational level and others factors. The goal of this study was to avalia-te the prevalence of intestines parasitosis among the inhabitants of Pedreiras municipality, Maranhão. This retrospective research reviewed patient records from the municipal laboratory of Pedreiras, from January to March of 2018. The collected data were age, sex and explicit diagnosis. Among 1.189 examined records, 67,7% were female. The average age was from 41 ± 7,1 years old, the age rate of 19 to 59 years old the most dominant (48,4%). Between protozoan and helminths, the most frequent were E. coli and A. lumbricoides, respectively, and the last one have been the most dominante among the identified intestinal parasites. There was predominance of uniparasitism (90,3%), and in the cases of double parasitism a association of E. coli/E. histolytica was the most frequent (64,1%). The municipality of Pedreiras presents a high prevalence of intestines parasitism, with the highlight to A. lumbricoides.  The female population among 19 – 59 years old is the most affected. From this research, public interventions may be drawn to reduce the impact of intestines parasitosis in this population. Key-words: Public health. Parasites Dieases. Intestines parasitosis. Protozoan infections. Helminths.El parásito intestinal es un gran desafío para la salud pública en Brasil. La prevalencia de estas enfermedades varía en diferentes regiones debido a las condiciones sanitarias, nivel educativo, entre otros factores. El objetivo de este estudio fue evaluar la prevalencia de parasitasis intestinales entre residentes del municipio de Pedreiras, Maranhão. Este estudio retrospectivo analizó las historias clínicas del laboratorio municipal de Pedreiras, de enero a marzo de 2018. Los datos recolectados fueron edad, sexo y diagnóstico descriptivo. De los 1.189 informes evaluados, 67,7% eran mujeres. La edad media fue de 41 ± 7,1 años, y el rango de 19 a 59 años fue el más prevalente (48,4%). Entre protozoos y helmintos, los más frecuentes fueron E. coli y A. lumbricoides, respectivamente, siendo estos últimos los más prevalentes entre todos los enteroparásitos identificados. Predominó el monoparasitismo (90,3%), y en los casos de biparasitismo la asociación E. coli/E. histolytica fue la más frecuente (64,1%). El municipio de Pedreiras tiene una alta prevalencia de enteroparásitos, especialmente A. lumbricoides.  La población femenina de entre 19 y 59 años es la más afectada. A partir de este estudio, se pueden elaborar medidas públicas para reducir el impacto de la enteroparasitasia en esta población.Parasitoses intestinais são um grande desafio para a saúde pública no Brasil. A prevalência destas doenças varia em diferentes regiões devido às condições sanitárias, nível educacional, entre outros fatores. O objetivo do estudo foi avaliar a prevalência de parasitoses intestinais entre residentes do município de Pedreiras, Maranhão. Este estudo retrospectivo analisou prontuários médicos do laboratório municipal de Pedreiras, no período de janeiro a março de 2018. Os dados coletados foram idade, sexo e diagnóstico descritivo. Dos 1.189 laudos avaliados, 67,7% eram do sexo feminino. A média de idade foi de 41 ± 7,1 anos, sendo a faixa de 19 a 59 anos a mais prevalente (48,4%). Entre protozoários e helmintos, os mais frequentes foram E. coli e A. lumbricoides, respectivamente, sendo o último o mais prevalente entre todos os enteroparasitos identificados. Houve uma predominância de monoparasitismo (90,3%), e nos casos de biparasitismo a associação E. coli/E. histolytica foi a mais frequente (64,1%). O município de Pedreiras apresenta uma alta prevalência de enteroparasitos, com destaque para A. lumbricoides.  A população do sexo feminino com idade entre 19 – 59 anos é a mais afetada. A partir deste estudo, medidas públicas podem ser elaboradas para reduzir o impacto das enteroparasitoses nesta população.  Parasitoses intestinais são um grande desafio para a saúde pública no Brasil. A prevalência destas doenças varia em diferentes regiões devido às condições sanitárias, nível educacional, entre outros fatores. O objetivo do estudo foi avaliar a prevalência de parasitoses intestinais entre residentes do município de Pedreiras, Maranhão. Este estudo retrospectivo analisou prontuários médicos do laboratório municipal de Pedreiras, no período de janeiro a março de 2018. Os dados coletados foram idade, sexo e diagnóstico descritivo. Dos 1.189 laudos avaliados, 67,7% eram do sexo feminino. A média de idade foi de 41 ± 7,1 anos, sendo a faixa de 19 a 59 anos a mais prevalente (48,4%). Entre protozoários e helmintos, os mais frequentes foram E. coli e A. lumbricoides, respectivamente, sendo o último o mais prevalente entre todos os enteroparasitos identificados. Houve uma predominância de monoparasitismo (90,3%), e nos casos de biparasitismo a associação E. coli/E. histolytica foi a mais frequente (64,1%). O município de Pedreiras apresenta uma alta prevalência de enteroparasitos, com destaque para A. lumbricoides.  A população do sexo feminino com idade entre 19 – 59 anos é a mais afetada. A partir deste estudo, medidas públicas podem ser elaboradas para reduzir o impacto das enteroparasitoses nesta população

Intimate partner homicide: A meta-analysis of risk factors

Homicide in intimate relationships is one of the most prevalent causes of death for women worldwide. This meta-analysis aims to identify and integrate, through analytical and statistical methodologies, the risk factors associated with intimate partner homicide. The research was performed in different databases and led to the inclusion of 28 empirical articles in this meta-analysis. Only quantitative papers with a comparison group (non-fatal perpetrators, other homicides, intimate partner homicide followed by suicide) were considered for this meta-analysis. The results showed that the risk factors related to abusive couple dynamics (threatening the victim with a weapon, any kind of threatening, death threats, bottlenecks, stalking and controlling behaviours, abuse during pregnancy and physical violence) are associated with a higher probability of intimate partner homicide. Further studies should provide more clarification of the factors associated with this phenomenon to improve the efficiency of the criminal investigation of intimate partner homicides, making crime repression and the protection of victims more effective.This study was partially conducted at the Psychology Research Center (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (UID/PSI/01662/2019), through the national funds (PIDDAC)