Impact of chronic disease on quality of life among the elderly in the state of São Paulo, Brazil: a population-based study

Determinar el impacto de las enfermedades crónicas y el número de enfermedades en los diversos aspectos de la calidad de vida relacionada con la salud (HRQOL) en adultos mayores de São Paulo, Brasil. MÉTODOS: Se empleó la encuesta de salud SF-36® para evaluar el impacto de las enfermedades crónicas de mayor prevalencia sobre la HRQOL. Se realizó un estudio poblacional transversal con un muestreo por conglomerados estratificado en dos etapas. Se obtuvieron los datos de una encuesta multicéntrica sobre la salud aplicada mediante entrevistas en hogares de varios municipios del estado de São Paulo. Se evaluaron siete enfermedades -artritis, dolor de espalda, depresión/ansiedad, diabetes, hipertensión arterial, osteoporosis y accidentes cerebrovasculares- y sus efectos sobre la calidad de vida. RESULTADOS: De los 1 958 adultos mayores de 60 años o más, 13,6% informaron no padecer ninguna de las enfermedades, mientras 45,7% presentaron tres enfermedades crónicas o más. La presencia de cualquiera de las siete enfermedades crónicas estudiadas influyó significativamente en la puntuación de casi todas las escalas de la SF-36®. La HRQOL alcanzó valores inferiores cuando la persona tenía depresión/ansiedad, osteoporosis o había sufrido un accidente cerebrovascular. A mayor número de enfermedades, mayores eran los efectos negativos en las dimensiones de la SF-36®. La presencia de tres enfermedades o más afectó significativamente la HRQOL en todas las áreas. Las escalas más afectadas por las enfermedades fueron dolor físico, salud general y vitalidad. CONCLUSIONES: Se encontró una alta prevalencia de enfermedades crónicas en la población de adultos mayores; la magnitud del efecto sobre la HRQOL dependió del tipo de enfermedad. Estos resultados destacan la importancia de prevenir y controlar las enfermedades crónicas para reducir la comorbilidad y disminuir su impacto sobre la HRQOL en los adultos mayores

The finding of Lutzomyia almerioi and Lutzomyia longipalpis naturally infected by Leishmania spp. in a cutaneous and canine visceral leishmaniases focus in Serra da Bodoquena, Brazil

To identify natural infections by Leishmania spp. in insect vectors of cutaneous and visceral leishmaniasis, we performed field studies in natural and anthropic environments in the Guaicurus Settlement (Bodoquena Range) of the Bonito municipality, Mato Grosso do Sul state, Brazil. From October 2002 to October 2003, a total of 1395 sandfly females were captured with Shannon and light traps and dissected in search of flagellates. The sample is composed of a total of 13 species, with Lutzomyia almerioi (59.9%) and Lutzomyia longipalpis (31.4%) predominant. Infections by flagellates were directly observed in three of the dissected of Lu. almerioi females (0.36%). To increase the sensitivity of detection, DNA extracted from pools of the 1220 dissected females (Lu. almerioi 808, Lu. longipalpis 399 and Nyssomyia whitmani 13) was subjected to small subunit rRNA-based polymerase chain reactions (SSU-PCR). DNA from Leishmania (L.) infantum chagasi was detected in at least 0.37% of Lu. almerioi females and in 0.25% of Lu. longipalpis females. The DNA of the Leishmania (Viannia) sp. was detected in 0.12% of Lu. almerioi and in 0.70% of Lu. longipalpis. Leishmania (L.) amazonensis was found in 1.25% of Lu. longipalpis. Mixed infections of L. (Leishmania) sp. and L. (Viannia) sp. were found in 0.50% of Lu. longipalpis. When considering that each positive pool contained at least a single infected specimen, we found a 1.23% rate of Leishmania spp. infection among the total population of dissected female sand flies as determined by PCR. This is the first report of natural infection by L. (L.) infantum chagasi and L. (Viannia) sp. in Lu. almerioi. It is also the first report of infection by L. (Viannia) sp. in Lu. longipalpis. The observation that Lu. longipalpis and Lu. almerioi are naturally infected by agents of both cutaneous and visceral leishmaniases suggests that these two species play a role in the transmission (continua) (continuação) of these diseases within the study area. Furthermore, the finding that Lu. longipalpis has been naturally infected by L. (L.) amazonensis and L. (Viannia) sp., and Lu. almerioi by L. (L.) infantum chagasi and L. (Viannia), suggests their participation as permissive vectors

The effects of the experimental onfection from a focus of transmissopn of Schistosoma mansoni in a population of Biomphalaria tenagophila (D'Orbigny, 1835) in the region of "Vale do Ribeira de Iguape", Brazil

Com objetivo de observar os efeitos da infecção parasitária na biologia de B. tenagophila, foram realizadas infecções experimentais em populações de campo e laboratório, ambas procedentes de Itariri, Vale do Ribeira, Brasil. Cada molusco recebeu 10 miracídios de Schistosoma mansoni (linhagem SJ), sendo observado durante o desenvolvimento dos parasitos. As variáveis biológicas foram comparadas segundo os critérios "grupo" e "fase de infecção". Os principais danos decorrentes do parasitismo se manifestaram na reprodução, na longevidade e em lesões na concha dos moluscos na fase patente. Foi encontrada uma taxa de infecção de 58,8 por cento. O estudo microanatômico da glândula digestiva e do ovoteste do molusco revelou a presença de formas larvárias em evolução e cercárias. Concluiu-se que os efeitos da infecção parasitária, sobre as duas populações, foram moderados, uma vez que os danos não impediram a reprodução e a eliminação de cercárias que se manteve por um longo período, apesar da baixa sobrevivência dos moluscos parasitados

Detection of a new mumps virus genotype during parotitis epidemic of 2006-2007 in the State of São Paulo, Brazil

Nucleotide sequence analyses of the SH gene of 18 mumps virus isolates collected in the 2006-2007 parotitis epidemic in the state of São Paulo identified a new genotype, designated genotype M. This new designation fulfills all the parameters required to define a new mumps virus genotype. The parameters were established by an expert panel in collaboration with the World Health Organization (WHO) in 2005. This information will enhance the mumps virus surveillance program both at the national and global levels

The expression of vulnerability through infant mortality in the municipality of Embu

CONTEXTO E OBJETIVO: A mortalidade infantil expressa uma conjunção de fatores relacionados às condições de vida, trabalho e acesso aos serviços de saúde, e a identificação desses fatores pode contribuir para definição de intervenções em saúde. O objetivo deste trabalho foi analisar a expressão da vulnerabilidade e conseqüentes diferenças de acesso aos serviços de saúde e na ocorrência de óbitos em menores de um ano no município do Embu. TIPO DE ESTUDO E LOCAL: Estudo descritivo, no município de Embu. MÉTODOS: Foram coletados dados secundários (declarações de óbitos) e primários (entrevistas a famílias de crianças residentes do município do Embu, falecidas nos anos de 1996 e 1997, antes de completarem um ano). Variáveis estudadas foram relacionadas às condições de vida, renda e trabalho, à assistência pré-natal, ao parto e à atenção à saúde da criança, as quais foram comparadas com resultados obtidos em estudo realizado no ano de 1996. RESULTADOS: Verificaram-se diferenças estatisticamente significantes quanto a renda, trabalho sem carteira assinada e acesso a plano privado de saúde entre famílias de crianças que foram ao óbito. Verificaram-se, também, diferenças quanto ao acesso e à qualidade da assistência pré-natal, à freqüência de baixo peso ao nascer e a intercorrências neonatais. CONCLUSÕES: A situação de emprego/desemprego foi decisiva na determinação da estabilidade familiar, conferindo maior vulnerabilidade para ocorrência de óbitos infantis, somada às condições de acesso e à qualidade dos serviços de saúde

Investigation of measles IgM-seropositive cases of febrile rash illnesses in the absence of documented measles virus transmission, State of São Paulo, Brazil, 2000-2004

Introdução: Revisar os casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no estado de São Paulo, Brasil, durante os cinco anos seguidos a interrupção da transmissão do vírus do sarampo. Métodos: Nós revisamos 463 casos de doenças febris exantemáticas com IgM reagente contra o sarampo, no estado de São Paulo, Brasil, de 2000 a 2004. Indivíduos vacinados contra o sarampo 56 dias antes da coleta de amostra foram considerados expostos à vacina. Soros da fase aguda e de convalescença foram testados para a evidência de infecção de sarampo, rubéola, parvovírus B19 e herpes vírus 6. Na ausência de soroconversão para imunoglobulina G contra o sarampo, casos com IgM reagente contra o sarampo foram considerados falsos positivos em pessoas com evidência de outras infecções virais. Resultados: Entre as 463 pessoas com doenças febris exantemáticas que testaram positivo para anticorpos IgM contra o sarampo durante o período, 297 (64 por cento) pessoas foram classificadas como expostas à vacina. Entre os 166 casos não expostos à vacina, 109 (66 por cento) foram considerados falsos positivos baseado na ausência de soroconversão, dos quais 21 (13 por cento) tiveram evidência de infecção por vírus da rubéola, 49 (30 por cento) parvovírus B19 e 28 (17 por cento) infecção por herpes vírus humano 6. Conclusões: Após a interrupção da transmissão do vírus do sarampo é necessária exaustiva investigação dos casos com IgM reagente contra o sarampo, especialmente dos casos não expostos à vacina. Testes laboratoriais para etiologias das doenças febris exantemáticas ajudam na interpretação destes casos

Storage effect on the acceptability of snacks made of pure amaranth and blends of amaranth and corn or chickpea

Snacks made by extrusion cooking of pure amaranth flour or mixtures of 80 per cent amaranth flour and 20 per centcorn grits or chickpea flour were developed to replace the traditional commercial ones with improved nutritional and functional quality. Pure amaranth snacks and the blended ones were flavored with salty and sweet flavors and evaluated for acceptability using a 9-point hedonic scale. The good acceptance observed for either salty or sweet flavored snacks indicated that they have characteristics to compete with similar commercial products. Acceptability of salty snacks increased with storage time at room temperature in BOPP (polypropylene bi-guided) packs whereas slightly decreased for the sweet ones. This type of storage proved to be very efficient for the conservation of the salty product and also suitable for the sweet ones

Influence of alpha-tocopherol on the levels of serum anti-oxLDL antibodies

Purpose - This paper aims to evaluate the association between the a-tocopherol with the levels of serum anti-oxLDL autoantibodies and the risk markers for cardiovascular disease. Design/methodology/approach - A normolipidemic control group (n=30) and a hypercholesterolemic group (n=33) were used. Plasma lipid profile (colorimetric method), anti-oxLDL autoantibodies (ELISA) and a-tocopherol (HPLC) were analysed. Findings - The a-tocopherol (ß=-0.714; p=0.001) is negatively associated with anti-oxLDL autoantibodies in serum and with other risk markers for cardiovascular disease (BMI, WC, total cholesterol, LDL-c) and positively associated with HDL-c. Originality/value - Oxidized low density lipoprotein (oxLDL) and their autoantibodies are increased in subjects with hypercholesterolemia. The a-tocopherol can influence the levels of serum anti-oxLDL autoantibodies

The influence of birthweight on arterial blood pressure of children

Background & aims.This study examined the relationship between birthweight and blood pressure in childhood. Methods.Prospective cohort study involving 472 Brazilian children ranging in age from 5 to 8 years. Birthweight, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), total cholesterol and fractions (LDL-c, HDL-c), and triglycerides were determined. Total cholesterol, LDL-c, HDL-c, and triglycerides were assessed by automated enzymatic methods. Blood pressure was measured with the HDI/Pulse Wave™ CR-2000 equipment. Multiple regression models were used to investigate the relationship between birthweight and SBP and DBP, controlling for the following variables: gender, age, BMI, total cholesterol, triglycerides, per capita income, and maternal education. Results.When adjusting for gender and BMI, we found a systolic blood pressure increase of 2.9 (95per cent CI = −5.33 to −0.56) mmHg per kilogram birthweight reduction. The unadjusted association was insignificant. Conclusion.Our data suggest that low birthweight is one of the factors contributing to blood pressure elevation at early ages. A way to prevent these diseases is by implementing public policies focused on good nutrition and adequate prenatal care for pregnant women

Explaining sleep duration in adolescents: the impact of socio-demographic and lifestyle factors and working status

Previous studies found students who both work and attend school undergo a partial sleep deprivation that accumulates across the week. The aim of the present study was to obtain information using a questionnaire on a number of variables (e.g., socio-demographics, lifestyle, work timing, and sleep-wake habits) considered to impact on sleep duration of working (n=51) and non-working (n=41) high-school students aged 14-21 yrs old attending evening classes (19:00-22:30 h) at a public school in the city of So Paulo, Brazil. Data were collected for working days and days off. Multiple linear regression analyses were performed to assess the factors associated with sleep duration on weekdays and weekends. Work, sex, age, smoking, consumption of alcohol and caffeine, and physical activity were considered control variables. Significant predictors of sleep duration were: work (p < 0.01), daily work duration (8-10 h/day; p < 0.01), sex (p=0.04), age 18-21 yrs (0.01), smoking (p=0.02) and drinking habits (p=0.03), irregular physical exercise (p < 0.01), ease of falling asleep (p=0.04), and the sleep-wake cycle variables of napping (p < 0.01), nocturnal awakenings (p < 0.01), and mid-sleep regularity (p < 0.01). The results confirm the hypotheses that young students who work and attend school showed a reduction in night-time sleep duration. Sleep deprivation across the week, particularly in students working 8-10 h/day, is manifested through a sleep rebound (i.e., extended sleep duration) on Saturdays. However, the different roles played by socio-demographic and lifestyle variables have proven to be factors that intervene with nocturnal sleep duration. ) The variables related to the sleep-wake cycle naps and night awakenings proved to be associated with a slight reduction in night-time sleep, while regularity in sleep and wake-up schedules was shown to be associated with more extended sleep duration, with a distinct expression along the week and the weekend. Having to attend school and work, coupled with other socio-demographic and lifestyle factors, creates an unfavorable scenario for satisfactory sleep duration

Effects of naps at work on the sleepiness of 12-hour night shift nursing personnel

Background and objective: The purpose of the present study was to evaluate the effects of a nap at work on the sleepiness of 12-hour, night-shift (registered and assistant) nursing personnel.Methods: Twelve nurses filled out daily logs, the Karolinska Sleepiness Scale (KS), and wore wrist actigraphs for two periods of four continuous days.Results: Mean nap duration during the night shifts was 138.3 (SD+39.8) minutes. The mean sleepiness level assessed by the KS score was lower, 3.3 (SD±1.6), when the nap was taken during the first span (00:01 - 03:00h) of the night shift, compared with 6.6 (SD±1.0) when there was no nap. The mean sleepiness level assessed by the KS score was also lower, 3.6 (SD±0.9), when the nap was taken during the second span (03:01 - 06:00h) of the night shift, compared with 7.0 (SD±1.1) when there was no nap. Thus, napping either during the first or second part of the night shift reduces sleepiness of 12-hour, night-shift nursing personnel. Moreover, the mean duration of the first sleep episode after night work was longer in those who did not nap than in those who did. Conclusions: The results of this study show that napping during the 12-hour, night-shift results in less sleepiness at work and less need for recovery sleep after work

Circulation of antibodies against yellow fever virus in a simian population in the area of Porto Primavera hydroeletric plant, São Paulo, Brazil

A febre amarela (FA) é doença infecciosa aguda de origem viral transmitida por mosquitos. No ciclo silvestre, o vírus é mantido por meio da infecção de macacos e da transmissão transovariana nos vetores. A vigilância sobre populações de primatas não humanos torna-se necessária para detectar a circulação viral, quando ainda está restrito a epizootias, e para determinar sua presença em regiões indenes ou de transição para a doença. Padronizou-se a técnica ELISA (Enzyme Linked Immunosorbent Assay) para determinar a prevalência de anticorpos da classe IgG contra o vírus da FA em soros de bugios (Alouatta caraya) da região do reservatório da Usina Hidrelétrica de Porto Primavera, SP. Foram testados soros de 570 macacos sendo que nenhuma amostra mostrou-se reativa para a presença de anticorpos contra o vírus da FA. Os resultados são coerentes com a epidemiologia da FA na região. Mesmo sendo área de transição, não se conhece, até o momento, ocorrência de epizootia ou surto de FA em humanos e investigações entomológicas não apontaram a presença de vetores para esta arbovirose. A técnica mostrou-se sensível, rápida e útil à vigilância epidemiológica como instrumento de busca ativa permitindo desencadear ações preventivas, como vacinação, antes mesmo do surgimento de epizootias

Microbiological indicators for the assessment of performance in the hazard analysis and critical control points (HACCP) system in meat lasagna production

The HACCP system is being increasingly used to ensure food safety. This study investigated the validation of the control measures technique in order to establish performance indicators of this HACCP system in the manufacturing process of Lasagna Bolognese (meat lasagna). Samples were collected along the manufacturing process as a whole, before and after the CCPs. The following microorganism s indicator (MIs) was assessed: total mesophile and faecal coliform counts. The same MIs were analyzed in the final product, as well as, the microbiological standards required by the current legislation. A significant reduction in the total mesophile count was observed after cooking (p < 0.001). After storage, there was a numerical, however non-significant change in the MI count. Faecal coliform counts were also significantly reduced (p < 0.001) after cooking. We were able to demonstrate that the HACCP system allowed us to meet the standards set by both, the company and the Brazilian regulations, proved by the reduction in the established indicators

Description of the immatures of the ant, Myrmelachista catharinae

The Neotropical ant genus Myrmelachista Roger comprises 69 described species and subspecies, and still is a poorly studied group. Larvae play a paramount role in colony nutrition in social hymenopterans and bear considerable value in the reconstruction of group phylogenies, however, they are generally neglected. Larvae of different instars of Myrmelachista catharinae Mayr (Hymenoptera: Formicidae) are herein described in detail by light and scanning electron microscopy. The number of larval instars was estimated as three based on the frequency distribution of maximum head capsule widths. The described larvae confirmed some traits typical of the genus: general shape of body and mandibles, general aspect and distribution of body hairs, and the number of sensilla on the palps and galea. Differently from other Myrmelachista larvae previously described, M. catharinae presented two distinct kinds of second instars, some additional types of body hairs, different number of antennal sensilla, and a distinct labrum shape. M. catharinae presented ten pairs of spiracles, which is the first record for this genus.

DESCRIPTION OF THE LARVAE OF TAPINOMA MELANOCEPHALUM (HYMENOPTERA: FORMICIDAE)

Morphological descriptions of the 4 instars of the ghost-ant Tapinoma melanocephalum Fabricius are presented along with illustrations and comparisons with other species of the same genus. Instars were similar, differing only in body length. The analyzed larvae presented many characteristics in common with other Tapinoma Forster larvae, such as: dolichoderoid body and mandibles, 9 pairs of spiracles, the presence of a terminal boss, and scarce body and head setae, all simple and short. We observed the following differences from other previous descriptions: the presence of a subapical mandibular tooth, setaceous sensilla on the medial anterior surface of the labrum, and fewer sensilla on maxillary and labial palps.