Metal embryotoxicity from urban particles in Sao Paulo city: An experimental study in chicken embryos

Chicken eggs were inoculated with suspensions of ambient air particles (<= 10 mu m, PM(10)) from Sao Paulo city in 3, 0.3 or 0.03 mu g doses on one of the four early days of embryo development. On the eleventh day of development alterations were observed on embryos inoculated with PM(10) 3 mu g on the third day. Particles analysis showed high content of metals. Hence, embryos were also inoculated with PM(10) (3 mu g) combined with metal chelating EDTA. PM(10) (3 mu g) embryos presented underdevelopment (stage 29.44 +/- 11.4) compared to vehicle and positive controls (stage 36.44 +/- 0.51 Saline and stage 31.20 +/- 9.7 Cyclophosphamide, p <= 0.05); higher (47%) mortality rate (23% Saline and 42% Cyclophosphamide) and low (68%) viability (100% Saline and 70% Cyclophosphamide, p = 0.04). Effects were attenuated when embryos received PM(10) + EDTA (stage 33.63 +/- 0.94, 18.9% mortality rate and 82% viability). PM(10) from Sao Paulo city is embryotoxic and metal may be implicated in the toxic mechanism. (C) 2010 Elsevier Inc. All rights reserved.

Exposure to contaminated water: perceptions and practices in a neighborhood in the city of Manaus, Brazil

Objective. To investigate the modes of water supply and the perception concerning the problems caused by this water among residents of a neighborhood without public supply of water, settled in an area previously used as a garbage dump in the city of Manaus, Brazil. Methods. One hundred and sixty-two semi-structured household interviews were conducted. In addition, a focal group with teachers from a local public school and a meeting with residents were held. The instruments employed focused on the perception and modes of water use and on the process of exposure to chemical contaminants through water. Results. Untreated well water was used by most families. This water was considered to be ""good"" by 64.8% of the individuals interviewed. Most residents (88.3%) declared knowledge about the garbage dump. Of these, 77.6% stated that the garbage dump caused health and environmental problems. However, qualitative analysis of the responses revealed that the residents were not aware of contamination by chemical elements or of the consequences of such contamination. The activities carried out with teachers revealed that they were partially aware of the problem, but did not design interventions to address the issue. In a meeting with neighborhood residents, the presence of social activism concerning the problem was identified, but it did not extend beyond the neighborhood or reach governmental spheres. Conclusions. The study identified a situation of critical exposure that tends to be maintained as a result of misperceptions and lack of social mobilization. The dissemination of research results to teachers and residents was useful to empower subjects.

Homicide mortality, socioeconomic development, and police violence in the city of Sao Paulo, Brazil

Objective. To analyze the association between police violence and homicide mortality rates taking into consideration the effect of contextual variables. Methods. This was an environmental, cross-sectional study that included the 96 census districts in the City of Sao Paulo. The association between the variables was analyzed using Spearman`s rank correlation and simple and multiple regression analysis. Results. Univariate analysis revealed a strong and significant association between homicide mortality coefficients and all the indicators of socioeconomic development and police violence. After controlling for potential confounding factors, the association between police violence and homicide mortality coefficients remained strong and significant. This significance was lost only after control for the size of the resident population. Conclusion. The results indicate that police action that violates basic human rights is not the right answer to urban violence. The combination of homicides from interpersonal violence and deaths from police violence results in negative socialization and promotes further violence.

Waves of Change Within Civil Society in Latin America: Mexico City and Sao Paulo

For the past half a century, Latin American scholars have been pointing toward the emergence of new social actors as agents of social and political democratization. The first wave of actors was characterized by the emergence of novel agents-mainly, new popular movements-of social transformation. At first, the second wave, epitomized by nongovernmental organizations (NGOs), was celebrated as the upsurge of a new civil society, but later on, it was the target of harsh criticism. The literature often portrays this development in Latin American civil society as a displacement trend of actors of the first wave by the second wave-""NGOization""-""and even denounces new civil society as rootless, depoliticized, and functional to retrenchment. Thus, supposedly, NGOization encumbers social change. The authors argue that NGOization diagnosis is a flawed depiction of change within civil society. Rather than NGOization related to the depoliticization and neoliberalization of civil society, in Mexico City and Sao Paulo, there has been modernization of organizational ecologies, changes in the functional status of civil society, and interestingly, specialization aimed at shaping public agenda. The authors argue that such specialization, instead of encumbering social change, brings about different repertoires of strategies and skills purposively developed for influencing policy and politics. Their argument relies on comparative systematic evidence. Through network analysis, they examine the organizational ecology of civil society in Mexico City and Sao Paulo.

Contextual politics of service delivery reforms: Lessons from Delhi, Mexico city and Sao Paulo comparison

Little attention has been given to the contextual politics of service delivery reforms. By focusing on cases of reform in the healthcare sector and, to a lesser extent, in the main policies in the social service sector in India, Mexico and Brazil, this article explores two dimensions of analysis which have enormous relevance in understanding the reach and effectiveness of service delivery reforms: (1) the historical timing of reforms and sectorial baselines, and (2) the degree and institutional locus of local discretion in policy. Findings show that depending on both dimensions, there is an extraordinary variation as to the degree, interests involved and meaning of changes which, in theory, correspond to these countries` commitment to the service delivery reforms, However, consideration of the contextual politics is relevant not for the sake of diversity but for the similarities that this diversity reveals, pointing to underlying analytic dimensions that receive attention in this article.

RACE, RESOURCES, AND POLITICAL PARTICIPATION IN A BRAZILIAN CITY

Does race influence political behavior in Brazil? Using data from Belo Horizonte, Brazil, we explore whether an individual`s propensity to take part in a political association is affected by race, independent of socioeconomic position and of the availability of resources derived from this position. We found that white individuals participate more in political associations than do black individuals; however, after taking into account the differences in all types of resources, we found no difference in participation by racial groups. Nevertheless, by interacting race, skills, and income, it turns out that different racial groups use the same resources differently. A white individual`s propensity to participate politically is significantly more affected by income than a similar black individual`s propensity. Therefore, we argue that race mediates the effect of resources on political participation, which means that either different groups may use different resources or different groups can differ in how intensively they use resources.

Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ""CORE-64"" trial (""Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors""). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows.

Is PHEEM a multi-dimensional instrument? An international perspective

Aim: To look at the characteristics of Postgraduate Hospital Educational Environment Measure (PHEEM) using data from the UK, Brazil, Chile and the Netherlands, and to examine the reliability and characteristics of PHEEM, especially how the three PHEEM subscales fitted with factors derived statistically from the data sets. Methods: Statistical analysis of PHEEM scores from 1563 sets of data, using reliability analysis, exploratory factor analysis and correlations of factors derived with the three defined PHEEM subscales. Results: PHEEM was very reliable with an overall Cronbach`s alpha of 0.928. Three factors were derived by exploratory factor analysis. Factor One correlated most strongly with the teaching subscale (R=0.802), Factor Two correlated most strongly with the role autonomy subscale (R=0.623) and Factor Three correlated most strongly with the social support subscale (R=0.538). Conclusions: PHEEM is a multi-dimensional instrument. Overall, it is very reliable. There is a good fit of the three defined subscales, derived by qualitative methods, with the three principal factors derived from the data by exploratory factor analysis.

Evaluation of serum trace element, biochemical and hematological data of a healthy elderly group residing in So Paulo city, Brazil

In this study, blood serum trace elements, biochemical and hematological parameters were obtained to assess the health status of an elderly population residing in So Paulo city, SP, Brazil. Results obtained showed that more than 93% of the studied individuals presented most of the serum trace element concentrations and of the hematological and biochemical data within the reference values used in clinical laboratories. However, the percentage of elderly presenting recommended low density lipoprotein (LDL) cholesterol concentrations was low (70%). The study indicated positive correlation between the concentrations of Zn and LDL-cholesterol (p < 0.06).

Effects of Chronic Exposure to Air Pollution from Sao Paulo City on Coronary of Swiss Mice, from Birth to Adulthood

To explore the hypothesis that air pollution promotes cardiovascular changes, Swiss mice were continuously exposed, since birth, in two open-top chambers (filtered and nonfiltered for airborne particles <= 0.3 mu m) placed 20 m from a street with heavy traffic in downtown Sao Paulo, twenty-four hours per day for four months. Fine particle (PM(2.5)) concentration was determined gravimetrically; hearts were analyzed by morphometry. There was a reduction of the PM(2.5) inside the filtered chamber (filtered = 8.61 +/- 0.79 mu g/m(3), nonfiltered = 18.05 +/- 1.25 mu g/m(3), p < .001). Coronary arteries showed no evidence of luminal narrowing in the exposed group but presented higher collagen content in the adventitia of LV large-sized and RV midsized vessels (p = .001) and elastic fibers in both tunicae adventitia and intima-media of almost all sized arterioles from both ventricles (p = .03 and p = .001, respectively). We concluded that chronic exposure to urban air since birth induces mild but significant vascular structural alterations in normal individuals, presented as coronary arteriolar fibrosis and elastosis. These results might contribute to altered vascular response and ischemic events in the adulthood.

Prevalence of, and risk factors for Kaposi`s sarcoma-associated herpesvirus infection among blood donors in Brazil: A multi-center serosurvey

Kaposi`s sarcoma-associated herpesvirus (KSHV) is endemic in the Amazon and rare in southern regions of Brazil. However, geographical distribution and epidemiological correlates of infection in this large country are still poorly defined. To estimate the seroprevalence of, and risk factors for, KSHV infection in Brazil, a multi-center study was conducted among 3,493 first-time voluntary unpaid blood donors from Salvador, Sao Paulo and Manaus. Antibodies against KSHV were detected using a whole-virus ELISA validated prior to the serosurvey. Antibodies against the latency-associated nuclear antigen (LANA) were detected by immuno-fluorescence assay (IFA) among ELISA-positive sera and a random sample of ELISA-negative sera. Overall, seroprevalence of KSHV by whole-virus ELISA was 21.7% (95% confidence interval (Cl): 20-23.4%) in men and 31.7% (95% Cl: 29-34.3%) in women (P<0.0001). KSHV antibodies were detected by IFA-LANA in 3% (95% Cl: 2-4.3%) of 867 ELISA-positive samples and in none of 365 randomly selected ELISA-negative samples. In multivariate analysis, KSHV seroprevalence by whole-virus ELISA was independently associated with female sex (odds ratio [OR] = 1.6, 95% Cl: 1.4-1.9); residence in the Amazon (OR = 1.4, 95% Cl: 1.2-1.8; compared to Salvador); Caucasian ethnicity (OR = 1.3, 95% Cl: 1.1-1.6) and herpes simplex virus type 2 (HSV-2) infection (OR = 1.3, 95% Cl: 1.1-1.6). KSHV seroprevalence did not significantly increase with age, nor was it associated with self-reported sexual behavior. KSHV seroprevalence is high among Brazilian blood donors, particularly from the Amazon region. This study supports the co-existence of sexual and non-sexual routes of KSHV transmission in this population.

Alcohol-related traffic accidents with fatal outcomes in the city of Sao Paulo

Aims: The aims of the present study were to characterize fatal traffic accident victims in a major urban center in Brazil and their association with alcohol consumption. Methods: Cross-sectional study of 907 fatal traffic accident victims in Sao Paulo, in 2005. Results: Adult males between the ages of 25 and 54 represented the majority of cases with positive blood alcohol concentrations (BAC). Overall, males had a higher proportional BAC and mean BAC than females. Pedestrians, particularly those with no detectable BAC, were typically older than other victims. Most accidents (total and BAC-positive) happened on weekends between midnight and 6 a.m. Considering all victims, 39.4% were positive (BAC over 0.1 g/l). When only drivers (automobile, motorcycle and bicycle) were evaluated. 42.3% had BAC over the legal limit (0.6 g/l). Conclusions: Alcohol is associated with nearly half of all traffic accident deaths in the city of Sao Paulo. especially for days and times associated with parties and bars (weekends between 12 a.m. and 6 a.m.). (C) 2010 Elsevier Ltd. All rights reserved.

Alcohol consumption in homicide victims in the city of Sao Paulo

Aims To assess the association between alcohol use and victimization by homicide in individuals autopsied at the Institute of Legal Medicine in Sao Paulo, Brazil. Design Cross-sectional study. Setting Excessive consumption of alcohol is a serious public health issue and a major factor in triggering violent situations, which suggests a strong association between alcohol ingestion and becoming a victim of homicide. Participants Data from 2042 victims of homicides in 2005 were obtained from medical examiner reports. Measurements The victim`s gender, age, ethnicity and blood alcohol concentration (BAC) were collected. The method of death and homicide circumstances, as well as the date, time and place of death were also studied. Findings Alcohol was detected in blood samples of 43% of the victims, and mean BAC levels were 1.55 +/- 0.86 g/l. The prevalence of positive BAC levels was higher among men (44.1%) than women (26.6%), P < 0.01. Firearms caused most of the deaths (78.6%), and alcohol consumption was greater among victims of homicide by sharp weapons (P < 0.01). A greater proportion of victims with positive BAC were killed at weekends compared to weekdays (56.4 and 38.5%, respectively; P < 0.01), and the correlation between homicide rates and the average BAC for the central area of the city was positive (r(s) = 0.90; P < 0.01). Conclusions These results highlight alcohol as a contributing factor for homicide victimization in the greatest urban center in South America, supporting public strategies and future research aiming to prevent homicides and violence related to alcohol consumption.

Vulnerability to heat-related mortality in Latin America: A case-crossover study in Sao Paulo, Brazil, Santiago, Chile and Mexico City, Mexico

Background Factors affecting vulnerability to heat-related mortality are not well understood. Identifying susceptible populations is of particular importance given anticipated rising temperatures from climatic change. Methods We investigated heat-related mortality for three Latin American cities (Mexico City, Mexico; Sao Paulo, Brazil; Santiago, Chile) using a case-crossover approach for 754 291 deaths from 1998 to 2002. We considered lagged exposures, confounding by air pollution, cause of death and susceptibilities by educational attainment, age and sex. Results Same and previous day apparent temperature were most strongly associated with mortality risk. Effect estimates remained positive though lowered after adjustment for ozone or PM(10). Susceptibility increased with age in all cities. The increase in mortality risk for those >= 65 comparing the 95th and 75th percentiles of same-day apparent temperature was 2.69% (95% CI: -2.06 to 7.88%) for Santiago, 6.51% (95% CI: 3.57-9.52%) for Sao Paulo and 3.22% (95% CI: 0.93-5.57%) for Mexico City. Patterns of vulnerability by education and sex differed across communities. Effect estimates were higher for women than men in Mexico City, and higher for men elsewhere, although results by sex were not appreciably different for any city. In Sao Paulo, those with less education were more susceptible, whereas no distinct patterns by education were observed in the other cities. Conclusions Elevated temperatures are associated with mortality risk in these Latin American cities, with the strongest associations in So Paulo, the hottest city. The elderly are an important population for targeted prevention measures, but vulnerability by sex and education differed by city.

Education Level Explains Differences in Stroke Incidence among City Districts in Joinville, Brazil: A Three-Year Population-Based Study

Background: Current evidence suggests an inverse association between socioeconomic status and stroke incidence. Our aim was to measure the variation in incidence among different city districts (CD) and their association with socioeconomic variables. Methods: We prospectively ascertained all possible stroke cases occurring in the city of Joinville during the period 2005-2007. We determined the incidence for each of the 38 CD, age-adjusted to the population of Joinville. By linear regression analysis, we correlated incidence data with mean years of education (MYE) and mean income per month (MIPM). Results: Of the 1,734 stroke cases registered, 1,034 were first-ever strokes. In the study period, the crude incidence in Joinville was 69.5 per 100,000 (95% confidence interval, 65.3-73.9). The stroke incidence among CD ranged from 37.5 (22.2-64.6) to 151.0 per 100,000 (69.0-286.6). The stroke incidence was inversely correlated with years of education (r = -0.532; p<0.001). MYE and MIPM were strongly related (R = 0.958), resulting in exclusion of MIPM by collinearity. Conclusions: Years of education can explain a wide incidence variation among CD. These results may be useful to guide the allocation of resources in primary prevention policies. Copyright (C) 2011 S. Karger AG, Basel