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

Objectives. To assess the impact of chronic disease and the number of diseases on the various aspects of health-related quality of life (HROOL) among the elderly in Såo Paulo, Brazil. Methods. The SF-36® Health Survey was used to assess the impact of the most prevalent chronic diseases on HRQOL. A cross-sectional and population-based study was carried out with two-stage stratified cluster sampling. Data were obtained from a multicenter health survey administered through household interviews in several municipalities in the state of São Paulo. The study evaluated seven diseases - arthritis, back-pain, depression/anxiety, diabetes, hypertension, osteoporosis, and stroke - and their effects on quality of life. Results. Among the 1 958 elderly individuals (60 years of age or older), 13.6% reported not having any of the illnesses, whereas 45.7% presented three or more chronic conditions. The presence of any of the seven chronic illnesses studied had a significant effect on the scores of nearly all the SF-36® scales. HROOL achieved lower scores when related to depression/ anxiety, osteoporosis, and stroke. The higher the number of diseases, the greater the negative effect on the SF-36® dimensions. The presence of three or more diseases significantly affected HROOL in all areas. The bodily pain, general health, and vitality scales were the most affected by diseases. Conclusions. The study detected a high prevalence of chronic diseases among the elderly population and found that the degree of impact on HROOL depends on the type of disease. The results highlight the importance of preventing and controlling chronic diseases in order to reduce the number of comorbidities and lessen their impact on HROOL among the elderly.

Highlights from the I international symposium of thrombosis and anticoagulation in internal medicine, October 23-25, 2008, Sao Paulo, Brazil

The importance of thrombosis and anticoagulation in clinical practice is rooted firmly in several fundamental constructs that can be applied both broadly and globally. Awareness and the appropriate use of anticoagulant therapy remain the keys to prevention and treatment. However, to assure maximal efficacy and safety, the clinician must, according to the available evidence, choose the right drug, at the right dose, for the right patient, under the right indication, and for the right duration of time. The first International Symposium of Thrombosis and Anticoagulation in Internal Medicine was a scientific program developed by clinicians for clinicians. The primary objective of the meeting was to educate, motivate and inspire internists, cardiologists and hematologists by convening national and international visionaries, thought-leaders and dedicated clinician-scientists in Sao Paulo, Brazil. This article is a focused summary of the symposium proceedings. © Springer Science+Business Media, LLC 2009.

Landscape reshaping of the asylum of san francisco de paula, located in jaboticabal, Sao Paulo State, Brazil

It is a commonly known fact that there are elderly who have no family or who do not receive any kind of help from their relatives, as the family does not normally have good financial conditions to help them. These elderly live in private or public shelters and generally, they do not have enough money to cover all the necessary costs, and are forced to survive from donations. Those shelters are based, primarily, on nutrition and health. Leisure and wellbeing are usually treated with little attention, but it could be obtained in a simple and effective way: green areas, which normally exist at the site, are often misused, so they can become rest areas through simple landscape projects. It is important to mention that a garden is not just a beautiful place, but it becomes important for the daily life of older people. The objective of this work was to study the need for contemplative leisure and labor in order to improve the life quality of the elderly that live at the San Francisco de Paula Asylum, in Jaboticabal City, Sao Paulo State, Brazil. In this study, a topographic and a photographic survey was conducted and an analysis of the local ground was done. The preferences of the employees and the visitors of the building were also recorded, as well as the critical points of the area. After this primary analysis, the landscape planning was done, with the help of the AutoCAD 2004 software, prioritizing the use of plants that are not dangerous and that are easy maintained. An orchid nursery was also created in order to provide weekly workshops of orchid cultivation.

Local and regional features of surface radiation fluxes over the tropical Atlantic ocean near Sao Pedro and Sao Paulo archipelago: Evidence of small scale upwelling

To properly describe the interactions between the ocean and atmosphere, it is necessary to assess a variety of time and spatial scales phenomena. Here, high resolution oceanographic and meteorological data collected during an observational campaign carried out aboard a ship in the tropical Atlantic Ocean, on May 15-24, 2002, is used to describe the radiation balance at the ocean interface. Data collected by two PIRATA buoys, along the equator at 23°W and 35°W and satellite and climate data are compared with the data obtained during the observational campaign. Comparison indicates remarkable similarity for daily and hourly values of radiation fluxes components as consequence of the temporal and spatial consistence presented by the air and water temperatures measured in situ and estimated from large scale information. The discrepancy, mainly in the Sao Pedro and Sao Paulo Archipelago area, seems to be associated to the local upwelling of cold water, which is not detected in all other estimates investigated here. More in situ data are necessary to clarify whether this upwelling flow has a larger scale effect and what are the meteorological and oceanographic implications of the local upwelling area on the tropical waters at the Brazilian coast.

Occurrence of mycobacteria in bovine milk samples from both individual and collective bulk tanks at farms and informal markets in the southeast region of Sao Paulo, Brazil

Background: Mycobacterium spp. is one of the most important species of zoonotic pathogens that can be transmitted from cattle to humans. The presence of these opportunistic, pathogenic bacteria in bovine milk has emerged as a public-health concern, especially among individuals who consume raw milk and related dairy products. To address this concern, the Brazilian control and eradication program focusing on bovine tuberculosis, was established in 2001. However, bovine tuberculosis continues to afflict approximately 1,3 percent of the cattle in Brazil. In the present study, 300 samples of milk from bovine herds, obtained from both individual and collective bulk tanks and informal points of sale, were cultured on Löwenstein-Jensen and Stonebrink media. Polymerase chain reaction (PCR)-based tests and restriction-enzyme pattern analysis were then performed on the colonies exhibiting phenotypes suggestive of Mycobacterium spp., which were characterized as acid-fast bacilli.Results: Of the 300 bovine milk samples that were processed, 24 were positively identified as Mycobacterium spp.Molecular identification detected 15 unique mycobacterial species: Mycobacterium bovis, M. gordonae, M. fortuitum, M. intracellulare, M. flavescens, M. duvalii, M. haemophilum, M. immunogenum, M. lentiflavum, M. mucogenicum, M. novocastrense, M. parafortuitum, M. smegmatis, M. terrae and M. vaccae. The isolation of bacteria from the various locations occurred in the following proportions: 9 percent of the individual bulk-tank samples, 7 percent of the collective bulk-tank samples and 8 percent of the informal-trade samples. No statistically significant difference was observed between the presence of Mycobacterium spp. in the three types of samples collected, the milk production profiles, the presence of veterinary assistance and the reported concerns about bovine tuberculosis prevention in the herds.Conclusion: The microbiological cultures associated with PCR-based identification tests are possible tools for the investigation of the presence of Mycobacterium spp. in milk samples. Using these methods, we found that the Brazilian population may be regularly exposed to mycobacteria by consuming raw bovine milk and related dairy products. These evidences reinforces the need to optimize quality programs of dairy products, to intensify the sanitary inspection of these products and the necessity of further studies on the presence of Mycobacterium spp. in milk and milk-based products. © 2013 Franco et al.; licensee BioMed Central Ltd.

Relative growth and reproduction in Achelous spinicarpus (Crustacea: Portunidae) on the south-eastern continental shelf of Brazil

This investigation aimed to study the relative growth, morphological sexual maturity and fecundity of the swimming crab Achelous spinicarpus in a tropical region, on the south-eastern continental shelf of Brazil (25°S). Biometry of all specimens was conducted, including measurements of the cephalothorax, cheliped, abdomen and gonopods. Relative growth was described based on the equation for allometry (y = axb), and size at sexual maturity was determined from inflections in relations involving the cheliped, gonopods (males), and abdomen (females), as dependent variables, related to the cephalothorax width (independent variable). Fecundity was estimated by the gravimetric method. The relations of the length of the chelar propodus and carpal spine to the carapace width without the lateral spines (CW) showed positive allometry in both sexes, with a significant variation in the constant 'b' for males between the developmental stages (juvenile and adult) and the size at maturity estimated at 37 mm CW. In females, the abdomen was most appropriate for the estimate of morphological maturity, which occurred at a smaller size (32 mm CW), with a change in the growth pattern between the stages, passing from isometric (juveniles) to positive allometric (adults). The gonopods also showed different growth rates between developmental stages, in synchrony with the variables of the cheliped. Mean fecundity for the species was 53,984 eggs, with a positive correlation between the number of eggs exteriorized and the size of the female; the equations allowed interconversion between these variables, due to the adjustment of the power function (r2 ≥ 86%). © 2012 Marine Biological Association of the United Kingdom.

Incidence of Leptospirosis infection in the East Zone of Sao Paulo City, Brazil

Background: Leptospirosis is a zoonosis which is spread through contamined running water. This contaminations is seriously affected by the flooding which occurs in the area surrounding the Aricanduva river. The transmission of the disease results mainly from the contact of water with soil contaminated by the urine of infected animals. We aimed to conduct an epidemiological survey on Leptospirosis cases in Sao Paulo East Zone area. Method. The analysis conducted in this study was based on data collected from the health authorities of that region close the Aricanduva river between 2007 and 2008 years, which give the rates of confirmed cases, mortality and death from human Leptospirosis. Other information concerned with the relationships among rainfall index, points of flooding and incidence of Leptospirosis. Results: We observed a direct and important water contamination. Records of flooding points and dates of the reported cases in the region showed a direct relationship from which the period of higher rainfall also recorded an increase in cases. The annual record of the city and the region and rainfall regions also presented correlation. Conclusion: The association between the indices of flooding and Leptospirosis cases indicates that preventive measures are necessary to avoid exposing the community. © 2013 Miyazato et al.; licensee BioMed Central Ltd.

Sexual abuse and alcohol use among women in metropolitan Sao Paulo, Brazil: a general population study

OBJECTIVE:The present study aimed at estimating the prevalence of lifetime sexual abuse among women and at investigating its association with alcohol consumption.METHOD:Population-based survey conducted through a representative and stratified cluster sample of metropolitan São Paulo. GENACIS questionnaire was used. Sample unit was the home, and all residents aged 18 years and over were interviewed. The outcome was lifetime sexual abuse. The univariate statistical analysis used the Rao-Scott test. Logistic regression was used for the multivariate analysis.RESULTS:The final sample totalized 1,216 women aged 18 years and over; the response rate was 75.0%. Most women were married (56.6%) and had less than 12 years of formal education (59.0%); 46.2% were aged between 25 and 44 years, and 44.4% had a low income. Of the respondents, 7.5% reported having suffered lifetime sexual abuse. Multiple logistic regression model showed an association between lifetime sexual abuse and being a heavy drinker (OR = 4.97) and being a former drinker (OR = 2.04).CONCLUSIONS:There are few population studies in Brazil investigating sexual abuse and its relation to alcohol use. Although the prevalence of lifetime sexual abuse in the present study was smaller than that observed in other studies, it is a highly expressive percentage on account of its social and economic impact, as well as its potential effect on the health system.

Entomological surveillance, spatial distribution, and diversity of culicidae (diptera) immatures in a rural area of the atlantic forest biome, state of sao paulo, brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Yellow fever: reemerging in the state of Sao Paulo, Brazil, 2009

OBJECTIVE: To describe the investigation of a sylvatic yellow fever outbreak in the state of Sao Paulo and the main control measures undertaken.METHODS: This is a descriptive study of a sylvatic yellow fever outbreak in the Southwestern region of the state from February to April 2009. Suspected and confirmed cases in humans and in non-human primates were evaluated. Entomological investigation in sylvatic environment involved capture at ground level and in the tree canopy to identify species and detect natural infections. Control measures were performed in urban areas to control Aedes aegypti. Vaccination was directed at residents living in areas with confirmed viral circulation and also at nearby cities according to national recommendation.RESULTS: Twenty-eight human cases were confirmed (39.3% case fatality rate) in rural areas of Sarutaia, Piraju, Tejupa, Avare, and Buri. The deaths of 56 non-human primates were also reported, 91.4% were Allouatta sp. Epizootics was confirmed in two non-human primates in the cities of Itapetininga and Buri. A total of 1,782 mosquitoes were collected, including Haemagogus leucocelaenus, Hg. janthinomys/capricornii, and Sabethes chloropterus, Sa. purpureus and Sa. undosus. Yellow fever virus was isolated from a group of Hg. Leucocelaenus from Buri. Vaccination was carried out in 49 cities, with a total of 1,018,705 doses. Nine serious post-vaccination adverse events were reported.CONCLUSIONS: The cases occurred between February and April 2009 in areas with no recorded yellow fever virus circulation in over 60 years. The outbreak region occurred outside the original recommended vaccination area with a high percentage of susceptible population. The fast adoption of control measures interrupted the human transmission within a month and the confirmation of viral circulation in humans, monkeys and mosquitoes. The results allowed the identification of new areas of viral circulation but further studies are required to clarify the dynamics of the spread of this disease.

Spatial Distribution of the Risk of Dengue and the Entomological Indicators in Sumare, State of Sao Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

A novel association between Rhodnius neglectus and the Livistona australis palm tree in an urban center foreshadowing the risk of Chagas disease transmission by vectorial invasions in Monte Alto City, Sao Paulo, Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Quantitative study of Babesia bovis infection in beef cattle from Sao Paulo state, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Sero-epidemiological survey for brucellosis, leptospirosis, and toxoplasmosis in free-ranging Alouatta caraya and Callithrix penicillata from Sao Paulo State, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)