Geographic and Educational Factors and Risk of the First Peritonitis Episode in Brazilian Peritoneal Dialysis Study (BRAZPD) Patients

Background and objectives Peritonitis remains as the most frequent cause of peritoneal dialysis (PD) failure, impairing patient's outcome. No large multicenter study has addressed socioeconomic, educational, and geographic issues as peritonitis risk factors in countries with a large geographic area and diverse socioeconomic conditions, such as Brazil.Design, setting, participants, & measurements Incident PD patients recruited from 114 dialysis centers and reporting to BRAZPD, a multicenter observational study, from December 2004 through October 2007 were included. Clinical, dialysis-related, demographic, and socioeconomic variables were analyzed. Patients were followed up until their first peritonitis. Cox proportional model was used to determine independent factors associated with peritonitis.Results In a cumulative follow-up of 2032 patients during 22.026 patient-months, 474 (23.3%) presented a first peritonitis episode. In contrast to earlier findings, PD modality, previous hemodialysis, diabetes, gender, age, and family income were not risk predictors. Factors independently associated with increased hazard risk were lower educational level, non-white race, region where patients live, shorter distance from dialysis center, and lower number of patients per center.Conclusions Educational level and geographic factors as well as race and center size are associated with risk for the first peritonitis, independent of socioeconomic status, PD modality, and comorbidities. Clin J Am Soc Nephrol 6: 1944-1951, 2011. doi: 10.2215/CJN.11431210

Factors associated to Theileria equi in equids of two microregions from Rio de Janeiro, Brazil

Amostras de soro de 714 equídeos das microrregiões de Itaguaí e Serrana, Rio de Janeiro, Brasil, foram submetidas ao teste de imunofluorescência indireta (título 1:80) para Theileria equi. A prevalência entre as microrregiões e os fatores associados à soropositividade foram avaliados e a razão de prevalência (RP) calculada. A prevalência geral para T. equi foi de 81,09% (n = 579), com maior prevalência (p < 0,05) para microrregião de Itaguaí (85,43%), quando comparado a Serrana (76,92%). A região, altitude, nível da propriedade e origem dos equídeos foram associados (p < 0,05) com a soropositividade para T. equi. Equídeos criados na microrregião de Itaguaí (RP = 1,11; p = 0,003) e em altitudes abaixo de 500 m (RP = 1.10; p = 0,014) apresentaram maior chance de se tornarem soropositivos para T. equi. Além disso, quando são criados em propriedades de nível ruim (RP = 1,13; p = 0,018) e nascidos na propriedade (RP = 1,10; p = 0,008) apresentaram mais chance de terem contato com T. equi. As principais espécies de carrapatos encontradas parasitando os equídeos foram Amblyomma cajennense e Dermacentor (Anocentor) nitens. As microrregiões estudadas são endêmicas para theileriose equina e de estabilidade enzoótica para T. equi. Apenas os fatores relacionados à área de coleta das amostras de soro influenciaram a soropositividade dos equídeos para T. equi naquela região.

Uso de medicamentos por pessoas com deficiências em áreas do estado de São Paulo

OBJETIVO: Analisar o consumo de medicamentos e os principais grupos terapêuticos consumidos por pessoas com deficiências físicas, auditivas ou visuais. MÉTODOS: Estudo transversal em que foram analisados dados do Inquérito Multicêntrico de Saúde no Estado de São Paulo (ISA-SP) em 2002 e do Inquérito de Saúde no Município de São Paulo (ISA-Capital), realizado em 2003. Os entrevistados que referiram deficiências foram estudados segundo as variáveis que compõem o banco de dados: área, sexo, renda, faixa etária, raça, consumo de medicamentos e tipos de medicamentos consumidos. RESULTADOS: A percentagem de consumo entre as pessoas com deficiência foi de: 62,8% entre os visuais; 60,2% entre os auditivos e 70,1% entre os físicos. As pessoas com deficiência física consumiram 20% mais medicamentos que os não-deficientes. Entre as pessoas com deficiência visual, os medicamentos mais consumidos foram os diuréticos, agentes do sistema renina-angiotensina e analgésicos. Pessoas com deficiência auditiva utilizaram mais analgésicos e agentes do sistema renina-angiotensina. Entre indivíduos com deficiência física, analgésicos, antitrombóticos e agentes do sistema renina-angiotensina foram os medicamentos mais consumidos. CONCLUSÕES: Houve maior consumo de medicamentos entre as pessoas com deficiências quando comparados com os não-deficientes, sendo os indivíduos com deficiência física os que mais consumiram fármacos, seguidos de deficientes visuais e auditivos.

Proxy-reported health-related quality of life of patients with juvenile idiopathic arthritis: Pediatric rheumatology international trials organization multinational quality of life cohort study

Objective. To investigate the proxy-reported health-related quality of life (HRQOL) and its determinants in patients with juvenile idiopathic arthritis (JIA).Methods. In this multinational, multicenter, cross-sectional study, HRQOL of patients with JIA was assessed through the Child Health Questionnaire (CHQ) and was compared with that of healthy children of similar age from the same geographic area. of joint inflammation, Childhood Health Assessment Questionnaire (CHAQ), and erythrocyte sedimentation rate.Results. A total of 6,639 participants (3,324 with JIA and 3,315 healthy) were enrolled from 32 countries. The mean SD physical and psychosocial summary scores of the CHQ were significantly lower in patients with JIA than in healthy children (physical: 44.5 +/- 10.6 versus 54.6 +/- 4.0, P < 0.0001; psychosocial: 47.6 +/- 8.7 versus 51.9 +/- 7.59 P < 0.0001), with the physical well-being domain being most impaired. Patients with persistent oligoarthritis had better HRQOL compared with other subtypes, whereas HRQOL was similar across patients with systemic arthritis, polyarthritis, and extended oligoarthritis. A CHAQ score > 1 and a pain intensity rating > 3.4 cm on a 10-cm visual analog scale were the strongest determinants of poorer HRQOL in the physical and psychosocial domains, respectively.Conclusion. We found that patients with JIA have a significant impairment of their HRQOL compared with healthy peers, particularly in the physical domain. Physical well-being was mostly affected by the level of functional impairment, whereas the intensity of pain had the greatest influence on psychosocial health.

Tolerância de perdas de solo na bacia do rio Itiquira, Mato Grosso, Brasil

The geographic area of the present study corresponds to the basin of the Itiquira river high course (Figure 1), in the portion that extends from the tributaries of its source, in the east of the plateau Correntes/Itiquira, in the neighbourhoods the city of Alto Garç as, to the scarp of the São Jerônimo mountain range, toward the west of Itiquira, in the state of Mato Grosso, totalizing 5,361 km 2. The area is placed in the eastern part of the Alto Paraguai basin, in the western portion of the Paraná Sedimentary Basin plateau. Through GIS techniques, it was possible to asses total soil losses from the Itiquira river basin, considering the years of 1966, 1985 and 1996, being based on the Universal Soil Loss Equation. Thus, in 1966 the basin lost 201,546.94 ton of soil, with an average loss of 0.37 ton/ha/year. Considering that the total area of the Itiquira river basin is of 536,100 ha, while in 1985 the soil losses had passed to 1,760,833.40 ton, with an increase of approximately 8.5 times. The average of soil losses in 1985 was of 3.28 ton/ha/year. In 1996 the basin lost 1,662,043.24 ton, with a reduction of only 9.4% in relation to 1985 but, in relation the 1966, the increase continued in the order of 8 times. The average losses per hectare in this year was in the order of 3.10 ton/ha/year (Chart 1). The map of potential of the laminar erosion for 1966 (Figure 3), shows to the highest values in small areas, situated in the northeast of the area, in Alto Garças, with values between 10 the 20 ton/ha/year and some spots in sources of the Itiquira and Ariranha rivers, with values between 1 the 5 ton/ha/year. In a general way, however, the area presents low soil loss for laminar erosion in this year, with inferior values to 1 ton/ha/year. The higher class of erosion, over 10 ton/ha/year, occupied 2,947 ha in 1966. In the year of 1985 (Figure 4), the erosive process spread over the entire studied area, and the class of erosion over of 10 ton/ha/year, already started to occupy 78,437 ha, implying an increase of approximately 27 times in 19 years. A strong increment in the erosive process was noticed in the western part of the area, to along the BR-163 road, exactly where great areas of natural vegetation (open pasture) had been transformed in culture and pasture areas. In the north-eastern part of the area it was also noticed an increment in the erosive process in agreement with the increase of culture areas and reduction of the natural areas, but it was not of so intense form as in the western portion of the area. In the year of 1996 (Figure 5), the class of erosion over of 10 ton/ha/year had diminished for a total of 53.499 ha noticing a retraction of the erosive process in the western part of the area, alongside the BR-163 road. On the other hand, it occurred a strong increment in the northern part of the area, in the neighbourhoods of the city of Alto Garças, alongside the BR-364 road and part of the MT-040 road. In a general way, in the outskirts of the city of Itiquira, in the central part of the area, it was verified an increase of the amount of zones with erosion between 0-1 ton/ha/year, passing to the immediately superior class, of 1-3 ton/ha/year; scarce data of hydrosedimentology in the UHE Itiquira (1999), shows good agreement with the values gotten for the EUPS (Chart 2). Based on the hydric classification proposal for FAO (1967) (Chart 3), it is noticed that areas with high degree of erosion (> 50) in the analysed area are very restricted, occupying 493 ha in 1985 and 332 ha in 1996 (Chart 4). In 1996 appeared as isolated spots in the north of Itiquira and Alto Garças, however beyond limits of the Itiquira river basin. These areas require special cares in its use as agricultural areas. Aiming at identifying and indicating the areas of potential risk of erosion and that need implementation of conservation practices, it was elaborated the map of limit of tolerance to the soil losses. In 1966 (Figure 6), areas with soil losses over of the tolerable were restricted to small spots located in the eastern part of the area, occupying 0.43% of the total of the area; already in 1985 (Figure 7), this percentage passed to 5.86%, spreading for all the area; in 1996 (Figure 8) it is observed a fast reduction of the areas with soil losses over of the tolerance limit, passing 5.43% of the total of the area. All the areas with losses over of the tolerable value must be considered as risk areas and were done in these areas studies for implementation of conservation practices.

Implantação de aterros sanitários: Comparação de métodos de seleção de áreas

Historically, the incorrect waste disposal has been related to epidemics which resulted in thousand of deaths. Despite the efforts to develop sanitary disposal methods in the 19 century, even today, uncontrolled dumps are often found in undeveloped countries. These places are responsible for environment pollution and for several diseases. The process of adequate waste disposal begins with the selection of suitable landfill areas, based on environmental characteristics. The goal of this research was to compare two methods of landfill site selection: the first one developed by IG-SMA (1999), and the other by Basílio (2001). Both methods were developed and applied in the same area - region of Campinas, São Paulo State, Brazil and this fact explains the choice for them; the comparison was made by superposing maps. Despite the same geographic area, the result was very different and few areas in common were found; IG-SMA (1999) obtained more suitable areas than Basílio (2001). This has been attributed to scale, criteria and attribute differences and, as a conclusion, Basílio (2001) was considered more restrictive than IG-SMA (1999).

A Liga da Defesa Nacional: um projeto de modernização para o Brasil

Pós-graduação em Ciências Sociais - FFC

Morfometria da microbacia hidrográfica do Ribeirão Faxinal Botucatu - SP e alterações em suas áreas de biomassa no período de 1972 a 2000

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Seleção de áreas para implantação de aterros sanitários: análise comparativa de métodos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Movimentos socioterritoriais: uma contribuição conceitual à pesquisa geográfica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Variabilidade espacial e temporal de fatores edafoclimáticos na Bacia do Rio Pontal, Pernambuco

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Indústria têxtil e crescimento econômico: uma abordagem geográfica da evolução, estrutura e dinâmica da aglomeração produtiva de redes de dormir em Jaguaruana - CE

Pós-graduação em Geografia - IGCE

DECREASING PREVALENCE OF THE ACUTE/SUBACUTE CLINICAL FORM OF PARACOCCIDIOIDOMYCOSIS IN MATO GROSSO DO SUL STATE, BRAZIL

Com o objetivo de avaliar o comportamento da paracoccidioidomicose nas últimas três décadas, dados clínicos e epidemiológicos de 595 pacientes atendidos dentre 1980 a 2009 no Hospital da Universidade Federal de Mato Grosso do Sul foram estudados. Sexo, faixa etária, forma clínica, associação com tuberculose ou AIDS e mortalidade foram comparados por década em que a doença foi diagnosticada. Observou-se, nas três décadas do estudo, uma redução do percentual de mulheres, de pacientes do grupo de 20 a 39 anos, assim como de casos com a forma aguda/subaguda. Estas alterações estão intimamente relacionadas e podem ser analisadas simultaneamente. Houve aumento de casos de coinfecção com AIDS da primeira para segunda década, coincidindo com o surgimento da epidemia, e manteve-se estável durante a década seguinte. Não houve alteração da taxa de coinfecção com tuberculose, que no geral foi de 6,9% o que reforça a importância desta comorbidade. A taxa geral de mortalidade foi de 6,7% e também não variou entre as décadas estudadas. A manutenção da taxa de óbitos chama a atenção para a relevância dessa doença negligenciada.

Visão futuro: comunidade autogestionável

Along of the Brazilian territory is to encourage a lot of self-management communities, seeking a new way of social organization through of cultural practices and economic antagonistic logic of the capitalist system. These communities create a lifestyle which we are not used in the context of modern life, they are focused to a greater preservation of nature, to an economy based on spiritualization and cultural exchange. The peculiarity of these communities is to offer the same structure as a modern city, electricity, clothing, basic sanitation, food among others, which the state already offers, but with alternative ways.For a more specific study was selected community-Porangaba Future Vision, São Paulo. Through this case of study, it is thought to enable a better understanding of how it is possible within a country emerge a community that creates its own structure encompassed by cultural practices and economic characteristics and finally understanding what are the effects on the geographic area

Candida albicans: genotyping methods and clade related phenotypic characteristics

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