Susceptibility of asthmatic children to respiratory infection

OBJECTIVE: A case-control study of patients with pneumonia was conducted to investigate whether wheezing diseases could be a risk factor. METHODS: A random sample was taken from a general university hospital in S. Paulo City between March and August 1994 comprising 51 cases of pneumonia paired by age and sex to 51 non-respiratory controls and 51 healthy controls. Data collection was carried out by two senior paediatricians. Diagnoses of pneumonia and presence of wheezing disease were independently established by each paediatrician for both cases and controls. Pneumonia was radiologically confirmed and repeatability of information on wheezing diseases was measured. Logistic regression analysis was used to identify risk factors. RESULTS: Wheezing diseases, interpreted as proxies of asthma, were found to be an important risk factor for pneumonia with an odds ratio of 7.07 (95%CI= 2.34-21.36), when the effects of bedroom crowding (odds ratio = 1.49 per person, 95%CI= 0.95-2.32) and of low family income (odds ratio = 5.59 against high family income, 95%CI= 1.38-22.63) were controlled. The risk of pneumonia attributable to wheezing diseases is tentatively calculated at 51.42%. CONCLUSION: It is concluded that at practice level asthmatics should deserve proper surveillance for infection and that at public health level pneumonia incidence could be reduced if current World Health Organisation's guidelines were reviewed as to include comprehensive care for this illness.

Influence of HIV positive status on sexual behavior among males

OBJECTIVE: To compare HIV seronegative (HIV-) and HIV seropositive (HIV+) males in terms of sexual behavior with female and male partners of different types. METHOD: Cross-sectional study. From August 1994 to February 1995, a sample of 236 respondents (150 HIV- and 86 HIV+) recruited from public health centers in the State of S. Paulo (Brazil), answered a questionnaire, including questions on demographic aspects, HIV and AIDS related knowledge, sexual orientation, use of alcohol and other drugs, sexual behavior with regular and casual female and male partners, and perceived risk of HIV infection. Sexual behavior with regular and casual female and male partners within the previous three months, was investigated. RESULTS: A lower proportion of HIV+ engaged in sexual contact with regular female partners (p < .01) and in vaginal intercourse with this type of partner (p < .01). A lower proportion of HIV+ engaged in overall sexual activity (p < .001) and reported lower frequency of penetrative sexual practices (p < .05). A high level of condom use with female and male partners was identified with no significant differences being found between the two serostatus groups. Some risky sexual behavior was identified, however, especially with regular partners, suggesting that some men were continuing to practice unsafe sex. CONCLUSIONS: The high level of condom use identified suggests that safer sex advice has been taken up. Condom use was not universal, however, and some men continue to place themselves at risk, especially with regular partners. Prevention programs should strive not only to encourage HIV- to practice safer sex, but also to encourage HIV+ to do so in order to prevent further transmission of the virus.

Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil

OBJECTIVE: To identify risk factors for low birth weight (LBW) among live births by vaginal delivery and to determine if the disappearance of the association between LBW and socioeconomic factors was due to confounding by cesarean section. METHODS: Data were obtained from two population-based cohorts of singleton live births in Ribeirão Preto, Southeastern Brazil. The first one comprised 4,698 newborns from June 1978 to May 1979 and the second included 1,399 infants born from May to August 1994. The risks for LBW were tested in a logistic model, including the interaction of the year of survey and all independent variables under analysis. RESULTS: The incidence of LBW among vaginal deliveries increased from 7.8% in 1978--79 to 10% in 1994. The risk was higher for: female or preterm infants; newborns of non-cohabiting mothers; newborns whose mothers had fewer prenatal visits or few years of education; first-born infants; and those who had smoking mothers. The interaction of the year of survey with gestational age indicated that the risk of LBW among preterm infants fell from 17.75 to 8.71 in 15 years. The mean birth weight decreased more significantly among newborns from qualified families, who also had the highest increase in preterm birth and non-cohabitation. CONCLUSIONS: LBW among vaginal deliveries increased mainly due to a rise in the proportion of preterm births and non-cohabiting mothers. The association between cesarean section and LBW tended to cover up socioeconomic differences in the likelihood of LBW. When vaginal deliveries were analyzed independently, these socioeconomic differences come up again.

Association of human herpesvirus 6 infection with exanthem subitum in Belem, Brazil

Recent human herpesvirus 6 (HHV-6) infection was detected in cases of exanthem subitum (ES) involving four children, aged 10 to 24 months, between April and August 1994, in Belém, Brazil. By using the indirect immunofluorescence antibody assay (IFA), significant increases (at least eight times) in antibody concentrations were noted from the acute to the convalescent serum samples, with titers ranging from <1:10/1:80 to <1:10/1:640 (patients 3 and 2, respectively). All children had high fever (over 39ºC) for three days, followed by generalized, maculo-papular skin rash. A physical examination of the children also revealed concomitant, cervical lymph node swelling and tonsillar pharyngitis in two of them.

Phenotypes of lung mononuclear phagocytes in HIV seronegative tuberculosis patients: evidence for new recruitment and cell activation

Mycobacterium tuberculosis preferentially resides in mononuclear phagocytes. The mechanisms by which mononuclear phagocytes keep M. tuberculosis in check or by which the microbe evades control to cause disease remain poorly understood. As an initial effort to delineate these mechanisms, we examined by immunostaining the phenotype of mononuclear phagocytes obtained from lungs of patients with active tuberculosis. From August 1994 to March 1995, consecutive patients who had an abnormal chest X-ray, no demostrable acid-fast bacilli in sputum specimens and required a diagnostic bronchoalveolar lavage (BAL) were enrolled. Of the 39 patients enrolled, 21 had microbiologically diagnosed tuberculosis. Thirteen of the 21 tuberculosis patients were either HIV seronegative (n = 12) or had no risk factor for HIV and constituted the tuberculosis group. For comparison, M. tuberculosis negative patients who had BAL samples taken during this time (n = 9) or normal healthy volunteers (n = 3) served as control group. Compared to the control group, the tuberculosis group had significantly higher proportion of cells expressing markers of young monocytes (UCHM1) and RFD7, a marker for phagocytic cells, and increased expression of HLA-DR, a marker of cell activation. In addition, tuberculosis group had significantly higher proportion of cells expressing dendritic cell marker (RFD1) and epithelioid cell marker (RFD9). These data suggest that despite recruitment of monocytes probably from the peripheral blood and local cell activation, host defense of the resident lung cells is insufficient to control M. tuberculosis.

Notes on the Phlebotomine Sand Flies from the Peruvian Southeast: I. Description of Lutzomyia (Helcocyrtomyia) adamsi n. sp. (Diptera: Psychodidae)

A new species of phlebotomine sand fly, Lutzomyia adamsi n. sp., is described and illustrated from specimens collected during August 1994, in Sandia, Department of Puno-Peru. According to the Oficina Nacional de Evaluacion de Recursos Naturales(ONERN 1976), this locality is situated in the life zone known as humid, mountain, low tropical forest (bh-MBT). Many areas in the northern part of Puno, mainly in the Inambari and Tambopata basins, are endemic to leishmaniasis. These areas are the continuation of others, largely known as "leishmaniasic" in the departments of Cusco and Madre de Dios. The morphological characteristics indicated that this species belongs to the genus Lutzomyia, subgenus Helcocyrtomyia Barretto, 1962

Biomass and nutrient cycling in pure and mixed stands of native tree species in southeastern Bahia, Brazil

The objective of this paper is to study selected components of the nutrient cycle of pure and mixed stands of native forest species of Atlantic Forest in southeastern Brazil. Tree diameter, height, above-ground biomass, and nutrient content were determined in 22-year-old stands. Litterfall, litter decomposition, and nutrient concentration were evaluated from August 1994 to July 1995. The following species were studied: Peltogyne angustiflora, Centrolobium robustum, Arapatiella psilophylla, Sclerolobium chrysophyllum, Cordia trichotoma, Macrolobium latifolium. The litter of a natural forest and a 40-year-old naturally regenerated second-growth forest was sampled as well. The mixed-species outmatched pure stands in height, stem volume and total biomass (29.4 % more). The greatest amount of forest litter was observed in the natural forest (9.3 Mg ha-1), followed by the mixed-species stand (7.6 Mg ha-1) and secondary forest (7.3 Mg ha-1), and least litterfall was measured in the pure C. robustum stand (5.5 Mg ha-1). Litterfall seasonality varied among species in pure stands (CV from 44.7 to 91.4 %), unlike litterfall in the mixed-tree stand, where the variation was lower (CV 31.2 %). In the natural and second-growth forest, litterfall varied by 57.8 and 34.0 %, respectively. The annual rate of nutrient return via litterfall varied widely among forest ecosystems. Differences were detected between forest ecosystems in both the litter accumulation and quantity of litterlayer nutrients. The highest mean nutrient accumulation in above-ground biomass was observed in mixed-species stands. The total nutrient accumulation (N + P + K+ Ca + Mg) ranged from 0.97 to 1.93 kg tree-1 in pure stands, and from 1.21 to 2.63 kg tree-1 in mixed-species stands. Soil fertility under mixed-species stands (0-10 cm) was intermediate between the primary forest and pure-stand systems. The litterfall rate of native forest species in a mixed-species system is more constant, resulting in a more continuous decomposition rate. Consequently, both nutrient availability and quantity of organic matter in the soil are higher and the production system ecologically more sustainable.

A dinâmica do mercado de açaí fruto no Estado do Pará: de 1994 a 2009

O objetivo deste trabalho foi analisar a dinâmica do mercado de açaí fruto no Estado do Pará, no período de 1994 a 2009, mediante a estimação simultânea da demanda e da oferta, pelo Método de Momentos Generalizados (MMG). Os resultados mostraram que a demanda e a oferta são inelásticas a preço. A elasticidade cruzada indicou que as outras frutas comercializadas no mercado paraense são substitutas do açaí. A elasticidade renda, com valor igual a 2,36, revelou que o açaí está enquadrado na categoria de bens de luxo. A elasticidade custo mostrou que o salário rural é fator de forte influência na redução da oferta do açaí, porque o sistema de produção é fortemente dependente de mão de obra. Por fim, a elasticidade de ajustamento mostrou que a produção de açaí de um ano exerce significativa influência no ajuste da oferta da safra do ano seguinte.

O sistema postal brasileiro em transformação: propostas e mudanças na regulação do mercado e na reestruturação do modelo organizacional da Empresa Brasileira de Correios e Telégrafos (1994-2011)

Objetiva-se neste artigo responder a seguinte questão: quais foram as propostas e as mudanças nos mecanismos de regulação do mercado postal brasileiro e na estrutura organizacional da Empresa Brasileira de Correios e Telégrafos (ECT) entre 1994 e 2011? Verifica-se que, entre 1994 e 2002, a proposta do governo federal, apresentada em 1999 por meio da "Nova Lei postal", previa a criação do Sistema Nacional de Correios, liberalizando o mercado postal, criando um órgão regulador e transformando a ECT em uma empresa de economia mista. Apesar da não aprovação do projeto de lei, algumas de suas propostas foram retomadas, a partir de 2008, pelos diagnósticos e propostas do governo Lula para reestruturar o setor postal brasileiro. As propostas subsidiaram a aprovação da Lei nº 12.490 de 2011, que internacionalizou a ECT, ampliou os segmentos de mercado da empresa e a reestruturou com base no modelo das sociedades anônimas.

O impacto da desvinculação de receitas nos gastos com educação da União: uma análise entre os anos de 1994 a 2012

A criação do Fundo Social de Emergência, em 1994, introduziu uma série de mecanismos utilizados pelo governo federal brasileiro para desvincular receitas de impostos e contribuições. Considerando essa situação, procurou-se identificar o possível impacto da desvinculação de receitas, em relação aos gastos com educação da União, realizados durante os anos de 1994 a 2012. Além da apuração do gasto realizado pelo governo federal com educação, foram computados os limites mínimos de gastos, considerando, em uma série, a redação original da Constituição Federal de 1988 e, na outra, a redação modificada pela inserção/alteração dos mecanismos de desvinculação. De acordo com as análises realizadas, não há indícios de que a desvinculação tenha afetado os gastos com educação, que foram superiores aos limites, em média e nos anos analisados.

Physiological age in Lutzomyia youngi (Diptera: Psychodidae) populations from an endemic area for cutaneous leishmaniasis, Venezuela

Batches of sylvatic females of Lutzomyia youngi (Phlebotominae) captured in a Shannon trap on twelve occasions over one year in a locality where subcutaneous leishmaniasis is endemic, near the city of Trujillo, Venezuela, were used to study: 1) the percentages of parous females according to previously established criteria and 2) the average number of eggs laid spontaneously by isolated females during 7 days after feeding on hamsters. The data on the batches of females captured on nights previous to the rainy period (prepluvial) were compared with those on females captured after the rains (postpluvial) . Significant differences were detected by variation analysis for two variables and different number of N, as also were consistent groupings by Duncan's Test for pre-and postpluvial lots of females. The females captured on nights prior to the rainy periods (January-March and August-September) presented higher rates of nulliparity (86-72%) and contained or laid a greater number of eggs (71-67) than those captured after the rains (March-June and November-December) which presented lower rates of nulliparity (60-24%) and a smaller number of eggs (50-30). The rainfall peaks occurred in April and September-October, respectively. It is considered that these differences can be used by epidemiological studies as a means of estimating the physiological age of female populations of L. youngy.

Prevalência de cárie e necessidades de tratamento em escolares de seis a doze anos de idade, Goiânia, GO, Brasil, 1994

OBJETIVO: Investigou-se a prevalência de cárie e necessidades de tratamento em escolares de Goiânia-GO, Brasil, que possui água fluoretada há 9 anos. METODOLOGIA: A amostra foi constituída de 1.400 escolares de 6 a 12 anos de idade que freqüentavam escolas públicas na zona urbana do município estudado. RESULTADOS: Os índices CPO-D e ceo-d encontrados no total da amostra foram 2,19 e 2,86, respectivamente, demonstrando uma redução de 57,1% em relação ao CPO-D verificado na região Centro-Oeste, em 1986. Para os escolares de 12 anos de idade, o CPO-D encontrado foi 4,59, estando acima da meta estabelecida para o ano 2.000 pela FDI/OMS. Verificou-se que a percentagem de escolares livres de cárie foi muito baixa em todas as idades, apresentando-se em torno de 11% para o total da amostra. Houve predomínio do tratamento restaurador na dentição decídua em todas as idades e na permanente a partir dos 9 anos de idade. CONCLUSÃO: A prevalência de cárie em escolares de Goiânia-GO é alta e comparável à situação verificada na maioria dos países da América Latina e nas regiões menos favorecidas de países desenvolvidos. Há necessidade de se implantar medidas educativas e preventivas em saúde bucal que intervenham nos reais determinantes da doença na população.

Caracterização epidemiológica da doença meningocócica na área metropolitana do Rio de Janeiro, Brasil, 1976 a 1994

INTRODUÇÃO: A doença meningocócica (DM) continua merecendo avaliações quanto a sua multicausalidade endêmica e epidêmica e seu comportamento evolutivo, nos diferentes locais. MATERIAL E MÉTODOS: Partindo da padronização da investigação epidemiológica da DM no Município do Rio de Janeiro a partir da epidemia da década de 70, foram analisados 4.155 casos notificados de 1976 a 1994, através de estudo retrospectivo, descritivo e analítico, com base nas fichas de investigação epidemiológica da Secretaria Municipal de Saúde. Os testes utilizados para análise estatística foram: o chi², o de Wilcoxon-Mann-Whitney e de Kruskal-Wallis. RESULTADOS: O estudo resultou na definição de três períodos, classificados como pós-epidêmico (1976/79), endêmico (1980/86) e epidêmico (1987/94), diferenciados pelas taxas de incidência e pelo sorogrupo do meningococo predominante. As taxas de incidência médias por período no município foram, respectivamente, de 3,51; 1,67 e 6,53 casos/100.000 habitantes. Os sorogrupos A e C predominaram no período pós-epidêmico, o B e o A no endêmico e o B no epidêmico. A letalidade média praticamente não se modificou no decorrer do tempo, mas variou segundo o hospital de internação, tendo sido sempre menor no hospital estadual de referência em relação aos demais públicos e privados. CONCLUSÃO: As maiores taxas de incidência e letalidade corresponderam aos menores de um ano e o risco de adoecer foi maior no sexo masculino. Os maiores coeficientes de incidência tenderam a ocorrer nas mesmas áreas do município, nos três períodos epidemiológicos, e a população que reside em favelas teve um risco de adoecimento duas vezes maior.