Hospitalization flow in the public and private systems in the state of Sao Paulo, Brazil

OBJECTIVE To describe the migration flows of demand for public and private hospital care among the health regions of the state of Sao Paulo, Brazil. METHODS Study based on a database of hospitalizations in the public and private systems of the state of Sao Paulo, Southeastern Brazil, in 2006. We analyzed data from 17 health regions of the state, considering people hospitalized in their own health region and those who migrated outwards (emigration) or came from other regions (immigration). The index of migration effectiveness of patients from both systems was estimated. The coverage (hospitalization coefficient) was analyzed in relation to the number of inpatient beds per population and the indexes of migration effectiveness. RESULTS The index of migration effectiveness applied to the hospital care demand flow allowed characterizing health regions with flow balance, with high emigration of public and private patients, and with high attraction of public and private patients. CONCLUSIONS There are differences in hospital care access and opportunities among health regions in the state of Sao Paulo, Brazil.

Vulnerabilities in snakebites in Sao Paulo, Brazil

ABSTRACT OBJECTIVE To describe elements of vulnerability of victims of snakebite. METHODS This qualitative, descriptive, cross-sectional study had, as theoretical framework, the concept of vulnerability in individual, social, and programmatic dimensions. We interviewed 21 patients admitted into a hospital specialized in the care of accidents caused by venomous animals. The interviews were analyzed according to a discourse analysis technique. RESULTS Patients were mainly young men, living in remote countryside areas, where health services frequently have limited resources. We found social and individual conditions of vulnerability, such as precarious schooling, low professional qualification, housing without access to piped water, no sewage treated, and no regular garbage collection, and lack of knowledge on this health problem. Regarding the programmatic dimension, we found limited accessibility to the health services that could affect the prognosis and the frequency of sequelae and deaths. CONCLUSIONS Considering such vulnerabilities evoke the need to improve the program for control the Accidents by Venomous Animals and the training of health workers, we highlight the potential use of the concept of vulnerability, which may amplify the understanding and the recommendations for the practice and education related to snakebites.

Determinants of the use of health care services: multilevel analysis in the Metropolitan Region of Sao Paulo

OBJECTIVE To evaluate the individual and contextual determinants of the use of health care services in the metropolitan region of Sao Paulo.METHODS Data from the Sao Paulo Megacity study – the Brazilian version of the World Mental Health Survey multicenter study – were used. A total of 3,588 adults living in 69 neighborhoods in the metropolitan region of Sao Paulo, SP, Southeastern Brazil, including 38 municipalities and 31 neighboring districts, were selected using multistratified sampling of the non-institutionalized population. Multilevel Bayesian logistic models were adjusted to identify the individual and contextual determinants of the use of health care services in the past 12 months and presence of a regular physician for routine care.RESULTS The contextual characteristics of the place of residence (income inequality, violence, and median income) showed no significant correlation (p > 0.05) with the use of health care services or with the presence of a regular physician for routine care. The only exception was the negative correlation between living in areas with high income inequality and presence of a regular physician (OR: 0.77; 95%CI 0.60;0.99) after controlling for individual characteristics. The study revealed a strong and consistent correlation between individual characteristics (mainly education and possession of health insurance), use of health care services, and presence of a regular physician. Presence of chronic and mental illnesses was strongly correlated with the use of health care services in the past year (regardless of the individual characteristics) but not with the presence of a regular physician.CONCLUSIONS Individual characteristics including higher education and possession of health insurance were important determinants of the use of health care services in the metropolitan area of Sao Paulo. A better understanding of these determinants is essential for the development of public policies that promote equitable use of health care services.

Finding Aedes aegypti in a natural breeding site in an urban zone, Sao Paulo, Southeastern Brazil

ABSTRACT This is the description of how nine Aedes aegypti larvae were found in a natural breeding site in the Pinheiros neighborhood, city of Sao Paulo, SP, Southeastern Brazil. The record was conducted in December 2014, during an entomological surveillance program of dengue virus vectors, with an active search of potential breeding sites, either artificial or natural. Finding Ae. aegypti larvae in a tree hole shows this species’ ability to use both artificial and natural environments as breeding sites and habitats, which points towards the importance of maintaining continuous surveillance on this mosquito in all kinds of water-holding containers.

Occurrence of campylobacter jejuni in diarrhoeic and non-diarrhoeic children in Sao Paulo, Brazil

Campylobacter jejuni was looked for in the feaces of 262 children, beeing 189 with acute diarrhoea, 31 with chronic diarrhoea and 42 controls. The organism was isolated from 14 (7.4%), 2 (6.5%) and 6 (14.3%) of the children, and each group, respectively.

SEROPREVALENCE OF CHAGASIC INFECTION IN YOUNG INDIVIDUALS IN A BLOOD CENTER IN THE STATE OF SAO PAULO, BRAZIL

SUMMARY This study aimed at estimating the number of cases of non-negative serological reactions to Chagas disease in blood donors at the Blood Center of Botucatu, São Paulo, Brazil, from 2003 to 2010 and at relating them to their cities of origin. Five hundred and seventy-four non-negative results for Chagas disease were evaluated. Of these, 371 (64.8%) were reagent, and 203 (35.4%) were inconclusive. The prevalence of Chagas disease in blood donors was 0.05%. There were, on average, 72 cases/year, and a prevalence of males was observed (64.8%). Forty-three (7.49%) individuals were 18 to 30 years old; 92 (16.02%) were 31 to 40; 147 (25.61%) 41 to 50, and 292 (50.87%) were older than 50 years. It was observed that 29.3% of females with reagent serology were at their fertile age (18 and 45 years). The majority of donors were originally from cities in the southwestern and central regions of São Paulo, but individuals from other states contributed with 20%. The provenance of most donors was the city of Botucatu/SP, followed by the city of Taquarituba/SP. Therefore, the profile of donors at this blood center favors the occurrence of a larger number of non-negative serological reactions. Although there has been a significant reduction in the number of new cases/year for this disease, it is still a public-health problem, and results suggest the need for new epidemiological assessments in the studied region.

Spontaneous reporting of adverse events following pandemic influenza A (H1N1) immunization in a reference center in the State of Sao Paulo, Brazil

Introduction This paper describes adverse events (AEs) temporally associated to the pandemic influenza A (H1N1) vaccine observed in a reference center in São Paulo, Brazil, during a 2010 mass vaccination campaign. Methods A retrospective study involving persons who sought medical care for AEs following influenza vaccination. Data were retrieved from medical records, vaccine AE notification forms, and a computerized system for immunobiological registration. Results Sixty-six vaccinees sought medical care for AEs after immunization. The most frequent AEs were fever, headache, myalgia, and pain at the injection site. No serious AEs were reported. Conclusions Few vaccinees spontaneously reported AEs to influenza A (H1N1) vaccine at this center.

Leishmania infections in Lutzomyia longipalpis (Diptera: Psychodidae) on the Island of Sao Luis, Maranhao State, Brazil

Dissection of Lutzomyia longipalpis, captured in the São Luis focus of visceral Leishmaniasis revealed a 1.8% promastigote infection rate.

The Harsh Fight against Poverty in Sao Tome and Principe

post-independence, and on the other hand, the testimonies from Sao Tomeans individuals from different social conditions and different degrees of political responsibility, this article approaches some possible connections between poverty and micro-violence in Sao Tome and Principe. It is offered an outline of research for the difficulties of the eradication of poverty and, concomitantly, the diffusion of a growing feeling of social disruption, processes in all contrary to the promises of independence for this archipelago. Frequently, the archipelago’s visitors make hasty opinions about the imaginary effortlessness of governing two islands with less than one hundred and fifty thousand citizens. However, contrary to this very common prejudice, the micro-insularity is considered an obstacle to development, a notion shared by many Sao Tomeans. Could micro-insularity equally be, under this outlook, an impoverishment-inducing factor? Regarding the development, there is some truth in this diagnosis, which the Sao Tomeans also use to justify their current difficulties. Throughout the 70s and 80s, the MLSTP – Movimento de Libertação de São Tomé e Príncipe (Movement for the Liberation of Sao Tome and Principe) endorsed a development founded on an expansion of cacao cultures, at the expenses of an intensified production rate, and on an incipient industrialization, which was intended to avoid importations and economic dependency. At the time, the Sao Tomeans leaders justified the rising daily difficulties, quite the opposite of the promises made during the independence, with an economic disarticulation resulting from the gradual abandonment of economic infrastructures inflicted by the last batch of colonists, which affected the cacao plantations too. Simultaneously, both the inefficiency and cost of the industrial endeavors launched after the independence and the erosion of labor and social relationships in nationalized farms had been rather neglected.

Agronomic and molecular traits of the 'Italia Muscat' clone in Sao Francisco River Valley

The objective of this study was to evaluate agronomic and molecular traits of the 'Italia Muscat' clone and compare it with the cv. 'Italia', providing information to support the cultivation of 'Italia Muscat' this cultivar in the São Francisco River Valley. Agronomic characteristics of both clones were evaluated for two seasons in 2004. The characteristics were phenology, bud break (%), bud fertility (%), yield (kg) mass of bunches (g), length and width of bunches (cm), mass of berries (g), length and diameter of berries (mm), TSS (ºBrix), ATT (% titratable acidity) and TSS/TTA. Molecular analysis of seven SSR markers were carried out. The clone 'Italia Muscat' showed larger berries, mass of bunches and better TSS/TA ratio than 'Italia'. The molecular analysis resulted in the same allelic profile in both clones, highlighting the need to use a larger number of microsatellite markers or other molecular technique to allow their discrimination. Based on their morpho-agronomic characteristics, 'Italia Muscat' seems to be a good table grape cultivar alternative for grape growers of São Francisco River Valley.

Occurrence of Helicoverpa armigera (Hübner, 1808) on citrus in the state of Sao Paulo, Brazil

The occurrence of Helicoverpa armigera (Hübner, 1808) was first reported in citrus orchard in the state of São Paulo (SP). High infestation levels of H. armigera were observed in October 2012, in the city of Botucatu, SP. The larvae was fed of all parts of the plants. The injuries on the leaves caused drastic reduction in the leaf area and the fruits attack occurred from an early stage of development to the ripe fruit. Thus, the first occurrence of H. armigera in this citrus culture adds to the list of hosts of this pest, and is of great importance, because it confirms H. armigera potential dispersion and polyphagia.

Moradia e segregaÇao na cidade de Sao Paulo

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