893 resultados para Epidemic Polyarthritis


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Pós-graduação em Enfermagem - FMB

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

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Introduction: The discrimination experienced by people with HIV / AIDS, not only by society but also by health professionals is one of the major problems observed relative the epidemic. Objective: To verify and to analyze the occurrence of discriminatory attitudes in the assistance to the health of people living with HIV/AIDS. Methods: It was a quantitative research was carried out with the participation of sixty-eight HIV-positive individuals from four Brazilian cities. The participants answered auto-administrate questionnaires that contained open and closed questions including the considered subject. Results: 41.2% of the total participants, HIV + people, said they had been discriminated against by health professionals. Among the discriminatory situations experienced by HIV patients, 34.2% nursing professionals were involved, in 34.2% dentists and in 31.6% doctors were involved. Those who have suffered discrimination, 78.6% said they had been discriminated against in public health service. Conclusion: The occurrence of discrimination in the assistance to the health of HIV-positive patients was high. The majority of discrimination situations occurred in the public health service. It is necessary the institution of strategies aiming at human attendance to these patients.

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The aim of this study was to evaluate the occlusal condition of 12 year-old children examined by the Oral Health Brazil 2003 Project in Cáceres city. The sample consisted of 170 children, boys and girls, selected at random among 20 schools that took part in this project. It was used for the analysis of the occlusal condition the Dental Aesthetic Index (DAI), as manual of basic epidemic rising in Oral Health extolled by the World Health Organization which describes the occlusal conditions in relation to dentition, space and occlusion of the permanent dentition. It was observed that the prevalence of the normal occlusion and of the malocclusion were, respectively, 21.18% and 78.82%. This last one was present due to the tooth crowding (74.93%), spacing in the incisor segment (23.88%), diastema (17.17%), anterior maxillary misalignment (58.95%) and anterior mandibular (61.19%), excessive overjet (11.94%), negative overjet (4.47%), open bite (1.5%) and molar relationship Class II or III (26.87%). It was concluded that the studied sample presents a high index of factors to compose the malocclusion.

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Obesity is characterized by an excess of fat on the body and can results several problems on the individual health. As an epidemic of modern times, the prevalence started to increase at an accelerated rate from the 90's in worldwide. Data on the epidemic in Brazil and medium-sized cities are scarce, and the monitoring of obesity is essential for development public policy. So, the objective was to analyze the individual factors associated with obesity such as age, gender, education, marital status, economic class and level of physical activity and make a monitoring of obesity in adults in the city of Rio Claro - SP. To do this, the survey was conducted longitudinally, consists of two times at an interval of seven years. At first (2008) were interviewed 1588 adults in the city of Rio Claro distributed throughout the city. At the second phase (2014/2015) was conducted a new interview with the same subject in 1588. In 2008, personal information collected and applied some questionnaires with the physical activity level, food intake and quality of life. To assess obesity in adults was calculated the body mass index (BMI) proposed by the World Health Organization (WHO) from the high reported weight and height. For older people it used a specific BMI. The prevalence was used percentages and their respective confidence intervals of 95%. For the incidence, was calculated by the formula of cumulative incidence, both stratified by personal characteristics (gender, economic class, education, marital status and age). Thus it was observed that there was an increase in the prevalence of obesity in 2008 (19.0%), increasing to 26.7% in 2015. The cumulative incidence was 14.4% in the range of 7 years. As for the groups, we observed a significant difference between economic class and obesity being less prevalent among people of class D / E. Regarding marital status, it was observed that married / cohabiting have a higher prevalence. Therefore, we can conclude...

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Pós-graduação em Enfermagem (mestrado profissional) - FMB

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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Tuberculosis, caused by Mycobacterium bovis, was first diagnosed in African buffalo in South Africa’s Kruger National Park in 1990. Over the past 15 years the disease has spread northwards leaving only the most northern buffalo herds unaffected. Evidence suggests that 10 other small and large mammalian species, including large predators, are spillover hosts. Wildlife tuberculosis has also been diagnosed in several adjacent private game reserves and in the Hluhluwe-iMfolozi Park, the third largest game reserve in South Africa. The tuberculosis epidemic has a number of implications, for which the full effect of some might only be seen in the long-term. Potential negative long-term effects on the population dynamics of certain social animal species and the direct threat for the survival of endangered species pose particular problems for wildlife conservationists. On the other hand, the risk of spillover infection to neighboring communal cattle raises concerns about human health at the wildlife–livestock–human interface, not only along the western boundary of Kruger National Park, but also with regards to the joint development of the Greater Limpopo Transfrontier Conservation Area with Zimbabwe and Mozambique. From an economic point of view, wildlife tuberculosis has resulted in national and international trade restrictions for affected species. The lack of diagnostic tools for most species and the absence of an effective vaccine make it currently impossible to contain and control this disease within an infected free-ranging ecosystem. Veterinary researchers and policy-makers have recognized the need to intensify research on this disease and the need to develop tools for control, initially targeting buffalo and lion.

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A 4.5 yr-old male white-tailed deer (Odocoileus virginianus) killed by a hunter during the 1994 firearm hunting season in northeastern Michigan (USA) had lesions suggestive of tuberculosis and was positive on culture for Mycobacterium bovis the causative agent for bovine tuberculosis. Subsequently, a survey of 354 hunter-harvested white-tailed deer for tuberculosis was conducted in this area from 15 November 1995 through 5 January 1996. Heads and/or lungs from deer were examined grossly and microscopically for lesions suggestive of bovine tuberculosis. Gross lesions suggestive of tuberculosis were seen in 15 deer. Tissues from 16 deer had acid-fast bacilli on histological examination and in 12 cases mycobacterial isolates from lymph nodes and/or lungs were identified as M. bovis. In addition, lymph nodes from 12 deer (11 females and 1 male) without gross or microscopic lesions were pooled into 1 sample from which M. bovis was cultured. Although more male (9) than female (3) deer had bovine tuberculosis infections, this difference was not statistically significant. Mycobacterium bovis culture positive deer ranged in age from 1.5 to 5.5 yr with a mean of 2.7 yr (median 2.5 yr) for males and 3.2 yr (median 3.5 yr) for females. This appears to be the first epidemic occurrence of M. bovis in free-ranging cervids in North America. A combination of environmental (high deer density and poor quality habit) and management-related factors (extensive supplemental feeding) may be responsible for this epizootic.

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Large winter roosts of blackbirds (Icteridae) and starlings (Sturnus vulgaris) often cause conflicts, both real and imagined, between the birds and local human popula- tions. These conflicts may range from objections to the noise and odor engendered by thousands or millions of birds, to fear of epidemic human and livestock diseases, and the possibility of economic losses from crop depredations. Many people believe the most direct way to combat these conflicts is to reduce local roosting populations by kill- ing the birds. In response to this perceived need for a roost toxicant, the U.S. Fish and Wildlife Service (FWS) developed PA-14, a surfactant which can be aerially applied to problem roosts for population reduction (Lefebvre and Seubert 1970). Successful use of this material, however, requires concurrent rainfall and low temperatures, conditions which may not occur sufficiently often to permit roost treatment at desired times or places. Because of this difficulty, and continued pressures from management person- nel and the agricultural community, the Service has continued its search for a safe, ef- fective roost toxicant usable without severe weather restrictions. One of the current candidate materials is N-(3-chloro-4-methylphenyl)acetamide (CAT, DRC-2698), a derivative of StarlicideR (DRC-1339). This compound was initially developed by S.A. Peoples of the University of California-Davis (Peoples et al. 1976). California researchers are still investigating the avicidal potential of CAT, mainly on baits and in wick perches, while FWS interest has centered thus far on its possible utility as an aerially applied roost treatment. This report is a summary of our investigations to date.

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BACKGROUND: Dengue is the most important arboviral disease in the world. Dengue viruses (DENVs) have produced huge outbreaks in Brazil in the past 25 years with more than 5 million reported cases. During these epidemics, asymptomatic individuals infected with DENV could donate blood and serve as a source of virus dissemination in the community. Here, we studied the circulation of DENV in healthy individuals during an epidemic outbreak. STUDY DESIGN AND METHODS: The study included 500 serum samples from healthy blood donors collected at the Hemotherapy Center of Ribeirao Preto, Brazil, during a dengue outbreak. The presence of DENV RNA in the serum samples was screened by real-time reverse transcriptionpolymerase chain reaction (PCR). The virus serotype was determined by a heminested PCR procedure. A partial fragment of the NS5 gene sequence was used for phylogenetic analysis. RESULTS: DENV RNA was detected in the serum sample of 2 of 500 (0.4%) individuals. Both of them were infected with DENV-3 Genotype III, a virus that has been circulating in Brazil in the past decade. CONCLUSION: Individuals with asymptomatic DENV infection can be blood donors and serve as a source of virus dissemination in the community. Further studies are needed to determine the risk of recipient infection by DENV as a result of transfusion in Brazil, especially during epidemic periods.

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The epidemic growth of dementia causes great concern for the society. It is customary to consider Alzheimer's disease (AD) as the most common cause of dementia, followed by vascular dementia (VaD). This dichotomous view of a neurodegenerative disease as opposed to brain damage caused by extrinsic factors led to separate lines of research in these two entities. Indeed, accumulated data suggest that the two disorders have additive effects and probably interact; however it is still unknown to what degree. Furthermore, epidemiological studies have shown "vascular" risk factors to be associated with AD. Therefore, a clear distinction between AD and VaD cannot be made in most cases, and is furthermore unhelpful. In the absence of efficacious treatment for the neurodegenerative process, special attention must be given to the vascular component, even in patients with presumed mixed pathology. Symptomatic treatment of VaD and AD is similar, although the former is less effective. For prevention of dementia it is important to treat all factors aggressively, even in stroke survivors who do not show evidence of cognitive decline. In this review, we will give a clinical and pathological picture of the processes leading to VaD and discuss its interaction with AD. (c) 2012 Elsevier B.V. All rights reserved.

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Background: Because various HIV vaccination studies are in progress, it is important to understand how often inter- and intra-subtype co/superinfection occurs in different HIV-infected high-risk groups. This knowledge would aid in the development of future prevention programs. In this cross-sectional study, we report the frequency of subtype B and F1 co-infection in a clinical group of 41 recently HIV-1 infected men who have sex with men (MSM) in Sao Paulo, Brazil. Methodology: Proviral HIV-1 DNA was isolated from subject's peripheral blood polymorphonuclear leukocytes that were obtained at the time of enrollment. Each subject was known to be infected with a subtype B virus as determined in a previous study. A small fragment of the integrase gene (nucleotide 4255-4478 of HXB2) was amplified by nested polymerase chain reaction (PCR) using subclade F1 specific primers. The PCR results were further confirmed by phylogenetic analysis. Viral load (VL) data were extrapolated from the medical records of each patient. Results: For the 41 samples from MSM who were recently infected with subtype B virus, it was possible to detect subclade F1 proviral DNA in five patients, which represents a co-infection rate of 12.2%. In subjects with dual infection, the median VL was 5.3 x 10(4) copies/ML, whereas in MSM that were infected with only subtype B virus the median VL was 3.8 x 10(4) copies/ML (p > 0.8). Conclusions: This study indicated that subtype B and F1 co-infection occurs frequently within the HIV-positive MSM population as suggested by large number of BF1 recombinant viruses reported in Brazil. This finding will help us track the epidemic and provide support for the development of immunization strategies against the HIV.

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The use of antiretroviral therapy has proven to be remarkably effective in controlling the progression of human immunodeficiency virus (HIV) infection and prolonging patient's survival. Therapy however may fail and therefore these benefits can be compromised by the emergence of HIV strains that are resistant to the therapy. In view of these facts, the question of finding the reason for which drug-resistant strains emerge during therapy has become a worldwide problem of great interest. This paper presents a deterministic HIV-1 model to examine the mechanisms underlying the emergence of drug-resistance during therapy. The aim of this study is to determine whether, and how fast, antiretroviral therapy may determine the emergence of drug resistance by calculating the basic reproductive numbers. The existence, feasibility and local stability of the equilibriums are also analyzed. By performing numerical simulations we show that Hopf bifurcation may occur. The model suggests that the individuals with drug-resistant infection may play an important role in the epidemic of HIV. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

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in 2009, during the influenza A (H1N1) epidemic, there were many reported cases of pulmonary infection with severe hypoxemia that was refractory to the ventilatory strategies and rescue therapies commonly used to treat patients with severe acute respiratory distress syndrome. Many of those cases were treated with extracorporeal membrane oxygenation (ECMO), which renewed international interest in the technique. The Extracorporeal Support Study Group was created in order to practice ECMO and to employ it in the treatment of patients with severe hypoxemia. In this article, we discuss the indications for using ECMO and report the case of a patient with refractory hypoxemia who was successfully treated with ECMO.