Produção científica publicada nos Anais Brasileiros de Dermatologia (2003-2007)

BACKGROUND - The scientific production of dermatology is not very known and studied in quantitative and qualitative aspects in Brazil.OBJECTIVE - To study the characteristics of the Brazilian scientific production published on the Anais Brasileiros de Dermatologia from 2003 to 2007.METHODS - A transversal study of articles published on the clinical, epidemiological, laboratory and therapeutic investigation, - case report and 'communication sections of the Anais Brasileiros de Dermatologia, from 2003 to 2007, were reviewed. The variables studied were: the dermatological subspecialty focused, methodological analysis used; diseases or disorders investigated and the understanding of authors related to the communication section.RESULTS - Among investigational manuscripts, clinical studies prevailed (60.3%), those with surgical or cosmetic interest accounted for 13%. Descriptive and observational studies were the most common (81.9%), particularly the case series (50%). Infectious (33.6%) and inflammatory disease (28.6%.) was the subject of investigation or case report, respectively, Case report was the most common subject on the communication section.CONCLUSION - Descriptive methods were predominant among the research articles published in the studied period. More sophisticated and elaborated methods were uncommon. Research designs and critical analysis of the scientific literature must be part of the curriculum of the graduate and residency programs in dermatology.

Preliminary Overview of the Economies of Latin America and the Caribbean 2008

Includes bibliography

Evolução do estado nutricional de escolares de 1ª a 4ª série da rede pública de Piracicaba/SP no período de 2003 a 2006

Pós-graduação em Alimentos e Nutrição - FCFAR

Meningococcal disease in the Sorocaba region, Sao Paulo State, Brazil, 1999-2008

The objective of this study was to describe the occurrence of meningococcal disease reported to the Regional Health Department in Sorocaba, Sao Paulo State, Brazil, from 1999 to 2008. Annual incidence of the disease was two cases per 100,000 inhabitants, with an increase from 2006 to 2008. Annual incidence rates were highest in the 0 to 4 year age bracket. Case-fatality was 21.8%, higher in the 0 to 4 year age bracket (26.4%), which also showed the highest incidence of the disease, and in the over 30-year age bracket (28%). Diagnosis was confirmed by laboratory test in 71% of cases (culture in 45.3%) and by clinical and epidemiological criteria in 22%. Serological groups were B in 45.7%, C in 47.3%, W135 in 3.7%, and Y in 1.5% of the identified cases, with a predominance of B from 1999 to 2003 and C from 2004 to 2008. The most frequent phenotypes were B:4, 7:P1.19,15 and C:23:P1.14-6. The results emphasize the need for regional surveillance of trends in the disease for early detection of outbreaks and monitoring circulating strains.

Classification and regression tree (CART) model to predict pulmonary tuberculosis in hospitalized patients

Background: Tuberculosis (TB) remains a public health issue worldwide. The lack of specific clinical symptoms to diagnose TB makes the correct decision to admit patients to respiratory isolation a difficult task for the clinician. Isolation of patients without the disease is common and increases health costs. Decision models for the diagnosis of TB in patients attending hospitals can increase the quality of care and decrease costs, without the risk of hospital transmission. We present a predictive model for predicting pulmonary TB in hospitalized patients in a high prevalence area in order to contribute to a more rational use of isolation rooms without increasing the risk of transmission. Methods: Cross sectional study of patients admitted to CFFH from March 2003 to December 2004. A classification and regression tree (CART) model was generated and validated. The area under the ROC curve (AUC), sensitivity, specificity, positive and negative predictive values were used to evaluate the performance of model. Validation of the model was performed with a different sample of patients admitted to the same hospital from January to December 2005. Results: We studied 290 patients admitted with clinical suspicion of TB. Diagnosis was confirmed in 26.5% of them. Pulmonary TB was present in 83.7% of the patients with TB (62.3% with positive sputum smear) and HIV/AIDS was present in 56.9% of patients. The validated CART model showed sensitivity, specificity, positive predictive value and negative predictive value of 60.00%, 76.16%, 33.33%, and 90.55%, respectively. The AUC was 79.70%. Conclusions: The CART model developed for these hospitalized patients with clinical suspicion of TB had fair to good predictive performance for pulmonary TB. The most important variable for prediction of TB diagnosis was chest radiograph results. Prospective validation is still necessary, but our model offer an alternative for decision making in whether to isolate patients with clinical suspicion of TB in tertiary health facilities in countries with limited resources.

Antibiotic susceptibility and resistance among bacterial enteropathogens isolated from international travelers to Mexico, Guatemala, and India, 2006--2008

The incidence rates of travelers' diarrhea (TD) have remained unchanged for the last fifty years. More recently, there have been increasing recommendations for self-initiated therapy and even prophylactic therapy for TD. There is no recent data on the in vitro activities of commonly used antibiotics for TD therapy and whether there have been any changes in susceptibilities over the last ten years. 456 enteropathogens were isolated from adult travelers to Mexico, India, and Guatemala between the years 2006 to 2008. MICs were determined for 10 different antimicrobials by the agar dilution method. Traditional antibiotics such as ampicillin, trimethoprim/sulfamethoxazole, and doxycycline continue to show high levels of resistance. Current first line antibiotic agents including fluoroquinolones and azithromycin had significantly higher MICs when compared to 10 years ago and MIC90 levels were beyond the CSLI cutoffs for resistance. There were significant geographical differences in resistance patterns when comparing Central America with India. Entertoxigenic Escherichia coli (ETEC) isolates were more resistant to ciprofloxacin (p=0.023), and levofloxacin (p=0.0078) in India; whereas, enteroaggregative Escherichia coli (EAEC) isolates from Central America showed more resistance. When compared to MICs of isolates 10 years prior, there was a four to ten-fold increase in MIC90s for ceftriaxone, ciprofloxacin, levofloxacin and azithromycin for both ETEC and EAEC. There were no significant changes in rifaximin MICs over the last ten years, which makes it a promising agent for TD. Rising MICs over time implicate the need for continuous surveillance of susceptibility patterns worldwide and for geography specific recommendations in TD therapy.^

Burden of invasive pneumococcal disease in Harris County, Texas (2003--2010) and the implication for enhanced public health surveillance of isolates

Invasive pneumococcal disease (IPD) causes significant health burden in the US, is responsible for the majority of bacterial meningitis, and causes more deaths than any other vaccine preventable bacterial disease in the US. The estimated National IPD rate is 14.3 cases per 100,000 population with a case-fatality rate of 1.5 cases per 100,000 population. Although cases of IPD are routinely reported to the local health department in Harris County Texas, the incidence (IR) and case-fatality (CFR) rates have not been reported. Additionally, it is important to know which serotypes of S. pneumoniae are circulating in Harris County Texas and to determine if ‘replacement disease’ is occurring. ^ This study reported incidence and case-fatality rates from 2003 to 2009, and described the trends in IPD, including the IPD serotypes circulating in Harris County Texas during the study period, particularly in 2008 and 2010. Annual incidence rates were calculated and reported for 2003 to 2009, using complete surveillance-year data. ^ Geographic information system (GIS) software was used to create a series of maps of the data reported during the study period. Cluster and outlier analysis and hot spot analysis were conducted using both case counts by census tract and disease rate by census tract. ^ IPD age- and race-adjusted IR for Harris County Texas and their 95% confidence intervals (CIs) were 1.40 (95% CI 1.0, 1.8), 1.71 (95% CI 1.24, 2.17), 3.13 (95% CI 2.48, 3.78), 3.08 (95% CI 2.43, 3.74), 5.61 (95% CI 4.79, 6.43), 8.11 (95% CI 7.11, 9.1), and 7.65 (95% CI 6.69, 8.61) for the years 2003 to 2009, respectively (rates were age- and race-adjusted to each year's midyear US population estimates). A Poisson regression model demonstrated a statistically significant increasing trend of about 32 percent per year in the IPD rates over the course of the study period. IPD age- and race-adjusted case-fatality rates (CFR) for Harris County Texas were also calculated and reported. A Poisson regression model demonstrated a statistically significant increasing trend of about 26 percent per year in the IPD case-fatality rates from 2003 through 2009. A logistic regression model associated the risk of dying from IPD to alcohol abuse (OR 4.69, 95% CI 2.57, 8.56) and to meningitis (OR 2.42, 95% CI 1.46, 4.03). ^ The prevalence of non-vaccine serotypes (NVT) among IPD cases with serotyped isolates was 98.2 percent. In 2008, the year with the sample more geographically representative of all areas of Harris County Texas, the prevalence was 96 percent. Given these findings, it is reasonable to conclude that ‘replacement disease’ is occurring in Harris County Texas, meaning that, the majority of IPD is caused by serotypes not included in the PCV7 vaccine. Also in conclusion, IPD rates increased during the study period in Harris County Texas.^

Participación económica, perfiles ocupacionales y condiciones de trabajo de los jóvenes del Gran La Plata en el período 2003-2006

Este trabajo se propone hacer un aporte al estudio de la situación laboral de los jóvenes en un aglomerado argentino en particular, el Gran La Plata, conformado por los partidos de La Plata 'capital de la Provincia de Buenos aires', Berisso y Ensenada. Se trata de un aglomerado urbano que, en líneas generales, ha atravesado por procesos similares a los constatados a nivel nacional en el mercado de trabajo, así como en relación con la evolución de los indicadores de pobreza e indigencia. Distintos estudios han aportado a una caracterización completa del mercado de trabajo local desde principios de los años noventa, pero no se han realizado investigaciones específicas sobre la problemática laboral juvenil en el aglomerado. El período seleccionado para realizar este estudio comprende los años 2003 a 2006, momento en el cual se produjo un crecimiento constante de la economía nacional en el que se visualizaron mejoras generales en los niveles de empleo y bajas en los niveles de pobreza e indigencia. Al tiempo que cabe tener en cuenta que estas mejoras 'si bien importantes' no representan una recuperación de los niveles previos a la década del noventa, es preciso destacar, como remarcan algunos autores, que los incrementos en el empleo y las disminuciones en las tasas de desocupación y subocupación no implican que se hayan revertido problemas estructurales como la segmentación y precarización laboral, con sus efectos sobre las condiciones de vida de los trabajadores. esto hace particularmente interesante el estudio de la situación de los jóvenes, dadas las especificidades como grupo que adquieren en el mercado de trabajo. Se utilizan los datos pertenecientes a la encuesta Permanente de Hogares del Indec disponibles de la versión continua (2003-2006), considerando el segundo semestre de cada año

Participación económica, perfiles ocupacionales y condiciones de trabajo de los jóvenes del Gran La Plata en el período 2003-2006

Este trabajo se propone hacer un aporte al estudio de la situación laboral de los jóvenes en un aglomerado argentino en particular, el Gran La Plata, conformado por los partidos de La Plata 'capital de la Provincia de Buenos aires', Berisso y Ensenada. Se trata de un aglomerado urbano que, en líneas generales, ha atravesado por procesos similares a los constatados a nivel nacional en el mercado de trabajo, así como en relación con la evolución de los indicadores de pobreza e indigencia. Distintos estudios han aportado a una caracterización completa del mercado de trabajo local desde principios de los años noventa, pero no se han realizado investigaciones específicas sobre la problemática laboral juvenil en el aglomerado. El período seleccionado para realizar este estudio comprende los años 2003 a 2006, momento en el cual se produjo un crecimiento constante de la economía nacional en el que se visualizaron mejoras generales en los niveles de empleo y bajas en los niveles de pobreza e indigencia. Al tiempo que cabe tener en cuenta que estas mejoras 'si bien importantes' no representan una recuperación de los niveles previos a la década del noventa, es preciso destacar, como remarcan algunos autores, que los incrementos en el empleo y las disminuciones en las tasas de desocupación y subocupación no implican que se hayan revertido problemas estructurales como la segmentación y precarización laboral, con sus efectos sobre las condiciones de vida de los trabajadores. esto hace particularmente interesante el estudio de la situación de los jóvenes, dadas las especificidades como grupo que adquieren en el mercado de trabajo. Se utilizan los datos pertenecientes a la encuesta Permanente de Hogares del Indec disponibles de la versión continua (2003-2006), considerando el segundo semestre de cada año

Participación económica, perfiles ocupacionales y condiciones de trabajo de los jóvenes del Gran La Plata en el período 2003-2006

Este trabajo se propone hacer un aporte al estudio de la situación laboral de los jóvenes en un aglomerado argentino en particular, el Gran La Plata, conformado por los partidos de La Plata 'capital de la Provincia de Buenos aires', Berisso y Ensenada. Se trata de un aglomerado urbano que, en líneas generales, ha atravesado por procesos similares a los constatados a nivel nacional en el mercado de trabajo, así como en relación con la evolución de los indicadores de pobreza e indigencia. Distintos estudios han aportado a una caracterización completa del mercado de trabajo local desde principios de los años noventa, pero no se han realizado investigaciones específicas sobre la problemática laboral juvenil en el aglomerado. El período seleccionado para realizar este estudio comprende los años 2003 a 2006, momento en el cual se produjo un crecimiento constante de la economía nacional en el que se visualizaron mejoras generales en los niveles de empleo y bajas en los niveles de pobreza e indigencia. Al tiempo que cabe tener en cuenta que estas mejoras 'si bien importantes' no representan una recuperación de los niveles previos a la década del noventa, es preciso destacar, como remarcan algunos autores, que los incrementos en el empleo y las disminuciones en las tasas de desocupación y subocupación no implican que se hayan revertido problemas estructurales como la segmentación y precarización laboral, con sus efectos sobre las condiciones de vida de los trabajadores. esto hace particularmente interesante el estudio de la situación de los jóvenes, dadas las especificidades como grupo que adquieren en el mercado de trabajo. Se utilizan los datos pertenecientes a la encuesta Permanente de Hogares del Indec disponibles de la versión continua (2003-2006), considerando el segundo semestre de cada año