Air quality and emissions management in the State of São Paulo, Brazil

The São Paulo State has 36 million people, 25 million living in three metropolitan areas. Only the São Paulo Metropolitan Region (SPMR) includes the state capital (São Paulo City) plus 38 cities, where ≈ 18 million people live, affected by frequent episodes of ozone, NOx, and fine particulate matter. In 2003, it was estimated that 15.1% of the SPMR vehicles used ethanol and 70.2% used the local gasoline. Natural gas vehicles have witnessed a booming participation in the last years, mainly through conversion of gasoline cars, and the present fleet is almost one million vehicles. To face the problems generated by light vehicles emissions the Federal Government set a program called PROCONVE - Program of Air Pollution Control from Vehicles - in 1986 and since then until now a significant reduction was reached, but the growth of the fleet hides most of the emission cuts. A discussion covers the evolution of the air pollution management in São Paulo; and innovative tools for air pollution management - both for mobile and stationary sources. This is an abstract of a paper presented at the 98th AWMA Annual Conference and Exhibition (Minneapolis, MN 6/21-24/2005).

Primary production of Utricularia foliosa L., Egeria densa Planchon and Cabomba furcata Schult & Schult.f from rivers of the coastal plain of the State of São Paulo, Brazil

Seasonal variation in gross primary production (GPP) of Utricularia foliosa Linnaeus, Egeria densa Planchon and Cabomba furcata Schult & Schult.f. in rivers of the coastal plain of the state of São Paulo, Brazil was examined in relation to water physico-chemistry. These three species do not affect the multiple uses of the streams and are present throughout the year. The most productive was U. foliosa (maximum production 24.7 mgO(2) g(-1) DW h(-1)), while C. furcata had an intermediate GPP (maximum production 17.5 mgO(2) g(-1) DW h(-1)) and E. densa was lowest at 5.6 mgO(2) g(-1) DW h(-1). Despite the low amplitude of seasonal variation in this south tropical area, the three species showed seasonal variation in the primary production: GPP was positively correlated with photosynthetic active radiation for U. foliosa and E. densa, and there was a negative correlation for C. furcata. For U. foliosa, GPP was positively correlated with temperature and dissolved inorganic carbon and the GPP of C. jurcata was positively correlated with dissolved inorganic carbon.

Socio-economic characteristics of the Cachoeira de Emas small-scale fishery in Mogi-Guaçu River, State of São Paulo, Brazil

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Piscinoodinium pillulare (Schäperclaus, 1954) Lom, 1981 (Dinoflagellida) infection in cultivated freshwater fish from the Northeast region of São Paulo State, Brazil: parasitological and pathological aspects

O Centro de Aqüicultura, Unesp, Jaboticabal, SP, Brasil, recebeu peixes para diagnose, os quais apresentavam aglomeração nas bordas dos viveiros e na entrada da água. Dos 194 casos diagnosticados, 53 apresentavam estruturas brancas circulares ou ovais, imóveis, medindo 162 mm de diâmetro, identificadas como o dinoflagelado Piscinoodinium pillulare. em 34 casos, os parasitos estavam presentes nas brânquias, em 2 casos, no corpo e em 9 casos, em ambos. Dos 53 casos observados, 31 eram o híbrido tambacu; 7, o Piaractus mesopotamicus; 6, o Colossoma macropomum; 5, o Leporinus macrocephalus; 3, o Oreochromis niloticus; e 1, o Prochilodus lineatus. Os peixes apresentaram aumento da produção de muco no corpo e nas brânquias e equimoses no pedúnculo caudal e nos opérculos. As brânquias também apresentaram palidez, congestão e petéquias. A histopatologia revelou a presença de grande número de trofontes situados entre as lamelas secundárias, fixados ou não ao epitélio. As lamelas primárias mostraram hemorragias intersticiais, severa hiperplasia do epitélio e das células caliciformes e infiltrado inflamatório. O presente trabalho é o primeiro relato de P. pillulare no Brasil e enfatiza a importância dos dinoflagelados, que causaram significativas perdas econômicas entre 1995 e 1997.

Spatial distribution of trachoma cases in the City of Bauru, State of São Paulo, Brazil, detected in 2006: defining key areas for improvement of health resources

Introduction: The objective of this study was to analyze the spatial behavior of the occurrence of trachoma cases detected in the City of Bauru, State of São Paulo, Brazil, in 2006 in order to use the information collected to set priority areas for optimization of health resources. Methods: the trachoma cases identified in 2006 were georeferenced. The data evaluated were: schools where the trachoma cases studied, data from the 2000 Census, census tract, type of housing, water supply conditions, distribution of income and levels of education of household heads. In the Google Earth® software and TerraView® were made descriptive spatial analysis and estimates of the Kernel. Each area was studied by interpolation of the density surfaces exposing events to facilitate to recognize the clusters. Results: of the 66 cases detected, only one (1.5%) was not a resident of the city's outskirts. A positive association was detected of trachoma cases and the percentage of heads of household with income below three minimum wages and schooling under eight years of education. Conclusions: The recognition of the spatial distribution of trachoma cases coincided with the areas of greatest social inequality in Bauru City. The micro-areas identified are those that should be prioritized in the rationalization of health resources. There is the possibility of using the trachoma cases detected as an indicator of performance of micro priority health programs.

Risk factors and presence of antibodies to Toxoplasma gondii in dogs from the coast of São Paulo State, Brazil

A toxoplasmose é causada por um protozoário parasita intracelular obrigatório, Toxoplasma gondii, e acomete vertebrados homeotérmicos incluindo animais de companhia e o homem. O cão apresenta importância epidemiológica por atuar como sentinela da infecção para o homem. O presente estudo objetivou determinar a ocorrência de anticorpos para T. gondii em 205 amostras de soro de cães do município de Ubatuba, SP, Brasil, pela reação de imunofluorescência indireta (RIFI), assim como os fatores de risco relacionados à infecção nos animais, como raça, idade, sexo, acesso a rua, ingestão de comida caseira, acesso a água não tratada e presença de roedores. 52/205 (25,4%) amostras foram positivas para toxoplasmose, com títulos variando de 16 a 256. Os resultados sorológicos apresentaram associação significativa (P<0,05) com consumo de comida caseira (45/118; 38,1%; IC95% 29,9%-47,2%) (OR=7,0; CI95% 3,0-16,6), e acesso a rua, em que aqueles que não tinham acesso a rua foram prevalentes (37/121; 30,6%; IC95% 23,1%-39,3%) (OR=0,5; CI95% 0,2-1,0). Estes resultados demonstram que a toxoplasmose na região está relacionada com problema de educação sanitária, principalmente quanto ao adequado cozimento dos alimentos, visto que a maioria dos animais positivos não apresentou associação significativa com presença de roedores ou consumo de água não tratada, porém os mesmos permaneciam em casa aos quais fora oferecida comida caseira. Portanto, a toxoplasmose consiste em um problema de saúde pública na região estudada, sendo necessárias medidas sanitárias para o controle da infecção, visto a estreita relação homem-cão e os fatores de risco presentes.

Corticolous green algae from tropical forest remnants in the northwest region of São Paulo State, Brazil

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

Bat rabies in the north-northwestern regions of the state of São Paulo, Brazil: 1997-2002

OBJETIVO: Os relatos sobre a ocorrência de raiva em morcegos no Brasil são esporádicos e isolados. Assim, o objetivo do estudo foi descrever a detecção do vírus da raiva em morcegos do Estado de São Paulo. MÉTODOS: Foram analisados 7.393 morcegos provenientes de 235 municípios do norte e noroeste do Estado de São Paulo, no período de 1997 a 2002 e identificados por meio de características morfológicas e morfométricas. Para a detecção do antígeno viral foi utilizada a técnica de imunofluorescência direta e o isolamento do vírus foi realizado por inoculação em camundongos. RESULTADOS: Das amostras examinadas, 1,3% foram positivas para raiva, com variação de 0,2% em 1997 a 1,6% em 2001. Foram encontrados 98 morcegos com o vírus, 87 deles em área urbana. O vírus da raiva foi detectado pela imunofluorescência direta em 77 do total de amostras positivas, enquanto 92 produziram doença em camundongos inoculados e o período de incubação variou entre 4-23 dias. em 43 municípios foi encontrado pelo menos um morcego positivo. Entre as espécies analisadas o vírus da raiva foi detectado com maior freqüência (33,7%) em Artibeus lituratus. Os vespertilionideos do gênero Eptesicus e Myotis totalizaram 24,5% dos morcegos positivos e as espécies do gênero Molossus (Molossus molossus e Molossus rufus), 14,3%. A distribuição do vírus da raiva foi semelhante entre fêmeas (33; 48,5%) e machos (35; 51,5%). CONCLUSÕES: Morcegos positivos para raiva foram encontrados em situações que colocam em risco tanto a população humana como animais de estimação, exigindo medidas voltadas para o manejo destas espécies e de educação da população.

Epidemiological aspects of enteroparasitosis at daycare centers in the city of Botucatu, State of São Paulo, Brazil

Estimou-se a prevalência e a incidência de parasitas intestinais em crianças e funcionários de 5 creches municipais em Botucatu/SP. Foram realizados dois estudos seccionais em 2002 (N=379) e 2003 (N=397) e um estudo longitudinal observacional, onde as crianças de 2002 e 2003 foram seguidas por um ano. Foram aplicados questionários nos funcionários e nos pais das crianças, onde foram coletadas as seguintes variáveis: nível sócio-econômico, hábitos sanitários, moradia, idade, sexo e presença de animais domésticos. Foram realizados exames coproparasitológicos nas crianças das creches. A prevalência de enteroparasitas em 2002 foi de 76,74% e 34% em 2003. As variáveis associadas à presença de enteroparasitas no ano de 2002 foram: localização das creches (OR=0,27 IC=0,15-0,47), renda familiar (OR=4,38 IC=1,91-10,04), sexo (OR=0,52 IC=0,32-0,85), faixa etária (OR=2,08 IC=1,06-4,08) e presença de animais domésticos na casa (OR=1,85 IC=1,10-3,11); em 2003, as variáveis foram: creche localizada em bairro periférico (OR=0,49 IC=0,31-0,78), renda familiar (OR=3,69 IC=2,19-6,24), nível educacional da mãe (OR=6,19 IC=1,81-21,21), sexo (OR=0,36 IC=0,36-0,93) e presença de animais domésticos (OR=1,68 IC=1,01-2,79). A coorte foi integrada por 253 crianças apresentando incidência de 23,22%. Os dados deste estudo evidenciam situações de risco em populações específicas (creches) e poderiam ser utilizados por Instituições que promovem o cuidado com as crianças.

Surveillance Programme for Healthcare Associated Infections in the State of São Paulo, Brazil. Implementation and the first three years' results

Governmental programmes should be developed to collect and analyse data on healthcare associated infections (HAIs). This study describes the healthcare setting and both the implementation and preliminary results of the Programme for Surveillance of Healthcare Associated Infections in the State of São Paulo (PSHAISP), Brazil, from 2004 to 2006. Characterisation of the healthcare settings was carried out using a national database. The PSHAISP was implemented using components for acute care hospitals (ACH) or long term care facilities (LTCF). The components for surveillance in ACHs were surgical unit, intensive care unit and high risk nursery. The infections included in the surveillance were surgical site infection in clean surgery, pneumonia, urinary tract infection and device-associated bloodstream infections. Regarding the LTCF component, pneumonia, scabies and gastroenteritis in all inpatients were reported. In the first year of the programme there were 457 participating healthcare settings, representing 51.1% of the hospitals registered in the national database. Data obtained in this study are the initial results and have already been used for education in both surveillance and the prevention of HAI. The results of the PSHAISP show that it is feasible to collect data from a large number of hospitals. This will assist the State of São Paulo in assessing the impact of interventions and in resource allocation. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

American visceral leishmaniasis: Factors associated with lethality in the state of São Paulo, Brazil

Objectives. To identify factors associated with death in visceral leishmaniasis (VL) cases. Patients and Methodology. We evaluated prognostic factors for death from VL in São Paulo state, Brazil, from 1999 to 2005. A prognostic study nested in a clinical cohort was carried out by data analysis of 376 medical files. A comparison between VL fatal cases and survivors was performed for clinical, laboratory, and biological features. Association between variables and death was assessed by univariate analysis, and the multiple logistic regression model was used to determine adjusted odds ratio for death, controlling confounding factors. Results. Data analysis identified 53 fatal cases out of 376 patients, between 1999 and 2005 in São Paulo state. Lethality was 14.1 (53/376), being higher in patients older than fifty years. The main causes of death were sepsis, bleeding, liver failure, and cardiotoxicity due to treatment. Variables significantly associated with death were severe anemia, bleeding, heart failure, jaundice, diarrhea, fever for more than sixty days, age older than fifty years, and antibiotic use. Conclusion. Educational health measures are needed for the general population and continuing education programs for health professionals working in the affected areas with the purpose of identifying and treating early cases, thus preventing the disease evolution towards death. © 2012 Geraldine Madalosso et al.

In search of the autonomous and critical individual: a philosophical and pedagogical analysis of the physical education curriculum of São Paulo (Brazil)

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

Barriers related to non-adherence in a mammography breast-screening program during the implementation period in the interior of São Paulo State, Brazil

Mammography is the best exam for early diagnosis of breast cancer. Developing countries frequently have a low income of mammography and absence of organized screening. The knowledge of vulnerable population and strategies to increase adherence are important to improve the implementation of an organized breast-screening program. A mammography regional-screening program was implemented in a place around 54.238 women, aged 40-69 years old. It was proposed to perform biannual mammography free of cost for the women. We analyze the first 2 years of the implementation of the project. Mammography was realized in 17.964 women. 42.1% of the women hadn't done de mammography in their lives and these women were principally from low socio-economic status (OR=2.99), low education (OR=3.00). The best strategies to include these women were mobile unit (OR=1.43) and Family Health Program (OR=1.79). The incidence of early breast tumors before the project was 14.5%, a fact that changed to 43.2% in this phase. Multivariate analysis showed that the association of illiterate and the mobile unit achieve more women who had not performed mammography in their lives. The strategies to increase adherence to mammography must be multiple and a large organization is necessary to overpass the barriers related to system health and education.

Dental caries associated factors in 12 year-old schoolchildren from a municipality in the state of São Paulo, Brazil

Objective To analyze the possible association between dental caries, fluorosis and the need for treatment in 12 year-old schoolchildren and the socioeconomic conditions of parents/guardians in the city of Franca, in the state of São Paulo. Methods A random sample of schoolchildren aged 12 was obtained from the school records in Franca, using a systematic random technique. The epidemiological survey was carried out by a single calibrated examiner, on 258 public and private schoolchildren in order to obtain the prevalence of dental caries, the need for treatment and the severity of dental fluorosis. Parents/guardians were also interviewed to assess their socioeconomic conditions (education and per capita income). We used multiple correlation analysis to investigate associations between category variables. Results It was possible to identify two distinct groups, with associations between the variables: the first group, represented by schoolchildren with average prevalence of caries, need for treatment, low level of parental education and income; and a second group represented by schoolchildren with low prevalence of caries, no need for treatment, high parental education and income. The two dimensions explained approximately 35% of total inertia. The factors within each group are related. Conclusion High income and parental education are associated with the low prevalence of dental caries but there is no association with dental fluorosis.

Toxoplasma gondii antibodies in wild rodents and marsupials from the Atlantic Forest, state of São Paulo, Brazil

Toxoplasma gondii é um protozoário parasita que infecta animais de sangue quente, incluindo seres humanos. Pequenos roedores e marsupiais têm papel importante na epidemiologia do T. gondii, pois são fontes de infecção para os felídeos domésticos e selvagens. Amostras de soro de 151 roedores e 48 marsupiais, capturados na Mata Atlântica, Estado de São Paulo, Sudeste do Brasil, foram analisadas para a pesquisa de anticorpos anti-T. gondii. Os anticorpos foram detectados pelo Teste de Aglutinação Modificada (MAT ≥ 25), com 8,6% (13/151) dos roedores e 10,4% (5/48) dos marsupiais soropositivos, com títulos variando de 25 a 6.400 e de 25 a 3.200, respectivamente, para os roedores e os marsupiais. Três das oito espécies de roedores (Akodon spp., Oligoryzomys nigripes e Rattus norvegicus) e uma das quatro espécies de marsupiais (Didelphis aurita) apresentaram animais positivos. A presença de anticorpos anti-T. gondii foi descrita pela primeira vez no roedor Oligoryzomys nigripes.