O artigo parte das paisagens de morte das duas maiores democracias das Américas – Brasil e Estados Unidos – na crise de covid-19, oferecendo uma engrenagem conceitual denominada binômio ...vulnerabilidade-morte para ponderar em que medida a política da tragédia é um ponto de inflexão no tratamento das vulnerabilidades e da morte na política institucional, enfatizando o trabalho da Comissão Interamericana de Direitos Humanos (CIDH). Analisando as respostas normativas da CIDH, percebeu-se não a articulação, mas a bifurcação da vulnerabilidade e da morte. Embora revele um não entrelaçamento normativo, a bifurcação não significa uma escolha entre caminhos binários. Ainda que as duas democracias das Américas tenham suscitado desafios institucionais, a CIDH revelou um aprofundamento do sentido da vulnerabilidade e empreendeu normativamente em torno da morte: questões historicamente ausentes da estrutura básica internacional e capazes de lançar um desafio produtivo para a teoria da justiça internacional.
Resumo: A dinâmica de transmissão da dengue é multifatorial e envolve aspectos socioeconômicos, ecológicos e ambientais, sendo este último intimamente relacionado às condições climáticas locais que ...interferem no ciclo reprodutivo dos vetores da doença. Por sua vez, o clima é dependente dos mecanismos oceânicos tropicais, a exemplo das fases de El Niño/La Niña sobre o Pacífico. O presente trabalho contribui com esta temática e reporta as correlações entre o índice MEI (Multivariate ENOS Index) do Pacífico e o número de casos notificados de dengue em sete capitais da Amazônia brasileira, no período de 2001 a 2012. Além disso, investiga-se o padrão de sazonalidade (médias trimestrais) dos casos de dengue ao longo da região. As evidências de que o fenômeno El Niño/La Niña provoca redução/aumento no padrão pluviométrico local é consistente com o número menor/maior de casos notificados de dengue na maior parte das capitais amazônicas, cujo resultado foi comprovado pelas correlações negativas estatisticamente significantes encontradas para Manaus (Amazonas), São Luís (Maranhão), Belém (Pará) e Palmas (Tocantins). As médias dos 12 anos (2001/2012) revelaram a presença de sazonalidade pronunciada na incidência de dengue na maioria das capitais, com picos acentuados de janeiro a março Rio Branco (Acre), Manaus, Belém e Palmas e de abril a junho (São Luís), correspondendo em torno de 50% a 70% do total anual. As localidades mais ao norte Boa Vista (Roraima) e Macapá (Amapá) revelaram registro da dengue ao longo de todos os trimestres do ano, não apresentando sazonalidade acentuada.
Cutaneous Leishmaniasis is a disease transmitted to men and animals by infected female phlebotomine sandflies and is considered a great environmental and public health problem in the Amazon region. ...Thus, the study aimed to analyze the spatial distribution of this disease in São Félix do Xingu, in the state of Pará, Brazil, and its relationship with epidemiological and environmental variables, in the period from 2012 to 2016.
The data used were from the Information System of the Pará State Secretariat of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics. The statistical and spatial analysis of the variables were done using non-parametric chi-square statistical test, kernel interpolation technique and the Bivariate Global Moran Index.
The municipality had 183 confirmed cases, non-homogeneously distributed in 5 administrative districts. The individuals most affected were adult males with brown skin, an elementary level of education and rural area residents. In the case series, a direct relationship was observed between the increase of the number of cases and deforestation in the study area. The spatial analysis showed different types of land use and cover related to case clusters in the municipality. Additionally, there was a presence of cases in protected areas and a great epidemiological silence in indigenous lands.
Thus, this disease is a large and complex public health problem in the municipality, related to social and environmental risk factors.
The NR3C1 glucocorticoid receptor (GR) gene is a component of the stress response system, which can be regulated by epigenetic mechanisms. NR3C1 methylation has been associated with trauma and mental ...issues, including depression, post-traumatic stress, anxiety, and personality disorders. Previous studies have reported that stressful events are involved in NR3C1 gene methylation, suggesting that its regulation under environmental effects is complex. The present study aimed to analyze associations involving stressors such as socioeconomic status, health conditions, and lifestyle in relation to NR3C1 methylation in adults. This study included 386 individual users of the Brazilian Public Unified Health System (SUS), and evaluated socioeconomic and health conditions, body mass index, cortisol levels, and lifestyle. Data were correlated with NR3C1 methylation, determined using DNA pyrosequencing. The results showed that alcohol consumption, overweight, and high cortisol levels were related to NR3C1 demethylation, while depression was related to its methylation. Habits, lifestyle, and health status may influence NR3C1 gene regulation via methylation, revealing the complexity of environmental impacts on NR3C1 methylation.
II Consenso Brasileiro em Paracoccidioidomicose - 2017 Shikanai-Yasuda, Maria Aparecida; Mendes, Rinaldo Pôncio; Colombo, Arnaldo Lopes ...
Epidemiologia e serviços de saúde,
11/2018, Volume:
27, Issue:
esp
Journal Article
Open access
Resumo A paracoccidioidomicose (PCM) é uma micose sistêmica, relacionada às atividades agrícolas, com incidência e prevalência subestimadas, pela ausência de notificação em várias Unidades da ...Federação (UFs). A evolução insidiosa do quadro clínico pode ter como consequência sequelas graves se o diagnóstico e o tratamento não forem instituídos precoce e adequadamente. Ao lado do complexo Paracoccidioides brasiliensis (P. brasiliensis), a descrição de nova espécie, Paracoccidioides lutzii (P. lutzii), em Rondônia, onde a doença alcançou níveis epidêmicos, bem como na região Centro-Oeste e no Pará, constituem-se em desafios para a instituição do diagnóstico e a urgente disponibilização de antígenos que tenham reatividade com os soros dos pacientes. Este consenso visa atualizar o primeiro consenso brasileiro em PCM, estabelecendo recomendações para o manejo clínico do paciente, com base nas evidências conhecidas. São apresentados dados de etiologia, epidemiologia, imunopatogenia, diagnóstico, terapêutica e sequelas, enfatizando-se o diagnóstico e a terapêutica, bem como recomendações e desafios atuais nessa área do conhecimento.
Objective
To evaluate the effects of continuous (CA) and intermittent (IA) aerobic training on hormonal and metabolic parameters and body composition of women with polycystic ovary syndrome (PCOS).
...Design
Prospective, interventional, randomized study.
Methods
Randomized controlled training (RCT) with sample allocation and stratification into three groups: CAT (n = 28) and IAT (n = 29) training and no training control (CG), n = 30. Before and after 16 weeks of intervention (CAT or IAT) or observation (CG), hormonal and metabolic parameters, body composition and anthropometric indices were evaluated. Aerobic physical training on a treadmill consisted of 30‐ to 50‐minute sessions with intensities ranging from 60% to 90% of the maximum heart rate.
Results
In the CA group, there was reduction in waist circumference (WC) (P = .045), hip circumference (P = .032), cholesterol (P ≤ .001), low‐density lipoprotein (P = .030) and testosterone (P ≤ .001). In the IAT group, there was a reduction in WC (P = .014), waist‐to‐hip ratio (P = .012), testosterone (P = .019) and the free androgen index (FAI) (P = .037). The CG showed increases in WC (P = .049), total body mass (P = .015), body fat percentage (P = .034), total mass of the arms (P ≤ .001), trunk fat percentage (P = .033), leg fat percentage (P = .021) and total gynoid mass (P = .011).
Conclusion
CAT and IAT training reduced anthropometric indices and hyperandrogenism in PCOS, whereas only IAT training reduced the FAI. Furthermore, only CAT training improved the lipid profile.
This study aimed to investigate the molecular pathways involved in muscle wasting in an animal model of osteoarthritis (OA) induced by anterior cruciate ligament transection (ACLT) in rats. Reduction ...of protein syntheses, increased proteolysis and impaired muscle regeneration are important pathways related to muscle wasting, and myogenin, MyoD, myostatin and MuRF-1 are some of their markers. Female Wistar rats were allocated into two groups: OA (submitted to the ACLT) and SHAM (submitted to surgery without ACLT). Nociception, spontaneous exploratory locomotion and body weight of animals were evaluated weekly. Twelve weeks after the disease induction, animals were euthanized, and the right knee joints were collected. Gastrocnemius muscle of the right hind paw were dissected and weighed. Gastrocnemius was used for evaluation of muscle atrophy and expression of IL-1β, TNF-α, Pax7, myogenin, MyoD, myostatin and MuRF-1. Histopathology of the knee confirmed the development of the disease in animals of OA group. Gastrocnemius of OA animals showed a reduction of about 10% in area and an increased IL-1β expression compared to animals of SHAM group. Expression of myostatin was increased in OA group, while myogenin expression was decreased. TNF-α, Pax7, MuRF-1 and MyoD expression was similar in both OA and SHAM groups. Nociception was significantly elevated in OA animals in the last two weeks of experimental period. Spontaneous exploratory locomotion, body weight and weight of gastrocnemius showed no difference between OA and SHAM groups. Gastrocnemius atrophy in OA induced by ACLT involves elevated expression of IL-1β within the muscle, as well as increased expression of myostatin and decreased expression of myogenin. Therefore, muscle wasting may be linked to impaired muscle regeneration.
Self-reported disability is potentially influenced by many factors in patients with rheumatoid arthritis (RA). In this sense, we evaluated the association between self-reported disability and (1) ...clinical features, (2) muscle strength and (3) physical performance over time among patients with RA from two distinct patient cohorts.
Two independent prospective RA cohorts were analyzed. The Health Assessment Questionnaire (HAQ), Disease Activity Score in 28 Joints (DAS28), handgrip test, chair stand test, timed-up-and-go (TUG) test and Short Physical Performance Battery (SPPB) were performed at baseline and in follow-up. T test for independent samples, Mann-Whitney U test, Spearman correlation coefficients and linear regression with generalized estimating equations were performed to assess associations between individual constructs at baseline and over time.
A total of 205 total RA patients were included North American Cohort (n = 115); Brazilian Cohort (n = 90). At enrollment, Brazilian men had better HAQ than North American men (p<0.001). Brazilian patients overall had lower muscle strength than North American patients (p<0.05). HAQ was associated with DAS28, handgrip test, chair stand test, TUG and SPPB (p<0.001) in both cohorts. Worsening of the DAS28 and chair stand test were each associated with worsening in HAQ in longitudinal analysis over time. Worsening of handgrip was also associated in with worsening HAQ in both cohorts (p<0.05). A worse TUG test was associated with worsening in HAQ in Brazilian cohort (p<0.05) and a worse SPPB was associated with worsening in HAQ in North American cohort (p<0.05).
Greater disability measured by HAQ is closely associated with disease activity, pain, muscle strength, and physical performance among RA. Worsening in self-reported disability correlate with worsening clinical factors including objectively-observed physical function.
O estudo objetivou analisar a distribuição espacial da LTA em Tucuruí e a sua relação com variáveis socioambientais e epidemiológicas, no período de 2012 a 2016. Os dados epidemiológicos foram ...obtidos no SINAN da SESPA e os cartográficos, populacionais, unidades de conservação e terras indígenas, foram obtidos no IBGE. Os ambientais foram obtidos no PRODES. As análises dos casos e da relação espacial destes com o desflorestamento utilizaram o Bioestat 5.0 e o ArcGis 10.5.1, respectivamente. O município teve 286 casos confirmados, distribuídos de forma não homogênea em seus setores censitários. Os indivíduos mais acometidos foram do sexo masculino, adultos, pardos, baixo nível de escolaridade e moradores da zona urbana. Foi verificado na série histórica um aumento de casos de LTA e do incremento do desmatamento. A análise espacial mostrou a presença de dois aglomerados de casos localizados na área urbana. Foi observado também a existência de um mosaico de ocupações e terras indígenas. A LTA é um grande e complexo problema de saúde pública em Tucuruí, relacionado à fatores de riscos socioambientais, gerados e condicionados pela insuficiência de políticas públicas no município, que pode ter contribuído para a exposição da população local a vários fatores de risco da doença.
PDF
