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An. bras. dermatol ; 94(2): 157-163, Mar.-Apr. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1001134


Abstract BACKGROUND: Skin cancer is common in Brazil and is related to sun exposure, among other risk factors. There are no data on the incidence of malignant skin neoplasm in rural workers in western Paraná. OBJECTIVE: To analyze the incidence and profile of rural workers who were diagnosed with skin cancer at a reference service in Cascavel, western Paraná, in the last five years (2011-2016). METHODS: This retrospective cross-sectional study was carried out through a review of the anatomopathological reports of rural workers diagnosed with skin cancer at Cascavel Oncology Center (CEONC), in Cascavel. The following variables were collected: year of diagnosis, age, gender, injury location and histological subtype. RESULTS: A total of 681 cases of malignant epithelial neoplasia were identified, with a higher frequency in the 61-70 age group. Data analysis showed an increase of about 210% in the occurrence of skin cancers in the last 5 years. The cephalic region was the most affected, and the most common histological subtype was nodular basal cell carcinoma. There was no association between gender and location. STUDY LIMITATIONS: This is a retrospective study and analysis of a secondary data bank. CONCLUSION: This study is a regional estimation of the incidence of cutaneous neoplasms and provides evidence of a considerable increase in the number of diagnoses in rural workers from western Paraná, Brazil. Moreover, it is possible to conclude that the sample group studied is at risk of developing skin cancer.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Melanoma/epidemiology , Rural Population/statistics & numerical data , Skin Neoplasms/etiology , Sunlight/adverse effects , Brazil/ethnology , Brazil/epidemiology , Carcinoma, Basal Cell/etiology , Carcinoma, Squamous Cell/etiology , Incidence , Cross-Sectional Studies , Retrospective Studies , Age Distribution , Face , Melanoma/etiology
Sex., salud soc. (Rio J.) ; (31): 57-80, enero-abr. 2019.
Article in Portuguese | LILACS (Americas) | ID: biblio-1004713


Resumo Este artigo se ocupa da trajetória da Turma OK, grupo fundado em 1961, dedicado a promover a sociabilidade entre homens homossexuais no Rio de Janeiro. Procuro compreender a história desse grupo à luz das tensões entre diferentes processos sociais, identidades e classificações sexuais construídas e reconstruídas pelas turmas de "bichas" nas décadas de 1960 e 1970. Busco compreender também como essa associação passa de um grupo de sociabilidade de "homens homossexuais" da Zona Sul do Rio de Janeiro que fazem reuniões fechadas em apartamentos para um espaço de shows e encontros que pretende se afirmar como um "patrimônio da Lapa". O trabalho de pesquisa foi fundamentado em observação participante, pesquisa documental e entrevistas em profundidade.

Abstract This article analyzes the trajectory of the Turma OK group, founded in 1961 to promote sociability among homosexual men in Rio de Janeiro. The history of this group is understood in light of the tensions between different social processes, identities and sexual classifications constructed and reconstructed by the groups of "bichas" (or "queers") in the decades of 1960 and 1970. The passage of this association from a group of sociability for "homosexual men" from affluent areas of Rio de Janeiro who held closed meetings in apartments to a space of shows and meetings claiming to be a bohemian "Lapa heritage". The research is based on participant observation, document analysis and in-depth interviews.

Resumen Este artículo se ocupa de la trayectoria de la Turma OK. Buscamos comprender la historia de ese grupo a la luz de las tensiones entre diferentes procesos sociales, identidades y clasificaciones sexuales construidas y reconstruidas por las clases de "bichas" en las décadas de 1960 y 1970. Buscamos comprender también cómo esa asociación pasa de un grupo de sociabilidad de "hombres homosexuales" de la Zona Sur de Río de Janeiro que hacen reuniones cerradas en apartamentos para un espacio de shows y encuentros que pretende afirmarse como un "patrimonio de Lapa". El trabajo de investigación fue fundamentado en observación participante, investigación documental y entrevistas en profundidad.

Humans , Brazil/ethnology , Homosexuality, Male/ethnology , Cultural Characteristics , Qualitative Research , Sexual and Gender Minorities , Gender Identity
Braz. J. Pharm. Sci. (Online) ; 55: e17584, 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039064


In South American folk medicine members of the genus Myrciaria are used for the treatment of malaria, diarrhoea, asthma, inflammation and post-partum uterine cleansing. The aim of this work was to evaluate its antileishmanial properties (in vitro) of essential oil derived from leaves of Myrciaria plinioides D. Legrand, a plant species that is native in South of Brazil. The essential oil was obtained by hydro-distillation using fresh leaves of M. plinioides. The chemical composition of this essential oil (MPEO, M. plinioides essential oil) was determined by gas chromatography coupled to mass spectrometry (GC-MS). MPEO was assayed in vitro for antileishmanial properties against promastigotes of Leishmania amazonensis and Leishmania infantum, and for cytotoxicity against murine peritoneal macrophages. The MPEO comprised 66 components and was rich in oxygenated sesquiterpenes (82.66%) containing spathulenol (21.12%) as its major constituent. The MPEO was effective against L. amazonensis with IC50 value of 14.16 ± 7.40 µg/mL, while against L. infantum the IC50 value was higher with 101.50 ± 5.78 µg/mL. The MPEO showed significant activity against L. amazonensis, and presented a selectivity index (SI) of 6.60. The results suggest that the essential oil from leaves of M. plinioides is a promising source for new antileishmanial agents against L. amazonensis.

In Vitro Techniques/instrumentation , Brazil/ethnology , Oils, Volatile/analysis , Myrtaceae/anatomy & histology , Leishmania infantum , Plant Leaves/classification , Leishmania
Braz. J. Pharm. Sci. (Online) ; 55: e17618, 2019. tab
Article in English | LILACS (Americas) | ID: biblio-1039043


An exploratory study was conducted to present the approach of Brazilian hospital pharmacists to registering, documenting, archiving and disseminating clinical practice. The data were collected using an electronic questionnaire (n=348). In fact, 97.41% of pharmacists record their clinical practice, out of which 64.01% (n=217) do in electronic form, mainly in private hospitals (p<0.000), in the central, southern and southeastern regions (p=0.040), and by professionals with 1-5 years of experience (p=0.001). The main software used is non-specific to clinical practice: an electronic spreadsheet (47.93%; n=104) and text editor (13.37%; n=29). The archiving of records is performed by 87.61% (n=297) of professionals, where 80.13% (n=238) do so in physical form; however, 77.31% (n=184) of these files are kept for less than the standard recommended time. Documentation in medical records is carried out by 55.17% (n=192) of pharmacists, increasing among those with 1-5 years of clinical practice (p=0.001), and dissemination is performed by 74.71% (n=260) of hospital pharmacists, with a lower frequency in public hospitals (p=0.012) and among professionals with fewer hours dedicated exclusively to clinical pharmacy (p=0.012). These results can undergird the revision of competency-based training programs of Brazilian clinical pharmacists to remain pharmacists as a valuable health team member

Pharmacists/classification , Pharmaceutical Services/organization & administration , Brazil/ethnology , Practice Guideline , Outcome and Process Assessment, Health Care , Pharmacy/standards , Pharmacy Service, Hospital/ethics , Formulary
Psicol. USP ; 30: e180093, 2019. graf
Article in Portuguese | LILACS (Americas), INDEXPSI | ID: biblio-1012809


Resumo A quimbanda, modalidade de culto afro-brasileiro habitualmente apresentada como mera inversão ético-moral da umbanda, preservou-se em rituais com entidades espirituais que supostamente contestam ou invertem a ordem moral vigente. Neste estudo acompanharam-se esses rituais e coletaram-se depoimentos de sacerdotes em comunidades religiosas afro-brasileiras, com o objetivo de revisar se de fato há uma pressão exercida por padrões ético-religiosos da sociedade envolvente que poderiam ter moderado ou modificado concepções africanas subjacentes. Na contramão de análises que implicitamente pressupõem a subordinação dos cultos afro-brasileiros a uma única concepção de moralidade, constatou-se que a vivência do sagrado implicada na quimbanda e na umbanda não atrela-se a essa moralidade vigente, e que nenhuma das suas manifestações pode ser corretamente descrita como amoral.

Résumé Le Quimbanda, une modalité de secte afro-brésilienne généralement présenté comme une simple inversion éthique et morale d'Umbanda, conservé dans les rituels avec des entités spirituelles qui sont supposés contester ou inverser l'ordre moral actuelle. Dans cette étude, ces rituels ont été suivis et les témoignages de prêtres ont été recueillis dans des communautés religieuses afro-brésiliennes, afin de vérifier si, en effet, il y a une pression exercée par les normes éthiques et religieuses de la société environnante qui pouvait modérer ou modifier les conceptions africaines sous-jacentes. Contrairement aux analyses qui supposent implicitement la subordination des sectes afro-brésiliens à une seule conception de la moralité, on a été constaté que l'expérience du sacré impliquée dans le Quimbanda et l'Umbanda n'est pas liée à cette moralité actuelle, et qu'aucune de ses manifestations peut être correctement décrit comme immorale.

Resumen La Quimbanda, modalidad de culto afrobrasileño y que generalmente se presenta como una mera inversión ético-moral de la Umbanda, conservó sus rituales con entidades espirituales que supuestamente invierten el orden moral vigente o lo contestan. En este estudio se acompañaron estos rituales y se recogieron declaraciones de sacerdotes en comunidades religiosas afrobrasileñas, con el objetivo de revisar si y en qué medida las presiones ejercidas por patrones ético-religiosos de la sociedad circundante podrían haber moderado o modificado las concepciones africanas subyacentes. Al contrario de los análisis que implícitamente presuponen la subordinación de los cultos afrobrasileños a una única concepción de moralidad, se encontró que la experiencia de lo sagrado involucrada en la Quimbanda y en la Umbanda no se vincula a esta moralidad vigente, y que ninguna de sus manifestaciones puede ser correctamente descrita como amoral.

Abstract Quimbanda is an African-Brazilian religious modality generally presented as a mere ethical and moral inversion of Umbanda that has been preserved through rituals made with spiritual entities that supposedly contest or reverse the prevailing morality. In this study, we followed rituals and collected interviews with priests in African-Brazilian religious communities, aiming to verify if there really is influence of an ethical standard from the surrounding society that could have moderated or modified subjacent African conceptions. Contrary to analyses that implicitly assume African-Brazilian cults as subjected to a single conception of morality, we found that the sacred experience involving Quimbanda and Umbanda is not attached to the prevailing morality, and that none of its manifestations can be properly described as amoral.

Humans , Religion and Psychology , Ethnic Groups/psychology , Ethnopsychology , Brazil/ethnology , Africa/ethnology
São Paulo; s.n; s.n; 2019. 93 p. tab, graf.
Thesis in Portuguese | LILACS (Americas) | ID: biblio-1049803


O presente estudo teve por finalidade desenvolver uma metodologia de dissolução discriminativa para avaliar comprimidos contendo diferentes polimorfos de atorvastatina cálcica (ATR). Este trabalho é conformado por quatro capítulos, no qual o primeiro apresenta uma breve revisão de literatura sobre as características dos polimorfos da ATR, abordando-se informações mais relevantes sobre o ATR em relação ao polimorfismo e sua influência na biodisponibilidade. No segundo capítulo, apresenta-se a importância da caracterização dos polimorfismos e suas implicações para a ATR. As amostras de ATR foram identificadas por difração raio X e análise térmica e, posteriormente, demonstrou-se as diferenças entre quatro amostras comercializadas no mercado brasileiro relacionadas ao hábito cristalino, tamanho de partícula e solubilidade. No terceiro capítulo, demonstra-se o desenvolvimento do método de dissolução discriminativo para comprimidos contendo duas formas polimórficas da ATR. Para tanto, avaliou-se a solubilidade destas pelo método do equilíbrio e determinou-se as condições experimentais mais adequadas para o ensaio de dissolução por intermédio de planejamento fatorial completo do tipo 23, sendo as variáveis independentes o meio de dissolução, a velocidade de agitação e as formas polimórficas (I e VIII). Os resultados obtidos foram tratados estatisticamente através da análise de variância, dos gráficos de Pareto e de superfície de resposta. Concluiu-se que a velocidade de agitação e o meio de dissolução impactam os resultados, afetando a dissolução das formulações com os polimorfos avaliados. Assim, as condições selecionadas foram: 750 mL de meio água a 65 rpm. Após o desenvolvimento do método, este foi comparado com o da Food and Drug Administration (FDA) para comprimidos de atorvastatina cálcica. Ao final dos ensaios, o método desenvolvido mostrou-se adequado para apontar diferenças entre os polimorfos da ATR. No quarto capítulo, o método desenvolvido foi utilizado para avaliar o perfil de dissolução de comprimidos comercializados em três países sul-americanos: Brasil, Peru e Bolívia. As porcentagens de fármaco dissolvidas e a Eficiência de Dissolução foram as variáveis estudadas e, posteriormente, tratadas estatisticamente através da análise de componentes principais, sendo possível comparar o perfil de dissolução de dessete formulações. Dessa forma, foi possível concluir que cinco formulações avaliadas (BR1, BR2 PE6, BR7 e BO3) possuíam a forma polimórfica VIII, enquanto duas formulações (BR5 e PE2) continham a forma polimórfica I. As demais, possivelmente, apresentam misturas ou outras formas polimórficas

This present study was aimed at developing a discriminative dissolution methodology to evaluate tablets containing different calcium atorvastatin (ATR) polymorphs. This paper consists of four chapters. The first chapter presents a brief literature review of the characteristics of ATR polymorphs, and addresses more relevant information about ATR in relation to polymorphism and its influence on bioavailability. The second chapter presents the importance of the characterization of polymorphs and their implications for ATR. The ATR samples were identified by X-ray diffraction and thermal analysis. Subsequently, the differences among the four samples marketed in the Brazilian market with relation to crystalline habit, particle size and solubility were demonstrated. The third chapter demonstrates the development of the discriminative dissolution method for tablets containing two polymorphic forms of ATR. For this, their solubilities were evaluated by the equilibrium method and the most suitable experimental conditions for the dissolution test were determined by means of complete factorial design of type 23, and the independent variables were the dissolution medium, the stirring speed and polymorphic forms (I and VIII). The results obtained were statistically treated through analysis of variance, Pareto and response surface graphs. It was concluded that the stirring speed and the dissolution medium influenced the results, affecting the dissolution of the formulations with the evaluated polymorphs. Thus, the selected condition was 750 mL of water at 65 rpm. Following the development of the method, it was compared with that of the Food and Drug Administration (FDA) for atorvastatin calcium tablets. At the end of the tests, the developed method was adequate to point out differences between the ATR polymorphs. In the fourth chapter, the developed method was used to evaluate the dissolution profile of tablets marketed in three South American countries: Brazil, Peru and Bolivia. Dissolved drug percentages and Dissolution Efficiency were the studied variables and statistically treated by principal component analysis. Through this method, it was possible to compare the dissolution profile of seventeen formulations. Thus, it was possible to conclude that five formulations evaluated (BR1, BR2, PE6, PE7 e BO3) had the polymorphic form VIII, while two formulations (BR5 e PE2) contained the polymorphic form I. The others possibly have mixtures or other forms polymorphic

Peru/ethnology , Tablets/analysis , Bolivia/ethnology , Brazil/ethnology , Dissolution/methods , Atorvastatin/analysis , Polymorphism, Genetic , Pharmaceutical Trade
Braz. J. Pharm. Sci. (Online) ; 55: e18148, 2019. tab, graf, ilus
Article in English | LILACS (Americas) | ID: biblio-1039038


According to Anvisa risk rating, hypodermic needles offer medium risk to the user's health. This study discussed the importance of the corrosion resistance test in tubes of hypodermic needles, in the product quality control. A review of cannulas of hypodermic needles was carried out according to ISO 9626:2003 and 9259:1997 ABNT NBR. For the results evaluation, a scale which classifies the extent of corrosion was adjusted. 174 samples of PNI needles from 17 States and 9 different record holders were analyzed. According to the methodology of ISO 9626:2003, 100% of the samples were considered satisfactory. However, in accordance with the methodology of ISO 9259:1997, 97.1% of the samples were rejected. Irregularities can lead to impairment of product quality, resulting in risks to the consumer's health. Since 2011 the product has undergone certification, so it is necessary to reflect on the importance of corrosion resistance testing and mandatory certification for health monitoring.

Quality Control , Corrosion , Needles/standards , Product Surveillance, Postmarketing , Brazil/ethnology , Chromium/analysis , Cannula , Legislation as Topic/standards
Braz. J. Pharm. Sci. (Online) ; 55: e18481, 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1039078


In general, topical ophthalmic drug products, especially those used for treating infections, present low effectiveness because of various reasons, from unfavorable drug physicochemical properties to physiological protective mechanisms of the eye. The fact is such group of products holds room for improvement, which could mean the development of better drugs or dosage forms. To achieve this, the knowledge of market composition is essential. The present work studied and compared the antimicrobial ophthalmic markets of Brazil and of the United States (US). Official databank of Brazilian Health Regulatory Agency and of US Food and Drug Administration were assessed for registered antimicrobial topical ophthalmic drug products. Brazilian market has registered greater number of drug products (119) than the US (94), but the latter involves more variety of substances and dosage forms. In both countries, non-innovative products registered as solutions of antibacterials, especially fluoroquinolones and aminoglycosides lead the market. Despite the clinical demand, the US has only one group of antimycotics (polyenes) registered, while in Brazil, there is not any ophthalmic antimycotic product marketed. This study evidences there is not only space for development of newer drugs and formulations but also a demand for already existing technologies and products in both countries.

Ophthalmology/classification , Pharmaceutical Preparations , Lubricant Eye Drops/analysis , United States/ethnology , Brazil/ethnology , Records/statistics & numerical data , Anti-Infective Agents/adverse effects
Cad. Saúde Pública (Online) ; 35(2): e00208517, 2019. tab
Article in English | LILACS (Americas) | ID: biblio-984134


Abstract: Although low socioeconomic status (SES) adolescents suffer from higher rates of adverse sexual and reproductive health outcomes, evidence on the association between SES and sexual behaviors has been less consistent. A cross-sectional analysis of the association between sociodemographic characteristics (household wealth, maternal education and race/ethnicity) and sexual behaviors (sexual initiation, multiple sexual partners, inconsistent condom use and inconsistent contraceptive use) of Brazilian adolescents was carried out using the 2015 Brazilian National Survey of School Health (PeNSE), a nationally representative school-based survey of 102,301 adolescents. Analyses included multivariable logistic models, which accounted for geographic and family characteristics. About 27.5% of adolescents were sexually initiated. Household wealth was associated with female sexual initiation, while race/ethnicity was associated with condom use and multiple sexual partners among males. For instance, black males had 35% higher odds of having multiple partners (aOR = 1.35, 95%CI: 1.13-1.62), but 22% lower odds of condom use (aOR = 0.78, 95%CI: 0.65-0.94), compared to white males. Frequent parental supervision was positively related to condom use (females, aOR = 1.28, 95%CI: 1.10-1.49; and males, aOR = 1.33, 95%CI: 1.18- 1.49). Results show the complex relationship between SES and sexual behaviors. Researchers should pay attention to gender, racial and social norms salient to adolescent sexual behaviors, as they can influence data collection and results. National policies should also support active parental supervision, since it can be a protective factor.

Resumo: Ainda que adolescentes de estado socieconômico baixo tenham taxas mais altas de desfechos adversos de saúde sexual e reprodutiva, as evidências sobre a associação entre estado socieconômico e comportamentos sexuais é menos consistente. Uma análise seccional da associação entre características sociodemográficas (renda familiar, escolaridade materna e raça/cor) e comportamentos sexuais (iniciação sexual, múltiplos parceiros sexuais, uso inconsistente de preservativo e uso inconsistente de contracepção) de adolescentes brasileiros foi realizada com base na Pesquisa Nacional de Saúde do Escolar (PeNSE) de 2015, um inquérito de representatividade nacional baseado em escolas com 102.301 adolescentes. As análises incluíram modelos logísticos multivariáveis levando em consideração características geográficas e familiares. Cerca de 27,5% dos adolescentes já haviam tido a primeira relação sexual. A renda domiciliar estava associada com a iniciação sexual feminina, enquanto raça/cor estava associada com uso de preservativo e múltiplos parceiros sexuais para os adolescentes. Por exemplo, adolescentes pretos tinham uma probabilidade 35% maior de ter múltiplos parceiros (ORa = 1,35; IC95%: 1,13-1,62), mas uma probabilidade 22% menor de usar preservativo (ORa = 0,78; IC95%: 0,65-0,94), quando comparados a adolescentes brancos. A supervisão parental frequente estava positivamente associada ao uso de preservativo (sexo feminino: ORa = 1,28; IC95%: 1,10-1,49 e sexo masculino: ORa = 1,33; IC95%: 1,18-1,49). Os resultados demonstram as relações complexas entre estado socieconômico e comportamentos sexuais. Pesquisadores devem prestar atenção nas normas de gênero, raciais e sociais relevantes para comportamentos sexuais em adolescentes, dado que elas podem influenciar a coleta de dados e os resultados. Políticas públicas nacionais também devem apoiar supervisão parental ativa, dado que esse pode ser um fator protetor.

Resumen: Pese a que los adolescentes que proceden de estratos socioeconómicos bajos sufren altas tasas relacionadas con problemas de su estado de salud reproductiva y sexual, las evidencias de asociación entre estratos socioeconómicos bajos y sus comportamientos sexuales han sido menos consistentes. En este estudio, se llevó a cabo un análisis trasversal de la asociación entre las características sociodemográficas (ingresos familiares, educación materna y raza/etnicidad) y comportamientos sexuales (iniciación sexual, múltiples parejas sexuales, uso ocasional del condón, al igual que de métodos anticonceptivos) con adolescentes brasileños, usando la Encuesta Nacional de Salud Escolar (PeNSE) del año 2015, una encuesta representativa a nivel nacional, basada en 102.301 adolescentes en edad escolar. Los análisis incluyeron modelos logísticos multivariables, que tuvieron en cuenta las características geográficas y familiares. Cerca de un 27,5% de los adolescentes ya estaban sexualmente iniciados. Los ingresos familiares estuvieron asociados con la iniciación sexual de la mujer, mientras que la raza/etnicidad estuvo asociada con el uso del condón y múltiples parejas sexuales entre los hombres. Por ejemplo, los hombres negros tenían un 35% mayores posibilidades de contar con múltiples parejas (aOR = 1,35; IC95%: 1,13-1,62), pero un 22% menos posibilidades de usar el condón (aOR = 0,78; IC95%: 0,65-0,94), comparados con los hombres blancos. La supervisión frecuente de los padres estuvo positivamente relacionada con el uso del condón (mujeres; aOR = 1,28; IC95%: 1,10-1,49, y hombres; aOR = 1.33; IC95%: 1.18-1,49). Los resultados muestran la compleja relación entre estratos socioeconómicos bajos y los comportamientos sexuales. Los investigadores deberían prestar atención al género, las pautas raciales y sociales para los comportamientos sexuales de los adolescentes, puesto que pueden influenciar la recogida de datos y resultados. Las políticas nacionales deberían apoyar la supervisión de los padres, puesto que puede tratarse de un factor protector.

Humans , Male , Female , Adolescent , Sexual Behavior/statistics & numerical data , Adolescent Behavior/ethnology , Sexual Behavior/ethnology , Socioeconomic Factors , Brazil/ethnology , Sex Factors , Cross-Sectional Studies , Condoms/statistics & numerical data , Contraception Behavior/statistics & numerical data , African Continental Ancestry Group , European Continental Ancestry Group
J. bras. pneumol ; 44(6): 449-455, Nov.-Dec. 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-984607


ABSTRACT Objective: To derive reference equations for spirometry in healthy Black adult never smokers in Brazil, comparing them with those published in 2007 for White adults in the country. Methods: The examinations followed the standards recommended by the Brazilian Thoracic Association, and the spirometers employed met the technical requirements set forth in the guidelines of the American Thoracic Society/European Respiratory Society. The lower limits were defined as the 5th percentile of the residuals. Results: Reference equations and limits were derived from a sample of 120 men and 124 women, inhabitants of eight Brazilian cities, all of whom were evaluated with a flow spirometer. The predicted values for FVC, FEV1, FEV1/FVC ratio, and PEF were better described by linear equations, whereas the flows were better described by logarithmic equations. The FEV1 and FVC reference values derived for Black adults were significantly lower than were those previously derived for White adults, regardless of gender. Conclusions: The fact that the predicted spirometry values derived for the population of Black adults in Brazil were lower than those previously derived for White adults in the country justifies the use of an equation specific to the former population.

RESUMO Objetivo: Derivar equações de referência para a espirometria forçada em adultos brasileiros negros, saudáveis, que nunca fumaram, e comparar os resultados com os valores previstos para a raça branca publicados em 2007. Métodos: Os exames seguiram as normas recomendadas pela Sociedade Brasileira de Pneumologia e Tisiologia, e os espirômetros preencheram os requisitos técnicos exigidos pelas diretrizes da American Thoracic Society/European Respiratory Society. Os limites inferiores foram derivados pela análise do 5º percentil dos resíduos. Resultados: Equações e limites de referência foram derivados de uma amostra com 120 homens e 124 mulheres, habitantes de oito cidades brasileiras, utilizando-se um espirômetro de fluxo. Os valores previstos para CVF, VEF1, relação VEF1/CVF e PFE foram mais bem ajustados por regressões lineares, enquanto os fluxos, por equações logarítmicas. Os valores de referência de VEF1 e CVF para ambos os sexos foram significativamente menores quando comparados aos previstos para adultos da raça branca no Brasil. Conclusões: O fato de que os valores previstos da espirometria forçada derivados para a população negra no Brasil tenham sido inferiores aos previstos para a raça branca no país justifica a utilização de uma equação específica para adultos negros.

Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Spirometry , Vital Capacity/physiology , Forced Expiratory Volume/physiology , Reference Values , Brazil/ethnology , Sex Factors , Anthropometry , Age Factors , African Continental Ancestry Group , European Continental Ancestry Group
Cad. Saúde Pública (Online) ; 34(10): e00131717, oct. 2018. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-952357


O objetivo deste estudo foi descrever a prevalência de deficiências visual, auditiva e motora e estimar a chance de se ter uma das três deficiências, separadamente, segundo grau de severidade, para a população indígena no Brasil. Os dados foram retirados do Censo Demográfico de 2010 coletados pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Os métodos utilizados incluem a padronização direta para o cálculo das prevalências e modelos de regressão logística multinomial. Os resultados padronizados mostram que homens e mulheres indígenas apresentam a maior prevalência em cada uma das deficiências examinadas neste trabalho, sendo a única exceção a deficiência visual de grau leve entre as mulheres. Os resultados dos modelos de regressão multinomial mostram uma desvantagem relativa dos povos indígenas em quase todos os tipos de deficiência.

This study aimed to describe the prevalence of visual, hearing, and motor impairments in the indigenous population in Brazil and to estimate the odds of presenting one of the three disabilities, separately, according to degree of severity. The data were obtained from the 2010 Population Census conducted by the Brazilian Institute of Geography and Statistics (IBGE). The methods included direct standardization for calculation of the prevalence rates and multinomial logistic regression models. According to the standardized results, indigenous men and women showed the highest prevalence in each of the three disabilities, except for mild visual impairment in women. The results of the multinomial regression models revealed a relative disadvantage for indigenous peoples in nearly all the types of disability.

El objetivo de este estudio fue describir la prevalencia de discapacidad visual, auditiva y motora y estimar la oportunidad de sufrir una de las tres discapacidades, separadamente, según el grado de severidad, en la población indígena de Brasil. Los datos se obtuvieron del Censo Demográfico de 2010, recogidos por el Instituto Brasileño de Geografía y Estadística (IBGE). Los métodos utilizados incluyen la estandarización directa para el cálculo de las prevalencias y modelos de regresión logística multinomial. Los resultados estandarizados muestran que hombres y mujeres indígenas presentan la mayor prevalencia en cada una de las discapacidades examinadas en este trabajo, siendo la única excepción la discapacidad visual de grado leve entre las mujeres. Los resultados de los modelos de regresión multinomial muestran una desventaja relativa de los pueblos indígenas en casi todos los tipos de discapacidad.

Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Young Adult , Indians, South American/statistics & numerical data , Disabled Persons/statistics & numerical data , Persons With Hearing Impairments/statistics & numerical data , Visually Impaired Persons/statistics & numerical data , Brazil/ethnology , Brazil/epidemiology , Prevalence , Censuses , Educational Status , Middle Aged
An. bras. dermatol ; 93(1): 148-150, Jan.-Feb. 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1038264


Abstract: Porphyria cutanea tarda has a complex etiology with genetic factors not completely elucidated. The miscegenation of the Brazilian population has important implications in the predisposition to diseases. There are no studies concerning the genetic ancestry of patients with porphyria cutanea tarda from a mixed population. Thirty patients living in Rio de Janeiro with sporadic porphyria cutanea tarda were studied for the genetic ancestry through informative markers - INDELS. There was a significant predominance of European ancestry across the sample of patients with porphyria cutanea tarda (70.2%), and a small contribution of African and Amerindian ancestry, 20.1% and 10.9%, respectively.

Humans , Porphyria Cutanea Tarda/genetics , European Continental Ancestry Group/genetics , Brazil/ethnology , Genetic Markers/genetics , Cross-Sectional Studies , Genotype
Braz. oral res. (Online) ; 32: e19, 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-889466


Abstract: The objective of this study was to analyze the epidemiological profile of oral health of Sateré-Mawé indigenous people living in Barreirinha, Amazonas (AM), Brazil, and the Tikuna indigenous people living in the urban area of Manaus (AM), in addition to characterizing the need for endodontic treatment between the two ethnic groups. A total of 138 individuals participated in the study, of whom 98 were Tikuna and 40 were Sateré-Mawé; they were distributed in age groups ranging from seven to 75 years. A very high prevalence of caries was observed in both ethnic groups. For the Sateré-Mawé in the 7-12 age group, the decayed, missing, and filled teeth (DMFT) index presented a mean value of 3.17. Comparing the DMFT index and the need for endodontic treatment in each of the ethnicities, these variables were found to be correlated, because as the DMFT index increases, the chances of needing endodontic treatment increase. The Sateré-Mawé presented a higher prevalence of need for endodontic treatment compared to the Tikuna. The association of comorbidities and the need for endodontic treatment were demonstrated only in the Tikuna, and there was only a correlation of this necessity with the presence of diabetes mellitus (DM) in one case. The need to expand access to oral health in these communities is emphasized, taking into account geographical access and technological, environmental, linguistic, and cultural barriers.

Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Young Adult , DMF Index , Indians, South American/statistics & numerical data , Needs Assessment/statistics & numerical data , Oral Health/statistics & numerical data , Root Canal Therapy/statistics & numerical data , Age Distribution , Brazil/ethnology , Comorbidity , Educational Status , Logistic Models , Prevalence , Socioeconomic Factors , Statistics, Nonparametric
Cad. Saúde Pública (Online) ; 34(11): e00063618, 2018.
Article in Portuguese | LILACS (Americas) | ID: biblio-974591


Resumo: Esta etnografia objetivou compreender a experiência de profissionais da saúde que trabalham em um Serviço de Atenção Especializada em HIV/aids num contexto de área remota, no Nordeste brasileiro. Para a coleta de dados, utilizaram-se observação participante e entrevista semiestruturada com sete profissionais que compunham a equipe do serviço estudado. Por meio da técnica de codificação temática, obtiveram-se três categorias: "eu não sabia nem o que era": aspectos do vir a ser profissional especializado em HIV/aids; "está todo mundo lá meio que escondido": estratégias de enfrentamento à (in)visibilidade do status sorológico; e "a gente vive em cima da corda bamba": experiências no processo de trabalho. O aspecto mais relevante deste estudo diz respeito à invisibilidade institucional do serviço como reflexo da atual configuração do dispositivo da aids no Brasil. Os resultados assinalaram algumas dificuldades próprias de serviços localizados em áreas remotas, notadamente a inexperiência dos profissionais e seu agravamento pela carência de educação permanente, necessidades infraestruturais, o lugar das ações de saúde em HIV/aids na agenda política local e a centralidade do fazer médico na organização do processo de trabalho. Destacou-se, ainda, a agência dos interlocutores na produção de estratégias de enfrentamento dessas dificuldades. Este estudo acrescenta ao ressaltar a dimensão local como um marcador social da diferença que modelava as experiências dos interlocutores, pois é ali onde as diretrizes e os princípios da política de saúde são performados por profissionais, gestores e usuários compondo materialidades diversas.

Abstract: This ethnographic study aimed to understand the experience of health professionals working in a Specialized Service for HIV/AIDS Care in a remote area of Northeast Brazil. Data collection used participant observation and a semi-structured interview with seven professionals in the health care team. The thematic coding technique yielded three categories: "I didn't even know what it was": aspects of becoming a specialist in HIV/AIDS; "They're all out there, kind of hidden": strategies for dealing with the (in)visibility of serological status; and "We live on the tightrope": experiences in the work process. The study's most relevant aspect was the service's institutional invisibility as a result of the current configuration of the AIDS structure in Brazil. The results revealed several difficulties that are typical of services located in remote areas, especially the health professionals' lack of experience, aggravated by the lack of continuing education, unmet infrastructure needs, the position of HIV/AIDS care on the local political agenda, and the physician-centered organization of the work process. The study also highlighted the interlocutors' agency in the production of strategies to deal with these difficulties. The study further emphasized the local dimension as a social marker of difference that modeled the interlocutors' experiences, where the health policy's guidelines and principles are performed by health professionals, administrators, and users, comprising diverse material forms.

Resumen: Este estudio etnográfico tuvo como objetivo comprender la experiencia de profesionales de salud, que trabajan en un Servicio de Atención Especializada en VIH/SIDA en un contexto de área remota, en el nordeste brasileño. Para la recogida de datos, se utilizaron técnicas observación participante y entrevista semiestructurada con siete profesionales que componían el equipo del servicio estudiado. Mediante la técnica de codificación temática, se obtuvieron tres categorías: "yo no sabía ni lo que era": aspectos de lo que supone convertirse en un profesional especializado en VIH/SIDA; "está todo el mundo allí medio escondido": estrategias de enfrentamiento a la (in)visibilidad del estatus serológico; y "la gente vive sobre una cuerda floja": experiencias en el proceso de trabajo. El aspecto más relevante de este estudio se refiere a la invisibilidad institucional del servicio, como reflejo de la actual red de atención al SIDA en Brasil. Los resultados señalaron algunas dificultades propias de servicios localizados en áreas remotas, resaltándose la inexperiencia de los profesionales y su agravamiento por la carencia de formación permanente; necesidad de infraestructuras; el lugar de las acciones de salud en relación con VIH/SIDA dentro de la agenda política local, y la centralidad del quehacer médico en la organización del proceso de trabajo. Se destaca, no obstante, la voluntad de los interlocutores para generar estrategias que enfrenten esas dificultades. Este estudio es relevante al resaltar la dimensión local, como un marcador social de las diferencias que modelaban las experiencias de los interlocutores, pues es allí donde se llevan a cabo las directrices y los principios de política de salud por parte de profesionales, gestores y usuarios formando materialidades diversas.

Humans , HIV Infections/ethnology , Acquired Immunodeficiency Syndrome/ethnology , Health Personnel/education , Rural Health Services , Patient Care Team , Professional-Patient Relations , Rural Population , Brazil/ethnology , HIV Infections/therapy , Health Knowledge, Attitudes, Practice , Acquired Immunodeficiency Syndrome/therapy , Delivery of Health Care , Qualitative Research
Cad. Saúde Pública (Online) ; 34(9): e00211717, 2018. tab, graf
Article in Portuguese | LILACS (Americas) | ID: biblio-952455


Os objetivos foram investigar a associação entre raça/cor e a sobrevivência em 10 anos de mulheres com câncer de mama e o papel do estadiamento como mediador. Coorte hospitalar com 481 mulheres com câncer invasivo de mama, diagnosticadas entre 2003 e 2005. Foram feitas comparações entre mulheres brancas e negras quanto às características sociodemográficas e ao estadiamento, usando o teste qui-quadrado, e à sobrevivência em 10 anos, usando os métodos de Kaplan-Meier e regressão de Cox. Foram estimados para a variável raça/cor efeitos diretos e indiretos, mediados pelo estadiamento, com ajuste para a condição social da área de residência e idade, utilizando o modelo de respostas potenciais (contrafactual) e regressão múltipla de Cox. As mulheres negras residiam em setores censitários de menor renda, eram usuárias do setor público em maior proporção e foram diagnosticadas com estadiamentos mais avançados. A sobrevivência específica em 10 anos foi de 64,3% (IC95%: 60,0; 68,9), com diferença significativa entre brancas (69,5%; IC95%: 64,8; 74,6) e negras (44%; IC95%: 35,2; 55,1). Nos modelos múltiplos, ajustados para renda e idade, as negras tiveram pior prognóstico (HR = 2,09; IC95%: 1,76; 2,51), e a proporção mediada pelo estadiamento foi de 40% (IC95%: 37; 42). Há disparidade racial na sobrevivência do câncer de mama em 10 anos, mediada principalmente pelo estadiamento mais avançado da doença nas mulheres negras. Isso aponta para a necessidade de ampliar a cobertura e a qualidade do programa de rastreamento dessa doença e facilitar o acesso ao diagnóstico e tratamento precoces, com vistas à redução da iniquidade racial.

The study's objectives were to investigate the association between race/color and 10-year survival in women with breast cancer and the role of staging as mediator. This was a hospital cohort with 481 women with invasive breast cancer diagnosed from 2003 to 2005. Comparisons were made between white and black women as to sociodemographic characteristics and staging, using the chi-square test, and 10-year survival, using Kaplan-Meier and Cox regression methods. For the race/color variable, direct and indirect effects were estimated, mediated by staging, with adjustment for the socioeconomic status of the woman's area of residence and age, using the potential responses (counterfactual) model and Cox multiple regression. Black women living in low-income census tracts were more likely to use the public health care system and to be diagnosed at more advanced stages. Breast cancer-specific 10-year survival was 64.3% (95%CI: 60.0; 68.9), with a significant difference between whites (69.5%; 95%CI: 64.8; 74.6) and blacks (44; 95%CI: 35.2%; 55.1). In the multivariate models adjusted for income and age, black women had worse prognosis (HR = 2.09; 95%CI: 1.76; 2.51), and the proportion mediated by staging was 40% (95%CI: 37; 42). There is racial disparity in 10-year breast cancer survival in Brazilian women, mediated mainly by more advanced staging at diagnosis in black women. This highlights the need to expand both the coverage and the quality of breast cancer screening and to facilitate access to early diagnosis and treatment in order to reduce racial inequality.

Los objetivos fueron investigar la asociación entre raza/color y la supervivencia en 10 años de mujeres con cáncer de mama y el papel de la fase de desarrollo como mediador. Se trata de una cohorte hospitalaria de 481 mujeres, con cáncer invasivo de mama, diagnosticadas entre 2003 y 2005. Se realizaron comparaciones entre mujeres blancas y negras, en cuanto a las características sociodemográficas y a la fase del cáncer, usando el test chi-quadrado, y la supervivencia en 10 años, usando los métodos de Kaplan-Meier y regresión de Cox. Se estimaron para la variable raza/color efectos directos e indirectos, mediados por las diferentes fases, con ajuste en la condición social del área de residencia y edad, utilizando el modelo de respuestas potenciales (contrafactual) y regresión múltiple de Cox. Las mujeres negras residían en sectores censitarios de menor renta, eran usuarias del sector público en mayor proporción y fueron diagnosticadas en fases más avanzadas. La supervivencia específica en 10 años fue de un 64,3% (IC95%: 60,0; 68,9), con una diferencia significativa entre blancas (69,5%; IC95%: 64,8%-74,6%) y negras (44%; IC95%: 35,2; 55,1). En los modelos múltiples, ajustados para renta y edad, las negras tuvieron un peor pronóstico (HR = 2,09; IC95%: 1,76-2,51), y la proporción mediada por el estadio fue de un 40% (IC95%: 37; 42). Existe disparidad racial en la supervivencia del cáncer de mama en 10 años, mediada principalmente por el estadio más avanzado de la enfermedad en las mujeres negras. Esto apunta la necesidad de ampliar la cobertura y calidad del programa de rastreo de esa enfermedad y facilitar el acceso al diagnóstico y tratamiento precoces, con vistas a la reducción de la inequidad racial.

Humans , Female , Aged , Breast Neoplasms/ethnology , Breast Neoplasms/mortality , Health Status Disparities , Socioeconomic Factors , Time Factors , Brazil/ethnology , Breast Neoplasms/pathology , Proportional Hazards Models , Survival Rate , Cohort Studies , Age Distribution , African Continental Ancestry Group , European Continental Ancestry Group , Kaplan-Meier Estimate , Healthcare Disparities/ethnology , Race Factors , Middle Aged , Neoplasm Staging
Cad. Saúde Pública (Online) ; 33(10): e00139516, oct. 2017. tab
Article in Portuguese | LILACS (Americas) | ID: biblio-952327


Resumo: A pré-hipertensão arterial é precursora da hipertensão arterial e fator de risco para doenças cardiovasculares. Populações vulneráveis estão mais propensas a esse tipo de agravo devido às dificuldades de acesso aos serviços de saúde. Pesquisa anterior realizada em comunidades quilombolas reportou elevada prevalência de hipertensão arterial. Este trabalho teve por objetivo estimar a prevalência de pré-hipertensão em quilombolas e avaliar fatores associados. Trata-se de um estudo transversal de base populacional realizado com indivíduos com 18 anos ou mais. A pré-hipertensão foi definida como pressão arterial sistólica ≥ 121mmHg e < 140mmHg e/ou diastólica ≥ 81mmgH e < 90mmHg. Empregou-se análise multivariada valendo-se de regressão de Poisson com variância robusta. Também foram calculadas frações atribuíveis populacionais (FAPs) para os fatores associados modificáveis. A prevalência de pré-hipertensão foi de 55% (IC95%: 50,2-59,7). O sexo masculino (RP = 1,54), a escolaridade de 1-4 anos completos de estudos (RP = 1,44) e as categorias de IMC sobrepeso (RP = 1,39) e obesidade (RP = 1,87) apresentaram associação positiva com a pré-hipertensão. Maiores frações atribuíveis foram observadas entre os indivíduos com escolaridade de 1-4 anos de estudos (13,7%) e entre os classificados com sobrepeso (9,35%) e obesidade (4,6%). A prevalência de pré-hipertensão nas comunidades quilombolas foi elevada, e sua identificação pode permitir o rastreamento e a sensibilização de um grupo com maior risco cardiovascular e de progressão para a hipertensão arterial. Observa-se a necessidade de amplo acesso a serviços de saúde e ações específicas voltadas à orientação, prevenção e promoção da saúde nessa população.

Abstract: Arterial prehypertension is a precursor of arterial hypertension and a risk factor for cardiovascular diseases. Vulnerable populations are more prone to this condition due to difficulties in access to health services. A previous study in quilombola communities (descendants of African slaves) reported a high prevalence of arterial hypertension. The current study aimed to estimate the prevalence of arterial prehypertension in quilombolas and to assess associated factors. This was a cross-sectional population-based study in individuals 18 years and older. Prehypertension was defined as arterial systolic pressure ≥ 121mmHg and < 140mmHg and/or diastolic ≥ 81mmHg and < 90mmHg. Multivariate Poisson regression with robust variance was used. Population-attributable fractions (PAF) were also calculated for the modifiable associated factors. Prevalence of prehypertension was 55% (95%CI: 50.2-59.7). Male gender (PR = 1.54), 1 to 4 complete years of schooling (PR = 1.44), and BMI classified as overweight (PR = 1.39) and obesity (PR = 1.87) showed positive association with prehypertension. Higher attributable fractions were observed in individuals with 1 to 4 years of schooling (13.7%) and those classified as overweight (9.35%) and obese (4.6%). Prevalence of prehypertension in quilombola communities was high, and its identification may allow screening and awareness-raising in a group with increased risk of cardiovascular disease and progression to full-blown hypertension. The study highlights the need for broad access to health services and specific measures for orientation, prevention, and health promotion in this population.

Resumen: La pre-hipertensión arterial es precursora de la hipertensión arterial y un factor de riesgo para enfermedades cardiovasculares. Las poblaciones vulnerables están más propensas a este tipo de problema de salud, debido a sus dificultades de acceso a los servicios de salud. La investigación anterior, realizada en comunidades quilombolas, reportó una elevada prevalencia de hipertensión arterial. Este trabajo tuvo como objetivo estimar la prevalencia de pre-hipertensión en quilombolas y evaluar sus factores asociados. Se trata de un estudio transversal de base poblacional, realizado con individuos con 18 años o más. La pre-hipertensión se definió como presión arterial sistólica ?≥ 121mmHg y < 140mmHg y/o diastólica ≥ 81mmHg y < 90mmHg. Se empleó un análisis multivariado, valiéndose de la regresión de Poisson con estimación robusta de la variancia. También se calcularon Fracciones Atribuibles Poblacionales (FAP) para los factores asociados modificables. La prevalencia de pre-hipertensión fue de un 55% (IC95%: 50,2-59,7). El sexo masculino (RP = 1,54), una escolaridad de 1 a 4 años completos de estudios (RP = 1,44) y las categorías de IMC sobrepeso (RP = 1,39) y obesidad (RP = 1,87) presentaron una asociación positiva con la pre-hipertensión. Mayores fracciones atribuibles se observaron entre los individuos con escolaridad de 1 a 4 años de estudios (13,7%) y entre los clasificados con sobrepeso (9,35%) y obesidad (4,6%). La prevalencia de pre-hipertensión en las comunidades quilombolas fue elevada, y su identificación puede permitir el rastreo y sensibilización de un grupo con mayor riesgo cardiovascular y con progresión hacia la hipertensión arterial. Se observa la necesidad de un amplio acceso a servicios de salud y acciones específicas dirigidas a la orientación, prevención y promoción de la salud en esa población.

Humans , Male , Female , Adolescent , Adult , Young Adult , Prehypertension/ethnology , Brazil/ethnology , Brazil/epidemiology , Body Mass Index , Sex Factors , Prevalence , Cross-Sectional Studies , Risk Factors , African Continental Ancestry Group , Overweight/ethnology , Overweight/epidemiology , Waist Circumference , Prehypertension/prevention & control , Prehypertension/epidemiology , Middle Aged
Medisan ; 21(2)feb. 2017.
Article in Spanish | LILACS (Americas) | ID: biblio-841662


Se presenta el caso clínico de un paciente de 10 años de edad, quien asistió al puesto médico de Santa Johana, municipio de Itamarandiba, estado brasileño de Minas Gerais, acompañado de su madre, por presentar dolor abdominal de tipo cólico, con deposiciones diarreicas mezcladas con sangre y falta de apetito, además ligera palidez cutaneomucosa, lo cual se correspondían con una esquistosomiasis mansónica. Se le realizaron los exámenes pertinentes y se le indicó el tratamiento oportuno, de manera que el niño evolucionó favorablemente

The case report of a 10 years patient is presented who attended Santa Johana doctor´s office, Itamarandiba municipality, Minas Gerais Brazilian state, accompanied by his mother, due to abdominal pain of colic type, with diarrhea mixed with blood and loss of appetite, also a light mucouscutaneous paleness, which corresponded to a schistosomiasis mansoni. The pertinent exams were carried out and the appropriate treatment was indicated, so that the boy had a favorable clinical course

Humans , Male , Child , Water Pollution , Schistosomiasis mansoni/diagnosis , Intestinal Diseases, Parasitic/therapy , Brazil/ethnology