Is there association between human development index and tuberculosis mortality risk? Evidence from a spatial analysis study in the south of Brazil.

The goal of this study was to analyse the spatial pattern of tuberculosis (TB) mortality using different approaches, namely: mortality rates (MR), spatial relative risks (RR) and Bayesian rates (Global and Local) and their association with human development index (HDI), Global and its three dimensions: education, longevity and income. An ecological study was developed in Curitiba, Brazil based on data from Mortality Information System (2008-2014). Spatial scan statistics were used to compute RR and identify high-risk clusters. Bivariate Local Indicator of Spatial Associations was used to assess associations. MR ranged between 0 and 25.24/100.000 with a mean (standard deviation) of 1.07 (2.66). Corresponding values for spatial RR were 0-27.46, 1.2 (2.99) and for Bayesian rates (Global and Local) were 0.49-1.66, 0.90 (0.19) and 0-6.59, 0.98 (0.80). High-risk clusters were identified for all variables, except for HDI-income and Global Bayesian rate. Significant negative spatial relations were found between MR and income; between RR and HDI global, longevity and income; and Bayesian rates with all variables. Some areas presented different patterns: low social development/low risk and high risk/high development. These results demonstrate that social development variables should be considered, in mortality due TB.

Lipoxin A4 inhibits UV radiation-induced skin inflammation and oxidative stress in mice.

BACKGROUND: Lipoxin A4 (LXA4) is a metabolic product of arachidonic acid. Despite potent anti-inflammatory and pro-resolution activities, it remains to be determined if LXA4 has effect on ultraviolet (UV) radiation-induced skin inflammation. OBJECTIVE: To investigate the effects of systemic administration with LXA4 on UV radiation-induced inflammation and oxidative damage in the skin of mice. METHODS: Varied parameters of inflammation and oxidative stress in the skin of mice were evaluated after UV radiation (4.14 J/cm2). RESULTS: Pretreatment with LXA4 significantly inhibited UV radiation-induced skin edema and myeloperoxidase activity. LXA4 efficacy was enhanced by increasing the time of pre-treatment to up to 72 h. LXA4 reduced UV radiation-induced skin edema, neutrophil recruitment (myeloperoxidase activity and LysM-eGFP+ cells), MMP-9 activity, deposition of collagen fibers, epidermal thickness, sunburn cell counts, and production of pro-inflammatory cytokines (TNF-α, IL-1ß, IL-6 and IL-33). Depending on the time point, LXA4 increased the levels of anti-inflammatory cytokines (TGF-ß and IL-10). LXA4 significantly attenuated UV radiation-induced oxidative damage returning the oxidative status to baseline levels in parameters such as ferric reducing ability, scavenging of free radicals, GSH levels, catalase activity and superoxide anion production. LXA4 also reduced UV radiation-induced gp91phox [nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2) subunit] mRNA expression and enhanced nuclear factor erythroid 2-related factor 2 (Nrf2) and its downstream target enzyme nicotinamide adenine dinucleotide (phosphate) quinone oxidoreductase (Nqo1) mRNA expression. CONCLUSION: LXA4 inhibited UV radiation-induced skin inflammation by diminishing pro-inflammatory cytokine production and oxidative stress as well as inducing anti-inflammatory cytokines and Nrf2.

Prevalencia de leptospirosis en humanos en el Distrito Capital / Prevalence of leptospirose in humans in the Capital District

Introducción: La leptospirosis es una enfermedad zoonotica de distribución mundial que afecta a los animales domésticos y salvajes, que eliminan el microorganismo por la orina. Los seres humanos son huéspedes accidentales y pueden presentar desde una enfermedad leve y autolimitada hasta una enfermedad mortal con insuficiencia multiorgánica. Objetivo: Determinar la prevalencia de 13 serovares de Leptospira en sueros de humanos ubicados en 20 localidades del Distrito Capital. Método: Estudio epidemiológico transversal entre agosto del 2006 y marzo del 2007, luego de procesar 1.307 sueros de humanos. Resultados: Los 1.307 sueros de humanos procesados se enfrentaron a 13 serovares, de los cuales resultaron positivos 165 sueros (230 reacciones positivas) y negativos resultaron 1.142 sueros. Se utilizo la icroaglutinacion (MAT) como la prueba serológica de referencia para el diagnostico de esta enfermedad. La prevalencia determinada para humanos fue de 12,62, situación que refleja la importancia de esta zoonosis. Conclusión: Es necesario desarrollar campanas de tipo educativo enfocadas en las personas en riesgo y en los propietarios de animales para que aprendan a reconocer estas zoonosis, con el fin de facilitar el diagnostico y el tratamiento. Palabras clave: leptospirosis, prevalencia, factores de riesgo, estudio epidemiológico, zoonosis.

Introduction: Leptospirosis is a world-wide spread zoonotic disease affecting domestic and wild animals, which eliminate the organism in the urine. Humans are accidental hosts and may get a mild and transient disease or even a fatal disease with multiple organ failure. The disease also compromises the health of animals. Aim: To determine the prevalence of thirteen Leptospira serovars in human serum samples taken from twenty zones in the Capital District. Method: A cross-sectional epidemiological study was done. The work was based on serological results obtained from 1,307 processed human serum samples. The work was based on the application of a structured epidemiological survey to people from the Capital District along four networks (20 zones). It was carried out between August 2006 and March 2007. Results: The 1,307 human serum samples were taken before 13 serovars (icterohaemorragiaeserogroup, serovars and copenhageniicterohaemorragiae; SerogroupAustralisserovarsaustralis and bratislava, canicolaserogroup, serovarcanicola; Cynopteriserogroup, serovarcynopteri; serogroup Pomona serovar Pomona; serogroupautumnalisserovarautumnale; serogroupshermanishermaniserovar, serogroupserovar Mini mini; serogroupserovar Hebdomadishebdomadis;serogroupserovar Bataviaebataviae; serogroupserovarGripotyphosagripotyphosa). 165 serum samples were positive (230 positive reactions) and 1142 were negative. Micro-agglutination Test (MAT) was used as the serological test to diagnose the disease. The prevalence was 12.62 for humans, which reflects the importance of this zoonosis. Conclusion: It is necessary to carry out educational campaigns targeted at persons at risk groups and pet owners so that they learn to recognize these zoonoses in order to facilitate the diagnosis and treatment.

City tuberculosis control coordinators' perspectives of patient adherence to DOT in São Paulo State, Brazil, 2005.

SETTING: Thirty-six priority cities in São Paulo State, Brazil, with a high incidence of tuberculosis (TB) cases, deaths and treatment default. OBJECTIVE: To identify the perspectives of city TB control coordinators regarding the most important components of adherence strategies adopted by health care teams to ensure patient adherence in 36 priority cities in the State of São Paulo, Brazil. DESIGN: Qualitative research with semi-structured interviews conducted with the coordinators of the National TB Control Programme involved in the management of TB treatment services in the public sector. RESULTS: The main issues thought to influence adherence to directly observed treatment (DOT) by coordinators include incentives and benefits delivered to patients, patient-health care worker bonding and comprehensive care, the encouragement given by others to follow treatment (family, neighbours and health professionals), and help provided by health professionals for patients to recover their self-esteem. CONCLUSION: The main aspects mentioned by city TB control coordinators regarding patient adherence to treatment and to DOT in São Paulo are improvements in communications, relationships based on trust, a humane approach and including the patients in the decision-making process concerning their health.

[Collective health: a challenge for nursing]. / Saúde Coletiva: um desafio para a enfermagem.

This study takes public health as the point of departure to discuss both the concept of collective health and its object and field of action, emphasizing the concepts of man, collective and individual spheres, and health-disease, through a discussion of the interdisciplinary construction of the collective health field. The authors then place nursing within this field, emphasizing what appears to be the greatest challenge, i.e., to approach nursing as a practice of relationships.

[Nurses work in the organization of health services and its inclusion in the informatics department of the health bureau of the city of Ribeirao Preto]. / O trabalho do enfermeiro na organização dos serviços de saúde e sua inserção no departamento de Informática da SMS-RP.

The purpose of this investigation was to analyse nurse's role in the organization of the health work at the Informatics Department of the Health Bureau of the city of Ribeirão Preto, regarding the process of municipalization. We verified that nurses were involved in the organization of this area since its implementation. Nurses also performed organization and control activities related to the production, storage and analysis of the necessary data about the different stages of the health care, as well as training and supervising activities of the individuals who work with the information system.

Nursing and the health system in Brazil.

The purpose of this article is to describe nursing in the Brazilian health system and to analyze the characteristics of nursing personnel in Brazil. This description includes types of health institutions, services rendered, and the distribution of nursing personnel by professional categories in 1956, 1982, and 1995. Discussion of the challenges facing Brazilian nurses is presented using data from the Brazilian Institute of Geography and Statistics (IBGE), Federal Nursing Board (COFEn), Regional Nursing Board (COREn), and the Brazilian Nursing Association (ABEn). An increase in the number of outpatient units and in diagnostic and therapeutic examinations has led to an increased the demand for nurses. Public health nurses participate in planning, management, sanitary education, health promotion, and supervision of nursing care provided by nursing technicians, assistants, and other helpers.