The Effect of Continuous Low-Intensity Exposure to Electromagnetic Fields from Radio Base Stations to Cancer Mortality in Brazil.

BACKGROUND: this study aims to estimate the rate of death by cancer as a result of Radio Base Station (RBS) radiofrequency exposure, especially for breast, cervix, lung, and esophagus cancers. METHODS: we collected information on the number of deaths by cancer, gender, age group, gross domestic product per capita, death year, and the amount of exposure over a lifetime. We investigated all cancer types and some specific types (breast, cervix, lung, and esophagus cancers). RESULTS: in capitals where RBS radiofrequency exposure was higher than 2000/antennas-year, the average mortality rate was 112/100,000 for all cancers. The adjusted analysis showed that, the higher the exposure to RBS radiofrequency, the higher cancer mortality was. The highest adjusted risk was observed for cervix cancer (rate ratio = 2.18). The spatial analysis showed that the highest RBS radiofrequency exposure was observed in a city in southern Brazil that also showed the highest mortality rate for all types of cancer and specifically for lung and breast cancer. CONCLUSION: the balance of our results indicates that exposure to radiofrequency electromagnetic fields from RBS increases the rate of death for all types of cancer.

Inducible laryngeal obstruction: Endoscopic quantitative analysis of glottic aperture.

OBJECTIVES: Using a method developed for this study, the objective was to perform a quantitative analysis of glottic aperture during the respiratory cycle in subjects suspected of having inducible laryngeal obstruction (ILO) and to compare results to healthy individuals. Correlations between glottic aperture and spirometric parameters were assessed. METHODS: Subjects with high clinical suspicion of ILO and atypical inspiratory findings in spirometry had the images of their laryngoscopy displayed alongside a respiratory flow chart and both were recorded simultaneously. This method allowed detailed analysis of the glottic aperture by measuring the angle of the anterior commissure during inspiration and expiration. Healthy volunteers who performed the same tests and agreed to provide data to this study were used as a control group. RESULTS: All 15 subjects with ILO and 16 healthy participants were evaluated successfully using the proposed method. Measures of the anterior commissure angle in the ILO versus control group were significantly different in all observed parameters and just three ILO subjects had an anterior commissure closure greater than 50% during the respiratory cycle. Inspired volume (FIF50 ) and mid-vital capacity ratio (FEF50 /FIF50 ) had a significant correlation with glottic aperture parameters when considering the evaluation of the subjects all together. CONCLUSION: The proposed method provided precise and quantitative analysis of glottic aperture during the respiratory cycle thus indicating that the usage of equipment that allows for such assessment should be encouraged. Also, the threshold of vocal cords closure accepted as indicative of ILO should be reconsidered, especially during the intercritical period of the disease. LEVEL OF EVIDENCE: 4 Laryngoscope, 130:E349-E356, 2020.

Factors associated with the vulnerability of older people living with HIV/AIDS in Belo Horizonte (MG), Brazil. / Fatores associados à vulnerabilidade de idosos vivendo com HIV/AIDS em Belo Horizonte (MG), Brasil.

The objective of this article was to identify the factors associated with the vulnerability of the elderly aged 60 years or older to HIV/AIDS, based on the perspective of older people living with the virus. Interviews were conducted with 20 participants, including 12 women and eight men, who were patients from a public hospital in Belo Horizonte, Minas Gerais, Brazil. The elderly interviewed had a low education level and low income, were currently or previously in a marital union, had perceptions and behaviors grounded in structural gender relations with power asymmetry and had a low capacity to respond to vulnerability. Most of the elderly interviewed were sexually active, but few reported protecting themselves by using condoms, and the lack of information reached all levels of vulnerability studied. The picture revealed by this article is worrying, underscoring the need to demystify the sexual invisibility of the elderly, ensuring them their right to a healthy and continuous sexual life.

Fatores associados à vulnerabilidade de idosos vivendo com HIV/AIDS em Belo Horizonte (MG), Brasil / Factors associated with the vulnerability of older people living with HIV/AIDS in Belo Horizonte (MG), Brazil

Resumo Este artigo tem como objetivo definir alguns fatores associados à vulnerabilidade dos idosos ao HIV/AIDS, na perspectiva daqueles que vivem com o vírus. Foram entrevistados 20 idosos, 12 mulheres e 8 homens (todos com idade igual ou superior a 60 anos), atendidos em hospital público de Belo Horizonte, Minas Gerais, Brasil. Os idosos entrevistados apresentam baixa escolaridade, baixa renda, estão ou estiveram unidos, têm percepções e comportamentos fundados em relações de gênero estruturadas com assimetria de poder e baixa capacidade de resposta à vulnerabilidade. A maioria dos idosos entrevistados tem vida sexual ativa, mas poucos deles declaram que se protegem. A falta de informações perpassa todos os níveis de vulnerabilidade estudados. O cenário é preocupante, ressaltando a necessidade de se desmitificar a invisibilidade sexual dos idosos, garantindo-lhes uma vida sexual saudável e contínua, o que lhes é de direito.

Abstract The objective of this article was to identify the factors associated with the vulnerability of the elderly aged 60 years or older to HIV/AIDS, based on the perspective of older people living with the virus. Interviews were conducted with 20 participants, including 12 women and eight men, who were patients from a public hospital in Belo Horizonte, Minas Gerais, Brazil. The elderly interviewed had a low education level and low income, were currently or previously in a marital union, had perceptions and behaviors grounded in structural gender relations with power asymmetry and had a low capacity to respond to vulnerability. Most of the elderly interviewed were sexually active, but few reported protecting themselves by using condoms, and the lack of information reached all levels of vulnerability studied. The picture revealed by this article is worrying, underscoring the need to demystify the sexual invisibility of the elderly, ensuring them their right to a healthy and continuous sexual life.

Burden of disease in Brazil and its regions, 2008.

The current study estimated DALY (disability-adjusted life years), an indicator of burden of disease, for Brazil in 2008. The North and Northeast regions showed higher burden of disease. Chronic noncommunicable diseases predominated in all regions of the country, especially cardiovascular diseases, mental disorders (particularly depression), diabetes, and chronic obstructive pulmonary disease. The study also showed a high burden of homicides and traffic accidents. Brazil's epidemiological profile appears even more complex when one considers the non-negligible burden of communicable diseases, maternal and perinatal conditions, and nutritional deficiencies. The analyses allowed a more detailed understanding of the Brazilian's population's health status, underscoring the need for crosscutting actions beyond specific health sector policies and greater attention to the quality of information on morbidity and mortality.

[Maternal deaths in Belo Horizonte, Brazil: perceptions of quality of care and preventability]. / Mortes maternas em Belo Horizonte, Brasil: percepções sobre qualidade da assistência e evitabilidade.

OBJECTIVE: To analyze maternal deaths in Belo Horizonte from 2003 to 2010 based on the perception of family members of women who died from pregnancy-related causes. METHODS: Maternal deaths were researched at the City of Belo Horizonte Department of Health's Maternal, Fetal, and Infant Death Prevention Committee. Family members of deceased women were recruited by telephone or personally. Sample size was not pre-defined; rather, a saturation criterion was employed. Nevertheless, an attempt was made to include families of women who received both public and private health care. The interviews focused on health history prior to the pregnancy; clinical history in the period from the start of pre-natal care until death; care received by the deceased women before, during and after delivery. After transcription and analysis of all interviews, the NVivo 9 qualitative analysis software was used to categorize and code the interviews. RESULTS: The family members of 11 women were interviewed. The victims were between 16 and 40 years old, died of various causes, and had various occupations. Most were in their first or second pregnancy, and most relied on public health care. Seven women had between 8 and 11 years of schooling, and seven were single. Ten women were white or brown. All the family members interviewed were female, with age ranging from 18 to 66 years. Most were the mothers of the deceased women, had little schooling, were married and worked in the home. The interviewees reported difficulties with the care received during the pregnancy, with little attention paid to the clinical status of the pregnant women. Nine deaths occurred after the delivery. CONCLUSIONS: According to the reports of family members, the maternal deaths recorded in Belo Horizonte between 2003 and 2010 were associated with issues that were possibly preventable, relating to the reproductive rights of women, to pregnancy, delivery, and perinatal care.

Carga de doença no Brasil e suas regiões, 2008 / Carga de enfermedad en Brasil y sus regiones, 2008 / Burden of disease in Brazil and its regions, 2008

No presente estudo, o DALY (anos de vida perdidos ajustados por incapacidade), indicador de estudos de carga de doença, foi estimado para o Brasil em 2008. Entre os principais resultados, observam-se maior carga de doença no Norte e Nordeste e preponderância das doenças crônicas não transmissíveis em todas as regiões do país, em particular as doenças cardiovasculares, os transtornos mentais, com destaque para a depressão, o diabetes e a doença pulmonar obstrutiva crônica. Também chama a atenção a elevada carga dos homicídios e dos acidentes de trânsito. O perfil epidemiológico apresenta-se ainda mais complexo quando se considera a carga não desprezível das doenças transmissíveis, das condições maternas, das condições perinatais e das deficiências nutricionais. As análises empreendidas ao longo do estudo possibilitaram conhecer de forma mais detalhada o status de saúde da população, evidenciando a demanda por ações transversais, que vão além de políticas específicas circunscritas à área de saúde, bem como a necessidade de ampliar o escopo de preocupação com a qualidade das informações sobre morbimortalidade no Brasil.

En este estudio, se estimó DALY (años de vida ajustados por discapacidad), un indicador de estudios de carga de enfermedad, para Brasil durante 2008. Entre los principales resultados se observan la mayor carga de enfermedad en las regiones Norte y Noreste y la preponderancia de las enfermedades crónicas no transmisibles en todas las regiones del país; en particular, las enfermedades cardiovasculares, los trastornos mentales, destacándose la depresión, la diabetes y la enfermedad pulmonar obstructiva crónica. Llama también la atención la elevada carga de homicidios y accidentes de tráfico. El perfil epidemiológico se revela más complejo cuando se considera la no despreciable carga de enfermedades transmisibles, condiciones maternas, perinatales y deficiencias nutricionales. Los análisis efectuados hicieron posible conocer el status de salud de la población, lo que pone en evidencia la demanda de acciones que van más allá de políticas específicas para el área de la salud, así como la necesidad de ampliar la preocupación con la calidad de las informaciones sobre morbimortalidad en Brasil.

The current study estimated DALY (disability-adjusted life years), an indicator of burden of disease, for Brazil in 2008. The North and Northeast regions showed higher burden of disease. Chronic noncommunicable diseases predominated in all regions of the country, especially cardiovascular diseases, mental disorders (particularly depression), diabetes, and chronic obstructive pulmonary disease. The study also showed a high burden of homicides and traffic accidents. Brazil’s epidemiological profile appears even more complex when one considers the non-negligible burden of communicable diseases, maternal and perinatal conditions, and nutritional deficiencies. The analyses allowed a more detailed understanding of the Brazilian’s population’s health status, underscoring the need for crosscutting actions beyond specific health sector policies and greater attention to the quality of information on morbidity and mortality.

Mortes maternas em Belo Horizonte, Brasil: percepções sobre qualidade da assistência e evitabilidade / Maternal deaths in Belo Horizonte, Brazil: perceptions of quality of care and preventability

OBJETIVO: Analisar a mortalidade materna em Belo Horizonte, no período de 2003 a 2010, a partir da percepção dos familiares de mulheres que faleceram por causas relacionadas à maternidade. MÉTODOS: Os óbitos maternos foram investigados junto ao Comitê de Prevenção do Óbito Materno, Fetal e Infantil na Secretaria Municipal de Saúde de Belo Horizonte. Os familiares das mulheres falecidas foram recrutados por telefone ou pessoalmente para entrevistas. O tamanho da amostra de entrevistados não foi previamente definido, tendo sido considerada como critério a saturação das informações obtidas. Entretanto, buscou-se a inclusão de famílias de mulheres atendidas tanto pelo sistema público quanto pelo sistema privado de saúde. As questões norteadoras das entrevistas foram: histórico de saúde prévio à gestação; história clínica do pré-natal até o falecimento; assistência recebida pela mulher falecida no pré-natal, parto e puerpério. Após transcrição e leitura de todas as entrevistas, utilizou-se o software de análise qualitativa NVivo 9 para categorização e codificação dos depoimentos. RESULTADOS: Foram entrevistados os familiares de 11 mulheres, que faleceram por causas variadas, possuíam ocupações diversas e tinham idade entre 16 e 40 anos. A maioria estava em sua primeira ou segunda gestação e era usuária do sistema público de saúde. Sete tinham de 8 a 11 anos de estudo; sete também eram solteiras; 10 eram brancas ou pardas. Todos os familiares entrevistados eram do sexo feminino, com idade variando de 18 a 66 anos. A maioria era de mães, com baixa escolaridade, casadas e que exerciam atividades do lar. Foram relatadas dificuldades com a assistência recebida durante a gravidez, com pouca valorização do quadro clínico das gestantes. Nove óbitos maternos ocorreram no período pós-parto. CONCLUSÕES: Conforme o relato dos familiares, os óbitos maternos registrados em Belo Horizonte entre 2003 e 2010 estiveram associados a questões possivelmente evitáveis, relacionadas aos direitos reprodutivos da mulher, à assistência à gravidez, ao parto e ao puerpério.

OBJECTIVE:To analyze maternal deaths in Belo Horizonte from 2003 to 2010 based on the perception of family members of women who died from pregnancy-related causes. METHODS: Maternal deaths were researched at the City of Belo Horizonte Department of Health's Maternal, Fetal, and Infant Death Prevention Committee. Family members of deceased women were recruited by telephone or personally. Sample size was not pre-defined; rather, a saturation criterion was employed. Nevertheless, an attempt was made to include families of women who received both public and private health care. The interviews focused on health history prior to the pregnancy; clinical history in the period from the start of pre-natal care until death; care received by the deceased women before, during and after delivery. After transcription and analysis of all interviews, the NVivo 9 qualitative analysis software was used to categorize and code the interviews. RESULTS: The family members of 11 women were interviewed. The victims were between 16 and 40 years old, died of various causes, and had various occupations. Most were in their first or second pregnancy, and most relied on public health care. Seven women had between 8 and 11 years of schooling, and seven were single. Ten women were white or brown. All the family members interviewed were female, with age ranging from 18 to 66 years. Most were the mothers of the deceased women, had little schooling, were married and worked in the home. The interviewees reported difficulties with the care received during the pregnancy, with little attention paid to the clinical status of the pregnant women. Nine deaths occurred after the delivery. CONCLUSIONS: According to the reports of family members, the maternal deaths recorded in Belo Horizonte between 2003 and 2010 were associated with issues that were possibly preventable, relating to the reproductive rights of women, to pregnancy, delivery, and perinatal care.

Evolução da mortalidade por causas externas em Manaus de 1980 a 2010 / Evolution of mortality from external causes in Manaus 1980-2010

Será apresentado aqui um quadro sucinto dos aspectos relacionados à mortalidade por causas externas no município de Manaus, com ênfase especial na evolução das mortes por agressões intencionais. Aborda a evolução dos óbitos por causas externas em Manaus, a prosperidade econômica e violência em Manaus, a violência e saúde em Manaus: o que mudou em trinta anos. (AU)

Diferenciais da carga de doença das condições maternas entre mulheres de 15 a 44 anos no Estado de Minas Gerais, 2004-2006 / Differences in disease burden related to condition of maternity among women ages 15-44 in the State of Minas Gerais, Brazil, 2004-2006 / Diferenciales de la carga de enfermedad de las condiciones maternas entre mujeres de 15 a 44 años en el Estado de Minas Gerais, 2004-2006

Embora seja um dos indicadores mais utilizados para avaliar a saúde da mulher, a mortalidade materna não é suficiente para descrever seu real estado de saúde, pois não leva em conta os anos vividos com incapacidade. Assim, para suprir essa deficiência, as condições maternas têm sido analisadas com base no DALY (Disability-Adjusted Life Years), indicador utilizado em estudos sobre carga de doença. O DALY tem sido considerado um indicador mais completo do estado de saúde de uma população, uma vez que incorpora, simultaneamente, as dimensões da mortalidade e da morbidade. O objetivo do presente estudo é estimar e avaliar o diferencial do impacto da carga de doença relativa às condições maternas, no Estado de Minas Gerais e em suas 13 macrorregiões de saúde, no período 2004-2006, entre mulheres em idade reprodutiva, aqui definidas como aquelas com 15 a 44 anos. Entre os principais resultados encontrados, destaca-se a enorme desigualdade nas taxas de DALY nas macrorregiões de Minas Gerais. As três macrorregiões mais pobres do Estado (Jequitinhonha, Nordeste e Norte de Minas) apresentaram as maiores taxas de DALY, correspondendo a 44% de toda a carga de doença das condições maternas estimadas para Minas Gerais, mostrando o quanto a morbimortalidade materna é sensível às iniquidades de renda, que geram situação desigual no que se refere à distribuição dos serviços de saúde.

Although maternal mortality is one of the most commonly used indicators for evaluating women’s health, it is inefficient for describing actual health status since it fails to take into account years lived with a given incapacity. To make up for this deficiency, the present article analyzes maternal conditions based on the Disability-Adjusted Life Years (DALY) Indicator used in studies on disease burden. DALY has been considered a broad and accurate indicator of the health status of a population because it incorporates the dimensions of mortality and morbidity simultaneously. The aim of the present study was to estimate and assess the differential of the impact of the burden of maternal-condition-related diseases in the State of Minas Gerais, Brazil, and in the state’s 13 macro health regions between 2004 and 2006, among women in child-bearing age, defined here as being women between ages 15 and. Among other findings, a very high disparity was seen in DALY rates among the different macro-regions of the state. The three poorest macro regions (Jequitinhonha, Northeast, and North of Minas) showed the highest DALY rates, corresponding to 44% of the entire estimated maternal-condition disease burden for Minas Gerais. This indicates how maternal morbidity and mortality are sensitive to income inequities, which, in turn, generate unequal status regarding the distribution of health services.

Aunque sea uno de los indicadores más utilizados para evaluar la salud de la mujer, la mortalidad materna no es suficiente para describir su real estado de salud, porque no tiene en cuenta los años vividos con incapacidad. De este modo, para suplir esta deficiencia, las condiciones maternas han sido analizadas en base al DALY (Disability-adjusted Life Years), indicador utilizado en estudios sobre carga de enfermedad. El DALY ha sido considerado como un indicador más completo del estado de salud de una población, una vez que incorpora, simultáneamente, las dimensiones de la mortalidad y de la morbilidad. El objetivo del presente estudio es estimar y evaluar el diferencial del impacto de la carga de enfermedad relativa a las condiciones maternas en el Estado de Minas Gerais y en sus 13 macroregiones de salud, en el periodo 2004-2006, entre mujeres en edad reproductiva, aquí definidas como aquellas que tienen de 15 a 44 años. Entre los principales resultados encontrados, se destaca la enorme desigualdad en las tasas de DALY en las macro-regiones de Minas Gerais. Las tres macro-regiones más pobres del Estado (Jequitinhonha, Nordeste y Norte de Minas) presentaron los mayores índices de DALY, lo que corresponde al 44% de toda la carga de enfermedad de las condiciones maternas estimadas para Minas Gerais, mostrando cómo la morbimortalidad materna es sensible a las iniquidades de renta, que generan una situación desigual en lo que se refiere a la distribución de los servicios de salud.

Molecular neuropathogenesis of Alzheimer's disease: an interaction model stressing the central role of oxidative stress.

Alzheimer's disease (AD) exhibits a complex etiology that simultaneously manifests as a complex cellular, neurobiological, molecular, anatomic-physiological and clinical entity. Other significant psychiatric conditions, such as depression and schizophrenia, may also present with complex and concurrent clinical and/or molecular phenotypes. These neuropsychiatric pathologies also originate from both environmental and genetic factors. We analyzed the molecular phenotypes of AD and discuss them with respect to the classical theories, which we integrated into mechanisms that share molecular and/or anatomical connections. Based on these mechanisms, we propose an interaction model and discuss the model in light of studies that refute or support it. Given the spectrum of AD phenotypes, we limit the scope of our discussion to a few, which facilitates concrete analysis. In addition, the study of specific, individual pathogenic phenotypes may be critical to defining the complex mechanisms leading to AD, thereby improving strategies for developing novel therapies.