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Hormone therapy and Hypertension in Postmenopausal Women: Results from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
No full textBackground: Hypertension is a major risk factor for cardiovascular morbidity and mortality in post-menopausal women.
Although menopausal hormone therapy (MHT) is a very effective treatment for vasomotor symptoms during this period,
the influence of this therapy on blood pressure is not yet clear.
Objective: To evaluate the relationship between the use of MHT and hypertension in participants of the ELSA-Brasil.
Methods: A cross-sectional study using the baseline ELSA-Brasil data in a cohort of 2,138 women who had
experienced natural menopause. This study analyzed hypertension, defined as arterial pressure ≥140/90 mmHg
or previous antihypertensive use, and use of MHT, with participants being classified into never, past, and
current users. Associations were assessed using an adjusted logistic regression model, with statistical significance
set at p<0.05.
Results: Overall, 1,492 women (69.8%) had never used MHT, 457 (21.4%) had used it in the past, and 189 (8.8%)
were current users. The use of MHT was more common in women who had a body mass index (BMI) <25 kg/m2 and
triglyceride levels <150 mg/dl, and who were physically less inactive, non-smokers, and non-diabetics. Current MHT
users were less likely to have hypertension (OR=0.59; 95% CI: 0.41-0.85) compared to those who had never used MHT.
In most cases, MHT was started at or before 59 years of age, within 10 years of becoming menopausal, and its use lasted
for up to five years
Tuberculose na Infância
No full textO controle da tuberculose (TB) envolve uma série de ações relacionadas a práticas clínicas, organização de serviços, interações com outras áreas dentro e fora do setor saúde e sistema de informação e vigilância (MS, 2019).FiocruzTex
Identification and characterization of microsatellite markers for population genetic studies of Panstrongylus megistus (Burmeister, 1835) (Triatominae: Reduviidae)
No full textBackground: Panstrongylus megistus is the most important vector of Chagas disease in Brazil. Studies show that the principal factor hindering the control of triatomines is reinfestation of houses previously treated with insecticides. Studies at the microgeographic level are therefore necessary to better understand these events. However, an efficient molecular marker is not yet available for carrying out such analyses in this species. The aim of the present study was to identify and characterize microsatellite loci for future population genetic studies of P. megistus.
Methods: This study work consisted of five stages: (i) sequencing of genomic DNA; (ii) assembly and selection of contigs containing microsatellites; (iii) validation of amplification and evaluation of polymorphic loci; (iv) standardization of the polymorphic loci; and (v) verification of cross-amplification with other triatomine species.
Results: Sequencing of males and females generated 7,908,463 contigs with a total length of 2,043,422,613 bp. A total of 2,043,690 regions with microsatellites in 1,441,091 contigs were obtained, with mononucleotide repeats being the most abundant class. From a panel of 96 loci it was possible to visualize polymorphisms in 64.55% of the loci. Of the 20 loci genotyped, the number of alleles varied from two to nine with an average of 4.9. Cross-amplification with other species of triatomines was observed in 13 of the loci.
Conclusions: Due to the high number of alleles encountered, polymorphism and the capacity to amplify from geographically distant populations, the microsatellites described here show promise for utilization in population genetic studies of P. megistus
Euthyroid Sick Syndrome and Changes in Thyroid Hormones in Dogs with Hemoparasitosis.
No full textBackground: Hemoparasitoses are extremely important in the clinical routine because they affect a large number of dogs. In spite of the abundance of studies on this topic, hormonal alterations caused by infection with these agents are still poorly known. Therefore, the goal of this work was to assess the serum levels of thyroid hormones of dogs infected with Ehrlichia canis (E. canis) alone, and dogs infected with E. canis and Babesia canis vogeli (B. vogeli) and/or Anaplasma platys (A. platys) before and after treatment with doxycycline chlorohydrate. This study also aimed at checking for presence of euthyroid sick syndrome (ESS) in these animals. Materials, Methods & Results: The concentrations of the thyroid hormones total triiodothyronine (TT3), total tetraiodothyronine (TT4), free tetraiodothyronine (FT4), and canine thyroid-stimulating hormone (cTSH) were assessed by chemiluminescence in 12 dogs. Nested polymerase chain reaction (nPCR) was used to confirm diagnoses. The dogs were divided into 2 groups: G1, which comprised animals infected by E. canis alone, and G2, which included animals simultaneously infected by E. canis and B. vogeli and/or A. platys. The serum concentrations of the thyroid hormones were measured at two time points: before (D1) and after (D2) the 28-day treatment with generic doxycycline chlorohydrate (DC) at a dose of 10 mg/kg SID. On D2, another nPCR was carried out to check the efficacy of the treatment. On D2, in both groups, all dogs became negative for E. canis; however, 8 animals remained infected or were reinfected by other hemoparasites. On D1, 4 dogs in G1 exhibited low TT3 in conjunction with low TT4; one of the dogs had increased TT3 alone, and another dog had an increased TT3 accompanied by decreased TT4. In G2, on D1, one dog exhibited high TT3 accompanied by a decreased concentration of TT4; 2 dogs had decreased TT4; 2 dogs had increased TT3; and one dog had both TT3 and TT4 decreased. On D2, with only one exception, the animals in G1 that became negative for all hemoparasites under study exhibited normal serum levels of TT3 and TT4. Three dogs in G1, which were reinfected on D2, sustained decreased TT4 serum concentrations. Whereas, in G1 on D2, only one dog remained with a reduced serum TT4 concentration. Discussion: DC was effective at eliminating infection by E. canis in all dogs on D2. Even though this drug was unable to prevent reinfection of the animals by other hemoparasites, and in spite of divergent results on its efficacy at eliminating babesiosis and anaplasmosis, a clinical improvement was observed in all patients. A decrease in the serum concentrations of thyroid hormones (ESS) may occur in dogs with severe non-thyroid related diseases. Different authors have demonstrated the presence of ESS in dogs with hemoparasitoses; however, this is the first study to provide evidence on the existence of this syndrome in dogs with hemoparasitoses in Brazil, including dogs simultaneously infected by E. canis and B. vogeli and/or A. platys. We observed a reduction in TT3 and/or TT4 in dogs infected by E. canis, B. vogeli, and A. platys. We believe these results may help assessment of prognosis and patient follow-up, as TT4 concentrations returned to normal levels in all dogs that became negative for all hemoparasites after treatment; and only one dog in G1 sustained increased TT3, albeit lower than observed on D1. In animals of G1 that were reinfected after treatment started, TT3 returned to normal, even though TT4 levels remained decreased. In sum, all dogs in G1 and G2 exhibited TT3 and/or TT4 concentrations outside of the reference value ranges on D1, which indicates that alterations in the levels of thyroid hormones were due to infection by the hemoparasites. The animals infected by E. canis alone or simultaneously infected by B. vogeli and/or A. platys exhibited ESS
Histología para Discapacitados Visuales: Un Estudio Aplicando Modelos en Universidades de España y Brasil
No full textThis study aimed to develop models that reproduce histological slide images and evaluate them with blind and sighted students from an inclusion perspective. A questionnaire with questions about the ideal characteristics of a model was answered by visually impaired (VI) students. Based on the responses and optical microscopy images from histological atlases, nine models were constructed with standardized materials. The models were tested at different times with VI students and with students who see. Our results indicate that morphology teaching, according to the students themselves, should make use of extra resources, such as models. The ideal characteristics for model efficiency as a teaching tool were representative textures and reliefs. The models built were evaluated by blind students in Spain and sighted students in Brazil because, from an inclusive perspective, it is ideal that the same material can meet the demands of all types of students. The use of the developed models enhanced learning in both groups, even when combined with microscopes for sighted students. According to student opinions, the use of relief models can represent an important pedagogical strategy used to teach morphological. The importance of developing that materials was also highlighted from an inclusion perspective, as these materials can be used in mixed classes, all students together, in cooperative learning. This study aids morphological subject teachers who teach visually impaired students to know where to start on the path to an inclusive and pedagogically coherent learning process
COVID-19 in northeast Brazil: first year of the pandemic and uncertainties to come
No full textOBJECTIVE:
To analyze the epidemic of COVID-19 in northeastern Brazil, one of the regions
most affected by the virus.
METHODS:
The official data for COVID-19, from March 2020 to March 2021 in the states of
the Northeast Region (NE), were used. The analysis of capital cities and states for accumulated
weekly cases and confirmed deaths was made using the JoinPoint Trend Analysis application.
RESULTS:
In one year, the Northeast region reported 22.9% of the cases and 21.5% of the deaths
in the country due to COVID-19. At the beginning of the pandemic, all states showed a growing
number of cases, first in the capitals and then in the interior. Following this wave, decreases
are observed in all states and their capitals, but with many still reporting a large number of
cases. In the middle of the 2nd semester of 2020 the number of cases begins to increase again
simultaneously in states and their capitals—some at explosive speed—especially in late 2020
and early 2021. A similar pattern is observed in deaths, which exceed or approach the peak seen
in the first wave. In the first wave, all capitals and northeastern states adopted intense isolation
measures. Fortaleza, Recife and Teresina reached the highest isolation index of all capitals, close
to 0.60. This index decreases, with a slight growth trend until the end of December. With the
exception of Fortaleza and Salvador, the other capitals fell to less than 0.40.
CONCLUSION:
The Brazilian NE and the country are in increasingly complicated health,
social and economic situations. It is necessary to speed up vaccinations and maintain non-
pharmacological measures: face masks, social distancing measures and hygiene care, in addition
to policies to protect workers who have lost their incomes and to subsidize small business owners
Boletim BIBSMC: fontes de informação e estratégias de busca em saúde
No full textBoletim nº3 produzido pela BIBSMC referente ao mês maio de 2021.Buscando ampliar seus canais de comunicação com seus usuários, a BibSMC lança o Boletim BiBSMC /Fontes de Informação, com periodicidade mensal. O objetivo é apresentar bases de dados disponíveis na área da saúde, uma estratégia de busca sobre temas de interesse de nossos usuários e informações pertinentes a nossa área temática
Guia de cooperação técnica nacional: Fiocruz: julho 2021
No full textO Manual de Cooperação Técnica da Fiocruz, passa, nessa edição a ser nomeado de Guia de Cooperação Técnica Nacional da Fiocruz.Disponibilizamos também o Relatório de Cooperação Técnica Nacional da Fundação Oswaldo Cruz, com todos os convênios vigentes.A organização dos capítulos deste Guia busca trazer informação sobre as principais questões formais envolvendo as atividades que necessitam de colaboração e cooperação para seu desenvolvimento. Cabe destacar que esse é um campo da Administração Pública em permanente aprimoramento, com extensa e concorrente legislação. A Coordenação-Geral de Planejamento Estratégico entende que esse documento jamais será exaustivo e, portanto, em permanente atualização. Com a sua publicação, a Cogeplan espera contar com a comunidade Fiocruz para a manutenção deste Guia como um documento vivo e sempre em sintonia com as inovações no campo da cooperação, da administração pública, da legislação e da inovação
Vacinas COVID-19 em gestantes, puérperas e lactantes
No full textSistematizamos as atuais recomendações do Ministério da Saúde do Brasil acerca da vacinação para COVID-19 de gestantes, puérperas e lactantes abordadas na Nota Técnica n.º 1/2021 - DAPES/SAPS/MS.FiocruzText
Analyzing Spatial Patterns of Health Vulnerability to Drought in the Brazilian Semiarid Region
No full textHealth determinants might play an important role in shaping the impacts related to long-term disasters such as droughts. Understanding their distribution in populated dry regions may help to map vulnerabilities and set coping strategies for current and future threats to human health. The aim of the study was to identify the most vulnerable municipalities of the Brazilian semiarid region when it comes to the relationship between drought, health, and their determinants using a multidimensional index. From a place-based framework, epidemiological, socio-economic, rural, and health infrastructure data were obtained for 1135 municipalities in the Brazilian semiarid region. An exploratory factor analysis was used to reduce 32 variables to four independent factors and compute a Health Vulnerability Index. The health vulnerability was modulated by social determinants, rural characteristics, and access to water in this semiarid region. There was a clear distinction between municipalities with the highest human welfare and economic development and those municipalities with the worst living conditions and health status. Spatial patterns showed a cluster of the most vulnerable municipalities in the western, eastern, and northeastern portions of the semiarid region. The spatial visualization of the associated vulnerabilities supports decision making on health promotion policies that should focus on reducing social inequality. In addition, policymakers are presented with a simple tool to identify populations or areas with the worst socioeconomic and health conditions, which can facilitate the targeting of actions and resources on a more equitable basis. Further, the results contribute to the understanding of social determinants that may be related to medium- and long-term health outcomes in the region