• 【巴西南卡罗来纳州弗洛里亚诺波利斯的年轻人和长寿老年人的死亡率相关的危险因素。】 复制标题 收藏 收藏
    DOI:10.1590/1413-81232020256.24172018 复制DOI
    作者列表:Confortin SC,Andrade SR,Ono LM,Figueiró TH,d'Orsi E,Barbosa AR
    BACKGROUND & AIMS: :This article aims to investigate risk factors associated with mortality in young (< 80 years) and long-lived (≥ 80 years) older adults in Florianópolis. A longitudinal population-based study of 1702 older adults participants of the EpiFloripa Ageing Study. Deaths were identified through searches in the Mortality Information System. The probability of survival was estimated using the Kaplan-Meier and Log-Rank methods. The effect of risk factors for mortality was evaluated using Cox Regression models, adjusted for gender, family income, leisure physical activity, depressive symptoms, functional disability, falls, smoking, cardiovascular disease, stroke, and diabetes mellitus. The overall survival probability was 89.9% and 52.6% for the young and long-lived older adults, respectively. For younger older adults, the risk of death was higher for males, ex-smokers and those with moderate/severe disability. For the long-lived older adults, only those with depressive symptoms had a higher risk of death. These results reveal different risk profiles of death among younger and older adults and the need for a differentiated look in the health care of this population.
    背景与目标: :本文旨在调查与弗洛里亚诺波利斯的年轻(<80岁)和长寿(≥80岁)老年人死亡率相关的危险因素。 EpiFloripa衰老研究的1702位年龄较大的成年人参加了一项基于人口的纵向研究。通过在死亡率信息系统中进行搜索来识别死亡。使用Kaplan-Meier和Log-Rank方法估算生存率。使用Cox回归模型评估了死亡风险因素的影响,并针对性别,家庭收入,休闲体育活动,抑郁症状,功能障碍,跌倒,吸烟,心血管疾病,中风和糖尿病进行了调整。年轻人和长寿老年人的总生存率分别为89.9%和52.6%。对于较年轻的成年人,男性,前吸烟者和中度/重度残疾者的死亡风险较高。对于长寿的老年人,只有那些具有抑郁症状的人才有更高的死亡风险。这些结果揭示了年轻人和老年人中不同的死亡风险特征,并且需要对该人群的医疗保健加以区别对待。
  • 【在巴西里约热内卢一个参考中心,青少年缺乏抗逆转录病毒依从性的相关因素。】 复制标题 收藏 收藏
    DOI:10.1258/ijsa.2008.008017 复制DOI
    作者列表:Filho LF,Nogueira SA,Machado ES,Abreu TF,de Oliveira RH,Evangelista L,Hofer CB
    BACKGROUND & AIMS: :The objective of this study was to describe the adherence to antiretroviral therapy (ART) among adolescents followed-up in Rio de Janeiro. This cross-sectional study included all adolescents (aged 10-19 years) followed at Instituto de Puericultura e Pediatria Martagão Gesteira and Hospital Universitário Clementino Fraga Filho. Adherence was determined by self-report (number of missed ART doses in three days prior to the interview). Adherence was categorized as taking > or = 95% of the ARTs (adherent), or < 95% (non-adherent). Variables related to demographics and treatment were evaluated and if P value < or = 0.15, they were selected for a logistic regression analysis. One hundred and one adolescents were interviewed. The mean time on ART was 91 months and the mean adherence was 94% of this, 21 were non-adherent, and 80 adherent. The risk factors associated with non-adherence were: if the patient was not concerned about ART, odds ratio (OR) = 3.47 (95% confidence interval [CI] = 1.13-10.68); if they do not carry an extra dose of ART, OR = 6.63 (95% CI = 1.73-25.47); if a health-care worker taught them how to take ART, OR = 0.27 (95% CI = 0.08-0.93). Adherence among adolescents was higher than expected. Factors associated with lack of adherence were: interviewees being unaware of ARTs and lack of commitment to the treatment. Interventions involving these factors must be evaluated.
    背景与目标: :这项研究的目的是描述在里约热内卢随访的青少年对抗逆转录病毒疗法(ART)的依从性。这项横断面研究包括所有年龄在10-19岁之间的青少年,分别在MartagãoGesteira的儿科儿科研究所和Clementino Fraga Filho大学医院进行。依从性由自我报告(访谈前三天内错过的ART剂量数)确定。依从性分类为服用>或= 95%的抗逆转录病毒药物(依从性)或<95%(不依从性)。评估与人口统计学和治疗有关的变量,如果P值<或= 0.15,则选择它们进行逻辑回归分析。采访了一百一十个青少年。接受ART的平均时间为91个月,平均坚持率为94%,其中21例不坚持,80例坚持。与不依从相关的危险因素为:如果患者不关心抗逆转录病毒治疗,优势比(OR)= 3.47(95%置信区间[CI] = 1.13-10.68);如果他们不携带额外剂量的ART,则OR = 6.63(95%CI = 1.73-25.47);如果医护人员教他们如何接受抗逆转录病毒疗法,则OR = 0.27(95%CI = 0.08-0.93)。青少年的依从性高于预期。与缺乏依从性相关的因素有:受访者不了解抗逆转录病毒疗法和缺乏治疗承诺。必须评估涉及这些因素的干预措施。
  • 【巴西圣卡塔琳娜州十几年来青少年的水果和蔬菜消费量。】 复制标题 收藏 收藏
    DOI:10.1590/1413-81232020252.32452017 复制DOI
    作者列表:Silva JAD,Silva KSD,Silva MC,Silveira PMD,Duca GFD,Benedet J,Nahas MV
    BACKGROUND & AIMS: :Understanding the changes in the trends of fruit and vegetable consumption among adolescents is important in order to implement public health actions. The scope of this article is to investigate the changes over a ten-year period in the daily fruit and vegetable consumption among adolescents from Santa Catarina, according to sex, age and housing area. It is a secondary analysis of a panel survey entitled "Lifestyle and Risk Behavior of Adolescents in the State of Santa Catarina, Brazil (ComPAC)." Adolescents (15-19 years of age) of state schools in 2001 (n=5.028) and 2011 (n=6.529) answered a questionnaire about fruit and vegetable consumption as well as about sociodemographic aspects. Descriptive statistics and logistic regression were applied, according to sex, age and housing area. There was a decrease in daily fruit (39.1% and 16.6%) and vegetable (40.1% and 20.6%) consumption. Different prevalence levels were observed when analyzing subgroups, mainly among girls. From 2001 to 2011, daily vegetable consumption among boys and adolescents in rural areas remained the same. The decrease in daily consumption of fruit and vegetables among adolescents aged 15 to 19 in Santa Catarina highlights the need for the development of strategies to reverse this scenario. :Compreender mudanças no consumo de frutas e verduras por adolescentes é importante para criação de ações de saúde pública. O objetivo deste artigo é investigar mudanças, em dez anos, no consumo diário de frutas e verduras por adolescentes, de acordo com sexo, idade e área de moradia. Estudo de painel (análise secundária) da pesquisa "Estilo de vida e comportamentos de risco de jovens catarinenses". Adolescentes (15-19 anos) de escolas estaduais, em 2001 (n = 5.028) e 2011 (n = 6.529), responderam questionário sobre consumo de frutas e verduras e aspectos sociodemográficos. Estatística descritiva e regressão logística (2001 vs 2011), estratificada para sexo, idade e área de moradia. Houve diminuição no consumo diário de frutas (39,1% e 16,6%) e de verduras (40,1% e 20,6%). Diferentes prevalências são observadas de acordo com subgrupos, principalmente entre moças. A chance para consumo diário de verduras entre rapazes e adolescentes de área rural continuou a mesma. A diminuição na prevalência do consumo diário de frutas e verduras por adolescentes catarinenses de 15 a 19 anos aponta necessidade de criação de estratégias para reversão deste cenário.
    背景与目标: :了解青少年水果和蔬菜消费趋势的变化对于实施公共卫生行动很重要。本文的目的是根据性别,年龄和居住面积,调查圣卡塔琳娜州青少年在十年中每日水果和蔬菜消费量的变化。这是对一项小组调查的次级分析,该小组调查的标题是“巴西圣卡塔琳娜州(ComPAC)青少年的生活方式和风险行为”。 2001年(n = 5.028)和2011(n = 6.529)州立学校的青少年(15-19岁)回答了有关水果和蔬菜消费以及社会人口统计学方面的问卷。根据性别,年龄和居住面积,采用描述性统计和逻辑回归。每日水果(39.1%和16.6%)和蔬菜(40.1%和20.6%)的消费量减少了。在分析亚组时,主要是在女孩中,观察到了不同的患病率。从2001年到2011年,农村地区男孩和青少年的日常蔬菜消费量保持不变。圣卡塔琳娜州15至19岁青少年的日常水果和蔬菜消费量减少,突显了制定应对这种情况的策略的必要性。
    :对未成年人的重要消费品进行补充。最好不要在青少年身上购买任何可食用的青少年产品,也不要在青少年中购买任何可食用的东西,也不必在青少年身上消费过任何东西即可享受购物的乐趣。daccess-ods.un.org daccess-ods.un.org daccess-ods.un.org daccess-ods.un.org daccess-ods.un.org Estudo de painel(análisesecundária)da pesquisa“ Estilo de vida e comportamentos de risco de jovens catarinenses”。青少年(15-19岁)的escolas estaduais,时间2001年(n = 5.028)和2011年(n = 6.529),回答者问题的解决方法,包括水果和蔬菜。 《逻辑分析》(2001年与2011年),《性别关系》,《远古时代》。减少生活消费的可能性(39,1%e 16,6%)和verduras(40,1%e 20.6%)。哥斯达黎加原住民先驱者协会(Diferentesprevalênciassãoobservadas de acordo com subgrupos)农村连续性消费者陷入困境的机会不断升级。对青少年青少年的预防和预防措施,由15岁至19岁的儿童在全国范围内进行预防性康复的必要条件。daccess-ods.un.org daccess-ods.un.org daccess-ods.un.org daccess-ods.un.org
  • 【在巴西,开始进行抗逆转录病毒治疗的患者中的自我报告的不良反应。】 复制标题 收藏 收藏
    DOI:10.1590/s1413-86702007000100007 复制DOI
    作者列表:Pádua CA,César CC,Bonolo PF,Acurcio FA,Guimarães MD
    BACKGROUND & AIMS: :A cross-sectional analysis was carried out to describe adverse reactions to antiretroviral therapy (ART) reported by HIV-infected patients initiating treatment at two public health AIDS referral centers in Belo Horizonte, Brazil, 2001-2003 and to verify their association with selected variables. Adverse reactions were obtained through interview at the first follow-up visit (first month) after the antiretroviral prescription. Socio-demographic and behavioral variables related to ART were obtained from baseline and follow-up interviews and clinical variables from medical charts. Patients with four or more reactions were compared to those with less than four. Odds ratio with 95% confidence interval were estimated using logistic regression model for both univariate and multivariate analyses. At least one adverse reaction was reported by 92.2% of the participants while 56.2% reported four or more different reactions. Antiretroviral regimens including indinavir/ritonavir, irregular use of antiretrovirals and switch in regimens were independently associated with four or more adverse reactions (OR=7.92, 5.73 and 2.03, respectively). The initial period of ARV treatment is crucial and patients' perception of adverse reactions should be carefully taken into account. Strategies for monitoring and management of adverse reactions including the choice of regimens and the prevention of irregular ART should be developed in AIDS/HIV referral centers in Brazil to promote better adherence to antiretroviral therapy.
    背景与目标: :进行了一项横断面分析,以描述2001-2003年在巴西贝洛哈里桑塔的两个公共卫生AIDS推荐中心接受HIV感染的患者开始治疗的抗逆转录病毒疗法(ART)的不良反应,并验证其与选定患者的相关性变量。在接受抗逆转录病毒治疗后的首次随访(第一个月)中,通过访谈获得了不良反应。与抗逆转录病毒疗法相关的社会人口统计学和行为变量是从基线和后续访谈中获得的,以及从医学图表中获得的临床变量。将反应超过四个的患者与反应少于四个的患者进行比较。对于单变量和多变量分析,使用逻辑回归模型估计了置信区间为95%的几率。 92.2%的参与者报告了至少一种不良反应,而56.2%的参与者报告了四种或更多种不同的反应。包括茚地那韦/利托那韦在内的抗逆转录病毒方案,不定期使用抗逆转录病毒剂和改用方案分别与四个或更多不良反应相关(分别为OR = 7.92、5.73和2.03)。抗逆转录病毒治疗的初期至关重要,应仔细考虑患者对不良反应的看法。巴西的艾滋病/艾滋病毒转诊中心应制定监测和管理不良反应的策略,包括选择治疗方案和预防不规则抗病毒治疗,以促进对抗逆转录病毒疗法的更好依从性。
  • 【性行为及其与持续性口腔损伤的关系:对POP-巴西研究的分析。】 复制标题 收藏 收藏
    DOI:10.1007/s00784-020-03407-0 复制DOI
    作者列表:da Cunha AR,Bessel M,Hugo FN,de Souza FMA,Pereira GFM,Wendland EMDR
    BACKGROUND & AIMS: OBJECTIVES:To investigate whether the presence of persistent self-reported oral lesions (PSOLs) is associated with sexual behaviors and with the presence of sexually transmitted infections (STIs) in individuals aged 16-25 years in the state capitals of Brazil. MATERIALS AND METHODS:Data from the POP-Brazil study were analyzed. An association analysis was performed by Poisson regression with the presence of PSOLs as the outcome. The exposure variables were the age at first sexual intercourse, the number of partners, oral sex practice, and aspects of condom use for model 1, and the presence of a self-reported STI or a positive rapid test for HIV/syphilis and the presence of genital human papillomavirus (HPV) for model 2. The results were adjusted for socioeconomic variables. RESULTS:The prevalence of PSOLs was 76% higher among individuals who had two or more sexual partners in the past year (p = 0.046) and 68% higher in those who reported not using condoms for contraception (p = 0.032). The group with HIV/syphilis or self-reported STI had a 140% higher PSOL prevalence (p = 0.003). CONCLUSIONS:The self-report of oral lesions in adolescents and young adults may suggest risky sexual behavior and the presence of STI. CLINICAL RELEVANCE:It is necessary to contextualize the reality of the young person to optimize oral health care.
    背景与目标: 目的:调查在巴西州首府16-25岁的人群中,是否存在持续自我报告的口腔损伤(PSOL)与性行为以及性传播感染(STI)是否相关。
    材料与方法:对来自POP-巴西研究的数据进行了分析。通过Poisson回归进行关联分析,并以PSOLs作为结果。暴露变量包括第一次性交的年龄,伴侣的数量,口交行为以及模型1使用安全套的方面,是否存在自我报告的性传播感染或对HIV /梅毒的快速快速检测以及是否存在模型2的生殖器人类乳头瘤病毒(HPV)的检测结果。根据社会经济变量对结果进行了调整。
    结果:在过去的一年中,有两个或更多性伴侣的人中PSOLs的患病率高76%(p = 0.046),而那些不使用避孕套进行避孕的人(p = 0.032)则高68%。 HIV /梅毒或自我报告的STI组的PSOL患病率高140%(p = 0.003)。
    结论:青少年和青年人口腔损伤的自我报告可能提示危险的性行为和性传播感染的存在。
    临床相关性:有必要根据年轻人的实际情况,以优化口腔保健。
  • 【人类脱落乳牙干细胞的生物库:在巴西的应用和发展概述。】 复制标题 收藏 收藏
    DOI:10.1159/000506677 复制DOI
    作者列表:Zalaf BR,Bringel M,Jorge PK,de Oliveira B,Tanabe K,Santos CF,Oliveira RC,Rios D,Cruvinel T,Lourenço Neto N,Oliveira TM,Machado MAAM
    BACKGROUND & AIMS: :A biobank is an organized collection of biological human material and its associated information stored for research according to regulations under institutional responsibility, without commercial purposes, being a mandatory and strategical activity for research, regenerative medicine, and innovation. Stem cells have largely been employed in research and frequently stored in biobanks, which have been used as an essential source of biological materials. Stem cells of human exfoliated deciduous teeth (SHED) are stem cells which have a high multipotency and can be easily obtained. Besides, this extremely accessible tissue has advantages with respect to storage, as the SHED obtained in childhood can be used in later life, which implies the necessity for the creation and regulation of biobanks. The proper planning for the creation of a biobank includes knowledge of the material types to be stored, requirements regarding handling and storage conditions, storage time, and room for the number of samples. Thus, this study aimed to establish an overview of the development of a SHED biobank. Ethical and legal standardization, current applications, specific orientations, and challenges for the implementation of a SHED biobank were discussed. Through this overview, we hope to encourage further studies to use SHED biobanks.
    背景与目标: :生物库是有组织的生物人类材料及其相关信息的集合,根据机构职责下的法规存储,用于研究,而没有商业目的,是研究,再生医学和创新的强制性和战略性活动。干细胞已广泛用于研究中,并经常存储在生物库中,生物库已被用作生物材料的重要来源。人脱落乳牙(SHED)的干细胞是具有高专能的干细胞,很容易获得。此外,这种极易接近的组织在储存方面具有优势,因为在童年时期获得的SHED可以在以后的生活中使用,这意味着必须建立和调节生物库。建立生物库的适当计划包括要存储的材料类型的知识,有关处理和存储条件的要求,存储时间以及样品数量的空间。因此,本研究旨在建立SHED生物库发展概况。讨论了道德和法律标准化,当前应用,特定方向以及实施SHED生物库的挑战。通过此概述,我们希望鼓励进一步研究以使用SHED生物库。
  • 【在巴西南部的肾脏移植患者中,HLA DR1阳性与基底细胞癌有关。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-4632.2011.05282.x 复制DOI
    作者列表:de Carvalho AV,Bonamigo RR,da Silva CM,Pinto AC
    BACKGROUND & AIMS: BACKGROUND:Renal transplant patients have a higher incidence of non-melanoma skin cancer (NMSC). Previous studies hypothesized that human leukocyte antigen (HLA), especially types DR1, DR4, and DR7, may influence the incidence of these tumors. This study investigates the association between NMSC and the presence of HLA DR1, DR4, and DR7 in renal transplant patients in southern Brazil. METHODS:In a historical cohort study, 1032 patients who underwent renal transplantation during the period from January 1993 to December 2006 were examined to identify occurrences of NMSC and HLA status prior to transplant. RESULTS:Of the 1032 patients examined, 59 (5.71%) developed NMSC (squamous cell carcinoma [SCC]: 2.42%; basal cell carcinoma [BCC]: 1.74%; both: 1.55%). The presence of HLA DR1 was associated with a higher probability of developing any NMSC and particularly with developing BCC (P < 0.05). There was no statistically significant association between the presence of HLA DR4 or DR7 and the occurrence of NMSC in this sample. CONCLUSIONS:HLA DR1 appears to be associated with the development of BCC, as well as with the higher number of NMSC lesions in renal transplant patients. This study supports the trend to associate the DR1 allele with BCC and not with SCC.
    背景与目标: 背景:肾移植患者非黑素瘤皮肤癌(NMSC)的发生率较高。先前的研究假设,人白细胞抗原(HLA),尤其是DR1,DR4和DR7型,可能会影响这些肿瘤的发病率。这项研究调查了巴西南部肾脏移植患者中NMSC与HLA DR1,DR4和DR7的相关性。
    方法:在一项历史性队列研究中,对1993年1月至2006年12月期间接受肾移植的1032例患者进行了检查,以鉴定其在移植前是否发生了NMSC和HLA状态。
    结果:在接受检查的1032例患者中,有59例(5.71%)发展为NMSC(鳞状细胞癌[SCC]:2.42%;基底细胞癌[BCC]:1.74%;两者:1.55%)。 HLA DR1的存在与发展任何NMSC的可能性更高,特别是与发展BCC的可能性更高(P <0.05)。在此样品中,HLA DR4或DR7的存在与NMSC的发生之间没有统计学上的显着关联。
    结论:HLA DR1似乎与肾移植患者BCC的发展以及NMSC病变的增多有关。这项研究支持将DR1等位基因与BCC而不与SCC相关的趋势。
  • 【通过两个不同的分子标记揭示了来自巴西,阿根廷和乌拉圭的红藻Triatoma rubrovaria(Reduviidae:Triatominae)的遗传变异性。】 复制标题 收藏 收藏
    DOI:10.1051/parasite/2007143231 复制DOI
    作者列表:Pacheco RS,Almeida CE,Klisiowicz DR,Costa J,Pires MQ,Panzera F,Bar ME,Mas-Coma S,Bargues ME
    BACKGROUND & AIMS: :Randomly amplified polymorphic DNA (RAPD) and nuclear ribosomal DNA sequence analyses were used to assess the genetic population structure of the South American triatomine species Triatomo rubrovario throughout its geographical distribution. To investigate the genetic variability at both intraspecific and intrapopulational levels the RAPD profiles and the nucleotide sequences of the rDNA intergenic spacers, ITS-1 and ITS-2, were analysed and compared. The phenetic analysis based on RAPD profiles show three distinct clusters diverging by similarity coefficients ranging from 0.62 to 0.96. The ITS-1 and ITS-2 sequence variability detected may be considered very high, suggesting reproductive isolation between populations. A total of seven composite haplotypes (CH) were found, among which three are specific for Brazil, other three for Uruguay, and the last one common for the three countries studied. The population studied in Argentina does not represent an independent CH. Sequence analyses proved that the five populations studied are easily differentiable and that there is heterogeneity within each one. True mutations and indels are the responsible of sequence differences between haplotypes and populations, suggesting that divergence processes may presently go on within this species. The large intraspecific variability detected may underlie the known plasticity of T. rubrovaria, making it a potential intradomiciliary invader and consequently an appropriate vector for Chagas disease transmission. Therefore, this triatomine species must be continuously monitored throughout.
    背景与目标: :随机扩增多态性DNA(RAPD)和核糖核糖体DNA序列分析被用于评估南美三atomine物种Triatomo rubrovario在整个地理分布中的遗传种群结构。为了研究种内和种群内水平的遗传变异性,分析并比较了rPD基因间隔子ITS-1和ITS-2的RAPD图谱和核苷酸序列。基于RAPD分布图的物候分析表明,三个相似的簇之间的相似系数相差0.62至0.96。检测到的ITS-1和ITS-2序列变异性可能被认为很高,这表明种群之间存在生殖隔离。总共发现了七个复合单倍型(CH),其中三个特定于巴西,另外三个特定于乌拉圭,最后一个常见于三个所研究的国家。在阿根廷研究的人口并不代表独立的CH。序列分析证明,所研究的五个种群易于区分,并且每个种群之间存在异质性。真正的突变和插入缺失是造成单倍型和种群之间序列差异的原因,这表明该物种目前可能正在进行分化过程。检测到的较大的种内变异性可能是已知的红锥衣原体可塑性的基础,使其成为潜在的菌内入侵者,因此是南美锥虫病传播的合适载体。因此,必须始终对这种三atomine物种进行连续监测。
  • 【新热带Monogenoidea。 52. Diechodactylus joaberi n。 g。 sp。来自巴西东南部的带状刀鱼Gymnotus carapo(Gymnotiformes:Gymnotidae)。】 复制标题 收藏 收藏
    DOI:10.1007/s11230-007-9107-5 复制DOI
    作者列表:Vianna RT,Boeger WA,Silva-Souza AT
    BACKGROUND & AIMS: :Diechodactylus joaberi n. g., n. sp. is described from the body surface of the banded knifefish Gymnotus carapo L. (Gymnotiformes: Gymnotidae) from southeastern Brazil. The new genus is proposed to accommodate species with five pairs of hooks in anterior bilateral clusters on the haptor, three pairs of hooks in a single cluster on the posterior margin of the haptor, sclerites R1 associated with the superficial bar, and confluent intestinal caeca. The presence of five pairs of hooks in two bilateral clusters anterior in the haptor permits the differentiation of species of Diechodactylus from species of all known genera of the Gyrodactylidae. The genus is likely a member of a clade of the Gyrodactylidae comprising genera with a similar hook distribution.
    背景与目标: :Diechodactylus joaberi n。 g。 sp。从巴西东南部的带状刀鱼Gymnotus carapo L.(Gymnotiformes:Gymnotidae)的体表描述。提出了新的属,以容纳具有五对钩的物种,在前臂的双侧前集群中有五对钩,在后臂的后缘的单个集群中有三对钩,与浅表杆相关的巩膜R1,和汇合的肠盲肠。在触角前部的两个双侧簇中,五对钩的存在允许区分狄氏龙虾属和所有已知的丁香龙属。该属很可能是包括具有相似钩分布的属的丁香科的进化枝的成员。
  • 【社区药房的药物保健:在巴西的实践和研究。】 复制标题 收藏 收藏
    DOI:10.1345/aph.1K080 复制DOI
    作者列表:de Castro MS,Correr CJ
    BACKGROUND & AIMS: OBJECTIVE:To discuss the provision of pharmaceutical services and pharmaceutical care in Brazil. FINDINGS:Professional training and pharmaceutical services are undergoing a period of restructuring in Brazil, including the adoption of incentives for pharmaceutical care. Some important national measures include the rational use of medications, evidence-based medicine, and pharmacovigilance. A new and more generalist pharmacy curriculum is being implemented and tailored for the Brazilian Public Health System; recently, the Brazilian government has provided resources for pharmaceutical care research. DISCUSSION:A proposal for national consensus in Brazilian pharmaceutical care was published in 2002. The components of this proposal include drug dispensing, counseling, health education, symptoms advice, and pharmacotherapy follow-up. Pharmacy practice is currently focused on drug dispensing and logistic aspects of drug distribution. Professionals are satisfied with patients' confidence in being counseled by pharmacists and reveal interest in extending their role in patient care. Most pharmacy customers were originally unaware of the term "pharmaceutical care"; however, following an explanation, they showed an interest in this service. Furthermore, over 50% stated that they would pay for this service. Despite these initiatives, numerous barriers to the development of pharmaceutical care remain, the main ones being the commercial objective of most pharmacies that sell medications and the insufficient training of professionals. Although government-owned pharmacies also distribute medications, they do not meet all of the needs of the population and lack sufficient pharmacists. CONCLUSIONS:Several actions are required to stimulate the implementation and development of pharmaceutical care and services in Brazil. Recent research incentives in pharmaceutical care and reorientation of pharmacy education will contribute to this development.
    背景与目标: 目的:讨论巴西的药品服务和药品护理服务。
    结果:在巴西,专业培训和制药服务正在进行重组,其中包括采用药品护理激励措施。一些重要的国家措施包括合理使用药物,循证医学和药物警戒。正在针对巴西公共卫生系统实施和量身定制的新的,更具通才的药学课程;最近,巴西政府已经为药物护理研究提供了资源。
    讨论:2002年发布了一项关于在巴西进行药物治疗的全国共识的提案。该提案的组成部分包括药物分配,咨询,健康教育,症状建议以及药物治疗的随访。药学实践目前集中在药物分配和药物分配的后勤方面。专业人士对患者对获得药剂师辅导的信心感到满意,并表示有兴趣扩大其在患者护理中的作用。大多数药房客户最初都不知道“药房护理”一词。然而,经过解释,他们对这项服务表现出了兴趣。此外,超过50%的人表示愿意为此服务付费。尽管采取了这些举措,但仍然存在许多阻碍药物治疗发展的障碍,主要的障碍是大多数出售药物的药房的商业目标以及对专业人员的培训不足。尽管政府拥有的药房也分发药品,但它们不能满足人群的所有需求,并且缺乏足够的药剂师。
    结论:需要采取一些行动来刺激巴西医药保健和服务的实施和发展。近期在药物护理和药物教育方向调整方面的研究激励措施将为这一发展做出贡献。
  • 【巴西老年人的神经病理学诊断和临床相关性:一项横断面研究。】 复制标题 收藏 收藏
    DOI:10.1371/journal.pmed.1002267 复制DOI
    作者列表:Suemoto CK,Ferretti-Rebustini RE,Rodriguez RD,Leite RE,Soterio L,Brucki SM,Spera RR,Cippiciani TM,Farfel JM,Chiavegatto Filho A,Naslavsky MS,Zatz M,Pasqualucci CA,Jacob-Filho W,Nitrini R,Grinberg LT
    BACKGROUND & AIMS: BACKGROUND:Clinicopathological studies are important in determining the brain lesions underlying dementia. Although almost 60% of individuals with dementia live in developing countries, few clinicopathological studies focus on these individuals. We investigated the frequency of neurodegenerative and vascular-related neuropathological lesions in 1,092 Brazilian admixed older adults, their correlation with cognitive and neuropsychiatric symptoms, and the accuracy of dementia subtype diagnosis. METHODS AND FINDINGS:In this cross-sectional study, we describe clinical and neuropathological variables related to cognitive impairment in 1,092 participants (mean age = 74 y, 49% male, 69% white, and mean education = 4 y). Cognitive function was investigated using the Clinical Dementia Rating (CDR) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE); neuropsychiatric symptoms were evaluated using the Neuropsychiatric Inventory (NPI). Associations between neuropathological lesions and cognitive impairment were investigated using ordinal logistic regression. We developed a neuropathological comorbidity (NPC) score and compared it to CDR, IQCODE, and NPI scores. We also described and compared the frequency of neuropathological diagnosis to clinical diagnosis of dementia subtype. Forty-four percent of the sample met criteria for neuropathological diagnosis. Among these participants, 50% had neuropathological diagnoses of Alzheimer disease (AD), and 35% of vascular dementia (VaD). Neurofibrillary tangles (NFTs), hippocampal sclerosis, lacunar infarcts, hyaline atherosclerosis, siderocalcinosis, and Lewy body disease were independently associated with cognitive impairment. Higher NPC scores were associated with worse scores in the CDR sum of boxes (β = 1.33, 95% CI 1.20-1.46), IQCODE (β = 0.14, 95% CI 0.13-0.16), and NPI (β = 1.74, 95% CI = 1.33-2.16). Compared to neuropathological diagnoses, clinical diagnosis had high sensitivity to AD and high specificity to dementia with Lewy body/Parkinson dementia. The major limitation of our study is the lack of clinical follow-up of participants during life. CONCLUSIONS:NFT deposition, vascular lesions, and high NPC scorewere associated with cognitive impairment in a unique Brazilian sample with low education. Our results confirm the high prevalence of neuropathological diagnosis in older adults and the mismatch between clinical and neuropathological diagnoses.
    背景与目标: 背景:临床病理学研究对于确定痴呆症的脑部病变至关重要。尽管几乎60%的痴呆症患者生活在发展中国家,但很少有临床病理研究关注这些人群。我们调查了1,092名巴西混合老年人的神经退行性疾病和与血管相关的神经病理病变的频率,它们与认知和神经精神症状的相关性以及痴呆亚型诊断的准确性。
    方法和结果:在这项横断面研究中,我们描述了1,092名参与者(平均年龄= 74岁,男性49%,白人69%,平均受教育程度= 4岁)中与认知障碍相关的临床和神经病理学变量。使用临床痴呆评分(CDR)和老年人认知功能下降知情问卷(IQCODE)调查认知功能;使用神经精神病学量表(NPI)评估神经精神病症状。使用序数逻辑回归分析研究神经病理病变与认知障碍之间的关联。我们开发了神经病理合并症(NPC)评分,并将其与CDR,IQCODE和NPI评分进行了比较。我们还描述并比较了神经病理学诊断与痴呆亚型临床诊断的频率。样本的百分之四十四符合神经病理学诊断标准。在这些参与者中,有50%的神经病理学诊断为阿尔茨海默病(AD),而35%的血管性痴呆(VaD)。神经原纤维缠结(NFTs),海马硬化,腔隙性梗塞,透明性动脉粥样硬化,铁蛋白钙化和路易体病与认知障碍独立相关。 NPC分数越高,则CDR盒总和的分数越低(β= 1.33,95%CI 1.20-1.46),IQCODE(β= 0.14,95%CI 0.13-0.16)和NPI(β= 1.74,95% CI = 1.33-2.16)。与神经病理学诊断相比,临床诊断对路易氏体/帕金森痴呆症的AD敏感性高,对痴呆症的特异性高。我们研究的主要局限性是一生中缺乏对参与者的临床随访。
    结论:在一个受教育程度低的独特巴西样本中,NFT沉积,血管病变和NPC高分与认知障碍有关。我们的结果证实了老年人神经病理学诊断的普遍性以及临床与神经病理学诊断之间的不匹配。
  • 【税收对巴西含糖饮料的价格影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.ehb.2020.100898 复制DOI
    作者列表:Pereda P,Garcia CP
    BACKGROUND & AIMS: :Sugary drink consumption is an important contributor to the current global epidemic of obesity. In recent years, 50 countries or jurisdictions have implemented taxes on sugary drinks as an instrument to discourage consumption. Against the tide, Brazil reduced taxes on these beverages in 2017 and 2018. However, a recent debate - raised by the federal government - has started over taxation of sugary and alcoholic beverages (sin taxes). The effectiveness of this policy will depend on how the taxes are transferred to prices. In this sense, this paper we aim to quantify the impacts of the tax reduction on prices of sugary drinks in Brazil, and therefore to contribute to the debate by calculating the pass-through of taxes to prices of these products in the Brazilian context. We analyze the Brazilian market using a panel data of products, by brand, collected by Euromonitor from 2013 to 2018. Our results suggest that the transfer of taxes to prices depends on the firm size and the type of product, with pass-through rates ranging from 15% to 124%.
    背景与目标: :饮用烈性酒是当前全球肥胖流行的重要原因。近年来,有50个国家或地区已对含糖饮料征税,以此作为抑制消费的手段。逆势而上,巴西在2017年和2018年降低了对这些饮料的税收。但是,联邦政府提出的最近辩论已开始对含糖和酒精饮料(罪恶税)征税。该政策的有效性将取决于税收如何转换为价格。从这个意义上讲,本文旨在量化税收减免对巴西含糖饮料价格的影响,因此通过计算税收在巴西范围内对这些产品价格的转嫁来为辩论做出贡献。我们使用Euromonitor于2013年至2018年收集的品牌产品面板数据来分析巴西市场。我们的结果表明,税收向价格的转移取决于企业的规模和产品类型,转嫁率范围为从15%到124%。
  • 【巴西低蛋白饮食的一种实用方法。】 复制标题 收藏 收藏
    DOI:10.1186/s12882-016-0305-8 复制DOI
    作者列表:Mafra D,Leal VO
    BACKGROUND & AIMS: BACKGROUND:Chronic kidney disease (CKD) is an emerging health public problem in Brazil. Nutritional counseling with focus on protein restriction is a promising strategy to treatment of nondialysis CKD patients due its effects on slowing renal loss. However, Brazilian people have high protein intake, which is a challenge when low protein diet (LPD) should be prescribed. This review describes a practical approach to the dietetic management of nondialysis CKD patients in Brazil. DISCUSSION:Although Brazilian cuisine varies greatly by region, Brazil has current trends of incorporating Western dietary habits, including high intake of red meat. Traditional plant-based foods, such as rice and beans, are also important contributors to the high protein content to the Brazilian diet. Thus, a successful implementation of LPD requires adaptation of these dietary habits, with reduction of portion sizes and adequate food substitution options. Intensive nutritional counseling with specialized renal dietitians is also important to improve compliance to the LPD. Moreover, the precarious health system organization and economic problems are barriers to nutritional care, which could be solved with intensive and specialized perspectives of treatment. The adherence to protein restriction is important for better metabolic and clinical control of nondialysis CKD patients. Early dietetic attention, nutrition education strategies and intensive specialized nutritional counseling are essential to achieve diet habits that promote adherence to the LPD without excluding cultural characteristics of the Brazilian diet.
    背景与目标: 背景:慢性肾脏病(CKD)是巴西一个新兴的健康公共问题。专注于蛋白质限制的营养咨询是治疗非透析CKD患者的一种有前途的策略,因为它对减慢肾功能有影响。但是,巴西人的蛋白质摄入量很高,这在应规定低蛋白质饮食(LPD)的情况下是一个挑战。这篇综述描述了巴西非透析CKD患者饮食管理的实用方法。
    讨论:尽管巴西的美食在不同地区之间差异很大,但巴西目前有融入西方饮食习惯的趋势,包括大量摄入红肉。传统的植物性食品,例如大米和豆类,也是导致巴西饮食中蛋白质含量高的重要原因。因此,LPD的成功实施需要适应这些饮食习惯,同时减少份量和适当的食物替代选择。专门的肾脏营养师进行强化营养咨询对于提高对LPD的依从性也很重要。此外,不稳定的卫生系统组织和经济问题是营养保健的障碍,可以通过深入和专业的治疗观点来解决。坚持蛋白质限制对于非透析CKD患者更好的代谢和临床控制很重要。早期的饮食注意,营养教育策略和强化的专业营养咨询对于实现饮食习惯,促进遵守LPD的饮食习惯(不排除巴西饮食的文化特征)至关重要。
  • 【巴西坎皮纳斯(Campinas)修改后的美国家庭粮食安全调查模块的心理计量学特性。】 复制标题 收藏 收藏
    DOI:10.1038/sj.ejcn.1602760 复制DOI
    作者列表:Melgar-Quinonez HR,Nord M,Perez-Escamilla R,Segall-Correa AM
    BACKGROUND & AIMS: OBJECTIVE:To assess the internal validity of a multiple-item measure of household food security in Brazil using statistical methods based on the single-parameter logistic (Rasch) measurement model. SUBJECTS/METHODS:Sample of the non-institutionalized civilian population living in the municipality of Campinas selected using stratified cluster sampling. Of the 1000 households randomly chosen, 847 responded to the interview. Responses to each of the 15 questions were coded into dichotomous items indicating whether the specific food-insecure condition had occurred (other than in just 1 or 2 days) during the 3 months before the survey. Scaling analyses were conducted separately as well as jointly for adult/household-related items and child-related items. Item-fit statistics were examined to determine the extent to which the items appear to measure the same underlying phenomenon, and item severity scores were compared with those of equivalent items in the US Current Population Survey. CONCLUSIONS:Except for one item, infit statistics were within a range considered adequate (0.80-1.2), indicating a common phenomenon being measured with approximately equal discrimination. The relative severities of the items in the Campinas survey were generally similar to those of equivalent items in the US Current Population Survey. Analysis of all 15 items together indicates a higher severity level for child-related items compared with equivalent adult-related items.
    背景与目标: 目的:采用基于单参数逻辑(Rasch)测量模型的统计方法,评估巴西一项多项家庭粮食安全措施的内部有效性。
    受试者/方法:采用分层整群抽样方法,选择了居住在坎皮纳斯市的非制度化平民人口的样本。在随机选择的1000个家庭中,有847个回答了采访。对这15个问题中的每一个问题的回答均被编码为两分项目,表明在调查前的3个月中是否发生了特定的粮食不安全状况(仅在1或2天内除外)。分别对成人/家庭相关项目和儿童相关项目进行了比例分析,也进行了联合分析。检查了项目适合度统计信息,以确定这些项目似乎可以衡量同一潜在现象的程度,并将项目严重性得分与美国当前人口调查中的同等项目进行了比较。
    结论:除一项外,不完全统计量在被认为适当的范围内(0.80-1.2),这表明在以近似相等的辨别力衡量一种普遍现象时。坎皮纳斯(Campinas)调查中这些项目的相对严重性与美国当前人口调查中的同等项目大致相同。对所有15个项目进行的分析表明,与儿童相关的项目相比,与成人相关的项目相比,严重程度更高。
  • 【[巴西500年。发现时的耶稣会士解剖学术语]。】 复制标题 收藏 收藏
    DOI:10.1590/s0104-42302000000200015 复制DOI
    作者列表:Bezerra AJ,Bezerra RF,Di Dio LJ
    BACKGROUND & AIMS: :The purpose of rendering easier for priests to hear confessions from Brazilian indians, in the beginning of the colonization of Brazil by the Portuguese, and in order to serve indians for better communication led Pero de Castilho, a jesuit born in Vila do Esp¿rito Santo, to prepare a list of names of parts of the human body. Such a list of tupi (language of the native indians) and portuguese terms of anatomical structures, in alphabetical order, seems to be the first Nomina Anatomica published in Brazil. Such a bilingual vocabulary constitutes a subsidy for the study of both languages spoken soon after the discovery of Brazil and represents a religious related document that contributes to the history of anatomy and medicine.
    背景与目标: :为了使牧师更容易听到巴西印第安人的供词,在葡萄牙殖民巴西之初,为了服务印第安人更好地交流,佩罗·德·卡斯蒂略(Pero de Castilho)出生于葡萄牙维拉杜埃斯皮里托(Vila doEsp¿ Santo,准备一份人体各部位的名称列表。这种按字母顺序排列的图皮(印第安人的母语)和葡萄牙语的解剖结构术语列表,似乎是巴西出版的第一部《解剖学名典》(Nomina Anatomica)。这样的双语词汇为研究发现巴西后不久使用的两种语言提供了补贴,并且代表了与宗教有关的文献,有助于解剖学和医学的发展。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录