Francisco Carlos Félix Lana

Análise espacial da Hanseníase na microrregião de Almenara, MG, Brasil

A hanseniase ainda e considerada um problema de saude publica no Brasil. O objetivo deste estudo e analisar a situacao epidemiologica da hanseniase na microrregiao de Almenara/MG segundo sua distribuicao espacial e suas relacoes com as condicoes socioeconomicas da populacao. Trata-se de um estudo ecologico. Os resultados colocam a microrregiao como uma area hiperendemica e indicam que os servicos de saude nao estao sendo capazes de detectar todos os casos existentes, contribuindo para manter a cadeia de transmissao da doenca. A analise espacial identificou dois clusters, sendo um com coeficientes de deteccao acima e outro abaixo do esperado. Acredita-se que os resultados obtidos servirao para balizar a elaboracao e implementacao de medidas de prevencao e controle da hanseniase na regiao.Hansens disease is still considered a public health problem in Brazil. The objective of this ecological study is to analyze the epidemiological status of Hansens disease in the microregion of Almenara, State of Minas Gerais, according to its spatial distribution and its relations with the socioeconomic conditions of the population. The results of this study classify the microregion as a hyperendemic area and indicate that the health services are not capable of detecting all existing cases, thus contributing to the maintenance of the disease transmission chain. The spatial analysis identified two clusters, one with detection coefficients above and the other below those expected. It is believed that the results of the study will help to establish guidelines for the development and implementation of prevention and control measures for Hansens disease in the region.

Toll-like Receptor 1 N248S Single-Nucleotide Polymorphism Is Associated With Leprosy Risk and Regulates Immune Activation During Mycobacterial Infection

Conflicting findings about the association between leprosy and TLR1 variants N248S and I602S have been reported. Here, we performed case-control and family based studies, followed by replication in 2 case-control populations from Brazil, involving 3162 individuals. Results indicated an association between TLR1 248S and leprosy in the case-control study (SS genotype odds ratio [OR], 1.81; P = .004) and the family based study (z = 2.02; P = .05). This association was consistently replicated in other populations (combined OR, 1.51; P < .001), corroborating the finding that 248S is a susceptibility factor for leprosy. Additionally, we demonstrated that peripheral blood mononuclear cells (PBMCs) carrying 248S produce a lower tumor necrosis factor/interleukin-10 ratio when stimulated with Mycobacterium leprae but not with lipopolysaccharide or PAM3cysK4. The same effect was observed after infection of PBMCs with the Moreau strain of bacillus Calmette-Guerin but not after infection with other strains. Finally, molecular dynamics simulations indicated that the Toll-like receptor 1 structure containing 248S amino acid is different from the structure containing 248N. Our results suggest that TLR1 248S is associated with an increased risk for leprosy, consistent with its hypoimmune regulatory function.

Hanseníase em menores de 15 anos no Vale do Jequitinhonha, Minas Gerais, Brasil

Hansens disease has a slow evolution, which mostly affects the adult population. Detecting cases in children shows that the endemic continues and there is early exposure of the population to the bacillus. This is an ecological study with the objective of analyzing the occurrence of Hansens disease in children under fifteen in the Jequitinhonha Valley through epidemiological and operational indicators. The results show that the endemic continues in the region, demonstrating that the health services are not proactive and must implement specific prevention and control measures for this age group in order to reduce the transmission of the disease and the possible damage it can bring to the life of individuals, especially when it affects them in their childhood.Hansen’s disease has a slow evolution, which mostly affects the adult population. Detecting cases in children shows that the endemic continues and there is early exposure of the population to the bacillus. This is an ecological study with the objective of analyzing the occurrence of Hansen’s disease in children under fifteen in the Jequitinhonha Valley through epidemiological and operational indicators. The results show that the endemic continues in the region, demonstrating that the health services are not proactive and must implement specific prevention and control measures for this age group in order to reduce the transmission of the disease and the possible damage it can bring to the life of individuals, especially when it affects them in their childhood. Descriptors: Leprosy; Epidemiology, descriptive; Prevention & control.

Evaluation of scientific periodicals and the brazilian production of nursing articles

This study aimed to identify nursing journals edited in Brazil indexed in the main bibliographic databases in the areas of health and nursing. It also aimed to classify the production of nursing graduate programs in 2007 according to the QUALIS/CAPES criteria used to classify scientific periodicals that disseminate the intellectual production of graduate programs in Brazil. This exploratory study used data from reports and documents available from CAPES to map scientific production and from searching the main international and national indexing databases. The findings from this research can help students, professors and coordinators of graduate programs in several ways: to understand the criteria of classifying periodicals; to be aware of the current production of graduate programs in the area of nursing; and to provide information that authors can use to select periodicals in which to publish their articles.O objetivo deste estudo foi identificar a indexacao das revistas da area da Enfermagem, editadas no Brasil, nas principais bases bibliograficas das areas da saude e Enfermagem, alem de classificar a producao dos programas de pos-graduacao da Enfermagem no ano 2007, de acordo com os criterios QUALIS/CAPES, utilizados para classificar os periodicos cientificos usados na divulgacao da producao intelectual dos programas de pos-graduacao stricto sensu no Brasil. E pesquisa exploratoria que usou, para o mapeamento da producao cientifica, dados do relatorio e documentos divulgados pela CAPES e consulta as principais bases indexadoras nacionais e internacionais. Os resultados oferecem subsidios a estudantes, docentes e coordenadores dos programas de pos-graduacao para a compreensao do modelo usado na classificacao dos periodicos, a situacao da producao da area e informacoes importantes para a selecao de periodicos pelos autores.

Resultados da assistência ao parto no Centro de Parto Normal Dr. David Capistrano da Costa Filho em Belo Horizonte, Minas Gerais, Brasil

This was a descriptive and retrospective study of 2,117 deliveries from January 2002 to July 2003 at the Dr. David Capistrano da Costa Filho Birthing Center in Belo Horizonte, Minas Gerais, Brazil. Widespread questions have been raised concerning the quality of services provided at birthing centers by obstetric nurses. The results of the current study were: 11.4% maternal transfer rate; 2.2% cesarean sections; 1.2% neonatal ICU admissions; and 1% 5-minute Apgar scores below 7. Delivery dystocia and the request for epidural anesthesia were the main reasons for maternal transfer, and respiratory distress was the main cause of neonatal ICU admission. Corrected neonatal mortality was 2 per 1,000 live births. The results at this birthing center did not differ significantly from those in a review of the international literature. The most striking finding was the low cesarean rate. Comparative studies and more comprehensive national data on low-risk gestations are needed.

A avaliação de periódicos científicos qualis e a produção brasileira de artigos da área de enfermagem

This study aimed to identify nursing journals edited in Brazil indexed in the main bibliographic databases in the areas of health and nursing. It also aimed to classify the production of nursing graduate programs in 2007 according to the QUALIS/CAPES criteria used to classify scientific periodicals that disseminate the intellectual production of graduate programs in Brazil. This exploratory study used data from reports and documents available from CAPES to map scientific production and from searching the main international and national indexing databases. The findings from this research can help students, professors and coordinators of graduate programs in several ways: to understand the criteria of classifying periodicals; to be aware of the current production of graduate programs in the area of nursing; and to provide information that authors can use to select periodicals in which to publish their articles.O objetivo deste estudo foi identificar a indexacao das revistas da area da Enfermagem, editadas no Brasil, nas principais bases bibliograficas das areas da saude e Enfermagem, alem de classificar a producao dos programas de pos-graduacao da Enfermagem no ano 2007, de acordo com os criterios QUALIS/CAPES, utilizados para classificar os periodicos cientificos usados na divulgacao da producao intelectual dos programas de pos-graduacao stricto sensu no Brasil. E pesquisa exploratoria que usou, para o mapeamento da producao cientifica, dados do relatorio e documentos divulgados pela CAPES e consulta as principais bases indexadoras nacionais e internacionais. Os resultados oferecem subsidios a estudantes, docentes e coordenadores dos programas de pos-graduacao para a compreensao do modelo usado na classificacao dos periodicos, a situacao da producao da area e informacoes importantes para a selecao de periodicos pelos autores.

Antigen-specific assessment of the immunological status of various groups in a leprosy endemic region

BackgroundSerological tests can be important tools to assist in the diagnosis of leprosy and can contribute to an earlier diagnosis. The aim of this study was to evaluate the antibody responses against phenolic glycolipid-1 (PGL-1), natural disaccharide linked to human serum albumin via an octyl (NDO-HSA), Leprosy IDRI Diagnostic-1 (LID-1) and natural disaccharide octyl - Leprosy IDRI Diagnostic-1 (NDO-LID) in leprosy patients, household contacts of patients and the general population.MethodsEnzyme-linked immunosorbent assays were used to analyze the antigen-specific antibody responsesof 94 leprosy cases, 104 household contacts of cases and 2.494 individuals from the general population.ResultsA positive correlation was observed for the antibody responses to all antigens studied. A higher proportion of seropositivity for all antigens, along with stronger magnitude of response, was observed in multibacillary (MB) leprosy patients and household contacts of MB leprosy patients compared with the levels observed in paucibacillary (PB) leprosy patients and household contacts of PB leprosy patients. A substantial and significant positive correlation was found between seropositivity and the bacterial index for the leprosy patients. Anti-PGL-1 tests were more frequently positive than anti-NDO-HSA tests among patients with all clinical forms of leprosy and among the group of household contacts. The LID-1 and NDO-LID antigens showed a greater capacity to identify household contacts and individuals from the general population infected with M. leprae.ConclusionsTests that measure the antibody responses against LID-1, NDO-LID, NDO-HSA and PGL-1 were effective tools for the detection of patients with MB leprosy. Our data indicate that the anti-LID-1 and anti-NDO-LID responses were more effective than an anti-NDO-HSA response for the identification of individuals with subclinical infection.

Deformities due to Leprosy in Children under Fifteen Years Old as an Indicator of Quality of the Leprosy Control Programme in Brazilian Municipalities

The present study aims at analysing the degree of deformity in leprosy cases diagnosed in children under 15 years old and its relationship with operational and epidemiological factors. This epidemiological cross-sectional study was carried out at municipalities of three microregions in a Brazilian hyperendemic area. Data between 1998 and 2010 was collected from the Information System for Notifiable Diseases database. The average coefficient of detection was 32.96/100.000 inhabitants; 7.61% of new cases were diagnosed in children under 15 years old; 5% in this age group were grade 2 deformity at diagnosis. Prevalence of leprosy cases in children under 15 years old with deformity was higher in males (PR = 2.65;P = 0.032; CI 95%: 1.09–6.45) and in multibacillary patients (PR = 14.68;P < 0.001; CI 95%: 3.54–60.87) and lower when the detection mode was passive (PR = 0.73,P = 0.47, CI 95%: 0.31–1.73). Such context suggests high transmissibility and early exposure to Mycobacterium leprae since a lot of cases were diagnosed in children under fifteen years old and the incubation period of the leprosy bacillus varies from 02 to 07 years. This situation contributes to maintaining the chain of disease transmission in the area and indicates that health care services should intensify leprosy control.

Avaliação da prevenção da transmissão vertical do HIV em Belo Horizonte, MG, Brasil

The study had as objective to analyze the prenatal care services offered by the East Districts primary healthcare network of the city of Belo Horizonte as well as actions for the prevention of vertical transmission of HIV. It discussed the still significant rates of transmission of HIV in the presence of appropriate technologies for its prevention. Barriers directly related to problems in the early uptake of pregnant women and the institution of appropriate therapy in time were identified through univariate descriptive analysis considering Sisprenatal and Sinan databases. The involvement of managers and the training of professionals are essential for the correct direction of actions that enable the effective prevention of vertical transmission of HIV.A pesquisa teve como objetivo analisar o pre-natal ofertado na rede basica de saude do Distrito Leste do municipio de Belo Horizonte e as acoes direcionadas a prevencao da transmissao vertical do HIV. Foi discutida a permanencia de taxas significativas de transmissao do HIV na vigencia de tecnologias adequadas para a sua prevencao. Por meio de uma analise descritiva e univariada, que abordou os bancos de dados Sisprenatal e Sinan, identificou-se entraves que se relacionam diretamente a problemas observados na captacao precoce de gestantes e na instituicao da terapeutica em tempo adequado. O envolvimento dos gestores e a capacitacao dos profissionais envolvidos e essencial para o correto direcionamento de acoes que possibilitem a prevencao efetiva da transmissao vertical do HIV.

Avaliação do estado nutricional de crianças menores de 10 anos no município de Ferros, Minas Gerais

Brazil is going through problems with obesity as well as malnutrition and starvation - the nutritional transition. This is a cross sectional study with a sample of 1322 children under 10 years of age, residents in Ferros, Minas Gerais, Brazil, enrolled in SISVAN. Results showed that: 20.7% of children had nutritional disorder (10.1% nutritional risk, 3.8% malnourished and 6.7% overweight risk). Malnutrition risk factors were also identified: low birth-weight, RP=3.57, IC 95% (1.96-6.52); stunting, RP=19.36, IC 95% (11.53-32.52); no breastfeeding, RP=2.23, IC 95% (1.19-4.18); family income below R