Marco Antônio Vasconcelos Rêgo

Clinical and Immunologic Evaluation of 31 Patients with Acute Schistosomiasis mansoni

Thirty-one patients with acute schistosomiasis were evaluated clinically and immunologically. Cytokine levels were determined in peripheral blood mononuclear cell (PBMC) supernatants. Levels of total and antigen-specific IgE, tumor necrosis factor (TNF)-alpha, and immune complexes were measured in serum samples. Clinical findings included general symptoms, liver damage, pulmonary involvement, and pericarditis. All patients had eosinophilia. Immune complexes were detected in 55% of the patients (mean+/-SD, 7.8+/-7.6 microg Eq/mL) and were associated with cough, dyspnea, and abnormal chest radiographic findings. Levels (mean +/- SD) of TNF-alpha (1349.3+/-767.6 pg/mL), interleukin (IL)-1 (2683+/-1270 pg/mL), and IL-6 (382 +/- 52.3 pg/mL) were elevated in PBMC. Serum TNF-alpha levels were elevated in 87% of the patients and were associated with abdominal pain. Higher interferon-gamma levels were detected in PBMC of patients with acute disease than in those of patients with chronic schistosomiasis; IL-5 levels were higher in those with chronic disease. Low IL-5 levels were associated with weight loss. Proinflammatory cytokines and immune complexes with low Th2 responses might explain the immunopathogenesis of acute schistosomiasis.

Comorbidade entre depressão e doenças clínicas em um ambulatório de geriatria

The aim of this study was to investigate the association between depression and clinical illness among a group of elderly in the city of Salvador, Bahia, Brazil. The study population included 1,120 individuals over 60 years of age treated at a geriatric outpatient clinic. Crude and stratified prevalence ratios were calculated. Data were stratified by gender, age, and nutritional status. Ninety-five percent of the sample presented at least one chronic disease, the most frequent being hypertension (62.2%), osteoarthritis (40%), and urinary incontinence (35%). Depression was diagnosed in 23.4%, more commonly among women (PR = 1.28; 95%CI: 0.99-1.65) and those under 75 years (PR = 1.24; 95%CI: 1.00-1.53). There was an association between number of chronic diseases (> 3) and depression (PR = 1.31; 95%CI: 1.04-1.66). Parkinsons disease was associated with depression, more evident among females (PR = 1.59; 95%CI: 1.05-2.41) and in the 70-79-year age group (PR = 2.02; 95%CI: 1.28-3.20). The study demonstrates an association between depression and chronic comorbidity. Since many elderly present multiple chronic diseases, health professionals should be alert to the possibility of depressive symptoms in these patients.

Hemoglobinopathies in newborns from Salvador, Bahia, Northeast Brazil

Hemoglobinopathies are hereditary disorders of the hemoglobin molecule with a high prevalence worldwide. Brazil has a prevalence of 0.1 to 0.3% of newborns with sickle cell anemia and 20.0 to 25.0% of heterozygous alpha2 thalassemia among African Brazilians. In the present study, we investigated the presence of variant hemoglobins and alpha2(3.7 Kb) and alpha2 (4.2 Kb) thalassemia in newborns from Salvador, Bahia, Brazil. Samples of umbilical cord blood from a total of 590 newborns were analyzed, of which 57 (9.8%) were FAS; 36 (6.5%) FAC; one (0.2%) SF; and five (0.9%) FSC. One hundred fourteen (22.2%) newborns had alpha2(3.7 Kb) thalassemia, of whom 101 (19.7%) were heterozygous and 13 (2.5%) homozygous, showing statistical significance for hematological data between newborns with normal alpha genes and alpha2(3.7 Kb) thalassemia carriers. The alpha2(4.2 Kb) thalassemia was not found. Frequencies found in the present study confirm that hemoglobinopathies are a public health problem in Brazil, emphasizing the need for neonatal screening and genetic counseling programs.

Vulnerabilidades e situações de riscos relacionados ao uso de agrotóxicos na fruticultura irrigada

A determinacao de situacoes de riscos na populacao que faz uso de agrotoxico e complexa. O objetivo desse estudo foi conhecer o contexto social, economico e cultural e algumas das vulnerabilidades para a saude relacionadas com o processo produtivo quimico dependente da fruticultura do Vale do Sao Francisco. Questionario semiestruturado foi aplicado a uma amostra aleatoria de trabalhadores rurais, para obtencao de informacoes socioeconomicas e culturais, assim como a morbidade relacionada com intoxicacao por agrotoxicos. Os trabalhadores rurais da regiao tem em sua maioria baixo grau de escolaridade, sendo esta uma importante vulnerabilidade para compreensao da rotulagem dos agrotoxicos e sua implicacao toxicologica e ambiental. Foi observado uso indiscriminado de agrotoxicos em condicoes inseguras de trabalho que comprometem a saude dos expostos. A sintomatologia sugestiva de intoxicacao por agrotoxicos aponta para quadros relacionados com exposicao a organofosforados, carbamatos e piretroides, em congruencia com os biocidas utilizados na fruticultura. 7% da populacao estudada referiram ter sofrido pelo menos um caso de intoxicacao no decorrer da vida. A assistencia tecnica relacionada com o manejo de agrotoxicos e precaria e nao se observaram acoes de protecao no âmbito da saude, do trabalho, da previdencia ou do ambiente. Estas vulnerabilidades institucionais corroboram aquelas relacionadas com o modelo tecnologico que objetiva meramente a produtividade e o rendimento financeiro.

Non-Hodgkin's lymphoma risk derived from exposure to organic solvents: a review of epidemiologic studies

The rate of non-Hodgkins lymphomas (NHL) has increased around the world during the last decades. Apart from the role of the human immunodeficiency virus (HIV) infection in the development of NHL, exposure to chemical agents like phenoxyacetic pesticides, hair dyes, metal fumes and organic solvents are suspected to be involved. The present review evaluates the results of studies that directly or indirectly searched for an association between solvent exposure and NHL. The selected studies comprised those published from 1979 to 1997, designed to investigate risk factors for NHL, whether specifically looking for solvent exposure or for general risks in which solvent exposure could be included. In 25 of the 45 reviewed studies (55.5%), fifty-four statistically significant associations between NHL and solvent exposure related occupations or industries were reported. Statistical significance was more frequently shown in studies where solvent exposure was more accurately defined. In eighteen of such studies, 13 (72.2%) defined or suggested organic solvents as possible risk factors for NHL.

C677T polymorphism of the MTHFR gene and variant hemoglobins: a study in newborns from Salvador, Bahia, Brazil

The C677T polymorphism in the methylenetetrahydrofolate reductase gene (MTHFR) is associated with an increase in total homocysteine serum levels (tHcy), described as a risk factor for cardiovascular disease. Eight hundred forty-three neonates from two different maternity hospitals, one public and another private, in Salvador, Bahia, Brazil were screened for this polymorphism by PCR and RFLP. The T-allele frequency in the total sample was 0.23, and the prevalence rates of heterozygous and homozygous carriers were 36.2% and 5.3%, respectively. The T-allele frequency differed and the T/T genotype was more prevalent at the private maternity hospital. The hemoglobin (Hb) profile was investigated by HPLC in 763 newborns. The frequency of variant Hb was higher at the public than at the private maternity hospital. The association of the C677T polymorphism and the Hb profile was investigated in 683 newborns, showing a relatively high frequency of variant Hbs and the T allele. These data could provide an important basis for further studies focusing on potential risks of vaso-occlusive events in these individuals.

MORTALITY RISK OF COLORECTAL CANCER IN BRAZIL FROM 1980 TO 2013

BACKGROUND - Colorectal cancer is one of the most common cancer worldwide, and variation in its mortality rates indicates the importance of environmental factors in its occurrence. While trend studies have indicated a reduction in colorectal cancer mortality rates in most developed countries, the same trends have not been observed in developing countries. Moreover, trends may differ when analyzed by age and sex. OBJECTIVE - The present study aimed to analyze the trends in risk of colorectal cancer death in Brazil based on sex and age group. METHODS - Death records were obtained from the Mortality Information System of the Ministry of Health. The risk of death and the average annual percent changes (AAPC) in the mortality rates were estimated using joinpoint analysis of long-term trends from 1980 to 2013. All of the statistical tests were two-sided and had a significance level of 5%. RESULTS - Colorectal cancer mortality rates were found to have increased in the last 15 years for both sexes and for all age ranges. The rate ratio (RR) was statistically higher at ages 70 to 79 for men (RR: 1.37; 95% CI: 1.26; 1.49) compared to women (RR: 1.14; 95% CI: 1.06; 1.24). Increases in AAPC were observed in both sexes. Although men presented higher percent changes (AAPC: 1.8; 95% CI: 1.1; 2.6) compared to women (AAPC: 1.2; 95% CI: 0.4; 2.0), this difference was not statistically significant. Growth trends in mortality rates occurred in all age groups except for in women over 70. CONCLUSION - Unlike Europe and the US, Brazil has shown increases in death rates due to colorectal cancer in the last three decades; however, more favorable trends were observed in women over 70 years old. The promotion of healthier lifestyles in addition to early diagnosis and improved treatment should guide the public health policies targeting reductions in colorectal cancer.

Exposição a radiações eletromagnéticas não ionizantes da telefonia celular e sintomas psiquiátricos

O objetivo desse estudo foi investigar a associacao entre exposicao a radiacoes eletromagneticas nao ionizantes da estacao radiobase de telefonia celular e sintomas a saude. Em um estudo transversal realizado em Salvador, Bahia, Brasil, entrevistaram-se 440 individuos. Queixas e diagnosticos psiquiatricos constituiram as variaveis dependentes e a distância do domicilio para estacao radiobase foi considerada a variavel independente principal. Realizou-se analise de regressao logistica hierarquizada para avaliacao de confundimento e efeito. Observou-se associacao entre sintomas psiquiatricos e residir proximo a estacao radiobase e formas de uso do telefone celular (sinal de cobertura fraco, perto do corpo, dois ou mais chips e nunca desligar o celular quando dorme) e com uso de outros eletroeletronicos. Concluiu-se que a exposicao a radiacao eletromagnetica nao ionizante de telefonia celular e a outros eletroeletronicos foi associada aos sintomas psiquiatricos independente do sexo, escolaridade e tabagismo. Recomenda-se a adocao de medidas precaucionarias no sentido de se reduzir este tipo de exposicao.The aim of this study was to investigate the association between exposure to non-ionizing electromagnetic radiation from mobile phone base stations and psychiatric symptoms. In a cross-sectional study in Salvador, Bahia State, Brazil, 440 individuals were interviewed. Psychiatric complaints and diagnoses were the dependent variables and distance from the individuals residence to the base station was considered the main independent variable. Hierarchical logistic regression analysis was conducted to assess confounding. An association was observed between psychiatric symptoms and residential proximity to the base station and different forms of mobile phone use (making calls with weak signal coverage, keeping the mobile phone close to the body, having two or more chips, and never turning off the phone while sleeping), and with the use of other electronic devices. The study concluded that exposure to electromagnetic radiation from mobile phone base stations and other electronic devices was associated with psychiatric symptoms, independently of gender, schooling, and smoking status. The adoption of precautionary measures to reduce such exposure is recommended.

Association between occupational exposure to benzene and chromosomal alterations in lymphocytes of Brazilian petrochemical workers removed from exposure

We aimed to investigate the association between chronic exposure to benzene and genotoxicity in the lymphocytes of workers removed from exposure. The study included 20 workers with hematological disorders who had previously worked in the petrochemical industry of Salvador, Bahia, Brazil; 16 workers without occupational exposure to benzene served as the control group. Chromosomal analysis was performed on lymphocytes from peripheral blood, to assess chromosomal breaks and gaps and to identify aneuploidy. The Kruskal-Wallis test was used to compare the mean values between two groups, and Student’s t test for comparison of two independent means. The frequency of gaps was statistically higher in and the exposed group than in the controls (2.13 ± 2.86 vs. 0.97 ± 1.27, p = 0.001). The frequency of chromosomal breaks was significantly higher among cases (0.21 ± 0.58) than among controls (0.12 ± 0.4) (p = 0.0002). An association was observed between chromosomal gaps and breaks and occupational exposure to benzene. Our study showed that even when removed from exposure for several years, workers still demonstrated genotoxic damage. Studies are still needed to clarify the long-term genotoxic potential of benzene after removal from exposure.

Exposure to non-ionizing electromagnetic radiation from mobile telephony and the association with psychiatric symptoms

O objetivo desse estudo foi investigar a associacao entre exposicao a radiacoes eletromagneticas nao ionizantes da estacao radiobase de telefonia celular e sintomas a saude. Em um estudo transversal realizado em Salvador, Bahia, Brasil, entrevistaram-se 440 individuos. Queixas e diagnosticos psiquiatricos constituiram as variaveis dependentes e a distância do domicilio para estacao radiobase foi considerada a variavel independente principal. Realizou-se analise de regressao logistica hierarquizada para avaliacao de confundimento e efeito. Observou-se associacao entre sintomas psiquiatricos e residir proximo a estacao radiobase e formas de uso do telefone celular (sinal de cobertura fraco, perto do corpo, dois ou mais chips e nunca desligar o celular quando dorme) e com uso de outros eletroeletronicos. Concluiu-se que a exposicao a radiacao eletromagnetica nao ionizante de telefonia celular e a outros eletroeletronicos foi associada aos sintomas psiquiatricos independente do sexo, escolaridade e tabagismo. Recomenda-se a adocao de medidas precaucionarias no sentido de se reduzir este tipo de exposicao.The aim of this study was to investigate the association between exposure to non-ionizing electromagnetic radiation from mobile phone base stations and psychiatric symptoms. In a cross-sectional study in Salvador, Bahia State, Brazil, 440 individuals were interviewed. Psychiatric complaints and diagnoses were the dependent variables and distance from the individuals residence to the base station was considered the main independent variable. Hierarchical logistic regression analysis was conducted to assess confounding. An association was observed between psychiatric symptoms and residential proximity to the base station and different forms of mobile phone use (making calls with weak signal coverage, keeping the mobile phone close to the body, having two or more chips, and never turning off the phone while sleeping), and with the use of other electronic devices. The study concluded that exposure to electromagnetic radiation from mobile phone base stations and other electronic devices was associated with psychiatric symptoms, independently of gender, schooling, and smoking status. The adoption of precautionary measures to reduce such exposure is recommended.