Pedro Sadi Monteiro

Environment, interactions between Trypanosoma cruzi and its host, and health

An epidemiological chain involving Trypanosoma cruzi is discussed at the environmental level, and in terms of fine molecular interactions in invertebrate and vertebrate hosts dwelling in different ecosystems. This protozoan has a complex, genetically controlled plasticity, which confers adaptation to approximately 40 blood-sucking triatomine species and to over 1,000 mammalian species, fulfilling diverse metabolic requirements in its complex life-cycle. The Tr. cruzi infections are deeply embedded in countless ecotypes, where they are difficult to defeat using the control methods that are currently available. Many more field and laboratory studies are required to obtain data and information that may be used for the control and prevention of Tr. cruzi infections and their various disease manifestations. Emphasis should be placed on those sensitive interactions at cellular and environmental levels that could become selected targets for disease prevention. In the short term, new technologies for social mobilization should be used by people and organizations working for justice and equality through health information and promotion. A mass media directed program could deliver education, information and communication to protect the inhabitants at risk of contracting Tr. cruzi infections.

Exposure to mixed asymptomatic infections with Trypanosoma cruzi, Leishmania braziliensis and Leishmania chagasi in the human population of the greater Amazon

Lack of conservation of the Amazon tropical rainforest has imposed severe threats to its human population living in newly settled villages, resulting in outbreaks of some infectious diseases. We conducted a seroepidemiological survey of 1100 inhabitants of 15 villages of Paço do Lumiar County, Brazil. Thirty‐five (3%) individuals had been exposed to Trypanosoma cruzi (Tc), 41 (4%) to Leishmania braziliensis (Lb) and 50 (4.5%) to Leishmania chagasi (Lc) infections. Also, 35 cases had antibodies that were cross‐reactive against the heterologous kinetoplastid antigens. Amongst these, the Western blot assays revealed that 11 (1%) had Tc and Lb, that seven (0.6%) had Lc and Tc, and that 17 (1.6%) had Lb and Lc infections. All of these cases of exposures to mixed infections with Leishmania sp, and eight of 11 cases of Tc and Lb were confirmed by specific PCR assays and Southern hybridizations. Two cases had triple infections. We consider these asymptomatic cases showing phenotype and genotype markers consistent with mixed infections by two or more kinetoplastid flagellates a high risk factor for association with Psychodidae and Triatominae vectors blood feeding and transmitting these protozoa infections. This is the first publication showing human exposure to mixed asymptomatic kinetoplastid infections in the Amazon.

Avaliação multidimensional de idosos submetidos à cirurgia cardíaca

OBJETIVO: Conocer aspectos multidimensionales Del anciano sometido a cirugia cardiaca. METODOS: Se trata de um estudio epidemiologico descriptivo, realizado en el Instituto de Cardiologia del Distrito Federal-IC/DF. Para la recoleccion de los datos se utilizo un instrumento que contenia las variables: sociodemograficas, clinicas, escores de evaluacion de la funcion cognitiva, capacidad funcional y emocional. Para el analisis de los datos se emplearon los tests del Chi-cuadrado y T de Student. RESULTADOS: De la poblacion total, el 64% era del sexo femenino; Ancianos analfabetos y con formacion minima que, sumados, representaban el 80%.Dislipidemia, e Hipertension arterial sistolica, fueron las enfermedades cronicas mas prevalentes. Mas del 50% de los ancianos presentaron alteraciones cognitivas y afectivas, y algun grado de dependencia funcional. CONCLUSION: Esos resultados apuntan hacia la complejidad del anciano respecto a su condicion de salud, asi como tambien, remite a la necesidad de un abordaje integral en salud que refleje en mejora de su calidad de vida.Objective: Know the multidimensional aspects of the elderly undergoing cardiac surgery. Methods: Descriptive epidemiological study conducted in the Cardiology Institute of the Distrito Federal-IC/DF. The instrument used for data collection contained the following variables: sociodemographic, clinical, assessment scores of cognitive function, emotional and functional capacity. Chi-square and Student’s T tests were used for data analysis. Results: Among the total population, 64% was female; illiterate elderly and with minimal training, combined, accounted for 80%. Dyslipidemia and systolic hypertension were the most prevalent chronic diseases. More than 50% of the elderly presented cognitive and emotional amendments, and functional dependency to some extent. Conclusion: These results point to the complexity of the elderly regarding their health condition, and also refer to the need for an integrated approach in health that reflects on improvements in the quality of life of the elderly.

Comunidade quilombola: análise do problema persistente do acesso à saúde, sob o enfoque da Bioética de Intervenção

A comunidade quilombola Kalunga, grupo etnico afro-brasileiro, ocupa a regiao do cerrado no nordeste do Estado de Goias. O presente estudo trata do perfil socio epidemiologico em ambiente rural, no qual sao consideradas as condicoes de vida que afetam a saude dos quilombolas, sob a perspectiva da Bioetica de Intervencao. Aplicou-se um questionario do tipo semiestruturado contendo variaveis relativas a identificacao dos participantes nos cenarios sanitario, socioeconomico e etnico-cultural. Os resultados apontam para a persistencia de fragilidades relacionadas as questoes sociais e de saude, bem como para a dificuldade de promocao dos processos inclusivos de universalidade e equidade em saude para aquela comunidade.

Multidimensional evaluation of the elderly undergoing cardiac surgery

OBJETIVO: Conocer aspectos multidimensionales Del anciano sometido a cirugia cardiaca. METODOS: Se trata de um estudio epidemiologico descriptivo, realizado en el Instituto de Cardiologia del Distrito Federal-IC/DF. Para la recoleccion de los datos se utilizo un instrumento que contenia las variables: sociodemograficas, clinicas, escores de evaluacion de la funcion cognitiva, capacidad funcional y emocional. Para el analisis de los datos se emplearon los tests del Chi-cuadrado y T de Student. RESULTADOS: De la poblacion total, el 64% era del sexo femenino; Ancianos analfabetos y con formacion minima que, sumados, representaban el 80%.Dislipidemia, e Hipertension arterial sistolica, fueron las enfermedades cronicas mas prevalentes. Mas del 50% de los ancianos presentaron alteraciones cognitivas y afectivas, y algun grado de dependencia funcional. CONCLUSION: Esos resultados apuntan hacia la complejidad del anciano respecto a su condicion de salud, asi como tambien, remite a la necesidad de un abordaje integral en salud que refleje en mejora de su calidad de vida.Objective: Know the multidimensional aspects of the elderly undergoing cardiac surgery. Methods: Descriptive epidemiological study conducted in the Cardiology Institute of the Distrito Federal-IC/DF. The instrument used for data collection contained the following variables: sociodemographic, clinical, assessment scores of cognitive function, emotional and functional capacity. Chi-square and Student’s T tests were used for data analysis. Results: Among the total population, 64% was female; illiterate elderly and with minimal training, combined, accounted for 80%. Dyslipidemia and systolic hypertension were the most prevalent chronic diseases. More than 50% of the elderly presented cognitive and emotional amendments, and functional dependency to some extent. Conclusion: These results point to the complexity of the elderly regarding their health condition, and also refer to the need for an integrated approach in health that reflects on improvements in the quality of life of the elderly.

Análise geoespacial: um estudo sobre a dengue

OBJECTIVE: To describe/analyze the geographic space of the incidence rates according to the urban area. METHOD: This was an analytical cross-sectional ecological study to evaluate hypotheses of the relationships of cause (socioeconomic and environmental variables) and effect (confirmed cases of dengue) simultaneously. It was ecological, as the observation unit passed from individuals to groups of individuals, in which geographical areas were used as units of analysis (spatial epidemiology). RESULTS: Revealed that the number of reported cases of dengue in Palmas (2011) increased 170% in relationship to the previous year. CONCLUSION: We call attention to an epidemic through the data presented. Thus, we suggest the need for changes in the strategies used today and enhancement of surveillance actions to control the mosquito Aedes aegypti, reducing the infestation to levels below 1%, and consequently to minimize the impact of the disease on the health of the population.

Conceitos de vulnerabilidade humana e integridade individual para a bioética

This article consists of a literature review of the meanings and concepts of vulnerability and integrity contained in the most significant international documents on bioethics, and aims to describe the categories most commonly used to classify vulnerabilities. Technological advances and the increase in clinical research studies in the 20th century have given rise to new forms of vulnerability, and have emphasized the vulnerabilities caused by social, political and environmental determinants, or in other words, social vulnerability. The intervention bioethics can be used by peripheral countries to address the problem of social exclusion through the use of prudence, prevention, precaution and protection. Latin American bioethics have been important for the expansion and politicization of moral conflicts in health care, allowing the construction of a global bioethics, in which vulnerability can be tackled by adding different perspectives to solve common problems.This article consists of a literature review of the meanings and concepts of vulnerability and integrity contained in the most significant international documents on bioethics, and aims to describe the categories most commonly used to classify vulnerabilities. Technological advances and the increase in clinical research studies in the 20th century have given rise to new forms of vulnerability, and have emphasized the vulnerabilities caused by social, political and environmental determinants, or in other words, social vulnerability. The intervention bioethics can be used by peripheral countries to address the problem of social exclusion through the use of prudence, prevention, precaution and protection. Latin American bioethics have been important for the expansion and politicization of moral conflicts in health care, allowing the construction of a global bioethics, in which vulnerability can be tackled by adding different perspectives to solve common problems.

Perfil parasitológico de moradores de uma comunidade quilombola

ObjectiveAnalyzing data on prevalence and species of intestinal parasites among residents of a maroon community.MethodsA non-probabilistic sample survey for accessibility or convenience was used. The sample consisted of 153 individuals who answered an epidemiological investigation form and underwent parasitological examination of feces by sedimentation technique of Hoffman-Pons-Janer and analysis of water, according to the multiple tube technique to estimate medium density of microorganisms. The selection of the sample collection sites took into consideration the environmental and sanitary criteria.ResultsThe proportion of infested individuals was 16.8% and the statistically significant variables were the municipality of residence (p = 0.048) and hygiene habits of hand washing (p≤0.001). Variables such as piped water, presence of thermotolerant coliforms in the water (p = 0.038) and treatment of drinking water (p≤0.001) were statistically associated with the variable of diarrheal episode in the last month (p = 0.008).ConclusionThe results indicated infestations by different species of parasites related to diarrheal episodes associated with poor hygiene conditions, especially the lack of drinking water treatment.

Evaluación multidimensional de ancianos sometidos a cirugía cardíaca

OBJETIVO: Conocer aspectos multidimensionales Del anciano sometido a cirugia cardiaca. METODOS: Se trata de um estudio epidemiologico descriptivo, realizado en el Instituto de Cardiologia del Distrito Federal-IC/DF. Para la recoleccion de los datos se utilizo un instrumento que contenia las variables: sociodemograficas, clinicas, escores de evaluacion de la funcion cognitiva, capacidad funcional y emocional. Para el analisis de los datos se emplearon los tests del Chi-cuadrado y T de Student. RESULTADOS: De la poblacion total, el 64% era del sexo femenino; Ancianos analfabetos y con formacion minima que, sumados, representaban el 80%.Dislipidemia, e Hipertension arterial sistolica, fueron las enfermedades cronicas mas prevalentes. Mas del 50% de los ancianos presentaron alteraciones cognitivas y afectivas, y algun grado de dependencia funcional. CONCLUSION: Esos resultados apuntan hacia la complejidad del anciano respecto a su condicion de salud, asi como tambien, remite a la necesidad de un abordaje integral en salud que refleje en mejora de su calidad de vida.Objective: Know the multidimensional aspects of the elderly undergoing cardiac surgery. Methods: Descriptive epidemiological study conducted in the Cardiology Institute of the Distrito Federal-IC/DF. The instrument used for data collection contained the following variables: sociodemographic, clinical, assessment scores of cognitive function, emotional and functional capacity. Chi-square and Student’s T tests were used for data analysis. Results: Among the total population, 64% was female; illiterate elderly and with minimal training, combined, accounted for 80%. Dyslipidemia and systolic hypertension were the most prevalent chronic diseases. More than 50% of the elderly presented cognitive and emotional amendments, and functional dependency to some extent. Conclusion: These results point to the complexity of the elderly regarding their health condition, and also refer to the need for an integrated approach in health that reflects on improvements in the quality of life of the elderly.