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Guaraldo L.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Guaraldo L.,Institute Pesquisa Clinica Evandro Chagas Fundacao Oswaldo Cruz | Cano F.G.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Cano F.G.,West Parana State University | And 2 more authors.
BMC Geriatrics | Year: 2011

Background: Inappropriate medication use (IMU) by elderly people is a public health problem associated with adverse effects on health. There are a number of methods for identifying IMU, some involving clinical judgment and others, consensually generated lists of drugs to be avoided. This review aims to describe studies that used information from insurance company and social security administrative databases to assess IMU among community-dwelling elderly and to present the risk factors most often associated with IMU. Methods. The paper search was conducted in Medline and Embase, using descriptors combined with free terms in the title or abstract. The limits applied were: publication date from January 1990 to June 2010, species (human) and publication type (excluding editorials, letters and reviews). Excluded were: case studies; studies in hospitals, nursing homes, or hospital emergency departments; studies of specific drugs or groups of drugs; studies exclusively of subgroups of ill, frail elderly or rural populations. Additional studies were identified from reference lists. Data were selected and extracted after independent reading by two of the authors, with disagreements resolved by a third author. The primary outcome assessed was prevalence of IMU, defined as the proportion of elderly who received at least one inappropriate medication. Results: Of the 628 studies, 19 met the inclusion criteria, 78.9% of them conducted in the USA. All papers included used explicit criteria of inappropriateness, most commonly Beers criteria (73.7%) in their three versions (1991, 1997 and 2002). Other methods used included Zhan, which is derived from on Beers criteria and was applied in 21% of the papers selected. The study found that prevalence of IMU ranged from 11.5% to 62.5%. Only 68.4% of the studies included examined inappropriate use-related factors, the most important being female sex, advanced age and larger number of drugs. Conclusions: The results show that the prevalence of IMU among community-dwelling elderly is high and depends partly on the method used to evaluate improper use. Besides the diversity of methods, other factors, such as patient sex, age and number of drugs used concurrently, appear to have influenced the estimates of IMU. © 2011 Guaraldo et al; licensee BioMed Central Ltd. Source


Iniguez A.M.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz IOC FIOCRUZ | Leles D.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Jaeger L.H.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz IOC FIOCRUZ | Carvalho-Costa F.A.,Instituto Oswaldo Cruz Fundacao Oswaldo Cruz IOC FIOCRUZ | Araujo A.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz
Transactions of the Royal Society of Tropical Medicine and Hygiene | Year: 2012

The molecular epidemiology of Ascaris spp. of human and pig origin has been studied as a means to assess the potential of pigs as reservoirs for human ascariasis. In this study, human (H) and pig (P) Ascaris spp. haplotypes from two Brazilian regions were characterised based on two mitochondrial genes, nad1 and cox1. The results show six haplotypes of the cox1 gene, with two haplotypes (H9P9 and P3) corresponding to haplotypes previously characterised in China. Because P3 was found in humans in this study, it was designated as H14P3. Furthermore, five new Ascaris spp. nad1 haplotypes from humans (H12- H16) and five from pigs (P16- P20) were observed, with one being highly frequent and present in both hosts, here designated as H12P17. Phylogenetic and network analysis demonstrated that the molecular epidemiology of Ascaris spp. in Brazil is driven by the globally distributed haplotypes cox1 H14P3 and nad1 H12P17. In conclusion, in this study genetic characterisation of Ascaris spp. showed that humans and pigs share common haplotypes that are also present in two widely separated geographical regions of Brazil. © 2012 Royal Society of Tropical Medicine and Hygiene. Source


Gomes A.P.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Gomes A.P.,Federal University of Vicosa | Rego S.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Rego S.,State University of Rio de Janeiro | And 3 more authors.
Revista da Associacao Medica Brasileira | Year: 2010

Bioethical analysis of the use of the newly deceased in medical training. Objective. The objective of this study is to carry out, a discussion on the subject of bioethics and cadavers based upon a critic review of literature. MethOds. Literature review based on a survey of articles published between 1977 and 2007 on websites Biblioteca Virtual de Saúde, PubMed and SciElo, using the following keywords: newly deceased patients, newly dead patients, simulators. The review was complemented by books on ethics and bioethics, as well as a critical evaluation of the subject. Results. The utilization of the newly deceased to learn invasive procedures is very common and seldom admitted. Procedures are usually carried out secretly, without family knowledge or consent, often without proper supervision from professors. In Brazil, moral and legal regulations do not back these practices, and their ethical aspects should be more widely discussed in undergraduate medical training. cOnclusiOn. It essential that the ethics of using the newly deceased to learn invasive procedures be discussed in academia (by professors and students alike) and be extended to practices as well. Performance of these procedures by students should always require authorization from family members. Simulators should be the first step in medical training. Source


Teixeira-Santos I.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Sianto L.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Araujo A.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Reinhard K.J.,University of Nebraska - Lincoln | Chaves S.A.M.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz
Quaternary International | Year: 2015

Pollen grains were recovered from six human coprolites associated with five skeletons from Furna do Estrago, Brejo da Madre de Deus county, Pernambuco State, northeast Brazil. The remains are dated between 1730±50 (BETA 145954) and 1610±70 (BETA 145955) years BP (before present). Previously, researchers showed that the local population was infected with intestinal parasites. This is a follow-up study to assess whether or not the population used medicinal plants to treat the symptoms of infection. Pollen from anthelminthic plants and other plants with medicinal and analgesic properties were found in all samples in high concentrations. This demonstrates that plants with medicinal properties were used by the population to adapt to the parasites in the area. © 2015 Elsevier Ltd and INQUA. Source


Novo S.P.C.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | de Souza M.B.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Villanova C.B.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | Merodio J.C.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz | de Medeiros Meira A.,Escola Nacional de Saude Publica Sergio Arouca Fundacao Oswaldo Cruz
Revista da Sociedade Brasileira de Medicina Tropical | Year: 2013

Introduction: The influx and efflux of military personnel in the possible endemic areas of leishmaniasis provided the impetus for research on the sandflies on Marambaia Island. Methods: Sandflies were collected with light traps installed in the 3 ecotypes of 3 areas chosen for their particular landscape aspects. Results: In 2009, were collected 32,006 specimens of sandflies belonging to 13 species. The species that showed highest density were Nyssomyia intermedia and Migoneimyia migonei. Conclusions: N. intermedia and M. migonei are the principal vectors of American tegumentary leishmaniasis (ATL) in Brazil; thus, extension studies related to the eco-epidemiology of these species of Marambaia Island are essential. Source

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