Saude, Brazil
Saude, Brazil

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Kopecky C.,University of Vienna | Genser B.,BGStats Consulting | Genser B.,University of Heidelberg | Genser B.,Institute Saude Coletiva | And 6 more authors.
Nieren- und Hochdruckkrankheiten | Year: 2015

Recent studies have shown that the quality rather than the mere quantity of high-density lipoproteins (HDL) plays a central role in cardiovascular risk protection. The protein composition of HDL is profoundly altered in several systemic diseases with elevated cardiovascular morbidity and mortality, including chronic kidney disease, resulting in impaired atheroprotective functions. Here we investigated if two proteins found enriched on HDL of end-stage renal disease patients, serum amyloid A (SAA) and surfactant-protein B (SP-B), are associated with cardiovascular outcomes in the German Diabetes and Dialysis study (4D study). In diabetic patients on hemodialysis, HDL-bound SAA and SP-B were significant predictors for cardiovascular events and mortality. Our findings indicate that specific HDL-associated proteins may serve as novel markers to predict cardioprotective effects of HDLs. © 2015 Dustri-Verlag Dr. Karl Feistle.


dos Anjos K.F.,Federal University of Bahia | de Oliveira Boery R.N.S.,State University of Southwest Bahia | Pereira R.,State University of Southwest Bahia | Pedreira L.C.,Federal University of Bahia | And 3 more authors.
Ciencia e Saude Coletiva | Year: 2015

Objective: to ascertain the association between the social support and the quality of life of relative caregivers of elderly dependents at home. Method: a cross-sectional study conducted with 58 relative caregivers of elderly dependents, registered in the Family Health Strategy. Data were collected from the Katz instrument, sociodemo-graphic, Zarit Burden Interview, WHOQOL-bref, and analyzed using descriptive statistics and multiple linear regression. Results: the majority of caregivers were women, who took care full-time and presented moderate to severe burden. Most caregivers are satisfied with their social relationships and the social support received. It is found that the burden and the time of care correlated with the social relationships domain, which is associated with social support, and consequently, reduced quality of life. Conclusion: social support for caregivers is important to prevent health implications, burden, biopsychosocial stress, and provide favorable conditions for quality of life, by allowing greater freedom to develop their daily activities. © 2015, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.


Paim J.,Federal University of Bahia | Paim J.,Institute Saude Coletiva | Travassos C.,Oswaldo Cruz Foundation | Almeida C.,Oswaldo Cruz Foundation | And 2 more authors.
The Lancet | Year: 2011

Brazil is a country of continental dimensions with widespread regional and social inequalities. In this report, we examine the historical development and components of the Brazilian health system, focusing on the reform process during the past 40 years, including the creation of the Unified Health System. A defining characteristic of the contemporary health sector reform in Brazil is that it was driven by civil society rather than by governments, political parties, or international organisations. The advent of the Unified Health System increased access to health care for a substantial proportion of the Brazilian population, at a time when the system was becoming increasingly privatised. Much is still to be done if universal health care is to be achieved. Over the past 20 years, there have been other advances, including investments in human resources, science and technology, and primary care, and a substantial decentralisation process, widespread social participation, and growing public awareness of a right to health care. If the Brazilian health system is to overcome the challenges with which it is presently faced, strengthened political support is needed so that financing can be restructured and the roles of both the public and private sector can be redefined. © 2011 Elsevier Ltd.


Paixao E.S.,London School of Hygiene and Tropical Medicine | Teixeira M.G.,Institute Saude Coletiva | Costa M.C.N.,Institute Saude Coletiva | Rodrigues L.C.,London School of Hygiene and Tropical Medicine
The Lancet Infectious Diseases | Year: 2016

Background: Little is known about the possible adverse effects of dengue infection during pregnancy on fetal outcomes. In this systematic review and meta-analysis we aimed to estimate the increase in risk of four adverse fetal outcomes in women who had dengue infection during pregnancy. Methods: For this systematic review and meta-analysis, we searched Medline, Embase, Global Health Library, and Scopus for articles published before Aug 1, 2015. We included original studies that reported any fetal outcomes for pregnant women who had dengue infection during the gestational period. Case-control, cohort, and cross-sectional studies and unselected case series were eligible for inclusion. We excluded case reports, ecological studies, reviews, in-vitro studies, and studies without data for pregnancy outcomes. We independently screened titles and abstracts to select papers for inclusion and scored the quality of those included in meta-analyses. For each study, we recorded study design, year of publication, study location, period of study, and authors and we extracted data for population characteristics such as the number of pregnancies, dengue diagnostic information, and the frequency of outcomes. We investigated four adverse fetal outcomes: stillbirth, miscarriage, preterm birth, and low birthweight. We estimated the increase in risk of these adverse fetal outcomes by use of Mantel-Haenszel methods. We assessed heterogeneity of odds ratios (OR) with the I2 statistic. Findings: We identified 278 non-duplicate records, of which 107 full-text articles were screened for eligibility. 16 studies were eligible for inclusion in the systematic review and eight were eligible for the meta-analyses, which included 6071 pregnant women, 292 of whom were exposed to dengue during pregnancy. For miscarriage, the OR was 3·51 (95% CI 1·15-10·77, I2=0·0%, p=0·765) for women with dengue infection during pregnancy compared with those without. We did not do a meta-analysis for stillbirth because this outcome was investigated in only one study with a comparison group; we calculated the crude relative risk to be 6·7 (95% CI 2·1-21·3) in women with symptomatic dengue compared with women without dengue. Preterm birth and low birthweight were the most common adverse pregnancy outcomes. The OR for the association with dengue was 1·71 (95% CI 1·06-2·76, I2=56·1%, p=0·058) for preterm birth and 1·41 (95% CI 0·90-2·21, I2=0·0%, p=0·543) for low birthweight. Interpretation: Evidence suggests that symptomatic dengue during pregnancy might be associated with fetal adverse outcomes. If confirmed, it would be important to monitor pregnancies during which dengue is diagnosed and to consider pregnant women in dengue control policies. Funding: National Council for Scientific and Technological Development (CNPq). © 2016 Elsevier Ltd.


Teixeira M.G.,Institute Saude Coletiva | Paixao E.S.,Institute Saude Coletiva | Costa M.C.N.,Institute Saude Coletiva | Cunha R.V.,Federal University of Mato Grosso do Sul | And 8 more authors.
PLoS Neglected Tropical Diseases | Year: 2015

Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF. A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities. There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years. Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue. © 2015 Teixeira et al.


Moura-Correa M.J.,Institute Saude Coletiva | Jacobina A.J.R.,Centro Estadual Of Referencia Em Saude Do Trabalhador | Dos Santos S.A.,Centro Estadual Of Referencia Em Saude Do Trabalhador | Pinto N.F.,Centro Estadual Of Saude Do Trabalhador
Ciencia e Saude Coletiva | Year: 2014

The scope of this article is to present the surveillance network’s experience of exposure to benzene in gas stations, describing its components developed in the Unified Health System. It is a report and analysis of the experience of monitoring and its impact on the health of gas station workers in six Brazilian states. It presents the prospect of action, operated by the circulation of information, national meetings, discussions of specific strategies and shared experiences, methodologies and common tools. Inspection procedures, individual assessments and training are described. Risk situations and occupational and environmental exposure were identified in 1,311 gas stations and 564 workers were assessed. Forecourt attendants, superintendents and measuring, offloading and testing employees were all exposed. The integrated and complementary features of this surveillance, implemented in the occupational and environmental areas, suggest intervention in a broader and network-linked territory. The intervention would transcend fragmentation between individual and collective practices, services and education, becoming an example of action for assessment and mitigation of the impact on health workers, the articulation of action in health, the environment and intersectorial connection. © 2014, Associacao Brasileira de Pos - Graduacao em Saude Coletiva. All rights reserved.


PubMed | Gonçalo Muniz Institute, Federal University of Bahia, Federal University of Mato Grosso do Sul, Federal University of Ceará and 3 more.
Type: Journal Article | Journal: PLoS neglected tropical diseases | Year: 2015

Currently, knowledge does not allow early prediction of which cases of dengue fever (DF) will progress to dengue hemorrhagic fever (DHF), to allow early intervention to prevent progression or to limit severity. The objective of this study is to investigate the hypothesis that some specific comorbidities increase the likelihood of a DF case progressing to DHF.A concurrent case-control study, conducted during dengue epidemics, from 2009 to 2012. Cases were patients with dengue fever that progressed to DHF, and controls were patients of dengue fever who did not progress to DHF. Logistic regression was used to estimate the association between DHF and comorbidities.There were 490 cases of DHF and 1,316 controls. Among adults, progression to DHF was associated with self-reported hypertension (OR = 1.6; 95% CI 1.1-2.1) and skin allergy (OR = 1.8; 95% CI 1.1-3.2) with DHF after adjusting for ethnicity and socio-economic variables. There was no statistically significant association between any chronic disease and progression to DHF in those younger than 15 years.Physicians attending patients with dengue fever should keep those with hypertension or skin allergies in health units to monitor progression for early intervention. This would reduce mortality by dengue.


PubMed | Institute Saude Coletiva, Centro Estadual Of Referencia Em Saude Do Trabalhador, Centro Estadual Of Saude Do Trabalhador and Diretoria de Vigilancia Sanitaria
Type: Journal Article | Journal: Ciencia & saude coletiva | Year: 2014

The scope of this article is to present the surveillance networks experience of exposure to benzene in gas stations, describing its components developed in the Unified Health System. It is a report and analysis of the experience of monitoring and its impact on the health of gas station workers in six Brazilian states. It presents the prospect of action, operated by the circulation of information, national meetings, discussions of specific strategies and shared experiences, methodologies and common tools. Inspection procedures, individual assessments and training are described. Risk situations and occupational and environmental exposure were identified in 1,311 gas stations and 564 workers were assessed. Forecourt attendants, superintendents and measuring, offloading and testing employees were all exposed. The integrated and complementary features of this surveillance, implemented in the occupational and environmental areas, suggest intervention in a broader and network-linked territory. The intervention would transcend fragmentation between individual and collective practices, services and education, becoming an example of action for assessment and mitigation of the impact on health workers, the articulation of action in health, the environment and intersectorial connection.


PubMed | State University of Southwest Bahia, Federal University of Bahia and Institute Saude Coletiva
Type: Journal Article | Journal: Ciencia & saude coletiva | Year: 2015

to ascertain the association between the social support and the quality of life of relative caregivers of elderly dependents at home.a cross-sectional study conducted with 58 relative caregivers of elderly dependents, registered in the Family Health Strategy. Data were collected from the Katz instrument, sociodemographic, Zarit Burden Interview, WHOQOL-bref, and analyzed using descriptive statistics and multiple linear regression.the majority of caregivers were women, who took care full-time and presented moderate to severe burden. Most caregivers are satisfied with their social relationships and the social support received. It is found that the burden and the time of care correlated with the social relationships domain, which is associated with social support, and consequently, reduced quality of life.social support for caregivers is important to prevent health implications, burden, biopsychosocial stress, and provide favorable conditions for quality of life, by allowing greater freedom to develop their daily activities.

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