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Martinho Campos, Brazil

Monteiro J.M.,University Hospital | Monteiro G.M.,Severino Sombra University | Caroli-Bottino A.,University Hospital | Pannain V.L.,University Hospital
Analytical Cellular Pathology | Year: 2014

Themorphological features of nonalcoholic fatty liver disease (NAFLD) range fromsteatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Liver biopsy remains the main tool for NASH diagnosis and many histological systems to diagnose and gradeNAFLD were proposed. We evaluated the relationship among NAFLD activity score (NAS), histological diagnoses (non-NASH, possible NASH, and definite NASH), and histological algorithm proposed by Bedossa et al.; additionally the degrees of morphological features were semiquantified and correlated with non-NASH and NASH. Seventy-one liver biopsies were studied. The agreement among the three systems considering NASH and non-NASH was excellent (K = 0.96). Among the 22 biopsies with NAS 3-4, 72.7% showed to be NASH according to Bedossa's algorithm. The degree of steatosis, ballooning, lobular inflammation, and fibrosis stage were correlated with NASH (K < 0.001). Fibrosis stage 1 was also found in non-NASH. Over the spectrum of NAFLD, no association was observed between intensity of steatosis and fibrosis grade.The degrees of lobular inflammation showed association with fibrosis stage (K < 0.0001). In conclusion, there is agreement among different NAFLD classifications and NAS >4 may be a better cutoff from which to consider NASH diagnosis; besides the highest degrees of steatosis, ballooning, inflammation, and fibrosis are associated with NASH. Copyright © 2014 Juliana Maya Monteiro et al.

Benedictine monks, who settled in Portuguese America in the late sixteenth century, made it their tenet to always have death in mind. The article describes diverse aspects of the Benedictine approach towards death as displayed at an eighteenth-century monastery in Rio de Janeiro. Relying on documentation stored at the monastery and highlighting performance-like activities, the article analyzes hierarchical arrangements, the ways death was represented, and the forms of sociability manifested at the time of burials. Focusing on the relations that were established, including the reciprocities that were invented and re-invented throughout the rituals, it is demonstrated that these events provided a basis for the distinction earned by clerics in a society ruled in part by the logics of the Ancién Regime.

Bortolon P.C.,Escola Nacional de Saude Publica Sergio Arouca | de Andrade C.L.T.,Escola Nacional de Saude Publica Sergio Arouca | de Andrade C.A.F.,Institute Pesquisa Clinica Evandro Chagas | de Andrade C.A.F.,Severino Sombra University
Cadernos de Saude Publica | Year: 2011

Osteoporosis is a multifactorial syndrome of the skeletal system, and hip fracture is the most serious consequence for the elderly, due to the high mortality and cost. This article describes osteoporotic hip fractures in Brazilian elderly in 2006-2008. Secondary data were obtained from the Authorization Forms for Hospital Admissions (AIH) and allowed the creation of indicators for hip fracture in elders. The proportion of elderly patients hospitalized for hip fractures in the Unified National Health System was 1%. The percentages of hospital admissions and deaths were higher in females, and increased with age. Hip fractures accounted for approximately 2% of health care expenditures for persons 60 years or older. Length of hospital stay ranged from one to seven days, 50.1% occurred in charity hospitals, and 42.7% occurred outside the county of residence. The findings emphasize the need for greater attention to osteoporosis and show the relevance of costs in hospital admissions for elderly with osteoporotic hip fractures. Understanding such hospitalizations can contribute to the formulation of health policies to address this issue.

Soares G.P.,Federal University of Rio de Janeiro | Soares G.P.,Severino Sombra University | Dias Brum J.,Federal University of Rio de Janeiro | de Oliveira G.M.M.,Federal University of Rio de Janeiro | And 2 more authors.
Arquivos Brasileiros de Cardiologia | Year: 2013

Background: Cardiovascular diseases are the major cause of death in Brazil. Objective: To correlate cardiovascular mortality rates in the states of Rio de Janeiro, São Paulo and Rio Grande do Sul, and in their capitals, between 1980 and 2008, with socioeconomic indicators collected from 1949 onwards. Methods: Population and death data were obtained from the Brazilian Unified Health System databank (Datasus). Mortality rates due to the following were calculated and adjusted by use of the direct method and compensated for poorly defined causes: ischemic heart diseases; cerebrovascular diseases; cardiovascular diseases; poorly defined causes; and all causes. Child mortality data were obtained from state and municipal health secretariats and from the Brazilian Institute of Geography and Statistics (IBGE). Information on gross domestic product (GDP) and educational level was obtained from the Brazilian Institute of Applied Economic Research (Ipea). The mortality rates and socioeconomic indicators were correlated by using the estimation of Pearson linear coefficients to determine optimized year lag. The inclination coefficients of the regression between the dependent variable "disease" and the independent variable "socioeconomic indicator" were estimated. Results: The three states showed a reduction in mortality, which was especially due to a decrease in cardiovascular mortality, mainly of cerebrovascular diseases. The decrease in cardiovascular mortality was preceded by a reduction in child mortality, an elevation in the per capita GDP, and an increase in the educational level, and a strong correlation between indicators and mortality rates was observed. Conclusion: The three indicators showed an almost maximum correlation with the reduction in cardiovascular mortality. Such relationship indicates the importance of improving quality of life to reduce cardiovascular mortality.

Braz A.S.,Federal University of Paraiba | de Andrade C.A.F.,Instituto Nacional Of Infectologia Evandro Chagas Fundacao Oswaldo Cruz | de Andrade C.A.F.,Severino Sombra University | da Mota L.M.H.,University of Brasilia | Lima C.M.B.L.,Federal University of Paraiba
Revista Brasileira de Reumatologia | Year: 2015

Intestinal parasites - helminths and protozoa - are cosmopolitan diseases which are most prevalent in tropical regions. Patients with diagnoses of autoimmune rheumatic diseases have, due to the underlying disease or its treatment, an increased risk of occurrence of severe manifestations of intestinal parasites. Although the prevalence of these parasitic infections is very high in our environment, not always is the rheumatologist attentive to the need for investigation and treatment of helminthiasis and protozooses before the use of immuno- modulatory, immunosuppressive therapies, and of biological drugs that are modifiers of the course of the disease. In this document, the Brazilian Society of Rheumatology establishes general recommendations on the diagnosis and treatment of intestinal parasitic infections in Brazil in patients with autoimmune rheumatic diseases, highlighting rheumatoid arthritis, systemic lupus erythematosus and spondyloarthritis. © 2014 Elsevier Editora Ltda. All rights reserved.

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