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OBJECTIVE: To assess the epidemiological profile and trend in hospitalizations for mental and behavioral disorders due to alcohol and other psychoactive substance use among Brazilian adolescents, between 2017 and 2022. METHODS: This was a time-series study using data from the Hospital Information System of the Brazilian National Health System; the trend analysis was performed by estimating the annual percentage change (APC) of hospitalization rates per 100,000 inhabitants and respective confidence intervals (95%CI), using the Prais-Winsten method. RESULTS: A total of 29,991 hospitalizations were recorded in the study period, with a decreasing trend observed, from 16.18/100,000 inhabitants in 2017 to 13.72/100,000 inhab. in 2022 (percent change of -2.65%; 95%CI -4.47;-0.80), a greater decline was found in males (-3.48%; 95%CI -5.20;-1.72), in the age group of 15 to 19 years (-2.79%; 95%CI -4.49;-1.06), in the South (-3.29%; 95%CI -5.37;-1.16) and Midwest (-3.64%; 95%CI -5.75;-1.49) regions of the country. CONCLUSION: Hospitalizations showed a decreasing trend in the study period, with sociodemographic disparities.
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Hospitalização , Transtornos Mentais , Transtornos Relacionados ao Uso de Substâncias , Humanos , Brasil/epidemiologia , Adolescente , Masculino , Hospitalização/estatística & dados numéricos , Feminino , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Mentais/epidemiologia , Adulto Jovem , Sistemas de Informação Hospitalar , Distribuição por Sexo , Alcoolismo/epidemiologiaRESUMO
Resumo Fundamento Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. Objetivo Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). Métodos Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. Resultados Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). Conclusões A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos.
Abstract Background Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. Objective To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). Methods Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. Results 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). Conclusions Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals.
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Paenibacillus sonchi genomovar Riograndensis SBR5T is a plant growth-promoting rhizobacterium (PGPR) isolated in the Brazilian state of Rio Grande do Sul from the rhizosphere of Triticum aestivum. It fixes nitrogen, produces siderophores as well as the phytohormone indole-3-acetic acid, solubilizes phosphate and displays antagonist activity against Listeria monocytogenes and Pectobacterium carotovorum. Comprehensive omics analysis and the development of genetic tools are key to characterizing and engineering such non-model microorganisms. Therefore, the complete genome of SBR5T was sequenced, and shown to encode 6,705 proteins, 87 tRNAs, and 27 rRNAs and it enabled a landscape transcriptome analysis that unveiled conserved transcriptional and translational patterns and characterized operon structures and riboswitches. The pangenome of P. sonchi species is open with a stable core pangenome. At the same time, the analysis of genes coding for nitrogenases revealed that the trait of nitrogen fixation is sparse within the Paenibacillaceae family and the presence of Fe-only nitrogenase in the P. sonchi group was exclusive to SBR5T. The development of genetic tools for SBR5T enabled genetic transformation, plasmid construction for constitutive and inducible gene expression, and gene repression using the CRISPRi system. Altogether, the work with P. sonchi can guide the study of non-model bacteria with economic potential.
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Resumo Revisitaremos uma constelação de respostas para garantir justiça reprodutiva para mulheres e meninas durante a crise do Zika no Brasil. As ações relatadas foram conduzidas pela Anis - Instituto de Bioética, uma ONG feminista. Argumentamos que, durante as emergências sanitárias, é necessário o uso de lentes feministas interseccionais para construir respostas efetivas e sensíveis às questões de gênero, em favor de mulheres e meninas. Apresentamos três táticas de incidência utilizadas na luta por justiça reprodutiva durante a crise do Zika: 1) construir narrativas baseadas em histórias de vida que retratem os efeitos desproporcionais da crise em mulheres e meninas; 2) produzir dados baseados em evidências para catalisar estratégias de incidência para revisão legal e de políticas públicas; 3) promover oportunidades para o fortalecimento de alianças e movimentos, bem como o compartilhamento de poder por meio de atividades de mobilização comunitária. Reconhecemos a importância de responder às necessidades das populações em tempo real, e para isso torna-se fundamental que as evidências sobre os impactos das emergências em saúde pública sejam produzidas e compartilhadas de maneira ágil. Os esforços em incidência não são estratégias fragmentadas, pois garantir a justiça reprodutiva exige uma estrutura abrangente e transformadora, incluindo soluções que envolvam o cotidiano das pessoas comuns e suas experiências de vida.
Abstract This article aims to revisit a constellation of responses to guarantee reproductive justice for women and girls during the Zika crisis in Brazil, that were conducted by Anis - Institute of Bioethics, a Brazilian feminist NGO. We argue that intersectional feminist lenses and gender-sensitive responses are necessary to build effective efforts for women and girls during a public health emergency. As such, we present three concomitant and intersectional learned tactics we used to fight for reproductive justice during the Zika crises, but also in its aftermath: 1. To build storytelling narratives that portray the disproportional effects of the crisis on women and girls; 2. To produce evidence-based data to catalyze advocacy strategies for legal and policy review; 3. To promote movement building opportunities and sharing power through community mobilization activities. We assume the importance of providing immediate evidence and gender sensitive framings to inform real-time public health responses. Advocacy efforts should not be seen as fragmented strategies, since ensuring reproductive justice demands a comprehensive and transformative framework that include solutions for multiple aspects of real-life experiences.
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Abstract Objective: To assess the epidemiological profile and trend in hospitalizations for mental and behavioral disorders due to alcohol and other psychoactive substance use among Brazilian adolescents, between 2017 and 2022. Methods: This was a time-series study using data from the Hospital Information System of the Brazilian National Health System; the trend analysis was performed by estimating the annual percentage change (APC) of hospitalization rates per 100,000 inhabitants and respective confidence intervals (95%CI), using the Prais-Winsten method. Results: A total of 29,991 hospitalizations were recorded in the study period, with a decreasing trend observed, from 16.18/100,000 inhabitants in 2017 to 13.72/100,000 inhab. in 2022 (percent change of -2.65%; 95%CI -4.47;-0.80), a greater decline was found in males (-3.48%; 95%CI -5.20;-1.72), in the age group of 15 to 19 years (-2.79%; 95%CI -4.49;-1.06), in the South (-3.29%; 95%CI -5.37;-1.16) and Midwest (-3.64%; 95%CI -5.75;-1.49) regions of the country. Conclusion: Hospitalizations showed a decreasing trend in the study period, with sociodemographic disparities.
Resumen Objetivo: Analizar el perfil epidemiológico y la tendencia de las hospitalizaciones por trastornos mentales y de comportamiento relacionados con el uso de alcohol y otras sustancias psicoactivas en adolescentes brasileños, desde 2017 hasta 2022. Métodos: Estudio de serie temporal utilizando el Sistema de Información Hospitalaria del Sistema Único de Salud; se evaluó la tendencia mediante la estimación del cambio porcentual anual (CPA) de las tasas de hospitalización por cada 100,000 habitantes y sus respectivos intervalos mediante el método de Prais-Winsten. Resultados: Se registraron 29.991 hospitalizaciones durante el período y se observó una tendencia decreciente en Brasil, desde 16,18 hospitalizaciones por cada 100.000 habitantes en 2017 hasta 13,72 en 2022 (variación de -2,65%; IC₉₅% -4,47;-0,80), con mayor declive en hombres (-3,48%; IC₉₅% -5,20;-1,72), en la edad de 15 a 19 años (-2,79%; IC₉₅% -4,49;-1,06), en las regiones del Sur (-3,29%; IC₉₅% -5,37; -1,16) y Centro-Oeste (-3,64%; IC₉₅% -5,75;-1,49). Conclusión: Las hospitalizaciones mostraron una tendencia decreciente en el período, con disparidades sociodemográficas.
Resumo Objetivo: Analisar o perfil epidemiológico e a tendência das internações hospitalares por transtornos mentais e comportamentais devido ao uso de álcool e de outras substâncias psicoativas em adolescentes brasileiros, de 2017 a 2022. Métodos: Estudo de série temporal com dados do Sistema de Informações Hospitalares do Sistema Único de Saúde. A tendência foi analisada estimando-se a variação percentual anual (VPA) das taxas de internação por 100 mil habitantes e respectivos Intervalos pelo método de Prais-Winsten. Resultados: Foram registradas 29.991 internações no período, sendo observada uma tendência decrescente das internações no Brasil, variando de 16,18 internações por 100 mil hab., em 2017, para 13,72 em 2022 (variação de -2,65%; IC₉₅% -4,47; -0,80), com maior declínio no sexo masculino (-3,48%; IC₉₅% -5,20;-1,72), na faixa etária de 15 a 19 anos (-2,79%; IC₉₅% -4,49;-1,06), nas regiões Sul (-3,29%; IC₉₅% -5,37;-1,16) e Centro-Oeste (-3,64%; IC₉₅% -5,75;-1,49). Conclusão: As internações apresentaram tendência decrescente no período, com disparidades sociodemográficas.
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Context: Confirmatory tests represent a fundamental step in primary aldosteronism (PA) diagnosis, but they are laborious and often require a hospital environment due to the risks involved. Objective: To evaluate the efficacy of oral furosemide as a new confirmatory test for PA diagnosis. Methods: We prospectively evaluated the diagnostic performance of 80â mg of oral furosemide in 64 patients with PA and 22 with primary hypertension (controls). Direct renin concentration (DRC) was measured before, and 2â hours and 3â hours after the oral furosemide. In addition, the oral furosemide test was compared with 2 other confirmatory tests: the furosemide upright test (FUT) and saline infusion test (SIT) or captopril challenge test (CCT) in all patients with PA. Results: The cut-off of 7.6â µU/mL for DRC at 2â hours after oral furosemide had a sensitivity of 92%, specificity of 82%, and accuracy of 90% for PA diagnosis. In 5 out of 6 controls with low-renin hypertension, which might represent a PA spectrum, renin remained suppressed. Excluding these 6 controls with low-renin hypertension, the DRC cut-off of 10â µU/mL at 2â hours after oral furosemide had a sensitivity of 95.3%, specificity of 93.7% and accuracy of 95% for PA diagnosis. DRC after 3â hours of oral furosemide did not improve diagnostic performance. Using the cut-off of 10â µU/mL, the oral furosemide test and the FUT were concordant in 62 out of 64 (97%) patients with PA. Only 4 out of 64 cases with PA (6.4%) ended the oral furosemide test with potassium <3.5â mEq/L. Hypotension was not evidenced in any patient with PA during the test. Conclusion: The oral furosemide test was safe, well-tolerated and represents an effective strategy for PA investigation.
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BACKGROUND: An individual's dietary pattern contributes in different ways to the prevention and control of recurrent cardiovascular events. However, the quality of the diet is influenced by several factors. The present study aimed to evaluate the quality of the diet of individuals with cardiovascular diseases and determine whether there is an association between sociodemographic and lifestyle factors. METHODS: This is a cross-sectional study carried out with individuals with atherosclerosis (coronary artery disease, cerebrovascular disease or peripheral arterial disease) recruited from 35 reference centres for the treatment of cardiovascular disease in Brazil. Diet quality was assessed according to the Modified Alternative Healthy Eating Index (mAHEI) and stratified into tertiles. For comparing two groups, the Mann-Whitney or Pearson's chi-squared tests were used. However, for comparing three or more groups, analysis of variance or Kruskal-Wallis was used. For the confounding analysis, a multinomial regression model was used. p < 0.05 was considered statistically significant. RESULTS: In total, 2360 individuals were evaluated: 58.5% male and 64.2% elderly. The median (interquartile range [IQR]) of the mAHEI was 24.0 (20.0-30.0), ranging from 0.4 to 56.0 points. When comparing the odds ratios (ORs) for the low (first tertile) and medium (second tertile) diet quality groups with the high-quality group (third tertile), it was observed that there was an association between diet quality with a family income of 1.885 (95% confidence intervals [CI] = 1.302-2.729) and 1.566 (95% CI = 1.097-2.235), as well as physical activity of 1.391 (95% CI = 1.107-1.749) and 1.346 (95% CI = 1.086-1.667), respectively. In addition, associations were observed between diet quality and region of residence. CONCLUSIONS: A low-quality diet was associated with family income, sedentarism and geographical area. These data are extremely relevant to assist in coping with cardiovascular disease because they enable an assessment of the distribution of these factors in different regions of the country.
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Doenças Cardiovasculares , Humanos , Masculino , Idoso , Feminino , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/prevenção & controle , Brasil , Estudos Transversais , Dieta , Dieta SaudávelRESUMO
BACKGROUND: An individual's dietary pattern contributes in different ways to the prevention and control of recurrent cardiovascular events. However, the quality of the diet is influenced by several factors. The present study aimed to evaluate the quality of the diet of individuals with cardiovascular diseases and determine whether there is an association between sociodemographic and lifestyle factors. METHODS: This is a cross-sectional study carried out with individuals with atherosclerosis (coronary artery disease, cerebrovascular disease or peripheral arterial disease) recruited from 35 reference centres for the treatment of cardiovascular disease in Brazil. Diet quality was assessed according to the Modified Alternative Healthy Eating Index (mAHEI) and stratified into tertiles. For comparing two groups, the Mann-Whitney or Pearson's chi-squared tests were used. However, for comparing three or more groups, analysis of variance or Kruskal-Wallis was used. For the confounding analysis, a multinomial regression model was used. p < 0.05 was considered statistically significant. RESULTS: In total, 2360 individuals were evaluated: 58.5% male and 64.2% elderly. The median (interquartile range [IQR]) of the mAHEI was 24.0 (20.0-30.0), ranging from 0.4 to 56.0 points. When comparing the odds ratios (ORs) for the low (first tertile) and medium (second tertile) diet quality groups with the high-quality group (third tertile), it was observed that there was an association between diet quality with a family income of 1.885 (95% confidence intervals [CI] = 1.302-2.729) and 1.566 (95% CI = 1.097-2.235), as well as physical activity of 1.391 (95% CI = 1.107-1.749) and 1.346 (95% CI = 1.086-1.667), respectively. In addition, associations were observed between diet quality and region of residence. CONCLUSIONS: A low-quality diet was associated with family income, sedentarism and geographical area. These data are extremely relevant to assist in coping with cardiovascular disease because they enable an assessment of the distribution of these factors in different regions of the country.
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Doenças Cardiovasculares , Dieta , Brasil , AteroscleroseRESUMO
In Brazil, the epicenter of the Zika crisis, brown, black, and indigenous poor women living in municipalities with scarce resources were disproportionally affected. The gendered consequences of the epidemic exposed how intersectional lenses are central to understand the impact of public health emergencies in the lives of women and girls. The demand for Zika-affected children and women to be research participants is relevant for an ethical analysis of participant protection procedures during a crisis. We investigated how women experienced research participation by analyzing their narratives. Two-year-long longitudinal qualitative study in Brazilian sites located in the epidemic's epicenter was performed using mixed methods: ethnography with women from two distinct states and individual semi-structured interviews with five women in different Zika-affected states, four of which were community leaders. All women in the study were mothers or grandmothers of Zika-affected children. Thematic analysis was used for data evaluation. Women perceived being pressured to participate in research and a lack of benefit sharing. Structural determinants of gender inequality, such as its effect on power distribution, were found to impact research participant protection. Formal procedures for research protocols approvals were insufficient in protecting participants because these instruments were unable to account for structural aspects. Communitarian mobilization, through WhatsApp groups, was found to be an important mechanism to create conditions to challenge oppressive structures. Strengthening public health, effective community-based participation in research planning and implantation of ethical strategies that promotes gender equality can have transformative effect on unequal power structures and promote participant protection.