The knowledge of the population of Viçosa, MG, about the ways of AIDS transmission

AIDS is a major public health problem reaching all social strata. Knowing about the ways of transmission is a way of preventing the disease. For evaluating the level of knowledge of the population of the city of Vi?osa about AIDS transmission, a questionnaire about the ways of transmission of the disease based on studies made in Europe was applied to 376 individuals. The questionnaire consisted of eleven multiple-choice questions about the ways of AIDS transmission, sex, age and educational level of the interviewees. The results showed that the ways of transmission emphasized in health campaigns are well assimilated, while the questions about everyday situations that offer no risk received a high number of incorrect answers. The differences were not significant when data were stratified by sex. The same data stratified by age or educational level showed significant differences for some questions; people aged over 55 and with a lower educational level had a significantly higher number of incorrect answers. It can be concluded that the population of Vi?osa knows the main ways of AIDS transmission, but a part of the population does not know that some everyday situations do not pose risk of transmission. These data can be useful for the preparation of elucidative campaigns for reducing prejudice.     

Evaluation of the Sources of Contamination in the Suburban Area of Koropi–Markopoulo, Athens, Greece

Heavy metal concentrations were monitored in agricultural soils and irrigation groundwaters of Koropi–Markopoulo area, a representative agricultural suburb in Athens, Greece, aiming at the identification of the sources of contaminants. Multivariate analyses of geochemical data demonstrated that agricultural practices and industrial activities considerably affected the quality of both environmental compartments. The levels of Ni, Cr, Co, Mn and Fe in agricultural soils were associated with geological parent materials whereas Pb, Zn and Cu mainly originated from anthropic activities. Referring to groundwaters, individual major anions and cations (K⁺, Na⁺, Ca²⁺, Mg²⁺, NO₃ ^?, SO₄ ^2?, Cl^?) were influenced by various natural and anthropogenic factors whereas Ni, Cr, Cu and Zn were controlled by industrial and agronomic activities. The identification of the sources of contaminants in soil and groundwater environments is a valuable basis for encouraging mitigation strategies preventing further quality degradation.     

SiRNA technology, the gene therapy of the future?

A new era in genetics started 17 years ago, when co-suppression in petunia was discovered. Later, co-suppression was identified as RNA interference (RNAi) in many plant and lower eukaryote animals. Although an ancient antiviral host defense mechanism in plants, the physiologic role of RNAi in mammals is still not completely understood. RNAi is directed by short interfering RNAs (siRNAs), one subtype of short double stranded RNAs. In this review we summarize the history and mechanisms of RNAi. We also aim to highlight the correlation between structure and efficacy of siRNAs. Delivery is the most important obstacle for siRNA based gene therapy. Viral and nonviral deliveries are discussed. In vivo delivery is the next obstacle to clinical trials with siRNAs. Although hydrodynamic treatment is effective in animals, it cannot be used in human therapy. One possibility is organ selective catheterization. The known side effects of synthesized siRNAs are also discussed. Although there are many problems to face in this new field of gene therapy, successful in vitro and in vivo experiments raise hope for treating human disease with siRNA.     

Characterization of the interactions of the pneumolysoid, Δ6 PLY, with human neutrophils in vitro

The pneumolysin toxoid, Δ6 PLY, is a prototype pneumococcal protein vaccine candidate. However, its potentially detrimental residual pro-inflammatory interactions with human neutrophils are unknown. In the current study the effects of the toxoid (8-1000 ng/ml) have been compared with those of wild-type pneumolysin (WT/PLY, 8 ng/ml) on neutrophil cytosolic Ca²⁺ fluxes, generation of leukotriene B₄ (LTB₄), and release of matrix metalloproteinase-9 (MMP-9), using spectrofluorimetric, and ELISA procedures (LTB₄ and MMP-9) respectively. Exposure of neutrophils to WT/PLY resulted in influx of Ca²⁺ and significant (P < 0.05) release of MMP-9 and generation of LTB₄. However, treatment of the cells with Δ6 PLY at concentrations of up to 1000 ng/ml had only trivial effects on Ca²⁺ influx and no effects on either release of MMP-9 or LTB₄ production. The observed absence of pro-inflammatory interactions of Δ6 PLY with neutrophils is clearly an important property of this pneumococcal protein vaccine candidate.     

The overdiagnosis of what? On the relationship between the concepts of overdiagnosis,disease, and diagnosis

Overdiagnosis and disease are related concepts. Widened conceptions of disease increase overdiagnosis and vice versa. This is partly because there is a close and complex relationship between disease and overdiagnosis. In order to address the problems with overdiagnosis, we may benefit from a closer understanding this relationship. Accordingly, the objective of this article is to elucidate the relationship between disease and overdiagnosis. To do so, the article starts with scrutinizing how overdiagnosis can explain the expansion of the concept of disease. Then it investigates how definitions of disease address various challenges of overdiagnosis. The article specifically investigates recent attempts to clarify the relationship between the concepts of disease and overdiagnosis. Several shortcomings are identified and lead to a closer analysis of overdiagnosis in the diagnostic process. Contrary to recent contributions to the field, it is argued that cases of overdiagnosis are not cases of disease. They are non-verified labelling of disease. It is revealed how overdiagnosis establishes an unwarranted link between indicative phenomena, such as polyps or cell changes, and harm, and thereby generates a link to disease. One implication of this study is that we should stop attributing disease language to indicative phenomena. That is, we should stop calling it “cancer screening” when we are actually searching for polyps. Another implications is that we should strive for scientific progress in differentiating phenomena that are of negative value to us from those that are not. In overdiagnosis we diagnose something that is not disease: it is over-diagnosis.     

Evaluation of the perception of the oral health teams of the municipal health department of Curitiba, Paraná State, regarding atraumatic restorative treatment (ART)

An evaluation was made of the perception of oral health teams regarding Atraumatic Restorative Treatment (ART) as a primary oral healthcare strategy used by the Municipal Health Department of Curitiba, Paraná State. A study was made both of Health Units (HU) that operate using the Family Health Strategy (FHSHU) and those that do not (Basic Healthcare Units--BHU). The sample involved 191 oral health professionals proportionally (CI=95%, e=6%). A questionnaire was used to collect data. The information was analyzed using the SPSS 13.0 program. The response rate was 82%. Chi-square testing did not reveal a statistically significant difference between the FHSHU (83.1%) and the BHU (74.3%) with regard to knowledge about the technique (p>0.05). A difference was found as to training in ART among the different HU (p<0.01) and the use of the technique by the services (p<0.01). The length of training and the length of service of dental health professionals at the municipal health service were relevant in relation to knowledge of the technique and the taking of clinical decisions as to ART. The conclusion was reached that training on ART is needed at the primary healthcare level as a result of the different perceptions revealed.     

A Comparison of the Effects of the Opioid Antagonists Naltrexone,Naltrindole, and β-Funaltrexamine on Ethanol Consumption in the Rat

The effects of the universal opioid antagonist naltrexone were compared to the δ-selective opioid antagonist naltrindole and the μ-selective opioid antagonist β-funaltrexamine on ethanol consumption in the absence of food or fluid deprivation using a limited access procedure in Wistar rats. Both naltrexone, at doses of 0.1, 0.25, 0.5, 1.0, 3.0, and 10 mg/kg, and β-funaltrexamine, at doses of 5.0 and 20.0 mg/kg, significantly decreased consumption of a 6% ethanol solution compared to saline control groups. Naltrindole, at doses of 5.0 and 15.0 mg/kg, failed to significantly reduce ethanol consumption. In addition, the highest doses of naltrexone, which antagonize δ as well as μ-opioid receptors, did not differ significantly from the lowest doses in their ability to reduce ethanol consumption. These data suggest that ethanol consumption using the limited access paradigm in the outbred rat is modulated by μ rather than δ-opioid receptors. Although this is not consistent with other data showing that δ antagonists decrease ethanol consumption, it is suggested that these difference may be related to the alcohol-preferring rats used in those experiments.     

Seroprevalence of rubella antibodies in the State of São Paulo,Brazil, 8 years after the introduction of vaccine

Rubella vaccine was introduced in the official immunization calendar of the State of S?o Paulo, in 1992, at 15 months of age, following a mass vaccination targeting all children between 1 and 10 years of age. This mixed strategy was designed taking into account serological data and mathematical models to estimate the optimal ages for vaccination. To evaluate the efficacy of routine vaccination on rubella infection in S?o José do Rio Preto, State of S?o Paulo, 8 years after the introduction of vaccine, a seroprevalence survey was carried out in December 2000, comprising 1,536 subjects aging from 6 months to 25 years. Rubella specific IgG was detected in blood samples by enzyme-linked immunosorbent assay (ELISA). From 18 months to 5 years of age (covered by a mass vaccination campaign 6 months before the study) the seroprevalence was above 90%. From 6 to 8 years of age (vaccinated by routine schedule at 15 months), the seroprevalence was 76%. From 9 to 18 years of age (vaccinated at the mass campaign that introduced the vaccine 8 years before) the seroprevalence was about 85%. After 20 years of age, protection was acquired by previous infection, as they were not covered by any vaccine program. From 20 to 25 years of age, the seroprevalence was 70%. As the seroprevalence remains low at ages not vaccinated, it should be expected low infection rates at this age window. Despite this, the present situation deserves care, as routine vaccination is given a protection below the minimum level necessary (80%). The efficacy of the proposed strategy depends on better routine vaccination coverage. A second dose of vaccine should also be considered.     

Contact, epidemics, and the body as agents of change: a study of AIDS among the Xokléng indians in the State of Santa Catarina, Brazil

Based on an analysis of AIDS cases among the Xokléng Indians in 1988, this article relates the illness phenomenon to socio-cultural disruptions and transformations in this indigenous group's universe, focusing on the history of their contact with Brazilian national society. The analysis and interpretation of this relationship are based on anthropological theories about the centrality of the body, corporeality, and degenerative bodily processes in Brazilian indigenous societies, according to which the body, society, and macro-situational elements are articulated by social praxis, and should thus be related in socio-anthropological studies of health-illness phenomena. The article briefly describes the history of epidemics emerging from contact and attempts to relate them to specific historical contexts. Ethnomedical categories, cosmology, and Xokléng concepts of corporeality are related to their social organization, which are thus connected to the AIDS cases. The latter are presented with a special focus on the relationship between their emergence and the changes occurring in the Xokléng world with the construction of a dam bordering on their land.     

The influence of the organizational structure on the internal controls of a foundation for cancer research, prevention and care in the interior of the state of São Paulo, Brazil

This work focuses on a discussion about the extent to which the level of organizational structure interferes in the internal control practices of non-governmental organizations (NGOs), especially those related to health. The objective of this work was to observe the efficiency of the internal control tests applied within the organizational structure of the Foundation for Cancer Research, Prevention and Care, checking the reliability of the accounting records and operational controls. A case study in a third sector health organization was the chosen methodology. The case study involved company interviews and the analysis of confidential reports. After an evaluation of the organizational structure (of the relations between officials and volunteers) and the application of evaluation proceedings on the quality of the internal controls, the extent to which the organizational structure interferes with the internal control practices of the hospital was assessed. It was revealed that there are structured mechanisms of control in the institution, however the implementation of these controls is inadequately performed. It was further detected that the level of the organizational structure does indeed interfere in internal control practices at the entity.     

Charge of the right brigade? Communities, coverage, and care for the uninsured

The Robert Wood Johnson Foundation's Communities in Charge (CIC) program funded projects in fourteen communities that aimed to expand health insurance coverage and improve care for their uninsured residents. Our examination of seven program sites suggests that despite solid community leadership and carefully crafted plans, political, economic, and organizational obstacles precluded much expansion of coverage and constrained reforms. Redistribution of financial and organizational resources among both mainstream and safety-net institutions in these communities was hard to achieve. CIC's record offers little evidence that communities are better equipped than are other sectors of U.S. society to solve the problem of uninsurance.     

Demographic dynamics of the Suyá, a Jê people of the Xingu Indigenous Park, Central Brazil, 1970-2004

This paper analyses the demographic dynamics of the Suyá, a Jê people, inhabitants of the Xingu Indigenous Park, Mato Grosso State, Brazil, during the years 1970-2004. Data was gathered from medical records of the S?o Paulo Federal University Health Program at the Xingu Indigenous Park. The demographic characteristics addressed include composition by age and sex, crude birth rates, general mortality rates, mortality rates by age and sex, proportional mortality by sex, age, and basic causes of death. The results show a population recovery process, with growth rates of 3% per year between 1970 and 2004. In addition to moderate birth rates and declining mortality rates, migration has also played an important role in the demographic dynamics. Mortality indicators show a decline in general and infant mortality rates, higher death rates among women, higher proportions of deaths among individuals < 1 and 50+ years of age, and major causes of death to be infectious diseases and cancer.     

Occurrence of schistosomiasis mansoni vectors on the Northern coast of the State of São Paulo, Brazil

This article comments on the detection of Biomphalaria tenagophila (d'Orbigny, 1835) infected with Schistosoma mansoni Sambon, 1907 in Caraguatatuba and the introduction of Biomphalaria straminea (Dunker, 1848) in Ilha Bela, two municipalities on the Northern coast of the State of S?o Paulo, Brazil. Infected snails were collected from a ditch located in the Olaria district. B. straminea and B. tenagophila were living in syntopy in a stream situated in Barra Velha. Such epidemiological findings indicate the risk of spread of schistosomiasis mansoni in the region, a consequence of inadequate basic sanitation.