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Objective: To describe the main functions of the “Systematic Review Support” web-based system for removing duplicate articles and aiding eligibility analysis during the process of conducting systematic review studies. Methods: The system was developed based on the incremental build model using the Agile methodology. The software is proprietary source code and was published on a proprietary platform. The architecture of the production environment allows the infrastructure used to increase or decrease according to demand. The system functions are presented with insertion of screenshots of the interfaces of the version for personal computers during the simulation of a systematic review. Results: After importing the files containing the abstracts retrieved from the Pubmed, Embase, and Web of Science databases, the system identifies and removes duplicates for later reading and analysis of title and abstract, a stage which can be performed by one or more reviewers independently. After unblinding of reviewers, the decisions on the eligibility of the studies are compared automatically to help the researchers reach a consensus on any disagreements. Results can be filtered and a PDF produced containing the eligible studies. Conclusion: Version 1.0 of the system is available on the web (sysrev.azurewebsites.net) to assist researchers in the initial stages of systematic reviews. RESUMO Objetivo: Descrever as principais funcionalidades do sistema “Apoio à Revisão Sistemática” na identificação e exclusão de artigos duplicados e no auxílio na análise de elegibilidade durante a condução de estudo de revisão sistemática. Métodos: O sistema foi desenvolvido com base em um modelo de processo incremental, utilizando-se metodologia Ágil. É de código fechado e foi publicado em plataforma proprietária. O ambiente de produção onde o sistema foi implantado possui arquitetura que permite que a infraestrutura utilizada aumente ou diminua conforme a demanda. As funcionalidades foram apresentadas com inserção de imagens das interfaces da versão para computadores, simulando uma revisão sistemática. Resultados: Após a importação dos resumos recuperados nas bases de dados PubMed, Embase e Web of Science, o sistema permite a identificação e eliminação de duplicatas para posterior leitura e análise de título e resumo, etapa que pode ser realizada por mais de um revisor de maneira independente. Após a quebra do cegamento entre os revisores, as respostas sobre a elegibilidade dos estudos podem ser comparadas automaticamente para facilitar a resolução de divergências pelos pesquisadores. É possível filtrar os resultados e gerar um arquivo PDF com os estudos elegíveis. Conclusão: A versão 1.0 do sistema “Apoio à Revisão Sistemática” encontra-se disponível na web (sysrev.azurewebsites.net) para auxiliar pesquisadores nas etapas iniciais de um estudo de revisão sistemática.

BackgroundGestational diabetes mellitus (GDM) is a common complication of pregnancy. It may predispose offspring to increased fat mass (FM) and the development of obesity, however few data from Latin America exist.ObjectiveTo investigate the influence of GDM on newborn FM in mother-newborn pairs recruited from a public maternity care center in São Paulo, Brazil.MethodsData were collected cross-sectionally in 2013-2014 from 72 mothers diagnosed with GDM, and 211 mothers with normal glucose tolerance (NGT). Newborn FM was evaluated by air-displacement plethysmography (PEA POD), and relevant demographic and obstetric data were collected from hospital records. Associations between maternal GDM status and newborn FM were investigated by multiple linear regression analysis, with adjustment for maternal age, pre-pregnancy BMI, gestational weight gain, type of delivery, sex of the child, and gestational age.ResultsFM was greater in GDM versus NGT newborns in a bivariable model (Median (IQR), GDM: 0.35 (0.3) kg vs. NGT: 0.27 (0.2) kg, p = 0.02), however GDM status was not a significant predictor of FM with adjustment for other variables. Rather, pre-pregnancy BMI (coefficient (β) 1.46; 95% confidence interval (CI) 0.66, 2.27), gestational weight gain (β 1.32; 95% CI 0.49, 2.15), and male sex (β -17.8; 95% CI -27.2, -8.29) predicted newborn FM. Analyzing GDM and NGT groups separately, pre-pregnancy BMI (β 6.75; 95% CI 2.36, 11.1) and gestational weight gain (β 5.64; 95% CI 1.16, 10.1) predicted FM in the GDM group, while male sex alone predicted FM in the NGT group (β -12.3; 95% CI -18.3, -6.34).ConclusionsCombined model results suggest that in our cohort, pre-pregnancy BMI and gestational weight gain are more important risk factors for increased neonatal FM than GDM. However, group-specific model results suggest that GDM status may contribute to variation in the relationship between maternal/offspring factors and FM. Our use of a binary GDM variable in the combined model may have precluded clearer results on this point. Prospective cohort studies including data on maternal pre-pregnancy BMI, GWG, and glycemic profile are needed to better understand associations among these variables and their relative influence on offspring FM.

Rural settlements are social arrangements expanding in the Amazon region, which generate disturbances in the natural environment, thus affecting the ecology of the species of Anopheles and thus the malaria transmission. Larval habitats are important sources for maintenance of mosquito vector populations, and holding back a natural watercourse is a usual process in the establishment of rural settlements, since the formation of micro-dams represents a water resource for the new settlers. Identifying characteristics of the larval habitats that may be associated with both the presence and abundance of Anopheles vectors species in an environment under ecological transition is background for planning vector control strategies in rural areas in the Amazon. Anopheles larvae collections were performed in two major types of habitats: natural and flow-limited water collections that were constructed by holding back the original watercourse. A total of 3123 Anopheles spp. larvae were captured in three field-sampling collections. The majority of the larvae identified were taken from flow-limited water collections belonged to species of the Nyssorhynchus subgenus (92%), whereas in the natural larval habitats a fewer number of individuals belonged to the Stethomyia (5%) and Anopheles (3%) subgenera. The total of Nyssorhynchus identified (1818), 501 specimens belonged to An. darlingi, 750 to An. triannulatus and 567 for others remaining species. In addition, 1152 could not be identified to subgenus/species level, because they were either in the first-instar or damaged. The primary vector in areas of the Amazon river basin, An. darlingi, was found exclusively in man-made habitats. Statistical analysis display An. triannulatus with specialist behavior for characteristics of man-made habitats. Modifications in the natural environment facilitate the rise of larval habitats for species with epidemiological importance for malaria in the region. This study showed that man-made habitats flow-limited water collections from dry lands could be a factor associated with the increase of An. darlingi and An. triannulatus populations, and other Nyssorhynchus species as well in endemic areas of the Amazon Region. Fil: Rufalco-Moutinho, Paulo. Universidade de Sao Paulo; Brasil Fil: Schweigmann, Nicolas Joaquin. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Departamento de Ecología, Genética y Evolución. Grupo de Estudio de Mosquitos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Ecología, Genética y Evolución de Buenos Aires. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Ecología, Genética y Evolución de Buenos Aires; Argentina Fil: Bergamaschi, Denise Pimentel. Universidade de Sao Paulo; Brasil Fil: Mureb Sallum, Maria Anice. Universidade de Sao Paulo; Brasil

On the ecological scale of an organism, a homogeneous geographical landscape can represent a mosaic of heterogeneous landscapes. The bionomy of Kerteszia mosquitoes can contribute to foundation landscape ecology by virtue of in the role of the configuration and composition of the habitat played in the distribution of mosquito species. Thus, this study aimed: to compare the abundance of Kerteszia in dense tropical rainforest, restinga and rural area, to assess the bioecological characteristics of the main bromeliads hosting Kerteszia, and to associate the bioecological arrangement of the bromeliads with Kerteszia distribution. Field collections were conducted in a monthly schedule from December of 2010 to November 2011. The vegetation of landscapes was characterized on the basis of a digital cartographic database, the manual of the Brazilian vegetation, environmental atlas information, satellite images and visits to the sites. Multivariate generalized linear models were employed using the R-project statistical program. The results were: Anopheles cruzii was the most frequent species in dense tropical rainforest (67.42%), with a positive association (deviance=25.8; P=0.002). Anopheles bellator was more abundant in the Restinga area (78.97%), with a positive association (deviance=10.4, P=0.018). There was a positive aggregation of Restinga with An. bellator (RR=2.42) but a lower level with An. cruzii (RR=0.31). Thus we can conclude that landscape characteristics influence the distribution of Kerteszia mosquitoes. An. bellator has a higher prevalence in Restinga areas, whereas An. cruzii was the most prevalent in the dense tropical rainforest.

To evaluate the nutritional profile of the population assisted at a reference center for cystic fibrosis treatment.Cross-sectional study including patients with cystic fibrosis assisted at a pediatric reference center in São Paulo, Brazil, in 2014. All patients attending regular visits who agreed to participate in the study were included. A questionnaire on dietary habits (24-hour diet recall) and socioeconomic characteristics was applied. Anthropometric data (compared with the reference from the World Health Organization, 2006 and 2007) and pulmonary function data were collected from medical records. Patients were stratified into age groups for statistical analysis.A total of 101 patients were included in the study (59.4% male, 86.4% Caucasian), with median age of 10 years old. Most patients (n=77; 75%) were classified as eutrophic, but lower values of body mass index (BMI) Z scores were observed in schoolchildren and adolescents. The proportion of underweight patients was 10% (n=2) among preschoolers and 35% (n=6) of the school age group. Dietary intake was adequate, and the use of only two supplements (medium chain triglycerides and complete powdered supplement) was associated with adequacy of macronutrient intake. The socioeconomic characteristics did not show any statistical association with the nutritional state or nutritional consumption. Lung function was not significantly different between neither adolescents nor individuals with worse nutritional status in this sample.Most of the patients presented adequate nutritional status and adequate consumption of calories and macronutrients, indicating appropriate nutritional management. New studies focusing on preschool children should be performed to assess if it is possible to reduce the nutritional risk of patients with cystic fibrosis at older ages.Avaliar o perfil nutricional da população atendida em centro de referência em fibrose cística.Estudo transversal incluindo pacientes com fibrose cística de um centro pediátrico de referência de São Paulo, em 2014. Todos os sujeitos que concordaram em participar do estudo foram incluídos. Foi aplicado um questionário sobre hábitos alimentares (recordatório de 24 horas) e características socioeconômicas. Dados antropométricos (comparados com referencial da Organização Mundial da Saúde de 2006 e 2007) e função pulmonar foram coletados do prontuário. Os integrantes da pesquisa foram estratificados em faixas etárias para análise estatística.Dos 101 pacientes incluídos no estudo, 59,4% eram masculinos, sendo a maioria caucasiana (86,4%), com mediana de idade de 10 anos. A maioria dos pacientes (n=77, 75%) foi classificada como eutrófica, mas valores menores de escore Z de índice de massa corpórea (IMC) foram observados em escolares e adolescentes. A proporção de pacientes com peso abaixo do esperado foi de 10% (n=2) na faixa etária pré-escolar e de 35% (n=6) em escolares. O consumo alimentar mostrou-se adequado, e somente dois suplementos (triglicérides de cadeia média e suplemento em pó completo) tiveram utilização ligada à adequação da ingesta de macronutrientes. Características socioeconômicas não apresentaram associação com o estado nutricional ou com o consumo nutricional. Valores de função pulmonar não apontaram diferença significante em adolescentes nem em indivíduos com pior estado nutricional no grupo estudado.A maioria dos pacientes apresentou estado nutricional e consumo alimentar adequados, indicando bom manejo das ações nutricionais. Novos estudos com foco em pré-escolares devem ser realizados para avaliar se é possível reduzir o risco nutricional de pacientes com fibrose cística em idades posteriores.

The study evaluated the nutritional status of 629 people living with HIV/AIDS attended at 12 specialized services of São Paulo's Municipal Health Department, Brazil. Data were obtained from medical records and through interviews during nutritional consultation. We used the classification criteria established by World Health Organization to assess malnourished individuals, a BMI < 18.5kg/m2. The prevalence of malnutrition in people with AIDS is 3.12 times that observed among people with HIV, and among people with co-infection it is 3.41 times that obtained among people without co-infection. This indicates how these conditions can harm the maintenance of the nutritional status, and shows that they demand a comprehensive understanding of the mechanisms involved in this phenomenon, as well as the development of strategies to improve the health care of individuals at nutritional risk.

Introduction The aim of this study was to identify the blood feeding sources of Nyssomyia intermedia (Ny. intermedia) and Nyssomyia neivai (Ny. neivai), which are Leishmania vectors and the predominant sandfly species in the Ribeira Valley, State of São Paulo, Brazil, an endemic area for cutaneous leishmaniasis. Methods Specimens were captured monthly between February 2001 and December 2003 on a smallholding and a small farm situated in the Serra district in the Iporanga municipality. The blood meals of 988 engorged females were tested using the avidin-biotin immunoenzymatic enzyme-linked immunosorbent assay (ELISA). Seven blood meal sources were investigated: human, dog, chicken, bovine, pig, horse and rat. Results The results showed that among the females that fed on one or more blood sources, the respective percentages for Ny. intermedia and Ny. neivai, respectively, were as follows: human (23% and 36.8%), pig (47.4% and 26.4%), chicken (25.7% and 36.8%) and dog (3.9% and 0%), and the differences in the blood sources between the two species were statistically significant (p = 0.043). Conclusions Both species had predominant reactivity for one or two blood sources, and few showed reactivity indicating three or four sources. Many different combinations were observed among the females that showed reactivity for more than one source, which indicated their opportunistic habits and eclecticism regarding anthropic environmental conditions.

Zoonotic Visceral leishmaniasis (ZVL) is a neglected tropical disease that in the Americas is caused by the infection of Leishmania infantum and the domestic dog (Canis familiaris) is the main parasite reservoir in urban areas. The parasite is mainly transmitted by populations of the sibling species Lutzomyia longipalpis that has been spreading in countries including Brazil, Argentina, Paraguay and more recently Uruguay. Although bionomic parameters such as population survival and the duration of the gonotrophic cycle are critical in evaluating vector capacity, field studies have rarely been applied to sand fly populations. The present study sought to evaluate basic bionomic parameters related to the vectorial capacity of the (S)-9-methylgermacrene-B population of the Lu. longipalpis complex in a visceral leishmaniasis area of Sao Paulo state. The daily survival rate, the duration of the gonotrophic cycle and the dispersal pattern were evaluated through the mark- release-recapture method. A total of 1,547 males and 401 females were marked and released in five experiments carried out between February 2013 and February 2014. The higher recapture rates occurred within 100 meters of the release point and the estimated daily survival rates varied between 0.69 and 0.89 for females and between 0.69 and 0.79 for males. The minimum duration of the gonotrophic cycle observed was five days. The absolute population size, calculated ranged from 900 to 4,857 females and from 2,882 to 9,543 males. Our results demonstrate a high survival rate of this vector population and low dispersal that could be associated with the presence of all necessary conditions for its establishment and maintenance in the peridomiciles of this area. Our findings contribute to the basic data necessary for the understanding of ZVL dynamics and the evaluation of the implementation of prevention and control measures., Author summary American Visceral leishmaniasis (VL) is an anthropozoonosis resulting from infection by Leishmania infantum mainly transmitted by the bite of females of the sand fly Lutzomyia longipalpis which feed mainly on domestic dogs. It is a serious tropical disease that in some countries has spread in association with several factors such as human migration, precarious urbanization and vector adaptation to urban areas. In Brazil, although control measures such as the elimination of infected dogs, the application of residual insecticide and environmental management have been applied by the health authorities, however, they have not resulted in any significant reduction in VL incidence. The knowledge of bionomic parameters of vector populations is critical for the understanding of the transmission dynamic of VL and to evaluate prevention and control measures. Therefore, in the present study we applied the mark-release-recapture (MRR) method to evaluate under field conditions some basic bionomic parameters of a population of the Lutzomyia longipalpis complex. Our findings demonstrate a high survival rate of this vector and a low population dispersal. These results suggest that measures applied to dog populations to prevent sand fly bites could contribute to the reduction of the surviving vector population and indirectly to the reduction of the host biting rate. Additionally, the low dispersal suggests that environmental management could contribute to the reduction of vector density. Our data serve as the first estimates of vector survival rates of populations of the sibling species Lu. longipalpis under natural conditions and could be applied in the evaluation of prevention and control measures.

The network of HIV counseling and testing centers in São Paulo, Brazil is a major source of data used to build epidemiological profiles of the client population. We examined HIV-1 incidence from November 2000 to April 2001, comparing epidemiological and socio-behavioral data of recently-infected individuals with those with long-standing infection. A less sensitive ELISA was employed to identify recent infection. The overall incidence of HIV-1 infection was 0.53/100/year (95% CI: 0.31-0.85/100/year): 0.77/100/year for males (95% CI: 0.42-1.27/100/year) and 0.22/100/ year (95% CI: 0.05-0.59/100/year) for females. Overall HIV-1 prevalence was 3.2% (95% CI: 2.8-3.7%), being 4.0% among males (95% CI: 3.3-4.7%) and 2.1% among females (95% CI: 1.6-2.8%). Recent infections accounted for 15% of the total (95% CI: 10.2-20.8%). Recent infection correlated with being younger and male (p = 0.019). Therefore, recent infection was more common among younger males and older females. Secretaria Municipal de Saúde de São Paulo Universidade de São Paulo Faculdade de Saúde Pública Departamento de Epidemiologia Santa Casa de São Paulo Faculdade de Ciências Médicas Departamento de Medicina Social Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Laboratório de Retrovirologia UNIFESP, EPM, Laboratório de Retrovirologia SciELO

To determine the prevalence of Neospora caninum antibodies and associated factors, blood sera from 623 female dairy cattle from 23 farms in the north of the state of Parana, Brazil, were analyzed by means of the indirect immunofluorescent-antibody test (IFAT > or = 25). Serum samples from 134 dogs living on the same farms also were tested for N. caninum antibodies (IFAT > or = 50), and the presence of dogs was associated with the prevalence of N. caninum antibodies in cattle. The overall seroprevalence in cattle was 14.3%, mainly in animals over 24 months of age. Seroprevalence in Holsteins (15.1% of 558) was greater than in mixed-breed cattle (7.7% of 65). Age (> or =24 months) of cattle, feeding silage and/or concentrate produced on the farm were associated; antibodies were found in 21.6% of dogs; and the presence of dogs was associated with the prevalence of N. caninum antibodies in cattle.

The nutritional status of people living with HIV/AIDS (PLWHA) is related to morbidity and mortality and its monitoring is important in the maintenance of the health status. This is a cross-sectional study carried out in Brazilian National Health System in the Municipality of São Paulo. It describes anthropometrical characteristics: weight and height; indices of weight for height (W/H), height for age (H/A), body mass index for age (BMI/A) and Z score for height and weight. The study includes 772 participants from all ages: children, adolescents, adults and elderly. The graphical analysis shows that in under-5s and in the 5 to 19 years old group, the W/H, the H/A and the BMI/A curves are similar to the reference population with an exception in the H/A for 5 to 19 years old group which is left-shifted (mean Z = -0.66). In the case of adults, graphics for the study population show median weight apparently lower than in the reference population for most age groups in the case of men, and when age is greater in women. The proportion of people over 20 years old with AIDS on anti-retroviral therapy is lower when coinfection is present (p < 0.001). The findings of the study showed that, for children and adolescents with HIV/AIDS, the average weight and height are lower than the values for non infected population. For adults and elderly, the weight average is lower than the reference population with a worsening among coinfected patients. This underscores the need to direct more effort in nutritional actions thus helping enhance the health status of this group. O estado nutricional de pessoas que vivem com HIV/aids (PVHA) está relacionado a morbidade e mortalidade e seu monitoramento auxilia na manutenção do estado de saúde. Este é um estudo de corte transversal realizado no Sistema Único de Saúde no Município de São Paulo. O presente estudo descreve características antropométricas: peso e altura; índices de peso para estatura (P/E), estatura para idade (E/I), índice de massa corporal para idade (IMC/I) e escore Z para peso e estatura. Inclui 772 participantes entre crianças, adolescentes, adultos e idosos. A análise gráfica mostra que, em crianças menores de 5 anos e no grupo de 5 a 19 anos, o P/E, a E/I e as curvas de IMC/I são semelhantes às da população de referência, com uma exceção onde a curva de E/I para o grupo de 5 a 19 anos é deslocada para a esquerda (média Z = -0,66). No caso dos adultos, observou-se mediana de peso aparentemente menor do que a população de referência para a maioria dos grupos de idade entre os homens e para as mulheres em idade mais avançada. A proporção de pessoas maiores de 20 anos com aids usando terapia antirretroviral é menor na presença de coinfecção (p < 0,001). As conclusões do estudo mostraram que crianças e adolescentes com HIV/aids apresentam estatura e peso médio inferior à população não infectada. Entre os adultos e idosos, o peso médio é menor que o da população de referência, principalmente na presença de coinfecção. Enfatiza-se a necessidade de reforçar ações nutricionais, contribuindo, assim, para melhoria do estado de saúde desse grupo.

To assess the reliability of the Lista de Atividades Físicas (Brazilian version of the Physical Activity Checklist Interview) in children.The study is part of a cross-cultural adaptation of the Physical Activity Checklist Interview, conducted with 83 school children aged between seven and ten years, enrolled between the 2nd and 5th grades of primary education in the city of São Paulo, Southeastern Brazil, in 2008. The questionnaire was responded by children through individual interviews. It is comprised of a list of 21 moderate to vigorous physical activities performed on the previous day, it is divided into periods (before, during and after school) and it has a section for interview assessment. This questionnaire enables the quantification of time spent in physical and sedentary activities and the total and weighed metabolic costs. Reliability was assessed by comparing two interviews conducted with a mean interval of three hours. For the interview assessment, data from the first interview and those from an external evaluator were compared. Bland-Altman's proposal, the intraclass correlation coefficient and Lin's concordance correlation coefficient were used to assess reliability.The intraclass correlation coefficient lower limits for the outcomes analyzed varied from 0.84 to 0.96. Precision and agreement varied between 0.83 and 0.97 and between 0.99 and 1, respectively. The line estimated from the pairs of values obtained in both interviews indicates high data precision. The interview item showing the poorest result was the ability to estimate time (fair in 27.7% of interviews). Interview assessment items showed intraclass correlation coefficients between 0.60 and 0.70, except for level of cooperation (0.46).The Brazilian version of the Physical Activity Checklist Interview shows high reliability to assess physical and sedentary activity on the previous day in children.

There is a lack of Brazilian questionnaires to assess physical activity in children. The Physical Activity Checklist Interview (PACI) was originally developed for North American children and allows assessing physical activity during the previous day. The objectives of this study were: i) to describe procedures for choosing the PACI for cross-cultural adaptation and ii) to assess conceptual, item, and semantic equivalence of the Brazilian version to be used with 7-to-10-year-old children. PACI was identified from a systematic review of 18 questionnaires. The process of choosing the instrument involved discussions with researchers. The PACI allows assessing the construct and its dimensions. Some kinds of physical activity that are uncommon in the Brazilian population had to be eliminated. The following steps were taken to evaluate semantic equivalence: translation, retranslation, connotative and referential meaning assessment, and a pretest with 24 children aged 7 to 10 years. We present the PACI in its Brazilian adapted version, called Lista de Atividades Físicas (LAF).

This article investigates the conceptual, item, and semantic equivalence between the Dysfunctional Voiding Scoring System (DVSS) originally developed in English and a Portuguese-language version for use in Brazil. The instrument is used to evaluate lower urinary tract dysfunction in children. The first stage evaluated the conceptual and item equivalence, followed by two independent translations of the original instrument into Portuguese. In the second stage, 63 individuals were interviewed and items were modified according to difficulties in interpretation. In the third stage, the Portuguese instrument was back-translated into English, and the semantic equivalence was evaluated, based on referential and general (connotative) meaning. In the fourth stage, the pre-test version of the instrument was applied to 20 individuals from the target population. The Portuguese version of the instrument is presented with conceptual, item, and semantic equivalence. Nevertheless, unlike the original instrument, DVSS information collection was more adequate for the Brazilian population when performed through interviews as compared to self-applied questionnaires.

BackgroundRecent studies have sought to describe HIV infection and transmission characteristics around the world. Identification of early HIV-1 infection is essential to proper surveillance and description of regional transmission trends. In this study we compare people recently infected (RI) with HIV-1, as defined by Serologic Testing Algorithm for Recent HIV Seroconversion (STARHS), to those with chronic infection.Methodology/principal findingsSubjects were identified from 2002-2004 at four testing sites in São Paulo. Of 485 HIV-1-positive subjects, 57 (12%) were defined as RI. Of the participants, 165 (34.0%) were aware of their serostatus at the time of HIV-1 testing. This proportion was statistically larger (p59 years-old age strata (pConclusions/significanceIn this study, we evaluated RI individuals and discovered that HIV-1 has been spreading among younger individuals in São Paulo and preventive approaches should, therefore, target this age stratum.

This study aimed to evaluate the operative group as a preventive approach among men who have sex with men that use two public health services in the city of São Paulo, Brazil. One hundred volunteers were randomly allocated to two groups (intervention and control, with 50 each). All participants answered questionnaires in two phases: before the intervention and six months after its conclusion. Effect was measured by comparing the groups for the following outcomes: median number of anal sex acts without condoms and responses from the participants to questions about HIV infection. 69 participants completed the study (34 in the prevention group and 35 in the control group). Analysis showed a decrease in the number of unprotected anal sex acts (p = 0.029) and an increase in the number of answers favoring prevention in the intervention group. The results indicate that the study group was responsive to a safer sex operative group intervention. Further research is necessary to evaluate the feasibility of this prevention approach as a public health strategy, including other social groups.

Vitamin A deficiency is a public health problem in the Northeast of Brazil. This study aimed to determine the prevalence of vitamin A deficiency and associated factors among preschool children in Teresina, Piauí, Brazil. We studied the serum retinol levels and socioeconomic and demographic characteristics of 631 children from 36 to 83 months of age. The statistical association between each of the above characteristics and serum retinol levels was investigated by univariate and multivariate linear regression analysis. Mean serum retinol was 1.21 mmol/L (95%CI: 1.17-1.25 micromol/L) and was independent of gender (p = 0.259). Prevalence of vitamin A deficiency (retinol0.69 micromol/L) was 15.4% (95%CI: 12.7-18.4), with a tendency to decrease with age. Acceptable but not adequate retinol levels (0.70 to 1.04 micromol/L) were observed in 29% of children (95%CI: 25.2-32.4). There were positive associations between retinol levels and age, income, vitamin A supplementation, and maternal schooling. Vitamin A deficiency appeared as a moderately serious public health problem, emphasizing the importance of strategies to combat this problem in the region.

OBJECTIVE: To assess infestation levels of Aedes aegypti using the oviposition trap (ovitrap) method and to compare these results with data obtained with the use of indices traditionally applied in public programs aimed at fighting this vector. METHODS: Nine sentinel areas in Northeastern, Brazil, were assessed and infestation levels were measured for a nine-month period. Egg density and container indices were estimated and compared with previous results found using the house index and Breteau index. RESULTS: The results indicated that the area studied was infested with this vector during the entire study period and that the infestation was widespread in all areas. Different results were found with the different indices studied. There were areas in which the house index and the Breteau index were negative or close to zero, whereas the container index for the same area was 11% and the egg density index was 8.3%. CONCLUSIONS: The container and egg density indices allow better assessment of infestation rates in a city than the conventionally used indices (house index and Breteau index). At lower operational costs and easier standardization, these indices can be applied as a measurement tool for assessing infestation rates during entomological surveillance in programs to fight Aedes aegypti.

To describe the hematophagous activity of Ae. aegypti and Ae. albopictus in an area under control and surveillance.The study was conducted during 18 months, from April, 1993 to October, 1994, in Cosmopolis, Sao Paulo state, Brazil. Human baits were used to collect mosquitoes. The number of females captured is presented monthly by area of the city and local in the household. The rainfall was measured and indices are presented without model adjustment.The presence of females of both species was observed in 83% (Ae albopictus) and 61% (Ae. aegypti) of the period studied. The months of January, February and March presented the highest rates of activity for females of both species, with Ae. albopictus being more frequently captured than Ae. aegypti. Both species were captured in central and peripheral areas of the city, during the day from 9 to 12 am and from 4 to 7 pm. By a Poisson regression, it was observed that Ae. albopictus females were more frequently captured in the peri-housed area, in an independent way considering the area of the city.It has been identified difference on the hematophagous activity only for Ae. albopictus, being of importance the outside area of the house.

Lower extremity amputation is an increasing problem among diabetic patients and an important public health problem. The study purpose was to identify factors associated with lower extremity amputation.A matched case-control study was carried out among diabetic patients. Cases were selected in public health programs of the city of São Paulo, Brazil. One hundred and seventeen cases of diabetics with lower extremity amputation were compared to 234 controls of diabetics without amputation, matched by sex, age, and duration of disease. Sociodemographic variables, life habits (smoking and alcohol drinking), clinical aspects, and health education in diabetes were included. Univariate analyses and conditional logistic regression method were applied to data.Data showed evidence of association for: smoking, last glucose testor = 200 mg/dl, presence of peripheral somatic neuropathy and vibratory perception (tuning fork 128 Hz), and peripheral vascular disease. Diabetes treatment and attending nursing appointments for diabetes education were important factors for preventing lower extremity amputation in diabetic patients.The knowledge of determinants and intervening factors for this condition will lead to cost reduction and better quality of care delivered in public health services.

The prevalence of anti-Toxoplasma gondii antibodies in dogs in an urban area of the municipality of Monte Negro, Rondonia, Brazil, was evaluated using an indirect immunofluorescent antibody test (IFAT). Blood samples were taken from 157 dogs living in 85 of the 94 blocks of the city. A seropositivity of 76.4% (120/157) was found and associations between the prevalence and the variables sex, age, type of raising and food were studied. The prevalence tended to increase with age (p

Neospora caninum is an important cause of abortion in dairy cattle worldwide. Dogs are important in the epidemiology of this parasite because they are the only hosts known to excrete N. caninum oocysts. Antibodies to N. caninum were assayed in serum samples from 157 dogs from Monte Negro, Rondonia, Amazon, Brazil using the indirect fluorescent antibody test. Antibodies to N. caninum were found in 13 (8.3%) of dogs in titers of 1:50 in 1, 1:100 in 2, 1:200 in 5, 1:800 in 1, 1:1600 in 2, and 1:3200 in 2 dogs. These data indicate that N. caninum infection is prevalent even in remote areas of the Amazon.