ResumoObjetivando traçar a evolução histórica da distribuição de médicos no Brasil segundo sexo, foi realizado estudo epidemiológico do tipo ecológico, por meio do cruzamento de bancos de dados secundários (linkage). Para a caracterização geral dos médicos foram consideradas as bases de dados dos 27 conselhos regionais de medicina, complementadas pelas bases de dados da Comissão Nacional de Residência Médica e da Associação Médica Brasileira. Os resultados mostram que, desde 2009, entre os novos médicos registrados há mais mulheres que homens. Na população de médicos em atividade os homens ainda predominam (60,1%), mas no grupo com 29 anos ou menos as mulheres já são maioria. A tendência consistente de maior participação das mulheres na profissão médica no Brasil, observada ao longo das últimas décadas e acentuada nos últimos anos, indica a necessidade de reavaliar e readequar as propostas para implementação de políticas públicas na área. Palavras-chave: Feminização. Medicina. Distribuição de médicos. Brasil. Resumen La feminización de la Medicina en BrasilCon el fin de trazar la evolución histórica de la distribución de los médicos en Brasil por sexo, se llevó a cabo un estudio epidemiológico del tipo ecológico, a través de la intersección de las bases de datos secundarias (linkage). Para la caracterización general de los médicos, se han considerado las bases de datos de los 27 Consejos Regionales de Medicina, complementados con las bases de datos de la Comisión Nacional de Residencia Médica y de la Asociación Médica Brasileña. Los resultados muestran que entre los nuevos médicos colegiados hay más mujeres que hombres desde 2009. En la población de los médicos en actividad todavía predominan los hombres (60,1%), pero en el grupo con 29 años o menos, las mujeres son la mayoría. La tendencia constante de aumento de la participación de las mujeres en la profesión médica en Brasil, observada durante las últimas décadas y notablemente en los últimos años, indica la necesidad de reevaluar y reajustar las propuestas para la implementación de políticas públicas en el área. Palabras-clave: Feminización. Medicina. Distribución de médicos. Brasil. Abstract The feminization of Medicine in BrazilAiming to settle the historical evolution of physicians' distribution in Brazil by gender, an ecological study was conducted by secondary database cross-checking (linkage). For a general characterization of the physicians were considered the 27 Regional Medicine Council, complemented by the National Medical Residency and the Brazilian Medical Association databases. The results show that since 2009, among new registered doctors there are more women than men. Although men still prevail (60.1%) in the active physicians population, in the group aged less than 29 years old, women have become majority. The consistent trend of increased participation of women in the medical profession in Brazil, observed over the past decades and intensified over the past few years, indicates the need to reassess and readjust the proposals for implementati...
Introduction Although patients’ clinical conditions have been shown to be associated with coronavirus disease (COVID-19) severity and outcome, their impact on hospital costs are not known. This economic evaluation of COVID-19 admissions aimed to assess direct and fixed hospital costs and describe their particularities in different clinical and demographic conditions and outcomes in the largest public hospital in Latin America, located in São Paulo, Brazil, where a whole institute was exclusively dedicated to COVID-19 patients in response to the pandemic. Methods This is a partial economic evaluation performed from the hospital´s perspective and is a prospective, observational cohort study to assess hospitalization costs of suspected and confirmed COVID-19 patients admitted between March 30 and June 30, 2020, to Hospital das Clínicas of the University of São Paulo Medical School (HCFMUSP) and followed until discharge, death, or external transfer. Micro- and macro-costing methodologies were used to describe and analyze the total cost associated with each patient's underlying medical conditions, itinerary and outcomes as well as the cost components of different hospital sectors. Results The average cost of the 3,254 admissions (51.7% of which involved intensive care unit stays) was US$12,637.42. The overhead cost was its main component. Sex, age and underlying hypertension (US$14,746.77), diabetes (US$15,002.12), obesity (US$18,941.55), chronic renal failure (US$15,377.84), and rheumatic (US$17,764.61), hematologic (US$15,908.25) and neurologic (US$15,257.95) diseases were associated with higher costs. Age strata >69 years, reverse transcription polymerase chain reaction (RT-PCR)-confirmed COVID-19, comorbidities, use of mechanical ventilation or dialysis, surgery and outcomes remained associated with higher costs. Conclusion Knowledge of COVID-19 hospital costs can aid in the development of a comprehensive approach for decision-making and planning for future risk management.
INTRODUÇÃO: A concentração de cães e gatos em áreas urbanas, associada a um número cada vez mais crescente da população errante desses animais, tem um papel epidemiológico importante na contaminação de solos de praças e parques públicos e na disseminação de infecções por variados gêneros de parasitas. O objetivo do presente estudo foi determinar a frequência de geo-helmintos com potencial zoonótico em solo de praças públicas e escolas municipais infantis da Cidade de Fernandópolis, Estado de São Paulo, Brasil, no período compreendido entre março de 2007 e fevereiro de 2008. MÉTODOS: Foram avaliadas todas as praças (32) e escolas (13) da cidade. As amostras foram testadas pelos métodos de Rugai adaptado, Willis e Caldwell e Caldwell. RESULTADOS: Foram avaliadas 225 amostras de solo com 30,2% (68) de positividade. Nas amostras provenientes de praças públicas, a positividade foi de 40% (64), ao passo que, nas escolas, foi de apenas 6,1% (6). Os ovos de parasitas encontrados foram Toxocara spp. 79,3% (47), Trichuris spp. 13,8% (8) e ancilostomídeos 6,9% (4). Variáveis relacionadas ao local, como o número de cães (OR 21,18 - IC95%: 10,81-41,51), de espécimes de fezes (OR 6,87 - IC95%: 3,51-13,47) e a utilização de cerca (OR 0,1 - IC95%: 0,05-0,20) tiveram impacto na contaminação do solo. CONCLUSÕES: Foram observados, nas amostras contaminadas, parasitas com potencial zoonótico, entre os quais estão os agentes etiológicos de doenças como a larva migrans visceral e cutânea, fato que representa risco a saúde da população que frequenta tais ambientes.
BackgroundToxocariasis is a worldwide helminthic zoonosis caused by infection with the larvae of the ascarid worms that comprise the Toxocara spp. Children are particularly prone to infection because they are exposed to the eggs in sandboxes and playgrounds contaminated with dog and cat feces. Certain behaviors, such as a geophagy habit, poor personal hygiene, a lack of parental supervision, close contact with young dogs, and ingestion of raw meat, as well as gender, age, and socioeconomic status, affect the prevalence of the disease. However, previous studies of the risk factors for toxocariasis have generally produced inconsistent results. An epidemiological cross-sectional study was conducted to evaluate the seroprevalence of IgG anti-Toxocara spp. antibodies and associated factors in schoolchildren from a region in the southeast of Brazil.Methodology/Principal FindingsA total of 252 schoolchildren aged 1 to 12 years (120 males and 132 females) were assessed. An enzyme-linked immunosorbent assay based on Toxocara canis larval excretory-secretory antigens was used to determine outcomes. A questionnaire was used to collect information on children, family, and home characteristics. Clinical and laboratory data completed the dataset investigated in this study. Seroprevalence was 15.5% (95%CI 11.5–19.8). Geophagy (aPR 2.38 [95%CI 1.36–4.18], p-value 0.029) and the habit of hand washing before meals (aPR 0.04 [95%CI 0.01–0.11], p-value ≤0.001) were factors associated with increased and decreased seroprevalence, respectively. The income factor and its related variables lost statistical significance after adjustment with a multiple Poisson regression model.Conclusions/SignificanceThe current study confirms that toxocariasis is a public health problem in the evaluated area; modifiable factors such as soil contact and personal hygiene appear to have a greater influence on the acquisition of infection than sociodemographic attributes, thus representing direct targets for disease prevention and control.
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