No Brasil, a transição epidemiológica não tem ocorrido de acordo com o modelo experimentado pela maioria dos países desenvolvidos. Velhos e novos problemas em saúde coexistem, com predominância das doenças crônico-degenerativas, embora as doenças transmissíveis ainda desempenhem um papel importante. Neste estudo, os diferenciais, em relação ao padrão epidemiológico, são descritos para o Brasil e grandes regiões, para o indicador de saúde dos estudos da carga de doença, o DALY. Entre os principais resultados encontrados, para o Brasil, destaca-se que o grupo das doenças não-transmissíveis, infecciosas/parasitárias/maternas/perinatais/nutricionais, e das causas externas representaram, respectivamente, 66,3%, 23,5% e 10,2% da carga total de doença estimada. A utilização do indicador DALY propicia a identificação de prioridades em função do perfil epidemiológico, facilitando a tomada de decisões e destinação adequada de recursos por parte dos gestores.
The objective of the study was to test the association between gestational weight gain, reproductive factors, and postpartum weight retention based on a cohort conducted with 405 women aged 18-45 y with follow-up waves at 0.5, 2, 6, and 9 mo postpartum. The outcome variable, postpartum weight retention, was calculated as the difference between the measured weight at each visit minus the prepregnancy weight. We estimated the statistical associations between the outcome variable and potential explanatory covariates of interest by fitting a longitudinal mixed-effects model. Women with gestational weight gain above the recommendations of the Institute of Medicine (IOM) retained significantly more weight than women with weight gain within or below the recommendations, independently of prepregnancy BMI [weight (kg)/height (m(2))] or body fat at baseline. Women with the highest gestational weight gain and with body fat >/=30 g/100 g at baseline had the highest likelihood of developing maternal obesity. The final longitudinal model showed that 35% of each kilogram of weight gained during pregnancy was retained 9 mo postpartum, even after adjustment for age, prepregnancy BMI, body fat at baseline, and years since first parturition. Each unit of increase in prepregnancy BMI was associated with a decrease of -0.51 kg in postpartum weight retention. In conclusion, gestational weight gain was one of the most important predictors for postpartum weight retention and must be monitored systematically with the aim of preventing postpartum obesity and the diseases that follow.
Impact on human health of particulate matter emitted from burnings in the Brazilian Amazon regionImpactos na saúde humana de partículas emitidas por queimadas na Amazônia brasileira ABSTRACT OBJECTIVE: To analyze the impact on human health of exposure to particulate matter emitted from burnings in the Brazilian Amazon region. METHODS:This was an ecological study using an environmental exposure indicator presented as the percentage of annual hours (AH%) of PM 2.5 above 80 μg/m 3 . The outcome variables were the rates of hospitalization due to respiratory disease among children, the elderly and the intermediate age group, and due to childbirth. Data were obtained from the National Space Research Institute and the Ministry of Health for all of the microregions of the Brazilian Amazon region, for the years 2004 and 2005. Multiple regression models for the outcome variables in relation to the predictive variable AH% of PM 2.5 above 80 μg/m 3 were analyzed. The Human Development Index (HDI) and mean number of complete blood counts per 100 inhabitants in the Brazilian Amazon region were the control variables in the regression analyses. RESULTS:The association of the exposure indicator (AH%) was higher for the elderly than for other age groups (β = 0.10). For each 1% increase in the exposure indicator there was an increase of 8% in child hospitalization, 10% in hospitalization of the elderly, and 5% for the intermediate age group, even after controlling for HDI and mean number of complete blood counts. No association was found between the AH% and hospitalization due to childbirth. CONCLUSIONS:The indicator of atmospheric pollution showed an association with occurrences of respiratory diseases in the Brazilian Amazon region, especially in the more vulnerable age groups. This indicator may be used to assess the effects of forest burning on human health.
Background: The neurotoxic effects of methylmercury (MeHg) have been demonstrated in both human and animal studies. Both adult and fetal brains are susceptible to the effects of MeHg toxicity. However, the specific effects of adult exposures have been less well-documented than those of children with prenatal exposures. This is largely because few studies of MeHg exposures in adults have used sensitive neurological endpoints. The present study reports on the results of neuropsychological testing and hair mercury concentrations in adults (>17 yrs) living in fishing communities of Baixada Cuiabana (Mato Grosso) in the Pantanal region of Brazil.
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