Suchergebnisse

Rodrigo Galhardi Gasparini,1 Ligia Yukie Sassaki,2 Rogerio Saad-Hossne3 1Department of Digestive Surgery and Gastroenterology, Sete Specialized Medical Center, Marília, Brazil; 2Department of Internal Medicine, Botucatu Medical School at Sao Paulo State University (UNESP), Botucatu, Brazil; 3Department of Surgery, Botucatu Medical School at Sao Paulo State University (UNESP), Botucatu, Brazil Purpose: This study aimed to estimate the incidence and prevalence of inflammatory bowel disease (IBD) in São Paulo, Brazil, for 2012–2015. Patients and methods: This observational, descriptive, and cross-sectional study included 22,638 IBD patients out of 43,046,555 inhabitants, who had initiated their treatment through the Governmental Program of the Brazilian Unified National Health System between the years of 2012 and 2015. The onset of the disease (used to determine incidence) was established as the date of the patient's initial registration in the Governmental Program with a diagnosis for Crohn's disease (CD) or ulcerative colitis (UC). Every patient registered in the system as of December 2015 was included in determining the prevalence. The demographic and clinical data, such as age and sex, were collected for each patient. Statistical analysis included mean and SD, absolute and percentage frequencies, and Pearson's chi-squared test (X²). The incidence and prevalence rates were calculated based on the estimated annual population of the State of São Paulo. Results: The study population consisted of 10,451 (46.16%) CD patients and 12,187 (53.84%) UC patients. The mean age was 42.66 (SD±16.2) years for the CD group and 47.87 (SD±16.6) years for the UC group. There was a predominance of females corresponding to 59.70% of the study population (female:male =1.48:1.00; P<0.0001). The incidence of IBD was 13.30 new cases/100,000 inhabitants per year, while the overall prevalence was 52.6 cases/100,000 inhabitants. Conclusion: This population-based study demonstrated a stability in IBD incidence rates and an increase in IBD prevalence rates in São Paulo state between 2012 and 2015. The IBD incidence and prevalence rates were comparable to European countries, with a higher occurrence in the female participants. Keywords: inflammatory bowel disease, Crohn's disease, ulcerative colitis, epidemiology, incidence, prevalence

Abstract The aim of the current article is to evaluate the ways of disposing medications in disuse adopted by the population in Itapetininga City, São Paulo State, Brazil. Cross-sectional study carried out with 182 subjects who attended health facilities. It was performed through a questionnaire about the disposal of medication kept in "home pharmacies". In total, 2.7% of the 182 respondents properly disposed medication (delivery to health facilities) - 5.5% accounted for the correct discard of it, but, yet, it was associated with some inappropriate behavior. There was no leftover medication in 14.8% of "home pharmacies" likely because of delivery at correct medication amount and of adherence to treatment - 77% of the ducts could cause environmental damage. In total, 65% of the 182 respondents kept medication in disuse for further use and 10% of them used to donate medication to neighbors, friends and relatives - these behaviors are considered inappropriate due to likely self-medication and storage issues. In conclusion, there is the need of environmental and health education for both the population and health professionals.

The state programs for low income housing in Brazil started in the 1930s, and most recently the well-advertised program 'My House, My Life' by the Federal government had on its goals to improve the quality of life of poor people, to reduce the housing deficit and to foster the economy. The question raised by this paper is how important was the contribution of the program for the economic growth observed in the Brazilian economy in previous years? In a way to shed light on this question, the case of the low income housing programs in the state of São Paulo is taken as an example. The State program being a joint venture among the federal, state and municipal governments. To do so, a specific interregional input-output model is estimated for two regions, São Paulo and Rest of Brazil, with the insertion in the model of 5 different typologies of low income housing, ranging from a single house to building complexes. The impacts are measured in terms of GDP, tax collection and employment in the State of São Paulo and in the Rest of Brazil, showing that depending on the housing typology, the impacts in the economy are different, and that part of the investments made returns to the government in terms of tax collection.

ABSTRACT: This paper aimed to identify the determinants of beef traceability adoption at farm level in São Paulo State, Brazil. A sample survey of 32 farmers who adopted the European Union certified traceability and 52 other farmers who did not adopt traceability provided data to test hypotheses on determinant factors. Three binomial logit models were used in the analysis. Results suggested that capital-intensive livestock production system, high scale production, access to specialized information and high level of human and social capital play significant role in the adoption decision.

Abstract This study investigated how farm size, economic activity and social group are related to declared native vegetation cover in rural lands in the state of São Paulo, Brazil, evaluating implications to environmental public policies. We analyzed data from Rural Environmental Registry System of São Paulo (SICAR-SP). More than one third of the farms does not have declared native vegetation and half of them have up to 3% of native vegetation cover. Percentage of declared native vegetation cover tends to increase with farm size. However, only community lands and silviculture farms larger than 500 hectares showed most properties (more than 50%) with at least 20% of its area covered with native vegetation, as determined by the Brazilian Forest Act (federal law 12,651/2012). Our results suggest that, beyond property size, property social group and economic activity are also important aspects to be considered into public policy design aiming at environmental conservation in rural landscapes.

OBJETIVO: Verificar a poluição de corpos d'água por esgotos domésticos e avaliar as condições de saneamento básico que contemplam domicílios e o conhecimento da população local sobre doenças parasitárias intestinais e seus riscos à saúde pública. MÉTODOS: Foram realizadas 13 coletas de água em quatro pontos em corpos d'água na região do Bairro da Serra, em Iporanga, Estado de São Paulo, e avaliados índices de coliformes totais e fecais apresentados em medianas para mostrar a contaminação por esgotos domésticos na localidade. Também foram aplicados questionários em 50% dos domicílios locais visando à obtenção de informações sobre abastecimento de água, destino de esgotos e resíduos sólidos domiciliares e identificação do conhecimento sobre transmissão, prejuízos à saúde; e profilaxia de doenças parasitárias intestinais. RESULTADOS: O Rio Betari apresentou índices microbiológicos que indicam poluição por esgotos domésticos. Tanto à montante do Bairro da Serra como à jusante foram verificados níveis mais elevados. Em dois de seus afluentes as amostras resultaram valores de mediana ainda superiores, indicando forte poluição por esgotos domésticos e inconformidades com a legislação pertinente. Entre os domicílios onde foram feitas as entrevistas, verificou-se que em 91% deles a disposição de esgotos é feita em fossas, na sua maioria rudimentares e contaminantes do ambiente. O conhecimento de 62% dos entrevistados quanto à transmissão de verminoses foi considerado insatisfatório. CONCLUSÕES: Os resultados apontam para riscos de proliferação de enteroparasitoses e demais doenças de veiculação hídrica, problemática agravada com acréscimos populacionais advindos da vocação local para o ecoturismo. ; OBJECTIVE: To assess the pollution of water bodies by domestic sewage and to evaluate the basic sanitation conditions of residences and the knowledge of the local population concerning intestinal parasitic diseases and the hazards they present to public health. METHODS: Thirteen water samples were collected from each of four sites in different water bodies of the Bairro da Serra region, in Iporanga, São Paulo State. Rates of total and fecal coliforms were measured and median values were presented so as to show domestic sewage contamination in the area. Questionnaires were administered to 50% of local households in order to obtain information on water supply and disposal of domestic sewage and solid waste, and to evaluate knowledge of the transmission, health hazards, and prevention of intestinal parasitic diseases among the local population. RESULTS: The Betari river showed microbiological indexes indicative of pollution by domestic sewage. Higher levels were verified both upstream and downstream from the Bairro da Serra. Median values were even higher in two of the river's tributary streams, indicating strong pollution by domestic sewage and lack of conformity with current legislation. In 91% of the households investigated, sewage disposal was done by means of septic tanks, most of which were rudimentary and contributed to the contamination of the environment. The knowledge of 62% of interviewed subjects concerning the transmission of helminthic diseases was considered as poor. CONCLUSIONS: Our results indicate a risk of proliferation of intestinal parasitoses and of other water-transmitted diseases, an issue which is aggravated by increases in population caused by the region's vocation for ecotourism.

It is often argued that liquid biofuels are cleaner than fossil fuels, and therefore better for human health, however, the evidence on this issue is still unclear. Brazil's high uptake of ethanol and role as a major producer makes it the most appropriate case study to assess the merits of different biofuel policies. Accordingly, we modeled the impact on air quality and health of two future fuel scenarios in São Paulo State: a business-as-usual scenario where ethanol production and use proceeds according to government predictions and a counterfactual scenario where ethanol is frozen at 2010 levels and future transport fuel demand is met with gasoline. The population-weighted exposure to fine particulate matter (PM2.5) and ozone was 3.0 μg/m3 and 0.3 ppb lower, respectively, in 2020 in the scenario emphasizing gasoline compared with the business-as-usual (ethanol) scenario. The lower exposure to both pollutants in the gasoline scenario would result in the population living 1100 additional life-years in the first year, and if sustained, would increase to 40,000 life-years in year 20 and continue to rise. Without additional measures to limit emissions, increasing the use of ethanol in Brazil could lead to higher air pollution-related population health burdens when compared to policy that prioritizes gasoline.

It is often argued that liquid biofuels are cleaner than fossil fuels, and therefore better for human health, however, the evidence on this issue is still unclear. Brazil's high uptake of ethanol and role as a major producer makes it the most appropriate case study to assess the merits of different biofuel policies. Accordingly, we modeled the impact on air quality and health of two future fuel scenarios in São Paulo State: a business-as-usual scenario where ethanol production and use proceeds according to government predictions and a counterfactual scenario where ethanol is frozen at 2010 levels and future transport fuel demand is met with gasoline. The population-weighted exposure to fine particulate matter (PM2.5) and ozone was 3.0 μg/m³ and 0.3 ppb lower, respectively, in 2020 in the scenario emphasizing gasoline compared with the business-as-usual (ethanol) scenario. The lower exposure to both pollutants in the gasoline scenario would result in the population living 1100 additional life-years in the first year, and if sustained, would increase to 40,000 life-years in year 20 and continue to rise. Without additional measures to limit emissions, increasing the use of ethanol in Brazil could lead to higher air pollution-related population health burdens when compared to policy that prioritizes gasoline.

Leptospirosis is a potentially fatal zoonosis caused by Leptospira bacteria. Some animal host species are adapted to specific serovars being potential carriers and environmental dispersers. From 2009 to 2011, 45 wild mammals (39 opossums Didelphis albiventris, four porcupines Sphiggurus villosus, one coypu Myocastor coypus and one capybara Hidrochoerus hidrochaeris) found by citizens in anthropic areas of Monte Mor municipality were captured, restrained and had sera samples collected for Leptospira antibody detection. The samples were titrated by the microagglutination technique (MAT) for different serogroups. A total of 35.56% (16/45) animals were reactive for Leptospira antibodies for 11 different serogroups. The most frequent serovar, among the 12 identified, was Icterohaemorrhagiae (6/16), followed by Gryppotyphosa (4/16) and Pyrogenes (2/16). Didelphis albiventris, the most abundant species in the study, had a prevalence of 35.9% (14/39) for Leptospira antibodies, while S. villosus had 0% (0/4), M. coypus (1/1) and H. hydrochaeris (1/1) 100%. Among the seropositive D. albiventris, 35.71% (5/14) and 28.57% (4/14) seroreacted for Leptospira interrogans species, serogroups Icterohaemorrhagiae and Gryppotyphosa respectively, indicating environmental contamination by these bacteria and the possibility of exposure and infection of humans and domestic animals in the studied area.