Health-disease Process Research Articles

One health and social research in disease ecology: A social contextual study of vector-borne diseases in the Yucatan Peninsula, Mexico

Although disease ecology recognizes the multiplicity of factors involved in the (re)emergence of vector-borne diseases (VBD), it is necessary to strengthen attention to the social context and the social determinants of health. It is essential to integrate a sociocultural approach to health into the biological analysis of VBD ecology. To implement a coherent One Health approach in the prevention and control of VBD, it is pivotal to first understand the social and ecological interactions of the local context. Between October 2021 and June 2022, a social contextual study was made through surveys, semi-structured interviews and participatory activities in 12 localities with diverse ecological, economic and socio-cultural contexts in the Yucatan Peninsula. Through the perceptions of the populations on health and VBD, specifically mosquitoes, we gained knowledge on socio-cultural dynamics that influence people's relationship with pathogens. Local knowledge, management, and control of vectors; interactions with domestic and wild animals; and health-landscape relationship, were identified as factors that determine health-disease processes. This study contributed to a better understanding of local contexts and therefore, to the design of socially pertinent strategies for the reduction of vector-borne diseases risk scenarios in the study sites with an integrated approach.

From HIV to Mpox: Socio-discursive Analysis of Communicable Diseases, Stigma, and Pathologization in Sexual Minorities in Brazil.

Discrimination and stigma are significant barriers to healthcare for the LGBTQIAPN+ community, necessitating a deeper analysis of their sociocultural causes. There is a notable gap in the literature regarding the understanding of socio-discursive representations and their impact on the stigmatization and pathologization of sexual minorities in the context of communicable diseases. This study aims to discuss the understanding of the sociodiscursive aspects of the health-disease process, particularly in stigmatized infectious diseases affecting the LGBTQIAPN+ community. The focus is on examining how news articles, or the set of analyzed texts (corpus), shape these perceptions. We conducted documentary research with a qualitative and discursive approach using news articles retrieved from Google NewsⓇ about diseases affecting the LGBTQIAPN+ population from 2011 to 2022. The analysis was based on critical discourse analysis, processed using MAXQDA and IRAMUTEQ software. The identified representations predominantly align with biomedical ideology, manifesting in a discourse that normalizes and medicalizes (normative-curative discourse), and notable for its pathologizing and stigmatizing nature. Six classes were found: Ethical professional dilemmas facing stigma, infection and contamination of the LGBT+ population, prejudice and discrimination in the form of information, stigma related to sexual behavior/orientation, Vulnerability and stigma related to infectious diseases, and strategies for minimizing health risk/stigma for the LGBT+ public. The most relevant analytical categories were related to infectious diseases and sexual identity. These themes were identified, indicating that media representations reinforce stigma and maintain unequal health practices (verticalization) for the LGBT+ community. Understanding these patterns within a broader historical context is crucial for promoting health education and strategies that challenge internalized prejudice. The need to reformulate cultural norms and develop health information and education policies is urgent. These policies should be led by professionals with a comprehensive and humanized vision, addressing the diverse needs of the LGBT+ population.

TOXOPLASMOSIS AND ITS WEAKENING EFFECTS AND IMPLICATIONS FOR AGING

Toxoplasmosis is an infection caused by the parasite Toxoplasma gondii, which involves complex interactions with the host's immune system. The pathogenic process includes innate and adaptive immune responses, with a highlight on phagocytic cells and T cells in defense against the parasite. Commonly, with aging, there are implications on the individual's immune mechanisms. Based on these premises, the aim is to discuss the interfaces of toxoplasmosis with aging, aiming to identify relevant factors for the outcomes of this health-disease process. For this purpose, a narrative review of the scientific literature available in databases such as Scielo, Google Scholar, and PubMed was carried out. It was possible to identify that toxoplasmosis prevention involves measures such as food hygiene, avoiding contact with cats, and serological screening during pregnancy. Treatment varies according to the severity of the infection and the patient's immune status, involving specific therapy against the parasite and supportive treatment for complications. Understanding the pathogenesis, implementing preventive measures, and ensuring adequate therapeutic management are essential to reduce the incidence and impact of toxoplasmosis on public health, especially in at-risk groups such as pregnant women, elderly individuals, and immunocompromised individuals

Analysis of conditions related to diabetic foot in the pre and post COVID-19 pandemic in Brazil

With the COVID-19 pandemic, an exacerbation of hospitalizations due to diabetic foot was noted in Brazil, which was due to the loss of access to primary health care by the population, especially the most economically disadvantaged in a country with a vast continental extension and very unequal, economically. We carried out an observational, retrospective and descriptive analysis of hospital data on hospitalization for diabetic foot treatment, using SIH/SUS and DataSUS between 2015 and 2023. Mortality, length of stay, costs, nature of care and demographic distribution of procedures were analyzed. During the period, 196,523 hospitalizations were recorded for the treatment of complicated diabetic foot. In addition, 5,711 cases of deaths were associated with a fatality rate of 0.54%. In relation to financial expenditure, the Northeast Region stood out with the highest expenditure rate. The most socially vulnerable regions had higher hospitalization and mortality rates, although there was little change in financial resources during the pre- and post-pandemic period. This situation highlights the need to promote greater regional equity in indicators and access to health to minimize preventable problems such as UPD. Situations such as the one experienced in the COVID-19 pandemic served to highlight the shortcomings of the country's health system and how the health-disease process is strongly linked to local socioeconomic conditions, making it necessary to promote collective health measures aimed at minimizing disparities regions in Brazilian territory. The lack of data collected by the health event registration system in the country constitutes a limitation in the present study, which makes us suggest greater rigor and diversity in the collection of information in order to better translate the reality of the data presented here.

Non-therapeutic hysterectomy in Mexican young females with intellectual disability: a problematized reality

Non-therapeutic hysterectomy in girls and adolescents with intellectual disability (ID) is an acceptable practice, even when there is a lack of prescriptive ethical reason. To determine the magnitude of the practice of hysterectomy in girls and adolescents with ID, and explore the emic factors associated with this procedure. Multicenter, intersectoral study with a mixed methods design. The quantitative results showed that 50 of 234 reported hysterectomies corresponded to females with ID. Average age at the time of surgery was 15 ± 2.9 years. Prophylactic abdominal hysterectomy was the most common procedure, and the justifications for it were "fertility control", "menstrual hygiene management", and "risk of sexual abuse". A qualitative analysis of 15 focus groups revealed that parents' main concern was how to manage their daughters' index disease and reproductive health; they perceived menstruation positively; they expressed their fear of dying and leaving them without support, and emphasized fertility control; none of them approved hysterectomy. The bodies that define health policies need to create a new philosophy that avoids the reductionist approach of current biomedical model, which separates (in the health-disease process) our interdependence with other humans.

Notable correlation between serum epidermal growth factor values and inflammatory status in patients with COVID-19.

Despite its crucial role in Epidermal Growth Factor Receptor (EGFR) activation, and the resulting impact on the health-disease process, epidermal growth factor (EGF) is an underexplored molecule in relation to how its serum concentrations relate to other analytes and clinical variables in pathological contexts. To clarify the possible correlation between EGF and clinical and analytical variables in the context of COVID-19. Cross-sectional observational and analytical study, in patients with virological and clinical diagnosis of COVID-19, selected by simple random sampling, admitted between August and September 2021. UMELISA-EGF commercial kits were used. Differences in overall EGF values were observed between groups (566.04 vs. 910.53 pg/ml, p = .0430). In COVID-19 patients, no notable correlations were observed for neutrophil, platelet, triglyceride or liver enzyme values (p > .05). Significant correlations were observed with the neutrophil-lymphocyte indicator (r = 0.4711, p = .0128) as well as with the platelet-lymphocyte index (r = 0.4553, p = .0155). Statistical results of multivariate regression analysis suggest NLR (β = .2232, p = .0353) and PLR (β = .2117, p = .0411) are predictors of inflammation in patients with COVID-19. Serum EGF concentrations in COVID-19 correlate positively with prognostic inflammatory markers of severity and could presumably act as an independent risk factor for the development of inflammation in response to new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The nursing ethnographic research into complex societies

Introduction: Multicultural societies of the postmodern world are characterized by the complexity of their structure, organization, and operation. In such societies, there is a heterogeneous set of social players who experience a variety of phenomena in their daily lives in cities. Within this context, nursing care has developed and nurses in recent years have turned to ethnography as a tool in understanding socio-cultural reality and experience from the perspective of those living these experiences. This is a theoretical study seeking to reflect upon the application of an ethnographic approach in Brazilian nursing research in complex societies.Ethnography in Brazilian nursing research in complex societies: Brazilian nurses have appropriated the methodological tools and theories of nursing and anthropological studies to investigate the experiences and meanings attributed to health-disease process, cultural influence on health-related behaviors, as well as to evaluate and manage work processes. Further studies are emphasized to attempt to theorize and reflect upon the methodological construction of this research. This move highlights a shift in focus on nursing research and practice for a more integrative and complex view of human beings and reality. Ethnography helps us learn about a given reality and, as a result, we obtain new insights for understanding the phenomena.Reflection: It is considered that anthropological knowledge extends the nurses’ views on the subject about which they devote their practice, refining it. Being closer to the lives and experience of subjects, permits the perception of phenomena from the perspective of the players involved, offering professionals a different view on the needs and outcomes of nursing care.

Vulnerability to loss of follow-up and death due to tuberculosis among homeless individuals in Brazil: a retrospective cohort study.

This retrospective cohort study identified factors associated with loss of follow-up and death due to tuberculosis (TB) in the homeless population (HP) in Brazil, estimating odds ratios (OR) and their 95% confidence intervals (95%CI) by multinomial logistic regression. A total of 3,831 TB cases in this population were analyzed, of which 57.0% had unfavorable outcomes. Loss of follow-up was associated with: history of abandonment (OR=2.38; 95%CI 2.05-2.77), unknown HIV serology (OR=1.79; 95%CI 1.38-2.32), HIV coinfection (OR=1.73; 95%CI 1.46-2.06), drug use (OR=1.54; 95%CI 1.31-1.80), age (OR=0.98; 95%CI 0.97-0.99), mixed clinical form (OR=0.64; 95%CI 0.42-0.97), extrapulmonary form (OR=0.46; 95%CI 0.29-0.73), government beneficiary (OR=0.64; 95%CI 0.50-0.81), and supervised treatment (OR=0.52; 95%CI 0.45-0.60). Regarding death, the following were associated: age (OR=1.03; 95%CI 1.01-1.05), unknown HIV serology (OR=2.39; 95%CI 1.48-3.86), alcohol consumption (OR=1.81; 95%CI 1.27-2.58), and supervised treatment (OR=0.70; 95%CI 0.51-0.96). Overlapping vulnerabilities in the health-disease process of homeless individuals with TB were observed, requiring comprehensive and cross-sectoral care practices.

Non-therapeutic hysterectomy in Mexican young females with intellectual disability: a problematized reality

Non-therapeutic hysterectomy in girls and adolescents with intellectual disability (ID) is an acceptable practice, even when there is a lack of prescriptive ethical reason. To determine the magnitude of the practice of hysterectomy in girls and adolescents with ID, and explore the emic factors associated with this procedure. Multicenter, intersectoral study with a mixed methods design. The quantitative results showed that 50 of 234 reported hysterectomies corresponded to females with ID. Average age at the time of surgery was 15 ± 2.9 years. Prophylactic abdominal hysterectomy was the most common procedure, and the justifications for it were "fertility control", "menstrual hygiene management", and "risk of sexual abuse". A qualitative analysis of 15 focus groups revealed that parents' main concern was how to manage their daughters' index disease and reproductive health; they perceived menstruation positively; they expressed their fear of dying and leaving them without support, and emphasized fertility control; none of them approved hysterectomy. The bodies that define health policies need to create a new philosophy that avoids the reductionist approach of current biomedical model, which separates (in the health-disease process) our interdependence with other humans.

Homeopathy as a Means to Improve Quality of Life.

Quality of life is a fundamental aspect of good health and differs from person to person, highlighting the importance of individualisation, which is one of the principles of homeopathic doctrine. Homeopathy aligns with the principles of the Brazilian public health system, reflecting the latter's ethos of universality, accessibility, care coordination, and comprehensiveness, offering a whole-person approach to health care. Homeopathy's individualised approach and expanded view of the health-disease process, with emphasis on healthy lifestyle guidance, contributes to the promotion of individual good health and quality of life. These attributes of homeopathy make it a valuable therapeutic option, with relevance to the health service of Brazil as well as to that of other countries across the world.

Towards a social determination of health framework for understanding climate disruption and health-disease processes.

We compare the social determinants of health (SDOH) and the social determination of health (SDET) from the school of Latin American Social Medicine/Collective Health. Whereas SDET acknowledges how capitalist rule continues to shape global structures and public health concerns, SDOH proffers neoliberal solutions that obscure much of the violence and dispossession that influence contemporary migration and health-disease experiences. Working in simultaneous ethnographic teams, the researchers here interviewed Honduran migrants in their respective sites of Honduras, Mexico, and the United States. These interlocutors connected their experiences of disaster and health-disease to lack of economic resources and political corruption. Accordingly, we provide an elucidation of the liberal and dehumanizing foundations of SDOH by relying on theorizations from Africana philosophy and argue that the social determination of health model better captures the intersecting historical inequalities that structure relationships between climate, health-disease, and violence.

Health-disease Process of Acute Chagas Disease According to One Health Approach

Health-disease Process of Acute Chagas Disease According to One Health Approach

International Migration, Refugees, and Spread of Tuberculosis in Brazil: Analysis of Clusters, Trends, and Associated Factors (2010-2021).

International migration is a global phenomenon with significant implications on the health-disease process due to exposures along transit routes and local/destination epidemiological indicators. We aimed to analyze the transmission and spread of tuberculosis among international migrants and refugees from a spatiotemporal perspective and the associated factors. This was an ecological study of cases of tuberculosis in international migrants in Brazil, between 2010 and 2021. Annual incidence rates were calculated and spatiotemporal scan techniques were used to identify municipalities at risk. Multiple logistic regression was used to identify factors associated with tuberculosis in international migrants. A total of 4037 cases of tuberculosis were reported in Brazil in international migrants. Municipalities at risk for this event were identified using the spatiotemporal scan technique, and a cluster was identified with ITT: +52.01% and ETT: +25.60%. A higher probability of TB infection was identified in municipalities with a TB incidence rate >14.40 cases/100 inhabitants, population >11,042 inhabitants, Gini index >0.49, and illiteracy rate >13.12%. A lower probability was found in municipalities with average per capita household income >BRL 456.43. It is recommended that health authorities implement monitoring and rigorous follow-up in affected areas to ensure proper diagnosis and treatment completion for international migrants, preventing disease spread to other communities.

Immigration and work, considerations about the challenges in Brazil: bibliographic review of the literature

Introduction: Migratory flows towards countries that have more labor supply are not recent. In this sense, the arrival of immigrants in host countries, in many cases, makes this population more susceptible to health risk situations because of work activities, lack of integration with the local population and the immigration process itself. Methods: The study used a bibliographic review of the literature as a method. In this context, integration policies and the recognition of educational training in the country of origin can contribute to improving the living conditions of this population in Brazil. Results: In this context, this study aims to provide a summary of the challenges faced by immigrants in search of improved living conditions. Furthermore, this study contributes to identifying the main challenges facing immigrants recently arrived in Brazil and the difficult process of integration into local society. It is observed that the authors highlight in common that, worldwide, in the different receiving countries, regardless of the social, political, and economic context in which the immigrants find themselves, there is some destructive process that conditions the health-disease process of this population, resulting from the various factors mentioned above. Conclusion: Yet the positive contribution of migration to development is increasingly recognized, and these targeted policies will maximize their benefits in both countries of origin and destination.

Thermal Comfort and the Health-Disease Process: A case study in the Nossa Senhora do Perpétuo Socorro community in the municipality of Tefé-AM

O objetivo desta pesquisa foi analisar os parâmetros do conforto térmico associados ao trabalho e saúde na comunidade Nossa Senhora do Perpétuo Socorro no município de Tefé-AM. O delineamento do trabalho desdobrou-se em três etapas: estudos bibliográficos, trabalho de campo e na terceira etapa foram utilizados dados meteorológicos do INMET (Instituto Nacional de Meteorologia) com a variável de temperatura máxima, média e mínima no período de 1991 a 2020, e a variável de umidade relativa do ar. Para o cálculo foi utilizado o índice de calor (IC), trabalhado para medir a temperatura aparente percebida pelo homem. Todos os dados foram tratados no software Excel, o resultado do cálculo do IC foi analisado de acordo com a tabela de Níveis de alerta do IC e suas consequências à saúde humana. Os dados evidenciaram que a exposição direta frequente e prolongada a radiação solar no trabalho e o desconforto para o calor, comprometem a saúde dos camponeses e desencadeia doenças, comprometendo o rendimento na produção, além de outros agravos como envelhecimento precoce, insônia, esgotamento físico e dores musculares em geral. Esta pesquisa serve como alerta a saúde dos camponeses, visibilidade e valorização a essa classe essencial para base alimentar tefeense.

OVERLOAD AND STRATEGIES TO FACE THE FAMILIES OF PEOPLE WITH MENTAL DISORDER IN THE FACE OF THE HEALTH PROCESS- DISEASE: A REVIEW OF LITERATURE

The family is the main support network for patients in psychological distress, however, in daily professional life, family members are overloaded. The study aims to present the knowledge produced about the burden on caregivers of people with mental disorders and recognize family members' coping strategies when faced with the health-disease process. This is a literature review carried out in the MEDLINE, LILACS, SCIELO and PEPSIC databases. 11 articles available in full were included, published between 2013 and 2023. It was evident that caregivers changed family dynamics, gave up professional and social life, as well as leisure activities. Coping strategies include using faith, seeking social and group support, using medication, trying to solve the problem, accepting responsibilities, positive reassessment, escape, avoidance and attempts at family integration. The importance of supporting caregivers of patients with severe mental disorders is evident, and it is essential to implement support programs for caregivers of these patients within the scope of the psychosocial care network.

Men's health in primary care: challenges faced by nurses regarding the determinants of the health-disease process

To identify the challenges faced by nurses working in primary health care in relation to the care provided to the male population. This is an integrative literature review, with a quantitative approach, carried out using the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Database - BDENF - and Scientific Electronic Library Online (SCIELO) and with the help of the Health Sciences descriptors (DeSC): "men's health", "primary health care" and "nursing". Fourteen studies were selected to make up the review. The challenges faced by nursing in relation to the health of the male population are mainly related to the socialization that gender involves, the deficit in the organization of services due to the feminization of systems, the incompatibility of schedules, the lack of training and qualification of health professionals who work in PHC. It was possible to identify that health services are deficient in meeting the demands presented by the male population. This study will provide a better insight into the structuring and preparation of health services to care for men of all ages.

Clinical aspects, prevention and diagnosis of yellow fever in Brazil

Yellow fever is an acute febrile illness caused by an arbovirus of the Flavivirus genus, transmitted to humans and non-human primates through the bite of infected mosquitoes. It is a disease with a high impact on morbidity and lethality, which has caused a great deal of concern these days, making it a major public health problem. The aim of this narrative review was to analyze and revise the main articles available on the clinical aspects, prevention and diagnosis of yellow fever in Brazil. The vaccine is the most effective way of preventing and controlling yellow fever. It is therefore necessary to use this technology to ensure comprehensive care, which must be resolutive and continuous, as well as to intervene in situations capable of influencing the health-disease processes of a given population.

Sexual invisibility in individual registrations: a study with Community Health Agents

The debate on gender and sexuality is crucial in Primary Health Care (PHC), given its influence on the health-disease process. Its initial approach occurs in the Individual Registration Form, a tool used by Community Health Agents (CHAs), through optional questions about the resident's gender identity (GI) and sexual orientation (SO). In this sense, the present study aims to investigate the factors related to the act of questioning or not questioning GI and SO in a sample of CHAs. It is a cross-sectional, quantitative, and descriptive study, using a structured questionnaire directed to CHAs affiliated with Family Health Units of the Integrated Health Care Territories project in the city of Campo Grande/MS. With 118 participants, 22.9% could not indicate their GI, and 80.5% rarely inquire about GI and SO. The majority (72.8% and 61%) has limited knowledge about GI and SO. The analysis revealed a positive association between the frequent discussion of the topic with CHAs and the frequent questioning of GI and SO (OR=6.45; 95% CI: 1.33-31.21), p<0.05. Therefore, the results highlight the importance of ongoing health education to promote equity in the care of LGBTQIAP+ individuals within the scope of PHC.

Study and analysis of the structural-biochemical characteristics in Mollicutes biofilms formation

Biofilms have a wide distribution in various environments and even in devices used in medical practice, for this reason its relevance to study these structures and consider strategies to prevent their development and the effects they imply. Due to the medical importance that mycoplasmas represent, the objective of the present work was to analyze the capacity of Mycoplasma fermentans P140 to form a biofilm on an inert surface and to document the characteristics of the process in the formation of biofilm in Mollicutes. The interaction of the culture of Mycoplasma fermentans P140 with intrauterine devices for 72 hours showed by macroscopic analysis the crystal violet staining of the technique to evaluate biofilm formation, stereoscopic microscopy showed the formation of cell aggregates and by scanning electron microscopy the characteristic formation of biofilm. The search for reports referring to studies of biofilm formation in Mollicutes showed that there is recent evidence of biofilm formation in this group of microorganisms, both of veterinary medical interest and of interest in public health. Through metabolomics studies, it will be possible to demonstrate the metabolic products during the formation of biofilms in the different genera and species of these bacteria. Representing these investigations relevance to the field of public health and other ecosystems where health-disease processes are related.