Objective:To estimate the association between exposure to fine particulate matter with an aerodynamic diameter <2.5 microns (PM2.5) and hospitalizations for pneumonia and asthma in children.Methods:An ecological study of time series was performed, with daily indicators of hospitalization for pneumonia and asthma in children up to 10 years of age, living in Taubaté (SP) and estimated concentrations of PM2.5, between August 2011 and July 2012. A generalized additive model of Poisson regression was used to estimate the relative risk, with lag zero up to five days after exposure; the single pollutant model was adjusted by the apparent temperature, as defined from the temperature and relative air humidity, seasonality and weekday.Results:The values of the relative risks for hospitalization for pneumonia and asthma were significant for lag 0 (RR=1.051, 95%CI; 1.016 to 1.088); lag 2 (RR=1.066, 95%CI: 1.023 to 1.113); lag 3 (RR=1.053, 95%CI: 1.015 to 1.092); lag 4 (RR=1.043, 95%CI: 1.004 to 1.088) and lag 5 (RR=1.061, 95%CI: 1.018 to 1.106). The increase of 5mcg/m3 in PM2.5 contributes to increase the relative risk for hospitalization from 20.3 to 38.4 percentage points; however, the reduction of 5µg/m3 in PM2.5 concentration results in 38 fewer hospital admissions.Conclusions:Exposure to PM2.5 was associated with hospitalizations for pneumonia and asthma in children younger than 10 years of age, showing the role of fine particulate matter in child health and providing subsidies for the implementation of preventive measures to decrease these outcomes.

Objective: Given that respiratory diseases are a major cause of hospitalization in children, the objectives of this study are to estimate the role of exposure to fine particulate matter in hospitalizations due to pneumonia and a possible reduction in the number of these hospitalizations and costs. Method: An ecological time-series study was developed with data on hospitalization for pneumonia among children under 10 years of age living in São José do Rio Preto, state of São Paulo, using PM 2.5 concentrations estimated using a mathematical model. We used Poisson regression with a dependent variable (hospitalization) associated with PM 2.5 concentrations and adjusted for effective temperature, seasonality and day of the week, with estimates of reductions in the number of hospitalizations and costs. Results: 1,161 children were admitted to hospital between October 1 st , 2011, and September 30 th , 2013; the average concentration of PM 2.5 was 18.7 µg/m 3 (≈32 µg/m 3 of PM 10 ) and exposure to this pollutant was associated with hospitalization four and five days after exposure. Conclusion: A 10 µg/m 3 decrease in concentration would imply 256 less hospital admissions and savings of approximately R$ 220,000 in a medium-sized city.

Objective:To estimate the association between exposure to fine particulate matter with an aerodynamic diameter <2.5 microns (PM2.5) and hospitalizations for pneumonia and asthma in children.Methods:An ecological study of time series was performed, with daily indicators of hospitalization for pneumonia and asthma in children up to 10 years of age, living in Taubaté (SP) and estimated concentrations of PM2.5, between August 2011 and July 2012. A generalized additive model of Poisson regression was used to estimate the relative risk, with lag zero up to five days after exposure; the single pollutant model was adjusted by the apparent temperature, as defined from the temperature and relative air humidity, seasonality and weekday.Results:The values of the relative risks for hospitalization for pneumonia and asthma were significant for lag 0 (RR=1.051, 95%CI; 1.016 to 1.088); lag 2 (RR=1.066, 95%CI: 1.023 to 1.113); lag 3 (RR=1.053, 95%CI: 1.015 to 1.092); lag 4 (RR=1.043, 95%CI: 1.004 to 1.088) and lag 5 (RR=1.061, 95%CI: 1.018 to 1.106). The increase of 5mcg/m3 in PM2.5 contributes to increase the relative risk for hospitalization from 20.3 to 38.4 percentage points; however, the reduction of 5µg/m3 in PM2.5 concentration results in 38 fewer hospital admissions.Conclusions:Exposure to PM2.5 was associated with hospitalizations for pneumonia and asthma in children younger than 10 years of age, showing the role of fine particulate matter in child health and providing subsidies for the implementation of preventive measures to decrease these outcomes.

CONTEXT AND OBJECTIVE: Exposure to air pollutants is one of the factors responsible for hospitalizations due to respiratory diseases. The objective here was to estimate the effect of exposure to particulate matter (such as PM 2.5 ) on hospitalizations due to certain respiratory diseases among residents in Volta Redonda (RJ). DESIGN AND SETTING: Ecological time series study using data from Volta Redonda (RJ). METHODS: Data on hospital admissions among residents of Volta Redonda (RJ), between January 1, 2012, and December 31, 2012, due to pneumonia, acute bronchitis, bronchiolitis and asthma, were analyzed. Daily data on PM 2.5 concentrations were estimated through the CCATT-BRAMS model. The generalized additive Poisson regression model was used, taking the daily number of hospitalizations to be the dependent variable and the PM 2.5 concentration to be the independent variable, with adjustment for temperature, relative humidity, seasonality and day of the week, and using lags of zero to seven days. Excess hospitalization and its cost were calculated in accordance with increases in PM 2.5 concentration of 5 µg/m 3 . RESULTS: There were 752 hospitalizations in 2012; the average concentration of PM 2.5 was 17.2 µg/m 3 ; the effects of exposure were significant at lag 2 (RR = 1.017), lag 5 (RR = 1.022) and lag 7 (RR = 1,020). A decrease in PM 2.5 concentration of 5 µg/m 3 could reduce admissions by up to 76 cases, with a decrease in spending of R$ 84,000 a year. CONCLUSION: The findings from this study provide support for implementing public health policies in this municipality, which is an important steelmaking center. RESUMOCONTEXTO E OBJETIVO: A exposição aos poluentes do ar é um dos fatores responsáveis por internações por doenças respiratórias; o objetivo foi estimar o efeito da exposição a material particulado (como PM 2,5 ) sobre as hospitalizações devido a certas doenças respiratórias em moradores de Volta Redonda (RJ). TIPO DE ESTUDO E LOCAL: Estudo ecológico de séries temporais utilizando dados de Volta Redonda (RJ).MÉTODOS: Foram analisados dados de internação hospitalar, entre 1 de janeiro de 2012 e 31 de dezembro de 2012, devida a pneumonia, bronquite aguda, bronquiolite e asma, em residentes em Volta Redonda (RJ), e dados diários das concentrações de PM 2,5 obtidos a partir do modelo CCATT-BRAMS. Utilizou-se o modelo aditivo generalizado de regressão de Poisson, sendo o número diário de internações a variável dependente e a concentração PM 2,5 a variável independente, ajustado para temperatura, umidade relativa, sazonalidade e dia da semana e defasagens entre zero e sete dias. Excesso de internação hospitalar e seu custo, de acordo com o aumento de 5 ug/m 3 na concentração de PM 2,5 , foram calculados. RESULTADOS: Ocorreram 752 internações em 2012; a concentração média de PM 2,5 foi de 17,2 ug/m 3 ; os efeitos da exposição foram significativos em lag 2 (RR = 1,017), lag 5 (RR = 1,022) e lag 7 (RR = 1,020). A redução em 5 ug/m 3 na concentração de PM 2,5 poderia reduzir até 76 casos as internações...

I-99, from October, 1, 2011, to September 30, 2012

Hospitalizations due to respiratory diseases generate financial costs for the Health System in addition to social costs. Objective of this study was to develop and validate a fuzzy linguistic model for prediction of hospitalization due to respiratory diseases. We constructed a fuzzy model for prediction of hospitalizations due to pneumonia, bronchitis, bronchiolitis and asthma second exposure to fine particulate matter (PM2.5) in residents of Volta Redonda, RJ, in 2012. The model contains two inputs, PM2.5 and temperature, with three membership functions for each input, and an output with three membership functions for admissions, which were obtained from DATASUS. There were 752 hospitalizations in the period, the average concentration of PM2.5 was 17.1 µg/m3 (SD = 4.4). The model showed a good accuracy with PM2.5, the result was between 90% and 76.5% for lags 1, 2 and 3, a sensitivity of up to 95%. This study provides support for creating executable software with a low investment, along with the use of a portable instrument could allow number of hospital admission due to respiratory diseases and provide support to local health managers. Furthermore, the fuzzy model is very simple and involves low computational costs, an implementation making possible.

No abstract

Case report: A 57-year-old woman was referred to our service after noticing difficulty in coordinating the movements of the right hand. The symptoms occurred after she consumed ayahuasca in a religious ceremony and persisted after the psychedelic effects weaned off. On the first evaluation, she had right hemiataxia and increased blood pressure (200/100 mmHg). The head computed tomography (CT) scan revealed a left basal ganglia hemorrhage. No abnormalities were found on CT angiography. The patient later reported that a few years earlier, she was diagnosed with a hemorrhagic stroke at another hospital, which also happened within a few hours of ayahuasca intake. However, she has not stopped using it monthly since then. Discussion: Ayahuasca is a potent plant-based hallucinogenic brew used traditionally for spiritual and medicinal purposes. The substance responsible for its effects is Dimethyltryptamine (DMT), which is known to be a potent serotonin receptor agonist, especially the 5HT2A. This substance may induce an acute raise in blood pressure and consequently trigger a hemorrhagic stroke. To this date, there are no cases reported of hemorrhagic stroke after using this drug. Conclusion: Although ayahuasca has been associated with spiritual and therapeutic benefits, its potential risks should not be ignored, including serious complications, such as hemorrhagic stroke.