ABSTRACT The COVID-19 pandemic has affected the continuity of cognitive rehabilitation worldwide. However, the use of teleneuropsychology to provide cognitive rehabilitation has contributed significantly to the continuity of the treatment. Objectives: To measure the effects of cognitive telerehabilitation on cognition, neuropsychiatric symptoms, and memory strategies in a cohort of patients with mild cognitive impairment. Methods: A sample of 60 patients with mild cognitive impairment according to Petersen’s criteria was randomly divided into two groups: 30 treatment cases and 30 controls (waiting list group). Subjects were matched by age, sex, and Montreal Cognitive Assessment. The treatment group received ten cognitive telerehabilitation sessions of 45 minutes duration once a week. Pre-treatment (week 0) and post-treatment (week 10) measures were assessed for both groups. Different linear mixed models were estimated to test treatment effect (cognitive telerehabilitation vs. controls) on each outcome of interest over time (pre/post-intervention). Results: A significant group (control/treatment) x time (pre/post) interaction revealed that the treatment group at week 10 had better scores in cognitive variables: memory (RAVLT learning trials p=0.030; RAVLT delayed recall p=0.029), phonological fluency (p=0.001), activities of daily living (FAQ p=0.001), satisfaction with memory performance (MMQ satisfaction p=0.004) and use of memory strategies (MMQ strategy p=0.000), as well as, and a significant reduction of affective symptomatology: depression (GDS p=0.000), neuropsychiatric symptoms (NPI-Q p=0.045), forgetfulness (EDO-10 p=0.000), and stress (DAS stress p=0.000). Conclusions: Our study suggests that CTR is an effective intervention.

RESUMO A pandemia do COVID-19 afetou a continuidade da reabilitação cognitiva em todo o mundo. No entanto, o uso de tele neuropsicologia para a reabilitação cognitiva tem contribuído significativamente para a continuidade do tratamento. Objetivos: Medir os efeitos da tele reabilitação cognitiva na cognição, nos sintomas neuropsiquiátricos e nas estratégias de memória em uma coorte de pacientes com comprometimento cognitivo leve. Métodos: Uma amostra de 60 pacientes com comprometimento cognitivo leve de acordo com os critérios de Petersen foi dividida aleatoriamente em dois grupos: 30 casos de tratamento e 30 controles (grupo de lista de espera). Os assuntos foram pareados por idade, sexo e Avaliação Cognitiva de Montreal. O grupo de tratamento recebeu dez sessões de tele reabilitação cognitiva de 45 minutos de duração uma vez por semana. As medidas pré-tratamento (semana 0) e pós-tratamento (semana 10) foram avaliadas para ambos os grupos. Diferentes modelos lineares mistos foram estimados para testar o efeito do tratamento (tele reabilitação cognitiva vs. controles) em cada desfecho de interesse ao longo do tempo (pré-/pós-intervenção). Resultados: Uma interação significativa grupo (controle/tratamento) x tempo (pré/pós) revelou que o grupo de tratamento teve melhores pontuações em variáveis cognitivas na semana 10: memória (ensaios de aprendizagem RAVLT p = 0,030; RAVLT recordação tardia p=0,029), fluência fonológica (p=0,001), atividades da vida diária (FAQ p=0,001), satisfação com o desempenho da memória (satisfação MMQ p=0,004) e uso de estratégias de memória (estratégia MMQ p=0,000), bem como uma significativa redução da sintomatologia afetiva: depressão (GDS p=0,000), sintomas neuropsiquiátricos (NPI-Q p=0,045), esquecimento (EDO-10 p=0,000) e estresse (DAS estresse p=0,000). Conclusões: Nosso estudo sugere que a CTR é uma intervenção eficaz.

RESUMEN Durante el último tiempo, las ciudades de Chile han sido afectadas por las restricciones de movilidad impuestas por las autoridades con el objetivo de frenar el avance de la COVID-19. Considerando esta problemática, el artículo se enfoca en la percepción de habitantes de Temuco, como una de las primeras ciudades del país en afrontar la cuarentena total, respecto a las transformaciones experimentadas a partir de las medidas políticas de limitación de movilidad. Mediante un diseño metodológico cualitativo se analizó la percepción de algunos habitantes en relación con los cambios generados en sus rutinas cotidianas producto de la emergencia de inmovilidades, lo cual se relaciona directamente con la comprensión de la movilidad como una práctica central de las ciudades contemporáneas. Entre los hallazgos destaca la inmovilidad como una categoría que implica diversas encrucijadas cotidianas en las personas, el papel de la movilidad como categoría central para el desarrollo de la vida social, las transformaciones en los hábitos diarios de las personas y, por último, la necesidad de reflexionar el derecho a la movilidad de las personas desde los territorios.

ABSTRACT Innovation is one of the most important pillars for sustainable competitiveness, especially in micro and small companies that operate in a dynamic and complex context. In this context, the objective of the study was to determine the influence of human, organizational, and technical innovation capacities on the level of innovation. For this, an economic model of multiple linear regression was developed. The sampling procedure was a stratified probabilistic sample of 26 micro and small exporting textile crafts enterprises from the South area of Peru, which answered a questionnaire of 52 items. The results reflect that the capacity for human, organizational, and technical innovation influence with a coefficient of determination of 96.7%, positive and significant in the level of innovation. In conclusion, human innovation capacity has a greater influence on the variability of the level of innovation, due to the creativity, motivation, and knowledge of people.

ABSTRACT Background: Neurological and psychiatric manifestations associated with SARS-CoV-2 infection have been reported throughout the scientific literature. However, studies on post-COVID cognitive impairment in people with no previous cognitive complaint are scarce. Objective: We aim to investigate the impact of COVID-19 on cognitive functions in adults without cognitive complaints before infection and to study cognitive dysfunction according to disease severity and cognitive risk factors. Methods: Forty-five post-COVID-19 patients and forty-five controls underwent extensive neuropsychological evaluation, which assessed cognitive domains such as memory, language, attention, executive functions, and visuospatial skills, including psychiatric symptomatology scales. Data were collected on the severity of infection, premorbid medical conditions, and functionality for activities of daily living before and after COVID-19. Results: Significant differences between groups were found in cognitive composites of memory (p=0.016, Cohen’s d= 0.73), attention (p<0.001, Cohen’s d=1.2), executive functions (p<0.001, Cohen’s d=1.4), and language (p=0.002, Cohen’s d=0.87). The change from premorbid to post-infection functioning was significantly different between severity groups (WHODAS, p=0.037). Self-reported anxiety was associated with the presence of cognitive dysfunction in COVID-19 subjects (p=0.043). Conclusion: Our results suggest that the presence of cognitive symptoms in post-COVID-19 patients may persist for months after disease remission and argue for the inclusion of cognitive assessment as a protocolized stage of the post-COVID examination. Screening measures may not be sufficient to detect cognitive dysfunction in post-COVID-19 patients.

RESUMEN Antecedentes: Las manifestaciones neurológicas de la infección por SARS-CoV-2 han sido reportadas en la literatura científica. Sin embargo, los estudios cognitivos post COVID-19 en personas sin queja cognitiva previa son escasos. Objetivo: Nuestro objetivo es investigar el impacto cognitivo del COVID-19 en adultos sin quejas cognitivas previas a la infección y estudiar el desempeño cognitivo de acuerdo a la severidad de la enfermedad y a los factores de riesgo cognitivo. Métodos: Cuarenta y cinco pacientes post COVID-19 y cuarenta y cinco controles sanos apareados por edad, género y educación realizaron una evaluación neuropsicológica, que evalúa memoria, lenguaje, atención, funciones ejecutivas, habilidades visuoespaciales, incluyendo además escalas de sintomatología psiquiátrica, y la recopilación de datos sobre la severidad de la infección, la salud premórbida y la funcionalidad. Resultados: Se encontraron diferencias significativas entre los grupos en los compuestos cognitivos de memoria (p=0,016, d de Cohen= 0,73), atención (p<0,001, d de Cohen= 1,2), funciones ejecutivas (p<0,001, d de Cohen=1,4) y lenguaje (p=0,002, d de Cohen=0,87). El cambio del funcionamiento premórbido al funcionamiento posterior a la infección, fue significativamente diferente entre los grupos de gravedad (WHODAS; p=0,037). La ansiedad autoinformada se asoció con la presencia de disfunción cognitiva en los sujetos de COVID-19 (p=0,043). Conclusión: Nuestros resultados sugieren que los síntomas cognitivos en pacientes post COVID-19 pueden permanecer hasta tres meses después de la remisión de la enfermedad. Este estudio aboga a favor de incluir la evaluación cognitiva como una etapa protocolizada del examen post COVID-19. Es posible que las medidas de cribado no sean suficientes para detectar la disfunción cognitiva en los pacientes post COVID-19.

Background: The coronavirus pandemic, started in the city of Wuhan in 2019, has disrupted the world and deeply affected surgical activity. Restricting the number of interventions dramatically, after initial reports of postoperative mortality over 20% in patients with COVID. The purpose of this study is to evaluate the figures for surgical mortality, during the coronavirus pandemic. Materials and Method: Retrospective cohort of patients operated between March 15, 2020 and July 31, 2020 at a university center. Clinical variables associated with surgical intervention and coinfection by SARS-CoV-2 were evaluated. Results: 344 patients with an overall mortality of 6.1% were analyzed. PCR testing for COVID was performed on 153 patients. Only from the ninth week of the pandemic did routine preoperative testing begin. Patients who presented a higher risk of mortality were: PCR COVID(+) (22.7%), arterial hypertension (11.6%) and age over 60 years (12.4%). In the present series, the following variables were not statistically significant risk factors for mortality: gender, obesity, diabetes mellitus, oncological pathology, emergency surgery and ASA classification. When analyzing two subgroups, we observed that COVID negative patients under 60 had a mortality rate of 1.26%, versus 36.36% in those over 60 years of age, COVID positive. Discussion: The results of the present study lead us to make every effort to rule out COVID infection preoperatively to reduce the risks of postoperative mortality. Although this is a series of cases and the extrapolation of its results should be cautious, having national figures can be a useful element to make decisions in this stage of reactivation of surgical activity.

Resumen Introducción: La pandemia de coronavirus, iniciada en Wuhan el año 2019, ha trastocado al mundo y afectado profundamente a la actividad quirúrgica al restringir el número de intervenciones en forma dramática, después de los reportes iniciales de mortalidad posoperatoria sobre el 20% en pacientes operados portadores de COVID. El objetivo del presente estudio fue evaluar las cifras de mortalidad quirúrgica, en pacientes intervenidos quirúrgicamente durante la pandemia del COVID-19. Materiales y Método: Cohorte retrospectiva de pacientes operados entre el 15 de marzo de 2020 y el 31 de julio de 2020 en un centro universitario. Se evaluó variables clínicas asociadas a la intervención quirúrgica y coinfección por SARS-CoV-2. Resultados: Se analizaron 344 pacientes quienes presentaron una mortalidad global de 6,1%. Se realizó examen de PCR para COVID a 153 pacientes. Presentaron un riesgo de mortalidad significativo los pacientes: PCR COVID(+) (22,7%), p = 0,01, portadores de hipertensión arterial (11,6%) p = 0,03 y mayores de 60 años (12,4%) p < 0,001. No fueron factores estadísticamente significativos de mayor riesgo de mortalidad, las siguientes variables: género, obesidad, diabetes mellitus, patología oncológica, cirugía de urgencia y clasificación de ASA. Al analizar dos subgrupos se observó que los pacientes menores de 60 años COVID negativo presentaron una cifra de mortalidad de 1,26% versus 36,3% en los mayores de 60 años, COVID positivos (p = 0,01). Discusión: Los resultados del presente estudio sugieren que se deben realizar los mayores esfuerzos para descartar la infección por SARS-CoV-2 en la evaluación preoperatoria para disminuir los riesgos de mortalidad posoperatoria.

Abstract: The objective of the following paper is to systematize the environmental history of the Chilean Patagonia through its territorial occupations in the Region of Los Lagos and the Region of Aysen. The diverse transformations that took place in the process of the use of resources are narrated according to the respective experiences of the prehispanic, colonial and republican periods; the particularities of the territorial occupations are highlighted in their historical and biocultural dimensions, reviewing a variety of sources with the aim of differentiating political, economic and lived territories. Results show that this environmental history, presented non-linearly, was possible under the framework of an absent State which created the geopolitical conditions for an internal frontier and a remote administration.

Resumen: El objetivo del presente artículo es sistematizar la historia ambiental de la Patagonia chilena a través de las ocupaciones territoriales en la región de Los Lagos y región de Aysén. Se narran las diversas transformaciones ocurridas en los procesos de uso de recursos, conforme a experiencias propias del período prehispánico, colonial y republicano; también se realzan las cualidades de las ocupaciones territoriales en su dimensión histórica y biocultural, revisando fuentes diversas que en conjunto apuntan a distinguir los territorios políticos, económicos y vividos. Los resultados demuestran que esta historia ambiental, presentada de manera no lineal, ha sido posible en los marcos de un Estado ausente que ha creado condiciones geopolíticas de una frontera interior y de administración a distancia.

Abstract: We present the development of a communicative and pedagogical device to address ethnic-racial discrimination in school environments. We work at High School No. 518 Carlos Fuentealba, in one of the neighborhoods with the largest Qom population in the city of Rosario (Argentina). The device, designed to guide academic and artistic research, uses performance as a methodological tool to investigate the African-Argentinean legacy and activate latent perceptions related to racism, a hidden and silenced issue in our country.

Resumen: Exponemos el proceso de construcción de un dispositivo comunicativo y pedagógico para abordar la discriminación étnico-racial en ámbitos escolares. Trabajamos en la escuela secundaria Nº 518 Carlos Fuentealba, ubicada en uno de los barrios con mayor población Qom, de la ciudad de Rosario (Argentina). El dispositivo, diseñado a partir del cruce entre investigaciones académicas y artísticas, utiliza la performance como herramienta metodológica para investigar el legado afroargentino y activar percepciones latentes relativas al racismo, en tanto problemática soterrada y silenciada en nuestro país.

Résumé: Nous présentons le procès de construction d’un dispositif communicatif et pédagogique pour traiter la discrimination ethnique-raciale dans les milieux scolaires. Nous travaillons au Collège n° 518 Carlos Fuentealba, de la ville de Rosario (Argentine), situé dans l’un des quartiers avec population Qom. Le dispositif, conçu au croisement de recherches académiques et artistiques, utilise la performance comme outil méthodologique pour étudier le héritage afro argentine, a la recherche de activer perceptions et idées latents à propos du racisme, un conflit couvert et taire dans notre pays.

The article presents a review and systematization of literature Jose Joaquin Brunner, the decades of the eighties and nineties, relieving their interest in building a criticism of the organization of the dominant culture in Chile by questioning the phenomena as elements comunicológicos centrality to understand the power and capitalist modernization processes associated with the production and symbolic circulation. The methodological strategy is organized and makes it clear interpretive criteria defined research data bases, and the procedures used to analyze the data from their own theoretical and methodological perspectives of the literature reviewed. The overall objective of the document is to add literature on the research agenda in communication and culture in Chile, bringing outsiders into the repertoire knowledge comunicológico current national who is articulate in two dimensions: 1) as useful input for the new generations of researchers in the field of Social Sciences and Humanities to build objects from criticism, in general; and 2) as a contribution to building a memory of the intellectual infrastructure and critical knowledge in communication produced in Chile and Latin America in particular

El artículo presenta una revisión y una sistematización de la literatura de José Joaquín Brunner, de las décadas de los años ochenta y noventa, que releva su interés por construir una crítica a la organización de la cultura dominante en Chile problematizando los fenómenos comunicológicos como elementos de centralidad para comprender el poder y los procesos de modernización capitalista asociados a la producción y circulación simbólica. La estrategia metodológica organizada es de carácter interpretativo y deja claro los criterios de pesquisa en bases de datos definidas, y los procedimientos utilizados para analizar la información desde las propias perspectivas teóricas y metodológicas de la literatura revisada. El objetivo general del documento es sumar bibliografía que aporte a la configuración de la agenda de investigación en comunicación y cultura en Chile, aportando saberes outsiders dentro del repertorio comunicológico actual que se articularían en dos dimensiones: 1) como insumos útiles para las nuevas generaciones de investigadores del ámbito de las Ciencias Sociales y las Humanidades que construyan objetos desde la crítica, en general; y, 2) como aporte a la construcción de una memoria de la infraestructura intelectual y los saberes críticos en comunicación producidos en Chile y Latinoamérica, en particular.

BACKGROUND: Reprimo (RPRM), a highly glycosylated protein, is a new downstream effector of p53-induced cell cycle arrest at the G2/M checkpoint, and a putative tumor suppressor gene frequently silenced via methylation of its promoter region in several malignances. The aim of this study was to characterize the epigenetic inactivation and its biological function in BC cell lines. METHODS: The correlation between RPRM methylation and loss of mRNA expression was assessed in six breast cancer cell lines by methylation specific PCR (MSP), 5'-Aza-2'-deoxycytidine treatment and RT-PCR assays. MDA-MB-231 cells were chosen to investigate the phenotypic effect of RPRM in cell proliferation, cell cycle, cell death, cell migration and invasion. RESULTS: In the cancer methylome system (CMS) (web-based system for visualizing and analyzing genome-wide methylation data of human cancers), the CpG island region of RPRM (1.1 kb) was hypermethylated in breast cancer compared to normal breast tissue; more interesting still was that ERa(+) tumors showed higher methylation intensity than ERa(-). Downregulation of RPRM mRNA by methylation was confirmed in MDA-MB-231 and BT-20 cell lines. In addition, overexpression of RPRM in MDA-MB-231 cells resulted in decreased rates of cell migration, wound healing and invasion in vitro. However, RPRM overexpression did not alter cell viability, phosphatidylserine (PS) translocation or G2/M cell cycle transition. CONCLUSION: Taken together, these data suggest that RPRM is involved in decreased cell migration and invasion in vitro, acting as a potential tumor suppressor gene in the MDA-MB-231 cell line.

Tonsil malignancy is uncommon in children. Tonsillar asymmetry is usually secondary to a benign process, either inflammatory conditions, differences in the tonsillar fossa depth or anterior pillar asymmetry. However, it may indicate a serious underlying disorder such as lymphoma. Lymphoma is the most common childhood malignancy in the head and neck. Approximately, 15% of the cases affect the Waldeyer's ring. The most common clinical manifestations of palatine tonsils lymphoma are unilateral tonsillar hypertrophy, alteration in the appearance of the mucosa and ipsilateral cervical lymphadenopathy. Early diagnosis and appropriate treatment are of great importance in the prognosis. We present a case of palatine tonsil lymphoma in a child with tonsillar asymmetry and we emphasize the importance of the examination of the oral cavity and the neck to identify suspicious alterations compatible with tonsillar lymphoma.

El tumor maligno de amígdalas es poco frecuente en niños. La asimetría amigdalina es, generalmente, secundaria a un proceso benigno, ya sea patología inflamatoria, diferencia en la profundidad de la fosa tonsilar o asimetría del pilar anterior. Sin embargo, puede indicar un trastorno subyacente grave, como el linfoma. El linfoma es el tumor maligno infantil más común en la cabeza y el cuello. En el 15% de los casos, afecta al anillo de Waldeyer. Las manifestaciones clínicas más comunes del linfoma de la amígdala palatina son la hipertrofia amigdalina unilateral, la alteración en la apariencia de la mucosa y la adenopatía cervical ipsilateral. El diagnóstico precoz y el tratamiento adecuado son de gran importancia en el pronóstico. Presentamos un caso de linfoma amigdalino en un niño con asimetría amigdalina y destacamos la importancia del examen de la cavidad oral y del cuello para identificar alteraciones sospechosas de linfoma tonsilar.

Hemoptysis is the expectoration of blood from the subglottic airway. The main causes in children are infections of the lower respiratory tract and aspiration of foreign bodies. Pulmonary arteriovenous malformation is a rare etiology of hemoptysis, which involves abnormal communication between the arterial and venous system. Most vascular malformations are present at birth and enlarge proportionately with the growth of the child. Signs and symptoms include dyspnea, exercise intolerance, cyanosis and hemorrhagic or neurologic complications. We describe the clinical manifestations, diagnostic methods and treatment of a child with this disease. We emphasize the importance of efficient systematic evaluation in every child with hemoptysis to identify the underlying etiology, since immediate treatment is essential because of the potential severity of this condition.

La hemoptisis es la expectoración de sangre proveniente de la vía aérea subglótica. Las causas principales en la infancia son las infecciones de la vía respiratoria inferior y la aspiración de cuerpos extraños. Una etiología rara de hemoptisis es la malformación arteriovenosa pulmonar, que consiste en la comunicación anormal entre el sistema arterial y venoso. La mayoría de las malformaciones vasculares están presentes desde el nacimiento y aumentan de tamaño proporcionalmente al crecimiento del niño. Los signos y síntomas de presentación incluyen la disnea, la intolerancia al ejercicio, la cianosis y las complicaciones hemorrágicas o neurológicas. Describimos las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de un niño con esta patología. Destacamos la importancia de la evaluación sistemática eficiente en todo niño con hemoptisis para identificar la etiología subyacente; el tratamiento inmediato es fundamental debido a la gravedad potencial de esta condición.

Ankyloglossia is a congenital anomaly characterized by an abnormally short lingual frenulum resulting in varying degrees of difficulty of tongue mobility. It may be asymptomatic or it may present with breastfeeding difficulties, speech and dentition disorders, and social problems related to the functional limitation of the tongue. While it is a common and known pathology, controversies and diversity of opinions persist regarding the indication, timing and method of surgical correction. We describe our experience with 35 children presenting this condition; they underwent successful surgical treatment.

La anquiloglosia es una anomalía congenita que se caracteriza por un frenillo lingual anormalmente corto, que resulta en grados variables de dificultad de la movilidad lingual. Puede ser asintomática o manifestarse con dificultades en la lactancia, trastornos en el habla y en la dentición, y problemas sociales relacionados con la limitación funcional de la lengua. Si bien es una patología frecuente y conocida, persisten controversias y diversidad de opiniones relacionadas con la indicación, el momento y el método de la corrección quirúrgica. Describimos nuestra experiencia con 35 niños que presentaban esta afección, tratados quirúrgicamente de forma exitosa.

Acute pharyngotonsillitis is one of the most common diseases in children and adolescents. The most frequent etiology is virus, followed by bacteria. The main bacterial agent is beta hemolytic Streptococcus group A. A rare complication of pharyngeal infectious processes is septic thrombophlebitis of the internal jugular vein. The diagnosis is suspected in the presence of an inflammatory unilateral neck swelling. The diagnosis is confirmed by contrast computed tomography. Treatment consists of prolonged administration of antibiotics, being the use of anticoagulants controversial. Early diagnosis and appropriate treatment are essential to prevent persistent vascular occlusion and progression of the thrombus, which can cause pulmonary emboli. In the present study, we present a teenager with thrombophlebitis of the internal jugular vein secondary to acute streptococcal pharyngotonsillitis. Clinical manifestations, diagnostic methods and treatment of this rare vascular complication are described herein.

La faringoamigdalitis aguda es una de las enfermedades más comunes en niños y adolescentes. La etiología más frecuente es la viral, seguida por la bacteriana. Entre las causas bacterianas, el principal agente es el estreptococo beta hemolítico del grupo A. Una complicación infrecuente de los procesos infecciosos faríngeos es la tromboflebitis séptica de la vena yugular interna. El diagnóstico se sospecha ante la tumefacción laterocervical unilateral de carácter inflamatorio. Se confirma mediante tomografía computada con contraste. El tratamiento consiste en la administración prolongada de antibióticos; el uso de anticoagulantes es controvertido. El diagnóstico precoz y el tratamiento apropiado son esenciales para evitar la oclusión vascular persistente y la progresión del trombo, que puede ocasionar émbolos pulmonares. Presentamos a una adolescente con tromboflebitis de la vena yugular interna secundaria a faringoamigdalitis aguda estreptocócica, con el objetivo de describir las manifestaciones clínicas, los métodos diagnósticos y el tratamiento de esta rara complicación vascular.

Os desastres naturais ainda são pouco pesquisados e compreendidos no âmbito da Saúde Coletiva no país, com impactos do curto ao longo prazos. O objetivo deste artigo é, a partir de dados sobre desastres registrados no país, analisar a inter-relação entre esses eventos e seus impactos sobre a saúde. A metodologia envolveu a sistematização de dados e informações contidos no Atlas Brasileiro dos Desastres Naturais 1991-2010 e diretamente na Secretária Nacional de Defesa Civil (SNDC). Os desastres foram organizados em quatro categorias de eventos (meteorológicos; hidrológicos; climatológicos; geofísicos/geológicos) e, para cada uma das mesmas, foram explorados os dados de afetados, morbidade, mortalidade e expostos, demonstrando diferentes tipos de impactos. Três categorias de desastres se destacaram: os eventos hidrológicos apresentaram maiores percentuais de mortalidade, morbidade e expostos; os climatológicos maiores percentuais de ocorrências e afetados; os geofísicos/geológicos maior média de expostos e óbitos por evento. Ao final propõe-se uma participação mais ativa do setor saúde na agenda política global pós-2015, particularmente as relacionadas ao desenvolvimento sustentável, mudanças climáticas e redução de riscos de desastres.

Natural disasters are still insufficiently studied and understood within the scope of public health in this country, with impacts in the short and long term. The scope of this article is to analyze the relationship between disasters and their impact on health based on disaster data recorded in the country. The methodology involved the systematization of data and information contained in the Brazilian Atlas of Natural Disasters 1991-2010 and directly from the National Department of Civil Defense (NSCD). Disasters were organized into four categories of events (meteorological; hydrological; climatological; geophysical/geological) and for each of the latter, the data for morbidity, mortality and exposure of those affected were examined, revealing different types of impacts. Three categories of disasters stood out: the hydrological events showed higher percentages of mortality, morbidity and exposure; climatological events had higher percentages of incidents and people affected; the geophysical/geological events had a higher average of exposure and deaths per event. Lastly, a more active participation of the health sector in the post-2015 global political agenda is proposed, particularly events related to sustainable development, climate change and disaster risk reduction.

Os desastres naturais ainda são pouco pesquisados e compreendidos no âmbito da Saúde Coletiva no país, com impactos do curto ao longo prazos. O objetivo deste artigo é, a partir de dados sobre desastres registrados no país, analisar a inter-relação entre esses eventos e seus impactos sobre a saúde. A metodologia envolveu a sistematização de dados e informações contidos no Atlas Brasileiro dos Desastres Naturais 1991-2010 e diretamente na Secretária Nacional de Defesa Civil (SNDC). Os desastres foram organizados em quatro categorias de eventos (meteorológicos; hidrológicos; climatológicos; geofísicos/geológicos) e, para cada uma das mesmas, foram explorados os dados de afetados, morbidade, mortalidade e expostos, demonstrando diferentes tipos de impactos. Três categorias de desastres se destacaram: os eventos hidrológicos apresentaram maiores percentuais de mortalidade, morbidade e expostos; os climatológicos maiores percentuais de ocorrências e afetados; os geofísicos/geológicos maior média de expostos e óbitos por evento. Ao final propõe-se uma participação mais ativa do setor saúde na agenda política global pós-2015, particularmente as relacionadas ao desenvolvimento sustentável, mudanças climáticas e redução de riscos de desastres.

Natural disasters are still insufficiently studied and understood within the scope of public health in this country, with impacts in the short and long term. The scope of this article is to analyze the relationship between disasters and their impact on health based on disaster data recorded in the country. The methodology involved the systematization of data and information contained in the Brazilian Atlas of Natural Disasters 1991-2010 and directly from the National Department of Civil Defense (NSCD). Disasters were organized into four categories of events (meteorological; hydrological; climatological; geophysical/geological) and for each of the latter, the data for morbidity, mortality and exposure of those affected were examined, revealing different types of impacts. Three categories of disasters stood out: the hydrological events showed higher percentages of mortality, morbidity and exposure; climatological events had higher percentages of incidents and people affected; the geophysical/geological events had a higher average of exposure and deaths per event. Lastly, a more active participation of the health sector in the post-2015 global political agenda is proposed, particularly events related to sustainable development, climate change and disaster risk reduction.

É inegável que a discussão sobre saúde, meio ambiente e desenvolvimento sustentável tem progredido muito em décadas recentes. Contudo, ganhos globais não têm sido distribuídos de maneira uniforme, deixando grandes grupos populacionais excluídos, com conseqüências negativas à saúde. Também estamos começando a reconhecer problemas globais emergentes que causam impactos locais significativos, principalmente em populações pobres, tanto em áreas rurais como urbanas. A saúde ambiental está numa encruzilhada, em que novos modelos e parcerias são necessários. Este artigo explora essas questões especificamente em relação aos países latino-americanos e caribenhos.

There has been undeniable progress in addressing health, environment and sustainable development in recent decades. Yet, global gains have not been distributed equally, leaving major populations groups excluded, with negative consequences to health. We are also beginning to recognize emerging global problems with significant local impacts, mostly in impoverished populations, both in rural and urban settings. Environmental health is at the crossroads, where new models and partnerships are required. This paper explores these issues with specific reference to the Latin American and Caribbean countries.