Analyse paramétrique des échanges d'énergie en turbulence barocline

Le mécanisme barocline crée des structures turbulentes spécifiques via l'instabilité barocline, et contribue de manière importante aux transferts d'énergie dans la dynamique des écoulements géophysiques. Il est non seulement essentiel pour la prédiction du mouvement atmosphérique à grande échelle, mais aussi pour évaluer l'efficacité du mélange aux échelles plus petites. Le phénomène barocline résulte de la combinaison d'une rotation de solide rigide avec un cisaillement de vitesse moyenne et un gradient moyen de densité stabilisant. De nombreuses études combinent deux de ces mécanismes, mais moins fréquemment les trois ensemble, en raison d'une complexité accrue qui requiert l'étude d'un espace paramétrique vaste, et nécessite de démêler les dynamiques respectives multiéchelles des modes d'énergies cinétique et potentielle, et de la vorticité potentielle. Pour cette raison, les géophysiciens ont d'abord utilisé une dynamique réduite sous la forme de modèles à base des équations quasi-géostrophiques (Charney, 1947; Eady, 1949). À notre connaissance peu d'études récentes ont porté sur la simulation numérique de la turbulence barocline, en systématisant l'ouverture de l'espace paramétrique. Nous proposons ici d'étudier la turbulence homogène barocline par des simulations numériques directes (DNS), dans lesquelles l'écoulement de base tournant verticalement est constitué d'un cisaillement vertical de vitesse moyenne zonale, et d'un gradient stabilisant vertical de densité. Dans ce contexte, un gradient horizontal de densité est également créé pour satisfaire les équations du vent thermique. Le jeu minimal de nombres adimensionnels sont les nombres de Richardson Ri et de Rossby Ro -- ce dernier pouvant être remplacé par le paramètre de baroclinicité E -- qui combinent les paramètres de rotation, cisaillement, stratification (f,S,N). Nous présenterons les limites d'instabilité obtenues par les DNS en liaison avec les approches linéarisées, le role de la vorticité potentielle, qui est un invariant dans la théorie linéaire, et nous identifierons les différentes régions du domaine (Ri,E) dans lesquelles les mécanismes d'instabilité barocline ou inertielle de cisaillement sont prépondérants. Pour cela, nous nous appuierons sur les équations de bilan d'énergie

Dissecção espontânea de carótida com paralisia residual do nervo hipoglosso: a importância da avaliação por ressonância magnética

Federal University of São Paulo Department of NeurologyUNIFESP, Department of NeurologySciEL

Dissecção da artéria carótida interna apresentando-se como cefaléia em salvas

Federal University of São Paulo Department of Neurology and NeurosurgeryHospital Israelita Albert Einstein Critical Care UnitUNIFESP, Department of Neurology and NeurosurgerySciEL

Dissecção arterial espontânea em paciente com infecção pelo HIV

BACKGROUND: The relationship between human immunodeficiency virus infection and stroke may be attributed in some cases to an underlying vasculopathy such as in spontaneous cervical arteries dissections. CASE REPORT: We report the case of an HIV-infected patient who developed a Wallemberg's syndrome due to a vertebral artery dissection. Screening laboratory exams showed hyperhomocysteinemia and also high C-reactive protein plasma levels. CONCLUSIONS: This is the first case describing the association between arterial dissection (AD) and HIV-infection. We suggest that AD should also be remembered as a possible mechanism of ischemic stroke in HIV-infected patients.INTRODUÇÃO: A relação entre AVC e infecção pelo vírus da imunodeficiência humana (HIV) pode ser atribuída em alguns casos a uma vasculopatia subjacente, assim como ocorre nas dissecções arteriais cervicais espontâneas. RELATO DO CASO: Relatamos o caso de um paciente com infecção pelo HIV que desenvolveu uma síndrome de Wallemberg devido a dissecção da artéria vertebral. Os exames laboratoriais revelaram aumento da homocisteina sérica e proteína C reativa. CONCLUSÃO: Este é o primeiro caso na literatura descrevendo a associação entre dissecção arterial e infecção pelo HIV. Sugerimos que o diagnóstico de dissecção arterial deve ser lembrado como um possível mecanismo de AVC isquêmico em pacientes com infecção pelo HIV.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of NeurologyUNIFESP, EPM, Department of NeurologySciEL

Clinical evaluation of the relationship of posture, breathing and swallowing in chronic-state post-stroke patients: case report

The Stroke is a neurological disorder that disables more adults. The breathing, posture and swallowing have a direct relationship in this disease, thus requiring a multidisciplinary approach. The goal of this study was to conduct a clinical evaluation integrated to analyze the relationship between these disorders. This case is a female patient aged 37 with six years of diagnosis of ischemic stroke with right hemiparesis complete predominantly crural, hypertension, dysphagia and dysarthrophonia. In history, reported symptoms related to dyspnea, pain in the lumbar spine, the presence of coughing and choking and drooling to food, especially during the speech. The patient has scoliosis, thoracic kyphosis and abdominal weakness. The evaluation showed a respiratory expiratory force below the expected range. The peak cough flow is lower than expected, demonstrating not have the strength to cough. The research revealed changes in speech increased time to eat, need to drink to help swallow solid food before any leaks, the need for multiple swallows due to the sense of stasis in laryngeal-pharyngeal cavity and decreased taste and thick and viscous saliva. Using physical and speech therapy evaluations, we concluded that a patient with stroke in chronic respiratory presents alterations that may prevent it from effectively protecting the lower airways, which, added to postural changes and swallowing show the importance of integrated assessment for future therapeutic interventions more effective.O Acidente Vascular Cerebral (AVC) é a doença neurológica que mais incapacita os adultos. A respiração, a postura e a deglutição possuem uma relação direta nesta doença, necessitando assim de uma intervenção multidisciplinar. O objetivo do presente estudo foi realizar uma avaliação clínica integrada para analisar a relação entres estas disfunções. Trata-se de uma paciente do sexo feminino com 37 anos, com seis anos de diagnóstico de AVC isquêmico com hemiparesia completa à direita de predomínio crural, hipertensão arterial sistêmica, disfagia e disartrofonia. Na anamnese, relatou sintomas referentes à dispnéia, dores na coluna lombar, presença de tosse e engasgos à alimentação e escape anterior de saliva, principalmente durante a fala. A paciente apresenta escoliose, hipercifose torácica e fraqueza dos músculos abdominais. A avaliação respiratória evidenciou uma força expiratória abaixo do limite esperado. O pico de fluxo da tosse está abaixo do esperado, demonstrando não possuir força para tossir. A investigação fonoaudiológica evidenciou alterações no tempo aumentado para se alimentar, necessidade de ingerir líquidos para ajudar na deglutição de sólidos, eventuais escapes anteriores de alimento, necessidade de deglutições múltiplas devido à sensação de estase em cavidade laringo-faríngea e diminuição do paladar, bem como saliva grossa e viscosa. Utilizando-se das avaliações fisioterápicas e fonoaudiológicas, foi possível concluir que uma paciente com AVC na fase crônica apresenta alterações respiratórias que podem impedi-la de proteger com eficiência as vias aéreas inferiores, o que, somado às alterações posturais e na deglutição demonstram a importância da avaliação integrada para futuras intervenções terapêuticas mais eficazes.Universidade de São PauloCentro Universitário São CamiloUniversidade Nove de JulhoUniversidade Federal de São Paulo (UNIFESP) Setor de Investigação de Doenças Neuromusculares AmbulatórioUniversidade Federal de São Paulo (UNIFESP)UNIFESP, Setor de Investigação de Doenças Neuromusculares AmbulatórioUNIFESPSciEL

Trends and forecasts of leprosy for a hyperendemic city from Brazil’s northeast: Evidence from an eleven-year time-series analysis

This study’s objective was to estimate the temporal trends of leprosy according to sex and age groups, as well as to estimate and predict the progression of the disease in a hyperendemic city located in the northeast of Brazil. This ecological time-series study was conducted in Imperatriz, Maranhão, Brazil. Leprosy cases diagnosed between 2006 and 2016 were included. Detection rates stratified by sex and age groups were estimated. The study of temporal trends was accomplished using the Seasonal-Trend Decomposition method and temporal modeling of detection rates using linear seasonal autoregressive integrated moving average model according to Box and Jenkins method. Trend forecasts were performed for the 2017–2020 period. A total of 3,212 cases of leprosy were identified, the average incidence among men aged between 30 and 59 years old was 201.55/100,000 inhabitants and among women in the same age group was 135.28/100,000 inhabitants. Detection rates in total and by sex presented a downward trend, though rates stratified according to sex and age presented a growing trend among men aged less than 15 years old and among women aged 60 years old or over. The final models selected in the timeseries analysis show the forecasts of total detection rates and rates for men and women presented a downward trend for the 2017–2020 period. Even though the forecasts show a downward trend in Imperatriz, the city is unlikely to meet a significant decrease of the disease burden by 2020

Analysis of Territories in Extreme Vulnerability and Trends in Southern Brazil

Publisher Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland.(1) Background: Tuberculosis presents an epidemiological trend toward inequality, especially among people in social exclusion and situations of vulnerability. This study aimed to analyze territories with a concentration of people diagnosed with tuberculosis in a street situation and who partake in chronic use of alcohol, tobacco, and illicit drugs. We also analyzed trends in this health condition in southern Brazil. (2) Methods: Ecological study, developed in the 399 municipalities of Paraná, southern Brazil, with all tuberculosis cases in the homeless population registered in the Information System of Notifiable Diseases between 2014 and 2018. For data analysis, we used descriptive statistics, the Prais–Winsten autoregression method for the time series, and the Getis-Ord Gi technique* for spatial analysis. (3) Results: in total, 560 cases were reported. We found a predominance of alcohol, smoking, and illicit drug users, with an increasing trend in the state and clusters of spatial risk in the East health macro-region. (4) Conclusions: We observed territories with critical levels of highly vulnerable people who use psychoactive substances and are in a street situation. The results highlight the importance of incorporating public policies of social protection for these individuals and resolutive health services that receive these cases and assist in eradicating TB.publishersversionpublishe

time trends and spatial determinants in Southern Brazil

Publisher Copyright: © 2022, The Author(s).Background: Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is a public health problem worldwide. It is estimated that 90% of the patients diagnosed with TB live in vulnerable environments with limited health resources, such as individuals living in correctional facilities. This study aimed to identify the consumption of alcohol, tobacco, and other drugs among prisoners diagnosed with TB and the spatial determinants and time trends of the phenomenon in southern Brazil. Methods: A cross-sectional study using data from the Brazilian Notifiable Diseases Information System was carried out. TB cases confirmed from 2014 to 2018 in prisons located in Paraná, Brazil, were selected. The Prais-Winsten procedure was performed to identify time trends by calculating monthly rates and the percentage of monthly variation. The Seasonal-Trend by Loess decomposition method was used to verify the time series and trends. The spatial association was verified with the Getis-Ord Gi* technique, and the risk areas were identified using spatial scan statistics. Results: A total of 1,099 TB cases were found in the studied population. The consumption of tobacco (n = 460; 41.9%), illegal drugs (n = 451; 41.0%), and alcohol (n = 179; 16.3%) stood out. An ascending trend was found for the consumption of alcohol (+ 19.4%/mo. (95%CI: 12.20–23.03)), tobacco (+ 20.2%/mo. (95%CI: 12.20–28.82)), and illegal drugs (+ 62.2%/mo. (95%CI: 44.54–81.97)). Spatial analysis revealed clusters for the use of alcohol, tobacco, and illegal drugs. Conclusions: This study advances knowledge presenting the burden of drug use and its typology among individuals diagnosed with TB in the prison system. There is a growing trend among patients to use drugs, especially illegal drugs. The clusters show differences between the places where the prisons are located.publishersversionpublishe