Vacinação contra a influenza nos idosos de Ipatinga-MG entre 2013 e 2018 / Influenza vaccination in the elderly of Ipatinga-MG between 2013 and 2018

Introdução: a influenza é uma patologia viral aguda do trato respiratório, com alta taxa de transmissibilidade. O vírus possui elevada variabilidade genética e capacidade de mutação, o que justifica as epidemias anuais recorrentes e o acometimento de quase todas as faixas etárias, em um curto espaço de tempo. A vacina contra a Influenza constitui a melhor estratégia de prevenção disponível. No entanto, a cobertura é ainda insatisfatória, em especial pela população idosa. Tornam-se fundamentais, portanto, a realização de estudos e a análise de dados sobre a cobertura vacinal desse grupo. Objetivo: identificar e descrever as características da cobertura vacinal contra influenza na população idosa da cidade de Ipatinga – Minas Gerais. Método: pesquisa descritiva com delineamento transversal, utilizando dados de 38.373 prontuários de idosos cadastrados nas Unidades Básicas de Saúde do município de Ipatinga – MG, fornecidos pela Secretaria Municipal da Saúde, entre o período de 2013 a 2018. Resultados: no período analisado, a cobertura vacinal em Ipatinga – MG não atingiu a meta do Ministério da Saúde, alcançando frequência média entre os idosos, no período compreendido entre 2013 e 2018, de 63,1%. Quanto maior a idade, melhor o percentual de cobertura; já a faixa etária compreendida entre 60 e 70 anos, com maior representatividade populacional entre os idosos (o que corresponde a 65,7%), foi a que apresentou menor cobertura vacinal, com margem de 57,9%. A análise anual revelou queda considerável na cobertura da vacina, que alcançou 78% em 2013, caindo para 50% em 2018. Das 21 Unidades Básicas de Saúde do município, 12 apresentaram variação com pouca significância no período e nove delas apresentaram queda significativa na cobertura. Conclusão: há, segundo o estudo, evidente queda do alcance das campanhas de vacinação, mais especificamente do grupo populacional idoso que, pela pesquisa, mostra baixa cobertura, que diminui ao longo dos anos. Indica-se, assim, a importância de aprofundar os estudos e reorganizar o programa e as políticas de vacinação, de forma a fomentar a capacidade dos profissionais em relação a educação para a promoção da saúde e melhoria da comunicação e o acesso à saúde, estimulando, por conseguinte, os idosos a aderirem às campanhas de vacinação

Efeito da deleção genética combinada do receptor Mas e daapolipoproteína e no metabolismo lipídico de camundongos

Exportado OPUSMade available in DSpace on 2019-08-12T10:44:59Z (GMT). No. of bitstreams: 1 tese_vers_o_biblioteca.pdf: 1011412 bytes, checksum: 35cae4ed74c28904edf90d00a7b49331 (MD5) Previous issue date: 21A partir do século XX, as doenças cardiovasculares (DCV) foram reconhecidas como a principal causa de morbimortalidade do mundo moderno. Desde então, os pesquisadores vêm buscando a compreensão dos eventos biológicos subjacentes a essas doenças e a identificação dos fatores de risco associados a tais enfermidades. A partir destes estudos, um aglomerado de fatores de risco foi descrito, mas se destacava sempre a presença simultânea de obesidade, hiperlipidemia e hipertensão arterial. Todos esses eventos relacionados e sua associação com a resistência à insulina levaram os cientistas a propor a existência de uma única condição fisiopatológica, denominada síndrome metabólica (KAHN et al., 2005)

Estudo dos efeitos do ave 0991, análogo não peptídico da angiotensina-(1-7), obre parâmetros cardiovasculares e metabólicos em hamsters submetidos à dieta hipercolesterolêmica.

O objetivo desse trabalho foi estudar os efeitos doAVE 0991, análogo não-peptídico da Angiotensina-(1-7), sobre lesões ateroscleróticas em hamsters tratados com uma dieta hipercolesterolêmica semi-purificada. Hamsters machos com aproximadamente 1 mês de idade foram divididos nos seguintes grupos: grupos controles tratados (GCT, n=7) ou não (GC, n=7), e grupos hipercolesterolêmicos tratados (GHT, n= 9) ou não (GH, n=10) com AVE 0991. A dieta hipercolesterolêmica foi similar a controle, porém, com acréscimo de 0,5% de colesterol e substituição de 8% de óleo de soja por 17% de gordura de coco. O AVE 0991 foi administrado, oralmente, nos últimos 30 dias de 120 dias de dieta. O colesterol total (CT) foi medido mensalmente e o colesterol HDL foi medido no final do experimento. No final do tratamento os animais foram anestesiados com uretana (1,2g/Kg i.p.) e a artéria femural foi canulada para medidas da pressão arterial média (PAM) e freqüência cardíaca (FC). O coração e arco aórtico foram corados com Sudam III para avaliações histológicas.O CT dos grupos hiper tratados ou não foram significativamente maiores em relação aosgrupos controles (tratados ou não) durante o experimento (294,8±25,3 mg/dL, GH e 256,8±21,6 mg/dL, GHT, comparado a 95,67±7,1 mg/dL, GC e 99,01±8,5 mg/dL, GCT, em 120 dias). Não houve efeito nos níveis de CT pelo tratamento com AVE. O HDL sérico estava elevado tanto no GH quanto no GHT (160,6 ± 10,9 mg/dL, GH e 132,0 ± 16,8 mg/dL, GHT) em relação ao GC e GCT (45,5 ± 3,8 mg/dL, GC e 61,2 ± 6,7 mg/dL, GCT). O tratamento com AVE 0991 não influenciou os níveis séricos de HDL. Não houve diferenças significativas tanto na PAM (87,86±5,3 mmHg, GC; 91,38±2,0 mmHg, GCT; 93,4±1,1 mmHg, GH; 94,8±3,1 mHg, GHT) quanto na FC (469,6±11,0 bpm, GC; 442,1±23,5, GCT; 484,5±6,6 bpm, GH; 471,5±11,2 bpm, GHT). As análises histológicas mostraram lesões ateroscleróticas no coração, válvula aórtica e arco aórtico em 33% dos animais do grupo hipercolesterolêmico, enquanto nos grupos tratados com AVE e controle (GC), nenhuma área corada foi encontrada. Esses dados sugerem que uma dieta semipurificada contendo 0,5% de colesterol e 17% degordura de coco foi eficiente em induzir o aparecimento de lesões ateroscleróticas em hamsters. Além disso, nossos resultados sugerem que o AVE 0991 produz uma atenuação das lesões vasculares induzidas pela dieta hipercolesterolêmica, independentemente de alterações na pressão arterialThe objective of this study was to study the effect of AVE 0991, an non-peptidic analogue of Angiotensin-(1-7), on atherosclerotic lesions in hamsters treated with a partially purified hypercholestolemic diet. Male hamsters about one months old were divided in the following groups: without treatment (CG, n=7), treated control group (TCG, n=7), and non-treated (HG, n=10) and treated (THG, n=9) hypercholesterolemic groups. The hypercholesterolemic diet was similar to the control one, but, with addition of 0.5 % cholesterol and replacement of 8 % soy oilby 17 % coconut oil. The AVE 0991 was administered, orally, in the last 30 days of the 120 days of diet. The total cholesterol (TC) was measured monthly and HDL cholesterol were measured in the end of experiment. At the end of the treatments the animals were anesthetized with urethane (1.2 g/ Kg, i.p.) and the femoral artery was cannulated for mean arterial pressure (MAP) and heart rate (HR) measurements. The heart and aortic tissues were stained with Sudan III for histological evaluation. The TC of HG and THG were significantly higher than the controls (CG+TCG) during the experiment (294.8±25.3 mg/dL, HG and 256.8±21.6 mg/dL, THG, compared to 95.67±7.1 mg/dL, CG and 99.01±8.5 mg/dL, TCG, in 120 days). There was no effect in TC levels with the AVE treatment. The serum HDL was enhanced in HG and THG (160.6 ± 10.9 mg/dL, HG and 132.0 ± 16.8 mg/dL, THG) in relation the CG and TCG (45.5 ± 3.8 mg/dL, CG and 61.2 ± 6.7 mg/dL, TCG). The treatment with AVE 0991 did not influenced the levels of serum HDL. There were no differences in both MAP (87.86±5.3 mmHg, CG; 91.38±2.0 mmHg, TCG; 93.4±1.1 mmHg, HG; 94.8±3.1 mmHg, THG) and HR (469.6±11.0 bpm, CG; 442.1±23.5, TCG; 484.5±6.6 bpm, HG; 471.5±11.2 bpm, THG). The histological analysis showed atherosclerotic lesions in the heart, aortic valve and aortic arch in33% of the animals of the of Hypercholesterolemic group while no stained areas were observed in AVEtreated and control-diet (CG) hamsters. These data suggest that the semipurified diet containing 0.5 % cholesterol and 17 % coconut oil was efficient to induce atherosclerotic vascular lesions. More importantly,our results suggest that AVE 0991 produces blood pressure-independent attenuation of hypercholesterolemic diet- induced vascular lesions

Intra- and extra-axonal axial diffusivities in the white matter: Which one is faster?

A two-compartment model of diffusion in white matter, which accounts for intra- and extra-axonal spaces, is associated with two plausible mathematical scenarios: either the intra-axonal axial diffusivity Da,‖ is higher than the extra-axonal De,‖ (Branch 1), or the opposite, i.e. Da,‖  De,‖. This result is fully consistent with other recent measurements of compartment axial diffusivities that used entirely different approaches, such as diffusion tensor encoding

Multi-slice passband bSSFP for human and rodent fMRI at ultra-high field

Balanced steady-state free precession (bSSFP) can be used as an alternative to gradient-echo (GE) EPI for BOLD functional MRI when image distortions and signal drop-outs are severe such as at ultra-high field. However, 3D-bSSFP acquisitions have distinct drawbacks on either human or animal MR systems. On clinical scanners, 3D imaging is suboptimal for localized fMRI applications. It can also display distortions when acceleration methods such as spiral read-outs are used, and, compared to multi-slice acquisitions, suffers from increased sensitivity to motion or physiological noise which further results in blurring. On pre-clinical systems, 3D acquisitions have low temporal resolution due to limited acceleration options, while single slice often results in insufficient coverage. The aim of the present study was to implement a multi-slice bSSFP acquisition with Cartesian read-out to obtain non-distorted BOLD fMRI activation maps in the human and rat brain at ultra-high field. We show that, when using a new pseudo-steady-state, the bSSFP signal characteristics are preserved. In the human brain at 7 T, we demonstrate that both task- and resting-state fMRI can be performed with multi-slice bSSFP, with a temporal SNR that matches that of 3D-bSSFP, resulting in - at least - equal performance. In the rat brain at 14 T, we show that the multi-slice bSSFP protocol has similar sensitivity to gradient-echo EPI for task fMRI, while benefitting from much reduced distortions and drop-outs. The advantages of passband bSSFP at 14 T in comparison with GE-EPI are expected to be even more marked for mouse brain

Update on the role of angiotensin in the pathophysiology of coronary atherothrombosis

Coronary atherothrombosis due to atherosclerotic plaque rupture or erosion is frequently associated with acute coronary syndromes (ACS). Significant efforts have been made to elucidate the pathophysiological mechanisms underlying acute coronary events

Dose-Dependent Neuroprotective Effects of Bovine Lactoferrin Following Neonatal Hypoxia–Ischemia in the Immature Rat Brain

Injuries to the developing brain due to hypoxia–ischemia (HI) are common causes of neurological disabilities in preterm babies. HI, with oxygen deprivation to the brain or reduced cerebral blood perfusion due to birth asphyxia, often leads to severe brain damage and sequelae. Injury mechanisms include glutamate excitotoxicity, oxidative stress, blood–brain barrier dysfunction, and exacerbated inflammation. Nutritional intervention is emerging as a therapeutic alternative to prevent and rescue brain from HI injury. Lactoferrin (Lf) is an iron-binding protein present in saliva, tears, and breast milk, which has been shown to have antioxidant, anti-inflammatory and anti-apoptotic properties when administered to mothers as a dietary supplement during pregnancy and/or lactation in preclinical studies of developmental brain injuries. However, despite Lf’s promising neuroprotective effects, there is no established dose. Here, we tested three different doses of dietary maternal Lf supplementation using the postnatal day 3 HI model and evaluated the acute neurochemical damage profile using 1H Magnetic Resonance Spectroscopy (MRS) and long-term microstructure alterations using advanced diffusion imaging (DTI/NODDI) allied to protein expression and histological analysis. Pregnant Wistar rats were fed either control diet or bovine Lf supplemented chow at 0.1, 1, or 10 g/kg/body weight concentration from the last day of pregnancy (embryonic day 21–E21) to weaning. At postnatal day 3 (P3), pups from both sexes had their right common carotid artery permanently occluded and were exposed to 6% oxygen for 30 min. Sham rats had the incision but neither surgery nor hypoxia episode. At P4, MRS was performed on a 9.4 T scanner to obtain the neurochemical profile in the cortex. At P4 and P25, histological analysis and protein expression were assessed in the cortex and hippocampus. Brain volumes and ex vivo microstructural analysis using DTI/NODDI parameters were performed at P25. Acute metabolic disturbance induced in cortical tissue by HIP3 was reversed with all three doses of Lf. However, data obtained from MRS show that Lf neuroprotective effects were modulated by the dose. Through western blotting analysis, we observed that HI pups supplemented with Lf at 0.1 and 1 g/kg were able to counteract glutamatergic excitotoxicity and prevent metabolic failure. When 10 g/kg was administered, we observed reduced brain volumes, increased astrogliosis, and hypomyelination, pointing to detrimental effects of high Lf dose. In conclusion, Lf supplementation attenuates, in a dose-dependent manner, the acute and long-term cerebral injury caused by HI. Lf reached its optimal effects at a dose of 1 g/kg, which pinpoints the need to better understand effects of Lf, the pathways involved and possible harmful effects. These new data reinforce our knowledge regarding neuroprotection in developmental brain injury using Lf through lactation and provide new insights into lactoferrin’s neuroprotection capacities and limitation for immature brains

Prevalence of gustatory changes in elderly people under chronic medication use

OBJECTIVE: To investigate the medication classes used, and which are likely to produce gustatory changes in elderly people and to identify the most prevalent gustatory change types. METHODS: The sample comprised 203 elderly from the Retiree and Pensioner Metal Workers Association of Ipatinga, Minas Gerais, Brazil, aged 60 years or older, from both genders, who make chronic use of any medication. The three-droplet test, which evaluates the four primary tastes, was used to investigate these elderly gustatory functions. RESULTS: The medication classes most commonly used by the elderly were anti-hypertensive (70.9%), lipid-lowering (36.0%), antacid (19.2%), oral hypoglycemic (17.7%), anti-platelet (15.3%), thyroid hormone (13.3%), antidepressant (11.3%) and benzodiazepines (9.4%). Elderly people using antihypertensive medications showed more chances of having gustatory changes for salty flavors (OR = 2.4; 95%CI 1.2 - 4.6) and sweet flavors (OR = 2.3; 95%CI 1.2 - 4.4). Among the antihypertensive medications, beta-blockers (OR = 1.8; 95%CI 1.3 - 4.2) and diuretic drugs (OR = 2.0; 95%CI 1.0 - 3.8) increased the patients' chance of developing gustatory changes for sweet flavors. The other antihypertensive classes, as well as antidepressant and antiplatelet medications were not significantly associated with gustatory changes. It was observed that 41.4% of the sample showed gustatory changes for salty tastes, 40.4% of them showed gustatory changes for sweet tastes, 14.3% for acid tastes and 13.8% for bitter tastes. CONCLUSION: This study showed the chronic medication use may lead to gustatory changes in elderly people, especially for sweet tastes. Among the medications evaluated, antihypertensive stood out among the medication classes, specifically beta-blockers and diuretics.</p

Synchronous nonmonotonic changes in functional connectivity and white matter integrity in a rat model of sporadic Alzheimer's disease

Brain glucose hypometabolism has been singled out as an important contributor and possibly main trigger to Alzheimer's disease (AD). Intracerebroventricular injections of streptozotocin (icv-STZ) cause brain glucose hypometabolism without systemic diabetes. Here, a first-time longitudinal study of brain glucose metabolism, functional connectivity and white matter microstructure was performed in icv-STZ rats using PET and MRI. Histological markers of pathology were tested at an advanced stage of disease. STZ rats exhibited altered functional connectivity and intra-axonal damage and demyelination in brain regions typical of AD, in a temporal pattern of acute injury, transient recovery/compensation and chronic degeneration. In the context of sustained glucose hypometabolism, these nonmonotonic trends – also reported in behavioral studies of this animal model as well as in human AD – suggest a compensatory mechanism, possibly recruiting ketone bodies, that allows a partial and temporary repair of brain structure and function. The early acute phase could thus become a valuable therapeutic window to strengthen the recovery phase and prevent or delay chronic degeneration, to be considered both in preclinical and clinical studies of AD. In conclusion, this work reveals the consequences of brain insulin resistance on structure and function, highlights signature nonmonotonic trajectories in their evolution and proposes potent MRI-derived biomarkers translatable to human AD and diabetic populations