PERFIL EPIDEMIOLÓGICO E SOCIODEMOGRÁFICO DOS PACIENTES COM HANSENÍASE, NO PERÍODO DE 2001 A 2017, EM VITÓRIA DA CONQUISTA, BAHIA, BRASIL.: EPIDEMIOLOGICAL AND SOCIODEMOGRAPHIC PROFILE OF PATIENTS WITH LEPROSY, IN THE PERIOD FROM 2001 TO 2017, IN VITÓRIA DA CONQUISTA, BAHIA, BRAZIL.

Leprosy is an infectious disease that causes concern in many countries. Despite efforts to combat the disease, endemic outbreaks in many regions are still reported as a problem for public health. This study aimed to describe the epidemiological and sociodemographic profile of patients diagnosed with leprosy during the period from 2001 to 2017, in the city of Vitória da Conquista (BA). In order to obtain the date of patients, we counted on the support of the Center of Pulmonology and Sanitary Dermatology of the city and the access to database of the main organs linked to health; in addition to the cooperation of the company responsible for basic sanitation in the region. During the mentioned period, 934 individuals with the disease were notified. There was a higher frequency in individuals aged over 41 years, female, of brown and white color, inhabitants of the urban zone, with incomplete primary education. The dimorphic and tuberculoid clinical forms were more frequently. Districts and villages with a high occurrence of the disease were reported. The rate of detection of new cases per 100,000 inhabitants was higher than recommended by the Ministry of Health. It was possible to report an overview of the epidemiological situation of patients with leprosy in Vitória da Conquista and it is expected that the development of measures, by the public agencies, as a purpose to combat and make the population aware of the risks of the disease.A hanseníase é uma doença infecciosa que gera preocupação em muitos países. Apesar dos esforços para o combate da doença ainda são notificados focos endêmicos em muitas regiões, constituindo um problema para a saúde pública. Este trabalho objetivou descrever o perfil epidemiológico e sociodemográfico dos pacientes diagnosticados com a hanseníase durante o período de 2001 a 2017, no município de Vitória da Conquista (BA). Para a obtenção dos dados dos pacientes, contou-se com o apoio do Centro de Pneumologia e Dermatologia Sanitária do município e do acesso a base de dados dos principais órgãos vinculados a saúde; além da cooperação da empresa responsável pelo saneamento básico na região. Foram notificados, durante o período mencionado, 934 indivíduos portadores da doença. Houve maior frequência em indivíduos na faixa etária maior que 41 anos, do sexo feminino, de cor parda e branca, moradores da zona urbana, com o ensino fundamental incompleto. As formas clínicas dimorfa e tuberculoide foram as mais frequentes. Foram notificados os bairros e povoados com grande ocorrência da doença. A taxa de detecção de casos novos por 100 mil habitantes esteve acima do preconizado pelo Ministério da Saúde. Foi possível relatar um panorama da situação epidemiológica dos pacientes com hanseníase em Vitória da Conquista e espera-se o desenvolvimento de medidas, por parte dos órgãos públicos, como propósito de combater e conscientizar a população acerca dos riscos da doença

Perfil de fisioterapeutas brasileiros que atuam em unidades de terapia intensiva

The purpose of this study was to outline a profile of physical therapists who work in intensive care units (ICU) in Brazil, focusing on service management, techniques used, and the degree of therapists' autonomy regarding invasive and non-invasive mechanical ventilation. Questionnaires were sent to the heads of physical therapy (PT) services of 1,192 hospitals registered at the Brazilian Intensive Care Medicine Association and 461 (39%) ICUs replied. In 88% of these, PT services are headed by physical therapists and up to eight therapists work in 78% of the ICUs. Therapists work 30 hours a week in 44.4% of the units; 46.1% are formally hired. PT 24-hour assistance is available in 32.8% of the ICUs and on weekends, in 88%. Concerning PT techniques, all therapists perform mobilization, positioning, and aspiration; 91.5% play an active role in non-invasive ventilation, with 42.5% working with full autonomy. As to invasive mechanical ventilation, 80% perform extubation, 79.2% adjusting and weaning; however, only 22% have full autonomy (the others requiring physicians' protocol). Brazilian physical therapists work mostly in private institution ICUs, in services headed by physiotherapists, and have relative autonomy in handling PT techniques and non-invasive mechanical ventilation; as to invasive mechanical ventilation, most depend on protocols or discussions with a physician.Este estudo visou investigar o perfil dos fisioterapeutas que atuam nas unidades de terapia intensiva (UTIs) no Brasil, focalizando a direção do serviço, técnicas fisioterapêuticas empregadas e nível de autonomia em relação à ventilação mecânica invasiva e não-invasiva. Questionários foram enviados aos chefes dos serviços de fisioterapia de 1.192 hospitais registrados na Associação Médica de Terapia Intensiva, com retorno de 461 (39%) UTIs. Em 88% destas, os serviços são chefiados por fisioterapeutas; em 78%, compostos por até oito fisioterapeutas; 44,4% dos fisioterapeutas trabalham em regime de 30 horas semanais e 46,1% têm contrato de trabalho. Há assistência fisioterapêutica durante 24 horas em 33,6% das UTIs; 88% delas mantêm assistência nos finais de semana. Quanto às técnicas fisioterapêuticas, todos realizam mobilização, posicionamento e aspiração; 91,5% atuam na ventilação não-invasiva, sendo que 43% trabalham com total autonomia. Em relação à ventilação mecânica invasiva, 80% realizam extubação; 79,2% realizam regulagem e desmame do ventilador; entretanto, só 22% têm total autonomia (78% necessitam de protocolo ou opinião da equipe médica). Os fisioterapeutas brasileiros atuam, em sua maioria, em instituições privadas e assistenciais, cujos serviços são chefiados por fisioterapeutas. Têm relativa autonomia quanto às técnicas fisioterapêuticas e o manuseio da ventilação mecânica não-invasiva mas, no caso da invasiva, atuam sob diretiva da equipe médica

Rhinitis associated with asthma is distinct from rhinitis alone: TARIA‐MeDALL hypothesis

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of “one-airway-one-disease,” coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitization and multimorbidity, (iii) advances in mHealth for novel phenotype definitions, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches, and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut, and neuropsychiatric multimorbidities, is the “Epithelial Barrier Hypothesis.” This review determined that the “one-airway-one-disease” concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme “allergic” (asthma) phenotype combining asthma, rhinitis, and conjunctivitis.info:eu-repo/semantics/publishedVersio

ARIA digital anamorphosis : Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.Peer reviewe

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed

POPULAÇÃO DE PLANTAS E RENDIMENTO DE GRÃOS EM FEIJOEIRO COMUM DE CICLO PRECOCE PLANT POPULATION AND YIELD OF EARLY DRY BEANS

<!-- @page { margin: 2cm } --> <p class="western" align="justify">O objetivo deste trabalho foi avaliar o efeito do espaçamento entre linhas e do número de plantas na linha, no rendimento de grãos, nos componentes do rendimento e nas taxas de acúmulo de massa seca e abortamento de vagens do feijoeiro comum (<em>Phaseolus</em> <em>vulgaris L.</em>), para subsidiar a seleção e avaliação de linhagens precoces. O experimento foi conduzido em condições de campo, na Embrapa Arroz e Feijão, GO, no inverno de 2000. Utilizou-se a cultivar de hábito de crescimento indeterminado Jalo Precoce e a linhagem experimental de hábito de crescimento determinado PR93201472, ambas com ciclo de 75 a 80 dias. Foram testados os espaçamentos de 0,30 m, 0,40 m e 0,50 m, com 10, 13 e 16 plantas/m. Durante o período de enchimento de grãos, avaliou-se o número de vagens e de grãos por planta, a massa seca de vagens e grãos, e as taxas de acúmulo de massa seca das vagens e de queda de vagens. O rendimento de grãos e os componentes do rendimento foram avaliados na maturação fisiológica. O rendimento de grãos foi afetado somente pelo espaçamento entre linhas, sendo o espaçamento de 0,40 m o que apresentou maior rendimento. O número de grãos por unidade de área foi a variável que melhor explicou as alterações no rendimento de grãos, em função dos espaçamentos estudados.</p> <p class="western">KEY-WORDS: <em>Phaseolus vulgaris</em>; row spacing; yield components.</p><!-- @page { margin: 2cm } --> <p class="western" align="justify">The objective of this research was to study the effect of ow spacing and the number of plants in the row on grain yield, ield components, pod growth and pod abortion rates of dry bean <em>Phaseolus</em> <em>vulgaris</em> <em>L.</em>), as variables for selecting and evaluating early lines. The experiment was conducted under field conditions at the ";Embrapa Arroz e Feijão research center, in Goiás, in the winter of 2000. The genotypes, Jalo Precoce, indeterminate growth habit and the PR93201472 line determinate growth habit, and both with cycles of 75 to 80 days were sowed in row spacings of 0.30 m, 0.40 m and 0.50 m, with ten, thirteen and sixteen plants per meter. During the pod filling period the traits evaluated were the numbers of pods and seeds per plant, pod and seed dry weight, pod growth rate and pod abortion rate. Grain yield and yield components were also evaluated at physiological maturity. Grain yield was significantly influenced by row spacing and maximum yield was obtained in the 0.40 m row spacing. The number of seeds per area was the trait that best explained seed yield variation.</p> <p class="western">KEY-WORDS: <em>Phaseolus vulgaris</em>; row spacing; yield components.</p&gt