Consumption of benzylpenicillin as a syphilis control indicator

Syphilis is a disease with compulsory and mandatory notification to the Notifiable Diseases Information System (SINAN), with benzathine benzylpenicillin being the treatment of choice. The aim of the study was to compare the consumption of benzylpenicillin benzathine, from the dispensation, between the health regions of a capital in the southern region of the country, according to the georeferencing of notified cases of syphilis. This is a descriptive, cross-sectional, retrospective study of the use of benzylpenicillin benzathine and of reported cases of syphilis. Data on syphilis cases were obtained from notifications made in SINAN, and drug consumption data were obtained from the Municipal Health Department computerized system for Drug Dispensing from January 1st, 2019 to December 31st, 2019. Notifications and drug consumption were georeferenced according to 8 health regions. From the compilation of data, the rates of cases and consumption in relation to the population of each region were calculated. A total of 3188 notifications and a total of 35191 vials of benzathine benzylpenicillin were analyzed. The ratio of vials by SINAN notifications showed that each patient took 11 vials of the drug, which is a higher value if we consider that the complete treatment is 2 to 6 vials per case

FTY720 induces apoptosis in B16F10-NEX2 murine melanoma cells, limits metastatic development in vivo, and modulates the immune system

OBJECTIVE: Available chemotherapy presents poor control over the development of metastatic melanoma. FTY720 is a compound already approved by the Food and Drug Administration for the treatment of patients with multiple sclerosis. It has also been observed that FTY720 inhibits tumor growth in vivo (experimental models) and in vitro (animal and human tumor cells). The aim of this study was to evaluate the effects of FTY720 on a metastatic melanoma model and in tumor cell lines. METHODS: We analyzed FTY720 efficacy in vivo in a syngeneic murine metastatic melanoma model, in which we injected tumor cells intravenously into C57BL/6 mice and then treated the mice orally with the compound for 7 days. We also treated mice and human tumor cell lines with FTY720 in vitro, and cell viability and death pathways were analyzed. RESULTS: FTY720 treatment limited metastatic melanoma growth in vivo and promoted a dose-dependent decrease in the viability of murine and human tumor cells in vitro. Melanoma cells treated with FTY720 exhibited characteristics of programmed cell death, reactive oxygen species generation, and increased β-catenin expression. In addition, FTY720 treatment resulted in an immunomodulatory effect in vivo by decreasing the percentage of Foxp3+ cells, without interfering with CD8+ T cells or lymphocyte-producing interferon-gamma. CONCLUSION: Further studies are needed using FTY720 as a monotherapy or in combined therapy, as different types of cancer cells would require a variety of signaling pathways to be extinguished.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Conselho Nacional de Pesquisa e Desenvolvimento (CNPq)Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina (EPM-UNIFESP) Departamento de Microbiologia, Imunologia e ParasitologiaUNIFESP, EPM, (EPM-UNIFESP) Depto. de Microbiologia, Imunologia e Parasitologia2008/51256-7SciEL

O PAPEL DO AGENTE COMUNITÁRIO DE SAÚDE FRENTE AO DESAFIO DA NOVA POLÍTICA NACIONAL DE ATENÇÃO BÁSICA

Este ensaio propõe-se a discorrer sobre o papel do Agente Comunitário de Saúde (ACS) à luz do novo texto da Política Nacional de Atenção Básica (PNAB). Partindo da atuação específica desse profissional, o artigo busca contribuir com reflexões acerca do modelo de atenção à saúde que poderá se consolidar a partir dessas transformações. O ACS é essencial na implementação do Sistema Único de Saúde (SUS) por fortalecer a integração entre os serviços de Atenção Básica à Saúde e a comunidade. É personagem protagonista na efetivação de uma prática que considere o conceito ampliado de saúde. Seu trabalho tem como principal objetivo contribuir para a qualidade de vida das pessoas e da comunidade, atuando desde a identificação dos fatores que interferem na saúde, promoção da saúde e prevenção de doenças, exercendo inclusive a função de estimular e organizar as reivindicações da comunidade. As mudanças no texto da PNAB devem ser acompanhadas com atenção, uma vez que o ACS enquanto profissional da equipe da Estratégia Saúde da Família, é um agente promotor de saúde que dialoga com as pessoas em seus territórios e que atua nas desigualdades em saúde

Inteligência artificial para interpretação de eletrocardiograma no diagnóstico de infarto do miocárdio

A utilização da Inteligência Artificial (IA) nos cuidados de saúde está a transformar a prática clínica, fornecendo ferramentas avançadas para diagnóstico e tratamento de diversas doenças, incluindo doenças cardiovasculares. Este artigo descreve a utilização da IA ​​na interpretação de eletrocardiogramas (ECGs) para diagnosticar com precisão o infarto agudo do miocárdio (IAM). Tradicionalmente, o IAM é detectado por alterações no ECG, um exame de baixo custo e fácil acesso em diferentes realidades no Brasil. No entanto, a interpretação correta dos ECGs pode ser difícil devido à sua complexidade. A IA, mais especificamente tecnologias como machine learning e deep learning, oferece formas promissoras de melhorar tal interpretação e auxiliar os profissionais de saúde a identificar o IAM precocemente e com precisão. Esta revisão integrativa detalha o uso de ferramentas de IA na leitura e interpretação de ECG para um diagnóstico significativo de IAM e destaca a sua importância na melhoria da qualidade do atendimento na pratica clínica. Ao revisar pesquisas relacionadas, chegamos a conclusão do potencial da IA ​​para revolucionar o diagnóstico cardiovascular e delineamos a direção de pesquisas futuras neste campo crescente

Análise dos fatores associados à Doença Hipertensiva específica da gravidez: estudo de caso controle

Introdução: As síndromes hipertensivas são a intercorrência clínica mais comum da gestação e representam a principal causa de morbimortalidade materna no mundo, dentre elas, destaca-se a doença hipertensiva específica da gravidez. Essa patologia possui diversos fatores de risco para o seu aparecimento, como por exemplo, o ganho de peso, aspecto comum da gestação, mas que sem o acompanhamento adequado, pode gerar complicações para a saúde. Objetivo: verificar a prevalência de excesso de peso em gestantes e, analisar as associações com DHEG. Metodologia: Trata-se de um estudo transversal, com análise quantitativa de dados. A amostra foi composta por cerca de 27 gestantes adultas, com idade gestacional maior que 20 (vinte) semanas. Resultados e discussão: Com relação ao estado nutricional, a prevalência de sobrepeso foi de 27%, de obesidade foi de 48,2%, considerando obesidade grau I, II e III. A chance de uma gestante apresentar a DHEG foi maior com a presença da obesidade, em comparação às mães com peso adequado ou apenas sobrepeso (OR= 8,9; p = 0,02). Conclusão: Foi possível evidenciar uma alta prevalência de excesso de peso nas gestantes analisadas, principalmente com casos de obesidade, seguido pelos casos de sobrepeso. As duas situações são complexas para o estado de saúde da mulher e devem ser consideradas frente a ações preventivas, pois esse excesso de peso apresentou forte relação com o desenvolvimento de doença hipertensiva específica da gravidez

Artisanal cheese of Minas Gerais, not all are AMC: a brief review

The artisanal Minas cheese (AMC) is a product widely produced and consumed throughout the state of Minas Gerais, with the regions of Araxá, Campo das Vertentes, Canastra, Cerrado, Ibitipoca, Serra do Salitre, Serro, Triângulo considered as the eight traditional regions of artisanal Minas cheese. With the publication of the Law 23,157, of December 18, 2018, related to the production and sale of artisanal cheeses in Minas Gerais, other artisanal cheese varieties could also be recognized and regularized, in addition to the AMC. Among the varieties of artisanal cheeses of Minas Gerais (ACM), which are not AMC, are: artisanal cheese from Alagoa, artisanal Mantiqueira de Minas cheese, Cabacinha cheese, artisanal cheese from Vale do Suaçuí, artisanal cheese from Serra Geral, and also the artisanal processed cheese, known as requeijão Moreno. While the AMC must follow a standard manufacturing technology in all regions where it is produced, other artisanal cheeses made in Minas Gerais have some particularities, such as heating and cooking the curd, melting, or stretching, among other steps that are not allowed in the AMC. In short, artisanal cheeses of Minas Gerais include artisanal Minas cheeses (AMC) and artisanal cheeses that have specific manufacturing technology only for their variety. The artisanal cheeses of Minas Gerais are part of history and culture of the state, however they have not yet been extensively studied, so there are not many scientific publications about their characteristics and how these cheeses are made. In this context, this review aimed to study the literature to elucidate the main characteristics of artisanal cheeses of Minas Gerais that do not fit the AMC classification, as well as their production regions and manufacturing technologies

Incidence of tuberculosis infection in spondyloarthritis patients treated with biological and conventional diseasemodifying anti-rheumatic drugs in an endemic area

Introduction: Registries of spondyloarthritis (SpA) patients’ follow-up provided evidence that tumor necrosis factor inhibitors (TNFi) increase the incidence of active tuberculosis infection (TB). However, most of these registries are from low burden TB areas. Few studies evaluated the safety of biologic agents in TB endemic areas. This study compares the TB incidence rate (TB IR) in anti-TNF-naïve and anti-TNFexperienced subjects with SpA in a high TB incidence setting. Methods: In this retrospective cohort study, medical records from patients attending a SpA clinic during 13 years (2004 to 2016) in a university hospital were reviewed. The TB IR was calculated and expressed as number of events per 105 patients/year; the incidence rate ratio (IRR) associated with the use of TNFi was calculated. Results: A total of 277 patients, 173 anti-TNF-naïve and 104 anti-TNF-experienced subjects, were evaluated; 35.7% (N = 35) of patients who were prescribed an antiTNF drug were diagnosed with latent tuberculosis infection (LTBI). Total follow-up time (person-years) was 1667.8 for anti-TNF-naïve and 394.9 for anti-TNF-experienced patients. TB IR (95% CI) was 299.8 (37.4-562.2) for anti-TNF naïve and 1012.9 (25.3-2000.5) for anti-TNF experienced subjects. The IRR associated with the use of TNFi was 10.4 (2.3- 47.9). Conclusions: In this high TB incidence setting, SpA patients exposed to anti-TNF therapy had a higher incidence of TB compared to anti-TNF-naïve subjects, although the TB incidence in the control group was significant

Measurement of the cosmic ray spectrum above 4×10184{\times}10^{18} eV using inclined events detected with the Pierre Auger Observatory

A measurement of the cosmic-ray spectrum for energies exceeding $4{\times}10^{18}$ eV is presented, which is based on the analysis of showers with zenith angles greater than $60^{\circ}$ detected with the Pierre Auger Observatory between 1 January 2004 and 31 December 2013. The measured spectrum confirms a flux suppression at the highest energies. Above $5.3{\times}10^{18}$ eV, the "ankle", the flux can be described by a power law $E^{-\gamma}$ with index $\gamma=2.70 \pm 0.02 \,\text{(stat)} \pm 0.1\,\text{(sys)}$ followed by a smooth suppression region. For the energy ($E_\text{s}$) at which the spectral flux has fallen to one-half of its extrapolated value in the absence of suppression, we find $E_\text{s}=(5.12\pm0.25\,\text{(stat)}^{+1.0}_{-1.2}\,\text{(sys)}){\times}10^{19}$ eV.Comment: Replaced with published version. Added journal reference and DO