Socio-demographic characteristics are related to the advanced clinical stage of oral cancer

Social determinants may be associated with the onset and progression of the clinical stage of oral cancer. Aim: To evaluate the impact of socio-demographic characteristics on the prevalence of advanced clinical stage of oral cancer. Information about 51,116 cases of oral cancer, from all Brazilian states, between 2000 and 2012, was obtained from the Cancer Registry Information System. The clinical stage of oral cancer (dependent variable) was classified as initial (stages I and II) or advanced (stages III and IV). The relationship between the clinical stage of oral cancer and the following independent variables was analyzed: sex, age, schooling, marital status, family history of cancer, and origin of referral. Analyses on frequency distribution and multivariate binary logistic regression model were performed (?<0.05). Compared to individuals with no schooling, those who attended elementary to high school (OR=2.461) and college education (OR = 3.050) had a higher prevalence of advanced cases of oral cancer. Individuals without a partner (OR = 14,209) demonstrated a higher prevalence compared to married individuals. Subjects aged 20-44 years (OR = 4.081) and 45-64 years (OR = 14.875) had a higher prevalence compared to those aged 15-19 years. The variables gender, family history of cancer and origin of referral integrated the binary model of logistic regression, but did not present statistical significance. Socioeconomic factors may be related to the advanced clinical stage of oral cancer

Physiological characteristics of grapevine under irrigation and fertilization management

The viticulture in the semiarid region of Brazil stands out in the country due to the expansion of its cultivated area and increased production, especially in the sub-mid São Francisco Valley. However, the supplying of water and an efficient replacement of nutrients to the soil are essential for these crops, due to the intrinsic climatic conditions of this region, such as low rainfall and high evapotranspiration. This study aimed at evaluating the physiological characteristics of ‘Itália’ grapevine (Vitis vinifera L.) under irrigation and fertilization management. The experiment was conducted in a randomized block design, with four replications, in a split-plot arrangement, with four irrigation water depths (0.75, 1.00, 1.25 and 1.5 times the crop coefficient) in the plots and four fertilizer rates (100 %, 75 %, 50 % and 25 %, based on the recommended fertilizer rates for this crop) in the subplots, with addition of organic compounds. The leaf water potential, leaf chlorophyll content, relative water content, photosynthesis, stomatal conductance, internal CO2 partial pressure, leaf temperature and biomass accumulation in the berries were evaluated. The highest leaf chlorophyll contents were found in treatments with fertilizer rates of 70-85 %. Stomatal conductance decreased with the increasing irrigation water depths, thus reducing the internal CO2 partial pressure and increasing the leaf temperature and air vapor pressure deficit. The reduction of 25 % in the conventional fertilization and irrigation of 135 % of the recommended coefficient resulted in the highest average weight of berries. The highest yields were obtained with the lowest irrigation water depths and fertilizer rates of 50-65 %

Spatiotemporal evolution of coronavirus disease 2019 mortality in Brazil in 2020

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APLICABILIDADE DAS PRÁTICAS INTEGRATIVAS NO SISTEMA ÚNICO DE SAÚDE.

Objective: To discuss the applicability of integrative practices in the single health system through the existing literature. Methods: This is a qualitative integrative literature review. The search for works involved in the research was carried out in the following databases: SCIELO, LILACS, BDENF and MEDLINE, using the descriptors in health sciences: "Comprehensive health care", "Complementary therapies" and "Single health system". The inclusion criteria were: articles published between 2013 and 2023, with free access to full texts, articles in Portuguese, English and Spanish and related to the theme. Exclusion criteria were: duplicate articles, incomplete articles, abstracts, reviews, debates, articles published in event proceedings and unavailable in full. Results: The therapeutic resources that make up ICPs are diverse, and in public health services they are more frequent because they favor lower costs. Conclusion: It can be concluded that integrative practices integrated into PHC have a very satisfactory effect on users' quality of life, and should minimize medication that is often unnecessary.Objetivo: Discutir por meio da literatura existente acerca da aplicabilidade das práticas integrativas no sistema único de saúde. Métodos: Trata-se de uma revisão integrativa da literatura de caráter qualitativo. A busca dos trabalhos envolvidos na pesquisa foi realizada nas seguintes bases de dados: SCIELO, LILACS, BDENF e MEDLINE, a partir dos descritores em ciências da saúde: “Assistência integral à saúde”, “Terapias complementares” e “Sistema único de saúde”. Os critérios de inclusão foram: publicados no período entre 2013 e 2023, cujo acesso ao periódico era livre aos textos completos, artigos em idioma português, inglês e espanhol e relacionados a temática. Critérios de exclusão foram: artigos duplicados, incompletos, resumos, resenhas, debates, artigos publicados em anais de eventos e indisponíveis na íntegra. Resultados: Os recursos terapêuticos que compõe as PICs são diversas, sendo que nos serviços públicos de saúde eles são mais frequentes por favorecerem a diminuição de custos. Conclusão: Conclui-se que as práticas integrativas integradas na APS têm um efeito muito satisfatório no que diz respeito a qualidade de vida dos usuários, devendo minimizar ações medicamentosas que muitas das vezes não são necessárias

Clinical and therapeutic aspects of canine giardiasis - a report of three cases: Aspectos clínicos e terapêuticos da giardíase canina - relato de três casos

A Giardia spp. é um protozoário flagelado que causa a giardíase, uma zoonose de notificação não obrigatória no Brasil, afetando animais domésticos, silvestres e humanos. A transmissão ocorre principalmente pela ingestão de água ou alimentos contaminados com cistos do parasito. Devido à sua recorrência e às implicações em problemas de saúde pública em nível mundial, este trabalho tem como objetivo relatar aspectos clínicos e terapêuticos da giardíase canina em três cães naturalmente infectados no estado de Sergipe, Nordeste do Brasil. Foram atendidos pela equipe do Laboratório de Doenças Parasitárias dos Animais da Universidade Federal de Sergipe, campus do Sertão, três cães adultos, com histórico de quadro de gastroenterite aguda. Ao exame físico alguns dos sinais clínicos observados foram anorexia, desidratação, mucosas hipocoradas, congestão ocular, além da presença de carrapatos sob a pelagem. Nos resultados do exame hematológico foi revelada presença de anemia e leucopenia, enquanto o parasitológico de fezes identificou a presença de Giardia spp. Como tratamento terapêutico, foi adotado protocolo giardicida associado a suplementação probiótica e vitamínica, além de orientações profiláticas para auxiliar no controle do parasito e na redução da contaminação ambiental

Chitosan microparticles loaded with essential oils inhibit duo-biofilms of Candida albicans and Streptococcus mutans

Oral candidiasis is a common fungal infection that affects the oral mucosa, and happens when Candida albicans interacts with bacteria in the oral microbiota, such as Streptococcus mutans, causing severe early childhood caries. C. albicans and S. mutans mixed biofilms are challenging to treat with conventional antimicrobial therapies, thus, new anti-infective drugs are required. Objective: This study aimed to test a drug delivery system based on chitosan microparticles loaded with geranium and lemongrass essential oils to inhibit C. albicans and S. mutans mixed biofilms. Methodology: Chitosan microparticles loaded with essential oils (CM-EOs) were obtained by spray-drying. Susceptibility of planktonic were performed according CLSI at 4 to 2,048 µg/mL. Mixed biofilms were incubated at 37ºC for 48 h and exposed to CM-EOs at 256 to 4,096 µg/mL. The antimicrobial effect was evaluated using the MTT assay, with biofilm architectural changes analyzed by scanning electron microscopy. RAW 264.7 cell was used to evaluate compound cytotoxicity. Results: CM-EOs had better planktonic activity against C. albicans than S. mutans. All samples reduced the metabolic activity of mixed C. albicans and S. mutans biofilms, with encapsulated oils showing better activity than raw chitosan or oils. The microparticles reduced the biofilm on the slides. The essential oils showed cytotoxic effects against RAW 264.7 cells, but encapsulation into chitosan microparticles decreased their toxicity. Conclusion: This study demonstrates that chitosan loaded with essential oils may provide an alternative method for treating diseases caused by C. albicans and S. mutans mixed biofilm, such as dental caries

A utilização de drogas sedativas em pacientes críticos submetidos à ventilação mecânica: uma revisão integrativa dos achados clínicos / The use of sedative drugs in critically ill patients submitted to mechanical ventilation: an integrative review of the clinical findings

Introdução A ocupação das unidades de terapia intensiva (UTIs) brasileiras representa é elevada, representando cerca de 85 % de acordo com agência nacional de saúde. O uso de drogas sedativas nas UTIs é frequente, uma vez que as mesmas buscam o controle da dor e melhor do quadro clínico do paciente grave. Destarte, deve-se considerar os achados ventilatórios que existem entre os pacientes sob assistência ventilatória mecânica (AVM) e o tratamento intensivo, já que os mesmos propiciam o uso adequado dessas drogas. Objetivo: realizar um levantamento retrospectivo de artigos científicos publicados e indexados a fim de produzir uma revisão integrativa acerca dos achados ventilatórios apresentados durante a utilização clínica de drogas sedativas e analgésicas em pacientes críticos sob AVM. Métodos: Os bancos de dados utilizados para obtenção dos artigos foram:  PubMed ,SciELO e  PEDro. O critério de escolha foi selecionar estudos dos últimos doze anos que avaliaram as principais alterações ventilatórias vistas em pacientes que utilizaram algum tipo de drogas sedativas ou analgésicas, baseados em humanos. Artigos de revisão foram excluídos.Resultados: Foram encontrados 583artigos. No entanto, pelos critérios de inclusão e exclusão foram incluídos 23estudos. Conclusão: Constatou-se a existência de relação entre o internamento de pacientes sob AVM e a ocorrência de doenças respiratórias, além de achados ventilatórios como: diminuição do volume minuto, diminuição do volume expirado de dióxido de carbono e redução do volume corrente. O estudo de Prin demonstra que uma parte considerável desses pacientes apresenta um desmame tardio e pneumonia induzida pela AVM. Por isso, o uso de protocolos acerca do uso de drogas sedativas e analgésicas em UTIs é fundamental para que não exista depressão da musculatura ventilatória, já que esse fator é precursor de complicações pulmonares. Ademais, pacientes críticos inspiram o manejo adequado do uso de drogas sedativas e analgésicas para conforto respiratório e redução do tempo de internamento

Acute Chagas disease associated with ingestion of contaminated food in Brazilian western Amazon

Funding Information: We would like to thank the following institutions for all the support they accorded: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Amazonas Health Surveillance Foundation Dr. Rosimary Costa Pinto (FVS‐RCP/AM), the Municipal Health Departments of the affected by the outbreaks and Fundação de Amparo à Pesquisa do Estado do Amazonas for their financial support in acquiring materials for the molecular detection of the parasite. We would also like to thank the public health surveillance teams and the patients who agreed to participate in this study. Publisher Copyright: © 2023 Belgian Society of Tropical Medicine and the Prince Leopold Institute of Tropical Medicine.Objective: To describe clinical, epidemiological and management information on cases of acute Chagas disease (ACD) by oral transmission in the state of Amazonas in western Amazon. Methods: Manual and electronic medical records of patients diagnosed with ACD at the Fundação de Medicina Tropical Doutor Heitor Vieira Dourado (FMT-HVD) were included. Results: There were 147 cases of acute CD registered from 10 outbreaks that occurred in the state of Amazonas between 2004 and 2022. The transmission pathway was through oral route, with probable contaminated palm fruit juice (açaí and/or papatuá), and involved people from the same family, friends or neighbours. Of 147 identified cases, 87 (59%) were males; cases were aged 10 months to 82 years. The most common symptom was the febrile syndrome (123/147; 91.8%); cardiac alterations were present in 33/100 (33%), (2/147; 1.4%) had severe ACD with meningoencephalitis, and 12 (8.2%) were asymptomatic. Most cases were diagnosed through thick blood smear (132/147; 89.8%), a few (14/147; 9.5%) were diagnosed by serology and (1/147; 0.7%) by polymerase chain reaction (PCR) and blood culture. In all these outbreaks, 74.1% of the patients were analysed by PCR, and Trypanosoma cruzi TcIV was detected in all of them. No deaths were recorded. The incidence of these foci coincided with the fruit harvest period in the state of Amazonas. Conclusion: The occurrence of ACD outbreaks in the Amazon affected individuals of both sexes, young adults, living in rural and peri-urban areas and related to the consumption of regional foods. Early diagnosis is an important factor in surveillance. There was a low frequency of cardiac alterations. Continuous follow-up of most patients was not carried out due to difficulty in getting to specialised centres; therefore, little is known about post-treatment.publishersversioninpres