Sintomas respiratórios na população da cidade de Ribeirão Preto, SP (Brasil): resultados da aplicação de um questionário padronizado

As doenças respiratórias constituem expressiva parcela da morbidade na população da cidade de Ribeirão Preto, como comprovam alguns autores. Em particular, as doenças pulmonares crônicas não-específicas motivam número grande de internações a cada ano. Tais doenças podem ser detectadas através de sintomas relatados em entrevistas pessoais, quando se usa um questionário padronizado. Em uma amostra de 3.353 indivíduos de mais de 3 anos de idade, correspondendo a 878 domicílios visitados, foi feito levantamento de sintomas respiratórios, na população do município de Ribeirão Preto, SP (Brasil), utilizando-se questionário padronizado. Os resultados mostraram: 3,4% de pessoas do sexo feminino e 2,4% do sexo masculino com sintomas sugestivos da asma brônquica; 5,5% do sexo masculino e 3,3% do sexo feminino com sintomas sugestivos de bronquite crônica; 15,5% dos homens e 11,3% das mulheres referiram tosse; dispnéia com limitação funcional foi relatada em 0,96% dos homens e 2,48% das mulheres.The prevalence of asthma, chronic bronchitis and some other respiratory symptoms was estimated on the basis of a standardized questionnaire. Three thousand three hundred and fifty-three people were interviewed at home. On the basis of the criteria adapted 3.49% of the females and 2.4% of the males were considered asthmatic. Likewise, in 5.54% of the males and 3.37% of females the symptoms were strongly suggestive of chronic bronchitis. Shortness of breath was recorded in 0.96% of the males and 2.48% of the females

COVID-19 and pulmonary embolism: do not forget the association!

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Incidence of tuberculous and non-tuberculous mycobacteria, differentiated by multiplex PCR, in clinical specimens of a large general hospital

OBJECTIVE: To determine the incidence of Mycobacterium tuberculosis complex and non-tuberculous mycobacterial isolates in the routine setting of a large general hospital using an "in-house" multiplex polymerase chain reaction method and to establish a paradigm for the definitive identification of mycobacteria isolated using semi-automated equipment. METHODS: Established tests, including polymerase chain reaction restriction enzyme analysis, PNB, and NAP inhibition tests as the gold standard, showed 100% agreement with an IS6110/hsp65 multiplex polymerase chain reaction when used to identify stock strains (n = 117). RESULTS: In a subsequent study, 8,790 clinical specimens producing 476 isolates were evaluated with multiplex PCR and also showed 100% agreement in identification using PRA-polymerase chain reaction as the gold standard. The application of this technique to routine analysis was demonstrated in this study. A method was established with the initial application of multiplex PCR for all positive liquid cultures and the subsequent identification of non-tuberculous mycobacteria by polymerase chain reaction restriction enzyme analysis. In total, 77% of isolates belonged to the Mycobacterium tuberculosis complex, and 23% were non-tuberculous mycobacteria. CONCLUSIONS: Several non-tuberculous mycobacterial species were identified, primarily M. avium, but other potentially pathogenic species were also frequently observed, including M. fortuitum, M. abscessus, and M. kansasii. The expeditious communication of these data to the clinical staff was fundamental for the diagnosis of clinical cases. Even in settings where tuberculosis is of major importance, the incidence of non-tuberculous mycobacteria infection is substantial

Tree-Network Overrun Model Associated with Pilots’ Actions and Flight Operational Procedures

The runway excursions are defined as the exit of an aircraft from the surface of the runway. These excursions can take place at takeoff or at landing and consist of two types of events: veer off and overrun. This last one, which occurs when the aircraft exceeds the limits at the end of the runway, is the event of interest in the current study. This chapter aims to present an accident model with a new approach in aeronautical systems, based on the tasks of the pilots related to the operational procedures necessary for the approach and landing, in order to obtain the chain of events that lead to this type of accident. Thus, the tree-network overrun model (TNO model) was proposed, unlike most traditional models, which consider only the hardware failures or which do not satisfactorily explain the interrelationship between the factors influencing the operator. The proposed model is developed in a fault tree and transformed into a Bayesian network up to the level of the basic elements. The results showed the qualitative model of the main tasks performed by the pilots and their relation to the accident. It has also been suggested how to find and estimate the probability of factors that can impact on each of the tasks

Evaluation of the patellar height in athletes with diagnosed with chronic tendinopathy of the knee extensor mechanism

OBJECTIVES: To carry out a radiographic evaluation of patellar height in athletes diagnosed with chronic tendinopathy of the knee extensor mechanism; METHODS: Radiographic assessments were carried out on 65 patients (110 knees) aged between 15 and 40 years, who practiced different kinds of sports, some with of chronic tendinopathy of the knee extensor mechanism (jumper's knee) and others without. The athletes were divided into two groups: those with diagnosed jumper's knee (group 1:38 athletes - 56 knees) and a control group (group 2:27 athletes - 54 knees). In group 1, 18 of the athletes presented the condition in both knees on examination. The height of the patella was measured using the Insall-Salvati and Blackburne-Peel x-ray methods. CONCLUSION: The presence of a high patella in the group of athletes with chronic tendinopathy of the knee extensor mechanism was significantly higher than in the control group.OBJETIVO: Avaliar radiograficamente a altura patelar de atletas com diagnóstico de tendinopatia crônica do aparelho extensor do joelho (TCAE). MÉTODOS: Na amostra foram avaliados radiograficamente 65 pacientes (110 joelhos) com idade entre 15 e 40 anos e de diferentes modalidades esportivas com e sem diagnóstico de tendinopatia crônica do aparelho extensor do joelho (jumper's knee). Os atletas foram divididos em dois grupos: aqueles com diagnóstico de TCAE (grupo 1: 38 atletas - 56 joelhos) e um grupo que denominamos de controle (grupo 2: 27 atletas - 54 joelhos). RESULTADOS: No grupo 1 tivemos 18 atletas que apresentavam a doença bilateralmente na ocasião dos exames. Para a medida da altura patelar utilizamos os índices radiográficos de Insall e Salvati e Blackburne e Peel. CONCLUSÃO: A presença de patela alta no grupo de atletas com tendinopatia crônica do aparelho extensor do joelho foi significante maior do que a observada no grupo controle.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Lean production associated with computer simulation: a systematic review in the healthcare

Lean manufacturing is currently one of the most widely used philosophies in the world. Prior to Lean, simulation emerged as an extremely powerful tool for analysis, comparison and learning. Despite the common objective, there are few records of joint studies. The objective of the present study is to perform a literature review and identify, which are the principles and tools of lean production used in the area of health care and the contributions of computer simulation, in the process of implementation and maintenance. The methodology used was the literature review and bibliometric analysis. The data were collected between the months of December 2020 and February 2021. At the end of the survey, 34 studies were classified for analysis. A relevant aspect is the identification of the role of simulation in the process of implementing and maintaining Lean. It is noticed that the joint contribution is greater than the isolated application, however, studies show that the application is restricted to one sector, in a greater proportion, emergency sectors. Among the most used tools is the flow mapping and the identification of value activities in the customer's view. Among the barriers identified, the lack of data or the need to collect information, in a preliminary way, related to the times, flow of care for patients or professionals, stands out. It is noted, a significant potential of this duet, however, the measurement of the results obtained after the application of the tools, seems to be a gap to be explored in the future

BRS Sarandi: A New Andropogon Gayanus Cultivar for Tropical Pastures

BRS Sarandi is adapted to low and medium fertility soils. It has a medium-high height, with a semi-erect growth habit and a high total number of tillers. The annual productivity of dry matter is 11 t ha-1, concentrated in the rainy season (90%). Of the total DM produced, 60% are leaves. The levels of crude protein (CP), in vitro dry matter digestibility (IVDMD), neutral detergent fiber (NDF) and acid detergent fiber (ADF) are, on average, 8.7, 56.5, 66.7 and 38.2%, respectively. . The average daily weight gain was 0.7 kg/head/day, the gain per was and 1.7 kg ha-1 day with no supplementation except for mineral salt. The weight gain per area (AG) reached 15 @/ha/year with an average stocking rate of 2.5 AU. BRS Sarandi was registered in the Brazilian Cultivar Registry (Registro Nacional de Cultivares - RNC/MAPA) and is protected in the National Cultivar Protection System (Sistema Nacional de Proteção de Cultivares - SNPC/MAPA)

Prevalence of Pain on Palpation of the Inferior Pole of the Patella Among Patients with Complaints of knee Pain

CONTEXT AND OBJECTIVE: Patellar tendinopathy is a common condition in sports. It may occur at any location of the patellar tendon, but the most commonly affected area is the inferior pole of the patella. Among various diagnostic tests, the one most used is palpation of the inferior pole of the patella. The aim of this study was to investigate the prevalence of pain complaints among individuals with pathological knee conditions and to evaluate palpation of the inferior pole of the patella as a diagnostic test for patellar tendinopathy. METHODS: Palpation of the patellar tendon was performed on 318 individuals who presented with knee-related complaints. Palpation was performed with the individual in the supine position and the knee extended. The age, gender, physical activity and labor activity of each individual were recorded at the time the symptoms appeared; the diagnosis was also recorded. RESULTS: Of the total number of individuals evaluated, 124 (39%) felt pain on palpation of the inferior pole of the patella. Of these, only 40 (32.3%) received a diagnosis of patellar tendinopathy. We did not observe any difference with respect to gender and age distribution. When evaluating daily physical activity levels, however, we observed that individuals with pain on palpation of the inferior pole of the patella experienced more intense physical activity. CONCLUSIONS: Palpation of the inferior pole of the patella is a diagnostic procedure with high sensitivity and moderate specificity for diagnosing patellar tendinopathy, especially among individuals who perform activities with high functional demands