Inflammatory cytokines in leprosy reactions and periodontal diseases

The inflammatory cytokines involved in the immune response to chronic periodontal disease (CPD) in the context of leprosy reactions (LR) were analyzed in 57 new cases of multibacillary leprosy (MBL). They were stratified by the presence of CPD and LR. Messenger RNA (mRNA) expression of inflammatory mediators was determined by qRT-PCR using skin biopsy and by ELISA using serum samples, maintaining 5% of significance level in ANOVA and correlation analyses. Twenty-three (40.4%) patients presented the first LR, whereas 22 (45.0%) patients presented CPD. IL-4 and IL-6 serum levels were significantly lower in patients with CPD and LR than in patients without CPD but with LR; IFN-γ serum levels were higher in patients with CPD and LR than in patients with no CPD and no LR; IL-4 serum levels were negatively correlated with TNF-α gene expression, while IL-6 serum levels were positively correlated with IFN-γ gene expression, in the skin of subjects with CPD and LR. The presence of DPC in individuals with LR immunoregulated IL-6, IFN-γ, and IL-4 concentrations. The presence of DPC decreased serum levels of IL-6 and IL-4 in reactional individuals. CPD concomitant to LR resulted in increased IFN-γ serum levels

Regulatory T cells in the actinic cheilitis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/109303/1/jop12207.pd

A influência do hiperdia no controle da hipertensão e do índice glicêmico: discussão acerca da saúde de idosos de uma comunidade de Maceió / The influence of hyperdia in the control of hypertension and the glycemic index: discussion about the health of elderly people in a community of Maceió

Hipertensão Arterial Sistêmica (HAS) e Diabetes Mellitus (DM) são as doenças crônicas que mais acometem a população brasileira, segundo pesquisa da Vigilância de Fatores de Risco e Proteção para Doenças Crônicas (VIGITEL) em 2019. Tais patologias estão muito associadas a Doenças cardiovasculares e suas complicações, especialmente em idosos, tais como AVC, infarto, doença renal e alteração vascular periférica. O tratamento dessas complicações onera de maneira significativa o Sistema Único de Saúde (SUS). Dessa forma, a portaria GM/MS 235 de 20 de fevereiro de 2001 instituiu o Plano de Reorganização da Atenção à Hipertensão Arterial e Diabetes Mellitus (Hiperdia) com o objetivo de reduzir fatores de risco para doenças cardiovasculares através do controle dessas doenças. Diante disso, destaca-se a necessidade de trabalhos que enalteçam a importância desse programa, bem como estimulem a sua fiel execução. Tendo em vista esse objetivo, o presente trabalho buscou promover saúde orientando uma comunidade em Maceió/AL sobre as complicações dessas doenças, como evitá-las ou reduzir seus danos e agravos. Para isso utilizou-se de um ambiente receptivo com café da manhã próprio para esse grupo, palestras, aferição de glicemia e pressão arterial. Como resultado dessa ação, observou-se idosos aderentes e não aderentes ao tratamento, que, após as palestras, tornaram-se conscientes da importância do acompanhamento regular e mudança de hábitos de vida. Neste sentido, foi evidenciada a relevância do programa Hiperdia no cuidado desses idosos

Prática mental da escovação dental em pessoas com Parkinson: estudo clínico randomizado / Mental practice of tooth brushing in people with Parkinsonism: randomized clinical trial

A Prática Mental (PM) é uma técnica que associa a execução motora ao imaginar somatossensorial da ação. Este estudo comparou a presença do biofilme microbiano antes e após 8 semanas de treinos de PM da escovação dental em pessoas com doença de Parkinson (DP), através do índice de O’Leary. A amostra foi composta por 32 pessoas com DP, de ambos os sexos, com idade entre 40 e 80 anos, classificados nos estágios I a III da doença. Esses foram divididos em dois grupos experimentais: Grupo Intervenção (GI) – 17 pessoas que realizaram a orientação à escovação associada à PM, e o Grupo Controle (GC) – 15 pessoas que receberam apenas orientação à escovação.  Os dados foram avaliados através de ANOVA fatorial 2x2 e post hoc Teste de Tukey considerando p<0,05. Observou-se que após a intervenção ocorreu uma melhora significativa do índice de O’Leary final quando comparado ao inicial (p= 0,0008) intragrupo, porém, não foram verificadas diferenças significativas intergrupo. Diante dos resultados obtidos, verificamos que a PM pode ser um método auxiliar da higienização oral de pessoas com DP, pois permitiu a redução e um melhor controle do biofilme microbiano oral

PACIENTES GERIÁTRICOS: PERSPECTIVA GERAL SOBRE A COORDENAÇÃO DE CUIDADOS CONTÍNUOS E INTEGRADOS

One of the achievements of humanity was the extension of life span. Reaching old age was previously a privilege for a few and today it has become common even in poor countries, however, the aging of the population is not enough in itself, it is necessary that the increase in life expectancy is also associated with quality and comfort for old age. In addition to a greater occurrence of diseases, the elderly population can also face social, cognitive and functional problems, therefore, their need for health care is greater and they end up using a disproportionate amount of health resources. Bearing this in mind, the objective of this work is to analyze and identify the best strategies to effectively care for elderly patients from the point of view of the coordination of geriatric continuing care, carrying out an in-depth study based on the indicators of the Cuidar program, which currently receives 16010 patients, with an average age of 75 years, who are assisted by nurses who monitor their evolution. With this analysis, the aim is to map the situation of the elderly in the country and the scientific progress in this area, aiming to contribute to the advancement of the discussion about the model and its consolidation in supplementary health.Uma das conquistas da humanidade foi a ampliação do tempo de vida. Chegar à velhice antes era um privilégio para poucos e hoje passou a ser comum mesmo em países carentes, no entanto, o envelhecimento da população não basta por si só, é necessário que o aumento da expectativa de vida esteja associado também à qualidade e conforto para a velhice. Além de uma maior ocorrência de doenças, a população idosa também pode enfrentar problemas sociais, cognitivos e funcionais, por isso, sua necessidade de assistência à saúde é maior e acabam utilizando uma quantidade desproporcional de recursos de saúde. Tendo isso em mente, objetiva-se neste trabalho  analisar e identificar as melhores estratégias para atender de forma eficaz os pacientes idosos a partir do olhar da coordenação de cuidados continuados geriátricos, realizando um estudo aprofundado com base nos indicadores do programa Cuidar+, que atualmente recebe 16010 pacientes, com média de 75 anos de idade, que são assistidos por enfermeiros que acompanham sua evolução. Com esta análise busca-se como resultado o mapeamento da situação do idoso no país e do avanço científico nesta área, visando contribuir para o avanço da discussão sobre o modelo e sua consolidação na saúde suplementar

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt