O papel da atenção primária na rede de atenção à saúde frente ao manejo da hanseníase: um estudo transversal

The objective was to analyze the clinical epidemiological profile of lerposy cases and associate this profile with primary health care from the perspective of health care networks. This is a cross-sectional study that covered three analytical stages: knowledge of the epidemiological profile; classification of the capacity of the APS to coordinate the RAS; correlation of this classification with the number of new cases, outcome and the Degree of Physical Disability (GIF), and correlation of the number of new cases and the average coverage of PHC, using the Pearson correlation coefficient. New cases of leprosy reported in the period 2014 to 2018 were considered. Of the 1,649 new cases, 63% were women, between 15 and 59 years (83%), with up to nine years of education (47%) and black (61% ). Healing accounted for 86% of the records. Predominance of GIF 0 in the diagnosis (58%) and absence of evaluation in the outcome (16%). All UBS were classified as 'good condition' in the RAS coordination. Dropout showed a 'moderate correlation' with the PHC's ability to coordinate the RAS and the mean PHC coverage with the number of cases indicated a 'very high' correlation. APS, from the perspective of RAS, proved to be effective in controlling and managing leprosy in the municipal territory.Objetivou-se analisar o perfil demográfico e clínico dos casos de hanseníase e associar os fatores relacionadas às incapacidades físicas com a Atenção Primária à Saúde (APS) na perspectiva de Redes de Atenção à Saúde em Sinop, Mato Grosso. Trata-se de um estudo transversal, que percorreu três etapas analíticas: conhecimento do perfil epidemiológico; classificação da capacidade da Atenção Primária em coordenar as Redes de Atenção à Saúde; correlação dessa classificação com o número de casos novos, desfecho e o Grau de Incapacidade Física e correlação do número de casos novos e a média de cobertura da Atenção Primária por meio do coeficiente de correlação de Pearson. Foram considerados os casos novos de hanseníase notificados no período de 2014 a 2018. Dos 1.649 casos novos, 63% foram mulheres, entre 15 e 59 anos (83%), com até nove anos de estudo (47%), e negros (61%). Cura respondeu por 86% dos registros. Predomínio de Grau de incapacidade física 0 no diagnóstico (58%) e ausência de avaliação no desfecho (17,1%). Todas as Atenção Primária à Saúde foram classificadas como ‘condição boa’ na coordenação das Redes de Atenção. O abandono apresentou ‘correlação moderada’ com a capacidade da Atenção Primária em coordenar as Redes de Atenção e a média de cobertura da Atenção Primária com o número de casos indicou correlação ‘muito alta’. A Atenção Primária, na perspectiva da Rede de Atenção, se mostrou efetiva no controle e na condução da hanseníase no território municipal.

Anti-inflammatory and antinociceptive activities of Campomanesia adamantium.

Ethnopharmacological relevance: Campomanesia species are used in folk medicine as anti-in?ammatory, anti-rheumatic, anti-diarrheal and hypocholesterolemic. Aim of the study: The present study investigated the in vivo anti-in?ammatory and antinociceptive properties of ethyl acetate (AE) and aqueous (Aq) extracts from leaves of Campomanesia adamantium and in vitro anti-in?ammatory activity of AE and its isolated ?avonols, myricitrin and myricetin. Materials and methods: The antinociceptive activity of AE and Aq was evaluated using acetic acid- induced writhing and formalin methods. The in vivo anti-in?ammatory effect of AE and Aq was evaluated using carrageenan-induced paw oedema in mice. AE, myricitrin and myricetin were evaluated for their abilities to modulate the production of NO, TNF-a and IL-10 in LPS/IFN-g stimulated J774.A1 macrophages. Results: It was found that orally administrated AE and Aq (125 and 250 mg/kg) inhibited carrageenan- induced paw oedema in mice. AE (125 and 250 mg/kg) and Aq (125 mg/kg) reduced the time to licking at the second phase of the formalin method in vivo in mice. AE (250 mg/kg) and Aq (125 mg/kg) also reduced the number of writhes. AE, myricitrin and myricetin inhibited NO (320 mg/mL and 6.25?100 mM, respectively) and TNF-a production by macrophages (320 mg/mL for AE, 100 mM for myricitrin and 25?100 mM for myricetin). AE (160 and 320 mg/mL), myricitrin (50 and 100 mM) and myricetin (25?100 mM) increased IL-10 production by macrophages. Conclusions: The ethyl acetate and aqueous extracts from Campomanesia adamantium showed anti- nociceptive and anti-in?ammatory effects supporting the use of the plant in folk medicine. The results suggest that anti-oedematogenic effect promoted by aqueous extract involves several anti- in?ammatory mechanisms of action. The antinociceptive effect shown by aqueous extract can be due to the modulation of release of in?ammatory mediators involved in nociception. The anti-in?ammatory effects of AE and of its isolated ?avonols may be attributed to inhibition of pro-in?ammatory cytokines production, TNF-a and NO and to the increased of IL-10 production

estudos artísticos

A revista Gama parece agir como um revelador de imagens latentes: a sua ação é uma ativação social, sempre de reforço simbólico, que permite auxiliar a discernir, e a identificar, aquilo a que todos chamamos de arte. É um projeto de legitimação apoiado nos criadores: que sejam os artistas a apontar os caminhos da arte, onde eles se escondem, onde ela pode passar a ser. Como em Espinosa, na ‘Ética,’ a arte pode ser uma ‘qualia’ de uma substância potente, que ao ser percebida e reconhecida, nas páginas do número 14 da revista Gama, nos seus 16 artigos, se percebe como coisa, ocorrência valiosa, ou melhor, ‘valente.’info:eu-repo/semantics/publishedVersio

Guillain-Barré syndrome during the Zika virus outbreak in Northeast Brazil: An observational cohort study

Objective: To determine the clinical phenotype of Guillain-Barré syndrome (GBS) after Zika virus (ZIKV) infection, the anti-glycolipid antibody signature, and the role of other circulating arthropod-borne viruses, we describe a cohort of GBS patients identified during ZIKV and chikungunya virus (CHIKV) outbreaks in Northeast Brazil. Methods: We prospectively recruited GBS patients from a regional neurology center in Northeast Brazil between December 2014 and February 2017. Serum and CSF were tested for ZIKV, CHIKV, and dengue virus (DENV), by RT-PCR and antibodies, and serum was tested for GBS-associated antibodies to glycolipids. Results: Seventy-one patients were identified. Forty-eight (68%) had laboratory evidence of a recent arbovirus infection; 25 (52%) ZIKV, 8 (17%) CHIKV, 1 (2%) DENV, and 14 (29%) ZIKV and CHIKV. Most patients with a recent arbovirus infection had motor and sensory symptoms (72%), a demyelinating electrophysiological subtype (67%) and a facial palsy (58%). Patients with a recent infection with ZIKV and CHIKV had a longer hospital admission and more frequent mechanical ventilation compared to the other patients. No specific anti-glycolipid antibody signature was identified in association with arbovirus infection, although significant antibody titres to GM1, GalC, LM1, and GalNAc-GD1a were found infrequently. Conclusion: A large proportion of cases had laboratory evidence of a recent infection with ZIKV or CHIKV, and recent infection with both viruses was found in almost one third of patients. Most patients with a recent arbovirus infection had a sensorimotor, demyelinating GBS. We did not find a specific anti-glycolipid antibody signature in association with arbovirus-related GBS

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Tools used for evaluation of Brazilian children's quality of life

OBJECTIVE:To review the available tools to evaluate children's quality of life validated for Brazilian language and culture.DATA SOURCES: Search of scientific articles in Medline, Lilacs and SciELO databases using the combination of descriptors "quality of life", "child" and "questionnaires" in Portuguese and English.DATA SYNTHESIS: Among the tools designed to assess children's quality of life validated for the Brazilian language and culture, the Auto questionnaire Qualité de Vie Enfant Imagé (AUQEI), the Child Health Questionnaire - Parent Form 50 (CHQ-PF50), the Pediatric Quality of Life Inventory (PedsQL(tm))version 4.0 and the Kidscreen-52 are highlighted. Some tools do not include all range of ages and some lack domains that are currently considered relevant in the context of childhood, such as bullying. Moreover, due to the cultural diversity of Brazil, it may be necessary to adapt some instruments or to validate other tools.CONCLUSIONS: There are validated instruments to evaluate children's quality of life in Brazil. However, the validation or the adaptation of other international tools have to be considered in order to overcome current deficiencie