Common mental disorders associated with tuberculosis: a matched case-control study.

INTRODUCTION: Despite the availability of treatment and a vaccine, tuberculosis continues to be a public health problem worldwide. Mental disorders might contribute to the burden of the disease. OBJECTIVE: The objective of this study was to investigate the association between common mental disorders and tuberculosis. METHODS: A matched case-control study was conducted. The study population included symptomatic respiratory patients who attended three referral hospitals and six community clinics in the city of Salvador, Brazil. A doctor's diagnosis defined potential cases and controls. Cases were newly diagnosed tuberculosis cases, and controls were symptomatic respiratory patients for whom tuberculosis was excluded as a diagnosis by the attending physician. Cases and controls were ascertained in the same clinic. Data collection occurred between August 2008 and April 2010. The study instruments included a structured interview, a self-reporting questionnaire for the identification of common mental disorders, and a questionnaire for alcoholism. An univariate analysis included descriptive procedures (with chi-square statistics), and a multivariate analysis used conditional logistic regression. RESULTS: The mean age of the cases was 38 years, and 61% of the cases were males. After adjusting for potential confounders, the odds of tuberculosis were significantly higher in patients diagnosed with a common mental disorder (OR: 1.34; 95% CI 1.05-1.70). CONCLUSION: There appears to be a positive and independent association between common mental disorders and tuberculosis; further epidemiological studies are required to increase our understanding of the possible biological and social mechanisms responsible for this association. Independent of the direction of the association, this finding has implications for the provision of care for mental disorders and for tuberculosis

Electromyographic analysis of the masseter and temporalis muscles and bite force in a patient treated by functional maxillary orthopedics: a case report

This case report evaluated electromyographic activity of the masseter and temporalis muscles and molar bite force, before and after with functional orthopedic. A 65 years woman presenting with orofacial pain symptoms, cervical tension, condyle subluxation and osteoarthrosis. The patient was diagnosed with temporomandibular dysfunction and treated with use of a Simões Network 9 modified type functional maxillary orthopedics appliance. The Myosystem BR1 apparatus was used to analyze the electromyographic activity of the masseter and temporalis muscles. The maximum molar bite force was measured with the digital dynamometer (Kratus). This study showed increased EMG activity of the masseter and temporalis muscles in postural conditions of mandible and molar bite force after 12 months of treatment. After twelve months of treatment, the patient had lack of pain symptoms as well as an improvement in the balance of the mastication muscles, as demonstrated by EMG activity and maximum molar bite force

Clinical evidence and diagnosis of temporal arteritis: a concise systematic review

Introduction: Temporal arteritis (TA), or giant cell arteritis, is a systemic autoimmune vasculitis that affects patients over 50 years of age. Temporal artery biopsy is considered the gold standard for diagnosis, although it has low sensitivity. It was shown that TA can lead to irreversible blindness in about 20% of untreated cases. Objective: A concise systematic review was carried out to contribute to the diagnosis and treatment of temporal arteritis, assessing whether a series of patients met the clinical and laboratory criteria for diagnosis, regardless of the biopsy result, as well as whether these results alter the management of these patients. Methods: The research was carried out from December 2022 to January 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, following the PRISMA rules for systematic review. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 140 articles were found, and a total of 32 articles were evaluated and 6 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies with a high risk of bias and 43 studies that did not meet GRADE. It was concluded that, regardless of the biopsy result, all patients should immediately start treatment with corticosteroids. Early diagnosis and treatment must be performed to avoid compromising the contralateral eye. In addition, it is necessary to perform other diagnostic imaging tools to increase the sensitivity and closure of the diagnosis of temporal arteritis

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Introduction: In the setting of corneal ectasias, keratoconus (KC) is a bilateral and asymmetrical disease that results in progressive thinning and tilting of the cornea, leading to irregular astigmatism and decreased visual acuity. The condition affects all ethnicities and both sexes. KC prevalence and incidence rates are close to between 0.2 and 4790 per 100,000 people and 1.5 and 25 cases per 100,000 person-years, respectively. For surgeons who implant Ferrara rings, the manufacturer has developed an online nomogram aimed at optimizing patient outcomes. Objective: The present study carried out a systematic review to present the main clinical outcomes of keratoconus treatment using the Ferrara ring. Methods: The systematic review rules of the PRISMA Platform were followed. The literature search was carried out from January to February 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 15 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 60 articles were found, of which only 21 were part of this systematic review, after an eligibility analysis.It was concluded that the insertion of Ferrara rings in keratoconic eyes with previous cross-linking history using the company's nomogram results in significant improvements in visual, refractive, and tomographic results. Corneal densitometry in the anterior layer of the cornea decreases after the implantation of intrastromal corneal ring segments and correlates with corneal keratometry. Over 5 years, Ferrara-type intrastromal corneal ring segment implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus old

Ferrara ring and the nomogram as the main strategy for correcting keratoconus: a systematic review of clinical findings

Introduction: In the setting of corneal ectasias, keratoconus (KC) is a bilateral and asymmetrical disease that results in progressive thinning and tilting of the cornea, leading to irregular astigmatism and decreased visual acuity. The condition affects all ethnicities and both sexes. KC prevalence and incidence rates are close to between 0.2 and 4790 per 100,000 people and 1.5 and 25 cases per 100,000 person-years, respectively. For surgeons who implant Ferrara rings, the manufacturer has developed an online nomogram aimed at optimizing patient outcomes. Objective: The present study carried out a systematic review to present the main clinical outcomes of keratoconus treatment using the Ferrara ring. Methods: The systematic review rules of the PRISMA Platform were followed. The literature search was carried out from January to February 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. Scientific articles from the last 15 years were selected. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 60 articles were found, of which only 21 were part of this systematic review, after an eligibility analysis.It was concluded that the insertion of Ferrara rings in keratoconic eyes with previous cross-linking history using the company's nomogram results in significant improvements in visual, refractive, and tomographic results. Corneal densitometry in the anterior layer of the cornea decreases after the implantation of intrastromal corneal ring segments and correlates with corneal keratometry. Over 5 years, Ferrara-type intrastromal corneal ring segment implantation is a safe, effective, and stable procedure for restoring vision in pediatric patients with keratoconus old

Efeitos Psicológicos Da Mastectomia Nas Mulheres

RESUMO: Órgão de amamentação e símbolo da feminilidade, os seios representam, ao mesmo tempo, fonte de vida, expressão da maternidade e de fertilidade, além do erotismo e de emancipação feminina. Porém, quando esse órgão adoece, surge um sentimento que afeta a autoestima da mulher. Uma das mais prevalentes doenças que acomete essa região é o câncer de mama que, dependendo do seu estadiamento, pode gerar a necessidade de retirada da mama. Este trabalho consiste em uma revisão bibliográfica que tem como objetivo analisar os impactos psicológicos envolvidos no póscirúrgico da mastectomia e relacioná-los aos aspectos familiar, religioso e individual da vida da mulher. Para isso, foram selecionados artigos, publicados por meio da plataforma BVS (Biblioteca Virtual em Saúde), com uso dos seguintes descritores: câncer de mama, mastectomia e psicológico. Além da sensação de perda de um órgão tão significante na vida da mulher, a cirurgia causa danos à funcionalidade do braço do lado afetado que impossibilita atividades simples e da rotina, aumentando ainda mais o impacto emocional. Tal impacto também está relacionado à rede de apoio a qual essa mulher pertence, à idade, à escolaridade, ao tempo decorrente ao pós-cirúrgico, à religiosidade,entre outros. Além das orientações e auxílios pré-operatórios, os apoios multiprofissional, familiar e religioso são de fundamental importância para recuperação e manutenção da qualidade de vida da mulher. É essencial que os profissionais de saúde lidem não somente com a questão física da doença, mas também entendam sobre a necessidade de amparo psicológico à mulhe

AVALIAÇÃO MICROBIOLÓGICA DE HORTALIÇAS E FRUTAS MINIMAMENTE PROCESSADAS COMERCIALIZADAS EM FORTALEZA (CE)

Avaliou-se a qualidade microbiológica de 15 amostras de hortaliças/tubérculos e de 15 amostras de frutas minimamente processadas, comercializadas em Fortaleza (CE). Foram realizadas análises de coliformes fecais e totais, pesquisa de Salmonella sp., contagem total de bolores e leveduras, contagem de Staphylococcus coagulase positiva e contagem total de psicrotróficos. Detectou-se a presença de Salmonella em 66,6% das amostras de hortaliças/tubérculos e em 26% das de frutas. Foi verificado que 13,3% das amostras de hortaliças/ tubérculos apresentaram contagem de coliformes fecais acima do limite estabelecido pela legislação brasileira. Contagens elevadas de coliformes totais, de bolores e leveduras e de psicrotróficos também foram encontradas em ambos os produtos, indicando condições inadequadas de higiene durante o processamento, comprometendo seu armazenamento e sua qualidade microbiológica. MICROBIOLOGICAL EVALUATION OF VEGETABLES AND FRUITS MINIMALLY PROCESSED MARKETED IN FORTALEZA (CE) Abstract The microbiological quality of 15 vegetables and 15 fruits minimally processed samples marketed in Fortaleza - CE (Brazil) was evaluated. The following analyses were carried out: total and fecal coliforms, Salmonella sp., total yeasts and moulds count, coagulase positive Staphylococcus count and total psychrotrophics count. Salmonella was detected in 66.6% of vegetable samples and 26% of fruit samples. Fecal coliforms count higher than legislation limit, it was verified in 13.3% of vegetable samples. High counts of total coliforms, yeasts and moulds and psychrotrophics were also found on both products, showing inadequate hygiene conditions during manufacturing, affecting storage and microbiological quality of minimally processed fruits and vegetables

Severe form of lymphocutaneous sporotrichosis: a case report

Sporotrichosis is the most frequent subcutaneous mycosis in Latin America. It is caused by species of the genus Sporothrix. Infection in humans occurs through the entry of the fungus into the skin. Zoonotic outbreaks involving cats in the transmission of the disease have been frequently reported. The lymphocutaneous form is the most commonly observed and the upper limbs are the most affected sites. We report a case of a 64-year-old healthy female patient with a lymphocutaneous form with rapid progression of lesions, which was refractory to initial treatment with itraconazole. Treatment with liposomal amphotericin B was performed with a satisfactory resolution, but aesthetic and functional sequelae in the left upper limb were installed

Apendicite aguda: aspectos gerais acerca da abordagem diagnóstica e cirúrgica / Acute appendicitis: general aspects about the diagnostic and surgical approach

A apendicite aguda (AA) é definida como a inflamação do apêndice vermiforme, órgão que exerce a função imunoprotetora. Quanto à etiologia, a causa envolvida na gênese da doença, é a obstrução do lúmen do apêndice por fecalitos, corpos estranhos, hiperplasia linfóide, parasitas ou tumores. Sua identificação depende de uma anamnese minuciosa, um exame físico bem detalhado e exames complementares. No que tange ao diagnóstico clínico, existem sinais semiológicos com grande acurácia para identificação da patologia, dos quais podemos mencionar os principais, como o Sinal de Blumberg e o Sinal de Rovsing. Para auxílio diagnóstico, lança-se mão da investigação laboratorial (concentração de proteína C reativa, o hemograma e a urina tipo I), e da investigação imagiológica, com a ultrassonografia, tomografia computadorizada e a ressonância nuclear magnética. Já a abordagem terapêutica, apresenta-se conservadora e cirúrgica, na qual a cirúrgica é dividida em apendicectomia por laparotomia, por laparoscopia (padrão multi-incisão), cirurgia endoscópica transluminal de orifício natural e a cirurgia laparoscópica de incisão única. A abordagem cirúrgica por videolaparoscopia é, atualmente, a mais indicada para o tratamento da AA, devido às suas vantagens quanto menor tempo de recuperação, redução das infecções do sítio cirúrgico e dor no pós-operatório. Apesar da abordagem videolaparoscópica promover um melhor prognóstico, as complicações ainda são presentes, principalmente em casos de AA complicada, sendo que as mais comuns são representadas por aderências pós-cirúrgicas e abscesso da parede abdominal

ADUBAÇÃO NITROGENADA E USO DE REGULADOR DE CRESCIMENTO NA PRODUÇÃO DE TRIGO DE SEQUEIRO

A adubação nitrogenada é uma importante prática de manejo em gramíneas e bastante complexa, em função dos diversos fatores que influenciam, como condições climáticas, sistemas de cultivo, doses e fontes disponíveis. Objetivou-se com o trabalho, avaliar diferentes doses de nitrogênio em cobertura e o efeito do regulador de crescimento etil trinexapac no trigo (Triticum aestivum L.). O experimento foi em blocos casualizados em esquema fatorial 5x2, com 4 repetições. Os tratamentos foram compostos por cinco doses de nitrogênio aplicado em cobertura (0, 20, 40, 80 e 160 kg ha-1 de N) e duas doses do etil trinexapac (0 e 100 g ha-1 do ingrediente ativo) na cultura do trigo. Foram avaliadas: Massa de matéria seca, altura de planta, altura da folha bandeira, altura de inserção de espiga, distância fonte e dreno, comprimento de espiga, número de espigas por metro quadrado, número de espiguetas por espiga, fertilidade das espiguetas, número de grãos por espiga, número de grãos por espigueta, massa de mil grãos, produtividade de grãos), peso hectolitro e proteína dos grãos. O regulador de crescimento altera os componentes morfológicos do trigo, porém não altera os componentes produtivos e a produtividade de grãos, não justificando seu uso nas condições em que ocorreu o estudo. A adubação nitrogenada não altera os componentes morfológicos das plantas do trigo, mas aumenta o número de espigas por m2 (afilhos) até dose de 52 kg ha-1 de N, refletindo no aumento da produtividade até a dose de 59 kg ha-1