Leprosy: clinical and epidemiological study in patients above 60 years in Espírito Santo State - Brazil

Abstract: Background: Leprosy is a chronic infectious disease that is endemic in Brazil and little studied in patients over 60 years old. Objective: The aim of this study was the epidemiological and clinical description of cases of leprosy in individuals older than 60 years, notified in the State of Espírito Santo - Brazil. Methods: It was an observational, descriptive and retrospective study of leprosy patients notified between 2001 and 2011. Results: Out of 16,025 notifications, 2,510 (15.6%) were of patients over 60 years of age; the distribution among the period was egalitarian except in the last 2 years, when there was a mild reduction of cases; the average was 70 years of age (±7 years); 46% were women, being 62% of those paucibacillary cases; 1,145 (50.5%) were dark-skined people in particular among paucibacillary cases; 1,638 (72.9%) were illiterates or poorly instructed n particular among multibacillary cases (P=0.022); 59.9% patients were clinically multibacillary cases and 37.4% had positive bacilloscopy; 37.9% patients had clinical alterations on peripheral nerves, 36.7% of all the multibacillary cases were classified as grade I and 15.3% as grade in assessment of disability. Study limitations: This was a retrospective study, which used secondary data generated by physicians and notified by other professionals, whar could have enabled possible errors on original data. Conclusions: Leprosy in this age group suggests a long incubation period with reactivation of latent focus or late infection. Men were more affected, as well as the afro descendent race was statistically significant in the paucibacillary cases (P=0.000) and illiterate/poor education in multibacillary cases (P=0.022). Nearly 40% of patients had positive bacilloscopy and grade I/II disability, demonstrating a late diagnosis.

Aplicação da classificação internacional de funcionalidade, incapacidade e saúde em Unidade de Terapia Intensiva Cardiotorácica / Application of the international classification of functioning, disability and health in Cardiothoracic Intensive Care Unit

Objetivos: Codificar, através da Classificação Internacional de Funcionalidade (CIF), o estado de saúde dos pacientes internados em Unidade de Terapia Intensiva (UTI) cardiotorácica e comparar a codificação da mobilidade destes na admissão e na alta da unidade. Métodos: Foi realizado um estudo observacional longitudinal descritivo, na UTI Cardiotorácica adulta, no segundo dia de internação e no dia da alta. Os dados foram coletados por meio de uma ficha de internação e de um checklist cardiológico da CIF. Resultados: Amostra composta por 43 pacientes, idade média de 50,58 ± 17,24 anos, com internação média de 3,42 ± 4,24 dias. Na codificação relacionada a transferência e locomoção, feita na avaliação e alta, observou-se resultados estatisticamente significantes (p < 0,001) para todas as variáveis analisadas. Conclusão: A CIF demonstrou grande capacidade de padronizar a linguagem entre os profissionais na UTI além de quantificar a evolução dos pacientes. (AU)

Objectives: To codify, using the International Classification of Functioning (ICF), the health status of patients hospitalized in the Cardiothoracic Intensive Care Unit (ICU) and compare the encoding of these mobility at admission and at discharge from the unit. Methods: A descriptive longitudinal study was performed in adult Cardiothoracic ICU on the second day of admission and day of discharge. Data were collected through a hospitalization form and a cardiology checklist of CIF. Results: A sample of 43 patients, 50.58 ± 17.24 years old, with an average hospital stay of 3.42 ± 4.24 days. We noticed that, in coding related to transfer and locomotion, made in the assessment and discharge, there was a statistically significant result (p < 0.001) for all variables. Conclusion: The ICF has shown great ability to standardize the language among professionals in the ICU as well as quantify the evolution of intensive care unit patients.(AU)

Eco-epidemiologic study of emerging fungi related to the work of babacu coconut breakers in the State of Maranhao, Brazil

Introduction: There are more than 300,000 extractors using the babaçu coconut as a source of income in the States of Maranhão, Pará, Tocantins and Piauí, and this activity is associated with fungal infections. The objective of this study was to examine the occurrence of emergent fungi in the conjunctiva, nails and surface and subcutaneous injuries of female coconut breakers in Esperantinópolis, Maranhão. Additionally, soil samples and palm structures were collected. Methods: The obtained samples were cultured in Petri dishes containing potato-dextrose-agar and chloramphenicol. The etiological agent was confirmed by a direct mycological exam and growth in culture. Results: In total, 150 domiciles were visited, and samples were collected from 80 patients. From the ground, the most frequently isolated fungus was Aspergillus niger (53. 8%). the most frequently detected fungus in babaçu coconut was Aspergillus niger (66.7%). Conjunctival fungal growth occurred in 76.3% of the women. The ocular fungal microbiota consisted of filamentous fungi (80.6%), and yeasts were present in 19.4% of cases. Onychomycosis was diagnosed in 44% (11/25) of the women. Conclusions: The identification of the genera Neosartorya, Rhizopus and Curvularia in onychomycoses shows that emergent filamentous fungi can be isolated. Aspergillus sp., Penicillium sp. and Scedosporium sp. were the predominant genera found in the babaçu coconut. From ocular conjunctiva, Candida spp. were the most prevalent species isolated, and Fusarium sp. was present only in one woman. The nearly permanent exposure of coconut breakers to the external environment and to the soil is most likely the reason for the existence of a mycotic flora and fungal infections, varying according to the individual's practices and occupation. .

Pain, masticatory performance and swallowing threshold in orthodontic patients

OBJECTIVE: The aim of this study was to assess pain, masticatory performance and swallowing threshold of patients undergoing orthodontic treatment. METHODS: Ten patients of both genders (mean age of 17.25 ± 5.21 years), with complete permanent dentition, who underwent orthodontic treatment with fixed appliances were evaluated. The masticatory performance and the swallowing threshold were assessed by patient's individual capacity of fragmenting an artificial test food (Optocal) which was chewed and had the resulting particles processed by a standardized sieving method, presenting the median particle size (MPS) of crushed units. The intensity of pain / discomfort during chewing was evaluated by means of a visual analog scale. All tests were performed at the following times: T0 - before activating the orthodontic appliance; T1 - 24 hours after activation, and T2 - 30 days after activation. RESULTS: The results showed a significant increase in pain at T1 (T0 - 0.60 ± 0.70 mm; T1 - 66.2 ± 34.5 mm), returning to baseline values at T2 (3.20 ± 3.82 mm). Masticatory performance was also reduced in T1 (MPS 10.15 ± 1.1 mm²) in comparison to T0 (MPS 7.01 ± 2.9 mm²) and T2 (MPS 6.76 ± 1.3 mm²). However, particle size was not affected in the swallowing threshold test (T0 - 5.47 ± 2.37 mm²; T1 - 6.19 ± 2.05 mm²; T2 - 5.94 ± 2.36 mm²). CONCLUSION: The orthodontic appliances did not interfere in the size of the particles that would be swallowed, even in the presence of pain.

OBJETIVO: o objetivo desse estudo foi avaliar a dor, a performance mastigatória e o limiar de deglutição em pacientes submetidos ao tratamento ortodôntico. MÉTODOS: foram avaliados dez pacientes de ambos os sexos (idade média 17,25 ± 5,21 anos), com dentição permanente completa, submetidos ao tratamento ortodôntico com aparelhos fixos. A performance mastigatória e o limiar de deglutição foram avaliados pela capacidade individual de fragmentação de um alimento teste artificial (Optocal), o qual foi mastigado e as partículas resultantes processadas por um método padronizado com peneiras, apresentando o tamanho mediano das partículas (TMP) das unidades trituradas. A intensidade da dor/desconforto foi avaliada com o uso de uma escala analógica visual. Todos os testes foram realizados nos seguintes momentos: T0: antes da ativação do aparelho ortodôntico; T1: 24 após a ativação, e T2: 30 dias após a ativação. RESULTADOS: os resultados demonstraram um aumento significativo na dor em T1 (T0: 0,60 ± 0,70mm; T1: 66,2 ± 34,5mm), retornando aos valores basais em T2 (3,20 ± 3,82mm). A performance mastigatória também foi reduzida em T1 (TMP: 10,15 ± 1,1mm²) comparada a T0 (TMP: 7,01 ± 2,9mm²) e T2 (TMP = 6,76 ± 1,3 mm²). Entretanto, o tamanho das partículas não foi afetado no teste do limiar de deglutição (T0: 5,47 ± 2,37mm²; T1: 6,19 ± 2,05mm²; T2: 5,94 ± 2,36mm²). CONCLUSÃO: os aparelhos ortodônticos não interferiram no tamanho das partículas que seriam deglutidas, mesmo na presença da dor.

Compostos bioativos e potencial antioxidante do pólen apícola produzido por abelhas africanizadas (Apis mellifera L) / Bioactive compounds contents and antioxidant potential of bee pollen produced by africanized bees (Apis mellifera L)

A concentração de compostos bioativos e a atividade antioxidante do pólen apícola podem variar em função da origem botânica. Trinta e três amostras de pólen apícola da região de Alagoinhas-BA foram analisadas quanto aos teores de compostos fenólicos, flavonoides, carotenoides e atividade antioxidante e, também, foi avaliada a correlação dos compostos bioativos com os tipos polínicos Mimosa pudica e Eucalyptus. O teor dos compostos fenólicos e sua fração de flavonoides nas amostras com ocorrência de Mimosa pudica variaram, respectivamente, de 14,31 a 64,14mg em GAE.g-1 de pólen e de 0,72 a 1,99mg e, nas amostras com ocorrência de Eucalyptus variaram, respectivamente, de 26,48 a 132,38mg em GAE.g-1 de pólen e de 1,55 a 2,5mg. O teor de carotenoides totais variou de 18,16 a 764,37µg.g-1 para o tipo polínico Mimosa pudica e de 3,01 a 46,08µg.g-1 para o tipo polínico Eucalyptus. A atividade antioxidante variou de 37,94 a 91,81% e de 78,96 a 93,21%, respectivamente, nas amostras com ocorrência do tipo polínico Mimosa pudica e Eucalyptus. Foi constatada correlação positiva entre o tipo polínico Eucalyptus e o teor de compostos fenólicos, porém não foi observada associação estatisticamente significativa entre o tipo polínico Mimosa pudica e o teor de carotenoides.

The concentration of bioactive compounds and antioxidant activity of pollen may vary depending on thebotanical origin. Thirty-three samples of bee pollen from the region of Alagoinhas-BA were investigated on the concentrations of phenolic compounds, flavonoids, carotenoids and antioxidant activity, and the correlation between bioactive compounds and Eucalyptus and Mimosa pudica pollens was assessed. The phenolic compounds contents and of its flavonoid fraction in samples with the occurrence of Mimosa pudica ranged from 14.31 to 64.14 mg in GAE.g-1 of pollen and from 0.72 to 1.99 mg, respectively; the sampleswith the occurrence of Eucalyptus ranged from 26.48 to 132.38 mg GAE.g-1 of pollen and from 1.55 to 2.5mg, respectively. The carotenoids contents ranged from 18.16 to 764.37 μg.g-1 in Mimosa pudica pollentype, and from 3.01 to 46.08 μg.g-1 in Eucalyptus pollen type. The antioxidant activity ranged from 37.94 to 91.81% and from 78.96 to 93.21% in samples with occurrence of Eucalyptus and Mimosa pudica pollen types, respectively. A positive correlation between the Eucalyptus pollen type and the phenolic compounds contents was found, however no statistically significant correlation was observed between the Mimosa pudica pollen type and carotenoids contents.

Resultados do registro de cirurgias colorretais videolaparoscópicas realizadas no estado de Minas Gerais - Brasil de 1996 a 2009 / Colorectal laparoscopic surgeries performed in the state of Minas Gerais - Brasil from 1996 to 2009

INTRODUÇÃO: A partir de 1991, a videolaparoscopia começou a ser considerada no tratamento de doenças colorretais. O aprimoramento da técnica cirúrgica associado aos benefícios encontrados em diversos estudos publicados levou a modificações nas perspectivas da videolaparoscopia. A partir da publicação do estudo COST as ressecções oncológicas laparoscópicas foram reconhecidas como alternativa viável, com resultados semelhantes à cirurgia convencional. PACIENTES E MÉTODOS: Realizou-se pesquisa através de formulário específico e consulta a prontuários dos principais serviços de coloproctologia de Belo Horizonte. Avaliando-se sexo, idade, indicação cirúrgica, procedimento realizado, técnica laparoscópica, complicações, conversão, estadiamento e recidiva (no caso de neoplasias). RESULTADOS: Foram levantados dados sobre 503 cirurgias colorretais laparoscópicas: 347 (68,9 por cento) em mulheres e 156 (31,1 por cento) homens. A técnica cirúrgica foi totalmente laparoscópica em 137 casos, vídeo-assistida 245 casos. O procedimento mais realizado foi a retossigmoidectomia (41,1 por cento), seguido pela colectomia direita (12,5 por cento), colectomia esquerda (6,9 por cento). Doenças benignas foram responsáveis por 259 (51,5 por cento) casos, destes as principais indicações cirúrgicas foram endometriose 126 (48,6 por cento), pólipos 40 (15,4 por cento), doença diverticular 30 (11,6 por cento). Das 240 cirurgias realizadas por doenças malignas as mais frequentes foram retossigmoidectomia 102 (42,5 por cento), colectomia direita 46 (19,1 por cento), colectomia esquerda 18 (7,5 por cento), amputação abdominoperineal 18 (7,5 por cento). Houve 54 conversões (10.7 por cento) dos casos, 12,9 por cento (31/240) nos casos de neoplasias, 8,5 por cento (22/259) nos de doenças benignas. Complicações sistêmicas ou cirúrgicas ocorreram em 31 (6,1 por cento) e 56 (11,1 por cento) casos, respectivamente. Foram registrados onze (2,18 por cento) óbitos nos primeiros...

INTRODUCTION: Since 1991, laparoscopic surgery started to be considered in the treatment of colorectal disease. With the improvement of the technique and the confirmation of the benefits shown in several studies, the perspective of laparoscopy has changed. Recently, the oncologic resections were recognized as a viable alternative, with similar results to the conventional technique. PATIENTS AND METHODS: Data were collected based on charter review and a specific form from the coloproctology reference centers in Minas Gerais. The data assessed were age, gender, indication for surgery, the procedure performed, the laparoscopic technique, complications, conversion rate and staging (in case of tumor). RESULTS: Data from 503 surgeries were analyzed: 347 (68.9 percent) were women, and 156 (31.1 percent) men. The technique was totally laparoscopic in 137 cases, laparoscopically-assisted in 245. The procedure most frequently performed was rectosigmoidectomy (41.1 percent), followed by right hemicolectomy (12.5 percent) and left hemicolectomy (6.9 percent). Conversion occurred in 10.7 percent (54) cases, being 12.9 percent (31/240) in cases of neoplasia and 8.5 percent (22/259) in benign diseases. Systemic or surgical complications occurred in 31 (6.1 percent) and 56 (11.1 percent) cases, respectively. The surgical mortality was 2.18 percent (11). Benign diseases were responsible for 259 (51.5 percent) cases, the most frequent indications were endometriosis 126 (48.6 percent), polyps 40 (15.4 percent) and diverticular disease 30 (11.6 percent) cases. From the 240 surgeries performed for malignant disease, the most frequent were rectosigmoidectomy 102 (42.5 percent), right hemicolectomy 46 (19.1 percent), left hemicolectomy 18 (7.5 percent) and abdominoperineal resection 18 (7.5 percent). CONCLUSION: This study was the first survey about the implementation of laparoscopic colorectal surgery done in Minas Gerais. The data are consistent with the...

The presence of antiautonomic membrane receptor antibodies do not correlate with brain lesions in Chagas' disease / A presença de anticorpos anti-autonômicos não se correlaciona a lesões cerebrais na doença de Chagas

We previously demonstrated correlation between parasympathetic dysfunction and brain white matter lesions in chronic chagasic patients. OBJECTIVE: To correlate serum functional circulating antibodies with beta adrenergic (Ab-β), muscarinic (Ab-M) or muscarinic and beta adrenergic (Ab-Mβ) activity, the autonomic system function and brain lesions in chronic chagasic patients. METHOD: In fifteen consecutive chagasic patients, the autonomic nervous system was evaluated and brain magnetic resonance imaging (MRI) was performed. The sera of all patients were tested to the presence of circulating functional antibodies. RESULTS: Sera from 11 of 15 chronic chagasic patients had some activity (Ab-β: 7; Ab-M: 1; Ab-Mβ: 3); however, there was no significant correlation between the presence of antibodies and the autonomic system function or the presence of hyperintensities in MRI. CONCLUSION: The mechanism involved in the genesis of hyperintense lesions seen in brain MRI of chronic chagasic patients is still unresolved, although apparently related to parasympathetic dysfunction.

A correlação entre disfunção parassimpática e lesões de substância branca cerebral em pacientes chagásicos já foi previamente demonstrada. OBJETIVO: Correlacionar a presença de anticorpos circulantes funcionais com atividade beta-adrenérgica (Ab-β), muscarínica (Ab-M) ou muscarínica e beta adrenérgica (Ab-Mβ), a presença de disautonomia e lesões de substância branca cerebral em pacientes chagásicos crônicos. MÉTODO: Em quinze pacientes chagásicos consecutivos, foram realizados a avaliação do sistema nervoso autônomo e ressonância magnética (RM) do crânio. O soro dos pacientes foi testado para a presença de anticorpos funcionais circulantes. RESULTADOS: O soro de 11 dos 15 pacientes chagásicos apresentou alguma atividade (Ab-β: 7; Ab-M: 1; Ab-Mβ: 3); porém não houve correlação significativa entre a presença de anticorpos circulantes e disautonomia ou de hiperintensidades à RM. CONCLUSÃO: O mecanismo envolvido na gênese das lesões hiperintensas à RM do crânio dos pacientes chagásicos crônicos não está esclarecida ainda, apesar de aparentemente relacionada à disfunção parassimpática.