Factors affecting successful antituberculosis treatment: a single-center experience

SUMMARY OBJECTIVE: The identification of factors that influence a favorable antituberculosis treatment outcome could be of great use for the promotion of specific health actions to increase the success rate. Thus, the objective of this study was to investigate the factors affecting successful antituberculosis treatment in patients seen at a reference service in the Western region of São Paulo State/Brazil. METHODS: A retrospective study was carried out from 2010 to 2016 based on the data obtained from the Notification Disease Information System of TB patients treated at a reference service in Brazil. The study included patients with treatment outcomes and excluded those from the penitentiary system or with resistant or multidrug-resistant TB. Patients were categorized as having a successful (cured) or unsuccessful (treatment default and death) treatment outcome. The association between TB treatment outcomes and social and clinical factors was analyzed. RESULTS: A total of 356 cases of TB were treated between 2010 and 2016. Among the cases, the majority were cured and the overall treatment success rate was 85.96%, with a range between 80.33% (2010) and 97.65% (2016). After the exclusion of resistant/multidrug-resistant TB, 348 patients were analyzed. In the final logistic regression model analysis, education less than 8 years (OR 1.66; p<0.0001) and people living with human immunodeficiency virus/acquired immunodeficiency syndrome (OR 0.23; p<0.0046) were found to be significantly related to an unfavorable treatment outcome. CONCLUSION: Low education and being a person living with human immunodeficiency virus/acquired immunodeficiency syndrome are vulnerability factors that can affect the successful outcome of antituberculosis treatment.

Tuberculosis space-temporal distribution from 2011 to 2016 in the municipality of Maputo, Mozambique / Distribución espacio-temporal de la tuberculosis de 2011 al 2016 en el municipio de Maputo, Mozambique

Abstract: Objective: Carry out a spatial-temporal characterization of the incidence of tuberculosis (TB) in Maputo, Mozambique. Method: a descriptive ecological study of tuberculosis cases reported in an information system. The annual mean incidence rate and the number of TB notification cases in the municipality of Maputo from 2011 to 2016 were analyzed. Descriptive statistics were used with calculations of measures of central tendency (mean) and an application of the Poisson linear regression model. Trimester notifications were stratified by district, clinical form, and age group. The quarterly average temperature of the evaluated area was added as a covariate in the model seasonal. Results: 34,623 TB cases were notified from 2011 to 2016, with a trimester average of 1,443 cases. The average annual incidence was higher in the Kampfumo district, with 909.8 per 100 thousand inhabitants (95% CI 854.1 - 968.2); almost twice as much as the incidence of the municipality of Maputo, 527.8 (95% CI 514, 3-541.6), and the country of Mozambique, 551 (95% CI 356 - 787). The clinical diagnosis of the tested cases was higher concerning the bacteriological diagnosis; 44%, and 35%, respectively. Conclusion: Maputo had similar incidence rates to the country of Mozambique, however, there was a heterogeneity rate by district and a reduction in the number of TB cases in both the general population (not co-infected with HIV) and those over 15 years old, being higher in the first trimester.

Resumen: Objetivo: realizar una caracterización espacio-temporal de la incidencia de tuberculosis (TB) en Maputo, Mozambique. Método: estudio ecológico descriptivo de casos de tuberculosis reportados en un sistema de información. Se analizó la tasa de incidencia media anual y el número de casos de notificación de TB en el municipio de Maputo entre 2011 y 2016. Se utilizó estadística descriptiva para calcular las medidas de tendencia central (media) y la aplicación del modelo de regresión lineal de Poisson Las notificaciones trimestrales se estratificaron por distrito, forma clínica y grupo de edad. Resultados: se notificaron 34,623 casos de TB entre 2011 y 2016, con un promedio trimestral de 1,443 casos. La incidencia anual promedio fue mayor en el distrito de Kampfumo, 909.8 por cada 100 mil habitantes (IC 95% 854.1 - 968.2), casi el doble que la incidencia del municipio de Maputo, 527.8 (IC 95% 514 , 3-541.6), y el país de Mozambique, 551 (95% CI 356 - 787). El diagnóstico clínico de los casos fue mayor en relación al diagnóstico bacteriológico, 44% y 35%, respectivamente. Conclusión: Maputo tuvo tasas de incidencia similares a las del país, sin embargo, hubo una heterogeneidad en las tasas por distrito y una reducción en el número de casos de TB en la población general (no coinfectados con VIH) y en los mayores de 15 años, siendo mayores en el primer trimestre.

Medicines for Malaria Venture COVID Box: a source for repurposing drugs with antifungal activity against human pathogenic fungi

BACKGROUND Treatment of mycoses is often ineffective, usually prolonged, and has some side effects. These facts highlight the importance of discovering new molecules to treat fungal infections. OBJECTIVES To search the Medicines for Malaria Venture COVID Box for drugs with antifungal activity. METHODS Fourteen human pathogenic fungi were tested against the 160 drugs of this collection at 1.0 µM concentration. We evaluated the ability of the drugs to impair fungal growth, their fungicidal nature, and morphological changes caused to cells. FINDINGS Thirty-four molecules (21.25%) presented antifungal activity. Seven are antifungal drugs and one is the agricultural fungicide cycloheximide. The other drugs with antifungal activity included antibiotics (n = 3), antimalarials (n = 4), antivirals (n = 2), antiparasitcs (n = 3), antitumor agents (n = 5), nervous system agents (n = 3), immunosuppressants (n = 3), antivomiting (n = 1), antiasthmatic (n = 1), and a genetic disorder agent (n = 1). Several of these drugs inhibited Histoplasma capsulatum and Paracoccidioides brasiliensis growth (15 and 20, respectively), while Fusarium solani was not affected by the drugs tested. Most drugs were fungistatic, but niclosamide presented fungicidal activity against the three dimorphic fungi tested. Cyclosporine affected morphology of Cryptococcus neoformans. MAIN CONCLUSIONS These drugs represent new alternatives to the development of more accessible and effective therapies to treat human fungal infections.

Cross-cultural adaptation of body image assessment instruments for university students: a systematic review

Abstract The theoretical-methodological process of cross-cultural adaptation of scales is fundamental for the expansion of research possibilities related to a given area and population, as instrument adequacy allows for the consistent assessment of the construct being studied. This article aims to highlight the different theoretical-methodological processes of cross-cultural adaptations of scales for assessing body image among young university students. The articles were selected in February 2020, with the following search descriptors: ("body image") and (young or "college students" or graduating or graduat *) and ("cross-cultural validation" or "cross-cultural adaptation"), in three databases—Scopus, PsycINFO, and Web of Science, without any time restrictions. Altogether, 304 studies were surveyed on the different bases mentioned above, and 14 studies published between 2010 and 2019 were evaluated. This study highlighted the methodological procedures used in the process of cross-cultural adaptation, as well as the population, the types of validity and reliability, and also the main limitations, strengths, and results reported in each study included in this review. The information presented in this review will allow new researchers to make more appropriate choices about instruments for assessing body image in young university students, in addition to presenting the methodological evolution on this theme.

ATIVIDADE FÍSICA E AMBIENTE: A INFLUÊNCIA DOS Parques verdes urbanos NA SAÚDE / Physical activity and environment: the influence of urban green spaces on health / Actividad física y ambiente: la influencia de los parques verdes urbanos en la salud

ABSTRACT Introduction: Urban green spaces can offer opportunities for regular physical activity, providing benefits in the lives of members of the population, such as physical, social and affective health. The aim of this article consists of analyzing the influence of urban green spaces on physical activity, focusing on urban environmental quality and the health of those who engage in physical activities in open areas. The study has a multidisciplinary approach from the perspective of environmental health. Method: The study design was based on qualitative research, using a bibliographic and document search as well as field surveys, whose technique involved direct observation (DO). The sample selection was based on Miot (2011), consisting of a total of 36 individuals aged between 18 and 40 years, who perform physical activities regularly, at least three times a week, for at least 50 minutes. Questionnaires were also applied using the IPAQ (assessment of physical activity) and Borg Scale parameters. Results: The study showed that the research participants became more active, possibly being stimulated and motivated by their surroundings with widespread vegetation cover, the good infrastructure of the venue and the guidance provided during the research. Conclusion: The research project showed that the greater the frequency and intensity of physical activity in open areas, the better the body's physiological adaptability. Level of Evidence II; Prognostic study.

RESUMO Introdução: Os parques verdes urbanos podem oferecer oportunidades para a prática regular de atividade física, proporcionando benefícios para a vida da população, como por exemplo, saúde física, social e afetiva. O objetivo do presente artigo consiste em analisar a influência dos parques verdes urbanos na prática de atividades físicas, focando-se na qualidade ambiental urbana e na saúde dos praticantes de atividades físicas em áreas abertas. O estudo tem uma abordagem multidisciplinar segundo a perspectiva da saúde ambiental. Método: O projeto de estudo baseou-se em pesquisa qualitativa, utilizando pesquisa bibliográfica e documental e levantamentos de campo, cuja técnica contou com a observação direta (DO). A seleção da amostra foi baseada em Miot (2011), contando com36 indivíduos com idade entre 18 e 40 anos que praticam regularmente atividades físicas, pelo menos, três vezes por semana, por no mínimo 50 minutos. Também foram realizados questionários utilizando o IPAC (nível de atividade física avaliado) e os parâmetros da Escala de Borg. Resultados: O estudo mostrou que os participantes da pesquisa se tornaram mais ativos, possivelmente, sendo estimulados e motivados pelo ambiente com grande presença de vegetação, a boa infraestrutura do local e as orientações feitas durante a pesquisa. Conclusão: A pesquisa mostrou que quanto maior a frequência e a intensidade da atividade física em áreas abertas, melhor é a adaptabilidade fisiológica do organismo. Nível de evidência II; Estudo prognóstico.

RESUMEN Introducción: Los parques verdes urbanos pueden ofrecer oportunidades para la práctica regular de actividad física, proporcionando beneficios para la vida de la población, como por ejemplo, salud física, social y afectiva. El objetivo del presente artículo consiste en analizar la influencia de los parques verdes urbanos en la práctica de actividades físicas, enfocándose en la calidad ambiental urbana y la salud de los practicantes de actividades físicas en áreas abiertas. El estudio tiene un abordaje multidisciplinario según la perspectiva de la salud ambiental. Método: El proyecto de estudio se basó en la investigación cualitativa, mediante búsqueda bibliográfica y documental, y levantamientos de campo, cuya técnica contó con la observación directa (OD). La selección de la muestra se basó en Miot (2011), contando con 36 individuos con edad entre 18 y 40 años, que practican regularmente actividades físicas, al menos tres veces por semana, durante al menos 50 minutos. También fueron realizados cuestionarios utilizando el IPAC (nivel de actividad física evaluado) y los parámetros de la Escala de Borg. Resultados: El estudio mostró que los participantes de la investigación se volvieron más activos, posiblemente siendo estimulados y motivados por el ambiente con gran presencia de vegetación y la buena infraestructura del local y las orientaciones realizadas durante la investigación. Conclusión: La investigación mostró que cuanto mayor es la frecuencia e intensidad de la actividad física en áreas abiertas, mejor es la adaptabilidad fisiológica del organismo. Nivel de evidencia II; Estudio pronóstico.

Evaluation of antimicrobial, hypotensive and diuretic effect of Eugenia uniflora extracts / Avaliação do efeito antimicrobiano, hipotensivo e diurético de extratos de Eugenia uniflora

The genus Eugenia sp. (Myrtaceae) comprises plants with reported antioxidant and antidiarrheal capability among other therapeutic potentials. The aim of this study was to evaluate the antimicrobial activity of essential oil; diuretic and hypotensive activities of aqueous extracts from leaves of Eugenia uniflora. The antimicrobial activity was evaluated . The diuretic and hypotensive activities were evaluated in normotensive Wistar rats by measuring blood pressure and urine flow after received four different concentrations of aqueous extracts (10%, 15%, 20% and 25%). Essential oil inhibited the growth of Candida parapsilosis and Candida albicans with MIC values lower than 14.41 mg/mL, equal to 57.75 mg/mL for Candida krusei. Among antibacterial effect, essential oil inhibited growth with a MIC equals to 153.93 mg/mL for all strains tested, except for Escherichia coli (MIC equals to 307.96 mg/mL. Aqueous extracts showed powerful reductions of the arterial pressure (34% and 31% lower than the control), after administration of 10% and 25% of aqueous extract, respectively. However, the animals that received the aqueous extract at the 15% and 20% concentrations presented a discrete hypotensive effect (20% and 21% lower than control group, respectively) concomitantly to powerful diuretic effect (280% and 91% higher than control group, respectively). These data confirmed the potential biological effect of this species, and represents an important step toward a depth study on the therapeutic properties of this species

O gênero Eugenia sp. (Myrtaceae) compreende plantas com capacidade antimicrobiana e antioxidante entre outros potenciais terapêuticos. O objetivo deste estudo foi avaliar a atividade antimicrobiana de óleo essencial; atividade diurética e hipotensora de extrato aquoso de folhas de Eugenia uniflora. A atividade antimicrobiana foi avaliada pela determinação da concentração inibitória mínima (MIC) e concentração mínima bactericida (MBC) de cepas bacterianas e concentração fungicida mínima (MFC) para fungos. A atividade diurética e hipotensora foi avaliada em ratos Wistar normotensos pela mensuração da pressão sanguínea e fluxo urinário após administração de quatro diferentes concentrações de extrato aquoso (10%, 15%, 20% e 25%). Óleo essencial inibiu o crescimento de Candida parapsilosis e Candida albicans com valores de MIC menores que 14,41 mg/mL, igual a 57,75 mg/mL para Candida krusei. A respeito do efeito antimicrobiano, o óleo essencial inibiu o crescimento de todas as cepas testadas, com MIC igual a 153,93 mg/mL, exceto para Escherichia coli (MIC igual a 307.96 mg/mL). O extrato aquoso mostrou redução importante da pressão arterial (34% e 31% quando comparado ao controle), após administração de 10% e 25% do extrato aquoso, respectivamente. Contudo, os animais que receberam o extrato aquoso na concentração de 15% e 20% apresentaram discreto efeito hipotensor (20% e 21% menor que o grupo controle, respectivamente) concomitantemente ao importante efeito diurético (280% e 91% maior quando comparado ao grupo controle, respectivamente). Esses achados confirmam o potencial efeito biológico dessa espécie, e representa um importante embasamento para estudos relacionados as propriedades terapêuticas da Eugenia uniflora

Evaluation of Staphylococcus aureus resistance profile isolated from nursing students in an institution of higher education / Avaliação do perfil de resistência de staphylococcus aureus isolados de estudantes de enfermagem de uma instituição de ensino superior

Staphylococcus aureus causes a large variety of infections, where many of them are acquired in the hospital environment. A significant part of the population is a nasal carrier of this type of microorganism. The present study evaluated the nasal colonization by S. aureus, identifying its resistance profile in nursing students from a private educational institute of higher education. Nasal swab samples were collected and identified for S. aureus. Moreover, an antibiogram assay was performed, followed by the search for ermA and ermC genes using PCR. Sixty -two students were included and we isolated 20 positive samples (32,5%) for S. aureus. For the phenotypic profile, 30% were found to be resistant to Erythromycin and 10% to Oxacillin and Cefoxitin. For the D-test in the genotypic profile, 25% presented mecA gene (MRSA), 5% of ermA gene, 35% of ermC gene and 10% with ermC and mecA genes. These data reinforce the necessity of monitoring bacterial colonization in hospital environment, which are potentially resistant in health professionals.

Staphylococcus aureus causa uma grande variedade de infecções, muitas delas adquiridas no ambiente hospitalar. Uma parcela significativa da população é carreadora nasal desses micro-organismos. O presente trabalho avaliou a colonização nasal por S. aureus identificando seu perfil de resistência em estudantes de enfermagem de uma instituição privada de ensino superior. Foram coletadas e identificadas amostras de swab nasal para S. aureus e realizado o antibiograma e a detecção por PCR dos genes mecA, ermA e ermC. Foram incluídos 62 alunos e isoladas 20 amostras (32,3%) positivas para S. aureus, no perfil fenotípico, 30% apresentaram resistência à Eritromicina e 10% para Oxacilina, Cefoxitina e para o teste D, no perfil genotípico 25% apresentaram gene mecA (MRSA), 5% do gene ermA e 35% do gene ermC, e 10% com genes ermC e mecA. Esses dados reforçam a necessidade de monitoramento de colonização por bactérias potencialmente resistente em profissionais da saúde.

Breast cancer metastasis in the stomach: when the gastrectomy is indicated? / Metástases gástricas de câncer de mama: quando a gastrectomia está indicada?

ABSTRACT Background: Breast cancer is the most common malignant neoplasm in the female population. However, stomach is a rare site for metastasis, and can show up many years after initial diagnosis and treatment of the primary tumor. Aim: Analyze a case series of this tumor and propose measures that can diagnose it with more precocity. Methods: Were analyzed 12 patients with secondary gastric tumors. Immunohistochemistry has demonstrated that primary tumor was breast cancer. We retrieved information of age, histological type, interval between diagnosis of the primary breast cancer and its metastases, immunohistochemistry results, treatment and survival. Results: The mean age was 71.3 years (ranging 40-86). Ten cases had already been underwent mastectomy in the moment of the diagnosis of gastric metastasis. Two patients had diagnosis of both primary and secondary tumors concomitantly. At average, diagnosis of gastric metastasis was seven years after diagnosis of primary breast cancer (ranging 0-13). Besides, nine cases had also metastases in other organs, being bones the most affected ones. Immunohistochemistry of the metastases has shown positivity for CK7 antibody in 83.34%, estrogen receptor in 91.67%, progesterone receptor in 66.67% and AE1AE3 antibody in 75%, considering all 12 cases. Moreover, CK20 was absent significantly (66.67%). The positivity of BRST2 marker did not present statistical significance (41.67%). Eight cases were treated with chemotherapy associated or not with hormonal blockade. Surgical treatment of gastric metastasis was performed in four cases: three of them with total gastrectomy and one with distal gastrectomy. Follow-up has shown a mean survival of 14.58 months after diagnosis of metastasis, with only two patients still alive. Conclusion: Patients with a history of breast cancer presenting endoscopic diagnosis of gastric cancer it is necessary to consider the possibility of gastric metastasis of breast cancer. The confirmation is by immunohistochemistry and gastrectomy should be oriented in the absence of other secondary involvement and control of the primary lesion.

RESUMO Racional: A neoplasia de mama é o tumor maligno mais comum na população feminina tendo o trato gastrointestinal, e mais especificamente o estômago, como local incomum para metástases. Objetivo: Analisar uma série de casos com esse tumor e propor medidas que possam diagnosticá-lo com maior precocidade. Métodos: Foram analisados retrospectivamente 12 pacientes com diagnóstico de neoplasia gástrica secundária a câncer de mama, confirmado por biópsia e imunoistoquímica. Foram analisados idade do diagnóstico, tipo histológico do tumor primário, intervalo de tempo entre o diagnóstico do tumor e a metástase, tratamento e sobrevida. Resultados: A idade média foi de 71,3 anos (40-86 anos). Em média, o diagnóstico da metástase gástrica foi de sete anos após o diagnóstico da lesão primaria (0-13 anos). Nove casos tiveram metástases em outros órgãos, sendo os ossos os locais mais acometidos. Evidenciou-se positividade de anticorpo CK7 em 90,9% casos, receptor de estrógeno em 91,67%, receptor de progesterona em 66,67% e BRST2 em 41,67%. A ausência de CK20 foi de 88,89%. Oito casos foram tratados com quimioterapia associada ou não ao bloqueio hormonal e em quatro foi indicada ressecção cirúrgica sendo em três gastrectomia total e em um caso gastrectomia subtotal. A sobrevida média foi de 14,58 meses. Conclusões: Em doentes com história prévia de câncer de mama apresentando diagnóstico endoscópico de neoplasia gástrica, é necessário considerar a possibilidade de metástase. A confirmação é feita por estudo imunoistoquímico e a gastrectomia deve ser orientada diante da ausência de outros locais de acometimento secundário e controle da lesão primária.

Qualidade de vida no trabalho: evoluçäo e análise no nível gerencial / Quality of life in the work: evolution and analysis at managenal level

Abordagem dos problemas comportamentais da organizaçäo com base nas necessidades do trabalhador e no novo contexto organizacional. Analisa as relaçöes homem X trabalho quanto às condiçöes de vida no trabalho e expectativas dos trabalhadores, desde as primeiras manifestaçöes ocorridas no século XVII até as modernas teorias comportamentais. O gerente é estudado através dos conceitos clássicos e sua evoluçäo, bem como em funçäo de seus papéis e dos conflitos decorrentes destes. Finaliza com a apresentaçäo de uma metodologia e das conclusöes sobre pesquisa realizada no nível gerencial brasileiro