Imbalance of Peripheral Temperature, Sympathovagal, and Cytokine Profile in Long COVID.

A persistent state of inflammation has been reported during the COVID-19 pandemic. This study aimed to assess short-term heart rate variability (HRV), peripheral body temperature, and serum cytokine levels in patients with long COVID. We evaluated 202 patients with long COVID symptoms categorized them according to the duration of their COVID symptoms (≤120 days, n = 81; >120 days, n = 121), in addition to 95 healthy individuals selected as controls. All HRV variables differed significantly between the control group and patients with long COVID in the ≤120 days group (p < 0.05), and participants in the long COVID ≤120 days group had higher temperatures than those in the long COVID >120 days group in all regions analysed (p < 0.05). Cytokine analysis showed higher levels of interleukin 17 (IL-17) and interleukin 2 (IL-2), and lower levels of interleukin 4 (IL-4) (p < 0.05). Our results suggest a reduction in parasympathetic activation during long COVID and an increase in body temperature due to possible endothelial damage caused by the maintenance of elevated levels of inflammatory mediators. Furthermore, high serum levels of IL-17 and IL-2 and low levels of IL-4 appear to constitute a long-term profile of COVID-19 cytokines, and these markers are potential targets for long COVID-treatment and prevention strategies.

Spatial distribution of malaria and primary healthcare in Cametá and Tucuruí, Pará state, Brazil.

INTRODUCTION: Malaria cases in Brazil are concentrated in the Amazon region. In the state of Pará, malaria is considered an endemic disease, and the population has different levels of exposure, which contributes to different types of occurrence in the municipalities. METHODOLOGY: A descriptive, cross-sectional, and ecological study was conducted using data from the Malaria Epidemiological Surveillance System of the municipalities of Cametá and Tucuruí, PA, Brazil, from 2014 to 2018; the Brazilian Institute of Geography and Statistics; and the National Registry of Health Institutions of the Ministry of Health. Statistical and spatial analyses of epidemiological, laboratory and public health service coverage variables were performed using the Bioestat 5.0 and ArcGis 10.5 software. RESULTS: 11,381 Malaria cases were reported in the two municipalities. The highest percentage of case notifications was reported in brown-skinned men aged from 19 and 59 years, and who had primary education levels. The predominant occupations were farming and livestock in Cametá and domestic activity in Tucuruí. The most common diagnostic examination used was a thick blood smear, and Plasmodium vivax was the species most often encountered. The percentage of primary care coverage increased during the study period. The spatial distribution of the disease was not homogeneous, and there were clusters of cases with different densities in Cametá and Tucuruí. CONCLUSIONS: Malaria is a public health problem in the municipalities of Cametá and Tucuruí, because of its transmission dynamics and variable spatial distribution as well as the coexistence of factors that favor the exposure of resident populations to epidemiological situations, thus reflecting health inequities.

Spatial distribution of human visceral leishmaniasis cases in Cametá, Pará, Eastern Amazon, Brazil.

INTRODUCTION: Human visceral leishmaniasis is considered a major public health problem in the municipality of Cametá, Pará, Brazil. METHODS: This ecological study was conducted using data obtained from official Brazilian agencies. Spatial analysis of the variables was performed using the kernel interpolation technique and the bivariate Global Moran's Index. RESULTS: The spatial distribution of the disease was not homogeneous, and it was associated with socio-environmental risk factors and public policies. CONCLUSIONS: Different relationships were observed between the variables studied and disease occurrence.

Uso da eletromiografia de superfície na resultância do treinamento muscular inspiratório com carga linear em portadores do vírus linfotrópico humano tipo 1 / Use of surface electromyography in results of inspiratory muscle training with linear load in patients with type 1 human lymphotropic virus

Este estudo visa avaliar por eletromiografia de superfície o comportamento dos músculos inspiratórios no treinamento muscular em voluntários com vírus linfotrópico de célula T humana do tipo 1. Trata-se de um ensaio clínico. Sete voluntários, com idade 58,85 ± 7,2) anos, realizaram treinamento muscular inspiratório domiciliar por 4 semanas, 3 vezes por semana, 30 minutos diários por meio de incentivador de carga linear. Para avaliação utilizou-se os dados de pressão inspiratória máxima e os dados da eletromiografia de superfície nas fases pré (T0), segunda semana (T2) e após a quarta semana (T4) de treinamento. Observou-se aumento progressivo da força muscular inspiratória de T0 a T4 (p = 0,007), assim como, aumento do recrutamento das unidades motoras pela análise da amplitude do sinal eletromiográfico, sendo mais evidente para o músculo esternocleidomastóideo (p = 0,12) em comparação ao músculo diafragma (p = 0,6). Verificou-se que no decurso do treinamento muscular ocorreu melhora significativa da força muscular inspiratória com maior recrutamento das fibras musculares dos músculos analisados na amostra. (AU)

This study aimed to evaluate by surface electromyography the behavior of inspiratory muscles in the muscle training of volunteers with human T-cell lymphotropic virus type 1. This was a clinical trial. Seven volunteers, 58,85 ± 7.21 years old, underwent inspiratory muscle training at home for 4 weeks, 3 times a week, 30 minutes daily by means of a linear load stimulator. The maximum inspiratory pressure data and the surface electromyography data were used for evaluation in the pre (T0), second week (T2) and after the fourth week (T4) training phases. There was a progressive increase in inspiratory muscle strength from T0 to T4 (p = 0.007), as well as an increase in the recruitment of motor units by analyzing the amplitude of the electromyographic signal, being more evident for the sternocleidomastoid muscle (p = 0.12) in comparison to the diaphragm muscle (p = 0.6). During the muscle training inspiratory muscle strength improves with greater recruitment of muscle fibers from the muscles analyzed in the sample. (AU)

Spatial distribution of human visceral leishmaniasis cases in Cametá, Pará, Eastern Amazon, Brazil

Abstract INTRODUCTION: Human visceral leishmaniasis is considered a major public health problem in the municipality of Cametá, Pará, Brazil. METHODS: This ecological study was conducted using data obtained from official Brazilian agencies. Spatial analysis of the variables was performed using the kernel interpolation technique and the bivariate Global Moran's Index. RESULTS: The spatial distribution of the disease was not homogeneous, and it was associated with socio-environmental risk factors and public policies. CONCLUSIONS: Different relationships were observed between the variables studied and disease occurrence.

A importância da liga acadêmica na promoção do envelhecimento saudável / The importance of the academic league in promoting healthy aging / La importancia de la liga académica para la promoción del envejecimiento saludable

Objetivo: Relatar a experiência de discentes de uma liga acadêmica de Fisioterapia em gerontologia em uma ação para promoção do envelhecimento saudável. Síntese dos dados: Trata-se da descrição da experiência de discentes de Fisioterapia em uma ação organizada pela Liga Acadêmica de Fisioterapia em Gerontologia (LAFIGE), vinculada à Universidade do Estado do Pará, na IV ação de extensão da liga, intitulada "Promoção do envelhecimento saudável", vivenciada em uma praça pública de Belém, Pará, Brasil. Nessa ação, participaram da organização: 13 membros da LAFIGE, sendo 12 acadêmicos e um orientador, e 50 participantes com idade igual ou superior a 20 anos. Antes da ação, o coordenador repassou as orientações aos discentes acerca de orientações (sob supervisão profissional) de condicionantes do envelhecimento saudável, avaliações físico-funcionais, exercícios físicos e incentivo à alimentação saudável. Tal experiência da ação possibilitou a troca de informações entre a comunidade e a academia, além de favorecer a educação em saúde da população acerca do processo de envelhecimento e da importância de preservar a capacidade funcional. Ademais, incentivou-se a construção de aprendizados científicos e interpessoais de forma bidirecional, entre os acadêmicos e participantes, enfatizando a importância da inserção da fisioterapia em gerontologia na promoção da saúde no envelhecimento. Conclusão: Observou-se a essencialidade da prática de educação em saúde em busca de uma velhice saudável, com a conscientização da população sobre o processo de envelhecimento, além de uma adequada capacitação dos ligantes envolvidos, incentivando ações que visem à promoção da saúde dos idosos.

Objective: To report the experience of students of a Physiotherapy in Gerontology Academic League in an action taken to promote healthy aging. Data synthesis: This study describes the experience of students in an action organized by the Physiotherapy in Gerontology Academic League (Liga Acadêmica de Fisioterapia em Gerontologia ­ LAFIGE) of the Pará State University and put into effect in the IV extension act promoted by the league, which was titled "Healthy Aging Promotion" and held in a public square in Belém. Pará, Brazil. Organizers of this action were: 13 LAFIGE members ­ 12 students and 1 tutor ­ and 50 participants aged 20 or over. Before the action, the coordinator briefed the students with guidelines (under professional supervision) on healthy aging conditioners, physical and functional assessments, physical exercises and promotion of healthy eating. Such experience with the action enabled the exchange of information between the community and the academia and favored the promotion of health education across the population with regard to the aging process and the importance of preserving functional capacity. Furthermore, the construction of scientific and interpersonal learning in a bidirectional way was encouraged between the students and the participants, with emphasis on the importance of the insertion of the physiotherapy in gerontology in order to promote health during aging. Conclusion: Health education practice is essentially needed for a healthy aging and for raising people's awareness of the aging process. In addition, there is a need for adequate training of the league members involved actions aimed at promoting the health of the older adults should be encouraged.

Objetivo: Relatar la experiencia de estudiantes de una liga académica de Fisioterapia en gerontología en una acción para la promoción del envejecimiento saludable. Síntesis de datos: Se trata de la descripción de experiencia de estudiantes de Fisioterapia en una acción de la Liga Académica de Fisioterapia en Gerontología (LAFIGE) que está conectada con la Universidad del Estado de Pará en la IV acción de la liga intitulada "Promoción del envejecimiento saludable" que ha sido vivenciada en una plaza pública de Belém, Pará, Brasil. Para la acción han participado de la organización 13 miembros de la LAFIGE de los cuales 12 académicos y uno tutor y 50 participantes con la edad igual o mayor de 20 años. Antes de la acción el coordinador ha hablado con los estudiantes sobre las orientaciones (bajo la observación de un profesional) de los condicionantes del envejecimiento saludable, las evaluaciones físico-funcionales, los ejercicios físicos y el incentivo para la alimentación saludable. La experiencia de la acción ha permitido el cambio de informaciones entre la comunidad y los académicos además del beneficio de la educación en salud para la población sobre el proceso de envejecimiento y de la importancia del mantenimiento de la capacidad funcional. Además, la experiencia ha incentivado la construcción de aprendizajes científicos e interpersonales de manera bidireccional entre los académicos y los participantes con énfasis para la inserción de la fisioterapia en la gerontología para la promoción de la salud en el envejecimiento. Conclusión: Se observó la esencialidad de la práctica de educación en salud para la vejez saludable con la concienciación de la población sobre el proceso de envejecimiento además de una capacitación adecuada de las personas involucradas para incentivar acciones para la promoción de la salud de mayores.

Leprosy in elderly people and the profile of a retrospective cohort in an endemic region of the Brazilian Amazon.

BACKGROUND: Leprosy has a global presence; more than 180 thousand new cases were registered in 2013, 15% of which were found in the Americas. The elderly are a very susceptible demographic in terms of developing illnesses, mainly because of characteristics natural to the senescence of the human organism. This study's goals were to analyze leprosy in an elderly population from a hyperendemic region of the Brazilian Amazon in a historical series from 2004 to 2013 and to determine the clinical and epidemiological profile of a series of leprosy cases of elderly people in the period spanning from 2009 to 2013. METHODS: To achieve these goals, an observational, longitudinal, retrospective and descriptive study was put together to analyze leprosy in elderly people from data acquired from the Notification Aggravations Information System. Furthermore, a profile of the disease from a retrospective cohort based on data collected from medical records was developed. RESULTS: The number of new cases and the leprosy detection rate decreased across the observed period but remained stable among the elderly. The trend for the next ten years indicates decreases in the number of cases and in the detection rate in the general population and an increase in only the elderly. The overall profile was characterized by a predominance of males (64.32%), the multibacillary clinical form (87.57%), Type 1 reaction episodes (37.50%) and some physical incapacity at diagnosis (49.19%). The risk of reaction was greater in the first six months of multidrug therapy, and the positive result from the skin smear was associated with the greater chance of reactional condition development. CONCLUSIONS: The resulting data demonstrate that leprosy amongst the elderly deserves attention because of the increased susceptibility to disability in this age group, with their higher risk of reaction and their greater level of co-morbidity.