RESUMO
OBJECTIVES: We aimed to compare the painless synovitis evolution with painful synovitis, based on bone erosion by ultrasonography over a year in women with longstanding rheumatoid arthritis. Ultrasound inflammatory measurements and radiographic, functional and clinical findings were also compared between groups at the end of the same follow-up. METHODS: A prospective cohort study was rolled out, involving 60 women with RA, divided into two groups: painless and painful, with 30 patients in each group. The wrist and MCPs joints were assessed by ultrasound and plain x-ray, initially and after 12 months (T0 and T12). There was also a clinical assessment (activity scores, functional tests, disease and treatment progression variables) at 6 and 12 months. RESULTS: Patients' average age was 58.0±12.8 and average length of disease 16.4±9.8 years. Initially, the demographic characteristics were similar between groups, however, the painful group had worse clinical and functional scores. There were no statistically significant differences in the majority of US bone erosions and US inflammatory measurements, nor in radiographic progression variables between the groups. Over one year, pinch strength test and DAS 28 remained worse in the painful group (p<0.05). Clinical worsening variables and change of treatment evolved similarly between the groups, on T6 and T12. CONCLUSIONS: According to the study, the painless group progressed similarly to the painful one over a year, as regards bone erosion, ultrasound inflammatory measurements, radiographic findings, clinical worsening and change of treatment in female longstanding RA patients.
Assuntos
Artrite Reumatoide , Sinovite , Idoso , Artrite Reumatoide/complicações , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/tratamento farmacológico , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Pessoa de Meia-Idade , Estudos Prospectivos , Sinovite/diagnóstico por imagem , UltrassonografiaRESUMO
Unplanned urbanization is one of the main factors responsible for worsening flood-related problems in cities, increasing the frequency of flooding and flooding depths, consequently degrading both the natural and built environment. Considering this, the use of engineering techniques that reduce runoff and promote urban requalification are an efficient option for managing rainwater. This paper presents a case study of a flood control project using a storm water detention pond, designed to allow multiple uses of an urban space. The operation of the system is evaluated by an urban flow-cell model, known as MODCEL. This application seeks the best configuration for the layout of 'Celso Peçanha' Detention Basin, considering the local restrictions imposed by the City of Mesquita - Brazil, and optimized to damp storm flows resulting from rainfall events with return periods up to 50 years. The solution proposed considers the possibility of social urban space uses in flood control projects, revitalizing degraded areas and giving them multiple functions.
Assuntos
Inundações/prevenção & controle , Brasil , Cidades , Inundações/estatística & dados numéricos , Modelos Teóricos , Chuva , UrbanizaçãoRESUMO
Ozone and obesity both increase IL-17A in the lungs. In mice, obesity augments the airway hyperresponsiveness and neutrophil recruitment induced by acute ozone exposure. Therefore, we examined the role of IL-17A in obesity-related increases in the response to ozone observed in obese mice. Lean wild-type and obese db/db mice were pretreated with IL-17A-blocking or isotype antibodies, exposed to air or ozone (2 ppm for 3 h), and evaluated 24 hours later. Microarray analysis of lung tissue gene expression was used to examine the mechanistic basis for effects of anti-IL-17A. Compared with lean mice, ozone-exposed obese mice had greater concentrations of BAL IL-17A and greater numbers of pulmonary IL-17A+ cells. Ozone-induced increases in BAL IL-23 and CCL20, cytokines important for IL-17A+ cell recruitment and activation, were also greater in obese mice. Anti-IL-17A treatment reduced ozone-induced airway hyperresponsiveness toward levels observed in lean mice. Anti-IL-17A treatment also reduced BAL neutrophils in both lean and obese mice, possibly because of reductions in CXCL1. Microarray analysis identified gastrin-releasing peptide (GRP) receptor (Grpr) among those genes that were both elevated in the lungs of obese mice after ozone exposure and reduced after anti-IL-17A treatment. Furthermore, ozone exposure increased BAL GRP to a greater extent in obese than in lean mice, and GRP-neutralizing antibody treatment reduced obesity-related increases in ozone-induced airway hyperresponsiveness and neutrophil recruitment. Our data indicate that IL-17A contributes to augmented responses to ozone in db/db mice. Furthermore, IL-17A appears to act at least in part by inducing expression of Grpr.
Assuntos
Peptídeo Liberador de Gastrina/imunologia , Interleucina-17/imunologia , Obesidade/patologia , Ozônio/toxicidade , Receptores da Bombesina/metabolismo , Hipersensibilidade Respiratória/imunologia , Animais , Anticorpos Bloqueadores/farmacologia , Quimiocina CCL20/imunologia , Quimiocina CXCL1/imunologia , Feminino , Subunidade p19 da Interleucina-23/imunologia , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Infiltração de Neutrófilos/imunologia , Neutrófilos/imunologia , Receptores da Bombesina/genéticaRESUMO
OBJECTIVE: To assess the effectiveness of the Pilates method on pain, function, quality of life, and consumption of pain medication in patients with mechanical neck pain. DESIGN: The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis. SETTING: The study took place in the outpatient clinic of the rheumatology department, referral center. PARTICIPANTS: Patients (N=64) with chronic mechanical neck pain were randomly allocated to 2 groups: the Pilates group (PG) and a control group (CG). INTERVENTIONS: The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises performed on a mat and on equipment and was adapted depending on the physical fitness of each participant; the repetitions varied from 6 to 12, respecting patient reports of fatigue and pain, using a single series for each exercise. The CG received only the standard pharmacological treatment. Both groups were instructed to use acetaminophen 750 mg if necessary. Patients were evaluated at baseline after 45, 90, and 180 days. MAIN OUTCOME MEASURES: We used the Numerical Pain Scale for pain, the Neck Disability Index for function, and the SF-36 questionnaire for quality of life. RESULTS: The groups were homogeneous at baseline, the only exception being body mass index (BMI), with the PG showing higher BMI. Regarding the assessment between groups over time, statistical differences were identified for pain (P<.001), function (P<.001) and the SF-36 (functional capacity, P=.019; pain, P<.001; general health, P=.022; vitality, P<.001; mental health, P=.012) with the PG consistently achieving better results. Drug consumption was lower in PG patients (P=.037). CONCLUSIONS: This trial demonstrated the effectiveness of the Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics.
Assuntos
Dor Crônica/terapia , Técnicas de Exercício e de Movimento/métodos , Cervicalgia/terapia , Adulto , Analgésicos/uso terapêutico , Dor Crônica/fisiopatologia , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Pescoço/fisiopatologia , Cervicalgia/fisiopatologia , Medição da Dor , Qualidade de Vida , Método Simples-Cego , Resultado do TratamentoRESUMO
OBJECTIVE: To assess the effectiveness of pilates method on patients with chronic non-specific low back pain (LBP). METHOD: A randomized controlled trial was carried out in sixty patients with a diagnosis of chronic non-specific LBP. Patients were randomly assigned to one of two groups: Experimental Group (EG) that maintained medication treatment with use of NSAID and underwent treatment with the pilates method and Control Group (CG) that continue medication treatment with use of NSAID and did not undergo any other intervention. A blinded assessor performed all evaluations at baseline (T0), after 45, 90, and 180 days (T45, T90 and T180) for: pain (VAS), function (Roland Morris questionnaire), quality of life (SF-36), satisfaction with treatment (Likert scale), flexibility (sit and reach test) and NSAID intake. RESULTS: The groups were homogeneous at baseline. Statistical differences favoring the EG were found with regard to pain (P < 0.001), function (P < 0.001) and the quality of life domains of functional capacity (P < 0.046), pain (P < 0.010) and vitality (P < 0.029). Statistical differences were also found between groups regarding the use of pain medication at T45, T90 and T180 (P < 0.010), with the EG taking fewer NSAIDs than the CG. CONCLUSIONS: The pilates method can be used by patients with LBP to improve pain, function and aspects related to quality of life (functional capacity, pain and vitality). Moreover, this method has no harmful effects on such patients.
Assuntos
Atividades Cotidianas , Diclofenaco/administração & dosagem , Técnicas de Exercício e de Movimento/métodos , Dor Lombar/terapia , Qualidade de Vida , Análise de Variância , Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/uso terapêutico , Atitude do Pessoal de Saúde , Diclofenaco/uso terapêutico , Feminino , Humanos , Dor Lombar/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Medição da Dor/métodos , Medição da Dor/estatística & dados numéricos , Satisfação do Paciente/estatística & dados numéricos , Método Simples-Cego , Estatísticas não ParamétricasRESUMO
The aim of this in vitro study was to evaluate the surface roughness, translucency, fatigue failure load (FFL), and number of cycles for fatigue failure (CFF) of a recently released lithia-based material called advanced lithium disilicate and three other ceramics indicated for monolithic restorations. First, ALD (advanced lithium disilicate, CEREC Tessera, Dentsply Sirona), LD (lithium disilicate, IPS e. max CAD, Ivoclar), LS (lithium silicate-disilicate, Suprinity, Vita Zahnfabrik), and 4Y-PSZ (Yttria-stabilized zirconia, IPS e.max ZirCAD MT, Ivoclar) discs (n = 15, Ø = 10 mm and thickness = 1.0 mm) were fabricated from CAD/CAM blocks/discs, A2 shade. The discs were sintered/crystallized and subsequently analyzed by a rugosimeter (Mitutoyo SJ-410) to determine Ra and Rz surface roughness parameters. Next, they were evaluated to determine the translucency parameter (TP) using a bench-top spectrophotometer (SP60, EX-Rite). The discs were subsequently cemented to glass fiber epoxy resin discs, and the specimens were tested under cyclic loading (Step-test), immersed in distilled water at a frequency of 20 Hz, with an initial cyclic load of 200 N for 5,000 cycles and increments of 50 N every 10,000 cycles until failure. Fatigue failure load (FFL) and number of cycles for fatigue failure (CFF) were recorded for subsequent Kaplan Meier analysis, with post-hoc Mantel-Cox and Weibull analysis (α = 0.05). Complementary fractographic, topographic and energy dispersive spectroscopy analyses (EDS) were performed. 4Y-PSZ showed higher survival (p < 0.05), with higher FFL and CFF (1077 N; 180,333 cycles), followed by LD (980 N; 161,000 cycles), LS (937 N; 152,333 cycles) and ALD (910 N; 147,000 cycles). No differences were observed between the tested groups regarding Weibull modulus. ALD presented TP (28.14) equal to DL (28.27) and higher than LS (25.51). All lithia-based materials had higher translucency than 4Y-PSZ (TP = 8.62) (p < 0.05). ALD appears to have a similar elemental composition to LD and LSD for oxygen and silicon. ALD and LSD have a similar zirconium content. Fractures originated on the cemented surface of the ceramic discs. Lithia-based ceramics showed lower surface roughness, with ALD (Ra = 0.04 µm; Rz = 0.66 µm) showing the lowest values (p < 0.05). Despite showing lower FFL when compared to LD and 4Y-PSZ, ALD has compatible translucency and mechanical fatigue performance with its indication for fabricating monolithic, anterior and posterior adhesively cemented single-unit restorations. However, further studies are needed to substantiate its clinical performance.
Assuntos
Cerâmica , Porcelana Dentária , Cerâmica/química , Propriedades de Superfície , Teste de Materiais , Análise do Estresse Dentário , Zircônio/química , Desenho Assistido por ComputadorRESUMO
BACKGROUND: Violence against women has a negative impact on multiple dimensions of women's health. During the Covid-19 pandemic, intimate partner violence against women has continued, and in some contexts has intensified. The aim of this study was to identify the prevalence of intimate partner violence against women during covid-19 pandemic and its association with socioeconomic, behavioral, and life-experience factors. METHODS AND FINDINGS: Cross-sectional, population-based study conducted in the municipality of Vitória, state of Espírito Santo, from January to May 2022, where 1,086 women aged 18 years and over were interviewed. The World Health Organization (WHO) instrument on violence against women was used to screen outcomes. The prevalence of violence during the pandemic (psychological, physical, and sexual) and bivariate analysis with sociodemographic, behavioral, family, and life history characteristics of women were estimated. The multivariate analysis was carried out for each type of violence, the Poisson regression model was performed with an estimate of robust variance, inserting the variables of interest with (p<0.20). Those with p<0.05 remained in the adjusted model. RESULTS: The prevalence of violence psychological against women perpetrated by an intimate partner during the pandemic was the most frequent (20.2%), followed by physical (9.0%) and sexual violence (6.5%). Women with less schooling and who were single had a higher prevalence of physical and psychological violence, as did those with a history of sexual abuse in childhood and whose mothers had been beaten by their intimate partners. Sexual violence was more prevalent among non-white, with up to eight years of schooling, whose mothers had a history of intimate partner violence, and who consumed alcohol during four days or more (p<0.01). CONCLUSION: Psychological, physical, and sexual violence perpetrated by the intimate partner during the pandemic presented high magnitude among women living in Vitória. Sociodemographic, behavioral factors, and personal and maternal experiences of violence were associated with the phenomenon.
Assuntos
COVID-19 , Violência por Parceiro Íntimo , Humanos , Feminino , Adolescente , Adulto , Brasil/epidemiologia , Estudos Transversais , Pandemias , COVID-19/epidemiologia , Violência por Parceiro Íntimo/psicologia , Parceiros Sexuais/psicologia , Prevalência , Fatores de RiscoRESUMO
This study aimed to compare the antinociceptive effects of tramadol 5% and lidocaine 2% on mental nerve block in horses of the Brazilian Pony breed. Eight adult non-pregnant mares were used in this study. The ponies were tranquilized with acepromazine (5 µg kg-1, IV), and the infiltration of the mental foramen was performed in Treatment 1- tramadol 5% (T, 150 mg) or Treatment 2- lidocaine 2% (L, 60 mg), both at a total dose of 3 ml in each foramen. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), rectal temperature (RT), and formation of skin lesions (SL) were evaluated. Evaluation of nociception of the outer lip (OL), inner lip (IL), and gingiva (GG) were performed using an electronic von Frey device with the evaluation of the ponies' reactions to each stimulus. From these reactions, we determined latency time (LT) and duration of antinociception (DAN). Analysis of variance with 16 observations was performed for HR, RR, SAP, DAP, MAP, LT and DAN. Data were expressed as mean ± standard deviation and the means were compared by the SNK and Student's t-test (P< 0.05). Changes in HR, RR, SAP, DAP, and MAP between evaluation times were associated with the effects of acepromazine (P>0.05). No formation of skin lesions was observed. Latency time did not differ between treatments (P>0.05). Both lidocaine 2% and tramadol 5% produced an antinociceptive effect. We conclude that the duration of the antinociceptive effect of tramadol 5% is longer than that of lidocaine 2%.
Assuntos
Lidocaína , Tramadol , Cavalos , Animais , Feminino , Lidocaína/farmacologia , Acepromazina/farmacologia , Analgésicos , Nervo MandibularRESUMO
Background and Aim: Flemish cattle in Brazil are on the brink of extinction and are found only in one herd in Lages, Santa Catarina State. This study aimed to uncover the reasons for the recurring abortions in the Flemish cattle herd. Materials and Methods: Seventeen Flemish fetuses underwent postmortem examinations, with samples collected for histopathology and microbiology culture tests, polymerase chain reaction (PCR) test for Neospora caninum, and reverse transcription-PCR (RT-PCR) test for bovine viral diarrhea virus (BVDV) from 2015 to 2020. Results: Of the 17 fetuses, N. caninum was the most common diagnosis and was found in 88% (15/17). One fetus (5.8%) had a coinfection with N. caninum and Citrobacter amalonaticus, leading to fibrinonecrotic pericarditis. All fetuses tested negative for BVDV by RT-PCR. Of the 107 dams tested by indirect immunofluorescence assay, 26 (25.2%) were anti-N. caninum seropositive, with 17 (65.4%) aborting and 5 (19.2%) having estrus repetition. Reverse transcription-PCR results showed that 9 (8.4%) of the serum samples collected from dams tested positive, which tested follow-up test 3 months later, indicating a BVDV transient infection. The factors that contributed to neosporosis included dogs' access to pastures and improper disposal of fetal remains, which made it easier for dogs to consume them. Conclusion: This study warns the occurrence of N. caninum as a cause of reproductive disorders that can lead to abortion in the studied Flemish cattle herd.
RESUMO
BACKGROUND: Children in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia. METHODS: A prospective population-based study on pneumonia was carried out as part of the Latin America Epidemiological Assessment of Pneumococcus (LEAP study). Chest x-rays were obtained for children one to 35 months old with suspected pneumonia presenting to emergency care centers and hospital emergency rooms in Goiania, Brazil. Chest radiographs were evaluated according to WHO guidelines. Clustering of radiologically-confirmed pneumonia were evaluated using a Poisson-based spatial scan statistic. Associations between census socioeconomic indicators and pneumonia incidence rates were analyzed using generalized linear models. RESULTS: From May, 2007 to May, 2009, chest radiographs were obtained from 11 521 children with clinical pneumonia; 3955 episodes were classified as radiologically-confirmed. Incidence rates were significantly higher in very low income areas (4825.2 per 105) compared to high income areas (1637.3 per 105). Spatial analysis identified clustering of confirmed pneumonia in Western (RR 1.78; p=0.001) and Southeast (RR 1.46; p=0.001) regions of the city, and clustering of hospitalized pneumonia in the Western region (RR 1.69; p=0.001). Lower income households and illiteracy were associated with pneumonia incidence. CONCLUSIONS: In infants the risk of developing pneumonia is inversely associated with the head of household income and with the woman educational level. Areas with deprived socioeconomic conditions had higher incidence of pneumonia and should be targeted for high vaccination coverage.
Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Pneumonia/epidemiologia , Pobreza/estatística & dados numéricos , Brasil/epidemiologia , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Incidência , Lactente , Masculino , Pneumonia/diagnóstico , Pneumonia/diagnóstico por imagem , Estudos Prospectivos , Radiografia Torácica , Fatores de RiscoRESUMO
Molecular studies have demonstrated the importance of the exacerbated immune response to SARS-CoV-2 infection, called the cytokine storm, in more severe COVID-19. The pathophysiology is complex and involves several homeostatic factors; among them, a deficit of vitamin D draws attention because of its high frequency in the population. Some evidence suggests that people with low serum vitamin D levels have worse outcomes, often requiring intensive care. This review analyzed the studies available in the global literature addressing the benefits of vitamin D in COVID-19, relating serum levels to the severity of the disease, and indicating vitamin D as a possible prophylactic and therapy in infection.
Assuntos
COVID-19 , Deficiência de Vitamina D , Síndrome da Liberação de Citocina , Humanos , SARS-CoV-2 , Vitamina D , Deficiência de Vitamina D/tratamento farmacológico , VitaminasRESUMO
In this study, the effect of early exercise, age, body weight (BW), and growth on the articular cartilage and subchondral bones of the tarsocrural joints was evaluated in 40 young Mangalarga Marchador horses allowed free choice exercise in pasture. Twenty of the horses had additional controlled exercise 3 days per week from a mean age of 30 ± 20 days until 36 months. The training program consisted of an increasing number of 15-minute gallop sprints in an oval paddock with a concrete floor covered by a thick layer of sand. BW, withers height (WH), and neck circumference were measured and body condition scores, cresty neck scores, and obesity index were rated. For each tarsus and foal, 5 standard radiographic projections were evaluated. All evaluations were performed at time point 1 (18 months of age) and time point 2 (36 months of age). Radiographic changes suggestive of tarsal osteoarthritis were observed in two male foals of the trained group at time point 2 (10% of 20). No horses from the untrained group developed OA. Training of the foals did not result in alterations of the morphometric parameters evaluated. However, significant differences were found between time point 1 and 2 in trained and untrained animals. At time point 2, the animals presented greater weights and WHs than at time point 1. We conclude that specific levels of physical activity during initial development do not increase the prevalence of osteoarthritic injury in Mangalarga Marchador foals.
Assuntos
Cartilagem Articular , Osteoartrite/veterinária , Condicionamento Físico Animal , Animais , Peso Corporal , Osso e Ossos , Cavalos , MasculinoRESUMO
Objetivo: identificar a frequência de notificação de violência interpessoal contra pessoas com deficiência no Espírito Santo (Brasil) entre 2011 e 2018, e os fatores associados. Materiais e método: estudo epidemiológico transversal, em que são identificadas as variáveis independentes: características da vítima, do agressor e do evento. Os dados foram analisados pelo programa stata 14.0 por frequências absolutas e relativas, análises bivariadas pelo teste Qui-Quadrado e exato de Fisher, e a associação entre as variáveis pelo modelo de regressão de Poisson. Resultado: a violência interpessoal contra pessoas com deficiência correspondeu a 65,3% das notificações. As principais faixas etárias associadas ao evento foram as crianças (rP: 1,64; iC 95%: 1,50-1,79) e os idosos (rP: 1,52; iC 95%: 1,40-1,64). As pessoas de cor preta/parda apresentaram 15% mais prevalência como vítimas em comparação com as de cor branca. Os agressores homens (rP: 1,29; iC 95%: 1,10- 1,51) de 25 anos ou mais (rP: 1,29; iC 95%: 1,10-1,51) e com suspeita de consumo de álcool (rP: 1,29; iC 95%: 1,10-1,51) apresentaram associação significativa. A via pública apresentou rP: 1,48 (iC 95%: 1,26-1,73) e a recorrência da violência rP: 1,27 (iC 95%: 1,09-1,48). Conclusões: o agravo se apresentou elevado no Espírito Santo e o reconhecimento de suas associações favorece a identificação dos casos e pode auxiliar na garantia da proteção de direitos.
Objetivo: identificar la frecuencia de denuncia de violencia interpersonal contra personas en condición de discapacidad y los factores asociados a este fenómeno en el estado de Espíritu Santo (Brasil) entre 2011 y 2018. Materiales y método: estudio epidemiológico transversal con las siguientes variables independientes: características de la víctima, del agresor y del hecho. Los datos se analizaron mediante el programa stata 14.0 para frecuencias absolutas y relativas, análisis bivariado mediante las pruebas Chi-cuadrado y exacta de Fisher y asociación entre variables mediante el modelo de regresión de Poisson. Resultados: la violencia interpersonal contra personas en condición de discapacidad representó el 65,3 % de los casos reportados. La población infantil (rP: 1,64; iC 95 %: 1,50-1,79) y los adultos mayores (rP: 1,52; iC 95 %: 1,40-1,64) son los principales grupos etarios asociados a este tipo de eventos. Adicionalmente, las personas de raza negra o morenas reportaron una prevalencia 15 % mayor de convertirse en víctimas, en comparación con las personas de raza blanca. Los hombres agresores (rP: 1,29; iC 95 %: 1,10-1,51) de 25 años o más (rP: 1,29; iC 95 %: 1,10-1,51) y con sospecha de consumo de alcohol (rP: 1,29; iC 95%: 1.10-1.51) mostraron una asociación significativa con este tipo de hechos de violencia. La vía pública presentó una rP de 1,48 (iC 95 %: 1,26-1,73) y la recurrencia de los hechos violentos una rP de 1,27 (iC 95 %: 1,09-1,48). Conclusiones: la ocurrencia de actos violentos en contra de personas en condición de discapacidad reportó altos índices en el estado de Espíritu Santo. El reconocimiento de los factores asociados a este fenómeno permite la identificación de casos y puede contribuir a garantizar la protección de los derechos de las personas.
Objective: To identify the frequency of reports of interpersonal violence against people with disabilities and the associated factors to this phenomenon in the state of Espírito Santo (Brazil) between 2011 and 2018. Materials and method: Cross-sectional epidemiological study with the following independent variables: characteristics of the victim, the aggressor, and the event. Data were analyzed using the stata 14.0 program for absolute and relative frequencies, while bivariate analysis was performed through Chi-square and Fisher's exact tests, and the association between variables was analyzed using the Poisson regression model. Results: Interpersonal violence against people with disabilities accounted for 65.3% of total reported cases. Children (Pr: 1.64; Ci 95%: 1.50-1.79) and the elderly (Pr: 1.52; Ci 95%: 1.40-1.64) are the main age groups affected by this type of violence. In addition, black/brown people had a 15% higher prevalence of becoming victims, compared to white people. Male aggressors (Pr: 1.29; 95% Ci: 1.10-1.51) aged 25 years or older (Pr: 1.29; 95% Ci: 1.10-1.51) and with suspicion of alcohol consumption (Pr: 1.29; 95% Ci: 1.10-1.51) showed a significant association with this type of violent episodes. The public road presented a Pr of 1.48 (95% Ci: 1.26-1.73) and the recurrence of violence one of 1.27 (95% Ci: 1.09-1.48). Conclusions: The occurrence of violent acts against people with disabilities reported high rates in the state of Espírito Santo. The recognition of the factors associated with this phenomenon favors the identification of cases and could contribute to ensure the protection of people's rights.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Violência , Pessoas com Deficiência , Exposição à Violência , NotificaçãoRESUMO
Resumo Objetivo Analisar os casos notificados de violência interpessoal contra as mulheres no estado do Espírito Santo. Métodos Estudo analítico, do tipo transversal, em que foram analisados os casos notificados de violência contra a mulher no período de 2011 a 2018 no Espírito Santo. Os dados que foram analisados neste estudo são resultantes das Fichas de Notificação/Investigação de Violência Interpessoal e Autoprovocada provenientes do Sistema de Informação de Agravos de Notificação (SINAN). As análises estatísticas foram realizadas por meio do teste de Qui-quadrado e regressão de Poisson, utilizando o software Stata 14.1, sendo considerados significativos valores de p menores que 0,05. Resultados A notificação de violência interpessoal no sexo feminino representou frequência de 74,9% (n=20.449; IC95%: 74,4-75,4). Foi observado que crianças e idosas apresentaram 35% mais prevalência desse agravo comparada aos adolescentes. Há maior frequência desse fenômeno entre pessoas de cor preta / parda (RP: 1,07; IC95%:1,05-1,08) comparada àquelas de cor branca. Quanto às características do agressor verifica-se maior prevalência na faixa etária de 25 anos e mais (RP: 1,09; IC95%: 1,06-1,11), do sexo masculino (RP: 3,02; IC95%: 2,88-3,17) e sob suspeita de uso de álcool no momento da agressão (IC95%: 1,05-1,08). Em relação ao evento, nota-se uma frequência 1,28 vezes maior em via pública. Conclusão Fatores sociodemográficos, comportamentais e experiências pessoais de violência influenciam a ocorrência do fenômeno.
Resumen Objetivo Analizar los casos notificados de violencia interpersonal contra mujeres en el estado de Espírito Santo. Métodos Estudio analítico, tipo transversal, en el que se analizaron los casos notificados de violencia contra la mujer en el período de 2011 a 2018 en Espírito Santo. Los datos que fueron analizados en este estudio son resultantes de las Fichas de Notificación/Investigación de Violencia Interpersonal y Autoprovocada provenientes del Sistema de Información de Agravios de Notificación (SINAN). Los análisis estadísticos se realizaron mediante la prueba χ2 de Pearson y regresión de Poisson, con el uso del software Stata 14.1, donde se consideraron significativos valores de p menores que 0,05. Resultados La notificación de violencia interpersonal en el sexo femenino representó una frecuencia de 74,9 % (n=20.449; IC95 %: 74,4-75,4). Se observó que niñas y adultas mayores presentan un 35 % más de prevalencia de este agravio, comparadas con adolescentes. Existe una mayor frecuencia de este fenómeno en personas de color negro / pardo (RP: 1,07; IC95 %:1,05-1,08), comparadas con las de color blanco. Respecto a las características del agresor, se verificó mayor prevalencia en el grupo de edad de 25 años o más (RP: 1,09; IC95 %: 1,06-1,11), de sexo masculino (RP: 3,02; IC95 %: 2,88-3,17) y con sospecha de uso de alcohol en el momento de la agresión (IC95 %: 1,05-1,08). Con relación al evento, se observa una frecuencia 1,28 veces mayor en la vía pública. Conclusión Factores sociodemográficos, de comportamiento y experiencias personales de violencia influyen para que suceda este fenómeno
Abstract Objective To analyze the reported cases of interpersonal violence against women in the state of Espírito Santo. Methods This is an analytical, cross-sectional study, which analyzed the reported cases of violence against women from 2011 to 2018 in Espírito Santo. The data that were analyzed in this study are the result of the Reporting Forms/Investigation of Interpersonal and Self-inflicted Violence from the Reporting Diseases Information System (SINAN). Statistical analyzes were performed using the chi-square test and Poisson regression, using Stata 14.1, with p-values lower than 0.05 being considered significant. Results Interpersonal violence reporting in females represented a frequency of 74.9% (n=20,449; 95%CI: 74.4-75.4). It was observed that children and older adults had a 35% higher prevalence of this condition compared to adolescents. There is a higher frequency of this phenomenon among black/brown people (PR: 1.07; 95%CI: 1.05-1.08) compared to white people. As for aggressor characteristics, there is a higher prevalence in the age group of 25 years and older (PR: 1.09; 95%CI: 1.06-1.11), male (PR: 3.02; 95%CI: 2.88-3.17) and under suspicion of alcohol consumption at the time of aggression (95%CI: 1.05-1.08). Regarding the event, there is a frequency 1.28 times higher on public thoroughfare. Conclusion Sociodemographic, behavioral factors and personal experiences of violence influence its occurrence.
RESUMO
Objetivo: identificar a frequência de casos notificados de violência autoprovocada no Espírito Santo entre os anos de 2011 a 2018 e os fatores associados. Método: trata-se de um estudo transversal que utilizou todos os casos notificados de violência autoprovocada registrados no Sistema de Informação de Agravos de Notificação entre 2011 e 2018 no estado do Espírito Santo. A análise multivariada foi realizada pela Regressão de Poisson e o estudo foi aprovado pelo Comitê de Ética em Pesquisa. Resultados: a prevalência da violência autoprovocada foi de 25,1% (IC95%: 24,6-25,5). O grupo de 10 a 19 anos de idade teve uma prevalência cerca de 19 vezes maior de notificação de violência autoprovocada, assim como, pessoas de raça/cor branca (RP: 1,26) e com deficiência/transtornos (RP: 2,85) apresentaram maior frequência desse agravo. Foi observado maior prevalência entre aqueles sem suspeita de uso de álcool (RP: 2,36), com a ocorrência cerca de 4 vezes maior na residência, e, um aumento em cerca de 50% dos casos sem caráter de repetição. Conclusão: a violência autoprovocada no Espírito Santo se apresentou elevada no período estudado e esteve associada a características da vítima e do evento. Profissionais de saúde são fundamentais no processo de rastreio desse agravo e consequentemente em traçar estratégias de prevenção e proteção das vítimas.(AU)
Objective: to analyze the prevalence of reported cases of self-inflicted violence and associated factors in Espírito Santo between 2011 and 2018.Method: this is a cross-sectional study that used all reported cases of self-inflicted violence registered in the Sistema de Informação de Agravos de Notificação between 2011 and 2018, in the state of Espírito Santo. Multivariate analysis was performed using Poisson Regression.Results: the prevalence of self-inflicted violence was 25.1%. The 10 to 19-year-old group had a prevalence of approximately 19 times greater self-inflicted violence report, as did people of white race/color (PR: 1.26) and people with disabilities/disorders (PR: 2.85) showed a higher frequency of this problem. A higher prevalence was observed among those without suspected alcohol use (PR: 2.36), with an occurrence approximately four times higher in the home, and an increase in approximately 50% of non-repeating cases.Conclusion: reports of self-inflicted violence in Espírito Santo were high during the period studied and were associated with characteristics of the victim and the event. Health professionals are fundamental in the process of tracking this problem and consequently in the process of designing prevention and protection strategies for victims.(AU)
Objetivo: analizar la prevalencia de casos notificados de violencia autoinfligida en Espírito Santo entre los años 2011 y 2018, así como los factores asociados. Método: se trata de un estudio transversal que utilizó todos los casos notificados de violencia autoinfligida registrados en el Sistema de Información de Agravios de Notificación entre 2011 y 2018 en el estado de Espírito Santo. El análisis multivariado se llevó a cabo mediante la Regresión de Poisson. Resultados: la prevalencia de la violencia autoinfligida fue del 25,1%. El grupo de 10 a 19 años de edad presentó una prevalencia aproximadamente 19 veces mayor de notificación de violencia autoinfligida. Asimismo, las personas de raza/color blanco (RP: 1,26) y con discapacidad/trastornos (RP: 2,85) mostraron una mayor frecuencia de este agravio. Se observó una mayor prevalencia entre aquellos sin sospecha de uso de alcohol (RP: 2,36), con una ocurrencia aproximadamente cuatro veces mayor en la residencia, y un aumento de alrededor del 50% en los casos sin carácter repetitivo. Conclusión: las notificaciones de violencia autoinfligida en Espírito Santo fueron elevadas en el período estudiado y se asociaron con características de la víctima y del evento. Los profesionales de la salud desempeñan un papel fundamental en el proceso de detección de este agravio y, consecuentemente, en el diseño de estrategias de prevención y protección de las víctimas.(AU)
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Automutilação , Suicídio , Tentativa de Suicídio , Violência/prevenção & controle , Fatores de Risco , Fatores Socioeconômicos , Estratégias de Saúde , Notificação/estatística & dados numéricos , Prevenção do SuicídioRESUMO
RESUMO Objetivo: identificar a frequência da notificação de violência física contra o sexo feminino no estado do Espírito Santo, no período de 2011 a 2018, e sua associação com as características da vítima, do agressor e da ocorrência. Método: estudo transversal, com análise dos casos de violência física contra mulheres notificadas no Sistema de Informação de Agravos de Notificação em 2011-2018. As associações foram testadas pelo teste qui-quadrado de Pearson e regressão de Poisson. Resultados: a notificação de violência física contra meninas e mulheres representou uma frequência de 54,1%. O grupo feminino de 20 a 59 anos tem cerca de 4,3 vezes mais prevalência de ser vítima de violência física quando comparado ao grupo de 0-9 anos. As mulheres pretas/pardas têm 1,06 vezes mais frequência de notificação de violência física. A maior parte das ocorrências do evento foi observado entre as sem deficiência/transtorno e residentes na zona urbana/periurbana. A violência física contra mulheres foi 1,71 vezes mais praticada por um conhecido, e com suspeita de uso de álcool (RP:1,07). Conclusão: a violência física contra o sexo feminino foi elevada e apresenta associação com determinadas características da vítima do agressor e da ocorrência, tais achados podem nortear as tomadas de decisões no enfrentamento a violência.
RESUMEN Objetivo: identificar la frecuencia de notificación de violencia física contra el sexo femenino en el estado del Espírito Santo-Brasil, en el período de 2011 a 2018, y su asociación con las características de la víctima, del agresor y de la ocurrencia. Método: estudio transversal, con análisis de los casos de violencia física contra mujeres notificados en el Sistema de Información de Agravios de Notificación en 2011-2018. Las asociaciones fueron comprobadas por la prueba Chi-cuadrado de Pearson y regresión de Poisson. Resultados: la notificación de violencia física contra niñas y mujeres representó una frecuencia de 54,1%. El grupo femenino de 20 a 59 años tiene cerca de 4,3 veces más prevalencia de ser víctima de violencia física cuando comparado al grupo de 0-9 años. Las mujeres negras/pardas tienen 1,06 veces más frecuencia de notificación de violencia física. La mayor parte de las ocurrencias del evento fue observada entre las sin discapacidad/trastorno y residentes en la zona urbana/periurbana. La violencia física contra mujeres fue 1,71 veces más practicada por un conocido, y con sospecha de uso de alcohol (RP:1,07). Conclusión: la violencia física contra el sexo femenino fue elevada y presenta asociación con determinadas características de la víctima del agresor y de la ocurrencia, tales hallazgos pueden guiar las tomas de decisiones en el enfrentamiento a la violencia.
ABSTRACT Objective: to identify the frequency of notification of physical violence against women in the state of Espírito Santo, from 2011 to 2018, and its association with the characteristics of the victim, the aggressor and the occurrence. Method: cross-sectional study with analysis of cases of physical violence against women reported in the Notifiable Diseases Information System in 2011-2018. The associations were tested by Pearson's chi-square test and Poisson regression. Results: the notification of physical violence against girls and women represented a frequency of 54.1%. The female group aged 20 to 59 years has about 4.3 times more prevalence of being a victim of physical violence when compared to the group aged 0-9 years. Black/brown women have 1.06 times more frequency of notification of physical violence. Most of the occurrences of the event were observed among those without disability/disorder and residents in the urban/periurban area. Physical violence against women was 1.71 times more practiced by an acquaintance, and with suspected alcohol use (PR:1.07). Conclusion: physical violence against women was high and presents association with certain characteristics of the victim of the aggressor and the occurrence, such findings can guide decision-making in coping with violence.
Assuntos
Humanos , Feminino , Violência contra a Mulher , Saúde da Mulher , Violência Doméstica , Monitoramento Epidemiológico , Sistemas de Informação em SaúdeRESUMO
BACKGROUND: Ozone increases IL-33 in the lungs, and obesity augments the pulmonary effects of acute ozone exposure. OBJECTIVES: We assessed the role of IL-33 in the augmented effects of ozone observed in obese mice. METHODS: Lean wildtype and obese db/db mice were pretreated with antibodies blocking the IL-33 receptor, ST2, and then exposed to ozone (2 ppm for 3 hr). Airway responsiveness was assessed, bronchoalveolar lavage (BAL) was performed, and lung cells harvested for flow cytometry 24 hr later. Effects of ozone were also assessed in obese and lean mice deficient in γδ T cells and their wildtype controls. RESULTS AND DISCUSSION: Ozone caused greater increases in BAL IL-33, neutrophils, and airway responsiveness in obese than lean mice. Anti-ST2 reduced ozone-induced airway hyperresponsiveness and inflammation in obese mice but had no effect in lean mice. Obesity also augmented ozone-induced increases in BAL CXCL1 and IL-6, and in BAL type 2 cytokines, whereas anti-ST2 treatment reduced these cytokines. In obese mice, ozone increased lung IL-13+ innate lymphoid cells type 2 (ILC2) and IL-13+ γδ T cells. Ozone increased ST2+ γδ T cells, indicating that these cells can be targets of IL-33, and γδ T cell deficiency reduced obesity-related increases in the response to ozone, including increases in type 2 cytokines. CONCLUSIONS: Our data indicate that IL-33 contributes to augmented responses to ozone in obese mice. Obesity and ozone also interacted to promote type 2 cytokine production in γδ T cells and ILC2 in the lungs, which may contribute to the observed effects of IL-33. Citation: Mathews JA, Krishnamoorthy N, Kasahara DI, Cho Y, Wurmbrand AP, Ribeiro L, Smith D, Umetsu D, Levy BD, Shore SA. 2017. IL-33 drives augmented responses to ozone in obese mice. Environ Health Perspect 125:246-253; http://dx.doi.org/10.1289/EHP272.
Assuntos
Poluentes Atmosféricos/toxicidade , Interleucina-13/metabolismo , Ozônio/toxicidade , Animais , Líquido da Lavagem Broncoalveolar , Camundongos , Testes de ToxicidadeRESUMO
OBJECTIVES: To assess the effect of a muscle stretching program using the global postural reeducation (GPR) method for patients with chronic low back pain. METHODS: A randomized, controlled, clinical trial with a single blinded examiner and intention-to-treat analysis was conducted. Sixty-one patients with chronic low back pain were randomly allocated to either the GPR group or a control group. Patients in the GPR group underwent one weekly 60-minute session of GPR for a period of 12 weeks. The control group remained on the waiting list under drug treatment, with no physical intervention. The following parameters were evaluated: pain (VAS), function capacity (Roland-Morris Questionnaire [RMQ]), quality of life (SF-36) and depressive symptoms (Beck Inventory). The evaluations were performed by a single blinded examiner at baseline, three and six months after the initial evaluation. RESULTS: The GPR group demonstrated statistical improvements (P<0.05) in the VAS and RMQ as well as the pain, emotional aspects, limitation in physical functioning, vitality and mental health subscales of the SF-36 immediately after the intervention (three months), which were maintained through to the six-month evaluation. DISCUSSIONS: Based on the findings, a stretching program using the GPR method showed effective at improving pain, function, some quality of life aspects (emotional, limitations in physical functioning, vitality and mental health) and had no effect on depressive symptoms in patients with chronic low back pain.
Assuntos
Dor Lombar/terapia , Exercícios de Alongamento Muscular/métodos , Postura , Doença Crônica , Feminino , Seguimentos , Humanos , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Medição da Dor , Qualidade de Vida , Método Simples-Cego , Inquéritos e Questionários , Resultado do TratamentoRESUMO
We examined the role of γδ T cells in the induction of alternatively activated M2 macrophages and the resolution of inflammation after ozone exposure. Wildtype (WT) mice and mice deficient in γδ T cells (TCRδ-/- mice) were exposed to air or to ozone (0.3 ppm for up to 72h) and euthanized immediately or 1, 3, or 5 days after cessation of exposure. In WT mice, M2 macrophages accumulated in the lungs over the course of ozone exposure. Pulmonary mRNA abundance of the M2 genes, Arg1, Retnla, and Clec10a, also increased after ozone. In contrast, no evidence of M2 polarization was observed in TCRδ-/- mice. WT but not TCRδ-/- mice expressed the M2c polarizing cytokine, IL-17A, after ozone exposure and WT mice treated with an IL-17A neutralizing antibody exhibited attenuated ozone-induced M2 gene expression. In WT mice, ozone-induced increases in bronchoalveolar lavage neutrophils and macrophages resolved quickly after cessation of ozone exposure returning to air exposed levels within 3 days. However, lack of M2 macrophages in TCRδ-/- mice was associated with delayed clearance of inflammatory cells after cessation of ozone and increased accumulation of apoptotic macrophages in the lungs. Delayed restoration of normal lung architecture was also observed in TCRδ-/- mice. In summary, our data indicate that γδ T cells are required for the resolution of ozone-induced inflammation, likely because γδ T cells, through their secretion of IL-17A, contribute to changes in macrophage polarization that promote clearance of apoptotic cells.
Assuntos
Pulmão/imunologia , Macrófagos/imunologia , Ozônio/toxicidade , Pneumonia/imunologia , Receptores de Antígenos de Linfócitos T gama-delta/imunologia , Linfócitos T/imunologia , Animais , Anticorpos Neutralizantes/farmacologia , Apoptose/imunologia , Arginase/genética , Arginase/imunologia , Líquido da Lavagem Broncoalveolar/química , Líquido da Lavagem Broncoalveolar/citologia , Movimento Celular/efeitos dos fármacos , Regulação da Expressão Gênica , Peptídeos e Proteínas de Sinalização Intercelular/genética , Peptídeos e Proteínas de Sinalização Intercelular/imunologia , Interleucina-17/antagonistas & inibidores , Interleucina-17/genética , Interleucina-17/imunologia , Lectinas Tipo C/genética , Lectinas Tipo C/imunologia , Pulmão/efeitos dos fármacos , Pulmão/patologia , Ativação de Macrófagos/efeitos dos fármacos , Macrófagos/efeitos dos fármacos , Macrófagos/patologia , Masculino , Camundongos , Camundongos Knockout , Neutrófilos/efeitos dos fármacos , Neutrófilos/imunologia , Neutrófilos/patologia , Pneumonia/induzido quimicamente , Pneumonia/genética , Pneumonia/patologia , Receptores de Antígenos de Linfócitos T gama-delta/deficiência , Receptores de Antígenos de Linfócitos T gama-delta/genética , Linfócitos T/efeitos dos fármacos , Linfócitos T/patologiaRESUMO
Bronchoalveolar lavage fluid (BALF) was analyzed to obtain information on leakage of acute-phase proteins from the blood into the respiratory lumen and about local synthesis. Ceruloplasmin, transferrin, albumin, α1-antitripsin, immunoglobulin G heavy, immunoglobulin G light, immunoglobulin A, haptoglobin, acidic glycoprotein, and P23 were measured in BALF from 30 horses without inflammatory disease by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). In serum, the same proteins were identified except for α1-antitrypsin. In conclusion, this study demonstrated that polyacrylamide gel electrophoresis (SDS-PAGE) can be used for the determination of acute-phase proteins in BALF samples from horses. In healthy horses, the values are very low, but they can be compared with reference values to assist in the diagnosis of animals with respiratory diseases.(AU)
O líquido obtido através da lavagem broncoalveolar (LBA) foi analisado para obter informações sobre as proteínas da fase aguda. Ceruloplasmina, transferrina, albumina, α1-antitripsina, imunoglobulina G pesada, imunoglobulina G leve, imunoglobulina A, haptoglobina, glicoproteína ácida e P23 foram medidas nos LBA de 30 cavalos sem doença inflamatória por eletroforese em gel de poliacrilamida com dodecilsulfato de sódio (SDS-PAGE). No soro, as mesmas proteínas foram identificadas, exceto a α1-antitripsina. Em conclusão, este estudo demonstra que a eletroforese em gel de poliacrilamida (SDS-PAGE) pode ser usada para a determinação de proteínas de fase aguda em amostras de LBA em cavalos. Em cavalos saudáveis, os valores são muito baixos, no entanto, podem ser comparados e auxiliar no diagnóstico de animais com doenças respiratórias.(AU)