RESUMO
BACKGROUND: Leptospirosis is an endemic disease in Brazil of social and economic relevance related to behavioural and socioenvironmental factors. This study aimed to analyse the spatiotemporal distribution of the incidence of leptospirosis and its association with social determinants in health in a state of northeastern Brazil. METHODS: An ecological study of temporal series with techniques of spatial analysis using secondary data of the cases of leptospirosis notified in the Information System of Notifiable Diseases of the state of Sergipe (2008-2017) was conducted. The analysis of temporal trends was performed using Poisson regression. Spatial analyses were performed using the Moran index, the local empirical Bayesian model, scan statistics and spatial regression. RESULTS: The incidence rate decreased from 3.66 to 1.44 cases per 100 000 inhabitants in 2008 and 2017, respectively. Leptospirosis was associated with social inequities, mostly affecting males aged 20-49 y living in urban areas. The space-time scan indicated the formation of a risk cluster in municipalities in the metropolitan region of the state. CONCLUSIONS: The data indicated the persistence of leptospirosis transmission, maintaining a pattern of high endemicity in some municipalities associated with social inequities. The study showed the temporal and spatial dynamics of the disease to better target specific actions for prevention and control.
Assuntos
Leptospirose , Teorema de Bayes , Brasil/epidemiologia , Cidades , Análise por Conglomerados , Humanos , Incidência , Leptospirose/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Análise Espacial , Análise Espaço-TemporalRESUMO
: Evaluate the in-vitro effect of Mentha crispa extract on blood coagulation, compare the conventional coagulometric tests with thrombin generation test (TGT), and study the qualitative micromolecular composition of M. crispa. Extract of M. crispa was incubated with plasma and used in the coagulometric tests: prothrombin and activated partial thromboplastin times, fibrinogen, and TGT. A phytochemical prospection was performed to evaluate the chemical composition of this extract. The extract was efficient in prolonging prothrombin time and activated partial thromboplastin time, and reducing fibrinogen levels and TGT parameters, indicating that the extract of M. crispa inhibited the intrinsic and extrinsic pathways of blood coagulation. The results obtained in TGT are in agreement with the results of conventional coagulometric tests and the in-vitro anticoagulant activity of M. crispa suggests that its use by patients using oral anticoagulants deserves caution.
Assuntos
Anticoagulantes/uso terapêutico , Testes de Coagulação Sanguínea/métodos , Coagulação Sanguínea/efeitos dos fármacos , Mentha/química , Anticoagulantes/farmacologia , Voluntários Saudáveis , HumanosRESUMO
Chronic nonspecific low back pain is common and one of the most disabling conditions in the world. There is moderate evidence that chronic low back pain patients present altered functional connectivity in areas related to pain processing. Quantitative sensory testing is a way of clinical measure of these alterations. Although there is not enough evidence, there are some reports that electroacupuncture is supposedly more effective in relieving pain than acupuncture because the addition of electric current could optimize the effects of traditional technique. Thus, the objective of this randomized clinical trial was to verify if electroacupuncture treatment reduces pain and changes quantitative sensory testing responses in patients with chronic nonspecific low back pain. Patients were evaluated before and after 10 sessions regarding pain (11-point numerical rating pain scale) and quantitative sensory testing (pressure pain threshold, temporal summation, and conditioned pain modulation). There were 1 treatment group (electroacupuncture (EA)) and three different control groups (CTR 1, CTR 2, and CTR 3). A total of 69 patients participated in the study. No significant differences were found in pain intensity or quantitative sensory testing responses when comparing electroacupuncture group to the three control groups. There was a significant reduction in both resting and movement pain intensity in groups EA, CTR 1, and CTR3. Although ten sessions of electroacupuncture have diminished pain intensity in both resting and movement, it could not change significantly quantitative sensory testing and diminish central sensitization in patients with chronic nonspecific low back pain. The implications of this study involve the fact that, maybe, in chronic nonspecific low back pain, electroacupuncture should be associated with other treatments that target central sensitization.