Resumen Los adultos fumadores con comorbilidades, y los ancianos, corren mayor riesgo de contraer infecciones y sus complicaciones. Las infecciones respiratorias comu nitarias por virus, neumococo y otras bacterias afectan tanto a adultos sanos como enfermos. Existen vacunas que el neumonólogo debe conocer y prescribir. Las ce pas blanco de la vacuna contra influenza son definidas por la OMS para el hemisferio sur considerando a las implicadas en la temporada precedente de influenza en el hemisferio norte. Su efectividad depende de la virulencia, la concordancia entre las cepas circulantes y las vacunales y la cobertura de la población. La vacuna anti-neumocócica polisacárida disponible desde 1983 está siendo reemplazada por vacunas conjugadas más eficaces para prevenir infecciones relacionadas a sero tipos presentes en las mismas. La inmunización contra SARS-CoV-2 redujo el contagio, la gravedad y la letalidad de COVID-19. La vacuna acelular contra Bordetella pertussis para adultos está presente para situaciones puntuales en el calendario para adultos, vacunarlos fortalece el control del contagio infantil. Las vacunas doble bacte riana (difteria + tétanos), y triple (doble + pertussis), y contra sarampión, varicela, rubeola, virus del papiloma humano, Haemophylus influenzae, meningococo, herpes zóster, fiebre hemorrágica argentina y fiebre amarilla, son de uso más limitado. Pronto contaremos con nuevas vacunas, como la recientemente aprobada por la FDA contra el virus sincicial respiratorio. Revisamos a través de un consenso de expertos en infecciones respiratorias las nuevas evidencias acerca de la inmunización de adultos que consultan al neumonólogo, y actualizamos así las recomendaciones sobre vacunación realizadas ocho años atrás.

Abstract Adult smokers, those with comorbidities, and the elderly, are at greater risk of contracting infections and their complications. Community acquired respiratory infections due to viruses, pneumococcus and other bac teria, affect both healthy and sick adults. There are vac cines that the pulmonologist must know and prescribe. The target strains of the influenza vaccine are defined by the WHO for the Southern hemisphere considering those involved in the previous influenza season in the Northern hemisphere. Its effectiveness depends on virulence, concordance between circulating and vaccine strains, and population coverage. The anti-pneumococcal polysaccharide vaccine available since 1983 is being replaced by more effective conjugate vaccines to pre vent infections related to serotypes present in them. Immunization against SARS-CoV-2 reduced the conta gion, severity, and lethality of COVID-19. The acellular vaccine against Bordetella pertussis for adults is present for specific situations in the adult calendar; vaccinating them strengthens the control of childhood contagion. The double (diphtheria + tetanus), and triple (double + pertussis) bacterial vaccines, and the vaccines against measles, chickenpox, rubella, human papillomavirus, Haemophilus influenzae, meningococcus, herpes zoster, Argentine hemorrhagic fever and yellow fever, are of a more limited use. Soon we will have new vaccines such as the one recently approved by the FDA against respi ratory syncytial virus. Through a consensus of experts in respiratory infections, we review the new evidence regarding the immunization of adults who consult a pulmonologist, and thus update the recommendations on vaccination made eight years ago.

Abstract: Atrial fibrillation (AF) is the most prevalent arrhythmia and is related to significant morbidity, mortality and costs. In spite of relevant advances in the prevention of embolic events and rhythm control, little has been done to reduce its prevalence, progression and impact since it increases with aging as well as with common risk factors such as alcohol intake, tobacco use and stress as well as with arterial hypertension, diabetes mellitus, heart failure, sleep apnea, kidney failure, chronic pulmonary obstructive disease, ischemic heart disease and stroke, among other important comorbidities. Fortunately, new evidence suggests that lifestyle modifications and adequate risk factors and comorbidities control could be effective in primary and secondary AF prevention, especially in its paroxysmal forms. This is why a multidisciplinary approach integrating lifestyle modifications, risk factors and comorbidities control is necessary for conjunction with rhythm or rate control and anticoagulation. Unfortunately, that holistic approach strategy is not considered, is scarcely studied or is subtilized in general clinical practice. The present statement’s objectives are to: a) Review the relationship between habits, risk factors and illnesses with AF, b) Review the individual and common physiopathology mechanisms of each one of those conditions that may lead to AF, c) Review the effect of control of habits, risk factors and co-morbidities on the control and impact of AF, d) Supply guidelines and recommendations to start multidisciplinary and integrative AF treatment.

Resumen: La fibrilación auricular (FA) es la arritmia más frecuente y se asocia con importante morbilidad, mortalidad y costos. A pesar de los grandes avances en la prevención de eventos embólicos y en el control del ritmo, poco se ha realizado para reducir su prevalencia, progresión e impacto, debido a que incrementa con la edad y con la presencia de múltiples factores de riesgo muy comunes en la población, como obesidad, sedentarismo, alcoholismo, tabaquismo y estrés, así como hipertensión arterial sistémica, diabetes mellitus, insuficiencia cardiaca, apnea del sueño, enfermedad renal crónica, enfermedad pulmonar obstructiva crónica, cardiopatía isquémica y enfermedad vascular cerebral, entre otras comorbilidades importantes. Nuevas evidencias demuestran que las modificaciones en el estilo de vida y el control adecuado de factores de riesgo y comorbilidades pueden ser efectivos en la prevención primaria y secundaria de la FA, especialmente en sus formas paroxísticas; para ello es necesario un manejo multidisciplinario que integre las modificaciones en el estilo de vida, el manejo de factores de riesgo y control de comorbilidades en el tratamiento de la FA en conjunto con el control de ritmo o frecuencia y la anticoagulación. Desafortunadamente, en la práctica clínica, estas estrategias frecuentemente no son tomadas en cuenta, son subutilizadas y poco estudiadas. Los objetivos del presente posicionamiento son: a) revisar la relación entre factores de riesgo y comorbilidades con FA, b) revisar los mecanismos fisiopatológicos de cada una de estas condiciones, c) revisar el impacto del control de factores de riesgo y comorbilidades en el control e impacto de la FA y d) proporcionar guías y recomendaciones para la puesta en práctica de programas de tratamiento multidisciplinario e integral en pacientes con FA.

Abstract Objectives: to analyze the impact of the covid-19 pandemic on screening, diagnosis and treatment of breast cancer in Pernambuco, Northeastern Brazil. Method: cross-sectional study, based on secondary data from consultations with a mastologist, ultrasound, mammogram, biopsies, new cases, chemotherapy, radiotherapy and surgery, carried out in women for the screening, diagnosis and treatment of breast cancer, from January to December of the years 2019 to 2021. Results: the covid-19 pandemic reduced consultations with mastology (46.3%), ultrasounds (34.8%), mammogram (41.5%), biopsy (49.6%), new cases 45.7 % and surgery 34.6% in 2020 compared to 2019. On the other hand, with the exception of consultations with a mastologist and surgeries, all services where a significant reduction was observed in 2020, increased significantly in 2021 and returned to the same level of production in the pre-pandemic period. The pandemic did not negatively affect the supply of chemotherapy and radiotherapy. Conclusions: the findings of this study indicate negative impacts on breast cancer care, due to covid-19, during the first year of the pandemic, especially in consultations with a mastologist and surgery, which continued with low production in 2021. It is reasonable to assume that the reduction observed in procedures may reflect an increase in late diagnoses and a higher mortality rate in the coming years

Resumo Objetivos: analisar o impacto da pandemia da covid-19 nos atendimentos para rastreamento, diagnóstico e tratamento do câncer de mama em Pernambuco, Nordeste do Brasil. Métodos: estudo transversal, com base em dados secundários de consultas com mastologista, ultrassonografia, mamografia, biópsias, casos novos, quimioterapia, radioterapia e cirurgia, realizadas em mulheres para o rastreamento, diagnóstico e tratamento do câncer de mama, de janeiro a dezembro dos anos 2019 a 2021. Resultados: a pandemia da covid-19 reduziu as consultas com a mastologia (46,3%), ultrassonografias (34,8%), mamografia (41,5%), biópsia (49,6%), casos novos 45,7% e cirurgia 34,6% no ano de 2020 em relação ao ano de 2019. Por outro lado, com exceção das consultas com mastologista e cirurgias, todos os serviços onde se observou redução significativa em 2020, aumentaram significativamente em 2021 e voltaram ao patamar de produção do período pré-pandemia. A pandemia não afetou negativamente a oferta de quimioterapia e radioterapia. Conclusões: os achados deste estudo apontam impactos negativos na atenção ao câncer de mama, em decorrência da covid-19, durante o primeiro ano da pandemia, sobretudo nas consultas com mastologista e cirurgia, que continuaram com baixa produção em 2021. É razoável supor que a redução constatada nos procedimentos poderá refletir em um aumento de diagnósticos tardios e maior taxa de mortalidades nos próximos anos.

Abstract Objective: To know the epidemiological behavior and associations of AF in Mexican population. Material and methods: 8,686 patients from 38 cardiologists participating in REMECAR were analyzed. They were divided by gender and age, the comorbidities studied were obesity, chronic kidney disease (CKD), high blood pressure (HBP), diabetes mellitus (DM), dyslipidemia, stroke, chronic obstructive pulmonary disease (COPD), hypothyroidism, heart failure (HF) and ischemic heart disease (IHD). Program used: IBM SPSS Statistic. Results: AF was diagnosed in 498 patients (5.7%), with higher prevalence in men (6.1% vs. 5.3%) and older age in women (74.3 ± 12.1 vs. 70.5 + -12.3 years, p<0.0001). In those under 60 years, AF was associated in women with HF, in men with CKD, DM, stroke, hypothyroidism and HF. In women older than 60 years, AF was associated with CKD, dyslipidemia, stroke, chronic COPD and HF, in men with CKD, stroke, COPD, hypothyroidism, HF and IHD. AF in women increase the probability 1.13 for obesity, 1.13 for HBP, 2.8 for CKD, 2.9 for COPD, 4.3 for stroke and 6.5 for HF, in men increase the probability 1.05 for HBP, 1.4 for DM, 2.1 for CKD, 2.4 for COPD, 3.0 for hypothyroidism, 4.7 for stroke and 6.0 for HF. Conclusions: AF is a very common arrhythmia, with a higher prevalence in patients attending the cardiology consultation, in men and with an older age of presentation in women. The older the age, the higher the prevalence of AF and comorbidities, HF is the most frequent condition associated with AF.

Resumen Objetivo: Conocer el comportamiento epidemiológico y asociaciones de la FA en población mexicana. Material y métodos: Analizamos 8,686 pacientes de 38 cardiólogos inscritos en REMECAR, divididos por edad y sexo. Comorbilidades estudiadas: obesidad, ERC, HTA, DM, dislipidemia, EVC, EPOC, hipotiroidismo, IC y CI. Programa: IBM SPSS. Resultados: FA en 498 pacientes (5.7%), mayor prevalencia en hombres (6.1 vs. 5.3%), mayor edad en mujeres (74.3 ± 12.1 vs. 70.5 ± 12.3 años, p < 0.0001). En mujeres menores de 60 años la FA se asoció con IC (p = 0.041), en hombres con ERC (p = 0.43), DM (p = 0.009), EVC (p = 0.001), hipotiroidismo (p = 0.001) e IC (p = 0.001). En mujeres mayores de 60 años se asoció con ERC (p = 0.001), dislipidemia (p = 0.001), EVC (p = 0.001), EPOC (p = 0.001) e IC (p = 0.001), en hombres con ERC (p = 0.002), EVC (p = 0.001), EPOC (p = 0.002), hipotiroidismo (p = 0.002), IC (p = 0.001) y CI (p = 0.033). En mujeres la FA se asoció con 1.13 veces mayor probabilidad de obesidad, 1.13 de HTA, 2.8 de ERC, 2.9 de EPOC, 4.3 de EVC y 6.5 de IC, en hombres la FA se asoció con 1.05 veces mas probabilidad de HTA, 1.4 de DM, 2.1 de ERC, 2.4 de EPOC, 3 de hipotiroidismo, 4.7 de EVC y 6 de IC. Conclusiones: La FA es una arritmia muy frecuente, con mayor prevalencia en pacientes que acuden a consulta de cardiología, en hombres y mayor edad de presentación en las mujeres. A mayor edad, mayor prevalencia de FA y de comorbilidades, la IC es la condición más frecuente con la que se asoció la FA.

Resumen La pandemia del COVID-19 y las medidas preventivas que se adoptaron han tenido un amplio abanico de consecuencias que trascienden los problemas de salud para la población de muchas ciudades del mundo. Con el propósito de entender por qué los impactos en la vida de los habitantes resultaron tan diferentes dentro de la ciudad, nos interesamos en las vulnerabilidades socio-espaciales preexistentes, tomando como ejemplo las metrópolis de Lima y Bogotá. Indagamos por la relación entre estructura urbana, patrones de movilidad cotidiana y efectos del COVID-19 durante las cuarentenas del 2020. Adoptamos para ello un enfoque multidimensional que se sustenta en datos censales, en las últimas encuestas origen-destino disponibles y en los niveles de contagio en ambas ciudades durante el 2020. Con base en un análisis factorial y un análisis de conglomerado, proponemos una tipologia y un mapa sintético de los factores de vulnerabilidad preexistentes. Los resultados permiten entender el rol de estos factores en las dificultades que tuvieron los habitantes para enfrentar la cuarentena, asi como la razón por la cual aquellos que moran en los barrios periféricos de bajos ingresos sufrieron las peores alteraciones en su cotidianidad.

Abstract The COVID-19 pandemic and the preventive measures that were adopted have had a wide range of consequences that went beyond health problems for the inhabitants of many cities around the world. In order to understand why the impacts on the dwellers' lives were so different within the city, we looked at pre-existing socio-spatial vulnerabilities, taking as an example the metropolises of Lima and Bogota. We investigated the relationship between urban structure, daily mobility patterns and the effects of COVID-19 during the 2020 quarantines. We adopted a multidimensional approach using census data, the latest available origin-destination surveys, and the levels of contagion in both cities during 2020. Based on a factor analysis and a cluster analysis, we devised a typology and a synthetic map of pre-existing vulnerability factors. The results allow us to understand the role of these factors in the difficulties that the populations had to face during the quarantine, and why people living in the low-income outskirts suffered the worst disruptions in their daily lives.

Résumé La pandémie du COVID 19 et les mesures préventives associées ont entraîné toute une série de conséquences qui sont allées bien audelà des seuls problèmes de santé pour les habitants de nombreuses villes du monde. Avec l'objectif de comprendre pourquoi les impacts vécus par les citadins ont été si différents d'un secteur à l'autre de la ville, nous nous intéressons aux vulnérabilités socio-spatiales préexistantes, en prenant comme terrains d'étude les cas de Lima et de Bogotá. Nous explorons la relation entre la structure urbaine, la mobilité quotidienne et les effets du COVID-19 durant les périodes de confinement de 2020. Nous proposons une approche multidimensionnelle qui s'appuie sur des données de recensement, les dernières enquêtes origine-destination disponibles et sur les niveaux de contagion dans les deux villes durant 2020. À l'aide d'une analyse factorielle et d'une classification, nous proposons une typologie et une cartographie synthétique des facteurs de vulnérabilité préexistants. Les résultats permettent de comprendre le rôle de ces facteurs dans les difficultés vécues par les habitants pour faire face au confinement, et pourquoi ceux qui vivent dans les quartiers périphériques populaires ont connu les plus fortes altérations de leur vie quotidienne.

Resumo A pandemia do COVID-19 e as medidas preventivas que se adotam têm tido uma ampla gama de consequências que vão além dos problemas de saúde para a população de muitas cidades do mundo. Com o propósito de entender por que os impactos na vida dos habitantes resultaram em diferenças dentro da cidade, nos interessamos nas vulnerabilidades socioespaciais pré-existentes, tomando-se como exemplo as metrópoles de Lima e Bogotá. Indagamos a relação entre a estrutura urbana cotidiana, os patronos da mobilidade e os efeitos do COVID-19 durante as quarentenas de 2020. Adotamos o enfoque multidimensional que sustenta os dados censales, nas últimas pesquisas de origem-destino disponíveis e nos níveis de contagio em ambas cidades durante o ano de 2020. Com base em uma análise fatorial e uma análise de conglomerado, propomos uma tipologia e um mapa sintético dos fatores de vulnerabilidade preexistentes. Os resultados permitem entender o papel desses fatores nas dificuldades que tuvieram os habitantes para enfrentar a quarentena, assim como a razão pela qual aquellos que moram nos bairros periféricos de baixa renda sofrem as peores alterações em sua cotidianidade.

Resumen Se evaluó el efecto del tratamiento térmico en los desechos de caolín de la minería sobre el comportamiento estructural y térmico de la poli (ε-caprolactona) (PCL). Los compuestos PCL/DC (desechos de caolín) y PCL/DCT (desechos de caolín tratados térmicamente) se procesaron en un mezclador interno y luego se caracterizaron por difracción de rayos X (DRX) y calorimetría de barrido diferencial (DSC). El residuo de caolín tenía caolinita y cuarzo en su composición, mientras que el tratamiento térmico a 1200 °C lo cambio a mullita, cuarzo y fase amorfa rica en sílice. Por XRD, hubo un aumento en la intensidad del pico 29 = 23,9° de los compuestos PCL/DC, en comparación con el PCL puro. Por el contrario, los compuestos PCL/DCT tendieron a reducir la intensidad máxima 2θ = 23,9°, especialmente con el 5 % de DCT. La temperatura de fusión cristalina y el grado de cristalinidad de los compuestos PCL/DC y PCL/DCT se mantuvieron prácticamente sin cambios, en relación al PCL. Sin embargo, el proceso de cristalización fue más eficiente con residuo de caolín (DC) sin tratamiento térmico, lo que indica que la fase amorfa del DCT inhibió la cristalización. El desarrollo de los PCL/DC promovió un aumento en la temperatura de cristalización, cristalinidad relativa y velocidad de cristalización, superando a la PCL y al sistema de los PCL/ DCT. Como resultado, el residuo de caolín tiene el potencial de acelerar el proceso de cristalización de la PCL, contribuyendo a agregar valor a un material que de otra manera sería descartado y minimizando los impactos ambientales.

Abstract The heat treatment effect on kaolin waste from mining was evaluated on the structural and thermal behavior of poly(ε-caprolactone) (PCL). The PCL/KW (kaolin waste) and PCL/HTKW (heat-treated kaolin waste) composites were processed in an internal mixer and subsequently characterized by X-ray diffraction (XRD) and differential scanning calorimetry (DSC). The kaolin waste showed kaolinite and quartz in its composition, while the heat treatment at 1200°C modified it to mullite, quartz and silica-rich amorphous phase. By XRD, there was an increase in the intensity of the peak 2θ = 23.9° of the PCL/KW composites compared to neat PCL. In contrast, PCL/HTKW composites tended to reduce the intensity of the peak 29 = 23.9°, especially at 5% HTKW. The crystalline melting temperature and the degree of crystallinity of PCL/KW and PCL/HTKW composites were practically unchanged, compared to PCL. However, the crystallization process was more effective with the kaolin waste (KW) without heat treatment, indicating that the HTKW amorphous phase inhibited crystallization. The PCL/KW development promoted an increase in crystallization temperature, relative crystallinity, and crystallization rate, surpassing PCL and the PCL/HTKW system. In view of this, kaolin waste has the potential to accelerate the PCL crystallization process, contributing to add value to a material that would otherwise be discarded and minimizing environmental impacts.

Resumen El uso de enzimas como α-amilasas, xilanasas y glucosidasas es una buena alternativa para obtener una mayor eficiencia en los productos de la industria panificadora, sin dejar de mencionar la lacasa que ha mostrado un potencial prometedor. Así, el objetivo de este estudio fue obtener concentrados enzimáticos de xilanasas, amilasas, celulasas y lacasas a partir de cepas nativas de Pycnoporus sanguineus. Para lo cual, se evaluó el efecto del medio de cultivo sobre la producción de lacasa juntamente con el escrutinio en medio sólido para la detección de xilanasas, amilasas y celulasas. A los concentrados enzimáticos obtenidos se les determinaron las unidades de lacasa y carbohidrolasas. Los títulos más altos de lacasa se presentaron en el medio Tx2. Con respecto a las carbohidrolasas, se detectaron en diferentes niveles de actividad y combinaciones. El concentrado con altos niveles de amilasa y lacasa fue CH116, mientras que LE90 tuvo la mayor actividad de xilanasa y LE133 de celulasa. La cepa CH116 fue productora de amilasa, celulasa, xilanasa y lacasa, siendo la de mayor potencial en la industria panificadora, mientras que LE90 puede ser utilizada en la industria papelera por su combinación de xilanasas y lacasa.

Abstract The use of enzymes such as α-amylases, xylanases and glucosidases is a good alternative to obtain higher efficiency in the bakery industry, not to mention laccase which has shown promising potential. Thus, the objective of this study was to obtain enzyme concentrates of xylanases, amylases, cellulases and laccases from Pycnoporus sanguineus native strains. For which, the effect of culture medium on the laccase production was evaluated together with the solid medium screening of xylanases, amylases and cellulases. Laccase and carbohydrolases units were determined from the enzyme concentrates obtained. The higher laccase titers occurred in the Tx2 medium. Regarding carbohydrolases, they were present at different levels of activity and combinations. The concentrate with higher titers of amylase and laccase was CH116, while LE90 had the greater xylanase activity and LE133 of cellulase. The CH116 strain was a producer of amylase, cellulase, xylanase and laccase, being the one with the higher potential in the bakery industry, while LE90 in the paper industry, due to its combination of xylanases and laccase.

Resumen El poli (ácido lactico) (PLA) es un termoplástico biodegradable ampliamente utilizado en la fabricación de aditivos, principalmente en productos fabricados mediante impresión 3D. Sin embargo, el PLA es muy frágil y tiene baja resistencia al impacto; por lo tanto, las mejoras en este sentido son industrial y tecnológicamente importantes. Con el fin de desarrollar una metodología adecuada para un PLA de mayor rendimiento, este trabajo investigó los efectos del recocido térmico en las propiedades mecánicas (impacto, tracción, dureza de la Shore D), temperatura de desviación térmica (HDT), temperatura de ablandamiento de Vicat (TAV) y cristalinidad (difracción de rayos X) del PLA. Las muestras inyectadas fueron recocidos en horno a 70, 80, 90 y 100 oC. El recocido a 70 oC no fue efectivo, sin cambios significativos verificados. Por otro lado, el recocido a 80, 90 y 100 oC proporciono picos cristalinos en la DRX, lo que indica el desarrollo de la organización estructural. Los resultados expresivos se lograron a 90 oC para resistencia al impacto, HDT, VST, dureza Shore D y resistencia a la tracción, relacionados con PLA sin recocido. Los resultados presentados en este trabajo son de importancia científica y tecnológica, ya que las propiedades mecánicas y termomecánicas del PLA se han mejorado utilizando una metodología simple que puede producir productos de mayor rendimiento principalmente para la industria de impresión 3D de PLA.

Abstract Poly (lactic acid) (PLA) is widely used biodegradable thermoplastic in the additive manufacturing, mainly on manufactured products through 3D printing. However, PLA is highly fragile and presents low impact strength; hence improvements on this way are industrially and technologically important. Aiming to develop proper methodology for higher PLA performance, this work investigated the effects of thermal annealing on the mechanical properties (impact, tensile, Shore D hardness), heat deflection temperature (HDT), Vicat softening temperature (VST) and crystallinity (X-ray diffraction) of PLA. Injected specimens were annealed in greenhouses at 70, 80, 90 and 100 oC. Annealing at 70 oC was not effective, without verified significant changes. On the other hand, annealing at 80, 90 and 100 oC provided crystalline peaks in DRX, indicating development of structural organization. Expressive results were achieved, at 90 oC, for impact strength, HDT, VST, Shore D hardness and tensile strength, related to non-annealed PLA. Provided results in this work have scientific and technological importance, since the mechanical and thermomechanical properties of PLA were improved using a simple methodology which may render higher performance products mainly for the 3D printing industry of PLA.

Resumo O trabalho analisa a distribuição espacial da hanseníase na Bahia e os determinantes sociais relacionados. Estudo ecológico com dados de hanseníase do período 2001-2015. Três indicadores epidemiológicos foram selecionados: coeficiente de detecção na população geral e em menores de 15 anos e a taxa de casos novos com grau II de incapacidade. Os indicadores foram suavizados pelo Modelo Bayesiano Empírico Local e aplicou-se estatística de Moran Global e Local. As variáveis independentes foram selecionadas a partir do Censo IBGE-2010. Regressões multivariadas foram empregadas, seguidas de regressão espacial. Observou-se distribuição heterogênea no estado, com concentração no eixo norte-oeste e região sul. Para o coeficiente de detecção geral, cinco variáveis compuseram o modelo: densidade demográfica, proporção da população urbana, renda per capita, proporção de extremamente pobres e domicílios com mais de três pessoas por dormitório. A proporção de analfabetismo compôs o modelo final para a taxa de grau II de incapacidade física. Não foram identificados determinantes da ocorrência da doença em menores de 15 anos. A modelagem utilizada contribuiu para demonstrar a heterogeneidade espacial e os determinantes sociais da doença na Bahia, colocando em evidência a complexidade do problema.

Abstract This work analyzes the spatial distribution of leprosy in Bahia and associated social determinants. It is an ecological study, with leprosy data from 2001-2015. Three epidemiological indicators were selected: coefficient of detection in the general population and in children under 15 and the rate of new cases with grade II physical disability. These indicators were flattened by the Local Empirical Bayesian Model and Global and Local Moran statistics were applied. The independent variables were selected from the IBGE-2010 Census. Multivariate regressions were employed, followed by spatial regression. Leprosy exhibited a heterogeneous distribution in the state, with concentration in the north-west axis and the south region. For the general detection coefficient, five variables composed the final model: demographic density, urban population proportion, per capita income, proportion of extremely poor and households with over three people per dormitory. The illiteracy proportion made up the final model for the grade II rate of physical disability. No determinants of the occurrence of the disease were identified in children under 15. The modeling used contributed to demonstrate the spatial heterogeneity and social determinants of the disease in Bahia, revealing the complexity of the problem.

Abstract Cardiovascular diseases are the leading cause of death in most regions of the world, usually followed by infectious diseases. For decades, infections in general, and particularly those involving the respiratory system, have been known to be associated with an increased risk of cardiovascular and cerebrovascular events, and their consequent morbidity and mortality. Although vaccines are an excellent strategy in the prevention of infectious diseases, the proportion of immunized adults in our country is frankly deficient. Multiple barriers contribute to perpetuating this problem, within which the lack of prescription of the same by professionals who care for vulnerable populations occupies a central place. Patients with cardiovascular disease represent a particularly risky subpopulation. The spectrum of pathologies that can trigger respiratory infections is wide: development or worsening of heart failure, arrhythmias, acute coronary syndromes and cerebrovascular diseases, among the main ones. The role of immunoprophylaxis with influenza, pneumococcal and tetanus vaccine in patients with different heart diseases is addressed here, evaluating the evidence supporting its use, and placing special emphasis on practical aspects of its use, such as adverse effects, contraindications and special care situations, such as congenital heart disease in adults, heart transplantation, anticoagulation or egg allergy. Thus, this document aims to assist in decision-making for any doctor involved in the care of patients with cardiovascular disease.

Resumen Las enfermedades cardiovasculares ocupan la primera causa de muerte en la mayoría de las regiones del mundo, seguidas habitualmente por las enfermedades infecciosas. Desde hace décadas se conoce que las infecciones en general, y particularmente las que involucran el aparato respiratorio, se vinculan con un incremento en el riesgo de eventos cardiovasculares y cerebrovasculares, y su consecuente morbimortalidad. Si bien las vacunas constituyen una excelente estrategia en la prevención de enfermedades infectocontagiosas, la proporción de adultos inmunizados en nuestro país es francamente deficitaria. Múltiples barreras contribuyen a perpetuar esta problemática, dentro de las cuales la falta de prescripción de las mismas por parte de los profesionales que atienden a poblaciones vulnerables ocupa un lugar central. Los pacientes con enfermedades cardiovasculares representan una subpoblación de particular riesgo. El espectro de enfermedades que pueden originar las infecciones respiratorias es amplio: desarrollo o empeoramiento de insuficiencia cardíaca, arritmias, síndromes coronarios agudos y enfermedades cerebrovasculares, entre los principales. Se aborda aquí el rol de la inmunoprofilaxis con vacuna antigripal, antineumocócica y antitetánica en pacientes con diferentes cardiopatías, valorando la evidencia que respalda su empleo y haciendo especial hincapié en aspectos prácticos de su utilización, como efectos adversos, contraindicaciones y situaciones especiales de atención: cardiopatías congénitas del adulto, trasplante cardíaco, individuos anticoagulados o con alergia al huevo. Así, este documento tiene como objetivo asistir en la toma de decisiones a cualquier médico involucrado en el cuidado de pacientes con enfermedad cardiovascular.

Resumo O trabalho analisa a distribuição espacial da hanseníase na Bahia e os determinantes sociais relacionados. Estudo ecológico com dados de hanseníase do período 2001-2015. Três indicadores epidemiológicos foram selecionados: coeficiente de detecção na população geral e em menores de 15 anos e a taxa de casos novos com grau II de incapacidade. Os indicadores foram suavizados pelo Modelo Bayesiano Empírico Local e aplicou-se estatística de Moran Global e Local. As variáveis independentes foram selecionadas a partir do Censo IBGE-2010. Regressões multivariadas foram empregadas, seguidas de regressão espacial. Observou-se distribuição heterogênea no estado, com concentração no eixo norte-oeste e região sul. Para o coeficiente de detecção geral, cinco variáveis compuseram o modelo: densidade demográfica, proporção da população urbana, renda per capita, proporção de extremamente pobres e domicílios com mais de três pessoas por dormitório. A proporção de analfabetismo compôs o modelo final para a taxa de grau II de incapacidade física. Não foram identificados determinantes da ocorrência da doença em menores de 15 anos. A modelagem utilizada contribuiu para demonstrar a heterogeneidade espacial e os determinantes sociais da doença na Bahia, colocando em evidência a complexidade do problema.

Abstract This work analyzes the spatial distribution of leprosy in Bahia and associated social determinants. It is an ecological study, with leprosy data from 2001-2015. Three epidemiological indicators were selected: coefficient of detection in the general population and in children under 15 and the rate of new cases with grade II physical disability. These indicators were flattened by the Local Empirical Bayesian Model and Global and Local Moran statistics were applied. The independent variables were selected from the IBGE-2010 Census. Multivariate regressions were employed, followed by spatial regression. Leprosy exhibited a heterogeneous distribution in the state, with concentration in the north-west axis and the south region. For the general detection coefficient, five variables composed the final model: demographic density, urban population proportion, per capita income, proportion of extremely poor and households with over three people per dormitory. The illiteracy proportion made up the final model for the grade II rate of physical disability. No determinants of the occurrence of the disease were identified in children under 15. The modeling used contributed to demonstrate the spatial heterogeneity and social determinants of the disease in Bahia, revealing the complexity of the problem.

Resumo O homicídio é a forma mais grave de violência com impacto negativo na população. Amplamente estudado no campo científico e divulgado por meios impressos e virtuais. O objetivo deste artigo é resgatar artigos de periódicos nacionais e internacionais, buscando a síntese do conhecimento e a incorporação da aplicabilidade de resultados de estudos significativos. Revisão integrativa a partir da plataforma SciELO, PubMed e LILACS dos artigos publicados entre 2006 e 2016. Utilizaram-se os descritores: Homicídio e Brasil. Selecionaram-se os artigos através da leitura do título, resumo e metodologia. Foram encontrados 427 artigos, dos quais 98 se referiam a estudos de homicídios e saúde no Brasil. Verificou-se publicações com destaque para o cenário nacional, seguido do estado de São Paulo e Pernambuco. O estudo quantitativo foi o mais utilizado, com a coleta através de dados secundários. Os artigos abordaram os homicídios na população em geral (48%), Feminicídio (14,3%) e Determinantes Sociais (7,1%). A produção científica brasileira em homicídios e saúde se encontra em fase de ascensão. É importante que os pesquisadores, analistas e editores voltem a atenção para o desenvolvimento de trabalhos no âmbito desse tema, objetivando aprimorar a qualidade dos artigos publicados.

Abstract Homicide is the most serious form of violence with a negative impact on the population. It is broadly studied in the scientific field and disseminated in print and in the virtual media. The scope of this article is to locate papers in national and international journals, seeking the synthesis of knowledge and the incorporation of the applicability of the results of significant studies. It involved an integrative review of the SciELO, PubMed and LILACS databases of articles published between 2006 and 2016. The following key words were researched: Homicide and Brazil. The publications were selected by the title, abstract and methodology. For homicide and health studies in Brazil, 427 papers were found, of which 98 were selected. There were publications with emphasis on the national scenario, followed by the state of São Paulo and Pernambuco. The quantitative study was the most used, with collection of secondary data. The papers dealt with homicides in the population in general (48%), Femicide (14.3%) and Social Determinants (7.1%). The Brazilian scientific production on homicide and health is on the increase. It is important that researchers, analysts and editors turn their attention to the development of papers in this area, aiming to improve the quality of published articles.

Resumo O homicídio é a forma mais grave de violência com impacto negativo na população. Amplamente estudado no campo científico e divulgado por meios impressos e virtuais. O objetivo deste artigo é resgatar artigos de periódicos nacionais e internacionais, buscando a síntese do conhecimento e a incorporação da aplicabilidade de resultados de estudos significativos. Revisão integrativa a partir da plataforma SciELO, PubMed e LILACS dos artigos publicados entre 2006 e 2016. Utilizaram-se os descritores: Homicídio e Brasil. Selecionaram-se os artigos através da leitura do título, resumo e metodologia. Foram encontrados 427 artigos, dos quais 98 se referiam a estudos de homicídios e saúde no Brasil. Verificou-se publicações com destaque para o cenário nacional, seguido do estado de São Paulo e Pernambuco. O estudo quantitativo foi o mais utilizado, com a coleta através de dados secundários. Os artigos abordaram os homicídios na população em geral (48%), Feminicídio (14,3%) e Determinantes Sociais (7,1%). A produção científica brasileira em homicídios e saúde se encontra em fase de ascensão. É importante que os pesquisadores, analistas e editores voltem a atenção para o desenvolvimento de trabalhos no âmbito desse tema, objetivando aprimorar a qualidade dos artigos publicados.

Abstract Homicide is the most serious form of violence with a negative impact on the population. It is broadly studied in the scientific field and disseminated in print and in the virtual media. The scope of this article is to locate papers in national and international journals, seeking the synthesis of knowledge and the incorporation of the applicability of the results of significant studies. It involved an integrative review of the SciELO, PubMed and LILACS databases of articles published between 2006 and 2016. The following key words were researched: Homicide and Brazil. The publications were selected by the title, abstract and methodology. For homicide and health studies in Brazil, 427 papers were found, of which 98 were selected. There were publications with emphasis on the national scenario, followed by the state of São Paulo and Pernambuco. The quantitative study was the most used, with collection of secondary data. The papers dealt with homicides in the population in general (48%), Femicide (14.3%) and Social Determinants (7.1%). The Brazilian scientific production on homicide and health is on the increase. It is important that researchers, analysts and editors turn their attention to the development of papers in this area, aiming to improve the quality of published articles.

RESUMO Neste estudo, foram avaliadas blendas de polipropileno copolímero (PPCop)/polipropileno reciclado (PPRec), proveniente de baldes industriais pós-consumo, em três proporções diferentes (80:20; 60:40 e 40:60% em peso). As blendas foram avaliadas por índice de fluidez, reometria de torque e reologia em regime dinâmico-oscilatório. Os resultados de índice de fluidez indicaram que a mistura de material reciclado com o PPCop promove uma diminuição da massa molar, em comparação ao PPCop. Por reometria de torque, verificou-se que as blendas melhoraram a processabilidade em comparação ao PPCop. Além disso, as blendas apresentaram estabilidade ao longo do processamento, indicando ausência de degradação para as condições de processos utilizadas. Por meio dos ensaios em regime dinâmico-oscilatório, observou-se que, em baixas frequências (< 1 rad/s), o PPCop e as blendas (PPCop/PPRec) apresentam um comportamento de fluido Newtoniano, enquanto que, para frequências maiores que 1 rad/s, um comportamento de fluido pseudoplástico. Os valores dos pontos de intersecção (G’ = G”) das curvas de módulo de armazenamento (G’) e de módulo de perda (G’’), em função da frequência angular (ω), indicaram que as blendas apresentaram uma redução da massa molar, sendo mais pronunciada na composição contendo 60% de PPRec. Os resultados reológicos das blendas PPCop/PPRec foram de grande relevância, uma vez que permitem analisar o comportamento de blendas contendo material reciclado.

ABSTRACT In this study, blends of copolymer polypropylene (PPCop /recycled polypropylene (PPRec) from industrial containers after consumption were evaluated in three different ratios (80:20, 60:40 and 40:60 wt.%). The blends were evaluated by melt flow index, torque rheometry and rheology in a dynamic oscillatory regime. The results from the melt flow index indicated that the blending of recycled material with PPCop causes a decrease in the molecular weight as compared to PPCop. By torque rheometry, it was verified that the blends showed improved processability in relation to PPCop. Also, the blends showed stability throughout the processing, indicating absence of degradation due to the process conditions used. By the dynamic-oscillatory regime tests, it was observed that, at low frequencies (<1 rad/s), the PPCop and the blends (PPCop / PPRec) demonstrated a Newtonian fluid behavior, whereas, at frequencies greater than 1 rad/s, a pseudoplastic fluid behavior was observed. The values of the intersection points (G ‘= G”) of the storage modulus curves (G’) and loss modulus (G’), as a function of the angular frequency (ω) indicated that the blends showed a reduction of the molecular weight, which was more pronounced in the composition containing 60% PPRec. The rheological results of the PPCop / PPRec blends were of great relevance, since they allowed the analysis of the blends behavior containing recycled material.