RESUMO Objetivo: Analisar a tendência da taxa de detecção de sífilis em pessoas idosas no Brasil no período de 2011 a 2019. Métodos: Estudo ecológico, de série temporal, com dados do Sistema de Informação de Agravos de Notificação. Analisou-se a tendência temporal das taxas de detecção de sífilis segundo o método de regressão linear de Prais-Winsten. Resultados: Foram notificados 62.765 casos de sífilis em pessoas idosas. Verificou-se tendência crescente na taxa de detecção de sífilis em pessoas idosas no Brasil. O aumento foi de, aproximadamente, seis vezes, com incremento médio de 25% a cada ano (variação percentual anual [VPA]: 25,0; IC95% 22,1–28,1). O aumento na taxa de detecção foi identificado em ambos os sexos e para todos os grupos etários, com destaque para o incremento no sexo feminino (VPA: 49,1; IC95% 21,9–26,8) e no grupo com 70 a 79 anos de idade (VPA: 25,8; IC95% 23,3–28,3). Todas as macrorregiões do país apresentaram tendência crescente, com destaque para as regiões Nordeste (VPA: 51,2; IC95% 43,0–59,8) e Sul (VPA: 49,2; IC95% 32,3–68,3). Conclusão: A tendência crescente da taxa de detecção de sífilis em pessoas idosas em todo território brasileiro evidencia a necessidade de planejamento e desenvolvimento de ações efetivas e multiprofissionais de prevenção e assistência adaptada a esse público.

ABSTRACT Objective: To analyze the trend in the detection rate of syphilis in elderly people in Brazil from 2011 to 2019. Methods: An ecological, time-series study with data from the Notifiable Diseases Information System. The temporal trend of syphilis detection rates was analyzed according to the Prais-Winsten linear regression method. Results: 62,765 cases of syphilis in aged people were reported. There was a growing trend in the rate of syphilis detection in aged people in Brazil. The increase was of approximately six times, with a mean increase of 25% each year (annual percent change [APC]: 25.0; 95%CI 22.1–28.1). The increase in the detection rate was identified in both genders and for all age groups, with emphasis on the increase in females (APC: 49.1; 95%CI 21.9–26.8) and in the group aged 70 to 79 years old (APC: 25.8; 95%CI 23.3–28.3). All macro-regions of the country showed an increasing trend, with emphasis on the Northeast (APC: 51.2; 95%CI 43.0–59.8) and South (APC: 49.2; 95%CI 32.3–68.3). Conclusion: The growing trend in the detection rate of syphilis in aged people throughout Brazil highlights the need for planning and developing effective and multidisciplinary prevention actions and assistance adapted to this public.

ABSTRACT Objective: To analyze the trend in the detection rate of syphilis in elderly people in Brazil from 2011 to 2019. Methods: An ecological, time-series study with data from the Notifiable Diseases Information System. The temporal trend of syphilis detection rates was analyzed according to the Prais-Winsten linear regression method. Results: 62,765 cases of syphilis in aged people were reported. There was a growing trend in the rate of syphilis detection in aged people in Brazil. The increase was of approximately six times, with a mean increase of 25% each year (annual percent change [APC]: 25.0; 95%CI 22.1–28.1). The increase in the detection rate was identified in both genders and for all age groups, with emphasis on the increase in females (APC: 49.1; 95%CI 21.9–26.8) and in the group aged 70 to 79 years old (APC: 25.8; 95%CI 23.3–28.3). All macro-regions of the country showed an increasing trend, with emphasis on the Northeast (APC: 51.2; 95%CI 43.0–59.8) and South (APC: 49.2; 95%CI 32.3–68.3). Conclusion: The growing trend in the detection rate of syphilis in aged people throughout Brazil highlights the need for planning and developing effective and multidisciplinary prevention actions and assistance adapted to this public.

RESUMO Objetivo: Analisar a tendência da taxa de detecção de sífilis em pessoas idosas no Brasil no período de 2011 a 2019. Métodos: Estudo ecológico, de série temporal, com dados do Sistema de Informação de Agravos de Notificação. Analisou-se a tendência temporal das taxas de detecção de sífilis segundo o método de regressão linear de Prais-Winsten. Resultados: Foram notificados 62.765 casos de sífilis em pessoas idosas. Verificou-se tendência crescente na taxa de detecção de sífilis em pessoas idosas no Brasil. O aumento foi de, aproximadamente, seis vezes, com incremento médio de 25% a cada ano (variação percentual anual [VPA]: 25,0; IC95% 22,1–28,1). O aumento na taxa de detecção foi identificado em ambos os sexos e para todos os grupos etários, com destaque para o incremento no sexo feminino (VPA: 49,1; IC95% 21,9–26,8) e no grupo com 70 a 79 anos de idade (VPA: 25,8; IC95% 23,3–28,3). Todas as macrorregiões do país apresentaram tendência crescente, com destaque para as regiões Nordeste (VPA: 51,2; IC95% 43,0–59,8) e Sul (VPA: 49,2; IC95% 32,3–68,3). Conclusão: A tendência crescente da taxa de detecção de sífilis em pessoas idosas em todo território brasileiro evidencia a necessidade de planejamento e desenvolvimento de ações efetivas e multiprofissionais de prevenção e assistência adaptada a esse público.

Abstract Introduction: Smoking is a serious public health issue, being a precursor of heart disease and a predictor of sudden death due to myocardial ischemia. Major events in the patient's health can lead to radical changes in habits and the choice for different myocardial revascularization methods might differently impact smoking cessation and relapse. Objective: To study the rate and perpetuation of smoking cessation after myocardial revascularization comparing coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI). Methods: Smokers submitted to myocardial revascularization were divided into CABG and PCI groups. The research was conducted through interviews at the Hospital Santa Lucinda outpatient clinic. Patients with smoking cessation longer than 90 days before hospital admission, combined procedures, hospital readmission before 360 days after discharge, cases of death at any time, and emergency procedures were excluded from the study. The start of the smoking cessation period was determined as just after hospital discharge, with a follow-up of 12 months. Results: The proportion of patients reporting smoking relapse was significantly lower in the CABG than in the PCI group at 30 (11.1% vs. 20.8%; P=0.039) and at 180 days (23.1% vs. 41.5%; P=0.002), but no differences were observed between the two groups at 360 days after hospital discharge (51.9% vs. 54.1%; P=0.719). High levels of nicotine dependence and passive smoking showed to be important predictors of smoking relapse in the long-term. Conclusion: The occurrence of a major surgical procedure seems to have beneficial psychological effects, representing an interesting setting for smoking cessation counseling to have higher chances of success.

ABSTRACTThe objective of this work was to evaluate the inclusion of Fabaceae Flemingia macrophylla (Willd.) Kuntze ex Merr. in the diet of lactating dairy goats arranged in a 5 × 5 Latin square. The diets were composed of 40% of concentrate and 60% of roughage, and the dietary treatments were defined by the level of Flemingia hay inclusion (0%, 8%, 16%, 24%, and 32% in the diet dry matter) replacing Cynodon dactyloncv. Tifton 85 hay. The diets were isonitrogenous, with 14% crude protein. Feed intake, nutrient digestibility, feeding behavior, and ruminal pH and ammonia nitrogen were evaluated. There was no difference in dry matter intake with the inclusion of Flemingia hay in the diet. The digestibility of dry matter, organic matter, crude protein, neutral detergent fiber, and total carbohydrates decreased with the inclusion of Flemingia in the diet. The diet did not change rumen ammonia nitrogen concentration or ruminal pH. There were no differences in the feeding behavior or feed and rumination efficiencies. Flemingia macrophylla can be used up to the level of 32% in the dry matter in diets for lactating goats.

RESUMO A ejaculação precoce é a disfunção sexual masculina mais frequente, com uma estimativa de acometimento de 20 a 30% dos homens em algum momento da vida. Foi realizada uma busca no Pubmed, do ano 2000 até os dias atuais, com a finalidade de revisar publicações relacionadas ao manejo e ao tratamento da ejaculação precoce. Terapias comportamentais foram a base do manejo da ejaculação precoce por muitos anos, embora as evidências de sua eficácia a curto prazo sejam limitadas. Terapias de uso tópico agem por meio de dessensibilização do pênis, mas não alteram a sensação da ejaculação. Os inibidores seletivos da recaptação da serotonina são utilizados para depressão e, em geral, também para tratar ejaculação precoce, com base na observação de que o retardo na ejaculação é um efeito colateral frequente dessa classe de drogas. A dapoxetina é um inibidor seletivo da recaptação da serotonina de curta ação, que foi formulado para tratar a ejaculação precoce, e seus resultados parecem muito promissores.

ABSTRACT Premature ejaculation is the most frequent male sexual dysfunction, estimated to affect 20 to 30% of men at some time in their life. A Pubmed search from the year 2000 to the present was performed to retrieve publications related to management or treatment of premature ejaculation. Behavioral techniques have been the mainstay of premature ejaculation management for many years, although evidence of their short-term efficacy is limited. Topical therapies for premature ejaculation act by desensitizing the penis and do not alter the sensation of ejaculation. Selective serotonin reuptake inhibitors (SSRIs), commonly used in the treatment of depression, are often used to treat premature ejaculation, based on the observation that delayed ejaculation is a frequent side effect of this drug class. Dapoxetine is a short-acting SSRI formulated to treat premature ejaculation, and results seem very promising.

O bom preparo e a correção do solo associados à boa qualidade no plantio são necessários para proporcionar o desenvolvimento adequado da cultura da cana-de-açúcar e garantir a longevidade das soqueiras. A importância das operações para o desenvolvimento na cultura e os custos associados a essas operações foram os fatores que determinaram o desenvolvimento deste trabalho cujo objetivo é o de identificar os fatores críticos e analisar o processo de melhoria contínua no plantio da cana-de-açúcar. Para tanto, o trabalho foi dividido em três etapas: definição dos itens críticos; avaliação dos itens e propostas de melhorias; início e avaliação das melhorias. Para a definição dos itens críticos aplicou-se o método FMEA e a avaliação foi realizada por meio de histogramas e carta de controle. No início das melhorias, utilizaram-se os princípios do ciclo PDCA. Obtiveram-se dezesseis itens críticos (potenciais de falha) e desses, dois foram avaliados. Com as melhorias, observou-se aumento dos valores dentro dos limites desejados, porém os itens analisados foram considerados como instáveis.

The association of a good soil correction and tillage, to the good quality on planting provides the proper development for sugar cane crop and guarantees the ratoon longevity. Cost and importance of these operations for the crop development determined the execution of this work, which is to identify the critical factors and to analyze the process of successive improvement on sugar cane planting. For that the work was divided in three steps: the definition of critical items; the evaluation of these items and purposes of improvement; establishment and evaluation of these improvements. FMEA method was applied for the definition of critical items and the evaluation was conducted by histograms and a control chart. Principles of PDCA circle were used for the establishment of these improvements. There were sixteen items (potentials of failures) and two of them were evaluated. It was possible to observe an increasing of the values within the expected limits, with the establishment of the improvements. However, the analyzed items were considered as instable.