Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01–1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29–3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

RESUMO: A salinidade tem afetado negativamente o cultivo de hortaliças, sobretudo em regiões semiáridas. Neste sentido, o uso de elicitores que atuem na indução de tolerância ao estresse salino, como ácido salicílico, tem se destacado como uma alternativa promissora. Objetivou-se com esse estudo, avaliar os efeitos da pulverização foliar do ácido salicílico na mitigação do estresse salino na morfofisiologia e produção do pimentão cv. All Big. O estudo foi conduzido em casa de vegetação em Campina Grande - PB, utilizando-se o delineamento inteiramente casualizado, em arranjo fatorial 4 x 4, sendo quatro níveis de condutividade elétrica da água de irrigação (0,8; 1,6; 2,4; e 3,2 dS m-1) e quatro concentrações de ácido salicílico (0; 1,2; 2,4 e 3,6 mM), com três repetições. A aplicação foliar de ácido salicílico na concentração de 1,6 mM atenuou os efeitos do estresse salino nas trocas gasosas, no crescimento, no peso médio de fruto e na produção total por planta, e diminuiu a porcentagem de extravasamento de eletrólitos intercelulares das plantas de pimentão cv. All Big aos 80 dias após o semeio.

ABSTRACT: Salinity has limited conventional vegetable cultivation, especially in semi-arid regions. In this regard, the use of elicitors that act to induce tolerance to salt stress, such as salicylic acid, has emerged as a promising alternative. This study evaluated the effects of foliar spraying with salicylic acid on the mitigation of salt stress on the morphophysiology and production of bell pepper cv. All Big. The study was conducted in a greenhouse in Campina Grande - PB, Brazil, adopting a completely randomized design, in a 4 x 4 factorial arrangement, corresponding to four levels of electrical conductivity of irrigation water (0.8; 1.6; 2.4; and 3.2 dS m-1) and four concentrations of salicylic acid (0; 1.2; 2.4 and 3.6 mM), with three replicates. The foliar application of salicylic acid at a concentration of 1.6 mM attenuated the effects of salt stress in gas exchange, growth, mean fruit weight, and total production per plant, and decreased the percentage of intercellular electrolyte leakage of sweet pepper cv. All Big plants, at 80 days after sowing.

ABSTRACT Objectives: to evaluate the quality of life before and after the application of auriculotherapy and the satisfaction of university students with the treatment during the covid-19 pandemic. Methods: quasi-experimental study conducted with 44 students in a University Health Center. The intervention consisted of ten sessions of auriculotherapy focusing on emotional changes with quality of life assessment before and after treatment. The study also investigated the satisfaction concerning the intervention. Results: predominated among the students: women, from health courses, in use of psychotropic drugs and complaining of emotional changes. There was a statistically significant increase in all domains of quality of life, and students were satisfied with the treatment. Conclusions: auriculotherapy improved the quality of life of university students during the covid-19 pandemic, and the level of satisfaction with the treatment was high.

RESUMEN Objetivos: evaluar la calidad de vida antes y después de la aplicación de auriculoterapia y satisfacción de estudiantes universitarios con el tratamiento durante la pandemia de covid-19. Métodos: estudio cuasi experimental, realizado con 44 estudiantes en centro de salud de una universidad. La intervención constituyó en diez sesiones de auriculoterapia, enfocado en las altercaciones emocionales, y la evaluación de la calidad de vida pasó antes y después del tratamiento. La satisfacción con la intervención también fue investigada. Resultados: predominaron entre los estudiantes: mujeres, de cursos del área de la salud, en uso de psicotrópicos y con queja de alteraciones emocionales. Hubo aumento estadísticamente significante en todos los dominios de la calidad de vida, y los estudiantes quedaron satisfechos con el tratamiento. Conclusiones: la auriculoterapia fue capaz de mejorar la calidad de vida de estudiantes universitarios durante la pandemia de covid-19, y el nivel de satisfacción con el tratamiento fue alto.

RESUMO Objetivos: avaliar a qualidade de vida antes e depois da aplicação da auriculoterapia e a satisfação de estudantes universitários com o tratamento durante a pandemia de covid-19. Métodos: estudo quase experimental, realizado com 44 estudantes em um centro de saúde de uma universidade. A intervenção consistiu em dez sessões de auriculoterapia, com foco nas alterações emocionais, e a avaliação da qualidade de vida ocorreu antes e depois do tratamento. A satisfação com a intervenção também foi investigada. Resultados: predominaram entre os estudantes: mulheres, de cursos da área da saúde, em uso de psicotrópicos e com queixa de alterações emocionais. Houve aumento estatisticamente significativo em todos os domínios da qualidade de vida, e os estudantes ficaram satisfeitos com o tratamento. Conclusões: a auriculoterapia foi capaz de melhorar a qualidade de vida de estudantes universitários durante a pandemia de covid-19, e o nível de satisfação com o tratamento foi alto.

ABSTRACT Objectives: to outline the teaching of ethics in undergraduate Nursing programs in Brazilian public higher education institutions. Methods: descriptive and exploratory study, carried out through the documentary analysis of pedagogical projects of undergraduate Nursing programs in Brazil. Results: 153 active undergraduate Nursing programs were found, of which 106 provide the pedagogical project. In addition to deontological teaching, the teaching of ethics was identified in a transversal way associated with themes such as Social Context, Hospital and Community Care, Pharmacology, Systematization of Nursing Care, Surgical Nursing, Epidemiology, Palliative Care, Management in Nursing, Diversity, Women’s, Children’s, Adolescent’s, Adult’s and Older People’s Health, and Mental Health. Final Considerations: the challenge in teaching nursing ethics is its integration with each action of caring, teaching and managing.

RESUMEN Objetivos: trazar el panorama de la enseñanza de la ética en los cursos de graduación en Enfermería en las instituciones públicas de enseñanza superior brasileñas. Métodos: estudio descriptivo y exploratorio, realizado por medio del análisis documental de proyectos pedagógicos de cursos de graduación en Enfermería en Brasil. Resultados: han sido encontrados 153 cursos activos de graduación en Enfermería, de los cuales 106 tienen disponible el proyecto pedagógico. Además de la enseñanza deóntica, fue identificado la enseñanza de ética de forma transversal relacionada a temas como Contexto Social, Atención Hospitalaria y Comunitaria, Farmacología, Sistematización de la Asistencia en Enfermería, Enfermería Quirúrgica, Epidemiología, Cuidados Paliativos, Gestión en Enfermería, Diversidad, Salud de la Mujer, Niño, Adolescente, Adulto y Anciano y Salud Mental. Consideraciones Finales: el desafío en la enseñanza de la ética en enfermería y su integración con cada acción de cuidar, enseñar y administrar.

RESUMO Objetivos: traçar o panorama do ensino da ética nos cursos de graduação em Enfermagem nas instituições públicas de ensino superior brasileiras. Métodos: estudo descritivo e exploratório, realizado por meio da análise documental de projetos pedagógicos de cursos de graduação em Enfermagem no Brasil. Resultados: foram encontrados 153 cursos ativos de graduação em Enfermagem, dos quais 106 disponibilizam o projeto pedagógico. Além do ensino deontológico, foi identificado o ensino de ética de forma transversal associada a temas como Contexto Social, Atenção Hospitalar e Comunitária, Farmacologia, Sistematização da Assistência em Enfermagem, Enfermagem Cirúrgica, Epidemiologia, Cuidados Paliativos, Gestão em Enfermagem, Diversidade, Saúde da Mulher, Criança, Adolescente, Adulto e Idoso e Saúde Mental. Considerações Finais: o desafio no ensino da ética em enfermagem é sua integração com cada ação de cuidar, ensinar e gerenciar.

ABSTRACT Objective To evaluate the association between the degree of food processing, overweight, and abdominal obesity in adolescents. Methods This is a cross-sectional study, with 576 adolescents aged 10 to 17 years, of both sexes. Food consumption was collected using the Food Frequency Questionnaire and foods classified as in natura or minimally processed, processed foods associated with culinary ingredients, and ultraprocessed foods. Sociodemographic data, body mass index, waist circumference and waist-to-height ratio were collected. The analysis was evaluated by the Mann-Whitney test and prevalence ratio with 95% confidence interval, considering p<0.05. Results An intake above the third quartile of processed foods associated with culinary ingredients (prevalence ratio of 1.64; 95%CI: 1.12-2.42) and ultraprocessed (prevalence ratio of 1.58; 95%CI: 1.07-2.34) was associated with a higher prevalence of overweight. Consumption above the third quartile of ultraprocessed foods was associated with a higher prevalence of abdominal obesity, assessed by waist circumference (prevalence ratio of 2.48; 95%CI: 1.41-4.36), and waist-height ratio (prevalence ratio of 2.09; 95%CI: 1.11-3.92). Conclusion A higher consumption of processed foods associated with culinary ingredients was related to being overweight, and ultraprocessed foods with overweight and abdominal obesity.

Abstract Introduction: effective ways of overcoming overweight may depend, in part, on the ability to identify mood disorders (anxiety is most prevalent) and their association with overeating and weight gain. The use of anthropometric indicators for such purposes can inform individual strategies for intervention before obesity sets in. Objective: to verify the association between anxiety and anthropometric indicators in university students. Methods: a cross-sectional study was conducted in 147 undergraduates across all programmes taught by the Federal University of Rio de Janeiro (UFRJ) at Macaé. A self-assessment questionnaire was administered in order to gather socioeconomic, lifestyle, and anxiety data. Anxiety status was estimated based on the State-Trait Anxiety Inventory (STAI), and interpreted based on the median of scores (p ≥ 50). An anthropometric assessment was conducted to measure the subjects' body mass, body mass index (BMI), and waist circumference (WC). Body fat percentage (%BF) data were obtained using bioelectrical impedance analysis (BIA). The data were then analyzed using the chi-square and logistic regression tests, with a 0.05 significance level. For analysis purposes, anxiety was defined as the exposure variable in the present study, and anthropometric indicators as the outcomes. Results: the students with an anxiety state p ≥ 50 presented an odds ratio (OR) of 2.69 for being overweight (p = 0.02), as well as an OR of 2.77 for having high BF (p = 0.02) in the adjusted models. Conclusion: a higher level of anxiety is associated with anthropometric indicators among university students, specifically for overweight or obesity and high BF percentages.

Resumen Introducción: determinar formas efectivas de combatir el sobrepeso puede depender parcialmente de identificar las alteraciones del estado de ánimo, entre las cuales prevalece la ansiedad, y asociarlas al consumo excesivo de alimentos. Puede ser útil utilizar identificaciones antropométricas en tal investigación para definir estrategias personalizadas antes de que aparezca la obesidad. Objetivo: verificar la asociación entre síntomas de ansiedad e indicadores antropométricos en estudiantes universitarios. Metodología: este trabajo es un estudio transversal con 147 estudiantes de graduación de la Universidad Federal de Río de Janeiro en Macaé. Se recopilaron los datos con un cuestionario autocompletado sobre rasgos socioeconómicos, estilo de vida y síntomas de ansiedad. Se estimó el estado de ansiedad considerando el Inventario del Estado de Ansiedad (STAI, por sus siglas en inglés) por encima de la mediana (p > 50). La evaluación antropométrica consistió en medir la masa corporal, el índice de masa corporal (IMC), la circunferencia de la cintura (CC) y el porcentaje de grasa corporal (GC), obtenidos por bioimpedancia eléctrica bipolar. El análisis de datos se realizó mediante pruebas de regresión logística y del chi cuadrado, con el nivel de significancia establecido en 0,05. A efectos del análisis, se definieron como exposición el estado de ansiedad y como resultados los indicadores antropométricos. Resultados: los estudiantes con STAI de p > 50 presentaron una razón de momios (RM) de 2,69 para el sobrepeso (p = 0,02) y de 2,77 para un nivel alto de GC (p = 0,02) en los modelos ajustados. Conclusión: entre los estudiantes universitarios, un nivel de ansiedad más alto se asocia a los indicadores antropométricos de sobrepeso u obesidad y de nivel alto de GC.

Resumo Este ensaio crítico tem como objetivo geral compreender a vertente neoliberal dos discursos do empreendedorismo e sua função de camuflagem da realidade das relações entre trabalho e capital. Baseando-se no pressuposto de que os discursos do empreendedorismo são depositários de uma ideologia neoliberal, analisa-se o desenvolvimento histórico do conceito e do seu campo de estudo; qualifica-se o caráter neoliberal do empreendedorismo; caracteriza-se o aparato teórico que sustenta e dissemina o empreendedorismo. O estudo conclui, criticamente, que o discurso do empreendedorismo isenta o Estado da responsabilidade de garantir mínimas condições de vida para os trabalhadores, colocando-os como responsáveis pelo seu sucesso ou fracasso, independentemente da importância das variáveis do contexto social.

Abstract This critical essay has the general objective of understanding the neoliberal aspect of entrepreneurship’s discourses and its function of camouflaging the reality of the relations between work and capital. This research analyzes the historical development of the concept and its field of study based on the assumption that these narratives are depositories of a neoliberal ideology. The research discusses the neoliberal nature of entrepreneurship and characterizes the theoretical apparatus that supports and disseminates entrepreneurship. Finally, the results critically point out that entrepreneurship’s discourse exempts the state from the responsibility of guaranteeing minimum living conditions for workers, meaning they are responsible for their success or failure, regardless of the importance of social context variables.

Resumen Este ensayo crítico tiene el objetivo general de comprender el aspecto neoliberal de los discursos del emprendimiento y su función de camuflaje de la realidad de las relaciones entre trabajo y capital. Partiendo del supuesto de que los discursos del emprendimiento son depositarios de una ideología neoliberal, se analiza el desarrollo histórico del concepto y su campo de estudio; se califica el carácter neoliberal del emprendimiento; y se caracteriza el aparato teórico que apoya y difunde el emprendimiento. El estudio concluye, críticamente, que el discurso del emprendimiento exime al Estado de la responsabilidad de garantizar condiciones mínimas de vida a los trabajadores, ubicándolos como responsables de su éxito o fracaso, independientemente de la importancia de las variables del contexto social.

RESUMO Trata-se de revisão narrativa com busca sistemática, tendo por objetivo investigar o impacto do isolamento social na alimentação (hábitos alimentares) durante a pandemia da Coronavirus Disease 2019. Foi realizado rastreio de estudos publicados no período de 1º de janeiro de 2019 a 18 de junho de 2020 nas bases PubMed, Web of Science e Embase. A busca foi estruturada utilizando os unitermos correspondentes a Coronavirus Disease 2019, isolamento social e alimentação. Todas as etapas foram executadas de forma independente por três revisores. Foram incluídos 12 estudos, totalizando 20.789 pessoas pesquisadas, com a predominância de estudos de corte transversal na população adulta. Os estudos analisados foram desenvolvidos na Itália (n=4), Espanha (n=2), Polônia (n=1), China (n=1), Índia (n=1), Estados Unidos da América (n=1), África do Sul (n=1) e multicêntrico continental (n=1). A análise dos estudos incluídos evidenciou que a maioria das pessoas relatou não mudar a dieta habitual, observando-se também o aumento do hábito de cozinhar, consumir frutas, legumes e verduras e a diminuição do consumo de bebidas alcoólicas. Constatou-se diminuição do consumo de peixes e aumento das chamadas comfort foods. Verificou-se que a alimentação sofreu alterações em tempos de isolamento social. Sugerimos que novas pesquisas sejam realizadas em diferentes contextos socioeconômicos e demográficos. Propomos a continuidade do estudo desta temática, com realização de revisão sistemática com ou sem metanálise.

ABSTRACT The objective of this narrative review, with a systematic survey, was to investigate the impact of social isolation on food (eating habits) during the 2019 Coronavirus disease pandemic. A retrieval of studies published from January 1st, 2019 to June 18th, 2020 was carried out in the PubMed, Web of Science and Embase databases. The screening was structured using the terms corresponding to Coronavirus disease 2019, social isolation and food. All steps were carried out independently by three reviewers. Twelve studies were included, totaling 20,789 people assessed, with a predominance of cross-sectional studies of adult population. The studies reviewed had been carried out in Italy (n=4), Spain (n=2), Poland (n=1), China (n=1), India (n=1), United States of America (n=1), South Africa (n=1) and in a continental multicenter (n=1). The analysis of the studies included showed that most people reported that they did not change their usual diet; in addition, an increase in cooking habits, consumption of fruits and vegetables and a decrease in the consumption of alcoholic beverages was observed. A decrease in fish consumption and an increase in comfort foods were also reported. It was found that food habits changed in times of social isolation. We suggest that new investigations be carried out in different socioeconomic and demographic frameworks. We propose to continue the study on this theme, with a systematic review with or without meta-analysis.

Abstract Background: Phoneutria nigriventer venom contains Phα1β. This toxin and its recombinant form have a remarkable analgesic potential that is associated with blockage of voltage-gated calcium channels and TRPA1 receptors. Although morphine is a mainstay drug to treat moderate and severe pain related to cancer, it has serious and dose-limiting side effects. Combining recombinant Phα1β and morphine to treat pain is an interesting approach that has been gaining attention. Therefore, a quantitative and reliable method to establish the strength of the antinociceptive interaction between these two substances is necessary. The present study was designed to investigate the nature of the functional antinociceptive (analgesic) interaction between Phα1β recombinant toxin and morphine in a model of cancer pain. Methods: Melanoma was produced by intraplantar inoculation of B16-F10 cells into the right paw of C57BL/6J mice. Von Frey filaments measured the paw-withdrawal threshold after intrathecal administration of morphine, recombinant Phα1β, and their combination. Thermal hyperalgesia was assessed using Hargreaves apparatus. The degree of interaction was evaluated using isobolographic analysis. Spontaneous and forced motor performance was assessed with the open-field and rotarod tests, respectively. Results: Co-administration of recombinant Phα1β and morphine synergistically reverses the melanoma-induced mechanical hyperalgesia. The potency of the mixture, measured as the effective dose to reach 50% of maximum possible effect (MPE) in ameliorating mechanical hyperalgesia, was about twice fold higher than expected if the interaction between morphine and recombinant Phα1β was merely additive. Treatment with the combination at doses necessary to reach 50% of MPE caused no spontaneous nor forced motor alterations. Conclusion: The combinatorial use of recombinant Phα1β and morphine allows significant and effective dose reduction of both agents, which has translational potential for opioid-sparing approaches in pain management related to cancer.

Abstract Aim: This study investigates the impact of social isolation, weight changes, and physical activity (PA) by the electronic tools (eTools) on the quality of life (QoL) of Brazilian medical students during the COVID-19 pandemic. Methods: In this observational longitudinal study, one hundred eighty-nine medical students completed an e-questionnaire, which used the WHOQOL-Bref instrument to report QoL and sociodemographic characteristics, health conditions, and lifestyles related to PA. Cronbach's alpha and Friedman/Dunn and Spearman's correlation tests were performed. Based on descriptive and inferential statistics, a multiple linear regression was used to evaluate the potential predictors of QoL. Results: The COVID-19 pandemic particularly affected the psychological and social domains. Time spent indoors and a non-ideal BMI had a negative impact on QoL. Being female and sexual minority-group membership were associated with lower QoL scores in the psychological and physical domains, respectively. Access to PA eTools was positively associated with QoL. Being monitored by a physical education teacher contributes to satisfactory PA levels during online classes. Conclusion: This study provides novel insights into the access of PA eTools on QoL during the COVID-19 pandemic. During periods of social distancing, people should pay extra attention to self-care strategies to protect mental health and promote positive lifestyle patterns. In addition, using online PA resources monitored by physical education teachers could be a strategy to maintain satisfactory levels of exercise.

Abstract Objective To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city. Method Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests. Results A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR = 2.09 (95%CI: 1.48-2.94; p = 0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%. Conclusions The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem.

Resumen Objetivo Evaluar la magnitud de los determinantes sociales en áreas de riesgo para la mortalidad por tuberculosis en una ciudad de alta incidencia de esta enfermedad. Método Estudio ecológico que recogió los casos de muerte por tuberculosis registrados entre 2006 y 2016 en la capital del Estado de Mato Grosso (Brasil). Los determinantes sociales se obtuvieron de las Unidades de Desarrollo Humano. Se utilizó la estadística de barrido para identificar las áreas de riesgo de muerte por tuberculosis. Se realizó un análisis de componentes principales para identificar dimensiones de determinantes sociales, y se aplicó regresión logística múltiple para verificar asociaciones entre las dimensiones de los determinantes sociales y el riesgo de muerte por tuberculosis. El error estándar se estableció en un 5% para todas las pruebas estadísticas. Resultados Se registraron 225 muertes por tuberculosis en el periodo, distribuidas heterogéneamente en el espacio. Se identificó un conglomerado de riesgo para la mortalidad por tuberculosis, con un riesgo relativo de 2,09 (intervalo de confianza del 95% [IC95%]: 1,48-2,94; p = 0,04). Los determinantes sociales «bajo nivel escolar» y «pobreza» se mostraron asociados al riesgo de muerte por tuberculosis (odds ratio [OR]: 2,92; IC95%: 1,17-7,28). La renta presentó asociación negativa con el riesgo de muerte por tuberculosis (OR: 0,05; IC95%: 0,00-0,70). El valor de la curva ROC del modelo fue del 92,1%. Conclusiones Los resultados confirman que el riesgo de muerte por tuberculosis es un problema asociado a los determinantes sociales. Las políticas de salud y los programas de protección social pueden contribuir a enfrentarse a este problema.

Abstract Objective To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city. Method Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests. Results A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR = 2.09 (95%CI: 1.48-2.94; p = 0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%. Conclusions The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem.

Resumen Objetivo Evaluar la magnitud de los determinantes sociales en áreas de riesgo para la mortalidad por tuberculosis en una ciudad de alta incidencia de esta enfermedad. Método Estudio ecológico que recogió los casos de muerte por tuberculosis registrados entre 2006 y 2016 en la capital del Estado de Mato Grosso (Brasil). Los determinantes sociales se obtuvieron de las Unidades de Desarrollo Humano. Se utilizó la estadística de barrido para identificar las áreas de riesgo de muerte por tuberculosis. Se realizó un análisis de componentes principales para identificar dimensiones de determinantes sociales, y se aplicó regresión logística múltiple para verificar asociaciones entre las dimensiones de los determinantes sociales y el riesgo de muerte por tuberculosis. El error estándar se estableció en un 5% para todas las pruebas estadísticas. Resultados Se registraron 225 muertes por tuberculosis en el periodo, distribuidas heterogéneamente en el espacio. Se identificó un conglomerado de riesgo para la mortalidad por tuberculosis, con un riesgo relativo de 2,09 (intervalo de confianza del 95% [IC95%]: 1,48-2,94; p = 0,04). Los determinantes sociales «bajo nivel escolar» y «pobreza» se mostraron asociados al riesgo de muerte por tuberculosis (odds ratio [OR]: 2,92; IC95%: 1,17-7,28). La renta presentó asociación negativa con el riesgo de muerte por tuberculosis (OR: 0,05; IC95%: 0,00-0,70). El valor de la curva ROC del modelo fue del 92,1%. Conclusiones Los resultados confirman que el riesgo de muerte por tuberculosis es un problema asociado a los determinantes sociales. Las políticas de salud y los programas de protección social pueden contribuir a enfrentarse a este problema.

RESUMO: Objetivo: Estimar a prevalência de polifarmácia, descrever as classes farmacoterapêuticas utilizadas e investigar se a polifarmácia está associada a indicadores demográficos e socioeconômicos, independentemente do número de morbidades, entre os participantes na linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) (2008-2010). Métodos: Participaram desta análise 14.523 adultos e idosos (35-74 anos). A polifarmácia foi caracterizada como uso regular de cinco ou mais medicamentos. Os indicadores demográficos e socioeconômicos analisados foram: sexo, idade, escolaridade, renda familiar per capita e acesso a plano de saúde particular. A associação independente entre os indicadores demográficos e econômicos e polifarmácia foi estimada por meio de regressão logística binária. Resultados: A prevalência de polifarmácia foi de 11,7%. Os medicamentos mais utilizados foram aqueles com ação no sistema cardiovascular. Após ajustes, incluindo número de doenças, a chance de estar sob tratamento com polifarmácia foi significativamente maior entre mulheres, participantes mais velhos e aqueles com maior número de doenças. Participantes de baixa renda e aqueles sem plano privado de saúde, no entanto, tiveram menor chance de estar sob polifarmácia. Conclusão: A ocorrência de polifarmácia entre os participantes da linha de base do ELSA-Brasil deveu-se principalmente a medicamentos para o tratamento de doenças crônicas. A relação entre polifarmácia e sexo feminino, bem como sua associação com maior idade, estão em consonância com os resultados obtidos em outros estudos. Apesar da ausência de associação entre a polifarmácia e a escolaridade, os resultados de renda e plano privado de saúde reforçam a existência de desigualdades sociais em relação ao uso de medicamentos.

ABSTRACT: Objective: To estimate the prevalence of polypharmacy, describe the pharmacotherapeutic classes used, and investigate whether polypharmacy is associated with demographic and socioeconomic indicators, regardless of the number of diseases, among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010). Method: In this analysis, 14,523 adults and elderly (35-74 years) participated. Polypharmacy was characterized as regular use of five or more medicines. The demographic and socioeconomic indicators analyzed were: gender, age, education level, per capita family income, and access to private health insurance. The independent association between demographic and economic indicators and polypharmacy was estimated by binary logistic regression. Results: The prevalence of polypharmacy was 11.7%. The most used drugs were those with action on the cardiovascular system. After adjustments, including by number of diseases, the chances of being on polypharmacy treatment were significantly higher among women, older participants and those with greatest number of diseases. Individuals without health insurance had lower chance to be under polypharmacy, as well as those with lower income. Conclusion: The occurrence of polypharmacy among ELSA-Brasil baseline participants was mainly due to drugs for the treatment of chronic diseases. The relation between polypharmacy and the female gender, as well as its association with old age, are in consonance with the results obtained in other studies. Despite the absence of an association between polypharmacy and education level, the income and health insurance results reinforce the existence of social inequalities regarding drug use.

RESUMO: Objetivo: Estimar a prevalência de polifarmácia, descrever as classes farmacoterapêuticas utilizadas e investigar se a polifarmácia está associada a indicadores demográficos e socioeconômicos, independentemente do número de morbidades, entre os participantes na linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) (2008-2010). Métodos: Participaram desta análise 14.523 adultos e idosos (35-74 anos). A polifarmácia foi caracterizada como uso regular de cinco ou mais medicamentos. Os indicadores demográficos e socioeconômicos analisados foram: sexo, idade, escolaridade, renda familiar per capita e acesso a plano de saúde particular. A associação independente entre os indicadores demográficos e econômicos e polifarmácia foi estimada por meio de regressão logística binária. Resultados: A prevalência de polifarmácia foi de 11,7%. Os medicamentos mais utilizados foram aqueles com ação no sistema cardiovascular. Após ajustes, incluindo número de doenças, a chance de estar sob tratamento com polifarmácia foi significativamente maior entre mulheres, participantes mais velhos e aqueles com maior número de doenças. Participantes de baixa renda e aqueles sem plano privado de saúde, no entanto, tiveram menor chance de estar sob polifarmácia. Conclusão: A ocorrência de polifarmácia entre os participantes da linha de base do ELSA-Brasil deveu-se principalmente a medicamentos para o tratamento de doenças crônicas. A relação entre polifarmácia e sexo feminino, bem como sua associação com maior idade, estão em consonância com os resultados obtidos em outros estudos. Apesar da ausência de associação entre a polifarmácia e a escolaridade, os resultados de renda e plano privado de saúde reforçam a existência de desigualdades sociais em relação ao uso de medicamentos.

ABSTRACT: Objective: To estimate the prevalence of polypharmacy, describe the pharmacotherapeutic classes used, and investigate whether polypharmacy is associated with demographic and socioeconomic indicators, regardless of the number of diseases, among participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline (2008-2010). Method: In this analysis, 14,523 adults and elderly (35-74 years) participated. Polypharmacy was characterized as regular use of five or more medicines. The demographic and socioeconomic indicators analyzed were: gender, age, education level, per capita family income, and access to private health insurance. The independent association between demographic and economic indicators and polypharmacy was estimated by binary logistic regression. Results: The prevalence of polypharmacy was 11.7%. The most used drugs were those with action on the cardiovascular system. After adjustments, including by number of diseases, the chances of being on polypharmacy treatment were significantly higher among women, older participants and those with greatest number of diseases. Individuals without health insurance had lower chance to be under polypharmacy, as well as those with lower income. Conclusion: The occurrence of polypharmacy among ELSA-Brasil baseline participants was mainly due to drugs for the treatment of chronic diseases. The relation between polypharmacy and the female gender, as well as its association with old age, are in consonance with the results obtained in other studies. Despite the absence of an association between polypharmacy and education level, the income and health insurance results reinforce the existence of social inequalities regarding drug use.

Resumo Introdução: Considerando seu potencial como forma de combate alternativo a bactérias multirresistentes, a terapia fotodinâmica vem sendo aperfeiçoada e mais bem estudada nos últimos anos, sendo importante determinar seus padrões otimizados de aplicação. Objetivo: O objetivo deste estudo foi avaliar a ação da terapia fotodinâmica antimicrobiana mediada pelo azul de metileno na ausência de pré-incubação dos agentes infecciosos no fotossenbilizante. Método: Foram usadas cepas padrão de Staphylococcus aureus e Pseudomonas aeruginosa, as quais foram submetidas ou não à 2 concentrações de azul de metileno (0,1 µg/mL and 500 mg/mL) aplicadas isoladamente ou em associação com variados parâmetros de emissão de laser vermelho (660 nm); em ambos os casos, a semeadura foi realizada imediatamente após a mistura entre o fotossensibilizante e a solução contendo as bactérias. Resultados: Nas placas em que houve somente aplicação de azul de metileno não houve qualquer efeito antibacteriano, assim como não houve inibição nos pontos de aplicação da terapia fotodinâmica no caso da bactéria Pseudomonas aeruginosa. No entanto, nas culturas de Staphylococcus aureus em que houve a emissão laser associada à concentração de 500 mg/ml do fotossensibilizante, houve presença de inibição nos pontos de aplicação do laser. Conclusão: Conclui-se que há indícios de que o tempo de exposição ao fotossensibilizante prévio à aplicação da fototerapia é um fator essencial para a otimização da terapia fotodinâmica, especialmente no caso de bactérias Gram-negativas.

Abstract Introduction: Considering its potential as an alternative therapy to combat multiresistant bacteria, photodynamic therapy has been improved and better studied in recent years, and determining its optimized application patterns is important. Objective: This study aimed to evaluate the action of antimicrobial photodynamic therapy mediated by methylene blue in the absence of preincubation of infectious agents in the photosensitizer. Method: Standard strains of Staphylococcus aureus and Pseudomonas aeruginosa were used, which was or was not submitted to two methylene blue concentrations (0.1 μg/mL and 500 mg/mL) applied alone or in combination with a variety of red laser emission parameters (660 nm); in both cases, the streak was performed immediately after mixing between the photosensitizer and the solution containing the bacteria. Results: In the dishes with only methylene blue application neither antibacterial was produced, nor inhibition at the application points of the photodynamic therapy in the case of the bacterium Pseudomonas aeruginosa. However, in the cultures of Staphylococcus aureus in which laser emission was associated with the concentration of 500 mg/mL of the photosensitizer, inhibition was present at the laser application points. Conclusion: The time of exposure to the photosensitizer prior to the application of phototherapy seems to be an essential factor for the optimized action of photodynamic therapy, especially in the case of Gram-negative bacteria.

Resumen Introducción: Considerando su potencial como forma de combate alternativo a bacterias multirresistentes, la terapia fotodinámica se ha perfeccionada y mejor estudiada en los últimos años, siendo importante determinar sus patrones optimizados de aplicación. Objetivo: El objetivo de este estudio fue evaluar la acción de la terapia fotodinámica antimicrobiana mediada por el azul de metileno en la ausencia de preincubación de los agentes infecciosos en el fotosenbilizante. Método: Se utilizaron cepas estándares de Staphylococcus aureus y Pseudomonas aeruginosa, las cuales fueron sometidas o no a las 2 concentraciones de azul de metileno (0,1 μg/mL y 500 mg/mL) aplicadas aisladamente o en asociación con variados parámetros de emisión de láser rojo (660 nm); en ambos casos, la siembra fue realizada inmediatamente después de la mezcla entre el fotosensibilizante y la solución conteniendo las bacterias. Resultados: En las placas con aplicación solamente de azul de metileno no hubo ningún efecto antibacteriano, así como no hubo inhibición en los puntos de aplicación de la terapia fotodinámica en el caso de la bacteria Pseudomonas aeruginosa. Sin embargo, en los cultivos de Staphylococcus aureus en los que se produjo la emisión láser asociada a la concentración de 500 mg/mL del fotosensibilizante, hubo presencia de inhibición en los puntos de aplicación del láser. Conclusión: Se concluye que hay indicios de que el tiempo de exposición al fotosensibilizante previo a la aplicación de la fototerapia es un factor esencial para la optimización de la terapia fotodinámica, especialmente en el caso de bacterias Gram-negativas.