Abstract

Introduction: In the last decades the number of leprosy cases has been decreasing in the world. This reduction has been questioned by researchers who believe there are more patients. Objectives: To analyze the temporal evolution of three epidemiological indicators (prevalence rate, grade II rate of physical disability and proportion of multibacillary cases) in order to find evidence of late diagnosis and hidden prevalence of leprosy in the state of Bahia, Brazil. Design and setting: This is an ecological study of time series. The unit of analysis was Bahia, Brazil. Methods: The data were obtained the DATASUS platform (http://datasus. saude.gov.br/). The inflection point regression model (joinpoint) was applied to assess the trend of the indicators from 2001 to 2015. The significance level of 5% and 95% confidence interval(95% CI). Results: There was a tendency to reduce the prevalence (AAPC -5.5%;p <0.001) accompanied by an increase in the rate of grade II (AAPC 2.7%; p <0.001). The presence of disabled individuals in the diagnosis, in addition to signaling for the late detection of the case, reflects the transcendence of the disease, that is, its social value. Finally, there was an increase in the proportion of multibacillary cases, increasing from 48.8% at the beginning of the time series to 66.5% at the end of it (AAPC 2.2%;p <0.001). Conclusions: This paradox suggests the existence of a late diagnosis and hidden prevalence in the state. Thus, the need to implement actions that make the diagnosis of new cases, reinforcing the hidden burden of leprosy and transmission, is reinforced.

Highlights

  • Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack

  • The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells

  • Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible

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Summary

Introduction

Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation

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