Summary. After applying the collocation method with piecewise polynomial functions, on linear two-point-boundary-value ordinary differential equations, we correct the approximated solution using the residual function of the operator equation. That residual function will be the second member of the error differential equation. Solving this by some accurate finite-difference method, say of order p, we correct the collocation approximation getting a new one which is of order p too.

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BACKGROUND There has been an increase in cases of inflammatory bowel disease (IBD) in recent years. There is also greater access and availability of immunosuppressive and biological agents, which increase the risk of opportunistic infection despite improving the quality of life and promoting mucosal healing. Tuberculosis (TB) remains a public health problem, and it has a high incidence in several countries. Therefore, knowledge of the risk of developing TB in patients with IBD is important. AIM To evaluate the risk of active TB in patients with IBD under treatment from an endemic area in Latin America. METHODS A standard questionnaire included demographic variables, clinical aspects of IBD disease, history of active TB during treatment, active TB characteristics and evolution, initial screening and results and time from the start of anti-tumor necrosis factor alpha (TNFα) to TB development. RESULTS Azathioprine, anti-TNFα and the combination of these two drugs were associated with a higher risk of active TB incidence. The TNFα blockers increased the relative risk of developing active TB compared to other treatments. All four multivariable models showed that the use of TNFα blockers alone or in combination with azathioprine was an important risk factor for the incidence of active TB. After adjustment for sex, age, type of IBD and latent TB, anti-TNFα with azathioprine increased the relative risk to 17.8 times more than conventional treatment. Late TB, which was diagnosed 3 mo after the start of anti-TNFα, was the most frequent. CONCLUSION Treatment with anti-TNFα increased the risk of active TB in IBD patients from an endemic area in Latin America. This risk was increased when anti-TNFα was combined with azathioprine. The time from the beginning of the treatment to the active TB diagnosis suggests a new TB infection.

O objetivo deste artigo é descrever a população atendida pelo HIPERDIA e avaliar o conhecimento dos pacientes sobre diabetes e hipertensão arterial, verificando mudanças no estilo de vida após ingresso no programa. Trata-se de uma pesquisa descritiva e explicativa, com abordagem qualitativa e quantitativa, realizada com 52 pacientes. Obteve-se alta prevalência de idosos e de sujeitos que afirmaram ter conhecimento sobre a patologia e suas complicações; 99% realizavam tratamento medicamentoso. Concluiu-se que, entre as mulheres, o sedentarismo é menor, porém os homens apresentaram modificações significativas nos hábitos alimentares após ingresso no programa, com redução de gordura (77,8%) e sal (18,8); encontrou-se Índice de Massa Corporal e circunferência abdominal acima dos padrões normais e 80% das mulheres com sobrepeso. Recomenda-se, de acordo com os achados, que a equipe de saúde da família realize mais ações de promoção de saúde e de incentivo a pratica de atividade física, assim como melhora nos registros em prontuário.