Abstract This article aims to describe the geographical distribution of hospital mortality from COVID-19 in children and adolescents during the 2020-2021 pandemic in Brazil. Ecological, census study (SIVEP GRIPE) with individuals up to 19 years of age, hospitalized with SARS due to COVID-19 or SARS not specified in Brazilian municipalities, stratified in two ways: 1) in the five macro-regions and 2) in three urban agglomerations: capital, municipalities of the metropolitan region and non-capital municipalities. There were 44 hospitalizations/100,000 inhabitants due to COVID-19 and 241/100,000 when including unspecified SARS (estimated underreporting of 81.8%). There were 1,888 deaths by COVID-19 and 4,471 deaths if added to unspecified SARS, estimating 57.8% of unreported deaths. Hospital mortality was 2.3 times higher in the macro-regions when considering only the cases of COVID-19, with the exception of the North and Center-West regions. Higher hospital mortality was also recorded in non-capital municipalities. The urban setting was associated with higher SARS hospital mortality during the COVID-19 pandemic in Brazil. Living in the North and Northeast macro-regions, and far from the capitals offered a higher risk of mortality for children and adolescents who required hospitalization. COVID19 COVID COVID-1 20202021 2020 2021 2020-202 Brazil Ecological SIVEP GRIPE 1 age ways macroregions macro regions 2 agglomerations capital noncapital non 4 hospitalizations100000 hospitalizations 100 000 hospitalizations/100,00 241100000 241 241/100,00 estimated 81.8%. 818 81.8% . 81 8 81.8%) 1888 888 1,88 4471 471 4,47 578 57 57.8 23 3 2. COVID19, 19, CenterWest Center West macroregions, regions, hospitalization COVID1 COVID- 2020202 202 2020-20 hospitalizations10000 10 00 hospitalizations/100,0 24110000 24 241/100,0 81.8 188 88 1,8 447 47 4,4 5 57. 202020 20 2020-2 hospitalizations1000 0 hospitalizations/100, 2411000 241/100, 81. 18 1, 4, 20202 2020- hospitalizations100 hospitalizations/100 241100 241/100 hospitalizations10 hospitalizations/10 24110 241/10 hospitalizations1 hospitalizations/1 2411 241/1 hospitalizations/ 241/

Resumo O objetivo deste artigo é descrever a distribuição geográfica da mortalidade hospitalar por COVID-19 em crianças e adolescentes durante a pandemia de 2020-2021 no Brasil. Estudo ecológico, censitário (SIVEP GRIPE), de indivíduos até 19 anos, internados com SRAG por COVID-19 ou SRAG não especificada, em municípios brasileiros, estratificados de duas formas: 1) nas cinco macrorregiões e 2) em três aglomerados urbanos: capital, municípios da região metropolitana e do interior. Verificou-se 44 internações/100 mil habitantes por COVID-19 e 241/100 mil ao se incluir a SRAG não especificada (subnotificação estimada de 81,8%). Ocorreram1.888 óbitos por COVID-19 e 4.471 óbitos se somados à SRAG não especificada, estimando-se subnotificação de 57,8% dos óbitos. A mortalidade hospitalar foi 2,3 vezes maior nas macrorregiões quando considerados apenas os casos de COVID-19, com exceção das regiões Norte e Centro-Oeste. Registrou-se também maior mortalidade hospitalar em municípios do interior. O contexto urbano esteve associado à maior mortalidade hospitalar por SRAG durante a pandemia de COVID-19 no Brasil. Residir nas macrorregiões Norte e Nordeste, e distante das capitais, ofereceu maior risco de mortalidade para crianças e adolescentes que necessitaram hospitalização. COVID19 COVID COVID-1 20202021 2020 2021 2020-202 Brasil ecológico SIVEP GRIPE, GRIPE , GRIPE) 1 anos brasileiros formas 2 urbanos capital interior Verificouse Verificou 4 internações100 internações 100 internações/10 241100 241 241/10 81,8%. 818 81,8% . 81 8 81,8%) Ocorreram1888 Ocorreram Ocorreram1 888 Ocorreram1.88 4471 471 4.47 estimandose estimando 578 57 57,8 23 3 2, COVID19, 19, CentroOeste. CentroOeste Centro Oeste. Oeste Centro-Oeste Registrouse Registrou Nordeste capitais hospitalização COVID1 COVID- 2020202 202 2020-20 internações10 10 internações/1 24110 24 241/1 81,8 Ocorreram188 88 Ocorreram1.8 447 47 4.4 5 57, 202020 20 2020-2 internações1 internações/ 2411 241/ 81, Ocorreram18 Ocorreram1. 4. 20202 2020-

Resumo O objetivo deste artigo é descrever a distribuição geográfica da mortalidade hospitalar por COVID-19 em crianças e adolescentes durante a pandemia de 2020-2021 no Brasil. Estudo ecológico, censitário (SIVEP GRIPE), de indivíduos até 19 anos, internados com SRAG por COVID-19 ou SRAG não especificada, em municípios brasileiros, estratificados de duas formas: 1) nas cinco macrorregiões e 2) em três aglomerados urbanos: capital, municípios da região metropolitana e do interior. Verificou-se 44 internações/100 mil habitantes por COVID-19 e 241/100 mil ao se incluir a SRAG não especificada (subnotificação estimada de 81,8%). Ocorreram1.888 óbitos por COVID-19 e 4.471 óbitos se somados à SRAG não especificada, estimando-se subnotificação de 57,8% dos óbitos. A mortalidade hospitalar foi 2,3 vezes maior nas macrorregiões quando considerados apenas os casos de COVID-19, com exceção das regiões Norte e Centro-Oeste. Registrou-se também maior mortalidade hospitalar em municípios do interior. O contexto urbano esteve associado à maior mortalidade hospitalar por SRAG durante a pandemia de COVID-19 no Brasil. Residir nas macrorregiões Norte e Nordeste, e distante das capitais, ofereceu maior risco de mortalidade para crianças e adolescentes que necessitaram hospitalização.

Abstract This article aims to describe the geographical distribution of hospital mortality from COVID-19 in children and adolescents during the 2020-2021 pandemic in Brazil. Ecological, census study (SIVEP GRIPE) with individuals up to 19 years of age, hospitalized with SARS due to COVID-19 or SARS not specified in Brazilian municipalities, stratified in two ways: 1) in the five macro-regions and 2) in three urban agglomerations: capital, municipalities of the metropolitan region and non-capital municipalities. There were 44 hospitalizations/100,000 inhabitants due to COVID-19 and 241/100,000 when including unspecified SARS (estimated underreporting of 81.8%). There were 1,888 deaths by COVID-19 and 4,471 deaths if added to unspecified SARS, estimating 57.8% of unreported deaths. Hospital mortality was 2.3 times higher in the macro-regions when considering only the cases of COVID-19, with the exception of the North and Center-West regions. Higher hospital mortality was also recorded in non-capital municipalities. The urban setting was associated with higher SARS hospital mortality during the COVID-19 pandemic in Brazil. Living in the North and Northeast macro-regions, and far from the capitals offered a higher risk of mortality for children and adolescents who required hospitalization.

Abstract Background: Noncommunicable diseases contribute to premature deaths and limitations. Disability retirement is linked to chronic conditions, particularly cardiovascular diseases. The II Brazilian Guideline for Severe Heart Disease established criteria for cardiovascular disease classification. However, there is a lack of research in this topic within federal institutions. Objectives: Evaluate the survival and causes of death among disabled retirees at UFRJ, focusing on the impact of severe heart disease. Methods: A retrospective cohort study based on retirement and death records over 15 years. Retirements were categorized into three groups: full retirement due to severe heart disease, full retirement due to other diseases and proportional. Causes of death were obtained from death certificates. Mortality rates, survival and the presence of matching diagnoses between retirement and death were evaluated. Chi-square, log-rank, Cox models, Kaplan-Meier curves were utilized. Statistical significance with a 95% confidence interval, considering p<0.05. Results: There were 630 retirements, 368 (51.4%) in females, with an average age of 52.9 (SD=7.8) years, and 169 (26.8%) deaths. Mortality was higher in professors (37.0%; p=0.113), in the age group between 65 and 70 years (48.4%; p=0.004), in males (34.0%; p=0.001), and in full retirements due to severe heart disease (41.5%; p<0.001). Matching diagnoses between retirement and death were more frequent in professors (74.1%; p=0.026) and in full retirements due to severe heart disease (72.7%; p<0.001). Conclusions: Severe heart disease diagnosis is associated with higher mortality and shorter survival in disabled retirees. Its frequent occurrence in retirement and death diagnoses underscores its significance in this context. Background limitations conditions classification However institutions Objectives UFRJ Methods 1 groups proportional certificates rates evaluated Chisquare, Chisquare Chi square, square Chi-square logrank, logrank log rank, rank log-rank models KaplanMeier Kaplan Meier utilized 95 interval p005 p 0 05 p<0.05 Results 63 36 51.4% 514 51 4 (51.4% females 529 52 9 52. SD=7.8 SD78 SD 7 8 (SD=7.8 16 26.8% 268 26 (26.8% 37.0% 370 37 (37.0% p=0.113, p0113 p=0.113 , 113 p=0.113) 6 48.4% 484 48 (48.4% p=0.004, p0004 p=0.004 004 p=0.004) 34.0% 340 34 (34.0% p=0.001, p0001 p=0.001 001 p=0.001) 41.5% 415 41 5 (41.5% p<0.001. p<0.001 . p<0.001) 74.1% 741 74 (74.1% p=0.026 p0026 026 72.7% 727 72 (72.7% Conclusions context p00 p<0.0 3 51.4 (51.4 SD=7. SD7 (SD=7. 26.8 2 (26.8 37.0 (37.0 p011 p=0.11 11 48.4 (48.4 p000 p=0.00 00 34.0 (34.0 41.5 (41.5 p<0.00 74.1 (74.1 p=0.02 p002 02 72.7 (72.7 p0 p<0. 51. (51. SD=7 (SD=7 26. (26. 37. (37. p01 p=0.1 48. (48. p=0.0 34. (34. 41. (41. 74. (74. 72. (72. p<0 (51 SD= (SD= (26 (37 p=0. (48 (34 (41 (74 (72 p< (5 (SD (2 (3 p=0 (4 (7 ( p=

Resumo Fundamento: As doenças não comunicáveis são responsáveis por mortes prematuras e limitações. A aposentadoria por invalidez está associada a condições crônicas, especialmente a doenças cardiovasculares. A II Diretriz Brasileira de Cardiopatia Grave definiu critérios para enquadramento das doenças cardiovasculares. Poucos estudos abordam esse tema em instituições federais. Objetivos: Avaliar sobrevida e causas de óbito de servidores aposentados por invalidez na UFRJ, com ênfase no impacto da cardiopatia grave. Métodos: Estudo de coorte retrospectivo baseado nos registros de aposentadorias e óbitos ao longo de 15 anos. As aposentadorias foram divididas em três grupos: integral por cardiopatia grave, integral por outras doenças e proporcional. As causas de óbito foram obtidas a partir das certidões de óbito. Foram avaliadas taxa de mortalidade, sobrevida e a presença de diagnósticos concordantes entre a aposentadoria e o óbito. Foram utilizados testes qui-quadrado, log-rank, modelos de Cox e curvas de Kaplan-Meier. Significância estatística com intervalo de confiança de 95%, considerando p < 0,05. Resultados: Foram 630 aposentadorias, 368 (51,4%) no sexo feminino, com idade média de idade de 52,9 (DP=7,8) anos, e 169 (26,8%) óbitos. A mortalidade foi maior nos professores (37,0%; p=0,113), na faixa etária entre 65 e 70 anos (48,4%; p=0,004), no sexo masculino (34,0%; p=0,001), e nas aposentadorias integrais por cardiopatia grave (41,5%; p < 0,001). Diagnósticos concordantes entre aposentadoria e óbito foram mais frequentes em professores (74,1%; p=0,026) e nas aposentadorias integrais por cardiopatia grave (72,7%; p < 0,001). Conclusões: O diagnóstico de cardiopatia grave confere maior taxa de mortalidade e menor sobrevida aos aposentados por invalidez, e sua presença em maior frequência nos diagnósticos de aposentadoria e óbito ressalta sua importância neste contexto. Fundamento limitações crônicas cardiovasculares federais Objetivos UFRJ Métodos 1 grupos proporcional quiquadrado, quiquadrado qui quadrado, quadrado qui-quadrado logrank, logrank log rank, rank log-rank KaplanMeier. KaplanMeier Kaplan Meier. Meier Kaplan-Meier 95 95% 005 0 05 0,05 Resultados 63 36 51,4% 514 51 4 (51,4% feminino 529 52 9 52, DP=7,8 DP78 DP 7 8 (DP=7,8 16 26,8% 268 26 (26,8% 37,0% 370 37 (37,0% p=0,113, p0113 p=0,113 , 113 p=0,113) 6 48,4% 484 48 (48,4% p=0,004, p0004 p=0,004 004 p=0,004) 34,0% 340 34 (34,0% p=0,001, p0001 p=0,001 001 p=0,001) 41,5% 415 41 5 (41,5% 0,001. 0001 0,001 . 0,001) 74,1% 741 74 (74,1% p=0,026 p0026 026 72,7% 727 72 (72,7% Conclusões contexto 00 0,0 3 51,4 (51,4 DP=7, DP7 (DP=7, 26,8 2 (26,8 37,0 (37,0 p011 p=0,11 11 48,4 (48,4 p000 p=0,00 34,0 (34,0 41,5 (41,5 000 0,00 74,1 (74,1 p=0,02 p002 02 72,7 (72,7 0, 51, (51, DP=7 (DP=7 26, (26, 37, (37, p01 p=0,1 48, (48, p00 p=0,0 34, (34, 41, (41, 74, (74, 72, (72, (51 DP= (DP= (26 (37 p0 p=0, (48 (34 (41 (74 (72 (5 (DP (2 (3 p=0 (4 (7 ( p=

Abstract Background: Facial nerve dysfunction is the principal postoperative complication related to parotidectomy. Objective: To test the hypothesis that the modified Sunnybrook Facial Grading System (mS-FGS) is superior to the original S-FGS in the assessment of facial nerve function following parotidectomy. Methods: Prospective, longitudinal study evaluating patients with primary or metastatic parotid neoplasms undergoing parotidectomy with facial nerve-sparing between 2016 and 2020. The subjects were assessed twice, on the first postoperative day and at the first outpatient evaluation, 20-30 days post-surgery. Facial assessments were performed using the original and modified (plus showing the lower teeth) versions of the Sunnybrook System and documented by pictures and video recordings. Intra- and inter-rater agreements regarding the assessment of the new expression were analyzed. Results: 101 patients were enrolled. In both steps, the results from the mS-FGS were significantly lower (p < 0.001). Subjects with a history of previous parotidectomy and those who underwent neck dissection had more severe facial nerve impairment. The mandibular marginal branch was the most frequently injured, affecting 68.3% of the patients on the first postoperative day and 52.5% on the first outpatient evaluation. Twenty patients (19.8%) presented an exclusive marginal mandibular branch lesion. The inter-rater agreement of the new expression assessment ranged from substantial to almost perfect. The intra-rater agreement was almost perfect (wk = 0.951). Conclusion: The adoption of the Modified Sunnybrook System, which includes evaluation of the mandibular marginal branch, increases the accuracy of post-parotidectomy facial nerve dysfunction appraisal. Background Objective mSFGS mS FGS (mS-FGS SFGS S Methods Prospective nervesparing sparing 201 2020 twice 2030 20 30 20-3 postsurgery. postsurgery post surgery. surgery post-surgery plus teeth recordings Intra interrater inter rater analyzed Results 10 enrolled steps p 0.001. 0001 0.001 . 0 001 0.001) impairment injured 683 68 3 68.3 525 52 5 52.5 19.8% 198 19 8 (19.8% lesion intrarater intra wk 0.951. 0951 0.951 951 0.951) Conclusion postparotidectomy appraisal 202 203 2 20- 1 000 0.00 00 6 68. 52. 19.8 (19.8 095 0.95 95 0.0 19. (19. 09 0.9 9 0. (19 (1 (

Resumo Antecedentes: A disfunção do nervo facial é a principal complicação pós-operatória relacionada à parotidectomia. Objetivo: Testar a hipótese de que o sistema Sunnybrook de graduação facial modificado (mS-FGS) é superior ao S-FGS original na avaliação da função do nervo facial após parotidectomia. Métodos: Estudo longitudinal prospectivo avaliando o pós-operatório de pacientes com neoplasias parotídeas primárias ou metastáticas, submetidos à parotidectomia com preservação do nervo facial, entre 2016 e 2020. Os indivíduos foram avaliados duas vezes, no primeiro dia de pós-operatório e na primeira avaliação ambulatorial, 20-30 dias após a cirurgia. As avaliações faciais foram realizadas usando as versões original e modificada (que incluem mostrar os dentes inferiores) do sistema Sunnybrook e documentadas por fotos e vídeos. Foram adicionalmente analisadas as concordâncias intra e interexaminadoras da avaliação da nova expressão. Resultados: Cento e um pacientes foram incluídos. Em ambas as etapas, os resultados do mS-FGS foram significativamente menores (p < 0,001). Indivíduos com história de parotidectomia prévia e aqueles submetidos ao esvaziamento cervical apresentaram comprometimento mais grave do nervo facial. O ramo marginal mandibular foi o mais afetado, acometendo 68,3% dos pacientes no primeiro dia de pós-operatório e 52,5% na primeira avaliação ambulatorial. Vinte pacientes (19,8%) apresentaram lesão exclusiva do ramo marginal mandibular. A concordância interexaminadores da avaliação da nova expressão variou de substancial a quase perfeita. A concordância intraexaminador foi quase perfeita (wk = 0,951). Conclusão: A adoção do sistema Sunnybrook modificado, que inclui a análise do ramo marginal mandibular, aumenta a precisão da avaliação da disfunção do nervo facial pós-parotidectomia. Antecedentes pósoperatória pós operatória Objetivo mSFGS mS FGS (mS-FGS SFGS S Métodos pósoperatório operatório metastáticas 201 2020 vezes ambulatorial 2030 20 30 20-3 cirurgia inferiores vídeos Resultados incluídos etapas p 0,001. 0001 0,001 . 0 001 0,001) afetado 683 68 3 68,3 525 52 5 52,5 19,8% 198 19 8 (19,8% wk 0,951. 0951 0,951 951 0,951) Conclusão pósparotidectomia. pósparotidectomia pós-parotidectomia 202 203 2 20- 000 0,00 00 6 68, 52, 19,8 1 (19,8 095 0,95 95 0,0 19, (19, 09 0,9 9 0, (19 (1 (

Abstract Introduction The acoustic analysis of speech (measurements of the fundamental frequency and formant frequencies) of different vowels produced by speakers with the Angle class II, division 1, malocclusion can provide information about the relationship between articulatory and phonatory mechanisms in this type of maxillomandibular disproportion. Objectives To investigate acoustic measurements related to the fundamental frequency (F0) and formant frequencies (F1 and F2) of the oral vowels of Brazilian Portuguese (BP) produced by male speakers with Angle class II, division 1, malocclusion (study group) and compare with men with Angle class I malocclusion (control group). Methods In total, 60 men (20 with class II, 40 with class I) aged between 18 and 40 years were included in the study. Measurements of F0, F1 and F2 of the seven oral vowels of BP were estimated from the audio samples containing repetitions of carrier sentences. The statistical analysis was performed using the Student t-test and the effect size was calculated. Results Significant differences (p-values) were detected for F0 values in five vowels ([e], [i], [o], [o] and [u]), and for F1 in vowels [a] and [ɔ], with high levels for class II, division 1. Conclusion Statistical differences were found in the F0 measurements with higher values in five of the seven vowels analysed in subjects with Angle class II, division 1. The formant frequencies showed differences only in F1 in two vowels with higher values in the study group. The data suggest that data on voice and speech production must be included in the protocol’s assessment of patients with malocclusion. II 1 disproportion F (F0 (F (BP group control . total 6 20 (2 4 sentences ttest t test calculated pvalues p (p-values e, e , ([e] i, i [i] o, o [o u, u [u]) a [a ɔ, ɔ [ɔ] protocols protocol s 2 ( ([e [i [u] [ɔ [u

Abstract Background The COVID-19 pandemic has changed food consumption. Objective Evaluate the association between metabolic phenotypes, changes in food consumption during the pandemic, and health outcomes in obese women. Methods Cross-sectional observational study including 491 women without previous diagnosis of chronic diseases, evaluated according to metabolic phenotype. During the pandemic, a subsample was re-evaluated by online questionnaires via Google Forms. Analyzed anthropometric, biochemical, and dietary data as well as health outcomes (coronary artery disease, type 2 diabetes, hypertension, dyslipidemia or death). Information on mortality was collected from the Internal Affairs Office of the State of Rio de Janeiro and the Health Department of the State of Rio de Janeiro. Statistical analysis was performed using the statistical program SPSS 21, with Mann-Whitney test, Pearson’s chi-squared, Spearman correlation, and binary logistic regression, at a significance level of 5%. Results The anthropometric, glucose, and lipid profiles showed significant differences between the metabolically healthy and metabolically unhealthy groups (p = 0.00). Before the pandemic, women in the metabolically unhealthy group had higher dietary intakes of lipids (p = 0.01), saturated fat (p = 0.01) and sodium (p = 0.04), during the pandemic, they consumed more energy (p = 0.04), lipids (p = 0.02), saturated fat (p = 0.02), proteins (p = 0.03) and sodium from ultra-processed foods (p = 0.03). Consequently, health outcomes were more prevalent in the metabolically unhealthy group (p = 0.00). Conclusion Observed that metabolically healthy women had qualitatively better food intake and fewer health outcomes throughout the study. COVID19 COVID 19 COVID-1 phenotypes Crosssectional Cross sectional 49 diseases phenotype reevaluated re Forms anthropometric biochemical coronary disease diabetes hypertension death. death . death) 21 MannWhitney Mann Whitney test Pearsons Pearson s chisquared, chisquared chi squared, squared chi-squared correlation regression 5 5% glucose p 0.00. 000 0.00 0 00 0.00) 0.01, 001 0.01 , 01 0.04, 004 0.04 04 0.04) 0.02, 002 0.02 02 0.02) 0.03 003 03 ultraprocessed ultra processed 0.03. Consequently COVID1 1 COVID- 4 0.0 0.

ABSTRACT Objective: To associate caregivers' sense of coherence (SOC) and untreated caries with oral health status in children covered by a dental public health system. Material and Methods: A convenience sample of caregivers/children in Angra dos Reis, Brazil, was surveyed. Caregivers' SOC was evaluated using the 13-question version questionnaire. For both caregivers/children, sociodemographic information was acquired and caries experience was evaluated by DMFT/dmft and PUFA/pufa index. Statistical associations between children's untreated carious teeth and interest variables from the caregivers were evaluated by binary logistic regression assessed by generalized linear modeling. Results: A total of 233 pairs of caregivers-children were included. Children's untreated permanent and primary carious teeth represented 34.8% and 62.2% of the caries experience, respectively and at least one PUFA/pufa scored tooth was detected in 22.7% of them. Caregivers' DMFT was 13.5±7.0, while 33.6% scored on PUFA. A total of 62.1% of them presented untreated carious lesions. Results from the univariate model, correlating children's untreated caries and caregivers' attributes showed a statistical significance for SOC values (p<0.015), untreated decayed teeth (p<0.035), self-perception of oral health (p<0.022) and oral impact on daily performance (p<0.010). The multivariate logistic first model kept the statistical significance only for the caregiver's untreated decayed teeth. Conclusion: Caregivers' SOC and untreated carious teeth could be used as indicators of dental treatment needs in their offspring. Objective (SOC system Methods caregiverschildren Reis Brazil surveyed Caregivers 13question question 13 questionnaire DMFTdmft dmft PUFApufa PUFA pufa index childrens s modeling 23 included Childrens Children 348 34 8 34.8 622 62 2 62.2 227 22 7 22.7 13570 5 0 13.5±7.0 336 33 6 33.6 621 1 62.1 lesions p<0.015, p0015 p p<0.015 , 015 (p<0.015) p<0.035, p0035 p<0.035 035 (p<0.035) selfperception self perception p<0.022 p0022 022 (p<0.022 p<0.010. p0010 p<0.010 . 010 (p<0.010) caregiver Conclusion offspring 3 34. 62. 22. 1357 13.5±7. 33. p001 p<0.01 01 (p<0.015 p003 p<0.03 03 (p<0.035 p<0.02 p002 02 (p<0.02 (p<0.010 135 13.5±7 p00 p<0.0 (p<0.01 (p<0.03 (p<0.0 13.5± p0 p<0. (p<0. 13.5 p<0 (p<0 13. p< (p< (p

Abstract Background Dietary treatment containing fiber-rich foods may contribute to lowering weight in obese women. Objective To investigate the effect of a hypoenergetic diet combined with pumpkin seed flour (PSF) consumption on diet quality, anthropometric indices, and glucose and lipid metabolism in obese women. Methods We conducted a randomized, double-blind, placebo-controlled, 90-day clinical trial with obese women, distributed into the following two groups: hypoenergetic diet + placebo (PG) and hypoenergetic diet + pumpkin seed flour (PSFG). A total of 100 participants were included in the PSFG (n = 47) and PG (n = 53). We evaluated neck circumference (NC); waist to height ratio; conicity index; fat mass (FM); lipid profile; blood concentrations of glucose and insulin; homeostatic model assessment for insulin resistance (HOMA-IR); quantitative insulin sensitivity check index (QUICKI); and blood pressure at baseline, 30, 60, and 90 days. Dietary analysis was determined by differences between diet quality indices before and after prescribing the experimental diet. Chi-squared, Student’s t-tests and analysis for repeated measures were used, and values were considered significant at p < 0.05. Results The dietary pattern improved after 90 days in both groups. The PSFG presented lower NC (p < 0.001), FM (p = 0.010), triglycerides (TG) (p = 0.025), insulin (p = 0.003), and HOMA-IR (p = 0.018). The PG presented a lower diastolic blood pressure (p = 0.004) and low-density lipoprotein cholesterol (LDL-c) (p = 0.056). Conclusion A hypoenergetic diet combined with PSF consumption contributes to lowering NC, FM, HOMA-IR, TG, and insulin concentrations. fiberrich fiber rich women (PSF randomized doubleblind, doubleblind double blind, blind double-blind placebocontrolled, placebocontrolled controlled, controlled placebo-controlled 90day day groups (PG PSFG. . (PSFG) 10 n 47 53. 53 53) (NC) ratio (FM) profile HOMAIR HOMA IR (HOMA-IR) QUICKI (QUICKI) baseline 30 60 9 Chisquared, Chisquared Chi squared, squared Chi-squared Students Student s ttests t tests used 005 0 05 0.05 0.001, 0001 0.001 , 001 0.001) 0.010, 0010 0.010 010 0.010) TG (TG 0.025, 0025 0.025 025 0.025) 0.003, 0003 0.003 003 0.003) 0.018. 0018 0.018 018 0.018) 0.004 0004 004 lowdensity low density LDLc LDL c (LDL-c 0.056. 0056 0.056 056 0.056) HOMAIR, IR, (PSFG 1 4 5 (NC (FM (HOMA-IR (QUICKI 3 6 00 0.0 000 0.00 0.01 01 002 0.02 02 0.

ABSTRACT OBJECTIVE To describe cases, deaths, and hospital mortality from covid-19 in children and adolescents in Brazil, according to age group, during the evolving phases of the pandemic in 2020 and 2021. METHODS Census of patients aged up to 19 committed with severe acute respiratory syndrome, due to covid-19 or unspecified, notified to the Brazilian Influenza Epidemiological Surveillance Information System, from January 1, 2020, to December 31, 2021. The two years were divided into six phases, covering the spread of the disease—first, second and third wave—as well as the impact of vaccination. The pediatric population was categorized into infants, preschoolers, schoolchildren, and adolescents. Hospital mortality was assessed by pandemic phase and age group. RESULTS A total of 144,041 patients were recorded in the two years, 18.2% of whom had confirmed cases of covid-19. Children under 5 years old (infants and preschoolers) accounted for 62.8% of those hospitalized. A total of 4,471 patients died, representing about 6.1 deaths per day. Infants were the ones who most progressed to the intensive care unit (24.7%) and had the highest gross number of deaths (n = 2,012), but mortality was higher among adolescents (5.7%), reaching 9.8% in phase 1. The first peak of deaths occurred in phase 1 (May/2020), and two other peaks occurred in phase 4 (March/2021 and May/2021). There was an increase in cases and deaths for younger ages since phase 4. Hospital mortality in the pediatric population was higher in phases 1, 4, and 6, following the phenomena of dissemination/interiorization of the virus in the country, beginning of the second wave and beginning of the third wave, respectively. CONCLUSION The absolute number of cases of covid-19 in children and adolescents is significant. Although complete vaccination in descending order of age provided a natural deviation in age range, there was a greater gap between the curve of new hospitalized cases and the curve of deaths, indicating the positive impact of immunization. covid19 covid covid-1 Brazil group 202 2021 syndrome unspecified System 31 diseasefirst, diseasefirst disease first, disease—first waveas infants preschoolers schoolchildren 144041 144 041 144,04 182 18 2 18.2 covid19. 19. 628 62 8 62.8 4471 471 4,47 died 61 6 6. day 24.7% 247 24 7 (24.7% n 2,012, 2012 2,012 , 012 2,012) 5.7%, 57 5.7% (5.7%) 98 9 9.8 May/2020, May2020 May May/2020 (May/2020) March/2021 March2021 March (March/202 May/2021. May2021 May/2021 . May/2021) disseminationinteriorization dissemination interiorization country respectively significant range immunization covid1 covid- 20 3 14404 14 04 144,0 18. 62. 447 47 4,4 24.7 (24.7 201 2,01 01 5.7 (5.7% 9. May202 May/202 (May/2020 March/202 March202 (March/20 1440 0 144, 44 24. (24. 2,0 5. (5.7 May20 May/20 (May/202 March/20 March20 (March/2 (24 2, (5. May2 May/2 (May/20 March/2 March2 (March/ (2 (5 May/ (May/2 March/ (March ( (May/ (May

RESUMO OBJETIVO Descrever casos, óbitos e mortalidade hospitalar por covid-19 em crianças e adolescentes no Brasil, conforme faixa etária, durante as fases de evolução da pandemia em 2020 e 2021. MÉTODOS Censo de pacientes de até 19 anos internados com síndrome respiratória aguda grave, por covid-19 ou não especificada, notificados ao Sistema de Informação de Vigilância Epidemiológica da Gripe do Brasil, entre 1 de janeiro de 2020 e 31 de dezembro de 2021. Os dois anos foram divididos em seis fases, abrangendo a disseminação da doença − primeira, segunda e terceira onda −, bem como o impacto da vacinação. A população pediátrica foi categorizada em lactentes, pré-escolares, escolares e adolescentes. A mortalidade hospitalar foi avaliada por fase da pandemia e faixa etária. RESULTADOS Foram contabilizados 144.041 pacientes nos dois anos, sendo 18,2% casos de covid-19 confirmados. Menores de 5 anos (lactentes e pré-escolares) corresponderam a 62,8% dos hospitalizados. Evoluíram a óbito 4.471, representando cerca 6,1 óbitos por dia. Os lactentes foram os que mais evoluíram para unidade de terapia intensiva (24,7%) e apresentaram o maior número bruto de óbito (n = 2.012), porém a mortalidade foi maior entre os adolescentes (5,7%), chegando a 9,8% na fase 1. O primeiro pico de óbitos ocorreu na fase 1 (maio/2020), e outros dois picos ocorreram na fase 4 (março/2021 e maio/2021). Verificou-se avanço de casos e óbitos para as idades inferiores desde a fase 4. A mortalidade hospitalar na população pediátrica foi maior nas fases 1, 4 e 6, acompanhando os fenômenos de disseminação/interiorização do vírus no país, início da segunda onda e início da terceira onda, respectivamente. CONCLUSÃO O número absoluto de casos de covid-19 em crianças e adolescentes é expressivo. Embora a vacinação completa em ordem decrescente de idade tenha proporcionado um desvio natural de faixa etária, ocorreu um distanciamento maior entre a curva de novos casos hospitalizados e a curva de óbitos, indicando o impacto positivo da imunização. covid19 covid covid-1 Brasil etária 202 2021 grave especificada 3 primeira préescolares, préescolares pré escolares, pré-escolares 144041 144 041 144.04 182 18 2 18,2 confirmados 628 62 8 62,8 4471 471 4.471 61 6 dia 24,7% 247 24 7 (24,7% n 2.012, 2012 2.012 , 012 2.012) 5,7%, 57 5,7% (5,7%) 98 9 9,8 maio/2020, maio2020 maio maio/2020 (maio/2020) março/2021 março2021 março (março/202 maio/2021. maio2021 maio/2021 . maio/2021) Verificouse Verificou se disseminaçãointeriorização interiorização país respectivamente expressivo imunização covid1 covid- 20 14404 14 04 144.0 18, 62, 447 47 4.47 24,7 (24,7 201 2.01 01 5,7 (5,7% 9, maio202 maio/202 (maio/2020 março/202 março202 (março/20 1440 0 144. 44 4.4 24, (24, 2.0 5, (5,7 maio20 maio/20 (maio/202 março/20 março20 (março/2 (24 2. (5, maio2 maio/2 (maio/20 março/2 março2 (março/ (2 (5 maio/ (maio/2 março/ (março ( (maio/ (maio

ABSTRACT Objective: To evaluate the presence of sequelae in primary teeth and their permanent successors, as well as associations between TDI and the presence of sequelae in both teeth. Material and Methods: In this 14-year retrospective study, 2.290 records were reviewed, 192 patients who suffered dental trauma in primary teeth were followed until the eruption of successor teeth were included. Descriptive, chi-square, and regression logistic with generalized estimating equations tests were performed (p<0.05). Results: 362 primary and successor teeth were followed. Sequelae were present in 71.8% of primary teeth and 25.7% of their successors. Teeth with complicated fracture (100%), extrusion (100%) and avulsion (100%) resulted in the largest amounts of sequelae in primary teeth and intrusion (61%) on their successors. Age was associated with sequelae in permanent teeth (p<0.01). Extrusion (OR 10.06; CI 2.12-47.63) and intrusion (OR 7.51; CI 2.73-20.70) had a higher risk to cause sequelae in primary and permanent teeth, respectively. Conclusion: The type of injury involved influenced the sequelae in traumatized teeth and their successors, and the age of the child influenced the presence of sequelae in permanent teeth. Objective successors Methods 14year year 14 study 2290 2 290 2.29 reviewed 19 included Descriptive chisquare, chisquare chi square, square chi-square p<0.05. p005 p p<0.05 . 0 05 (p<0.05) Results 36 718 71 8 71.8 257 25 7 25.7 100%, 100 100% , (100% 61% 61 (61% p<0.01. p001 p<0.01 01 (p<0.01) OR 10.06 1006 10 06 2.1247.63 2124763 2.12 47.63 12 47 63 2.12-47.63 7.51 751 51 2.7320.70 2732070 2.73 20.70 73 20 70 2.73-20.70 respectively Conclusion 1 229 29 2.2 p00 p<0.0 (p<0.05 3 71. 25. (100 6 (61 (p<0.01 10.0 1247 2.1247.6 212476 212 2.1 4763 47.6 4 2.12-47.6 7.5 75 5 7320 2.7320.7 273207 273 2.7 2070 20.7 2.73-20.7 22 2. p0 p<0. (p<0.0 (10 (6 10. 124 2.1247. 21247 21 476 47. 2.12-47. 7. 732 2.7320. 27320 27 207 20. 2.73-20. p<0 (p<0. (1 ( 2.1247 2124 2.12-47 2.7320 2732 2.73-20 p< (p<0 2.124 2.12-4 2.732 2.73-2 (p< 2.12- 2.73- (p

Abstract Introduction: Currently, two types of phenotypes have been recognized in individuals who are obese. Among the factors related to lifestyle, diet has a relevant influence, although there is no consensus regarding the role of diet in metabolic phenotypes; furthermore, diet is a strong moderator of chronic systemic inflammation. Objective: Investigate dietary inflammatory potential between metabolic phenotypes and to compare the differences between anti-inflammatory and pro-inflammatory diets in individuals with the same phenotype. Methods: This is a cross-sectional observational study that utilized the database of 533 individuals divided into 4 groups, according to metabolic phenotype and dietary inflammatory characteristic. Sociodemographic, clinical, anthropometric and biochemical characteristics were evaluated and the inflammatory index of the diet was calculated. Results: The mean Dietary Inflammatory index (DII) of the total sample was 0.974±1.02, with a maximum of 4.34 and a minimum of −1.74. In the metabolically unhealthy groups, we found a statistical difference in relation to systolic blood pressure when comparing the anti-inflammatory [median 120 (110.0-130.0)] and pro-inflammatory diets [median 130 (120.0-140.0); p = 0.022], and mean isoprostane concentrations were lower in the metabolically healthy group with anti-inflammatory diet. In regression analysis, the only variable that demonstrated a higher risk of alterations in all groups when compared to the metabolically healthy and anti-inflammatory group were isoprostane concentrations. Conclusion: We are able to conclude that an anti-inflammatory diet is associated with lower oxidative stress in metabolically healthy obese, and a pro-inflammatory diet is associated with higher systolic blood pressure values. Introduction Currently obese lifestyle influence furthermore inflammation Objective antiinflammatory anti proinflammatory pro Methods crosssectional cross sectional 53 characteristic Sociodemographic clinical calculated Results DII (DII 0974102 0 974 1 02 0.974±1.02 434 34 4.3 174 74 −1.74 median 12 110.0130.0 11001300 110.0 130.0 110 (110.0-130.0) 13 120.0140.0 12001400 120.0 140.0 140 (120.0-140.0) 0.022, 0022 0.022 , 022 0.022] analysis Conclusion values 5 097410 97 0.974±1.0 43 3 4. 17 7 −1.7 0130 110.0130. 1100130 1100 110. 1300 130. 11 (110.0-130.0 0140 120.0140. 1200140 1200 120. 1400 140. 14 (120.0-140.0 002 0.02 09741 9 0.974±1. −1. 013 110.0130 110013 (110.0-130. 014 120.0140 120014 (120.0-140. 00 0.0 0974 0.974±1 −1 01 110.013 11001 (110.0-130 120.014 12001 (120.0-140 0. 097 0.974± − 110.01 (110.0-13 120.01 (120.0-14 09 0.974 (110.0-1 (120.0-1 0.97 (110.0- (120.0- 0.9 (110.0 (120.0 (110. (120. (110 (120 (11 (12 (1 (

RESUMO OBJETIVO Descrever casos, óbitos e mortalidade hospitalar por covid-19 em crianças e adolescentes no Brasil, conforme faixa etária, durante as fases de evolução da pandemia em 2020 e 2021. MÉTODOS Censo de pacientes de até 19 anos internados com síndrome respiratória aguda grave, por covid-19 ou não especificada, notificados ao Sistema de Informação de Vigilância Epidemiológica da Gripe do Brasil, entre 1 de janeiro de 2020 e 31 de dezembro de 2021. Os dois anos foram divididos em seis fases, abrangendo a disseminação da doença − primeira, segunda e terceira onda −, bem como o impacto da vacinação. A população pediátrica foi categorizada em lactentes, pré-escolares, escolares e adolescentes. A mortalidade hospitalar foi avaliada por fase da pandemia e faixa etária. RESULTADOS Foram contabilizados 144.041 pacientes nos dois anos, sendo 18,2% casos de covid-19 confirmados. Menores de 5 anos (lactentes e pré-escolares) corresponderam a 62,8% dos hospitalizados. Evoluíram a óbito 4.471, representando cerca 6,1 óbitos por dia. Os lactentes foram os que mais evoluíram para unidade de terapia intensiva (24,7%) e apresentaram o maior número bruto de óbito (n = 2.012), porém a mortalidade foi maior entre os adolescentes (5,7%), chegando a 9,8% na fase 1. O primeiro pico de óbitos ocorreu na fase 1 (maio/2020), e outros dois picos ocorreram na fase 4 (março/2021 e maio/2021). Verificou-se avanço de casos e óbitos para as idades inferiores desde a fase 4. A mortalidade hospitalar na população pediátrica foi maior nas fases 1, 4 e 6, acompanhando os fenômenos de disseminação/interiorização do vírus no país, início da segunda onda e início da terceira onda, respectivamente. CONCLUSÃO O número absoluto de casos de covid-19 em crianças e adolescentes é expressivo. Embora a vacinação completa em ordem decrescente de idade tenha proporcionado um desvio natural de faixa etária, ocorreu um distanciamento maior entre a curva de novos casos hospitalizados e a curva de óbitos, indicando o impacto positivo da imunização.

ABSTRACT OBJECTIVE To describe cases, deaths, and hospital mortality from covid-19 in children and adolescents in Brazil, according to age group, during the evolving phases of the pandemic in 2020 and 2021. METHODS Census of patients aged up to 19 committed with severe acute respiratory syndrome, due to covid-19 or unspecified, notified to the Brazilian Influenza Epidemiological Surveillance Information System, from January 1, 2020, to December 31, 2021. The two years were divided into six phases, covering the spread of the disease—first, second and third wave—as well as the impact of vaccination. The pediatric population was categorized into infants, preschoolers, schoolchildren, and adolescents. Hospital mortality was assessed by pandemic phase and age group. RESULTS A total of 144,041 patients were recorded in the two years, 18.2% of whom had confirmed cases of covid-19. Children under 5 years old (infants and preschoolers) accounted for 62.8% of those hospitalized. A total of 4,471 patients died, representing about 6.1 deaths per day. Infants were the ones who most progressed to the intensive care unit (24.7%) and had the highest gross number of deaths (n = 2,012), but mortality was higher among adolescents (5.7%), reaching 9.8% in phase 1. The first peak of deaths occurred in phase 1 (May/2020), and two other peaks occurred in phase 4 (March/2021 and May/2021). There was an increase in cases and deaths for younger ages since phase 4. Hospital mortality in the pediatric population was higher in phases 1, 4, and 6, following the phenomena of dissemination/interiorization of the virus in the country, beginning of the second wave and beginning of the third wave, respectively. CONCLUSION The absolute number of cases of covid-19 in children and adolescents is significant. Although complete vaccination in descending order of age provided a natural deviation in age range, there was a greater gap between the curve of new hospitalized cases and the curve of deaths, indicating the positive impact of immunization.

Resumo O mercúrio (Hg) é uma substância tóxica, sendo o consumo de pescados uma das principais fontes de exposição da população. Este artigo visa avaliar a associação entre anemia e exposição ao Hg na população infanto-juvenil de seis comunidades ribeirinhas da Amazônia Brasileira. Realizou-se a análise secundária de dados de estudos seccionais, incluindo 1.318 indivíduos, divididos em dois grupos segundo a influência do garimpo (grupo A sob influência, e grupo B sem influência). Métodos de análise multivariada foram realizados para verificar a associação entre variável de exposição (Hg no cabelo) e anemia, estratificando pelos grupos. Foram observados 348 casos de anemia (27,1%), sendo 206 entre o grupo B e 142 no grupo A. Houve diferença na mediana dos níveis de Hg entre os grupos (A = 12,8µg/g e B = 4,3µg/g, p = 0,01). Foi observada associação entre Hg no cabelo ≥ 6,0µg/g e anemia (OR = 1,38; IC95% = 1,02-1,87), fato que foi magnificado para o grupo A quando realizada estratificação (OR = 2,23; IC95% = 1,28-3,90). O estudo mostrou elevados níveis de Hg, principalmente no grupo A, e que essa substância pode ser um possível fator de risco para anemia. Além disso, as áreas geográficas pareceram modificar esse efeito, apontando para influência de outros fatores, fato que deve ser melhor avaliado.

Abstract Mercury (Hg) is a toxic substance, and fish consumption is one of the main sources of exposure for the population. This article aims to evaluate the association between exposure to Hg and anemia among children and adolescents from six riverside communities in the Brazilian Amazon. Secondary data analysis from cross-sectional studies, including 1,318 individuals, divided into two groups according to gold mining exposure (group A under the influence, and group B without it). Multivariate analysis methods were performed to assess the association between exposure to Hg (hair Hg) and anemia, stratifying by groups. Three hundred and forty-eight anemia cases were observed (27.1%), with 206 from group B and 142 out of group A. There was a difference in the median of Hg levels between groups (A = 12.8µg/g and B = 4.3µg/g, p = 0.01). An association was observed between hair Hg levels ≥ 6.0µg/g and anemia (OR = 1.38; 95%CI = 1.02-1.87), a fact that was magnified for group A, when stratification was performed (OR = 2.23; 95%CI = 1.28-3.90). This study showed high Hg levels, especially in group A and this substance might be a possible risk factor for anemia. Also, geographical areas seemed to modify this effect, pointing to the influence of other factors, which should be better evaluated.

Resumo O mercúrio (Hg) é uma substância tóxica, sendo o consumo de pescados uma das principais fontes de exposição da população. Este artigo visa avaliar a associação entre anemia e exposição ao Hg na população infanto-juvenil de seis comunidades ribeirinhas da Amazônia Brasileira. Realizou-se a análise secundária de dados de estudos seccionais, incluindo 1.318 indivíduos, divididos em dois grupos segundo a influência do garimpo (grupo A sob influência, e grupo B sem influência). Métodos de análise multivariada foram realizados para verificar a associação entre variável de exposição (Hg no cabelo) e anemia, estratificando pelos grupos. Foram observados 348 casos de anemia (27,1%), sendo 206 entre o grupo B e 142 no grupo A. Houve diferença na mediana dos níveis de Hg entre os grupos (A = 12,8µg/g e B = 4,3µg/g, p = 0,01). Foi observada associação entre Hg no cabelo ≥ 6,0µg/g e anemia (OR = 1,38; IC95% = 1,02-1,87), fato que foi magnificado para o grupo A quando realizada estratificação (OR = 2,23; IC95% = 1,28-3,90). O estudo mostrou elevados níveis de Hg, principalmente no grupo A, e que essa substância pode ser um possível fator de risco para anemia. Além disso, as áreas geográficas pareceram modificar esse efeito, apontando para influência de outros fatores, fato que deve ser melhor avaliado.

Abstract Mercury (Hg) is a toxic substance, and fish consumption is one of the main sources of exposure for the population. This article aims to evaluate the association between exposure to Hg and anemia among children and adolescents from six riverside communities in the Brazilian Amazon. Secondary data analysis from cross-sectional studies, including 1,318 individuals, divided into two groups according to gold mining exposure (group A under the influence, and group B without it). Multivariate analysis methods were performed to assess the association between exposure to Hg (hair Hg) and anemia, stratifying by groups. Three hundred and forty-eight anemia cases were observed (27.1%), with 206 from group B and 142 out of group A. There was a difference in the median of Hg levels between groups (A = 12.8µg/g and B = 4.3µg/g, p = 0.01). An association was observed between hair Hg levels ≥ 6.0µg/g and anemia (OR = 1.38; 95%CI = 1.02-1.87), a fact that was magnified for group A, when stratification was performed (OR = 2.23; 95%CI = 1.28-3.90). This study showed high Hg levels, especially in group A and this substance might be a possible risk factor for anemia. Also, geographical areas seemed to modify this effect, pointing to the influence of other factors, which should be better evaluated.

Abstract Objective: To investigate the association between caries experience and school performance among children and adolescents living in an island community without fluoridated water supply and to compare data according to the type of attended school (full-time or part-time). Material and Methods: A cross-sectional oral health survey in a convenience sample of students (n=147) attending four public schools was performed. Students were examined by one calibrated dentist in the school environment to the obtain prevalence of dental caries (DMFT/dmft) and its consequences using the PUFA/pufa index. Self-reported oral health behavior was also accessed. Data from each student’s school performance and absenteeism were extracted from official sources and the school performance was classified into “good” and “fair”. The final sample consisted of 120 students. Descriptive statistics, Mann-Whitney, Kruskal-Wallis, chi-square tests and binary logistic regression were performed to evaluate collected data. Results: Students´ age ranged between 5 to 19 years (10±4.3). DMFT/dmft mean were 1.3 (±2.3) and 3.05 (±3.4), respectively. Conclusion: Participants from the full-time school presented better oral health status than their peers in the part-time schools (p<0.05). A significant association was found between the prevalence of caries-free participants and good school performance when the factor age range was controlled (OR=2.87). Moreover, attendance to full-time schools appeared to be a protective factor for good oral health conditions.