Resumen Introducción: el incremento del consumo de alimentos procesados y ultraprocesados puede predisponer a alteraciones metabólicas. Objetivo: verificar la asociación del consumo de alimentos con el fenotipo metabólico en trabajadores de un hospital cuaternario de Rio de Janeiro, Brasil. Métodos: fueron elegibles trabajadores de ambos sexos de edad > 18 años. El cuestionario de frecuencia de alimentos y la clasificación NOVA se utilizaron en el análisis del consumo de alimentos. El fenotipo metabólico consideró la presencia de al menos una alteración metabólica (glucemia, lípidos séricos y presión arterial) combinada con el IMC (eutrófico o exceso de peso) de la siguiente manera: 1) eutrófico metabólicamente saludable (EHM); 2) eutróficos metabólicamente no saludables (MUE); 3) exceso de peso metabólicamente saludable (MHEW); 4) exceso de peso metabólicamente no saludable (MUEW). Resultados: de los 160 participantes incluidos (edad media: 45,2 ± 1,1 años, 59,5 % de mujeres), el 21,9 % refirieron hipertensión arterial y el 4,4 % diabetes. La mayoría presentaron exceso de peso (74,6 %), siendo aproximadamente un 40 % obesos. El fenotipo MUEW presentó mayor porcentaje de grasa corporal y adiposidad central representada por mayor CC y VFA en comparación con los otros fenotipos. La masa corporal magra fue similar entre los grupos. La mediana de alimentos ultraprocesados fue de 32,4 % para los eutróficos, 32,7 % para el sobrepeso y 34,3 % para los obesos. No se observaron asociaciones significativas entre el consumo de ultraprocesados y el fenotipo eutrófico metabólicamente no saludable (OR: 1,01; IC 95 %: 0,96-1,06), exceso de peso metabólicamente saludable (OR: 1,03; IC 95 %: 0,98-1,08) y exceso de peso metabólicamente no saludable (OR: 1,00; IC 95 %: 0,96-1,05) en comparación con los eutróficos metabólicamente sanos. Conclusión: el consumo de alimentos ultraprocesados fue elevado. En este análisis transversal, no se observó asociación de fenotipos metabólicos y consumo de grupos de alimentos según el grado de procesamiento de los alimentos.

Abstract Introduction: an increase in the consumption of processed and ultra-processed foods may predispose to metabolic abnormalities. Objective: to verify the association of food consumption with metabolic phenotype in workers from a quaternary hospital in Rio de Janeiro, Brazil. Methods: workers of both sexes aged > 18 years were eligible. A food frequency questionnaire and the NOVA classification were used in the food consumption analysis. Metabolic phenotype considered the presence of at least one metabolic alteration (blood glucose, serum lipids, and blood pressure) combined with BMI (eutrophic or excess weight) as follows: 1) metabolically healthy eutrophic (MHE); 2) metabolically unhealthy eutrophic (MUE); 3) metabolically healthy excess weight (MHEW); 4) metabolically unhealthy excess weight (MUEW). Results: from the included 160 participants (mean age, 45.2 ± 1.1 years; 59.4 %, women), 21.9 % self-reported arterial hypertension and 4.4 % diabetes. Most presented excess weight (74.6 %), with approximately 40 % being obese. The MUEW phenotype had higher body fat percentage and central adiposity represented by higher WC and VFA in comparison to the other phenotypes. The lean body mass was similar between the groups. The median of ultra-processed foods was 32.4 % for eutrophic, 32.7 % for overweight, and 34.3 % for obese subjects. No significant associations were observed between ultra-processed food consumption and metabolically unhealthy eutrophic (OR: 1.01; 95 % CI: 0.96-1.06), metabolically healthy excess weight (OR: 1.03; 95 % CI: 0.98-1.08), and metabolically unhealthy excess weight (OR: 1.00; 95 % CI: 0.96-1.05) in comparison to metabolically healthy eutrophic. Conclusion: consumption of ultra-processed food was high. In this cross-sectional analysis, no association of metabolic phenotypes with consumption of food groups according to degree of food processing were observed.

Resumo Objetivo Descrever metodologia para o desenvolvimento de tecnologias sociais em enfermagem/saúde centradas no usuário Métodos Estudo de desenvolvimento tecnológico que apresenta proposição metodológica para a expansão de tecnologias sociais, com foco na solução de problemas oriundos de demandas dos usuários de saúde. Resultados A metodologia de aplicação tecnológica foi concebida e sistematizada em cinco fases sequenciais, quais sejam: Diagnóstico situacional, Idealização e prototipagem, Validação, Implementação, Fidelização e impacto social da aplicação. Conclusão Pretende-se, com essa nova proposta de desenvolvimento tecnológico, contribuir para a fidelização e o impacto das tecnologias sociais centradas nas necessidades dos usuários de saúde, a partir de abordagens como o Design Thinking e o Design Centrado no Usuário. enfermagemsaúde enfermagem saúde sequenciais sejam situacional prototipagem Validação Implementação Pretendese, Pretendese Pretende se, se Pretende-se Usuário

Resumen Objetivo Describir metodología para el desarrollo de tecnologías sociales en enfermería/salud centradas en el usuario Métodos Estudio de desarrollo tecnológico que presenta una proposición metodológica para la expansión de tecnologías sociales, con enfoque en la solución de problemas originarios de demandas de los usuarios de salud. Resultados La metodología de aplicación tecnológica fue formulada y sistematizada en cinco etapas secuenciales, a saber: Diagnóstico situacional, Idealización y creación de prototipo, Validación, Implementación, Fidelización e impacto social de la aplicación. Conclusión Con esta nueva propuesta de desarrollo tecnológico se pretende contribuir para la fidelización y para el impacto de las tecnologías sociales centradas en las necesidades de los usuarios de salud, a partir de intervenciones como el Design Thinking y el Design Centrado en el Usuario. enfermeríasalud enfermería salud secuenciales saber situacional prototipo Validación Implementación Usuario

Abstract Objective To describe the methodology for developing user-centered social technologies in nursing/health Methods A technological development study that presents a methodological proposal for the expansion of social technologies, with a focus on solving problems arising from the demands of healthcare users. Results The technological application methodology was conceived and systematized in five sequential steps, namely: Situational diagnosis, Ideation and prototyping, Validation, Implementation, Reliability, and social impact of the application. Conclusion With this new technological development proposal, we intend to contribute to the reliability and impact of social technologies centered on health users’ needs, based on approaches such as Design Thinking and User-Centered Design. usercentered user nursinghealth nursing users steps namely diagnosis prototyping Validation Implementation Reliability needs UserCentered User Centered

Resumo Fundamento As doenças oro-valvares têm prevalência mundial expressiva, e a cirurgia de troca valvar melhorou a sobrevida dos pacientes. Objetivos Descrever aspectos clínico-laboratoriais dos pacientes submetidos a implante valvar mecânico e determinar a incidência de trombose de próteses valvares (TPV). Métodos Estudo de coorte retrospectivo com seguimento até nove anos; as variáveis de estudo foram buscadas em prontuários físicos e eletrônicos. Os cálculos foram realizados pelo programa Jamovi 1.2.2.; p<0,05 foi considerado estatisticamente significante. Foram construídas curvas de Kaplan Meier, e realizada análise de regressão de Cox para fatores relacionados à mortalidade. Resultados Foram incluídos 473 pacientes com média de idade de 46,9 ±11,3 anos. A doença reumática foi a principal etiologia. Em média de acompanhamento de 4,43 anos, a mortalidade foi de 16,1%. Pacientes com implantes de próteses na posição aórtica tiveram sobrevida melhor que os portadores em posição mitro-aórtica (p=0,026). Entre os fatores ajustados para mortalidade, apenas classe funcional e insuficiência renal crônica apresentaram significância estatística. A incidência de TPV foi de 0,24/100 pacientes/ano, com primeiro evento após 1000 dias da cirurgia. Tabagismo e pannus foram estatisticamente associados a TPV. Não houve diferenças na variabilidade de INR entre pacientes com e sem trombose por posição protética, mas houve diferença estatística no INR pré-evento trombótico comparado aos que não apresentaram trombose (INR= 2,20[1,80-2,20] vs 2,80[2,20-3,40]; p= 0,040). Identificamos 4,4% de acidentes vasculares cerebrais e 5,2% de sangramentos. Conclusões A população mostrou-se jovem e valvopatia reumática foi frequente. A frequência de TPV foi semelhante à descrita na literatura, apesar da baixa renda e escolaridade da amostra.

Abstract Background Valvular heart diseases are highly prevalent in the world, and surgical valve replacement has improved patients’ survival. Objectives To describe clinical and laboratory data of patients undergoing mechanical valve replacement, and to determine the incidence of prosthetic valve thrombosis (PVT). Methods Retrospective cohort study with a follow-up of up to nine years. The study variables were collected from conventional and electronic medical charts. Statistical calculations were performed using the Jamovi software version 1.2.2.; a p<0.05 was considered statistically significant. Kaplan Meier curves were constructed, and Cox regression analysis was performed for analysis of factors related to mortality. Results A total of 473 patients were included, mean age of 46.9 ±11.3 years. Rheumatic disease was the most common etiology. In a mean follow-up period of 4.43 years, mortality rate was 16.1%. Patients with aortic prosthesis showed higher survival than patients with double implant (mitral and aortic) (p=0.026). Of the factors adjusted for mortality, only functional class and chronic renal failure showed statistically significant association. The incidence of PVT was 0.24/100 patients/year, and the first event occurred more than 1000 days after the implant. Smoking and pannus formation were significantly associated with PVT. No differences were found in INR variability between patients with and without thrombosis by prosthetic position, but significant differences were found in INR before thrombosis as compared with patients without thrombosis (INR= 2.20 [1.80-2.20] vs. 2.80 [2.20-3.40]; p= 0.040). The incidence of stroke and bleeding was 4.4% and 5.2% respectively. Conclusions The study population was young, and rheumatic valve disease was common in this group. The prevalence of PVT was similar to that described in the literature, despite the low income and low educational level of our sample.

ABSTRACT Introduction: Heart rate control by the autonomic nervous system (ANS) is impaired in heart transplant (HT) recipients, leading to increased resting heart rate, metabolic demand, and fatigue, which can impair their quality of life (QoL). In this study, we hypothesized the association of hemodynamics and autonomic function as predictors of QoL in HT recipients. Methods: This is a cross-sectional study conducted with HT recipients aged ≥ 18 years at ambulatorial accompaniment. Blood pressure was used for hemodynamics assessment, and heart rate variability (HRV) was used for ANS assessment. QoL was assessed by the 36-item Short Form Health Survey. The significance level was set as P≤0.05. Results: Twenty-two volunteers were included in the study. Systolic blood pressure (SBP) and double product (DP) were significantly negatively associated with the physical functioning domain of QoL. DP, the number of consecutive normal RR interval differences > 50 ms (NN50), and the percentage of normal RR intervals that differed by > 50 ms from the adjacent interval (PNN50) exhibited negative association with the physical role domain. NN50 and PNN50 were significantly associated with bodily pain, social functioning, and emotional role domains. SBP was negatively associated with the vitality domain. Considering general and mental health domains, no variable demonstrated significant association. DP, NN50, and PNN50 were negatively associated with the total score of QoL. Conclusion: This study demonstrated DP and HRV as predictors of QoL in HT recipients. These innovative results can become a relevant therapeutic target for improving QoL in HT recipients prior to its deterioration.

Abstract Covid-19 is a novel infectious disease whose spectrum of presentation ranges from absence of symptoms to widespread interstitial pneumonia associated with severe acute respiratory syndrome (SARS), leading to significant mortality. Given the systemic pattern of Covid-19, there are many factors that can influence patient's functional capacity after acute infection and the identification of such factors can contribute to the development of specific rehabilitation strategies. Pulmonary impairment is the primary cause of hospitalization due to Covid-19, and can progress to SARS as well as increase length of hospitalization. Moreover, cardiac involvement is observed in approximately 30% of hospitalized patients, with an increased risk of acute myocarditis, myocardial injury, and heart failure, which may compromise functional capacity in the long-term. Thromboembolic complications have also been reported in some patients with Covid-19 and are associated with a poor prognosis. Musculoskeletal complications may result from long periods of hospitalization and immobility, and can include fatigue, muscle weakness and polyneuropathy. Studies that address the functional capacity of patients after Covid-19 infection are still scarce. However, based on knowledge from the multiple systemic complications associated with Covid-19, it is reasonable to suggest that most patients, especially those who underwent prolonged hospitalization, will need a multiprofessional rehabilitation program. Further studies are needed to evaluate the functional impact and the rehabilitation strategies for patients affected by Covid-19.

Abstract The aim of this study was to incorporate tucuma oil (Astrocaryum vulgare) into PolyCaprolactone (PCL) electrospun fibers and evaluate its physicochemical properties and cell viability. FTIR and DRX confirmed that tucuma oil (TO) does not affect the chemical properties of PCL and that the oil was loaded into the PCL microstructure, while TGA analysis showed that the oil increased the thermal stability of the polymeric fibers. SEM showed that the addition of the oil modified fibers structure by reducing the average fiber size from 5.5 μm to 1.7 μm for TO loaded samples. Cell viability assay demonstrated an increment on cell proliferation from 80% of pure PCL to 100% for samples containing TO. Therefore, it can be concluded that tucuma oil can be incorporated into PCL to form fibers by electrospinning, without meaningful changes in its physicochemical properties and increasing its biocompatibility.

RESUMO A obtenção de scaffolds bioativos a partir da blenda polimérica de poli (ácido láctico-co-glicólico) (PLGA) e poliisopreno (IR) com diferentes adições de Hidroxiapatita (HAp) é proposta como uma alternativa à engenharia de tecidos. Para o preparo das soluções poliméricas, a blenda de PLGA/IR e a HAp foram dissolvidas em clorofórmio. Posteriormente, o scaffold foi processado por electrospinning, variando-se a distância entre a seringa e o coletor. As amostras foram caracterizadas quanto a composição química e estrutural por potencial zeta, difração de raios-X (DRX) e espectroscopia de infravermelho por transformada de Fourier (FTIR). Para avaliação da morfologia usou-se a microscopia eletrônica de varredura (MEV) e para o comportamento citotoxicológico utilizou-se a metodologia de analises de viabilidade celular. O valor de potencial zeta da HAp foi de -22 mV e o FTIR e DRX foram condizentes com a literatura. As imagens de MEV permitiram a análise do tamanho médio e desvio padrão das fibras obtidas, comprovando uma diferença significativa entre as amostras. O ensaio de citotoxicidade mostrou que o produto obtido é biocompatível, porém as amostras com menor formação de fibras são menos biocompatíveis. Os resultados demonstraram a ampla influência da distância entre o coletor e a ponta da seringa e da relação blenda/HAp, sendo que o scaffold obtido com a maior distância coletor/seringa e maior relação HAp/blenda apresentou fibras com tamanho médio menores e maior homogeneidade e baixa citotoxicidade celular.

ABSTRACT The aim of this paper is the obtainment of bioactive scaffolds from poly (lactic acid-co-glycolic acid) (PLGA) and polyisoprene (IR) polymer blends with different additions of hydroxyapatite (HAp) as an alternative for tissue engineering. For the preparation of the polymer solutions, the PLGA/IR blend and the HAp were dissolved in chloroform. Subsequently, the scaffold was processed by electrospinning, varying the dis-tance between the syringe and the collector. Scaffolds chemical and phase composition were characterized by zeta potential, X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). Scanning electron microscopy (SEM) was used to evaluate the morphology and for the cytotoxic behavior the cellular viability analysis methodology was used. The zeta potential value of the HAp was -22 mV and the FTIR and XRD were consistent with the literature. The SEM images allowed the analysis of the mean size and standard deviation of the obtained fibers, demonstrating a significant difference among the samples. The results showed the great influence of the distance between the collector and the tip of the syringe and the blend/HAp ratio, and the scaffold obtained with the largest collector/ syringe distance and the highest HAp/blend ratio showed fibers with a smaller mean size and greater homogeneity and low cellular cytotoxicity.