Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.

La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.

A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.

ABSTRACT: Pornunça (Manihot sp.) is a potential forage to feed ruminants in drylands worldwide; however, evaluations of animal diets are necessary. This study assessed intake and digestibility of dry matter and nutrients, physiological responses, ingestive behavior, water intake, as well as hematological and biochemical responses of lambs fed diets containing increasing levels of Pornunça silage (PS) replacing Tifton-85 bermudagrass hay (Cynodon spp.). Treatments consisted of 0, 33, 66, and 100 % PS considering the roughage portion of the diet (% dry matter – DM). The experimental design was completely randomized with six replicates. Cyanide acid (HCN) levels in fresh Pornunça leaves were 207.7 mg kg−1 DM and 76.78 mg kg−1 DM in PS. Intake of DM and crude protein (CP), and neutral detergent fiber corrected for ash and protein (NDFap) increased linearly with increasing levels of PS in the diet. Digestibility of DM, NDF, and CP were higher with increasing levels of PS. Idle time decreased linearly, while water balance, water intake via food, and total water in feces increased with PS. Nitrogen balance, physiological, and hematological responses were not influenced by treatments, while the final alanine aminotransferase increased for lambs fed all diets evaluated. The PS up to 100 % of the roughage portion increased DM and nutrient intake and digestibility without altering physiological responses and the hematological and biochemical parameters, resulting in greater water intake via food.

Abstract The iAtlantic Project has established an international collaborative strategy to improve mapping and characterization of deep and open ocean ecosystems in understudied regions of the Atlantic and evaluate their health. In December 2022, the first iAtlantic expedition in the South Atlantic set off to map and explore seafloor ecosystems in the Santos Basin slope (200-1,000 m depths) in collaboration with the Petrobras ‘Santos Basin - Regional Characterization Project.’ The 17-day ‘iAtlantic_BR10-Petrobras’ cruise was conducted on board the research vessel NPqHOc Vital de Oliveira (Brazilian Navy) and performed (a) water column structure characterization, (b) seafloor morphology mapping, (c) description of benthic habitats and communities by seafloor imagery and biological/ geological sampling, and (d) ex-situ experiments to assess the functioning of sedimentary ecosystems and their responses to climate-related environmental changes. This study describes the rationale behind the iAtlantic_BR10-Petrobras cruise science plan, reports its sampling strategy and methods, and summarizes its collected data and preliminary results.

Abstract The objective of this work was to evaluate the genetic diversity of Xanthomonas phaseoli p v. manihotis (Xpm) from eight populations from five cassava producing states in Brazil, through the rep-PCR (BOX-PCR and ERIC-PCR) and variable number of tandem repeat (VNTR) markers. Cassava leaves with symptoms of cassava bacterial blight were collected in eight municipalities, and the Xpm isolates were identified by amplification with primers specific for these isolates. The identity of the Xpm isolates was confirmed with the BOX-PCR, ERIC-PCR, and VNTR markers. The observed selection pressure, together with the mode of reproduction and the mechanisms that increase genetic variability, allows of the pathogen populations to adapt according to microclimate variation, contributing to a differentiated reproductive success. ERIC-PCR and VNTRs are the best markers for evaluating the genetic variability in the eight studied Xpm populations. However, ERIC-PCR is the marker that best separated the groups by population and presented a higher similarity between the isolates of the same population. The study of the genetic diversity of Xpm is key to improve disease monitoring and management strategies in cassava crops.

Resumo O objetivo deste trabalho foi avaliar a diversidade genética de Xa nthomona s phaseoli p v . ma nihot i s (Xpm) de oito populações de cinco estados produtores de mandioca no Brasil, por meio de marcadores rep-PCR (BOX-PCR e ERIC-PCR) e variable number of tandem repeats (VNTRs). Folhas de mandioca com sintomas de crestamento bacteriano foram coletadas em oito municípios, e os isolados Xpm foram identificados por amplificação com iniciadores específicos para esses isolados. A identidade dos isolados Xmp foi confirmada com os marcadores BOX-PCR, ERIC-PCR e VNTRs. A pressão de seleção observada, junto com o modo de reprodução e os mecanismos que aumentam a variabilidade genética, permite que as populações do patógeno se adaptem de acordo com a variação dos microclimas, o que contribui para o sucesso reprodutivo diferenciado. ERIC-PCR e VNTRs são os melhores marcadores para avaliar a variabilidade genética das oito populações Xpm estudadas. No entanto, ERIC-PCR é o marcador que melhor separou os grupos por população e apresentou maior similaridade entre os isolados de uma mesma população. O estudo da diversidade genética de Xpm é fundamental para delinear estratégias de manejo e monitoramento de doenças na cultura da mandioca.

Abstract Introduction Perinatal hypothyroidism has a negative repercussion on the development and maturation of auditory system function. However, its long-term effect on auditory function remains unsettled. Objective To evaluate the effect of prenatal hypothyroidism on the auditory function of adult offspring in rats. Methods Pregnant Wistar rats were given the antithyroid drug methimazole (0.02%-1-methylimidazole-2-thiol– MMI) in drinking water, ad libitum, from gestational day (GD) 9 to postnatal day 15 (PND15). Anesthetized offspring from MMI-treated dams (OMTD) and control rats were evaluated by tympanometry, distortion product otoacoustic emission (DPOAE), and auditory brainstem response (ABR) at PNDs 30, 60, 90, and 120. Results Our data demonstrated no middle ear dysfunction, with the OMTD compliance lower than that of the control group. The DPOAE revealed the absence of outer hair cells function, and the ABR showed normal integrity of neural auditory pathways up to brainstem level in the central nervous system. Furthermore, in the OMTD group, hearing loss was characterized by a higher electrophysiological threshold. Conclusion Our data suggest that perinatal hypothyroidism leads to irreversible damage to cochlear function in offspring.

ABSTRACT BACKGROUND: During childhood and adolescence, there are significant increases in bone mineral content (BMC) and bone mineral density (BMD). OBJECTIVE: To investigate physical growth parameters associated with BMD and BMC among children and adolescents diagnosed with human immunodeficiency virus (HIV). DESIGN AND SETTING: Cross-sectional study conducted in Florianópolis, Brazil, among 63 children and adolescents (aged 8-15 years) diagnosed with HIV. METHOD: BMD, BMC and fat percentage z score were evaluated using dual X-ray absorptiometry. Age/height z score and body mass index (BMI)/age z score were obtained in accordance with international recommendations, and bone age was obtained through hand-wrist radiography. Sex, family income, information on HIV infection (T CD4+ lymphocyte count, viral load and type of antiretroviral therapy, moderate-vigorous physical activity and sedentary behavior) were used as adjustment variables in the analyses. Simple and multiple linear regression analyses were performed, with a significance level of P ≤ 0.05. RESULTS: Subtotal BMD (without the head region) was directly associated with bone age, BMI/age z score and fat percentage z score, even after adjusting for covariates. Subtotal BMC/height was directly associated with bone age, height/age z score, BMI/age z score and fat percentage z score, even after adjusting for covariates. CONCLUSION: Subtotal BMD and subtotal BMC/height were directly associated with physical growth indicators among children and adolescents diagnosed with HIV.

Abstract Objective: The objective of this study was to evaluate the effect of Kangaroo Position (KP) in microcirculation (MC) of the flexor muscles of preterm newborns. Method: A controlled clinical trial was conducted in the city of Recife, Brazil, with 26 preterm children randomized in the Kangaroo Group (13) and in the Control Group (13). Assessments of blood flow, temperature, and tissue oxygen saturation (SO2) were made at two different times and in the biceps brachii muscle and hamstrings muscle group: before the KP and after 24 h of KP. In the Control Group, the registrations were performed at the times corresponding to those of the Kangaroo Group. The mean values among the times were analyzed by paired t-test for repeated measures. The clinical trial was recorded in Clinical Trials (NCT03611088). Results: In the Kangaroo Group there was an increase in tissue temperature and blood flow at the time evaluation periods (p < 0.05). In the control group, there was no statistical difference between the recording moments hamstring muscles group, but in the biceps brachii, there was a reduction in mean blood flow (p = 0.023). Conclusion: In conclusion, the KP has effects on the microcirculation of the flexor muscles of preterm newborns.

Resumo Introdução: Monitorar a qualidade da água nos serviços de diálise móvel (DM), avaliando os pontos críticos e caracterizando os riscos inerentes ao processo, é fundamental para evitar riscos à saúde do paciente. Este estudo avaliou a qualidade microbiológica da água na DM de 36 hospitais com tratamento intensivo no município do Rio de Janeiro. Métodos: Foram coletadas 204 amostras de água dos pontos de entrada da rede (REDE), pós-osmose (PO) e solução de diálise (SD). As amostras foram avaliadas quanto à contagem de bactérias heterotróficas, pesquisa de patógenos, presença de endotoxinas e teor de alumínio. Resultados: A contaminação bacteriana, em 3 pontos de coleta nos 36 hospitais, foi de 30% (32/108), sendo 42% provenientes da SD, 31% da PO e 17% da REDE, com presença de Pseudomonas aeruginosa, Stenotrophomonas maltophilia, Burkholderia cepacia e Ralstonia pickettii nos 3 pontos. Concentrações de endotoxina acima de 0,25 EU/mL ocorreram em 77% das amostras (17/22) analisadas na PO. No teor de alumínio, os valores acima de 0,01 mg/L foram apresentados em 47% (7/15) das amostras da PO e 27% (4/15) das amostras da REDE. Não existe uma legislação específica para água utilizada na DM; logo, foram utilizados os limites da RDC da Agência Nacional de Vigilância Sanitária (Anvisa) 11/2014, que regulamenta os serviços de hemodiálise convencional. Conclusão: Os resultados ressaltam a importância da avaliação da qualidade da água nos serviços de DM para garantir a segurança do paciente e subsidiar o monitoramento sanitário desse processo como um promotor de saúde.

Abstract Introduction: Monitoring water quality in mobile dialysis (MD) services, assessing critical points and characterizing the risks inherent in the process, is essential to avoid risks to the patient's health. This study evaluated the microbiological quality of water in the MD of 36 hospitals with intensive treatment in the city of Rio de Janeiro. Methods: 204 water samples were collected from the points of entry to the network (NET), post-osmosis (PO) and dialysis solution (DS). The samples were evaluated for heterotrophic bacteria count, pathogen search, presence of endotoxins and aluminum content. Results: Bacterial contamination at 3 collection points in 36 hospitals was 30% (32/108); 42% from DS, 31% from PO and 17% from NET, with the presence of Pseudomonas aeruginosa, Stenotrophomonas maltophilia , Burkholderia cepacia and Ralstonia pickettii in the 3 points. Endotoxin concentrations above 0.25 EU/mL occurred in 77% of the samples (17/22) analyzed in the PO. In the aluminum content, values above 0.01 mg/L were presented in 47% (7/15) of PO samples and 27% (4/15) of NET samples. There is no specific legislation for water used in the MD; therefore, the limits of the RDC of the National Health Surveillance Agency (Anvisa) 11/2014 were used; which regulates conventional hemodialysis services. Conclusion: The results highlight the importance of evaluating water quality in MD services to ensure patient safety and support the sanitary monitoring of this process as a healthcare promoter.

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

ABSTRACT. Fruit residues represent alternative ingredients that can be included in diets of tambaqui, Colossoma macropomum. This study evaluated the growth performance of tambaqui fed diets containing different levels of guava agroindustrial residue. The experiment was based on a completely randomised design, with 105 fish randomly distributed in 15 plastic 60 L-1 boxes with a water recirculation system. Feeding was carried out to apparent satiety for 45 days, using diets with 0, 50, 100, 150 and 200 g kg-1 inclusion of guava residue. Biometrics were performed every 15 days. Quadratic effect (p < 0.05) was observed for daily feed intake and apparent feed conversion, with optimum levels of 4.86 and 6.05% inclusion of guava residue, respectively. There was no significant difference (p > 0.05) in relation to final weight, weight gain, specific growth rate, hepato-somatic index, survival rate and protein efficiency rate by the dietary treatments. The inclusion of up to 150 g kg-1 of the guava agroindustrial residue in the feed did not compromise the performance of tambaqui juveniles.

Resumo Objetivo Determinar a presença de sintomas depressivos e seus fatores associados no idoso que vive na cidade de São Paulo durante o isolamento da pandemia da covid-19. Método Trata-se de um estudo quantitativo, descritivo e transversal realizado com 411 idosos, que vivem na cidade de São Paulo. Foram utilizados os instrumentos de perfil demográfico, Escala de Depressão Geriátrica e listagem de sintomas físicos, psicológicos e uso de substâncias. Resultados Identificou-se predomínio do sexo feminino, entre 60 e 69 anos, com companheiro, estudo superior, e sem alteração da renda. Ademais, não ter companheiro (p=0,02), sintomas psicológicos como falta de esperança (p=0,001), medo (p=0,008) e vontade de morrer (p=0,003), e sintomas físicos como tremor (p=0,003) e cansaço (p<0,001) foram associados com sintomas depressivos. Por outro lado, não usar substâncias ilegais (p=0,03) foi considerado um fator protetor à presença desses sintomas. Conclusão É necessário estar alerta a quaisquer sinais ou sintomas que possam indicar algum sofrimento mental, sugerindo-se a adoção de medidas de socialização.

Abstract Objective To determine the presence of depressive symptoms and their associated factors in the elderly living in the city of São Paulo during the isolation of the covid-19 pandemic. Method This is a quantitative, descriptive and cross-sectional study carried out with 411 elderly people living in the city of São Paulo. Demographic profile instruments, the Geriatric Depression Scale and a list of physical and psychological symptoms and substance use were used. Results There was a predominance of females, between 60 and 69 years old, with a partner, higher education, and with no change in income. In addition, not having a partner (p=0,02), psychological symptoms such as lack of hope (p=0,001), fear (p=0,008) and desire to die (p=0,003), and physical symptoms such as tremor (p=0,03) and tiredness (p<0,0001) were associated with depressive symptoms. On the other hand, not using illegal substances (p=0,03) was considered a protective factor against the presence of these symptoms. Conclusion It is necessary to be alert to any signs or symptoms that may indicate some mental suffering, suggesting the adoption of socialization measures.

Resumo Objetivo Analisar a relação entre os Determinantes Sociais de Saúde e o uso de drogas psicoativas em gestantes de risco habitual. Métodos Estudo documental e retrospectivo, realizado com 344 prontuários. A coleta de dados utilizou um questionário semiestruturado, com questões relacionadas a aspectos sociodemográficos, clínicos e obstétricos. As variáveis preditoras se configuraram como os Determinantes Sociais da Saúde. Os dados foram processados no Statistical Package for the Social Sciences e discutidos segundo o Modelo de Dahlgren e Whitehead. Resultados Sobre o uso de drogas psicoativas, a mais presente entre a população estudada foi o álcool, 12 (3,5%), seguida de drogas ilícitas, 9 (2,6%) e do tabaco, 8 (2,3%). Percebeu-se associação dos determinantes proximais, pertencentes à segunda camada do modelo, com o etilismo, entre as multigestas. Referente aos determinantes intermediários, evidenciou-se que as mulheres que tiveram um número de consultas inadequado durante o pré-natal apresentaram quase cinco vezes mais chances de praticar o etilismo. Suplementação inadequada esteve associada ao tabagismo e escolaridade esteve associada a tabagismo e uso de drogas ilícitas. Conclusão Dessa forma, o presente estudo demonstrou a relação entre os Determinantes Sociais de Saúde multigestação, inadequação do número de consultas pré-natais, suplementação inadequada e escolaridade com o uso de drogas psicoativas em gestantes de risco habitual, que poderá facilitar a detecção de gestantes suscetíveis, permitindo ao profissional de saúde fortalecer ações de promoção da saúde visando a redução de danos ao binômio.

Abstract Objective To analyze the relationship between social determinants of health and psychoactive drug use in pregnant women at habitual risk. Methods This is a documentary and retrospective study carried out with 344 medical records. Data collection used a semi-structured questionnaire, with questions related to sociodemographic, clinical and obstetric aspects. The predictor variables were configured as social determinants of health. Data were processed in the Statistical Package for the Social Sciences and discussed according to the Dahlgren and Whitehead Model. Results About psychoactive drug use, the most common among the population studied was alcohol, 12 (3.5%), followed by illicit drugs, 9 (2.6%) and tobacco, 8 (2.3%). An association of the proximal determinants belonging to the second layer of the model with alcoholism was noticed among the multigravidas. Regarding the intermediate determinants, it was evident that women who had an inadequate number of consultations during prenatal care were almost five times more likely to practice alcoholism. Inadequate supplementation was associated with smoking and education was associated with smoking and illicit drug use. Conclusion Thus, the present study demonstrated the relationship between the multiparity social determinants of health, inadequate number of prenatal consultations, inadequate supplementation and education with psychoactive drug use in pregnant women at usual risk, which may facilitate the detection of susceptible pregnant women, allowing the healthcare professional to strengthen health promotion actions aimed at reducing damage to the binomial.

Resumen Objetivo Analizar la relación entre los Determinantes Sociales de Salud y el uso de drogas psicoactivas en embarazadas con riesgo normal. Métodos Estudio documental y retrospectivo, realizado con 344 historias clínicas. La recopilación de datos utilizó un cuestionario semiestructurado, con preguntas relacionadas con aspectos sociodemográficos, clínicos y obstétricos. Las variables predictoras se configuraron como los Determinantes Sociales de Salud. Los datos se procesaron en el Statistical Package for the Social Sciences y discutidos de acuerdo con el Modelo de Dahlgren y Whitehead. Resultados Sobre el uso de drogas psicoactivas, la más presente en la población estudiada fue el alcohol, 12 (3,5 %), seguida por las drogas ilegales, 9 (2,6 %) y el tabaco, 8 (2,3 %). Se notó una asociación de los determinantes proximales, que pertenecen a la segunda camada del modelo, con el etilismo, entre las multigestas. Referente a los determinantes intermedios, se evidenció que las mujeres que tuvieron un número de consultas inadecuado durante el control prenatal presentaron casi cinco veces más posibilidades de practicar el etilismo. La suplementación inadecuada estuvo asociada al tabaquismo y la escolaridad estuvo asociada al tabaquismo y al uso de drogas ilegales. Conclusión De esa forma, el presente estudio demostró la relación entre los Determinantes Sociales de Salud embarazo múltiple, inadecuación del número de consultas prenatales, suplementación inadecuada y escolaridad con el uso de drogas psicoactivas em mujeres embarazadas con riesgo normal, que podrá facilitar la detección de embarazadas susceptibles, posibilitándole al profesional de salud fortalecer acciones de promoción de la salud con el objetivo de reducir los daños al binomio.

Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.

Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.

Background: A population study is an important tool that can be used to understand the actual epidemiological scenario of the Covid-19 in different territories, identify its magnitude, understand its transmission dynamics, and its demographic, geographical, and social distribution. Objective: The aim of this study was to determine the prevalence and dynamics of SARS-CoV-2 infection in the population of two Brazilian cities during the pandemic first wave and subsequent socioeconomic and health effects. Materials &amp; methods: This paper described the methodological procedures adopted and the prevalence of the SARS-CoV-2 infection in the population. A household survey was conducted between October and December 2020, in two historic cities of Brazil's mining region. Anti-SARS-CoV-2 antibody was detected using the Wondfo® rapid test. The face-to-face interview consisted of administration of a questionnaire containing registration data, sociodemographic and economic variables, living habits, general health condition, mental health, sleep habits, and eating and nutrition. Results: We evaluated 1,762 residents, of which 764 (43.4%) were in Mariana and 998 (56.6%) in Ouro Preto. For both cities, 51.9% of the interviewees were female, with a predominance of the age range 35 to 59 years old (47.2%). The prevalence of the SARS-CoV-2 infection was 5.5% in all cities, 6.2% in Ouro Preto, and 4.7% in Mariana. The prevalence was similar between cities (P&gt;0.05). Conclusion: The study was effective in verifying the seroprevalence of infection by the virus and its findings will enable further analyses of the health conditions of the population related to social isolation and the risk of infection with SARS-CoV-2.

RESUMO Objetivos: Analisar a percepção dos profissionais de enfermagem sobre a sua inserção no processo de gerenciamento de materiais em unidades hospitalares. Métodos: Estudo exploratório de abordagem qualitativa realizado em um hospital universitário no Paraná. A coleta de dados foi realizada entre outubro e dezembro de 2019, por meio de entrevista semiestruturada e gravada em áudio. Os dados foram transcritos e submetidos à análise de conteúdo temática. Resultados: Participaram do estudo 35 profissionais de enfermagem. Dos discursos, emergiram quatro categorias: Participação no processo de planejamento e provimento dos materiais; Dimensionamento de recursos materiais; Participação no controle de qualidade dos materiais; e, Dificuldades enfrentadas no processo de gerenciamento de materiais. Conclusão: Os resultados indicam que os profissionais de enfermagem possuem uma baixa participação no processo de gerenciamento de materiais, e inferem que participam ativamente somente do processo de controle de qualidade por meio das avaliações e notificações.

ABSTRACT Objectives: To analyze the perception of nursing professionals about their insertion in the material management process in hospital units. Methods: Exploratory study with a qualitative approach carried out in a university hospital in Paraná. Data collection was carried out between October and December 2019, through semi-structured interviews recorded in audio. The data were transcribed and submitted to thematic content analysis. Results: 35 nursing professionals participated in the study. From the speeches, four categories emerged: Participation in the process of planning and provision of materials; Sizing of resources in the institution; Participation in the quality control of materials; and Difficulties confronted in the material management process. Conclusion: The results indicate that nursing professionals have a low participation in the material management process and infer that they actively participate only in the quality control process through evaluations and notifications.

RESUMEN Objetivos: Analizar la percepción de los profesionales de enfermería acerca de su inserción en el proceso de gestión de materiales en unidades hospitalarias. Métodos: Estudio exploratorio con enfoque cualitativo realizado en un hospital universitario en Paraná. Se realizó a la recogida de los datos entre octubre y diciembre de 2019, a través de entrevistas semiestructuradas y grabadas en audio. Se transcribió a los datos y se los sometió a un análisis de contenido temático. Resultados: Participaron en el estudio 35 profesionales de enfermería. Surgieron cuatro categorías de los discursos: Participación en la planificación y provisión de materiales; Dimensionamiento de recursos materiales; Participación en el control de calidad de materiales; y, Dificultades enfrentadas en el proceso de gestión de materiales. Conclusión: Los resultados indican que los profesionales de enfermería tienen una baja participación en el proceso de gestión de materiales, e infieren que solo participan activamente en el proceso de control de calidad a través de evaluaciones y notificaciones.