ABSTRACT This note proposes a technical approach towards the disaster occurred on January 8, 2022, in the tourism region of Capitólio (Minas Gerais state, Brazil), where a massive quartzite rock broke from a cliff and toppled on to pleasure boaters drifting on a lake, leaving 10 people dead and 30 others injured. Even though the rockfall was decisive in the tragedy, it is reasonable to affirm that the submersion-wave impact certainly potentialized the accident. Along these lines, this work not only aims to videographically explore the geometric / kinematic characteristics of the solid block, but also to discuss the specificities pertaining the event. Lastly, with basis on the Noda Method (1970), this manuscript also estimates the resulting wave amplitude (near the impact) and the energy-transfer coefficient between the block and the body of water.

RESUMO Esta nota propõe uma abordagem técnica para o desastre ocorrido em 8 de janeiro de 2022, na região turística de Capitólio (MG), onde uma enorme rocha quartzítica se desprendeu de um penhasco e tombou sobre barqueiros de recreio à deriva em um lago, deixando 10 mortos e outros 30 feridos. Ainda que a queda da rocha tenha sido decisiva na tragédia, é razoável afirmar que o impacto da onda de submersão certamente potencializou o acidente. Nessa linha, este trabalho não só tem como objetivo explorar videograficamente as características geométricas/cinemáticas do bloco sólido, mas também discutir as especificidades pertinentes ao evento. Por fim, com base no Método de Noda (1970), este manuscrito também estima a amplitude de onda resultante (próxima ao impacto) e o coeficiente de transferência de energia entre o bloco e o corpo d'água.

RESUMO O modelo numérico SWAN (Simulating WAves Nearshore) tem sido usado e validado em vários estudos de regiões costeiras abertas e estuarinas. Sua aplicação em águas interiores ou restritas (reservatório de barragens) não é apenas inovadora e desafiadora, mas também uma importante contribuição científica, preenchendo uma lacuna na literatura. Analisamos o desempenho do SWAN na caracterização da agitação causada pela ação das ondas geradas pelo vento no reservatório da barragem de Ilha Solteira, considerando velocidades de vento medidas e uma complexa batimetria. A área estudada está próxima a um trecho da hidrovia Tietê-Paraná, no Brasil. As condições do vento foram obtidas por um anemômetro sônico 2D instalado no reservatório durante uma das campanhas de medição, por um período de 3 meses. As estimativas da amplitude das ondas geradas no reservatório foram comparadas com as medidas da elevação da superfície livre obtidas por um sensor de pressão Druck instalado no reservatório da barragem, a cerca de 300 m da margem (já em águas intermediárias/profundas), e a 1,0 m de profundidade. Os resultados obtidos (amplitudes e períodos de onda) mostraram-se promissores e, com alturas significativas superestimadas, poderiam ser utilizados em nível de anteprojetos de engenharia.

ABSTRACT The SWAN (Simulating WAves Nearshore) numerical model has been used and validated in numerous studies of open coastal and estuarine regions. Its application on inland or restricted waters (dam reservoir) is not only innovative and challenging, but also an important scientific contribution, filling a gap in the literature. We analyze the performance of the SWAN in the characterization of the agitation caused by the action of wind waves in the reservoir of the Ilha Solteira dam, considering measured wind velocities and a complex bathymetry. The studied area is close to a segment of the Tietê-Paraná waterway, in Brazil. Wind conditions were obtained by a 2D sonic anemometer installed in the reservoir during one of the measurement campaigns, for a period of 3 months. The estimates of the amplitude of waves generated in the reservoir were compared with measurements of the free surface elevation obtained by a Druck pressure sensor installed in the reservoir of the dam, about 300 m from the margin (already in intermediate/deep waters), and 1.0 m deep. The results obtained (amplitudes and wave periods) were shown to be promising and, albeit with significative heights overestimated, could be used for engineering preliminary drafts.

Abstract: This cross-sectional study evaluated factors associated with toothache in 12-year-old adolescents from the state of Minas Gerais in Brazil. Secondary data were collected from the SB Minas Gerais 2012 epidemiological survey. The dependent variable was toothache in the past 6 months. The independent variables were grouped into two levels: individual (sex, ethnic group, family income, periodontal condition, dental caries, dental treatment needs, and type of service used) and contextual (allocation factor, Human Development Index, Gini coefficient, gross domestic product, unemployment, illiteracy, basic sanitation, garbage collection, family income, half or a quarter of a minimum wage, primary healthcare coverage, primary oral healthcare team coverage, oral health technician, access to individual dental care, and supervised tooth brushing). A multilevel analysis was performed using the Hierarchical Linear and Nonlinear Modeling Software Program to assess the association of individual and contextual variables with toothache in the last 6 months. The prevalence of toothache in the last six months among the adolescents of this study was 19.1%. An association was found with family income (p <0.001), dental caries (p <0.001), primary oral healthcare team coverage (p = 0.015) and oral health technician (p = 0.008). Socioeconomic conditions and the most prevalent oral diseases, such as dental caries, as well as the use of public services, were related to toothache in adolescents aged 12 years. These findings reinforce the need to develop and implement public policies to address the oral health problems of this population.

RESUMEN Objetivo El objetivo del trabajo fue evaluar la tasa de mujeres embarazadas satisfechas con la consulta odontológica que realiza el Sistema Único de Salud-Brasil (SUS-Brasil) y factores asociados. Metodología Estudio de tipo transversal. Para colección de los dados se elaboró un cuestionario que abordaba las variables sociodemográficas y relacionadas con la gestación. La colección de los datos fue realizada por medio de entrevistas cara a cara en un hospital de maternidad de la región metropolitana del Porto Alegre, Brasil. Para comprobar la asociación de los factores con la satisfacción de las mujeres embarazadas con la consulta odontológica se usó el test de chi-cuadrado y la regresión del Poisson, con varianza robusta (p<0,05). Resultados De las 302 mujeres entrevistadas, 50% (n=151) realizaron consulta odontológica durante de la gestación y estas 86%(n=131) manifestaron estar satisfechas con la consulta. En el análisis multivariado se encontró que la variable que evaluaba las consultas prenatales como buenas aumentaba en un 14% [Razón de Prevalencia (RP)=1,14; Intervalo de Confianza (IC) del 95%:1,01-1,27] la probabilidad de que las mujeres expresaran satisfacción con la variable de resultado. Conclusiones Se concluyó que un alto índice de satisfacción con las consultas odontológicas realizadas en el SUS por parte de las embarazadas y la evaluación de las consultas prenatales como buenas fue un factor asociado. Estos resultados podrían ser considerados durante la planificación estratégica, ejecución y evaluación de las políticas de la salud pública direccionadas para este grupo operativo.

ABSTRACT Objective The study aimed to verify the rate of satisfaction among pregnant women with dental consults performed in the Brazilian Unified Health System (BUHS), and associated factors. Methodology The design of the study was cross-sectional. To collect data a questionnaire approaching variables sociodemographic and relationship whit pregnancy were used. The data gathering was realized across interviews face to face in a maternity hospital in the metropolitan region of Porto Alegre-RS-Brazil. The chi-square test and Poisson regression with robust variance (p<0.05) were used for the bivariate and multivariate analyses. Results A total of 302 pregnant women were interviewed, 50% (n=151) performed dental consults, and 86% (131) related that they were satisfied with the consult. In the multivariate analysis it was found that the variable evaluating prenatal visits as good increased the likelihood of women expressing satisfaction with the outcome variable by 14% [Prevalence Ratio (PR) =1.14; 95% Confidence Interval (CI): 1.01-1.27]. Conclusions The present study suggests that a high satisfaction rate with dental consult could be due to the highest satisfaction in prenatal consults performed in primary health care units, materializing the relationship of trust/connection between professional and user. This variable can be considered by workers and health managers during estrategic planning, performance, and evaluation of health policies.

RESUMO Objetivo O objetivo do trabalho foi verificar a taxa de gestantes satisfeitas com a consulta odontológica realizada no Sistema Único de Saúde (SUS-Brasil) e fatores associados. Metodologia O estudo foi do tipo transversal. Para coleta de dados foi elaborado um questionário abordando variáveis sociodemográficas e relacionadas a gestação. A coleta de dados foi realizada através de entrevistas face a face em um hospital maternidade da região metropolitana de Porto Alegre-RS-Brasil. O teste de qui-quadrado e a regressão de Poisson com variância robusta (p<0,05) foram utilizados nas análises bi e multivariada. Resultados Das 302 mulheres entrevistadas, 50%(n=151) realizaram consulta odontológica durante a gestação e destas, 86% (n=131) estavam satisfeitas com a consulta. Na análise multivariada verificou-se que a variável avaliação das consultas de pré-natal como boa aumentou em 14% [Razão de Prevalência (RP)=1,14; Intervalo de Confiança (IC) 95%:1,01-1,27] a probabilidade de as mulheres expressarem satisfação com a variável desfecho. Conclusão Conclui-se que foi alta taxa de satisfação com as consultas odontológicas realizadas no SUS pelas gestantes e avaliação das consultas de pré-natal como boa foi fator associado. Estes resultados poderiam ser considerados durante o planejamento estratégico, execução e avaliação das políticas de saúde direcionadas para este grupo operativo.

Objective: Clinical and biological correlates of resilience in major depressive disorder are scarce. We aimed to investigate the effect of the Val66Met polymorphism in the BDNF gene on resilience scores in major depressive disorder patients and evaluate the polymorphism’s moderation effect on resilience scores in response to cognitive therapy. Method: A total of 106 major depressive disorder patients were enrolled in this clinical randomized study. The Resilience Scale and the Hamilton Rating Scale for Depression were applied at baseline, post-treatment, and at six months of follow-up. Blood samples were obtained at baseline for molecular analysis. Results: The baseline resilience scores were higher in patients with the Met allele (114.6±17.6) than in those with the Val/Val genotype (104.04±21.05; p = 0.037). Cognitive therapy treatment increased resilience scores (p ≤ 0.001) and decreased depressive symptoms (p ≤ 0.001). In the mixed-effect model, the Val/Val genotype represented a decrease in resilience scores (t218 = -1.98; p = 0.048), and the Val66Met polymorphism interacted with sex to predict an increase in total resilience scores during cognitive treatment (t218 = 2.69; p = 0.008). Conclusion: Our results indicate that cognitive therapy intervention could improve resilience in follow-up, considering that gender and genetic susceptibility are predicted by the Val66Met polymorphism.

Resumo O aquecimento global torna necessário o benchmarking do tecido urbano para desenvolver políticas que possam promover a resiliência urbana ao calor. O objetivo desta pesquisa é identificar padrões do tecido urbano que produzem a retroalimentação negativa do sistema climático urbano naturalmente. O método contempla o uso de imagens Landsat-8, para estimar e mapear a temperatura das superfícies e suas características espectrais (albedo, emissividade, fração de cobertura de vegetação e índice de umidade por diferença normalizada), a integração dos dados em um espaço celular georreferenciado, análises de correlação, autocorrelação e de clusters, e identificação de zonas climáticas locais. A área de estudos é São José dos Campos, SP, Brasil, onde a zona climática local 3, com construções compactas de pequeno porte, é predominante. A maior diferença de temperatura de superfície entre clusters foi 12 °C e ocorreu entre áreas verdes e permeáveis e áreas áreas plenamente impermeabilizadas com extensas construções. As análises permitiram inferir a dependência espacial da temperatura da superfície, apesar da variabilidade sazonal, indicando que ela pode ser utilizada para identificar fatores que influenciam processos de retroalimentação do sistema climático urbano, zonas climáticas locais, e auxiliar no desenvolvimento de políticas de adaptação e resiliência urbana ao calor.

Abstract Global warming makes urban fabric benchmarking necessary for the development of policies that promote urban heat resilience. This research is aimed at identifying urban fabric patterns, which can promote the negative feedback of the urban climate system naturally. The method includes the use of Landsat-8 satellite images to estimate and to map the land surface temperatures and its spectral features (albedo, emissivity, fraction vegetation cover and normalised difference moisture index), the data integration at a cellular georeferenced space, correlation, autocorrelation and clusters analyses and the identification of local climate zones. The study area is São José dos Campos, SP, Brazil, where local climate zone 3, where compact, small buildings predominate. The biggest difference in surface temperature was 12 °C and was detected between areas with permeable and shaded surfaces, associated with the presence of trees, and fully impermeable surfaces with large buildings. The analyses showed the spatial dependence of surface temperature, despite seasonal variability, indicating that it can be used to identify factors which influence feedback processes of the urban climate system, which can help in the development of policies to promote urban adaptation and heat resilience.

Abstract The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had missing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97–3.32 and PR = 3.28; 95%CI: 1.61–6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03–1.67 and PR = 2.30; 95%CI: 1.18–4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes.

Abstract This study aimed to identify the prevalence of molar-incisor hypomineralization (MIH) in schoolchildren and its association with dental caries experience. This was a cross-sectional study with a sample of 471 children aged 8 to 10 years. Data were collected via a sociodemographic questionnaire. Intra-oral clinical examination was done to identify and diagnose MIH (EAPD Criteria) as well as dental caries (ICDAS Index). Statistical analyses were performed with Person’s Chi-square, Fisher’s exact, and Mann-Whitney tests, and Poisson regression models were built. Statistical significance was set at an alpha-level of 0.05. The prevalence of MIH in our participants was 9.8%, with lesions being mostly of the mild form (65.2%) and affecting the first permanent molars but not the incisors in 54.2% of the children. Dental caries was observed in 88.1% of subjects. We observed a significant association between dental caries and the following variables: presence of MIH (p < 0.01; PR = 1.13), dental visit (p < 0.02; PR=0.92), and parents or legal guardians’ education level (p < 0.05; PR = 1.07). A MIH diagnosis was also significantly associated with family income (p < 0.05; PR = 4.09). Children with MIH had more caries lesions on molar surfaces (p < 0.01; PR = 4.05). The prevalence of MIH was found to be moderate, based on previous studies, and the presence of enamel defect was associated with dental caries. The teeth most affected by MIH lesions were the first permanent molars.

RESUMO Ondas pulsantes (tipo roll waves) podem surgir na superfície livre de eventos extremos como corridas de detritos e lamas, dentre outros, potencializando os danos causados. Esta nota técnica tem por objetivo informar sobre a fenomenologia das roll waves evoluindo na superfície livre de escoamentos laminares e analisar seus critérios de geração com foco nos conceitos de Froude mínimo e da frequência de perturbação. A análise de estabilidade linear completa do novo modelo das equações promediadas na vertical, mostrou-se como ferramenta teórica útil na determinação dos novos critérios de geração de roll waves evoluindo em fluidos não-newtonianos. Os resultados demonstraram que a geração de roll waves depende, de fato, de dois critérios: o primeiro associado ao número de Froude mínimo e o segundo relacionado à frequência de corte. Além disso, testou-se e confirmou-se que esses novos critérios de geração foram também atendidos, quando da simulação numérica obtida por um segundo modelo baseado nas equações completas, neste caso, o software Fluent. Globalmente, o surgimento de roll waves é favorecido pelas propriedades não-newtonianas do fluido escoante com a frequência de corte diminuindo com o número de Froude. Por fim, ambos os critérios de geração foram aplicados em um estudo de caso com presença de roll waves em uma bacia de drenagem.

ABSTRACT Pulsating waves (also known as roll waves) might occur on the free surface of extreme events like mud and debris flows, among others, usually intensifying the caused damage. This technical note aims to inform about the roll wave phenomenon developing in a free-surface laminar flow, and analyze its generation criteria, centered on the concepts of Froude number and disturbance frequency. The complete linear stability analysis of the new depth-averaged model was proven a useful theoretical tool in determining new generation criteria for roll waves developing in non-Newtonian fluids. The results showed that the roll wave generation depends on two criteria: the first is associated to the minimum Froude number, and the second is related to the cut-off frequency. In addition, we have confirmed that the new generation criteria can be verified via numerical simulation based on a second model with full equations (Fluent software). Globally, the emergence of roll waves is favored by the non-Newtonian properties of the flowing fluid and the fact that the cut-off frequency decreases along with the minimum Froude number. Lastly, both generation criteria were tested in order to examine a case study involving the occurrence of roll waves in a watershed.

Abstract The aim of this study was to assess the use and need of conventional removable prostheses (total and partial) and their associated factors among institutionalized elders. A cross-sectional study was conducted with 1003 elderly people living in non-profit private long-term care institutions in Belo Horizonte, Brazil. Inclusion criteria required a minimum Mini Mental State of Examination (MMSE) score of 21. After the test, 191 individuals were included. Oral examination and interviews were conducted to identify participants’ use (throughout the day/every day) and need (do not have/have but do not use) of removable dental prostheses. Socioeconomic health indicators and behaviours were collected from institutional records and via interviews. Bivariate analysis was performed using chi-square test (p<0.05). Poisson regression with robust variance was used in multivariate analysis. Most elders were female (76.4%) and independent in their daily activities (56.5%). Elderly men (PR 1.26) and those whose dental visit was more than one year ago (PR 1.38) showed higher need of dental prostheses. Elderly women (PR 1.68) and individuals with morbidities (PR 1.33) had higher prostheses use. This study demonstrates how socio-demographic characteristics, health indicators, and oral health services impact the use and need of dental prostheses among elders and how these can contribute to public oral health policy development.

Abstract The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37–0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07–2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11–1.40), periodontal health (OR = 1.80; 95%CI = 1.04–3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96–12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.

RESUMO Neste artigo foi proposto um modelo matemático simplificado para inferir sobre a capacidade erosiva de um escoamento lamoso em regime laminar com presença de roll waves (efeito pulsante) na superfície livre. Na perspectiva de aplicação de resultados no contexto de desastres naturais (corridas de lama), foi determinada a evolução da velocidade média e da tensão de cisalhamento no fundo do canal. O modelo proposto é baseado nas equações de águas rasas e na reologia de Herschel-Bulkley, como representativa das lamas. A validação e a aplicação do modelo foram feitas a partir de dados experimentais de roll waves geradas em canal no laboratório confrontados com resultados de simulações numéricas. Os resultados obtidos mostram um incremento na capacidade erosiva, na presença de roll waves, da ordem de 12% em relação ao escoamento base, valor este em concordância com os 10% apontados por Ng e Mei (1994) para uma reologia mais simplificada.

ABSTRACT In this paper, we proposed and validated a simplified mathematical model to estimate the erosive capacity of a muddy laminar flow with roll waves (pulsating effect) on the free surface. From the perspective of applying results in the context of natural disasters (mudflows), the evolution of mean velocity and bottom shear stress in the channel were determined. The proposed model is based on shallow water equations and Herschel-Bulkley rheology as representative of the muds. The model was validated by comparison with results of numerical simulations and experimental data of roll waves generated in a channel. In-depth comparative analyses were made for inferring the erosive capacity of this sort of flow. The obtained results show an increase of erosive capacity (12%) due to the presence of roll waves in relation to the uniform flow’s. Similar values (10%) were found by Ng and Mei (1994) for a more simplified rheology model.

ABSTRACT This clinical case presents a patient with a raised and ulcerative lesion with erythematous edges in the mouth, on the lower lip that was unsuccessfully treated as herpes labialis. Clinical data and laboratory tests (Montenegro skin test, indirect immunofluorescence, direct parasite search and polymerase chain reaction) led to the diagnosis of American tegumentary leishmaniasis caused by Leishmania (Viannia) sp. Treatment with pentavalent antimonial (Glucantime®) for 120 days was not effective and administration of amphotericin B for 30 days resulted in wound healing. Glucantime® treatment protocol was longer than the recommended by the Brazilian Ministry of Health in the handbook of mucosal leishmaniasis. This suggests that amphotericin B should have been administered earlier, preventing the psychological and social problems faced by the patient. This study reports a rare clinical case of primary mucosal leishmaniasis on the lip that had a delayed diagnosis, highlighting the precariousness in the management of disease and showing that, despite the importance of leishmaniasis in Brazil, it is still neglected by health professionals.

ABSTRACT Research involving the process of death regarding dysthanasia, which is defined as therapeutic obstinacy practiced with the aim to postpone death, and Orthothanasia, which is death in its natural process, without further treatment. The study aimed to recognize the perception that professionals of the health team working in an intensive care unit have about situations of Orthothanasia and Dysthanasia. The study was conducted in a university hospital. Data were collected through semi-structured interviews with 25 health professionals and submitted to thematic content analysis. Three related categories emerged: Seizing Orthothanasia and Dysthanasia; Realizing the decision-making context; Pondering Orthothanasia and Dysthanasia in the finitude of life. The perception of health professionals regarding Orthothanasia and Dysthanasia requires discussions that consider the ethical concepts involved in interventions adopted in the process of death in order to provide basis to the multidisciplinary team, family and patients in decision making at the end of life.

RESUMEN Investigación que implica el proceso de muerte, tratando la distanasia, que constituye en la obstinación terapéutica a fin de aplazar la muerte, y la Ortotanasia, que constituye en la muerte en su proceso natural, sin prolongar el tratamiento. Tuvo como objetivo reconocer la percepción de los profesionales del equipo de salud que actúan en la unidad de cuidados intensivos, acerca de las situaciones de Ortotanasia y Distanasia. Realizado en un hospital universitario. Los datos fueron recolectados a través de entrevistas semiestructuradas con 25 profesionales de salud y sometidos al análisis de contenido temático. Surgieron tres categorías relacionadas: Comprendiendo la Ortotanasia y la Distanasia; Percibiendo el contexto de la toma de decisión; Ponderando la Ortotanasia y la Distanasia en la finitud de la vida. La percepción de los profesionales de salud referente a la Ortotanasia y a la Distanasia exige discusiones sobre los conceptos éticos que comprenden las intervenciones en el proceso de muerte, posibilitando una base del equipo multiprofesional, familiares y pacientes en la toma de decisión en el final de la vida.

RESUMO Pesquisa que envolve o processo de morte, abordando a distanásia, a qual se constitui na obstinação terapêutica a fim de adiar a morte, e a Ortotanásia, que se constitui na morte em seu processo natural, sem prolongar o tratamento. Teve como objetivo reconhecer a percepção dos profissionais da equipe de saúde que atuam em unidade de terapia intensiva, acerca das situações de Ortotanásia e Distanásia. Realizado em um hospital universitário. Os dados foram coletados por meio de entrevistas semiestruturadas com 25 profissionais de saúde e submetidos à análise de conteúdo temática. Emergiram três categorias relacionadas: Apreendendo a Ortotanásia e a Distanásia; Percebendo o contexto da tomada de decisão; Ponderando a Ortotanásia e a Distanásia na finitude da vida. A percepção dos profissionais de saúde referente à Ortotanásia e à Distanásia exige discussões referentes aos conceitos éticos que envolvem as intervenções no processo de morte, possibilitando um embasamento da equipe multiprofissional, familiares e pacientes na tomada de decisão no final da vida.

Objective:To evaluate the occurrence, clinical presentations and diagnostic methods for tuberculosis in a cohort of HIV-infected infants, children and adolescents from Latin America.Methods:A retrospective analysis of children with tuberculosis and HIV was performed within a prospective observational cohort study conducted at multiple clinical sites in Latin America.Results:Of 1114 HIV-infected infants, children, and adolescents followed from 2002 to 2011, 69 that could be classified as having confirmed or presumed tuberculosis were included in this case series; 52.2% (95% CI: 39.8-64.4%) had laboratory-confirmed tuberculosis, 15.9% (95% CI: 8.2-26.7%) had clinically confirmed disease and 31.9% (95% CI: 21.2-44.2%) had presumed tuberculosis. Sixty-six were perinatally HIV-infected. Thirty-two (61.5%) children had a history of contact with an adult tuberculosis case; however information on exposure to active tuberculosis was missing for 17 participants. At the time of tuberculosis diagnosis, 39 were receiving antiretroviral therapy. Sixteen of these cases may have represented immune reconstitution inflammatory syndrome.Conclusions:Our study emphasizes the need for adequate contact tracing of adult tuberculosis cases and screening for HIV or tuberculosis in Latin American children diagnosed with either condition. Preventive strategies in tuberculosis-exposed, HIV-infected children should be optimized.