ABSTRACT Introduction: The perception of prejudice against, and stigmatization of, sickle cell disease (SCD) leads the patient to perceive a different treatment, due to the disease stigma and maybe related to a worse quality of life (QoL). Objectives: Describe and evaluate the perception of the prejudice against the disease and its impact on the quality of life of patients with sickle cell disease. Methods: This is a cross-sectional study conducted between March 2019 and February 2020, with patients diagnosed with SCD. Patients were questioned about the perception of prejudice in any kind of situation, choosing between “Yes” or “No”, not differentiating situations related to prejudice. To assess the QoL and impact of the disease, the volunteers answered a version of the SF-36 questionnaire translated and validated into Brazilian Portuguese. Results: In this study, 113 patients with SCD were followed up, 92% were classified as HbSS and the rest, divided between HbSC and HbS-β-0. Regarding the SF-36, the worst scores were in the summary of the physical components (mean 48.19 ± 21.51) and the physical aspect had the lowest mean (30.75 ± €42.65). When questioned if they had already perceived any kind of prejudice, including the SCD, 32.74% answered “Yes”. For this comparison, there was a significant difference in the summary of the physical and mental components, with worse QoL for those who had already suffered prejudice. Conclusion: Patients diagnosed with SCD who reported perception of prejudice had statistically significant worse QoL, revealing the negative impact, that might lead to sadness and social isolation.

ABSTRACT Objective To identify the food environment healthy eating potential in the authorized food services on the campus of a Brazilian university. Methods This is an observational study carried out between March and April 2014 on a campus of a public university in Rio de Janeiro, Brazil. The elements of the food environment were evaluated using an audit instrument, containing 86 questions: availability (amount of food services and types of food offered), convenience (days and hours of operation), incentives and barriers to healthy eating (nutrition information, payment strategies and food advertisements). Preparations based on whole grains and fresh or minimally processed products were considered healthy foods; and, preparations with high caloric density, sugar-sweetened beverages, sweets, desserts, cookies, and savory snacks were considered unhealthy food. The questionnaire allowed us to calculate a score for each service, which could range from 0 to 36 points, and indicates the potential for promoting healthy eating in the establishment, with higher scores indicating a greater presence of elements that contribute to healthy eating. The different types of food service facilities were compared based on the scores (p<0.05 for statistical significance). Results Among the establishments evaluated, 24% were snack bars/cafeterias, 26%, restaurants, and 50% offered mixed services. Healthy food items were scarcely available in the establishments (fruits: 24%; vegetables: 20%; brown rice: 15%); while added-sugar beverages (98%), sweets and treats (76%) were widely offered. There was a higher frequency of advertising encouraging consumption of unhealthy items than that aimed at healthy foods (44% vs 30%). In general, the score was 13,2 points (SD=3.3) and the mean score for snack bars/cafeterias (9.3 points) was lower (p<0,05) than that of restaurants and mixed establishments (14,4 points). Conclusion On the campus assessed, the food environment had limited potential for healthy eating, since elements that did not favor healthy food choices were more frequent.

RESUMO Objetivo Identificar o potencial do ambiente alimentar para alimentação saudável em serviços permissionários no campus de uma universidade brasileira. Métodos Realizou-se um estudo observacional entre março e abril de 2014, em 54 serviços de alimentação permissionários de um campus de uma universidade pública do Rio de Janeiro, Brasil. Os elementos do ambiente alimentar foram avaliados por meio de instrumento de auditoria contendo 86 questões: disponibilidade (quantidade de serviços de alimentação e tipos de alimentos comercializados), conveniência (dias e horários de funcionamento), estímulos e barreiras para a alimentação saudável (informação nutricional, estratégias de pagamento e propagandas de alimentos). As preparações à base de cereais integrais e produtos frescos ou minimamente processados foram considerados alimentos saudáveis e aquelas com elevada densidade calórica, bebidas com adição de açúcar, doces, sobremesas, guloseimas, biscoitos e lanches salgados foram considerados não saudáveis. O questionário permitiu calcular um escore, para cada serviço, que poderia variar entre 0 a 36 pontos, e indica o potencial para promoção da alimentação saudável no estabelecimento, sendo que escores mais elevados indicam maior presença de elementos que favorecem a alimentação saudável. Os diferentes tipos de serviços de alimentação permissionários foram comparados segundo os escores (p<0,05 para significância estatística). Resultados Dos estabelecimentos avaliados, 24% eram lanchonetes/cafeterias, 26%, restaurantes e 50%, mistos. Itens saudáveis eram disponibilizados de forma incipiente nos estabelecimentos (frutas: 24%; hortaliças: 20%; arroz integral: 15%), enquanto bebidas com adição de açúcar (98%) e doces e guloseimas (76%) eram amplamente ofertados. Havia maior frequência de propagandas incentivando o consumo de itens não saudáveis do que aquelas voltadas para alimentos saudáveis (44% vs 30%). De modo geral, o escore foi de 13,2 pontos (DP=3,3) e a média do escore de lanchonetes/cafeterias (9,3 pontos) era menor (p<0,05) do que a de restaurantes e estabelecimentos mistos (14,4 pontos). Conclusão O ambiente alimentar do campus avaliado apresentou potencial limitado para a alimentação saudável, uma vez que eram mais frequentes os elementos que não favoreciam escolhas alimentares saudáveis.

ABSTRACT AIDS-related disseminated histoplasmosis (DH) can cause septic shock and multiorgan dysfunction with mortality rates of up to 80%. A 41-year-old male presented with fever, fatigue, weight loss, disseminated skin lesions, low urine output, and mental confusion. Three weeks before admission, the patient was diagnosed with HIV infection, but antiretroviral therapy (ART) was not initiated. On day 1 of admission, sepsis with multiorgan dysfunction (acute renal failure, metabolic acidosis, hepatic failure, and coagulopathy) was identified. A chest computed tomography showed unspecific findings. Yeasts suggestive of Histoplasma spp. were observed in a routine peripheral blood smear. On day 2, the patient was transferred to the ICU, where his clinical condition progressed with reduced level of consciousness, hyperferritinemia, and refractory septic shock, requiring high doses of vasopressors, corticosteroids, mechanical ventilation, and hemodialysis. Amphotericin B deoxycholate was initiated. On day 3, yeasts suggestive of Histoplasma spp. were observed in the bone marrow. On day 10, ART was initiated. On day 28, samples of peripheral blood and bone marrow cultures revealed Histoplasma spp. The patient stayed in the ICU for 32 days, completing three weeks of intravenous antifungal therapy. After progressive clinical and laboratory improvement, the patient was discharged from the hospital on oral itraconazole, trimethoprim-sulfamethoxazole, and ART. This case highlights the inclusion of DH in the differential diagnosis of patients with advanced HIV disease, septic shock and multiorgan dysfunction but without respiratory failure. In addition, it provides early in-hospital diagnosis and treatment and comprehensive management in the ICU as determining factors for a good outcome.

Abstract: Aim The Aurá River, located in the second-largest Brazilian Amazon city, has been experiencing the effects of human activities from riverine communities and the Aurá landfill for many years. In this study, we assess the occurrence, sources, and distribution of selected sterol markers in surface sediments of Aurá River in order to evaluate the organic matter inputs in this water body. Methods Gas chromatography-tandem mass spectrometry (GC/MS/MS) was used to identify and quantify sterol compounds. Pearson correlation, principal component analysis (PCA) and sterol ratios were used to assess sewage pollution. Results The sterol markers identified, the related diagnostic ratios, and statistical analysis showed that Aurá River sediments presented two primary sterol sources: anthropogenic (domestic sewage and inputs from Aurá landfill) and biogenic sources (terrestrial higher plants). Station 1 (the closest site to the Aurá landfill) presented the highest level of coprostanol (219.8 ng g-1). This maximum level of coprostanol and the sterol ratios indicate moderate human fecal contamination in the upper reach of the Aurá River. Coprostanol levels were similar to the lower to midrange concentrations reported for surficial river sediments around the world. Conclusions This study demonstrated that domestic sewage pollution from riverine communities and organic matter inputs from Aurá landfill might be assumed as potential threats to environmental and human health.

Resumo: Objetivo O rio Aurá, no nordeste da Amazônia brasileira, vem sofrendo influência antrópica de comunidades ribeirinhas e do aterro sanitário Aurá há muitos anos. Neste trabalho, avaliamos a ocorrência, fontes e distribuição de seis marcadores de esteróis em sedimentos superficiais do Rio Aurá para avaliar aportes orgânicos neste corpo d'água. Métodos A cromatografia gasosa-acoplada a espectrometria de massas (GC/MS) foi empregada para determinar os esteróis. A análise de correlação de Pearson, análise de componentes principais (PCA) e razões de esteróis foram utilizadas para avaliar a poluição por esgoto. Resultados Os analitos de interesse identificados e as razões diagnósticas indicaram que os sedimentos do rio estudado apresentam compostos orgânicos provenientes de fontes tanto antropogênicas (esgotos domésticos e MO do aterro sanitário) quanto biogênicas autóctones (plantas superiores terrestres). A Análise de Componentes Principais (PCA) corrobora com esse resultado e possibilitou o agrupamento dos pontos de amostragem segundo essas fontes. A estação 1 (ponto mais próximo do aterro Aurá) apresentou o maior nível de contaminação observado e o coprostanol foi detectado em maior concentração 219,8 ng g-1 nesse local, o que indica contaminação fecal humana moderada. Conclusões Este trabalho demonstrou que a poluição por esgoto doméstico e insumos de MO do aterro do Aurá podem ser ameaças potenciais ao ecossistema e à saúde humana da região estudada.

Abstract Introduction Ideal timing of Renal Replacement Therapy (RRT) discontinuation in Acute Kidney Injury (AKI) is still unknown. We aimed to study the role of creatinine-related variables in predicting RRT successful discontinuation and to propose a clinical predictive score. Methods In this single-centre retrospective study, we evaluated all AKI patients in whom RRT was interrupted for at least 48 hours. Patients who were still RRT-independent 7 days after initial RRT cessation were included in the “Success” group and opposed to the “Failure” group. We evaluated baseline characteristics and variables collected at the time of RRT interruption, as well as the Kinetic estimated Glomerular Filtration Rate (KeGFR), the simple variation in serum Creatinine (ΔsCr), and the incremental creatinine ratio on the first three days after RRT interruption. Multivariable analysis was performed to evaluate prediction of success. Internal validation using a simple binomial generalized regression model with Lasso estimation and 5-fold cross validation method was performed. Results We included 124 patients, 49 in the “Failure” group and 75 in the “Success” group. All creatinine-related variables predicted success in simple and multiple logistic regression models. The best model generated a clinical score based on the odds ratio obtained for each variable and included urine output, non-renal SOFA score, fluid balance, serum urea, serum potassium, blood pH, and the variation in sCr values after RRT discontinuation. The score presented an area under the ROC of 0.86 (95% CI 0.76‒1.00). Conclusion Creatinine variation between the first 2 consecutive days after RRT discontinuation might predict success in RRT discontinuation. The developed clinical score based on these variables might be a useful clinical decision tool to guide hemodialysis catheter safe removal.

Aim This study assessed the color and translucency stability of a polymer infiltrated ceramic network (PICN) and compared it with a resin composite (RC) and a feldspathic ceramic (FEL). Methods Disc-shaped samples of a PICN (Vita Enamic), a feldspathic ceramic (Vitablocks Mark II), and a resin composite (Brava block) were prepared from CAD/CAM blocks. PICN and RC surfaces were finished with a sequence of polishing discs and diamond paste. FEL samples received a glaze layer. The samples were subjected to 30-min immersions in red wine twice a day for 30 days. CIE L*a*b* coordinates were assessed with a spectrophotometer at baseline and after 15 and 30 days of immersion. Color alteration (∆E 00 ) and translucency parameter (TP 00 ) were calculated with CIEDE2000. Average roughness was measured before the staining procedures. Color difference and translucency data were analyzed with repeated-measures ANOVA and Tukey’s tests. Roughness was analyzed with the Kruskal-Wallis test. Results Roughness was similar among the experimental groups. All materials had their color alteration significantly increased from 15 to 30 days of staining. PICN reached an intermediate ∆E 00 between FEL and RC at 15 days. PICN revealed a color alteration as high as the composite after 30 days. No statistical difference was observed regarding translucency. Conclusion PICN was not as color stable as the feldspathic ceramic at the end of the study. Its color alteration was comparable to the resin composite when exposed to red wine. However, the translucency of the tested materials was stable throughout the 30-day staining.

One of the recurrent problems of the agroindustry sector is the incorrect disposal of waste because of the complexity of the material, moisture, among other factors. Waste is not used in tonnage, but is systematically used. Examples of residues are malt bagasse and cassava peel, produced in large quantities in the brewing industry and flour production, respectively. In this context, the objective of this study was to evaluate bioactive compounds of flours produced from agroindustry waste to potentiate their use as an ingredient rich in antioxidants. The flours produced from agroindustry waste were evaluated for phenolic compounds, total carotenoids, antioxidant activity, and the attainment of phenolic profiles and fingerprints by paper spray mass spectrometry. It was possible to identify a broad class of compounds in both flours, such as phenolic acids, flavonoids, among others. The flours can be possibly included in food commodities or packaging formulation since they are natural antioxidants, thus adding value to these products and reducing environmental issues. However, further analysis is needed to ensure bioavailability as well as food safety.

ABSTRACT Monkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.

ABSTRACT In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.

Resumo Em meio à crise ambiental global, a importância dos ambientes naturais para a sociedade tem sido cada vez mais estudada e incorporada em políticas públicas urbanas, ambientais, de lazer e saúde. A crescente urbanização da população mundial evidencia o papel desempenhado pelas áreas verdes na proteção de serviços ecossistêmicos diversos, com destaque para os benefícios à saúde e bem-estar, tanto para a população adulta, quanto para crianças e adolescentes. Nesse sentido, o presente trabalho buscou investigar as motivações e os benefícios percebidos por visitantes de quatro parques urbanos no Brasil, relacionados a dez dimensões do bem-estar, e para o desenvolvimento infantil. A partir de levantamento realizado com 816 visitantes de parques localizados nos municípios de Brasília, Rio de Janeiro e Juiz de Fora, foi identificado um perfil sociodemográfico semelhante. As motivações para visitar e os benefícios percebidos com a visita aos parques urbanos foram elevadas para todas as dimensões do bem-estar, com destaque para a dimensão emocional, seguida do bem-estar físico, ambiental, espiritual e social. Foram identificadas diferenças significativas entre as cidades. Três em cada quatro visitantes concorda ou concorda totalmente que os parques urbanos trazem benefícios para o desenvolvimento das crianças, principalmente benefícios físicos, respiratórios, sociais, para o desenvolvimento cognitivo e redução da ansiedade. Os resultados destacam, portanto, a relevância dos parques urbanos no Brasil para a promoção do bem-estar da sociedade e para o desenvolvimento infantil, o que reforça a necessidade de investimento em políticas públicas voltadas à criação e implementação de áreas verdes acessíveis e adequadas para permitir o usufruto cotidiano a todos os cidadãos, particularmente no contexto urbano.

Abstract In the global environmental crisis, the importance of natural environments for society has been increasingly studied and incorporated into urban, environmental, leisure, and health public policies. The growing urbanization of the world population highlights the role played by green areas in the protection of diverse ecosystem services. Mostly, with emphasis on the benefits to health and well-being, both for the adult population and for children and adolescents. In this sense, this work aims to investigate the motivations and benefits perceived by visitors of urban parks in Brazil, related to ten dimensions of well-being, and child development. From a survey carried out with 816 visitors of parks located in the cities of Brasília, Rio de Janeiro, and Juiz de Fora, a similar sociodemographic profile was identified. The motivations to visit and the perceived benefits of visiting urban parks were high for all dimensions of well-being, with emphasis on the emotional dimension, followed by physical, environmental, spiritual, and social well-being. Significant differences were identified between cities. Three out of four visitors agree or strongly agree that urban parks bring benefits to children's development, mainly physical, respiratory, social, cognitive development, and anxiety reduction. The results, therefore, highlight the importance of urban parks in Brazil, promoting the well-being of society and benefits to child development. This reinforces the need for investment in public policies aiming at the creation and implementation of accessible and suitable green areas to allow everyday enjoyment to all citizens, particularly in the urban context.

ABSTRACT Healthcare workers, the elderly and other vulnerable populations were the first to receive COVID-19 vaccines in public health programs. There were few vaccine safety data available on the elderly. This observational study aimed to evaluate the inactivated vaccine (CoronaVac) safety in the elderly, at the beginning of the vaccination program, in Sao Paulo city, Brazil. The elderly people that received CoronaVac at the Reference Center for Special Immunobiologicals (CRIE) or at home, administered by the Interdisciplinary Home Care Team (NADI) of the Hospital das Clinicas were invited to participate in this phase 4 observational study. The vaccination schedule included two CoronaVac doses 28 days apart. The information on solicited and unsolicited adverse events following immunization were collected by phone calls on days 4 and 8 after each vaccine dose. We enrolled 158 adults aged 65 to 101 years (mean of 84.1 years); 63.9% were females and 95.6% had chronic conditions, 21.5% had moderate or severe impairment in daily living activities; 34.2% were pre-frail and 19.6% were frail. We were able to contact 95.6% and 91.6% of the vaccinated people, after the first and second doses, respectively; 31.8% and 23.4% of the contacted participants reported some adverse events (AE) following the first and second doses, respectively. Pain at the injection site, fatigue, myalgia and headaches were the most frequent solicited AE. Most AE were mild to moderate. There were eight severe adverse events, but none of them were considered related to the vaccine. The CoronaVac was safe and well tolerated by these adults of advanced age with frailty and comorbidities.

Resumo Este estudo apresenta a formação do Arranjo Local da Penha, uma rede territorial comunitária criada em 2016, no complexo de favelas da Penha, Zona Norte da cidade do Rio de Janeiro. Protagonizada essencialmente por mulheres e voltada à promoção da agricultura urbana (ancorada nas bases da agroecologia), a rede se constrói a partir de articulações locais. Por meio da inserção em campo e observação participante, foi possível compreender as práticas dessa articulação em rede, analisando temas geradores, tais como: 1. mulheres e agroecologia, 2. saúde e 3. alimentação saudável. A partir deste território, será apresentada uma descrição da trajetória do Arranjo e os limites e as possibilidades de mobilização e desenvolvimento da agricultura urbana. Como resultados do Arranjo, observa-se a promoção do protagonismo das mulheres e a construção dos laços afetivos entre elas e o lugar, principalmente ao possibilitar o acesso à “comida de verdade” na favela. Destacamos, portanto, a importância desta experiência de mobilização territorial que parte do cuidado feminino com o entorno da casa, sendo a produção local de alimentos o caminho para se alcançar resgates de memória, a promoção da saúde e uma nova relação de percepção e potencialização do senso de pertencimento das moradoras.

Abstract This paper studies the development of Arranjo Local da Penha, a territorial community network created in 2016 in the favelas of Penha, rooted in the north zone of Rio de Janeiro. This network is led mostly by women practicing urban agriculture based on agroecology, who build and expand their project through local organization. Through field research and participant observation, the paper sheds new light on the practices and dynamics of this network. The paper describes the Arranjo’s trajectory, pointing out the limits and possibilities to the development of urban agriculture in the favelas of Penha. Overall, this research indicates an increase in women’s protagonistic role, in parallel to the building of strong emotional ties between Penha´s territory and them. These are outcomes of their effort to create access to “comida de verdade” (“real food”) in the favelas. The paper reinforces the importance of local food production as a path to promote not only health and well-being, but also the debates about memory and culture - leading to the strengthening of people´s social ties and their sense of belonging to the community.

Green Cavendish banana peel and pulp flours were obtained by three drying methods: oven dryer at 70 °C; air fryer at 180 °C and domestic oven at 180 °C, being the latter two new possibilities. Bioactive constituents using paper spray ionization mass spectrometry (PS-MS), phenolic identification and quantification by ultra-performance liquid chromatography with UV-Visible detection (UPLC/UV-Vis) and antioxidant capacity were evaluated. Phenolic acids showed distinct thermal stability between the treatments. Gallic acid was the predominant compound, ranging from (29.56 to 1211.74 mg 100 g-1) and had higher concentration than that found in other bananas described in literature. Green Cavendish banana flour is an advantageous source of bioactive compounds and antioxidant capacity, especially its peel. 26 compounds were identified by PS-MS: phenolics, organic acids, sugars, amino acid, phytosterol, iridoid and coumarin derivatives. Green Cavendish banana flour has great functional potential, and the air fryer can be a promising alternative for drying.

Resumo As unidades neonatais devem ser organizadas como uma linha de cuidados progressivos com leitos de cuidado intensivo e intermediário (convencional e canguru). O objetivo deste estudo foi avaliar a situação e a adequação dos leitos neonatais em maternidades da Rede Cegonha. Estudo descritivo, realizado em 606 maternidades em todas as regiões do Brasil. Os bancos de dados utilizados foram os da Avaliação da Atenção ao Parto e Nascimento em Maternidades da Rede Cegonha e do Sistema Nacional de Nascidos Vivos. Para avaliar a distribuição de leitos neonatais por tipologia, foram utilizados os parâmetros propostos na Portaria GM/MS nº 930/2012. A minoria das unidades se organiza como uma linha de cuidados progressiva com as três tipologias de leito previstas (24,42%). Os leitos de cuidado intermediário Canguru são a minoria dos leitos implantados (11,27%). Há uma concentração de leitos intensivos e intermediários nas regiões Sudeste e Sul, que apresentam déficit de leitos de cuidado intermediário Canguru. Ao analisar a adequação dos leitos pelo número de nascidos vivos, verifica-se inadequação dos leitos de cuidado Canguru em todas as regiões do Brasil, déficit de leitos intensivos nas regiões Norte e Nordeste e adequação de leitos de cuidado intermediário convencional em todas as regiões.

Abstract Neonatal units should be organized as a progressive care line, with intermediate and intensive care beds (conventional and kangaroo). The aim of this study was to evaluate the status and adequacy of neonatal beds in maternity hospitals linked to the ‘Stork Network’ (“Rede Cegonha”). A descriptive study was conducted in 606 maternity hospitals in all regions of Brazil. The databases used belonged to the Stork Network Evaluation Survey and the National Live Birth System. To assess the distribution of neonatal beds by typology, the parameters proposed in Ordinance N. 930/2012 of the Ministry of Health were used. Most neonatal units are not organized as a progressive care line with the three types of bed planned. Kangaroo intermediate care beds comprise the minority of implanted beds. There is a concentration of intensive and intermediate beds in the Southeast and South regions, which show a kangaroo intermediate care bed deficit. Analyzing the adequacy of beds by the number of live births, one can observe an inadequacy of Kangaroo care beds in all regions of Brazil, as well as intensive bed deficit in the North and Northeast regions, and adequacy of conventional intermediate care beds in all regions.

Resumo As unidades neonatais devem ser organizadas como uma linha de cuidados progressivos com leitos de cuidado intensivo e intermediário (convencional e canguru). O objetivo deste estudo foi avaliar a situação e a adequação dos leitos neonatais em maternidades da Rede Cegonha. Estudo descritivo, realizado em 606 maternidades em todas as regiões do Brasil. Os bancos de dados utilizados foram os da Avaliação da Atenção ao Parto e Nascimento em Maternidades da Rede Cegonha e do Sistema Nacional de Nascidos Vivos. Para avaliar a distribuição de leitos neonatais por tipologia, foram utilizados os parâmetros propostos na Portaria GM/MS nº 930/2012. A minoria das unidades se organiza como uma linha de cuidados progressiva com as três tipologias de leito previstas (24,42%). Os leitos de cuidado intermediário Canguru são a minoria dos leitos implantados (11,27%). Há uma concentração de leitos intensivos e intermediários nas regiões Sudeste e Sul, que apresentam déficit de leitos de cuidado intermediário Canguru. Ao analisar a adequação dos leitos pelo número de nascidos vivos, verifica-se inadequação dos leitos de cuidado Canguru em todas as regiões do Brasil, déficit de leitos intensivos nas regiões Norte e Nordeste e adequação de leitos de cuidado intermediário convencional em todas as regiões.

Abstract Neonatal units should be organized as a progressive care line, with intermediate and intensive care beds (conventional and kangaroo). The aim of this study was to evaluate the status and adequacy of neonatal beds in maternity hospitals linked to the ‘Stork Network’ (“Rede Cegonha”). A descriptive study was conducted in 606 maternity hospitals in all regions of Brazil. The databases used belonged to the Stork Network Evaluation Survey and the National Live Birth System. To assess the distribution of neonatal beds by typology, the parameters proposed in Ordinance N. 930/2012 of the Ministry of Health were used. Most neonatal units are not organized as a progressive care line with the three types of bed planned. Kangaroo intermediate care beds comprise the minority of implanted beds. There is a concentration of intensive and intermediate beds in the Southeast and South regions, which show a kangaroo intermediate care bed deficit. Analyzing the adequacy of beds by the number of live births, one can observe an inadequacy of Kangaroo care beds in all regions of Brazil, as well as intensive bed deficit in the North and Northeast regions, and adequacy of conventional intermediate care beds in all regions.