Groundwater is considered an important source of water aid for human consumption. However, this water can be contaminated by impurities, such contamination spots that might reach the water tables. The aim of this study was to investigate the quality of shallow groundwater in Flores neighborhood, located in the municipality of Benevides, within Belém metropolitan region, State of Pará, Brazil. Recommendations described in Standard Methods for Examination of Water and Wastewater were followed at the time to determine physical-chemical parameters such as potential hydrogen (pH), electrical conductivity (EC), total dissolved solids (TDS), apparent color, turbidity, total hardness (TH), ions and trace elements. Multivariate statistical analysis has shown that most predictive water-quality parameters set for human consumption are associated with natural events involving weathering and leaching processes. Nevertheless, parameters of nitrate, phosphate, EC, TDS and pH are also influenced by anthropic conditions in the surroundings, mainly phosphate and nitrate ions. Therefore, it can be concluded that shallow groundwaters in Flores neighborhood are unsuitable for human consumption, making it necessary for municipal public authorities to take action to solve the problem of water shortage in the borough, thus preventing the population from use those shallow groundwaters, as their consumption can bring health problems. However impurities tables Benevides region Pará Brazil physicalchemical physical chemical pH, , (pH) EC (EC) TDS, (TDS) color turbidity TH, TH (TH) elements waterquality processes Nevertheless surroundings Therefore borough problems (pH (EC (TDS (TH

ABSTRACT Purpose: To describe the epidemiological and clinical profile of hospitalized patients with retinoblastoma in Brazil. Methods: Using data from the Hospital Cancer Registry of the Instituto Nacional de Câncer, patients with the morphological codes of retinoblastoma who were diagnosed between 2000 to 2018, aged 0–19 years, and followed up in registered hospitals (analytical cases) were selected. The relative and absolute frequencies of demographic, clinical, diagnostic, therapeutic, and outcome variables were described. Hospital performance indicators were calculated and compared between hospitals qualified and not qualified to treat pediatric oncology cases and between hospitals with different case volumes (<20, 20-75, >75 cases). Results: Of the 2,269 identified analytical cases from 86 institutions, 48% were from the Southeast, 54% were male, and 66% were aged <4 years. The proportion of missing data (NA) was too high for several variables. Approximately 84% of the patients were from the public health system, 40% had a positive family history, and 88% had unilateral involvement. The first treatment included surgery in 58.3% of the patients (NA=2), Approximately 36.6% of these patients achieved complete remission, 10.8% achieved partial remission, and 12.7% died (NA=59%). Hospital performance indicators were within the target in >90% of the patients. The median time between the first appointment and diagnosis (6 days, interquartile range [IQR] 1–14) was significantly lower and the median time to death was longer (343 days, IQR, 212-539) in high-volume hospitals (>75 cases) than in medium- and low-volume hospitals. Conclusions: Despite the high proportion of missing data, we found that the delay in diagnosis is due to prehospital factors. Additionally, there is a need for educational programs for healthcare professionals and families that emphasize early identification and referral to specialized centers. Future studies should focus on the impact of Hospital Cancer Registry data completeness on outcomes, causes of delay in diagnosis, regional inequalities, and barriers to accessing specialized services. Purpose Brazil Methods Câncer 200 2018 019 0 19 0–1 years selected demographic diagnostic therapeutic described <20, 20 (<20 2075, 2075 75, 75 20-75 >7 cases. . Results 2269 2 269 2,26 8 institutions 48 Southeast 54 male 66 4 < NA (NA 84 system 40 history 88 involvement 583 58 3 58.3 NA=2, NA2 NA=2 , (NA=2) 366 36 6 36.6 remission 108 10 10.8 127 12 7 12.7 NA=59%. NA59 NA=59% 59 (NA=59%) 90 >90 ( days IQR [IQR 1–14 114 1 14 343 (34 212539 212 539 212-539 highvolume volume (>7 medium lowvolume low Conclusions factors Additionally centers outcomes inequalities services 201 01 0– <20 (<2 207 20-7 > 226 26 2,2 5 58. NA= (NA=2 36. 10. 12. NA5 NA=59 (NA=59% 9 >9 1–1 11 34 (3 21253 21 53 212-53 (> <2 (< 20- 22 2, (NA= NA=5 (NA=59 1– 2125 212-5 (NA=5 212-

RESUMO Objetivo: Avaliar a sazonalidade da bronquiolite aguda no Brasil durante a temporada 2020–2022 e compará-la com a das temporadas anteriores. Métodos: Os dados de incidência de internações por bronquiolite aguda em lactentes <1 ano de idade foram obtidos do Departamento de Informática da base de dados da Saúde Pública Brasileira para o período entre 2016 e 2022. Esses dados também foram analisados por macrorregiões do Brasil (Norte, Nordeste, Sudeste, Sul e Centro-Oeste). Para descrever características sazonais e de tendência ao longo do tempo, utilizamos o Modelo de Médias Móveis Integradas Autorregressivas Sazonais. Resultados: Em comparação com o período pré-COVID-19, a incidência de hospitalizações relacionadas com bronquiolite aguda diminuiu 97% durante as intervenções não farmacológicas (março de 2020 – agosto de 2021), mas aumentou 95% após a flexibilização das intervenções não farmacológicas (setembro de 2021 – dezembro de 2022), resultando no aumento geral de 16%. Durante o período pré-COVID-19, as hospitalizações por bronquiolite aguda seguiram um padrão sazonal, que foi interrompido em 2020–2021, mas recuperaram-se em 2022, com um pico ocorrido em maio, aproximadamente 4% superior ao pico pré-COVID-19. Conclusões: Este estudo ressalta a influência significativa das intervenções contra a COVID-19 nas hospitalizações por bronquiolite aguda no Brasil. A restauração de um padrão sazonal em 2022 sublinha a interação entre as medidas de saúde pública e a dinâmica das doenças respiratórias em crianças pequenas. Objetivo 20202022 2020–202 comparála compará la anteriores Métodos 1 < 201 Norte, Norte (Norte Nordeste Sudeste CentroOeste. CentroOeste Centro Oeste . Centro-Oeste) tempo Sazonais Resultados préCOVID19, préCOVID19 préCOVID pré COVID 19, 19 pré-COVID-19 97 março 202 2021, , 2021) 95 setembro 2022) 16 16% 20202021 2020–2021 recuperaramse recuperaram se maio 4 préCOVID19. 19. Conclusões COVID19 COVID-1 pequenas 2020202 2020–20 20 Centro-Oeste préCOVID1 pré-COVID-1 9 COVID1 COVID- 202020 2020–2 2 pré-COVID- 20202 2020– pré-COVID

ABSTRACT Objective: To evaluate the seasonality of acute bronchiolitis in Brazil during the 2020–2022 season and compare it with the previous seasons. Methods: Data from the incidence of hospitalizations due to acute bronchiolitis in infants <1 year of age were obtained from the Department of Informatics of the Brazilian Public Health database for the period between 2016 and 2022. These data were also analyzed by macro-regions of Brazil (North, Northeast, Southeast, South, and Midwest). To describe seasonal and trend characteristics over time, we used the Seasonal Autoregressive Integrated Moving Averages Model. Results: Compared to the pre-COVID-19 period, the incidence of hospitalizations related to acute bronchiolitis decreased by 97% during non-pharmacological interventions (March 2020 – August 2021) but increased by 95% after non-pharmacological interventions relaxation (September 2021 – December 2022), resulting in a 16% overall increase. During the pre-COVID-19 period, hospitalizations for acute bronchiolitis followed a seasonal pattern, which was disrupted in 2020–2021 but recovered in 2022, with a peak occurring in May, approximately 4% higher than the pre-COVID-19 peak. Conclusions: This study underscores the significant influence of COVID-19 interventions on acute bronchiolitis hospitalizations in Brazil. The restoration of a seasonal pattern in 2022 highlights the interplay between public health measures and respiratory illness dynamics in young children. Objective 20202022 2020–202 seasons Methods 1 < 201 macroregions macro regions North, North (North Northeast Southeast South Midwest. Midwest . Midwest) time Model Results preCOVID19 preCOVID pre COVID 19 pre-COVID-1 97 nonpharmacological non pharmacological March 202 95 September , 2022) 16 increase 20202021 May 4 Conclusions COVID19 COVID-1 children 2020202 2020–20 20 preCOVID1 pre-COVID- 9 COVID1 COVID- 202020 2020–2 2 pre-COVID 20202 2020–

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

Abstract: This study had the general objective of verifying the relationship between burnout syndrome, social skills, coping strategies, and socio-occupational variables in a sample of 166 elementary school teachers from 13 public schools of Minas Gerais, Brazil, aged between 23 and 65 years, 73 % of whom were female. The Burnout Syndrome Inventory (ISB), the Social Skills Inventory 2 (IHS-2), the Coping Strategies Inventory (IEC), and a socio-occupational questionnaire developed especially for this research were used. A negative correlation was obtained between burnout and repertoire of social skills (r = -.273 and p < .001). The coping strategies that positively correlated with social skills were seeking social support, problem solving, and positive reappraisal. Furthermore, there was a positive correlation between coping and professional fulfillment, indicating that teachers who adopted coping strategies were more likely to feel professionally satisfied. The burnout predictor variables were age, marital status, family provision, number of children, length of service, ongoing health care and social resourcefulness. The implications of these results were discussed concerning protective actions for the mental health of teachers and the importance of socio-emotional development in schools.

Resumen: Este estudio tuvo como objetivo general verificar la relación entre el síndrome de burnout, las habilidades sociales, el afrontamiento y las variables sociolaborales en una muestra de 166 profesores de educación básica de 13 escuelas públicas del interior de Minas Gerais, Brasil, con edades entre 23 y 65 años, el 73 % de los cuales son mujeres. Se utilizó el Inventario de Síndrome de Burnout (ISB), el Inventario de Habilidades Sociales 2 (IHS-2), el Inventario de Estrategias de Afrontamiento (IEC) y un cuestionario sociolaboral desarrollado especialmente para esta investigación. Se obtuvo una correlación negativa entre el burnout y el repertorio de habilidades sociales (r = -.273 y p = .001). Las estrategias de afrontamiento que se correlacionaron positivamente con las habilidades sociales fueron: búsqueda de apoyo social, resolución de problemas y reevaluación positiva. Además, hubo una correlación positiva entre el afrontamiento y la realización profesional, lo que indica que los profesores que adoptaron estrategias de afrontamiento tenían más probabilidades de sentirse realizados profesionalmente. Las variables predictoras del agotamiento fueron la edad, el estado civil, la provisión familiar, el número de hijos, el tiempo de servicio, la atención médica continua y la desenvoltura social. Se discuten las implicaciones de estos resultados respecto de las acciones protectoras para la salud mental de los docentes y la relevancia del desarrollo socioemocional en las escuelas.

Resumo: Este estudo teve como objetivo geral verificar a relação entre síndrome de burnout, habilidades sociais, coping e variáveis sócio-ocupacionais em uma amostra de 166 professores do ensino fundamental de 13 escolas públicas do interior de Minas Gerais, Brasil, com idades entre 23 e 65 anos, sendo 73 % do sexo feminino. Foram utilizados o Inventário da Síndrome de Burnout (ISB), o Inventário de Habilidades Sociais 2 (IHS-2), o Inventário de Estratégias de Coping (IEC) e um questionário sócio-ocupacional desenvolvido especialmente para esta pesquisa. Obteve-se correlação negativa entre o burnout e o repertório de habilidades sociais (r = -0,273 e p < 0,01). As estratégias de coping que se correlacionaram positivamente com as habilidades sociais foram: busca de suporte social, resolução de problemas e reavaliação positiva. Ademais, houve correlação positiva entre coping e realização profissional, indicando que professores que adotaram estratégias de enfrentamento apresentaram maior tendência a sentirem-se realizados profissionalmente. As variáveis preditoras do burnout foram idade, estado civil, provimento familiar, número de filhos, tempo de serviço, tratamento contínuo de saúde e desenvoltura social. Discutiu-se a implicação desses resultados no tocante às ações protetivas de saúde mental docente e quanto à relevância do desenvolvimento socioemocional nas escolas.

Resumen: La presencia de bacterias coliformes en el agua presenta una amenaza potencial a la salud pública, ya que puede incrementar el riesgo de enfermedades infecciosas en la población más vulnerable. El asunto resulta más complicado cuando se desconoce la calidad fisicoquímica y microbiológica del agua que se consume. El presente estudio tiene la finalidad de evaluar el estado actual de la calidad de agua de consumo en tres Organizaciones Territoriales de Base (OTB’s) del Municipio de Vinto-Cochabamba y la relación de dependencia de los parámetros microbiológicos con las OTB’s. Los análisis de laboratorio de 30 muestras tomadas en los diferentes domicilios (10 muestras por OTB) muestran el cumplimiento de los límites máximos permisibles de los parámetros fisicoquímicos (pH, conductividad, alcalinidad y dureza) según la Norma Boliviana 512 (NB 512). Respecto a los parámetros microbiológicos para coliformes totales, de las 30 muestras analizadas solo 11 cumplieron con el límite máximo permisible, a diferencia del parámetro de coliformes termorresistentes, donde 25 de las 30 muestras cumplieron con el límite máximo permisible. Los parámetros microbiológicos fueron sometidos al análisis de chi-cuadrado, dando evidencia suficiente para afirmar con un 95% de confianza que los resultados de coliformes totales y termorresistentes no depende de la OTB (p=0.36). Al contrastar los resultados de agua de consumo domiciliario con la del agua suministrada, puede especularse que la contaminación de origen microbiológico ocurre ya sea en las tuberías de distribución, tanques domiciliarios y/o las prácticas de uso del agua de cada domicilio

Abstract:The presence of coliform bacteria in water presents a potential threat to public health, as it can increase the risk of infectious diseases in the most vulnerable population. The matter is more complicated when the physicochemical and microbiological quality of the water consumed is unknown. The purpose of this study is to evaluate the current state of the quality of drinking water in three Territorial Base Organizations (OTB’s) of the Municipality of Vinto-Cochabamba and the relationship of dependence of the microbiological parameters with the OTB’s. Laboratory analyzes of 30 samples taken from different homes (10 samples per OTB) show compliance with the maximum permissible limits of physicochemical parameters (pH, conductivity, alkalinity and hardness) according to Bolivian Standard 512 (NB 512). Regarding the microbiological parameters for total coliforms, of the 30 samples analyzed, only 11 met the maximum permissible limit, unlike the total coliform parameter, where 25 of the 30 samples met the maximum permissible limit. The microbiological parameters were subjected to chi-square analysis, providing sufficient evidence to affirm with 95% confidence that the results of total and heat-resistant coliforms do not depend on the OTB (p=0.36). By contrasting the results of household water consumption with that of water supplied, it can be speculated that contamination of microbiological origin occurs either in the distribution pipes, household tanks and/or the water use practices of each household.

Resumen La bacteria Escherichia coli causa la colibacilosis en animales de granja que actúan como reservorios de cepas patógenas. La resistencia antimicrobiana de E. coli productor de betalactamasas de espectro extendido [BLEE] es un grave problema de salud pública y se puede atribuir a factores relacionados con el consumo de alimentos y el contacto con animales domésticos. El objetivo de este estudio fue determinar la presencia y patrones de resistencia antimicrobiana de E. coli BLEE aislado en muestras fecales provenientes de bovinos productores de leche de la provincia de Pichincha. Se analizaron un total 182 muestras de heces de bovinos: 112 muestras de bovinos faenados en el Camal Metropolitano de la provincia de Pichincha y 70 muestras de la colección de la Unidad de Investigación de Enfermedades Transmitidas por Alimentos y Resistencias a los Antimicrobianos [UNIETAR], se realizó el aislamiento de E. coli BLEE, la identificación bioquímica y pruebas de resistencia a los principales antibióticos utilizados. Se logró identificar 93 muestras positivas a E. coli BLEE (51 %), el análisis fenotípico reveló que los antibióticos amoxicilina más ácido clavulánico, cefepime, ceftazidima, ciprofloxacina, amikacina y tetraciclina presentaron porcentajes de resistencia mayores al 80 %. Además, se observó una baja resistencia a la nitrofurantoína, cefoxitin y ertapenem, mientras que ningún aislado fue resistente a la tigeciclina. El 100 % de los aislados presentaron fenotipos de multirresistencia y el patrón más frecuente estuvo compuesto por 7 familias de antibióticos. En conclusión, estos resultados sugieren que E. coli originaria de bovinos lecheros podría ser un reservorio de genes BLEE.

Abstract Escherichia coli causes colibacillosis in farm animals that act as reservoirs for pathogenic strains. Antimicrobial resistance of E. coli producing Extended Spectrum Beta-lactamases [ESBL] is a serious public health problem that can be attributed to factors related to food consumption and contact with domestic animals. This study aimed to determine the presence and patterns of antimicrobial resistance of ESBL E. coli isolated from fecal samples from dairy cattle in the Pichincha province. A total of 182 bovine feces samples were analyzed, 112 samples from cattle slaughtered at the official slaughterhouse in Quito-Pichincha province, and 70 samples from the collection of the Foodborne Diseases and Antimicrobial Resistance Research Unit [UNIETAR]. The isolation of ESBL E. coli, biochemical identification, and resistance tests using the main antibiotics were carried out at UNIETAR. It was possible to identify 93 positive samples for ESBL E. coli (51%), phenotypic analysis revealed that antibiotics such as amoxicillin plus clavulanic acid, cefepime, ceftazidime, ciprofloxacin, amikacin, tetracycline, presented resistance higher than 80%. Furthermore, low resistance to nitrofurantoin, cefoxitin, and ertapenem was observed, while no isolate was resistant to tigecycline. One hundred percent of the isolates presented multi-resistance phenotypes, with the most frequent pattern being composed of 7 families of antibiotics. In conclusion, these results suggest that E. coli from dairy cattle origin could be an important reservoir of ESBL genes.

Abstract Purpose: To analyze diabetes mellitus (DM) in a multifactorial manner with the consumption of sugar-sweetened beverages (SSB) and variables like nutritional status, sex, genetic predisposition, age and ethnicity; in order to determine the relationship between BGA and DM in the Mazahua Otomí (MO) community. Methodological design: This quantitative survey on social and nutritional variables was designed, validated and applied. A logistic model was developed to find the relationship of DM in relation to the variables: SSB consumption, sex, genetic predisposition, age, body mass index and ethnicity. Results: The Mazahua otomi community has a monthly family income below the extreme poverty line; they do not have disease control: 68% are obese or overweight and SSB consumption is medium to high in 90% of the population. In a multifactorial manner and according to the model, there is a probability of manifesting DM depending on the variables mentioned above; while, with the exception of nutritional status and age, the others are the most significant. In taste and preferences, 52% opt for the Coca-Cola SSB brand. Research limitations: The results found should be complemented in other case studies in communities with similar characteristics and a broader probabilistic population sample. Finding: In the MO community there is a relationship between BGA consumption and DM and there is no control of the disease. This work contributes to the design of public policies to prevent health damage because of excessive consumption of SSB and its relationship with DM; likewise, those policies that rescue and promote good nutritional practices of the communities of indigenous peoples.

Resumen Objetivo: Analizar en forma multifactorial la diabetes mellitus (DM) con el consumo de las bebidas gaseosas azucaradas (BGA) y de las variables estado nutricional, sexo, predisposición genética, edad y etnia, para determinar la relación de las BGA y la DM en la comunidad Mazahua Otomí (MO). Diseño Metodológico: El estudio fue cuantitativo. Se diseñó, validó y aplicó una encuesta estructurada sobre variables sociales y nutricionales. Se elaboró un modelo logístico para encontrar la relación de DM con las variables: consumo de BGA, sexo, predisposición genética, edad, índice de masa corporal y etnia. Resultados: En la comunidad MO que se investigó un padre de familia promedio tiene un ingreso mensual por debajo de la línea de pobreza extrema y no existe control de la enfermedad de estudio: 68% tiene obesidad o sobrepeso y el consumo de BGA es entre medio y alto en 90% de la población. En forma multifactorial, hay probabilidad de manifestar la DM en función de las variables antes señaladas; mientras que, a excepción de estado nutricional y la edad, las demás son las más significativas. En gustos y preferencias, 52% opta por la marca de BGA Coca-Cola. Limitaciones de la investigación: Los resultados encontrados deberán complementarse con estudios de caso en comunidades con características similares y una muestra poblacional probabilística más amplia. Hallazgos: En la comunidad MO existe una relación entre el consumo de BGA y la DM y no hay control de la enfermedad. Este trabajo aporta al diseño de políticas públicas de prevención del daño a la salud por el consumo excesivo de BGA y su relación con la DM. De igual manera aquellas políticas públicas que rescaten y fomenten las buenas prácticas nutritivas entre las comunidades de los pueblos originarios.

ABSTRACT The recent global health crisis highlighted the fundamental role of family farming and public procurement policies in guaranteeing the human right to adequate food. This documentary analysis compares public procurement experiences (2019 to 2022) in a region of Brazil and another in Colombia, focusing on family farming from a gender perspective to identify challenges and best practices. Among the findings, it is noteworthy that although structured policies for public procurement already exist in Brazil, regional realities pointed to challenges during the period. Advances in Colombia were noted with the issuance of Law 2046 of 2020. In both countries, the low role of women in the ownership of rural properties and decision-making was evident, despite their participation in the rural family productive workforce.

RESUMEN La pasada crisis sanitaria mundial evidenció el papel fundamental de la agricultura familiar y las políticas de compras pública para garantizar el derecho humano a la alimentación adecuada. En este análisis documental, se compararon las experiencias de compras públicas (2019 a 2022), en una región de Brasil y otra de Colombia, de la agricultura familiar, desde una perspectiva de género, con el objetivo de identificar desafíos y buenas prácticas. Entre los hallazgos, se destaca que, aunque ya existen políticas estructuradas para las compras públicas en Brasil, la realidad regional señaló desafíos en el período. Se señalaron los avances en Colombia, con la expedición de la Ley 2046 de 2020. En ambos países se evidenció el bajo rol de la mujer en la titulación de las propiedades rurales y en la toma de decisiones, aunque se evidencia su participación en la fuerza productiva rural familiar.

Abstract This article's econometric approach to socio-demographic indicators from the National Institute of Statistics and Census, such as births, deaths and hospital discharges of the Venezuelan population in Ecuador between 2015 and 2022, shows a notable impact on the migratory balance of this community. The sustained growth of Venezuelan migrants in the country underlines the importance of designing public policies that address the evidence of the data obtained and apply a human rights approach. The study shows that one of the most urgent needs of this population is access to public health.

Resumen El acercamiento econométrico que propone este artículo a indicadores sociodemográficos del Instituto Nacional de Estadística y Censos, como nacimientos, defunciones y egresos hospitalarios de la población venezolana en Ecuador entre 2015 y 2022, muestra un impacto notable en el saldo migratorio de esta comunidad. El crecimiento sostenido de migrantes venezolanos en el país subraya la importancia de diseñar políticas públicas que atiendan la evidencia de los datos obtenidos y apliquen un enfoque en derechos humanos. El estudio muestra que una de las necesidades más urgentes de esta población es el acceso a la salud pública.

Objetivo: comparar el número de citologías oncóticas planificadas y las realizadas en la ciudad de Río de Janeiro entre los años 2013 y 2022 . Métodos: utilizando la población femenina de Río de Janeiro, se estimó cuántas pruebas se deberían realizar si se recomienda el tamizaje. realizado por el Ministerio de Salud se realizó de manera ideal y luego se comparó con la cantidad de pruebas disponibles en la base de datos pública. Resultados: En este periodo se realizaron 1.364.325 frente a una estimación de 7.886.720. Después del ajuste por el uso de asistencia sanitaria complementaria, la pandemia y los exámenes fuera de la edad recomendada, se observó el 36% del ideal. Conclusión: la cantidad realizada está muy por debajo de lo ideal, incluso después de ajustes, lo que aumenta los costos para el servicio público de salud, haciendo necesarias nuevas políticas públicas para mejorar el seguimiento.

Objetivo: comparar a quantidade de colpocitologias oncóticas ideias e a realmente realizadas no município do Rio de Janeiro entre os anos de 2013 e 2022. Métodos: através da população feminina do Rio de Janeiro, foi feita estimativa de quantos exames deveriam ser realizados caso o rastreio preconizado pelo Ministério da Saúde fosse feito de forma ideal e posteriormente foi comparado com a quantidade de exames disponíveis na base de dados pública. Resultados: foram realizados 1.364.325 nesse período comparado a 7.886.720 estimados. Após ajuste pelo uso de saúde suplementar, pandemia e exames fora da idade recomendada, observou-se 36% do ideal. Conclusão: a quantidade realizada está muito abaixo da ideal, mesmo após os ajustes, o que aumenta custos para o serviço de saúde pública, sendo necessárias novas políticas públicas para melhorar o rastreamento.

Objective: to compare the number of planned oncotic smear tests and those actually performed in the city of Rio de Janeiro between the years 2013 and 2022 . Methods: using the female population of Rio de Janeiro, an estimate was made of how many tests should be carried out if screening recommended by the Ministry of Health was done in an ideal way and was subsequently compared with the number of tests available in the public database. Results: 1,364,325 were carried out in this period compared to an estimated 7,886,720. After adjustment for the use of supplementary healthcare, the pandemic and exams outside the recommended age, 36% of the ideal was observed. Conclusion: the quantity carried out is far below ideal, even after adjustments, which increases costs for the public health service, making new public policies necessary to improve tracking.

Resumo As arboviroses são endêmicas em vários países e representam um preocupante problema de saúde pública. A mais importante delas é a dengue, que teve um aumento progressivo do número de casos, atingindo a marca dos milhões de casos anuais no Brasil desde a última década. Outras arboviroses de importância para a saúde pública incluem a chikungunya e a Zika, ambas causas de epidemias recentes, e a Febre Amarela, que também tem causado surtos epidêmicos em nosso país. Assim como a maioria das doenças infecciosas, as arboviroses têm o potencial de acometer os rins, por meio de diversos mecanismos que levam à injúria renal, incluindo ação direta dos vírus, inflamação sistêmica, fenômenos hemorrágicos e outras complicações, além da toxicidade de drogas utilizadas no tratamento. Neste artigo de revisão, serão abordados os aspectos epidemiológicos das principais arboviroses no Brasil e em outros países onde estas doenças são endêmicas, os aspectos clínicos e as principais alterações laboratoriais encontradas, incluindo as alterações na função renal. Como as arboviroses se comportam nos pacientes transplantados renais também será descrito. Serão também descritos os mecanismos fisiopatológicos da injúria renal associada às arboviroses e, por fim, o tratamento recomendado para cada doença e as recomendações para o suporte renal neste contexto. dengue década Zika recentes Amarela país infecciosas rins vírus sistêmica complicações revisão encontradas descrito fim contexto

Abstract Arboviruses are endemic in several countries and represent a worrying public health problem. The most important of these diseases is dengue fever, whose numbers continue to rise and have reached millions of annual cases in Brazil since the last decade. Other arboviruses of public health concern are chikungunya and Zika, both of which have caused recent epidemics, and yellow fever, which has also caused epidemic outbreaks in our country. Like most infectious diseases, arboviruses have the potential to affect the kidneys through several mechanisms. These include the direct action of the viruses, systemic inflammation, hemorrhagic phenomena and other complications, in addition to the toxicity of the drugs used in treatment. In this review article, the epidemiological aspects of the main arboviruses in Brazil and other countries where these diseases are endemic, clinical aspects and the main laboratory changes found, including changes in renal function, are addressed. It also describes how arboviruses behave in kidney transplant patients. The pathophysiological mechanisms of kidney injury associated with arboviruses are described and finally the recommended treatment for each disease and recommendations for kidney support in this context are given. problem fever decade Zika epidemics country viruses inflammation complications article found function addressed patients given

Resumo Historicamente, são necessários, em média, 17 anos para que novos tratamentos passem da evidência clínica para a prática diária. Considerando os tratamentos altamente eficazes disponíveis atualmente para prevenir ou retardar o início e a progressão da doença renal, esse período é demasiadamente longo. Agora é o momento de reduzir a lacuna entre o que sabemos e aquilo que fazemos. Existem diretrizes claras para a prevenção e o manejo dos fatores de risco comuns para doenças renais, como hipertensão e diabetes, mas apenas uma fração das pessoas com essas condições é diagnosticada mundialmente, e um número ainda menor recebe tratamento adequado. Da mesma forma, a grande maioria das pessoas que sofrem de doença renal não têm conhecimento de sua condição, pois ela costuma ser silenciosa nos estágios iniciais. Mesmo entre pacientes que foram diagnosticados, muitos não recebem tratamento adequado para a doença renal. Levando em consideração as graves consequências da progressão da doença renal, insuficiência renal ou óbito, é imperativo que os tratamentos sejam iniciados precocemente e de maneira adequada. As oportunidades para diagnosticar e tratar precocemente a doença renal devem ser maximizadas, começando no nível da atenção primária. Existem muitas barreiras sistemáticas, que vão desde o paciente até o médico, passando pelos sistemas de saúde e por fatores sociais. Para preservar e melhorar a saúde renal para todos em qualquer lugar, cada uma dessas barreiras deve ser reconhecida para que soluções sustentáveis sejam desenvolvidas e implementadas sem mais demora. Historicamente necessários média 1 diária longo fazemos renais diabetes mundialmente forma condição iniciais diagnosticados óbito adequada maximizadas primária sistemáticas médico sociais lugar demora

Abstract Historically, it takes an average of 17 years for new treatments to move from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. Now is the time to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions are diagnosed worldwide, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because it is often silent in the early stages. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from the patient to the clinician to the health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay. Historically 1 practice progression long diabetes worldwide target Similarly condition stages failure death appropriately level everywhere

RESUMO A doença renal crônica (DRC) representa um dos principais problemas de saúde pública da atualidade. A dosagem da creatinina sérica e a estimativa da taxa de filtração glomerular (TFG) são as principais ferramentas para avaliação da função renal. Para a estimativa da TFG, existem diversas equações, sendo a mais recomendada a CKD-EPI (Chronic Kidney Disease – Epidemiology). Existem ainda algumas controvérsias com relação à dosagem da creatinina sérica e da estimativa da TFG, uma vez que vários fatores podem interferir nesse processo. Uma importante mudança recente foi a retirada da correção por raça das equações para estimativa da TFG, que superestimavam a função renal, e consequentemente retardavam a implementação de tratamentos como diálise e transplante renal. Neste documento de consenso da Sociedade Brasileira de Nefrologia e Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial são revisados os principais conceitos relacionados à avaliação da função renal, possíveis controvérsias existentes e recomendações para a estimativa da TFG na prática clínica. DRC (DRC atualidade (TFG CKDEPI CKD EPI Chronic Epidemiology. Epidemiology . Epidemiology) processo clínica

ABSTRACT Chronic kidney disease (CKD) represents one of today’s main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease – Epidemiology) is the most recommended one. There are still some controversies regarding serum creatinine measurement and GFR estimation, since several factors can interfere in this process. An important recent change was the removal of the correction for race from the equations for estimating GFR, which overestimated kidney function, and consequently delayed the implementation of treatments such as dialysis and kidney transplantation. In this consensus document from the Brazilian Societies of Nephrology and Clinical Pathology and Laboratory Medicine, the main concepts related to the assessment of renal function are reviewed, as well as possible existing controversies and recommendations for estimating GFR in clinical practice. CKD (CKD todays today s problems (GFR CKDEPI EPI Epidemiology process transplantation Medicine reviewed practice

Resumo Nas últimas décadas, uma epidemia de doença renal crônica (DRC) tem sido associada a fatores ambientais e ocupacionais (estresse térmico decorrente de cargas de trabalho elevadas em altas temperaturas e exposição a produtos químicos, como agrotóxicos e metais), denominada DRC de origem não tradicional (DRCnt). Esta revisão descritiva tem como objetivo apresentar evidências recentes sobre estresse térmico, agrotóxicos e metais como possíveis causas de DRCnt e fornecer uma visão geral das estratégias brasileiras de regulamentação, fiscalização e vigilância sanitária relacionadas. Os trabalhadores brasileiros são comumente expostos a condições extremas de calor e outros fatores de risco de DRCnt, incluindo o aumento da exposição a agrotóxicos e metais. Além disso, há uma falta de regulamentação e fiscalização, políticas públicas e estratégias adequadas para proteger a saúde renal dos trabalhadores em relação aos principais fatores de risco. É provável que a DRCnt seja uma causa significativa de DRC no Brasil, uma vez que a etiologia da doença é desconhecida em muitos pacientes e diversas condições para seu desenvolvimento estão presentes no país. Estudos epidemiológicos devem ser realizados para explorar associações causais e estimar o impacto do calor, dos agrotóxicos e dos metais na DRCnt no Brasil. Além disso, as políticas públicas devem priorizar a redução da exposição dos trabalhadores e a promoção de sua saúde e segurança. décadas (DRC químicos metais, , metais) DRCnt. . (DRCnt) relacionadas disso Brasil país segurança (DRCnt

Abstract In the past decades, an epidemic of chronic kidney disease (CKD) has been associated with environmental and occupational factors (heat stress from high workloads in hot temperatures and exposure to chemicals, such as pesticides and metals), which has been termed CKD of non-traditional origin (CKDnt). This descriptive review aims to present recent evidence about heat stress, pesticides, and metals as possible causes of CKDnt and provide an overview of the related Brazilian regulation, enforcement, and health surveillance strategies. Brazilian workers are commonly exposed to extreme heat conditions and other CKDnt risk factors, including increasing exposure to pesticides and metals. Furthermore, there is a lack of adequate regulation (and enforcement), public policies, and strategies to protect the kidney health of workers, considering the main risk factors. CKDnt is likely to be a significant cause of CKD in Brazil, since CKD’s etiology is unknown in many patients and several conditions for its development are present in the country. Further epidemiological studies may be conducted to explore causal associations and estimate the impact of heat, pesticides, and metals on CKDnt in Brazil. Moreover, public policies should prioritize reducing workers´ exposure and promoting their health and safety. decades (CKD chemicals metals, , metals) nontraditional non traditional CKDnt. . (CKDnt) enforcement Furthermore enforcement) Brazil CKDs s country Moreover safety (CKDnt