Abstract Introduction: Oropharyngeal cancer is a neoplasm with a high incidence in the head and neck region. Despite its location being easily visible during physical examination and advances in its diagnosis, oropharyngeal cancer is often detected at advanced stages. As primary therapeutic strategies, in the context of advanced disease, surgery and/or radiotherapy may be considered as treatments. Methodology: The aim of this study was to analyze the survival of patients with advanced oropharyngeal cancer (stages III and IV of the TNM) who received intended curative treatment with radiotherapy. Thirty-one patients from the Dr. Manuel Quintela Clinics Hospital, who were evaluated in the radiotherapy and otolaryngology clinics between 2013 and 2022, were studied. Results: The patients were mostly smokers, alcoholics, male, with an average age of 60 years. A 5-year overall survival rate of 67,7% (95% CI 47,6 – 84,9) was observed. The mean overall survival at 5 years was 66,3 months (95% CI 47,6 – 84,9). The median overall survival was not reached in the study. Disease persistence after radiotherapy treatment was the only factor that significantly influenced survival. Univariate analysis using Log-Rank showed a mean of 92,3 months (95% CI 77,9 - 106,7) for patients without disease persistence vs. 7,5 months (95% CI 4,9 - 10) with a median of 8 months (95% CI 3 - 12,9) for patients with disease persistence (p< 0,001). Conclusions: The observed survival may be due to the small number of patients included in the study. Incomplete tumor response to treatment proved to be the most relevant factor in survival. The follow-up of these patients is of utmost importance since all deaths were recorded within the first 24 months after diagnosis.

Resumo Introdução: O câncer de orofaringe é uma neoplasia com alta incidência em cabeça e pescoço. Apesar de ocorrer em uma região de fácil visibilidade no exame físico e dos avanços no diagnóstico, o câncer de orofaringe geralmente é detectado em estágios avançados. Como principais estratégias terapêuticas no contexto da doença avançada, podem ser considerados tratamentos como cirurgia e/ou radioterapia. Metodologia: O objetivo deste estudo foi analisar a sobrevida de pacientes com câncer de orofaringe em estágio avançado (estágios III e IV do TNM) que receberam tratamento com intenção curativa por meio de radioterapia. Foram analisados 31 pacientes do Hospital de Clínicas Dr. Manuel Quintela, avaliados nas policlínicas de radioterapia e otorrinolaringologia entre 2013 e 2022. Resultados: A maioria dos pacientes era tabagista, alcoólatra, do sexo masculino, com idade média de 60 anos. Foi observada uma taxa de sobrevida global em 5 anos de 67,7% (47,6 – 84,9 IC 95%). A média de sobrevida global em 5 anos foi de 66,3 meses (47,6 – 84,9 IC 95%). A mediana de sobrevida global não foi atingida no estudo. A persistência da doença após o tratamento com radioterapia foi o único fator que teve influência significativa na sobrevida. A análise univariada por meio do Log-Rank evidenciou uma média de 92,3 meses (77,9 – 106,7 IC 95%) para pacientes sem persistência da doença vs. 7,5 meses (4,9 - 10 IC 95%) com uma mediana de 8 meses (3 – 12,9 IC 95%) para pacientes com persistência da doença (p< 0,001). Conclusões: A sobrevida observada pode ser explicada pelo número reduzido de pacientes incluídos no estudo. A resposta incompleta do tumor ao tratamento demonstrou ser o fator de maior relevância na sobrevida. O acompanhamento desses pacientes é de extrema importância, considerando que todos os óbitos foram registrados nos primeiros 24 meses após o diagnóstico.

Resumen Introducción: El cáncer de orofaringe es una neoplasia con alta incidencia en cabeza y cuello. A pesar de presentarse en un sitio de fácil visibilidad al examen físico y a los avances en su diagnóstico, el cáncer de orofaringe suele detectarse en etapas avanzadas. Como principales estrategias terapéuticas, en el contexto de la enfermedad avanzada, se pueden plantear como tratamientos la cirugía y/o la radioterapia. Metodología: El objetivo de este estudio fue analizar la sobrevida de pacientes con cáncer de orofaringe en estado avanzado (estadios III y IV del TNM) que recibieron tratamiento pretendidamente curativo con radioterapia. Se estudiaron 31 pacientes pertenecientes al Hospital de Clínicas Dr. Manuel Quintela, que fueron valorados en las policlínicas de radioterapia y otorrinolaringología entre 2013 y 2022. Resultados: Los pacientes fueron en su mayoría tabaquistas, alcoholistas, de sexo masculino, con un promedio de edad de 60 años. Fue observada una tasa de sobrevida global a los 5 años del 67,7% (47,6 – 84,9 IC 95%). La media de sobrevida global a los 5 años fue de 66,3 meses (47,6 – 84,9 IC 95%). La mediana de sobrevida global no fue alcanzada en el estudio. La persistencia de la enfermedad después del tratamiento con radioterapia fue el único factor que tuvo una influencia significativa en la sobrevida. El análisis univariado mediante Log-Rank evidenció una media de 92,3 meses (77,9 – 106,7 IC 95%) para pacientes sin persistencia de la enfermedad vs. 7,5 meses (4,9 - 10 IC 95%) con una mediana de 8 meses (3 – 12,9 IC 95%) para pacientes con persistencia de la enfermedad (p< 0,001). Conclusiones: La sobrevida observada puede ser debido al número reducido de pacientes incluidos en el estudio. La respuesta incompleta del tumor al tratamiento demostró ser el factor de mayor relevancia en la sobrevida. El seguimiento de estos pacientes es de suma importancia dado que todos los fallecimientos fueron registrados dentro de los primeros 24 meses luego del diagnóstico.

Resumo Introdução A nefrite lúpica (NL) afeta até 50% dos pacientes com lúpus eritematoso sistêmico (LES) e pode levar à falência renal e necessidade de transplante renal (TR). Os resultados em comparação à TR por outras causas são controversos, e visamos avaliar evolução clínica, complicações e sobrevida de pacientes com NL submetidos a TR. Metodologia Coorte retrospectiva de 99 TR por NL de 1977 a 2023 em um único centro, divididos em dois grupos conforme o período de imunossupressão: G1 (antes de 2009) e G2 (a partir de 2009). As características clínicas, demográficas e evolução clínica foram comparadas. Resultados Pacientes eram na maioria brancos (65,9%), sexo feminino (86,9%), no primeiro TR (83,8%). A idade mediana foi 20,0 (11,5–25,0) anos no diagnóstico de LES e 30,0 (23,0–40,0) anos no TR. Biópsia do enxerto renal foi indicada para 46% dos pacientes, com rejeição em 23% e recorrência de NL em 5%. Avaliando os dois períodos distintos de imunossupressão padrão, não houve diferença na mediana de taxa de filtração glomerular e de proteinúria em 1 ano e em 5 anos, nem da sobrevida em 5 anos. Em todo o acompanhamento, 37,4% dos pacientes perderam o enxerto e 13% morreram com enxerto funcionante. Nenhuma perda foi atribuída à recorrência de NL. Conclusão TR é um tratamento bem-sucedido na NL, com taxas de sobrevida do enxerto semelhantes às de transplantes por outras causas. A recorrência de NL não esteve associada à perda do enxerto renal. (NL 50 (LES . (TR) controversos 9 197 202 centro G antes 2009 2009. clínicas comparadas 65,9%, 659 65,9% , 65 (65,9%) 86,9%, 869 86,9% 86 (86,9%) 83,8%. 838 83,8% 83 8 (83,8%) 200 20 0 20, 11,5–25,0 115250 11 25 (11,5–25,0 300 30 30, 23,0–40,0 230400 23 40 (23,0–40,0 46 5% padrão acompanhamento 374 37 4 37,4 13 funcionante bemsucedido bem sucedido (TR 19 65,9 6 (65,9% 86,9 (86,9% 83,8 (83,8% 2 11,5–25, 11525 (11,5–25, 3 23,0–40, 23040 (23,0–40, 37, 65, (65,9 86, (86,9 83, (83,8 11,5–25 1152 (11,5–25 23,0–40 2304 (23,0–40 (65, (86, (83, 11,5–2 115 (11,5–2 23,0–4 230 (23,0–4 (65 (86 (83 11,5– (11,5– 23,0– (23,0– (6 (8 11,5 (11,5 23,0 (23,0 ( 11, (11, 23, (23, (11 (23 (1 (2

Abstract Introduction Lupus nephritis (LN) affects up to 50% of patients with systemic lupus erythematosus (SLE) and may lead to kidney failure and require kidney transplantation (KT). Results compared to KT from other causes are controversial, and we aimed to assess the clinical course, complications, and survival of LN patients undergoing KT. Methodology Retrospective cohort of 99 KT due to LN from 1977 to 2023 at a single center, divided into two groups according to the immunosuppression period: G1 (before 2009) and G2 (from 2009 onwards). Clinical and demographic characteristics, as well as clinical evolution, were compared. Results Patients were predominantly white (65.9%), female (86.9%), in their first KT (83.8%). The median age was 20.0 (11.5–25.0) years at SLE diagnosis, and 30.0 (23.0–40.0) years at KT. Renal graft biopsy was indicated in 46% of patients, with rejection observed in 23%, and LN recurrence in 5%. When assessing the two distinct periods of standard immunosuppression, there was no difference in median glomerular filtration rate and proteinuria at 1 and 5 years, nor in 5-year survival. Throughout follow-up, 37.4% of patients lost their graft, and 13% died with a functioning graft. No graft loss was attributed to LN recurrence. Conclusion KT is a successful treatment for LN, with graft survival rates similar to those of transplants from other causes. LN recurrence was not associated with renal graft loss. (LN 50 (SLE . (KT) controversial course complications 9 197 202 center period G before 200 onwards. onwards onwards) characteristics evolution 65.9%, 659 65.9% , 65 (65.9%) 86.9%, 869 86.9% 86 (86.9%) 83.8%. 838 83.8% 83 8 (83.8%) 20 0 20. 11.5–25.0 115250 11 25 (11.5–25.0 diagnosis 300 30 30. 23.0–40.0 230400 23 40 (23.0–40.0 46 23% 5% 5year year followup, followup follow up, follow-up 374 37 4 37.4 13 (KT 19 65.9 6 (65.9% 86.9 (86.9% 83.8 (83.8% 2 11.5–25. 11525 (11.5–25. 3 23.0–40. 23040 (23.0–40. 37. 65. (65.9 86. (86.9 83. (83.8 11.5–25 1152 (11.5–25 23.0–40 2304 (23.0–40 (65. (86. (83. 11.5–2 115 (11.5–2 23.0–4 230 (23.0–4 (65 (86 (83 11.5– (11.5– 23.0– (23.0– (6 (8 11.5 (11.5 23.0 (23.0 ( 11. (11. 23. (23. (11 (23 (1 (2

Este artigo descreve aspectos metodológicos e caracteriza a participação no primeiro ano do estudo Impacto da Regulamentação do Ambiente Alimentar Escolar. O estudo visa monitorar a comercialização de alimentos nas cantinas e no entorno de escolas privadas de três cidades brasileiras com distintos contextos regulatórios, bem como investigar a percepção dos escolares sobre a cantina escolar. Trata-se de um estudo transversal repetido (2023/24 e 2025), com amostras independentes, em Recife (PE), Niterói (RJ) e Porto Alegre (RS). Para o Módulo Cantina, planejou-se uma amostragem de escolas privadas de ensino fundamental e médio, estratificada pelo porte escolar e com reposição inversa. Para o Módulo Ambulante, uma amostra de conveniência. E para o Módulo Aluno, uma amostra por conglomerados em três estágios. Os dois primeiros módulos replicam a metodologia do estudo Comercialização de Alimentos em Escolas Brasileiras – Caeb. A primeira coleta de dados ocorreu entre setembro de 2023 e maio de 2024. Participaram 202 escolas e 532 alunos. Apenas três vendedores ambulantes foram localizados. As taxas de participação escolar foram de 47,8% em Porto Alegre, 53,9% em Niterói e 69,9% em Recife. Houve resistência das escolas em receber a pesquisa, o que prolongou a coleta de dados e exigiu adaptações metodológicas. O artigo discute os desafios enfrentados no trabalho de campo e os ajustes metodológicos para o segundo ano de acompanhamento, trazendo recomendações para futuros estudos no ambiente escolar. Este projeto é fruto da colaboração entre academia e sociedade civil organizada, que demandou informações para apoiar ações de advocacy pela alimentação saudável na escola. As evidências geradas poderão subsidiar a formulação e o aprimoramento de políticas de proteção do ambiente alimentar escolar em outras cidades e níveis governamentais.

This article describes the methodological aspects and characterizes participation in the first year of the Impact of School Food Environment Regulation study. The study aims to monitor the commercialization of foods in canteens and the surrounding areas of private schools in three Brazilian cities with distinct regulatory contexts, as well as to investigate students' perceptions of the school canteen. It is a repeated cross-sectional study (2023/24 and 2025) with independent samples, conducted in Recife (PE), Niterói (RJ), and Porto Alegre (RS). For the Canteen Module, a stratified sampling of private elementary and high schools was planned, considering school size and using inverse replacement. The Street Vendor Module used a convenience sample, while the Student Module employed a three-stage cluster sampling. The first two modules replicate the methodology of the Commercialization of Food in Brazilian Schools (Caeb) study. The first data collection occurred between September 2023 and May 2024, involving 202 schools and 532 students. Only three street vendors were found. School participation rates were 47.8% in Porto Alegre, 53.9% in Niterói, and 69.9% in Recife. Schools' reluctance to participate in the study prolonged the data collection period and required methodological adaptations. This article discusses the challenges in fieldwork and the methodological adjustments planned for the second year of follow-up, offering recommendations for future studies in the school environment. This project results from a collaboration between academia and organized civil society, which sought information to support advocacy efforts for healthy eating in schools. The evidence generated may contribute to the development and improvement of policies aimed at protecting the school food environment in other cities and at different government levels.

ABSTRACT: Introduction: autoimmune diseases are diseases in which an immune response against self antigens develops, affecting some organs or mucous membranes. Some of these diseases include mucous membrane pemphigoid, pemphigus vulgaris, foliaceous, and paraneoplastic. Objective: to analyze the similarities and differences between mucous membrane pemphigoid and pemphigus vulgaris from a clinical and histological point of view in order to determine an adequate diagnosis and treatment. Materials and methods: This is a retrospective and descriptive study based on a series of clinical cases of pemphigus and pemphigoid. Demographic data, clinical characteristics were collected and different diagnostic methods were used to corroborate it, treatments and clinical response were recorded, follow-up evaluations were carried out to document the evolution of the disease and adverse events. Results: The established treatment was effective for each case, it eliminated the lesions, improving the quality of life of the patients. Medications and a comprehensive approach were used to prevent recurrences. Physical and emotional well-being improved with treatment. Conclusions: The diagnosis of autoimmune blistering diseases is based on clinical, histopathological and immunological findings, in addition to immunofluorescence tests. Treatment involves the use of corticosteroids and immunosuppressants. Knowing these diagnostic tools is crucial for proper case management.

RESUMEN: Las enfermedades autoinmunes son enfermedades en las que se desarrolla una respuesta inmune contra antígenos propios, afectando algunos órganos o mucosas. Algunas de estas enfermedades incluyen el penfigoide de las membranas mucosas, el pénfigo vulgar, el foliáceo y el paraneoplásico. El objetivo del estudio fue analizar las similitudes y diferencias entre el penfigoide de membranas mucosas y el pénfigo vulgar desde un punto de vista clínico e histológico para así determinar un diagnóstico y tratamiento adecuado. El estudio es retrospectivo y descriptivo basado en una serie de casos clínicos de pénfigo y penfigoide. Se recopilaron datos demográficos, características clínicas y se utilizaron diferentes métodos diagnósticos para corroborarlo, se registraron los tratamientos y la respuesta clínica, se realizaron evaluaciones de seguimiento para documentar la evolución de la enfermedad y los eventos adversos. El tratamiento instaurado fue efectivo para cada caso, eliminó las lesiones, mejorando la calidad de vida de los pacientes. Se utilizaron medicamentos y un enfoque integral para prevenir recurrencias. El bienestar físico y emocional mejoró con el tratamiento. El diagnóstico de las enfermedades ampollosas autoinmunes se basa en hallazgos clínicos, histopatológicos e inmunológicos, además de las pruebas de inmunofluorescencia. El tratamiento involucra el uso de corticosteroides e inmunosupresores. Conocer estas herramientas diagnósticas es crucial para un manejo adecuado de los casos.

BACKGROUND. Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease characterised by an isolated thrombocytopenia of <100 × 10(9)/L in the absence of identifiable secondary causes. Treatment is indicated when the platelet count is <20 - 30 × 10(9)/L, but may be commenced at higher platelet counts when the risk of bleeding is high. Corticosteroids are the backbone of initial treatment of ITP. There is a paucity of data in South Africa (SA) on the outcomes of newly diagnosed ITP patients treated with corticosteroids. OBJECTIVES. To describe the response, remission and clinical outcomes of newly diagnosed primary ITP patients on first-line corticosteroids. METHODS. This was a retrospective cohort study of 68 patients with a new diagnosis of ITP, seen at the Clinical Haematology Unit at Groote Schuur Hospital, Cape Town, SA, over a 5-year period (2016 - 2020). Demographic and clinical data were obtained from paper and electronic record systems. All participants with secondary causes were excluded. The initial platelet responses to corticosteroids and the final outcomes at last follow-up were determined. Initial platelet responses were classified into no response (NR), partial response (PR) and complete response (CR) in accordance with consensus definitions. Remission was defined as maintenance of a CR after being off corticosteroids for <6 months. Categorical variables were described by frequencies and percentages, while numerical variables were described by medians and interquartile ranges (IQRs) as data were non-parametric. RESULTS. The majority of patients were female (88.2%) and the median (IQR) age at diagnosis was 36 (23.0 - 55.5) years. The female to male ratio was 7.5:1. Most (92.4%) patients responded to corticosteroids, with 74.2% achieving a CR and 18.2% achieving a PR. Only five patients failed to respond (7.6%). The median (IQR) time to achieve CR was 15 (8 - 25) days, and the median (IQR) time to achieve PR was 10.5 (8 - 22) days. Half of the patients went into remission. Following remission, two patients (6.1%) subsequently relapsed at day 344 and day 777, respectively. Hypertension and/or diabetes mellitus were newly diagnosed in 10.6% of patients. CONCLUSION. Corticosteroids are effective first-line therapy for ITP, but are not remission-inducing in all patients. For those patients progressing to chronic ITP, there is a need to investigate cost-effective treatment. Some patients are at high risk of developing new hypertension and diabetes mellitus on corticosteroids, and should be monitored.

RESUMO O objetivo deste artigo foi analisar as concepções acerca da cronicidade na saúde mental no campo da reforma psiquiátrica e da reabilitação psicossocial brasileira. Realizou-se uma revisão integrativa da produção científica contemporânea brasileira a respeito dessa temática. Como resultado, pode-se perceber que, para a literatura, a cronicidade é predominantemente determinada pela institucionalização e por determinadas formas de atenção ao sofrimento psíquico e às crises, que incluem: a permanência de práticas manicomiais de tutela e isolamento (as reinternações, levando à impermanência do sujeito no território); a assistência centrada nos diagnósticos psiquiátricos e nos medicamentos, e não na singularidade; fragmentação da assistência. Alguns autores chegaram a retratar uma nova cronicidade, com características como a porta-giratória e a vinculação permanente a ambulatórios, como uma evidência da falência das intenções da psiquiatria reformada. Superar a reprodução da cronicidade em saúde mental, segundo a literatura, envolve o cuidado em rede, territorializado, intersetorial, desmedicalizante, de forma a garantir o acompanhamento integral e em liberdade. Cabe destacar a presença irrisória, nos artigos, de reflexões sobre outras determinações, não assistenciais, do sofrimento psíquico permanente, como as transformações nas condições de vida e trabalho e a inserção em coletividades particulares (classe social, categorias profissionais, gênero, etnia/raça etc.).

ABSTRACT The aim of this article was to analyze the conceptions regarding chronicity in mental health in the field of the Brazilian psychiatric reform and psychosocial rehabilitation. An integrative review of Brazilian contemporary scientific production was carried out considering this theme. As a result, it can be seen how, for literature, chronicity is predominantly determined by institutionalization and specific care practices for psychic suffering and crises, which include: the permanence of the mental hospital model of guardianship and isolation practices (hospital readmissions, leading to the impermanence of the subject in the territory); assistance based on psychiatric diagnoses and medicines and not on individual’s singularity; care fragmentation. Some authors have even portrayed a new kind of chronicity, withfeatures such as the ‘revolving door’ and permanent attachment to outpatient clinics, as evidence of the failure of reformed psychiatry’s intentions. Overcoming the reproduction of mental health chronicity, according to literature, involves territorialized networking, intersectoral and demedicalizing assistance, in order to ensure follow-up integrality and freedom. It is worth highlighting the negligible presence, in the articles, of reflections on other non-assistance determinations of permanent psychic suffering, such as living and work conditions transformations, and insertion in certain communities (social class, professional categories, gender, ethnicity/race etc.).

RESUMEN Introducción: La inestabilidad anterior de hombro afecta en gran parte a población jóven y deportista, donde los deportes de contacto o colisión son los que tienen mayor riesgo de provocarla y mayor tasa de recidiva. Es por esto, que existe una tendencia a realizar el procedimiento de Latarjet en esta población. El objetivo de este trabajo es analizar los resultados funcionales y complicaciones luego de realizar este procedimiento en jugadores de rugby operados en Uruguay. Materiales y métodos: Se incluyeron un total de 21 pacientes tratados quirurgicamente con el procedimiento de Latarjet de forma abierta. Se evaluaron clinicamente registrando rangos de movilidad del hombro y dolor mediante escala visual analógica (EVA). También se aplicó el score de Western Ontario Shoulder Instability Index (WOSI). Se valoró retorno al deporte o no, y nivel del mismo. Todas las complicaciones relacionadas fueron documentadas. Resultados: El seguimiento promedio fue de 3 años y medio. En 5 casos (23.8%) se realizó la cirugía de Latarjet como revisón de un primer procedimiento de Bankart. Se obtuvo un rango de movilidad completo en todos los pacientes. El dolor según la escala de EVA fue de 1.3. El score funcional de WOSI promedio fue de 75%. El retorno al deporte se dio en el 95.2% de los pacientes, donde el 71.5% lo realizaron al mismo nivel competitivo. No se registraron casos de recidiva con luxaciones o subluxaciones, 1 paciente quedo con aprhensión del hombro operado. 3 casos (14.8%) presentaron una artrosis glenohumeral en estadío 2. Conclusión: La técnica de Latarjet muestra excelentes resultados para la inestabilidad anterior de hombro logrando articulaciones estables, con un bajo grado de recurrencia y artrosis para los pacientes sometidos tanto a cirugías primarias como de revisión.

ABSTRACT Introduction: Anterior shoulder instability largely affects the young and athletic population, where contact or collision sports have the highest risk of causing it and the highest recurrence rate. For this reason, there is a tendency to perform the Latarjet procedure in this population. The aim of this work is to analyze the functional results and complications after performing this procedure in rugby players operated in Uruguay. Materials and methods: A total of 21 patients treated surgically with the open Latarjet procedure were included. They were clinically evaluated by recording ranges of shoulder mobility and pain using a visual analog scale (VAS). The Western Ontario Shoulder Instability Index (WOSI) score was also applied. Return to sport or not, and level of sport were assessed. All related complications were documented. Results: The average follow-up was 3.5 years. In 5 cases (23.8%) Latarjet surgery was performed as a revision of a first Bankart procedure. Full range of motion was obtained in all patients. Pain according to the VAS scale was 1.3. The average WOSI functional score was 75%. Return to sport occurred in 95.2% of patients, 71.5% of whom returned to the same competitive level. There were no cases of recurrence with dislocations or subluxations, 1 patient remained with apprehension of the operated shoulder. 3 cases (14.8%) presented stage 2 glenohumeral arthrosis. Conclusion: The Latarjet technique shows excellent results for anterior shoulder instability achieving stable joints, with a low degree of recurrence and arthrosis for patients who underwent both primary and revision surgeries.

RESUMO Introdução: A instabilidade anterior do ombro afecta em grande parte a população jovem e atlética, onde os desportos de contacto ou colisão têm o maior risco de a causar e a maior taxa de recorrência. Por este motivo, existe uma tendência para realizar o procedimento de Latarjet nesta população. O objetivo deste estudo é analisar os resultados funcionais e as complicações após este procedimento em jogadores de rúgbi operados no Uruguai. Materiais e métodos: Foram incluídos 21 pacientes tratados cirurgicamente com o procedimento aberto de Latarjet. Foram avaliados clinicamente através do registo das amplitudes de mobilidade do ombro e da dor utilizando uma escala visual analógica (EVA). Foi também utilizada a pontuação do Western Ontario Shoulder Instability Index (WOSI). Foram avaliados o regresso ou não ao desporto e o nível de prática desportiva. Todas as complicações relacionadas foram documentadas. Resultados: O seguimento médio foi de 3,5 anos. Em 5 casos (23,8%), a cirurgia de Latarjet foi efectuada como revisão de um primeiro procedimento de Bankart. Foi obtida uma amplitude de movimentos completa em todos os doentes. A dor, de acordo com a escala VAS, foi de 1,3. A pontuação funcional WOSI média foi de 75%. O regresso ao desporto ocorreu em 95,2% dos doentes, sendo que 71,5% regressaram ao mesmo nível competitivo. Não houve casos de recidiva com luxações ou subluxações, 1 paciente permaneceu com impacto no ombro. 3 casos (14,8%) apresentaram artrose glenoumeral estágio 2. Conclusão: A técnica de Latarjet apresenta excelentes resultados para a instabilidade anterior do ombro, conseguindo articulações estáveis, com baixo grau de recidiva e osteoartrose, tanto em pacientes submetidos à cirurgia primária como à cirurgia de revisão.

RESUMEN La proliferación del tejido placentario origina un conjunto de enfermedades relacionadas, incluidas todas en el término de enfermedad trofoblástica estacional (ETG). Las lesiones incluyen: la mola hidatiforme (completa y parcial), la mola invasiva, el coriocarcinoma, el tumor trofoblástico del sitio placentario, tumor trofoblasticoepitelioide. Se describe en este reporte un caso de mola invasora diagnóstica posterior a un procedimiento de aspirado manual endouterino, el cual se detectó por niveles séricos de gonadotropina coriónica humana (β-hCG) cuantitativo en ascenso en sus controles. Por lo que se demuestra la importancia del seguimiento con controles seriados en sangre de β-hCG cuantitativo, para un oportuno diagnóstico y tratamiento.

ABSTRACT The proliferation of placental tissue causes a set of related diseases, all included in the term seasonal trophoblastic disease (STD). Lesions include: hydatidiform mole (complete and partial), invasive mole, choriocarcinoma, trophoblastic tumor of the placental site, and epithelioid trophoblastic tumor. This report describes a case of invasive mole diagnosed after a manual endouterine aspiration procedure, which was detected by increasing serum levels of quantitative BCHG in its controls. Therefore, the importance of follow-up with serial controls of quantitative BCHG blood is demonstrated, for an opportune diagnosis and treatment.

RESUMEN Introducción: los síntomas del Trastorno de Estrés Postraumático (TEPT) es un problema de salud pública frecuente en población adolescente. La evidencia empírica demuestra que los acontecimientos adversos durante la adolescencia pueden afectar la adultez temprana y predecir diversos problemas psicológicos. La evaluación continua sobre el TEPT es fundamental para la prevención y resulta necesario la disposición de instrumentos psicológicos confiables y basados en evidencia. Objetivo: analizar las propiedades psicométricas de la Escala de impacto de eventos-6 (IES-6) en población general adolescente. Metodología: investigación instrumental, enfoque cuantitativo y transversal. Participaron 2877 adolescentes de Huancavelica, que contestaron el IES-6 y otros instrumentos psicológicos. Los análisis estadísticos se realizaron con el modelamiento de ecuaciones estructurales y teoría de respuesta al ítem. Resultados: el IES-6 presenta adecuada evidencia de validez de contenido, estructura unidimensional, confiabilidad, invarianza de medición según sexo y relación con la ideación suicida, ansiedad generalizada y depresión. Los ítems 5 y 3 presentaron la mayor discriminación e información, además la escala resulta precisa para niveles altos del TEPT. Conclusión: el IES-6 presenta adecuadas fuentes de evidencia de validez y resulta un instrumento útil para la evaluación de los síntomas del TEPT en adolescentes peruanos. Se recomienda su uso en la investigación y los programas de prevención y seguimiento de salud pública y educación.

ABSTRACT Introduction: symptoms of Post Traumatic Stress Disorder (PTSD) are a frequent public health problem in adolescent population. Empirical evidence shows that adverse events during adolescence can affect early adulthood and predict various psychological problems. Ongoing assessment of PTSD is essential for prevention and the availability of reliable, evidence-based psychological instruments is necessary. Objective: to analyze the psychometric properties of the Impact of Events Scale-6 (IES-6) in the general adolescent population. Methodology: we used an instrumental research, quantitative and cross-sectional approach. A total of 2877 adolescents from Huancavelica participated, who answered the IES-6 and other psychological instruments. Statistical analyses were performed with structural equation modeling and item response theory. Results: the IES-6 presents adequate evidence of content validity, unidimensional structure, reliability, measurement invariance according to sex and relationship with suicidal ideation, generalized anxiety and depression. Items 5 and 3 presented the highest discrimination and information, and the scale is accurate for high levels of PTSD. Conclusion: the IES-6 presents adequate sources of validity evidence and is a useful instrument for the assessment of PTSD symptoms in Peruvian adolescents. Its use is recommended in research and prevention and follow-up programs in public health and education.

BACKGROUND: Prevention of mother-to-child transmission (PMTCT) programmes are designed to prevent HIV transmission to infants and children. Despite efforts to achieve this goal, several factors continue to pose challenges OBJECTIVES: To investigate the level of adherence, perceptions, knowledge, and factors associated with adherence to the PMTCT programme in primary healthcare facilities METHOD: A descriptive cross-sectional study design and quantitative research approach was used, and clinical records were reviewed to determine the prevalence of seroconverted babies of mothers enrolled in a PMTCT programme for the past 2 years in the community healthcare centres. Bivariate and multivariate logistic regression analyses were performed RESULTS: A total of 341 mother-baby pairs were recruited and took part in the study. Most women (263; 77%), perceived that a pregnant woman living with HIV can transmit the virus to her unborn baby. The following factors were independently associated with non-adherence: being unmarried, the period of maternal HIV diagnosis and initiation on antiretroviral therapy, unsuppressed viral load results, missed clinic appointments, side effects, and getting tired of taking HIV medication CONCLUSION: This study investigated adherence to and perceptions of all components of the PMTCT programme by pregnant and breastfeeding women in primary healthcare facilities. Despite the significant progress made, maternal and paediatric HIV pandemic pose a challenge to the PMTCT services. There is a need for follow-up research to monitor the ongoing adherence to the PMTCT programme and its long-term impact in reducing the rate of transmission of HIV in mothers

RESUMEN Introducción: Las secuelas circulatorias en personas mayores con antecedentes de COVID-19 incluyen fatiga, dificultad respiratoria y aumento del riesgo de trombosis, lo que afecta la calidad de vida y la movilidad. Objetivo: Exponer las secuelas circulatorias en personas mayores con antecedentes de COVID-19. Desarrollo: La COVID-19 es responsable de una serie afecciones que repercuten en la calidad de vida de las personas a nivel mundial. Los pacientes de edad avanzada con antecedentes de la enfermedad pueden experimentar trombosis, embolias y otras alteraciones de la circulación sanguínea. La inflamación sistémica provocada por el virus puede dañar los vasos sanguíneos y aumentar el riesgo de enfermedades cardiovasculares. Además, la inmovilización durante la enfermedad puede contribuir a la formación de coágulos. Es esencial que los profesionales de la salud realicen seguimiento adecuado de estos pacientes, lo que promueve hábitos de vida saludables y, en algunos casos, tratamiento anticoagulante para mitigar complicaciones a largo plazo y mejorar su calidad de vida. Conclusiones: Las secuelas circulatorias en personas mayores con antecedentes de COVID-19 son preocupantes y requieren atención. Los hallazgos sugieren un aumento en problemas cardiovasculares, lo cual subraya la importancia de monitorear la salud circulatoria en esta población. Se recomienda un seguimiento médico regular para prevenir complicaciones y mejorar la calidad de vida.

ABSTRACT Introduction: Circulatory sequelae in older people with a history of COVID-19 include fatigue, respiratory distress and increased risk of thrombosis, affecting quality of life and mobility. Objective: To report on circulatory sequelae in older people with a history of COVID-19. Development: The COVID-19 is responsible for a series of conditions that impact people's quality of life, worldwide. Elderly patients with a history of the disease may experience thrombosis, embolism and other blood circulation disorders. Systemic inflammation caused by the virus can damage blood vessels, increasing the risk of cardiovascular disease. Additionally, immobilization during illness can contribute to clot formation. It is essential that health professionals carry out adequate follow-up of these patients, promoting healthy lifestyle habits and, in some cases, anticoagulant treatment to mitigate long-term complications and improve their quality of life. Conclusions: Circulatory sequelae in older people with a history of COVID-19 are worrying and require attention. The findings suggest an increase in cardiovascular problems, which underscores the importance of monitoring circulatory health in this population. Regular medical follow-up is recommended to prevent complications and improve quality of life.

ABSTRACT Objective: The objective of this study was to analyze the implications of social contingency measures and interruption of outpatient follow-up on weight gain in children and adolescents with a previous diagnosis of obesity. Methods: This is an observational study with data from electronic medical records of children and adolescents followed up at a specialized outpatient clinic from 2019 to 2023. Weight gain, height, BMI variation, BMI z-score, laboratory tests, and associated comorbidities were analyzed. The data were computed and analyzed using the Statistical Package for the Social Sciences (SPSS), and the results were considered statistically significant when p<0.05. Results: There was a weight gain of approximately 17.66% in the total set of participants, corresponding to a median increase of 14 kg. When analyzing between genders, we observed an approximate increase of 21.38% in body weight for men, while for women, it was 21.45%. Conclusions: The COVID-19 pandemic has led to significant weight gain among previously obese children and adolescents in follow-up at a specialized outpatient clinic. Objective followup follow obesity Methods 201 2023 height variation zscore, zscore z score, score z-score tests SPSS, SPSS , (SPSS) p005 p 0 05 p<0.05 Results 1766 17 66 17.66 participants 1 kg genders 2138 21 38 21.38 men women 2145 45 21.45% Conclusions COVID19 COVID 19 COVID-1 20 202 (SPSS p00 p<0.0 176 6 17.6 213 2 3 21.3 214 4 21.45 COVID1 COVID- p0 p<0. 17. 21. 21.4 p<0 p<

RESUMO Objetivo: Analisar as implicações das medidas de contingenciamento social e interrupção do acompanhamento ambulatorial sobre o ganho de peso de crianças e adolescentes com diagnóstico prévio de obesidade. Métodos: Estudo observacional com dados proveniente de prontuários eletrônicos de crianças e adolescentes acompanhadas no Ambulatório de Obesidade na Criança e no Adolescente do Hospital de Clínicas da Universidade Estadual de Campinas, no período de 2019 a 2023. Analisaram-se ganho ponderal, altura, variação do índice de massa corporal (IMC), escore Z de IMC, exames laboratoriais e comorbidade associadas. Os dados foram computados e analisados pelo programa StatisticalPackage for the Social Sciences (SPSS). Os resultados foram considerados estatisticamente significativos quando p<0,05. Resultados: Constatou-se aumento ponderal de aproximadamente 17,6% no conjunto total de participantes, correspondendo ao acréscimo mediano de 14 kg. Ao analisarmos os gêneros, observamos elevação aproximada de 21,38% no peso corporal do sexo masculino, enquanto a do sexo feminino foi de 21,4%. Conclusões: A pandemia de COVID-19 levou a ganho peso significante entre crianças e adolescentes previamente obesos, que estavam em seguimento em ambulatório especializado. Objetivo obesidade Métodos Campinas 201 2023 Analisaramse Analisaram se altura IMC , (IMC) associadas SPSS. SPSS . (SPSS) p005 p 0 05 p<0,05 Resultados Constatouse Constatou 176 17 6 17,6 participantes 1 kg gêneros 2138 21 38 21,38 masculino 214 4 21,4% Conclusões COVID19 COVID 19 COVID-1 obesos especializado 20 202 (IMC (SPSS p00 p<0,0 17, 213 2 3 21,3 21,4 COVID1 COVID- p0 p<0, 21, p<0 p<

ABSTRACT Objective: The aim of this study was to describe the epidemiological characteristics of pediatric patients with sickle cell disease (SCD) and evaluate the use of medicinal plants in these patients concomitantly with their drug treatment. Methods: This is a review of the medical records of pediatric patients at a public institution with tertiary care. The selection criterion was to be a child or adolescent with SCD undergoing pediatric follow-up at this outpatient clinic. In the medical records of the patients selected, records of the use of plants for medicinal purposes were sought. Results: In total, 154 records (100% of total active patients followed in this clinic) were reviewed: 99 children and 55 adolescents. The predominant genotype was SS (58.4%), followed by SC (29.2%). The use of at least one medication for SCD was reported in 95.5% of the medical records. The use of medicinal plants was reported by 70.1% of patients, with 276 citations in the medical records referring to 64 different types of plants. Six plants were used for the treatment of SCD, the main one being Lemonvine/Ora-pro-nóbis (Pereskia aculeata). The use of medicinal plants was reported for flu-like symptoms and/or COVID-19 (both for prevention and treatment) by 60.5% of the citations, with 35 different plants reported for this use, exclusively or not. This use was followed by pain symptoms (14.2% of citations). Conclusions: The majority of patients in this study use both conventional and traditional/complementary/alternative medicine, highlighting the need for more studies in the area, with a special focus on patient safety. Objective (SCD Methods care followup follow up clinic selected sought Results 15 100% 100 (100 reviewed 9 5 adolescents 58.4%, 584 58.4% , 58 4 (58.4%) 29.2%. 292 29.2% . 29 2 (29.2%) 955 95 95.5 701 70 1 70.1 27 6 Lemonvine/Orapronóbis LemonvineOrapronóbis Lemonvine/Ora pro nóbis Lemonvine Ora Pereskia aculeata. aculeata aculeata) flulike flu like andor COVID19 COVID 19 COVID-1 605 60 60.5 3 not 14.2% 142 14 (14.2 citations. citations) Conclusions traditionalcomplementaryalternative traditional complementary alternative medicine area safety 10 (10 58.4 (58.4% 29.2 (29.2% 95. 7 70. Orapronóbis LemonvineOra COVID1 COVID- 60. 14.2 (14. (1 58. (58.4 29. (29.2 14. (14 ( (58. (29. (58 (29 (5 (2

RESUMO Objetivo: Descrever as características epidemiológicas de pacientes pediátricos com doença falciforme (DF) e avaliar o uso de plantas medicinais concomitantemente ao tratamento medicamentoso. Métodos: Realizou-se revisão de prontuários de pacientes pediátricos de uma instituição pública com nível de atendimento terciário; o critério de seleção foi ser criança ou adolescente com DF em acompanhamento pediátrico neste ambulatório. Nos prontuários dos pacientes selecionados foi procurado o registro do uso de plantas com finalidades medicinais. Resultados: Foram revisados 154 prontuários (100% dos pacientes ativos desse ambulatório): 99 crianças e 55 adolescentes. O genótipo predominante foi SS (58,4%), seguido do SC (29,2%). O uso de ao menos uma medicação para a DF foi relatada em 95,5% dos prontuários. Em 70,1% dos prontuários havia o relato do uso de plantas medicinais, em 276 citações, sendo 64 plantas citadas ao todo; destas, seis espécies foram citadas para o tratamento da doença de base (DF), sendo “ora-pro-nobis” (Pereskia aculeata) a principal. Das 276 citações de plantas medicinais nos prontuários, 60,5% incluíram o uso de plantas medicinais em sintomas gripais e/ou COVID-19 (tanto prevenção quanto tratamento), sendo relatadas 35 para este uso, exclusivamente ou não. Essa foi a principal finalidade de uso encontrada nos prontuários dos pacientes, seguida do uso para sintomas de dor (14,2% das citações). Conclusões: Notou-se que a maioria dos pacientes avaliados faz uso da medicina convencional, aliada à tradicional/ complementar/ alternativa, o que leva à necessidade de mais estudos nessas áreas, especialmente na pediatria, visando principalmente à segurança do paciente. Objetivo (DF medicamentoso Métodos Realizouse Realizou se terciário ambulatório Resultados 15 100% 100 (100 ambulatório) 9 5 adolescentes 58,4%, 584 58,4% , 58 4 (58,4%) 29,2%. 292 29,2% . 29 2 (29,2%) 955 95 95,5 701 70 1 70,1 27 6 todo destas DF, orapronobis ora pro nobis “ora-pro-nobis Pereskia aculeata 605 60 60,5 eou COVID19 COVID 19 COVID-1 tanto tratamento, tratamento) 3 não 14,2% 142 14 (14,2 citações. citações) Conclusões Notouse Notou convencional tradicional complementar alternativa áreas pediatria paciente 10 (10 58,4 (58,4% 29,2 (29,2% 95, 7 70, 60, COVID1 COVID- 14,2 (14, (1 58, (58,4 29, (29,2 14, (14 ( (58, (29, (58 (29 (5 (2

ABSTRACT BACKGROUND: The diagnosis and treatment of latent tuberculosis infection (LTBI) are crucial for tuberculosis (TB) control. Household contacts (HHC) of patients with pulmonary TB are at a high risk of LTBI due to their close proximity to source cases. OBJECTIVE: To describe the diagnosis and treatment of LTBI among HHC. DESIGN AND SETTING: This cross-sectional follow-up study was conducted in the municipality of Paulo Afonso, northeastern Brazil, between 2013 and 2022. METHODS: We retrieved secondary data from the medical records of HHC who were followed up at a specialized referral center for TB. LTBI prevalence estimates were calculated and are presented with 95% confidence intervals (CIs). RESULTS: In total, 622 HHC were screened for LTBI, with 620 evaluated using the tuberculin skin test (TST). Of these, 40 (6.5%) did not return for TST reading. The overall prevalence of LTBI was 53.1% (95% CI: 49–57.1%), with a high prevalence among females and individuals aged 25–34 years. The overall LTBI treatment initiation rate was 26.1% (95%CI: 21.5–31.3%), and 64.2% (95%CI: 53.3–73.8%) of HHC who initiated treatment completed their course. CONCLUSION: This study revealed a high prevalence of LTBI among HHC, particularly among women and individuals aged 25–34 years, underscoring the ongoing TB transmission within the community. Only 26.1% of the diagnosed HHC initiated treatment, with approximately 64% completing their course. This highlights the challenges in managing LTBI and emphasizes the need for targeted screening and interventions for high-risk groups. BACKGROUND (LTBI (TB control (HHC cases OBJECTIVE SETTING crosssectional cross sectional followup follow Afonso Brazil 201 2022 METHODS 95 CIs. CIs . (CIs) RESULTS total 62 TST. (TST) these 4 6.5% 65 6 5 (6.5% reading 531 53 1 53.1 (95 CI 49–57.1%, 49571 49–57.1% , 49 57 49–57.1%) 2534 25 34 25–3 years 261 26 26.1 95%CI 95CI (95%CI 21.5–31.3%, 215313 21.5–31.3% 21 31 3 21.5–31.3%) 642 64 2 64.2 53.3–73.8% 533738 73 8 course CONCLUSION community highrisk groups 20 202 9 (CIs (TST 6.5 (6.5 53. (9 4957 49–57.1 253 25– 26. 21531 21.5–31.3 64. 53.3–73.8 53373 7 6. (6. ( 495 49–57. 2153 21.5–31. 53.3–73. 5337 (6 49–57 215 21.5–31 53.3–73 533 49–5 21.5–3 53.3–7 49– 21.5– 53.3– 21.5 53.3 21.

ABSTRACT Objective: To investigate the methods used by dentists for diagnosis and treatment of dental caries lesions. Material and Methods: This cross-sectional study was developed by sending a validated questionnaire to dentists in the southeastern region of Brazil with questions about detection methods and the indicated procedures for treating lesions. Results: Three hundred and ninety-eight responses were identified after distributing the questionnaire. The state with the highest percentage of respondents was Espírito Santo (n=140). The respondents' mean time since dental school graduation was 12.9 years (±11.4). Regarding the diagnosis, 39.4% of the dentists used the explorer probe to detect occlusal lesions, 79.6% performed drying with an air jet, 65.8% of dentists performed biofilm removal and follow-up for active initial occlusal lesions, and 60.3% applied fluorides. For active caries lesions reaching the enamel dentinal junction, the dentists performed selective caries removal followed by restoration for both occlusal lesions (79.6%) and proximal lesions (78.1%). Conclusion: Visual-tactile and radiographic examinations were the detection methods of most dentists. A conservative approach was identified more frequently for initial, non-cavitated lesions and an operative approach for dentine tissue lesions. Conservative, non-invasive treatment still seems challenging for professionals when lesions reach the dentine tissue. Objective Methods crosssectional cross sectional Results ninetyeight ninety eight n=140. n140 n n=140 . 140 (n=140) 129 12 9 12. ±11.4. 114 ±11.4 11 4 (±11.4) 394 39 39.4 796 79 6 79.6 jet 658 65 8 65.8 followup follow up 603 60 3 60.3 fluorides junction (79.6% 78.1%. 781 78.1% 78 1 (78.1%) Conclusion Visualtactile Visual tactile noncavitated non cavitated Conservative noninvasive invasive n14 n=14 14 (n=140 ±11. (±11.4 39. 7 79. 65. 60. (79.6 78.1 (78.1% n1 n=1 (n=14 ±11 (±11. (79. 78. (78.1 n= (n=1 ±1 (±11 (79 (78. (n= ± (±1 (7 (78 (n (± (