ABSTRACT The objective was to investigate the working conditions and physical and mental health of health professionals working on the front lines of COVID-19 in urgent, emergency, and intensive care services in Brazil, in the second year of the pandemic. Cross-sectional study, using an electronic questionnaire, through which data on working conditions, and physical and mental health were collected, in addition to the Depression, Anxiety and Stress Scale (DASS-21) instrument. The sample (n=209) included nurses (28.7%), nursing technicians (30.1%), physiotherapists (33%), and physicians (8.2%). The professionals had an average age of 34.6 years and reported an average workload of 53.5 hours/week. There was an increase in hours worked (62%) and in the number of patients (84%). Most reported a good relationship with their boss (89%) and job satisfaction (87%). The prevalence of symptoms of stress, anxiety, and depression was greater than 45%, with a predominance of severe or extremely severe symptoms. The prevalence of musculoskeletal pain and fatigue was 84.7% and 83.3%, respectively. Health professionals showed an increase in workload and demand during the COVID-19 pandemic. There was also intense damage to the physical and mental health of these workers.

RESUMO Objetivou-se investigar as condições de trabalho e a saúde física e mental de profissionais de saúde atuantes na linha de frente da covid-19 em serviços de urgência, emergência e terapia intensiva no Brasil, no segundo ano da pandemia. Estudo transversal, com uso de questionário eletrônico, por meio do qual coletaram-se dados sobre condições de trabalho, saúde física e mental, além do instrumento Depression, Anxiety and Stress Scale (DASS-21). A amostra (n=209) incluiu enfermeiros (28,7%), técnicos de enfermagem (30,1%), fisioterapeutas (33%) e médicos (8,2%). Os profissionais possuíam idade média de 34,6 anos e relataram uma carga horária média de 53,5 horas/semana. Verificou-se aumento das horas trabalhadas (62%) e da quantidade de pacientes (84%). A maioria relatou bom relacionamento com o chefe (89%) e satisfação com o trabalho (87%). A prevalência de sintomas de estresse, ansiedade e depressão foi superior a 45%, com predomínio de sintomas graves ou extremamente graves. A prevalência de dor musculoesquelética e fadiga foi de 84,7% e 83,3%, respectivamente. Os profissionais de saúde apresentaram aumento de volume de trabalho e de exigência durante a pandemia de covid-19. Observou-se, ainda, intenso prejuízo à saúde física e mental desses trabalhadores.

RESUMO Objetivou-se investigar as condições de trabalho e a saúde física e mental de profissionais de saúde atuantes na linha de frente da covid-19 em serviços de urgência, emergência e terapia intensiva no Brasil, no segundo ano da pandemia. Estudo transversal, com uso de questionário eletrônico, por meio do qual coletaram-se dados sobre condições de trabalho, saúde física e mental, além do instrumento Depression, Anxiety and Stress Scale (DASS-21). A amostra (n=209) incluiu enfermeiros (28,7%), técnicos de enfermagem (30,1%), fisioterapeutas (33%) e médicos (8,2%). Os profissionais possuíam idade média de 34,6 anos e relataram uma carga horária média de 53,5 horas/semana. Verificou-se aumento das horas trabalhadas (62%) e da quantidade de pacientes (84%). A maioria relatou bom relacionamento com o chefe (89%) e satisfação com o trabalho (87%). A prevalência de sintomas de estresse, ansiedade e depressão foi superior a 45%, com predomínio de sintomas graves ou extremamente graves. A prevalência de dor musculoesquelética e fadiga foi de 84,7% e 83,3%, respectivamente. Os profissionais de saúde apresentaram aumento de volume de trabalho e de exigência durante a pandemia de covid-19. Observou-se, ainda, intenso prejuízo à saúde física e mental desses trabalhadores. Objetivouse Objetivou se covid19 covid 19 covid-1 urgência Brasil transversal eletrônico coletaramse coletaram Depression DASS21. DASS21 DASS 21 . (DASS-21) n=209 n209 n 209 (n=209 28,7%, 287 28,7% , 28 7 (28,7%) 30,1%, 301 30,1% 30 1 (30,1%) 33% 33 (33% 8,2%. 82 8,2% 8 2 (8,2%) 346 34 6 34, 535 53 5 53, horassemana semana horas/semana Verificouse Verificou 62% 62 (62% 84%. 84 84% (84%) 89% 89 (89% 87%. 87 87% (87%) estresse 45 45% 847 84,7 833 83 3 83,3% respectivamente covid19. 19. Observouse, Observouse Observou se, Observou-se ainda trabalhadores covid1 covid- DASS2 (DASS-21 n=20 n20 20 (n=20 28,7 (28,7% 30,1 (30,1% (33 8,2 (8,2% (62 (84% (89 (87% 4 84, 83,3 (DASS-2 n=2 n2 (n=2 28, (28,7 30, (30,1 (3 8, (8,2 (6 (84 (8 (87 83, (DASS- n= (n= (28, (30, ( (8, (DASS (n (28 (30 (2

ABSTRACT The objective was to investigate the working conditions and physical and mental health of health professionals working on the front lines of COVID-19 in urgent, emergency, and intensive care services in Brazil, in the second year of the pandemic. Cross-sectional study, using an electronic questionnaire, through which data on working conditions, and physical and mental health were collected, in addition to the Depression, Anxiety and Stress Scale (DASS-21) instrument. The sample (n=209) included nurses (28.7%), nursing technicians (30.1%), physiotherapists (33%), and physicians (8.2%). The professionals had an average age of 34.6 years and reported an average workload of 53.5 hours/week. There was an increase in hours worked (62%) and in the number of patients (84%). Most reported a good relationship with their boss (89%) and job satisfaction (87%). The prevalence of symptoms of stress, anxiety, and depression was greater than 45%, with a predominance of severe or extremely severe symptoms. The prevalence of musculoskeletal pain and fatigue was 84.7% and 83.3%, respectively. Health professionals showed an increase in workload and demand during the COVID-19 pandemic. There was also intense damage to the physical and mental health of these workers. COVID19 COVID 19 COVID-1 urgent emergency Brazil pandemic Crosssectional Cross sectional study questionnaire collected Depression DASS21 DASS 21 (DASS-21 instrument n=209 n209 n 209 (n=209 28.7%, 287 28.7% , 28 7 (28.7%) 30.1%, 301 30.1% 30 1 (30.1%) 33%, 33 33% (33%) 8.2%. 82 8.2% . 8 2 (8.2%) 346 34 6 34. 535 53 5 53. hoursweek week hours/week 62% 62 (62% 84%. 84 84% (84%) 89% 89 (89% 87%. 87 87% (87%) stress anxiety 45 45% 847 84.7 833 83 3 83.3% respectively workers COVID1 COVID- DASS2 (DASS-2 n=20 n20 20 (n=20 28.7 (28.7% 30.1 (30.1% (33% 8.2 (8.2% (62 (84% (89 (87% 4 84. 83.3 (DASS- n=2 n2 (n=2 28. (28.7 30. (30.1 (33 8. (8.2 (6 (84 (8 (87 83. (DASS n= (n= (28. (30. (3 (8. ( (n (28 (30 (2

SUMMARY OBJECTIVE: This study aimed to evaluate the quality of sleep in individuals with systemic sclerosis and its correlation with the quality of life and disability. METHODS: This is a cross-sectional study, carried out in a tertiary service of a university hospital. Inclusion criteria were diagnosis of systemic sclerosis according to the criteria of the American College of Rheumatology/European League Against Rheumatism 2013 or the preliminary criteria of the American College of Rheumatology 1980, age ≥ 18 years; regularly monitored at the outpatient clinic of rheumatology. Clinical and demographic data of the patients were obtained through a structured interview and evaluation of the medical records. Sleep quality was assessed using the Pittsburgh Sleep Quality Index questionnaire, daytime sleepiness using the Epworth Sleepiness Scale, quality of life using 12-item short-form health survey, and disability using the scleroderma health assessment questionnaire. RESULTS: A total of 50 patients with systemic sclerosis were included, with 92% female, mean age 48.9 years, mean disease duration 8.9 years, and 60% limited cutaneous form. Most systemic sclerosis patients (84%) have poor sleep quality and 20% have excessive daytime sleepiness. There was a significant negative correlation between Pittsburgh Sleep Quality Index and the physical and mental components of the 12-item short-form health survey (r=-0.42, p=0.003 and r=-0.43, p=0.002, respectively) and a positive correlation with the scleroderma health assessment questionnaire (r=0.52, p=<0.001). CONCLUSION: This study showed that poor sleep quality is a very common finding among systemic sclerosis patients, and it negatively affects both the quality of life and the degree of disability. OBJECTIVE METHODS crosssectional cross sectional hospital RheumatologyEuropean European 201 1980 1 years rheumatology records Scale 12item item 12 shortform short form RESULTS 5 included 92 female 489 48 9 48. 89 8 8. 60 84% 84 (84% 20 r=0.42, r042 r r= 0.42, 0 42 (r=-0.42 p0003 p 003 p=0.00 r=0.43, r043 0.43, 43 r=-0.43 p0002 002 p=0.002 respectively r=0.52, r052 52 (r=0.52 p=<0.001. p0001 p=<0.001 . 001 p=<0.001) CONCLUSION 198 4 6 (84 2 r=0.42 r04 042 0.42 (r=-0.4 p000 00 p=0.0 r=0.43 043 0.43 r=-0.4 r=0.52 r05 (r=0.5 p=<0.00 19 (8 r=0.4 r0 04 0.4 (r=-0. p00 p=0. r=-0. r=0.5 (r=0. p=<0.0 ( r=0. 0. (r=-0 p0 p=0 r=-0 (r=0 p=<0. r=0 (r=- p= r=- (r= p=<0 (r p=<

BACKGROUND Streptococcus agalactiae capsular type III strains are a leading cause of invasive neonatal infections. Many pathogens have developed mechanisms to escape from host defense response using the host membrane microdomain machinery. Lipid rafts play an important role in a variety of cellular functions and the benefit provided by interaction with lipid rafts can vary from one pathogen to another. OBJECTIVES This study aims to evaluate the involvement of membrane microdomains during infection of human endothelial cell by S. agalactiae. METHODS The effects of cholesterol depletion and PI3K/AKT signaling pathway activation during S. agalactiae-human umbilical vein endothelial cells (HUVEC) interaction were analysed by pre-treatment with methyl-β-cyclodextrin (MβCD) or LY294002 inhibitors, immunofluorescence and immunoblot analysis. The involvement of lipid rafts was analysed by colocalisation of bacteria with flotillin-1 and caveolin-1 using fluorescence confocal microscopy. FINDINGS In this work, we demonstrated the importance of the integrity of lipid rafts microdomains and activation of PI3K/Akt pathway during invasion of S. agalactiae strain to HUVEC cells. Our results suggest the involvement of flotillin-1 and caveolin-1 during the invasion of S. agalactiae strain in HUVEC cells. CONCLUSIONS The collection of our results suggests that lipid microdomain affects the interaction of S. agalactiae type III belonging to the hypervirulent ST-17 with HUVEC cells through PI3K/Akt signaling pathway.

BACKGROUND Streptococcus agalactiae can causes sepsis, pneumonia, and meningitis in neonates, the elderly, and immunocompromised patients. Although the virulence properties of S. agalactiae have been partially elucidated, the molecular mechanisms related to reactive oxygen species (ROS) generation in infected human endothelial cells need further investigation. OBJECTIVES This study aimed to evaluate the influence of oxidative stress in human umbilical vein endothelial cells (HUVECs) during S. agalactiae infection. METHODS ROS production during S. agalactiae-HUVEC infection was detected using the probe CM-H2DCFDA. Microfilaments labelled with phalloidin-FITC and p47phox-Alexa 546 conjugated were analysed by immunofluorescence. mRNA levels of p47phox (NADPH oxidase subunit) were assessed using Real Time qRT-PCR. The adherence and intracellular viability of S. agalactiae in HUVECs with or without pre-treatment of DPI, apocynin (NADPH oxidase inhibitors), and LY294002 (PI3K inhibitor) were evaluated by penicillin/gentamicin exclusion. Phosphorylation of p47phox and Akt activation by S. agalactiae were evaluated by immunoblotting analysis. FINDINGS Data showed increased ROS production 15 min after HUVEC infection. Real-Time qRT-PCR and western blotting performed in HUVEC infected with S. agalactiae detected alterations in mRNA levels and activation of p47phox. Pre-treatment of endothelial cells with NADPH oxidase (DPI and apocynin) and PI3K/Akt pathway (LY294002) inhibitors reduced ROS production, bacterial intracellular viability, and generation of actin stress fibres in HUVECs infected with S. agalactiae. CONCLUSIONS ROS generation via the NADPH oxidase pathway contributes to invasion of S. agalactiae in human endothelial cells accompanied by cytoskeletal reorganisation through the PI3K/Akt pathway, which provides novel evidence for the involvement of oxidative stress in S. agalactiae pathogenesis.

GBS serotypes III and V were the most prevalent in pregnant women and exhibited resistance to tetracycline, clindamycin and sulfamethoxazole/trimethoprim. Serotype III showed high sialic acid content and PFGE analysis discerned 33 heterogeneous profiles. Phenotypic and genotypic characterization could be relevant to control GBS infections unaffected by intra-partum chemoprophylaxis.