Abstract Considering the scientific evidence regarding the harmful effects on health from consuming ultra-processed foods, the regulation on food environments has been prioritized as a way of promoting adequate and healthy eating. In this context, Bill 4198/2021 was proposed in the Legislative assembly of Rio de Janeiro, to ban the sale of ultra-processed foods in the schools in the state. In the second voting session of the proposition conservative rhetoric was widely used by the opposing congressmen. In this essay, these positions were classified, finding common points between them, considering the analysis of the legislative process. In making this categorization, it was possible to identify three argumentative bases that were explored: the defense of freedom of trade; the right to a “family autonomy,” the primacy of the family in children’s education; and individual responsibility for obesity. These rhetorics have been analyzed together with their counterpoint, in the conclusions of the specialized literature. Beyond the plurality of ideas in the legislative debate, it was possible to identify how the discussion of Bill 4198/21 was permeated by the reproduction of disinformation and violence. In this way, the scrutiny of the conservative rhetoric used and the understanding of the context of this discussion are contributions proposed here to consolidate the repertoire of defense of the health of children and adolescents.

Resumo Diante das evidências científicas acerca dos malefícios à saúde do consumo de alimentos ultraprocessados, a regulação dos ambientes alimentares vem sendo priorizada como forma de promover uma alimentação adequada e saudável. Nesse contexto, foi proposto o Projeto de Lei 4198/2021 na Assembleia Legislativa do Rio de Janeiro, para proibir o comércio de ultraprocessados nas escolas do estado. Na segunda sessão em plenário da proposição, houve ampla utilização de retóricas conservadoras pelos deputados contrários. Neste presente ensaio foram classificados esses posicionamentos, encontrando-se pontos comuns entre eles, à luz da análise da tramitação legislativa. Ao realizar essa categorização, foi possível identificar três bases argumentativas exploradas: a defesa da liberdade de comércio; o direito à “pátria família”, de primazia da família na educação infantojuvenil; e a responsabilização individual da obesidade. Tais retóricas foram analisadas em conjunto com suas contraposições, presentes nas conclusões da literatura especializada. Para além da pluralidade de ideias do debate legislativo, foi possível identificar como a discussão do PL 4198/21 foi permeada pela reprodução de desinformação e violência. Desse modo, o escrutínio das retóricas conservadoras utilizadas e a compreensão do contexto dessa discussão são contribuições aqui propostas para a consolidação do repertório de defesa da saúde de crianças e adolescentes.

ABSTRACT Objective Determining the etiology of hyperprolactinemia is fundamental for selecting the most appropriate treatment strategy. The aim of this study was to evaluate the usefulness and accuracy of prolactin levels in predicting the etiology of nonphysiological hyperprolactinemia. Subjects and methods In this retrospective study, we reviewed medical records of patients with nonphysiological hyperprolactinemia seen at two neuroendocrine reference centers located in Recife, Brazil, from January 2000 to December 2019. Results The study included 770 patients aged 12-73 years (65% female). The three most frequent etiologies of hyperprolactinemia were prolactinomas (n = 263; 34.2%), drug-induced hyperprolactinemia (n = 160; 20.8%), and macroprolactinemia (n = 120; 15.6%). The highest mean prolactin levels were observed in cases of prolactinomas and idiopathic hyperprolactinemia. Most patients with hyperprolactinemia due to other etiologies had prolactin levels < 100 ng/mL, but these levels were also found in 16.5% of patients with microproplactinomas and in 20% of those with idiopathic hyperprolactinemia. Likewise, prolactin levels largely overlapped among patients with microprolactinomas, macroprolactinemia, and drug-induced hyperprolactinemia. Notably, prolactin levels > 250 ng/mL enabled a clear distinction between the etiologies of macroprolactinoma and nonfunctioning pituitary adenoma. Moreover, prolactin levels > 500 ng/mL were highly suggestive of macroprolactinomas, although they were also found in very few patients (<2%) with microprolactinomas or drug-induced hyperprolactinemia. Conclusion Despite considerable overlap in prolactin levels among the different etiologies of hyperprolactinemia, values > 250 ng/mL allowed a clear distinction between macroprolactinomas and nonfunctioning pituitary adenomas. Furthermore, prolactin levels > 500 ng/mL were almost exclusively found in patients with prolactinomas. strategy Recife Brazil 200 2019 77 1273 12 73 12-7 65% 65 (65 female. female . female) n 263 34.2%, 342 34.2% , 34 2 34.2%) druginduced drug induced 160 20.8%, 208 20.8% 20 8 20.8%) 120 15.6%. 156 15.6% 15 6 15.6%) 10 ngmL ng mL 165 16 5 16.5 Likewise Notably 25 adenoma Moreover 50 <2% (<2% adenomas Furthermore 201 7 127 1 12- (6 26 34.2 3 20.8 15.6 16. <2 (<2 ( 34. 20. 15. (<

Abstract Background The increased screen media use among children aged 3 to 5, particularly in the post-COVID era, is concerning. Despite several organizations’ recommendation of a one-hour screen limit for young children, actual usage often exceeds this guideline. Objective: This study explored the influence of parental characteristics such as self-efficacy, motivation, socioeconomic status, and cognitive abilities on children’s screen time habits. Methods Employing a feature selection model, 251 caregivers answered an online survey, presenting data from themselves and on-screen usage for 126 girls and 125 boys. We found that the caregiver’s executive functions, including cognitive flexibility, initiation, task monitoring, and material organization, significantly impact children’s screen time. Results: Our analysis highlighted the vital role of caregivers’ self-efficacy in moderating children’s screen usage. Family net income, children’s age and gender, and motivations related to children’s desires and behavioral control were also significant contributors to usage patterns. Conclusion This study offers insights into interventions and effective parenting strategies in the digital age, highlighting the importance of addressing socio-demographic factors in understanding this complex issue. 5 postCOVID post COVID era concerning organizations onehour one hour guideline Objective selfefficacy, selfefficacy self efficacy, efficacy motivation status childrens s habits model 25 survey onscreen 12 boys caregiver functions flexibility initiation monitoring organization Results income gender patterns sociodemographic socio demographic issue 2 1

RESUMO RACIONAL: A incidência das lesões de vias biliares (LVB) permanece maior na colecistectomia laparoscópica (CL) em comparação à colecistectomia aberta. A Visão Crítica de Segurança (VCS) foi introduzida por Strasberg como estratégia para redução dessa catastróficas complicação. OBJETIVOS: Avaliar com que frequência a VCS adequada é alcançada durante a CL, os fatores determinantes e as complicações cirúrgicas associadas. MÉTODOS: É um estudo prospectivo. Fotografias da VCS de todas as CL realizadas consecutivamente pelo mesmo cirurgião entre 2020 e 2023 foram feitas. O sucesso na obtenção da VCS foi analisado pela própria cirurgiã e, posteriormente, por cirurgiões hepatobiliares. Os pacientes foram classificados em dois grupos: VCS obtida e VCS não obtida. Foi utilizada regressão logística multivariável para avaliar a associação entre fatores pré-operatórios e complicações cirúrgicas em ambos os grupos. RESULTADOS: Trezentos e nove pacientes foram submetidos a CL. Desses, 73,5% foram cirurgias eletivas e 26,5% apresentavam colecistite aguda. A idade variou entre 14 a 87 e 76,8% eram mulheres. O IMC médio foi 26,7. Cirurgias abdominais prévias ocorreram em 64%. A VCS foi obtida em 79,9% dos pacientes e não houve complicações cirúrgicas neste grupo. Os fatores associados à não obtenção da VCS foram colecistite aguda (p=0,007), sexo masculino (p=0,014) e cirurgias abdominais prévias (p=0,021). Três pacientes necessitaram de colecistectomia subtotal devido à inflamação grave. Não houve correlação estatística entre a obtenção da VCS e complicações cirúrgicas. CONCLUSÕES: A VCS é obtida na maioria dos pacientes. Colecistite aguda, sexo masculino, e cirurgias abdominais prévias estão associados a dificuldades na obtenção da VCS. RACIONAL LVB (LVB (CL aberta (VCS complicação OBJETIVOS associadas MÉTODOS prospectivo 202 feitas posteriormente hepatobiliares grupos préoperatórios pré operatórios RESULTADOS Desses 735 73 5 73,5 265 26 26,5 1 8 768 76 76,8 mulheres 267 7 26,7 64 64% 799 79 9 79,9 grupo p=0,007, p0007 p p=0,007 , 0 007 (p=0,007) p=0,014 p0014 014 (p=0,014 p=0,021. p0021 p=0,021 . 021 (p=0,021) grave CONCLUSÕES 20 73, 2 26, 76, 6 79, p000 p=0,00 00 (p=0,007 p=0,01 p001 01 (p=0,01 p002 p=0,02 02 (p=0,021 p00 p=0,0 (p=0,00 (p=0,0 (p=0,02 p0 p=0, (p=0, p=0 (p=0 p= (p= (p

ABSTRACT BACKGROUND: The incidence of biliary duct injuries remains higher in laparoscopic cholecystectomy (LC) in comparison to open surgery. The Critical View of Safety (CVS) was introduced by Strasberg as a strategy for reducing this catastrophic complication. AIM: The aim of this study was to evaluate how often an adequate CVS is achieved during LC, the determining factors for its success, and the associated surgical outcomes. METHODS: This is a prospective study. CVS photographs of all patients who underwent LC by the same surgeon between 2020 and 2023 were taken. Success in achieving CVS was analyzed by the surgeon herself and posteriorly by hepatobiliary specialists. Patients were classified into two groups: CVS achieved and CVS not achieved. Finally, multivariable logistic regression was used to examine the association between preoperatory factors and surgical complications. RESULTS: Three hundred and nine consecutive patients were submitted to LC. There were 73.5% elective CL and 26.5% acute cholecystitis. The age ranged from 14 to 87 years, and 76.8% were female. The median body mass index was 26.7. Previous abdominal surgeries were present in 64%, and 26% were obese. The CVS was achieved in 79.9% of the patients, and there were no surgical complications in this group. The factors associated with nonachievement were acute cholecystitis (p=0.007), male sex (p=0.014), and previous surgeries (p=0.021). Three patients needed a subtotal cholecystectomy due to severe inflammation. There was no statistical correlation between the identification of CVS and surgical complications. CONCLUSIONS: The CVS is achieved in most patients. Acute cholecystitis, male sex, and previous abdominal operations are associated with difficulties in obtaining CVS. BACKGROUND (LC surgery (CVS complication AIM success outcomes METHODS 202 taken specialists groups Finally RESULTS 735 73 5 73.5 265 26 26.5 1 8 years 768 76 76.8 female 267 7 26.7 64 64% obese 799 79 9 79.9 group p=0.007, p0007 p p=0.007 , 0 007 (p=0.007) p=0.014, p0014 p=0.014 014 (p=0.014) p=0.021. p0021 p=0.021 . 021 (p=0.021) inflammation CONCLUSIONS 20 73. 2 26. 76. 6 79. p000 p=0.00 00 (p=0.007 p001 p=0.01 01 (p=0.014 p002 p=0.02 02 (p=0.021 p00 p=0.0 (p=0.00 (p=0.01 (p=0.02 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

Resumo Diante das evidências científicas acerca dos malefícios à saúde do consumo de alimentos ultraprocessados, a regulação dos ambientes alimentares vem sendo priorizada como forma de promover uma alimentação adequada e saudável. Nesse contexto, foi proposto o Projeto de Lei 4198/2021 na Assembleia Legislativa do Rio de Janeiro, para proibir o comércio de ultraprocessados nas escolas do estado. Na segunda sessão em plenário da proposição, houve ampla utilização de retóricas conservadoras pelos deputados contrários. Neste presente ensaio foram classificados esses posicionamentos, encontrando-se pontos comuns entre eles, à luz da análise da tramitação legislativa. Ao realizar essa categorização, foi possível identificar três bases argumentativas exploradas: a defesa da liberdade de comércio; o direito à “pátria família”, de primazia da família na educação infantojuvenil; e a responsabilização individual da obesidade. Tais retóricas foram analisadas em conjunto com suas contraposições, presentes nas conclusões da literatura especializada. Para além da pluralidade de ideias do debate legislativo, foi possível identificar como a discussão do PL 4198/21 foi permeada pela reprodução de desinformação e violência. Desse modo, o escrutínio das retóricas conservadoras utilizadas e a compreensão do contexto dessa discussão são contribuições aqui propostas para a consolidação do repertório de defesa da saúde de crianças e adolescentes. saudável 41982021 4198 2021 4198/202 Janeiro estado proposição contrários posicionamentos encontrandose encontrando se eles legislativa categorização exploradas pátria família, , família” infantojuvenil obesidade contraposições especializada legislativo 419821 21 4198/2 violência modo adolescentes 4198202 419 202 4198/20 41982 2 4198/ 419820 41 20 4

Abstract Considering the scientific evidence regarding the harmful effects on health from consuming ultra-processed foods, the regulation on food environments has been prioritized as a way of promoting adequate and healthy eating. In this context, Bill 4198/2021 was proposed in the Legislative assembly of Rio de Janeiro, to ban the sale of ultra-processed foods in the schools in the state. In the second voting session of the proposition conservative rhetoric was widely used by the opposing congressmen. In this essay, these positions were classified, finding common points between them, considering the analysis of the legislative process. In making this categorization, it was possible to identify three argumentative bases that were explored: the defense of freedom of trade; the right to a “family autonomy,” the primacy of the family in children’s education; and individual responsibility for obesity. These rhetorics have been analyzed together with their counterpoint, in the conclusions of the specialized literature. Beyond the plurality of ideas in the legislative debate, it was possible to identify how the discussion of Bill 4198/21 was permeated by the reproduction of disinformation and violence. In this way, the scrutiny of the conservative rhetoric used and the understanding of the context of this discussion are contributions proposed here to consolidate the repertoire of defense of the health of children and adolescents. ultraprocessed ultra processed eating 41982021 4198 2021 4198/202 Janeiro state congressmen essay classified them process categorization explored trade autonomy, autonomy childrens s education obesity counterpoint literature debate 419821 21 4198/2 violence adolescents 4198202 419 202 4198/20 41982 2 4198/ 419820 41 20 4

Objetivo: mapear as características e as finalidades das tecnologias de Realidade Virtual (RV) para os idosos na comunidade. Método: revisão de escopo, segundo às recomendações do JBI e descrito de acordo com o Preferred Reporting Items for Systematic Reviewas and Meta-Analyses Extension for Scoping Reviews . Foram incluídas dez bases de dados e quatro plataformas referentes à literatura cinzenta. A seleção dos estudos foi realizada após a remoção de duplicatas e a avaliação individual e em pares. A análise de similitude foi utilizada para identificar as concorrências entre as palavras e seus resultados. Resultados: foram mapeados 20 estudos de RV para os idosos, sendo a maioria de uso de dispositivos não imersivos. As principais finalidades do uso de RV com os idosos foram melhorar e/ou reabilitar as funções que entram em declínio com o envelhecimento, de forma fisiológica ou advindas de doenças ou agravos. Os dispositivos de RV constituem uma potencial ferramenta para a prevenção de quedas e declínio cognitivo, e favorecem a execução de atividades instrumentais de vida diária. A análise de similitude resultou na geração da árvore máxima, que permitiu identificar a inter-relação com os termos “realidade virtual” e “idoso”, como elemento central e intermediário, respectivamente. Conclusão: recomenda-se o desenvolvimento de novos estudos, em outros ambientes, o que poderá permitir uma maior amplitude no uso de RV, por profissionais de saúde, em especial dos enfermeiros, na assistência prestada aos idosos. Objetivo (RV comunidade Método escopo MetaAnalyses Meta Analyses cinzenta pares resultados Resultados 2 imersivos eou envelhecimento agravos cognitivo diária máxima interrelação inter relação realidade virtual idoso, idoso , “idoso” intermediário respectivamente Conclusão recomendase recomenda se ambientes saúde enfermeiros “idoso

Objective to map the characteristics and purposes of Virtual Reality (VR) technologies for the elderly in the community. Method scoping review, according to JBI recommendations and described according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Ten databases and four platforms referring to gray literature were included. Studies were selected after duplicates were removed and individual and peer reviews were carried out. Similarity analysis was used to identify competition between words and their results. Results 20 studies on VR for the elderly were mapped, the majority of which used non-immersive devices. The main purpose of using VR with the elderly is to improve and/or rehabilitate functions that decline with aging, either physiologically or as a result of illness or injury. VR devices are a potential tool for the prevention of falls and cognitive decline and favor the performance of instrumental activities of daily living. Similarity analysis resulted in the generation of a maximum tree, which identified the interrelationship between the terms “virtual reality” and “elderly” as the central and intermediate elements, respectively. Conclusion it is recommended that further studies be carried out in other environments, which could allow for a wider use of VR by health professionals, especially nurses, in the care provided to the elderly. (VR community review MetaAnalyses Meta Analyses included results 2 mapped nonimmersive non immersive andor aging injury living tree virtual reality “elderly elements respectively environments professionals nurses

Objetivo: mapear las características y las finalidades de las tecnologías de Realidad Virtual (RV) para adultos mayores en la comunidad. Método: revisión de escopo, según la recomendaciones del JBI ( Joanna Briggs Institute ) y descrito de acuerdo con el Preferred Reporting Items for Systematic Reviewas and Meta-Analyses Extension for Scoping Reviews . Fueron incluidas diez bases de datos y cuatro plataformas referentes a la literatura gris. La selección de los estudios fue realizada después de la remoción de duplicados, evaluación individual y también en pares. El análisis de similitud fue utilizado para identificar las afinidades entre las palabras y sus resultados. Resultados: fueron mapeados 20 estudios de RV para los adultos mayores, siendo la mayoría del uso de dispositivos no inmersivos. Las principales finalidades del uso de la RV con adultos mayores fueron mejorar y/o rehabilitar las funciones que entran en declino con el envejecimiento, de forma fisiológica o provenientes de enfermedades o daños. Los dispositivos de RV constituyen una potencial herramienta para la prevención de caídas y disminución cognitiva, y favorecen la ejecución de actividades instrumentales de la vida diaria. El análisis de similitud resultó en la generación del árbol máximo, que permitió identificar la interrelación con los términos “realidad virtual” y “adulto mayor”, como elemento central e intermediario, respectivamente. Conclusión: se recomienda el desarrollo de nuevos estudios, en otros ambientes, para permitir una mayor amplitud en el uso de la RV, por profesionales de la salud, en especial de los enfermeros, en la asistencia prestada a los adultos mayores. Objetivo (RV comunidad Método escopo MetaAnalyses Meta Analyses gris duplicados pares resultados Resultados 2 inmersivos yo envejecimiento daños cognitiva diaria máximo realidad virtual adulto mayor, , mayor” intermediario respectivamente Conclusión ambientes salud enfermeros

Objective: To analyze and identify in the scientific literature how remote teaching is being used and how it was evaluated in postgraduate health courses. Methods: Systematic review with a search in the Virtual Health Library (VHL), with the descriptors distance education, remote learning, residency, graduate studies and health in Portuguese and English, between 2017 and 2021, in Portuguese, English and Spanish. Results: From 750 initial results, 19 articles were included. The United States leads with the largest number of publications on the subject. The evaluation of students who studied through remote teaching is positive. Conclusion: Remote teaching was introduced very quickly for a large number of specialties in the world, with this, even showing positive aspects in this type of teaching, some negative points were evident and that future improvements must be made

Objetivo: Analizar e identificar en la literatura científica el uso de la enseñanza a distancia y su evaluación en los cursos de posgrado en salud. Métodos: Revisión sistemática en las bases de datos Medline, Lilacs, BDEnf, IBECS, BBO y BDENF con los descriptores educación a distancia, aprendizaje a distancia, residencia, estudios de posgrado y salud entre 2017 y 2021, en portugués, inglés y español. Resultados: La búsqueda inicial identificó 750 resultados. En la fase de análisis de títulos y resúmenes quedaron 66 estudios. Finalmente, se incluyeron 19 artículos. Estados Unidos lidera con el mayor número de publicaciones sobre el tema. La valoración de los alumnos que estudiaron a través de la docencia a distancia es positiva. Conclusión: La enseñanza a distancia se implementó muy rápidamente para una gran cantidad de especialidades en el mundo, con lo que, aun mostrando aspectos positivos en este tipo de enseñanza, se evidenciaron algunos puntos negativos y que se deben realizar mejoras futuras

Objetivo: Analisar e identificar na literatura científica a utilização do ensino remoto e sua avaliação em cursos de pós-graduação em saúde. Métodos: Revisão sistemática nas bases de dados Medline, Lilacs, BDEnf, IBECS, BBO e BDENF com os descritores educação a distância, ensino remoto, residência, pós-graduação e saúde entre 2017 a 2021, nos idiomas português, inglês e espanhol. Resultados: A busca inicial identificou 750 resultados. Na fase de análise dos títulos e resumos sobraram 66 estudos. Por fim foram incluídos 19 artigos. Os Estados Unidos lideram com o maior número de publicações acerca do tema. A avaliação dos discentes que estudaram através do ensino remoto é positiva. Conclusão: O ensino remoto foi colocado de forma muito rápida para uma grande quantidade de especialidades no mundo, com isso, mesmo evidenciando-se aspectos positivos nesse tipo de ensino, ficou evidente alguns pontos negativos e que se deve fazer melhorias futuras.

ABSTRACT Monkeypox (MPX) transmission outside non-endemic countries has been reported since May 2022, rapidly evolving into a multi-country outbreak. A potential role of sexual contact in transmission dynamics, as well as a predominance of anogenitallesions, are remarkable features of current cases. Screening for sexually transmitted infections (STIs) plays an important role in the evaluation of patients with suspected MPX infection. Herein we report the first case of a patient diagnosed with both MPX and acute HIV infection in Latin America. He had no major complications during his clinical course, and antiretroviral therapy was promptly initiated. Diagnosis of acute HIV requires a high level of suspicion and appropriate laboratory investigation. Health practitioners need to consider this diagnosis while evaluating patients with suspected MPX with a recent unprotected sexual contact. (MPX nonendemic non endemic 2022 multicountry multi country outbreak dynamics anogenitallesions cases STIs (STIs America course initiated investigation 202 20 2

Resumen Este artículo tiene como objetivo presentar perspectivas sobre el compromiso estudiantil, sus posibilidades y los desafíos encontrados por los estudiantes durante su trayectoria en la educación superior. A través de una investigación bibliométrica, se buscaron publicaciones en la base de datos de SciELO para identificar las diferentes aproximaciones relacionadas con el tema. A partir de los datos recopilados, se seleccionaron 24 artículos para su análisis. Se observó que el término “compromiso estudiantil” abarca diversos aspectos, como el comportamiento, las emociones y los aspectos cognitivos. Además, este término tiene características variadas y particulares. Además, en los artículos se pudo observar que no existe una correlación clara entre el compromiso y el aprendizaje, lo cual puede ser objeto de estudio para investigaciones futuras. estudiantil superior bibliométrica tema recopilados 2 análisis comportamiento cognitivos Además particulares aprendizaje futuras

Resumo O propósito principal deste artigo consiste em fornecer uma ampla variedade de visões e perspectivas a respeito do engajamento estudantil no ensino superior, explorando suas múltiplas possibilidades e os desafios enfrentados pelos alunos ao longo de sua trajetória acadêmica. Assim, com o intuito de realizar uma pesquisa completa e abrangente, realizou-se uma análise bibliométrica na extensa base de dados da SciELO - Scientific Electronic Library Online, com o objetivo de localizar publicações pertinentes ao tema em questão. Desse modo, a partir da seleção criteriosa de 24 artigos, foi possível identificar uma ampla gama de aspectos englobados pelo conceito de “engajamento estudantil”, conglomerando não apenas elementos comportamentais, mas também emocionais e cognitivos. Adicionalmente, percebeu-se que esse termo apresenta características distintas e peculiares, que merecem atenção especial. Ademais, é relevante ressaltar que os artigos analisados não evidenciaram uma correlação clara entre o engajamento e o processo de aprendizagem, o que abre caminho para futuras pesquisas e investigações nesse âmbito. superior acadêmica Assim abrangente realizouse realizou se Online questão modo 2 estudantil, , estudantil” comportamentais cognitivos Adicionalmente percebeuse percebeu peculiares especial Ademais aprendizagem âmbito

Abstract This article aims to present perspectives on student engagement, its possibilities and the challenges faced by students during their path in Higher Education. Thus, through bibliometric research, we searched the SciELO database for publications to identify the different approaches referring to the theme of this work. From the collected data, we selected 24 articles for analysis. We found that the use of the term student engagement encompasses several aspects, such as: behavioral, emotional, and cognitive. In addition, we noticed that the term has varied and peculiar characteristics. Furthermore, we observed in the articles that there is no clear correlation between engagement and learning, a factor that may be the subject of studies for future research. Education Thus research work data 2 analysis aspects as behavioral emotional cognitive addition characteristics Furthermore learning

Abstract Background Recent reports in the literature have indicated that infection by coronavirus disease 2019 (COVID-19) causes cardiac complications, such as heart failure, arrhythmia, myocardial infarction, and even fulminant myocarditis. These complications have been identified as the cause of death in some patients infected with SARS-CoV-2. Objectives To analyze echocardiographic and electrocardiographic changes, treatments used, and clinical outcomes in patients with myocarditis and COVID-19. Methods The items described for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. This review included articles in English, Portuguese, and Spanish that reported cardiac involvement, injury, or myocardial inflammation in patients who acquired COVID-19 (SARS-CoV-2). Results Five databases were consulted to find 1,726 articles. After applying the eligibility criteria, a total of 22 studies were considered qualified. ST-segment (section of the electrocardiogram corresponding the end of the S wave to the beginning of the T wave) elevation and tachyarrhythmia were the most common changes found in the electrocardiographic analysis of patients affected with COVID-19. Concerning echocardiography, there was a high frequency of decreased ejection fraction and occurrence of pericardial effusion. Conclusion This systematic review provides a potential tool for the analysis of cardiac changes and implications caused in patients affected by SARS-CoV-2 infection, with emphasis on the presence of tachyarrhythmia on electrocardiogram (ECG) and decreased ejection fraction on echocardiogram. 201 COVID19 COVID 19 (COVID-19 failure arrhythmia infarction SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. 2 used COVID19. 19. MetaAnalyses Meta Analyses PRISMA (PRISMA followed English Portuguese involvement injury COVID-1 . (SARS-CoV-2) 1726 1 726 1,72 criteria qualified STsegment ST segment section echocardiography effusion SARS-CoV- ECG (ECG echocardiogram 20 COVID1 (COVID-1 COVID- (SARS-CoV-2 172 72 1,7 SARS-CoV (COVID- (SARS-CoV- 17 7 1, (COVID (SARS-CoV

ABSTRACT Background: We evaluated the association between polymorphisms in the tumor necrosis factor alpha (TNF-α) (-G308A) gene and upper gastrointestinal bleeding (UGIB) in schistosomiasis. Methods: This was a transverse study involving 294 Brazilian patients infected with Schistosoma mansoni. Results: The homozygous A/A genotype in TNF-α (-G308A) showed a risk association (prevalence ratio = 1.90, p = 0.008) with UGIB. There was no statistically significant difference in serum TNF-α levels between the clinical groups. Conclusions: The polymorphic TNF-α (-G308A) can be a risk factor for UGIB, in addition to being a potentially predictive factor for the severity of UGIB in schistosomiasis. Background TNFα TNF α (TNF-α G308A GA G A (-G308A (UGIB schistosomiasis Methods 29 mansoni Results AA prevalence 190 1 90 1.90 0.008 0008 0 008 groups Conclusions 2 19 9 1.9 0.00 000 00 1. 0.0 0.

Abstract Spinal muscular atrophy (SMA) is considered one of the most common autosomal recessive disorders, with an estimated incidence of 1 in 10,000 live births. Testing for SMA has been recommended for inclusion in neonatal screening (NBS) panels since there are several therapies available and there is evidence of greater efficacy when introduced in the pre/early symptomatic phases. In Brazil, the National Neonatal Screening Program tests for six diseases, with a new law issued in 2021 stating that it should incorporate more diseases, including SMA. In the present study, dried blood spot (DBS) samples collected by the Reference Services of Neonatal Screening of RS and SP, to perform the conventional test were also screened for SMA, using real-time PCR, with SALSA MC002 technique. A total of 40,000 samples were analyzed, enabling the identification of four positive cases of SMA, that were confirmed by MLPA. Considering our sampling, Brazil seems to have an incidence comparable to the described in other regions. This work demonstrated that the use of the MC002 technique in samples routinely collected for the conventional NBS program is suitable to screen for SMA in our conditions and can be included in the expansion of the neonatal screening programs. (SMA disorders 10000 10 000 10,00 births (NBS preearly pre early phases diseases 202 study DBS (DBS SP realtime real time PCR MC MC00 40000 40 40,00 analyzed MLPA sampling regions programs 1000 00 10,0 20 MC0 4000 4 40,0 100 0 10, 2 400 40,

Resumo Fundamento: Apesar da importância das mulheres na pesquisa clínica, não existe uma avaliação da fração de mulheres em posições de autoria nos periódicos de cardiologia da SBC. Objetivos: Avaliar a fração de mulheres autoras na International Journal of Cardiovascular Sciences (IJCS) e nos Arquivos Brasileiros de Cardiologia (ABC Cardiol) nas últimas décadas. Métodos: Realizamos busca dos artigos originais dos ABC Cardiol, entre 2000 e 2019, e da IJCS, entre 2010 e 2019. Foi feito levantamento do número de primeiras e últimas autoras e do total de artigos originais de 2010 a 2019. Calculamos as proporções totais de autorias femininas e comparamos o primeiro quinquênio com o segundo. Para avaliar a evolução temporal das duas décadas, analisamos apenas dados dos ABC Cardiol. Utilizamos o teste Qui-quadrado para analisar as diferenças dentro de cada revista e entre ambas. O software IBM® SPSS® foi utilizado nas análises. O nível de significância adotado foi de 5%. Resultados: De 2010 a 2019, foram publicados 1157 artigos originais nos ABC Cardiol e 398 na IJCS. Observamos que as mulheres têm maior predominância como primeiras autoras na IJCS em relação aos ABC Cardiol, mas os homens predominam como últimos autores em ambos. De 2010 a 2019, não houve modificação significativa na proporção de autorias femininas. Ao longo das décadas analisadas para os ABC Cardiol, houve projeção de crescimento linear de autorias femininas, sendo que a inclinação da reta é maior na projeção da primeira autoria que na autoria sênior. Conclusões: Há disparidade de gênero com menor representatividade feminina nas autorias dos artigos dos periódicos cardiológicos brasileiros analisados: Arquivos Brasileiros de Cardiologia e International Journal of Cardiovascular Sciences. Acreditamos que a partir destes resultados mais esforços devam ser implementados em busca de equidade de gênero na produção científica cardiológica veiculada por estes periódicos.

Abstract Background: Despite the importance of women in clinical research, no assessment has been made of the fraction of women in a leadership positions in the Cardiology journals of the SBC. Objectives: To assess the fraction of female authors in the International Journal of Cardiovascular Sciences (IJCS) and the Arquivos Brasileiros de Cardiologia (ABC Cardiol) over the last decades. Methods: We searched the original articles of the ABC Cardiol, from 2000 to 2019, and of the IJCS, from 2010 to 2019. We surveyed the number of first and senior female authors and the total number of original articles from 2010 to 2019. We calculated the total proportion of female authorship and compared the first quinquennium with the second. Only data from the ABC Cardiol were analyzed to assess the temporal evolution of the two decades. We used the chi-square test to assess the differences within each journal and between them. The IBM® SPSS® software was used in the analyses. The level of significance adopted was 5%. Results: From 2010 to 2019, 1,157 original articles were published in the ABC Cardiol and 398 in the IJCS. We observed that women are more prevalent as first authors in the IJCS compared to the ABC Cardiol, but men prevail as senior authors in both journals. From 2010 to 2019, there was no significant change in the proportion of female authorship. Throughout the decades analyzed for the ABC Cardiol, there was a projection of linear growth of female authorship, with the slope of the line being greater in the first authorship than in senior authorship. Conclusions: There is gender disparity, with lower female representativeness in authorship in the articles from the Brazilian Cardiology journals analyzed: Arquivos Brasileiros de Cardiologia and International Journal of Cardiovascular Sciences. We believe that based on these results, more efforts should be implemented in the search for gender equity in the cardiology scientific production published by these journals.

RESUMO Objetivo: Avaliar se as escalas de desempenho físico funcional e a pergunta surpresa (“Eu ficaria surpreso se esse paciente morresse em 6 meses?”) predizem limitações de suporte de vida e mortalidade em pacientes críticos não cirúrgicos. Metódos: Participaram desta coorte prospectiva 114 pacientes admitidos do serviço de emergência em uma unidade de terapia intensiva. O desempenho físico funcional foi avaliado pelo Palliative Prognostic Score, pela Escala de Desempenho de Karnofsky e pela escala de Atividades de Vida Diária de Katz. Dois intensivistas responderam à pergunta surpresa. Resultados: Os escores de desempenho físico funcional propostos foram significativamente menores em pacientes com limitações de suporte de vida e naqueles que vieram a óbito durante a hospitalização. A resposta negativa à pergunta surpresa foi mais frequente no mesmo subgrupo de pacientes. A análise univariada ajustada mostrou aumento da razão de chances para limitações de suporte de vida e morte em relação à escala de Atividades de Vida Diária (1,35 [1,01 - 1,78] e 1,34 [1,0 - 1,79], respectivamente) e uma resposta negativa para a pergunta surpresa (42,35 [11,62 - 154,43] e 47,79 [11,41 - 200,25], respectivamente), com p < 0,05 para todos os resultados. Conclusão: Todas as escalas de desempenho físico funcional apresentaram escores mais baixos em não sobreviventes e em pacientes com limitações de suporte de vida. A redução da capacidade funcional prévia à internação e a resposta negativa à pergunta surpresa aumentaram as chances de limitações de suporte de vida e mortalidade em nossa coorte de pacientes não cirúrgicos da unidade de terapia intensiva com entrada no serviço de emergência.

ABSTRACT Objective: To assess whether scales of physical functional performance and the surprise question (“Would I be surprised if this patient died in 6 months?”) predict life support limitations and mortality in critically ill nonsurgical patients. Methods: We included 114 patients admitted from the Emergency Department to an intensive care unit in this prospective cohort. Physical functional performance was assessed by the Palliative Prognostic Score, Karnofsky Performance Status, and the Katz Activities of Daily Living scale. Two intensivists responded to the surprise question. Results: The proposed physical functional performance scores were significantly lower in patients with life support limitations and those who died during the hospital stay. A negative response to the surprise question was more frequent in the same subset of patients. Adjusted univariable analysis showed an increased odds ratio for life support limitations and death regarding the activities of daily living scale (1.35 [1.01 - 1.78] and 1.34 [1.0 - 1.79], respectively) and a negative response for the surprise question (42.35 [11.62 - 154.43] and 47.79 [11.41 - 200.25], respectively); with a p < 0.05 for all results. Conclusion: All physical functional performance scales showed lower scores in nonsurvivors and patients with life support limitations. The activities of daily living score and the surprise question increased the odds of life support limitations and mortality in our cohort of nonsurgical intensive care unit patients admitted from the Emergency Department.

ABSTRACT OBJECTIVE To evaluate the support of the Brazilian population to the alcohol-policies proposed by the World Health Organization to decrease alcohol harm (specifically: to decrease alcohol availability and advertising, and to increase pricing). In addition, we evaluated the factors associated with being against those policies. METHODS Data from 16,273 Brazilians, aged 12–65 years, interviewed in the 3rd Brazilian Household Survey on Substance Use (BHSU-3) were analyzed. The BHSU-3 is a nationwide, probability survey conducted in 2015. Individuals were asked if they would be against, neutral, or in favor of seven alcohol policies grouped as: 1) Strengthen restrictions on alcohol availability; 2) Enforce bans or restrictions on alcohol advertising, sponsorship, and promotion; and 3) Raise prices on alcohol through excise taxes and pricing. Generalized linear models were fitted to evaluate factors associated with being against each one of those policies and against all of policies. RESULTS Overall, 28% of the Brazilians supported all the above mentioned policies, whereas 16% were against them. The highest rate of approval refers to restricting advertising (53%), the lowest refers to increasing prices (40%). Factors associated with being against all policies were: being male (AOR = 1.1; 95%CI: 1.0–1.3), not having a religion (AOR = 1.4; 95%CI: 1.1–1.8), being catholic (AOR = 1.3; 95%CI: 1.1–1.5), and alcohol dependence (AOR = 1.6; 95%CI: 1.1–2.4). CONCLUSIONS The Brazilian government could count on the support of most of the population to restrict alcohol advertising. This information is essential to tackle the lobby of the alcohol industry and its clever marketing strategy.