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‘De repente, tudo fechou’: rede de cuidado à População em Situação de Rua na pandemia de covid-19 De repente fechou fechou’ covid19 covid 19 covid-1 covid1 1 covid-
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Marinho, Rafaela Alves

; Martins, Ana Luisa Jorge

; Souza, Anelise Andrade de

; Fernandes, Luísa da Matta Machado

; Dantas, Ana Carolina de Moraes Teixeira Vilela

; Oliveira, Ana Maria Caldeira

; Paes-Sousa, Rômulo

Saúde em Debate

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aug 2024, Volume 48 N. spe1 elocation e8554

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO A pandemia de covid-19 se impôs de modo mais agudo e dramático aos grupos políticos e socialmente mais vulnerabilizados, como a População em Situação de Rua (PSR). A literatura sobre as respostas às demandas de saúde e de assistência social dos mais vulnerabilizados, durante a pandemia, ainda é escassa. Neste artigo, descreve-se a rede de cuidado à PSR, considerando os caminhos formalmente instituídos e aqueles produzidos durante a pandemia de covid-19, no município de Belo Horizonte. Para tanto, realizaram-se análise documental, visitas técnicas a serviços assistenciais, entrevistas em profundidade e grupos focais com atores que compõem a rede de cuidado. Os resultados mostraram que a rede é composta por quatro componentes com interseções: pela rede da saúde, da assistência social, da Pastoral Nacional do Povo da Rua (sociedade civil organizada) e a rede criada para cuidado de sintomáticos respiratórios. As mudanças de fluxos impostas pela pandemia repercutiram em dificuldades no acesso aos serviços de cuidado da PSR. Contudo, observou-se a potencialidade para a oferta da integralidade do cuidado, mediante articulações realizadas na pandemia entre a saúde, a assistência social e a sociedade civil organizada. covid19 covid 19 covid-1 vulnerabilizados PSR . (PSR) escassa artigo descrevese descreve covid19, 19, Horizonte tanto realizaramse realizaram documental assistenciais interseções organizada respiratórios Contudo observouse observou covid1 1 covid- (PSR

ABSTRACT The COVID-19 pandemic has imposed itself in a acutely and dramatically way, particularly on politically and socially vulnerable groups, such as the homeless population (HP). The literature on health emergency and response and social care needs of the most vulnerable during the pandemic is scarce. This article describes the network of care for HP, including formally instituted pathways of care and those produced during the pandemic of COVID-19, in the city of Belo Horizonte. The methodological path used documentary analysis, technical visits to care services, in-depth interviews and focus groups with the care network stakeholders. The results showed that the network is composed of four components with intersections: the health network, the social care network, the ‘National Pastoral Care of the Homeless People’ (non-governmental organization) and the network created to care for people with respiratory symptoms. The workflow changes imposed by the pandemic resulted in access barriers in different centers offering care for HP. However, it was observed the potentiality of the integral care offer, through the connections built during the pandemic between health, social care, and the non-governmental organizations. COVID19 COVID 19 COVID-1 way HP . (HP) scarce COVID19, 19, Horizonte analysis services indepth depth stakeholders intersections National People nongovernmental non governmental organization symptoms However offer organizations COVID1 1 COVID- (HP

https://doi.org/10.1590/2358-28982024e18554p

Atenção infantil na rede de cuidados à pessoa com deficiência no Brasil: um estudo multicêntrico Brasil
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Mendonça, Ayrles Silva Gonçalves Barbosa

; Oliveira, Bianca Larissa Lesca de

; Fernandes, Tiótrefis Gomes

; Barroso, Ralf Braga

; Ribeiro, Kátia Suely Queiroz Silva

; Schmitt, Ana Carolina Basso

Ciência & Saúde Coletiva

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aug 2024, Volume 29 N. 8 elocation e06802023

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Objetivou-se identificar fatores associados à atenção à saúde infantil na atenção primária à saúde (APS), na perspectiva das ações preconizadas pela Rede de Cuidados à Pessoa Deficiência (RCPCD), quanto à identificação precoce de deficiências e acompanhamento do desenvolvimento infantil. Trata-se de estudo transversal, multicêntrico, realizado em oito estados brasileiros. A coleta de dados envolveu a aplicação de questionário estruturado com profissionais de saúde de nível superior atuantes na APS, com amostra aleatória estratificada por estado e município. Foram realizadas regressões de Poisson com variância robusta para duas variáveis resposta. Entre os 1.488 trabalhadores que compuseram a amostra final, 63,6% realizam ações de identificação precoce de deficiências e 49% efetuam acompanhamento do desenvolvimento infantil. As equipes de Saúde da Família (eSF) identificam e acompanham mais do que as equipes do modelo tradicional, e os Núcleos Ampliados de Saúde da Família e Atenção Básica realizam mais ações de acompanhamento do que essas equipes. Conclui-se que os fatores mais associados com a identificação e o acompanhamento de crianças com deficiências na APS foram aqueles relativos à formação profissional, à eSF e ao conhecimento de normativas relativas à RCPCD. Objetivouse Objetivou se , (APS) RCPCD, RCPCD (RCPCD) Tratase Trata transversal multicêntrico brasileiros município resposta 1488 1 488 1.48 final 636 63 6 63,6 49 (eSF tradicional Concluise Conclui profissional (APS (RCPCD 148 48 1.4 63, 4 14 1.

Abstract The aim of this study was to identify factors associated with early identification of disabilities and developmental follow-up of children in primary health care (PHC) services under the Care Network for People with Disabilities (RCPCD). We conducted a cross-sectional study using data from a multicenter study undertaken in eight states. The data were collected using a structured questionnaire answered by PHC professionals with degree-level qualifications selected using random sampling and stratified by state and municipality. Poisson regression with robust variance was performed for the two outcomes. Of the 1,488 workers in the final sample, 63.6% performed early identification of disabilities and 49% provided developmental follow-up. Family health teams performed early identification of disabilities and follow-up more than traditional model teams, and expanded family health teams provided developmental follow-up more than both these teams. The factors that showed the strongest association with identification and developmental follow-up were profession, working in a family health team and knowledge of the RCPCD. followup follow up (PHC RCPCD . (RCPCD) crosssectional cross sectional states degreelevel degree level municipality outcomes 1488 1 488 1,48 sample 636 63 6 63.6 49 followup. up. profession (RCPCD 148 48 1,4 63. 4 14 1,

https://doi.org/10.1590/1413-81232024298.06802023

Thyroid abnormality in patients with psoriasis: prevalence and association with severity psoriasis
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Fernandes, Luiza de Castro

; Arruda, Ana Carolina Belini Bazan

; Baeninger, Lisa Gava

; Almeida, Debora Pedroso

; Villagelin, Danilo

Anais Brasileiros de Dermatologia

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jan 2024, Volume 99 N. 1 Pages 80 - 89

Abstract: En | Text: En | PDF: En

Abstract Background: Psoriasis is associated with several comorbidities and its association with thyroid abnormality has been hypothesized. Objective: To assess the prevalence of thyroid abnormality in Brazilian patients with psoriasis and to analyze its association with severity, presence of psoriatic arthritis and immunobiological treatment. Additionally, to compare results with literature as a control. Methods: In this observational study, clinical and laboratory data of patients followed from January 2018 to December 2019 were analyzed. Thyroid abnormality was assessed through the current history of thyroid disease and laboratory tests – thyrotropin (TSH), free thyroxine (FT4), antithyroid peroxidase (anti-TPO) and antithyroglobulin (anti-TG) antibodies. Patients were classified according to psoriasis severity – Psoriasis Area and Severity Index (PASI), presence of psoriatic arthritis, and current treatment. Subsequently, the results were compared with a control group selected from the literature review. Results: Of the 250 included patients, 161 were eligible. The prevalence of thyroid abnormality was 28.57% and of hypothyroidism, 14.91%. The mean age was 55 years and the median PASI was 2.2. There was no association between thyroid abnormality and PASI (p = 0.8), presence of psoriatic arthritis (p = 0.87), or use of immunobiological therapy (p = 0.13). The literature control group included 6,227 patients and there was a statistically significant difference for the hypothyroidism variable (p < 0.0001). Background hypothesized Objective treatment Additionally Methods study 201 analyzed TSH, TSH , (TSH) FT4, FT4 FT (FT4) antiTPO anti TPO (anti-TPO antiTG TG (anti-TG antibodies PASI, (PASI) Subsequently review Results 25 16 eligible 2857 28 57 28.57 1491 14 91 14.91% 5 22 2 2.2 p 0.8, 08 0.8 0 8 0.8) 0.87, 087 0.87 87 0.87) 0.13. 013 0.13 . 13 0.13) 6227 6 227 6,22 0.0001. 00001 0.0001 0001 0.0001) 20 (TSH (FT4 (PASI 1 285 28.5 149 9 14.91 2. 0. 01 0.1 622 6,2 0000 0.000 000 (FT 28. 14.9 62 6, 0.00 00 14. 0.0

https://doi.org/10.1016/j.abd.2022.12.007

Malignant tumors affecting the head and neck region in ancient times: Comprehensive study of the CRAB Database times
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AULESTIA-VIERA, Patricia Verónica

; RODRIGUES-FERNANDES, Carla Isabelly

; BRANDÃO, Thaís Bianca

; ROCHA, André Caroli

; VARGAS, Pablo Agustin

; LOPES, Marcio Ajudarte

; JOHNSON, Newell Walter

; KOWALSKI, Luiz Paulo

; RIBEIRO, Ana Carolina Prado

; SANTOS-SILVA, Alan Roger

Brazilian Oral Research

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2024, Volume 38 elocation e014

Abstract: En | Text: En | PDF: En

Abstract In the modern world, cancer is a growing cause of mortality, but archeological studies have shown that it is not exclusive to modern populations. The aim of this study is to examine the epidemiologic, social, and clinicopathologic features of head and neck cancers in ancient populations. To do this, we extracted all records that described malignant lesions in the head and neck region available in the Cancer Research in Ancient Bodies Database (CRAB). The estimated age, sex, physical condition of the remains (skeletonized, mummified), anatomic location of tumors, geographic location, chronology, tumor type, and methods of tumor diagnosis were collected. One hundred and sixty-seven cases were found, mostly originating from Europe (51.5%). Most records were of adults between 35 and 49 years of age (37.7%). The most involved site was the skullcap (60.4%), and the most common malignancies were metastases to the bone (65.3%) and multiple myeloma (17.4%). No primary soft tissue malignancies were registered. The results of our study indicate that head and neck cancers were present in ancient civilizations, at least since 500,000 BCE. The available data can help to improve the current understanding of the global distribution of head and neck cancer and its multidimensional impacts on populations in the contemporary world. world mortality epidemiologic social CRAB. CRAB . (CRAB) sex skeletonized, skeletonized (skeletonized mummified, mummified , mummified) tumors chronology type collected sixtyseven sixty seven found 51.5%. 515 51.5% 51 5 (51.5%) 3 4 37.7%. 377 37.7% 37 7 (37.7%) 60.4%, 604 60.4% 60 (60.4%) 65.3% 653 65 (65.3% 17.4%. 174 17.4% 17 (17.4%) registered civilizations 500000 500 000 500,00 BCE (CRAB 51.5 (51.5% 37.7 (37.7% 60.4 6 (60.4% 65.3 (65.3 17.4 1 (17.4% 50000 50 00 500,0 51. (51.5 37. (37.7 60. (60.4 65. (65. 17. (17.4 5000 0 500, (51. (37. (60. (65 (17. (51 (37 (60 (6 (17 (5 (3 ( (1

https://doi.org/10.1590/1807-3107bor-2024.vol38.0014

Space-temporal analysis of the Specialized Services of the Health Care Network for Persons with Disabilities in Brazil
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Medeiros, Arthur de Almeida

; Schmitt, Ana Carolina Basso

; Zanella, Ângela Kemel

; Silva, Silvia Lanziotti Azevedo da

; Fernandes, Tiótrefis Gomes

; Ribeiro, Kátia Suely Queiroz Silva

Ciência & Saúde Coletiva

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2024, Volume 29 N. 5 elocation e01342023

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Considerando a instituição da Rede de Atenção à Pessoa com Deficiência (RCPD) no Brasil, o estudo analisa a distribuição espacial e a tendência temporal da implantação de serviços especializados que receberam apoio financeiro nos primeiros oito anos dessa política. Realizamos um estudo ecológico com base nos dados do Cadastro Nacional de Estabelecimentos de Saúde no período de abril/2012 a março/2020. Uma regressão joinpoint foi usada para análise de tendência temporal e mapas temáticos foram produzidos para análise espacial de modalidades de reabilitação e tipos de serviços. Os serviços mais disponíveis foram reabilitação física e intelectual. As regiões Sudeste e Nordeste apresentaram maior concentração de serviços especializados. Apesar do menor número de serviços, houve crescimento médio anual entre 9,6% e 41,3%. Esse achado indica aumento de serviços especializados para pessoas com deficiência no período analisado, mas ainda se verificam lacunas assistenciais nas macrorregiões do Brasil.

Abstract Considering the institution of the Care Network for People with Disabilities (RCPD) in Brazil, this study analyzed the spatial distribution and the temporal trend of implementing specialized services that received financial support in the first eight years of this policy. We realized an ecological study based on the National Register of Health Facilities data from April/2012 to March/2020. A joinpoint regression was used for temporal trend analysis, and thematic maps were produced for spatial analysis of rehabilitation modalities and types of services. The most available services were physical and intellectual rehabilitation. The Southeast and Northeast regions had a higher concentration of specialized services. Despite the lower number of services, there was an average annual growth between 9.6% and 41.3%. This finding indicates an increase in specialized services for people with disabilities in the period analyzed, but care gaps are still being verified in the macro-regions of Brazil.

https://doi.org/10.1590/1413-81232024295.01342023

Atenção infantil na rede de cuidados à pessoa com deficiência no Brasil: um estudo multicêntrico
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Mendonça, Ayrles Silva Gonçalves Barbosa

; Oliveira, Bianca Larissa Lesca de

; Fernandes, Tiótrefis Gomes

; Barroso, Ralf Braga

; Ribeiro, Kátia Suely Queiroz Silva

; Schmitt, Ana Carolina Basso

Ciência & Saúde Coletiva

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2024, Volume 29 N. 8 elocation e06802023

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232024298.06802023

Noteworthy records of the ticks Ornithodoros rostratus and Amblyomma sculptum parasitizing Pteronura brasiliensis in the central-western region of Brazil, with pathogen investigation notes centralwestern central western Brazil
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Barros-Battesti, Darci Moraes

; André, Marcos Rogério

; Hoppe, Estevam Guilherme Lux

; Sanches, Gustavo Seron

; Bassini-Silva, Ricardo

; Calchi, Ana Claúdia

; Andrade, Lívia Oliveira

; Perin, Patrícia Parreira

; Martins, Thiago Fernandes

; Castro-Santiago, Ana Carolina

; Leuchtenberger, Caroline

; Almeida, Samara

; Foerster, Nathalie

; Furtado, Mariana

; de Castro Jacinavicius, Fernando

Revista Brasileira de Parasitologia Veterinária

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2024, Volume 33 N. 1 elocation e014523

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Um macho de Pteronura brasiliensis (Carnivora: Mustelidae) foi encontrado morto às margens do Rio Negro, no Pantanal do estado de Mato Grosso do Sul, município de Aquidauana. Dois carrapatos encontrados aderidos à sua pele foram identificados, morfologicamente, como uma ninfa de segundo ínstar de Ornithodoros rostratus (Argasidae) e um macho de Amblyomma sculptum (Ixodidae). Para complementar a identificação morfológica, esses espécimes de carrapatos foram submetidos à extração de DNA e testados por meio de ensaios de PCR, para confirmar a identidade molecular dos espécimes. Além disso, os extraídos dos carrapatos foram testados e revelaram-se negativos nos ensaios de PCR para todos os patógenos testados. Também foram examinados 30 lotes, compostos por 174 indivíduos de O. rostratus, depositados na Coleção Acari do Instituto Butantan, e encontramos material de quatro estados brasileiros, incluindo-se um lote contendo 2 machos e 2 fêmeas de Aquidauana, estado de Mato Grosso do Sul (MS), coletado do solo. Este foi, portanto, o primeiro registro de O. rostratus parasitando P. brasiliensis e o primeiro registro de localidade (Aquidauana). Da mesma forma, A. sculptum é comumente encontrado no Pantanal e relatado aqui, pela segunda vez, parasitando a ariranha, hospedeiro pouco estudado em relação a ectoparasitas. Carnivora (Carnivora Mustelidae Negro Aquidauana identificados morfologicamente Argasidae (Argasidae Ixodidae. Ixodidae . (Ixodidae) morfológica disso revelaramse revelaram se 3 lotes 17 O Butantan brasileiros incluindose incluindo MS, MS , (MS) solo portanto P (Aquidauana) forma A aqui vez ariranha ectoparasitas (Ixodidae 1 (MS (Aquidauana

Abstract A male of Pteronura brasiliensis (Carnivora: Mustelidae) was found dead on the banks of the Rio Negro, in the Pantanal wetlands of Mato Grosso do Sul state, Aquidauana municipality. Two ticks found attached to its skin were morphologically identified as a second-instar nymph of Ornithodoros rostratus (Argasidae) and a male of Amblyomma sculptum (Ixodidae). In order to complement the morphological identification, these tick specimens were subjected to DNA extraction, and tested using PCR assays to confirm the molecular identity the specimens. Also, the tick DNA samples were tested and were negative in the PCR assays for all the pathogens tested. We also examined 30 batches, consisting of 174 individuals of O. rostratus deposited in the Acari Collection of the Butantan Institute, and we found material from four Brazilian states, including one batch containing 2 males and 2 females from Aquidauana, of Mato Grosso do Sul state, collected from the soil. This was therefore the first record of O. rostratus parasitizing P. brasiliensis and the first locality record (Aquidauana). Likewise, A. sculptum is commonly found in the Pantanal and is reported here for the second time parasitizing the giant otter, which is a host little studied regarding the ectoparasites. Carnivora (Carnivora Mustelidae Negro state municipality secondinstar instar Argasidae (Argasidae Ixodidae. Ixodidae . (Ixodidae) identification extraction Also 3 batches 17 O Institute states soil P Aquidauana. (Aquidauana) Likewise otter ectoparasites (Ixodidae 1 (Aquidauana

https://doi.org/10.1590/s1984-29612024003

‘De repente, tudo fechou’: rede de cuidado à População em Situação de Rua na pandemia de covid-19
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Marinho, Rafaela Alves

; Martins, Ana Luisa Jorge

; Souza, Anelise Andrade de

; Fernandes, Luísa da Matta Machado

; Dantas, Ana Carolina de Moraes Teixeira Vilela

; Oliveira, Ana Maria Caldeira

; Paes-Sousa, Rômulo

Saúde em Debate

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2024, Volume 48 N. spe1 elocation e8554

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/2358-28982024e18554p

Space-temporal analysis of the Specialized Services of the Health Care Network for Persons with Disabilities in Brazil Spacetemporal Space temporal
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Medeiros, Arthur de Almeida

; Schmitt, Ana Carolina Basso

; Zanella, Ângela Kemel

; Silva, Silvia Lanziotti Azevedo da

; Fernandes, Tiótrefis Gomes

; Ribeiro, Kátia Suely Queiroz Silva

Ciência & Saúde Coletiva

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2024, Volume 29 N. 5 elocation e01342023

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-81232024295.01342023

10.

Leishmania (Sauroleishmania) tarentolae versus pathogenic species: comparative evaluation of protease activity, glycoconjugates, resistance to complement and metabolome composition Sauroleishmania (Sauroleishmania species activity glycoconjugates
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Andrade, Filipe Fideles Duarte

; Vitório, Jéssica Gardone

; Canuto, Gisele André Baptista

; Nunes, Fernanda Freire Campos

; Rodrigues, Isabela Aurora

; Almeida, Ana Paula Martins Morais

; Nascimento, Frederico Crepaldi

; Costa, Adriana Oliveira

; Vieira, Tamara da Silva

; Silva, Ana Carolina Carvalho

; André, Leiliane Coelho

; Gontijo, Célia Maria Ferreira

; Junqueira, Caroline

; Toledo, Juliano Simões de

; Fernandes, Ana Paula

; Soares, Rodrigo Pedro

Memórias do Instituto Oswaldo Cruz

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2024, Volume 119 elocation e230243

Abstract: En | Text: En | PDF: En

BACKGROUND Leishmania tarentolae is a non-pathogenic species found in lizards representing an important model for Leishmania biology. However, several aspects of this Sauroleishmania remain unknown to explain its low level of virulence. OBJECTIVES We reported several aspects of L. tarentolae biology including glycoconjugates, proteolytic activities and metabolome composition in comparison to pathogenic species (Leishmania amazonensis, Leishmania braziliensis, Leishmania infantum and Leishmania major). METHODS Parasites were cultured for extraction and purification of lipophosphoglycan (LPG), immunofluorescence probing with anti-gp63 and resistance against complement. Parasite extracts were also tested for proteases activity and metabolome composition. FINDINGS Leishmania tarentolae does not express LPG on its surface. It expresses gp63 at lower levels compared to pathogenic species and, is highly sensitive to complement-mediated lysis. This species also lacks intracellular/extracellular activities of proteolytic enzymes. It has metabolic differences with pathogenic species, exhibiting a lower abundance of metabolites including ABC transporters, biosynthesis of unsaturated fatty acids and steroids, TCA cycle, glycine/serine/threonine metabolism, glyoxylate/dicarboxylate metabolism and pentose-phosphate pathways. MAIN CONCLUSIONS The non-pathogenic phenotype of L. tarentolae is associated with alterations in several biochemical and molecular features. This reinforces the need of comparative studies between pathogenic and non-pathogenic species to elucidate the molecular mechanisms of virulence during host-parasite interactions. nonpathogenic non However L glycoconjugates amazonensis braziliensis major. major . major) LPG, , (LPG) antigp63 antigp anti gp anti-gp6 complement surface gp6 complementmediated mediated lysis intracellularextracellular intracellular extracellular enzymes transporters steroids cycle glycineserinethreonine glycine serine threonine glyoxylatedicarboxylate glyoxylate dicarboxylate pentosephosphate pentose phosphate pathways features hostparasite host parasite interactions (LPG antigp6 anti-gp

https://doi.org/10.1590/0074-02760230243

11.

Prospective, randomized, controlled trial assessing the effects of a driving pressure–limiting strategy for patients with acute respiratory distress syndrome due to community-acquired pneumonia (STAMINA trial): protocol and statistical analysis plan Prospective randomized pressurelimiting pressure limiting communityacquired community acquired STAMINA trial)
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Maia, Israel Silva

; Medrado Jr, Fernando Azevedo

; Tramujas, Lucas

; Tomazini, Bruno Martins

; Oliveira, Júlia Souza

; Sady, Erica Regina Ribeiro

; Barbante, Letícia Galvão

; Nicola, Marina Lazzari

; Gurgel, Rodrigo Magalhães

; Damiani, Lucas Petri

; Negrelli, Karina Leal

; Miranda, Tamiris Abait

; Santucci, Eliana

; Valeis, Nanci

; Laranjeira, Ligia Nasi

; Westphal, Glauco Adrieno

; Fernandes, Ruthy Perotto

; Zandonai, Cássio Luis

; Pincelli, Mariangela Pimentel

; Figueiredo, Rodrigo Cruvinel

; Bustamante, Cíntia Loss Sartori

; Norbin, Luiz Fernando

; Boschi, Emerson

; Lessa, Rafael

; Romano, Marcelo Pereira

; Miura, Mieko Cláudia

; Alencar Filho, Meton Soares de

; Dantas, Vicente Cés de Souza

; Barreto, Priscilla Alves

; Hernandes, Mauro Esteves

; Grion, Cintia Magalhães Carvalho

; Laranjeira, Alexandre Sanches

; Mezzaroba, Ana Luiza

; Bahl, Marina

; Starke, Ana Carolina

; Biondi, Rodrigo Santos

; Dal-Pizzol, Felipe

; Caser, Eliana Bernadete

; Thompson, Marlus Muri

; Padial, Andrea Allegrini

; Veiga, Viviane Cordeiro

; Leite, Rodrigo Thot

; Araújo, Gustavo

; Guimarães, Mário

; Martins, Priscilla de Aquino

; Lacerda, Fábio Holanda

; Hoffmann Filho, Conrado Roberto

; Melro, Livia

; Pacheco, Eduardo

; Ospina-Táscon, Gustavo Adolfo

; Ferreira, Juliana Carvalho

; Freires, Fabricio Jocundo Calado

; Machado, Flávia Ribeiro

; Cavalcanti, Alexandre Biasi

; Zampieri, Fernando Godinho

Critical Care Science

Journal Metrics
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2024, Volume 36 elocation e20240210en

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Contexto: Em estudos observacionais sobre a síndrome do desconforto respiratório agudo, sugeriu-se que a driving pressure é o principal fator de lesão pulmonar induzida por ventilador e de mortalidade. Não está claro se uma estratégia de limitação da driving pressure pode melhorar os desfechos clínicos. Objetivo: Descrever o protocolo e o plano de análise estatística que serão usados para testar se uma estratégia de limitação da driving pressure envolvendo a titulação da pressão positiva expiratória final de acordo com a melhor complacência respiratória e a redução do volume corrente é superior a uma estratégia padrão envolvendo o uso da tabela de pressão positiva expiratória final baixa do protocolo ARDSNet, em termos de aumento do número de dias sem ventilador em pacientes com síndrome do desconforto respiratório agudo devido à pneumonia adquirida na comunidade. Métodos: O estudo STAMINA (ventilator STrAtegy for coMmunIty acquired pNeumoniA) é randomizado, multicêntrico e aberto e compara uma estratégia de limitação da driving pressure com a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet em pacientes com síndrome do desconforto respiratório agudo moderada a grave devido à pneumonia adquirida na comunidade internados em unidades de terapia intensiva. Esperamos recrutar 500 pacientes de 20 unidades de terapia intensiva brasileiras e duas colombianas. Eles serão randomizados para um grupo da estratégia de limitação da driving pressure ou para um grupo de estratégia padrão usando a tabela de pressão positiva expiratória final baixa do protocolo ARDSnet. No grupo da estratégia de limitação da driving pressure, a pressão positiva expiratória final será titulada de acordo com a melhor complacência do sistema respiratório. Desfechos: O desfecho primário é o número de dias sem ventilador em 28 dias. Os desfechos secundários são a mortalidade hospitalar e na unidade de terapia intensiva e a necessidade de terapias de resgate, como suporte de vida extracorpóreo, manobras de recrutamento e óxido nítrico inalado. Conclusão: O STAMINA foi projetado para fornecer evidências sobre se uma estratégia de limitação da driving pressure é superior à estratégia da tabela de pressão positiva expiratória final baixa do protocolo ARDSnet para aumentar o número de dias sem ventilador em 28 dias em pacientes com síndrome do desconforto respiratório agudo moderada a grave. Aqui, descrevemos a justificativa, o desenho e o status do estudo. Contexto sugeriuse sugeriu clínicos Objetivo ARDSNet Métodos ventilator pNeumoniA randomizado 50 2 colombianas Desfechos resgate extracorpóreo inalado Conclusão Aqui justificativa 5

ABSTRACT Background: Driving pressure has been suggested to be the main driver of ventilator-induced lung injury and mortality in observational studies of acute respiratory distress syndrome. Whether a driving pressure-limiting strategy can improve clinical outcomes is unclear. Objective: To describe the protocol and statistical analysis plan that will be used to test whether a driving pressure-limiting strategy including positive end-expiratory pressure titration according to the best respiratory compliance and reduction in tidal volume is superior to a standard strategy involving the use of the ARDSNet low-positive end-expiratory pressure table in terms of increasing the number of ventilator-free days in patients with acute respiratory distress syndrome due to community-acquired pneumonia. Methods: The ventilator STrAtegy for coMmunIty acquired pNeumoniA (STAMINA) study is a randomized, multicenter, open-label trial that compares a driving pressure-limiting strategy to the ARDSnet low-positive end-expiratory pressure table in patients with moderate-to-severe acute respiratory distress syndrome due to community-acquired pneumonia admitted to intensive care units. We expect to recruit 500 patients from 20 Brazilian and 2 Colombian intensive care units. They will be randomized to a driving pressure-limiting strategy group or to a standard strategy using the ARDSNet low-positive end-expiratory pressure table. In the driving pressure-limiting strategy group, positive end-expiratory pressure will be titrated according to the best respiratory system compliance. Outcomes: The primary outcome is the number of ventilator-free days within 28 days. The secondary outcomes are in-hospital and intensive care unit mortality and the need for rescue therapies such as extracorporeal life support, recruitment maneuvers and inhaled nitric oxide. Conclusion: STAMINA is designed to provide evidence on whether a driving pressure-limiting strategy is superior to the ARDSNet low-positive end-expiratory pressure table strategy for increasing the number of ventilator-free days within 28 days in patients with moderate-to-severe acute respiratory distress syndrome. Here, we describe the rationale, design and status of the trial. Background ventilatorinduced induced pressurelimiting limiting unclear Objective endexpiratory end expiratory lowpositive low ventilatorfree free communityacquired community Methods (STAMINA multicenter openlabel open label moderatetosevere moderate severe units 50 Outcomes inhospital hospital support oxide Conclusion Here rationale 5

https://doi.org/10.62675/2965-2774.20240210-en

12.

Association between childhood trauma and postpartum depression among Brazilian puerperal women
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Camargo Júnior, Elton Brás

; Andrade, Ana Carolina de Sousa

; Fernandes, Maria Neyrian de Fátima

; Gherardi-Donato, Edilaine Cristina da Silva

Revista Latino-Americana de Enfermagem

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2024, Volume 32 elocation e4170

Abstract: Pt En Es | Text: Pt En Es | PDF: Pt | PDF: En | PDF: Es

Objetivo: avaliar a associação entre diferentes formas de trauma na infância e depressão pós-parto em puérperas brasileiras. Método: estudo transversal incluiu 253 puérperas que foram avaliadas pela Edinburgh Postnatal Depression Scale e pelo Childhood Trauma Questionnaire . Análises multivariadas de regressão logística foram realizadas para verificar a associação entre diferentes tipos de trauma e a coocorrência de formas de abuso e negligência com depressão pós-parto. Resultados: a depressão pós-parto foi identificada em 93 mulheres (36,8%; Intervalo de Confiança de 95%: 30,8-42,7). Todas as formas de trauma na infância avaliadas (abuso emocional, negligência emocional, abuso físico, negligência física e abuso sexual) foram independentemente associadas à depressão pós-parto após ajuste para variáveis de confusão. O abuso emocional permaneceu associado à depressão pós-parto quando foi analisada a coocorrência de todas as formas de trauma na infância. Conclusão: os resultados sugerem associação entre as diferentes formas de trauma na infância e depressão pós-parto. Nesse sentido, o trauma na infância é um indicador para os profissionais de Enfermagem rastrearem fatores de risco de depressão pós-parto durante o acompanhamento obstétrico. Objetivo pósparto pós parto brasileiras Método 25 pósparto. parto. Resultados 9 36,8% 368 36 8 (36,8% 95% 95 30,842,7. 308427 30,8 42,7 30 42 7 30,8-42,7) físico sexual confusão Conclusão sentido obstétrico 2 36,8 3 (36,8 842 30,842,7 30842 308 30, 427 42, 4 30,8-42,7 36, (36, 84 30,842, 3084 30,8-42, (36 30,842 30,8-42 (3 30,84 30,8-4 ( 30,8-

Objective: to evaluate the association between different forms of childhood trauma and postpartum depression in Brazilian puerperal women. Method: this cross-sectional survey included 253 puerperal women who were evaluated using the Edinburgh Postnatal Depression Scale and the Childhood Trauma Questionnaire. Multivariate logistic regression analyses were performed to verify the association of different types of trauma and the co-occurrence of forms of abuse and neglect with postpartum depression. Results: postpartum depression was identified in 93 women (36.8%; 95% Confidence Interval: 30.8-42.7). All forms of childhood trauma assessed (emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse) were independently associated with postpartum depression after adjusting for confounding variables. Emotional abuse remained associated with postpartum depression when the co-occurrence of all forms of childhood trauma was analyzed. Conclusion: the results suggest an association between the different forms of childhood trauma and postpartum depression. In this sense, childhood trauma is an indicator for Nursing professionals to screen for risk factors of postpartum depression during obstetric_follow-up. Objective Method crosssectional cross sectional 25 Questionnaire cooccurrence co occurrence Results 9 36.8% 368 36 8 (36.8% 95 Interval 30.842.7. 308427 30.8 42.7 . 30 42 7 30.8-42.7) variables analyzed Conclusion sense obstetric_followup. obstetricfollowup obstetric_follow up. obstetric follow up obstetric_follow-up 2 36.8 3 (36.8 842 30.842.7 30842 308 30. 427 42. 4 30.8-42.7 followup obstetric_followup obstetricfollow 36. (36. 84 30.842. 3084 30.8-42. (36 30.842 30.8-42 (3 30.84 30.8-4 ( 30.8-

Objetivo: evaluar la asociación entre diferentes formas de traumas en la infancia y depresión posparto en puérperas brasileñas. Método: en este estudio transversal se incluyó a 253 puérperas que fueron evaluadas con la Edinburgh Postnatal Depression Scale y el Childhood Trauma Questionnaire . Se realizaron análisis de regresión logística multivariados para verificar la asociación de diferentes tipos de trauma y la coocurrencia de formas de abuso y negligencia con la depresión posparto. Resultados: se identificó depresión posparto en 93 mujeres (36,8%; intervalo de confianza del 95%: 30,8-42,7). Todas las formas de traumas en la infancia que se evaluaron (abuso emocional, negligencia emocional, abuso físico, negligencia física y abuso sexual) estuvieron asociadas de manera independiente con la depresión posparto después de ajustar por variables de confusión. El abuso emocional siguió estando asociado con la depresión posparto cuando se analizó la coocurrencia de todas las formas de traumas en la infancia. Conclusión: los resultados sugieren una asociación entre las diferentes formas de traumas en la infancia y la depresión posparto. En este sentido, los traumas en la infancia son un indicador para que los profesionales de Enfermería detecten factores de riesgo para la depresión posparto en los controles obstétricos. Objetivo brasileñas Método 25 Resultados 9 36,8% 368 36 8 (36,8% 95% 95 30,842,7. 308427 30,8 42,7 30 42 7 30,8-42,7) físico sexual confusión Conclusión sentido obstétricos 2 36,8 3 (36,8 842 30,842,7 30842 308 30, 427 42, 4 30,8-42,7 36, (36, 84 30,842, 3084 30,8-42, (36 30,842 30,8-42 (3 30,84 30,8-4 ( 30,8-

https://doi.org/10.1590/1518-8345.6761.4170

13.

Risk factors for healthcare-associated infections and their relationship with waves of the COVID-19 pandemic in an intensive care unit: a nested case-control study healthcareassociated healthcare associated COVID19 COVID 19 COVID-1 unit casecontrol case control COVID1 1 COVID-
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Menezes, Fernando Gatti de

; Corrêa, Thiago Domingos

; Bravim, Bruno de Arruda

; Tuma, Paula

; Silva Júnior, Moacyr

; Gouveia, Emy Akiyama

; Toniolo, Alexandra do Rosário

; Paiva, Graziela Geanfrancisco Matta de

; Martineli, Paula Fernanda

; Castagna, Helena Maria Fernandes

; Moraes, Talita Silva Sarro

; Santiago, Ana Carolina

; Gonçalves, Priscila

; Pereira, Brunna Oliveira

; Gonçalves, Nathalia Thomazi

; Malheiro, Daniel Tavares

; Teich, Vanessa Damazio

; Cendoroglo Neto, Miguel

einstein (São Paulo)

Journal Metrics
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2024, Volume 22 elocation eAO0939

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate the risk factors for healthcare-related infections during the COVID-19 pandemic in intensive care units, to investigate the impact of COVID-19 on Central Line-Associated Bloodstream Infection, Catheter-Associated Urinary Tract Infection, and ventilator-associated pneumonia, and to describe healthcare-associated infections in the waves of the COVID-19 pandemic. Methods: This nested case-control study was conducted in a 137-bed adult medical/surgical intensive care unit at a private hospital in São Paulo, Brazil, between January 11, 2019, and May 21, 2022. Case patients were identified using the Nosocomial Infection Control Committee database and control patients were identified using the intensive care unit's EPIMED system. For the analysis of risk factors, the chi-square test, multiple logistic regression model, and Kaplan-Meier method were used to identify independent risk factors, considering p<0.05. Results: The Case Group consisted of 189 healthcare-associated infections, including ventilator-associated pneumonia (61.4%), Central Line-Associated Bloodstream Infection (30.1%), Catheter-Associated Urinary Tract Infection (8.5%), and the Control Group consisted of 6,834 patients. The independent risk factors were COVID-19 infection (OR=2.84, 95%CI=1.92–4.23, p<0.01), length of stay in intensive care greater than 14 days (OR=3.15, 95%CI=1.95–5.14, p<0.01), length of hospital stay greater than 30 days (OR=3.64, 95%CI=2.44–5.51, p<0.01), and patients who were in the third wave (OR=1.72, 95%CI=1.05–2.91, p=0.04). Ventilator-associated pneumonia was the only healthcare-related infection for which COVID-19 infection was an independent risk factor (OR=3.32, 95%CI=1.92–5.94, p<0.01). Conclusion: COVID-19 and length of hospital stay were independent risk factors for healthcare-associated infections, and only ventilator-associated pneumonia was affected by the COVID-19 pandemic. Objective healthcarerelated healthcare related COVID19 COVID 19 COVID-1 units LineAssociated Line Associated CatheterAssociated Catheter ventilatorassociated ventilator associated healthcareassociated Methods casecontrol case 137bed bed 137 medicalsurgical medical surgical Paulo Brazil 11 2019 21 2022 s system chisquare chi square test model KaplanMeier Kaplan Meier p005 p 0 05 p<0.05 Results 18 61.4%, 614 61.4% , 61 4 (61.4%) 30.1%, 301 30.1% 1 (30.1%) 8.5%, 85 8.5% 8 5 (8.5%) 6834 6 834 6,83 OR=2.84, OR284 OR 2 84 (OR=2.84 95CI192423 CI 95 92 23 95%CI=1.92–4.23 p<0.01, p001 p<0.01 01 p<0.01) OR=3.15, OR315 3 15 (OR=3.15 95CI195514 95%CI=1.95–5.14 OR=3.64, OR364 64 (OR=3.64 95CI244551 44 51 95%CI=2.44–5.51 OR=1.72, OR172 72 (OR=1.72 95CI105291 91 95%CI=1.05–2.91 p=0.04. p004 p=0.04 . 04 p=0.04) Ventilatorassociated Ventilator OR=3.32, OR332 32 (OR=3.32 95CI192594 94 95%CI=1.92–5.94 p<0.01. Conclusion COVID1 COVID- 13 201 202 p00 p<0.0 61.4 (61.4% 30.1 (30.1% 8.5 (8.5% 683 83 6,8 OR=2.84 OR28 (OR=2.8 95CI19242 9 95%CI=1.92–4.2 OR=3.15 OR31 (OR=3.1 95CI19551 95%CI=1.95–5.1 OR=3.64 OR36 (OR=3.6 95CI24455 95%CI=2.44–5.5 OR=1.72 OR17 7 (OR=1.7 95CI10529 95%CI=1.05–2.9 p=0.0 OR=3.32 OR33 (OR=3.3 95CI19259 95%CI=1.92–5.9 20 p0 p<0. 61. (61.4 30. (30.1 8. (8.5 68 6, OR=2.8 OR2 (OR=2. 95CI1924 95%CI=1.92–4. OR=3.1 OR3 (OR=3. 95CI1955 95%CI=1.95–5. OR=3.6 95CI2445 95%CI=2.44–5. OR=1.7 OR1 (OR=1. 95CI1052 95%CI=1.05–2. p=0. OR=3.3 95CI1925 95%CI=1.92–5. p<0 (61. (30. (8. OR=2. (OR=2 95CI192 95%CI=1.92–4 OR=3. (OR=3 95CI195 95%CI=1.95–5 95CI244 95%CI=2.44–5 OR=1. (OR=1 95CI105 95%CI=1.05–2 p=0 95%CI=1.92–5 p< (61 (30 (8 OR=2 (OR= 95CI19 95%CI=1.92– OR=3 95%CI=1.95– 95CI24 95%CI=2.44– OR=1 95CI10 95%CI=1.05– p= (6 (3 ( OR= (OR 95CI1 95%CI=1.92 95%CI=1.95 95CI2 95%CI=2.44 95%CI=1.05 95CI 95%CI=1.9 95%CI=2.4 95%CI=1.0 95%CI=1. 95%CI=2. 95%CI=1 95%CI=2 95%CI= 95%CI

https://doi.org/10.31744/einstein_journal/2024ao0939

14.

Recommendations on cutaneous and hematological manifestations of Sjögren’s disease by the Brazilian Society of Rheumatology Sjögrens Sjögren s
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Pugliesi, Alisson

; Egypto, Danielle Christinne Soares do

; Duffles, Guilherme

; Cantali, Diego Ustárroz

; Pasoto, Sandra Gofinet

; Oliveira, Fabiola Reis

; Valim, Valeria

; Lopes, Maria Lucia Lemos

; Miyamoto, Samira Tatiyama

; Fernandes, Marilena Leal Mesquita Silvestre

; Fialho, Sonia Cristina de Magalhães Souza

; Pinheiro, Aysa César

; Santos, Laura Caldas dos

; Appenzeller, Simone

; Ribeiro, Sandra Lucia Euzébio

; Libório-Kimura, Tatiana Nayara

; Santos, Maria Carmen Lopes Ferreira Silva

; Gennari, Juliana D´Agostino

; Pernanbuco, Roberta

; Capobiano, Karina Gatz

; Civile, Vinicius Tassoni

; Pinto, Ana Carolina Pereira Nunes

; Rocha-Filho, César Ramos

; Rocha, Aline Pereira da

; Trevisani, Virginia Fernandes Moça

Advances in Rheumatology

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2024, Volume 64 elocation 51

Abstract: En | Text: En | PDF: En

Abstract Sjogren’s disease (SjD) is an autoimmune disease that is characterized not only by the sicca symptoms it causes but also by its systemic nature, which is capable of several and not yet fully understood extraglandular manifestations. To gain a clearer understanding of these manifestations as well as a better practical approach, a panel of experts from the Brazilian Society of Rheumatology conducted a systematic review and meta-analysis on the identification of epidemiologic and clinical features of the extraglandular manifestations present in ESSDAI (EULAR Sjogren´s syndrome disease activity index), followed by a voting panel with recommendations for clinical practice. This publication is complementary to others already published and covers cutaneous and hematological manifestations, with prevalence data generated by a meta-analysis of 13 clinical or laboratory manifestations and 6 clinical management recommendations. Sjogrens Sjogren s SjD (SjD nature approach metaanalysis meta analysis EULAR index, index , index) practice 1

https://doi.org/10.1186/s42358-024-00391-x

15.

Evaluation of long-term caffeine consumption and cardiovascular risk in medical students longterm long term
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Laureth, Aline Alvarenga

; Manhães, Ana Carolina Tavares Gomes

; Ramos, Letícia Dalla Bernardina Pereira

; Firme, Nathália Rodrighes

; Silva, Bruno Spalenza da

; Quintela-Castro, Fernanda Cristina de Abreu

; Bellettini-Santos, Tatiani

; Teixeira, Sarah Fernandes

Brazilian Journal of Pharmaceutical Sciences

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2024, Volume 60 elocation e23555

Abstract: En | Text: En | PDF: En

Abstract Caffeine consumption by academics, especially those in medical school, is done indiscriminately due to the need to reduce fatigue during their activities and, consequently, increasing their performance. Although it seems to be a harmless practice, it can be related to some health problems. Among these other damages are: arrhythmias, urinary incontinence, loss of appetite, nausea, increased blood pressure, insomnia and sudden death. In this context, this work evaluated cardiovascular damage associated to long-term use of caffeine based on clinical evaluation of students aged 18 years or older in a private medical college in Espírito Santo. Analysis was performed through a brief questionnaire followed by assessment of heart rate and blood pressure. The work was performed with 26 men and 69 women and an average of 70% of the population claimed to consume caffeine. It was also seen that among the students who had the greatest changes in relation to blood pressure were those who were in the 1st and 3rd years of the course. In short, no significant changes were observed in relation to caffeine consumption throughout graduation or cardiovascular impacts associated with its use. However, the evaluated individuals are mostly young and the study follow-up time was short. academics school consequently performance practice problems arrhythmias incontinence appetite nausea death context longterm long term 1 Santo 2 6 70 st rd course short However followup follow up 7

https://doi.org/10.1590/s2175-97902024e23555

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