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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

Diretrizes Brasileiras de Medidas da Pressão Arterial Dentro e Fora do Consultório – 2023 202 20 2
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Feitosa, Audes Diogenes de Magalhães

; Barroso, Weimar Kunz Sebba

; Mion Junior, Decio

; Nobre, Fernando

; Mota-Gomes, Marco Antonio

; Jardim, Paulo Cesar Brandão Veiga

; Amodeo, Celso

; Oliveira, Adriana Camargo

; Alessi, Alexandre

; Sousa, Ana Luiza Lima

; Brandão, Andréa Araujo

; Pio-Abreu, Andrea

; Sposito, Andrei C.

; Pierin, Angela Maria Geraldo

; Paiva, Annelise Machado Gomes de

; Spinelli, Antonio Carlos de Souza

; Machado, Carlos Alberto

; Poli-de-Figueiredo, Carlos Eduardo

; Rodrigues, Cibele Isaac Saad

; Forjaz, Claudia Lucia de Moraes

; Sampaio, Diogo Pereira Santos

; Barbosa, Eduardo Costa Duarte

; Freitas, Elizabete Viana de

; Cestario, Elizabeth do Espirito Santo

; Muxfeldt, Elizabeth Silaid

; Lima Júnior, Emilton

; Campana, Erika Maria Gonçalves

; Feitosa, Fabiana Gomes Aragão Magalhães

; Consolim-Colombo, Fernanda Marciano

; Almeida, Fernando Antônio de

; Silva, Giovanio Vieira da

; Moreno Júnior, Heitor

; Finimundi, Helius Carlos

; Guimarães, Isabel Cristina Britto

; Gemelli, João Roberto

; Barreto-Filho, José Augusto Soares

; Vilela-Martin, José Fernando

; Ribeiro, José Marcio

; Yugar-Toledo, Juan Carlos

; Magalhães, Lucélia Batista Neves Cunha

; Drager, Luciano F.

; Bortolotto, Luiz Aparecido

; Alves, Marco Antonio de Melo

; Malachias, Marcus Vinícius Bolívar

; Neves, Mario Fritsch Toros

; Santos, Mayara Cedrim

; Dinamarco, Nelson

; Moreira Filho, Osni

; Passarelli Júnior, Oswaldo

; Vitorino, Priscila Valverde de Oliveira

; Miranda, Roberto Dischinger

; Bezerra, Rodrigo

; Pedrosa, Rodrigo Pinto

; Paula, Rogerio Baumgratz de

; Okawa, Rogério Toshiro Passos

; Póvoa, Rui Manuel dos Santos

; Fuchs, Sandra C.

; Lima, Sandro Gonçalves de

; Inuzuka, Sayuri

; Ferreira-Filho, Sebastião Rodrigues

; Fillho, Silvio Hock de Paffer

; Jardim, Thiago de Souza Veiga

; Guimarães Neto, Vanildo da Silva

; Koch, Vera Hermina Kalika

; Gusmão, Waléria Dantas Pereira

; Oigman, Wille

; Nadruz Junior, Wilson

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 4 elocation e20240113

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20240113

Condições de vida, nutrição e saúde materno infantil no povo indígena Baniwa, noroeste amazônico, Brasil vida Baniwa amazônico
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Santos Junior, Hernane Guimarães dos

; Ferreira, Aline Alves

; Souza, Mirian Carvalho de

; Garnelo, Luiza

Ciência & Saúde Coletiva

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2024, Volume 29 N. 12 elocation e07152024

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

Resumo Inquéritos epidemiológicos por grupos étnicos são escassos no Brasil. As condições de saúde e nutrição dos povos indígenas, que enfrentam situações de iniquidades e desigualdades sociais, influenciam negativamente seus indicadores de saúde. Esta é a mais ampla investigação sobre o tema já realizada sobre a etnia Baniwa, uma das mais numerosas do país. O inquérito teve como objetivo analisar condições de vida e perfil nutricional de crianças menores 60 meses e de mulheres entre 14 e 49 anos da referida etnia, residentes no noroeste do estado do Amazonas, na Terra Indígena Alto Rio Negro, área fronteiriça entre Brasil, Colômbia e Venezuela. Os resultados apresentam elevadas prevalências de desnutrição crônica em 52,5% (IC95% 48,9-56,1) e anemia em 68,3% (IC95% 64-5-71,8) das crianças menores de 60 meses, além de sobrepeso em 26,3% (IC95% 18,4-27,0) e anemia em 52,3% (IC95% 43,6-53,6) das mulheres. As situações de insegurança alimentar observadas estão ligadas às más condições de renda e saneamento. A magnitude desses agravos expressa a baixa efetividade das ações de atenção primária ofertada pelo sistema de saúde, com expressivo percentual de internações decorrentes de agravos sensíveis aos cuidados básicos em nível de atenção primária. Brasil indígenas sociais Baniwa país 6 1 4 Amazonas Negro Venezuela 525 52 5 52,5 IC95% IC95 IC (IC95 48,956,1 489561 48,9 56,1 48 9 56 48,9-56,1 683 68 3 68,3 64571,8 645718 64 71,8 71 8 64-5-71,8 263 26 26,3 18,427,0 184270 18,4 27,0 18 27 0 18,4-27,0 523 52,3 43,653,6 436536 43,6 53,6 43 53 43,6-53,6 saneamento 52, IC9 (IC9 956 48,956, 48956 489 48, 561 56, 48,9-56, 68, 64571 64571, 718 71, 7 64-5-71, 2 26, 427 18,427, 18427 184 18, 270 27, 18,4-27, 653 43,653, 43653 436 43, 536 53, 43,6-53, (IC 95 48,956 4895 48,9-56 6457 64-5-71 42 18,427 1842 18,4-27 65 43,653 4365 43,6-53 48,95 48,9-5 645 64-5-7 18,42 18,4-2 43,65 43,6-5 48,9- 64-5- 18,4- 43,6- 64-5 64-

Abstract Epidemiological surveys by ethnic groups are scarce in Brazil. The health and nutrition conditions of indigenous peoples who face situations of social inequities and inequalities, negatively influence their health indicators. This study is the widest investigation on the subject ever carried out on the Baniwa ethnic group, one of the most numerous in the country. The survey aimed to analyze the living conditions and nutritional profile of children aged under 60 months and women aged 14 to 49 years of the Baniwa ethnic group, residing in the northwest region of the state of Amazonas, in the Indigenous Land of Alto Rio Negro, an area that serves as a border connecting Brazil, Colombia, and Venezuela. The results show a high prevalence of chronic malnutrition in 52.5% (95%CI 48.9-56.1) and anemia in 68.3% (95%CI 64-5-71.8) of children under 60 months, in addition to overweight in 26.3% (95%CI 18.4-27.0) and anemia in 52.3% (95%CI 43.6-53.6) of the women. The situations of food insecurity observed in this study are linked to poor income and sanitation conditions. The magnitude of these injuries expresses the low effectiveness of primary care actions offered by the health system, with a significant percentage of hospitalizations resulting from injuries sensitive to basic care at the primary care level. Brazil inequalities indicators group country 6 1 4 Amazonas Negro Colombia Venezuela 525 52 5 52.5 95%CI 95CI CI 95 48.956.1 489561 48.9 56.1 48 9 56 48.9-56.1 683 68 3 68.3 64571.8 645718 64 71.8 71 8 64-5-71.8 263 26 26.3 18.427.0 184270 18.4 27.0 18 27 0 18.4-27.0 523 52.3 43.653.6 436536 43.6 53.6 43 53 43.6-53.6 system level 52. 956 48.956. 48956 489 48. 561 56. 48.9-56. 68. 64571 64571. 718 71. 7 64-5-71. 2 26. 427 18.427. 18427 184 18. 270 27. 18.4-27. 653 43.653. 43653 436 43. 536 53. 43.6-53. 48.956 4895 48.9-56 6457 64-5-71 42 18.427 1842 18.4-27 65 43.653 4365 43.6-53 48.95 48.9-5 645 64-5-7 18.42 18.4-2 43.65 43.6-5 48.9- 64-5- 18.4- 43.6- 64-5 64-

Resumen Las encuestas epidemiológicas por grupos étnicos son escasas en Brasil. Las condiciones de salud y nutrición de los pueblos indígenas que enfrentan situaciones de inequidades y desigualdades sociales influyen negativamente en sus indicadores de salud. Este estudio es la investigación más extensa sobre el tema jamás realizada sobre la etnia Baniwa, una de las más numerosas del país. La encuesta tuvo como objetivo analizar las condiciones de vida y el perfil nutricional de niños menores de 60 meses y mujeres entre 14 y 49 años de la etnia Baniwa, residentes en el noroeste del estado de Amazonas, en la Tierra Indígena Alto Río Negro, frontera zona entre Brasil, Colombia y Venezuela. Los resultados muestran alta prevalencia de desnutrición crónica en un 52,5% (IC95% 48,9-56,1) y anemia en un 68,3% (IC95% 64-5-71,8) de los niños menores de 60 meses, además de sobrepeso en un 26,3% (IC95% 18,4-27,0) y anemia en el 52,3% (IC95% 43,6-53,6) de las mujeres. Las situaciones de inseguridad alimentaria observadas están vinculadas a malas condiciones de ingresos y saneamiento. La magnitud de estas condiciones expresa la baja efectividad de las acciones de atención primaria ofrecidas por el sistema de salud, con un porcentaje importante de hospitalizaciones resultantes de condiciones sensibles a la atención básica en el nivel de atención primaria. Brasil Baniwa país 6 1 4 Amazonas Negro Venezuela 525 52 5 52,5 IC95% IC95 IC (IC95 48,956,1 489561 48,9 56,1 48 9 56 48,9-56,1 683 68 3 68,3 64571,8 645718 64 71,8 71 8 64-5-71,8 263 26 26,3 18,427,0 184270 18,4 27,0 18 27 0 18,4-27,0 523 52,3 43,653,6 436536 43,6 53,6 43 53 43,6-53,6 saneamiento 52, IC9 (IC9 956 48,956, 48956 489 48, 561 56, 48,9-56, 68, 64571 64571, 718 71, 7 64-5-71, 2 26, 427 18,427, 18427 184 18, 270 27, 18,4-27, 653 43,653, 43653 436 43, 536 53, 43,6-53, (IC 95 48,956 4895 48,9-56 6457 64-5-71 42 18,427 1842 18,4-27 65 43,653 4365 43,6-53 48,95 48,9-5 645 64-5-7 18,42 18,4-2 43,65 43,6-5 48,9- 64-5- 18,4- 43,6- 64-5 64-

https://doi.org/10.1590/1413-812320242912.07152024

Geochemistry and U-Pb geochronology of columbite of the Cachoeirinha Deposit, Rondônia Tin Province, Brazil UPb U Pb Deposit Province
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Silva, Raquel Guimarães da

; Souza, Valmir da Silva

; Gonçalves, Guilherme de Oliveira

; Ferreira, Luiza dos Santos

; Santos Júnior, Paulo Sérgio Mendes dos

Brazilian Journal of Geology

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2024, Volume 54 N. 1 elocation e20230054

Abstract: En | Text: En | PDF: En

Abstract The Cachoeirinha Sn ± (Nb-Ta) deposit is an important producer of the Rondônia Tin Province. It is inserted in the regional unit named Rondônia Intrusive Suite (995–956 Ma) and hosts granular accumulations of columbite group minerals (CGM) embedded in thick Cenozoic colluvial-alluvial covers. Cachoeirinha CGM have subrounded to angular grains, with irregular to regular internal zoning, micro-inclusion, and exsolution features. They have columbite-(Fe) as the dominant mineral phase, with variation in the Ta/(Ta+Nb) ratio and with Sn, Ti, W, U, Ba, Cr, REE, and V as chemical impurities. It has high total REE content (LREEN depleted, HREEN enriched, Ce and Eu anomalies), δ18O = 2.78‰, and with two U-Pb age groups: 1052 ± 6 and 909 ± 7 Ma. This information indicates that physicochemical oscillations favored the ionic substitutions and resorption mechanisms between Nb ↔ Ta, as well as coupled substitutions with the entry of geochemical impurities, according to the equation: 3(Sn, Ti, U, Si)4+ + (W, Cr)6+ ↔ 2(V, Nb, Ta)5+ + 2(Al, REE)3+ + (Fe, Mn, Ba)2+, at the temperature range between 400° and 500°C. Finally, the Cachoeirinha Sn ± (Nb-Ta) alluvial deposit host ore is related to at least two Neo-Mesoproterozoic magmatic pulses. NbTa Ta (Nb-Ta Province 995–956 995956 995 956 (995–95 Ma (CGM colluvialalluvial colluvial covers grains zoning microinclusion, microinclusion micro inclusion, inclusion micro-inclusion features columbiteFe Fe columbite-(Fe phase Ta/Ta+Nb TaTaNb Ta/ Ta+Nb Ta/(Ta+Nb Ti W U Ba Cr impurities LREEN depleted enriched anomalies, anomalies , anomalies) δO δ O 278 2 78 2.78‰ UPb Pb groups 105 90 equation 3Sn, 3Sn 3 3(Sn Si4+ Si4 Si 4+ 4 Si)4 (W Cr6+ Cr6 6+ Cr)6 2V, 2V V, 2(V Ta5+ Ta5 5+ 5 Ta)5 2Al, 2Al Al Al, 2(Al REE3+ REE3 3+ REE)3 Fe, (Fe Mn Ba2+, Ba2 2+, Ba)2+ 400 500C C 500 500°C Finally NeoMesoproterozoic Neo Mesoproterozoic pulses 995–95 99595 99 95 (995–9 TaNb 27 2.78 10 9 Si) Cr) Ta) REE) Ba2+ 2+ Ba)2 40 50 995–9 9959 (995– 2.7 1 Ba) 995– (995 2. (99 (9 (

https://doi.org/10.1590/2317-4889202420230054

Atitudes diante da morte e espiritualidade em estudantes de Medicina: um ensaio educacional Medicina
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Santos, Luiza Freire de Almeida Barros dos

; Costa, Maria Eduarda Rodrigues

; Santos, Maria Eduarda Barbosa Abrantes

; Melo, Nathallya Thamyres dos Santos

; Ferreira, Alberto Gorayeb de Carvalho

Revista Brasileira de Educação Médica

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2024, Volume 48 N. 2 elocation e044

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

RESUMO Introdução: Apesar de ser parte essencial do cuidado, os profissionais de saúde não recebem, durante a formação, o preparo adequado para que possam lidar com os sentimentos consequentes da morte de um paciente, o que pode gerar impactos negativos no bem-estar deles. Por conta disso, é imprescindível realizar uma reflexão sobre essa temática. Objetivo: Este estudo teve como objetivo analisar as atitudes dos estudantes de Medicina acerca do processo de morte e o índice de espiritualidade antes e depois da vivência do módulo “Saúde do Idoso, Envelhecimento e Terminalidade da Vida”, dirigido aos alunos do oitavo período da Faculdade Pernambucana de Saúde, em 2021. Método: Realizou-se um ensaio educacional, do tipo antes e depois, analítico, baseado na abordagem da morte e do processo de morrer por meio do referido módulo. Os participantes responderam a um questionário contendo as variáveis de interesse e instrumentos validados (Perfil de atitudes frente à morte - Revisado (DAP-R) e Spirituality Self Rating Scale - SSRS). Para análise estatística, adotou-se o teste do qui-quadrado, considerando o valor de p < 0,05. Resultado: Não houve mudança significativa da atitude diante da morte antes e depois do módulo (p = 0,236), destacando-se predominância de atitudes negativas (p = 0,775), em especial evitamento da morte, nos dois momentos do estudo. Entre os estudantes com espiritualidade alta, atitudes negativas também foram mais prevalentes, sem diferença significativa nos períodos pré e pós-módulo. Conclusão: A ausência de mudanças de atitude corrobora a hipótese de que a atual abordagem acerca dessa temática não é suficiente para que os estudantes desenvolvam atitudes adaptativas necessárias para lidar com a morte no âmbito profissional. Introdução cuidado recebem formação paciente bemestar bem estar deles disso Objetivo Saúde Idoso Vida, Vida , Vida” 2021 Método Realizouse Realizou se educacional analítico Perfil DAPR DAP R (DAP-R SSRS. SSRS . SSRS) estatística adotouse adotou quiquadrado, quiquadrado qui quadrado, quadrado qui-quadrado 005 0 05 0,05 Resultado 0,236, 0236 0,236 236 0,236) destacandose destacando 0,775, 0775 0,775 775 0,775) alta prevalentes pósmódulo. pósmódulo pós pós-módulo Conclusão profissional 202 00 0,0 023 0,23 23 077 0,77 77 20 0, 02 0,2 2 07 0,7 7

ABSTRACT Introduction: Despite being an essential part of medical care, professionals do not receive adequate preparation during their training to best face all the feelings resulting from the loss of a patient, generating negative impacts on the well being of these professionals, and justifying the need to reflect on the approach to this theme. Objective: The present study analyzed the attitudes of medical students regarding the process of death and spirituality before and after the completion of the module “Health of the Elderly, Aging, and Terminality of Life”, for medical students of the 8th period at the Faculdade Pernambucana de Saúde, in 2021. Method: This is a clinical educational trial, of the analytical before-and-after type, focused on the approach to death and the dying process through the mentioned module. The participants answered a questionnaire containing the variables of interest and validated instruments (Death Attitude Profile Revised and Spirituality Self Rating Scale). For statistical analysis the chi-square test was used, considering a value of p<0.05. Result: There was no significant change in attitude towards death before and after the module (p=0.236), with a predominance of negative attitudes (p=0.775), especially avoidance of death, in both moments of the study. Among students with high spirituality, negative attitudes were also more prevalent, with no significant difference between the two moments of the survey. Conclusion: The lack of changes in attitude corroborates the hypothesis that the current approach to this topic is not sufficient for students to develop the adaptive attitudes necessary to deal with death in the professional environment. Introduction care patient theme Objective Health Elderly Aging Life, Life , Life” th Saúde 2021 Method trial beforeandafter type Death Scale. Scale . Scale) chisquare chi square used p005 p 0 05 p<0.05 Result p=0.236, p0236 p=0.236 236 (p=0.236) p=0.775, p0775 p=0.775 775 (p=0.775) prevalent survey Conclusion environment 202 p00 p<0.0 p023 p=0.23 23 (p=0.236 p077 p=0.77 77 (p=0.775 20 p0 p<0. p02 p=0.2 2 (p=0.23 p07 p=0.7 7 (p=0.77 p<0 p=0. (p=0.2 (p=0.7 p< p=0 (p=0. p= (p=0 (p= (p

https://doi.org/10.1590/1981-5271v48.2-2023-0137

Assessment of cognitive function in elderly patients with heart failure
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Silva, Leandro Marques da

; Sampaio, Carla Priscilla Belchior Marques

; Guimarães, Nair Eloá dos Santos

; Moreno, Luiza Pinto

; Pontes, Gedean Souza

; Ferreira, Emmanuela de Jesus Furtado

; Figueiredo Neto, José Albuquerque de

Revista da Associação Médica Brasileira

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2024, Volume 70 N. 8 elocation e20240429

Abstract: En | Text: En | PDF: En

SUMMARY OBJECTIVE: To compare the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) tests for the identification of cognitive deficit (CD) in elderly patients with heart failure (HF). METHODS: This was a cross-sectional study with an observational design involving 43 elderly patients with HF of both sexes, treated by the Unified Health System, who were able to understand and follow the study instructions. A sociodemographic and clinical questionnaire and the MMSE and MoCA neurocognitive tests were applied. RESULTS: The mean age of the patients was 67 years; 67.44% were male; 53.49% were white; 58.14% had 1–4 years of schooling; 58.14% had an income of half to one minimum wage; 55.81% were married; 53.49% had a family history of HF; 90.7% denied smoking; 83.72% denied alcohol intake; 65.12% did not practice physical activity; 83.72% were hypertensive; 30.23% were diabetic; 57.89% had LVEF ≥ 50%; 39.53% have NYHA II; and 88.37% did not have a pacemaker. In the identification of CD, the MMSE test detected it in 25.58% of the patients, while the MoCA test identified it in 23.26% (p=0.043). CONCLUSION: It was concluded that the MMSE test performed better than the MoCA test in the identification of CD in elderly patients with HF. OBJECTIVE MiniMental Mini Mental (MMSE (MoCA (CD . (HF) METHODS crosssectional cross sectional 4 sexes System instructions applied RESULTS 6 6744 44 67.44 male 5349 53 49 53.49 white 5814 58 14 58.14 1 1– schooling wage 5581 55 81 55.81 married 907 90 7 90.7 smoking 8372 83 72 83.72 intake 6512 65 12 65.12 activity hypertensive 3023 30 23 30.23 diabetic 5789 57 89 57.89 50% 50 3953 39 39.53 II 8837 88 37 88.37 pacemaker 2558 25 25.58 2326 26 23.26 p=0.043. p0043 p p=0.043 0 043 (p=0.043) CONCLUSION (HF 674 67.4 534 5 53.4 581 58.1 558 8 55.8 9 90. 837 83.7 651 65.1 302 3 2 30.2 578 57.8 395 39.5 883 88.3 255 25.5 232 23.2 p004 p=0.04 04 (p=0.043 67. 53. 58. 55. 83. 65. 30. 57. 39. 88. 25. 23. p00 p=0.0 (p=0.04 p0 p=0. (p=0.0 p=0 (p=0. p= (p=0 (p= (p

https://doi.org/10.1590/1806-9282.20240429

Family caregivers’ perceptions of the quality of primary healthcare services for people with disabilities: a cross-sectional study caregivers disabilities crosssectional cross sectional
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Silva, Luiza de Sousa

; Pontes-Silva, André

; Schott, Eloise

; Figueiredo, Francisco Winter dos Santos

; Santos, Leidiene Ferreira

; Nascimento, Ladislau Ribeiro do

; Quaresma, Fernando Rodrigues Peixoto

Revista da Associação Médica Brasileira

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2024, Volume 70 N. 9 elocation e20240778

Abstract: En | Text: En | PDF: En

SUMMARY BACKGROUND: How do caregivers of people with disabilities perceive the quality of health services in primary healthcare? OBJECTIVE: The objective of this study was to show the quality of health services for people with disabilities in primary healthcare, based on the perceptions of family caregivers. METHODS: This is a cross-sectional study. During data collection, 49 family caregivers who use the center were interviewed. The assessment instruments used were the Socio-Economic and Demographic Questionnaire and the PCATool-Brasil (Primary Care Assessment Tool), in the reduced adult and child versions, to assess the level of essential and derived characteristics of primary healthcare. RESULTS: Women were the main caregivers (40; 82%), and the main disability was mental (28; 58%). The highest scores were observed in affiliation (100%), utilization (73.4%), and information system (83.7%). The lowest scores were found in longitudinal (26.5%), integration of care, available services, services provided (28.6%), and derived scores (28.6–22.4%) related to family guidance and community guidance. The population showed a low orientation toward primary healthcare, with a high total score (22.4%). The economic situation showed a positive association (p=0.017). CONCLUSION: According to the characteristics of primary healthcare, care is fragmented and disjointed and does not meet the needs of people with disabilities and their caregivers. BACKGROUND healthcare OBJECTIVE METHODS crosssectional cross sectional collection 4 interviewed SocioEconomic Socio Economic PCAToolBrasil PCATool Brasil Primary Tool, Tool , Tool) versions RESULTS 40 (40 82%, 82 82% 82%) 28 (28 58%. 58 58% . 58%) 100%, 100 100% (100%) 73.4%, 734 73.4% 73 (73.4%) 83.7%. 837 83.7% 83 7 (83.7%) 26.5%, 265 26.5% 26 5 (26.5%) 28.6%, 286 28.6% 6 (28.6%) 28.6–22.4% 286224 22 (28.6–22.4% 22.4%. 224 22.4% (22.4%) p=0.017. p0017 p p=0.017 0 017 (p=0.017) CONCLUSION (4 8 2 (2 10 (100% 73.4 (73.4% 83.7 (83.7% 26.5 (26.5% 28.6 (28.6% 28.6–22.4 28622 (28.6–22.4 22.4 (22.4% p001 p=0.01 01 (p=0.017 ( 1 (100 73. (73.4 83. (83.7 26. (26.5 28. (28.6 28.6–22. 2862 (28.6–22. 22. (22.4 p00 p=0.0 (p=0.01 (10 (73. (83. (26. (28. 28.6–22 (28.6–22 (22. p0 p=0. (p=0.0 (1 (73 (83 (26 28.6–2 (28.6–2 (22 p=0 (p=0. (7 (8 28.6– (28.6– p= (p=0 (p= (p

https://doi.org/10.1590/1806-9282.20240778

Quality of Formosa Papaya: Effect of Peracetic Acid and Modified Atmosphere Papaya
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Miguel, Luiza Celeste Vieira

; Morais, Patrícia Lígia Dantas de

; Morais, Maria Aparecida dos Santos

; Melo, Marlenildo Ferreira

; Lima, Rydley Klapeyron Bezerra

; Silva, Carla Sonale Azevêdo Soares

; Bezerra, Lucilândia de Sousa

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24230864

Abstract: En | Text: En | PDF: En

Abstract The present work aimed to evaluate the use of modified atmosphere and peracetic acid on the quality and postharvest conservation of organic Formosa 'Tainung I' papaya. The experimental design was completely randomized (DIC) in a (2 x 3) x 5 split-plot scheme, with peracetic acid treatments (with and without 500ppm application) and packaging (Xtend® 815-pp64, Xtend® 815-pp65, and without packaging) in the plot, and days of storage (0, 10, 18, 26, 34 days) in the subplot, with five replicates of one fruit each. Peracetic acid treatment in combination with packaging maintained the postharvest quality attributes of organic Formosa 'Tainung I' papaya during storage. Peracetic acid-treated fruits stored in Packaging 1 (Xtend® 815 pp64) maintained their vitamin C, soluble solids, sugars, and beta-carotene contents. In Packaging 2 (Xtend® 815 pp65), fruits showed better external appearance, maintaining acceptable commercial quality for up to 26 days. Tainung I DIC (DIC ( 3 splitplot split plot scheme ppm application Xtend (Xtend 815pp64, 815pp64 pp pp64, pp64 815-pp64 815pp65, 815pp65 pp65, pp65 815-pp65 0, 0 (0 10 18 subplot each acidtreated treated 81 C solids sugars betacarotene beta carotene contents , pp65) appearance 815pp6 pp6 815-pp6 8 815pp 815-pp

https://doi.org/10.1590/1678-4324-2024230864

Niobium/Hydroxyapatite Composite as a Potential Stimulator of Bone Formation in Critical Size Calvarial Defects in Rats NiobiumHydroxyapatite Niobium Hydroxyapatite
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Silva, Salomé Ribeiro da

; Martins, Agnes Andrade

; Melo, Rômulo Camilo de Oliveira

; Araújo, Valkleidson Santos

; Silva, Davi Neto de Araújo

; Chalmers, Jaclyn

; Silveira, Taciane Menezes da

; Pirih, Flavia Queiroz

; Andrade, Raphael Victor Silva

; Silva, Rafaela Alcindo

; Silva, José Sandro Pereira da

; Delmonte, Mauricio Roberto Bomio

; Motta, Fabiana Villela

; Castro, Mario Andrean Macedo

; Lopes, Maria Luiza Diniz de Sousa

; Leitão, Renata Ferreira Carvalho

; Araújo Júnior, Raimundo Fernandes de

; Clebis, Naianne Kelly

; Araújo, Aurigena Antunes de

Brazilian Archives of Biology and Technology

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2024, Volume 67 elocation e24240152

Abstract: En | Text: En | PDF: En

Abstract This study aimed to analyze the physical features and effect of hydroxyapatite (HAp) and Niobium/HAp CaNb2O6/Ca3(PO4)2 composite on critical size defect in rat calvaria. Biomaterials were characterized by X-ray diffraction (XRD), X-ray fluorescence (XRF), Particle size distribution (PSD) and Scanning Electron Microscopy (SEM). Critical size (8 mm) calvarial defects were created in Wistar rats (n = 24) distributed in three groups (90 days): Control group (CG): critical defect no treatment; HAp group: Hydroxyapatite; CNb/CPO group: CaNb2O6/Ca3(PO4)2 composite. After 90 days, calvaria samples were subjected to histological, and immunohistochemical reactions for osteopontin and osteocalcin, and Micro-CT analyses. XRD analysis confirmed the formation of a crystalline structure of CNb/CPO. XRF measurements confirmed the presence of Nb added in the sample CNb/CPO. Fracture toughness from CNb/CPO composite was 0.82 MPa.m1/2. Micro-CT showed increased trabecular number (p˂0.001), decreased porosities (%) (p˂0.001) and decreased trabecular separation (mm) (p˂0.001) in the CNb/CPO compared to CG group. In CNb/CPO group showed presence of new bone in which connective tissue differentiates to form or indicate a bone matrix score 3 (3-3.75, p˂0.05) and strong immunoexpression of osteopontin (p<0.05). The findings indicate that CNb/CPO showed resistance to the propagation of cracks and stimulated bone formation in calvaria defects in rats. (HAp NiobiumHAp Niobium CaNb2O6/Ca3PO42 CaNb2O6Ca3PO42 CaNbOCaPO CaNb2O6/Ca3 PO4 2 CaNb2O6 Ca3 CaNb O Ca PO CaNb2O6/Ca3(PO4) Xray X ray XRD, , (XRD) XRF, (XRF) PSD (PSD SEM. SEM . (SEM) 8 ( mm n 24 (9 days days) (CG) treatment Hydroxyapatite CNbCPO CNb CPO 9 histological osteocalcin MicroCT Micro CT analyses 082 0 82 0.8 MPam12 MPam MPa m1 m MPa.m1/2 p˂0.001, p0001 p p˂0.001 001 % (% (p˂0.001 (mm 33.75, 3375 3.75, 75 (3-3.75 p˂0.05 p005 05 p<0.05. p<0.05 (p<0.05) Ca3PO42 CaNb2O6/Ca3PO4 CaNb2O6Ca3PO4 CaNb2O6Ca3 CaNbOCa CaNb2O6/Ca CaNbO CaNb2O CaNb2O6/Ca3(PO4 (XRD (XRF (SEM (CG 08 0. MPam1 MPa.m1/ p000 p˂0.00 00 (p˂0.00 33 33.75 337 375 3.75 7 (3-3.7 p˂0.0 p00 p<0.0 (p<0.05 CaPO Ca3PO4 CaNb2O6/Ca3PO CaNb2O6Ca3PO CaNb2O6Ca CaNb2O6/Ca3(PO MPa.m1 (p˂0.0 33.7 37 3.7 (3-3. p˂0. p0 p<0. (p<0.0 Ca3PO MPa.m (p˂0. 33. 3. (3-3 p˂0 p<0 (p<0. (p˂0 (3- p˂ p< (p<0 (p˂ (3 (p< (p

https://doi.org/10.1590/1678-4324-2024240152

10.

Diretriz Brasileira sobre a Saúde Cardiovascular no Climatério e na Menopausa – 2024 202 20 2
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Oliveira, Gláucia Maria Moraes de

; Almeida, Maria Cristina Costa de

; Arcelus, Carolina María Artucio

; Neto Espíndola, Larissa

; Rivera, Maria Alayde Mendonça

; Silva-Filho, Agnaldo Lopes da

; Marques-Santos, Celi

; Fernandes, César Eduardo

; Albuquerque, Carlos Japhet da Matta

; Freire, Claudia Maria Vilas

; Izar, Maria Cristina de Oliveira

; Costa, Maria Elizabeth Navegantes Caetano

; Castro, Marildes Luiza de

; Lemke, Viviana de Mello Guzzo

; Lucena, Alexandre Jorge Gomes de

; Brandão, Andréa Araujo

; Macedo, Ariane Vieira Scarlatelli

; Polanczyk, Carisi Anne

; Lantieri, Carla Janice Baister

; Nahas, Eliana Petri

; Alexandre, Elizabeth Regina Giunco

; Campana, Erika Maria Gonçalves

; Bragança, Érika Olivier Vilela

; Colombo, Fernanda Marciano Consolim

; Barbosa, Imara Correia de Queiroz

; Rivera, Ivan Romero

; Kulak, Jaime

; Moura, Lidia Ana Zytynski

; Pompei, Luciano de Mello

; Baccaro, Luiz Francisco Cintra

; Barbosa, Marcia Melo

; Rodrigues, Marcio Alexandre Hipólito

; Albernaz, Marco Aurelio

; Decoud, Maria Sotera Paniagua de

; Paiva, Maria Sanali Moura de Oliveira

; Sanchez-Zambrano, Martha Beatriz

; Campos, Milena dos Santos Barros

; Acevedo, Monica

; Ramirez, Monica Susana

; Souza, Olga Ferreira de

; Medeiros, Orlando Otávio de

; Carvalho, Regina Coeli Marques de

; Machado, Rogerio Bonassi

; Silva, Sheyla Cristina Tonheiro Ferro da

; Rodrigues, Thais de Carvalho Vieira

; Avila, Walkiria Samuel

; Costa-Paiva, Lucia Helena Simões da

; Wender, Maria Celeste Osorio

Arquivos Brasileiros de Cardiologia

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2024, Volume 121 N. 7 elocation e20240478

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.36660/abc.20240478

11.

Brazilian Guideline on Menopausal Cardiovascular Health – 2024 202 20 2
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Oliveira, Gláucia Maria Moraes de

; Almeida, Maria Cristina Costa de

; Arcelus, Carolina María Artucio

; Espíndola Neto, Larissa

; Rivera, Maria Alayde Mendonça

; Silva-Filho, Agnaldo Lopes da

; Marques-Santos, Celi

; Fernandes, César Eduardo

; Albuquerque, Carlos Japhet da Matta

; Freire, Claudia Maria Vilas

; Izar, Maria Cristina de Oliveira

; Costa, Maria Elizabeth Navegantes Caetano

; Castro, Marildes Luiza de

; Lemke, Viviana de Mello Guzzo

; Lucena, Alexandre Jorge Gomes de

; Brandão, Andréa Araujo

; Macedo, Ariane Vieira Scarlatelli

; Polanczyk, Carisi Anne

; Lantieri, Carla Janice Baister

; Nahas, Eliana Petri

; Alexandre, Elizabeth Regina Giunco

; Campana, Erika Maria Gonçalves

; Bragança, Érika Olivier Vilela

; Colombo, Fernanda Marciano Consolim

; Barbosa, Imara Correia de Queiroz

; Rivera, Ivan Romero

; Kulak, Jaime

; Moura, Lidia Ana Zytynski

; Pompei, Luciano de Mello

; Baccaro, Luiz Francisco Cintra

; Barbosa, Marcia Melo

; Rodrigues, Marcio Alexandre Hipólito

; Albernaz, Marco Aurelio

; Decoud, Maria Sotera Paniagua de

; Paiva, Maria Sanali Moura de Oliveira

; Sanchez-Zambrano, Martha Beatriz

; Campos, Milena dos Santos Barros

; Acevedo, Monica

; Ramirez, Monica Susana

; Souza, Olga Ferreira de

; Medeiros, Orlando Otávio de

; Carvalho, Regina Coeli Marques de

; Machado, Rogerio Bonassi

; Silva, Sheyla Cristina Tonheiro Ferro da

; Rodrigues, Thais de Carvalho Vieira

; Avila, Walkiria Samuel

; Costa-Paiva, Lucia Helena Simões da

; Wender, Maria Celeste Osorio

Revista Brasileira de Ginecologia e Obstetrícia

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2024, Volume 46 elocation e-rbgo100

Abstract: En | Text: En | PDF: En

https://doi.org/10.61622/rbgo/2024rbgo100

12.

Safety of CoronaVac and ChAdOx1 vaccines against SARS-CoV-2 in patients with rheumatoid arthritis: data from the Brazilian multicentric study safer ChAdOx SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- arthritis SARS-CoV
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Cruz, Vitor Alves

; Guimarães, Camila

; Rêgo, Jozelia

; Machado, Ketty Lysie Libardi Lira

; Miyamoto, Samira Tatiyama

; Burian, Ana Paula Neves

; Dias, Laiza Hombre

; Pretti, Flavia Zon

; Batista, Danielle Cristina Filgueira Alves

; Mill, José Geraldo

; Oliveira, Yasmin Gurtler Pinheiro de

; Gadelha, Carolina Strauss Estevez

; Gouveia, Maria da Penha Gomes

; Moulin, Anna Carolina Simões

; Souza, Bárbara Oliveira

; Aguiar, Laura Gonçalves Rodrigues

; Vieira, Gabriel Smith Sobral

; Grillo, Luiza Lorenzoni

; Lima, Marina Deorce de

; Pasti, Laís Pizzol

; Surlo, Heitor Filipe

; Faé, Filipe

; Moulaz, Isac Ribeiro

; Macabú, Mariana de Oliveira

; Ribeiro, Priscila Dias Cardoso

; Magalhães, Vanessa de Oliveira

; Aguiar, Mariana Freitas de

; Biegelmeyer, Erika

; Peixoto;, Flávia Maria Matos Melo Campos

; Kayser, Cristiane

; Souza, Alexandre Wagner Silva de

; Castro, Charlles Heldan de Moura

; Ribeiro, Sandra Lúcia Euzébio

; Telles, Camila Maria Paiva França

; Bühring, Juliana

; Lima, Raquel Lima de

; Santos, Sérgio Henrique Oliveira Dos

; Dias, Samuel Elias Basualto

; Melo, Natália Seixas de

; Sanches, Rosely Holanda da Silva

; Boechat, Antonio Luiz

; Sartori, Natália Sarzi

; Hax, Vanessa

; Dória, Lucas Denardi

; Rezende, Rodrigo Poubel Vieira de

; Baptista, Katia Lino

; Fortes, Natália Rodrigues Querido

; Melo, Ana Karla Guedes de

; Melo, Tâmara Santos

; Vieira, Rejane Maria Rodrigues de Abreu

; Vieira, Adah Sophia Rodrigues

; Kakehasi, Adriana Maria

; Tavares, Anna Carolina Faria Moreira Gomes

; Landa, Aline Teixeira de

; Costa, Pollyana Vitoria Thomaz da

; Azevedo, Valderilio Feijó

; Martins-Filho, Olindo Assis

; Peruhype-Magalhães, Vanessa

; Pinheiro, Marcelo de Medeiros

; Monticielo, Odirlei André

; Reis-neto, Edgard Torres Dos

; Ferreira, Gilda Aparecida

; Souza, Viviane Angelina de

; Teixeira-Carvalho, Andréa

; Xavier, Ricardo Machado

; Sato, Emilia Inoue

; Valim, Valeria

; Pileggi, Gecilmara Salviato

; Silva, Nilzio Antonio da

Advances in Rheumatology

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2024, Volume 64 elocation 58

Abstract: En | Text: En | PDF: En

Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26

https://doi.org/10.1186/s42358-024-00397-5

13.

Condições de vida, nutrição e saúde materno infantil no povo indígena Baniwa, noroeste amazônico, Brasil
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Santos Junior, Hernane Guimarães dos

; Ferreira, Aline Alves

; Souza, Mirian Carvalho de

; Garnelo, Luiza

Ciência & Saúde Coletiva

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2024, Volume 29 N. 12 elocation e07152024

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

https://doi.org/10.1590/1413-812320242912.07152024

14.

Cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for use on Brazilian adolescents Crosscultural Cross cultural DHLI (DHLI
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Barbosa, Mariane Carolina Faria

; Baldiotti, Ana Luiza Peres

; Braga, Náyra Santos

; Lopes, Camila Takáo

; Paiva, Saul Martins

; Granville-Garcia, Ana Flávia

; Ferreira, Fernanda de Morais

Brazilian Dental Journal

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oct 2023, Volume 34 N. 5 Pages 104 - 114

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

Resumo O estudo teve o objetivo de adaptar transculturalmente o Digital Health Literacy Instrument (DHLI) para adolescentes nativos do idioma português do Brasil (DHLI-BrA). O estudo de adaptação transcultural consistiu nas seguintes etapas: tradução, avaliação e adequação de equivalência cultural da tradução por comitê de especialistas; retrotradução e síntese das retrotraduções. Foi realizada a testagem cognitiva em pré-teste com adolescentes, utilizando-se entrevistas cognitivas com perguntas de sondagem sobre a compreensão e interpretação dos itens e opções de resposta. O alfa de Cronbach e ômega de McDonald’s foram utilizados para estimar a confiabilidade do instrumento. Participaram do pré-teste 42 adolescentes brasileiros com média de idade de 16,0 ± 2,0 (variação de 13-19) anos. Os itens com dificuldade de compreensão foram adaptados ao contexto dos adolescentes brasileiros. O coeficiente alfa de Cronbach e o ômega de McDonald’s, para os 21 itens do DHLI-BrA foi respectivamente, 0,79 e 0,80. O coeficiente alfa de Cronbach para as subescalas do instrumento de autorrelato foi de 0,53-0,79 (variação), demonstrando boa confiabilidade no instrumento total e confiabilidade moderada nas subescalas. Este estudo fornece a versão adaptada transculturalmente do Digital Health Literacy Instrument (DHLI), um instrumento de mensuração do letramento digital em saúde, para utilização em adolescentes brasileiros (DHLI-BrA). DHLI (DHLI DHLIBrA. DHLIBrA BrA . (DHLI-BrA) etapas especialistas retrotraduções préteste pré teste utilizandose utilizando se resposta McDonalds McDonald s 4 160 16 0 16, 20 2 2, variação 1319 13 19 13-19 anos McDonalds, s, respectivamente 079 79 0,7 080 80 0,80 0,530,79 053079 0,53 53 0,53-0,7 variação, , (variação) DHLI, saúde (DHLI-BrA 1 131 13-1 07 7 0, 08 8 0,8 530 0,530,7 05307 053 0,5 5 0,53-0, 13- 0,530, 0530 05 0,53-0 0,530 0,53-

Abstract The present study aimed to perform the cross-cultural adaptation of the Digital Health Literacy Instrument (DHLI) for native Brazilian Portuguese-speaking adolescents (DHLI-BrA). Cross-cultural adaptation consisted of the following steps: translation, assessment, and adjustments by the expert committee to ensure cultural equivalence; back-translation, and synthesis of back-translations. Cognitive testing was then performed in a pretest with adolescents using cognitive interviews with probing questions on the item's understanding interpretation and response options. Cronbach’s alpha coefficient and McDonald’s omega were used to estimate the instrument’s reliability. Forty-two Brazilian adolescents participated in the study (mean age: 16.0 ± 2.0 years; range: 13 to 19 years). Items that were difficult to understand were adapted to the context of Brazilian adolescents. Cronbach’s alpha coefficient and McDonald’s omega for the 21 items of the DHLI-BrA were, respectively, 0.79 and 0.80. Cronbach’s alpha coefficient for the subscales of the self-report instrument was 0.53-0.79 (range), demonstrating good reliability in the total instrument and moderate reliability in the subscales. This study provides the cross-cultural adapted version of the Digital Health Literacy Instrument (DHLI), which is an instrument for measuring digital Health literacy, for use in Brazilian adolescents (DHLI-BrA). crosscultural cross DHLI (DHLI Portuguesespeaking Portuguese speaking DHLIBrA. DHLIBrA BrA . (DHLI-BrA) Crosscultural Cross steps translation assessment equivalence backtranslation, backtranslation back back-translation backtranslations. backtranslations translations. translations back-translations item s options Cronbachs Cronbach McDonalds McDonald instruments Fortytwo Forty two mean age 160 16 0 16. 20 2 2. years range 1 years. years) respectively 079 79 0.7 080 80 0.80 selfreport self report 0.530.79 053079 0.53 53 0.53-0.7 range, , (range) DHLI, literacy (DHLI-BrA 07 7 0. 08 8 0.8 530 0.530.7 05307 053 0.5 5 0.53-0. (range 0.530. 0530 05 0.53-0 0.530 0.53-

https://doi.org/10.1590/0103-6440202305346

15.

[SciELO Preprints] - Brazilian Guidelines for In-office and Out-of-office Blood Pressure Measurement – 2023
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Feitosa, Audes Diógenes de Magalhães Barroso, Weimar Kunz Sebba Mion Júnior, Décio Nobre, Fernando Mota-Gomes, Marco Antonio Jardim, Paulo Cesar Brandão Veiga Amodeo, Celso Camargo, Adriana Alessi, Alexandre Sousa, Ana Luiza Lima Brandão, Andréa Araujo Pio-Abreu, Andrea Sposito, Andrei Carvalho Pierin, Angela Maria Geraldo Paiva, Annelise Machado Gomes de Spinelli, Antonio Carlos de Souza Machado, Carlos Alberto Poli-de-Figueiredo, Carlos Eduardo Rodrigues, Cibele Isaac Saad Forjaz, Cláudia Lúcia de Moraes Sampaio, Diogo Pereira Santos Barbosa, Eduardo Costa Duarte Freitas, Elizabete Viana de Cestário , Elizabeth do Espírito Santo Muxfeldt, Elizabeth Silaid Lima Júnior, Emilton Campana, Erika Maria Gonçalves Feitosa, Fabiana Gomes Aragão Magalhães Consolim-Colombo, Fernanda Marciano Almeida, Fernando Antônio de Silva, Giovanio Vieira da Moreno Júnior, Heitor Finimundi, Helius Carlos Guimarães, Isabel Cristina Britto Gemelli, João Roberto Barreto Filho, José Augusto Soares Vilela-Martin, José Fernando Ribeiro, José Marcio Yugar-Toledo, Juan Carlos Magalhães, Lucélia Batista Neves Cunha Drager, Luciano Ferreira Bortolotto, Luiz Aparecido Alves, Marco Antonio de Melo Malachias, Marcus Vinícius Bolívar Neves, Mario Fritsch Toros Santos, Mayara Cedrim Dinamarco, Nelson Moreira Filho, Osni Passarelli Júnior, Oswaldo Valverde de Oliveira Vitorino, Priscila Valverde de Oliveira Miranda, Roberto Dischinger Bezerra, Rodrigo Pedrosa, Rodrigo Pinto Paula, Rogério Baumgratz de Okawa, Rogério Toshiro Passos Póvoa, Rui Manuel dos Santos Fuchs, Sandra C. Inuzuka, Sayuri Ferreira-Filho, Sebastião R. Paffer Fillho, Silvio Hock de Jardim, Thiago de Souza Veiga Guimarães Neto, Vanildo da Silva Koch, Vera Hermina Gusmão, Waléria Dantas Pereira Oigman, Wille Nadruz, Wilson

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Publication date: 2023-09-23

Abstract: En Es Pt

Hypertension is one of the primary modifiable risk factors for morbidity and mortality worldwide, being a major risk factor for coronary artery disease, stroke, and kidney failure. Furthermore, it is highly prevalent, affecting more than one-third of the global population. Blood pressure measurement is a MANDATORY procedure in any medical care setting and is carried out by various healthcare professionals. However, it is still commonly performed without the necessary technical care. Since the diagnosis relies on blood pressure measurement, it is clear how important it is to handle the techniques, methods, and equipment used in its execution with care. It should be emphasized that once the diagnosis is made, all short-term, medium-term, and long-term investigations and treatments are based on the results of blood pressure measurement. Therefore, improper techniques and/or equipment can lead to incorrect diagnoses, either underestimating or overestimating values, resulting in inappropriate actions and significant health and economic losses for individuals and nations. Once the correct diagnosis is made, as knowledge of the importance of proper treatment advances, with the adoption of more detailed normal values and careful treatment objectives towards achieving stricter blood pressure goals, the importance of precision in blood pressure measurement is also reinforced. Blood pressure measurement (described below) is usually performed using the traditional method, the so-called casual or office measurement. Over time, alternatives have been added to it, through the use of semi-automatic or automatic devices by the patients themselves, in waiting rooms or outside the office, in their own homes, or in public spaces. A step further was taken with the use of semi-automatic devices equipped with memory that allow sequential measurements outside the office (ABPM; or HBPM) and other automatic devices that allow programmed measurements over longer periods (HBPM). Some aspects of blood pressure measurement can interfere with obtaining reliable results and, consequently, cause harm in decision-making. These include the importance of using average values, the variation in blood pressure during the day, and short-term variability. These aspects have encouraged the performance of a greater number of measurements in various situations, and different guidelines have advocated the use of equipment that promotes these actions. Devices that perform HBPM or ABPM, which, in addition to allowing greater precision, when used together, detect white coat hypertension (WCH), masked hypertension (MH), sleep blood pressure alterations, and resistant hypertension (RHT) (defined in Chapter 2 of this guideline), are gaining more and more importance. Taking these details into account, we must emphasize that information related to diagnosis, classification, and goal setting is still based on office blood pressure measurement, and for this reason, all attention must be given to the proper execution of this procedure.

La hipertensión arterial (HTA) es uno de los principales factores de riesgo modificables para la morbilidad y mortalidad en todo el mundo, siendo uno de los mayores factores de riesgo para la enfermedad de las arterias coronarias, el accidente cerebrovascular (ACV) y la insuficiencia renal. Además, es altamente prevalente y afecta a más de un tercio de la población mundial. La medición de la presión arterial (PA) es un procedimiento OBLIGATORIO en cualquier atención médica o realizado por diferentes profesionales de la salud. Sin embargo, todavía se realiza comúnmente sin los cuidados técnicos necesarios. Dado que el diagnóstico se basa en la medición de la PA, es claro el cuidado que debe haber con las técnicas, los métodos y los equipos utilizados en su realización. Debemos enfatizar que una vez realizado el diagnóstico, todas las investigaciones y tratamientos a corto, mediano y largo plazo se basan en los resultados de la medición de la PA. Por lo tanto, las técnicas y/o equipos inadecuados pueden llevar a diagnósticos incorrectos, subestimando o sobreestimando valores y resultando en conductas inadecuadas y pérdidas significativas para la salud y la economía de las personas y las naciones. Una vez realizado el diagnóstico correcto, a medida que avanza el conocimiento sobre la importancia del tratamiento adecuado, con la adopción de valores de normalidad más detallados y objetivos de tratamiento más cuidadosos hacia metas de PA más estrictas, también se refuerza la importancia de la precisión en la medición de la PA. La medición de la PA (descrita a continuación) generalmente se realiza mediante el método tradicional, la llamada medición casual o de consultorio. Con el tiempo, se han agregado alternativas a través del uso de dispositivos semiautomáticos o automáticos por parte del propio paciente, en salas de espera o fuera del consultorio, en su propia residencia o en espacios públicos. Se dio un paso más con el uso de dispositivos semiautomáticos equipados con memoria que permiten mediciones secuenciales fuera del consultorio (AMPA; o MRPA) y otros automáticos que permiten mediciones programadas durante períodos más largos (MAPA). Algunos aspectos en la medición de la PA pueden interferir en la obtención de resultados confiables y, en consecuencia, causar daños en las decisiones a tomar. Estos incluyen la importancia de usar valores promedio, la variación de la PA durante el día y la variabilidad a corto plazo. Estos aspectos han alentado la realización de un mayor número de mediciones en diversas situaciones, y diferentes pautas han abogado por el uso de equipos que promuevan estas acciones. Los dispositivos que realizan MRPA o MAPA, que además de permitir una mayor precisión, cuando se usan juntos, detectan la hipertensión de bata blanca (HBB), la hipertensión enmascarada (HM), las alteraciones de la PA durante el sueño y la hipertensión resistente (HR) (definida en el Capítulo 2 de esta guía), están ganando cada vez más importancia. Teniendo en cuenta estos detalles, debemos enfatizar que la información relacionada con el diagnóstico, la clasificación y el establecimiento de objetivos todavía se basa en la medición de la presión arterial en el consultorio, y por esta razón, se debe prestar toda la atención a la ejecución adecuada de este procedimiento.

A hipertensão arterial (HA) é um dos principais fatores de risco modificáveis para morbidade e mortalidade em todo o mundo, sendo um dos maiores fatores de risco para doença arterial coronária, acidente vascular cerebral (AVC) e insuficiência renal. Além disso, é altamente prevalente e atinge mais de um terço da população mundial. A medida da PA é procedimento OBRIGATÓRIO em qualquer atendimento médico ou realizado por diferentes profissionais de saúde. Contudo, ainda é comumente realizada sem os cuidados técnicos necessários. Como o diagnóstico se baseia na medida da PA, fica claro o cuidado que deve haver com as técnicas, os métodos e os equipamentos utilizados na sua realização. Deve-se reforçar que, feito o diagnóstico, toda a investigação e os tratamentos de curto, médio e longo prazos são feitos com base nos resultados da medida da PA. Assim, técnicas e/ou equipamentos inadequados podem levar a diagnósticos incorretos, tanto subestimando quanto superestimando valores e levando a condutas inadequadas e grandes prejuízos à saúde e à economia das pessoas e das nações. Uma vez feito o diagnóstico correto, na medida em que avança o conhecimento da importância do tratamento adequado, com a adoção de valores de normalidade mais detalhados e com objetivos de tratamento mais cuidadosos no sentido do alcance de metas de PA mais rigorosas, fica também reforçada a importância da precisão na medida da PA. A medida da PA (descrita a seguir) é habitualmente feita pelo método tradicional, a assim chamada medida casual ou de consultório. Ao longo do tempo, foram agregadas alternativas a ela, mediante o uso de equipamentos semiautomáticos ou automáticos pelo próprio paciente, nas salas de espera ou fora do consultório, em sua própria residência ou em espaços públicos. Um passo adiante foi dado com o uso de equipamentos semiautomáticos providos de memória que permitem medidas sequenciais fora do consultório (AMPA; ou MRPA) e outros automáticos que permitem medidas programadas por períodos mais prolongados (MAPA). Alguns aspectos na medida da PA podem interferir na obtenção de resultados fidedignos e, consequentemente, causar prejuízo nas condutas a serem tomadas. Entre eles, estão: a importância de serem utilizados valores médios, a variação da PA durante o dia e a variabilidade a curto prazo. Esses aspectos têm estimulado a realização de maior número de medidas em diversas situações, e as diferentes diretrizes têm preconizado o uso de equipamentos que favoreçam essas ações. Ganham cada vez mais espaço os equipamentos que realizam MRPA ou MAPA, que, além de permitirem maior precisão, se empregados em conjunto, detectam a HA do avental branco (HAB), HA mascarada (HM), alterações da PA no sono e HA resistente (HAR) (definidos no Capítulo 2 desta diretriz). Resguardados esses detalhes, devemos ressaltar que as informações relacionadas a diagnóstico, classificação e estabelecimento de metas ainda são baseadas na medida da PA de consultório e, por esse motivo, toda a atenção deve ser dada à realização desse procedimento.

https://doi.org/10.1590/SciELOPreprints.7057

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