Abstract This study aimed to develop and validate a self-administered questionnaire in Brazilian Portuguese to verify the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women, named “Considerations on Orthodontic Treatment during Pregnancy, Lactation, and Postmenopausal Periods.” The development and validation of the questionnaire consisted of the following steps: a) item generation; b) item reduction; c) questionnaire design; and d) validity and reliability tests in a cross-sectional study with 258 orthodontists working in the field from different Brazilian states. A total of 60 orthodontists participated in test-retest over a mean period of 45 days. The preliminary questionnaire consisted of a total of 60 questions. After item reduction, 40 questions were selected for the final version of the questionnaire, with eight questions about pregnant women; six about lactating women; 18 about postmenopausal women, and eight about general knowledge in dentistry. Each item had three response options in the Likert scale format. Face and content validity analysis, reliability assessment through internal consistency (Cronbach’s alpha and McDonald’s omega), and test-retest reliability through the intraclass correlation coefficient (ICC) and Spearman’s correlation coefficient were performed. Face and content validity indicated that the questionnaire was considered valid, objective, and easily understandable. The questionnaire had good internal consistency (Cronbach’s alpha = 0.77; McDonald’s omega = 0.78) and good test-retest reliability (ICC = 0.71; Spearman’s correlation coefficient = 0.51). The questionnaire was considered valid and reliable to assess the level of knowledge of orthodontists in the care of pregnant, lactating, and postmenopausal women. selfadministered self administered women Considerations Pregnancy Lactation Periods. Periods steps generation b reduction c design d crosssectional cross sectional 25 states 6 testretest test retest 4 days 1 dentistry format analysis Cronbachs Cronbach s McDonalds McDonald omega, , omega) ICC Spearmans Spearman performed objective understandable 0.77 077 0 77 0.78 078 78 0.71 071 71 0.51. 051 0.51 . 51 0.51) 2 0.7 07 7 05 0.5 5 0.

Resumo Atrofia muscular espinhal ligada ao cromossomo 5 (AME-5q) é uma doença genética de herança autossômica recessiva causada por mutações no gene SMN1. A AME-5q cursa com degeneração progressiva dos motoneurônios medulares e bulbares, acarretando grave comprometimento motor e respiratório com redução da sobrevida, especialmente nas suas formas clínicas mais graves. Nos últimos anos, terapias modificadoras da doença altamente eficazes, ou que atuam regulando o splicing do exon 7 do gene SMN2 ou adicionando uma cópia do gene SMN1 via terapia gênica, têm surgido, proporcionando uma mudança drástica na história natural da doença. Dessa forma, o desenvolvimento de guias terapêuticos e de consensos de especialistas torna-se importante no sentido de direcionar o uso dessas terapias na prática clínica. Este consenso, preparado por especialistas brasileiros, teve como objetivos revisar as principais terapias modificadoras de doença disponíveis, analisar criticamente os resultados dos estudos clínicos dessas terapias e prover recomendações para seu uso na prática clínica para pacientes com AME-5q. Aspectos relativos ao diagnóstico, aconselhamento genético e seguimento dos pacientes em uso das terapias também são abordados nesse consenso. Assim, esse consenso promove valiosas informações a respeito do manejo atual da AME-5q auxiliando decisões terapêuticas na prática clínica e promovendo ganhos adicionais nos desfechos finais. AME5q AMEq AME 5q q (AME-5q SMN bulbares sobrevida graves anos eficazes gênica surgido forma tornase torna se brasileiros disponíveis AME5q. 5q. diagnóstico Assim finais

Abstract Spinal muscular atrophy linked to chromosome 5 (SMA-5q) is an autosomal recessive genetic disease caused by mutations in the SMN1. SMA-5q is characterized by progressive degeneration of the spinal cord and bulbar motor neurons, causing severe motor and respiratory impairment with reduced survival, especially in its more severe clinical forms. In recent years, highly effective disease-modifying therapies have emerged, either acting by regulating the splicing of exon 7 of the SMN2 gene or adding a copy of the SMN1 gene through gene therapy, providing a drastic change in the natural history of the disease. In this way, developing therapeutic guides and expert consensus becomes essential to direct the use of these therapies in clinical practice. This consensus, prepared by Brazilian experts, aimed to review the main available disease-modifying therapies, critically analyze the results of clinical studies, and provide recommendations for their use in clinical practice for patients with SMA-5q. This consensus also addresses aspects related to diagnosis, genetic counseling, and follow-up of patients under drug treatment. Thus, this consensus provides valuable information regarding the current management of SMA-5q, helping therapeutic decisions in clinical practice and promoting additional gains in outcomes. SMA5q SMAq SMA 5q q (SMA-5q SMN neurons survival forms years diseasemodifying modifying emerged therapy way experts studies SMA5q. 5q. diagnosis counseling followup follow up treatment Thus SMA5q, 5q, outcomes

ABSTRACT Hyalohyphomycosis and phaeohyphomycosis are groups of mycoses caused by several agents and show different clinical manifestations. We report a case of an immunocompromised patient who presented rare manifestations of opportunistic mycoses: mycetoma-like hyalohyphomycosis on his right foot caused by Colletotrichum gloeosporioides, followed by cutaneous phaeohyphomycosis on his right forearm caused by Exophiala oligosperma. Further to the rarity of this case, the patient's lesion on the foot shows that the clinical aspects of mycetomas could falsely appear in other fungal infections similar to hyalohyphomycosis. We also show that the muriform cells that were seen in the direct and anatomopathological examination of the skin are not pathognomonic of chromoblastomycosis, as observed in the lesion of the patient's forearm. mycetomalike mycetoma like gloeosporioides oligosperma patients s chromoblastomycosis

ABSTRACT Inactivated COVID-19 vaccines data in immunocompromised individuals are scarce. This trial assessed the immunogenicity of two CoronaVac doses and additional BNT162b2 mRNA vaccine doses in immunocompromised (IC) and immunocompetent (H) individuals. Adults with solid organ transplant (SOT), hematopoietic stem cell transplant, cancer, inborn immunity errors or rheumatic diseases were included in the IC group. Immunocompetent adults were used as control group for comparison. Participants received two CoronaVac doses within a 28-day interval. IC received two additional BNT162b2 doses and H received a third BNT162b2 dose (booster). Blood samples were collected at baseline, 28 days after each dose, pre-booster and at the trial end. We used three serological tests to detect antibodies to SARS-CoV-2 nucleocapsid (N), trimeric spike (S), and receptor binding domain (RBD). Outcomes included seroconversion rates (SCR), geometric mean titers (GMT) and GMT ratio (GMTR). A total of 241 IC and 100 H adults participated in the study. After two CoronaVac doses, IC had lower SCR than H: anti-N, 33.3% vs 79%; anti-S, 33.8% vs 86%, and anti-RBD, 48.5% vs 85%, respectively. IC also showed lower GMT than H: anti-N, 2.3 vs 15.1; anti-S, 58.8 vs 213.2 BAU/mL; and anti-RBD, 22.4 vs 168.0 U/mL, respectively. After the 3rd and 4th BNT162b2 doses, IC had significant anti-S and anti-RBD seroconversion, but still lower than H after the 3rd dose. After boosting, GMT increased in IC, but remained lower than in the H group. CoronaVac two-dose schedule immunogenicity was lower in IC than in H. BNT162b2 heterologous booster enhanced immune response in both groups. COVID19 COVID 19 COVID-1 scarce BNTb BNT b BNT162b (IC (H SOT, SOT , (SOT) cancer comparison 28day day interval booster. . (booster) baseline 2 prebooster pre end SARSCoV2 SARSCoV SARS CoV SARS-CoV- N, N (N) S, S (S) RBD. RBD (RBD) SCR, (SCR) (GMT GMTR. GMTR (GMTR) 24 10 study antiN, antiN anti anti-N 333 33 3 33.3 79% 79 antiS, antiS 338 8 33.8 86 86% antiRBD, antiRBD RBD, 485 48 5 48.5 85 85% respectively 23 2. 15.1 151 15 1 588 58 58. 2132 213 213. BAU/mL BAUmL BAU mL 224 22 4 22. 1680 168 0 168. UmL U U/mL rd th boosting twodose groups COVID1 COVID- (SOT (booster SARS-CoV (N (S (RBD (SCR (GMTR 33. 7 48. 15. 21 16

In this study, we describe a light-driven photocatalytic decarboxylation of palmitic acid and related fatty acids using Chlorella variabilis fatty acid photodecarboxylase (CvFAP). By utilizing violet light emitting diode (LED) light (50 W; 397 nm), we achieved a remarkable conversion efficiency of 99% within just 4 min, surpassing the previous 79% conversion achieved in 60 min using blue LED light (300 W; 439 nm). Importantly, the use of 50 W violet LED light also resulted in a lower enzyme photoinactivation rate when compared to 300 W blue LED. Comparing the whole-cell biocatalyst with the enzymatic extract, we found that the former demonstrated superior catalytic performance and reduced susceptibility to photoinactivation. Furthermore, whole-cell biocatalyst reuse was demonstrated after five sequential batches. Employing this approach, we successfully synthesized 26 mmol L-1 h-1 of pentadecane, showcasing a promising strategy to improve productivity. These findings represent a significant advancement in CvFAP photodecarboxylation processes compared to the literature, utilizing an alternative light source, with potential implications to the biofuel sector. study lightdriven driven CvFAP. . (CvFAP) (LED (5 39 nm, nm , nm) 99 79 6 (30 43 nm. Importantly 5 30 wholecell whole cell extract Furthermore batches approach 2 L1 L 1 L- h1 h h- pentadecane productivity literature source sector (CvFAP ( 3 9 7 (3

A new ruthenium polypyridine complex, cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF6)2 (WP1), where 1-meimN and pyCHO are the ligands 1-methylimidazole and 4-pyridinecarboxaldehyde, respectively, was prepared as a prototype for use in phototherapeutic process. This compound was characterized by electronic absorption in UV-Visible, FTIR, 1H and 13C NMR, cyclic voltammetry, besides DFT that supported its molecular structure. The compound WP1 was photoreactive, where blue or green light promoted the release of 4-pyCHO ligand. Additionally, this compound was able to interact with DNA, mainly through electrostatic interactions showing photoinduced nuclease activity. There is also photoproduction of superoxide ions using blue or green light suggesting a route for DNA damage. These promising results opened new opportunities for the potential use of this system and analogues as phototherapeutic agents, which is an ongoing study in our lab. complex cisRubpy21meimN4pyCHOPF62 cisRubpymeimNpyCHOPF cis Ru bpy 2 1 meimN 4 PF6 PF cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF6) WP1, WP , (WP1) 1meimN 1methylimidazole methylimidazole 4pyridinecarboxaldehyde, 4pyridinecarboxaldehyde pyridinecarboxaldehyde pyridinecarboxaldehyde, 4-pyridinecarboxaldehyde respectively process UVVisible, UVVisible UV Visible, Visible UV-Visible FTIR H C NMR voltammetry structure photoreactive 4pyCHO ligand Additionally activity damage agents lab cisRubpy pyCHOPF cisRubpy21meimN4pyCHOPF6 cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF6 (WP1 cisRubpy21meimN4pyCHOPF cis-[Ru(bpy)2(1-meimN)(4-pyCHO)](PF (WP

RESUMO A maioria das pessoas com demência vive em países de baixa/média renda, onde recursos essenciais para a saúde cerebral, como educação de qualidade, ainda não são amplamente acessíveis. No Brasil, o analfabetismo ainda é frequente, especialmente em comunidades de baixo nível socioeconômico. O estudo PROAME teve como objetivo explorar a educação básica tardia em pessoas analfabetas como ferramenta para o aumento da reserva cognitiva. Objetivo: Investigar a relação entre nível socioeconômico com aprendizado e com desempenho em testes cognitivos, em adultos analfabetos. Métodos: Este estudo clínico de seis meses (NCT04473235) contou com 108 participantes inscritos no projeto Educação para Jovens e Adultos (EJA), dos quais 77 completaram os testes. O nível socioeconômico de cada participante foi medido usando-se: o Índice de Qualidade de Vida Urbana, o Índice de Desenvolvimento Humano Municipal e o nível socioeconômico doméstico. Avaliações cognitivas incluíram: o Teste de Recordação Seletiva Livre e Guiada (TRSLG), uma lista de palavras para avaliar leitura e a matriz Beta III. Resultados: A amostra era predominantemente feminina, com idade média de 58,5. Os participantes melhoraram a leitura (p=0,01) e o TRSLG (p=0,003). Com relação à memoria episódica, as mulheres tiveram resultados superiores aos dos homens (p=0,007) e participantes mais jovens melhoraram mais que seus colegas mais velhos (p=0,001). Não foi observada nenhuma relação entre o nível socioeconômico e o desempenho cognitivo. Conclusão: Independentemente do nível socioeconômico, participantes obtiveram resultados positivos após frequentar a educação básica. Isso sugere que a educação tardia pode ser uma medida preventiva não farmacológica importante, especialmente em países de baixa/média renda. baixamédia baixa renda cerebral qualidade acessíveis Brasil frequente cognitiva Objetivo cognitivos analfabetos Métodos NCT04473235 NCT (NCT04473235 10 EJA, EJA , (EJA) 7 usandose usando se usando-se Urbana doméstico incluíram TRSLG, (TRSLG) III Resultados feminina 585 58 5 58,5 p=0,01 p001 p 0 01 (p=0,01 p=0,003. p0003 p=0,003 . 003 (p=0,003) episódica p=0,007 p0007 007 (p=0,007 p=0,001. p0001 p=0,001 001 (p=0,001) cognitivo Conclusão importante NCT0447323 (NCT0447323 1 (EJA (TRSLG 58, p=0,0 p00 (p=0,0 p000 p=0,00 00 (p=0,003 (p=0,00 (p=0,001 NCT044732 (NCT044732 p=0, p0 (p=0, NCT04473 (NCT04473 p=0 (p=0 NCT0447 (NCT0447 p= (p= NCT044 (NCT044 (p NCT04 (NCT04 NCT0 (NCT0 (NCT

ABSTRACT The majority of people with dementia live in low or middle-income countries (LMICs) where resources that play a crucial role in brain health, such as quality education, are still not widely available. In Brazil, illiteracy remains a prevalent issue, especially in communities with lower socioeconomic status (SES). The PROAME study set out to explore basic education in illiterate adults as a means to improve cognitive reserve. Objective: This manuscript aims to explore the relationship between SES and learning, as well as cognitive outcomes, in an older illiterate population. Methods: This six-month clinical trial (NCT04473235) involved 108 participants, of which 77 concluded all assessments, enrolled in late-life basic education. SES assessments included Quality of Urban Living Index, Municipal Human Development Index and Household SES calculated for each participant. Cognitive assessments encompassed the Free and Cued Selective Reminding Test (FCSRT), a word list to assess reading, and the Beta III matrix. Results: The sample consisted primarily of women, with a mean age of 58.5. Participants improved their reading (p=0.01) and their FCSRT (p=0.003). Regarding episodic memory, women outperformed men (p=0.007) and younger participants improved more than their older counterparts (p=0.001). There was no association observed between SES and cognitive outcomes. Conclusion: Irrespective of SES, participants demonstrated positive outcomes after attending basic education. These findings highlight that late life education could be an important non-pharmacologic preventative measure, especially in LMICs. middleincome middle income LMICs (LMICs health available Brazil issue SES. . (SES) reserve Objective learning population Methods sixmonth six month NCT04473235 NCT (NCT04473235 10 7 latelife participant FCSRT, , (FCSRT) matrix Results 585 58 5 58.5 p=0.01 p001 p 0 01 (p=0.01 p=0.003. p0003 p=0.003 003 (p=0.003) memory p=0.007 p0007 007 (p=0.007 p=0.001. p0001 p=0.001 001 (p=0.001) Conclusion nonpharmacologic non pharmacologic measure (SES NCT0447323 (NCT0447323 1 (FCSRT 58. p=0.0 p00 (p=0.0 p000 p=0.00 00 (p=0.003 (p=0.00 (p=0.001 NCT044732 (NCT044732 p=0. p0 (p=0. NCT04473 (NCT04473 p=0 (p=0 NCT0447 (NCT0447 p= (p= NCT044 (NCT044 (p NCT04 (NCT04 NCT0 (NCT0 (NCT

Aim The aim of this study was to investigate the impact of pre-treatment with ethanolic solutions of caffeic acid phenethyl ester (CAPE) at varying concentrations on the dentin collagen matrix, specifically focusing on its biomodification potential. This was assessed through evaluations of the modulus of elasticity and changes in mass. Methods Seventy dentin collagen matrices (demineralized sticks) were prepared to receive treatments with ethanolic solutions of CAPE at concentrations of 0.05%, 0.1%, 0.5%, or 2.5%, or with control treatment solutions (distilled water or ethanol) for one hour. The dentin matrices were evaluated for modulus of elasticity and mass before (baseline), immediately after treatment (immediately), and after storage in Simulated Body Fluid (SBF) for time intervals of 1 and 3 months. Results Generalized linear models for repeated measures over time indicated no significant differences between groups (p=0.7530) or between different time points (p=0.4780) in terms of the modulus of elasticity. Regarding mass variation, no differences were observed in the time interval between 1 month and the immediate time (p=0.0935). However, at the 3-month mark compared to the immediate time, the 0.1% CAPE group exhibited less mass loss compared to the water group (p=0.0134). Conclusion This study concludes that various concentrations of CAPE in an ethanolic solution did not affect the modulus of elasticity of dentin, suggesting that CAPE lacks biomodifying potential in this context. However, it was observed that 0.1% CAPE positively influenced the variation in mass over different evaluation time intervals. pretreatment pre (CAPE matrix demineralized sticks 005 0 05 0.05% 01 5 0.5% 25 2 2.5% distilled ethanol hour baseline, baseline , (baseline) immediately, (immediately) SBF (SBF months p=0.7530 p07530 p 7530 (p=0.7530 p=0.4780 p04780 4780 (p=0.4780 p=0.0935. p00935 p=0.0935 . 0935 (p=0.0935) However 3month 0.1 p=0.0134. p00134 p=0.0134 0134 (p=0.0134) context 00 0.05 0.5 2.5 (baseline (immediately p=0.753 p0753 753 (p=0.753 p=0.478 p0478 478 (p=0.478 p0093 p=0.093 093 (p=0.0935 0. p0013 p=0.013 013 (p=0.0134 0.0 2. p=0.75 p075 75 (p=0.75 p=0.47 p047 47 (p=0.47 p009 p=0.09 09 (p=0.093 p001 p=0.01 (p=0.013 p=0.7 p07 7 (p=0.7 p=0.4 p04 4 (p=0.4 p00 p=0.0 (p=0.09 (p=0.01 p=0. p0 (p=0. (p=0.0 p=0 (p=0 p= (p= (p

RESUMO A deficiência de alfa-1 antitripsina (DAAT) é uma herança genética autossômica codominante, relativamente rara, que resulta em concentração reduzida de alfa-1 antitripsina (AAT) no soro e, portanto, redução na atividade antielastase nos pulmões e aumento do risco de enfisema pulmonar, cirrose hepática e paniculite necrotizante. Resulta de diferentes mutações no gene SERPINA1 levando a mudanças na glicoproteína AAT, que podem alterar a sua concentração, conformação e/ou função. Infelizmente, o subdiagnóstico é muito comum, e é possível que apenas 10% dos casos estejam diagnosticados. A variante Z é a deficiência mais comum, e estima-se que mais de 3 milhões de pessoas em todo o mundo tenham combinações de alelos associadas à deficiência grave de AAT. É necessária a determinação da concentração sérica de AAT e a identificação de variantes alélicas por fenotipagem ou genotipagem. É fundamental o acompanhamento da função pulmonar, principalmente por espirometria, pois essa informa sobre a progressão da doença. A densitometria pulmonar parece ser a medida mais sensível da progressão do enfisema, mas não deve ser usada no acompanhamento de pacientes na prática clínica de rotina. O tratamento geral é semelhante ao indicado para pacientes com DPOC não causada por DAAT. A administração exógena de AAT derivada de soro humano purificado é o único tratamento específico aprovado para DAAT em pacientes não fumantes e com deficiência grave (nível sérico < 57 mg/dL ou AAT sérica < 11 μM), com comprovação de perda funcional acima da fisiológica. alfa1 alfa 1 alfa- (DAAT codominante rara (AAT portanto necrotizante SERPINA eou Infelizmente comum 10 diagnosticados estimase estima se genotipagem espirometria doença rotina nível 5 mgdL mg dL μM, μM , μM) fisiológica

ABSTRACT Alpha-1 antitrypsin deficiency (AATD) is a relatively rare genetic disorder, inherited in an autosomal codominant manner, that results in reduced serum AAT concentrations, with a consequent reduction in antielastase activity in the lungs, as well as an increased risk of diseases such as pulmonary emphysema, liver cirrhosis, and necrotizing panniculitis. It results from different mutations in the SERPINA1 gene, leading to changes in the AAT glycoprotein, which can alter its concentration, conformation, and function. Unfortunately, underdiagnosis is quite common; it is possible that only 10% of cases are diagnosed. The most common deficiency is in the Z variant, and it is estimated that more than 3 million people worldwide have combinations of alleles associated with severe AATD. Serum AAT concentrations should be determined, and allelic variants should be identified by phenotyping or genotyping. Monitoring lung function, especially through spirometry, is essential, because it provides information on the progression of the disease. Although pulmonary densitometry appears to be the most sensitive measure of emphysema progression, it should not be used in routine clinical practice to monitor patients. In general, the treatment is similar to that indicated for patients with COPD not caused by AATD. Exogenous administration of purified human serum-derived AAT is the only specific treatment approved for AATD in nonsmoking patients with severe deficiency (serum AAT concentration of < 57 mg/dL or < 11 µM), with evidence of functional loss above the physiological level. Alpha1 Alpha 1 Alpha- (AATD disorder manner lungs cirrhosis panniculitis SERPINA gene glycoprotein conformation function Unfortunately 10 diagnosed variant determined genotyping spirometry essential disease general serumderived derived 5 mgdL mg dL µM, µM , µM) level

ABSTRACT Paracoccidioidomycosis, the most important systemic mycosis in Latin America, is closely linked to rural activities. In Brazil, it is an endemic disease, with an estimated 4,000 to 6,000 annual cases, accounting for over 80% of the global diagnoses. We present an intriguing case of this disease with an intestinal manifestation in a 71-year-old woman. The involvement of the cecal appendix led to a complication of cholangitis that mimicked cholangiocarcinoma. Paracoccidioidomycosis America activities Brazil 4000 4 000 4,00 6000 6 6,00 cases 80 diagnoses 71yearold yearold 71 year old woman cholangiocarcinoma 400 00 4,0 600 6,0 8 7 40 0 4, 60 6,

Abstract The present study aimed to evaluate the effectiveness of two doses of CoronaVac in preventing SARS-CoV-2 symptomatic disease with virological confirmation, as well as in the prevention of COVID-19 moderate and severe cases. A test-negative unmatched case-control design was used, in which cases were patients with suspected COVID-19 (presenting at least two of the following symptoms: fever, chills, sore throat, headache, cough, runny nose, olfactory or taste disorders) with virological confirmation, and controls were those whose SARS-CoV-2 test was negative. As for exposure, participants were classified as unvaccinated, or vaccinated with a complete schedule. Suspected COVID-19 cases were identified from March to November 2021, in two cities located in the State of São Paulo, Brazil. All participants signed the Informed Consent Form before enrollment. RT-PCR results and vaccination data were obtained from the local surveillance systems. Up to two phone calls were made to obtain information on the outcome of the cases. A total of 2981 potential participants were screened for eligibility, of which 2163 were included, being 493 cases and 1670 controls. Vaccination, age, the reported contact with a COVID-19 suspected or confirmed case in the 14 days before symptoms onset, and the educational level were the variables independently associated with the outcome. The adjusted vaccine effectiveness for symptomatic COVID-19 (AVE) was 39.0 % (95 % CI 6.0-60.0 %). The AVE in the prevention of moderate and severe disease was 91.0 % (95 % CI 76.0-97.0 %). Our results were influenced by the waning of the Gamma variant, in the second trimester of 2021, followed by the increase in vaccination coverage, and a drop in the number of cases in the second half of the year. The study demonstrated the high effectiveness of CoronaVac in preventing moderate/severe COVID-19 cases. SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- confirmation COVID19 COVID 19 COVID-1 testnegative negative casecontrol control used presenting fever chills throat headache cough nose disorders exposure unvaccinated schedule 2021 Paulo Brazil enrollment RTPCR RT PCR systems 298 eligibility 216 included 49 167 Vaccination age 1 onset (AVE 390 39 0 39. 95 (9 6.060.0 60600 6.0 60.0 6 60 6.0-60. %. . %) 910 91 91. 76.097.0 760970 76.0 97.0 76 97 76.0-97. variant coverage year moderatesevere SARS-CoV COVID1 COVID- 202 29 21 4 16 3 9 ( 060 6.060. 6060 6. 600 60. 6.0-60 097 76.097. 76097 760 76. 970 97. 7 76.0-97 20 06 6.060 606 6.0-6 09 76.097 7609 76.0-9 6.06 6.0- 76.09 76.0-

ABSTRACT BACKGROUND: Vaccination hesitation spans from historical diseases such as smallpox to the current challenges with the coronavirus disease (COVID-19). In Brazil, vaccination faces obstacles related to trust and convenience. Despite the National Immunization Program, fear of adverse effects as well as misinformation challenge confidence in vaccines, and anti-vaccine movements have gained momentum. OBJECTIVES: This study investigated childhood vaccine refusal, including COVID-19 vaccines, by comparing the reasons for and sociodemographic differences between vaccinated individuals and those who hesitated or refused immunization. DESIGN AND SETTING: A cross-sectional study was conducted in São Paulo, Brazil, using questionnaires administered during pediatric consultations between January and April 2023. METHODS: This study investigated vaccine hesitancy and the attitudes of parents and caregivers of children (0–12 years) towards vaccines. The questionnaire was administered during routine pediatric consultations at three different locations, each with 50 participants for a total of 150 participants, to avoid selection bias. RESULTS: Marked differences were evident among caregivers in terms of sex, race, income, education, and religion, which influenced their attitudes toward vaccination. There was an increase in the refusal of seasonal vaccinations and a significant distrust of the efficacy of the COVID-19 vaccine (52%), with concerns about its side effects. Although most patients did not stop vaccination, significant delays occurred, especially in the clinical setting (58%). CONCLUSIONS: This study emphasizes the importance of childhood health decisions, indicating the need to build trust in vaccines, tailor health policies, and investigate the causes of distrust to promote childhood immunizations. BACKGROUND COVID19. COVID19 COVID 19 . (COVID-19) Brazil convenience Program vaccines antivaccine anti momentum OBJECTIVES COVID-1 immunization SETTING crosssectional cross sectional Paulo 2023 METHODS 0–12 012 0 12 (0–1 years locations 5 15 bias RESULTS sex race income education religion 52%, 52 52% , (52%) occurred 58%. 58 58% (58%) CONCLUSIONS decisions policies immunizations COVID1 1 (COVID-19 COVID- 202 0–1 01 (0– (52% (58% (COVID-1 20 0– (0 (52 (58 (COVID- 2 ( (5 (COVID

Resumo Objetivo Analisar o monitoramento de contatos de pacientes com tuberculose (TB) na perspectiva de Agentes Comunitários de Saúde (ACS). Métodos Estudo descritivo, transversal e qualitativo, com ACS de oito Unidades Básicas de Saúde da Supervisão Técnica de Saúde Casa Verde/Cachoerinha/Limão do Município de São Paulo, SP. Foram realizadas entrevistas semiestruturadas de junho a julho de 2021. A Vigilância à Saúde constituiu o referencial conceitual e os depoimentos foram submetidos a análise de conteúdo. Resultados Os ACS (51) tinham um tempo médio de atuação de 7,4 anos e 169 famílias sob sua responsabilidade; referiram já ter tido casos de TB na microárea de atuação (68,7%) e algum treinamento em relação à doença (70,6%). Em geral, o monitoramento de contatos não era conhecido pelos participantes, que também não reconheciam essa atividade como uma tarefa de sua responsabilidade. Várias dificuldades foram identificadas na rotina de trabalho, incluindo: resistência dos contatos em ser avaliados em consulta e realizar os exames solicitados, aceitar a possibilidade de ter TB, não conseguir acessar os contatos, dentre outras. Conclusão O desconhecimento da necessidade de monitorar os contatos pode fragilizar a detecção precoce de casos novos de Tuberculose e a Infecção Latente por Tuberculose, e contribuir para a manutenção da transmissão da doença. Dada a importância dos ACS para essa prática, e considerando que são um importante elo entre a comunidade e a equipe de saúde, recomenda-se sua devida instrumentalização para a identificação precoce de novos casos de TB e para o monitoramento adequado dos contatos. (TB ACS. . (ACS) descritivo qualitativo VerdeCachoerinhaLimão Verde Cachoerinha Limão Paulo SP 2021 conteúdo 51 (51 74 7 4 7, 16 responsabilidade 68,7% 687 68 (68,7% 70,6%. 706 70,6% 70 6 (70,6%) geral participantes trabalho incluindo solicitados outras prática saúde recomendase recomenda se (ACS 202 5 (5 1 68,7 (68,7 70,6 (70,6% 20 ( 68, (68, 70, (70,6 2 (68 (70, (6 (70 (7

Abstract Objective To analyze the monitoring of contacts of tuberculosis (TB) patients from the perspective of Community Health Workers (CHWs). Methods This was a descriptive, cross-sectional, qualitative study with CHWs from eight Primary Care Center in the Casa Verde/Cachoerinha/Limão Technical Health Supervision in the city of São Paulo, SP. Semi-structured interviews were conducted from June to July 2021. Health Surveillance was the conceptual framework and the statements were subjected to content analysis. Results The CHWs (51) had an average working time of 7.4 years and 169 families under their responsibility; they reported having already had cases of TB in the micro-area they worked in (68.7%) and had some training in the disease (70.6%). In general, the monitoring of contacts was not known by the participants, who also did not recognize this activity as a task for which they were responsible. Several difficulties were identified in the work routine, including: contacts’ resistance to being assessed at appointments and carrying out the tests requested, accepting the possibility of having TB, not being able to access contacts, among others. Conclusion Ignorance of the need to monitor contacts can weaken the early detection of new cases of tuberculosis and latent tuberculosis infection, and contribute to maintaining the transmission of the disease. Given the importance of CHWs for this practice, and considering that they are an important link between the community and the health team, it is recommended that they be properly trained for the early identification of new TB cases and for the proper monitoring of contacts. (TB CHWs. . (CHWs) descriptive crosssectional, crosssectional cross sectional, sectional cross-sectional VerdeCachoerinhaLimão Verde Cachoerinha Limão Paulo SP Semistructured Semi structured 2021 analysis 51 (51 74 7 4 7. 16 responsibility microarea micro area 68.7% 687 68 (68.7% 70.6%. 706 70.6% 70 6 (70.6%) general participants responsible routine including requested others infection practice team (CHWs 202 5 (5 1 68.7 (68.7 70.6 (70.6% 20 ( 68. (68. 70. (70.6 2 (68 (70. (6 (70 (7

Resumen Objetivo Analizar el monitoreo de contactos de pacientes con tuberculosis (TB) bajo la perspectiva de agentes comunitarios de salud (ACS). Métodos Estudio descriptivo, transversal y cualitativo, con ACS de ocho Unidades Básicas de Salud de la Supervisión Técnica de Salud Casa Verde/Cachoerinha/Limão del municipio de São Paulo, estado de São Paulo. Se realizaron entrevistas semiestructuradas de junio a julio de 2021. La Vigilancia de la Salud constituyó el marco conceptual y los testimonios fueron sometidos al análisis de contenido. Resultados Los ACS (51) contaban con un tiempo promedio de actuación de 7,4 años y 169 familias bajo su responsabilidad. Declararon haber tenido casos de TB en su microárea de actuación (68,7 %) y alguna capacitación relacionada con la enfermedad (70,6 %). En general, los participantes no conocían el monitoreo de contactos y tampoco reconocían esa actividad como una tarea bajo su responsabilidad. Se identificaron varias dificultades en la rutina de trabajo: resistencia de los contactos a ser evaluados en consulta y realizar los exámenes solicitados, aceptar la posibilidad de tener TB, no poder acceder a los contactos, entre otras. Conclusión La falta de conocimiento de la necesidad de monitorear los contactos puede debilitar la detección temprana de nuevos casos de tuberculosis y de infección por tuberculosis latente, lo que contribuye a mantener la transmisión de la enfermedad. Dada la importancia de los ACS para esta práctica y considerando que son un importante eslabón entre la comunidad y el equipo de salud, se recomienda que sean debidamente preparados para la identificación temprana de nuevos casos de TB y para el monitoreo adecuado de los contactos. (TB ACS. . (ACS) descriptivo cualitativo VerdeCachoerinhaLimão Verde Cachoerinha Limão Paulo 2021 contenido 51 (51 74 7 4 7, 16 responsabilidad 68,7 687 68 (68, % 70,6 706 70 6 (70, %. general trabajo solicitados otras latente (ACS 202 5 (5 1 68, (68 70, (70 20 ( (6 (7 2

RESUMO Nos últimos anos, a precisão diagnóstica da doença de Alzheimer tem sido aprimorada pelo desenvolvimento de diferentes tipos de biomarcadores que indicam a presença dos processos neuropatológicos. Além de melhorar a seleção de pacientes para ensaios clínicos, os biomarcadores podem avaliar os efeitos de novos tratamentos nos processos patológicos. No entanto, há preocupação com o uso indiscriminado e mal fundamentado de biomarcadores, especialmente em indivíduos assintomáticos ou com declínio cognitivo subjetivo. As dificuldades na interpretação desses testes, os altos custos e o acesso desigual tornam esse cenário ainda mais desafiador no cuidado assistencial. Neste artigo, são apresentadas as recomendações do Departamento Científico de Neurologia Cognitiva e Envelhecimento da Academia Brasileira de Neurologia quanto ao uso racional e interpretação de biomarcadores da doença de Alzheimer na prática clínica. O diagnóstico clínico da síndrome cognitivo-comportamental é recomendado como o passo inicial para orientar a solicitação de biomarcadores. anos neuropatológicos clínicos patológicos entanto subjetivo testes assistencial artigo clínica cognitivocomportamental comportamental

ABSTRACT In recent years, the diagnostic accuracy of Alzheimer’s disease has been enhanced by the development of different types of biomarkers that indicate the presence of neuropathological processes. In addition to improving patient selection for clinical trials, biomarkers can assess the effects of new treatments on pathological processes. However, there is concern about the indiscriminate and poorly supported use of biomarkers, especially in asymptomatic individuals or those with subjective cognitive decline. Difficulties interpreting these tests, high costs, and unequal access make this scenario even more challenging in healthcare. This article presents the recommendations from the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology (Departamento Científico de Neurologia Cognitiva e Envelhecimento da Academia Brasileira de Neurologia) regarding the rational use and interpretation of Alzheimer’s disease biomarkers in clinical practice. The clinical diagnosis of cognitive-behavioral syndrome is recommended as the initial step to guide the request for biomarkers. years Alzheimers Alzheimer s processes trials However decline tests costs healthcare Departamento practice cognitivebehavioral behavioral