SUMMARY OBJECTIVE: The aim of the study was to evaluate the impact of laparoscopic surgical treatment of endometriosis on the levels of health-related depression in patients using a validated questionnaire. METHODS: A prospective study was carried out between September 2020 and May 2022 in a private hospital (São Luís, Maranhão, Brazil), which analysed depression using the Beck Depression Inventory-II, on 103 patients undergoing surgical treatment for endometriosis, evaluated preoperatively and 3 and 6 months after the procedure. Patients with unsuccessful clinical treatment for endometriosis and pain level ≥7 on Visual Analog Scale and who agreed to participate in the study were included. Demographic data were acquired by consulting medical records. RESULTS: The average age of the participants was 36±6.3 years; the majority of patients were brown (68.6%), married (66.6%), overweight (55.8%), had had hormonal treatments with progestogens (50.9%), low fertility (50.9%), severe endometriosis (39.3%), endometriosis surgery+myomectomy (29.4%) and one (1%) patient withdrew from the study. There was a statistically significant reduction in mean Beck Depression Inventory between the preoperative period and 6 months after surgery (p<0.0001). CONCLUSION: Surgical treatment of endometriosis appears to have a positive impact on the symptoms of depression in the patients evaluated. OBJECTIVE healthrelated health related questionnaire METHODS 202 São Luís Maranhão Brazil, Brazil , Brazil) InventoryII, InventoryII II, II Inventory-II 10 procedure 7 ≥ included records RESULTS 3663 36 36±6. years 68.6%, 686 68.6% 68 (68.6%) 66.6%, 666 66.6% 66 (66.6%) 55.8%, 558 55.8% 55 8 (55.8%) 50.9%, 509 50.9% 50 9 (50.9%) 39.3%, 393 39.3% 39 (39.3%) surgerymyomectomy myomectomy 29.4% 294 29 4 (29.4% 1% 1 (1% p<0.0001. p00001 p p<0.0001 . 0 0001 (p<0.0001) CONCLUSION 20 366 36±6 68.6 (68.6% 66.6 (66.6% 55.8 5 (55.8% 50.9 (50.9% 39.3 (39.3% 29.4 2 (29.4 (1 p0000 p<0.000 000 (p<0.0001 36± 68. (68.6 66. (66.6 55. (55.8 50. (50.9 39. (39.3 29. (29. ( p000 p<0.00 00 (p<0.000 (68. (66. (55. (50. (39. (29 p00 p<0.0 (p<0.00 (68 (66 (55 (50 (39 (2 p0 p<0. (p<0.0 (6 (5 (3 p<0 (p<0. p< (p<0 (p< (p

ABSTRACT Introduction: Blood transfusion is one of the most common medical practices worldwide. However, current scientific literature has shown that the immunomodulatory effects of blood transfusion are associated with an increased likelihood of infection, prolonged hospitalization, and morbimortality. Also, it means high costs for healthcare systems. Methods: In this context, acknowledging that blood transfusions are essentially heterologous cell transplantations, the use of therapeutic options has gained strength and is collectively known as the patient blood management (PBM) program. PBM is an approach based on three main pillars: (1) treating anemias and coagulopathies in an optimized manner, especially in the preoperative period; (2) optimizing perioperative hemostasis and the use of blood recovery systems to avoid the loss of the patient's blood; (3) anemia tolerance, with improved oxygen delivery and reduced oxygen demand, particularly in the postoperative period. Results: Current scientific evidence supports the effectiveness of PBM by reducing the need for blood transfusions, decreasing associated complications, and promoting more efficient and safer blood management. Thus, PBM not only improves clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. Conclusion: The aim of this review was to summarize PBM strategies in a comprehensive, evidence-based approach through a systematic and structured model for PBM implementation in tertiary hospitals. The recommendations proposed herein are from researchers and experts of a high-complexity university hospital in the network of the Sistema Único de Saúde, presenting itself as a strategy that can be followed as a guideline for PBM implementation in other settings. Introduction worldwide However infection hospitalization morbimortality Also Methods context transplantations (PBM program pillars 1 (1 manner period 2 (2 s 3 (3 tolerance demand Results complications Thus Conclusion comprehensive evidencebased hospitals highcomplexity complexity Saúde settings (

Abstract We investigated the vasodilatory effects of Hymenaea rubriflora Ducke stem bark extract (HR- HAc). Vascular reactivity of the aortic rings of Wistar rats was tested by in vitro cumulative doses (0.1 - 729 μg/mL). Rats (n=5) were treated with 25 (G25), 50 (G50) and 100 (G100) mg/ kg of HR-HAc or saline (control group - CG) for four weeks. An in vitro assay resulted in dose-dependent relaxation of the aortic rings with functional endothelium, which was inhibited in the presence of L-NAME. Rings of the treated animals increased acetylcholine relaxing potency at all doses, with a greater effect on G50 (pD2 = 7.8±0.1, Emax = 95.6±1.1) and a decreased contractile potency to phenylephrine in G25 (pD2 = 6.9±0.06, Emax = 61.5±6.0%) and G50 (pD2= 6.6±0.06, Emax = 71.0±8.5%) when compared to the CG in the presence and absence of endothelium (pD2= 6.4± 0.1, 6.4±0.1 and 6.9±0.1, respectively). Cumulative doses of nitroprusside resulted in increased relaxing potency in all treated groups and maintained Emax at 100%. It is concluded that HR-HAc has vasorelaxant capacity and inhibitory vascular contraction activity applied either directly to aortic rings or after treatment with in vivo supplementation, which places this extract as a potential nutraceutical or pharmacological agent for treating diseases associated with vascular dysfunction. HR (HR HAc. HAc . HAc) 0.1 01 0 1 (0. 72 μg/mL. μgmL μg/mL μg mL μg/mL) n=5 n5 n 5 (n=5 2 G25, G , (G25) (G50 10 G100 (G100 mg HRHAc control weeks dosedependent dose dependent LNAME. LNAME L NAME. NAME L-NAME G5 pD2 pD (pD 7801 7 8 7.8±0.1 95.6±1.1 95611 95 6 G2 69006 9 06 6.9±0.06 61.5±6.0% 61560 61 pD2= 66006 6.6±0.06 71.0±8.5% 71085 71 64 4 6.4 6401 6.4±0. 6901 6.9±0.1 respectively. respectively respectively) 100% supplementation dysfunction 0. (0 n= (n= (G25 (G5 G10 (G10 780 7.8±0. 95.6±1. 9561 6900 6.9±0.0 61.5±6.0 6156 6600 6.6±0.0 71.0±8.5 7108 6. 640 6.4±0 690 6.9±0. ( (n (G2 (G G1 (G1 78 7.8±0 95.6±1 956 61.5±6. 615 660 6.6±0. 71.0±8. 710 69 6.9±0 7.8± 95.6± 61.5±6 66 6.6±0 71.0±8 6.9± 7.8 95.6 61.5± 6.6± 71.0± 6.9 7. 95. 61.5 6.6 71.0 61. 71.

RESUMO Contexto A traqueobronquite associada ao ventilador é uma condição comum entre pacientes ventilados invasivamente em unidades de terapia intensiva, para a qual se desconhece atualmente a melhor estratégia de tratamento. Desenhamos o estudo VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) para avaliar se uma estratégia de tratamento antibiótico de espera vigilante não é inferior ao tratamento antibiótico de rotina para traqueobronquite associada ao ventilador em relação aos dias sem ventilador mecânico. Métodos O VATICAN é um estudo randomizado, controlado, aberto e multicêntrico de não inferioridade. Os pacientes com suspeita de traqueobronquite associada ao ventilador sem evidência de pneumonia associada ao ventilador ou instabilidade hemodinâmica devido a uma provável infecção serão designados para uma estratégia de espera vigilante, sem administração profilática de antimicrobianos contra traqueobronquite associada ao ventilador e prescrição de antimicrobianos somente em casos de pneumonia associada ao ventilador, sepse ou choque séptico, ou outro diagnóstico infeccioso, ou para uma estratégia de tratamento antimicrobiano de rotina por 7 dias. O desfecho primário será o número de dias sem ventilador mecânico em 28 dias, e um desfecho secundário importante será a sobrevida sem pneumonia associada ao ventilador. Por meio de uma estrutura de intenção de tratar com análise de sensibilidade por protocolo, a análise do desfecho primário abordará a não inferioridade com margem de 20%, o que se traduz em uma diferença de 1,5 dia sem ventilador. Outras análises seguirão uma estrutura de análise de superioridade. Conclusão O VATICAN seguirá todos os padrões éticos nacionais e internacionais. O objetivo é publicar o estudo em um periódico geral de alta visibilidade e apresentá-lo em conferências de cuidados intensivos e doenças infecciosas para divulgação. Estes resultados provavelmente serão imediatamente aplicáveis à beira do leito após a conclusão do estudo e fornecerão informações com baixo risco de viés para o desenvolvimento de diretrizes. intensiva VentilatorAssociated Ventilator Associated Evaluation randomizado controlado séptico infeccioso 2 protocolo 20 20% 15 1 5 1, superioridade internacionais apresentálo apresentá lo divulgação diretrizes

ABSTRACT Background Ventilator-associated tracheobronchitis is a common condition among invasively ventilated patients in intensive care units, for which the best treatment strategy is currently unknown. We designed the VATICAN (Ventilator-Associated Tracheobronchitis Initiative to Conduct Antibiotic Evaluation) trial to assess whether a watchful waiting antibiotic treatment strategy is noninferior to routine antibiotic treatment for ventilator-associated tracheobronchitis regarding days free of mechanical ventilation. Methods VATICAN is a randomized, controlled, open-label, multicenter noninferiority trial. Patients with suspected ventilator-associated tracheobronchitis without evidence of ventilator-associated pneumonia or hemodynamic instability due to probable infection will be assigned to either a watchful waiting strategy, without antimicrobial administration for ventilator-associated tracheobronchitis and prescription of antimicrobials only in cases of ventilator-associated pneumonia, sepsis or septic shock, or another infectious diagnosis, or to a routine antimicrobial treatment strategy for seven days. The primary outcome will be mechanical ventilation-free days at 28 days, and a key secondary outcome will be ventilator-associated pneumonia-free survival. Through an intention-to-treat framework with a per-protocol sensitivity analysis, the primary outcome analysis will address noninferiority with a 20% margin, which translates to a 1.5 difference in ventilator-free days. Other analyses will follow a superiority analysis framework. Conclusion The VATICAN trial will follow all national and international ethical standards. We aim to publish the trial in a high-visibility general journal and present it at critical care and infectious disease conferences for dissemination. These results will likely be immediately applicable to the bedside upon trial completion and will provide information with a low risk of bias for guideline development. Ventilatorassociated Ventilator associated units unknown VentilatorAssociated Associated Evaluation ventilatorassociated ventilator ventilation randomized controlled openlabel, openlabel open label, label open-label shock diagnosis ventilationfree 2 pneumoniafree survival intentiontotreat intention treat perprotocol per protocol 20 margin 15 1 5 1. ventilatorfree standards highvisibility high visibility dissemination development

Resumo Este artigo tem como objetivo discutir as experiências de cuidado de mães de crianças autistas durante a pandemia de Covid-19. Trata-se de uma pesquisa qualitativa, de caráter exploratório, que entrevistou 12 mães de crianças autistas que frequentavam um CAPSi no ano de 2021. A partir da análise das narrativas, foram construídas categorias destacando a experiência vivenciada na pandemia, o papel desempenhado pelo CAPSi e a presença ou ausência de parcerias e recursos institucionais na lida cotidiana. Como resultados, identificamos vivências marcadas por sofrimentos psicossociais, exclusão e sobrecarga, com as mães assumindo múltiplas demandas de cuidado e sentindo-se insuficientes e isoladas; o CAPSi como um espaço de acolhimento e permanência para mães e crianças, representando uma fonte de confiança e continuidade em um cenário adverso; a ausência de demais atores e instituições que poderiam configurar redes de apoio, com exceção dos grupos on-line de ajuda mútua. Conclui-se que as mães tiveram suas vivências demarcadas pela distinção de gênero nas tarefas de cuidado e pela atipia de seus filhos, acentuando a solidão e sobrecarga já conhecidas. Nesse contexto de escassez, o CAPSi destacou-se como referência no território, sendo espaço de cuidado e acolhimento para mães e crianças autistas. Covid19. Covid19 Covid 19. 19 Covid-19 Tratase Trata se qualitativa exploratório 1 2021 narrativas cotidiana resultados psicossociais sentindose sentindo isoladas adverso apoio online on line mútua Concluise Conclui filhos conhecidas escassez destacouse destacou território Covid1 Covid-1 202 Covid- 20 2

Abstract This article aims to discuss the care experiences of mothers of autistic children during the Covid-19 pandemic. This qualitative exploratory research interviewed 12 mothers of autistic children who attended a CAPSi in 2021. From the analysis of the narratives, categories were built to highlight the experience of the pandemic, the role played by the CAPSi, and the presence or absence of partnerships and institutional resources in daily dealings. As a result, we identified experiences marked by psychosocial suffering, exclusion, and overload, with mothers taking on multiple care demands and feeling insufficient and isolated; the CAPSi as a welcoming and permanent space for mothers and children, representing a source of trust and continuity in an adverse scenario; the absence of other actors and institutions that could set up support networks, except for online mutual help groups. It is concluded that the mothers' experiences were marked by the distinction of gender in care tasks and by the atypia of their children, accentuating the already-known loneliness and overload. In this context of scarcity, the CAPSi stood out as a reference in the territory, being a space of care and reception for mothers and autistic children. Covid19 Covid 19 Covid-1 pandemic 1 2021 narratives dealings result suffering exclusion overload isolated scenario networks groups alreadyknown already known scarcity territory Covid1 Covid- 202 20 2

Abstract This article aims to discuss the care experiences of mothers of autistic children during the Covid-19 pandemic. This qualitative exploratory research interviewed 12 mothers of autistic children who attended a CAPSi in 2021. From the analysis of the narratives, categories were built to highlight the experience of the pandemic, the role played by the CAPSi, and the presence or absence of partnerships and institutional resources in daily dealings. As a result, we identified experiences marked by psychosocial suffering, exclusion, and overload, with mothers taking on multiple care demands and feeling insufficient and isolated; the CAPSi as a welcoming and permanent space for mothers and children, representing a source of trust and continuity in an adverse scenario; the absence of other actors and institutions that could set up support networks, except for online mutual help groups. It is concluded that the mothers' experiences were marked by the distinction of gender in care tasks and by the atypia of their children, accentuating the already-known loneliness and overload. In this context of scarcity, the CAPSi stood out as a reference in the territory, being a space of care and reception for mothers and autistic children.

Resumo Este artigo tem como objetivo discutir as experiências de cuidado de mães de crianças autistas durante a pandemia de Covid-19. Trata-se de uma pesquisa qualitativa, de caráter exploratório, que entrevistou 12 mães de crianças autistas que frequentavam um CAPSi no ano de 2021. A partir da análise das narrativas, foram construídas categorias destacando a experiência vivenciada na pandemia, o papel desempenhado pelo CAPSi e a presença ou ausência de parcerias e recursos institucionais na lida cotidiana. Como resultados, identificamos vivências marcadas por sofrimentos psicossociais, exclusão e sobrecarga, com as mães assumindo múltiplas demandas de cuidado e sentindo-se insuficientes e isoladas; o CAPSi como um espaço de acolhimento e permanência para mães e crianças, representando uma fonte de confiança e continuidade em um cenário adverso; a ausência de demais atores e instituições que poderiam configurar redes de apoio, com exceção dos grupos on-line de ajuda mútua. Conclui-se que as mães tiveram suas vivências demarcadas pela distinção de gênero nas tarefas de cuidado e pela atipia de seus filhos, acentuando a solidão e sobrecarga já conhecidas. Nesse contexto de escassez, o CAPSi destacou-se como referência no território, sendo espaço de cuidado e acolhimento para mães e crianças autistas.

Resumo O objetivo deste artigo é apresentar as narrativas da Comunidade Ballroom de São Paulo, para situar como as práticas de prevenção combinada ao HIV se dão em pessoas negras LGBTQIAPN+, identificando como as estratégias se conformam, com que elementos e influências, ausências e restrições. Trata-se de uma pesquisa qualitativa no campo da Saúde Coletiva que utiliza entrevistas semiestruturadas com lideranças dessa comunidade para reconstruir as narrativas sobre HIV, abrindo um arquivo negro sobre prevenção. Tal perspectiva, alinhado ao trabalho de Saidiya Hartman pela perspectiva do pensamento negro radical, debruça-se sobre as histórias que não foram e ainda serão contadas: uma forma de imaginar radicalmente o futuro da negridade. Enquanto força analítica, o arquivo negro da prevenção tem a função de reparação, ampliando narrativas pela ótica racial, ocluindo uma história única da epidemia de HIV/Aids. Paulo LGBTQIAPN LGBTQIAPN+ conformam influências restrições Tratase Trata radical debruçase debruça contadas negridade analítica reparação racial HIVAids Aids HIV/Aids

Abstract This article aims to present the narratives of the Ballroom Community in São Paulo to situate how combined HIV prevention practices are carried out in these people, identifying how the strategies conform, with what elements and influences, absences and restrictions. This is a qualitative research in the field of Collective Health that uses semi-structured interviews with Ballroom leaders to reconstruct narratives about HIV, opening a black archive on prevention. Such a perspective, in line with Saidiya Hartman's work from the perspective of radical black thought, focuses on the stories that have not been and will still be told: a way of radically imagining the future of blackness. As an analytical force, the black archive has the function of reparation, expanding narratives from a racial perspective, occluding a unique history of the HIV/Aids epidemic. people conform influences restrictions semistructured semi structured Hartmans Hartman s thought told blackness force reparation HIVAids Aids epidemic

Resumen Objetivo Describir la construcción y validación de contenido de definiciones operativas y de enunciados de diagnósticos, resultados e intervenciones de enfermería contenidos en el Subconjunto de la CIPE® para la atención a la mujer, a las infancias y a la familia en proceso de lactancia. Métodos Estudio metodológico realizado en dos etapas: construcción de definiciones operativas, diagnósticos e intervenciones de enfermería para la atención en el proceso de lactancia; validación por 37 jueces seleccionados por muestreo de bola de nieve y mediante búsqueda en la plataforma Lattes, que evaluaron 58 definiciones operativas, 8 diagnósticos/resultados y 29 intervenciones de enfermería. En el análisis de datos se utilizó el Índice de Concordancia. Resultados Solo cuatro enunciados de diagnósticos de enfermería y cinco intervenciones del subconjunto en cuestión están incluidos en la última versión de la CIPE®. De las 58 definiciones operativas, 54 fueron validadas (93,1 %), de las cuales 39 tuvieron Índice de Concordancia ≥0,8 (67,2 %); y 15 (25,8 %) Índice de Concordancia entre ≥0,70 y <0,80. Conclusión Fueron validadas 54 definiciones operativas, 6 diagnósticos/resultados de enfermería y 29 intervenciones de enfermería para componer el Subconjunto Terminológico de la CIPE® para atención en el proceso de lactancia. CIPE mujer lactancia etapas 3 Lattes 5 diagnósticosresultados 2 93,1 931 93 1 (93, %, % , 08 0 ≥0, 67,2 672 67 (67, 25,8 258 25 (25, 070 70 ≥0,7 080 80 <0,80 93, 9 (93 ≥0 67, (67 25, (25 07 7 <0,8 (9 ≥ (6 (2 <0, ( <0 <

Resumo Objetivo Descrever a construção e validação de conteúdo de definições operacionais e de enunciados de diagnósticos, resultados e intervenções de enfermagem contidos no Subconjunto da CIPE® para assistência à mulher, à criança e à família em processo de amamentação. Métodos Estudo metodológico realizado em duas etapas: construção de definições operacionais, diagnósticos e intervenções de enfermagem para assistência no processo de amamentação; validação com 37 juízes, selecionados por amostragem em bola de neve e por meio de busca na plataforma Lattes, que avaliaram 58 definições operacionais, 8 diagnósticos/resultados e 29 intervenções de enfermagem. Na análise dos dados utilizou-se o Índice de Concordância. Resultados Apenas quatro enunciados de diagnósticos de enfermagem e cinco intervenções do subconjunto em questão estão contidos na última versão da CIPE®. Das 58 definições operacionais, 54 foram validadas (93,1%), sendo 39 com Índice de Concordância ≥0,8 (67,2%); e 15 (25,8%) com Índice de Concordância entre ≥0,70 e <0,80. Conclusão Foram validadas 54 definições operacionais, 6 diagnósticos/resultados de enfermagem e 29 intervenções de enfermagem para compor o Subconjunto Terminológico da CIPE® para assistência ao processo de amamentação. CIPE mulher amamentação etapas 3 juízes Lattes 5 diagnósticosresultados 2 utilizouse utilizou se 93,1%, 931 93,1% , 93 1 (93,1%) 08 0 ≥0, 67,2% 672 67 (67,2%) 25,8% 258 25 (25,8% 070 70 ≥0,7 080 80 <0,80 93,1 9 (93,1% ≥0 67,2 (67,2% 25,8 (25,8 07 7 <0,8 93, (93,1 ≥ 67, (67,2 25, (25, <0, (93, (67, (25 <0 (93 (67 (2 < (9 (6 (

Abstract Objective To describe the construction and content validity of operational definitions and statements of nursing diagnoses, outcomes and interventions contained in an ICNP® subset for woman, child and family care in the breastfeeding process. Methods This is a methodological study carried out in two stages: construction of operational definitions, diagnoses and nursing interventions for assistance in the breastfeeding process; validity with 37 judges, selected by snowball sampling and through a search on the Plataforma Lattes, who assessed 58 operational definitions, 8 nursing diagnoses/outcomes and 29 nursing interventions. The Concordance Index was used for data analysis. Results Only four statements of nursing diagnoses and five interventions of the subset in question are contained in the latest version of ICNP®. Of the 58 operational definitions, 54 were validated (93.1%), 39 with a Concordance Index ≥0.8 (67.2%) and 15 (25.8%) with a Concordance Index between ≥0.70 and <0.80. Conclusion A total of 54 operational definitions, 6 nursing diagnoses/outcomes and 29 nursing interventions were validated to compose an ICNP® terminology subset for assistance in the breastfeeding process. ICNP woman process stages 3 judges Lattes 5 diagnosesoutcomes 2 analysis 93.1%, 931 93.1% , 93 1 (93.1%) 08 0 ≥0. 67.2% 672 67 (67.2% 25.8% 258 25 (25.8% 070 70 ≥0.7 080 80 <0.80 93.1 9 (93.1% ≥0 67.2 (67.2 25.8 (25.8 07 7 <0.8 93. (93.1 ≥ 67. (67. 25. (25. <0. (93. (67 (25 <0 (93 (6 (2 < (9 (

Resumen Objetivo Analizar el riesgo de caídas y su relación con el síndrome de fragilidad y variables sociodemográficas en adultos mayores. Métodos Estudio transversal, analítico y multicéntrico, llevado a cabo en dos hospitales universitarios, durante el período de agosto de 2019 a enero de 2020, con 323 adultos mayores, utilizando el Brazil Old Age Schedule (BOAS) para la caracterización sociodemográfica, la Morse Fall Scale (MFS) para la definición del riesgo de caídas y la Edmonton Frail Scale (EFS) para la identificación del síndrome de fragilidad. Los datos fueron analizados por medio de estadística descriptiva e inferencial. Resultados Hubo una relación entre el riesgo de caídas y adultos mayores con edad superior a los 70 años, con más de cuatro enfermedades preexistentes, sin actividad laboral, con déficit cognitivo, estado general de salud malo, con dependencia funcional de cinco a ocho actividades, tomando cinco o más medicamentos, con pérdida de peso, bajo desempeño funcional, humor triste o deprimido y con síndrome de fragilidad instalado. Adultos mayores que viven solos, con edad superior a los 70 años, con cuatro o más enfermedades previas, con dependencia funcional, humor deprimido, que realizan la prueba Timed Up and Go (TUG) en un tiempo superior a 20 segundos, que utilizan cinco o más medicamentos al día y que se olvidan de utilizar esos fármacos tienen más posibilidades de riesgo de caídas. Conclusión Factores relacionados con el deterioro de funciones físicas, psicológicas y mentales en adultos mayores y que están exacerbados en el síndrome de fragilidad, aumentan el riesgo de episodios de caídas en esa población. transversal multicéntrico universitarios 201 2020 32 BOAS (BOAS sociodemográfica MFS (MFS EFS (EFS inferencial 7 años preexistentes laboral cognitivo malo actividades peso instalado solos previas TUG (TUG 2 segundos físicas población 202 3

Resumo Objetivo Analisar o risco de quedas e sua relação com a síndrome da fragilidade e variáveis sociodemográficas em idosos. Métodos Estudo transversal, analítico e multicêntrico, desenvolvido em dois hospitais universitários, no período de agosto de 2019 a janeiro de 2020, com 323 idosos, utilizando o Brazil Old Age Schedule (BOAS) para caracterização sociodemográfica, a Morse Fall Scale (MFS) para definição do risco de quedas e a Edmonton Frail Scale (EFS) para identificação da síndrome da fragilidade. Os dados foram analisados por estatística descritiva e inferencial. Resultados Houve associação entre o risco de quedas e idosos com idade acima de 70 anos, com mais de quatro doenças preexistentes, sem atividade laboral, com déficit cognitivo, estado geral de saúde ruim, com dependência funcional em cinco a oito atividades, fazendo uso de cinco ou mais medicamentos, com perda de peso, baixo desempenho funcional, humor triste ou deprimido e com a síndrome da fragilidade instalada. Idosos que moram sozinhos, com idade acima de 70 anos, que têm quatro ou mais doenças prévias, com dependência funcional, humor deprimido, que realizam o teste Timed Up and Go (TUG) em um tempo maior que 20 segundos, que utilizam cinco ou mais medicamentos por dia e que esquecem de utilizar esses fármacos têm mais chances para o risco de quedas. Conclusão Fatores relacionados ao declínio de funções físicas, psicológicas e mentais nos idosos, e que se encontram exacerbados na síndrome da fragilidade, aumentam o risco para a ocorrência de quedas nessa população. transversal multicêntrico universitários 201 2020 32 BOAS (BOAS sociodemográfica MFS (MFS EFS (EFS inferencial 7 anos preexistentes laboral cognitivo ruim atividades peso instalada sozinhos prévias TUG (TUG 2 segundos físicas população 202 3

Abstract Objective To analyze fall risk and its relationship with the frailty syndrome and sociodemographic variables in older adults. Methods This is a cross-sectional, analytical and multicenter study, carried out in two university hospitals, from August 2019 to January 2020, with 323 older adults, using the Brazil Old Age Schedule (BOAS), for sociodemographic characterization, the Morse Fall Scale (MFS), to define fall risk, and the Edmonton Frail Scale (EFS), to identify the frailty syndrome. Data were analyzed using descriptive and inferential statistics. Results There was an association between fall risk and older adults aged over 70 years, with more than four preexisting diseases, without work activity, with cognitive impairment, poor general health status, with functional dependence in five to eight activities, using five or more medications, with weight loss, low functional performance, sad or depressed mood and with the installed frailty syndrome. Older adults who live alone, aged over 70 years, who have four or more previous illnesses, with functional dependence, depressed mood, who perform the Timed Up and Go (TUG) test in a time longer than 20 seconds, who use five or more medications per day and who forget to use these medications are more likely to fall at risk. Conclusion Factors related to the decline of physical, psychological and mental functions in older adults, which are exacerbated in the frailty syndrome, increase fall risk in this population. crosssectional, crosssectional cross sectional, sectional cross-sectional study hospitals 201 2020 32 BOAS, BOAS , (BOAS) characterization MFS, MFS (MFS) EFS, EFS (EFS) statistics 7 years diseases activity impairment status activities loss performance alone illnesses TUG (TUG 2 seconds physical population 202 3 (BOAS (MFS (EFS

SUMMARY OBJECTIVE: This study aimed to evaluate the quality of life of patients with endometriosis before and after surgical treatment. METHODS: An observational, longitudinal, and prospective study was conducted with 102 women with pelvic pain and endometriosis that was unimproved by clinical treatment and indicated for surgical treatment. The patients’ quality of life was assessed using the 30-item Endometriosis Health Profile (EHP-30) questionnaire before and 3 and 6 months after surgery. The statistical tests were analyzed using the Statistical Package for Social Sciences version 17.0, and the Friedman test was used. RESULTS: There was a reduction in EHP-30 scores 3 and 6 months after surgery compared to before surgery, as well as 6 months after surgery compared to 3 months after surgery, in the central questionnaire (PART 1) and in Sections A, B, C, E, and F (p<0.0001). For Section D, there was a reduction in scores 6 months after surgery compared to before surgery (p<0.0001). CONCLUSION: Surgical treatment of endometriosis improves quality of life in several areas assessed by the EHP-30 questionnaire. OBJECTIVE METHODS observational longitudinal 10 30item item 30 EHP30 EHP (EHP-30 170 17 0 17.0 used RESULTS EHP-3 PART 1 A B C E p<0.0001. p00001 p p<0.0001 . 0001 (p<0.0001) D CONCLUSION EHP3 (EHP-3 17. EHP- p0000 p<0.000 000 (p<0.0001 (EHP- p000 p<0.00 00 (p<0.000 (EHP p00 p<0.0 (p<0.00 p0 p<0. (p<0.0 p<0 (p<0. p< (p<0 (p< (p

ABSTRACT AIDS-related disseminated histoplasmosis (DH) can cause septic shock and multiorgan dysfunction with mortality rates of up to 80%. A 41-year-old male presented with fever, fatigue, weight loss, disseminated skin lesions, low urine output, and mental confusion. Three weeks before admission, the patient was diagnosed with HIV infection, but antiretroviral therapy (ART) was not initiated. On day 1 of admission, sepsis with multiorgan dysfunction (acute renal failure, metabolic acidosis, hepatic failure, and coagulopathy) was identified. A chest computed tomography showed unspecific findings. Yeasts suggestive of Histoplasma spp. were observed in a routine peripheral blood smear. On day 2, the patient was transferred to the ICU, where his clinical condition progressed with reduced level of consciousness, hyperferritinemia, and refractory septic shock, requiring high doses of vasopressors, corticosteroids, mechanical ventilation, and hemodialysis. Amphotericin B deoxycholate was initiated. On day 3, yeasts suggestive of Histoplasma spp. were observed in the bone marrow. On day 10, ART was initiated. On day 28, samples of peripheral blood and bone marrow cultures revealed Histoplasma spp. The patient stayed in the ICU for 32 days, completing three weeks of intravenous antifungal therapy. After progressive clinical and laboratory improvement, the patient was discharged from the hospital on oral itraconazole, trimethoprim-sulfamethoxazole, and ART. This case highlights the inclusion of DH in the differential diagnosis of patients with advanced HIV disease, septic shock and multiorgan dysfunction but without respiratory failure. In addition, it provides early in-hospital diagnosis and treatment and comprehensive management in the ICU as determining factors for a good outcome. AIDSrelated AIDS related (DH 80 80% 41yearold yearold 41 year old fever fatigue loss lesions output confusion admission infection (ART initiated acute failure acidosis coagulopathy identified findings spp smear 2 consciousness hyperferritinemia vasopressors corticosteroids ventilation hemodialysis 3 10 28 days improvement itraconazole trimethoprimsulfamethoxazole, trimethoprimsulfamethoxazole trimethoprim sulfamethoxazole, sulfamethoxazole trimethoprim-sulfamethoxazole disease addition inhospital outcome 8 4

Abstract The establishment of epigenetic marks during the reprogramming window is susceptible to environmental influences, and stimuli during this critical stage can cause altered DNA methylation in offspring. In a previous study, we found that low levels of sulphur and cobalt (low S/Co) in the diet offered to oocyte donors altered the DNA methylome of bovine embryos. However, due to the extensive epigenetic reprogramming that occurs during embryogenesis, we hypothesized that the different methylation regions (DMRs) identified in the blastocysts may not maintain in adulthood. Here, we aimed to characterize DMRs previously identified in embryos, in the blood and sperm of adult progenies of two groups of heifers (low S/Co and control). We used six bulls and characterized the DNA methylation levels of KDM2A, KDM5A, KMT2D, and DOT1L genes. Our results showed that all DMRs analysed in both groups and tissues were hypermethylated unlike that noticed in the embryonic methylome profiles. These results suggest that embryo DMRs were reprogrammed during the final stages of de novo methylation during embryogenesis or later in development. Therefore, due to the highly dynamic epigenetic state during early embryonic development, we suggest that is essential to validate the DMRs found in embryos in adult individuals. influences offspring study SCo S Co However (DMRs adulthood Here control. control . control) KDM2A KDMA KDM A KDM5A KMT2D KMTD KMT D DOTL DOT L genes profiles development Therefore individuals

Abstract This article aims to present the narratives of the Ballroom Community in São Paulo to situate how combined HIV prevention practices are carried out in these people, identifying how the strategies conform, with what elements and influences, absences and restrictions. This is a qualitative research in the field of Collective Health that uses semi-structured interviews with Ballroom leaders to reconstruct narratives about HIV, opening a black archive on prevention. Such a perspective, in line with Saidiya Hartman's work from the perspective of radical black thought, focuses on the stories that have not been and will still be told: a way of radically imagining the future of blackness. As an analytical force, the black archive has the function of reparation, expanding narratives from a racial perspective, occluding a unique history of the HIV/Aids epidemic.

Resumo O objetivo deste artigo é apresentar as narrativas da Comunidade Ballroom de São Paulo, para situar como as práticas de prevenção combinada ao HIV se dão em pessoas negras LGBTQIAPN+, identificando como as estratégias se conformam, com que elementos e influências, ausências e restrições. Trata-se de uma pesquisa qualitativa no campo da Saúde Coletiva que utiliza entrevistas semiestruturadas com lideranças dessa comunidade para reconstruir as narrativas sobre HIV, abrindo um arquivo negro sobre prevenção. Tal perspectiva, alinhado ao trabalho de Saidiya Hartman pela perspectiva do pensamento negro radical, debruça-se sobre as histórias que não foram e ainda serão contadas: uma forma de imaginar radicalmente o futuro da negridade. Enquanto força analítica, o arquivo negro da prevenção tem a função de reparação, ampliando narrativas pela ótica racial, ocluindo uma história única da epidemia de HIV/Aids.

Resumo Fundamento O infarto do miocárdio com elevação do segmento-ST (IAMCSST) é definido por sintomas acompanhados por alterações típicas do eletrocardiograma. Entretanto, a caracterização dos sintomas isquêmicos não é clara, principalmente em subgrupos, como mulheres e idosos. Objetivos Analisar a tipificação dos sintomas isquêmicos, métricas temporais e observar a ocorrência de desfechos intra-hospitalares, em análise dos escores preditivos, em pacientes com IAMCSST, em estratégia fármaco-invasiva. Métodos Estudo envolvendo 2.290 pacientes. Tipos de apresentações clínicas pré-definidas: dor típica, dor atípica, dispnéia, sincope. Medimos o tempo entre o início dos sintomas à demanda pelo atendimento e o intervalo entre a chegada à unidade-médica e trombólise. Odds-ratios (OR; IC-95%) foram estimadas em modelo de regressão. Curvas ROCs foram construídas para preditores de mortalidade. Nível de significância adotado (alfa) foi de 5%. Resultados Mulheres apresentaram alta prevalência de sintomas atípicos; maior tempo entre o início dos sintomas e a procura por atendimento; atraso entre a chegada ao pronto-socorro e a fibrinólise. A mortalidade hospitalar foi de 5,6%. Predição de risco pela classificação Killip-Kimball: AUC: [0,77 (0,73-0,81)] em classe ≥II. Subgrupos estudados [OR (IC-95%)]: mulheres [2,06 (1,42-2,99); p=0,01]; insuficiência renal crônica [3,39 (2,13-5,42); p<0,001]; idosos [2,09 (1,37-3,19) p<0,001]; diabéticos [1,55 (1,04-2,29); p=0,02]; obesos 1,56 [(1,01-2,40); p=0,04]; acidente vascular cerebral prévio [2,01 (1,02-3,96); p=0,04] correlacionaram-se com maiores taxas de mortalidade. Conclusão Apesar das mais altas taxas de mortalidade em alguns subgrupos, disparidade significativa persiste nas mulheres, com atrasos no reconhecimento dos sintomas e trombólise imediata. Destaca-se a aplicabilidade do escore Killip-Kimball na predição, independentemente da apresentação clínica. segmentoST segmento ST IAMCSST (IAMCSST eletrocardiograma Entretanto clara subgrupos intrahospitalares, intrahospitalares intra hospitalares, hospitalares intra-hospitalares preditivos fármacoinvasiva. fármacoinvasiva fármaco invasiva. invasiva fármaco-invasiva 2290 2 290 2.29 prédefinidas pré definidas pré-definidas típica atípica dispnéia sincope unidademédica unidade médica Oddsratios Odds ratios OR (OR IC95% IC95 IC 95% 95 IC-95% regressão alfa (alfa 5 5% atípicos prontosocorro pronto socorro fibrinólise 56 6 5,6% KillipKimball Killip Kimball AUC 0,77 077 0 77 [0,7 0,730,81 073081 0,73 0,81 73 81 (0,73-0,81) II ≥II (IC-95%)] 2,06 206 06 [2,0 1,422,99 142299 1,42 2,99 1 42 99 (1,42-2,99) p=0,01 p001 p 01 p=0,01] 3,39 339 3 39 [3,3 2,135,42 213542 2,13 5,42 13 (2,13-5,42) p<0,001 p0001 001 p<0,001] 2,09 209 09 1,373,19 137319 1,37 3,19 37 19 (1,37-3,19 1,55 155 55 [1,5 1,042,29 104229 1,04 2,29 04 29 (1,04-2,29) p=0,02 p002 02 p=0,02] 156 1,5 1,012,40 101240 1,01 2,40 40 [(1,01-2,40) p=0,04 p004 2,01 201 1,023,96 102396 1,02 3,96 96 (1,02-3,96) correlacionaramse correlacionaram se imediata Destacase Destaca predição clínica 229 2.2 IC9 9 IC-95 5,6 0,7 07 7 [0, 730 0,730,8 07308 073 081 0,8 8 (0,73-0,81 (IC-95%) 2,0 20 [2, 422 1,422,9 14229 142 1,4 299 2,9 4 (1,42-2,99 p=0,0 p00 3,3 33 [3, 135 2,135,4 21354 213 2,1 542 5,4 (2,13-5,42 p<0,00 p000 00 373 1,373,1 13731 137 1,3 319 3,1 (1,37-3,1 15 [1, 042 1,042,2 10422 104 1,0 2,2 (1,04-2,29 1, 012 1,012,4 10124 101 240 2,4 [(1,01-2,40 023 1,023,9 10239 102 396 3,9 (1,02-3,96 22 2. IC-9 5, 0, [0 0,730, 0730 08 (0,73-0,8 (IC-95% 2, [2 1,422, 1422 14 (1,42-2,9 p=0, p0 3, [3 2,135, 2135 21 54 (2,13-5,4 p<0,0 1,373, 1373 31 (1,37-3, [1 1,042, 1042 10 (1,04-2,2 1,012, 1012 24 [(1,01-2,4 1,023, 1023 (1,02-3,9 IC- [ 0,730 (0,73-0, (IC-95 1,422 (1,42-2, p=0 2,135 (2,13-5, p<0, 1,373 (1,37-3 1,042 (1,04-2, 1,012 [(1,01-2, 1,023 (1,02-3, (0,73-0 (IC-9 (1,42-2 p= (2,13-5 p<0 (1,37- (1,04-2 [(1,01-2 (1,02-3 (0,73- (IC- (1,42- (2,13- p< (1,37 (1,04- [(1,01- (1,02- (0,73 (IC (1,42 (2,13 (1,3 (1,04 [(1,01 (1,02 (0,7 (1,4 (2,1 (1, (1,0 [(1,0 (0, (2, (1 [(1, (0 (2 ( [(1 [(

Abstract Background ST-segment elevation myocardial infarction (STEMI) is defined by symptoms accompanied by typical electrocardiogram changes. However, the characterization of ischemic symptoms is unclear, especially in subgroups such as women and the elderly. Objectives To analyze the typification of ischemic symptoms, temporal metrics and observe the occurrence of in-hospital outcomes, in the analysis of predictive scores, in patients with STEMI, in a drug-invasive strategy. Methods Study involving 2,290 patients. Types of predefined clinical presentations: typical pain, atypical pain, dyspnea, syncope. We measured the time between the onset of symptoms and demand for care and the interval between arrival at the medical unit and thrombolysis. Odds-ratios (OR; CI-95%) were estimated in a regression model. ROC curves were constructed for mortality predictors. The adopted significance level (alpha) was 5%. Results Women had a high prevalence of atypical symptoms; longer time between the onset of symptoms and seeking care; delay between arrival at the emergency room and fibrinolysis. Hospital mortality was 5.6%. Risk prediction by Killip-Kimball classification: AUC: [0.77 (0.73-0.81)] in class ≥II. Subgroups studied [OR (CI-95%)]: women [2.06 (1.42-2.99); p=0.01]; chronic renal failure [3.39 (2.13-5.42); p<0.001]; elderly [2.09 (1.37-3.19) p<0.001]; diabetics [1.55 (1.04-2.29); p=0.02]; obese 1.56 [(1.01-2.40); p=0.04]: previous stroke [2.01 (1.02-3.96); p=0.04] correlated with higher mortality rates. Conclusion Despite higher mortality rates in some subgroups, significant disparity persists in women, with delays in symptom recognition and prompt thrombolysis. We highlight the applicability of the Killip-Kimball score in prediction, regardless of the clinical presentation. STsegment ST segment STEMI (STEMI changes However unclear inhospital hospital outcomes scores druginvasive drug invasive strategy 2290 2 290 2,29 presentations pain dyspnea syncope thrombolysis Oddsratios Odds ratios OR (OR CI95% CI95 CI 95% 95 CI-95% model predictors alpha (alpha 5 5% fibrinolysis 56 6 5.6% KillipKimball Killip Kimball classification AUC 0.77 077 0 77 [0.7 0.730.81 073081 0.73 0.81 73 81 (0.73-0.81) II ≥II (CI-95%)] 2.06 206 06 [2.0 1.422.99 142299 1.42 2.99 1 42 99 (1.42-2.99) p=0.01 p001 p 01 p=0.01] 3.39 339 3 39 [3.3 2.135.42 213542 2.13 5.42 13 (2.13-5.42) p<0.001 p0001 001 p<0.001] 2.09 209 09 1.373.19 137319 1.37 3.19 37 19 (1.37-3.19 1.55 155 55 [1.5 1.042.29 104229 1.04 2.29 04 29 (1.04-2.29) p=0.02 p002 02 p=0.02] 156 1.5 1.012.40 101240 1.01 2.40 40 [(1.01-2.40) p=0.04 p004 2.01 201 1.023.96 102396 1.02 3.96 96 (1.02-3.96) presentation 229 2,2 CI9 9 CI-95 5.6 0.7 07 7 [0. 730 0.730.8 07308 073 081 0.8 8 (0.73-0.81 (CI-95%) 2.0 20 [2. 422 1.422.9 14229 142 1.4 299 2.9 4 (1.42-2.99 p=0.0 p00 3.3 33 [3. 135 2.135.4 21354 213 2.1 542 5.4 (2.13-5.42 p<0.00 p000 00 373 1.373.1 13731 137 1.3 319 3.1 (1.37-3.1 15 [1. 042 1.042.2 10422 104 1.0 2.2 (1.04-2.29 1. 012 1.012.4 10124 101 240 2.4 [(1.01-2.40 023 1.023.9 10239 102 396 3.9 (1.02-3.96 22 2, CI-9 5. 0. [0 0.730. 0730 08 (0.73-0.8 (CI-95% 2. [2 1.422. 1422 14 (1.42-2.9 p=0. p0 3. [3 2.135. 2135 21 54 (2.13-5.4 p<0.0 1.373. 1373 31 (1.37-3. [1 1.042. 1042 10 (1.04-2.2 1.012. 1012 24 [(1.01-2.4 1.023. 1023 (1.02-3.9 CI- [ 0.730 (0.73-0. (CI-95 1.422 (1.42-2. p=0 2.135 (2.13-5. p<0. 1.373 (1.37-3 1.042 (1.04-2. 1.012 [(1.01-2. 1.023 (1.02-3. (0.73-0 (CI-9 (1.42-2 p= (2.13-5 p<0 (1.37- (1.04-2 [(1.01-2 (1.02-3 (0.73- (CI- (1.42- (2.13- p< (1.37 (1.04- [(1.01- (1.02- (0.73 (CI (1.42 (2.13 (1.3 (1.04 [(1.01 (1.02 (0.7 (1.4 (2.1 (1. (1.0 [(1.0 (0. (2. (1 [(1. (0 (2 ( [(1 [(