Resumo O cuidador informal presta cuidados permanentes ou regulares a pessoas idosas em situação de dependência, sem remuneração. Objetivou-se identificar as percepções de cuidadores informais sobre motivações, necessidades e benefícios do cuidado ao idoso dependente. Estudo qualitativo realizado com 10 cuidadoras informais portuguesas, a partir de um instrumento com questões sobre o cuidado prestado ao idoso e suas percepções sobre o exercício dessa função. Os resultados revelaram como motivações para o cuidado: relação de proximidade e confiança, dever de cuidar, familiar mais disponível, proximidade da residência, inexistência de vagas e elevado custo das instituições de acolhimento e desejo do idoso permanecer na sua habitação. Os principais cuidados aos idosos são: hidratação, higiene, alimentação, administração terapêutica, companhia, apoio emocional, conforto, entretenimento, promoção da autonomia e dignidade. As necessidades identificadas pelas cuidadoras foram: apoio domiciliário, da segurança social e da entidade empregadora do cuidador, ajuda financeira, suporte psicológico e capacitação para cuidar do idoso. Os benefícios do cuidado informal para o idoso dependente apontados foram: celeridade do apoio familiar, segurança física e emocional, afeto e companheirismo. Este estudo dá voz a cidadãos cruciais. dependência remuneração Objetivouse Objetivou se 1 portuguesas função confiança disponível residência habitação são hidratação higiene alimentação terapêutica companhia emocional conforto entretenimento dignidade foram domiciliário financeira companheirismo cruciais

Abstract The informal caregiver provides non-remunerated permanent or regular care to dependent older adults. This qualitative study aimed to identify the perceptions of informal caregivers about motivations, needs, and benefits of caring for dependent older adults. It was conducted with ten Portuguese informal caregivers, based on an instrument with questions about the care provided to older adults and their perceptions about performing this role. The results revealed the following motivations for care: proximity and trust relationship, duty of care, more available family members, home proximity, lack of vacancies, high cost of shelter institutions, and older adults’ desire to remain in their homes. The primary care activities for older adults are hydration, hygiene, food, therapeutic administration, companionship, emotional support, comfort, entertainment, and promoting autonomy and dignity. The needs identified by the caregivers were home, social security, and the caregiver’s employer support, financial help, psychological support, and training to care for the older adults. The benefits of informal care for dependent older adults were prompt family support, physical and emotional security, affection, and companionship. This study gives voice to crucial citizens. nonremunerated non remunerated role relationship members vacancies institutions homes hydration hygiene food administration companionship support comfort entertainment dignity security s help affection citizens

Resumo O cuidador informal presta cuidados permanentes ou regulares a pessoas idosas em situação de dependência, sem remuneração. Objetivou-se identificar as percepções de cuidadores informais sobre motivações, necessidades e benefícios do cuidado ao idoso dependente. Estudo qualitativo realizado com 10 cuidadoras informais portuguesas, a partir de um instrumento com questões sobre o cuidado prestado ao idoso e suas percepções sobre o exercício dessa função. Os resultados revelaram como motivações para o cuidado: relação de proximidade e confiança, dever de cuidar, familiar mais disponível, proximidade da residência, inexistência de vagas e elevado custo das instituições de acolhimento e desejo do idoso permanecer na sua habitação. Os principais cuidados aos idosos são: hidratação, higiene, alimentação, administração terapêutica, companhia, apoio emocional, conforto, entretenimento, promoção da autonomia e dignidade. As necessidades identificadas pelas cuidadoras foram: apoio domiciliário, da segurança social e da entidade empregadora do cuidador, ajuda financeira, suporte psicológico e capacitação para cuidar do idoso. Os benefícios do cuidado informal para o idoso dependente apontados foram: celeridade do apoio familiar, segurança física e emocional, afeto e companheirismo. Este estudo dá voz a cidadãos cruciais.

Abstract The informal caregiver provides non-remunerated permanent or regular care to dependent older adults. This qualitative study aimed to identify the perceptions of informal caregivers about motivations, needs, and benefits of caring for dependent older adults. It was conducted with ten Portuguese informal caregivers, based on an instrument with questions about the care provided to older adults and their perceptions about performing this role. The results revealed the following motivations for care: proximity and trust relationship, duty of care, more available family members, home proximity, lack of vacancies, high cost of shelter institutions, and older adults’ desire to remain in their homes. The primary care activities for older adults are hydration, hygiene, food, therapeutic administration, companionship, emotional support, comfort, entertainment, and promoting autonomy and dignity. The needs identified by the caregivers were home, social security, and the caregiver’s employer support, financial help, psychological support, and training to care for the older adults. The benefits of informal care for dependent older adults were prompt family support, physical and emotional security, affection, and companionship. This study gives voice to crucial citizens.

This work aims to synthesize the alloy Co64Nb30B6 through mechanical alloying using a planetary ball mill. A disc rotation per minute and a ball/powder weight ratio of 300 rpm and 10:1 were used, with a milled time of 10 h, respectively. The characterization of the Co64Nb30B6 alloy was performed by X-ray diffraction (XRD), examined by scanning electron microscope-energy dispersive X-ray spectroscopy (SEM-EDS), thermoanalytical techniques (TGA/DTA), vibrating sample magnetometer (VSM) and confirmed by Braunauer, Emmet e Teller (BET) method type IV isotherms with a hysteresis loop for mesoporous materials. The results indicated that the evolution of the amorphous phase in the Co64Nb30B6 composition through the mechanical alloying process exhibited good soft magnetic properties with the addition of the metalloid element B and its excellent unique ferromagnetic properties. Through thermoanalytical analysis (TGA/DTA), it was shown that at higher temperatures, Co and Nb ions are oxidized by the environment and, therefore, the mass can be slightly increased to 14.9% and a probable contribution of boron in evolution stability thermal and magnetic in the amorphous phase, respectively. This suggests that the newly developed high-performance amorphous alloy Co64Nb30B6 has great application potential. CoNbB Co64Nb30B mill ballpowder powder 30 101 1 10: used h respectively Xray X ray XRD, XRD , (XRD) microscopeenergy microscope energy SEMEDS, SEMEDS SEM EDS (SEM-EDS) TGA/DTA, TGADTA TGA/DTA TGA DTA (TGA/DTA) VSM (VSM Braunauer BET (BET materials temperatures therefore 149 14 9 14.9 highperformance high performance potential 3 (XRD (SEM-EDS (TGA/DTA 14.

RESUMO Contexto: Doença inflamatória intestinal (DII), representada pela doença de Crohn (DC) e retocolite ulcerativa (RCU), é uma condição crônica e progressiva que afeta todas as faixas etárias, embora predomine em indivíduos jovens. Atualmente, tem sido documentado um aumento na prevalência de DII, de forma paralela ao aumento da população idosa. O escasso número de estudos que melhor caracterizem o impacto da DII na qualidade de vida (QV) em idosos motivou o presente estudo. Objetivo: Avaliar o impacto da DII na QV de idosos atendidos em um centro terciário de DII. Métodos: Estudo prospectivo transversal que incluiu pacientes idosos (idade ≥60 anos) com DII, atendidos pelo Centro de DII do HU-UFJF, entre março de 2019 a dezembro de 2022, e que apresentavam remissão clínica ou atividade leve de doença. Acompanhantes idosos sem comorbidades graves que compareceram à consulta com os pacientes foram incluídos como grupo controle. Foram registradas características sociodemográficas e relativas a DII. A QV foi avaliada por meio de questionários previamente validados (WHOQOL-BREF e IBDQ). Pacientes com DII com atividade moderada a grave, história de hospitalização recente ou iminente, infecções graves ou oportunistas nos últimos 6 meses, neoplasia prévia, demência, dificuldade de compreensão/ preenchimento dos questionários foram excluídos. Resultados: Foram incluídos 123 pacientes (74 com DII e 49 no grupo controle), com idade média de 67±6,2 anos, sendo 52,7% com DC e 47,3% com RCU. Atividade leve da doença foi observada em 31,1%. Ambos os grupos (pacientes com DII e controle) foram comparáveis com base na idade, sexo, IMC e Índice de Comorbidade de Charlson. Pacientes com DII e controle apresentaram escores de QV similares nos diferentes domínios avaliados pelo WHOQOL-BREF. Por outro lado, quando avaliada a faceta geral de QV, pacientes com DII apresentaram escores significativamente menores na QV geral (3,71±0,87 versus 4,02±0,62, respectivamente; P=0,021) e na saúde geral (3,32±1,05 versus 3,69±0,94, respectivamente; P=0,035). A presença de atividade leve impactou negativamente nos escores de saúde geral e de domínio físico do WHOQOL-BREF quando comparados com pacientes em remissão (2,91±0,99 versus 3.47±1,04, respectivamente; P=0,035 e 12,27±2.63 versus 13,86±2,61, respectivamente; P=0,019). Não foi observado impacto na QV com a aplicação do questionário IBDQ no que se refere ao tipo de DII (161±38.5 versus 163.1±42,6 para DC e RCU, respectivamente; P=0.84) ou a presença de atividade (152.5±38.8 versus 166.4±40.5, respectivamente; P=0.17). Conclusão: Não foram encontradas diferenças estatisticamente significativas entre pacientes idosos com DII em atividade leve ou quiescente e pacientes idosos sem DII quando observados os escores globais de QV. Porém, a DII impactou negativamente a faceta geral de QV, assim como a presença de atividade leve esteve associada a menores escores na saúde geral e no domínio físico avaliado pelo WHOQOL-BREF. Pacientes com DII tratados com terapia biológica apresentaram melhor QV do que aqueles em terapia convencional. Estudos futuros são necessários para escolha de ferramenta mais adequada para avaliação de QV nessa população. Contexto , (DII) (DC RCU (RCU) etárias jovens Atualmente idosa (QV estudo Objetivo Métodos 60 ≥6 anos HUUFJF, HUUFJF HU UFJF, UFJF HU-UFJF 201 2022 WHOQOLBREF WHOQOL BREF IBDQ. . IBDQ) grave iminente meses prévia demência compreensão excluídos Resultados 12 74 (7 4 controle, 6762 67 2 67±6, 527 52 7 52,7 473 47 3 47,3 311 31 1 31,1% sexo Charlson WHOQOLBREF. BREF. lado 3,71±0,87 371087 71 0 87 (3,71±0,8 402062 02 62 4,02±0,62 respectivamente P=0,021 P0021 P 021 3,32±1,05 332105 32 05 (3,32±1,0 369094 69 94 3,69±0,94 P=0,035. P0035 035 P=0,035) 2,91±0,99 291099 91 99 (2,91±0,9 347104 04 3.47±1,04 P=0,03 1227263 27 63 12,27±2.6 1386261 13 86 61 13,86±2,61 P=0,019. P0019 P=0,019 019 P=0,019) 161±38.5 161385 161 38 5 (161±38. 1631426 163 42 163.1±42, P=0.84 P084 84 152.5±38.8 1525388 152 8 (152.5±38. 1664405 166 40 166.4±40.5 P=0.17. P017 P=0.17 17 P=0.17) Conclusão Porém convencional (DII (RCU ≥ 20 202 ( 676 67±6 52, 47, 31,1 3,71±0,8 37108 (3,71±0, 40206 4,02±0,6 P=0,02 P002 3,32±1,0 33210 (3,32±1, 36909 9 3,69±0,9 P003 03 2,91±0,9 29109 (2,91±0, 34710 3.47±1,0 P=0,0 122726 12,27±2. 138626 13,86±2,6 P001 P=0,01 01 161±38. 16138 16 (161±38 163142 163.1±42 P=0.8 P08 152.5±38. 152538 15 (152.5±38 166440 166.4±40. P01 P=0.1 67± 31, 3,71±0, 3710 (3,71±0 4020 4,02±0, P00 3,32±1, 3321 (3,32±1 3690 3,69±0, 2,91±0, 2910 (2,91±0 3471 3.47±1, P=0, 12272 12,27±2 13862 13,86±2, 161±38 1613 (161±3 16314 163.1±4 P=0. P0 152.5±38 15253 (152.5±3 16644 166.4±40 3,71±0 371 (3,71± 402 4,02±0 3,32±1 332 (3,32± 369 3,69±0 2,91±0 291 (2,91± 347 3.47±1 P=0 1227 12,27± 1386 13,86±2 161±3 (161± 1631 163.1± 152.5±3 1525 (152.5± 1664 166.4±4 3,71± 37 (3,71 4,02± 3,32± 33 (3,32 36 3,69± 2,91± 29 (2,91 34 3.47± P= 122 12,27 138 13,86± 161± (161 163.1 152.5± (152.5 166.4± 3,71 (3,7 4,02 3,32 (3,3 3,69 2,91 (2,9 3.47 12,2 13,86 (16 163. 152.5 (152. 166.4 3,7 (3, 4,0 3,3 3,6 2,9 (2, 3.4 12, 13,8 (1 152. (152 166. 3, (3 4, 2, (2 3. 13, (15

ABSTRACT Background: Inflammatory bowel disease (IBD), represented by Crohn’s disease (CD) and ulcerative colitis (UC), is a chronic condition that affects all age groups, predominantly in young individuals. Currently, an increase in the prevalence of IBD has been documented, in parallel with the increase in the elderly population. The scarce number of studies that better characterize the impact of IBD on Quality of Life (QoL) in the elderly motivated the present study. Objective: To evaluate the impact of IBD on the QoL of elderly people treated at a Tertiary IBD Center. Methods: Prospective cross-sectional study that included elderly patients (age ≥60 years) with quiescent or mildly active IBD treated at the HU-UFJF IBD Center between March 2019 and December 2022. Elderly companions without severe comorbidities who attended the consultation with the patients were included as a control group. Sociodemographic and IBD-related characteristics were recorded. QoL was assessed using previously validated questionnaires (WHOQOL-BREF and IBDQ). Patients with IBD with moderate to severe activity, history of recent or imminent hospitalization, serious or opportunistic infections in the last 6 months, previous neoplasia, dementia, and difficulty understanding/fulfilling the questionnaires were excluded. Results: A total of 123 patients were included (74 with IBD and 49 in the control group), with a mean age of 67±6.2 years, 52.7% with CD, and 47.3% with UC. Mild disease activity was observed in 31.1%. Both groups (IBD patients and control) were comparable based on age, sex, BMI, and the Charlson Comorbidity Index. Patients with IBD and controls had similar QoL scores in the different domains assessed by the WHOQOL-BREF. On the other hand, when evaluating the general facet of QoL, IBD patients had significantly lower scores in General QoL (3.71±0.87 versus 4.02±0.62, respectively; P=0.021) and General Health (3.32±1.05 versus 3.69±0.94, respectively; P=0.035). The presence of mildly active IBD negatively impacted the general health score (2.91±0.99 versus 3.47±1.04, respectively; P=0.035) and the physical domain of the WHOQOL-BREF (12.27±2.63 versus 13.86±2.61, respectively; P=0.019) when compared to patients in remission. Conversely, no impact on QoL was observed with the Application of the IBDQ questionnaire regarding the type of the disease (161±38.5 versus 163.1±42.6 for CD and UC, respectively; P=0.84) or the presence of activity (152.5±38.8 versus 166.4±40.5, respectively; P=0.17). Conclusion: No statistically significant differences were found between elderly patients with mildly active or quiescent IBD and elderly patients without IBD when observing global QoL scores. However, IBD negatively impacted the general facet of QoL, just as mild activity was associated with lower scores in general health and the physical domain assessed by the WHOQOL-BREF. Patients with IBD treated with biological therapy had better Qol than those on conventional therapy. Future studies are needed to choose the most appropriate tool for assessing QoL in this population. Background IBD, , (IBD) Crohns Crohn s (CD UC (UC) individuals Currently documented population (QoL Objective Methods crosssectional cross sectional 60 ≥6 years HUUFJF HU UFJF 201 2022 group IBDrelated related recorded WHOQOLBREF WHOQOL BREF IBDQ. . IBDQ) hospitalization months neoplasia dementia understandingfulfilling understanding fulfilling excluded Results 12 74 (7 4 group, group) 6762 67 2 67±6. 527 52 7 52.7 473 47 3 47.3 311 31 1 31.1% sex BMI Index WHOQOLBREF. BREF. hand 3.71±0.87 371087 71 0 87 (3.71±0.8 402062 02 62 4.02±0.62 respectively P=0.021 P0021 P 021 3.32±1.05 332105 32 05 (3.32±1.0 369094 69 94 3.69±0.94 P=0.035. P0035 P=0.035 035 2.91±0.99 291099 91 99 (2.91±0.9 347104 04 3.47±1.04 12.27±2.63 1227263 27 63 (12.27±2.6 1386261 13 86 61 13.86±2.61 P=0.019 P0019 019 remission Conversely 161±38.5 161385 161 38 5 (161±38. 1631426 163 42 163.1±42. P=0.84 P084 84 152.5±38.8 1525388 152 8 (152.5±38. 1664405 166 40 166.4±40.5 P=0.17. P017 P=0.17 17 P=0.17) Conclusion However (UC ≥ 20 202 ( 676 67±6 52. 47. 31.1 3.71±0.8 37108 (3.71±0. 40206 4.02±0.6 P=0.02 P002 3.32±1.0 33210 (3.32±1. 36909 9 3.69±0.9 P003 P=0.03 03 2.91±0.9 29109 (2.91±0. 34710 3.47±1.0 12.27±2.6 122726 (12.27±2. 138626 13.86±2.6 P=0.01 P001 01 161±38. 16138 16 (161±38 163142 163.1±42 P=0.8 P08 152.5±38. 152538 15 (152.5±38 166440 166.4±40. P01 P=0.1 67± 31. 3.71±0. 3710 (3.71±0 4020 4.02±0. P=0.0 P00 3.32±1. 3321 (3.32±1 3690 3.69±0. 2.91±0. 2910 (2.91±0 3471 3.47±1. 12.27±2. 12272 (12.27±2 13862 13.86±2. 161±38 1613 (161±3 16314 163.1±4 P=0. P0 152.5±38 15253 (152.5±3 16644 166.4±40 3.71±0 371 (3.71± 402 4.02±0 3.32±1 332 (3.32± 369 3.69±0 2.91±0 291 (2.91± 347 3.47±1 12.27±2 1227 (12.27± 1386 13.86±2 161±3 (161± 1631 163.1± P=0 152.5±3 1525 (152.5± 1664 166.4±4 3.71± 37 (3.71 4.02± 3.32± 33 (3.32 36 3.69± 2.91± 29 (2.91 34 3.47± 12.27± 122 (12.27 138 13.86± 161± (161 163.1 P= 152.5± (152.5 166.4± 3.71 (3.7 4.02 3.32 (3.3 3.69 2.91 (2.9 3.47 12.27 (12.2 13.86 (16 163. 152.5 (152. 166.4 3.7 (3. 4.0 3.3 3.6 2.9 (2. 3.4 12.2 (12. 13.8 (1 152. (152 166. 3. (3 4. 2. (2 12. (12 13. (15

Abstract Objective To evaluate the risk factors for postpartum hemorrhage (PPH) according to the Robson Classification in a low-risk maternity hospital. Methods We conducted retrospective cohort study by analyzing the medical records of pregnant women attended in a low-risk maternity hospital, during from November 2019 to November 2021. Variables analyzed were: maternal age, type of delivery, birth weight, parity, Robson Classification, and causes of PPH. We compared the occurrence of PPH between pregnant women with spontaneous (Groups 1 and 3) and with induction of labor (2a and 4a). Chi-square and Student t-tests were performed. Variables were compared using binary logistic regression. Results There were 11,935 deliveries during the study period. According to Robson’s Classification, 48.2% were classified as 1 and 3 (Group I: 5,750/11,935) and 26.1% as 2a and 4a (Group II: 3,124/11,935). Group II had higher prevalence of PPH than Group I (3.5 vs. 2.7%, p=0.028). Labor induction increased the occurrence of PPH by 18.8% (RR: 1.188, 95% CI: 1.02-1.36, p=0.030). Model including forceps delivery [x2(3)=10.6, OR: 7.26, 95%CI: 3.32-15.84, R2 Nagelkerke: 0.011, p<0.001] and birth weight [x2(4)=59.0, OR: 1.001, 95%CI:1.001-1.001, R2 Nagelkerke: 0.033, p<0.001] was the best for predicting PPH in patients classified as Robson 1, 3, 2a, and 4a. Birth weight was poor predictor of PPH (area under ROC curve: 0.612, p<0.001, 95%CI: 0.572-0.653). Conclusion Robson Classification 2a and 4a showed the highest rates of postpartum hemorrhage. The model including forceps delivery and birth weight was the best predictor for postpartum hemorrhage in Robson Classification 1, 3, 2a, and 4a. (PPH lowrisk low hospital 201 2021 age parity Groups . 4a) Chisquare Chi square ttests t tests performed regression 11935 11 935 11,93 period Robsons s 482 48 2 48.2 5,750/11,935 575011935 5 750 261 26 26.1 3,124/11,935. 312411935 3,124/11,935 124 3,124/11,935) 3.5 35 (3. vs 27 7 2.7% p=0.028. p0028 p p=0.028 0 028 p=0.028) 188 18 8 18.8 RR (RR 1188 1.188 95 CI 1.021.36, 102136 1.02 1.36, 02 36 1.02-1.36 p=0.030. p0030 p=0.030 030 p=0.030) x23=10.6, x23106 x x2 =10.6, 10 6 [x2(3)=10.6 OR 726 7.26 95%CI 95CI 3.3215.84, 3321584 3.32 15.84, 32 15 84 3.32-15.84 R Nagelkerke 0011 011 0.011 p<0.001 p0001 001 x24=59.0, x24590 4 =59.0, 59 [x2(4)=59.0 1001 1.001 95%CI1.0011.001, 95CI10011001 95%CI:1.001-1.001 0033 033 0.033 area curve 0612 612 0.612 0.5720.653. 05720653 0.572 0.653 572 653 0.572-0.653) 20 202 1193 93 11,9 48. 5,750/11,93 57501193 75 26. 31241193 3,124/11,93 12 3. (3 2.7 p002 p=0.02 18. 118 1.18 9 021 1.021.36 10213 102 1.0 136 1.36 1.02-1.3 p003 p=0.03 03 x23 x23=10.6 x2310 106 =10.6 [x2(3)=10. 72 7.2 3215 3.3215.84 332158 332 3.3 1584 15.84 3.32-15.8 01 0.01 p<0.00 p000 00 x24 x24=59.0 x2459 590 =59.0 [x2(4)=59. 100 1.00 CI1 95%CI1.0011.001 95CI1001100 95%CI:1.001-1.00 003 0.03 061 61 0.61 5720 0.5720.653 0572065 0572 0.57 0653 0.65 57 65 0.572-0.653 119 11, 5,750/11,9 5750119 3124119 3,124/11,9 ( 2. p00 p=0.0 1.1 1.021.3 1021 1. 13 1.3 1.02-1. x23=10. x231 =10. [x2(3)=10 7. 321 3.3215.8 33215 33 158 15.8 3.32-15. 0.0 p<0.0 x24=59. x245 =59. [x2(4)=59 95%CI1.0011.00 95CI100110 95%CI:1.001-1.0 06 0.6 0.5720.65 057206 057 0.5 065 0.572-0.65 5,750/11, 575011 312411 3,124/11, p0 p=0. 1.021. 1.02-1 x23=10 =10 [x2(3)=1 3.3215. 3321 15. 3.32-15 0. p<0. x24=59 =59 [x2(4)=5 95%CI1.0011.0 95CI10011 95%CI:1.001-1. 0.5720.6 05720 05 0.572-0.6 5,750/11 57501 31241 3,124/11 p=0 1.021 1.02- x23=1 =1 [x2(3)= 3.3215 3.32-1 p<0 x24=5 =5 [x2(4)= 95%CI1.0011. 95CI1001 95%CI:1.001-1 0.5720. 0.572-0. 5,750/1 5750 3124 3,124/1 p= x23= = [x2(3) 3.321 3.32- p< x24= [x2(4) 95%CI1.0011 95CI100 95%CI:1.001- 0.5720 0.572-0 5,750/ 575 312 3,124/ [x2(3 [x2(4 95%CI1.001 95CI10 95%CI:1.001 0.572- 5,750 31 3,124 [x2( 95%CI1.00 95CI1 95%CI:1.00 5,75 3,12 [x2 95%CI1.0 95%CI:1.0 5,7 3,1 [x 95%CI1. 95%CI:1. 5, 95%CI1 95%CI:1

RESUMO A atualização de 2020 da Global Initiative for Asthma (GINA) trouxe mudanças relativamente à gestão farmacológica dos doentes asmáticos, que perduram até à atualidade. Destaca-se a recomendação universal, em indivíduos com idade superior a 12 anos, da utilização de corticosteroide inalado (ICS) como terapêutica de controlo para uma redução do risco de agudizações, bem como a advertência para os riscos inerentes à utilização isolada de agonista beta2 de curta ação de duração (SABA) como terapêutica de alívio, sendo fortemente aconselhada a sua substituição ou associação com ICS desde os estádios mais precoces de doença. Objetivos: Avaliar a qualidade da prescrição de terapêutica de alívio na asma ligeira-moderada numa unidade de cuidados de saúde primários (CSP). Paralelamente, procedeu-se à análise demográfica dos fatores de risco e provas de função respiratória nestes doentes. Métodos: Estudo transversal descritivo que incluiu todos os utentes inscritos com seguimento na unidade de estudo, com idade igual ou superior a 12 anos, codificados com asma como problema ativo e com terapêutica inalatória de alívio prescrita nos dois anos prévios. Resultados: Foram incluídos 271 utentes depois de aplicados os critérios mencionados. A maioria não tinha ICS incluído na terapêutica de alívio (72,5%), estando 87,9% medicados apenas com SABA. Não havia registo de qualquer espirometria em 45,8% dos doentes. Os fatores de risco mais prevalentes eram a rinite alérgica, obesidade e tabagismo. Conclusões: A prescrição de terapêutica de alívio da maioria dos utentes não vai ao encontro das recomendações internacionais atuais, aumentando o risco de agudizações, hospitalizações e mortalidade associadas à asma. Também foi possível aferir a reduzida codificação de asma, a escassa avaliação e/ou reavaliação da função pulmonar com espirometria e a elevada prevalência de fatores de risco modificáveis bem conhecidos, onde a intervenção médica precoce tem um papel preponderante.

ABSTRACT The 2020 update of the Global Initiative for Asthma (GINA) brought some updates regarding the pharmacological management of asthmatic patients. Noteworthy is the recommendation of inhaled corticosteroids (ICS) as a control therapy to reduce the exacerbation risk for ages above 12 years old, as well as the caution about the inherent risk concerning the isolated use of short-acting beta-agonists (SABA) as reliever medication, which should be replaced or associated with ICS from the earliest stages of the disease. Objectives: The aim of this study was to assess the quality of the prescription of reliever medication for mild-to-moderate asthma in a Primary Health Care unit. Simultaneously, the analysis of demographic data, risk factors and pulmonary function tests was carried out for the same sampled population. Methods: Descriptive cross-sectional study of internal evaluation that included all users enrolled in a healthcare unit, aged 12 years old and above, coded with asthma as an active problem and with reliever medication prescribed in the last 2 years. Results: 271 patients were included in the study after applying the above criteria. Most had no ICS included in reliever medication (72.5%), of which 87.9% were prescribed with SABA alone. Almost half (45.8%) had no record of any previous spirometry. The most prevalente risk factors observed were allergic rhinitis, obesity and smoking. Conclusions: The prescription of reliever medication for most users does not meet current international recommendations, increasing the risk of associated exacerbations, hospitalizations and mortality. It was also possible to assess the reduced codification of asthma, the poor assessment and/or reassessment of lung function with spirometry and the high prevalence of well-known modifiable risk factors, in which early medical intervention plays a major role.

Abstract The Centers for Disease Control and Prevention propose the term long COVID or post-COVID conditions for symptoms that develop during or after COVID-19, continue for at least two months, and are not explained by an alternative diagnosis. In this cross-sectional study, we aimed at estimating the proportion of COVID-19 patients that presented post-COVID conditions, describing their baseline characteristics and main persisting symptoms. We included 497 adult patients who had recovered from mild to moderate COVID-19, using a structured questionnaire, 12 to 16 weeks after disease onset. The cumulative incidence for post-COVID conditions was 47.5% (n=236). The most frequent symptoms were fatigue (n=151, 30.4%) and dyspnea (n=131, 26.4%). After adjusting for covariables male gender was found to be associated with lower odds of post-COVID conditions (OR=0.36, p<0.001). Body Mass Index <20 (OR=0.28, p=0.014) and [30-35[ (OR=0.42, p=0.006) seemed to have less persistent symptoms when compared to [20-25[. No other baseline demographic or clinical features were found to be significantly associated with post-COVID conditions. Our study suggests that post-COVID conditions persist in a large subset of non-severe diseases. Physicians should continue to monitor these patients to identify and treat post-acute sequelae of SARS-CoV-2 infection, particularly in what concerns primary care.

Resumo O Centro para Controlo e Prevenção de Doenças propõe o termo COVID longo ou condições pós-COVID para sintomas desenvolvidos durante ou após a COVID-19 e que persistem pelo menos dois meses, não sendo explicados por outros diagnósticos. Este estudo transversal tem como objetivo determinar a proporção de doentes com condições pós-COVID, descrevendo as suas características demográficas e clínicas e sintomas persistentes mais comuns. Foram incluídos 497 adultos com doença ligeira a moderada por COVID-19, avaliados por questionário estruturado após 12 a 16 semanas da infeção por SARS-CoV-2. A incidência cumulativa de condições pós-COVID foi de 47,5% (n=236). Os sintomas persistentes mais frequentes foram a astenia (n=151, 30,4%) e a dispneia (n=131, 26,4%). Após análise multivariada verificou-se que o sexo masculino está associado a menor incidência de condições pós-COVID (OR=0,36, p<0,001). Constatou-se ainda que índices de massa corporal <20 (OR=0,28, p=0,014) e [30-35[ (OR=0,42, p=0,006) apresentaram menor persistência de sintomas quando comparados com [20-25[. Nenhuma outra característica demográfica ou clínica apresentou associação estatisticamente significativa para condições pós-COVID. O estudo sugere que as condições pós-COVID são frequentes na doença não-severa. O acompanhamento destes doentes deverá manter-se com o intuito de identificar e tratar sequelas pós-infeção aguda por SARS-CoV-2, particularmente no que respeita aos cuidados de saúde primários.

Resumo As Diretrizes Brasileiras de Reabilitação do Acidente Vascular Cerebral (AVC) - Parte II, desenvolvida pelo Departamento Científico de Reabilitação Neurológica da Academia Brasileira de Neurologia é voltada para intervenções específicas de técnicas de reabilitação de déficits neurológicos e incapacidades. Seguindo o mesmo modelo da Parte I, a Parte II também se baseia em estudos randomizados, revisões sistemáticas, metanálises e outras diretrizes sobre o mesmo tema. A segunda parte aborda os distúrbios da comunicação, disfagia, controle postural e equilíbrio, ataxias, espasticidade, reabilitação do membro superior, marcha, cognição, negligência espacial unilateral, déficits sensoriais, reabilitação domiciliar, aderênciaao usode medicamentos, cuidados paliativos,ofuturodareabilitação no AVC, e websites de orientação sobre AVC para pacientes e cuidadores. Nosso objetivo é fornecer aos profissionais envolvidos na reabilitação conhecimento atualizado e recomendações para um melhor cuidado no pós-AVC. (AVC incapacidades I randomizados sistemáticas tema comunicação disfagia equilíbrio ataxias espasticidade superior marcha cognição unilateral sensoriais domiciliar medicamentos paliativosofuturodareabilitação paliativos ofuturodareabilitação cuidadores pósAVC. pósAVC pós AVC. pós-AVC

Abstract The Brazilian Practice Guidelines for Stroke Rehabilitation – Part II, developed by the Scientific Department of Neurological Rehabilitation of the Brazilian Academy of Neurology (Academia Brasileira de Neurologia, in Portuguese), focuses on specific rehabilitation techniques to aid recovery from impairment and disability after stroke. As in Part I, Part II is also based on recently available evidence from randomized controlled trials, systematic reviews, meta-analyses, and other guidelines. Part II covers disorders of communication, dysphagia, postural control and balance, ataxias, spasticity, upper limb rehabilitation, gait, cognition, unilateral spatial neglect, sensory impairments, home rehabilitation, medication adherence, palliative care, cerebrovascular events related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the future of stroke rehabilitation, and stroke websites to support patients and caregivers. Our goal is to provide health professionals with more recent knowledge and recommendations for better rehabilitation care after stroke. Academia Neurologia Portuguese, Portuguese , Portuguese) I trials reviews metaanalyses, metaanalyses meta analyses, analyses meta-analyses guidelines communication dysphagia balance ataxias spasticity gait cognition neglect impairments adherence SARSCoV2 SARSCoV SARS CoV (SARS-CoV-2 infection caregivers (SARS-CoV- (SARS-CoV

ABSTRACT Some studies have shown that secondary infections during the COVID-19 pandemic may have contributed to the high mortality. Our objective was to identify the frequency, types and etiology of bacterial infections in patients with COVID-19 admitted to an intensive care unit (ICU) and to evaluate the results of ICU stay, duration of mechanical ventilation (MV) and in-hospital mortality. It was a single-center study with a retrospective cohort of patients admitted consecutively to the ICU for more than 48 h between March and May 2020. Comparisons of groups with and without ICU- acquired infection were performed. A total of 191 patients with laboratory-confirmed COVID-19 were included and 57 patients had 97 secondary infectious events. The most frequent agents were Acinetobacter baumannii (28.9%), Pseudomonas aeruginosa (22.7%) and Klebsiella pneumoniae (14.4%); multi-drug resistance was present in 96% of A. baumannii and in 57% of K. pneumoniae. The most prevalent infection was ventilator-associated pneumonia in 57.9% of patients with bacterial infections, or 17.3% of all COVID-19 patients admitted to the ICU, followed by tracheobronchitis (26.3%). Patients with secondary infections had a longer ICU stay (40.0 vs. 17 days; p < 0.001), as well as a longer duration of MV (24.0 vs 9.0 days; p= 0.003). There were 68 (35.6%) deaths overall, of which 27 (39.7%) patients had bacterial infections. Among the 123 survivors, 30 (24.4%) had a secondary infections (OR 2.041; 95% CI 1.080 - 3.859). A high incidence of secondary infections, mainly caused by gram-negative bacteria has been observed. Secondary infections were associated with longer ICU stay, MV use and higher mortality.

Contexto: Apesar de su naturaleza ubicua, la práctica del cateterismo venoso periférico no es homogénea en contextos clínicos internacionales. En Portugal, la información sobre la práctica del cateterismo venoso periférico está dispersa en la literatura, haciéndolo imposible un análisis lo suficientemente completo de su naturaleza e implicaciones. Objetivos: Mapear los estudios realizados en Portugal en el ámbito del cateterismo venoso periférico. Método de revisión: Metodología de scoping review propuesta por Joanna Briggs Institute. Se definió un protocolo adecuado a cada base/repositorio para identificar estudios que respondan a los criterios delineados. El proceso de análisis da relevancia, extracción y síntesis de los datos será desarrollado por revisores independientes. Presentación e interpretación de los resultados: El mapeo de los estudios realizados en Portugal en esta área contribuirá a la identificación de los principales indicadores de estructura, proceso y resultado descritos en estudios nacionales. Conclusión: Se espera que esta revisión contribuya al desarrollo de futuras intervenciones y revisiones sistemáticas que mejoren la eficacia/seguridad de la atención del paciente con catéter periférico.

Contexto: Apesar da sua natureza ubíqua, a prática de cateterização venosa periférica não é homogénea entre contextos clínicos internacionais. Em Portugal, a informação referente à prática de cateterismo venoso periférico encontra-se dispersa na literatura, impossibilitando uma análise suficientemente compreensiva e abrangente da sua natureza e implicações. Objetivos: Mapear os estudos realizados em Portugal no âmbito do cateterismo venoso periférico. Método de revisão: Metodologia de scoping review proposta pelo Joanna Briggs Institute. Foi definido um protocolo adequado a cada base/repositório, que visa a identificação de estudos que respondam aos critérios delineados. O processo de análise da relevância, extração e síntese dos dados será desenvolvido por revisores independentes. Apresentação e interpretação dos resultados: O mapeamento dos estudos realizados em Portugal neste âmbito contribuirá para a identificação dos principais indicadores de estrutura, processo e resultado descritos em estudos nacionais. Conclusão: Espera-se que esta revisão sustente o desenvolvimento de intervenções e revisões sistemáticas futuras que potenciem a eficácia/segurança dos cuidados prestados ao doente com cateter periférico.

Background: Despite its ubiquitous nature, the practice of peripheral venous catheterization is not homogeneous among international clinical contexts. In Portugal, the information regarding the practice of peripheral venous catheterization is scattered in the literature, hindering efforts of a comprehensive analysis of its nature and implications. Objetive: To map the studies developed in Portugal in the field of peripheral venous catheterization. Review method: Scoping review methodology proposed by the Joanna Briggs Institute. An adequate protocol was established for each base/repository in order to identify studies that meet the criteria outlined. The analysis of data relevance, extraction and synthesis will be performed by independent reviewers. Presentation and interpretation of results: the mapping of the studies carried out in Portugal in this area will contribute to the identification of the main indicators of structure, process and outcome described in national studies. Conclusion: It is expected that this review will support the development of future interventions and systematic reviews that enhance the efficacy/safety of the care provided to patients with peripheral catheter.

ABSTRACT. Because of climatic changes, the cultivation of temperate climate plants such as peach in subtropical climates has become a challenge. In these areas, temperatures exceeding 25°C often occur during the pre-flowering and flowering phases. The high temperature causes damages by acting during the early stages of pollen-pistil interaction processes. The objective of this work was to evaluate the stigmatic receptivity of peach flowers at 18°C and 30°C. The pollen adherence was evaluated as well as the germination and presence of pollen tubes in the transmitting tissue of the style. The genotypes responded differently to temperature. ‘Granada,’ ‘Diamante’, and ‘Sensação’ had a stigmatic receptivity that was less affected when flowers were exposed to the higher temperature. Most genotypes showed a reduction in the number of pistils with pollen tubes growing in the style, particularly when pollination was delayed.

Abstract Rheumatic heart disease (RHD) remains a major cause of preventable death and disability in children and young adults. Despite significant advances in medical technology and increased understanding of disease mechanisms, RHD continues to be a serious public health problem throughout the world, especially in low- and middle-income countries. Echocardiographic screening has played a key role in improving the accuracy of diagnosing RHD and has highlighted the disease burden. Most affected patients present with severe valve disease and limited access to life-saving cardiac surgery or percutaneous valve intervention, contributing to increased mortality and other complications. Although understanding of disease pathogenesis has advanced in recent years, key questions remain to be addressed. Preventing or providing early treatment for streptococcal infections is the most important step in reducing the burden of this disease.

RESUMO O objetivo deste trabalho foi avaliar a influência de diferentes áreas úteis proporcionadas pelos espaçamentos de plantio (3 × 1, 3 × 2, 3 × 3, 3 × 4 m) na produção e na permeabilidade do cerne e do alburno da madeira de clones de Eucalyptus grandis e Eucalyptus grandis × Eucalyptus urophylla, aos 4 anos de idade. Independente do clone, não houve efeito do espaçamento de plantio na relação cerne/alburno e na permeabilidade da madeira. Todos os clones apresentaram um decréscimo na quantidade de cerne com o aumento da altura do fuste, independentemente do espaçamento de plantio, e o E. grandis (B) foi o único que a percentagem de cerne correlacionou-se positiva e significativamente com as variáveis dendrométricas (DAP e altura comercial). O uso do composto dymethil yellow foi indispensável na demarcação das regiões do cerne e do alburno nas amostras a partir de 50% da altura do fuste. A permeabilidade do cerne foi baixa em todos os clones avaliados, sugerindo obstrução dos vasos por tilas ou outras substâncias, enquanto a permeabilidade do alburno atingiu 405,4 cm3/cm.atm.s.

ABSTRACT The objective of this work was to evaluate the influence of different useful areas provided by the planting spacings (3 × 1, 3 × 2, 3 × 3, 3 × 4 m) on the production and permeability of heartwood and sapwood of Eucalyptus grandis and Eucalyptus grandis × Eucalyptus urophylla clones at 4 years old. Regardless of the clone, there was no effect of planting spacing on the heartwood/sapwood relation and wood permeability. All clones showed a heartwood decrease with increased height, regardless of planting spacing, and E. grandis (B) was the only one that had its heartwood percentage positively and significantly correlated with the dendrometric variables (DBH and commercial height). The use of the dymethil yellow compound was indispensable in defining the heartwood and sapwood regions in the samples from 50% of the stem height. The heartwood permeability was low in all evaluated clones, suggesting vessel obstruction by tyloses or other deposits, while sapwood permeability reached 405.4 cm3/cm.atm.s.

ABSTRACT BACKGROUND: While the global prevalence of obesity is rapidly increasing, this pandemic has received less attention in sub-Saharan Africa, particularly in the light of the persistent undernutrition that exists in the context of maternal and child health. We aimed to describe obesity trends among women of childbearing age over recent decades, along with trends in over and undernutrition among children under five years of age, in sub-Saharan African countries. DESIGN AND SETTING: Ecological study with temporal trend analysis in 13 sub-Saharan African countries. METHODS: This was a description of temporal trends in nutritional status: adult obesity, childhood overweight, low height-for-age (stunting), low weight-for-height (wasting), low weight-for-age (underweight) and low birth weight. Publicly available data from repeated cross-sectional national surveys (demographic and health surveys and multiple-indicator cluster surveys) were used. We chose 13 sub-Saharan African countries from which at least four surveys conducted since 1993 were available. We investigated women aged 15-49 years and children under five years of age. RESULTS: In multilevel linear models, the prevalence of obesity increased by an estimated 6 percentage points over 20 years among women of childbearing age, while the prevalence of overweight among children under 5 years old was stable. A major decrease in stunting and, to a lesser extent, wasting accompanied these findings. CONCLUSIONS: The upward trend in obesity among women of childbearing age in the context of highly prevalent childhood undernutrition suggests that the focus of maternal and child health in sub-Saharan Africa needs to be expanded to consider not only nutritional deficiencies but also nutritional excess.