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Abstract Introduction: Osteoporosis (OP) is the most frequent metabolic bone disease, associated with fragility fractures and increased morbimortality. Despite population aging, there has been a downward trend in the implementation of anti-osteoporotic therapy. Objectives: To determine the therapeutic inertia in OP in postmenopausal women in primary health care. Verify whether age, T-score, the FRAX value, and anti-osteoporotic therapeutic inertia are associated. Methods: Cross-sectional observational study. Inclusion criteria: women aged between 55 and 85 coded with OP (ICPC-2 - L95) or fractures (ICPC-2 - L72-76) in the list of problems. A simple random sample was selected. Therapeutic inertia was defined based on the Portuguese Society of Rheumatology recommendations. Results: A sample of 217 patients was obtained. Therapeutic inertia was found in 17.5% of women, which increased to 48.6% in those who suffered fractures (p<0.001). There was a statistically significant difference between the ages of patients with and without therapeutic inertia (77.5 vs 73.0, p<0.010). The median FRAX for major osteoporotic fracture (16.5 vs 9.65, p<0.001) and hip fracture (7.6 vs 3.3, p<0.001) was higher in the group with therapeutic inertia. The difference between T-score values for the lumbar spine (2.45 vs 2.71) and the femoral neck (2.07 vs 2.02) did not reach statistical significance (p=0.299). Conclusion: This study highlights the application of the most recent national guidelines regarding osteoporosis treatment in the studied health care unit, but underlines the need for broader intervention in osteoporosis-related fractures and at older ages.

Resumo Introdução: A osteoporose (OP) é a doença óssea metabólica mais frequente, associando-se a fraturas de fragilidade e aumento de morbimortalidade. Apesar do envelhecimento populacional tem-se verificado uma tendência decrescente na implementação de terapêutica antiosteoporótica. Objetivos: Determinar a inércia terapêutica na OP em mulheres pós-menopáusicas ao nível dos cuidados de saúde primários. Verificar se existe associação entre a idade dos utentes, o T-score e o valor de FRAX e a inércia terapêutica antiosteoporótica. Métodos: Estudo observacional transversal. Critérios de inclusão: mulheres com idades entre os 55 e os 85 anos codificadas com OP (ICPC-2 - L95) ou fraturas (ICPC-2 - L72-76) na lista de problemas. Foi selecionada uma amostra aleatória simples. A inércia terapêutica foi definida com base nas recomendações da Sociedade Portuguesa de Reumatologia. Resultados: Obteve-se uma amostra de 217 utentes. Apurou-se inércia terapêutica em 17,5% das mulheres, valor que aumenta para 48,6% nas que sofreram fraturas (p<0,001). As idades diferem de forma estatisticamente significativa entre os utentes com e sem inércia terapêutica (77,5 vs 73,0, p<0,010). A mediana do FRAX para fratura osteoporótica major (16,5 vs 9,65, p<0,001) e fratura da anca (7,6 vs 3,3, p<0,001) foi superior no grupo com inércia terapêutica. Os valores de T-score da coluna lombar (2,45 vs 2,71) e do colo do fémur (2,07 vs 2,02) não diferiram de forma estatisticamente significativa (p=0,299). Conclusão: Este estudo realça a aplicação da evidência mais atual ao nível do tratamento da OP na unidade estudada, mas salienta a necessidade de maior intervenção na OP fraturária e em idades mais avançadas.

https://doi.org/10.32385/rpmgf.v40i5.13974

Effects of forest fragmentation on natural populations of Anadenanthera colubrina (Vell.) Brenan: Insights for conservation and sustainable management Vell. Vell (Vell. Brenan (Vell
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Silva, Karla Daniele Araújo da

; Silva Júnior, Adelson Lemes da

; Souza, Mariana Cruz de

; Souza, Lucimara Cruz de

; Miranda, Fábio Demolinari de

; Caldeira, Marcos Vinicius Winckler

; Azevedo, Cássia dos Santos

; Soares, Taís Cristina Bastos

CERNE

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2024, Volume 30 elocation e-103316

Abstract: En | Text: En | PDF: En

ABSTRACT Background: The objective of this study is to characterize the diversity and genetic structure of A. colubrina in three Atlantic Forest fragments in the south of Espírito Santo state, using Inter Simple Sequence Repeats (ISSR) molecular markers. Genomic DNA from 85 trees was analyzed using 12 ISSR primers, generating 147 fragments, of which 109 were polymorphic (74%). Markers were characterized as moderately informative, with a mean polymorphic informational content of 0.34. Results: Low genetic diversity was found for the three fragments and in the total sample, based on Nei’s diversity parameters (H* = 0.26) and Shannon’s index (I* = 0.38). In the dissimilarity analysis, four groups were observed in the dendrogram with an exclusive clustering trend by location. The analysis of molecular variance confirmed that most of the genetic variation is found within populations (73.50%), however, with high genetic differentiation between them (Φ ST = 0.26). This result was supported by the Bayesian approach that indicated genetically structured populations. Conclusion: The data obtained reveal that forest fragmentation affected the diversity and genetic structure of A. colubrina and allow expanding knowledge for the development of effective strategies for the conservation and management of the species. Background A state (ISSR markers 8 1 primers 14 10 74%. 74 74% . (74%) informative 034 0 34 0.34 Results sample Neis Nei s H* H (H 0.26 026 26 Shannons Shannon I* I (I 0.38. 038 0.38 38 0.38) location 73.50%, 7350 73.50% , 73 50 (73.50%) however Φ 0.26. Conclusion species 7 (74% 03 3 0.3 0.2 02 2 735 73.50 5 (73.50% (74 0. 73.5 (73.50 (7 73. (73.5 ( (73. (73

https://doi.org/10.1590/01047760202430013316

You are what you eat: a systematic review exploring the interaction between Brazilian sand flies and their vertebrate food sources eat
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Dutra-Rêgo, Felipe

; Silva, Michelli Santos da

; Isnard, Ana Paula

; Medeiros, Jansen Fernandes

; Andrade Filho, José Dilermando

; Freire, Mariana Lourenço

Memórias do Instituto Oswaldo Cruz

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2024, Volume 119 elocation e240055

Abstract: En | Text: En | PDF: En

Sand flies play a crucial role as vectors of bacteria, viruses, and protists, with Leishmania being the most notable among them, transmitted to vertebrate hosts during blood feeding. Understanding the feeding behaviours of sand flies is imperative for gaining insights into their eco-epidemiological roles in the transmission of these infectious agents. This systematic review aimed to answer the question ‘What are the blood-feeding sources identified in Brazilian sand flies?’ to provide an analysis of their blood-feeding habits. The diverse range of at least 16 vertebrate orders identified as blood sources for 54 sand fly species across different geographic regions was summarised, and the factors potentially associated with the risk of bias in the included studies were analysed. The findings broaden the discussion concerning methods used to identify blood meal sources and shed light on the implications of sand fly feeding behaviours for the transmission dynamics of Leishmania. bacteria viruses protists them ecoepidemiological eco epidemiological agents What bloodfeeding flies? habits 1 5 summarised analysed

https://doi.org/10.1590/0074-02760240055

Software for the care of people with cardiovascular risk: construction and evidence of validity risk
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Félix, Nuno Damácio de Carvalho

; Carneiro, Raércia dos Santos

; Pacheco, Luis Filippe Rasia

; Cunha, Brenda Silva

; Cruz Neto, João

; Boness, Johann Aires

; Gavazza, Mariana Carvalho

; Barros, Alba Lúcia Bottura Leite de

Revista Brasileira de Enfermagem

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2024, Volume 77 N. 6 elocation e20240276

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

RESUMO Objetivos: construir e validar um software para o cuidado à pessoa com risco cardiovascular. Métodos: estudo metodológico, aplicado para desenvolvimento de software, ancorado em uma teoria e sistema de classificação de enfermagem, em três etapas: 1) engenharia de requisitos; 2) arquitetura de software e codificação; e 3) testes e validação de conteúdo por 12 especialistas da área das ciências da computação, com escore da Razão de Validade de Conteúdo. Resultados: denominada de e-TEORISC, em formato de software, para o cuidado de enfermagem a pessoas com risco cardiovascular, online e offline, contendo um banco de dados vinculados às etapas do Processo de Enfermagem. Os especialistas consideraram que os atributos de adequação funcional, eficiência de desempenho, confiabilidade, manutenibilidade, usabilidade, segurança e portabilidade obtiveram escores desejáveis. Conclusões: o e-TEORISC possui evidências de validade para instrumentalizar o cuidado à pessoa em risco cardiovascular, com potencial de transferência tecnológica para o Sistema Único de Saúde. Objetivos cardiovascular Métodos metodológico 1 requisitos 2 codificação 3 computação Conteúdo Resultados eTEORISC, eTEORISC TEORISC, TEORISC offline Enfermagem funcional desempenho confiabilidade manutenibilidade usabilidade desejáveis Conclusões Saúde

ABSTRACT Objectives: to build and validate software for the care of people with cardiovascular risk. Methods: a methodological study, applied to software development, anchored in a nursing theory and classification system, in three stages: 1) requirements engineering; 2) software architecture and coding; and 3) testing and content validity by 12 experts in computer science, with a Content Validity Ratio score. Results: called e-TEORISC, in software format, for nursing care for people with cardiovascular risk, online and offline, containing a database linked to the Nursing Process stages. Experts considered that the attributes of functional suitability, performance efficiency, reliability, maintainability, usability, safety and portability obtained desirable scores. Conclusions: e-TEORISC has evidence of validity to instrumentalize care for people at cardiovascular risk, with potential for technology transfer to the Brazilian Health System. Objectives risk Methods study development system stages 1 engineering 2 coding 3 science score Results eTEORISC, eTEORISC e TEORISC, TEORISC format offline suitability efficiency reliability maintainability usability scores Conclusions System

RESUMEN Objetivos: construir y validar software para la atención de personas con riesgo cardiovascular. Métodos: estudio metodológico, aplicado al desarrollo de software, anclado en una teoría y sistema de clasificación de enfermería, en tres etapas: 1) ingeniería de requisitos; 2) arquitectura y codificación de software; y 3) pruebas y validación de contenido por parte de 12 expertos en el campo de la informática, con un puntaje de Ratio de Validez del Contenido. Resultados: denominado e-TEORISC, en formato software, para la atención de enfermería a personas con riesgo cardiovascular, online y offline, que contiene una base de datos vinculada a las etapas del Proceso de Enfermería. Los expertos consideraron que los atributos de adecuación funcional, eficiencia de desempeño, confiabilidad, mantenibilidad, usabilidad, seguridad y portabilidad obtuvieron puntuaciones deseables. Conclusiones: e-TEORISC tiene evidencia de validez para brindar atención a personas en riesgo cardiovascular, con potencial de transferencia tecnológica al Sistema Único de Salud. Objetivos cardiovascular Métodos metodológico 1 requisitos 2 3 informática Contenido Resultados eTEORISC, eTEORISC e TEORISC, TEORISC offline Enfermería funcional desempeño confiabilidad mantenibilidad usabilidad deseables Conclusiones Salud

https://doi.org/10.1590/0034-7167-2024-0276

Diabetes mellitus tipo 2 e pandemia COVID-19: qual o impacto?
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Lopes, Nina

; Mina, Isabel

; Gonçalves, Maria João

; Fonseca, Clara Barros

; Henriques, Manuel Amaral

; Outeirinho, Conceição

; Pereira, Paulo Lima

; Silva, Mariana Cruz

; Costa, Rodrigo

; Calafate, Ana

Revista Portuguesa de Medicina Geral e Familiar

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oct 2023, Volume 39 N. 5 Pages 406 - 412

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

Abstract Introduction: Diabetes mellitus is one of the main causes of morbi-mortality worldwide. In this study, we aim to verify if the COVID-19 pandemic had repercussions on the metabolic and cardiovascular control of patients with type 2 diabetes at USF Garcia de Orta, from ACeS Porto-Ocidental. Methods: Cross-sectional observational analytical study. The study’s population consists of patients registered at the USF GO with the diagnosis of DM (ICPC-2 code T89 and T90) in the list of active problems. After applying inclusion and exclusion criteria, the sample was obtained by simple randomization. Glycated hemoglobin (HbA1c), LDL-cholesterol, body mass index (BMI), systolic (BP) and diastolic (DP) blood pressure values recorded in a pre-pandemic period were compared with those in a pandemic period. Results: The sample consisted of 218 patients, with a mean age of 70.9 ± 11.1 years. The median of HbA1c (6.75 vs 6.80) and LDL-cholesterol (82.80 vs 91.60) was lower in the pandemic period. The opposite was verified in relation to the BMI, with the highest median in the pandemic period (27.03 vs 26.87). Only the analysis of cholesterol-LDL obtained a statistically significant result. On average, the values of BP (134.06 vs 133.41) and DP (77.97 vs 76.59) were higher in the pandemic period compared to the pre-pandemic period, although without statistical significance. Discussion: With the exception of BMI, BP and DP, there was an improvement in the pandemic period. In the literature found, there are contradictory results on the impact of the pandemic on the variables studied. These results may reflect the quality of the teleconsultations carried out during the pandemic period and/or the effort of diabetics to maintain healthy habits. Conclusion: We cannot conclude that, in the period evaluated, the COVID-19 pandemic had a negative impact on the metabolic and cardiovascular control of patients with DM2 in our population.

Resumo Introdução: A diabetes mellitus é uma das principais causas de morbimortalidade em todo o mundo. Pretende-se verificar se a pandemia COVID-19 teve repercussões no controlo metabólico e cardiovascular dos doentes com diabetes mellitus tipo 2 (DM2) da USF Garcia de Orta (GO), do ACeS Porto Ocidental. Método: Estudo observacional, transversal, analítico. A população do estudo corresponde aos utentes inscritos na USF GO com o diagnóstico de DM (código T89 e T90 da ICPC-2) na lista de problemas ativos. Depois de aplicados os critérios de inclusão e exclusão obteve-se a amostra por aleatorização simples. Foram comparados valores de hemoglobina glicada (HbA1c), colesterol-LDL, índice de massa corporal (IMC), pressão arterial sistólica (PAs) e diastólica (PAd), registados num período pré-pandémico com os de um período pandémico. Resultados: A amostra foi de 218 pacientes, com média de idades de 70,9 ±11,1 anos. Na amostra a mediana de HbA1c (6,75 vs 6,80) e do colesterol-LDL (82,80 vs 91,60) foi inferior no período pandémico. Verificando-se o oposto em relação ao IMC, com a mediana superior no período pandémico (27,03 vs 26,87). Apenas na análise do colesterol-LDL se obteve um resultado estatisticamente significativo. Na análise do controlo tensional, em média, os valores de PAs (134.06 vs 133.41) e PAd (77.97 vs 76.59) foram superiores no período pandémico face ao pré-pandémico, mas sem significado estatístico. Discussão: No estudo encontrou-se, à exceção do IMC, da PAs e da PAd, uma melhoria dos valores no período pandémico. Em relação ao impacto da pandemia nas variáveis estudadas estão descritos na literatura resultados contraditórios. Estes resultados podem refletir a qualidade das teleconsultas realizadas no período pandémico e/ou no esforço dos diabéticos por manter hábitos saudáveis. Conclusão: Não se pode afirmar que, no período avaliado, a pandemia COVID-19 teve impacto negativo no controlo metabólico e cardiovascular dos pacientes com DM2 da população estudada.

https://doi.org/10.32385/rpmgf.v39i5.13504

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak selflimited self limited 20172019 2017 2019 (2017-2019 202 2017201 201 (2017-201 20 201720 (2017-20 2 20172 (2017-2 (2017- (2017 (201 (20 (2 (
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Gregianini, Tatiana Schäffer

; Salvato, Richard Steiner

; Barcellos, Regina Bones

; Godinho, Fernanda Marques

; Ruivo, Amanda Pellenz

; de Melo, Viviane Horn

; Schroder, Júlio Augusto

; Martiny, Fernanda Letícia

; Möllmann, Erica Bortoli

; Favreto, Cátia

; Baethgen, Ludmila Fiorenzano

; Ferreira, Vithoria Pompermaier

; de Lima, Lívia Eidt

; Piazza, Cláudia Fasolo

; Machado, Taís Raquel Marcon

; Becker, Irina Marieta

; Ramos, Raquel Rocha

; Frölich, Guilherme Carey

; Rossetti, Alana Fraga

; Almeida, Lucas da Cunha

; Rodrigues, Tahiana Machado Antunes

; Bragança, Isabella Tabelli

; Campos, Aline Alves Scarpellini

; Manzoni, Verônica Baú

; Machado, Lais Ceschini

; da Silva, Luisa Maria Inácio

; de Oliveira, André Luiz Sá

; Paiva, Marcelo Henrique Santos

; Nunes, Zenaida Marion Alves

; de Almeida, Paula Rodrigues

; Demoliner, Meriane

; Gularte, Juliana Schons

; da Silva, Mariana Soares

; Filippi, Micheli

; Pereira, Vyctoria Malayhka de Abreu Góes

; Spilki, Fernando Rosado

; da Veiga, Ana Beatriz Gorini

; Wallau, Gabriel Luz

Memórias do Instituto Oswaldo Cruz

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2023, Volume 118 elocation e220259

Abstract: En | Text: En | PDF: En

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk. mosquitoborne mosquito borne 2014 Brazil AsianCaribbean Asian Caribbean AC (AC EastCentralSouthAfrican East Central South African (ECSA states RS, , (RS) 2016 (CHIKF 20172021. 20172021 2017 2021. 2021 2017-2021 period 2020 limited Then lineage population 1 risk 201 (RS 2017202 202 2017-202 20 201720 2017-20 2 20172 2017-2 2017-

https://doi.org/10.1590/0074-02760220259

Experiências pedagógicas para a construção da interdisciplinaridade em saúde coletiva
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Gonçalves, Glaciene Mary da Silva

; Santos, Mariana Olívia Santana dos

; Gurgel, Aline do Monte

; Costa, André Monteiro

; Gonçalves, José Erivaldo

; Gurgel, Idê Gomes Dantas

; Augusto, Lia Giraldo da Silva

Saúde em Debate

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dec 2022, Volume 46 N. 135 Pages 1238 - 1248

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

ABSTRACT This article narrates the experience of an interdisciplinary practice of research, teaching and cooperation for the intersection between health, environment, production and work from the constitution of the Laboratory of Health, Environment and Work (LASAT) and contribution to the Postgraduate Program in Public Health at the Aggeu Magalhães Institute/Oswaldo Cruz Fundation (PPGSP/IAM/ FIOCRUZ). LASAT was instituted in 1997, one year after the creation of the PPGSP. Its group of researchers recognized the complexity of its research object and sought new epistemic frameworks and adequate methods following a systemic and interdisciplinary perspective. The objective of this article is to present the main operational concepts adopted and academic products obtained. The method was the analysis of the reports of the experiences of the LASAT researchers regarding the course of formation of the own team; research projects carried out; compulsory and optional subjects offered; and significant cooperation activities. In all activities, it was sought to illustrate how interdisciplinarity was implemented. It presents as results the set of concepts adopted and some effective academic products, concluding with the challenges of consolidating the new area of concentration, expand the technical-scientific cooperation network and constitute an interdisciplinary support network for the PPGSP.

RESUMO Este artigo narra a experiência de uma prática interdisciplinar de pesquisa, ensino e cooperação para a interseção entre saúde, ambiente, produção e trabalho, a partir da constituição do Laboratório de Saúde, Ambiente e Trabalho (Lasat) e sua contribuição para o Programa de Pós-Graduação em Saúde Pública do Instituto Aggeu Magalhães/Fundação Oswaldo Cruz (PPGSP/IAM/Fiocruz). O Lasat foi instituído em 1997, um ano após a criação do PPGSP. Seu grupo de pesquisadores reconheceu a complexidade dos objetos de pesquisa e buscou novos marcos epistêmicos e métodos adequados seguindo a perspectiva sistêmica e interdisciplinar. O objetivo deste artigo é apresentar os principais conceitos operativos adotados e os produtos acadêmicos obtidos. O método foi a análise dos relatos das experiências dos pesquisadores do Lasat quanto ao percurso de formação da equipe; projetos de pesquisa realizados; disciplinas obrigatórias e opcionais regulares; e atividades de cooperação significantes. Em todas as atividades, buscou-se ilustrar como a interdisciplinaridade foi aplicada. Apresentam-se como resultados o conjunto de conceitos adotados e alguns produtos acadêmicos efetivados, concluindo com os desafios de consolidar a nova área de concentração, ampliar a rede de cooperação técnico-científica e constituir uma rede interdisciplinar de suporte para a PPGSP.

https://doi.org/10.1590/0103-1104202213520

Experiências pedagógicas para a construção da interdisciplinaridade em saúde coletiva
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Gonçalves, Glaciene Mary da Silva

; Santos, Mariana Olívia Santana dos

; Gurgel, Aline do Monte

; Costa, André Monteiro

; Gonçalves, José Erivaldo

; Gurgel, Idê Gomes Dantas

; Augusto, Lia Giraldo da Silva

Saúde em Debate

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dec 2022, Volume 46 N. 135 Pages 1238 - 1248

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

https://doi.org/10.1590/0103-1104202213520

Fatigue in amyotrophic lateral sclerosis and correlated factors
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Alencar, Mariana Asmar

; Soares, Bruna Laura

; Rangel, Marcela Ferreira de Andrade

; Abdo, Juliana Silva

; Almeida, Rayane Alves Pereira de

; Araújo, Caroline Martins de

; Souza, Leonardo Cruz de

; Gomes, Gisele de Cássia

Arquivos de Neuro-Psiquiatria

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oct 2022, Volume 80 N. 10 Pages 1045 - 1051

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

Resumo Antecedentes Esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa fatal que leva à fraqueza muscular e paralisia. Fadiga é um sintoma incapacitante, frequentemente relatado na ELA, mas permanece pouco investigado nessa população. Assim, uma investigação acurada deste sintoma e dos possíveis fatores associados é necessária para auxiliar em uma abordagem terapêutica adequada. Objetivo Investigar a presença de fadiga em indivíduos com ELA e possíveis fatores correlacionados a este sintoma. Métodos Participaram 65 indivíduos com ELA esporádica. Aspectos demográficos, clínicos e funcionais foram investigados. Foram utilizadas: Escala de Severidade de Fadiga (FSS, na sigla em inglês), Escala Funcional de ELA (ALSRFS-R, na sigla em inglês) e questionário de Qualidade de Vida (QV) (ALSAQ-40, na sigla em inglês). Análises descritivas e de correlação foram realizadas no programa SPSS para Windows versão 19.0 (IBM Corp., Armonk, NY, USA). Resultados Dos 65 indivíduos avaliados, 44,6% (n = 29) apresentaram fadiga pela FSS. A intensidade da fadiga foi 5,4 ± 1,2 e apenas 10,4% usavam medicamento específico para fadiga. Diferenças entre os grupos com e sem fadiga foram encontradas em relação ao sexo (p = 0,049), intensidade da dor (p = 0,026), funcionalidade (p = 0,004), gravidade da doença (p = 0,029) e QV (p = 0,000). A fadiga foi correlacionada com a intensidade da dor (r = 0,425; p = 0,001), força muscular (r = - 0,356; p = 0,004), funcionalidade (r = - 0,363; p = 0,003) e QV (r = 0,481; p = 0,000). Não foram encontradas correlações com idade, tempo de diagnóstico, cãibras ou outros parâmetros de mobilidade. Conclusões A fadiga é um sintoma comum entre os indivíduos com ELA e pode estar presente em todos os estágios da doença. Este sintoma estava correlacionado à pior funcionalidade, pior QV, gravidade, intensidade da dor, fraqueza muscular e sexo feminino em indivíduos com ELA. (ELA paralisia incapacitante população Assim adequada 6 esporádica demográficos investigados utilizadas FSS, FSS (FSS inglês, inglês , ALSRFSR, ALSRFSR ALSRFS R, R (ALSRFS-R (QV ALSAQ40, ALSAQ40 ALSAQ 40, 40 (ALSAQ-40 inglês. . 190 19 0 19. IBM Corp Corp. Armonk NY USA. USA USA) avaliados 446 44 44,6 n 29 54 5 4 5, 12 1 2 1, 104 10 10,4 0,049, 0049 0,049 049 0,049) 0,026, 0026 0,026 026 0,026) 0,004, 0004 0,004 004 0,004) 0,029 0029 029 0,000. 0000 0,000 000 0,000) r 0,425 0425 425 0,001, 0001 0,001 001 0,001) 0,356 0356 356 0,363 0363 363 0,003 0003 003 0,481 0481 481 idade diagnóstico mobilidade ALSAQ4 (ALSAQ-4 44, 10, 0,04 04 002 0,02 02 0,00 00 0,42 042 42 0,35 035 35 0,36 036 36 0,48 048 48 (ALSAQ- 0,0 0,4 0,3 03 3 (ALSAQ 0,

Abstract Background Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease that leads to muscle weakness and paralysis. Fatigue is a disabling symptom, frequently reported in ALS, but remains under-investigated in this population. Thus, an accurate investigation of this symptom and possible associated factors in this clinical condition is needed to assist in the establishment of an adequate treatment approach. Objective To investigate the presence of fatigue in individuals with ALS and possible factors correlated with this symptom. Methods Sixty-five individuals with sporadic ALS participated in the present study. Demographic, clinical, and functional aspects were investigated. Evaluations involved the Fatigue Severity Scale (FSS), ALS Functional Scale (ALSRFS-R), and Quality of Life (QoL) questionnaire (ALSAQ-40). Descriptive and correlation analyses were performed with SPSS statistical program for Windows version 19.0 (IBM Corp., Armonk, NY, USA). Results Among the 65 individuals evaluated, 44.6% (n = 29) presented fatigue based on the FSS. The mean fatigue intensity was 5.4 ± 1.2 and only 10.4% used a specific medication for fatigue. Differences between the groups with and without fatigue were found regarding sex (p = 0.049), pain intensity (p = 0.026), functioning (p = 0.004), disease severity (p = 0.029), and QoL (p = 0.000). Fatigue was correlated with pain intensity (r = 0.425; p = 0.001), muscle strength (r = - 0.356; p = 0.004), functioning (r = - 0.363; p = 0.003), and QoL (r = 0.481; p = 0.000). No correlations were found with age, time since diagnosis, cramps, or other mobility parameters. Conclusions Fatigue is a common symptom among individuals with ALS and may be present in all stages of the disease. This symptom was correlated with worse functioning, poorer QoL, greater pain intensity, disease severity, muscle weakness, and the female sex in individuals with ALS. (ALS paralysis underinvestigated under investigated population Thus approach Sixtyfive Sixty five study Demographic FSS, FSS , (FSS) ALSRFSR, ALSRFSR ALSRFS R (ALSRFS-R) (QoL ALSAQ40. ALSAQ40 ALSAQ 40 . (ALSAQ-40) 190 19 0 19. IBM Corp Corp. Armonk NY USA. USA USA) 6 evaluated 446 44 44.6 n 29 54 5 4 5. 12 1 2 1. 104 10 10.4 0.049, 0049 0.049 049 0.049) 0.026, 0026 0.026 026 0.026) 0.004, 0004 0.004 004 0.004) 0.029, 0029 0.029 029 0.029) 0.000. 0000 0.000 000 0.000) r 0.425 0425 425 0.001, 0001 0.001 001 0.001) 0.356 0356 356 0.363 0363 363 0.003, 0003 0.003 003 0.003) 0.481 0481 481 age diagnosis cramps parameters (FSS (ALSRFS-R ALSAQ4 (ALSAQ-40 44. 10. 0.04 04 002 0.02 02 0.00 00 0.42 042 42 0.35 035 35 0.36 036 36 0.48 048 48 (ALSAQ-4 0.0 0.4 0.3 03 3 (ALSAQ- 0. (ALSAQ

https://doi.org/10.1055/s-0042-1758563

10.

Quality of life, disability, and clinical variables in amyotrophic lateral sclerosis
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Alencar, Mariana Asmar

; Silva, Izaura Monique Moura da

; Hilário, Stéfanie Marcelle

; Rangel, Marcela Ferreira de Andrade

; Abdo, Juliana Silva

; Araújo, Caroline Martins de

; Souza, Leonardo Cruz de

Arquivos de Neuro-Psiquiatria

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mar 2022, Volume 80 N. 3 Pages 255 - 261

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

RESUMO Antecedentes: Esclerose lateral amiotrófica (ELA) é uma doença do neurônio motor que resulta em um aumento progressivo das disfunções, limitações e restrições ao longo do tempo, o que pode afetar a qualidade de vida (QV). Ampliar o conhecimento sobre QV e os possíveis fatores associados permitirá o desenvolvimento de ações que garantam maior bem-estar. Objetivo: Avaliar a QV na ELA e verificar a associação com aspectos demográficos, funcionais e clínicos. Métodos: Participaram 45 indivíduos com ELA (5,4 ± 11,1 anos). Foram avaliados aspectos demográficos, clínicos, funcionais (ALS Functional Ranting Scale-Revised / ALSFRS-R), QV (ALS Assessment Questionnaire/ ALSAQ-40, respectivamente) e fadiga (Escala de gravidade da fadiga). Uma análise descritiva, correlação e regressão linear múltipla foram realizadas no programa estatístico SPSS. Resultados: Escore do ALSAQ-40 foi de 279,0 ± 118,3 para a população de ELA avaliada. Verificou-se pior QV significativa em mulheres (p=0,001), incapacidade de andar (p=0,014), dor (p=1,021) e com gravidade da doença (p≤0,002). QV correlacionou-se fortemente com ALSFRS-R (r =-0,82) e de moderada a fraca com mobilidade [virar na cama (r =-0,62), locomoção (r =-0,33) e sentar-se em pé (r=-0,40)], força (r=-0,49), fadiga (r=0,35) e dor (r=-0,32) (p<0,03). A análise de regressão encontrou ALSFRS-R (β=-0,76; p=0,00) e Fadiga (β=0,20; p=0,04) como preditores de QV. Conclusões: QV estava pior nas mulheres, em idosos, estágios de maior gravidade da ELA, na disfunção de mobilidade, no baixo desempenho e na dor. A funcionalidade e a fadiga na ELA são preditores de QV.

ABSTRACT Background: Amyotrophic lateral sclerosis (ALS) is a motor neuron disease that results in a progressive increase in dysfunctions, limitations and restrictions over time, which can impact on quality of life (QoL). Therefore, expanding knowledge on QoL and possible factors associated with ALS can enable the development of actions to ensure greater wellbeing for the population. Objective: To investigate QoL in ALS and determine associations with demographic, functional and clinical aspects. Methods: Forty-five individuals with ALS (56.4±11.1 years) participated in the study. Demographic, clinical and functional aspects were investigated. Functioning and QoL were assessed using disease-specific tools (ALS Functional Ranting Scale-Revised/ALSFRS-R and ALS Assessment Questionnaire/ALSAQ-40). Fatigue was assessed using the Fatigue Severity Scale. Descriptive, correlation and stepwise multiple linear regression analyses were performed with the aid of the SPSS. Results: The mean ALSAQ-40 score was 279.0±118.3. QoL was significantly worse among women (p=0.001) and poor QoL was associated with the inability to walk (p=0.014), pain (p=0.021) and disease severity (p≤0.002). QoL was strongly correlated with the ALSFRS-R score (r=-0.82). Moderate to weak correlations were found for mobility [turning in bed (r=-0.62), locomotion (r=-0.33) and sit to stand (r=-0.40)], strength (r=-0.49), fatigue (r=0.35) and pain (r=-0.32) (p<0.03). The regression analysis revealed that the ALSFRS-R score (β=-0.76; p=0.00) and fatigue (β=0.20; p=0.04) were predictors of QoL. Conclusions: QoL was worse in women, older people, severe stages of ALS, patients with impaired mobility, those with a poorer physical performance and those who reported pain. Functional status and fatigue are predictors of QoL in ALS.

https://doi.org/10.1590/0004-282x-anp-2021-0201

11.

Mitochondrial dysfunction on Leishmania (Leishmania) amazonensis induced by ketoconazole: insights into drug mode of action
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Nunes, Débora Cristina de Oliveira Silva

; Costa, Mônica Soares

; Bispo-da-Silva, Luiz Borges

; Ferro, Eloísa Amália Vieira

; Zóia, Mariana Alves Pereira

; Goulart, Luiz Ricardo

; Rodrigues, Renata Santos

; Rodrigues, Veridiana de Melo

; Yoneyama, Kelly Aparecida Geraldo

Memórias do Instituto Oswaldo Cruz

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2022, Volume 117 elocation e210157

Abstract: En | Text: En | PDF: En

BACKGROUND Leishmania parasites cause leishmaniasis that range from self-limiting cutaneous lesions to more serious forms of the disease. The search for potential drug targets focusing on biochemical and metabolic pathways revealed the sterol biosynthesis inhibitors (SBIs) as a promising approach. In this class of inhibitors is found ketoconazole, a classical inhibitor of 14α-methysterol 14-demethylase. OBJECTIVE The present study aimed to better understand the biological response of Leishmania (Leishmania) amazonensis promastigotes at the cellular level after ketoconazole treatment. METHODS Herein, techniques, such as fluorimetry, flow cytometry, fluorescence microscopy, electron and scanning microscopy were used to investigate the cellular structures and to identify organelles affected by ketoconazole treatment. FINDINGS The study demonstrated, for the first time, the effect of ketoconazole on mitochondrion functioning and its probable relationship to cell cycle and death on L. (L.) amazonensis promastigotes (IFLA/BR/67/PH8 strain). MAIN CONCLUSIONS Ketoconazole-induced mitochondrial damages led to hyperpolarisation of this single organelle and autophagic vacuoles formation, as a parasite survival strategy. These damages did not reflect directly on the parasite cell cycle, but drove the parasites to death, making them susceptible to ketoconazole treatment in in vitro models.

https://doi.org/10.1590/0074-02760210157

12.

Transforming growth factor-ß as a therapeutic target for the cardiac damage of Chagas disease
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Waghabi, Mariana Caldas

; Ferreira, Roberto Rodrigues

; Abreu, Rayane da Silva

; Degrave, Wim

; de Souza, Elen Mello

; Bailly, Sabine

; Feige, Jean-Jacques

; de Araújo-Jorge, Tania C

Memórias do Instituto Oswaldo Cruz

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2022, Volume 117 elocation e210395

Abstract: En | Text: En | PDF: En

Transforming growth factor beta (TGF-β) is deeply involved on the pathogenesis of Chagas disease. Our group has been investigating the participation of this pleiotropic cytokine in different aspects of Chagas disease over the last 20 years. Important observations have been made, such as: (i) the ability of Trypanosoma cruzi in activating latent TGF-β; (ii) the potential involvement of TGF-β pathway on T. cruzi invasion of host cells; (iii) association of TGF-β with parasite intracellular replication; (iv) cardiac fibrosis development and maintenance; (v) disruption of Connexin-43 plaque structures and (vi) inflammation and immune response. In this perspective article we intend to discuss the advances of the potential use of new therapies targeting TGF-β to treat the cardiac alterations of Chagas disease-affected patients.

https://doi.org/10.1590/0074-02760210395

13.

Functional ambulation decline and factors associated in amyotrophic lateral sclerosis
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Alencar, Mariana Asmar

; Guedes, Maria Clara Batista

; Pereira, Tayná Amaral Leite

; Rangel, Marcela Ferreira de Andrade

; Abdo, Juliana Silva

; Souza, Leonardo Cruz de

Fisioterapia em Movimento

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2022, Volume 35 elocation e35127

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

Resumo Introdução: A esclerose lateral amiotrófica (ELA) é uma doença neurodegenerativa incapacitante, que compromete a locomoção e a independência funcional. Como o objetivo da fisioterapia é manter a capacidade de locomoção e independência do indivíduo pelo maior tempo possível, é necessário conhecer melhor os possíveis fatores associados à perda dessa capacidade. Objetivo: Avaliar a deambulação funcional em pacientes com ELA e possíveis fatores associados ao seu declínio. Métodos: Realizou-se um estudo transversal com ELA esporádica. Aspectos demográficos e clínicos/funcionais foram avaliados. A Escala Funcional de ELA (ALSFRS-R), a Escala de Categoria de Deambulação Funcional (FAC), a Medical Research Council Scale e a Escala de Severidade de Fadiga (FSS) foram usadas. Foram realizadas análises descritivas e comparativas dos grupos capazes e incapazes de deambulação funcional. A regressão logística binária (método stepwise forward) foi realizada para determinar os potenciais fatores associados à perda da deambulação funcional. Resultados: Entre os 55 pacientes (média de idade: 56,9 ± 11,2 anos), 74,5% eram capazes de deambular funcionalmente. Encontraram-se diferenças entre os grupos quanto ao tempo de diagnóstico, número de quedas, dor, uso de ventilação não invasiva, gastrostomia, capacidade de se virar no leito, auxiliares de locomoção, adaptações domiciliares, desempenho funcional, força muscular e fadiga. Os possíveis preditores de incapacidade de locomoção foram força muscular geral (OR = 0,837; p = 0,003) e fadiga (OR = 1,653; p = 0,034). Conclusão: A força muscular e a fadiga estão associadas ao declínio da capacidade de deambulação em pacientes com ELA. Diante da complexidade dos elementos envolvidos na caminhada, são necessários mais estudos que investiguem a influência desses aspectos nessa população.

Abstract Introduction: Amyotrophic lateral sclerosis (ALS) is a disabling neurodegenerative disease, which compromises locomotion and functional independence. As the goal of physical therapy is to maintain the individual's locomotion capacity and independence as long as possible, it is necessary to gain a better understanding of the possible factors associated with the loss of this capacity. Objective: To evaluate functional ambulation in patients with ALS and possible factors associated with its decline. Methods: A cross-sectional study was conducted with sporadic ALS patients. Demographic and clinical/functional aspects were evaluated. ALS Functional Rating Scale-Revised (ALSFRS-R), Functional Ambulation Category, Medical Research Council scale and Fatigue Severity Scale were used. Descriptive and comparative analyses were conducted of the groups capable and incapable of functional ambulation. Binary logistic regression (stepwise forward method) was performed to determine potential factors associated with the loss of functional ambulation. Results: Among the 55 patients (mean age: 56.9 ± 11.2 years), 74.5% were able to walk functionally. Differences were found between groups regarding time of diagnosis, number of falls, pain, use of noninvasive ventilation, gastrostomy, ability to turn in bed, mobility aids, home adaptations, functional performance, muscle strength and fatigue. The possible predictors of walking disability were overall muscle strength (OR = 0.837; p = 0.003) and fatigue (OR =1.653; p = 0.034). Conclusion: Muscle strength and fatigue are associated with the decline in ambulation capacity in patients with ALS. In view of the complexity of elements involved in walking, further studies are needed to investigate the influence of these aspects in this population.

https://doi.org/10.1590/fm.2022.35127

14.

Exposição ‘Zika Vidas que Afetam’: um relato de experiência
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Silva, Lenir

; Albuquerque, Mariana

; Mayrink, Marta Fabíola

Saúde em Debate

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sep 2021, Volume 45 N. 130 Pages 861 - 870

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

ABSTRACT The Zika virus epidemic in Brazil mainly affected women and children and mobilized responses from science, society, and governments between 2015 and 2018. The Zika Social Sciences Network promoted the exhibition ‘Zika Affecting Lives’, an unprecedented event for Fiocruz 120th anniversary. This narrative aims to report the experience of constructing the exhibition, emphasizing the contribution of women - mothers, managers, health professionals, and researchers. The exhibition is a scientific dissemination device built collectively from October 2018 to August 2020. The method involved the participation of various groups and institutions affected by the epidemic representatives - researchers, users, professionals, and health managers - through interviews, workshops, and meetings. Such participation included the design, production, finalization, validation, and readaptation of the exhibition to an online version format, in the context of the Covid-19 pandemic. The results show the potential and the challenges of collective construction - an experience that could affect other experiences. The exhibition’s narrative is made chiefly by women, from different viewpoints, based on the issues that affect them, and highlights their prominent role in mobilizing and responding to Zika in science, politics, and society.

RESUMO A epidemia do vírus Zika, que atingiu o Brasil entre 2015 e 2018, afetou, sobretudo, mulheres e crianças, mobilizando respostas da ciência, sociedade e governos. A Rede Zika Ciências Sociais promoveu a exposição ‘Zika Vidas que Afetam’, mostra inédita para os 120 anos da Fundação Oswaldo Cruz (Fiocruz). O objetivo desse relato foi trazer a experiência da construção da exposição, com destaque para a contribuição das mulheres - mães, gestoras, profissionais de saúde e pesquisadoras. A exposição é um dispositivo de divulgação científica construído coletivamente, entre outubro de 2018 e agosto de 2020. O método envolveu a participação, por meio de entrevistas, oficinas e reuniões, de representantes dos vários grupos e instituições afetados pela epidemia: cientistas, usuários, profissionais e gestores da saúde. Tal participação ocorreu desde a concepção, produção, finalização, validação e readequação da exposição à versão on-line, no contexto da pandemia de Covid-19. Os resultados mostram as potencialidades e os desafios do modo de construção coletiva - uma experiência que pode afetar outras experiências. A narrativa da exposição é feita majoritariamente por mulheres, sob diferentes pontos de vista, a partir das questões que as afetam, e evidencia o seu papel destacado na mobilização e resposta à Zika, na ciência, na política e na sociedade.

https://doi.org/10.1590/0103-1104202113022

15.

Exposição ‘Zika Vidas que Afetam’: um relato de experiência
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Silva, Lenir

; Albuquerque, Mariana

; Mayrink, Marta Fabíola

Saúde em Debate

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sep 2021, Volume 45 N. 130 Pages 861 - 870

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

https://doi.org/10.1590/0103-1104202113022 81 downloads

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