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Desastres e icebergs: precisamos ir além
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Freitas, Carlos Machado de

Cadernos de Saúde Pública

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2023, Volume 39 N. 4 elocation e00052523

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.1590/0102-311xpt052523

Desastres e icebergs: precisamos ir além
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Freitas, Carlos Machado de

Cadernos de Saúde Pública

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2023, Volume 39 N. 4 elocation e00052523

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

https://doi.org/10.1590/0102-311xpt052523

Productivity and nutrient export in a maize and forage grasses intercropping under semiarid conditions
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PONTE FILHO, Francisco Augusto Machado da

; GUEDES, Fernando Lisboa

; POMPEU, Roberto Cláudio Fernandes Franco

; SAGRILO, Edvaldo

; ANDRADE, Hosana Aguiar Freitas de

; COSTA, Carlos Pedro de Meneses

; SOUZA, Henrique Antunes de

Revista Brasileira de Saúde e Produção Animal

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2023, Volume 24 elocation 20220029

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

ABSTRACT The aim was to evaluate the productive performance and nutrient export of maize intercropped with drought-tolerant forage grasses. The experimental design was a randomized blocks in a 2x2x2+1 factorial scheme (two forage grasses species – Massai and Buffel; two forage sowing methods - in the furrow and broadcast; and two forage sowing times - anticipated and simultaneous; and monoculture maize as an additional control), with three replicates. The maize+forage intercropping promoted greater competition for resources, especially water, limiting N uptake, chlorophyll synthesis, and biomass production by maize under semiarid conditions. Early sowing gave forage plants a competitive advantage, favoring forage establishment before or immediately after the sowing of maize. Thus, the simultaneous sowing of forage grasses in a semiarid environment is a more appropriate option considering the importance of high levels of chlorophyll to ensure high photosynthetic activity in maize plants and greater capacity of biomass synthesis. Massai intercropped with maize exhibits a greaterpotential for biomass production than Buffel under semiarid conditions. Maize+Buffel result in highest macronutrient export by maize, while maize+Massai result in highest macronutrient exports by total forage biomass under a semiarid environment. The choice of the forage species and its sowing time in relation to maize are the main determinants of successful intercropping systems under semiarid conditions.

RESUMO O objetivo foi avaliar o desempenho produtivo e a exportação de nutrientes do consórcio de milho com gramíneas forrageiras tolerantes ao estresse hídrico. O experimento foi delineado em blocos casualizados em esquema fatorial 2x2x2+1 (duas espécies de gramíneas forrageiras – Massai e Buffel; dois métodos de semeadura – no sulco e a lanço; e duas épocas de semeadura – antecipada e simultânea; e monocultivo de milho como um controle adicional), com três repetições. O consórcio milho+forragem promoveu maior competição por recursos, principalmente água, limitando a absorção de N, síntese de clorofila e produção de biomassa pelo milho para condições semiáridas. A semeadura precoce deu vantagem competitiva às plantas forrageiras, favorecendo seu estabelecimento antes ou imediatamente após a semeadura do milho. Assim, a semeadura simultânea de gramíneas forrageiras em ambiente semiárido é uma opção mais adequada, considerando a importância de garantir altos teores de clorofila e, consequentemente, alta atividade fotossintética nas plantas de milho para garantir a capacidade de síntese de biomassa.Massai consorciado com milho apresenta maior potencial para produção de biomassa do que Buffel em condições semiáridas.Milho+Buffel resulta em maior exportação de macronutrientes pelo milho, enquanto milho+Massai resulta em maior exportação de macronutrientes pela biomassa forrageira total em ambiente semiárido.A escolha da espécie forrageira e sua época de semeadura em relação ao milho são os principais determinantes do sucesso do consórcio no semiárido.

https://doi.org/10.1590/s1519-994020220029

Diretrizes Brasileiras para o tratamento farmacológico de pacientes hospitalizados com COVID-19: Diretriz conjunta da Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia e Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Stein, Cinara

; Amaral, José Luiz Gomes do

; Azevedo, Luciano Cesar Pontes de

; Belli, Karlyse Claudino

; Colpani, Verônica

; Cunha, Clóvis Arns da

; Dal-Pizzol, Felipe

; Dias, Maria Beatriz Souza

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Monteiro, José Tadeu

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Prado, Clementina Corah Lucas

; Santos, Vania Cristina Canuto

; Silva, Rosemeri Maurici da

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Vidal, Ávila Teixeira

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Machado, Flávia Ribeiro

; Carvalho, Carlos Roberto Ribeiro de

Revista Brasileira de Terapia Intensiva

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mar 2022, Volume 34 N. 1 Pages 1 - 12

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

RESUMO Objetivos: Há diversas terapias sendo utilizadas ou propostas para a COVID-19, muitas carecendo de apropriada avaliação de efetividade e segurança. O propósito deste documento é elaborar recomendações para subsidiar decisões sobre o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: Um grupo de 27 membros, formado por especialistas, representantes do Ministério da Saúde e metodologistas, integra essa diretriz. Foi utilizado o método de elaboração de diretrizes rápidas, tomando por base a adoção e/ou a adaptação de recomendações a partir de diretrizes internacionais existentes (GRADE ADOLOPMENT), apoiadas pela plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Foram geradas 16 recomendações. Entre elas, estão recomendações fortes para o uso de corticosteroides em pacientes em uso de oxigênio suplementar, para o uso de anticoagulantes em doses de profilaxia para tromboembolismo e para não uso de antibacterianos nos pacientes sem suspeita de infecção bacteriana. Não foi possível fazer uma recomendação quanto à utilização do tocilizumabe em pacientes hospitalizados com COVID-19 em uso de oxigênio, pelas incertezas na disponibilidade e de acesso ao medicamento. Foi feita recomendação para não usar azitromicina, casirivimabe + imdevimabe, cloroquina, colchicina, hidroxicloroquina, ivermectina, lopinavir/ ritonavir, plasma convalescente e rendesivir. Conclusão: Até o momento, poucas terapias se provaram efetivas no tratamento do paciente hospitalizado com COVID-19, sendo recomendados apenas corticosteroides e profilaxia para tromboembolismo. Diversos medicamentos foram considerados ineficazes, devendo ser descartados, de forma a oferecer o melhor tratamento pelos princípios da medicina baseada em evidências e promover economia de recursos não eficazes.

ABSTRACT Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.

https://doi.org/10.5935/0103-507x.20220001-pt

Os impactos das mudanças climáticas na Segurança Alimentar e Nutricional: uma revisão da literatura
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Alpino, Tais de Moura Ariza

; Mazoto, Maíra Lopes

; Barros, Denise Cavalcante de

; Freitas, Carlos Machado de

Ciência & Saúde Coletiva

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jan 2022, Volume 27 N. 1 Pages 273 - 286

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

Resumo A interface entre as Mudanças Climáticas e a Segurança Alimentar e Nutricional (SAN) tem se destacado na agenda de desenvolvimento sustentável desde o início da década de 1990. Desde então, estudos demonstram que as mudanças climáticas possuem efeitos negativos na SAN, potencializados pela pobreza e desigualdade social. O objetivo deste artigo é realizar uma revisão relacionando mudanças climáticas e SAN. A pesquisa foi realizada no PubMed utilizando os descritores “climate change and food security” no título, selecionando somente artigos em português, espanhol e inglês e com relação direta com os temas. Os principais impactos das mudanças climáticas na SAN foram no acesso, produção, qualidade nutricional e volatilidade dos preços dos alimentos. Estratégias de mitigação/adaptação aos efeitos das mudanças climáticas na SAN também foram apontadas nos estudos, além de um panorama geográfico das publicações com domínio de estudos na África e Ásia, continentes marcados por desigualdade social e pobreza. As mudanças climáticas afetam as dimensões da SAN, especialmente em populações mais pobres e em situação de desigualdade social. A relevância dos temas suscita a premência de maior investimento em políticas públicas, estudos e pesquisas acerca da temática no mundo.

Abstract The interface between Climate Changes and Food and Nutrition Security (FNS) has been standing out in the sustainable development agenda since the early 1990’s. Since then, studies show that climate changes have negative effects on the FNS, aggravated by poverty and social inequality. The purpose of this paper is to perform a review evidencing the relationships between climate changes and FNS. The research was carried out in PubMed using the descriptors “climate change and food security” on the headline, selecting only papers in Portuguese, Spanish, and English languages, and with a direct relation to the themes. The main impacts of climate changes on the FNS were related to the access, production, nutritional quality, and volatility of food prices. The studies also indicated mitigation/adaptation strategies to the effects of climate changes on the FNS, as well as a geographic panorama of the publications with fields of study in Africa and Asia, continents marked by social inequality and poverty. Climate changes affect the dimensions of FNS, especially in poorer populations in situation of social inequality. The relevance of the themes raises concern on the urgency of higher investments in public policies, studies, and research on the subject around the world.

https://doi.org/10.1590/1413-81232022271.05972020

Os impactos das mudanças climáticas na Segurança Alimentar e Nutricional: uma revisão da literatura
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Alpino, Tais de Moura Ariza

; Mazoto, Maíra Lopes

; Barros, Denise Cavalcante de

; Freitas, Carlos Machado de

Ciência & Saúde Coletiva

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jan 2022, Volume 27 N. 1 Pages 273 - 286

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

https://doi.org/10.1590/1413-81232022271.05972020

Mining dams disasters as systemic risks
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Freitas, Carlos Machado de

; Silva, Mariano Andrade da

; Menezes, Fernanda Carvalho de

; Luz, Zélia Maria Profeta da

Revista Brasileira de Epidemiologia

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2022, Volume 25 Suppl. 2 elocation e220004

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

ABSTRACT: Between 2015 and 2019, Brazil recorded the two most serious disasters involving mining dams of the 21st century. The purpose of this article is to offer an understanding of these disasters as systemic risks. They involve from global and national processes related to social determinants that materialize in a complex system of dams distributed throughout the country with their intrinsic risks. When they occur, result in a set of impacts with potential damage and immediate effects combined with secondary and tertiary impacts that can trigger chain reactions, which promote risk factors of heterogeneous and complex occurrence. Approaching these events from the point of view of systemic risk allows for a broader understanding of both the singularity of each of these disasters and their multiple exposure, risk and disease processes, as well as the structural characteristics in which social, political processes and dynamics and economic factors reproduce in multiple territories a common pattern of disasters and their effects. We conclude that the promotion of population health and sustainable territories should guide the organization of production processes and not the opposite, with the externalization of human, environmental and social costs of mining and its disasters.

RESUMO: Entre 2015 e 2019, o Brasil registrou os dois mais graves desastres envolvendo barragens de mineração do século XXI. O objetivo deste artigo é oferecer a compreensão desses desastres como riscos sistêmicos, que envolvem desde processos globais e nacionais relacionados aos determinantes sociais que se concretizam em um complexo sistema de barragens distribuídas pelo País com seus riscos intrínsecos. Quando ocorrem, resultam em um conjunto de impactos com potencial de danos e efeitos imediatos combinados com impactos secundários e terciários que podem desencadear reações em cadeia, promovendo fatores de riscos de ocorrência heterogênea e complexa. Abordar esses eventos com base no conceito de risco sistêmico permite uma compreensão mais ampla tanto da singularidade de cada um desses desastres e seus múltiplos processos de exposição, riscos e doenças, como também das características estruturais com que os processos e dinâmicas sociais, políticas e econômicas reproduzem, em múltiplos territórios, um padrão comum de desastres e seus efeitos. Concluímos que a promoção da saúde da população e de territórios sustentáveis deve orientar a organização dos processos produtivos e não o contrário, com a externalização dos custos humanos, ambientais e sociais da mineração e seus desastres.

https://doi.org/10.1590/1980-549720220004.supl.2

Brumadinho Health Project: methodological aspects and epidemiological profile of participants in the cohort baseline
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Peixoto, Sérgio Viana

; Firmo, Josélia Oliveira Araújo

; Fróes-Asmus, Carmen Ildes Rodrigues

; Mambrini, Juliana Vaz de Melo

; Freitas, Carlos Machado de

; Lima-Costa, Maria Fernanda

; Souza Júnior, Paulo Roberto Borges de

Revista Brasileira de Epidemiologia

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2022, Volume 25 Suppl. 2 elocation e220002

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

ABSTRACT: Objective: To present the methodological aspects of the Brumadinho Health Project and to describe the epidemiological profile of participants in the baseline cohort. Methods: Prospective, population-based cohort study in a representative sample of residents (aged 12 and over) of Brumadinho, Minas Gerais, after a mining tailings dam failure. Information for the baseline was collected in 2021, two years after the mining tailings dam collapsed, including sociodemographic, health and service use aspects, among others. Prevalence estimates of health outcomes were described in Brumadinho, as well as in the Metropolitan Region of Belo Horizonte and Minas Gerais, using data from the 2019 National Health Survey. All analyses were performed in the software Stata 17.0, considering the sampling weights and design effect. Results: 3,080 (86.4%) residents participated in the study, most of them being females (56.7%) and with a mean age of 46.1 years. The diseases more frequently reported were arterial hypertension (30.1%), high cholesterol (23.1%) and depression (22.5%), similarly to what was observed in the Metropolitan Region of Belo Horizonte and Minas Gerais, although the prevalence in Brumadinho was higher. At least one medical appointment and one hospitalization occurred in 75.2% and 9.4% of residents in the past year, respectively. Conclusion: It is important to monitor health, physical and mental conditions of residents after the occurrence of a disaster of this magnitude. This information can contribute with risk management of these processes, not only in the affected municipality, but also in other areas where populations are at risk of major disasters.

RESUMO: Objetivo: Apresentar os aspectos metodológicos do Projeto Saúde Brumadinho e descrever o perfil epidemiológico dos participantes da linha de base da coorte. Métodos: Coorte prospectiva, de base populacional, em amostra representativa dos residentes (12 anos ou mais de idade) de Brumadinho, Minas Gerais, após rompimento de barragem de rejeitos de mineração. As informações para a linha de base foram coletadas em 2021, dois anos após o rompimento da barragem de rejeitos de mineração, incluindo aspectos sociodemográficos, de saúde, uso de serviços, entre outros. Foram descritas prevalências de desfechos em saúde em Brumadinho, bem como na região metropolitana de Belo Horizonte e em Minas Gerais, utilizando os dados da Pesquisa Nacional de Saúde de 2019. Todas as análises foram realizadas no Stata 17.0, considerando-se os pesos amostrais e o efeito de delineamento. Resultados: Participaram 3.080 (86,4%) moradores, sendo a maioria do sexo feminino (56,7%) e com média de idade de 46,1 anos. As doenças referidas mais frequentes foram hipertensão arterial (30,1%), colesterol alto (23,1%) e depressão (22,5%). Pelo menos uma consulta médica e uma hospitalização no último ano ocorreram em 75,2% e 9,4% dos entrevistados, respectivamente. Conclusão: É importante o monitoramento das condições de saúde, físicas e mentais, após ocorrência de um desastre dessa magnitude. Esse conhecimento poderá contribuir para a gestão de risco desses processos não só no município atingido, mas em outras áreas nas quais as populações estão sob risco de grandes desastres.

https://doi.org/10.1590/1980-549720220002.supl.2

Os modos de fazer saúde na Amazônia das Águas
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El Kadri, Michele Rocha

; Schweickardt, Julio Cesar

; Freitas, Carlos Machado de

Interface - Comunicação, Saúde, Educação

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2022, Volume 26 elocation e220056

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

This article describes how the characteristics of the Amazon floodplain affect the organization of local health systems. We chose a region in the west of the state of Amazonas which is characteristic of this situation. We interviewed local health managers and mapped the routes taken by users to access health services. Smaller municipalities are extremely dependent on services in the regional hub and capital of the state. Patients, except emergency patients, are transported via waterways, resulting in longer travel times and higher costs than land routes. The seasonal flooding cycle also affects travel times, costs and prevalent health problems. We identified some points of tension between the rules and regulations governing the configuration of local health regions and the regional reality. Promoting health in the Amazon inevitably requires the health system to adapt and be resilient to local geographical characteristics and patient flows.

Descrevemos como a organização do sistema de saúde é afetada pelas características da várzea amazônica. Elegemos uma região a oeste do estado do Amazonas que bem caracteriza esse cenário. Entrevistamos gestores de saúde e mapeamos os trajetos percorridos pelos usuários para acessar a rede sanitária. Municípios menores são extremamente dependentes da rede de serviço do polo regional e da capital estadual. O transporte de usuários, à exceção de emergências, é feito por via fluvial com maior tempo e maior custo em relação à via terrestre. O ciclo vazante-cheia também interfere no tempo, no custo e nos agravos prevalentes. Identificamos alguns pontos de tensão entre o instituído normativamente para conformação das regiões de saúde e a realidade regional. Promover saúde na Amazônia passa inevitavelmente pela adaptação e pela resiliência do sistema de saúde no diálogo com as características do território e dos fluxos dos usuários.

Describimos cómo la organización del sistema de salud se ve afectada por las características de la vega amazónica. Elegimos una región del oeste del Estado de Amazonas que caracteriza bien ese escenario. Entrevistamos a gestores de salud y mapeamos los trayectos recorridos por los usuarios para tener acceso a la red sanitaria. Los municipios menores son extremadamente dependientes de la red de servicio del polo regional y de la capital del estado. El transporte de usuarios, a no ser en casos de emergencia, se realiza por vía fluvial con mayor tiempo y costo con relación a la vía terrestre. El ciclo subida y bajada de las aguas también interfiere en el tiempo, costos y problemas prevalentes. Identificamos algunos puntos de tensión entre lo instituido normativamente para conformación de las regiones de salud y la realidad regional. La promoción de la salud en la Amazonia pasa inevitablemente por la adaptación y resiliencia del sistema de salud en el diálogo con las características del territorio y de los flujos de los usuarios.

https://doi.org/10.1590/interface.220056

10.

Os modos de fazer saúde na Amazônia das Águas
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El Kadri, Michele Rocha

; Schweickardt, Julio Cesar

; Freitas, Carlos Machado de

Interface - Comunicação, Saúde, Educação

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2022, Volume 26 elocation e220056

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

https://doi.org/10.1590/interface.220056

11.

Does the school environment exert influence on quality of life related to traumatic dental injury in children?
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QUEZADA-CONDE, Maritza Del Carmen

; ALVAREZ-VELASCO, Patricia Lourdes

; BALSECA-IBARRA, Mariela Cumanda

; FREITAS, Raíza Dias

; ARDENGHI, Thiago Machado

; MICHEL-CROSATO, Edgard

; PANNUTI, Claudio Mendes

; FRIAS, Antonio Carlos

; RAGGIO, Daniela Prócida

; MENDES, Fausto Medeiros

Brazilian Oral Research

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2022, Volume 36 elocation e105

Abstract: En | Text: En | PDF: En

Abstract The aim of this cross-sectional study was to assess whether favorable factors related to school characteristics have a positive effect on the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL). An epidemiological survey of oral health was conducted with 12-year-old schoolchildren from Quito, Ecuador. Children were examined for TDI, dental caries, and malocclusion. Individual socioeconomic data were also collected. Information on the physical environment, health practices, and occurrence of negative episodes at school was collected from the school coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was used to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth-brushing environment for their students exhibited a lower impact on OHRQoL, even after adjustment for the occurrence of TDI and other variables. A favorable school environment may exert a positive effect on OHRQoL, independent of the occurrence of TDI.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0105

12.

Contribution of Pseudobombax aff. petropolitanum to Nutrient Cycling in Woody Vegetation from a Neotropical Inselberg
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Freitas, Carlos Antônio Araújo de

; Souza, Rodrigo Camara de

; Pereira, Marcos Gervasio

; Caldeira, Marcos Vinicius Winckler

; Couto, Dayvid Rodrigues

; Kunz, Sustanis Horn

; Moreau, Julia Siqueira

; Dias, Henrique Machado

; Momolli, Dione Richer

Floresta e Ambiente

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2022, Volume 29 N. 4 elocation e20220034

Abstract: En | Text: En | PDF: En

Abstract The aim of the study was to investigate Pseudobombax aff. petropolitanum (PP) contribution on annual fine litterfall, carbon content, and nutrient concentration, compared to other woody species (OS) on a neotropical inselberg in Espírito Santo state, Brazil. Annual fine litterfall was systematic monthly collected (November 2011-October 2012) by means of 15 littertraps (0.25 m2) placed in five transects, oven-dried (65 °C, 72 h), weighed, and C content and nutrients concentration (N, P, K, Ca, Mg, S, B, Cu, Fe, Mn, Zn) were estimated. PP performed lower litterfall, C content, and nutrient concentration excepting higher K concentration, compared to OS. The results suggested that PP performed higher nutrient conservation, which indicated its potential in restoring degraded areas observed in the inselberg.

https://doi.org/10.1590/2179-8087-floram-2022-0034

13.

Brazilian guidelines for the treatment of outpatients with suspected or confirmed COVID-19. A joint guideline of the Brazilian Association of Emergency Medicine (ABRAMEDE), Brazilian Medical Association (AMB), Brazilian Society of Angiology and Vascular Surgery (SBACV), Brazilian Society of Geriatrics and Gerontology (SBGG), Brazilian Society of Infectious Diseases (SBI), Brazilian Society of Family and Community Medicine (SBFMC), and Brazilian Thoracic Society (SBPT)
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Falavigna, Maicon

; Belli, Karlyse Claudino

; Barbosa, Alexandre Naime

; Zavascki, Alexandre Prehn

; Nastri, Ana Catharina de Seixas Santos

; Santana, Christiane Machado

; Stein, Cinara

; Gräf, Débora Dalmas

; Cadegiani, Flavio Adsuara

; Guimarães, Hélio Penna

; Monteiro, José Tadeu

; Ferreira, Juliana Carvalho

; de Azevedo, Luciano Cesar Pontes

; Magri, Marcelo Mihailenko Chaves

; Sobreira, Marcone Lima

; Dias, Maria Beatriz Gandra de Souza

; de Oliveira, Maura Salaroli

; Corradi, Mirian de Freitas Dal Ben

; Rosa, Regis

; Heinzelmann, Ricardo Souza

; da Silva, Rosemeri Maurici

; Belfort Junior, Rubens

; Cimerman, Sergio

; Colpani, Verônica

; Veiga, Viviane Cordeiro

; de Carvalho, Carlos Roberto Ribeiro

Brazilian Journal of Infectious Diseases

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2022, Volume 26 N. 2 elocation 102347

Abstract: En | Text: En | PDF: En

ABSTRACT Background Several therapies have been used or proposed for the treatment of COVID-19, although their effectiveness and safety have not been properly evaluated. The purpose of this document is to provide recommendations to support decisions about the drug treatment of outpatients with COVID-19 in Brazil. Methods A panel consisting of experts from different clinical fields, representatives of the Brazilian Ministry of Health, and methodologists (37 members in total) was responsible for preparing these guidelines. A rapid guideline development method was used, based on the adoption and/or adaptation of recommendations from existing international guidelines combined with additional structured searches for primary studies and new recommendations whenever necessary (GRADE-ADOLOPMENT). The rating of quality of evidence and the drafting of recommendations followed the GRADE method. Results Ten technologies were evaluated, and 10 recommendations were prepared. Recommendations were made against the use of anticoagulants, azithromycin, budesonide, colchicine, corticosteroids, hydroxychloroquine/chloroquine alone or combined with azithromycin, ivermectin, nitazoxanide, and convalescent plasma. It was not possible to make a recommendation regarding the use of monoclonal antibodies in outpatients, as their benefit is uncertain and their cost is high, with limitations of availability and implementation. Conclusion To date, few therapies have demonstrated effectiveness in the treatment of outpatients with COVID-19. Recommendations are restricted to what should not be used, in order to provide the best treatment according to the principles of evidence-based medicine and to promote resource savings by aboiding ineffective treatments.

https://doi.org/10.1016/j.bjid.2022.102347

14.

Brumadinho Health Project: methodological aspects and epidemiological profile of participants in the cohort baseline
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Peixoto, Sérgio Viana

; Firmo, Josélia Oliveira Araújo

; Fróes-Asmus, Carmen Ildes Rodrigues

; Mambrini, Juliana Vaz de Melo

; Freitas, Carlos Machado de

; Lima-Costa, Maria Fernanda

; Souza Júnior, Paulo Roberto Borges de

Revista Brasileira de Epidemiologia

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2022, Volume 25 Suppl. 2 elocation e220002

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

https://doi.org/10.1590/1980-549720220002.supl.2

15.

Mining dams disasters as systemic risks
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Freitas, Carlos Machado de

; Silva, Mariano Andrade da

; Menezes, Fernanda Carvalho de

; Luz, Zélia Maria Profeta da

Revista Brasileira de Epidemiologia

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2022, Volume 25 Suppl. 2 elocation e220004

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

https://doi.org/10.1590/1980-549720220004.supl.2

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