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ABSTRACT Wild birds have great prominence in the transmission of diseases to humans, mainly due to their ease of access to human populations, raising concerns about the potential impact of that proximity on public health. The present study reports ARV and PBV occurrence in wild birds from an environmental protection area in the Amazon biome, in Pará state, Brazil. We obtained 155 fecal specimens from 47 species of wild birds for RNA extraction, ARV and PBV detection utilizing molecular methods, nucleotide sequencing, and phylogenetic analysis. ARV prevalence was 0.6% (1/155), being positive in an individual of Myrmotherula longipennis, and PBV prevalence was 1.29% (2/155), affecting two individuals of Guira guira. The PBV strains were assigned to genogroup I based on phylogenetic analysis, and they shared a strong phylogenetic link with strains isolated from different geographic locations. The ARV strain was more closely related to strains that had previously circulated in the same region. The presence of ARV and PBV in this habitat suggests that infection cycles of these agents occur naturally in the wild ecosystem, potentially triggering transmission events between bird species and humans. This is the first study on ARV detection in wild birds in Brazil and the first report on the occurrence of PBV in wild Guira guira. Additional studies are required to determine the epidemiology, origin, evolution, and emergence of new potentially pathogenic viruses in the Amazon.

RESUMO As aves silvestres têm grande destaque na transmissão de doenças ao homem, principalmente pela facilidade de acesso à população humana, levantando preocupações sobre o potencial impacto dessa proximidade no contexto da saúde pública. O presente estudo relata a ocorrência de ARV e PBV em aves silvestres de uma área de proteção ambiental no bioma Amazônico. Obtivemos 155 espécimes fecais de 47 espécies de aves silvestres, que foram submetidos a extração de RNA, detecção de ARV e PBV por técnicas moleculares, sequenciamento nucleotídico e análise filogenética. A prevalência de infecção por ARV foi 0,6% (1/155), sendo positivo em um indivíduo de Myrmotherula longipennis, e a prevalência de PBV foi 1,29% (2/155), afetando dois insdivíduos de Guira guira. A análise filogenética agrupou as cepas de PBV no genogrupo I, mostrando intensa relação filogenética com cepas isoladas de outras regiões geográficas. A cepa de ARV esteve mais relacionada filogeneticamente a cepas previamente circulantes na mesma região. Este é o primeiro estudo sobre detecção de ARV em aves silvestres no Brasil e o primeiro relato sobre a ocorrência de PBV em Guira guira. A circulação de ARV e PBV nesse ambiente demonstra que os ciclos desses agentes estão ocorrendo de forma natural no ecossistema silvestre, o que pode desencadear possíveis eventos de transmissão entre as espécies aviárias e humanos. Estudos adicionais são necessários para determinar a epidemiologia, origem, evolução e surgimento de novos vírus potencialmente patogênicos na Amazônia.

https://doi.org/10.1590/1809-4392202300120

Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials
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Almeida, Paula Ribeiro Lopes

; Person, Osmar Clayton

; Puga, Maria Eduarda dos Santos

; Giusti, Maria Fernanda

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira

; Atallah, Álvaro Nagib

Sao Paulo Medical Journal

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apr 2023, Volume 141 N. 2 Pages 168 - 176

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Tocilizumab is an anti-human interleukin 6 receptor monoclonal antibody that has been used to treat coronavirus disease 2019 (COVID-19). However, there is no consensus on its efficacy for the treatment of COVID-19. OBJECTIVE: To evaluate the effectiveness and safety of tocilizumab for treating COVID-19. DESIGN AND SETTING: Systematic Review of randomized controlled trials (RCTs), Universidade Federal de São Paulo (UNIFESP), São Paulo (SP), Brazil. METHODS: We searched MEDLINE via PubMed, EMBASE, CENTRAL, and IBECS for RCTs published up to March 2021. Two authors selected studies and assessed the risk of bias and the certainty of the evidence following Cochrane Recommendations. RESULTS: Eight RCTs with 6,139 participants were included. We were not able to find differences between using tocilizumab compared to standard care on mortality in hospitalized patients with COVID-19 (risk ratio (RR) 0.97, 95% confidence interval (CI) 0.84 to 1.13; 8 trials; 5,950 participants; low-certainty evidence). However, hospitalized patients under tocilizumab plus standard care treatment seemed to present a significantly lower risk of needing mechanical ventilation (risk ratio = 0.78; 95% CI 0.64−0.94 moderate-certainty of evidence). CONCLUSIONS: To date, the best evidence available shows no difference between using tocilizumab plus standard care compared to standard care alone for reducing mortality in patients with COVID-19. However, as a finding with a practical implication, the use of tocilizumab in association to standard care probably reduces the risk of progressing to mechanical ventilation in those patients. REGISTRATION: osf.io/qe4fs.

https://doi.org/10.1590/1516-3180.2022.0170.r1.01072022

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak
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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.

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

WhatsApp use in a health education group with women
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Ribeiro, Ellen Letícia da Silva

; Silva, Ana Maria Nunes da

; Modes, Priscilla Shirley Siniak dos Anjos

; Marcon, Sonia Silva

; Oliveira, Jeane Cristina Anschau Xavier de

; Corrêa, Áurea Christina de Paula

; Pereira, Maira Liliane dos Santos

Revista Gaúcha de Enfermagem

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2023, Volume 44 elocation e20220232

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

ABSTRACT Objective: To analyze the use of Information and Communication Technologies and the interaction in a health education group with women on WhatsApp. Methodology: Descriptive-exploratory, qualitative research with mothers assisted in two Basic Health Units in Sinop - MT, part of a University Extension Project that used three health education strategies (“G-Day”, “Health Tips”, and “Educational Video”) and project team members. Data were collected between October and December 2021 from messages in the WhatsApp group and submitted to Thematic Content Analysis. Results: Two categories were identified, showing the information provided by the team and specific information requested by the mothers; the doubts expressed by the mothers mobilized the communication-interaction among the participants and little to no interaction was provoked by the health information contained in the educational strategies used. Final consideration: WhatsApp proved to be an important resource/strategy in communication-interaction for health education with women.

RESUMEN Objetivo: Analizar el uso de Tecnologías de Información y Comunicación y la interacción en un grupo de educación para la salud con mujeres en WhatsApp. Metodología: Investigación cualitativa con madres pertenecientes a dos Unidades Básicas de Salud de Sinop - MT incluidas en un Proyecto de Extensión que utilizó estrategias educativas en salud (“Día G”, “Consejos de Salud” y “Video Educativo”) y miembros del equipo del proyecto. Los datos se recopilaron entre octubre y diciembre de 2021, a partir de mensajes en el grupo de WhatsApp, y se enviaron al Análisis de contenido temático. Resultados: Se identificaron dos categorías que muestran las informaciones puestas a disposición por el equipo y las solicitadas por las madres específicamente; las dudas expresadas por las madres movilizaron la comunicación-interacción entre los participantes y poca o ninguna interacción suscitaron las informaciones de salud contenidas en las estrategias educativas utilizadas. Consideraciones finales: WhatsApp demostró ser un recurso/estrategia importante en la comunicación-interacción para la educación en salud con mujeres.

RESUMO Objetivo: Analisar o uso de Tecnologias de Informação e Comunicação e a interação em um grupo de educação em saúde com mulheres no WhatsApp. Metodologia: Pesquisa qualitativa com mães pertencentes a duas Unidades Básicas de Saúde de Sinop - MT incluídas em um Projeto de Extensão que utilizou estratégias educativas em saúde (“Dia G”, “Dicas em saúde” e “Vídeo Educativo”) e membros da equipe do projeto. Os dados foram coletados entre outubro-dezembro de 2021, a partir das mensagens no grupo de WhatsApp e submetidos à Análise de Conteúdo Temática. Resultados: Foram identificadas duas categorias, as quais mostram as informações disponibilizadas pela equipe e as solicitadas pelas mães pontualmente; que as dúvidas manifestadas pelas mães mobilizaram a comunicação-interação entre os participantes e que pouca ou nenhuma interação foi suscitada pelas informações de saúde contidas nas estratégias educativas utilizadas. Considerações finais: O WhatsApp mostrou-se como importante recurso/estratégia na comunicação-interação para educação em saúde com mulheres.

https://doi.org/10.1590/1983-1447.2023.20220232.en

Choking, gagging and complementary feeding methods in the first year of life: a randomized clinical trial
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Paiva, Christielly Santos Silveira de

; Nunes, Leandro Meirelles

; Bernardi, Juliana Rombaldi

; Moreira, Paula Ruffoni

; Mariath, Adriela Azevedo Souza

; Gomes, Erissandra

Jornal de Pediatria

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2023, Volume 99 N. 6 Pages 574 - 581

Abstract: En | Text: En | PDF: En

Abstract Objective: Compare the occurrence of choking and gagging in infants subjected to three complementary feeding (CF) methods. Methods: Randomized clinical trial with mother-infant pairs, allocated according to the following methods of CF: a) Parent-Led Weaning (PLW) — group control, b) Baby-Led Introduction to SolidS (BLISS), and c) mixed (initially BLISS and if the infant presents a lack of interest or dissatisfaction, PLW), with the last two methods guided by the infant. Mothers received nutritional intervention on CF and prevention of choking and gagging according to the method at 5.5 months of age and remained in follow-up until 12 months. Frequencies of choking and gagging were collected by questionnaire at nine and 12 months. The comparison between groups was performed using the analysis of variance test (p < 0.05). Results: 130 infants were followed, and 34 (26.2%) children presented choking between six and 12 months of age, 13 (30.2%) in PLW, 10 (22.2%) BLISS, and 11 (26.2%) mixed method, no significative difference between methods (p > 0.05). The choking was caused mainly by the semi-solid/solid consistency. Moreover, 100 (80%) infants aged from six to 12 months presented gagging and their characteristics were not statistically different among groups (p > 0.05). Conclusion: Infants following a baby-led feeding method that includes advice on minimizing choking risk do not seem more likely to choke than infants following traditional feeding practice that includes advice on minimizing choking risk.

https://doi.org/10.1016/j.jped.2023.05.011

AVALIAÇÃO DE PRESCRIÇÕES MÉDICAS DE MEDICAMENTOS EM UMA EMERGÊNCIA HOSPITALAR
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Costa, Laiza Carvalho

; Oliveira, Ana Paula de Freitas

; Pires, Patricia da Silva

; Cunha, Juliana Xavier Pinheiro da

; Nunes, Emanuelle Caires Dias Araújo

; Jesus, Jaqueline Santos de

Cogitare Enfermagem

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2023, Volume 28 elocation e90954

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

ABSTRACT Objective: To evaluate the adherence of medical prescriptions to patient safety recommendations using the Medication Prescription Safety Checklist. Method: This is an observational, cross-sectional study carried out between May and June 2022, with 341 medical prescriptions for medicines in a hospital emergency room in the interior of Bahia - Brazil, whose data were analyzed through descriptive analysis. Results: 80% to 89% of the prescriptions adhered to the safety recommendations; the item with the highest adherence was identification of the date of the prescription, and the lowest adherence was having drugs with similar names identified in upper case or bold. Around 18.63% (n=514) of the drugs prescribed are on the list of potentially dangerous drugs for hospital use. Conclusion: The evaluation of medical prescriptions for medicines highlighted existing barriers in clinical practice, which makes it possible to develop more effective mechanisms to promote patient safety.

RESUMEN Objetivo: Evaluar la adhesión de las prescripciones médicas a las recomendaciones de seguridad del paciente utilizando la checklist - Lista de verificación de la Seguridad de la Prescripción de Medicamentos. Método: Se trata de un estudio observacional, transversal, realizado entre mayo y junio de 2022, con 341 prescripciones médicas de medicamentos, en la sala de urgencias de un hospital del interior de Bahia - Brasil, cuyos datos fueron analizados mediante análisis descriptivo. Resultados: Entre el 80% y el 89% de las prescripciones cumplieron las recomendaciones de seguridad; el punto con mayor cumplimiento fue la identificación de la fecha de la prescripción, y el de menor cumplimiento, que los medicamentos con nombres similares se identificaran en mayúsculas o en negrita. Alrededor del 18,63% (n=514) de los medicamentos prescriptos figuran en la lista de medicamentos potencialmente peligrosos de uso hospitalario. Conclusiones: La evaluación de las prescripciones médicas de medicamentos puso de manifiesto los obstáculos existentes en la práctica clínica, lo que permite desarrollar mecanismos más eficaces para promover la seguridad de los pacientes.

RESUMO Objetivo: avaliar a adesão das prescrições médicas de medicamentos às recomendações para segurança do paciente por meio do checklist - Lista de Verificação de Segurança na Prescrição de Medicamentos. Método: trata-se de um estudo observacional, transversal, realizado entre maio a junho de 2022, com 341 prescrições médicas de medicamentos, numa emergência hospitalar no interior da Bahia - Brasil, cujos dados foram analisados através de análise descritiva. Resultados: 80% a 89% das prescrições tiveram adesão às recomendações de segurança; o item de maior adesão foi identificação da data da prescrição, menor adesão foi possuir medicamentos com nomes semelhantes identificados com caixa alta ou negrito. Cerca de 18,63% (n=514) dos medicamentos prescritos fazem parte da lista de medicamentos potencialmente perigosos de uso hospitalar. Conclusão: a avaliação das prescrições médicas de medicamentos evidenciou barreiras existentes na prática clínica, o que possibilita a elaboração de mecanismos mais efetivos para promoção da segurança do paciente.

https://doi.org/10.1590/ce.v28i0.90954

Contribution of public oral pathology services to the diagnosis of oral and oropharyngeal cancer in Brazil
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LOUREDO, Brendo Vinicius Rodrigues

; CURADO, Maria Paula

; PENAFORT, Paulo Victor Mendes

; DE ARRUDA, José Alcides Almeida

; ABREU, Lucas Guimarães

; MESQUITA, Ricardo Alves

; PINTO-JÚNIOR, Décio dos Santos

; ABRAHÃO, Aline Corrêa

; ANDRADE, Bruno Augusto Benevenuto de

; AGOSTINI, Michelle

; MORAES, Renata Mendonça

; ANBINDER, Ana Lia

; DOURADO, Pedro Henrique Silva

; SANTOS, Teresa Cristina Ribeiro Bartholomeu dos

; PIRES, Fábio Ramoa

; BORDIGNON, Natalia Cristina Trentin

; GONDAK, Rogério Oliveira

; DE OLIVEIRA, Marcia Gaiger

; CARRARD, Vinicius Coelho

; MARTINS, Manoela Domingues

; SOUSA-NETO, Sebastião Silvério

; ARANTES, Diego Antônio Costa

; MENDONÇA, Elismauro Francisco

; CIESLAK-SANCHES, Silvia Roberta

; ANTUNES, Daniella Moraes

; AMARAL-SILVA, Gleyson Kleber do

; MANIERI, Patricia Rubia

; RAMALHO, Luciana Maria Pedreira

; DOS SANTOS, Jean Nunes

; LEONEL, Augusto César Leal da Silva

; PEREZ, Danyel Elias da Cruz

; VERHEUL, Hannah Carmem Carlos Ribeiro Silva

; BARROSO, Keila Martha Amorim

; RODRIGUES, Flávia Luiza Santos

; GONZAGA, Amanda Katarinny Goes

; FERNANDES, Romana Renery

; DE SOUZA, Lélia Batista

; SOUZA, Lucas Lacerda de

; PONTES, Flávia Sirotheau Corrêa

; PONTES, Hélder Antônio Rebelo

; SILVA, Caroline Alfaia

; CÂMARA, Jeconias

; LIBÓRIO-KIMURA, Tatiana Nayara

; SANTOS-SILVA, Alan Roger

; LOPES, Márcio Ajudarte

; ALMEIDA, Oslei Paes de

; ROMAÑACH, Mário José

; VARGAS, Pablo Agustin

Brazilian Oral Research

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2023, Volume 37 elocation e126

Abstract: En | Text: En | PDF: En

Abstract This study aimed to evaluate the contribution of oral and maxillofacial pathology laboratories (OMPLs) in Brazilian public universities to the diagnosis of lip, oral cavity, and oropharyngeal squamous cell carcinoma (SCC). A cross-sectional study was performed using biopsy records from a consortium of sixteen public OMPLs from all regions of Brazil (North, Northeast, Central-West, Southeast, and South). Clinical and demographic data of patients diagnosed with lip, oral cavity, and oropharyngeal SCC between 2010 and 2019 were collected from the patients’ histopathological records. Of the 120,010 oral and maxillofacial biopsies (2010-2019), 6.9% (8,321 cases) were diagnosed as lip (0.8%, 951 cases), oral cavity (4.9%, 5,971 cases), and oropharyngeal (1.2%, 1,399 cases) SCCs. Most cases were from Brazil’s Southeast (64.5%), where six of the OMPLs analyzed are located. The predominant profile of patients with lip and oral cavity SCC was Caucasian men, with a mean age over 60 years, low schooling level, and a previous history of heavy tobacco consumption. In the oropharyngeal group, the majority were non-Caucasian men, with a mean age under 60 years, had a low education level, and were former/current tobacco and alcohol users. According to data from the Brazilian National Cancer Institute, approximately 9.9% of the total lip, oral cavity, and oropharyngeal SCCs reported over the last decade in Brazil may have been diagnosed at the OMPLs included in the current study. Therefore, this data confirms the contribution of public OMPLs with respect to the important diagnostic support they provide to the oral healthcare services extended by the Brazilian Public Health System.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0126

Assessing small fiber neuropathy and subtle cardiac involvement in Fabry disease
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Braune, Caroline Bittar

; Souza, Fábio de

; Nucera, Ana Paula Cassetta dos Santos

; Simões, Kelma Macedo Pohlmann

; Vanzan Filho, Andre Bertola

; Nunes, Jean Costa

; Lima, Maria Angelica de Faria Domingues de

Journal of Inborn Errors of Metabolism and Screening

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2023, Volume 11 elocation e20230001

Abstract: En | Text: En | PDF: En

Abstract Fabry disease (FD) is an X-linked lysosomal storage disorder characterized by reduced or absent activity of the enzyme α-galactosidase A. Due to systemic accumulation of glycolipids, FD phenotype is diverse, and diagnosis may be challenging. Clinical manifestations include small fiber neuropathy, renal dysfunction, cardiac involvement, cerebrovascular disease, among others. In the present study, we describe biopsy proven small fiber neuropathy and subclinical cardiac involvement in two cousins diagnosed with FD secondary to a recently described pathogenic variant, highlighting the importance of diagnostic tools to document organ damage and allow early treatment. (FD Xlinked X linked αgalactosidase α galactosidase A glycolipids diverse challenging dysfunction others study variant treatment

https://doi.org/10.1590/2326-4594-jiems-2023-0001

Diversidade de artrópodes bioindicadores em dois sistemas culturais do Ribatejo: Monocultura/sucessão cultural
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Valério, Elsa

; Godinho, Maria

; Coelho, Rosa Santos

; Nunes, Ana Paula

; Figueiredo, Elisabete

Revista de Ciências Agrárias

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dec 2022, Volume 45 N. 4 Pages 181 - 190

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

Resumo Os artrópodes representam uma grande percentagem do total de espécies da fauna do solo e, independentemente das funções que desempenham fornecem importantes serviços ao ecossistema que dependem de práticas culturais/fitossanitárias que condicionam espécies presentes e suas interações. Neste trabalho, avaliou-se abundância dos taxa de artrópodes considerados como bioindicadores de qualidade do solo, entre 2018 e 2021, no Ribatejo, em dois campos piloto com diferentes sistemas culturais: (i) rotação de batata e milho (Golegã) e (ii) sistema de monocultura de tomate para indústria (Vila Franca Xira). Nos dois campos instalaram-se 16 armadilhas “pitfall” com etilenoglicol, em cada momento de amostragem/local, tendo sido recolhidas após 7 dias. Os artrópodes capturados foram separados em morfotipos e identificados. O número total de morfotipos separados foi 62, 157, 132 e 117, em 2018, 2019, 2020 e 2021, respetivamente. O campo com monocultura manifestou, durante os 4 anos de amostragem, biodiversidade de artrópodes inferior ao campo com rotação. No que diz respeito aos carabídeos, no campo com rotação observaram-se 9 (2019) e 13 morfotipos (2020), respetivamente, e no campo com monocultura 3 morfotipos (2019) e nenhum carabídeo (2020). Os resultados indicam tendência para maior biodiversidade e populações mais equilibradas com a continuação da prática de rotação.

Abstract Arthropods represent a large percentage of the soil fauna and, regardless of the functions they perform, they all provide important ecosystem services, which depend on cultural/phytosanitary practices that influence the species present and their interactions. In the present study, the abundance of different taxa of arthropod bioindicators of soil quality were evaluated along 2018-2021 in the Ribatejo region in two sperimental fields with different crop systems: (i) potato and maize rotation (Golegã) and (ii) processing tomato monoculture system (Vila Franca Xira). Sixteen pitfall traps with ethylene glycol were installed for 7 days at each sampling time/site. The captured arthropods were separated into morphotypes and identified. The results revealed that the total number of separate morphotypes was 62, 157, 132 and 117, in 2018, 2019, 2020 and 2021, respectively. The field with monoculture revealed, during the 4 years of sampling, an arthropod biodiversity lower than the field with crop rotation. With regard to carabids, in the field with rotation, 9 (2019) and 13 morphotypes (2020) were observed, respectively; and in the field with monoculture only 3 morphotypes (2019) and no carabid (2020) were collected. A trend towards greater biodiversity and more balanced populations was observed with the rotation practice maintenance.

https://doi.org/10.19084/rca.28417

10.

Effect of the COVID-19 pandemic on patients with inherited neuromuscular disorders
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Moreno, Cristiane Araujo Martins

; Camelo, Clara Gontijo

; Sampaio, Pedro Henrique Marte de Arruda

; Fonseca, Alulin Tácio Quadros Santos Monteiro

; Estephan, Eduardo de Paula

; Silva, André Macedo Serafim

; Pirola, Renann Nunes

; Silva, Luiz Henrique Libardi

; Lima, Karlla Danielle Ferreira

; Albuquerque, Marco Antônio Veloso de

; Camelo Filho, Antonio Edvan

; Marques, Marcos Vinícius Oliveira

; Yanagiura, Mario Teruo

; Cavalcante, Wagner Cid Palmeira

; Matsui Junior, Ciro

; Isihi, Lucas Michielon de Augusto

; Mendonça, Rodrigo Holanda

; Pouza, Ana Flávia Pincerno

; Carvalho, Mary Souza de

; Reed, Umbertina Conti

; Zanoteli, Edmar

Arquivos de Neuro-Psiquiatria

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jun 2022, Volume 80 N. 6 Pages 563 - 569

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

RESUMO Antecedentes: A Pandemia por COVID-19 tem trazido desafios subtanciais para a prática clínica no tratamento das doenças neuromusculares hereditárias (DNMh). A infecção não tem sido a única preocupação para os pacientes. O distanciamento social tem comprometido a assistência multidisciplinar, atividade física e tem trazido problemas mentais em decorrência do próprio isolamento. Nós apresentamos aqui um seguimento de 363 pacientes com DNMh de um centro terciário Brasileiro durante o pico da Pandemia de Covid-19. Objetivos: Mostrar a frequência e gravidade da infecção por Sars-Cov-2 em pacientes com DNMh e demonstrar os efeitos da pandemia nos hábitos de vida, na progressão da doença e no cuidado multidisciplinary. Métodos Trezentos e sessenta e três pacientes (58% homens and 42% mulheres) foram acompanhados por 3 meses através de 3 teleconsultas durante o pico da Pandemia de Covid-19 no Brasil. Resultados Houve um decréscimo no número de pacientes que faziam terapia física, respiratória e fonoaudiológica. Em muitos pacientes, o apetite (33%) e hábitos do sono (25%) se alteraram. Exercícios físicos e terapias foram interrompidas pela maioria dos pacientes. Physical exercises and therapies were interrupted for most of the patients. Eles relataram piora ou aparecimento de fadiga (17%), dor (17%), retrações (14%), e escoliose (7%). Irritabilidade, mudanças no sono, peso e apetite, sendo principalmente diminuição do apetite e peso foram mais frequentemente encontrados em pacientes que apresentaram piora clinica da doença. Houve uma baixa taxa de contaminação por Covid-19 (0.8%), e todos os pacientes infectado apresentaram quadro clinico leve. Conclusão O isolamento por si só se mostrou protetor na perspectiva de infecção por Covid-19, mas pode desencadear um cenário complexo com mudanças nos hábitos de vida e curso desfavorável da doença de base.

ABSTRACT Background The COVID-19 pandemic has brought substantial challenges for current practices in treating hereditary neuromuscular disorders (hNMDs). However, this infection has not been the only concern for these patients. Social distancing has compromised multidisciplinary assistance and physical activity, and has brought about several mental health issues. We presented a follow-up on 363 patients with hNMDs at a Brazilian tertiary center during the peak of the COVID-19 pandemic. Objective We aimed to show the frequency and severity of SARS-CoV-2 infection among hNMD patients and to demonstrate the effects of the pandemic on life habits, disease progression and multidisciplinary supportive care status. Methods Three hundred and sixty-three patients (58% male and 42% female) were followed for three months through three teleconsultations during the peak of the COVID-19 pandemic in Brazil. Results There were decreases in the numbers of patients who underwent physical, respiratory and speech therapies. For several patients, their appetite (33%) and sleep habits (25%) changed. Physical exercises and therapies were interrupted for most of the patients. They reported new onset/worsening of fatigue (17%), pain (17%), contractions (14%) and scoliosis (7%). Irritability and sleep, weight and appetite changes, and especially diminished appetite and weight loss, were more frequent in the group that reported disease worsening. There was a low COVID-19 contamination rate (0.8%), and all infected patients had a mild presentation. Conclusion The isolation by itself was protective from a COVID-19 infection perspective. However, this isolation might also trigger a complex scenario with life habit changes that are associated with an unfavorable course for the NMD.

https://doi.org/10.1590/0004-282x-anp-2021-0166

11.

Aspects of trauma related to violence, accidents and falls before and during the COVID-19 pandemic
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Fermandes, Paulo Cesar Rozental

; Ilias, Elias Elias Jirjoss

; Ribeiro, Ana Paula

; Garcia, Diego Ferreira Andrade

; Pereira, Thales Felipe dos Santos

; Freitas, Letícia Dantas Marques de

; Leite, Isabelle Sacchi

; Nascimento, Lucas Netto

; França, Carolina Nunes

; Juliano, Yara

; Novo, Neil Ferreira

Medicina Legal de Costa Rica

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mar 2022, Volume 39 N. 1 Pages 81 - 97

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

Resumen Introducción: El trauma es la segunda causa de mortalidad y la sexta de hospitalización en el país, siendo la violencia, los accidentes y las caídas las más prevalentes. Sin embargo, el país está experimentando reflejos de una pandemia de COVID-19, junto a una falta de estudios sobre el trauma, así como sobre la atención clínica. Objetivo: Analizar las características clínicas y epidemiológicas del trauma junto a la violencia, accidentes y caídas entre los años 2019, 2020 y 2021, considerados antes y durante la pandemia COVID-19. Materiales y métodos: Estudio de cohorte retrospectivo, con adultos de 25 a 55 años, que sufrieron trauma relacionado con violencia, caídas y otros accidentes, en el período comprendido entre marzo y junio de 2019, 2020 y 2021, en la ciudad de São Paulo. Las encuestas de datos fueron realizadas por el sistema TABNET, por el Departamento Municipal de Salud. Dentro de este sistema, la búsqueda se realizó a través del Sistema de Información para la Vigilancia de Accidentes, de la Coordinación de Vigilancia en Salud, en el cual las situaciones de violencia fueron notificadas y registradas por el Sistema Nacional de Información de Enfermedades Notificables. Posteriormente, se accedió al Sistema de Información de Vigilancia de Violencia y Accidentes, con enfoque en notificaciones y registro de caídas y otros accidentes. Resultados: El trauma siguió siendo más prevalente para los hombres, con educación primaria completa y raza predominantemente entre blancos y morenos. Al analizar los diferentes tipos de violencia: física, tortura y sexual, hubo mayores porcentajes de prevalencia durante el año 2019, período prepandémico de COVID-19, a excepción de la violencia psicológica / moral, que fue mayor en 2021. Nótese que los diferentes mecanismos de violencia fueron significativamente más prevalentes en 2019, así como las diferentes causas de violencia, caídas y traumatismos automovilísticos que involucran a peatones, ocupantes, conductores y pasajeros. La atención ambulatoria confirmó la tendencia de superioridad en el período prepandémico, sin embargo, la atención hospitalaria de emergencia mostró un mayor número de solicitudes en 2020 y 2021. Conclusión: Los traumas de violencia, accidentes y caídas son más prepandémico en comparación con el período durante la pandemia COVID-19; así como la búsqueda de asistencia sanitaria en hospitales y clínicas. Estos hallazgos muestran una posible reducción en los informes de trauma y una menor demanda de asistencia durante la pandemia.

Abstract Introduction: Trauma is the second leading cause of mortality and the sixth leading cause of hospitalization in the country, with violence, accidents, and falls being the most prevalent. However, the country is experiencing reflexes of the COVID-19 pandemic, together with a lack of studies on trauma, as well as on clinical care. Objective: To analyze the clinical and epidemiological characteristics of trauma related to violence, accidents, and falls among the years 2019, 2020, and 2021, considered as before and during the COVID-19 pandemic. Material and Methods: Retrospective cohort study, with adults aged 25-55 years, who suffered trauma related to violence, falls, and other accidents, in the period between March and June of 2019, 2020, and 2021, in the city of São Paulo. Data surveys were carried out using the TABNET system, of the Municipal Health Department. Within this system, the search was carried out through the Information System for the Surveillance of Accidents, of the Coordination of Health Surveillance, in which situations of violence were notified and recorded by the National Information System for Notifiable Diseases. Subsequently, the Information System for Surveillance of Violence and Accidents was accessed, focusing on notifications and records of falls and other accidents. Results: Trauma remained more prevalent for males, with complete primary education, and ethnicity predominantly between white or brown. When analyzing the different types of violence: physical, torture, and sexual, there was a prevalence of higher percentages during the year 2019, the pre-pandemic period of COVID-19, except for psychological/moral violence, which was higher in 2021. It should also be noted that the different mechanisms of violence were significantly more prevalent in 2019, as well as the different causes of violence, falls, and car trauma involving pedestrians, occupants, drivers, and passengers. Outpatient care confirmed the higher trend in the pre-pandemic period; however, emergency hospital care showed a greater number of requests in 2020 and 2021. Conclusión: Trauma from violence, accidents, and falls was higher pre-pandemic compared to the period during the COVID-19 pandemic; as well as the search for health care in hospitals and outpatient clinics. These findings show a possible reduction in trauma reports and lower demand for assistance during the pandemic.

12.

Oral lesions in patients with COVID-19 hospitalized in an intensive care unit: a case-series study
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BATISTA, Amanda Alves Feitosa

; RAMOS, Karen Perez Pereira

; AMARAL, Mayra Alves Soares do

; PRADO, Luiz Flávio Andrade

; ARAÚJO, Adriano Antunes de Souza

; MARTINS-FILHO, Paulo Ricardo

; NUNES, Paula Santos

Brazilian Oral Research

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2022, Volume 36 elocation e108

Abstract: En | Text: En | PDF: En

Abstract This study evaluated the presence of oral lesions in patients with COVID-19 hospitalized in an intensive care unit (ICU). Data included demographic, clinical, and laboratory information. Clinical assessment of the oral cavity was performed on the 2 nd and 5 th days of orotracheal intubation. Thirty-eight patients were evaluated and 16 (42.1%) presented oral lesions during their ICU stay. The median age and length of stay were 75 years and 15 days, respectively. Among the patients with oral lesions, ulcerative oral lesions were reported in 14 (87.5%) patients, of which 11 (78.6%) were found on the lips. This study highlights the importance of oral examination for patients admitted to the ICU with COVID-19.

https://doi.org/10.1590/1807-3107bor-2022.vol36.0108

13.

Effectiveness and safety of tocilizumab for COVID-19: a systematic review and meta-analysis of randomized clinical trials
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Almeida, Paula Ribeiro Lopes

; Person, Osmar Clayton

; Puga, Maria Eduarda dos Santos

; Giusti, Maria Fernanda

; Pinto, Ana Carolina Pereira Nunes

; Rocha, Aline Pereira

; Atallah, Álvaro Nagib

Sao Paulo Medical Journal

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2022, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.1590/1516-3180.2022.0170.r1.01072022

14.

ANALYSIS OF POST-TRAUMATIC STRESS DISORDER IN NURSING PROFESSIONALS DURING THE COVID-19 PANDEMIC
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Almeida, Thaynara Fontes

; Silva, Silmara de Oliveira

; Duarte, Fernando Hiago da Silva

; Queiroz, Cintia Galvão

; Araújo, Pedro Lucas Oliveira de

; Dantas, Rodrigo Assis Neves

; Dantas, Daniele Vieira

; Nunes, Paula Santos

Texto & Contexto - Enfermagem

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2022, Volume 31 elocation e20220139

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

RESUMO Objetivo analisar a prevalência de Transtorno de Estresse Pós-Traumático e os fatores associados ao desenvolvimento do Transtorno de Estresse Pós-Traumático em profissionais de enfermagem durante a pandemia da COVID-19. Método estudo observacional, analítico e transversal, realizado com 309 profissionais de enfermagem, utilizando questionário para avaliar dados sociodemográficos e informações sobre o trabalho, além da Escala do Impacto do Evento - Revisada (IES-R), que visa coletar informações relacionadas à sintomatologia do Transtorno de Estresse Pós-Traumático. Resultados o estudo contou com 176 enfermeiros e 133 técnicos de enfermagem, sendo 83,82% do sexo feminino e 56,96% de enfermeiros. Quanto ao trabalho, 55,66% possuíam carga horária de até 40 horas semanais, 47,90% tinham mais de um vínculo, 89,32% atuaram na linha de frente da pandemia e 60,19% apontaram aumento da carga de trabalho. Não obstante, 64,40% apresentaram sintomas ou foram diagnosticados com COVID-19 e 43,37% apontaram prejuízo emocional. Utilizando as classificações do escore geral da Escala do Impacto do Evento - Revisada, 29, 53,40% atingiram pontuação maior ou igual a 33, ponto de corte para o provável diagnóstico de Transtorno do Estresse Pós-Traumático. Conclusão foi evidenciado que mais da metade da amostra do estudo apresentou na escala Escala do Impacto do Evento - Revisada alto risco de desenvolver Transtorno do Estresse Pós-Traumático. Como fatores associados ao desenvolvimento do Transtorno de Estresse Pós-Traumático em profissionais de enfermagem durante a pandemia da COVID-19, estão o uso de medicamentos psicotrópicos, idade até 35 anos, mudança financeira e emocional.

ABSTRACT Objective to analyze the prevalence of Post-Traumatic Stress Disorder and factors associated with its development in Nursing professionals during the COVID-19 pandemic. Method an observational, analytical and cross-sectional study conducted with 309 Nursing professionals, using a questionnaire to assess sociodemographic data and work-related information, in addition to the Impact Event Scale - Revised, which aims at collecting diverse information related to Post-Traumatic Stress Disorder symptoms. Results the study participants were 176 nurses and 133 nursing technicians: 83.82% female and 56.96% male nurses. As for the hour load, 55.66% asserted working up to 40 weekly hours 47.90% had more than one employment contract, 89.32% were active in the front line against the pandemic, and 60.19% reported an increase in workload. However, 64.40% presented symptoms or were diagnosed with COVID-19 and 43.37% indicated emotional impairment. Using the classifications of the overall Impact Event Scale - Revised score, 29 (53.40%) obtained scores of at least 33, the cutoff point for likely diagnosis of Post-Traumatic Stress Disorder. Conclusion it was evidenced that more than half of the study sample presented a high risk of developing Post-Traumatic Stress Disorder in the Impact Event Scale - Revised scale. Factors associated with the development of Post-Traumatic Stress Disorders in Nursing professionals during the COVID-19 pandemic include use of psychotropic drugs, age up to 35 years old, and occurrence of physical and emotional changes.

RESUMEN Objetivo analizar la prevalencia del Trastorno de Estrés Post-Traumático y los factores asociados al desarrollo de dicho trastorno en profesionales de Enfermería durante la pandemia de COVID-19. Método estudio observacional, analítico y transversal, realizado con 309 profesionales de Enfermería por medio de un cuestionario para evaluar datos sociodemográficos y diversa información sobre el trabajo, además de la Escala de Impacto del Evento - Revisada, que tiene como objetivo recolectar diversa información relacionada con la sintomatología del Trastorno de Estrés Post-Traumático. Resultados el estudio contó con la participación de 176 enfermeros y 133 técnicos de Enfermería: 83,82% del sexo femenino y 56,96% de enfermeros. En cuanto al trabajo, el 55,66% poseían una carga horaria de hasta 40 horas semanales, el 47,90% tenían más de un vínculo laboral, el 89,32% trabajaba en la primera línea de lucha contra la pandemia y el 60,19% señaló un aumento en la carga de trabajo. No obstante, el 64,40% presentó síntomas o fueron diagnosticados con COVID-19 y el 43,37% indicó perjuicios emocionales. Utilizando las clasificaciones de la puntuación general de la escala Escala de Impacto del Evento - Revisada, 29 (53,40%) obtuvieron un puntaje de al menos 33, punto de corte para el probable diagnóstico de Trastorno de Estrés Post-Traumático. Conclusión se hizo evidente que, en la escala Escala de Impacto del Evento - Revisada, más de la mitad de la muestra del estudio presentó alto riesgo de desarrollar el Trastorno de Estrés Post-Traumático. Como factores asociados al desarrollo del Trastorno de Estrés Post-Traumático en profesionales de Enfermería durante la pandemia de COVID-19 figuran los siguientes: uso de medicamentos psicotrópicos, edad de hasta 35 años, y cambios en estado financiero y emocional.

https://doi.org/10.1590/1980-265x-tce-2022-0139en

15.

Espiritualidade na concepção do paciente oncológico em tratamento antineoplásico
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Batista, Nayara Tomazi

; Trettene, Armando dos Santos

; Farinha, Francely Tineli

; Nunes, Cláudia Regina Matiole

; Razera, Ana Paula Ribeiro

Revista Bioética

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dec 2021, Volume 29 N. 4 Pages 791 - 797

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

Resumo Além de ser uma modalidade de enfrentamento, ressignificação do sofrimento e concepção de vida, a espiritualidade é fonte de esperança e confiança para pacientes oncológicos. Com base nessas premissas, objetivou-se desvelar a concepção de espiritualidade de pacientes oncológicos em tratamento antineoplásico a fim de compreender sua influência no enfrentamento da doença. Trata-se de estudo descritivo, de delineamento qualitativo, realizado no ambulatório de quimioterapia de um hospital público brasileiro. A amostra foi composta por 18 pacientes oncológicos submetidos a sessões de quimioterapia, em tratamento ambulatorial, maiores de 18 anos, de ambos os sexos. Para confecção dos resultados, utilizou-se a análise de conteúdo temática, que revelou duas categorias: 1) espiritualidade como fonte de esperança e confiança; e 2) espiritualidade como fonte de ressignificação do sofrimento e de uma renovada concepção de vida.

Abstract In addition to being a way of coping with and attributing new meanings to suffering and conceiving life, spirituality is a source of hope and confidence for cancer patients. From these premises, the aim of this study was to present the perception of spirituality of cancer patients undergoing antineoplastic treatment in order to understand its influence on how patients cope with the disease. This is a descriptive and qualitative study carried out in the outpatient chemotherapy clinic of a Brazilian public hospital. The study sample consisted of 18 cancer patients undergoing outpatient chemotherapy, over 18 years of age, of both genders. Thematic content analysis was used, which revealed two thematic categories: 1) spirituality as a source of hope and confidence; and 2) spirituality as a source of new meanings to suffering and of a renewed view of life.

Resumen Además de ser una modalidad de afrontamiento, resignificación del sufrimiento y concepción de la vida, la espiritualidad es una fuente de esperanza y confianza para los pacientes oncológicos. Partiendo de estas premisas, el objetivo de este trabajo fue desvelar la concepción de la espiritualidad de los pacientes con cáncer sometidos a tratamiento antineoplásico para comprender su influencia en el afrontamiento de la enfermedad. Se trata de un estudio descriptivo de diseño cualitativo, realizado en el ambulatorio de quimioterapia de un hospital público brasileño. La muestra se compuso de 18 pacientes oncológicos sometidos a sesiones de quimioterapia, en tratamiento ambulatorio, mayores de 18 años, de ambos sexos. Para confeccionar los resultados, se utilizó el análisis de contenido temático, que reveló dos categorías: 1) la espiritualidad como fuente de esperanza y confianza; y 2) la espiritualidad como fuente de resignificación del sufrimiento y de una concepción renovada de la vida.

https://doi.org/10.1590/1983-80422021294512

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