RESUMO: O objetivo deste estudo retrospectivo foi avaliar o impacto da apresentação clínica da piometra na morbimortalidade das cadelas afetadas. Foram avaliados os registros clínicos de 47 cadelas tratadas cirurgicamente para piometra entre maio e dezembro de 2017. Os dados recolhidos na admissão foram analisados para classificar os animais quanto à apresentação clínica da piometra, presença de critérios da Síndrome da Resposta Inflamatória Sistêmica (SRIS) e disfunções orgânicas - cardiovascular, neurológica, renal e hemostática. Foi registrado o desfecho durante 14 dias. A mortalidade global foi de 13%. Piometra aberta e fechada foram identificadas em 62% (n= 29) e 38% (n= 18) respectivamente. SRIS esteve presente em 44 (94%) cadelas e 27 (57%) tiveram pelo menos uma disfunção orgânica. A disfunção mais prevalente foi a hemostática, seguida da neurológica, cardiovascular e renal. A apresentação clínica da piometra e a presença de SRIS não se correlacionaram entre si ou com presença de disfunção orgânica e mortalidade. No entanto, a quantidade de disfunções orgânicas (r=0.532, P=<0.001) e a presença das disfunções neurológica (r= -0.371; P=0.012) e renal (r=0.303; P=0.041) foram correlacionados com mortalidade. Assim, a identificação de disfunções orgânicas através do exame físico e análises laboratoriais de rotina mostrou-se mais eficaz na identificação e previsão de pacientes críticos do que os critérios de SRIS ou a apresentação clínica da doença.

ABSTRACT: This retrospective study evaluated the impact of the clinical presentation of pyometra on the morbidity and mortality of the affected bitches. The medical records of 47 bitches surgically treated for pyometra between May and December 2017 were evaluated. The admission data were analyzed to classify the animals according to the clinical presentation of pyometra, presence of systemic inflammatory response syndrome (SIRS) and organic dysfunctions (cardiovascular, neurological, renal, and hemostatic). The outcomes were recorded for up to 14 days. The overall mortality rate was 13%. Open and closed pyometra were identified in 62% (n= 29) and 38% (n= 18) of the cases, respectively. The SIRS was present in 44 (94%) bitches, and 27 (57%) had at least one organ dysfunction. The most prevalent dysfunction was hemostatic, followed by neurological, cardiovascular, and renal dysfunction. The clinical presentation of pyometra and the presence of SIRS did not correlate with each other, or with the presence of organ dysfunction and mortality. However, cumulative organ dysfunction (r=0.532, P=<0.001) and the presence of neurological (r= -0.371; P=0.012) and renal dysfunction (r=0.303; P=0.041) were correlated with mortality. Thus, the identification of organ dysfunction through physical examination and routine laboratory analysis proved to be more effective in identifying and predicting the critically ill patients than the SIRS criteria or clinical presentation of the disease.

Abstract Background Cardiovascular risk factors are prognostic factors in coronavirus disease 2019 (COVID-19) and have been scarcely studied in Brazil. Objective The aim of this study was to assess the impact of cardiovascular risk factors on the outcomes of patients admitted for COVID-19. Methods From July 2020 to February 2021, 200 patients from two public hospitals were enrolled. Patients were included if they had typical symptoms or signs of COVID-19, a positive real-time polymerase chain reaction test (RT-PCR) for COVID-19, and an age above 18 years. This is a prospective, observational, and longitudinal study. Data were collected within 24 h of admission. The primary endpoint was a combination of hospital lethality, mechanical ventilation, hemodialysis, or length of hospital stay >28 days. Continuous variables were compared with the Student’s t-test for independent samples or the Mann-Whitney test. For comparisons of proportions, the χ 2 test was applied. ROC curves and survival curves were constructed. Multivariate logistic regression was performed to identify independent predictors of events. The level of significance was 0.05. Results There were 98 (49%) events during the hospital course, and 72 (36%) died in the hospital. Patients with a primary endpoint were older and more likely to have a history of hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Vital signs at admission associated with events were diastolic blood pressure, respiratory rate, and oxygen saturation in ambient air (O 2 Sat). Serum creatinine >1.37 mg/dL at admission had a sensitivity of 51.6 and a specificity of 82% to predict the primary endpoint, with an area under the curve (AUC) of 0.68. In multivariate analysis, age, diabetes, CKD, and COPD were independent predictors of the primary endpoint. Age and CKD were independent predictors of in-hospital lethality. Conclusion Cardiovascular risk factors, such as diabetes and CKD, were related to a worse prognosis in patients hospitalized with COVID-19 in this sample from two public hospitals in the state of Rio de Janeiro.

RESUMO Objetivos: analisar os fatores psicossociais correlacionados com a intenção comportamental das pessoas com diabetes mellitus tipo 2 (DM2) para uso de insulina. Métodos: estudo transversal. Instrumento validado com base na Teoria do Comportamento Planejado foi utilizado para identificar as medidas diretas (atitude, norma subjetiva e controle percebido), medidas indiretas (crenças comportamentais, normativas e de controle) e intenção comportamental para uso da insulina. Análise descritiva e correlação de Spearman foram realizadas para a análise dos dados. Resultados: um total de 211 indivíduos participaram do estudo, com uma mediana positiva de intenção comportamental. Atitude, crenças normativas e comportamentais foram os preditores que apresentaram uma correlação significante (r=0,16, r=-0,15 e r=0,25, respectivamente; p<0,05) com a intenção. Conclusões: há uma intenção comportamental positiva no uso da insulina por pessoas com DM2. Atitude, crenças Normativas e crenças comportamentais têm uma correlação de baixa magnitude com a intenção das pessoas com DM2 de usar insulina.

ABSTRACT Objectives: to analyze the psychosocial factors correlated with the behavioral intention of people with Type 2 Diabetes Mellitus (T2DM) towards insulin use. Methods: a cross-sectional study; a validated instrument based on the Theory of Planned Behavior was used to identify the direct measures (attitude, subjective norm and perceived control), indirect measures (behavioral, normative and control beliefs) and behavioral intention for the use of insulin. Descriptive analysis and Spearman’s correlation were performed for data analysis. Results: a total of 211 individuals participated in the study, with a positive median of behavioral intention. Attitude, normative and behavioral beliefs were the psychosocial factors that presented a significant correlation (r=0.16, r=-0,15 and r=0.25, respectively; p<0.05) with the intention. Conclusions: there is a positive behavioral intention in the use of insulin by people with T2DM. Attitude, normative beliefs and behavioral beliefs have a low magnitude correlation with the intention of people with T2DM to use insulin.

RESUMEN Objetivos: analizar los factores psicosociales correlacionados con la intención conductal de personas con diabetes mellitus tipo 2 (DM2) para uso de insulina. Métodos: estudio transversal. Instrumento validado basado en la Teoría de Conducta Planeada fue utilizada para identificar las medidas directas (actitud, norma subjetiva y control percibido), medidas indirectas (creencias conductuales, normativas y de control) e intención conductal para uso de insulina. Análisis descriptivo y correlación de Spearman fueron realizados para el análisis de datos. Resultados: un total de 211 individuos participaron del estudio, con una mediana positiva de intención conductal. Actitud, creencias normativas y conductuales fueron los predictores que presentaron una correlación significante (r=0,16, r=-0,15 y r=0,25, respectivamente; p<0,05) con la intención. Conclusiones: hay una intención conductal positiva en el uso de insulina por personas con DM2. Actitud, creencias Normativas y creencias conductuales tienen una correlación de baja magnitud con la intención de personas con DM2 de usar insulina.

RESUMO Objetivo: Avaliar a prevalência e os fatores associados ao tabagismo em adolescentes com fissura de lábio e/ou palato. Métodos: Estudo de corte transversal, desenvolvido em um hospital público e terciário brasileiro entre novembro de 2018 e agosto de 2019. Foram incluídos adolescentes com idade entre 12 e 19 anos, submetidos previamente às cirurgias de queiloplastia e/ou palatoplastia. A coleta de dados foi realizada por meio de entrevista, guiada por questionários referentes a questões sociodemográficas, uso e fatores associados ao tabagismo. Para a análise estatística, utilizaram-se os testes: exato de Fisher, qui-quadrado, t de Student e regressão logística bivariada, todos com nível de significância de 5% (p ≤ 0,05). Resultados: Participaram 102 adolescentes. A prevalência do tabagismo foi de 20,6% (n=21). Possuir fissura de lábio e palato associou-se ao tabagismo (p=0,012). A análise bivariada mostrou que não namorar (p=0,001; OR=0,19) e possuir habitação própria (p=0,032; OR=0,33) configuraram fatores de proteção para o ato de ser tabagista, enquanto acreditar que fumar facilita a interação com os jovens ou com o grupo de amigos (p=0,043; OR=2,95), ter amigos que usam bebida alcoólica (p=0,002; OR=8,40), ter amigos que usam drogas, exceto o cigarro (p=0,002; OR=5,33), usar bebida alcoólica (p<0,001; OR=10,67) e iniciação sexual (p<0,001; OR=7,00) associaram-se a ser tabagista. Conclusões: Pelo conhecimento do perfil dos adolescentes mais vulneráveis ao uso do tabaco, é possível planejar e programar ações educativas e preventivas.

Abstract Objective: To assess the prevalence and factors associated with smoking in adolescents with cleft lip and/or palate. Methods: This is a cross-sectional study, developed in a Brazilian public and tertiary hospital between November 2018 and August 2019. Adolescents aged between 12 and 19 years old, previously submitted to cheiloplasty and/or palatoplasty surgeries were included. Data collection was carried out through interviews, guided by questionnaires referring to sociodemographic issues, use and factors associated with smoking. For statistical analysis, Fisher’s Exact Test, Chi-square, Student’s t test and bivariate logistic regression were used, all with a significance level of 5% (p≤0.05). Results: 102 adolescents participated. The prevalence of smoking was 20.6% (n=21). Having cleft lip and palate was associated with smoking (p=0.012). The bivariate analysis showed that not dating (p=0.001; OR=0.19) and owning a home (p=0.032; OR=0.33) were configured as protective factors for the act of being a smoker, while believing that smoking facilitates interaction with young people or with the group of friends (p=0.043; OR=2.95), having friends who use alcoholic beverages (p=0.002; OR=8.40), having friends who use drugs, except cigarettes (p=0.002; OR=5.33), use alcoholic beverages (p<0.001; OR=10.67) and sexual initiation (p<0.001; OR=7.00), were associated with being a smoker. Conclusions: From the knowledge of the profile of adolescents most vulnerable to tobacco use, it is possible to plan and implement educational and preventive actions.

Resumo Objetiva-se analisar especificidades da concepção e realização das modalidades de grupo focal on-line (GFO), técnica qualitativa alternativa ao grupo focal tradicional frente ao distanciamento físico imposto pela pandemia de COVID-19. Realizou-se uma revisão integrativa da literatura nas bases PubMed Central e BVS. Foram identificados 291 artigos, a inclusão de 24 após avaliação por etapas. Foram identificados 291 artigos. Após avaliação por etapas, foram incluídos 24 artigos nacionais e internacionais dos últimos dez anos que descrevem e discutem a realização do GFO. As modalidades de GFO encontradas foram: síncrono ou assíncrono por escrito; síncrono por vídeo/áudio ou áudio. O GFO foi realizado em variadas pesquisas do campo da saúde. Uma mesma ferramenta pode ser usada para diferentes modalidades, garantindo a segurança dos participantes e o anonimato. A falta de atmosfera de vida real pode impactar o engajamento dos participantes, uma limitação manejável. As modalidades de GFO podem produzir dados de qualidade, economizar tempo e custo, ampliar a participação de sujeitos dispersos geograficamente, mas limitar em relação aos que têm dificuldades de acesso à internet. Este estudo auxilia pesquisadores na escolha de uma modalidade de GFO. Sugere-se pesquisas que avaliem os limites do GFO no Brasil e que abordem a modalidade assíncrona por áudio.

Abstract The scope of this study is to analyze the specificities of conception and execution of the different modalities of online focus groups (OFGs), a qualitative technique that is an alternative to a traditional focus group, due to the social distancing required by the COVID-19 pandemic. An integrative literature review was conducted in PubMed Central and BVS. National and international studies published in the last 10 years that describe and discuss OFGs were included. A total of 291 articles were identified and 24 were included after evaluation in stages. Four OFG modalities were found: synchronous or asynchronous by writing; synchronous by video/audio or audio. The OFG was used to research different health topics. The same platform can be used for realizing different OFG modalities, guaranteeing the participants’ security and anonymity. The lack of a real-life atmosphere can impact participant engagement, but it can be resolved. An OFG can produce quality data, save time and expense, expand the participation of people who are geographically dispersed, but limit those with restricted internet access. This study can help researchers who intend to choose anOFG modality. Studies that assess the limits of OFGs in Brazil are suggested, as well those which address the asynchronous OFG by audio.

Resumo Objetiva-se analisar especificidades da concepção e realização das modalidades de grupo focal on-line (GFO), técnica qualitativa alternativa ao grupo focal tradicional frente ao distanciamento físico imposto pela pandemia de COVID-19. Realizou-se uma revisão integrativa da literatura nas bases PubMed Central e BVS. Foram identificados 291 artigos, a inclusão de 24 após avaliação por etapas. Foram identificados 291 artigos. Após avaliação por etapas, foram incluídos 24 artigos nacionais e internacionais dos últimos dez anos que descrevem e discutem a realização do GFO. As modalidades de GFO encontradas foram: síncrono ou assíncrono por escrito; síncrono por vídeo/áudio ou áudio. O GFO foi realizado em variadas pesquisas do campo da saúde. Uma mesma ferramenta pode ser usada para diferentes modalidades, garantindo a segurança dos participantes e o anonimato. A falta de atmosfera de vida real pode impactar o engajamento dos participantes, uma limitação manejável. As modalidades de GFO podem produzir dados de qualidade, economizar tempo e custo, ampliar a participação de sujeitos dispersos geograficamente, mas limitar em relação aos que têm dificuldades de acesso à internet. Este estudo auxilia pesquisadores na escolha de uma modalidade de GFO. Sugere-se pesquisas que avaliem os limites do GFO no Brasil e que abordem a modalidade assíncrona por áudio.

Abstract The scope of this study is to analyze the specificities of conception and execution of the different modalities of online focus groups (OFGs), a qualitative technique that is an alternative to a traditional focus group, due to the social distancing required by the COVID-19 pandemic. An integrative literature review was conducted in PubMed Central and BVS. National and international studies published in the last 10 years that describe and discuss OFGs were included. A total of 291 articles were identified and 24 were included after evaluation in stages. Four OFG modalities were found: synchronous or asynchronous by writing; synchronous by video/audio or audio. The OFG was used to research different health topics. The same platform can be used for realizing different OFG modalities, guaranteeing the participants’ security and anonymity. The lack of a real-life atmosphere can impact participant engagement, but it can be resolved. An OFG can produce quality data, save time and expense, expand the participation of people who are geographically dispersed, but limit those with restricted internet access. This study can help researchers who intend to choose anOFG modality. Studies that assess the limits of OFGs in Brazil are suggested, as well those which address the asynchronous OFG by audio.

ABSTRACT. Waste oil from olive oil extraction industry was used, instead of soybean oil, in heavy roosters’ diet in order to evaluate birds’ reproductive parameters. A total of forty roosters were housed individually in boxes with 1.2 m². Two experimental diets were used: control diet, based on corn, soybean meal, and soybean oil; and test diet, where soybean oil was totally replaced by waste oil. In order to verify weight gain and feed intake, animals were individually weighed weekly. Seven semen collections were performed with fifteen-day interval. Reproductive variables analyzed sperm volume, motility, concentration, and morphology. No statistical difference (p > 0.05) was observed between treatments at the different collection periods for the variables sperm volume, motility, and concentration. There was a statistically significant difference between treatments for body weight in periods three (p = 0.04), and seven (p = 0.04). Statistical differences (p = 0.01) were also observed between treatments for abnormal sperm morphology. Among collection periods, statistical difference was observed for motility (p = 0.00), and sperm concentration (p = 0.01). Total replacement of soybean oil by waste oil from olive oil extraction in young heavy roosters’ diets does not affect sperm volume, motility, and concentration; reduces defects in sperm tail, and promotes better weight gain control.

Abstract Acromegaly is a rare disease characterized by changes in the bone and soft tissue systems, induced by excess growth hormone and insulin-like growth factor type 1. Among the skin lesions associated with acromegaly is cutis verticis gyrata, an hypertrophic, and coarse folding of the skin of the scalp, an association of uncommon incidence and unknown prevalence. This case report describes the case of a patient diagnosed with acromegaly at age 60 with previously unidentified cutis verticis gyrata. This report aims to review the literature on cutis verticis gyrata and its unusual association with acromegaly.

Resumo O objetivo deste artigo é construir e validar um instrumento de medida da intenção de uso de preservativos entre mulheres em contexto de vulnerabilidade social. Pesquisa metodológica cuja etapa de construção envolveu 111 mulheres em estudo prévio e a validação do conteúdo e face contou com 166 participantes, entre usuárias de um serviço de saúde, juízes especialistas e docentes. No processo de validação foram utilizados o Índice de Validade de Conteúdo por Item, Índice de Validade de Conteúdo Geral e Alfa de Cronbach. O instrumento constou de 29 itens, com Índice de Validade de Conteúdo Geral 0,99. A validação semântica resultou na inserção de sinais pictóricos nas escalas de resposta. O estudo piloto gerou Alfa de Cronbach 0,61 (IC: 0,48-0,72). O instrumento validado constitui-se ferramenta que pode auxiliar trabalhadores da saúde e pesquisadores na predição do uso de preservativos, guiando intervenções preventivas na direção de práticas sexuais seguras entre mulheres em situação de vulnerabilidade social.

Abstract The scope of this article is to build and validate an instrument to measure the intention to use condoms among women in a context of social vulnerability. It involved methodological research, the elaboration stage of which involved 111 women from a previous study, and the content validation stage had 166 participants, including female frequenters of a healthcare service, specialized referees and teachers. In the validation process, the Content Validity Index per Item, General Content Validity Index and Cronbach’s Alpha were used. The instrument included 29 items and had a General Content Validity Index of 0.99. The semantic validation resulted in the insertion of pictorial signs in the response scales. The pilot study generated Cronbach’s alpha of 0.61 (CI: 0.48-0.72). The validated instrument is a tool that can assist health workers and researchers in predicting condom use, providing input for preventive interventions towards safe sexual practices among women in situations of social vulnerability.

Resumo O objetivo deste artigo é construir e validar um instrumento de medida da intenção de uso de preservativos entre mulheres em contexto de vulnerabilidade social. Pesquisa metodológica cuja etapa de construção envolveu 111 mulheres em estudo prévio e a validação do conteúdo e face contou com 166 participantes, entre usuárias de um serviço de saúde, juízes especialistas e docentes. No processo de validação foram utilizados o Índice de Validade de Conteúdo por Item, Índice de Validade de Conteúdo Geral e Alfa de Cronbach. O instrumento constou de 29 itens, com Índice de Validade de Conteúdo Geral 0,99. A validação semântica resultou na inserção de sinais pictóricos nas escalas de resposta. O estudo piloto gerou Alfa de Cronbach 0,61 (IC: 0,48-0,72). O instrumento validado constitui-se ferramenta que pode auxiliar trabalhadores da saúde e pesquisadores na predição do uso de preservativos, guiando intervenções preventivas na direção de práticas sexuais seguras entre mulheres em situação de vulnerabilidade social.

Abstract The scope of this article is to build and validate an instrument to measure the intention to use condoms among women in a context of social vulnerability. It involved methodological research, the elaboration stage of which involved 111 women from a previous study, and the content validation stage had 166 participants, including female frequenters of a healthcare service, specialized referees and teachers. In the validation process, the Content Validity Index per Item, General Content Validity Index and Cronbach’s Alpha were used. The instrument included 29 items and had a General Content Validity Index of 0.99. The semantic validation resulted in the insertion of pictorial signs in the response scales. The pilot study generated Cronbach’s alpha of 0.61 (CI: 0.48-0.72). The validated instrument is a tool that can assist health workers and researchers in predicting condom use, providing input for preventive interventions towards safe sexual practices among women in situations of social vulnerability.

ABSTRACT Background: Aedes aegypti is the primary vector of viruses, such as Zika, chikungunya, yellow fever, and dengue. In this context, a biomonitored chemical study was conducted to evaluate the activity of the crude extract of the endophytic fungus Phomopsis sp. against the larvae of Aedes aegypti. Methods: Crude extract, fractions, and isolated substances were evaluated in in-vitro assays against third-stage larvae of Aedes aegypti. Results: We isolated 3-nitropropionic acid with an LC50 of 15.172 ppm and LC90 of 18.178 ppm after 24 hours of larval exposure. Conclusions: The results indicated that 3-nitropropionic acid exerted larvicidal activity.

Resumo Objetivo Discutir as medidas de prevenção da covid-19 no contexto da vulnerabilidade das pessoas idosas institucionalizadas e analisar o apoio social ofertado às Instituições de Longa Permanência para Idosos durante a pandemia. Método Pesquisa qualitativa realizada com trabalhadores de 24 instituições filantrópicas do Rio Grande do Norte. Os conceitos de vulnerabilidade em saúde e apoio social embasaram a organização e discussão dos dados submetidos à análise temática. Resultados As instituições adotaram, parcialmente, as medidas de prevenção recomendadas pela Agencia Nacional de Vigilância Sanitária, em evidência: cancelamento de visitas, uso de Equipamentos de Proteção Individual e limpeza dos ambientes. Em sua maioria, as instituições priorizaram o controle da transmissão viral, secundarizando a redução dos impactos sociopsicológicos referentes ao distanciamento e isolamento social. Foram observadas medidas não recomendadas e sem evidência científica, como o uso de ivermectina. Ainda, a atuação das redes de assistência social e de saúde se efetivou de forma mais integrada, melhorando o apoio social oferecido às instituições na perspectiva da pandemia. O Sistema Único de Saúde se destacou pelas recomendações sanitárias, oferta de insumos e atenção da Estratégia Saúde da Família, enquanto o Sistema Único de Assistência Social atuou de maneira menos expressiva. Conclusão Em geral, as medidas adotadas foram insuficientes para a prevenção da covid-19 diante das suscetibilidades dos idosos institucionalizados. Embora a pandemia tenha ampliado a rede de apoio social e a visibilidade das Instituições de Longa Permanência para Idosos, tornam-se necessários maiores investimentos do poder público para efetivar a redução de vulnerabilidade dessas pessoas idosas.

Abstract Objective Discuss covid-19 prevention measures in the context of the vulnerability of institutionalized elderly people and analyze the social support offered to Long Stay Institutions for the Elderly during the pandemic. Method Qualitative research carried out with workers from 24 philanthropic institutions in Rio Grande do Norte. The concepts of vulnerability in health and social support supported the organization and discussion of data submitted to thematic analysis. Results The institutions partially adopted the prevention measures recommended by the National Health Surveillance Agency, in evidence: cancellation of visits, use of Personal Protective Equipment and cleaning of environments. For the most part, institutions prioritized the control of viral transmission, putting the reduction of socio-psychological impacts related to social distancing and isolation in the background. Measures not recommended and without scientific evidence were observed, such as the use of ivermectin. Also, the performance of social assistance and health networks was carried out in a more integrated way, improving the social support offered to institutions in the perspective of the pandemic. The Unified Health System stood out for its sanitary recommendations, supply of supplies and attention from the Family Health Strategy, while the Unified Social Assistance System acted in a less expressive way. Conclusion In general, the measures adopted were insufficient to prevent covid-19 in view of the susceptibilities of institutionalized elderly people. Although the pandemic has expanded the social support network and the visibility of Long-Stay Institutions for the Elderly, greater investments by the government are necessary to effectively reduce the vulnerability of these elderly people.

Abstract Background Cardiovascular risk factors are prognostic factors in coronavirus disease 2019 (COVID-19) and have been scarcely studied in Brazil. Objective The aim of this study was to assess the impact of cardiovascular risk factors on the outcomes of patients admitted for COVID-19. Methods From July 2020 to February 2021, 200 patients from two public hospitals were enrolled. Patients were included if they had typical symptoms or signs of COVID-19, a positive real-time polymerase chain reaction test (RT-PCR) for COVID-19, and an age above 18 years. This is a prospective, observational, and longitudinal study. Data were collected within 24 h of admission. The primary endpoint was a combination of hospital lethality, mechanical ventilation, hemodialysis, or length of hospital stay >28 days. Continuous variables were compared with the Student’s t-test for independent samples or the Mann-Whitney test. For comparisons of proportions, the χ 2 test was applied. ROC curves and survival curves were constructed. Multivariate logistic regression was performed to identify independent predictors of events. The level of significance was 0.05. Results There were 98 (49%) events during the hospital course, and 72 (36%) died in the hospital. Patients with a primary endpoint were older and more likely to have a history of hypertension, diabetes, chronic obstructive pulmonary disease (COPD), and chronic kidney disease (CKD). Vital signs at admission associated with events were diastolic blood pressure, respiratory rate, and oxygen saturation in ambient air (O 2 Sat). Serum creatinine >1.37 mg/dL at admission had a sensitivity of 51.6 and a specificity of 82% to predict the primary endpoint, with an area under the curve (AUC) of 0.68. In multivariate analysis, age, diabetes, CKD, and COPD were independent predictors of the primary endpoint. Age and CKD were independent predictors of in-hospital lethality. Conclusion Cardiovascular risk factors, such as diabetes and CKD, were related to a worse prognosis in patients hospitalized with COVID-19 in this sample from two public hospitals in the state of Rio de Janeiro.

Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.

Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.

Resumo A avalição da efetividade de vacinas é feita com dados do mundo real e é essencial para monitorar o desempenho dos programas de vacinação ao longo do tempo bem como frente a novas variantes. Até o momento, a avaliação da efetividade das vacinas para COVID-19 tem sido baseada em métodos clássicos como estudos de coorte e caso controle teste-negativo, que muitas vezes podem não permitir o adequado controle dos vieses intrínsecos da alocação das campanhas de vacinação. O objetivo dessa revisão foi discutir os desenhos de estudo disponíveis para avaliação de efetividade das vacinas, enfatizando os estudos quase-experimentais, que buscam mimetizar os estudos aleatorizados ao introduzir um componente exógeno para atribuição ao tratamento, bem como suas vantagens, limitações e aplicabilidade no contexto dos dados brasileiros. O emprego de métodos quase-experimentais, incluindo as séries temporais interrompidas, o método de diferença em diferenças, escore de propensão, variáveis instrumentais e regressão descontínua, são relevantes pela possibilidade de gerar estimativas mais acuradas da efetividade de vacinas para COVID-19 em cenários como o brasileiro, que se caracteriza pelo uso de várias vacinas, com respectivos número e intervalos entre doses, aplicadas em diferentes faixas etárias e em diferentes momentos da pandemia.

Abstract The evaluation of vaccine effectiveness is conducted with real-world data. They are essential to monitor the performance of vaccination programmes over time, and in the context of the emergence of new variants. Until now, the effectiveness of COVID-19 vaccines has been assessed based on classic methods, such as cohort and test-negative case-control studies, which may often not allow for adequate control of inherent biases in the assignment of vaccination campaigns. The aim of this review was to discuss the study designs available to evaluate vaccine effectiveness, highlighting quasi-experimental studies, which seek to mimic randomized trials, by introducing an exogenous component to allocate to treatment, in addition to the advantages, limitations, and applicability in the context of Brazilian data. The use of quasi-experimental approaches, such as interrupted time series, difference-in-differences, propensity scores, instrumental variables, and regression discontinuity design, are relevant due to the possibility of providing more accurate estimates of COVID-19 vaccine effectiveness. This is especially important in scenarios such as the Brazilian, which characterized by the use of various vaccines, with the respective numbers and intervals between doses, applied to different age groups, and introduced at different times during the pandemic.