Resumo Introdução: A reorganização dos cuidados de saúde imposta pela pandemia COVID-19 relevou a capacidade de trabalho de todos os profissionais de saúde, espelhando o papel basilar da Medicina Interna. Este trabalho pretende evidenciar a complexidade da gestão do doente COVID-19, pautada muitas vezes pela ausência de suporte teórico/científico face ao desconhecido. Métodos: Avaliação retrospetiva e descritiva de todos os doentes com infeção SARS-CoV-2 internados numa enfermaria do serviço de Medicina Interna, da Unidade Local de Saúde de Viseu Dão-Lafões (ULS Viseu Dão-Lafões), no período compreendido entre janeiro-abril e julho-novembro de 2021 (picos pandémicos de 2021). Resultados: Durante os 9 meses em estudo, foram avaliados 394 doentes, com predomínio do género masculino 56,60% (n = 223) e uma idade média de 70,42 anos. O tempo médio de internamento foi de 13,95 dias. A maioria apresentava pelo menos um fator de risco cardiovascular e apenas 29,44% (n = 116) eram vacinados contra a COVID-19. Quanto à terapêutica, 84,26% (n = 332) realizaram dexametasona e 85,79% (n = 338) necessitaram de oxigenoterapia suplementar; cerca de 22,08% (n = 87) necessitaram de ventilação mecânica não invasiva e 7,61% (n = 30) de ventilação mecânica invasiva. Registaram-se 23,86% (n = 94) óbitos. A infeção SARS-CoV-2 foi o diagnóstico principal na maioria dos doentes, mas muitos foram os diagnósticos secundários. Conclusão: A gravidade e complexidade de uma entidade nosológica totalmente desconhecida num contexto pandémico é de uma enorme exigência profissional e pessoal, como representado através da caracterização desta amostra. Salienta-se o espetro de doentes graves e com necessidade de suporte ventilatório mecânico, numa curva de admissões que se revelou exponencial.

Abstract Introduction: The reorganization of health care imposed by the COVID-19 pandemic revealed the work capacity of all health professionals, mirroring the fundamental role of In-ternal Medicine. This work intended to highlight the complexity of managing the COVID-19 patient, often guided by the absence of theoretical/scientific support in the face of the unknown. Methods: A retrospective and descriptive evaluation of all patients with SARS-COV2 infection admitted to a ward of the Internal Medicine service, Unidade Local de Saúde de Viseu Dão-Lafões (ULS Viseu Dão-Lafões), in the period between January-April and July-November 2021 (pandemic peaks of 2021). Results: During the nine months under study, 394 patients were evaluated, with a predominance of males 56.60% (n = 223) and an average age of 70.42 years. The average length of stay was 13.95 days. Most had at least one cardiovascular risk factor, and only 29.44% (n = 116) were vaccinated against COVID-19. Of the therapy, 84.26% (n=332) received dexamethasone, 85.79% (n =3 38) needed supplemental oxygen therapy; approximately 22.08% (n = 87) required non-invasive mechanical ventilation, and 7.61% (n = 30) underwent invasive mechanical ventilation/high-flow oxygen therapy. There were 23.86% (N = 94) dea-ths. COVID-19 infection was the primary diagnosis in most patients, but many were secondary diagnoses. Conclusion: The severity and complexity of an unknown nosological disease, in the pandemic phase, is of enormous professional and personal demand, as represented by the characterization of this sample. The spectrum of critically ill patients in need of mechanical ventilatory support stands out, in an admissions curve that turned out to be exponential.

ABSTRACT Objective: To evaluate autoinflammatory diseases (AID) according to age at diagnosis and sex, and response to therapy in a large population. Methods: This is a cross-sectional observational study of a Latin American registry using a designed web system for data storage, collected between 2015 and 2018. Any altered findings during follow-up were recorded. The forms were translated into Portuguese and Spanish, including demographic, clinical, laboratory, genetic and treatment characteristics. Results: We included 152 patients, 51.3% male and 75% Caucasian. The median age at disease onset was 2.1 years (0–15.6 years) and median age at diagnosis 6.9 years (0–21.9 years); 111 (73%) were children (0–9 years old), and 41 (27%) were adolescents and young adults (AYA) (10–21 years old). Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) occurred in 46/152 (30%), chronic non-bacterial osteomyelitis (CNO) in 32/152 (21%), and familial Mediterranean fever (FMF) in 24/152 (15.7%). PFAPA was significantly higher in young children than in AYA (38.7% vs. 7.3%, p<0.001), while CNO were lower (13.5% vs. 41.5%, p<0.001). The frequency of females was significantly higher in CNO (28.4% vs. 14.1%, p=0.031) and lower in FMF (8.1% vs. 23.1%, p=0.011). The most used drugs were glucocorticoids, non-steroidal anti-inflammatory drugs (NSAID), and colchicine. Glucocorticoids and colchicine treatment were used in all AID with good to moderate response. However, cryopyrin-associated periodic syndromes (CAPS) seemed unresponsive to glucocorticoids. NSAIDs and methotrexate were the main medications used to treat CNO. Conclusions: Differences among AID patients were observed in the LA population regarding sex and age at disease diagnosis. Objective (AID Methods crosssectional cross sectional storage 201 2018 followup follow up recorded Spanish demographic clinical laboratory characteristics Results 15 513 51 3 51.3 75 Caucasian 21 2 1 2. 0–15.6 0156 0 6 (0–15. 69 9 6. 0–21.9 0219 (0–21. 11 73% 73 (73% 0–9 09 (0– old, old , old) 4 27% 27 (27% (AYA 10–21 1021 10 (10–2 old. . stomatitis pharyngitis (PFAPA 46152 46 46/15 30%, 30 30% (30%) nonbacterial non bacterial (CNO 32152 32 32/15 21%, 21% (21%) (FMF 24152 24 24/15 15.7%. 157 15.7% 7 (15.7%) 38.7% 387 38 (38.7 vs 7.3% p<0.001, p0001 p p<0.001 001 p<0.001) 13.5% 135 13 5 (13.5 415 41.5% p<0.001. 28.4% 284 28 (28.4 141 14 14.1% p=0.031 p0031 031 8.1% 81 8 (8.1 231 23 23.1% p=0.011. p0011 p=0.011 011 p=0.011) glucocorticoids nonsteroidal steroidal antiinflammatory anti inflammatory NSAID, NSAID (NSAID) However cryopyrinassociated cryopyrin associated CAPS (CAPS Conclusions 20 51. 0–15. 015 (0–15 0–21. 021 (0–21 (73 0– (0 (27 10–2 102 (10– 4615 46/1 (30% 3215 32/1 (21% 2415 24/1 15.7 (15.7% 38.7 (38. 7.3 p000 p<0.00 00 13.5 (13. 41.5 28.4 (28. 14.1 p=0.03 p003 03 8.1 (8. 23.1 p001 p=0.01 01 (NSAID 0–15 (0–1 0–21 02 (0–2 (7 ( (2 10– (10 461 46/ (30 321 32/ (21 241 24/ 15. (15.7 38. (38 7. p00 p<0.0 13. (13 41. 28. (28 14. p=0.0 8. (8 23. 0–1 0–2 (1 (3 (15. p0 p<0. p=0. (15 p<0 p=0 p< p=

RESUMO Objetivo: Avaliar as doenças autoinflamatórias (DAI) de acordo com sexo e idade no momento do diagnóstico e a resposta terapêutica em uma grande população. Métodos: Este é um estudo observacional transversal de um registro latino-americano que usou um sistema de dados coletados entre 2015 e 2018. Quaisquer achados alterados ao longo do acompanhamento foram registrados. Os formulários foram traduzidos para os idiomas português e espanhol, incluindo características demográficas, clínicas, laboratoriais, genéticas e de tratamento. Resultados: Incluímos 152 pacientes, sendo 51,3% do sexo masculino e 75% da raça branca. A média de idade de início da doença foi de 2,1 anos (0–15,6 anos) e a média de idade de diagnóstico 6,9 anos (0–21,9 anos); 111 (73%) eram crianças (0–9 anos) e 41 (27%) adolescentes/adultos jovens (10–21 anos). A síndrome de febre periódica, estomatite aftosa, faringite e adenite (PFAPA) ocorreu em 46/152 (30%), osteomielite não bacteriana crônica (CNO) em 32/152 (21%) e febre familiar do Mediterrâneo (FMF) em 24/152 (15,7%). A PFAPA foi significativamente maior em crianças pequenas (38,7 vs. 7,3%, p<0,001), e a CNO, em adolescentes/adultos jovens (13,5 vs. 41,5%, p<0,001). A frequência do sexo feminino foi significativamente maior na CNO (28,4 vs. 14,1%, p=0,031) e menor na FMF (8,1 vs. 23,1%, p=0,011). Os medicamentos mais utilizados foram glicocorticoides, anti-inflamatórios não esteroidais (AINE) e colchicina. O tratamento com glicocorticoides e colchicina foi usado em todas as DAI com resposta boa a moderada. No entanto, as síndromes periódicas associadas à criopirina (CAPS) pareciam não responder aos glicocorticoides. AINE e metotrexato foram os principais medicamentos utilizados no tratamento da CNO. Conclusões: Diferenças de pacientes com DAI foram observadas na população latino-americana em pacientes agrupados por sexo e idade ao diagnóstico da doença. Objetivo (DAI Métodos latinoamericano latino americano 201 2018 registrados espanhol demográficas clínicas laboratoriais Resultados 15 513 51 3 51,3 75 branca 21 2 1 2, 0–15,6 0156 0 6 (0–15, 69 9 6, 0–21,9 0219 (0–21, 11 73% 73 (73% 0–9 09 (0– 4 27% 27 (27% adolescentesadultos adolescentes adultos 10–21 1021 10 (10–2 anos. . periódica aftosa (PFAPA 46152 46 46/15 30%, 30 30% , (30%) (CNO 32152 32 32/15 21% (21% (FMF 24152 24 24/15 15,7%. 157 15,7% 7 (15,7%) 38,7 387 38 (38, vs 7,3% p<0,001, p0001 p p<0,001 001 p<0,001) 13,5 135 13 5 (13, 415 41,5% p<0,001. 28,4 284 28 (28, 141 14 14,1% p=0,031 p0031 031 8,1 81 8 (8, 231 23 23,1% p=0,011. p0011 p=0,011 011 p=0,011) antiinflamatórios anti inflamatórios (AINE moderada entanto CAPS (CAPS Conclusões latinoamericana americana 20 51, 0–15, 015 (0–15 0–21, 021 (0–21 (73 0– (0 (27 10–2 102 (10– 4615 46/1 (30% 3215 32/1 (21 2415 24/1 15,7 (15,7% 38, (38 7,3 p000 p<0,00 00 13, (13 41,5 28, (28 14,1 p=0,03 p003 03 8, (8 23,1 p001 p=0,01 01 0–15 (0–1 0–21 02 (0–2 (7 ( (2 10– (10 461 46/ (30 321 32/ 241 24/ 15, (15,7 (3 7, p00 p<0,0 (1 41, 14, p=0,0 23, 0–1 0–2 (15, p0 p<0, p=0, (15 p<0 p=0 p< p=

RESUMEN Objetivo: analizar las asociaciones entre sospecha de Trastornos Mentales Comunes y percepción del riesgo en el trabajo de Enfermería en unidades hospitalarias exclusivas para COVID-19 y conocer los elementos entrelazados en estas relaciones, desde la perspectiva de los trabajadores. Método: estudio de métodos mixtos paralelo-convergente, realizado con 327 trabajadores da Enfermería de unidades exclusivas para COVID-19 de siete hospitales del estado de Rio Grande do Sul, Brasil. Los datos cuantitativos se recolectaron por medio de un cuestionario sociodemográfico, laboral y de percepción de riesgos, además de utilizarse el Self-Reporting Questionnaire, y se los sometió a análisis estadístico inferencial. Los datos cualitativos se produjeron por medio de entrevistas semiestructuradas y se los procesó sobre la base de análisis temático de contenido. Resultados: el 76,4% indicó que desempeñarse en la atención a pacientes con Covid-19 aumentó considerablemente o en demasía los riesgos en el trabajo. Con respecto a la intensidad de exposición a los riesgos, los trabajadores consideran estar muy expuestos a los siguientes riesgos: infección por Covid-19 (51,4%); contaminar a su familia (45,9%); que algún familiar desarrolle la forma grave da Covid-19 (46,5%); padecer perjuicios psicológicos (47,7%); sufrir alteraciones en el sueño (45,9) o en los hábitos alimenticios (40,7); u aislarse de familiares y amigos (48%). Todas estas variables demostraron estar asociadas a la sospecha de Trastornos Mentales Comunes. Cualitativamente, se evidenció que el sentimiento que señalizó la intersección entre percepción de riesgo y padecimiento mental fue el miedo. Conclusión: la sospecha de Trastornos Mentales Comunes se asoció a la percepción de múltiples riesgos, donde el miedo fue el principal elemento entrelazado en esa relación. Objetivo COVID19 COVID 19 COVID-1 relaciones Método paraleloconvergente, paraleloconvergente paralelo convergente, convergente paralelo-convergente 32 Sul Brasil sociodemográfico SelfReporting Self Reporting Questionnaire inferencial contenido Resultados 764 76 4 76,4 Covid19 Covid Covid-1 51,4% 514 51 (51,4%) 45,9% 459 45 9 (45,9%) 46,5% 465 46 5 (46,5%) 47,7% 477 47 7 (47,7%) 45,9 (45,9 40,7 407 40 (40,7) 48%. 48 48% . (48%) Cualitativamente Conclusión relación COVID1 1 COVID- 3 76, Covid1 Covid- 51,4 (51,4% (45,9% 46,5 (46,5% 47,7 (47,7% 45, (45, 40, (40,7 (48% 51, (51,4 46, (46,5 47, (47,7 (45 (40, (48 (51, (46, (47, (4 (40 (51 (46 (47 ( (5

ABSTRACT Objective: to analyze the associations between suspected Common Mental Disorders and risk perception in Nursing work at Covid-19 hospital units and to understand the elements intertwined in these relationships, from the workers' perspective. Method: a parallel-convergent mixed-methods study, carried out with 327 Nursing workers from Covid-19 units in seven hospitals from the state of Rio Grande do Sul, Brazil. The quantitative data were collected through a sociodemographic, work-related and risk perception questionnaire, added to the Self-Reporting Questionnaire and subjected to inferential statistical analysis. The qualitative data were produced through semi-structured interviews and treated in the light of thematic content analysis. Results: in all, 76.4% of the participants reported that their performance during the Covid-19 pandemic considerably or greatly increased the risks in their job. Regarding the risk exposure intensity, the workers consider themselves very exposed to the following risks: Covid-19 infection (51.4%); contaminating their family (45.9%); a family member developing a severe form of Covid-19 (46.5%); suffering psychological harms (47.7%); experiencing sleep (45.9%) or dietary pattern (40.7%) disorders; and isolating themselves from friends and family (48%). All of these variables were associated with suspected Common Mental Disorders. Qualitatively, it was evident that fear was the feeling signaling the intersection between risk perception and mental illness. Conclusion: suspected Common Mental Disorders were associated with the perception of multiple risks, with fear as the main element intertwined in this relationship. Objective Covid19 Covid 19 Covid-1 relationships perspective Method parallelconvergent parallel convergent mixedmethods mixed methods study 32 Sul Brazil sociodemographic workrelated related questionnaire SelfReporting Self Reporting analysis semistructured semi structured Results all 764 76 4 76.4 job intensity 51.4% 514 51 (51.4%) 45.9% 459 45 9 46.5% 465 46 5 (46.5%) 47.7% 477 47 7 (47.7%) (45.9% 40.7% 407 40 (40.7% disorders 48%. 48 48% . (48%) Qualitatively illness Conclusion relationship Covid1 1 Covid- 3 76. 51.4 (51.4% 45.9 46.5 (46.5% 47.7 (47.7% (45.9 40.7 (40.7 (48% 51. (51.4 45. 46. (46.5 47. (47.7 (45. 40. (40. (48 (51. (46. (47. (45 (40 (4 (51 (46 (47 ( (5

RESUMO Objetivo: analisar as associações entre a suspeita de Transtornos Mentais Comuns e a percepção de risco no trabalho da enfermagem em unidades hospitalares Covid-19 e conhecer os elementos imbricados nestas relações, na perspectiva dos trabalhadores. Método: estudo de métodos mistos paralelo-convergente, realizado com 327 trabalhadores da enfermagem de unidades Covid-19 de sete hospitais do estado do Rio Grande do Sul, Brasil. Os dados quantitativos foram coletados por meio de um questionário sociodemográfico, laboral e de percepção de riscos, somado ao Self-Reporting Questionnaire e submetidos a analise estatística inferencial. Os dados qualitativos foram produzidos por meio de entrevistas semiestruturadas e tratados à luz da análise temática de conteúdo. Resultados: 76,4% referiram que a atuação na Covid-19 aumentou consideravelmente ou muito os riscos no seu trabalho. No que tange à intensidade de exposição dos riscos, trabalhadores se consideram muito expostos ao risco de infecção por Covid-19 (51,4%); risco de levar a contaminação para sua família (45,9%); risco de que alguém da família desenvolva a forma grave da Covid-19 (46,5%); risco de sofrer danos psicológicos (47,7%); risco de sofrer alterações do sono (45,9); do padrão alimentar (40,7); e de se isolar de amigos e familiares (48%). Todas estas variáveis se mostraram associadas a suspeita de Transtornos Mentais Comuns. Qualitativamente, evidenciou-se que o medo era o sentimento balizador da intersecção entre a percepção de risco e o adoecimento mental. Conclusão: a suspeita de Transtornos Mentais Comuns associou-se à percepção de múltiplos riscos, sendo que o medo foi o principal elemento imbricado nessa relação. Objetivo Covid19 Covid 19 Covid-1 relações Método paraleloconvergente, paraleloconvergente paralelo convergente, convergente paralelo-convergente 32 Sul Brasil sociodemográfico SelfReporting Self Reporting inferencial conteúdo Resultados 764 76 4 76,4 51,4% 514 51 (51,4%) 45,9% 459 45 9 (45,9%) 46,5% 465 46 5 (46,5%) 47,7% 477 47 7 (47,7%) 45,9 (45,9) 40,7 407 40 (40,7) 48%. 48 48% . (48%) Qualitativamente evidenciouse evidenciou mental Conclusão associouse associou relação Covid1 1 Covid- 3 76, 51,4 (51,4% (45,9% 46,5 (46,5% 47,7 (47,7% 45, (45,9 40, (40,7 (48% 51, (51,4 46, (46,5 47, (47,7 (45, (40, (48 (51, (46, (47, (45 (40 (4 (51 (46 (47 ( (5

Abstract Background Vitiligo is the most common pigmentary disorder and is considered a chronic, cumulative, multifactorial disease. The crucial role of cytotoxic CD8+ T lymphocytes and the IFNγ/CXCL10 axis has been demonstrated in its pathogenesis. Objective To evaluate the clinical profile and immuno-inflammatory markers in patients with vitiligo in a reference medical center. Methods Cross-sectional study in which all patients with vitiligo seen at the medical center the from 2019 to 2022 were evaluated, to outline the clinical profile. Moreover, cardiovascular risk biomarkers (neutrophil/lymphocyte ratio and C-reactive protein levels) were measured, as well as cytokines and chemokines (TNFα, IFNγ, IL10, IL15 and CXCL10) in the serum of a subgroup of 30 patients. Results There was a predominance of females, with a mean age of 43 years. Most were phototypes IV or V (71.3%), without comorbidities (77.55%), and without a family history of vitiligo (70.41%). Higher levels of neutrophil/lymphocyte ratio, C-reactive protein, and inflammatory cytokines/chemokines were documented in vitiligo patients when compared to the control group (non-significant). As relevant data, the highest values of CXCL10 were detected in patients with vitiligo versus controls, as well as in patients with disease of shorter duration (p < 0.05). Study limitations The number of assessed patients was small due to recruitment difficulties caused by the COVID-19 pandemic. Conclusion The present data contribute to confirming the relevant role of the IFNγ/CXCL10 axis in the pathogenesis of vitiligo, highlighting CXCL10 as a possible activity marker. chronic cumulative CD8 CD IFNγCXCL10 IFNγCXCL IFNγ CXCL IFNγ/CXCL1 immunoinflammatory immuno Crosssectional Cross sectional 201 202 evaluated Moreover neutrophillymphocyte neutrophil lymphocyte Creactive C reactive measured TNFα, TNFα (TNFα IL10 IL IL1 3 females 4 years 71.3%, 713 71.3% , 71 (71.3%) 77.55%, 7755 77.55% 77 55 (77.55%) 70.41%. 7041 70.41% . 70 41 (70.41%) cytokineschemokines nonsignificant. nonsignificant non significant (non-significant) CXCL1 controls p 0.05. 005 0.05 0 05 0.05) COVID19 COVID 19 COVID-1 pandemic marker IFNγCXCL1 IFNγ/CXCL 20 71.3 7 (71.3% 775 77.55 5 (77.55% 704 70.41 (70.41% (non-significant 00 0.0 COVID1 1 COVID- 2 71. (71.3 77.5 (77.55 70.4 (70.41 0. (71. 77. (77.5 70. (70.4 (71 (77. (70. (7 (77 (70 (

Résumé Notre objectif est d’analyser le programme national nommé Brasil Carinhoso, de 2012 à 2015, à partir des cadres théoriques de la transversalité et de l’intersectorialité, mettant l’accent sur les dimensions du soin. Le programme fédéral Brasil Carinhoso, centré sur le développement de l’enfant, s’articulait autour des questions de l’éducation, de la santé, de l’assistance sociale et de la nutrition. Appuyés sur une analyse qualitative de documents officiels et d’entretiens, nous avons constaté que le programme avait une conception intersectorielle, comprenant des innovations en matière de financement et de gestion, même si sa mise en œuvre était principalement sectorielle. Aucune transversalité de genre n’a pas été identifiée quand l’analyse s’est penchée sur la conception du programme. En effet, les approches du soin n’ont pas pris en considération le genre de la personne qui donne les soins et se concentrant uniquement sur celle qui les reçoit. danalyser d analyser Carinhoso 201 2015 lintersectorialité, lintersectorialité l intersectorialité, intersectorialité l’intersectorialité laccent accent lenfant, lenfant enfant, enfant l’enfant sarticulait s articulait léducation, léducation éducation, éducation l’éducation santé lassistance assistance nutrition dentretiens, dentretiens entretiens, entretiens d’entretiens intersectorielle gestion sectorielle na n a lanalyse sest effet nont ont reçoit 20 2

Resumen Nuestro propósito es analizar el Brasil Carinhoso, de 2012 a 2015, desde los lentes teóricos de la transversalidad y la intersectorialidad, destacando también las dimensiones del cuidado. El Brasil Carinhoso fue una iniciativa federal centrada en el desarrollo infantil, articulando educación, salud, asistencia social y nutrición. A partir de un análisis cualitativo de documentos oficiales y entrevistas, evidenciamos una concepción intersectorial del programa, abarcando innovaciones en el financiamiento y en la gestión, aunque su implementación haya sido, en gran medida, sectorial. La transversalidad de género no fue identificada, ni siquiera en la concepción de la iniciativa analizada, especialmente porque los enfoques de cuidado del Brasil Carinhoso dejan de considerar quién cuida, centrándose sólo en quién es cuidado. 201 2015 intersectorialidad infantil educación salud nutrición entrevistas programa gestión sido medida sectorial identificada analizada cuida 20 2

Abstract Our purpose in this article is to analyze Brasil Carinhoso from 2012 to 2015 through the theoretical lenses of mainstreaming and intersectorality, and highlight those dimensions of care it covers. Brasil Carinhoso was a federal child development initiative, which linked aspects of children’s education, health, social assistance and nutrition. Based on a qualitative analysis of official documents and interviews, we provide evidence of an intersectoral concept of the program, which included innovations in funding and management, even though its implementation was largely sectoral. We were unable to identify evidence of gender mainstreaming, not even in the conception of the initiative we analyzed, especially because the approaches to care adopted in Brasil Carinhoso fail to take into consideration those who provide the care, and focus only on those who are cared for. 201 intersectorality covers childrens children s education health nutrition interviews program management sectoral analyzed for 20 2

Resumo Nosso propósito é analisar o Brasil Carinhoso, de 2012 a 2015, a partir das lentes teóricas da transversalidade e da intersetorialidade, destacando, ainda, as dimensões do cuidado. O Brasil Carinhoso foi uma iniciativa federal voltada ao desenvolvimento infantil, articulando educação, saúde, assistência social e nutrição. Com base em uma análise qualitativa de documentos oficiais e de entrevistas, evidenciamos uma concepção intersetorial do programa, abrangendo inovações no financiamento e na gestão, ainda que sua implementação tenha sido, em grande medida, setorial. A transversalidade de gênero não foi identificada, nem mesmo na concepção da iniciativa analisada, especialmente porque as abordagens de cuidado do Brasil Carinhoso deixam de considerar quem cuida, enfocando apenas quem é cuidado. 201 2015 intersetorialidade destacando infantil educação saúde nutrição entrevistas programa gestão sido medida setorial identificada analisada cuida 20 2

Abstract The Federal University of Goiás (UFG) and the University of Brasília (UnB), in partnership with the company Eletrobras Furnas, have developed research and, based on this, extension projects aimed at education in a broad sense, in which they seek to disseminate and popularise technical-scientific knowledge. This paper aims to present and evaluate educational actions carried out in the area of soil science and geotechnics applied to engineering, geography, and the environment. To do so, the educational experiences developed within the scope of two extension projects are shared. Besides that, the relevance of publishing books and primer, with language adapted to lay society, within the scope of research projects, is analysed. The results collected regarding the effectiveness of the extension actions as a tool for learning point to a positive evaluation by the students. Furthermore, social networks are an important tool for scientific dissemination and have the potential to disseminate knowledge more widely than in a classroom course. By comparing the number of citations in Google Scholar of the books and booklets with the papers arising from these projects, one can observe the reach of this type of publication, although its purpose is the popularisation of science, with reach in places not considered in the technical-scientific publication metrics. Finally, for effective scientific development, it is necessary to have public policies, effective interaction between universities, research centres and schools, and the participation of professional associations, funding and evaluation agencies, Education Departments and the Ministry of Education, Science, Technology, and Innovation. UFG (UFG UnB, UnB , (UnB) Furnas sense technicalscientific technical engineering geography environment so shared that primer society analysed students Furthermore course metrics Finally development policies universities schools associations agencies Science Technology Innovation (UnB

Abstract Background A cost of illness (COI) study aims to evaluate the socioeconomic burden that an illness imposes on society as a whole. This study aimed to describe the resources used, patterns of care, direct cost, and loss of productivity due to systemic lupus erythematosus (SLE) in Brazil. Methods This 12-month, cross-sectional, COI study of patients with SLE (ACR 1997 Classification Criteria) collected data using patient interviews (questionnaires) and medical records, covering: SLE profile, resources used, morbidities, quality of life (12-Item Short Form Survey, SF-12), and loss of productivity. Patients were excluded if they were retired or on sick leave for another illness. Direct resources included health-related (consultations, tests, medications, hospitalization) or non-health-related (transportation, home adaptation, expenditure on caregivers) hospital resources. Costs were calculated using the unit value of each resource and the quantity consumed. A gamma regression model explored cost predictors for patients with SLE. Results Overall, 300 patients with SLE were included (92.3% female, mean [standard deviation (SD)] disease duration 11.8 [7.9] years), of which 100 patients (33.3%) were on SLE-related sick leave and 46 patients (15.3%) had stopped schooling. Mean (SD) travel time from home to a care facility was 4.4 (12.6) hours. Antimalarials were the most commonly used drugs (222 [74.0%]). A negative correlation was observed between SF-12 physical component and SLE Disease Activity Index (- 0.117, p = 0.042), Systemic Lupus International CollaboratingClinics/AmericanCollegeofRheumatology Damage Index (- 0.115, p = 0.046), medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific drugs/day (- 0.113, p = 0.051), and lost productivity (- 0.570, p < 0.001). For the mental component, a negative correlation was observed with medications/day for multiple co-morbidities (- 0.272, p < 0.001), SLE-specific medications/day (- 0.113, p = 0.051), and missed appointments (- 0.232, p < 0.001). Mean total SLE cost was US$3,123.53/patient/year (median [interquartile range (IQR)] US$1,618.51 [$678.66, $4,601.29]). Main expenditure was medication, with a median (IQR) cost of US$910.62 ($460, $4,033.51). Mycophenolate increased costs by 3.664 times (p < 0.001), and inflammatory monitoring (erythrocyte sedimentation rate or C-reactive protein) reduced expenditure by 0.381 times (p < 0.001). Conclusion These results allowed access to care patterns, the median cost for patients with SLE in Brazil, and the differences across regions driven by biological, social, and behavioral factors. The cost of SLE provides an updated setting to support the decision-making process across the country. (COI whole (SLE Brazil 12month, 12month month 12 month, 12-month crosssectional, crosssectional cross sectional, sectional cross-sectional ACR 199 Criteria questionnaires (questionnaires records covering profile morbidities 12Item Item Survey SF12, SF12 SF , SF-12) healthrelated health related consultations, consultations (consultations tests medications hospitalization nonhealthrelated non transportation, transportation (transportation adaptation caregivers consumed Overall 30 92.3% 923 92 3 (92.3 female standard SD 118 11 8 11. 7.9 79 7 9 [7.9 years, years years) 10 33.3% 333 33 (33.3% SLErelated 4 15.3% 153 15 (15.3% schooling (SD 44 4. 12.6 126 6 (12.6 hours 222 (22 74.0%. 740 74.0% . 74 0 [74.0%]) SF-1 ( 0117 117 0.117 0.042, 0042 0.042 042 0.042) CollaboratingClinicsAmericanCollegeofRheumatology CollaboratingClinics AmericanCollegeofRheumatology 0115 115 0.115 0.046, 0046 0.046 046 0.046) medicationsday day comorbidities co 0272 272 0.272 0.001, 0001 0.001 001 0.001) SLEspecific specific drugsday 0113 113 0.113 0.051, 0051 0.051 051 0.051) 0570 570 0.570 0.001. 0232 232 0.232 US312353patientyear USpatientyear US 123 53 year interquartile IQR US161851 1 618 51 US$1,618.5 $678.66, 67866 678 66 [$678.66 $4,601.29. 460129 $4,601.29 601 29 $4,601.29]) medication (IQR US91062 910 62 US$910.6 $460, 460 ($460 $4,033.51. 403351 $4,033.51 033 $4,033.51) 3664 664 3.66 erythrocyte Creactive C reactive protein 0381 381 0.38 biological social factors decisionmaking decision making country 19 SF1 92.3 (92. 7. [7. 33.3 (33.3 15.3 (15.3 12. (12. 22 (2 74.0 [74.0%] SF- 011 0.11 004 0.04 04 027 27 0.27 000 0.00 00 005 0.05 05 057 57 0.57 023 23 0.23 patientyear 5 US16185 61 US$1,618. $678.66 6786 67 [$678.6 46012 $4,601.2 60 2 $4,601.29] US9106 91 US$910. $460 ($46 40335 $4,033.5 03 366 3.6 038 38 0.3 92. (92 [7 33. (33. 15. (15. (12 74. [74.0% 01 0.1 0.0 02 0.2 0.5 US1618 US$1,618 $678.6 [$678. 4601 $4,601. US910 US$910 $46 ($4 4033 $4,033. 36 3. 0. (9 [ (33 (15 (1 [74.0 US161 US$1,61 $678. [$678 $4,601 US91 US$91 $4 ($ 403 $4,033 (3 [74. US16 US$1,6 $678 [$67 $4,60 US9 US$9 $ 40 $4,03 [74 US1 US$1, $67 [$6 $4,6 US$ $4,0 US$1 $6 [$ $4,

ABSTRACT Objective: To evaluate glycemic control according to the number of daily basal rates (BRs) in type 1 diabetes patients using continuous subcutaneous insulin infusion (CSII). Subjects and methods: Cross-sectional study of patients treated with an open-loop CSII for at least 6 months and using a flash glucose monitoring system. Patients were divided into 2 groups: group 1 (G1) and group 2 (G2), with ≤4 and >4 BRs/24h, respectively. The groups were compared regarding HbA1c, time in range (TIR), time above range (TAR), time below range (TBR), glucose management indicator (GMI), glucose variability and data related to hypoglycemia. Regression models were performed. Results: The study included 99 patients (n = 55 in G1; n = 44 in G2). Median (Interquartile range) overall age was 30 (17) years, with 19.5 (48) and 51 (77) months of CSII use, respectively. The median number of different BRs was 3 (2) for G1 and 6 (2) for G2. There were no differences concerning age, sex, educational stage, weight, and insulin analog used. G2 had longer disease duration, longer CSII use, and higher total basal daily dose/kg. No significant differences regarding HbA1c, median glucose, GMI, TIR, TAR, and CV were found. G2 patients had more hypoglycemia, more asymptomatic hypoglycemia, and higher TBR. After adjusting for potential confounders, G1 maintained a lower risk of asymptomatic hypoglycemia. Conclusion: Programming open-loop CSII devices with more than 4 BRs does not improve metabolic control. Additionally, it seems to be a risk factor for hypoglycemia and was an independent predictor for asymptomatic hypoglycemia. Objective (BRs CSII. . (CSII) methods Crosssectional Cross sectional openloop open loop system G (G1 G2, , (G2) ≤ > BRs24h BRsh 24h h BRs/24h respectively HbA1c HbAc HbA c TIR (TIR) TAR (TAR) TBR, TBR (TBR) GMI (GMI) performed Results 9 5 G2) Interquartile 17 (17 years 195 19 19. 48 (48 77 (77 use (2 sex stage weight used duration dosekg dose kg dose/kg found confounders Conclusion Additionally (CSII (G (G2 (TIR (TAR (TBR (GMI (1 (4 7 (7 (

Abstract The current study proposes to investigate the diversity and phylogeny of trypanosomes parasitizing wild birds from the Brazilian Atlantic Forest. Cytological examination was carried out by light microscopy of blood smears and positive birds were selected for amplification of the 18S rDNA sequence through PCR. The resulting amplicons were subjected to purification, cloning, and sequencing analysis. Phylogenetic reconstruction was conducted, including all avian trypanosomes representative’s lineages. A total of ten bird samples from species of Turdus flavipes (N=1/12), T. albicollis (N=1/8), Tachyphonus coronatus (N=6/121), Thamnophilus caerulescens (N=1/22) and Synallaxis spixi (N=1/8) were positive for Trypanosoma spp. In the six specimens of T. coronatus, five distinct lineages of Trypanosoma spp. 18S-rRNA were observed in ninety sequences obtained, and using the strategy of cloning independent PCR, it was possible to observe that two of them were related to T. avium (JB01/JB02), and three were closed related to T. bennetti (JB03/ JB04/JB05). Addionaly, all fifteen sequences obtained from T. caerulescens/ S. spixi/T. flavipes/T. albicollis were identical. The present research is the first study to access molecular diversity and polyparasitism by avian trypanosomes in Brazil. The current research exhibits the wide genetic variability in avian trypanosomes and its non-specific relationship with its avian hosts. Forest S PCR purification analysis conducted representatives representative s N=1/12, N112 N N=1/12 , 1 12 (N=1/12) T N=1/8, N18 N=1/8 8 N=6/121, N6121 N=6/121 6 121 (N=6/121) N=1/22 N122 22 (N=1/22 (N=1/8 spp 18SrRNA SrRNA rRNA JB01/JB02, JB01JB02 JBJB JB01/JB02 JB01 JB02 JB (JB01/JB02) JB03/ JB03 (JB03 JB04/JB05. JB04JB05 JB04/JB05 . JB04 JB05 JB04/JB05) Addionaly spixiT spixi/T flavipesT flavipes/T identical Brazil nonspecific non specific hosts N11 N=1/1 (N=1/12 N1 N=1/ N612 N=6/12 (N=6/121 N=1/2 N12 2 (N=1/2 (N=1/ JB01JB0 JB01/JB0 JB0 (JB01/JB02 (JB0 JB04JB0 JB04/JB0 (N=1/1 N=1 N61 N=6/1 (N=6/12 (N=1 JB01JB JB01/JB (JB01/JB0 (JB JB04JB JB04/JB N= N6 N=6/ (N=6/1 (N= (JB01/JB N=6 (N=6/ (N (N=6

Abstract Immunodiagnostic tests for detecting dengue virus infections encounter challenges related to cross-reactivity with other related flaviviruses. Our research focuses on the development of a synthetic multiepitope antigen tailored for dengue immunodiagnostics. Selected dengue epitopes involved structural linearity and dissimilarity from the proteomes of Zika and Yellow fever viruses which served for computationally modeling the three-dimensional protein structure, resulting in the design of two proteins: rDME-C and rDME-BR. Both proteins consist of seven epitopes, separated by the GPGPG linker, and a carboxy-terminal 6 × -histidine tag. The molecular weights of the final proteins rDME-C and rDME-BR are 16.83 kDa and 16.80 kDa, respectively, both with an isoelectric point of 6.35. The distinguishing factor between the two proteins lies in the origin of their epitope sequences, where rDME-C is based on the reference dengue proteome, while rDME-BR utilizes sequences from prevalent Dengue genotypes in Brazil from 2008 to 2019. PyMol analysis revealed exposure of epitopes in the secondary structure. Successful expression of the antigens was achieved in soluble form and fluorescence experiments indicated a disordered structure. In subsequent testing, rDME-BR and rDME-C antigens were assessed using an indirect Elisa protocol against Dengue infected serum, previously examined with a commercial diagnostic test. Optimal concentrations for antigens were determined at 10 µg/mL for rDME-BR and 30 µg/mL for rDME-C, with serum dilutions ranging from 1:50 to 1:100. Both antigens effectively detected IgM and IgG antibodies in Dengue fever patients, with rDME-BR exhibiting higher sensitivity. Our in-house test showed a sensitivity of 77.3 % and 82.6 % and a specificity of 89.4 % and 71.4 % for rDME-C and rDEM-BR antigens. No cross-reactivity was observed with serum from Zika-infected mice but with COVID-19 serum samples. Our findings underscore the utility of synthetic biology in crafting Dengue-specific multiepitope proteins and hold promise for precise clinical diagnosis and monitoring responses to emerging Dengue vaccines. crossreactivity cross reactivity flaviviruses immunodiagnostics threedimensional three dimensional structure rDMEC rDME C rDMEBR. rDMEBR BR. BR linker carboxyterminal carboxy terminal histidine tag 1683 16 83 16.8 1680 80 respectively 635 35 6.35 proteome 200 2019 testing 1 µgmL µg mL 3 rDMEC, C, 150 50 1:5 1100. 1100 100. 100 1:100 patients inhouse house 773 77 77. 826 82 82. 894 89 4 89. 714 71 71. rDEMBR rDEM Zikainfected COVID19 COVID 19 COVID-1 samples Denguespecific specific vaccines 168 8 16. 63 6.3 20 201 15 5 1: 110 1:10 7 COVID1 COVID- 6. 2 11 1:1

RESUMEN Objetivo: Analizar la asociación entre la cultura de seguridad del paciente y la calidad de vida profesional de los profesionales de enfermería. Método: Estudio correlacional realizado en un hospital de Salvador, Bahía, Brasil, con 180 participantes. Los datos fueron recolectados a través de los instrumentos Hospital Survey on Patient Safety Culture y Professional Quality of Life Scale y analizados con pruebas de correlación. Resultados: El uso del modelo de Calidad de Vida Profesional, que engloba la Satisfacción por compasión, el Burnout y el Estrés Traumático, demostró que una mejor evaluación de la cultura de seguridad se asoció negativamente con el Burnout. Respecto a las dimensiones de la cultura, mejores evaluaciones de la percepción general de la seguridad, el trabajo en equipo y la dotación de personal se asociaron negativamente con el Burnout y el estrés traumático. Un mayor Burnout se asoció negativamente con un mejor cambio de turno y un mayor estrés traumático se asoció positivamente con la comunicación de errores. Conclusión: Mayores niveles de Burnout se asociaron con peor percepción de la cultura de seguridad y peores evaluaciones del trabajo en equipo; la dotación de personal y la percepción general de seguridad se asociaron con un mayor nivel de Burnout y Estrés Traumático, lo que enfatiza la importancia de la inversión en estas áreas. Objetivo enfermería Método Salvador Bahía Brasil 18 participantes correlación Resultados Profesional compasión Traumático errores Conclusión áreas 1

RESUMO Objetivo: Analisar a associação entre cultura de segurança do paciente e qualidade de vida profissional de trabalhadores de enfermagem. Método: Estudo correlacional, realizado em um hospital de Salvador-BA, com 180 participantes. Os dados foram coletados por meio do Hospital Survey on Patient Safety Culture e da Professional Quality of Life Scale e analisados por testes de correlação. Resultados: O emprego do modelo Qualidade de Vida Profissional, que engloba a Satisfação por compaixão, o Burnout e o Estresse Traumático, permitiu verificar que melhor avaliação da cultura de segurança esteve associada negativamente ao Burnout. Referente às dimensões da cultura, melhores avaliações na percepção geral da segurança, trabalho em equipe e dimensionamento de pessoal associaram-se negativamente ao Burnout e ao Estresse Traumático. Maior Burnout associou-se negativamente à melhor passagem de plantão e maior Estresse Traumático positivamente à comunicação sobre erro. Conclusão: Maiores níveis de Burnout estiveram associados à pior percepção da cultura de segurança e piores avaliações acerca do trabalho em equipe; dimensionamento e percepção geral da segurança se associaram ao maior nível de Burnout e de Estresse Traumático, destacando a importância de investimentos nessas áreas. Objetivo enfermagem Método correlacional SalvadorBA, SalvadorBA Salvador BA, BA Salvador-BA 18 participantes correlação Resultados Profissional compaixão associaramse associouse associou erro Conclusão áreas 1

ABSTRACT Objective: To analyze the association between patient safety culture and professional quality of life in nursing professionals. Method: Correlational study carried out in a hospital in Salvador, Bahia, Brazil, with 180 participants. The data were collected through the Hospital Survey on Patient Safety Culture and Professional Quality of Life Scale and analyzed with correlation tests. Results: The use of the Quality of Professional Life model, which encompasses Compassion Satisfaction, Burnout and Traumatic Stress, showed that a better assessment of the safety culture was negatively associated with Burnout. Regarding the dimensions of culture, better evaluations of the general perception of safety, teamwork and staffing were negatively associated with Burnout and Traumatic Stress. Higher Burnout was negatively associated with better handoffs and greater Traumatic Stress was positively associated with error communication. Conclusion: Higher levels of Burnout were associated with worse perception of safety culture and worse teamwork evaluations; staffing and general perception of safety were associated to a higher level of Burnout and Traumatic Stress, which emphasizes the importance of investment in these areas. Objective professionals Method Salvador Bahia Brazil 18 participants tests Results model Satisfaction communication Conclusion areas 1

Abstract Background: the SARS-COV2 pandemic has conditioned the functioning of Higher Education Institutions, leading to the adoption of measures to ensure the teaching process, until then face-to-face, towards a synchronous non-face-to-face teaching typology. Objective: to evaluate the effectiveness of synchronous remote teaching in higher health education in response to the pandemic, from the student's perspective, and their satisfaction. Methodology: mixed, descriptive and exploratory study, with data collection through an online questionnaire. The target population are students who transitioned to synchronous non-face-to-face teaching. Statistical analysis using the SPSS® program, version 27.0 and content analysis according to Bardin (2016). Ethical requirements met. Results: 48 students participated who showed a lower average level of satisfaction with synchronous remote teaching compared to face-to-face teaching, a highly significant relationship (t=3.09; p=0.003). Teacher-student and student-student interaction is considered of lower quality, however, it is considered that synchronous remote teaching demonstrates effectiveness in maintaining students' training paths. Conclusion: the technological conditions for access to synchronous remote teaching were considered adequate, as well as the degree of effectiveness, although with lower levels of satisfaction compared to face-to-face teaching.

Resumen Marco contextual: la pandemia del SARS-COV2 ha condicionado el funcionamiento de las Instituciones de Educación Superior, llevando a la adopción de medidas para asegurar el proceso docente, hasta entonces presencial, hacia una tipología docente sincrónica no presencial. Objetivo: evaluar la efectividad de la enseñanza a distancia sincrónica en la educación superior en salud en respuesta a la pandemia, desde la perspectiva del estudiante y su satisfacción. Metodología: estudio mixto, descriptivo y exploratorio, con recolección de datos a través de un cuestionario en línea. La población objetivo son los estudiantes que hicieron la transición a la enseñanza sincrónica no presencial. Análisis estadístico mediante el programa SPSS®, versión 27.0 y análisis de contenido según Bardin (2016). Requisitos éticos cumplidos. Resultados: participaron 48 estudiantes que mostraron un nivel medio de satisfacción más bajo con la docencia a distancia síncrona en comparación con la docencia presencial, relación altamente significativa (t=3,09; p=0,003). La interacción docente-alumno y alumno-alumno se considera de menor calidad, sin embargo, se considera que la enseñanza a distancia síncrona demuestra efectividad en el mantenimiento de las trayectorias formativas de los estudiantes. Conclusión: las condiciones tecnológicas para el acceso a la docencia a distancia síncrona se consideraron adecuadas, así como el grado de efectividad, aunque con menores niveles de satisfacción respecto a la docencia presencial.

Resumo Enquadramento: a pandemia por SARS-COV2 condicionou o funcionamento das Instituições de Ensino Superior, levando à adoção de medidas para assegurar o processo de ensino, até então presencial, para uma tipologia de ensino não presencial síncrono. Objetivo: avaliar a efetividade do de ensino não presencial síncrono no ensino superior da saúde em resposta à pandemia, na perspetiva do estudante, e sua satisfação. Metodologia: estudo misto, descritivo e exploratório, com recolha de dados através de questionário online. A população-alvo são estudantes que transitaram para o ensino não presencial síncrono. Análise estatística com recurso ao programa SPSS®, versão 27.0 e análise de conteúdo de acordo com Bardin (2016). Cumpridos requisitos éticos. Resultados: participaram 48 estudantes que evidenciam menor nível médio de satisfação com o ensino não presencial síncrono em relação com o ensino presencial, sendo essa relação altamente significativa (t=3,09; p=0,003). A interação docente-estudante e estudante-estudante é considerada de menor qualidade, contudo, considera-se que o ensino não presencial síncrono demonstra efetividade na manutenção dos percursos formativos dos estudantes. Conclusão: as condições tecnológicas de acesso ao ensino não presencial síncrono foram consideradas adequadas, assim como o grau de efetividade, embora com menores níveis de satisfação relativamente ao ensino presencial.

Abstract Studying the quality of journalism in Portugal is important, given the current financial crisis the business landscape is going through, where newsrooms are increasingly smaller and with precarious working conditions. In this context, how do Portuguese television and radio journalists assess the quality of journalism practised in Portugal and the conditions they have to produce news? This article seeks to answer two research questions, through the use of semistructured interviews with 11 radio and television journalists in Portugal: (a) how do television and radio journalists define quality journalism; and (b) how do television and radio journalists assess the quality of journalism produced in Portugal? The interviewees stressed the importance of following the profession’s ethical rules, maintaining accuracy and impartiality, as well as other more formal aspects, such as the quality of their writing or the ability to captivate their audience. As for the conditions needed to practise good journalism, the importance of time and job stability stood out, which the interviewees agreed are in short supply. Although the interviewees were not unanimous in their assessment of the quality of television and radio journalism in Portugal - even the most positive ones had criticisms to make - most of the journalists interviewed considered that their working conditions for producing good journalism fall short of what is desired.

Resumo Estudar a qualidade do jornalismo em Portugal manifesta-se como relevante perante uma paisagem empresarial em crise financeira e redações cada vez mais pequenas com condições de trabalho precárias. Neste contexto, como é que os jornalistas portugueses de televisão e de rádio avaliam a qualidade do jornalismo praticado em Portugal e as condições que têm para o produzir? Através de entrevistas semiestruturadas a 11 jornalistas de rádio e de televisão em Portugal, procuramos responder a duas perguntas de investigação: (a) como é que os jornalistas de televisão e de rádio definem o jornalismo de qualidade?; e (b) como é que os jornalistas de televisão e de rádio avaliam a qualidade do jornalismo produzido em Portugal? Os entrevistados destacam a importância de seguir as regras deontológicas da profissão, de manter o rigor e a isenção e também outros tipos de características mais formais como, por exemplo, a qualidade da escrita ou a capacidade de cativar a audiência. Quanto às condições necessárias para praticar bom jornalismo, sobressai a importância do tempo e da estabilidade laboral, sobre as quais os entrevistados concordam estarem em escassez. Embora não sejam unânimes na sua avaliação da qualidade do jornalismo televisivo e radiofónico em Portugal - mesmo os mais positivos têm críticas a fazer -, a maior parte dos jornalistas entrevistados considera que as suas condições de trabalho para produzir bom jornalismo ficam aquém do desejado.

RESUMEN Introducción y objetivos: La Asociación de Cardiología Intervencionista de la Sociedad Española de Cardiología (ACI-SEC) y el Grupo de Trabajo de Hemodinámica de la Sociedad Española de Cardiología Pediátrica y Cardiopatías Congénitas (GTH-SECPCC) presentan su informe anual de actividad hemodinámica en cardiopatías congénitas correspondiente al año 2021. Métodos: Se invitó a participar a los centros españoles con laboratorio de hemodinámica y actividad intervencionista en cardiopatías congénitas. La recogida de datos fue telemática y su análisis lo efectuó una empresa externa junto con miembros de la ACI-SEC y el GTH-SECPCC. Resultados: Participaron 16 centros (15 públicos y 1 privado) que acumulan 34 salas de hemodinámica con actividad en cardiopatías congénitas, 7 (20,5%) de ellas con dedicación exclusiva a pacientes pediátricos. Se registraron 1.094 estudios diagnósticos (5,1% más que en 2020) y 1.553 cateterismos intervencionistas (6,4% más que en 2020). Las técnicas más frecuentes fueron el cierre de comunicación interauricular (336 casos), la angioplastia de ramas pulmonares (231 casos) y el cierre de ductus (228 casos). Respecto al año anterior se incrementaron significativamente las técnicas de implantación de válvulas percutáneas (29,3%), cierre de ductus (20,6%) y angioplastia aórtica (12,8%). La tasa de éxito en los procedimientos intervencionistas fue del 95%, con una tasa de complicaciones mayores del 2,7% y una mortalidad intrahospitalaria del 0,2%. Conclusiones: Este trabajo es la segunda publicación del Registro Español de Intervencionismo en Cardiopatías Congénitas. Se ha constatado un aumento significativo de los procedimientos diagnósticos y terapéuticos, destacando el incremento en la implantación de válvulas percutáneas, el cierre de ductus y la angioplastia aórtica. La mayoría de las técnicas intervencionistas siguen demostrando excelentes datos de seguridad y eficacia.

ABSTRACT Introduction and objectives: This is the 2021 annual activity report from the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC), and the Interventional Working Group of the Spanish Society of Pediatric Cardiology (GTH-SECPCC). Methods: All Spanish centers with cath lab capabilities and interventional activity in congenital heart diseases were invited to participate. Data were collected online, analyzed by an external company, and ACI-SEC and GTH-SECPCC members. Results: A total of 16 centers participated 15 public and 1 private including 34 cath labs with experience in congenital heart diseases, 7 of them (20.5%) exclusively dedicated to pediatric patients. A total of 1094 diagnostic studies (4.5% more than 2020) and 1553 interventional catheterizations (5.8% more than 2020) were registered. The most common procedures were atrial septal defect closure (336 cases), pulmonary branch artery angioplasty (231 cases), and percutaneous closure of the patent ductus arteriosus (228 cases). Interventional procedures were considered successful in 95% of the cases with rates of major procedural complication and in-hospital mortality of 2.7% and 0.2%, respectively. Conclusions: This is the second Spanish Cardiac Catheterization in Congenital Heart Diseases Registry report. A significant increase of diagnostic and interventional procedures was reported with a special increase of percutaneous valve implantation, ductus arteriosus closure, and aortic angioplasty. Most interventional techniques continue to demonstrate excellent safety and efficacy outcomes.

Abstract Introduction: This study aimed to assess the clinical, economic, and humanistic impact of short-bowel syndrome/chronic intestinal failure (SBS/CIF) in Portugal. Methods: This is a retrospective multicenter cohort chart review study, with a cross-sectional component for quality-of-life (QoL) evaluation. Inclusion criteria comprised patients with SBS/CIF, aged ≥1 year, with stable parenteral nutrition (PN). Data collection included patient chart review over a 12-month period and patient/caregiver self-report and SF-36/PedsQL™ questionnaires. Main endpoints comprised clinical and PN characterization, healthcare resource use (HRU), direct costs, and patient QoL. Results: Thirty-one patients were included (11 adults and 20 children). Patients’ mean age (standard deviation [SD]) was 57.9 (14.3) years in adults and 7.5 (5.0) years in children, with a mean time since diagnosis of 10.2 (5.9) and 6.6 (4.2) years, respectively. PN was administered for a mean of 5.2 and 6.6 days/week in adults and children, respectively; home PN occurred in 81.8% of adults and 90.0% of children for a mean of 9.6 and 10.8 months/year, respectively. The mean annual number of hospitalizations was 1.9 and 2.0 which lasted for a mean of 34.0 and 29.4 days in adults and children, respectively. Twenty-one and forty hospitalization episodes were reported in adults and children, respectively, of which 71.4% and 85.0% were due to catheter-related complications. Mean annual direct costs per patient amounted to 47,857.53 EUR in adults and 74,734.50 EUR in children, with PN and hospitalizations as the main cost-drivers. QoL assessment showed a clinically significant impaired physical component in adults and a notable deterioration in the school functioning domain in children. Conclusion: In Portugal, SBS/CIF patient management is characterized by a substantial therapeutic burden and HRU, translating into high direct costs and a substantial impairment of the adults’ physical function and children’s school functioning.

Resumo Introdução: Este estudo teve como objetivo avaliar o impacto clínico, económico e social da síndrome do intestino curto/falência intestinal crónica (SIC/FIC) em Portugal. Métodos: Estudo de coorte retrospectivo e multicêntrico de revisão dos processos clínicos incluindo uma componente transversal para avaliação da qualidade de vida (QV). Os critérios de elegibilidade incluíram doentes com SIC/FIC, idade ≥1 ano, em nutrição parenteral (NP) e clinicamente estáveis. A recolha de dados incluiu a revisão dos processos clínicos ao longo de um período de 12 meses e a aplicação de questionários auto-administrados a doentes e cuidadores e de questionários de QV (SF-36/ PedsQL™). Os indicadores principais foram a caracterização clínica e da NP, a utilização de recursos de saúde, custos diretos e QV dos doentes. Resultados: Foram incluídos 31 doentes (11 adultos e 20 crianças). A idade média (desvio padrão: DP) foi de 57.9 (14.3) anos nos adultos e de 7.5 (5.0) nas crianças com um tempo médio desde o diagnóstico de 10.2 (5.9) e 6.6 (4.2) anos, respetivamente. A NP foi administrada durante uma média de 5.2 e 6.6 dias por semana, em adultos e crianças respetivamente, em 81.8% e 90.0% dos adultos/crianças foi feita em casa durante uma média de 9.6 ou 10.8 meses por ano, respetivamente. O número médio anual de hospitalizações foi de 1.9 (1.6) e 2.0 (1.5) com uma duração média de 34.0 (47.4) e 29.4 (32.3) dias, em adultos e crianças, respetivamente. Foram reportados 21 e 40 episódios de hospitalização em adultos/crianças, dos quais 71.4% e 85.0% foram devido a complicações relacionadas ao uso de cateter. Os custos diretos anuais médios por doente ascenderam a 47,857.53 EUR nos adultos e a 74,734.50 EUR nas crianças, sendo que os maiores responsáveis foram a NP e as hospitalizações. A avaliação da QV mostrou um comprometimento clinicamente significativo da componente física nos adultos e uma deterioração relevante da dimensão escolar nas crianças. Conclusões: A gestão dos doentes com SIC/FIC em Portugal é caracterizada por uma sobrecarga substancial a nível terapêutico e de utilização de recursos de saúde, o que se traduz em elevados custos diretos e comprometimento substancial da componente física nos adultos e do desempenho escolar nas crianças.