ABSTRACT Objective: To analyze the spatiotemporal epidemiological dynamics of meningitis in Brazil, between 2010 and 2019. Methods: Descriptive ecological study with cases and deaths due to meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação – SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher's exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran's index, and Kernel density. Results: 182,126 cases of meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (−9.5%, 95% confidence interval — 95%CI −13.92; −4.96, p<0.01) and mortality (−11.74%, 95%CI −13.92; −9.48, p<0.01), while lethality remained stable (−2.08%, 95%CI −4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted. Conclusion: A decrease in meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage.

RESUMO Objetivo: Analisar a dinâmica epidemiológica espaçotemporal das meningites no Brasil, entre os anos de 2010 e 2019. Métodos: Estudo ecológico descritivo com os casos e óbitos por meningites no Brasil (2010–2019) no Sistema de Informações de Agravos de Notificação. Realizaram-se (I) análises de frequências dos casos e óbitos, taxas de prevalência, mortalidade, letalidade, testes de exato de Fisher e qui-quadrado; (II) regressão de Prais-Winsten; e (III) índice de Moran global, local e densidade de Kernel. Resultados: Notificaram-se 182.126 casos de meningites no Brasil, dos quais 16.866 (9,26%) evoluíram para óbito, com taxas de prevalência de 9,03/100.000/habitantes, mortalidade de 0,84/100.000/habitantes e letalidade de 9,26%. Destaca-se a tendência de decrescimento das taxas de prevalência (−9,5%, intervalo de confiança de 95% — IC95% −13,92; −4,96, p<0,01) e mortalidade (−11,74%, IC95% −13,92; −9,48, p<01,01), enquanto a letalidade se manteve estacionária (−2,08%, IC95% −4,9; 0,8; p<0,1941). A maioria dos casos foi de meningites virais (45,7%), entre 1 e 9 anos (32,2%), enquanto a maior parcela dos óbitos foi por meningites bacterianas (68%), entre 40 e 59 anos (26,3%). Nos mapas de Moran e Kernel das taxas de prevalência e mortalidade, destacaram-se com altas taxas os municípios do sul, sudeste e a capital de Pernambuco, no nordeste; já na letalidade, evidenciaram-se o norte, o nordeste e o litoral do sudeste. Conclusão: Encontrou-se decréscimo dos casos e óbitos por meningites neste estudo, entretanto a taxa de letalidade foi maior em áreas com menor prevalência, reforçando a necessidade do aprimoramento das ações de identificação, vigilância e assistência em saúde dos casos, bem como da ampliação da cobertura vacinal.

Abstract Ensiling maniçoba (Manihot pseudoglaziovii) is essential to preserve the nutrients of this forage plant. However, the plant moisture content may generate undesirable fermentations. The objective of this study was to evaluate the effects of different cornmeal inclusion levels (0%, 10%, 20%, and 30%) on the chemical composition and fermentation parameters of maniçoba silage, in addition to identifying the variables most affected by cornmeal. The concentrations of dry matter (DM), non-fiber carbohydrates (NFC), total digestible nutrients (TDN), and propionic acid increased with cornmeal inclusion levels (P < 0.05). Crude protein (CP), lignin, and butyric acid contents, as well as pH, were reduced by the additive (P < 0.05). Principal component analysis resulted in two main groups. Group I was formed by variables positively affected by cornmeal inclusion, namely DM, hemicellulose, NFC, and TDN. Group II contained variables that were negatively affected by cornmeal, namely CP, lignin, mineral matter, and butyric acid. Regardless of the addition of cornmeal, maniçoba silage displays an adequate chemical composition and a good fermentation profile for ruminant feeding. Dry matter and total digestible nutrients are the chemical variables most influenced by cornmeal inclusion, whereas pH and butyric acid are the fermentative parameters most affected by the moisture-absorbent additive. Including moderate levels of cornmeal in maniçoba silage is recommended to achieve the best fermentation profile and the highest concentration of digestible nutrients without mischaracterizing it as a roughage feed. Manihot pseudoglaziovii However fermentations 0%, 0 (0% 10 10% 20 20% 30% 30 DM , (DM) nonfiber non fiber NFC (NFC) TDN, TDN (TDN) P 0.05. 005 0.05 . 05 0.05) CP (CP) lignin contents groups hemicellulose feeding moistureabsorbent absorbent feed 0% (0 1 2 3 (DM (NFC (TDN 00 0.0 (CP ( 0.

Resumo A ensilagem da maniçoba (Manihot pseudoglaziovii) é importante para preservar os nutrientes dessa planta forrageira. Todavia, o teor de umidade da planta pode gerar fermentações indesejáveis. Objetivou-se avaliar efeito de níveis de fubá de milho (0, 10, 20 e 30%) sobre a composição bromatológica e parâmetros fermentativos da silagem de maniçoba, além de identificar as variáveis mais afetada pelo aditivo. As concentrações de matéria seca (MS), carboidratos não-fibrosos (CNF), nutrientes digestíveis totais (NDT) e ácido propiônico aumentaram em função dos níveis de fubá de milho (P<0,05). Os teores de proteína bruta (PB), lignina e ácido butírico, além do pH, foram reduzidos pelo aditivo (P<0,05). Dois grupos foram formados na análise de componentes principais. O grupo I foi formado por variáveis afetadas positivamente pela inclusão do fubá de milho: MS, hemicelulose, CNF e NDT. O grupo II foi formado por variáveis que tiveram seus valores reduzidos pela inclusão do aditivo: PB, lignina, matéria mineral e ácido butírico. A silagem de maniçoba, com ou sem fubá de milho, apresenta bom perfil fermentativo e composição bromatológica adequada para a alimentação de ruminantes. Os teores de MS e NDT são as variáveis da composição químico-bromatológica mais influenciadas pela inclusão do fubá de milho, enquanto pH e ácido butírico são as variáveis do perfil fermentativo mais afeadas pelo aditivo absorvente. Sugere-se a inclusão de níveis moderados de fubá na silagem de maniçoba para obter melhor perfil de fermentação e a maior concentração de nutrientes digestíveis, sem descaracterizar o alimento como volumoso. Manihot pseudoglaziovii forrageira Todavia indesejáveis Objetivouse Objetivou se 0, 0 (0 10 2 30% 30 , (MS) nãofibrosos não fibrosos CNF, (CNF) (NDT P<0,05. P005 P P<0,05 . 05 (P<0,05) PB (PB) principais hemicelulose ruminantes químicobromatológica químico absorvente Sugerese Sugere volumoso ( 1 3 (MS (CNF P00 P<0,0 (P<0,05 (PB P0 P<0, (P<0,0 P<0 (P<0, P< (P<0 (P< (P

ABSTRACT Introduction: Protocols for obtaining the maximum threshold pressure have been applied with limited precision to evaluate inspiratory muscle endurance. In this sense, new protocols are needed to allow more reliable measurements. The purpose of the present study was to compare a new incremental ramp load protocol for the evaluation of inspiratory muscle endurance with the most used protocol in healthy individuals. Methods: This was a prospective cross-sectional study carried out in a single center. Ninety-two healthy individuals (43 men [22 ± 3 years] and 49 women [22 ± 3 years]) were randomly allocated to perform: (i) incremental ramp load protocol and (ii) incremental step loading protocol. The sustained pressure threshold (or maximum threshold pressure), maximum threshold pressure/dynamic strength index ratio, time until task failure, as well as difference between the mean heart rate of the last five minutes of baseline and the peak heart rate of the last 30 seconds of each protocol were measured. Results: Incremental ramp load protocol with small increases in the load and starting from minimum values of strength index was able to evaluate the inspiratory muscle endurance through the maximum threshold pressure of healthy individuals. Conclusion: The present study suggests that the incremental ramp load protocol is able to measure maximum threshold pressure in a more thorough way, with less progression and greater accuracy in the load stratification compared to the limited incremental step loading protocol and with a safe and expected cardiovascular response in healthy individuals. Introduction sense measurements Methods crosssectional cross sectional center Ninetytwo Ninety two 43 (4 22 [2 years 4 perform i (i ii (ii or pressure, , pressure) pressuredynamic dynamic ratio failure measured Results Conclusion way ( 2 [

RESUMO Objetivo: Este estudo teve como objetivo comparar a influência na fala causada por quatro diferentes contenções ortodônticas removíveis superiores. Material e Métodos: Os critérios de elegibilidade para seleção da amostra foram: indivíduos com 20 a 40 anos de idade, com oclusão aceitável, falantes nativos de português. Os voluntários (n=21) foram divididos em quatro grupos, randomizados com proporção de alocação de 1:1:1:1. Os quatro grupos utilizaram os quatro tipos de contenção, em ordem aleatória e em período integral por 21 dias cada, com período de wash-out de sete dias. As contenções superiores removíveis foram: wraparound convencional, wraparound com orifício anterior, wraparound em U e contenção termoplástica. Três voluntários foram excluídos. A amostra final foi composta por 18 indivíduos (11 homens; 7 mulheres) com idade média de 27,08 anos (DP=4,65). A avaliação da fala foi realizada em gravações de trechos vocais, realizadas antes, imediatamente após e 21 dias após a instalação de cada contenção, com análise perceptivo-auditiva e acústica das frequências formantes F1 e F2 das vogais. ANOVA de medidas repetidas e teste de Friedman com Tukey foram utilizados para comparação estatística. Resultados: As alterações de fala aumentaram imediatamente após a instalação das contenções wraparound e termoplástica, e reduziram após 21 dias, mas não para níveis normais. Porém, esse aumento foi estatisticamente significativo apenas para as contenções wraparound com orifício anterior e termoplástica. As frequências dos formantes das vogais foram alteradas no momento inicial e, após três semanas, as alterações se mantiveram com as contenções convencional, em forma de U e termoplástica. Conclusões: A contenção termoplástica foi mais prejudicial à fala do que os aparelhos wraparound. Oswraparounds convencional e em forma de U interferiram menos na fala. O período de três semanas não foi suficiente para adaptação da fala. Objetivo Métodos 2 4 aceitável português n=21 n21 n (n=21 1111. 1111 1 1. 1:1:1:1 washout wash out excluídos 11 (1 homens mulheres 2708 27 08 27,0 DP=4,65. DP465 DP DP=4,65 . 65 (DP=4,65) vocais antes perceptivoauditiva perceptivo auditiva F estatística Resultados normais Porém Conclusões n=2 n2 (n=2 111 1:1:1: ( 270 0 27, DP46 DP=4,6 6 (DP=4,65 n= (n= 1:1:1 DP4 DP=4, (DP=4,6 (n 1:1: DP=4 (DP=4, 1:1 DP= (DP=4 1: (DP= (DP

ABSTRACT Objective: This study aimed to compare the influence of four different maxillary removable orthodontic retainers on speech. Material and Methods: Eligibility criteria for sample selection were: 20-40-year subjects with acceptable occlusion, native speakers of Portuguese. The volunteers (n=21) were divided in four groups randomized with a 1:1:1:1 allocation ratio. The four groups used, in random order, the four types of retainers full-time for 21 days each, with a washout period of 7-days. The removable maxillary retainers were: conventional wraparound, wraparound with an anterior hole, U-shaped wraparound, and thermoplastic retainer. Three volunteers were excluded. The final sample comprised 18 subjects (11 male; 7 female) with mean age of 27.08 years (SD=4.65). The speech evaluation was performed in vocal excerpts recordings made before, immediately after, and 21 days after the installation of each retainer, with auditory-perceptual and acoustic analysis of formant frequencies F1 and F2 of the vowels. Repeated measures ANOVA and Friedman with Tukey tests were used for statistical comparison. Results: Speech changes increased immediately after conventional wraparound and thermoplastic retainer installation, and reduced after 21 days, but not to normal levels. However, this increase was statistically significant only for the wraparound with anterior hole and the thermoplastic retainer. Formant frequencies of vowels were altered at initial time, and the changes remained in conventional, U-shaped and thermoplastic appliances after three weeks. Conclusions: The thermoplastic retainer was more harmful to the speech than wraparound appliances. The conventional and U-shaped retainers interfered less in speech. The three-week period was not sufficient for speech adaptation. Objective Methods 2040year year 20 40 occlusion Portuguese n=21 n21 n (n=21 1111 1 1:1:1: ratio order fulltime full time 2 7days. 7days days. 7-days Ushaped U shaped excluded 11 (1 male female 2708 27 08 27.0 SD=4.65. SD465 SD SD=4.65 . 4 65 (SD=4.65) before auditoryperceptual auditory perceptual F comparison Results levels However weeks Conclusions threeweek week adaptation n=2 n2 (n=2 111 1:1:1 ( 270 0 27. SD46 SD=4.6 6 (SD=4.65 n= (n= 1:1: SD4 SD=4. (SD=4.6 (n 1:1 SD=4 (SD=4. 1: SD= (SD=4 (SD= (SD

ABSTRACT Objective: To analyze the spatiotemporal epidemiological dynamics of meningitis in Brazil, between 2010 and 2019. Methods: Descriptive ecological study with cases and deaths due to meningitis in Brazil (2010-2019) in the National Notifiable Diseases Information System (Sistema de Informações de Agravos de Notificação – SINAN). The following analyses were performed: (I) frequency analyses of cases and deaths, prevalence rates, mortality, lethality, Fisher's exact test, and chi-square test; (II) Prais-Winstein regression; and (III) Global, Local Moran's index, and Kernel density. Results: 182,126 cases of meningitis were reported in Brazil, of which 16,866 (9.26%) resulted in death, with prevalence rates of 9.03/100,000 inhabitants, mortality of 0.84/100,000 inhabitants, and lethality of 9.26%. There was a noted trend of decreasing prevalence rates (−9.5%, 95% confidence interval — 95%CI −13.92; −4.96, p<0.01) and mortality (−11.74%, 95%CI −13.92; −9.48, p<0.01), while lethality remained stable (−2.08%, 95%CI −4.9; 0.8; p<0.1941). The majority of cases were viral meningitis (45.7%), among 1-9 years old (32.2%), while the highest proportion of deaths was due to bacterial meningitis (68%), among 40-59 years old (26.3%). In the Moran and Kernel maps of prevalence and mortality rates, municipalities in the South, Southeast, and the capital of Pernambuco in the Northeast stood out with high rates; as for lethality, the North, Northeast, and Southeast coastal areas were highlighted. Conclusion: A decrease in meningitis cases and deaths was found in this study; however, the lethality rate was higher in areas with lower prevalence, emphasizing the need to enhance actions for identifying, monitoring, and providing health care for cases, as well as expanding vaccination coverage. Objective 201 2019 Methods 20102019 (2010-2019 Sistema SINAN. SINAN . SINAN) performed I (I Fishers Fisher s test chisquare chi square II (II PraisWinstein Prais Winstein regression III (III Global Morans index density Results 182126 182 126 182,12 16866 16 866 16,86 9.26% 926 9 26 (9.26% death 903100000 03 100 000 9.03/100,00 inhabitants 084100000 0 84 0.84/100,00 −9.5%, 95 5 (−9.5% 95CI CI −13.92 1392 13 92 496 4 96 −4.96 p<0.01 p001 p 01 −11.74%, 1174 11 74 (−11.74% 948 48 −9.48 p<0.01, , −2.08%, 208 2 08 (−2.08% −4.9 49 0.8 8 p<0.1941. p01941 p<0.1941 1941 p<0.1941) 45.7%, 457 45.7% 45 7 (45.7%) 19 1 1- 32.2%, 322 32.2% 32 (32.2%) 68%, 68 68% (68%) 4059 40 59 40-5 26.3%. 263 26.3% 3 (26.3%) South North highlighted Conclusion however identifying monitoring coverage 20 2010201 (2010-201 18212 18 12 182,1 1686 86 16,8 9.26 (9.26 90310000 10 00 9.03/100,0 08410000 0.84/100,0 −9.5% (−9.5 −13.9 139 p<0.0 p00 −11.74% 117 (−11.74 94 −9.4 −2.08% (−2.08 −4. 0. p0194 p<0.194 194 45.7 (45.7% 32.2 (32.2% 6 (68% 405 40- 26.3 (26.3% 201020 (2010-20 1821 182, 168 16, 9.2 (9.2 9031000 9.03/100, 0841000 0.84/100, −9.5 (−9. −13. p<0. p0 −11.74 (−11.7 −9. −2.08 (−2.0 −4 p019 p<0.19 45. (45.7 32. (32.2 (68 26. (26.3 20102 (2010-2 9. (9. 903100 9.03/100 084100 0.84/100 (−9 −13 p<0 −11.7 (−11. −9 −2.0 (−2. − p01 p<0.1 (45. (32. (6 (26. (2010- (9 90310 9.03/10 08410 0.84/10 (− −1 p< −11. (−11 −2. (−2 (45 (32 ( (26 (2010 9031 9.03/1 0841 0.84/1 −11 (−1 −2 (4 (3 (2 (201 903 9.03/ 084 0.84/ (20 90 9.03 0.84 9.0

RESUMO Objetivo: Analisar a dinâmica epidemiológica espaçotemporal das meningites no Brasil, entre os anos de 2010 e 2019. Métodos: Estudo ecológico descritivo com os casos e óbitos por meningites no Brasil (2010–2019) no Sistema de Informações de Agravos de Notificação. Realizaram-se (I) análises de frequências dos casos e óbitos, taxas de prevalência, mortalidade, letalidade, testes de exato de Fisher e qui-quadrado; (II) regressão de Prais-Winsten; e (III) índice de Moran global, local e densidade de Kernel. Resultados: Notificaram-se 182.126 casos de meningites no Brasil, dos quais 16.866 (9,26%) evoluíram para óbito, com taxas de prevalência de 9,03/100.000/habitantes, mortalidade de 0,84/100.000/habitantes e letalidade de 9,26%. Destaca-se a tendência de decrescimento das taxas de prevalência (−9,5%, intervalo de confiança de 95% — IC95% −13,92; −4,96, p<0,01) e mortalidade (−11,74%, IC95% −13,92; −9,48, p<01,01), enquanto a letalidade se manteve estacionária (−2,08%, IC95% −4,9; 0,8; p<0,1941). A maioria dos casos foi de meningites virais (45,7%), entre 1 e 9 anos (32,2%), enquanto a maior parcela dos óbitos foi por meningites bacterianas (68%), entre 40 e 59 anos (26,3%). Nos mapas de Moran e Kernel das taxas de prevalência e mortalidade, destacaram-se com altas taxas os municípios do sul, sudeste e a capital de Pernambuco, no nordeste; já na letalidade, evidenciaram-se o norte, o nordeste e o litoral do sudeste. Conclusão: Encontrou-se decréscimo dos casos e óbitos por meningites neste estudo, entretanto a taxa de letalidade foi maior em áreas com menor prevalência, reforçando a necessidade do aprimoramento das ações de identificação, vigilância e assistência em saúde dos casos, bem como da ampliação da cobertura vacinal. Objetivo 201 2019 Métodos 2010–2019 20102019 (2010–2019 Notificação Realizaramse Realizaram I (I quiquadrado qui quadrado qui-quadrado II (II PraisWinsten Prais Winsten Prais-Winsten III (III global Resultados Notificaramse Notificaram 182126 182 126 182.12 16866 16 866 16.86 9,26% 926 26 (9,26% óbito 903100000habitantes habitantes 03 100 000 9,03/100.000/habitantes 084100000habitantes 0 84 Destacase Destaca −9,5%, 95 5 (−9,5% IC95 IC −13,92 1392 13 92 496 4 96 −4,96 p<0,01 p001 p 01 −11,74%, 1174 11 74 (−11,74% 948 48 −9,48 p<01,01, p0101 p<01,01 , p<01,01) −2,08%, 208 2 08 (−2,08% −4,9 49 0,8 8 p<0,1941. p01941 p<0,1941 . 1941 p<0,1941) 45,7%, 457 45,7% 45 7 (45,7%) 32,2%, 322 32,2% 32 (32,2%) 68%, 68 68% (68%) 26,3%. 263 26,3% 3 (26,3%) destacaramse destacaram sul Pernambuco evidenciaramse evidenciaram norte Conclusão Encontrouse Encontrou estudo identificação vacinal 20 2010–201 2010201 (2010–201 18212 18 12 182.1 1686 86 16.8 9,26 (9,26 10 00 −9,5% (−9,5 IC9 −13,9 139 p<0,0 p00 −11,74% 117 (−11,74 94 −9,4 p010 p<01,0 −2,08% (−2,08 −4, 0, p0194 p<0,194 194 45,7 (45,7% 32,2 (32,2% 6 (68% 26,3 (26,3% 2010–20 201020 (2010–20 1821 182. 168 16. 9,2 (9,2 −9,5 (−9, −13, p<0, p0 −11,74 (−11,7 −9, p01 p<01, −2,08 (−2,0 −4 p019 p<0,19 19 45, (45,7 32, (32,2 (68 26, (26,3 2010–2 20102 (2010–2 9, (9, (−9 −13 p<0 −11,7 (−11, −9 p<01 −2,0 (−2, − p<0,1 (45, (32, (6 (26, 2010– (2010– (9 (− −1 p< −11, (−11 −2, (−2 (45 (32 ( (26 (2010 −11 (−1 −2 (4 (3 (2 (201 (20

Abstract Objective To review key evidence-based recommendations for the diagnosis and treatment of peripheral facial palsy in children and adults. Methods Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on peripheral facial palsy were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results The topics were divided into 2 main parts: (1) Evaluation and diagnosis of facial palsy: electrophysiologic tests, idiopathic facial palsy, Ramsay Hunt syndrome, traumatic peripheral facial palsy, recurrent peripheral facial palsy, facial nerve tumors, and peripheral facial palsy in children; and (2) Rehabilitation procedures: surgical decompression of the facial nerve, facial nerve grafting, surgical treatment of long-term peripheral facial palsy, and non-surgical rehabilitation of the facial nerve. Conclusions Peripheral facial palsy is a condition of diverse etiology. Treatment should be individualized according to the cause of facial nerve dysfunction, but the literature presents better evidence-based recommendations for systemic corticosteroid therapy. evidencebased based adults methods search citations studies inclusion Physicians Associations Association s interventions parts 1 (1 tests syndrome tumors (2 procedures grafting longterm long term nonsurgical non etiology dysfunction therapy (

SUMMARY OBJECTIVE: The objective of this study was to assess the predictors of survival among patients with coronavirus disease 2019 who underwent tracheal intubation, as part of a hospital cohort study. METHODS: This retrospective cohort study in the Rio do Sul County Hospital, Santa Catarina, Brazil, from April 2020 to May 2021, focused on patients aged 18 years or older intubated for coronavirus disease 2019. We assessed the 90-day survival of intubated patients by estimating the hazard ratio using a Cox proportional hazards regression model. RESULTS: The study included 132 participants, with an average age of approximately 60 years. Tracheal intubation was successfully accomplished in 97% of cases within two attempts. The overall mortality rate was 62.9%. Notably, mortality rates were significantly higher in patients aged over 60 years (hazard ratio=2.57; 95%CI 1.54–4.29; p<0.001), those with blood oxygen saturation below 85% (hazard ratio=1.92; 95%CI 1.03–3.57; p=0.04), instances where tracheal intubation was carried out using a conventional laryngoscope (hazard ratio=2.59; 95%CI 1.22–5.48; p=0.013), and when performed by emergency physicians (hazard ratio=3.96; 95%CI 1.51–10.4; p=0.005). CONCLUSION: Our analysis unveiled that the risk of death in intubated coronavirus disease 2019 patients is four times higher when an emergency physician, as opposed to an anesthesiologist, leads the tracheal intubation team. OBJECTIVE 201 METHODS Hospital Catarina Brazil 202 2021 1 90day day 90 model RESULTS 13 participants 6 97 attempts 629 62 9 62.9% Notably ratio=2.57 ratio257 2 57 95CI CI 95 1.54–4.29 154429 54 4 29 p<0.001, p0001 p p<0.001 , 0 001 p<0.001) 85 ratio=1.92 ratio192 92 1.03–3.57 103357 03 3 p=0.04, p004 p=0.04 04 p=0.04) ratio=2.59 ratio259 59 1.22–5.48 122548 22 5 48 p=0.013, p0013 p=0.013 013 p=0.013) ratio=3.96 ratio396 96 1.51–10.4 151104 51 10 p=0.005. p0005 p=0.005 . 005 p=0.005) CONCLUSION physician anesthesiologist team 20 62.9 ratio=2.5 ratio25 1.54–4.2 15442 p000 p<0.00 00 8 ratio=1.9 ratio19 1.03–3.5 10335 p00 p=0.0 1.22–5.4 12254 p001 p=0.01 01 ratio=3.9 ratio39 1.51–10. 15110 p=0.00 62. ratio=2. ratio2 1.54–4. 1544 p<0.0 ratio=1. ratio1 1.03–3. 1033 p0 p=0. 1.22–5. 1225 ratio=3. ratio3 1.51–10 1511 ratio=2 1.54–4 154 p<0. ratio=1 1.03–3 103 p=0 1.22–5 122 ratio=3 1.51–1 151 ratio= 1.54– 15 p<0 1.03– p= 1.22– 12 1.51– 1.54 p< 1.03 1.22 1.51 1.5 1.0 1.2 1.

Abstract Objectives: To review and provide evidence-based recommendations for the diagnosis and treatment of otosclerosis. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on otosclerosis were eligible for inclusion. The American College of Physicians’ guideline grading system and the American Thyroid Association’s guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: 1) Diagnosis – audiologic and radiologic; 2) Treatment – hearing AIDS, pharmacological therapy, stapes surgery, and implantable devices - bone-anchored devices, active middle ear implants, and Cochlear Implants (CI). Conclusions: The pathophysiology of otosclerosis has not yet been fully elucidated, but environmental factors and unidentified genes are likely to play a significant role in it. Women with otosclerosis are not at increased risk of worsening clinical condition due to the use of contraceptives or during pregnancy. Drug treatment has shown little benefit. If the patient does not want to undergo stapedotomy, the use of hearing aids is well indicated. Implantable systems should be indicated only in rare cases, and the CI should be indicated in cases of profound deafness. Objectives evidencebased based Methods methods search citations studies inclusion Physicians Associations Association s interventions Results parts 1 radiologic AIDS therapy surgery boneanchored bone anchored implants CI. . (CI) Conclusions elucidated it pregnancy benefit stapedotomy deafness (CI

Resumen El mejoramiento genético de los cultivares de soja a lo largo de los años se ha centrado en aumentar la capacidad productiva y la tolerancia a algunos factores abióticos y bióticos. Sin embargo, durante la transferencia de genes de interés, algunos genes responsables de una menor tolerancia a los herbicidas pueden integrarse en el genoma del nuevo cultivar. El objetivo de este estudio fue evaluar la selectividad de las asociaciones de herbicidas apli cadas en la post-emergencia de tres cultivares de soja. El diseño experimental utilizado fue un bloque completamente al azar, con cuatro repeticiones. Los cultivares seleccionados fueron M7110 IPRO®, Foco IPRO® y Bônus IPRO®. Los herbicidas y las respectivas dosis (g a.i. ha-1) utilizados fueron: glyphosate (1176), glyphosate + bentazon (1176 + 600), glyphosate + fomesafen (1176 + 175), glyphosate + lactofen (1176 + 120), glyphosate + imazethapyr (1176 + 100), glyphosate + chlorimuron (1176 + 10), glyphosate + cloransulam (1176 + 39,5), y un control sin aplicación de herbicida. Se hizo una nota visual de intoxicación para cada tratamiento. Los componentes de crecimiento y rendimiento evaluados fueron: altura, rodal, peso de cien granos y rendimiento. La aplicación de herbicidas en post-emergencia no alteró la masa vegetal de los cultivares de soja. Además, estos herbicidas no redujeron el rendimiento de los cultivares M7110 IPRO® y Foco IPRO®. Tanto el glifosato aislado como mezclado con lactofen o imazethapyr redujeron el rendimiento del cultivar Bônus IPRO®.

Abstract The genetic improvement of soybean cultivars over the years has focused on increasing the yield potential and tolerance to some abiotic and biotic factors. However, during the transfer of genes of interest, some genes responsible for a lower tolerance to herbicides can be integrated into the genome of the new cultivar. Thus, the objective of this study was to evaluate the selectivity of herbicide associations applied in the postemergence period of three soybean cultivars. The experiment was conducted in a randomized completely block design, with four replications. The selected cultivars were M7110 IPRO®, Foco IPRO®, and Bônus IPRO®. The herbicides and the respective doses (g a.i. ha-1) used were glyphosate (1176), glyphosate + bentazon (1176 + 600), glyphosate + fomesafen (1176 + 175), glyphosate + lactofen (1176 + 120), glyphosate + imazethapyr (1176 + 100), glyphosate + chlorimuron (1176 + 10), glyphosate + cloransulam (1176 + 39.5), and a control without herbicide application. The visual note of intoxication was evaluated for each treatment. The components of growth and yield evaluated were height, stand, weight of one hundred grains, and yield. The application of postherbicide herbicides did not alter the plant stands of soybean cultivars. Additionally, these herbicides did not reduce the yield of the M7110 IPRO® and Foco IPRO® cultivars. Glyphosate isolated and in association with lactofen or imazethapyr reduced the grain yield of the Bônus IPRO® cultivar.

ABSTRACT Introduction To evaluate the possible effects of the coronavirus disease 2019 (COVID-19) pandemic on the oncologic results of patients with prostate cancer regarding clinical staging, presence of adverse pathological outcomes, and perioperative complications. Materials and methods This retrospective study included patients who underwent radical prostatectomy. The time between biopsy and surgery, staging tests, final histopathological evaluation after surgery, lymphadenectomy rate, postoperative complications, and prostatic specific antigen (PSA) levels (initial and 30 days after surgery) were analyzed and compared in a group of patients before and during the pandemic period. Results We included 226 patients: 88 in the pre-pandemic period and 138 during the pandemic period. There was no statistically significant difference in mean age, body mass index, ASA, pathological locally advanced disease, the proportion of patients who underwent lymphadenectomy, and ISUP grade in the biopsy between the groups. Positive surgical margins, prostatic extracapsular extension, and PSA levels at 30 days were also similar between the groups. The mean time between medical consultation and surgery was longer in the pandemic period than in the pre-pandemic (124 vs. 107 days, p<0.001), and the mean time between biopsy and medical consultation (69.5 days vs. 114 days, p<0.001) and between biopsy and surgery (198.5 days vs. 228 days, p=0.013) was shorter during the pandemic. The incidence of severe early and late perioperative complications was similar between the periods. Conclusions There was no delay between diagnosis and treatment at our institution during the COVID-19 pandemic period. No worsening of the prostate cancer features was observed. 201 COVID19 COVID 19 (COVID-19 outcomes prostatectomy tests rate (PSA initial 3 22 8 prepandemic pre 13 age index ASA groups margins extension 124 (12 vs 10 p<0.001, p0001 p p<0.001 , 0 001 69.5 695 69 5 (69. 11 198.5 1985 198 (198. p=0.013 p0013 013 periods COVID-1 observed 20 COVID1 1 (COVID-1 2 12 (1 p000 p<0.00 00 69. 6 (69 198. (198 p=0.01 p001 01 COVID- (COVID- ( p00 p<0.0 (6 (19 p=0.0 (COVID p0 p<0. p=0. p<0 p=0 p< p=

Abstract Background Computerized cognitive training programs may have benefited the self-assessment of memory, quality of life, and mood among older adults during the coronavirus disease 2019 (COVID-19) pandemic. Objective To determine the subjective impacts of computerized cognitive training on mood, frequency of forgetfulness, memory complaints, and quality of life in the elderly using an online platform. Methods In total, 66 elderly participants of USP 60 +, a program for the elderly offered by Universidade de São Paulo, who voluntarily enrolled in the study were selected and randomized with an allocation ratio of 1:1 into 2 groups: the training group (n = 33) and the control group (n = 33). After signing the free and informed consent form, they answered a protocol which included a sociodemographic questionnaire, the Memory Complaints Questionnaire (MAC-Q), the McNair and Kahn’s Frequency of Forgetfulness Scale, the Geriatric Depression Scale (GDS-15), the Geriatric Anxiety Inventory (GAI), and the Control, Autonomy, Self-Realization, and Pleasure (CASP-19) questionnaire. The training cognitive game platform aimed to stimulate various cognitive aspects, including memory, attention, language, executive functions (reasoning, logical thinking), and visual and spatial skills. Results The participants of the training group showed a reduction in the MAC-Q, MacNair and Kahn, and GAI scores in the pre- and posttest comparison. Significant differences were identified between the groups regarding the total scores of the MAC-Q in the post-test, which was also evidenced by the logistic regression. Conclusion Participation in a computerized cognitive intervention promoted reductions in memory complaints, frequency of forgetfulness, and anxiety symptoms, in addition to improving self-reported quality of life. selfassessment self assessment 201 COVID19 COVID 19 (COVID-19 pandemic forgetfulness complaints 6 + Paulo 11 1 1: n 33 33. . form questionnaire MACQ, MACQ MAC Q , (MAC-Q) Kahns Kahn s GDS15, GDS15 GDS 15 (GDS-15) GAI, (GAI) Control Autonomy SelfRealization, SelfRealization Self Realization, Realization Self-Realization CASP19 CASP (CASP-19 aspects attention language reasoning, reasoning (reasoning thinking, thinking thinking) skills Q, pre comparison posttest, post test, test post-test regression symptoms selfreported reported 20 COVID1 (COVID-1 3 (MAC-Q GDS1 (GDS-15 (GAI CASP1 (CASP-1 (COVID- (GDS-1 (CASP- (COVID (GDS- (CASP (GDS

Resumo Antecedentes Programas informatizados de treinamento cognitivo podem ter beneficiado a autoavaliação da memória, a qualidade de vida e o humor entre os idosos durante a pandemia de doença do coronavírus 2019 (coronavirus disease 2019, COVID-19, em inglês). Objetivo Determinar os impactos subjetivos do treinamento cognitivo computadorizado no humor, na frequência de esquecimento, nas queixas de memória, e na qualidade de vida em idosos utilizando uma plataforma online. Métodos Ao todo, 66 idosos participantes do programa USP 60 +, oferecido à terceira idade pela Universidade de São Paulo, e inscritos voluntariamente no estudo, foram selecionados e randomizados em uma razão de 1:1 em 2 grupos: grupo treinamento (n = 33) e grupo controle (n = 33). Após assinarem o termo de consentimento livre e esclarecido, os participantes responderam a um protocolo que incluía um questionário sociodemográfico, o Questionário de Queixas de Memória (Memory Complaints Questionnaire, MAC-Q), A Escala de Frequência de Esquecimento de McNair e Kahn, a Escala de Depressão Geriátrica (Geriatric Depression Scale, GDS-15), o Inventário de Ansiedade Geriátrica (Geriatric Anxiety Inventory, GAI), e –o questionário de Controle, Autonomia, Autorrealização e Prazer (Control, Autonomy, Self-Realization, and Pleasure, CASP-19). A plataforma de jogos cognitivos de treinamento visou estimular diversos aspectos cognitivos, incluindo memória, atenção, linguagem, funções executivas (raciocínio, raciocínio lógico) e habilidades visuais e espaciais. Resultados Na comparação pré e pós-teste, os participantes do grupo de treinamento apresentaram redução nas pontuações do MAC-Q, da escala McNair e Kahn e do GAI. Diferenças significativas entre os grupos quanto às pontuações totais da escala MAC-Q no pós-teste também foram evidenciadas pela regressão logística. Conclusão A participação em uma intervenção cognitiva computadorizada promoveu reduções nas queixas de memória, frequência de esquecimento e sintomas de ansiedade, além de melhorar a qualidade de vida autorrelatada. memória 201 coronavirus COVID19, COVID19 COVID 19, 19 COVID-19 inglês. inglês . inglês) online todo 6 + Paulo estudo 11 1 1: n 33 33. esclarecido sociodemográfico Memory Questionnaire MACQ, MACQ MAC Q , MAC-Q) Geriatric Scale GDS15, GDS15 GDS 15 GDS-15) Inventory GAI, GAI GAI) Controle Autonomia Control, Control (Control Autonomy SelfRealization, SelfRealization Self Realization, Realization Self-Realization Pleasure CASP19. CASP19 CASP CASP-19) atenção linguagem raciocínio, (raciocínio lógico espaciais pósteste, pósteste pós teste, teste Q, logística ansiedade autorrelatada 20 COVID1 COVID-1 3 GDS1 GDS-15 CASP1 CASP-19 COVID- GDS-1 CASP-1 GDS- CASP-

ABSTRACT Objective: This study aims to investigate the ability of the six-minute walk distance (6MWD) as a prognostic marker for midterm clinical outcomes three months after coronary artery bypass grafting (CABG), to identify possible predictors of fall in 6MWD in the early postoperative period, and to establish the percentage fall in early postoperative 6MWD, considering the preoperative baseline as 100%. Methods: A prospective cohort of patients undergoing elective CABG were included. The percentage fall in 6MWD was assessed by the difference between preoperative and postoperative day (POD) five. Clinical outcomes were evaluated three months after hospital discharge. Results: There was a significant decrease in 6MWD on POD5 compared with preoperative baseline values (percentage fall of 32.5±16.5%, P<0.0001). Linear regression analysis showed an independent association of the percentage fall of 6MWD with cardiopulmonary bypass (CPB) and preoperative inspiratory muscle strength. Receiver operating characteristic curve analysis revealed that the best cutoff value of percentage fall in 6MWD to predict poorer clinical outcomes at three months was 34.6% (area under the curve = 0.82, sensitivity = 78.95%, specificity = 76.19%, P=0.0001). Conclusion: This study indicates that a cutoff value of 34.6% in percentage fall of 6MWD on POD5 was able to predict poorer clinical outcomes at three months of follow-up after CABG. Use of CPB and preoperative inspiratory muscle strength were independent predictors of percentage fall of 6MWD in the postoperative period. These findings further support the clinical application of 6MWD and propose an inpatient preventive strategy to guide clinical management over time.

RESUMO OBJETIVO Estimar a prevalência da exposição ao vírus SARS-CoV-2 entre indivíduos vivendo em restrição de liberdade. MÉTODOS Foi realizado inquérito de soroprevalência com a população da penitenciária feminina do Centro de Progressão Penitenciária (CPP) do Butantan (município de São Paulo), entre 24 de junho e 20 de agosto de 2020. Nesse período, segundo a Secretaria de Administração Penitenciária (SAP), a positividade dos testes rápidos entre detentos variou de 65 a 78%. O método de avaliação utilizado no estudo foi o teste rápido “One Step COVID-19” (cromatografia), da empresa Wondfo, empregando-se também o método RT-PCR em participantes sintomáticos para confirmação do quadro viral. A população do estudo foi constituída por 879 reeducandas e 170 funcionários da instituição. RESULTADOS A prevalência de anticorpos totais (IgG/IgM) contra o vírus SARS-CoV-2 na população total de 1.049 participantes do estudo foi de 6,1%; entre a população de 879 reeducandas foi observada prevalência de 5,8% e entre os servidores da instituição, 7,5%. CONCLUSÃO Houve baixa prevalência de covid-19 no CPP do Butantan, o que se deve à implementação de medidas de prevenção simples na instituição, como o uso de máscaras (com trocas adequadas), ênfase na higiene, lavagem das mãos e distanciamento social, além de outras estratégias, como suspensão de visitas de familiares e amigos das reeducandas, cortes de consultas médicas eletivas e do trabalho externo.

ABSTRACT OBJECTIVE To estimate the prevalence of exposure to the SARS-CoV-2 virus among individuals living in restricted freedom. METHODS A seroprevalence survey was carried out with the population of the female penitentiary of the Centro de Progressão Penitenciária (CPP) in Butantan (municipality of São Paulo), between June 24 and August 20, 2020. During this period, according to the Secretariat of Penitentiary Administration (SAP), the positivity of rapid tests among inmates ranged from 65% to 78%. The evaluation method used in the study was the “One Step COVID-19” rapid test (chromatography), from the company Wondfo, also using the RT-PCR method in symptomatic participants to confirm the viral condition. The study population consisted of 879 female inmates and 170 employees of the institution. RESULTS The prevalence of total antibodies (IgG/IgM) against the SARS-CoV-2 virus in the total population of 1049 study participants was 6.1%; among the population of 879 inmates,a prevalence of 5.8% was observed, and among the institution’s employees, 7.5%. CONCLUSIONS The prevalence of covid-19 at the Butantan CPP was low, which is due to the implementation of simple prevention measures at the institution, such as the use of masks (with appropriate changes), emphasis on hygiene, hand washing and social distancing, in addition to other strategies, such as suspending inmates’ visits from relatives and friends and cutting back on elective medical appointments and outside work.

Resumo Objetivo: Avaliar os parâmetros de saúde física e mental, de qualidade de vida relacionada à saúde (QVRS), em adolescentes com deficiência física matriculados em organização não governamental (ONG) esportiva vs. em adolescentes sem deficiência, durante a pandemia da doença do coronavírus 2019 (COVID-19). Métodos: Este estudo transversal incluiu 30 adolescentes com deficiência e 86 adolescentes sem deficiência que responderam a questionário online com dados sociodemográficos e informações de rotina de saúde autoavaliadas durante a quarentena da COVID-19. Versões validadas de autorrelato do Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL4.0), Pittsburgh Sleep Quality Index (PSQI) e Pediatric Outcome Data Collection Instrument (PODCI) também foram aplicadas. Resultados: A mediana de problemas emocionais [4(0–10) vs. 5(0–10),p=0,018] e pró-social [7(0–10) vs. 9(3–10),p=0,006] foi menor em adolescentes com deficiência vs. adolescentes sem deficiência. Adolescentes com deficiência tiveram função global significantemente inferior [68(21–99) vs. 94(67–100),p <0,001] e pontuações de felicidade mais altas do PODCI [90(65–100) vs. 80(0–100),p=0,016] em comparação com o grupo sem deficiências. A análise de regressão logística demonstrou que a atividade física/semana (odds ratio — OR=1,03; intervalo de confiança — IC95%=1,01–1,05,p=0,002) foi maior nos adolescentes com deficiência. No entanto, atividades domésticas (OR=0,14; IC95%=0,04–0,43,p=0,001) e tempo de tela ≥3 horas/dia (OR=0,09; IC95%=0,02–0,38,p=0,001) foram menores nos adolescentes com deficiência. Conclusões: Os adolescentes com deficiência que frequentam uma organização não governamental (ONG) esportiva não tiveram maior risco de apresentar indicadores adversos à saúde; apesar de apresentarem função física reduzida, relataram mais atividade física, maior felicidade e menos tempo de tela em comparação com adolescentes sem deficiência durante a pandemia da COVID-19.

Abstract Objective: This study aimed to assess physical and mental health, and health-related quality of life (HRQL) parameters in adolescents with physical disabilities enrolled in a sports nongovernmental organization (NGO) versus adolescents without disabilities during coronavirus disease 2019 (COVID-19) pandemic. Methods: This cross-sectional study included 30 adolescents with disabilities and 86 adolescents without disabilities who responded to an online questionnaire with sociodemographic data and self-rated healthcare routine information during the COVID-19 quarantine. Validated self-report versions of the Strengths and Difficulties Questionnaire (SDQ), Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Outcome Data Collection Instrument (PODCI) were also applied. Results: The median of emotional [4 (0–10) vs. 5 (0–10), p=0.018] and prosocial [7 (0–10) vs. 9 (3–10), p=0.006] problems was lower in adolescents with disabilities versus adolescents without disabilities. Adolescents with disabilities had significantly lower global function [68 (21–99) vs. 94 (67–100), p<0.001] and higher happiness scores in the PODCI scale [90 (65–100) vs. 80 (0–100), p=0.016] compared to controls. Logistic regression analysis demonstrated that physical activity/week (OR=1.03; 95%CI 1.01–1.05, p=0.002) was higher in adolescents with disabilities compared to adolescents without disabilities. However, housework activities (OR=0.14; 95%CI 0.04–0.43, p=0.001) and screen time ≥3 h/day (OR=0.09; 95%CI 0.02–0.38, p=0.001) were lower in adolescents with disabilities compared to adolescents without disabilities. Conclusion: Adolescents with disabilities attending a sports NGO were not at higher risk of adverse health-related indicators; despite showing reduced physical function, they reported more physical activity, higher happiness, and less screen time compared to adolescents without disabilities during the COVID-19 pandemic.

A sífilis reemergiu enquanto problema sério de saúde pública no Brasil e no mundo, afetando de maneira desproporcional homens que fazem sexo com homens (HSH), travestis e mulheres transgênero. São relativamente escassos os estudos sobre infecções sexualmente transmissíveis (IST) entre adolescentes pertencentes a essas populações-chave. O estudo transversal multicêntrico brasileiro analisou a prevalência de sífilis na linha de base da coorte PrEP15-19 de HSH, travestis e mulheres transgênero adolescentes, sexualmente ativos, recrutados entre abril de 2019 e dezembro de 2020. As análises foram realizadas com as dimensões de vulnerabilidade a ISTs/HIV, e modelos de regressão logística foram construídos para estimar as razões de chances da associação entre as variáveis preditoras e um teste treponêmico positivo para sífilis na entrada do estudo. Foram analisados 677 participantes. A idade mediana era 18,9 anos (IIQ: 18,1-19,5), 70,5% (477) se autoidentificaram como pretos, 70,5% (474) como homossexuais/gays e 48 (7,1%) como mulheres trans ou travestis. A prevalência de sífilis na linha de base era 21,3%. No modelo final de regressão logística, as seguintes variáveis estiveram associadas com chances maiores de sífilis: autorrelato de episódio de IST nos últimos 12 meses (OR = 5,92; IC95%: 3,74-9,37), profissional do sexo (OR = 3,39; IC95%: 1,32-8,78) e menos de 11 anos de escolaridade (OR = 1,76; IC95%: 1,13-2,74). A prevalência de sífilis entre HSH, travestis e mulheres transgênero adolescentes entre 15 e 19 anos de idade foi alarmante, muito acima da taxa relatada na população geral nesta faixa etária, e esteve associada a fatores de vulnerabilidade. Os achados reforçam a necessidade urgente de fortalecer os programas de saúde pública com a discussão sobre raça, gênero, sexualidade e prevenção.

La sífilis ha resurgido como un problema serio de salud pública en Brasil y en todo el mundo, afectando desproporcionadamente a hombres que tienen sexo con hombres (HSH), travestis y mujeres transgénero (TrTGW). Los estudios de las enfermedades trasmitidas sexualmente (ETS) en adolescentes de estas poblaciones clase son relativamente escasos. Se trata de un estudio transversal brasileño multicéntrico, con análisis de prevalencia de la base de referencia de la cohorte PrEP1519 de hombres activos sexualmente que mantienen sexo con hombres y adolescentes TrTGW, reclutados desde abril de 2019 a diciembre de 2020. Se hicieron análisis, usando las dimensiones de vulnerabilidad a las ETS/VIH, y se realizaron modelos de regresión logística para estimar las odds ratios de la asociación entre las variables predictoras y la prueba treponémica positiva para la sífilis al comenzar el estudio. Se analizaron a 677 participantes. La media de edad fue 18,9 años (IQR: 18,1-19,5), 70,5% (477) se autodeclararon como negros, 70,5% (474) como homosexuales/gays y 48 (7,1%) como mujeres trans o travestis. La base de referencia de prevalencia de sífilis fue 21,3%. En el modelo final de regresión logística, se asociaron con una posibilidad más alta de sífilis: un episodio autoinformado de ETS en los últimos 12 meses (OR = 5,92; IC95%: 3,74-9,37), trabajadores sexuales (OR = 3,39; IC95%: 1,32-8,78) y < 11 años de estudio (OR = 1,76; IC95%: 1,13-2,74). La prevalencia de sífilis entre adolescentes HSH/TrTGW con edades de 15 a 19 años fue alarmante, mucho más que lo descrito para la población general en este rango de edad y asociado con factores de vulnerabilidad. Esto refuerza la urgente necesidad de fortalecer los programas de salud pública, discutiendo cuestiones de raza, género, sexualidad y prevención.

Syphilis has reemerged as a serious public health problem in Brazil and worldwide, disproportionately affecting men who have sex with men (MSM) and travestis and transgender women (TrTGW). Studies on sexually transmitted infections (STI) in adolescents from these key populations are relatively scarce. This is a Brazilian multi-center, cross study with prevalence analysis, using as baseline the PrEP1519 cohort of sexually active MSM and TrTGW adolescents, recruited from April 2019 to December 2020. Analyses were made using the dimensions of vulnerability to STI/HIV and logistic regression models were conducted to estimate the odds ratios of the association between the predictor variables and positive treponemal test for syphilis at the moment of entry in the study. In total, 677 participants were analyzed; participants’ median age was 18.9 years (IQR: 18.1-19.5); 70.5% (477) self-declared as black; 70.5% (474), as homosexuals/gays; and 48 (7.1%), as trans women or travestis. The baseline prevalence of syphilis was 21.3%. In the final logistic regression model, higher chance of syphilis was associated with: self-reported episode of STI in the last 12 months (OR = 5.92; 95%CI: 3.74-9.37), sex worker (OR = 3.39; 95%CI: 1.32-8.78), and < 11 years of schooling (OR = 1.76; 95%CI: 1.13-2.74). The prevalence of syphilis among MSM/TrTGW adolescents aged from 15 to 19 years was alarming, much higher than the described for the general population within this age range and associated with vulnerability factors. This reinforces the urgent need to strengthen public health programs to debate about race, gender, sexuality, and prevention.