SUMMARY OBJECTIVE: The aim of this study was to evaluate serum 25(OH)D concentrations in the homebound elderly people and relate them to level of dementia, nutritional risk, and route of dietary administration. METHODS: This is a cross-sectional study involving 207 bedridden elderly people assisted by the Home Care Service in the city of Santo André – SP, from June to December 2016. The following factors were evaluated: dietary intake of vitamin D, arm circumference, triceps skin fold thickness, calf circumference, nutritional risk by Mini-Nutritional Assessment, level of dementia by the adapted Clinical Dementia Rating questionnaire, and laboratory tests such as serum concentrations of 25(OH)D, ultrasensitive C-reactive protein, alkaline phosphatase, serum calcium, and parathormone. RESULTS: The mean age of the elderly people was 81.6 (9.2) years. Deficiency of 25(OH)D was observed in 76.3% of the elderly people. There was an inverse correlation between serum concentrations of 25(OH)D: parathormone (r=-0.418, p<0.001) and alkaline phosphatase (r=-0.188, p=0.006) and a direct correlation with serum calcium (r=-0.158, p=0.022). Logistic regression showed that vitamin D deficiency was directly and independently associated with oral feeding (odds ratio 7.71; 95%CI 2.91–20.40). CONCLUSION: Bedridden households showed high prevalence of vitamin D deficiency without association with nutritional risk and level of dementia. Oral diet was associated with vitamin D deficiency, possibly due to low consumption of source foods. OBJECTIVE 25OHD OHD 25 OH administration METHODS crosssectional cross sectional 20 SP 2016 evaluated circumference thickness MiniNutritional Mini Nutritional Assessment questionnaire 25OHD, Creactive C reactive protein RESULTS 816 81 6 81. 9.2 92 9 2 (9.2 years 763 76 3 76.3 r=0.418, r0418 r r= 0.418, 0 418 (r=-0.418 p<0.001 p0001 p 001 r=0.188, r0188 0.188, 188 (r=-0.188 p=0.006 p0006 006 r=0.158, r0158 0.158, 158 (r=-0.158 p=0.022. p0022 p=0.022 . 022 p=0.022) odds 7.71 771 7 71 95CI CI 95 2.91–20.40. 2912040 2.91–20.40 91 40 2.91–20.40) CONCLUSION foods 201 8 9. (9. 76. r=0.418 r041 0418 0.418 41 (r=-0.41 p<0.00 p000 00 r=0.188 r018 0188 0.188 18 (r=-0.18 p=0.00 r=0.158 r015 0158 0.158 15 (r=-0.15 p002 p=0.02 02 7.7 77 291204 2.91–20.4 4 (9 r=0.41 r04 041 0.41 (r=-0.4 p<0.0 p00 r=0.18 r01 018 0.18 1 (r=-0.1 p=0.0 r=0.15 015 0.15 7. 29120 2.91–20. ( r=0.4 r0 04 0.4 (r=-0. p<0. p0 r=0.1 01 0.1 p=0. 2912 2.91–20 r=0. 0. (r=-0 p<0 p=0 291 2.91–2 r=0 (r=- p< p= 29 2.91– (r= 2.91 (r 2.9 2.

ABSTRACT OBJECTIVE To compare the incidence of covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the covid-19 pandemic. After follow-up, covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with covid-19 symptoms. CONCLUSION The lower adherence to social distancing among the control group greatly influences the development of covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against covid-19, considering that they maintained greater social distancing than control participants.

ABSTRACT OBJECTIVE To compare the incidence of covid-19 symptoms between informal home-based workers and a control group and to assess the association of these cases with blood elements concentrations and other relevant risk factors for Sars-Cov-2 infection. METHODS Welders chemically exposed to potentially toxic elements (PTEs) (n = 26) and control participants (n = 25) answered questionnaires on adherence to social distancing and signs and symptoms of the disease for five months during the covid-19 pandemic. After follow-up, covid-19 serology tests were performed on a subsample of 12 chemically exposed workers and 20 control participants. Before the pandemic, PTE concentrations in blood (As, Mn, Ni, Cd, Hg, Sb, Sn, Cu, Zn, and Pb) were measured by ICP-MS. RESULTS The chemically exposed group had higher lead and cadmium levels in blood (p < 0.01). The control group presented lower adherence to social distancing (p = 0.016). Although not significant, welders had a 74% greater chance of having at least one covid-19 symptom compared with control participants, but their adherence to social distancing decreased this chance by 20%. The use of taxis for transportation was a risk factor significantly associated with covid-19 symptoms. CONCLUSION The lower adherence to social distancing among the control group greatly influences the development of covid-19. The literature lacks data linking exposure to PTEs and Sars-Cov-2 infection and/or severity. In this study, despite chemical exposure, working from home may have protected welders against covid-19, considering that they maintained greater social distancing than control participants. covid19 covid 19 covid-1 homebased based SarsCov2 SarsCov Sars Cov 2 Sars-Cov- (PTEs n 26 25 pandemic followup, followup follow up, up follow-up 1 As, As (As Mn Ni Cd Hg Sb Sn Cu Zn Pb ICPMS. ICPMS ICP MS. MS ICP-MS p 0.01. 001 0.01 . 0 01 0.01) 0.016. 0016 0.016 016 0.016) significant 74 20% covid19. 19. andor or severity study covid19, 19, covid1 covid- Sars-Cov 00 0.0 7 0.

ABSTRACT Objective To compare serum amyloid A concentrations between overweight and eutrophic children and adolescents and to relate it to lipid profiles, glucose tolerance, and carotid intima-media thickness. Methods One hundred children and adolescents (mean age: 10.8±3.16 years) were included and divided into two groups: overweight and non-overweight. The following were evaluated: Z-score body mass index, carotid intima-media thickness, lipid metabolism biomarkers (lipid profile and apolipoproteins A1 and B), inflammatory biomarkers (ultra-sensitive C-reactive protein and serum amyloid A), and glucose homeostasis model assessment of insulin resistance. Results The groups were homogeneous in age, sex, and pubertal stage. Higher levels of triglycerides, apolipoprotein B, homeostasis model assessment of insulin resistance, ultrasensitive C-reactive protein, serum amyloid A, and carotid intima-media thickness were observed in the overweight group. In the multivariate analysis, age (OR=1.73; 95%CI: 1.16-2.60, p=0.007), Z-score body mass index (OR=3.76; 95%CI: 1.64-8.59, p=0.002), apolipoprotein-B (OR=1.1; 95%CI: 1.01-1.2, p=0.030), and carotid intima-media thickness (OR=5.00; 95%CI: 1.38-18.04, p=0.014) were independently associated with serum amyloid A levels above the fourth quartile of the studied sample (>9.4mg/dL). Conclusion Overweight children and adolescents had higher serum amyloid A concentrations than eutrophic children. There was an independent association between higher concentrations of serum amyloid A and Z-score, body mass index, apolipoprotein B, and carotid intima-media thickness, indicating the importance of this inflammatory biomarker in identifying the early risk of atherosclerosis. profiles tolerance intimamedia intima media mean 108316 10 8 3 16 10.8±3.1 years nonoverweight. nonoverweight non overweight. non-overweight evaluated Zscore Z score B , B) ultra sensitive Creactive C reactive A) resistance sex stage triglycerides group analysis OR=1.73 OR173 OR 1 73 (OR=1.73 95%CI 95CI CI 95 1.162.60, 116260 1.16 2.60, 2 60 1.16-2.60 p=0.007, p0007 p p=0.007 0 007 p=0.007) OR=3.76 OR376 76 (OR=3.76 1.648.59, 164859 1.64 8.59, 64 59 1.64-8.59 p=0.002, p0002 p=0.002 002 p=0.002) apolipoproteinB OR=1.1 OR11 (OR=1.1 1.011.2, 10112 1.01 1.2, 01 1.01-1.2 p=0.030, p0030 p=0.030 030 p=0.030) OR=5.00 OR500 5 00 (OR=5.00 1.3818.04, 1381804 1.38 18.04, 38 18 04 1.38-18.04 p=0.014 p0014 014 >9.4mg/dL. 94mgdL mgdL >9.4mg/dL . 9 4mg dL mg (>9.4mg/dL) Zscore, score, atherosclerosis 10831 10.8±3. OR=1.7 OR17 7 (OR=1.7 162 1.162.60 11626 116 1.1 260 2.60 6 1.16-2.6 p000 p=0.00 OR=3.7 OR37 (OR=3.7 648 1.648.59 16485 164 1.6 859 8.59 1.64-8.5 OR=1. OR1 (OR=1. 011 1.011.2 1011 101 1.0 12 1.2 1.01-1. p003 p=0.03 03 OR=5.0 OR50 (OR=5.0 3818 1.3818.04 138180 138 1.3 1804 18.04 1.38-18.0 p=0.01 p001 (>9.4mg/dL 1083 10.8±3 1.162.6 1162 11 1. 26 2.6 1.16-2. p00 p=0.0 OR=3. OR3 (OR=3. 1.648.5 1648 85 8.5 1.64-8. OR=1 (OR=1 1.011. 1.01-1 OR=5. OR5 (OR=5. 381 1.3818.0 13818 13 180 18.0 1.38-18. 108 10.8± 1.162. 2. 1.16-2 p0 p=0. OR=3 (OR=3 1.648. 8. 1.64-8 OR= (OR= 1.011 1.01- OR=5 (OR=5 1.3818. 1381 18. 1.38-18 10.8 1.162 1.16- p=0 1.648 1.64- (OR 1.3818 1.38-1 10. p= 1.381 1.38-

SUMMARY OBJECTIVE: The aim of this study was to investigate the role of irisin in type 2 diabetes mellitus and its association with metabolic alterations and obesity. METHODS: A cross-sectional case-control study was conducted on participants treated at Centro Universitário FMABC between August 2018 and July 2019, by comparing a control group (n=14) with type 2 diabetes mellitus patients (n=16). The control group consisted of participants aged above 21 years with no chronic diseases, diabetes, smoking, or illicit drug use. The type 2 diabetes mellitus group included patients aged above 21 years, who were diagnosed with type 2 diabetes for at least 5 years (glycated hemoglobin>7%). Exclusion criteria were not willing to continue, recent hospitalization, and failure to meet inclusion criteria. Biochemical parameters included blood glucose, glycated hemoglobin, plasma irisin levels, and irisin gene expression in peripheral blood. RESULTS: Type 2 diabetes mellitus patients exhibited significantly higher plasma glucose levels [143 (40) vs. 92 (13) mg/dL, *p<0.05] and glycated hemoglobin levels [7.1% (1.6) vs. 5.6% (0.5), *p<0.05] compared to the control group. Irisin gene expression in type 2 diabetes mellitus patients was lower 0.02288 (0.08050) than the control group 8.506e-006 (1.412e-005) (p=0.06). Correlation analysis revealed a positive association between irisin expression and body mass index in type 2 diabetes mellitus (Rho=0.5221, 95%CI -0.058 to 0.838, p=0.06), while plasma irisin showed a negative correlation with body mass index (Rho=-0.656, 95%CI -0.836 to 0.215, p=0.03). No significant correlations were found between plasma glucose or glycated hemoglobin levels and irisin expression. CONCLUSION: The data suggests that body mass index directly influences plasma irisin levels and the regulation of irisin gene expression, possibly linking irisin to adiposity changes observed in obesity-related type 2 diabetes mellitus. OBJECTIVE obesity METHODS crosssectional cross sectional casecontrol case 201 2019 n=14 n14 n 14 (n=14 n=16. n16 n=16 . 16 (n=16) diseases smoking use hemoglobin>7%. hemoglobin7 hemoglobin>7% 7 hemoglobin>7%) continue hospitalization RESULTS 143 [14 40 (40 vs 9 13 (13 mgdL mg dL mg/dL *p<0.05 p005 p 0 05 7.1% 71 1 [7.1 1.6 6 (1.6 56 5.6 0.5, 0.5 , (0.5) 002288 02288 0.0228 0.08050 008050 08050 (0.08050 8.506e006 8506e006 e 8.506e 006 8 506e 8.506e-00 1.412e005 1412e005 1.412e 005 412e (1.412e-005 p=0.06. p006 p=0.06 06 (p=0.06) Rho=0.5221, Rho05221 Rho 5221 (Rho=0.5221 95CI CI 95 0.058 0058 058 -0.05 0838 838 0.838 p=0.06, p=0.06) Rho=0.656, Rho0656 Rho= 0.656, 656 (Rho=-0.656 0.836 0836 836 -0.83 0215 215 0.215 p=0.03. p003 p=0.03 03 p=0.03) CONCLUSION obesityrelated related 20 n=1 n1 (n=1 (n=16 hemoglobin>7 [1 4 (4 (1 *p<0.0 p00 7.1 [7. 1. (1. 5. 0. (0.5 00228 0228 0.022 0.0805 00805 0805 (0.0805 506e006 8.506e00 8506e00 8506e 00 8.506e-0 412e005 1.412e00 1412e00 1412e (1.412e-00 p=0.0 (p=0.06 Rho=0.5221 Rho0522 522 (Rho=0.522 0.05 -0.0 083 83 0.83 Rho=0.656 Rho065 0656 0.656 65 (Rho=-0.65 -0.8 021 0.21 n= (n= hemoglobin> [ ( *p<0. p0 7. [7 (0. 0022 022 0.02 0.080 0080 080 (0.080 506e00 8.506e0 8506e0 8.506e- 412e00 1.412e0 1412e0 (1.412e-0 p=0. (p=0.0 Rho=0.522 Rho052 52 (Rho=0.52 0.0 -0. 08 0.8 Rho=0.65 Rho06 065 0.65 (Rho=-0.6 02 0.2 (n *p<0 (0 002 0.08 008 (0.08 506e0 412e0 (1.412e- p=0 (p=0. Rho=0.52 Rho05 (Rho=0.5 -0 Rho=0.6 Rho0 0.6 (Rho=-0. *p< (0.0 (1.412e p= (p=0 Rho=0.5 (Rho=0. - Rho=0. (Rho=-0 *p (p= (Rho=0 Rho=0 (Rho=- (p (Rho= (Rho

ABSTRACT Objective To evaluate the effects of the Covid-19 pandemic on the profile of emergency eye-related visits and compare the findings with the same period before the pandemic. Methods Cross-sectional study performed during one year at a reference eye hospital. Cases registered at the emergency Municipal Hospital Complex of Santo Andre, Brazil, between March, 2019 and February, 2020 were included in the study as the Pre-pandemic group. Cases registered between March, 2020 and February, 2021 were included as the Pandemic group. Cases were classified according to the International Classification of Diseases ICD-10 and Related Health Problems. Results There was a decrease of 52.1% in the emergency eye care visits during the pandemic period (n=9,198) when compared to the pre-pandemic period (n=19,220), with significant reductions in nonspecific cases (-98.1%), postoperative visits (-67.0%), disorders of the conjunctiva (-54.1%), tear film (-49.4%) and refraction (-85.6%) during the pandemic period. Conditions such as retina disorders (+202.7%), sclera disorders (+76.2%), orbit disorders (+20.2%), glaucoma (+66.6%) and trauma (+19.4%) have shown increased rates, as well as those related to eyelids (+186.9%), cornea (+33.4%), uvea (+40.2%), and herpes (+55.3%). Conclusion A drastic reduction in the number of eye-related emergency visits was observed during the Covid-19 pandemic, outlining a new profile of care, with higher frequency of sight-threatening conditions and lower frequency of contagious and non-specific diagnosis. Covid19 Covid 19 Covid-1 eyerelated Crosssectional Cross sectional hospital Andre Brazil March 201 February 202 Prepandemic Pre group ICD10 ICD 10 ICD-1 Problems 521 52 1 52.1 n=9,198 n9198 n 9 198 (n=9,198 prepandemic pre n=19,220, n19220 n=19,220 , 220 (n=19,220) 98.1%, 981 98.1% 98 (-98.1%) 67.0%, 670 67.0% 67 0 (-67.0%) 54.1%, 541 54.1% 54 (-54.1%) 49.4% 494 49 4 (-49.4% 85.6% 856 85 6 (-85.6% +202.7%, 2027 +202.7% 7 (+202.7%) +76.2%, 762 +76.2% 76 2 (+76.2%) +20.2%, +20.2% 20 (+20.2%) +66.6% 666 66 (+66.6% +19.4% 194 (+19.4% rates +186.9%, 1869 +186.9% 186 (+186.9%) +33.4%, 334 +33.4% 33 (+33.4%) +40.2%, 402 +40.2% 40 (+40.2%) +55.3%. 553 +55.3% . 55 3 (+55.3%) sightthreatening sight threatening non specific diagnosis Covid1 Covid- ICD1 ICD- 5 52. n=9,19 n919 (n=9,19 n1922 n=19,22 22 (n=19,220 98.1 (-98.1% 67.0 (-67.0% 54.1 (-54.1% 49.4 (-49.4 85.6 8 (-85.6 +202.7 (+202.7% +76.2 (+76.2% +20.2 (+20.2% +66.6 (+66.6 +19.4 (+19.4 +186.9 18 (+186.9% +33.4 (+33.4% +40.2 (+40.2% +55.3 (+55.3% n=9,1 n91 (n=9,1 n192 n=19,2 (n=19,22 98. (-98.1 67. (-67.0 54. (-54.1 49. (-49. 85. (-85. +202. (+202.7 +76. (+76.2 +20. (+20.2 +66. (+66. +19. (+19. +186. (+186.9 +33. (+33.4 +40. (+40.2 +55. (+55.3 n=9, n9 (n=9, n19 n=19, (n=19,2 (-98. (-67. (-54. (-49 (-85 +202 (+202. +76 (+76. +20 (+20. +66 (+66 +19 (+19 +186 (+186. +33 (+33. +40 (+40. +55 (+55. n=9 (n=9 n1 n=19 (n=19, (-98 (-67 (-54 (-4 (-8 (+202 +7 (+76 +2 (+20 +6 (+6 +1 (+1 +18 (+186 +3 (+33 +4 (+40 +5 (+55 n= (n= n=1 (n=19 (-9 (-6 (-5 (- + (+7 (+2 (+ (+18 (+3 (+4 (+5 (n (n=1 (

RESUMO Objetivo Avaliar os efeitos da pandemia da Covid-19 no perfil dos atendimentos oftalmológicos de emergência e comparar os achados com os do período anterior à pandemia. Métodos Estudo transversal realizado ao longo de 1 ano em um hospital oftalmológico de referência. Casos registrados no Complexo Hospitalar Municipal de Emergências de Santo André (SP, Brasil) entre março de 2019 e fevereiro de 2020 foram incluídos no estudo como Grupo Pré-Pandemia. Os casos registrados entre março de 2020 e fevereiro de 2021 foram incluídos no Grupo Pandemia. Os casos foram classificados de acordo com a Classificação Internacional de Doenças e Problemas Relacionados à Saúde. Resultados Houve redução de 52,1% no número de atendimentos oftalmológicos de emergência durante o período pandêmico (n=9.198) quando comparado ao pré-pandêmico (n=19.220), com reduções significativas em casos inespecíficos (-98,1%), visitas pós-operatórias (-67,0%), distúrbios da conjuntiva (-54,1%), filme lacrimal (-49,4%) e refração (-85,6%) durante o período de pandemia. Condições como distúrbios da retina (+202,7%), distúrbios da esclera (+76,2%), distúrbios da órbita (+20,2%), glaucoma (+66,6%) e trauma (+19,4%) apresentaram taxas aumentadas, bem como aquelas relacionadas a pálpebras (+186,9%), córnea (+33,4%), úvea (+40,2%) e herpes (+55,3%). Conclusão Observou-se drástica redução no número de atendimentos oftalmológicos durante a pandemia da Covid-19, delineando um novo perfil de atendimento, com maior frequência de quadros que levam à baixa de visão e à menor frequência de diagnósticos contagiosos e inespecíficos. Covid19 Covid 19 Covid-1 referência SP, SP (SP Brasil 201 202 PréPandemia. PréPandemia Pré Pandemia Pré-Pandemia Saúde 521 52 52,1 n=9.198 n9198 n 9 198 (n=9.198 prépandêmico pré n=19.220, n19220 n=19.220 , 220 (n=19.220) 98,1%, 981 98,1% 98 (-98,1%) pósoperatórias pós operatórias 67,0%, 670 67,0% 67 0 (-67,0%) 54,1%, 541 54,1% 54 (-54,1%) 49,4% 494 49 4 (-49,4% 85,6% 856 85 6 (-85,6% +202,7%, 2027 +202,7% 7 (+202,7%) +76,2%, 762 +76,2% 76 2 (+76,2%) +20,2%, +20,2% 20 (+20,2%) +66,6% 666 66 (+66,6% +19,4% 194 (+19,4% aumentadas +186,9%, 1869 +186,9% 186 (+186,9%) +33,4%, 334 +33,4% 33 (+33,4%) +40,2% 402 40 (+40,2% +55,3%. 553 +55,3% . 55 3 (+55,3%) Observouse Observou se Covid19, 19, atendimento Covid1 Covid- 5 52, n=9.19 n919 (n=9.19 n1922 n=19.22 22 (n=19.220 98,1 (-98,1% 67,0 (-67,0% 54,1 (-54,1% 49,4 (-49,4 85,6 8 (-85,6 +202,7 (+202,7% +76,2 (+76,2% +20,2 (+20,2% +66,6 (+66,6 +19,4 (+19,4 +186,9 18 (+186,9% +33,4 (+33,4% +40,2 (+40,2 +55,3 (+55,3% n=9.1 n91 (n=9.1 n192 n=19.2 (n=19.22 98, (-98,1 67, (-67,0 54, (-54,1 49, (-49, 85, (-85, +202, (+202,7 +76, (+76,2 +20, (+20,2 +66, (+66, +19, (+19, +186, (+186,9 +33, (+33,4 +40, (+40, +55, (+55,3 n=9. n9 (n=9. n19 n=19. (n=19.2 (-98, (-67, (-54, (-49 (-85 +202 (+202, +76 (+76, +20 (+20, +66 (+66 +19 (+19 +186 (+186, +33 (+33, +40 (+40 +55 (+55, n=9 (n=9 n1 n=19 (n=19. (-98 (-67 (-54 (-4 (-8 (+202 +7 (+76 +2 (+20 +6 (+6 +1 (+1 +18 (+186 +3 (+33 +4 (+4 +5 (+55 n= (n= n=1 (n=19 (-9 (-6 (-5 (- + (+7 (+2 (+ (+18 (+3 (+5 (n (n=1 (

SUMMARY OBJECTIVE: Due to the speed of development observed in breast cancer, several studies aimed at discovering new biomarkers have been carried out in order to arrive at an early diagnosis. As survivin plays a fundamental role in the evasion of apoptosis in tumor cells, the aim of this study was to verify the expression profile of the survivin gene in paraffin-embedded breast tumor samples and associate it with the clinical characteristics of the patients. METHODS: This is a cross-sectional study, for which 100 tumor samples were obtained from cancer patients treated throughout the year 2019 at Instituto de Mama do Cariri (Juazeiro do Norte, in the state of Ceará). This study included women over 30 years old who had confirmed breast cancer through anatomopathological examination but excluded those with non-neoplastic breast comorbidities, other neoplasms, or chronic diseases. Survivin gene expression was assessed by quantitative polymerase chain reaction. RESULTS: The expression of survivin is associated with the lack of expression of estrogen (p=0.027) and progesterone (p>0.0005) receptors. It means that survivin expression is higher in patients in which labeling was absent for estrogen receptor and progesterone receptor. CONCLUSION: Our data reinforce that survivin expression is higher in estrogen receptor-patients, thus representing an additional prognostic tool. OBJECTIVE diagnosis cells paraffinembedded paraffin embedded METHODS crosssectional cross sectional 10 201 Juazeiro Norte Ceará. Ceará . Ceará) 3 nonneoplastic non neoplastic comorbidities neoplasms diseases reaction RESULTS p=0.027 p0027 p 0 027 (p=0.027 p>0.0005 p00005 0005 (p>0.0005 receptors CONCLUSION receptorpatients, receptorpatients patients, receptor-patients tool 1 20 p=0.02 p002 02 (p=0.02 p>0.000 p0000 000 (p>0.000 2 p=0.0 p00 (p=0.0 p>0.00 p000 00 (p>0.00 p=0. p0 (p=0. p>0.0 (p>0.0 p=0 (p=0 p>0. (p>0. p= (p= p>0 (p>0 (p p> (p>

Abstract Objective: The nutritional status resultant from dietary habits along with socioeconomic conditions and the school environment are directly related to the individual's health condition not only in their childhood but also throughout adulthood. The aim of this study was to evaluate the effects of socioeconomic factors on the anthropometric profile and to analyze a probable association between this profile and biochemical markers in children attending public daycare centers. Methods: It is a transversal study developed in a probability sample of clusters of children from 6 months to 5 years old. Anthropometric and socioeconomic data were gathered at the CMEIs, questionnaires on the nutritional status were applied and blood was collected at the Family Health Units (USFs). Results: Female children are three times more likely to be underweight; in families with five members, it is 1/3 more likely that children of higher-educated parents are overweight. Among the results of the biochemical tests, hypervitaminosis A was a relevant aspect, positively correlating with copper (p=0.005) and zinc (p=0.008). Conclusion: Therefore, since the influence of the family is an important predictor of overweight and its future outcomes related to nutritional deficiencies and inadequate dietary intake, educational interventions are vital as a way to pave the path to prevention.

SUMMARY OBJECTIVE: The aim of this study was to assess the quality of primary health care services through self-reports by caregivers of children and adolescents living in quilombola communities in Brazil. METHODS: This is a cross-sectional study in accordance with the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology). Exposure variables included sociodemographic characteristics; and outcome variable was the quality of primary health care offered to quilombola children and adolescents. RESULTS: A total of 68 individuals participated in the survey. Quilombolas have a low income, a lower level of education, do not work, and receive government benefits. Our results showed that the quality of primary health care, measured by the experience of caregivers of quilombola children and adolescents, generally presents satisfactory values. CONCLUSION: The quality of primary health care has generally satisfactory values. However, as these results differ from most studies, more research should be conducted.

RESUMO O câncer de pulmão é o primeiro em incidência e mortalidade, sendo responsável mundialmente por cerca de 1,8 milhão de mortes. No Brasil, 31.270 casos novos foram diagnosticados em 2018, sendo 18.740 em homens e 12.350 em mulheres. Um dos principais desafios do câncer de pulmão é o diagnóstico precoce, na maioria das vezes a doença é detectada em fases tardias, o que implica em mau prognóstico. Os biomarcadores tumorais são extremamente relevantes no diagnóstico precoce, compreensão da carcinogênese, determinação do prognóstico e escolha terapêutica. O presente trabalho revisa biomarcadores de câncer de pulmão de células não pequenas descritos na literatura e suas aplicações diagnósticas, prognósticas e terapêuticas, intervenção e controle terapêutico para terapia individualizada. Embora ainda exista um vasto universo a ser explorado, estudos revelam um futuro promissor para o tratamento do câncer de pulmão com terapias cada vez mais personalizadas e assertivas que aumentam as chances de sobrevida livre de progressão.

ABSTRACT Lung cancer is the first in terms of incidence and mortality, being responsible worldwide for about 1.8 million deaths. In Brazil 31,270 new cases were diagnosed in 2018, 18,740 in men and 12,350 in women. One of the main challenges about lung cancer is performing an early diagnosis, in most cases the disease is detected in the late stages, which implies in poor prognoses. Tumor biomarkers are hugely relevant in early diagnosis, understanding of carcinogenesis, prognostic determination and therapeutic choice. The present paper reviews non-small cell lung cancer biomarkers described in the literature and their diagnostic, prognostic and therapeutic applications, intervention and therapeutic control for individualized therapy. Although there is still a vast universe to be explored, studies reveal a promising future for lung cancer treatment with increasingly personalized and assertive therapies that increase the chances of progression-free survival.

Resumo Objetivo: verificar a estabilidade do cloridrato de vancomicina em soluções de selo antimicrobiano sem e com associação de heparina sódica segundo a temperatura e tempo de associação. Método: estudo experimental delineado para análise de potencial hidrogeniônico e concentração por cromatografia líquida de alta eficiência de soluções de cloridrato de vancomicina (n=06) e cloridrato de vancomicina e heparina sódica (n=06). Submeteram-se as soluções estudadas à ausência de luz, 22°C e 37°C. Análises em triplicadas (n=192) ocorreram no momento inicial (T0), três (T3), oito (T8) e 24 horas (T24) após preparo. Os dados foram submetidos à análise de variância (p≤0,05). Resultados: a concentração do antimicrobiano a 22°C apresentou redução (T0-T8) e posterior elevação (T24); o potencial hidrogeniônico diminuiu significativamente ao longo do tempo. Em 37°C a concentração aumentou em até T3 e reduziu em T24, com redução de potencial hidrogeniônico até 24 horas. A concentração das soluções de cloridrato de vancomicina e heparina sódica apresentaram variação com redução a 22°C acompanhada de aumento de potencial hidrogeniônico. Observou-se formação de precipitado por inspeção visual da associação cloridrato de vancomicina e heparina sódica (T3). Conclusão: evidenciou-se estabilidade farmacológica do cloridrato de vancomicina (5 mg/mL) e incompatibilidade física com heparina sódica (100 UI/mL) após três horas de associação nas soluções de selo antimicrobiano estudadas.

Abstract Objective: to verify the stability of vancomycin hydrochloride in antimicrobial seal solutions with and without association of heparin sodium according to temperature and association time. Method: an experimental study designed for the analysis of hydrogenionic potential and concentration by means of high-efficiency liquid chromatography of vancomycin hydrochloride (n=06) and vancomycin hydrochloride and heparin sodium (n=06). The solutions studied were submitted to absence of light, as well as to 22°C and 37°C. Analyses in triplicate (n=192) were performed at the initial moment (T0) and three (T3), eight (T8) and 24 hours (T24) after preparation. The data were submitted to analysis of variance (p≤0.05). Results: concentration of the antimicrobial at 22°C presented a reduction (T0-T8) and a subsequent increase (T24); hydrogenionic potential decreased significantly over time. At 37°C, the concentration increased up to T3 and decreased at T24, with a reduction of hydrogenionic potential up to 24 hours. Concentration of the vancomycin hydrochloride and heparin sodium solutions varied with a reduction at 22°C, accompanied by increased hydrogenionic potential. Precipitate formation was observed by visual inspection of the vancomycin hydrochloride-heparin sodium association (T3). Conclusion: pharmacological stability of vancomycin hydrochloride (5 mg/mL) and physical incompatibility with heparin sodium (100 IU/mL) were evidenced after three hours of association in the antimicrobial seal solutions studied.

Resumen Objetivo: verificar la estabilidad del clorhidrato de vancomicina en soluciones de sellado antimicrobiano solo y combinado con heparina sódica según la temperatura y el tiempo de combinación. Método: estudio experimental diseñado para analizar el potencial de hidrógeno y la concentración por cromatografía líquida de alta resolución de soluciones de clorhidrato de vancomicina (n=06) y de clorhidrato de vancomicina y heparina sódica (n=06). Las soluciones estudiadas fueron sometidas a ausencia de luz, 22°C y 37°C. Se realizaron análisis por triplicado (n=192) en el momento inicial (T0), a las tres (T3), ocho (T8) y 24 horas (T24) después de la preparación. Los datos fueron sometidos a análisis de varianza (p≤0,05). Resultados: la concentración de antimicrobiano a 22°C mostró una reducción (T0-T8) y un posterior aumento (T24); el potencial de hidrógeno disminuyó significativamente con el tiempo. A 37°C, la concentración aumentó hasta T3 y disminuyó en T24, el potencial de hidrógeno disminuyó hasta las 24 horas. La concentración de las soluciones de clorhidrato de vancomicina y heparina sódica mostró variación con la reducción a 22°C acompañada de un aumento del potencial de hidrógeno. Mediante inspección visual se observó la formación de un precipitado al combinar clorhidrato de vancomicina y heparina sódica (T3). Conclusión: el clorhidrato de vancomicina (5 mg/ml) presentó evidencia de estabilidad farmacológica e incompatibilidad física con la heparina sódica (100 UI/ml) después de las tres horas de haberse realizado la combinación en las soluciones de sellado antimicrobiano estudiadas.

RESUMO A vigilância da qualidade dos esgotos sanitários pode representar uma ferramenta complementar para monitoramento de doenças infecciosas e prevenção de surtos epidêmicos, especialmente quando a capacidade para testes clínicos é limitada. Dessa maneira, o presente estudo descreve o detalhamento técnico de um método de baixo custo para a concentração e extração de ácidos nucleicos de amostras de esgoto sanitário como etapa prévia para a detecção de vírus e outros agentes patogênicos. Para validar a metodologia proposta, após as etapas de concentração e extração, analisaram-se a presença do ácido ribonucleico do SARS-CoV-2 (COVID-19) nas amostras, por meio de reação em cadeia da polimerase em tempo real. O ácido ribonucleico do vírus foi detectado em 80% das amostras de esgoto sanitário analisadas, comprovando o êxito do procedimento metodológico adotado. A detecção precoce de um patógeno associado ao trabalho de equipes multidisciplinares possibilita a prática da vigilância epidemiológica, que auxilia na tomada de decisões na Saúde Única — união indissociável entre a saúde animal, humana e ambiental.

ABSTRACT Sewage quality surveillance can represent a complementary tool for monitoring infectious diseases and preventing epidemic outbreaks, especially when the capacity for clinical testing is limited. Thus, the present study describes the technical details of a low-cost method for concentrating and extracting nucleic acids from sewage samples, as a preliminary step for the detection of viruses and other pathogens. To validate the proposed methodology, after the concentration and extraction steps, the presence of the SARS coronavirus-2 (COVID-19) in the samples was analyzed using real-time polymerase chain reaction. The virus’ ribonucleic acid was detected in 80% of the sewage samples analyzed, proving the success of the methodological procedure adopted. The early detection of a pathogen associated with the work of multidisciplinary teams allows the practice of epidemiological surveillance, which assists in making decisions about One Health — an inseparable union between animal, human, and environmental health.

RESUMO OBJETIVO: Caracterizar os efeitos da aspiração nasal com Proetz® no pico do fluxo inspiratório nasal (Pnif) em pacientes com sinusite pediátrica (SP) com obstrução nasal. MÉTODOS: Trata-se de um ensaio clínico analítico descritivo, não randomizado, com abordagem quantitativa. A amostra foi composta por 30 crianças. Inicialmente, o Pnif foi medido e a escala visual analógica (EVA) foi utilizada para obstrução nasal, seguida do procedimento de aspiração nasal. O questionário Snot-22 foi aplicado ao responsável legal de cada criança e, uma semana depois, foi reaplicado para fins de acompanhamento. RESULTADOS: Dezesseis (53,3%) pacientes eram do sexo feminino e 14 (46,7%) do sexo masculino, com idade média de 6,4±1,8 anos (entre 4 e 10 anos). A análise da EVA para obstrução antes da intervenção revelou que dez dos participantes (33,3%) apresentaram níveis moderados e 20 deles (66,7%), níveis graves. No entanto, após a aplicação do método Proetz®, todas as amostras (n=30) apresentaram níveis leves. O Pnif aumentou significativamente após a utilização da técnica, com uma melhoria de 23,4% nos valores médios. Não houve correlação significativa entre EVA e Pnif. CONCLUSÃO: A aspiração nasal com o método Proetz® melhorou significativamente o quadro clínico de pacientes com sinusite com obstrução nasal, de acordo com a escala visual analógica, o Pnif e o questionário Snot-22. Não foi encontrada correlação entre EVA e Pnif. O estudo confirma a importância de intervenções não farmacológicas no tratamento da sinusite em crianças, resultando em melhoria na sua qualidade de vida.

SUMMARY OBJECTIVE: To characterize the effects of nasal aspiration with Proetz® in peak nasal inspiratory flow (PNIF) in pediatric sinusitis (PS) patients with nasal obstruction. METHODS: This is a non-randomized descriptive-analytical clinical trial with a quantitative approach. The sample comprised 30 children. Initially, the PNIF was measured and the Visual Analogical Scale (VAS) was used for nasal obstruction, followed by the nasal aspiration procedure. The SNOT-22 questionnaire was applied to the legal guardian of each child, and one week later, it was reapplied for the sake of follow-up. RESULTS: 16 (53.3%) patients were females and 14 (46.7%) were males, with an average age of 6.4±1.8 years (between 4 and 10 years of age). Analyses of the VAS for obstruction before the intervention revealed that 10 of the participants (33.3%) presented moderate levels, and 20 of them (66.7%) severe levels. However, after the Proetz® method was applied, all the samples (n=30) had mild levels. The PNIF significantly increased after the technique was used, with an improvement of 23.4% in mean values. There was no significant correlation between the VAS and the PNIF. CONCLUSION: Nasal aspiration with the Proetz® method significantly improved the clinical condition of sinusitis patients with nasal obstruction according to the visual analogical scale, the PNIF, and the SNOT-22 questionnaire. No correlation between the VAS and the PNIF could be found. The study confirms the importance of non-pharmacological interventions in the treatment of sinusitis in children, thus resulting in an improvement in their quality of life.

RESUMO Introdução: A terapia de substituição renal continua associada a altas taxas de hospitalização e baixa qualidade de vida. A morbimortalidade por todas as causas na terapia de substituição renal é superior a 20% ao ano, sendo 44 vezes maior quando a diabetes está presente e mais de 10 vezes a da população em geral. Independentemente do tratamento, a sobrevida em 5 anos é de 40%, superando muitos tipos de câncer. A irisina é um hormônio que converte tecido adiposo branco em tecido adiposo bege, agregando efeitos positivos como o controle de massa gorda, tolerância à glicose, resistência à insulina, prevenção de perda muscular e redução da inflamação sistêmica. Objetivos: Determinar os níveis séricos de troponina I em pacientes em hemodiálise submetidos ao pré-condicionamento isquêmico remoto (PCIR) associado à expressão da irisina. Métodos: Estudo clínico prospectivo, randomizado, duplo-cego, com pacientes com doença renal crônica submetidos à hemodiálise por um período de 6 meses. Os níveis de troponina I, IL-6, uréia, TNF-α e creatinina foram determinados a partir de amostras de sangue. As expressões de irisina, tioredoxina, Nf-kb, GPX4, selenoproteína e GADPH foram também avaliadas por RT-PCR. Resultados: Foram analisadas amostras de 14 pacientes hipertensos, 9 (64,3%) dos quais eram diabéticos tipo 2, com idades entre 44 e 64 anos e 50% de cada gênero. A diferença entre os níveis pré e pós-intervenção de troponina I não foi significativa. Não houve diferenças entre os grupos PCIR e controle, exceto pela IL-6, embora tenha sido observada correlação significativa entre irisina e troponina I. Conclusão: O pré-condicionamento isquêmico remoto não modificou a expressão de irisina ou troponina I, independentemente do tempo de coleta.

ABSTRACT Background: Renal replacement therapy continues to be related to high hospitalization rates and poor quality of life. All-cause morbidity and mortality in renal replacement therapy in greater than 20% per year, being 44 times greater when diabetes is present, and over 10 times that of the general population. Regardless of treatment, the 5-year survival is 40%, surpassing many types of cancers. Irisin is a hormone that converts white adipose tissue into beige adipose tissue, aggregating positive effects like fat mass control, glucose tolerance, insulin resistance, prevention of muscle loss, and reduction in systemic inflammation. Objectives: To determine the serum levels of troponin I in hemodialysis patients submitted to remote ischemic preconditioning (RIPC) associated with irisin expression. Methods: This was a prospective, randomized, double-blind clinical trial with patients with chronic kidney disease submitted to hemodialysis for a 6-month period. Troponin I, IL-6, urea, TNF-α, and creatinine levels were determined from blood samples. The expressions of irisin, thioredoxin, Nf-kb, GPX4, selenoprotein and GADPH were also evaluated by RT-PCR. Results: Samples from 14 hypertensive patients were analyzed, 9 (64.3%) of whom were type 2 diabetics, aged 44-64 years, and 50% of each sex. The difference between pre- and post-intervention levels of troponin I was not significant. No differences were verified between the RIPC and control groups, except for IL-6, although a significant correlation was observed between irisin and troponin I. Conclusion: Remote ischemic preconditioning did not modify irisin or troponin I expression, independent of the time of collection.

Resumo Fundamento: O surgimento da doença cardíaca coronariana aumenta com a menopausa, inatividade física e dislipidemia. Sabe-se que o treinamento físico promove a melhora das funções cardiovasculares Objectivo: Investigar os efeitos do treinamento físico aeróbico sobre o ventrículo esquerdo em camundongos LDL knockout ovariectomizadas. Métodos: Trinta animais foram divididos em 6 grupos (n = 5): controle sedentário não ovariectomizado, controle sedentário ovariectomizado, controle treinado ovariectomizado, sedentário LDL-knockout não ovariectomizado, sedentário LDL-knockout ovariectomizado e treinado LDL-knockout ovariectomizado. Analisamos os parâmetros médios da densidade de volume de fibras colágenas tipo I e III, e metaloproteinases 2 e 9. Valores de p < 0,05 foram considerados significativos. Resultados: Os resultados mostram que o protocolo de exercício proposto alterou o volume de fibras colágenas do tipo I e os parâmetros de remodelamento do colágeno (MMP-2), e ainda reduziu o parâmetro de estresse oxidativo do 8-hidroxi-2’-deoxiganosina (8-OhdG). Conclusão: O treinamento aeróbico de intensidade moderada age sobre o volume das fibras colágenas e sobre o remodelamento de colágeno, com redução do estresse oxidativo em ventrículos esquerdos de camundongos ovariectomizados LDLr Knockout.

Abstract Background: The emergence of coronary heart disease is increased with menopause, physical inactivity and with dyslipidemia. Physical training is known to promote the improvement of cardiovascular functions. Objective: To investigate the effects of aerobic physical training on the left ventricle in ovariectomized LDL knockout mice. Methods: Thirty animals were divided into 6 groups (n = 5): Sedentary non-ovariectomized control; Sedentary ovariectomized control; Trained ovariectomized control; Sedentary non-ovariectomized LDL-knockout, sedentary ovariectomized LDL-knockout and trained ovariectomized LDL-knockout. We analyzed the average parameters of apparent density of collagen fibers types I and III, and metalloproteinase type 2 and type 9, were considered significant p < 0.05. Results: The results showed that the proposed exercise protocol altered the volume of type I collagen fibers, altered collagen remodeling parameters (MMP-2), and also reduced the 8-hydroxy-2’-deoxyguanosine (8OHdG) oxidative stress parameter. Conclusion: Moderate intensity aerobic training acts on collagen fiber volume, on collagen remodeling with the reduction of oxidative stress in the left ventricles of ovariectomized LDL-knockout mice.