SUMMARY OBJECTIVE: The aim of this study was to measure the reliability, internal consistency, and construct validity of the Kidney Symptom Questionnaire for the Brazilian population. METHODS: This is a cross-cultural adaptation and questionnaire validation study. We included native Brazilians of both sex aged>18 years, as well as hypertensive and/or diabetic patients. All participants were assessed using Screening for Occult Renal Disease, EuroQol 5 Dimensions, 36-Item Short Form Survey, and the Kidney Symptom Questionnaire. We used Spearman’s coefficient (rho) to measure the correlations between the Kidney Symptom Questionnaire and other instruments; Cronbach’s alpha to measure internal consistency; and intraclass correlation coefficient, standard error of measurement, and minimum detectable change to measure test-retest reliability. RESULTS: The sample was formed by 121 adult participants, mostly female, with systemic arterial hypertension and/or diabetes mellitus. We found excellent reliability (intraclass correlation coefficient≥0.978), adequate internal consistency (Cronbach’s alpha≥0.860), and adequate construct validity on the Kidney Symptom Questionnaire domains; besides, we observed significant correlations between the Kidney Symptom Questionnaire and other instruments. CONCLUSION: The Brazilian version of the Kidney Symptom Questionnaire has adequate measurement properties to assess chronic/occult kidney disease in patients who do not require renal replacement therapy. OBJECTIVE population METHODS crosscultural cross cultural aged18 aged 18 aged>1 years andor or Disease Dimensions 36Item Item 36 Survey Spearmans Spearman s rho (rho instruments Cronbachs Cronbach testretest test retest RESULTS 12 female mellitus coefficient≥0.978, coefficient0978 coefficient≥0.978 , 0 978 coefficient≥0.978) alpha≥0.860, alpha0860 alpha≥0.860 860 alpha≥0.860) domains besides CONCLUSION chronicoccult chronic occult therapy aged1 1 aged> 3 coefficient097 coefficient≥0.97 97 alpha086 alpha≥0.86 86 coefficient09 coefficient≥0.9 9 alpha08 alpha≥0.8 8 coefficient0 coefficient≥0. alpha0 alpha≥0. coefficient≥0 alpha≥0 coefficient≥ alpha≥

Abstract SARS-CoV-2 is a matter of concern. Here, biosensors were prepared using iron magnetic nanoparticles containing antibodies against the receptor binding domain (RBD) of the spike protein. Antibodies were adsorbed to nanoparticles in three configurations, including direct adsorption without functionalization (DANPs). Nanoparticles were added to a glassy carbon electrode and connected to an electrochemical cell. Electrochemical impedance spectroscopy and ELISA experiments indicated that antibodies were desorbed from the DANPs upon the addition of the RBD. DANPs-based biosensors produced linear curves with decreasing charge transfer resistance due to the removal of antibodies. Thus, a detection method can be based on antibody desorption. SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- concern Here RBD (RBD protein configurations DANPs. . (DANPs) cell DANPsbased Thus desorption SARS-CoV (DANPs

ABSTRACT OBJECTIVE To translate and cross-culturally adapt the COPD in Low- and middle-income countries (LMICs) Assessment (COLA) questionnaire into Brazilian Portuguese, a case-finding instrument for chronic obstructive pulmonary disease (COPD). METHODS Translation and cross-cultural adaptation were completed in six steps: the original version was translated into Brazilian Portuguese by two native speakers of the target language; the translated versions were synthesized; back-translation was performed by two native speakers of the original language; the back-translation and the Brazilian Portuguese version of the COLA were reviewed and harmonized by an expert committee of specialists; and, then, the pre-final version was tested by 30 health professionals who were asked if the items were clear to understand. The acceptability, clarity, and understandability of the translated version were evaluated. A final review of the questionnaire was produced by the authors and approved by the author of the original questionnaire. RESULTS Some idiomatic, semantic, and experiential inconsistencies were identified and properly adjusted. Item 3 was considered the most unclear item (23,3%). Items 7, 8, and 9 presented clarity above 80% (93%, 90%, and 90%, respectively). Suggestions were discussed and incorporated into the tool and COLA was found to be clear and easy to understand. CONCLUSIONS The Brazilian version of the COLA was easily understood by healthcare professionals and adapted to Brazilian culture. Translation and cultural adaptation of the COLA instrument into Brazilian Portuguese can be an important case-finding instrument for chronic obstructive pulmonary disease in Brazil. crossculturally cross culturally Low middleincome middle income LMICs (LMICs (COLA casefinding case finding COPD. . (COPD) crosscultural steps language synthesized backtranslation back translation specialists then prefinal pre understand acceptability evaluated idiomatic semantic adjusted 23,3%. 233 23,3% 23 (23,3%) 7 8 80 93%, 93 (93% 90 90% respectively. respectively respectively) culture Brazil (COPD 23,3 2 (23,3% 93% (93 23, (23,3 (9 (23, ( (23 (2

Abstract In order to know the morphological variations of Goyazana castelnaui, we conducted an ontogenetic study from the first crab stage to the adult stage using geometric morphometry. We studied 36 females, 43 males and 162 juveniles collected in the Pajeú River, Brazil. We photographed crabs’ carapace, pleon and right cheliped with they arranged parallel to the plane, afterwards landmarks and semi-landmarks were strategically distributed in the images. Through principal components analysis, we observed that the variation occurred mainly in the frontal and posterior region of the carapace. The pleon presented marked variations in the posterior and anterolateral region, while chelipeds presented greater variations at the base of the fixed finger. The canonical variation between sexes and between juveniles and adults (p<0.05) varied significantly. Correct allocations obtained by discriminant analysis (p<0.05) varied between 89.3% and 100.0%. The carapace shows a constant dimorphism along the ontogenetic trajectory, and both sexes reach similar centroid sizes (p>0.05). While the pleon and the cheliped, both sexes are similar when juvenile, diverging along the trajectory and reaching different centroid sizes (p<0.05). Females have a larger pleon and males a larger cheliped, corroborating the monophyletic theory of Brachyura. castelnaui morphometry 3 females 4 16 River Brazil crabs plane semilandmarks semi images finger p<0.05 p005 p 0 05 (p<0.05 significantly 893 89 89.3 1000 100 100.0% p>0.05. p>0.05 . (p>0.05) juvenile p<0.05. Brachyura 1 p<0.0 p00 (p<0.0 8 89. 10 100.0 p>0.0 (p>0.05 p<0. p0 (p<0. 100. p>0. (p>0.0 p<0 (p<0 p>0 (p>0. p< (p< p> (p>0 (p (p>

Abstract Background Prediabetes (PD) is defined as impaired fasting glucose and/or impaired glucose tolerance (IGT) and may be associated with high risk of cardiovascular injury. It is recommended that PD patients be screened for signs of arterial stiffness and cardiovascular injury to reinforce therapeutic strategies. Objectives To identify pulse wave velocity values discriminative for arterial stiffness and cardiovascular injury in PD patients. Methods A cross-sectional study was conducted with PD (N=43) and normoglycemic (N=37) patients who underwent clinical evaluation, arterial stiffness assessment by carotid-femoral pulse wave velocity (cfPWV) using SphygmoCor, laboratory blood analysis, investigation of morphological and functional cardiac variables by transthoracic echocardiogram, and assessment of carotid intima-media-thickness (CIMT) by carotid ultrasonography. A statistical analysis was performed using SPSS software and values of p<0.05 were considered significant. Results A cfPWV cut-off value of 6.9 m/s was identified for IGT (Sensitivity [SE]: 74% and Specificity [SP]: 51%). Comparison of general data and risk factors between subsets with values above and below this cutoff value revealed higher rates of fasting glucose (p=0.02), obesity (p=0.03), dyslipidemia (p=0.004), early signs of left ventricle (p=0.017) and right ventricle (p=0.03) impaired diastolic function, and elevated CIMT in subjects with cfPWV ≥ 6.9m/s (p=0.04). Conclusions In PD patients, a cfPWV cutoff of 6.9 m/s was considered a discriminative value for arterial stiffness. These findings highlight the value of early investigation of cardiovascular injury and aggressive therapy strategies with good control of risk factors in PD. (PD andor or (IGT crosssectional cross sectional N=43 N43 N 43 (N=43 N=37 N37 37 (N=37 evaluation carotidfemoral femoral (cfPWV SphygmoCor echocardiogram intimamediathickness intima media thickness (CIMT ultrasonography p005 p 0 05 p<0.0 significant cut off 69 6 9 6. ms m s Sensitivity SE [SE] 74 SP [SP] 51%. 51 51% . 51%) p=0.02, p002 p=0.02 , 02 (p=0.02) p=0.03, p003 p=0.03 03 p=0.004, p0004 p=0.004 004 (p=0.004) p=0.017 p0017 017 (p=0.017 (p=0.03 function 69ms 9m p=0.04. p004 p=0.04 04 (p=0.04) N=4 N4 4 (N=4 N=3 N3 3 (N=3 p00 p<0. [SE 7 [SP 5 p=0.0 (p=0.02 p000 p=0.00 00 (p=0.004 p=0.01 p001 01 (p=0.01 (p=0.0 (p=0.04 N= (N= p0 p<0 p=0. (p=0.00 (p=0. (N p< p=0 (p=0 p= (p= (p

Resumo Contexto O pré-diabetes (PD) é definido como glicemia de jejum alterada e/ou tolerância à glicose alterada (TGA) e pode estar associado a alto risco de lesão cardiovascular. Recomenda-se discriminar quais pacientes com PD podem apresentar sinais de rigidez arterial e lesão cardiovascular para reforçar as estratégias terapêuticas. Objetivos Identificar os valores discriminativos da velocidade de onda de pulso determinantes de rigidez arterial e lesão cardiovascular em pacientes com PD. Métodos Estudo transversal em pacientes com PD (N=43) e normoglicêmicos (N=37) submetidos a avaliação clínica, avaliação da rigidez arterial pela velocidade da onda de pulso carótido-femoral (cfPWV) utilizando SphygmoCor, análise laboratorial de sangue, investigação de alterações morfológicas e variáveis cardíacas funcionais por ecocardiograma transtorácico e avaliação da espessura íntima-média carotídea (EIMC) pela ultrassonografia da carótida. A análise estatística foi realizada no software SPSS, e valores de p<0,05 foram considerados significativos. Resultados Foi identificado um valor de corte cfPWV de 6,9 m/s para TGA (sensibilidade 74% e especificidade 51%). A comparação dos dados e fatores de risco entre valores acima e abaixo do valor de corte estabelecido revelou glicemia de jejum elevada (p=0,02), obesidade (p=0,03), dislipidemia (p=0,004), sinais precoces de função diastólica prejudicada do ventrículo esquerdo (p=0,017) e ventrículo direito (p=0,03) e maior EIMC em cfPWV ≥6,9m/s (p=0,04). Conclusões Em pacientes com PD, o cfPWV de 6,9 m/s foi considerado um valor discriminativo de rigidez arterial. Esses achados reforçam que a investigação precoce da lesão cardiovascular e uma estratégia com terapia agressiva são valiosas no controle dos fatores de risco na PD. prédiabetes pré diabetes (PD eou ou (TGA Recomendase Recomenda se terapêuticas N=43 N43 N 43 (N=43 N=37 N37 37 (N=37 clínica carótidofemoral carótido femoral (cfPWV SphygmoCor sangue íntimamédia íntima média (EIMC carótida SPSS p005 p 0 05 p<0,0 significativos 69 6 9 6, ms m s sensibilidade 74 51%. 51 51% . 51%) p=0,02, p002 p=0,02 , 02 (p=0,02) p=0,03, p003 p=0,03 03 p=0,004, p0004 p=0,004 004 (p=0,004) p=0,017 p0017 017 (p=0,017 (p=0,03 69ms 9m p=0,04. p004 p=0,04 04 (p=0,04) N=4 N4 4 (N=4 N=3 N3 3 (N=3 p00 p<0, 7 5 p=0,0 (p=0,02 p000 p=0,00 00 (p=0,004 p=0,01 p001 01 (p=0,01 (p=0,0 (p=0,04 N= (N= p0 p<0 p=0, (p=0,00 (p=0, (N p< p=0 (p=0 p= (p= (p

Abstract Background Self-care in the management of systemic arterial hypertension (SAH) is crucial, and validated instruments can help researchers and health professionals to plan strategies to improve self-care in people with SAH. Objective The main objective of this study was to translate, cross-culturally adapt, and validated the Hypertension Self-Care Profile (HBP-SCP) for Brazilian Portuguese. Methods The translation and cross-cultural adaptation was performed in five phases, and the pre-final version was tested in 30 individuals, native speakers of Portuguese with a diagnosis of hypertension. The final version was administered in 100 individuals. The inclusion criteria were: diagnosis of SAH, characterized by systolic arterial blood pressure ≥ 140 mmHg and/or diastolic arterial blood pressure ≥ 90mmHg, regular use of antihypertensive medications and over 18 years of age. The present study also used two other questionnaires, previously validated for the Brazilian population, to verify the validity of the construct, the Healthy Habits Perception Questionnaire (HHPQ) and the Quality of Life in Hypertension Mini-Questionnaire (MINICHAL-BRASIL). Results During the translation and cross-cultural adaptation phase, there were no disagreements. Adequate reliability — intraclass correlation coefficient (ICC) ≥ 0.89, standard error of measurement (SEM) % ≤ 4.34, minimum detectable change (MDC) % ≤ 12.04 — and internal consistency (Cronbach's alpha ≥ 0.75) were observed. The behavior domain of HBP-SCP obtained significant correlations (p < 0.05) with the self-efficacy domain and HHPQ; the motivation domain with the self-efficacy domain; and the self-efficacy domain with the somatic manifestation domain of MINICHAL-BRASIL. No ceiling and floor effects were observed. Conclusions The Brazilian Portuguese version of the HBP-SCP has adequate psychometric properties, according to the best scientific recommendations. Selfcare Self care SAH (SAH crucial selfcare self translate crossculturally cross culturally adapt SelfCare Care HBPSCP HBP SCP (HBP-SCP crosscultural cultural phases prefinal pre 3 individuals 10 14 andor or 90mmHg 1 age questionnaires population construct HHPQ (HHPQ MiniQuestionnaire Mini MINICHALBRASIL. MINICHALBRASIL MINICHAL BRASIL . (MINICHAL-BRASIL) phase disagreements ICC (ICC 089 0 89 0.89 SEM (SEM 434 4 34 4.34 MDC (MDC 1204 12 04 12.0 Cronbachs Cronbach s 0.75 075 75 observed p 0.05 005 05 selfefficacy efficacy BRASIL. MINICHAL-BRASIL properties recommendations (MINICHAL-BRASIL 08 8 0.8 43 4.3 120 12. 0.7 07 7 0.0 00 0. 4.

ABSTRACT OBJECTIVE To translate and cross-culturally adapt the COPD in Low- and middle-income countries (LMICs) Assessment (COLA) questionnaire into Brazilian Portuguese, a case-finding instrument for chronic obstructive pulmonary disease (COPD). METHODS Translation and cross-cultural adaptation were completed in six steps: the original version was translated into Brazilian Portuguese by two native speakers of the target language; the translated versions were synthesized; back-translation was performed by two native speakers of the original language; the back-translation and the Brazilian Portuguese version of the COLA were reviewed and harmonized by an expert committee of specialists; and, then, the pre-final version was tested by 30 health professionals who were asked if the items were clear to understand. The acceptability, clarity, and understandability of the translated version were evaluated. A final review of the questionnaire was produced by the authors and approved by the author of the original questionnaire. RESULTS Some idiomatic, semantic, and experiential inconsistencies were identified and properly adjusted. Item 3 was considered the most unclear item (23,3%). Items 7, 8, and 9 presented clarity above 80% (93%, 90%, and 90%, respectively). Suggestions were discussed and incorporated into the tool and COLA was found to be clear and easy to understand. CONCLUSIONS The Brazilian version of the COLA was easily understood by healthcare professionals and adapted to Brazilian culture. Translation and cultural adaptation of the COLA instrument into Brazilian Portuguese can be an important case-finding instrument for chronic obstructive pulmonary disease in Brazil.

ABSTRACT Objective: To investigate the influence of a passive mobilization session on endothelial function in patients with sepsis. Methods: This was a quasi-experimental double-blind and single-arm study with a pre- and postintervention design. Twenty-five patients with a diagnosis of sepsis who were hospitalized in the intensive care unit were included. Endothelial function was assessed at baseline (preintervention) and immediately postintervention by brachial artery ultrasonography. Flow mediated dilatation, peak blood flow velocity and peak shear rate were obtained. Passive mobilization consisted of bilateral mobilization (ankles, knees, hips, wrists, elbows and shoulders), with three sets of ten repetitions each, totaling 15 minutes. Results: After mobilization, we found increased vascular reactivity function compared to preintervention: absolute flow-mediated dilatation (0.57mm ± 0.22 versus 0.17mm ± 0.31; p < 0.001) and relative flow-mediated dilatation (17.1% ± 8.25 versus 5.08% ± 9.16; p < 0.001). Reactive hyperemia peak flow (71.8cm/s ± 29.3 versus 95.3cm/s ± 32.2; p < 0.001) and shear rate (211s ± 113 versus 288s ± 144; p < 0.001) were also increased. Conclusion: A passive mobilization session increases endothelial function in critical patients with sepsis. Future studies should investigate whether a mobilization program can be applied as a beneficial intervention for clinical improvement of endothelial function in patients hospitalized due to sepsis. Objective Methods quasiexperimental quasi experimental doubleblind double blind singlearm single arm pre design Twentyfive Twenty five included preintervention (preintervention ultrasonography obtained ankles, ankles (ankles knees hips wrists shoulders, shoulders , shoulders) each 1 minutes Results flowmediated 0.57mm 057mm mm 0 57mm 022 22 0.2 017mm 17mm 0.31 031 31 0.001 0001 001 17.1% 171 17 (17.1 825 8 25 8.2 508 5 08 5.08 9.16 916 9 16 0.001. . 71.8cm/s 718cms cms 71 8cm s cm 293 29 3 29. 953cms 95 3cm 32.2 322 32 2 211s 11 144 Conclusion 02 0. 0.3 03 0.00 000 00 17.1 (17. 82 8. 50 5.0 9.1 91 7 32. 14 0.0 17. (17 5. 9. (1 (

RESUMO Objetivo: Investigar a influência de uma sessão de mobilização passiva na função endotelial de pacientes com sepse. Métodos: Este foi um estudo quase-experimental duplo-cego e de braço único com desenho pré e pós-intervenção. Participaram 25 pacientes com diagnóstico de sepse hospitalizados em unidade de terapia intensiva. Avaliou-se a função endotelial basal (pré-intervenção) e imediatamente pós-intervenção por meio de ultrassonografia da artéria braquial. Foram obtidas a dilatação mediada pelo fluxo, a velocidade pico de fluxo sanguíneo e a taxa de cisalhamento pico. A mobilização passiva consistiu na mobilização bilateral (tornozelos, joelhos, quadris, pulsos, cotovelos e ombros), com três séries de dez repetições cada, totalizando 15 minutos. Resultados: Após a mobilização, encontramos aumento da função de reatividade vascular em relação à pré-intervenção: dilatação mediada pelo fluxo absoluta (0,57mm ± 0,22 versus 0,17mm ± 0,31; p < 0,001) e dilatação mediada pelo fluxo relativa (17,1% ± 8,25 versus 5,08% ± 9,16; p < 0,001). O pico de fluxo sanguíneo na hiperemia (71,8cm/s ± 29,3 versus 95,3cm/s ± 32,2; p < 0,001) e a taxa de cisalhamento (211s ± 113 versus 288s ± 144; p < 0,001) também aumentaram. Conclusão: Uma sessão de mobilização passiva foi capaz de aumentar a função endotelial em pacientes graves com sepse. Estudos futuros são necessários para investigar se um programa de mobilização pode ser aplicado como intervenção benéfica para melhorar clinicamente a função endotelial em pacientes hospitalizados por sepse. Objetivo Métodos quaseexperimental quase experimental duplocego duplo cego pósintervenção. pósintervenção pós intervenção. 2 intensiva Avaliouse Avaliou préintervenção (pré-intervenção braquial tornozelos, tornozelos (tornozelos joelhos quadris pulsos ombros, ombros , ombros) cada 1 minutos Resultados pré-intervenção 0,57mm 057mm mm 0 57mm 022 22 0,2 017mm 17mm 0,31 031 31 0,001 0001 001 17,1% 171 17 (17,1 825 8 8,2 508 5 08 5,08 9,16 916 9 16 0,001. . 71,8cm/s 718cms cms 71 8cm s cm 293 29 3 29, 953cms 95 3cm 32,2 322 32 211s 11 144 aumentaram Conclusão 02 0, 0,3 03 0,00 000 00 17,1 (17, 82 8, 50 5,0 9,1 91 7 32, 14 0,0 17, (17 5, 9, (1 (

SUMMARY OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20–30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06–0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48–0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

Abstract The number of deaths from COVID-19 is closely associated with multimorbidities. This study aimed to review the clinical and functional conditions of patients who recovered from COVID-19. Additionally, identify the relationship with risk factors and comorbidities. Systemic arterial hypertension (SAH) was more frequently observed in patients with severe COVID-19. Diabetes mellitus (DM) is one of the comorbidities that has contributed the most to the increase in the number of hospitalizations due to complications and the number of deaths due to infection by COVID-19. Obesity has been shown to be a risk factor for hospitalization in patients with COVID-19 under 60 years of age. Most survivors of COVID-19 suffer primarily from muscle fatigue or weakness. In addition, patients who were more seriously ill during their hospital stay have greater impairment of functional capacity, pulmonary diffusion and fatigue symptoms, and are the main target population for long-term recovery interventions. To optimize the post-hospitalization rehabilitation of patients after discharge from COVID-19, the need for multidisciplinary work in rehabilitation, the reinforcement of public policies to ensure equity in access to the public health system and training should be considered of the health team in view of the new demands and realities generated by COVID-19.

Resumo O número de mortes por COVID-19 está intimamente associado a multimorbidades. O presente estudo teve como objetivo revisar as condições clínicas e funcionais de pacientes que se recuperaram da COVID-19. Adicionalmente, identificar a relação com fatores de risco e comorbidades. A hipertensão arterial sistêmica (HAS) foi observada com mais frequência em pacientes com COVID-19 grave. O diabetes mellitus (DM) é uma das comorbidades que mais tem contribuído para o aumento do número de internações por complicações e do número de óbitos por infecção por COVID-19. A obesidade demonstrou ser um fator de risco para hospitalização em pacientes com COVID-19 com menos de 60 anos. A maioria dos sobreviventes da COVID-19 sofre principalmente de fadiga ou fraqueza muscular. Além disso, os pacientes que estiveram mais gravemente enfermos durante sua internação hospitalar apresentam maior prejuízo da capacidade funcional, pior difusão pulmonar e sintomas de fadiga, sendo assim a população-alvo para intervenções de recuperação a longo prazo.. Para otimizar a reabilitação pós-hospitalização de pacientes após alta por COVID-19, deve-se considerar a necessidade de trabalho multiprofissional na reabilitação, o reforço das políticas públicas para garantir a equidade no acesso ao sistema público de saúde e o treinamento da equipe de saúde frente às novas demandas e realidades geradas pelo COVID-19.

Resumo O número de mortes por COVID-19 está intimamente associado a multimorbidades. O presente estudo teve como objetivo revisar as condições clínicas e funcionais de pacientes que se recuperaram da COVID-19. Adicionalmente, identificar a relação com fatores de risco e comorbidades. A hipertensão arterial sistêmica (HAS) foi observada com mais frequência em pacientes com COVID-19 grave. O diabetes mellitus (DM) é uma das comorbidades que mais tem contribuído para o aumento do número de internações por complicações e do número de óbitos por infecção por COVID-19. A obesidade demonstrou ser um fator de risco para hospitalização em pacientes com COVID-19 com menos de 60 anos. A maioria dos sobreviventes da COVID-19 sofre principalmente de fadiga ou fraqueza muscular. Além disso, os pacientes que estiveram mais gravemente enfermos durante sua internação hospitalar apresentam maior prejuízo da capacidade funcional, pior difusão pulmonar e sintomas de fadiga, sendo assim a população-alvo para intervenções de recuperação a longo prazo.. Para otimizar a reabilitação pós-hospitalização de pacientes após alta por COVID-19, deve-se considerar a necessidade de trabalho multiprofissional na reabilitação, o reforço das políticas públicas para garantir a equidade no acesso ao sistema público de saúde e o treinamento da equipe de saúde frente às novas demandas e realidades geradas pelo COVID-19.

Abstract The number of deaths from COVID-19 is closely associated with multimorbidities. This study aimed to review the clinical and functional conditions of patients who recovered from COVID-19. Additionally, identify the relationship with risk factors and comorbidities. Systemic arterial hypertension (SAH) was more frequently observed in patients with severe COVID-19. Diabetes mellitus (DM) is one of the comorbidities that has contributed the most to the increase in the number of hospitalizations due to complications and the number of deaths due to infection by COVID-19. Obesity has been shown to be a risk factor for hospitalization in patients with COVID-19 under 60 years of age. Most survivors of COVID-19 suffer primarily from muscle fatigue or weakness. In addition, patients who were more seriously ill during their hospital stay have greater impairment of functional capacity, pulmonary diffusion and fatigue symptoms, and are the main target population for long-term recovery interventions. To optimize the post-hospitalization rehabilitation of patients after discharge from COVID-19, the need for multidisciplinary work in rehabilitation, the reinforcement of public policies to ensure equity in access to the public health system and training should be considered of the health team in view of the new demands and realities generated by COVID-19.

RESUMO Objetivo: Pacientes com DPOC são propensos a remodelamento cardíaco; no entanto, pouco se sabe sobre a função cardíaca em pacientes em recuperação de exacerbação aguda da DPOC (EADPOC) e sua associação com a capacidade de exercício. O objetivo deste estudo foi avaliar a função e estrutura cardíaca e comparar sua relação com a capacidade de exercício em pacientes com EADPOC recente e pacientes com DPOC clinicamente estável. Métodos: Estudo transversal com 40 pacientes com DPOC divididos igualmente em dois grupos: grupo EADPOC recente (GEA) e grupo DPOC clinicamente estável (GCE). Realizou-se ecocardiografia para avaliar a função cardíaca e a estrutura das câmaras. A distância percorrida no teste de caminhada de seis minutos (DTC6) e o Duke Activity Status Index (Vo2 estimado) foram utilizados para avaliar a capacidade de exercício. Resultados: Não foram encontradas diferenças significativas na função e estrutura cardíaca entre os grupos. A DTC6 apresentou associação com a razão entre as velocidades de enchimento diastólico mitral precoce e tardia (r = 0,50; p < 0,01), a espessura da parede posterior do ventrículo esquerdo (r = −0,33; p = 0,03) e o índice de volume do átrio direito (r = −0,34; p = 0,04), enquanto o Vo2 apresentou associação com o índice de volume do átrio direito (r = −0,40; p = 0,02). Conclusões: Independentemente da condição clínica (EADPOC recente vs. DPOC estável), a função e estrutura cardíaca eram semelhantes entre os grupos, e a capacidade de exercício (determinada pela DTC6 e pelo Vo2) apresentou associação com as características cardíacas.

ABSTRACT Objective: Patients with COPD are prone to cardiac remodeling; however, little is known about cardiac function in patients recovering from an acute exacerbation of COPD (AECOPD) and its association with exercise capacity. The aim of this study was to evaluate the cardiac function and structure and to compare their relationship with exercise capacity in patients with a recent AECOPD and patients with clinically stable COPD. Methods: This was a cross-sectional study including 40 COPD patients equally divided into two groups: recent AECOPD group (AEG) and clinically stable COPD group (STG). Echocardiography was performed to assess cardiac function and chamber structure. The six-minute walk distance (6MWD) and the Duke Activity Status Index (estimated Vo2) were used in order to assess exercise capacity. Results: No significant differences in cardiac function and structure were found between the groups. The 6MWD was associated with early/late diastolic mitral filling velocity ratio (r = 0.50; p < 0.01), left ventricular posterior wall thickness (r = −0.33; p = 0.03), and right atrium volume index (r = −0.34; p = 0.04), whereas Vo2 was associated with right atrium volume index (r = −0.40; p = 0.02). Conclusions: Regardless of the clinical condition (recent AECOPD vs. stable COPD), the cardiac function and structure were similar between the groups, and exercise capacity (determined by the 6MWD and Vo2) was associated with cardiac features.

Abstract Objective To evaluate objective criteria of Magnetic Resonance Imaging (MRI) of Placenta Accreta Spectrum disorder (PAS) analyzing interobserver agreement and to derive a model including imaging and clinical variables to predict PAS. Methods A retrospective review including patients submitted to MRI with suspicious findings of PAS on ultrasound. Exclusion criteria were lack of pathology or surgical information and missing or poor-quality MRI. Two radiologists analyzed six MRI features, and significant clinical data were also recorded. PAS confirmed on pathology or during intraoperative findings were considered positive for the primary outcome. Variables were tested through logistic regression models. Results Final study included 96 patients with a mean age of 33 years and 73.0% of previous C-sections. All MRI features were significantly associated with PAS for both readers. After logistic regression fit, including MRI signs with a moderate or higher interobserver agreement, intraplacental T2 dark band was the most significant radiologic criteria, and ROC analysis resulted in an AUC = 0.782. After including the most relevant clinical data (previous C-section) to the model, the ROC analysis improved to an AUC = 0.893. Conclusion Simplified objective criteria on MRI, including intraplacental T2 dark band associated with clinical information of previous C-sections, had the highest accuracy and was used for a predictive model of PAS.

ABSTRACT Objective To evaluate the standards of practice of Brazilian cataract surgeons in relation to the protective measures adopted to mitigate the risks of transmission of COVID-19 during cataract surgery, in asymptomatic patients. Methods A descriptive, cross-sectional, quantitative paradigm study, developed from a self-administered electronic questionnaire sent to ophthalmologists and residents/specialists in ophthalmology in Brazil, who performed cataract surgeries in 2019 and 2020, connected through social media and mail listing from local societies. Results Of the 303 participating surgeons, 159 (n=52.2%) performed elective cataract surgeries between March 20th, 2020 to June 1st, 2020. Among the measures adopted by ophthalmologists with the purpose of preventing viral transmission, the patient’s temperature was measured by 84.3% (n=134), and the verification of respiratory symptoms and contact/exposure to cases of COVID-19 by 87.4% (n=139). Most did not submit their patients to laboratory tests to detect COVID-19 (145; 91.2%). In surgery, 44.7% (n=71) used an N95 mask, and 69.2% (n=110) kept their patients with a mask. No stage of phacoemulsification was modified in 144 (90.6%) participants, 13 (8.2%) added methylcellulose under the main incision, and two (1.3%), modified another surgical stage. Conclusion The COVID-19 pandemic significantly interrupted part of cataract surgeries in Brazil from March to June 2020 and measures to prevent viral spread are being heterogeneously adopted by surgeons. Understanding these measures could be the first step to improve strategies to return to pre-pandemic levels.

Abstract: The aim of the study was to evaluate the perception and satisfaction of body image of university students and the association with nutritional status. Cross-sectional study, carried out with university students of both sexes, enrolled in health courses, in the city of Fortaleza, Ceará. A questionnaire was applied with questions related to gender, age, race / skin colour, family income, physical activity and image evaluation. Weight, height, waist circumference and hip circumference were measured. The weight condition was classified based on the Body Mass Index and Waist-Hip Ratio. Body image was investigated using the Adult Silhouettes Scale and for the assessment of body distortion, the values of the "current" and real body mass index were used. Pearson's Chi-square tests and Poisson regression were used to assess possible associations between variables (p < 0.05). Of the 388 university students, 15.2% were satisfied with their body image and 77.3% showed distortion, 33.5% wanted to be bigger and 51.3% wanted to be smaller than they appeared. College students had a high prevalence of distortion (77.3%) and dissatisfaction (84.8%) with their body image. Overweight and abdominal obesity were associated with both distortion and dissatis-faction with body image. Dissatisfaction and distortion of body image are associated with the nutritional status of university students, being more evident in females.

Resumo: O objetivo do presente estudo foi avaliar a percepção e a satisfação da imagem corporal de universitários e sua associação com o estado nutricional. Estudo transversal, realizado com universitários de ambos os sexos, matriculados nos cursos de saúde, no município de Fortaleza, Ceará. Aplicou-se questionário com questões relativas ao sexo, idade, raça/cor da pele, renda familiar, prática de atividade física e avaliação da imagem. Foram aferidas medidas de peso, altura, circunferências da cintura e circunferência do quadril. A condição de peso foi classificada com base no Índice de Massa Corporal e Relação Cintura-Quadril. A imagem corporal foi investigada através da Escala de Silhuetas para Adultos e para a avaliação da distorção corporal, utilizou-se os valores do Índice de massa corporal “atual” e real. Utilizou-se os testes do Qui-quadrado de Pearson e a regressão de Poisson para avaliar as possíveis associações entre variáveis. Dos 388 universitários, 15,2% estavam satisfeitos com sua imagem corporal e 77,3% apresentou distorção da mesma. O excesso de peso e a obesidade abdominal estiveram associados tanto à distorção como à insatisfação com a imagem corporal. A insatisfação e a distorção da imagem corporal estão associadas ao estado nutricional dos universitários.