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ABSTRACT Purpose: To compare the differences between the apparent and actual chord μ. Methods: In this prospective, comparative, non-randomized, and non-interventional study, imaging examinations using Pentacam and the HD Analyzer were performed in the same room under the same scotopic conditions. The inclusion criteria were patients aged 21-71 years, able to provide informed consent, myopia up to 4D, and anterior topographic astigmatism up to 1D. Patients using contact lenses, those with previous eye diseases or surgeries, corneal opacities, corneal tomographic changes, or suspected keratoconus were excluded. Results: Altogether, 116 eyes of 58 patients were analyzed. The patients’ mean age was 30.69 (±7.85) years. In the correlation analyses, Pearson’s correlation coefficient of 0.647 indicates a moderate positive linear relationship between apparent and actual chord μ. The mean actual and apparent chord μ were 226.21 ± 128.53 and 278.66 ± 123.90 μm, respectively, with a mean difference of 52.45 μm (p=0.01). The analysis of mean pupillary diameter resulted in 5.76 mm using the HD Analyzer and 3.31 mm using the Pentacam. Conclusions: We found a correlation between the two measurement devices, and even though we found considerable differences, both can be used in daily practice. Given their differences, we should respect their peculiarities as well.

RESUMO Objetivo: Comparar as diferenças entre a chord aparente μ e o chord real μ. Métodos: Estudo prospectivo, comparativo, não randomizado e não intervencionista. Os exames de imagem (Pentacam e HD Analyzer) foram realizados na mesma sala e nas mesmas condições escotópicas. Os critérios de inclusão foram idade de 21 a 71 anos; compreensão do termo de consentimento; miopia até 4D e astigmatismo topográfico anterior até 1D. Os critérios de exclusão foram usuários de lentes de contato; pacientes com doenças oculares prévias ou cirurgias; opacidades da córnea; a presença de alterações tomográficas da córnea ou suspeita de ceratocone. Resultados: Em nosso estudo foram analisados 116 olhos de 58 pacientes. A média de idade foi de 30,69 anos (± 7,85). Análises de correlação foram desenvolvidas e o coeficiente de correlação de Pearson (0,647) indica uma relação linear positiva moderada entre as variáveis. A média do chord μ real foi 226,21 ± 128,53 μm e a média do chord μ média foi 278,66 ± 123,90 μm, com diferença média de 52,45 μm (p=0,01). A análise do diâmetro pupilar médio apresentou: 5,76mm no HD Analyzer e 3,31mm no Pentacam. Conclusões: Entendemos a existência de uma diferença significativa entre os métodos e assim a medida de ambos os dispositivos com base em princípios diferentes devemos respeitar suas peculiaridades. Como encontramos correlação entre as duas medidas, acreditamos que ambas podem ser utilizadas na prática diária.

https://doi.org/10.5935/0004-2749.2022-0035

Blastoma Pleuropulmonar de presentación antenatal asociado a Síndrome DICER1: diagnóstico diferencial de Malformación Pulmonar Congénita
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Catán Valenzuela, Catalina

; Vargas Innocenti, Paula

; Hachim Gutierrez, Aquiles

; Jorquera Pinto, Pablo

; Claverie Ramos, Ximena

; Carrasco Gaete, Ruby

; Flores Catalán, Álvaro

; Alarcon Arias, Pablo

; Campos Varas, José

Andes pediatrica

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Dez 2023, Volume 94 Nº 6 Páginas 729 - 735

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: Pleuropulmonary blastoma (PPB) is the most common pediatric malignant primary lung tumor. It’s associated with the DICER1 gene pathogenic germline variants. Antenatal presentation is infrequent and poses a challenge in the differential diagnosis of congenital pulmonary airway malformation (CPAM). Objective: to report a case of unusual presentation of PPB associated with DICER1 syndrome and to describe the difficulty in differentiating it from CPAM. Clinical Case: Male patient with prenatal diagnosis of hypervascular left lung lesion, with mediastinal shift and progressive growth, initially interpreted as CPAM. He was born at 38 weeks, requiring transitory treatment with positive pressure due to ventilatory impairment. A CT scan with contrast showed a large multilocular cystic mass containing air causing mass effect, requiring open left upper lobectomy. Histology results were compatible with type I PPB, with negative margins, and positive genetic study for DICER1 syndrome. Seven weeks post-resection, an aerial image was detected in the upper left side of the chest, with progressive growth, requiring a new tumor resection and upper segmentectomy, with biopsy corresponding to recurrence of type I PPB with negative margins. He received adjuvant treatment with chemotherapy, with follow-up for 2 years, remaining asymptomatic, without recurrence, and with negative screening for other neoplasms associated with DICER1 syndrome. Among the family history, the mother had papillary thyroid cancer and tested positive for the mutation. Conclusion: PPB is a rare cancer, difficult to distinguish from CPAM, especially in its antenatal presentation. Nowing its association with DICER1 syndrome and performing a genetic study are key to the early detection of BPP and the search for other tumors associated with the syndrome.

Resumen: El blastoma pleuropulmonar (BPP) es el tumor pulmonar primario maligno pediátrico más común. Se asocia a variantes patogénicas de línea germinal del gen DICER1. La presentación antenatal es infrecuente y determina un desafío en el diagnóstico diferencial de malformación pulmonar congénita (MPC). Objetivo: comunicar un caso de presentación inhabitual de BPP asociado a síndrome DICER1 y describir la dificultad en diferenciarlo de MPC. Caso Clínico: Paciente masculino con diagnóstico antenatal de lesión pulmonar izquierda hipervascularizada, con desplazamiento medias- tínico y crecimiento progresivo, interpretada como MPC. Nació de 38 semanas y progresó con deterioro ventilatorio. La Tomograña Computada (TC) con contraste mostró una extensa masa quística multilocular con contenido aéreo con efecto de masa. Se realizó lobectomía superior izquierda abierta. La histología fue compatible con BPP tipo I, con bordes negativos y estudio genético para DICER1 positivo. Siete semanas post-resección se pesquisó imagen aérea en la parte superior del tórax izquierdo, requiriendo nueva resección tumoral y segmentectomía superior, con biopsia correspondiente a recidiva de BPP tipo 1 con bordes negativos. Recibió tratamiento adyuvante con quimioterapia, con seguimiento por 2 años, manteniéndose asintomático, sin nuevas recidivas, screening negativo para otras neoplasias asociadas a DICER1. Entre los antecedentes familiares, destacaba cáncer papilar de tiroides de la madre, quien resultó positiva para la mutación. Conclusión: el BPP es un cáncer poco frecuente, siendo difícil distinguirlo de MPC, especialmente en su presentación antenatal. Conocer su asociación al Síndrome DICER1 y hacer estudio genético son claves para detectar precozmente el BPP y buscar otros tumores asociados al síndrome.

https://doi.org/10.32641/andespediatr.v94i6.4663

Dapagliflozin in patients with critical illness: rationale and design of the DEFENDER study
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Tavares, Caio de Assis Moura

; Azevedo, Luciano César Pontes de

; Rea-Neto, Álvaro

; Campos, Niklas Söderberg

; Amendola, Cristina Prata

; Bergo, Ricardo Reinaldo

; Kozesinski-Nakatani, Amanda Christina

; David-João, Paula Geraldes

; Westphal, Glauco Adrieno

; Guimarães Júnior, Mário Roberto Rezende

; Lobo, Suzana Margareth Ajeje

; Tavares, Marcos Soares

; Dracoulakis, Marianna Deway Andrade

; Souza, Guilherme Martins de

; Almeida, Guacyra Margarita Batista de

; Gebara, Otavio Celso Eluf

; Tomba, Pablo Oscar

; Albuquerque, Camila Santos N

; Silva, Mariana Castaldi Ramalho

; Pereira, Adriano José

; Damiani, Lucas Petri

; Corrêa, Thiago Domingos

; Serpa-Neto, Ary

; Berwanger, Otavio

; Zampieri, Fernando Godinho

Critical Care Science

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Set 2023, Volume 35 Nº 3 Páginas 256 - 265

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Background: Critical illness is a major ongoing health care burden worldwide and is associated with high mortality rates. Sodium-glucose cotransporter-2 inhibitors have consistently shown benefits in cardiovascular and renal outcomes. The effects of sodium-glucose cotransporter-2 inhibitors in acute illness have not been properly investigated. Methods: DEFENDER is an investigator-initiated, multicenter, randomized, open-label trial designed to evaluate the efficacy and safety of dapagliflozin in 500 adult participants with acute organ dysfunction who are hospitalized in the intensive care unit. Eligible participants will be randomized 1:1 to receive dapagliflozin 10mg plus standard of care for up to 14 days or standard of care alone. The primary outcome is a hierarchical composite of hospital mortality, initiation of kidney replacement therapy, and intensive care unit length of stay, up to 28 days. Safety will be strictly monitored throughout the study. Conclusion: DEFENDER is the first study designed to investigate the use of a sodium-glucose cotransporter-2 inhibitor in general intensive care unit patients with acute organ dysfunction. It will provide relevant information on the use of drugs of this promising class in critically ill patients. ClinicalTrials.gov registry: NCT05558098

RESUMO Antecedentes: A doença crítica é um importante ônus permanente da assistência médica em todo o mundo e está associada a altas taxas de mortalidade. Os inibidores do cotransportador de sódio-glicose do tipo 2 têm demonstrado consistentemente benefícios nos desfechos cardiovasculares e renais. Os efeitos dos inibidores do cotransportador de sódio-glicose do tipo 2 em doenças agudas ainda não foram devidamente investigados. Métodos: O DEFENDER é um estudo de iniciativa do investigador, multicêntrico, randomizado, aberto, desenhado para avaliar a eficácia e a segurança da dapagliflozina em 500 participantes adultos com disfunção orgânica aguda hospitalizados na unidade de terapia intensiva. Os participantes aptos serão randomizados 1:1 para receber 10mg de dapagliflozina e o tratamento padrão por até 14 dias ou apenas o tratamento padrão. O desfecho primário é um composto hierárquico de mortalidade hospitalar, início de terapia renal substitutiva e tempo de internação na unidade de terapia intensiva, até 28 dias. O monitoramento da segurança será rigoroso durante todo o estudo. Conclusão: O DEFENDER é o primeiro estudo desenvolvido para investigar o uso de um inibidor do cotransportador de sódio-glicose do tipo 2 em pacientes de unidade de terapia intensiva geral com disfunção orgânica aguda. O estudo fornecerá informações relevantes sobre o uso de medicamentos dessa classe promissora em pacientes críticos. Registro ClincalTrials.gov: NCT05558098

https://doi.org/10.5935/2965-2774.20230129-en

Teachers’ perception of the english curriculum change in Costa Rica: The action-oriented approach
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Vargas Solís, María Antonieta

; Zumbado Venegas, Álvaro

; Salazar Miranda, Jimmy

; Vargas Badilla, Estefannía

; Jiménez Murillo, Edgardo

; Arroyo Chaves, Deily

; Campos Solís, Vanessa

; Arias Zúñiga, Abigail

Revista Educación

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Jun 2023, Volume 47 Nº 1 Páginas 255 - 276

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

Resumen El presente estudio cualitativo explora la percepción de ocho docentes de sétimo grado de colegios académicos de la región de educación de Occidente de Costa Rica sobre la implementación del Enfoque orientado a la acción. El objetivo principal fue valorar la percepción de docentes sobre la implementación de dicho enfoque para explorar su precisión con respecto a los principios del enfoque y las pautas del Ministerio de Educación Pública de Costa Rica. Los datos fueron recolectados a través de una entrevista semiestructurada y luego codificados considerando tres constructos principales: la definición del enfoque según las personas participantes, sus fortalezas y debilidades, y las continuidades, variaciones e innovaciones que surgieron con el cambio del enfoque. La codificación se llevó a cabo bajo los principios de la teoría fundamentada para identificar los puntos en común entre las personas participantes. Los resultados muestran una percepción favorable del enfoque, pero las personas participantes no lo pudieron definir claramente, ya que percibieron los materiales, los roles del estudiante y del docente como fortalezas; y las pruebas, los materiales y la planeación de clases como debilidades. Las continuidades y variaciones no estaban ligadas al enfoque y las innovaciones más destacadas fueron la guía del profesorado y el mini proyecto. Las personas investigadoras concluyeron que existen discrepancias entre la comprensión del grupo de participantes sobre el enfoque orientado a la acción y los principios reales de este.

Abstract This qualitative study explores the perception of eight seventh-grade teachers from academic schools in the western region of Costa Rica about implementing the action-oriented approach (AOA). As the main objective, the researchers sought to assess the professors' perception of the execution of this approach in order to explore its precision regarding its principles and the guidelines of the Ministerio de Educación Pública de Costa Rica. The data were collected through a semi-structured interview and then coded considering three primary constructs: the participants’ definition of AOA, its strengths and weaknesses, and the continuities, variations, and innovations that arose with the change from the CLT to the AOA. Regarding the coding, the researchers carried it out under the principles of grounded theory to identify commonalities among participants. The results show a favorable perception of the approach, yet the individuals could not clearly define the AOA for they perceived the materials, the student, and the teacher’s roles as strengths; and tests, materials, and planning as weaknesses. The continuities and variations were not tied to the approach and the most salient innovations were the teacher’s guide and the mini-project. The researchers concluded that there exist discrepancies between the participants’ understanding of the AOA and the actual tenets of the approach.

https://doi.org/10.15517/revedu.v47i1.49916

Características de los pacientes pediátricos hospitalizados con COVID-19 durante la tercera ola (variante ómicron) en un hospital de referencia del Perú
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Alvarado-Gamarra, Giancarlo

; Zarate-Campos, Vanessa

; Saavedra Díaz, Jimena A.

; Sánchez Julca, Renato M.

; Tahua Vega, Andrea

; Borcic, Aida

; Taype-Rondan, Alvaro

; Franchi Prato, Luis Miguel

; Lanata, Claudio F.

; Dominguez-Rojas, Jesús

; Garcés-Ghilardi, Raquel

; Estupiñan-Vigil, Matilde

Revista Peruana de Medicina Experimental y Salud Pública

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Jun 2023, Volume 40 Nº 2 Páginas 200 - 206

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN El objetivo del presente estudio fue describir las características de los pacientes pediátricos (entre 28 días y 14 años) hospitalizados con COVID-19 durante la tercera ola (variante ómicron) en el Hospital Nacional Edgardo Rebagliati Martins (HNERM) (Lima, Perú). En esta cohorte retrospectiva, se revisaron las historias clínicas de 122 pacientes pediátricos que fueron atendidos en el HNERM entre enero e inicios de abril del 2022 (55% varones, mediana de edad de 5 años), 77,9% durante el primer mes, y la mitad presentaron alguna comorbilidad. Se hospitalizaron principalmente por dificultad respiratoria, comorbilidad descompensada y deshidratación. El 6,6% ingresaron a cuidados intensivos, 4,9% a ventilación mecánica invasiva, 5,7% requirieron algún vasoactivo y 1,6% fallecieron. Los fármacos más usados fueron antibióticos (43,4%) y corticoides (27,1%). En conclusión, se encontró un incremento rápido de hospitalizaciones en comparación con las olas anteriores, la mayoría con evolución favorable, y con un amplio uso empírico de antibióticos.

ABSTRACT This study aimed to describe the characteristics of pediatric patients (28 days to 14 years of age) hospitalized with COVID-19 during the third wave of the pandemic (omicron variant) at the Hospital Nacional Edgardo Rebagliati Martins (HNERM) (Lima, Peru). In this retrospective cohort, we reviewed the medical records of 122 pediatric patients who attended HNERM between January and early April 2022 (55% male, median age: 5 years); 77.9% attended HNERM during the first month, and half of them had some comorbidity. Participants were hospitalized mainly for respiratory distress, decompensated comorbidity, and dehydration. Of the participants, 6.6% were admitted to intensive care, 4.9% to invasive mechanical ventilation, 5.7% required some vasoactive agent and 1.6% died. The most commonly used drugs were antibiotics (43.4%) and corticosteroids (27.1%). In conclusion, hospitalizations rapidly increased during the third wave, when compared to previous waves, most of them with favorable progression and with a wide empirical use of antibiotics.

https://doi.org/10.17843/rpmesp.2023.402.12409

Características de los pacientes pediátricos hospitalizados con COVID-19 durante la tercera ola (variante ómicron) en un hospital de referencia del Perú
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Alvarado-Gamarra, Giancarlo

; Zarate-Campos, Vanessa

; Saavedra Díaz, Jimena A.

; Sánchez Julca, Renato M.

; Tahua Vega, Andrea

; Borcic, Aida

; Taype-Rondan, Alvaro

; Franchi Prato, Luis Miguel

; Lanata, Claudio F.

; Dominguez-Rojas, Jesús

; Garcés-Ghilardi, Raquel

; Estupiñan-Vigil, Matilde

Revista Peruana de Medicina Experimental y Salud Publica

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Abr 2023, Volume 40 Nº 2 Páginas 200 - 206

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

https://doi.org/10.17843/rpmesp.2023.402.12409

Brazilian national bariatric registry - pilot study
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SILVA, LYZ BEZERRA

; QUADROS, LUIZ GUSTAVO DE

; CAMPOS, JOSEMBERG MARINS

; BOAS, MARCOS LEÃO VILLAS

; MARCHESINI, JOÃO CAETANO

; FERRAZ, ÁLVARO ANTONIO BANDEIRA

; KAISER JUNIOR, ROBERTO LUIZ

; ELIAS, ALEXANDRE AMADO

; VITOR, RICARDO

; CHAVES, LUIZ CLAUDIO

; RAMOS, ALMINO CARDOSO

Revista do Colégio Brasileiro de Cirurgiões

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2023, Volume 50 elocation e20233382

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Introduction: Brazil is a world leader in bariatric surgery. However, the actual number of surgeries performed in the country is still unknown. It is necessary to implement an instrument to monitor the quality of care provided. This study evaluated the implementation of a Bariatric Surgery Data Registry in Brazil. Methodology: the registry was developed with Dendrite Clinical Systems Ltd., with data collected prospectively on an internet-based software. Seven centers were selected based on surgical volume and data entry commitment. The project covered three years after system implementation. Results: 1,363 procedures performed by 17 surgeons were included. Most patients were female (67.2%), with average age of 39 years old and average baseline BMI of 41.5kg/m2. Diabetes mellitus was present in 34.5%, and hypertension in 40.1%. Roux-en-Y gastric bypass was performed in 79.3%, 95.5% by laparoscopy. There was one in-hospital death of cardiovascular cause. The average hospital stay was 2.03 days. The surgery-related complication rate was 0.97% in the first month, with three reoperations. Short-term follow-up was recorded in 75.6% and one-year follow-up in 21.64%. Total body weight loss was 10% in 30 days, rising to 33.3% after one year, with no difference between surgical techniques. Conclusions: the population profile was in accordance with the global registry of the International Federation for the Surgery of Obesity and Metabolic Disorders. The main difficulty encountered was low postoperative data entry. The experience acquired in this project will help advance data collection and knowledge of the safety and effectiveness of bariatric surgery in Brazil.

RESUMO Introdução: o Brasil é líder mundial em cirurgia bariátrica. No entanto, o número de cirurgias realizadas no país ainda é desconhecido. É necessário um instrumento para monitorar a qualidade da assistência prestada. Este estudo avaliou a implantação de um Registro de Dados de Cirurgia Bariátrica no Brasil. Metodologia: O registro foi desenvolvido com a Dendrite Clinical Systems Ltd., com dados coletados prospectivamente em software na internet. Sete centros foram selecionados, baseado no volume cirúrgico e compromisso de inserção de dados. O projeto abrangeu três anos após implementação. Resultados: foram incluídos 1.363 procedimentos realizados por 17 cirurgiões. A maioria dos pacientes eram mulheres (67,2%), com idade média de 39 anos e IMC basal médio de 41,5kg/m2. Diabetes mellitus estava presente em 34,5% e hipertensão em 40,1%. Bypass gástrico em Y de Roux foi realizado em 79,3%, 95,5% por laparoscopia. Houve um óbito hospitalar de causa cardiovascular. A média de permanência hospitalar foi de 2,03 dias. A taxa de complicações relacionadas à cirurgia foi 0,97% no primeiro mês, com três reoperações. Seguimento de curto prazo foi registrado em 75,6% e de um ano em 21,64%. A perda de peso corporal total foi de 10% em 30 dias, aumentando para 33,3% após um ano, sem diferença entre técnicas cirúrgicas. Conclusões: o perfil populacional está de acordo com o registro global da IFSO. A principal dificuldade encontrada foi a baixa inserção de dados pós-operatórios. A experiência adquirida neste projeto ajudará no conhecimento da segurança e eficácia da cirurgia bariátrica no Brasil.

https://doi.org/10.1590/0100-6991e-20233382-en

Measurement of the visual axis through two different methods: quantification and differences for measuring chord μ
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Rodrigues, Pablo Felipe

; Moscovici, Bernardo Kaplan

; Lamazales, Luciano

; Freitas, Marcela Mara Silva

; Gomes, José Álvaro Pereira

; Nosé, Walton

; Campos, Mauro Silveira

Arquivos Brasileiros de Oftalmologia

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2023, Nº ahead

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.5935/0004-2749.2022-0035

Exposure to intimate partner violence and lack of asthma control in adults: a cross-sectional study
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Lima, Valmar Bião de

; Vazquez, Vanessa Serva

; Campos, Ana Clara Paixão

; Santos, Letícia Marques dos

; Cruz, Álvaro Augusto

Sao Paulo Medical Journal

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2023, Volume 141 Nº 6 elocation e2022336

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Asthma is a chronic airway disease that affects 339 million people worldwide. It is a heterogeneous disease with different risks, including in family environments, where intimate partner violence occurs. OBJECTIVE: This study aimed to investigate the possible association between psychosocial factors and asthma control in adults exposed to intimate partner violence. DESIGN AND SETTING: This cross-sectional study was conducted at a Brazilian public higher education institution in Salvador, Bahia, Brazil. METHODS: The study population consisted of adults clinically diagnosed with severe asthma and those with mild/moderate asthma identified at an asthma referral outpatient clinic. The sample comprised 492 participants who underwent clinical evaluation and completed questionnaires to assess asthma control, depression, stress, and resilience. The Conflict Tactics Scale, which measures tactics for managing marital conflicts, was used to estimate the level of intimate partner violence. RESULTS: Of the 492 participants, 76.2% were women and 91% self-referenced color black/brown, 37.8% reported low family income, 87.4% reported low education level, 71.7% reported high stress, 32.5% reported low resilience, 18.5% reported moderate or severe depression, 83.3% reported resolute negotiation, 49.4% reported major psychological aggression, 19.6% reported major physical aggression, 15.5% reported major injury, and 7.3% reported major sexual coercion. Regression analysis revealed that sex was an effect modifier. CONCLUSION: Women in situations of social vulnerability, with low income and poor education, with depression, severe asthma, and those who used aggression to resolve marital conflicts had a profile associated with a lack of asthma control.

https://doi.org/10.1590/1516-3180.2022.0336.r2.30032023

10.

Detection of HPV DNA in vaginal samples self-collected by women living with HIV treated through the Brazilian public health system: Prevalence and analysis of risk factors
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Silveira, Mariângela Freitas da

; Buffarini, Romina

; Gaspar, Pâmela Cristina

; Machado, Hanalydia de Melo

; Bazzo, Maria Luiza

; Scherer, Aline

; Colusso, Álvaro Luis

; Travassos, Ana Gabriela Álvares

; Arakaki-Sanchez, Denise

; Baia-da-Silva, Djane Clarys

; Oliveira, Eduardo Campos de

; Zago, Isabella Ribeiro

; Moura, Marcos de Assis

; Lacerda, Marcus Vinicius Guimarães de

; Martins, Simone Murta

; Reuter, Tânia

; Pinto, Valdir Monteiro

; Perini, Waltesia

; Pereira, Gerson Fernando Mendes

; Miranda, Angélica Espinosa

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0277-2023

Resumo: En | Texto: En | PDF: En

ABSTRACT Background: Women living with human immunodeficiency virus (HIV) (WLWH) are more likely to be infected with the oncogenic human papillomavirus (HPV). We assessed the prevalence of high-risk (HR) (16/18/31/33/35/39/45/51/52/56/58/59/68/73/82), probable high-risk (pHR) (26/53/66), and low-risk (LR) (6/11/40/42/43/44/54/61/70) HPV types and their associated risk factors. Methods: This cross-sectional study of WLWH aged 18-64 years included one laboratory and eight HIV-specialty healthcare facilities in the pilot network. Descriptive statistics were used to assess sociodemographic and behavioral characteristics. Adjusted analyses were conducted to evaluate risk factors associated with HR and/or pHR HPV infection in WLWH. Results: From May/2021 to May/2022, 1,914 (92.5%) WLWH participated in the pilot study and had valid HPV-DNA results of self-collected vaginal samples. The median age of the participants was 45 years, 60.1% had ≥ 9 years of schooling, 80.5% were ≤ 18 years at first sexual intercourse, and 51.7% had > 4 sexual partners throughout life. The prevalence of any HPV type, HR HPV, pHR HPV, and LR HPV was 65.8%, 49.6%, 16.7%, and 40.0%, respectively. Age was inversely associated with pHR and/or HR-HPV (p < 0.001), and education level was inversely associated with HR-HPV (p = 0.003) types. Any HR or pHR was associated with being single (p = 0.029) and exchanging sex for drugs (p = 0.037). Conclusions: The prevalence of HPV, especially HR HPV, among WLWH is high in Brazil, highlighting the need for HPV screening in this population. Self-collection of vaginal samples is an important strategy for increasing testing access.

https://doi.org/10.1590/0037-8682-0277-2023

11.

Anisakidosis en peces frescos comercializados en tres ciudades de la Región del Bío Bío, Chile
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Fernández F., Italo

; Suarez R., Pilar

; Madrid V., Verónica

; Valenzuela S., Ariel

; Opazo V., Álvaro

; Campos A., Víctor

Revista chilena de infectología

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Out 2022, Volume 39 Nº 5 Páginas 559 - 564

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract Background: Human anisakidosis is a food-borne zoonosis, caused by the intake of fish meat parasitized by anisakid nematodes. Research of anisakids parasites in commercialized fish, without previous cooking or freezing, in the south central region of Chile is scarce. Aim: To identify anisakid nematodes in fourteen species of marine fish, obtained by artisanal fishing and commercialized in Concepción, Talcahuano and Lebu, cities from Bío Bío Region, Chile. Methods: During 2018 to 2020, we examinated for anisakids to 334 fresh marine fishes. Results: Larvae of Anisakis spp. and Pseudoterranova sp. were identified in specimens of seven and four fish species, respectively. Most of the larvae were found alive and located at the visceral level. Conclusion: Most of the positive fish species are recognized intermediate hosts for these parasites. The presence of anisakids in the musculatura of these species indicates that their preparation, in smoked or raw form, is a risk to public health, and it is recommended to buy these products in gutted and / or frozen form, together with promoting their cooking.

Resumen Introducción: La anisakidosis humana es una zoonosis transmitida por alimentos, causada por la ingestión de carne de pescado parasitada por nematodos anisákidos. Investigaciones sobre la presencia de anisákidos en pescados comercializados, sin cocción o congelación previa, en la región centro sur de Chile son escasas. Objetivo: Identificar nematodos anisákidos en catorce especies de peces marinos, obtenidos por pesca artesanal y comercializados en Concepción, Talcahuano y Lebu, ciudades de la Región del Bío Bío, Chile. Métodos: Entre los años 2018 y 2020, se examinó en busca de anisákidos a 334 pescados marinos frescos. Resultados: Se identificó larvas de Anisakis spp. y Pseudoterranova sp. en ejemplares de siete y cuatro especies de peces, respectivamente. La mayoría de las larvas se encontraron vivas y ubicadas a nivel visceral. Conclusión: La mayoría de las especies de peces que resultaron positivas son reconocidos hospederos intermediarios de estos parásitos. La presencia de anisákidos en la musculatura de estas especies indica que su preparación, en forma ahumada o cruda, es un riesgo para salud pública, recomendándose comprar estos productos en forma eviscerada y/o congelada, junto a promover su cocción.

12.

Brazilians’ level of knowledge, attitudes and practices towards COVID-19: a cross-sectional study
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Gardona, Rodrigo Galvão Bueno

; da Silva, José Vitor

; Arruda, Gisele

; Damin, Silvana

; Abdala, Edson

; Lima, Christiana Almeida Salvador

; Vasconcellos, Leonardo de Souza

; Queiroz, Wladimir

; Zandonái, Alini Cristini

; Danielsk, Ailla Mazon

; Villar de Sena, Ana Carolina

; Cattani, Álvaro Cesar

; Bringhentti, Amanda

; Denardi, Angélica

; Alérico, Ana Lígia Scotti

; Fergutz, Gabriella

; Ribas, Izabela de Oliveira

; Spricigo, Laura Maria Voss

; Gandolfo, Lara

; Correa, Liamara

; Bordignon, Jardel Cristiano

; de Oliveira, Juliana Girotto

; Stefanel, Michel Pandolfo

; Reis, Beatriz Castro

; de Campos, Vilson Geraldo

; Ortigoso, Danilo

; Figueiredo, Gerusa Maria

Sao Paulo Medical Journal

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Jun 2022, Volume 140 Nº 3 Páginas 331 - 340

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Brazil is facing increasing cycles of numbers of infected people and deaths resulting from coronavirus disease 2019 (COVID-19). This situation involves a series of factors, including the behavior of the population, that can be decisive for controlling the disease. OBJECTIVE: To determine the knowledge, attitudes and practices of the Brazilian population regarding COVID-19. DESIGN AND SETTING: Cross-sectional survey-type study, conducted using a population sample from different Brazilian states. METHODS: A quantitative, descriptive and analytical approach was used. Sampling was done according to convenience and via snowballing. The data collection instrument was a knowledge, attitudes and practices system. RESULTS: 1,655 people from all over Brazil participated in the survey; 80% were living in the southern region and 70.15% were female. More than 90% had knowledge and good attitudes relating to the means of transmission, preventive care and symptoms associated with COVID-19, although their knowledge and attitudes were not fully reflected in daily practices, for which there was lower adherence (80%). Greater knowledge was correlated with older participants, larger number of children, female sex and marital status; better attitude, with female sex and complete higher education; and better practices, with greater age, larger number of children and female sex. CONCLUSION: A large part of the population has general knowledge about COVID-19, but not all knowledge was applied in practice. Older people, females and university graduates stood out as the best informed and most committed to controlling the disease.

https://doi.org/10.1590/1516-3180.2021.0541.23072021

13.

Undernutrition and short duration of breastfeeding association with child development: a population-based study
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Rocha, Hermano A.L.

; Correia, Luciano L.

; Leite, Álvaro J.M.

; Rocha, Sabrina G.M.O.

; Machado, Márcia M.T.

; Campos, Jocileide S.

; Cunha, Antonio J.L.A.

; Silva, Anamaria C. e

; Sudfeld, Christopher R.

Jornal de Pediatria

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Jun 2022, Volume 98 Nº 3 Páginas 316 - 322

Resumo: En | Texto: En | PDF: En

Abstract Objective: To explore the relationship of undernutrition and the short duration of breastfeeding with child development of children 0–66 months of age residing in Ceará, Brazil. Methods: The authors of the present study utilized population-based data from children enrolled in the Study on Maternal and Child Health in Ceará, Brazi (PESMIC). Children’s development was assessed with the Ages and Stages Questionnaire third version, validated in Brazil. Undernutrition was accessed through anthropometric measures obtained by trained staff. Breastfeeding information was obtained through the mothers' report and confirmed in the child's governmental booklet. The authors used logistic regressions adjusted for sample clusters used in PESMIC design in a theoretical model for known determinants of child development following the World Health Organization nurturing framework. Results: A total of 3,566 children were enrolled in the sixth PESMIC study and had their development assessed. The authors found that 8.2%, 3.0%, 2.1%, and 3.6% of children were stunted, underweight, or wasted, at the time of the interview, respectively. All studied factors were associated with a higher prevalence of child development impairment in at least one of the assessed domains. Underweight was the factor with the strongest effect, with an adjusted odds ratio (AOR) of 4,14 (2,26–7,58), p < 0.001. Breastfeeding for up to two months compared to more than six months (AOR2,08 (1,38–3,12)) was also associated. Conclusions: The authors found that undernutrition and short duration of breastfeeding are associated with development outcomes among Brazilian children. As a result, integrated nutritional programs may improve child development outcomes.

https://doi.org/10.1016/j.jped.2021.07.003

14.

Prevalence and factors associated with adverse early childhood experiences: a population-based study in Ceará, Brazil
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Martins, Maria Iara Socorro

; Rocha, Hermano Alexandre Lima

; Leite, Álvaro Jorge Madeiro

; Rocha, Sabrina Gabriele Maia Oliveira

; Araújo, David Augusto Batista Sá

; Machado, Márcia Maria Tavares

; Campos, Jocileide Sales

; Sampaio, Edgar Gomes Marques

; Silva, Anamaria Cavalcante e

; Correia, Luciano Lima

Revista Brasileira de Epidemiologia

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2022, Volume 25 elocation e220035

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Estimar a prevalência de experiências adversas na infância e identificar fatores associados. Métodos: O estudo transversal de base populacional compreendeu os dados de uma amostra de 3.200 domicílios com 3.566 crianças menores de seis anos, representativa do estado do Ceará, Brasil. Foi utilizado um processo de amostragem multiestágio, com estratificação entre a capital do estado, Fortaleza, e os 28 municípios do interior, nos quais foram sorteados 160 setores censitários, cada qual com um conglomerado de 20 domicílios. A variável desfecho foi estruturada com base nas situações de experiências adversas na infância sugeridas pelo grupo Centers for Disease Control and Prevention, de acordo com o número de situações a que a criança foi exposta: 0–2, 3–5 e 6–9. O modelo multivariado de regressão logística ordinal foi utilizado para avaliar as associações. Resultados: Das 3.566 crianças estudadas, 89,7% (intervalo de confiança — IC95% 88,7–90,7) foram expostas a pelo menos uma experiência adversa, sendo as mais prevalentes negligência e abuso emocional/físico. Os principais fatores associados às experiências adversas na infância foram a idade materna mais elevada e o tabagismo materno, a ausência paterna, a baixa escolaridade do chefe da família, a insegurança alimentar e a falta de rede de apoio social. Conclusão: O estudo encontrou alta ocorrência de experiências adversas na primeira infância, principalmente entre crianças nascidas de mães de idade mais elevada e tabagistas, sem a presença paterna, e em situação de vulnerabilidade social e econômica, como a insegurança alimentar, que deve ser alvo prioritário de medidas de prevenção e controle.

ABSTRACT Objective: To estimate the prevalence of adverse childhood experiences and identify associated factors. Methods: A population-based cross-sectional study comprised data from a sample of 3,200 households with 3,566 children under 6 years of age, representative of the state of Ceará, Brazil. A multistage sampling approach was used, with stratification among the state capital, Fortaleza, and the 28 countryside municipalities, in which 160 census tracts were randomly selected, each one with a cluster of 20 households. The outcome variable was structured based on adverse childhood experiences as suggested by the Center for Disease Control and Prevention, according to the number of situations to which the child was exposed: 0–2, 3–5, and 6–9. Ordinal logistic regression multivariate model was applied to assess associations. Results: Among the 3,566 children studied, 89.7% (95%CI 88.7–90.7) were exposed to at least one adverse experience, of which the most prevalent were neglect, and emotional/physical abuse. The main factors associated were maternal advanced age and smoking, paternal absence, low education level of the head of the family, food insecurity and lack of a social support network. Conclusion: The study found a high occurrence of adverse early childhood experiences, particularly among preschool children born to mothers of older age, solo, who smoke and in a situation of social and economic vulnerability, including food insecurity, who should be target of control and prevention measures.

https://doi.org/10.1590/1980-549720220035

15.

Prevalence and factors associated with adverse early childhood experiences: a population-based study in Ceará, Brazil
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Martins, Maria Iara Socorro

; Rocha, Hermano Alexandre Lima

; Leite, Álvaro Jorge Madeiro

; Rocha, Sabrina Gabriele Maia Oliveira

; Araújo, David Augusto Batista Sá

; Machado, Márcia Maria Tavares

; Campos, Jocileide Sales

; Sampaio, Edgar Gomes Marques

; Silva, Anamaria Cavalcante e

; Correia, Luciano Lima

Revista Brasileira de Epidemiologia

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2022, Volume 25 elocation e220035

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

https://doi.org/10.1590/1980-549720220035

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