Abstract Gastrointestinal tuberculosis is an uncommon entity, in which clinical presentation can be widely variable, from mild and nonspecific symptoms to an acute abdomen and gastrointestinal bleeding. Gastric involvement by Mycobacterium tuberculosis is rare, especially when it occurs without other recognized infectious foci - primary gastric tuberculosis - with only a few reported cases. Endoscopic findings can be very heterogeneous, from areas of hyperemia to pseudotumor lesions. We present a case of primary gastric tuberculosis in an immuno-competent patient, in which the absence of an epidemiological context and nonspecificendoscopic findings led to a delay in the diagnosis. Bite-on-bite biopsies proved to be essential, allowing to obtain samples from deeper layers of the sub-mucosa where M. tuberculosis was identified. This case aimed to increase awareness for this entity, especially in endemic countries or regions with a high prevalence of tuberculosis since the diagnosis is based mainly on a high index of suspicion.

Resumo A tuberculose gastrointestinal é uma entidade pouco comum, com uma apresentação clínica amplamente variável, desde sintomas ligeiros e inespecíficos até quadros de abdómen agudo e hemorragia digestiva. O envolvimento gástrico pelo Mycobacterium tuberculosis é raro, especialmente quando ocorre sem outros focos infeciosos reconhecidos - tuberculose gástrica primária -, havendo apenas alguns casos descritos na literatura. Os achados endoscópicos podem ser muito heterogéneos, variando desde áreas de mucosa hiperemiada até lesões pseudo-tumorais. Apresentamos o caso de uma doente imunocompetente com diagnóstico de tuberculose gástrica primária, em que a ausência de um contexto epidemiológico e achados endoscópicos inespecíficos conduziram a um atraso no diagnóstico. As biópsias sobre biópsias mostraram ser essenciais para o diagnóstico, pois permitiram obter amostras de camadas mais profundas da submucosa do antro gástrico onde foi identificado o agente infecioso. Este caso pretende sensibilizar para existência desta entidade, especialmente em países endémicos ou regiões com alta prevalência de tuberculose, uma vez que o seu diagnóstico implica um elevado grau de suspeição.

Abstract Background: The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (panenteric capsule endoscopy [PCE]). Summary: We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives. In non-stricturing and non-penetrating Crohn’sdisease affecting the small bowel and colon, PCE monitors disease activity by assessing mucosal healing, a major treatment outcome, with a higher diagnostic yield than cross-sectional imaging or conventional colonoscopy. Also in ulcerative colitis, double-headed capsules have been used to monitor disease activity noninvasively. Currently, validated scoring systems have been specifically devised for these double-headed capsules and permit a standardized assessment of the inflammatory burden. In suspected mid-lower digestive bleeding, some exploratory studies have demonstrated the feasibility and high diagnostic yield of PCE, which may work as a filter indicating which patients may benefit of further invasive procedures, namely, for planned hemostatic procedures. The possibility of using PCE is also discussed in the context of polyposis syn-dromes with simultaneous involvement of the small intestine and colon. Key Messages: PCE is a feasible, effective, and safe diagnostic procedure to evaluate the small bowel and colon. It has been increasingly explored in the setting of inflammatory bowel diseases and, more recently, in suspected mid-lower digestive bleeding. PCE is expected to reduce the demand for invasive procedures and expand the scope of noninvasive intestinal evaluation in the coming future.

Resumo Introdução: O papel da endoscopia por cápsula na avaliação do intestino delgado encontra-se bem estabelecido, e as orientações atuais posicionam-na como um teste de primeira linha numa variedade de cenários clínicos. O advento das cápsulas de dupla câmara permitiu expandir a sua aplicação para a avaliação endoscópica da mucosa do cólon, oferecendo a oportunidade de um exame não invasivo de todo o intestino (endoscopia pan-entérica por cápsula, PCE). Sumário: Procedemos a uma revisão de vários aspectos do procedimento e preparação dos doentes para a PCE, bem como as aplicações clínicas atuais e as perspetivas futuras das cápsulas de dupla câmara. Na doença de Crohn não estenosante e não penetrante localizada ao intestino delgado e cólon, a PCE permite monitorizar a atividade da doença e avaliar a cicatrização da mucosa, um indicador importante da eficácia da terapêutica, com um rendimento de diagnóstico superior aos métodos convencionais, nomeadamente os exames imagiológicos ou a colonoscopia invasiva. Também na colite ulcerosa, as cápsulas de dupla câmara têm sido utilizadas para monitorizar a atividade da doença de forma não invasiva. Existem índices endoscópicos validados e especificamente concebidos para as cápsulas de dupla câmara, que permitem uma avaliação sistematizada e quantificação objetiva da atividade inflamatória. Na suspeita de hemorragia digestiva média ou baixa, alguns estudos exploratórios demonstraram a aplicabilidade e o elevado rendimento diagnóstico da PCE, podendo funcionar como um filtro de modo a permitir indicar quaisosdoentesquemaisirãobeneficiar de um procedimento invasivo subsequente, nomeadamente para arealizaçãodeprocedimentos hemostáticos dirigidos. A possibilidade de utilização da PCE é também discutida no contexto das síndromes de polipose com envolvimento simultâneo do intestino delgado e do cólon. Mensagens-chave: A PCE é um procedimento diagnóstico eficaz e seguro para avaliar diretamente a mucosa do intestino delgado e cólon. A sua aplicação tem vindo a expandir-se no contexto das Doenças Inflamatórias Intestinais e, mais recentemente, na suspeita de hemorragia digestiva média ou baixa. Existe a expectativa de que no futuro próximo possamos assistir a uma redução substancial da demanda por procedimentos endoscópicos invasivos, face à utilização crescente da PCE enquanto método de diagnóstico pan-intestinal não invasivo.

Abstract Brazilian Red Propolis is a resinous material produced by Apis mellifera bees through the collection of the exudates of Dalbergia ecastaphyllum , rich in flavonoids, and Symphonia globulifera and Clusia species, which are rich in polyprenylated benzophenones. More than 200 compounds, including flavonoids and polyprenylated benzophenones have been found in Brazilian red propolis. The objective of the present study was to evaluate the chemical composition and antiviral activity of an ethanolic extract of red propolis from Alagoas, Brazil, against Herpes Simplex Virus (HSV-1). In the HPLC-PDA-ESI-MS/MS analysis were detected flavanones, isoflavones, chalcones, pterocarpans and polyprenylated benzophenones. The measurement of antiviral activity of red propolis extract was performed by DNA quantification through quantitative real-time PCR assay and negative staining Electron Microscopy. The pretreatment, post-treatment, and virucide assays using ethanolic extract of red propolis with concentration of 8, 12, 24, 48, or 96 µ g/mL, indicated an inhibition of the viral binding and viral entry into cells as well as the replication of HSV-1. In the electron microscopy imaging was observed the disruption of the viral membrane in the HSV-1 treated with red propolis, when compared with HSV-1 that was treated with phosphate buffered saline alone, indicating that ethanolic extract from red propolis can act directly on the viral envelope, through lipid membrane degradation and/or directly blocking the enriched proteins on the viral surface. species 20 compounds Alagoas Brazil HSV1. HSV1 HSV 1 . (HSV-1) HPLCPDAESIMS/MS HPLCPDAESIMSMS HPLC PDA ESI MS/MS MS flavanones isoflavones chalcones realtime real time Microscopy pretreatment posttreatment, posttreatment post treatment, treatment post-treatment 8 12 24 48 9 gmL g mL g/mL 1. HSV- alone envelope andor surface 2 (HSV-1 HPLCPDAESIMS MSMS 4 (HSV- (HSV

Abstract Genetic, epigenetic and environmental factors play an important role in the genesis of Type 2 Diabetes Mellitus (T2D). In the genetic context, one of the strategies used to investigate possible associations with diabetes is the search for Single Nucleotide Polymorphisms (SNPs), involving the comparison of alelle frequencies, the phenotypic variations and other relevant factors, such as environmental influences and lifestyle choices, Thus, the aim of this study was to find the relationship of risk variants for T2D in SNPs (rs4994) in the ADRB3 gene; (rs1799854) in the ABCC8 gene; (rs7901695 and rs12255372) in the TCF7L2 gene; and (rs8050136) in the FTO gene in a sample of the population of the municipality of Santarém (PA), Brazilian Amazon, in the northern region of Brazil. ABCC8 (rs1799854 C>T) showed a statistically significant association with T2D. Each chosen gene and SNP has been previously implicated in T2D risk according to existing scientific literature, owing to their roles in glucose regulation and body fat. Genetic TD . T D (T2D) context SNPs, , (SNPs) frequencies choices Thus rs4994 rs (rs4994 ADRB rs1799854 ABCC rs7901695 (rs790169 rs12255372 TCFL TCF L TCF7L rs8050136 (rs8050136 PA, PA (PA) Amazon Brazil (rs179985 C>T CT C literature fat (T2D (SNPs rs499 (rs499 rs179985 rs790169 (rs79016 rs1225537 rs805013 (rs805013 (PA (rs17998 rs49 (rs49 rs17998 rs79016 (rs7901 rs122553 rs80501 (rs80501 (rs1799 rs4 (rs4 rs1799 rs7901 (rs790 rs12255 rs8050 (rs8050 (rs179 (rs rs179 rs790 (rs79 rs1225 rs805 (rs805 (rs17 rs17 rs79 (rs7 rs122 rs80 (rs80 (rs1 rs1 rs7 rs12 rs8 (rs8

ABSTRACT Pigment dispersion syndrome is associated with clinical features such as Krukenberg's spindles, trabecular pigmentation, Scheie's stripe and Zentmayer's ring. Another less common feature of this syndrome is retrolental pigment deposits due to anterior hyaloid detachment or a defect in the Wieger's ligament. We present two cases of pigment deposits on the posterior lens capsule. In both cases, there is bilateral dispersion of pigment throughout the anterior segment. The retrolental deposits are unilateral in the first case and bilateral in the second. Both patients report a history of ocular trauma. This is a possible important clinical sign of pigment dispersion syndrome, rarely described. Krukenbergs Krukenberg s spindles pigmentation Scheies Scheie Zentmayers Zentmayer ring Wiegers Wieger ligament capsule segment second trauma described

RESUMO A síndrome de dispersão pigmentar associa-se a sinais clínicos característicos como fuso de Krukenberg, hiperpigmentação da malha trabecular, linha de Scheie e anel de Zentmeyer. Um sinal menos comum dessa síndrome é o depósito de pigmento posterior ao cristalino, que ocorre por um descolamento da hialoide anterior ou um defeito no ligamento de Wieger. Apresentamos dois casos de depósitos de pigmento posterior à cápsula posterior do cristalino. Em ambos os casos, existia dispersão bilateral de pigmento por todo o segmento anterior. No primeiro caso, os depósitos eram unilaterais e, no segundo, estavam presentes em ambos os olhos. Este pode corresponder a um sinal potencialmente importante da síndrome de dispersão pigmentar, raramente descrito. associase associa se Krukenberg trabecular Zentmeyer cristalino Wieger caso segundo olhos descrito

ABSTRACT Multiple myeloma (MM) associated with Chagas disease is rarely described. This disease and its therapy suppress T cell and macrophage functions and increase regulatory T cell function, allowing the increase of parasitemia and the risk of Chagas Disease Reactivation (CDR). We aimed to analyze the role of conventional (cPCR) and quantitative Polymerase Chain Reaction (qPCR) for prospective monitoring of T. cruzi parasitemia, searching for markers of preemptive antiparasitic therapy in MM patients with Chagas disease. Moreover, we investigated the incidence and management of hematological diseases and CDR both inside and outside the transplant setting in the MEDLINE database. We found 293 studies and included 31 of them. Around 1.9–2.0% of patients with Chagas disease were reported in patients undergoing Stem Cell Transplantation. One case of CDR was described in eight cases of MM and Chagas disease. We monitored nine MM and Chagas disease patients, seven under Autologous Stem Cell Transplantation (ASCT), during 44.56±32.10 months (mean±SD) using parasitological methods, cPCR, and qPCR. From these patients, three had parasitemia. In the first, up to 256 par Eq/mL were detected, starting from 28 months after ASCT. The second patient dropped out and died soon after the detection of 161.0 par Eq/mL. The third patient had a positive blood culture. Benznidazole induced fast negativity in two cases; followed by notably lower levels in one of them. Increased T. cruzi parasitemia was related to the severity of the underlying disease. We recommend parasitemia monitoring by qPCR for early introduction of preemptive antiparasitic therapy to avoid CDR. (MM function . (CDR) cPCR (cPCR (qPCR Moreover database 29 3 them 1920 1 9 2 0 1.9–2.0 ASCT, ASCT , (ASCT) 44563210 44 56 32 10 44.56±32.1 mean±SD meanSD mean SD (mean±SD methods first 25 EqmL Eq mL detected 1610 161 161. culture (CDR 192 1.9–2. (ASCT 4456321 4 5 44.56±32. 16 19 1.9–2 445632 44.56±32 1.9– 44563 44.56±3 1.9 4456 44.56± 1. 445 44.56 44.5 44.

RESUMEN Objetivo: Comprender si, desde la perspectiva de los coordinadores/directores de carreras de enfermería y enfermeros con competencias en el área de desastres, el estudiante de enfermería tiene la madurez cognitiva necesaria para articular las diversas dimensiones inherentes al área de desastres, permitiendo desempeño eficiente. Método: Estudio con enfoque metodológico cualitativo, basado en razonamientos inductivos y descripción rigurosa de los fenómenos, basado en investigación exploratoria. Resultados: Dada la especificidad y complejidad de estos fenómenos, la inclusión del dominio de desastres en el proceso de enseñanza-aprendizaje, para apoyar la construcción de conocimientos válidos y permitir el desarrollo y madurez de los procesos cognitivos del estudiante de enfermería, es crucial. Conclusión: Actualmente, la reducida formación técnico-científica en el campo de los desastres en Portugal constituye una barrera en el desarrollo de la madurez cognitiva de los estudiantes de enfermería, impidiendo su capacidad de respuesta ante fenómenos de esta complejidad. Objetivo si coordinadoresdirectores coordinadores directores eficiente Método cualitativo exploratoria Resultados enseñanzaaprendizaje, enseñanzaaprendizaje enseñanza aprendizaje, aprendizaje enseñanza-aprendizaje crucial Conclusión Actualmente técnicocientífica técnico científica

ABSTRACT Objective: To understand whether, from the perspective of coordinators/directors of nursing courses and nurses with skills in the field of disasters, nursing students have the necessary cognitive maturity to articulate the various dimensions inherent to the area of disasters, allowing efficient performance. Method: A study with a qualitative methodological approach, based on inductive reasoning and rigorous phenomenon description, based on exploratory research. Results: Given the specificity and complexity of these phenomena, the inclusion of the disaster domain in the teaching-learning process, supporting valid knowledge construction and allowing the development and maturity of nursing students’ cognitive processes, is crucial. Conclusion: Currently, reduced technical-scientific training in the field of disasters in Portugal constitutes a barrier in the development of nursing students’ cognitive maturity, impeding their ability to respond when faced with phenomena of this complexity. Objective whether coordinatorsdirectors coordinators directors performance Method approach description research Results teachinglearning teaching learning process processes crucial Conclusion Currently technicalscientific technical scientific

RESUMO Objetivo: Compreender se, na perspectiva dos coordenadores/diretores dos cursos de licenciatura em enfermagem e enfermeiros com competências no domínio de desastres, o estudante de enfermagem apresenta a necessária maturidade cognitiva para articular as diversas dimensões inerentes à área de desastres, permitindo um desempenho eficiente. Método: Estudo de abordagem metodológica qualitativa, sustentado no raciocínio indutivo e na descrição rigorosa dos fenômenos, alicerçado na pesquisa exploratória. Resultados: Diante da especificidade e da complexidade desses fenômenos, a inclusão do domínio de desastres no processo de ensino-aprendizagem, para subsidiar a construção de conhecimento válido e permitir o desenvolvimento e maturidade dos processos cognitivos do estudante de licenciatura em enfermagem, é determinante. Conclusão: Atualmente, a redutora formação técnico-científica no domínio de desastres em Portugal constitui uma barreira no desenvolvimento da maturidade cognitiva do estudante de enfermagem, impedindo a sua capacidade de resposta quando confrontado com fenômenos dessa complexidade. Objetivo se coordenadoresdiretores coordenadores diretores eficiente Método qualitativa exploratória Resultados ensinoaprendizagem, ensinoaprendizagem ensino aprendizagem, aprendizagem ensino-aprendizagem determinante Conclusão Atualmente técnicocientífica técnico científica

Abstract In low and middle-income countries such as Brazil, most maternal deaths are related to hypertensive complications. Preeclampsia is the leading cause of maternal mortality and morbidity. Significant proportion is associated with the following factors: lack of identification of high-risk women, lack of adequate prevention, difficulty in maintaining a high-risk prenatal follow-up, delayed diagnosis, insecurity and low use of magnesium sulphate, delayed pregnancy interruption and lack of postpartum follow-up of these high-risk cases. Four major actions are proposed to minimize this alarming clinical picture and reduce the mortality rates due to preeclampsia, called the "4 P Rule" (Adequate Prevention – Vigilant Prenatal Care – Timely Delivery (Parturition) – Safe Postpartum). From this simple "rule" we can open a range of important processes and reminders that may help in the guidance of preeclampsia management. middleincome middle income Brazil complications morbidity factors highrisk high risk women prevention followup, followup follow up, up diagnosis sulphate cases 4 " Rule Adequate Parturition (Parturition Postpartum. Postpartum . Postpartum) rule "rule management

ABSTRACT OBJECTIVE To assess regional and national mortality and years of life lost (YLL) related to adverse drug events in Brazil. METHODS This is an ecological study in which death records from 2009 to 2018 from the Mortality Information System were analyzed. Codes from the International Classification of Diseases 10th revision (ICD-10) that indicated drugs as the cause of death were identified. The number of deaths and the YLL due to adverse drug events were obtained. Crude, age- and gender-specific, and age-adjusted mortality rates and YLL rates per 100,000 inhabitants were formed by year, age group, gender, and Brazilian Federative Unit. Rate ratios were calculated by comparing rates from 2009 to 2018. A joinpoint regression model was applied for temporal analysis. RESULTS For the selected ICD-10 codes, a total of 95,231 deaths and 2,843,413 YLL were recorded. Mortality rates from adverse drug events increased by a mean of 2.5% per year, and YLL rates increased by 3.7%. Increases in rates were observed in almost all age groups for both genders. Variations in rates were found between Federative Units, with the highest age-adjusted mortality and YLL rates occurring in the Distrito Federal. CONCLUSIONS The numbers and rates of deaths and YLL increased during the study period, and variations in rates of deaths and YLL were observed between Brazilian Federative Units. Information on multiple causes of death from death certificates can be useful for quantifying adverse drug events and analyzing them geographically, by age and by gender. (YLL Brazil 200 201 analyzed th ICD10 ICD 10 (ICD-10 identified obtained Crude genderspecific, genderspecific gender specific, specific gender-specific ageadjusted adjusted 100000 100 000 100,00 year group Unit analysis ICD-1 codes 95231 95 231 95,23 2843413 2 843 413 2,843,41 recorded 25 5 2.5 37 3 7 3.7% genders Units Federal period geographically 20 ICD1 1 (ICD-1 10000 00 100,0 ICD- 9523 9 23 95,2 284341 84 41 2,843,4 2. 3.7 (ICD- 1000 0 100, 952 95, 28434 8 4 2,843, 3. (ICD 2843 2,843 284 2,84 28 2,8 2,

ABSTRACT Introduction: Blood transfusion is one of the most common medical practices worldwide. However, current scientific literature has shown that the immunomodulatory effects of blood transfusion are associated with an increased likelihood of infection, prolonged hospitalization, and morbimortality. Also, it means high costs for healthcare systems. Methods: In this context, acknowledging that blood transfusions are essentially heterologous cell transplantations, the use of therapeutic options has gained strength and is collectively known as the patient blood management (PBM) program. PBM is an approach based on three main pillars: (1) treating anemias and coagulopathies in an optimized manner, especially in the preoperative period; (2) optimizing perioperative hemostasis and the use of blood recovery systems to avoid the loss of the patient's blood; (3) anemia tolerance, with improved oxygen delivery and reduced oxygen demand, particularly in the postoperative period. Results: Current scientific evidence supports the effectiveness of PBM by reducing the need for blood transfusions, decreasing associated complications, and promoting more efficient and safer blood management. Thus, PBM not only improves clinical outcomes for patients but also contributes to the economic sustainability of healthcare systems. Conclusion: The aim of this review was to summarize PBM strategies in a comprehensive, evidence-based approach through a systematic and structured model for PBM implementation in tertiary hospitals. The recommendations proposed herein are from researchers and experts of a high-complexity university hospital in the network of the Sistema Único de Saúde, presenting itself as a strategy that can be followed as a guideline for PBM implementation in other settings. Introduction worldwide However infection hospitalization morbimortality Also Methods context transplantations (PBM program pillars 1 (1 manner period 2 (2 s 3 (3 tolerance demand Results complications Thus Conclusion comprehensive evidencebased hospitals highcomplexity complexity Saúde settings (

RESUMO Objetivo: Estimar as prevalências e fatores associados com as hepatites A, B e C em mulheres trans e travestis em cinco regiões do Brasil. Métodos: Estudo transversal com mulheres trans e travestis em cinco capitais brasileiras (Campo Grande, Manaus, Porto Alegre, Salvador e São Paulo), entre dezembro/2019 e julho/2021. As amostras foram submetidas à detecção de marcadores das infecções pelos vírus das hepatites A (HAV), B (HBV) e C (HCV), utilizando-se testes rápidos e quimioluminescência. Amostras positivas foram submetidas à detecção de HBV-DNA e HCV-RNA por PCR em tempo real e genotipadas por sequenciamento de Sanger. Resultados: As análises de 1.317 amostras indicaram taxas de prevalências nas mulheres trans e travestis recrutadas de 69,1%, 24,4% e 1,5% para exposição ao HAV, HBV e HCV, respectivamente. Elevada taxa de suscetibilidade ao HBV (35,7%) e baixa prevalência do marcador vacinal (40,0%) foram observadas. Mostraram-se associadas à presença de anti-HAV: idade maior que 26 anos, autodeclarar-se preta-parda, ter apenas educação básica, história de encarceramento e uso de preservativo na última relação sexual com parceiro casual. Quanto à exposição ao HBV, foi associada a idade maior que 26 anos, cor da pele preto-parda, ter sido profissional do sexo e história de encarceramento. Idade maior de 37 anos, história de abuso sexual e consumo frequente de álcool foram associadas ao HCV. Conclusão: As maiores prevalências de HAV nessa população encontram-se nas regiões Norte e Nordeste. Com relação ao HBV, a prevalência encontrada foi superior à encontrada na população geral, sugerindo maior vulnerabilidade. A prevalência do HCV foi semelhante à encontrada na população geral. Objetivo Brasil Métodos Campo Grande Manaus Alegre Paulo, Paulo , Paulo) dezembro2019 dezembro 2019 dezembro/201 julho2021 julho 2021 julho/2021 (HAV) (HBV (HCV) utilizandose utilizando se quimioluminescência HBVDNA DNA HCVRNA RNA Sanger Resultados 1317 1 317 1.31 691 69 69,1% 244 24 4 24,4 15 5 1,5 respectivamente 35,7% 357 35 7 (35,7% 40,0% 400 40 0 (40,0% observadas Mostraramse Mostraram antiHAV anti anti-HAV 2 anos autodeclararse autodeclarar pretaparda, pretaparda preta parda, parda preta-parda básica casual pretoparda, pretoparda preto preto-parda 3 Conclusão encontramse encontram Nordeste geral vulnerabilidade dezembro201 201 dezembro/20 julho202 202 julho/202 (HAV (HCV 131 31 1.3 6 69,1 24, 1, 35,7 (35,7 40,0 (40,0 dezembro20 20 dezembro/2 julho20 julho/20 13 1. 69, 35, (35, 40, (40, dezembro2 dezembro/ julho2 julho/2 (35 (40 julho/ (3 (4 (

ABSTRACT Objective: To estimate the prevalence and factors associated with hepatitis A, B, and C in transgender women and travestis's networks, in 5 regions of Brazil. Methods: This cross-sectional study includedtransgender women and travestis in five Brazilian capitals (Campo Grande, Manaus, Porto Alegre, Salvador, and São Paulo), between December/2019 and July/2021. All samples were subjected to detection of serological markers of hepatitis virus A (HAV), B (HBV), and C (HCV) infections through rapid tests and chemiluminescent microparticle immunoassays. Positive samples in the screening tests were submitted to detect HBV DNA and HCV-RNA by real-time PCR and genotyped by Sanger sequencing. Results: Analysis of 1,317 samples showed network prevalence rates of 69.1%, 25.1%, and 1.5% for HAV, HBV, and HCV exposure, respectively. A high susceptibility rate to HBV infection (35.7%) and low prevalence of vaccine response markers (40%) were also observed. Age greater than 26 years, self-declared black/brown skin color, having only primary education, history of incarceration, and use of a condom in the last sexual intercourse with a casual partner were associated with total anti-HAV. Exposure to HBV was associated with age greater than 26 years, self-declared black/brown, history of being a sex worker, and incarceration. Age > 37 years, history of sexual abuse, and frequent alcohol consumption were associated with hepatitis C infection. Conclusion: The highest prevalence of HAV in this population was found in the North and Northeast regions, and the prevalence found was higher than that in the general population, suggesting greater vulnerability. The prevalence of HCV infection in our study was similar to that observed in the general population. Objective travestiss s networks Brazil Methods crosssectional cross sectional Campo Grande Manaus Alegre Salvador Paulo, Paulo , Paulo) December2019 December 2019 December/201 July2021 July 2021 July/2021 (HAV) (HBV) (HCV immunoassays HCVRNA RNA realtime real time sequencing Results 1317 1 317 1,31 691 69 69.1% 251 25 25.1% 15 1.5 exposure respectively 35.7% 357 35 7 (35.7% 40% 40 (40% 2 years selfdeclared self declared blackbrown black brown color education incarceration antiHAV. antiHAV anti HAV. anti-HAV worker 3 abuse Conclusion vulnerability December201 201 December/20 July202 202 July/202 (HAV (HBV 131 31 1,3 6 69.1 25.1 1. 35.7 (35.7 4 (40 December20 20 December/2 July20 July/20 13 1, 69. 25. 35. (35. (4 December2 December/ July2 July/2 (35 ( July/ (3

ABSTRACT OBJECTIVE To assess regional and national mortality and years of life lost (YLL) related to adverse drug events in Brazil. METHODS This is an ecological study in which death records from 2009 to 2018 from the Mortality Information System were analyzed. Codes from the International Classification of Diseases 10th revision (ICD-10) that indicated drugs as the cause of death were identified. The number of deaths and the YLL due to adverse drug events were obtained. Crude, age- and gender-specific, and age-adjusted mortality rates and YLL rates per 100,000 inhabitants were formed by year, age group, gender, and Brazilian Federative Unit. Rate ratios were calculated by comparing rates from 2009 to 2018. A joinpoint regression model was applied for temporal analysis. RESULTS For the selected ICD-10 codes, a total of 95,231 deaths and 2,843,413 YLL were recorded. Mortality rates from adverse drug events increased by a mean of 2.5% per year, and YLL rates increased by 3.7%. Increases in rates were observed in almost all age groups for both genders. Variations in rates were found between Federative Units, with the highest age-adjusted mortality and YLL rates occurring in the Distrito Federal. CONCLUSIONS The numbers and rates of deaths and YLL increased during the study period, and variations in rates of deaths and YLL were observed between Brazilian Federative Units. Information on multiple causes of death from death certificates can be useful for quantifying adverse drug events and analyzing them geographically, by age and by gender.

ABSTRACT Objective: To estimate the prevalence and factors associated with hepatitis A, B, and C in transgender women and travestis's networks, in 5 regions of Brazil. Methods: This cross-sectional study includedtransgender women and travestis in five Brazilian capitals (Campo Grande, Manaus, Porto Alegre, Salvador, and São Paulo), between December/2019 and July/2021. All samples were subjected to detection of serological markers of hepatitis virus A (HAV), B (HBV), and C (HCV) infections through rapid tests and chemiluminescent microparticle immunoassays. Positive samples in the screening tests were submitted to detect HBV DNA and HCV-RNA by real-time PCR and genotyped by Sanger sequencing. Results: Analysis of 1,317 samples showed network prevalence rates of 69.1%, 25.1%, and 1.5% for HAV, HBV, and HCV exposure, respectively. A high susceptibility rate to HBV infection (35.7%) and low prevalence of vaccine response markers (40%) were also observed. Age greater than 26 years, self-declared black/brown skin color, having only primary education, history of incarceration, and use of a condom in the last sexual intercourse with a casual partner were associated with total anti-HAV. Exposure to HBV was associated with age greater than 26 years, self-declared black/brown, history of being a sex worker, and incarceration. Age > 37 years, history of sexual abuse, and frequent alcohol consumption were associated with hepatitis C infection. Conclusion: The highest prevalence of HAV in this population was found in the North and Northeast regions, and the prevalence found was higher than that in the general population, suggesting greater vulnerability. The prevalence of HCV infection in our study was similar to that observed in the general population.

RESUMO Objetivo: Estimar as prevalências e fatores associados com as hepatites A, B e C em mulheres trans e travestis em cinco regiões do Brasil. Métodos: Estudo transversal com mulheres trans e travestis em cinco capitais brasileiras (Campo Grande, Manaus, Porto Alegre, Salvador e São Paulo), entre dezembro/2019 e julho/2021. As amostras foram submetidas à detecção de marcadores das infecções pelos vírus das hepatites A (HAV), B (HBV) e C (HCV), utilizando-se testes rápidos e quimioluminescência. Amostras positivas foram submetidas à detecção de HBV-DNA e HCV-RNA por PCR em tempo real e genotipadas por sequenciamento de Sanger. Resultados: As análises de 1.317 amostras indicaram taxas de prevalências nas mulheres trans e travestis recrutadas de 69,1%, 24,4% e 1,5% para exposição ao HAV, HBV e HCV, respectivamente. Elevada taxa de suscetibilidade ao HBV (35,7%) e baixa prevalência do marcador vacinal (40,0%) foram observadas. Mostraram-se associadas à presença de anti-HAV: idade maior que 26 anos, autodeclarar-se preta-parda, ter apenas educação básica, história de encarceramento e uso de preservativo na última relação sexual com parceiro casual. Quanto à exposição ao HBV, foi associada a idade maior que 26 anos, cor da pele preto-parda, ter sido profissional do sexo e história de encarceramento. Idade maior de 37 anos, história de abuso sexual e consumo frequente de álcool foram associadas ao HCV. Conclusão: As maiores prevalências de HAV nessa população encontram-se nas regiões Norte e Nordeste. Com relação ao HBV, a prevalência encontrada foi superior à encontrada na população geral, sugerindo maior vulnerabilidade. A prevalência do HCV foi semelhante à encontrada na população geral.

ABSTRACT Objective: The aim of the study was to assess the impact of the Gamma coronavirus disease 2019 (COVID-19) variant on pregnant and postpartum women with Cardiovascular Disease (CVD). Methods: The Influenza Epidemiological Surveillance System database (SIVEP-Gripe), a compulsory notification system for cases of Severe Acute Respiratory Syndrome (SARS), was investigated for notified cases of pregnant and postpartum women with reported CVD and SARS due to COVID-19 between February 16, 2020 and May 1, 2021 (when vaccination began), was investigated. In this retrospective cohort, two groups were formed based on symptom onset date, according to the predominance of the variants: original (group 2020) and Gamma (group 2021). Cases with missing information on the presence or absence of CVD were excluded. The comparative analysis was controlled for confounding variables. Results: Among 703 COVID-19 cases notified with CVD (406 patients in 2020 and 297 patients in 2021), compared to 2020, cases in 2021 had more respiratory symptoms (90.6 % vs. 80.1 %, p < 0.001), greater ventilatory support need (75.3 % vs. 53.9 %, p < 0.001), more ICU admission (46.6 % vs. 34.3 %, p = 0.002), longer duration (20.59 ± 14.47 vs. 16.52 ± 12.98 days, p < 0.001), higher mortality (25.6 % vs. 15.5 %, p < 0.001), with more than two-times mortality likelihood in the third trimester (adjusted OR = 2.41, 95 % CI 1.50–3.88, p < 0.001) or puerperium periods (adjusted_OR = 2.15, 95 % CI 1.34-3.44, p = 0.001). Conclusions: In Brazil, pregnant and postpartum women with CVDs in the Gamma variant phase have higher morbidity and mortality than those affected by the original variant of Coronavirus-19. Objective 201 COVID19 COVID 19 (COVID-19 CVD. . (CVD) Methods SIVEPGripe, SIVEPGripe SIVEP Gripe , (SIVEP-Gripe) SARS, (SARS) COVID-1 16 202 1 when began, began began) cohort date variants group 2021. 2021) excluded variables Results 70 406 (40 29 2021, 90.6 906 90 6 (90. vs 801 80 80. 0.001, 0001 0.001 0 001 75.3 753 75 3 (75. 539 53 9 53. 46.6 466 46 (46. 343 34 34. 0.002, 0002 0.002 002 0.002) 20.59 2059 20 59 (20.5 1447 14 47 14.4 1652 52 16.5 1298 12 98 12.9 days 25.6 256 25 (25. 155 15 5 15. twotimes times adjusted 241 2 41 2.41 150388 50 88 1.50–3.88 adjusted_OR adjustedOR 215 2.15 1.343.44, 134344 1.34 3.44, 44 1.34-3.44 0.001. Conclusions Brazil Coronavirus19. Coronavirus19 Coronavirus 19. Coronavirus-19 COVID1 (COVID-1 (CVD (SIVEP-Gripe (SARS COVID- 7 40 (4 90. (90 8 000 0.00 00 75. (75 46. 4 (46 20.5 205 (20. 144 14. 165 16. 129 12. 25. (25 24 2.4 15038 1.50–3.8 21 2.1 1.343.44 13434 134 1.3 344 3.44 1.34-3.4 Coronavirus1 Coronavirus-1 (COVID- ( (9 0.0 (7 20. (20 (2 2. 1503 1.50–3. 1.343.4 1343 13 1. 3.4 1.34-3. Coronavirus- (COVID 0. 150 1.50–3 1.343. 3. 1.34-3 1.50– 1.343 1.34- 1.50 1.5

Resumo Background: O mundo mudou após o ano de 2020 devido à pandemia provocada pelo vírus SARS-COV-2, que originou inúmeros desafios na saúde. Mundialmente foram implementadas medidas de contenção. Isto alterou o quotidiano das crianças/adolescentes que ficaram privados da convivência com os seus pares, da aprendizagem em regime presencial e da sensação de segurança (Rao e Fischer, 2021). É na interação entre as crianças e o ambiente que se processa o desenvolvimento de competências, assim, é pertinente questionar se as alterações vivenciadas tiveram consequências ao nível do desenvolvimento infantil. Métodos: Foi conduzida uma pesquisa em três passos, de acordo com o Joanna Briggs Institute (Peters et al., 2020). 1) Foi conduzida uma pesquisa na MEDLINE e na CINAHL, seguida de uma análise das palavras do título, abstract e palavras indexadas; 2) As palavras-chave e os termos indexados foram pesquisados em todas as bases de dados incluídas; 3) Foram pesquisadas as referências bibliográficas de todos os artigos incluídos. Resultados: Durante a pesquisa efectuada foram encontrados um total de 455 artigos, excluíndo duplicados. Após a leitura do título foram excluídos 420 resultados por não se enquadrarem no estudo, obtendo 35. Destes, posteriormente à leitura do resumo, foram excluídos 20 resultados, deixando 15 artigos para serem avaliados integralmente. Destes 11 foram incluídos no estudo, e após análise da lista de referências e recomendações dos peritos, foram incluídos 2 novos estudos, perfazendo um total de 13 estudos incluídos. Conclusão: Deverão ser conduzidos novos estudos no futuro por forma a lidar com os desafios a nível do desenvolvimento e que intervenções podem promover o desenvolvimento infantil. Devem ser implementados planos de saúde com as crianças/adolescentes e os seus cuidadores, guiando-os na promoção do desenvolvimento infantil numa óptica de parceria de cuidados com a equipa multidisciplinar.

Abstract Background:The world has changed due to the pandemic SARS-COV-2, which led to multiple challenges. Containment measures have been implemented worldwide. This changed the daily lives of children who remained deprived of living with their peers, face-to-face learning, and a sense of security (Rao & Fischer, 2021). It is in the interaction between children and the environment that the development of skills takes place, so it is pertinent to question whether the changes experienced had consequences in child development. Methods: A three-step search strategy was conducted, according to the Joanna Briggs Institute (Peters et al., 2020). 1) A search of MEDLINE and CINAHL was undertaken, followed by an analysis of the words contained in the title, abstract and the index terms; 2) The keywords and index terms were searched across all the included databases; 3) Search of the reference lists of all the included articles. Findings: During the search performed, a total of 455 articles were found, excluding duplicates. After reading the title, 420 results were excluded because they did not fit the study, obtaining 35. Of these, after reading the abstract, 20 results were excluded, leaving 15 articles to be fully evaluated. Of these 11 were included in the study, and after reviewing the list of references and experts' recommendations, 2 new studies were included, making a total of 13 included studies. Conclusion: As implications for research, studies should be carried out that deal with the new challenges at the level of development and which interventions can promote child development. Health care plans should be built and implemented in partnership with the child/adolescent and their caregivers, to guide them in promoting child development, working in an integrated manner in the multidisciplinary team.