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Abstract Background Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. Objective To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. Methods This data are from the study “Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases,” a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. Results A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. Conclusion In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity. immunemediated immune mediated (IMRDs COVID19 COVID 19 COVID-1 risks (RA outcomes comorbidities However SARSCoV2 SARSCoV SARS CoV 2 SARS-CoV- Safety Diseases, Diseases Brazil (AEs ChAdOx Oxford/AstraZeneca OxfordAstraZeneca Oxford AstraZeneca (Oxford/AstraZeneca Sinovac/Butantan. SinovacButantan Sinovac/Butantan . Sinovac Butantan (Sinovac/Butantan) diary 18 include 90 female 10 79 46,7%, 467 46,7% , 46 7 (46,7%) 39,4%, 394 39,4% 39 4 (39,4%) 30,5% 305 30 5 (30,5% 26,6%, 266 26,6% 26 6 (26,6%) 66% 66 (66 3 % 0.001 0001 0 001 62% 62 (62 22 22% 45% 45 (45 20 20% 37%, 37 37% (37%) 31%, 31 31% (31%) 23%, 23 23% (23%) 21% 21 (21% 18%. 18% (18%) 41,4% 414 41 (41,4 25 25% 0.02 002 02 51,4% 514 51 (51,4 27 27% related level summary COVID1 1 COVID- SARS-CoV (Sinovac/Butantan 9 46,7 (46,7% 39,4 (39,4% 30,5 (30,5 26,6 (26,6% (6 0.00 000 00 (4 (37% (31% (23% (21 (18% 41,4 (41, 0.0 51,4 (51, 46, (46,7 39, (39,4 30, (30, 26, (26,6 ( (37 (31 (23 (2 (18 41, (41 0. 51, (51 (46, (39, (30 (26, (3 (1 (5 (46 (39 (26

https://doi.org/10.1186/s42358-024-00397-5

Injection of Freshly Collected Adipose Tissue for the Treatment Complex Cryptoglandular Anal Fistula: Case Report Fistula
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Estrada, Daniel Mauricio Londoño

; Fernandes, Cristiane Koizimi Martos

; Oliveira, Marina Barbarela Grisolia de

; Souza, Gustavo Moreira Costa de

; França-Neto, Paulo Rocha

; Queiroz, Fábio Lopes de

; Lacerda-Filho, Antônio

Journal of Coloproctology (Rio de Janeiro)

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Dez 2023, Volume 43 Nº 4 Páginas 316 - 320

Resumo: En | Texto: En | PDF: En

Abstract Introduction Perianal fistula is a common colorectal disease which is caused mainly by cryptoglandular disease. Although most cases are treated successfully by surgery, management of complex perianal fistulas (CPAF) remains a challenge with limited results in recurrence and sometimes associated with fecal incontinence. The CPAF treatment with autologous adipose-derived mesenchymal stem cells (ASCs) had become a research hotspot. The technique started to be used in the treatment of Crohn's disease (CD) fistulas, where the studies showed safe and goods result from the procedure. Cultured ASCs have been used but this approach requires the preceding collection of adipose tissue, time for isolation of ASCs and subsequent in vitro expansion, need for laboratory facilities, and expertise in cell culturing. These factors have been getting over by using the commercially available alternative, allogenic ASCs. Treatment with allogeneic ASCs has shown good results in patients with CD fistulas, however with the disadvantage of being expensive. Objective To show that the injection with freshly collected adipose tissue is an alternative to treatment with autologous or allogenic ASCs with several advantages. Methods: In this case report, we show our first experience in the treatment of CPAF with the application of collected adipose tissue in a tertiary referral hospital from Belo Horizonte, Brazil. Results The patient had a good postoperative recuperation with a complete fistula healing after 8 months without adverse effects. Conclusion Injection with freshly collected adipose tissue is a promising and apparently safe sphincter-sparing technique in the treatment of CPAF. surgery (CPAF incontinence adiposederived derived (ASCs hotspot Crohns Crohn s (CD procedure expansion facilities culturing expensive advantages Methods report Horizonte Brazil effects sphinctersparing sphincter sparing

https://doi.org/10.1055/s-0043-1773784

Detection of Bartonella henselae DNA in the blood of patients with livedoid vasculopathy
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Drummond, Marina Rovani

; Santos, Luciene Silva dos

; Souza, Lais Bomediano

; Mitsuushi, Gabriela Nero

; Cintra, Maria Letícia

; França, Andrea Fernandes Eloy da Costa

; Souza, Elemir Macedo de

; Velho, Paulo Eduardo Neves Ferreira

Anais Brasileiros de Dermatologia

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Ago 2023, Volume 98 Nº 4 Páginas 472 - 479

Resumo: En | Texto: En | PDF: En

Abstract Background: Livedoid vasculopathy (LV) manifests as ulcers and atrophic white scars on the lower extremities. The main known etiopathogenesis is hypercoagulability with thrombus formation, followed by inflammation. Thrombophilia, collagen and myeloproliferative diseases may induce LV, but the idiopathic (primary) form predominates. Bartonella spp. may cause intra-endothelial infection and skin manifestations caused by these bacteria may be diverse, including leukocytoclastic vasculitis and ulcers. Objective: The aim of this study was to investigate the presence of bacteremia by Bartonella spp. in patients with difficult-to-control chronic ulcers diagnosed as primary LV. Methods: Questionnaires and molecular tests (conventional PCR, nested PCR and real-time PCR) were applied and liquid and solid cultures were performed in the blood samples and blood clot of 16 LV patients and 32 healthy volunteers. Results: Bartonella henselae DNA was detected in 25% of LV patients and in 12.5% of control subjects but failed to reach statistically significant differences (p = 0.413). Study limitations: Due to the rarity of primary LV, the number of patients studied was small and there was greater exposure of the control group to risk factors for Bartonella spp. infection. Conclusion: Although there was no statistically significant difference between the groups, the DNA of B. henselae was detected in one of every four patients, which reinforces the need to investigate Bartonella spp. in patients with primary LV. Background (LV extremities formation inflammation Thrombophilia (primary predominates spp intraendothelial intra endothelial diverse Objective difficulttocontrol difficult Methods conventional realtime real time 1 3 volunteers Results 25 125 12 5 12.5 p 0.413. 0413 0.413 . 0 413 0.413) limitations Conclusion groups B 2 12. 041 0.41 41 04 0.4 4 0.

https://doi.org/10.1016/j.abd.2022.07.007

Bartonella henselae as a putative trigger for chronic type 2 leprosy reactions
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Santos, Luciene Silva dos

; Drummond, Marina Rovani

; Goulart, Isabela Maria Bernardes

; França, Andrea Fernandes Eloy da Costa

; Souza, Elemir Macedo de

; Velho, Paulo Eduardo Neves Ferreira

Brazilian Journal of Infectious Diseases

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2023, Volume 27 Nº 6 elocation 103701

Resumo: En | Texto: En | PDF: En

Abstract Leprosy reactions are an acute inflammatory phenomenon that can arise before diagnosis, during treatment, or after cure of leprosy. These reactions are considered one of the main diseases that cause physical disabilities. Immunosuppressive treatment for these immune responses makes these patients susceptible to coinfections, which can trigger new leprosy reactions. The main objective of this study was to evaluate the occurrence of infection by Bartonella sp. in blood samples from 47 patients who had untreatable episodes of type 2 leprosy reactions for more than six months, comparing them with a control group. Cultures and molecular methods (PCR) were used. Amplicons from species-specific reactions and sequencing showed a higher prevalence of Bartonella henselae infection in patients, 19/47 (40.4 %), compared to control, 9/50 (18.0 %), p= 0.0149. Five patients accepted treatment for coinfection, and all showed improvement in leprosy reactions with treatment for B. henselae infection. We conclude that these bacteria can trigger chronic reactions of type 2 leprosy and should be investigated in these patients. Summary line Patients who have chronic type 2 leprosy reactions are more susceptible to Bartonella henselae infection than controls: 19/47 (40.4 %) compared 9/50 (18.0 %), p= 0.0149. diagnosis disabilities coinfections sp 4 months group PCR (PCR used speciesspecific species specific 1947 19 19/4 40.4 404 40 (40. %, % , 950 9 50 9/5 18.0 180 18 0 (18. p 00149 0149 0.0149 coinfection B controls 194 1 19/ 40. (40 95 5 9/ 18. (18 0014 014 0.014 (4 (1 001 01 0.01 ( 00 0.0 0.

https://doi.org/10.1016/j.bjid.2023.103701

Dysarthria in hereditary spastic paraplegia type 4
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Jacinto-Scudeiro, Lais Alves

; Rothe-Neves, Rui

; Santos, Vanessa Brzoskowski dos

; Machado, Gustavo Dariva

; Burguêz, Daniela

; Padovani, Marina Martins Pereira

; Ayres, Annelise

; Rech, Rafaela Soares

; González-Salazar, Carelis

; França Junior, Marcondes Cavalcante

; Saute, Jonas Alex Morales

; Olchik, Maira Rozenfeld

Clinics

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2023, Volume 78 elocation 100128

Resumo: En | Texto: En | PDF: En

Abstract Objective: To describe the speech pattern of patients with hereditary Spastic Paraplegia type 4 (SPG4) and correlated it with their clinical data. Methods: Cross-sectional study was carried out in two university hospitals in Brazil. Two groups participated in the study: the case group (n = 28) with a confirmed genetic diagnosis for SPG4 and a control group (n = 17) matched for sex and age. The speech assessment of both groups included: speech task recording, acoustic analysis, and auditory-perceptual analysis. In addition, disease severity was assessed with the Spastic Paraplegia Rating Scale (SPRS). Results: In the auditory-perceptual analysis, 53.5% (n = 15) of individuals with SPG4 were dysarthric, with mild to moderate changes in the subsystems of phonation and articulation. On acoustic analysis, SPG4 subjects’ performances were worse in measurements related to breathing (maximum phonation time) and articulation (speech rate, articulation rate). The articulation variables (speech rate, articulation rate) are related to the age of onset of the first motor symptom. Conclusion: Dysarthria in SPG4 is frequent and mild, and it did not evolve in conjunction with more advanced motor diseases. This data suggest that diagnosed patients should be screened and referred for speech therapy evaluation and those pathophysiological mechanisms of speech involvement may differ from the length-dependent degeneration of the corticospinal tract. Objective SPG (SPG4 Methods Crosssectional Cross sectional Brazil n 28 17 included recording analysis auditoryperceptual auditory perceptual addition SPRS. SPRS . (SPRS) Results 535 53 5 53.5 15 dysarthric subjects maximum time rate rate. symptom Conclusion diseases lengthdependent length dependent tract (SPG 2 1 (SPRS 53.

https://doi.org/10.1016/j.clinsp.2022.100128

Soroconversão de Anticorpos Anti-SARS-CoV-2 em Receptores de Transplante Renal Convalescentes com COVID-19 em Comparação com Pacientes Não Transplantados AntiSARSCoV2 AntiSARSCoV Anti SARS CoV 2 Anti-SARS-CoV- COVID19 COVID 19 COVID-1 Anti-SARS-CoV COVID1 1 COVID-
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Garcia, Ricardo Martins

; Gomes, Vinicius Lafico Teixeira

; Foresto, Renato Demarchi

; Nakamura, Mônica Rika

; Jesus, Marcia Araújo Toffoli de

; Lucena, Elisabeth França

; Rissoni, Renata Pimentel

; Cristelli, Marina Pontello

; Silva Junior, Helio Tedesco

; Requião-Moura, Lúcio

; Pestana, José Medina

Brazilian Journal of Transplantation

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2023, Volume 26 elocation e2523

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

RESUMO Objetivo: Devido à imunossupressão, receptores de transplante renal (RTRs) podem ter menor soroconversão após COVID-19 do que indivíduos não-transplantados. Assim, nosso objetivo foi avaliar a taxa de soroconversão após COVID-19 entre RTRs e não-RTRs. Métodos: Este estudo de coorte envolveu três grupos não pareados de pacientes com COVID-19: 601 RTRs, 211 profissionais de saúde (PSs) e 170 habitantes não transplantados (HNTs) em uma cidade do interior do Brasil. O anticorpo anti-SARS-CoV-2 foi avaliado 14 dias após o diagnóstico. O desfecho primário foi a taxa de soroconversão. Resultados: Os RTRs eram mais idosos, com mais comorbidades e COVID-19 grave. Em comparação com profissionais de saúde e HNTs, admissão na unidade de terapia intensiva (UTI; 44,9% vs. 0% vs. 1,8%, p<0,001), necessidade de ventilação mecânica (32,3% vs. 0% vs. 1,8%, p<0,001), e óbito (28,8% vs. 0% vs. 1,2%, p<0,001) foram significativamente maiores em RTRs. A soroconversão não diferiu entre os grupos: 76,2% em RTRs, 74,9% em PSs e 82,2% em HNTs (p=0,35). Em uma regressão logística multivariada ajustada ao grupo, enquanto um curto período entre a infecção e a coleta da amostra de sangue reduziu a probabilidade de soroconversão (odds ratio [aOR] = 0,986), a presença de febre (aOR = 1,737, p = 0,017), tosse (aOR=1,785, p=0,005) e necessidade de suporte ventilatório (OR=1,981, p=0,017) aumentaram o risco. Conclusões: A gravidade clínica, a necessidade de ventilação mecânica e a morte por COVID-19 foram significativamente maiores entre os RTRs. No entanto, entre os sobreviventes, os RTRs tiveram prevalência de soroconversão semelhante associada aos parâmetros de gravidade clínica e menor tempo de coleta de amostra de sangue. Objetivo imunossupressão (RTRs COVID19 COVID 19 COVID-1 nãotransplantados. nãotransplantados transplantados. não-transplantados Assim nãoRTRs. nãoRTRs não-RTRs Métodos 60 21 (PSs 17 (HNTs Brasil antiSARSCoV2 antiSARSCoV anti SARS CoV 2 anti-SARS-CoV- 1 diagnóstico Resultados idosos grave UTI (UTI 449 44 9 44,9 vs 0 18 8 1,8% p<0,001, p0001 p<0,001 , 001 32,3% 323 32 3 (32,3 28,8% 288 28 (28,8 12 1,2% 762 76 76,2 749 74 74,9 822 82 82,2 p=0,35. p035 p=0,35 . 35 (p=0,35) grupo odds aOR [aOR 0,986, 0986 0,986 986 0,986) 1737 737 1,737 0,017, 0017 0,017 017 0,017) aOR=1,785, aOR1785 785 (aOR=1,785 p=0,005 p0005 005 OR=1,981, OR1981 OR 981 (OR=1,981 p=0,017 p0017 risco Conclusões entanto sobreviventes COVID1 COVID- 6 anti-SARS-CoV 4 44, 1,8 p000 p<0,00 00 32,3 (32, 28,8 (28, 1,2 7 76, 74, 82, p03 p=0,3 (p=0,35 098 0,98 98 173 73 1,73 0,01 01 aOR=1,785 aOR178 78 (aOR=1,78 p=0,00 OR=1,981 OR198 (OR=1,98 p=0,01 p001 1, p00 p<0,0 32, (32 28, (28 p0 p=0, (p=0,3 09 0,9 1,7 0,0 aOR=1,78 aOR17 (aOR=1,7 p=0,0 OR=1,98 OR19 (OR=1,9 p<0, (3 (2 p=0 (p=0, 0, aOR=1,7 aOR1 (aOR=1, OR=1,9 OR1 (OR=1, p<0 ( p= (p=0 aOR=1, (aOR=1 OR=1, (OR=1 p< (p= aOR=1 (aOR= OR=1 (OR= (p aOR= OR= (OR

ABSTRACT Objective: Due to immunosuppression, kidney transplant recipients (KTRs) might have lower seroconversion after COVID-19 than non-KTRs. Thus, we aimed to evaluate the seroconversion rate after COVID-19 between KTRs and non-KTRs. Methods: This cohort study enrolled three non-paired groups of patients with COVID-19: 601 KTRs, 211 healthcare workers (HCWs), and 170 non-transplanted inhabitants (INHs) in a countryside city in Brazil. The anti-severe acute respiratory syndrome coronavirus 2 nucleocapsid antibody was assessed 14 days after diagnosis. The primary outcome was seroconversion. Results: The KTRs were older, had more comorbidities and severe COVID-19. Compared to HCWs and INHs, admission to the intensive care unit (ICU; 44.9% vs. 0% vs. 1.8%, p<0.001), mechanical ventilation requirement (32.3% vs. 0% vs. 1.8%, p<0.001), and death (28.8% vs. 0% vs. 1.2%, p<0.001) were significantly higher in KTRs. Seroconversion did not differ between the groups: 76.2% in KTRs, 74.9% in HCWs, and 82.2% in INHs (p=0.35). In a group-adjusted multivariable logistic regression, while a short period between infection and blood sample collection reduced the probability of seroconversion (adjusted odds ratio [aOR]=0.986), the presence of fever (aOR=1.737, p=0.017), cough (aOR=1.785, p=0.005), and requirement for ventilatory support (OR=1.981, p=0.017) increased the risk. Conclusions: Clinical severity, mechanical ventilation requirement and death by COVID-19 were significantly higher among the KTRs. However, among the survivors, KTRs had a similar seroconversion prevalence associated with clinical severity parameters and a shorter time of blood sample collection. Objective immunosuppression (KTRs COVID19 COVID 19 COVID-1 nonKTRs. nonKTRs non non-KTRs Thus Methods nonpaired paired 60 21 , (HCWs) 17 nontransplanted transplanted (INHs Brazil antisevere anti 1 diagnosis Results older COVID19. 19. ICU (ICU 449 44 9 44.9 vs 0 18 8 1.8% p<0.001, p0001 p p<0.001 001 32.3% 323 32 3 (32.3 28.8% 288 28 (28.8 12 1.2% 762 76 76.2 749 74 74.9 822 82 82.2 p=0.35. p035 p=0.35 . 35 (p=0.35) groupadjusted group adjusted regression aOR=0.986, aOR0986 aOR =0.986 986 [aOR]=0.986) aOR=1.737, aOR1737 737 (aOR=1.737 p=0.017, p0017 p=0.017 017 aOR=1.785, aOR1785 785 (aOR=1.785 p=0.005, p0005 p=0.005 005 p=0.005) OR=1.981, OR1981 OR 981 (OR=1.981 risk Conclusions However survivors COVID1 COVID- 6 (HCWs 4 44. 1.8 p000 p<0.00 00 32.3 (32. 28.8 (28. 1.2 7 76. 74. 82. p03 p=0.3 (p=0.35 aOR=0.986 aOR098 0986 =0.98 98 [aOR]=0.986 aOR=1.737 aOR173 73 (aOR=1.73 p001 p=0.01 01 aOR=1.785 aOR178 78 (aOR=1.78 p=0.00 OR=1.981 OR198 (OR=1.98 1. p00 p<0.0 32. (32 28. (28 p0 p=0. (p=0.3 aOR=0.98 aOR09 098 =0.9 [aOR]=0.98 aOR=1.73 aOR17 (aOR=1.7 p=0.0 aOR=1.78 OR=1.98 OR19 (OR=1.9 p<0. (3 (2 p=0 (p=0. aOR=0.9 aOR0 09 =0. [aOR]=0.9 aOR=1.7 aOR1 (aOR=1. OR=1.9 OR1 (OR=1. p<0 ( p= (p=0 aOR=0. =0 [aOR]=0. aOR=1. (aOR=1 OR=1. (OR=1 p< (p= aOR=0 = [aOR]=0 aOR=1 (aOR= OR=1 (OR= (p aOR= [aOR]= (aOR OR= (OR [aOR] [aOR

https://doi.org/10.53855/bjt.v26i1.518_port

Energy supplementation as strategy of pasture management
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Santos, Alyce Raiana Monteiro

; Cabral, Carla Heloísa Avelino

; Cabral, Carlos Eduardo Avelino

; Barros, Lívia Vieira de

; Pires, Deborah França

; Rosa, Altieres dos Santos

; Alves, Guilherme Ribeiro

; Coutinho, Marina Pereira Souza

Acta Scientiarum. Animal Sciences

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2022, Volume 44 elocation e55761

Resumo: En | Texto: En | PDF: En

ABSTRACT. This study evaluated the effect of increased energy via supplementation on the performance, ingestive behavior, nutrient digestibility, and nitrogen metabolism of grazing heifers fed tropical forage in the rainy-dry transition season. Treatments consisted of mineral supplementation ad libitum (control) and multiple supplements formulated to provide different energy levels and the same amount of protein (300 g CP animal d-1) and were denominated as low (LE; 340 g TDN animal d-1), medium (ME; 780 g TDN animal d-1) and high (HE; 1220 g TDN animal d-1) energy. Animals supplemented with ME, and HE had a greater average daily gain in relation to the control treatment, with an increase of 41 and 46%, respectively. Greater values for total apparent digestibility of neutral detergent fiber were observed for the treatment HE. Lesser values of urinary urea N were observed for the control and HE treatments. Our results define the use of energy levels in the supplement as a tool for pasture management. If the purpose of the production system is to enhance forage intake, the option is to supply supplements with less energy levels. In contrast, if the purpose is to increase the stocking rate, supplements with greater energy levels should be used.

https://doi.org/10.4025/actascianimsci.v44i1.55761

Violência contra crianças e adolescentes e pandemia – Contexto e possibilidades para profissionais da educação
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Oliveira, Ana Paula França de

; Souza, Marina Soares de

; Sabino, Fabiano Henrique de Oliveira

; Vicente, Aparecido Renan

; Carlos, Diene Monique

Escola Anna Nery

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2022, Volume 26 Nº spe elocation e20210250

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

Resumo Objetivo compreender as percepções de profissionais da educação sobre as violências contra crianças e adolescentes em contexto de pandemia pela Covid-19. Método pesquisa com abordagem qualitativa, ancorada no Paradigma Complexo, realizada com sete profissionais da educação entre setembro e outubro de 2020. A coleta de dados se deu por entrevistas semiestruturadas realizadas em plataforma virtual gratuita, sendo os dados analisados tematicamente. Resultados emergiram dois temas finais “Violência e pandemia” e “(Não) percepção de possibilidades de atuação”. A violência contra crianças e adolescentes é vislumbrada como fenômeno multidimensional pelos participantes. Pelas especificidades de maior ocorrência nas famílias, as alterações da vida impostas pela pandemia, em especial, o afastamento escolar, podem implicar no aumento de casos e maior dificuldade para identificação de violências contra essa população. Os impactos à saúde mental de crianças e adolescentes nesse período foi reforçado. Conclusão e implicações para a prática apesar da compreensão de maior exposição às violências durante a pandemia, os profissionais não conseguiram propor estratégias para enfrentamento. Novos estudos sobre o tema com diferentes atores envolvidos, e articulação intersetorial para enfrentamento do fenômeno, são necessários.

Abstract Objective to understand the education professionals' perception about violence against children and adolescents in the COVID-19 pandemic context. Method a research study with a qualitative approach, anchored in the Complex Paradigm, carried out with seven education professionals between September and October 2020. Data collection took place through semi-structured interviews carried out on a free virtual platform, and the data were thematically analyzed. Results Two final themes emerged: “Violence and the pandemic” and “(Non)perception of action possibilities”. Violence against children and adolescents is seen as a multidimensional phenomenon by the participants. Due to the specificities that occur more frequently in families, the life changes imposed by the pandemic, especially distancing from the school, can lead to an increase in the number of cases and to greater difficulty identifying violence against this population. The impacts on children's and adolescents' mental health during this period were reinforced. Conclusion and implications for the practice despite the understanding of greater exposure to violence during the pandemic, the professionals were unable to propose coping strategies. New studies on the subject matter with different actors involved are needed, as well as intersectoral articulation to face the phenomenon.

Resumen Objetivo comprender las percepciones de los profesionales de la educación sobre la violencia contra niños y adolescentes en el contexto de pandemia por Covid-19. Método investigación con enfoque cualitativo, anclada en el Paradigma Complejo, realizada con siete profesionales de la educación entre septiembre y octubre de 2020. La recolección de datos se llevó a cabo a través de entrevistas semiestructuradas realizadas en una plataforma virtual libre, y los datos fueron analizados temáticamente. Resultados Surgieron dos temas finales “Violencia y pandemia” y “(No) percepción de posibilidades de actuación”. La violencia contra niños y adolescentes es vista por los participantes como un fenómeno multidimensional. Debido a las especificidades que ocurren con mayor frecuencia en las familias, los cambios en la vida que impone la pandemia, especialmente el alejamiento de las escuelas, pueden conllevar un aumento de casos y una mayor dificultad para identificar la violencia contra esta población. Se reforzaron los impactos en la salud mental de niños y adolescentes durante este período. Conclusión e implicaciones para la práctica a pesar de comprender que se manifiesta una mayor exposición a la violencia durante la pandemia, los profesionales no pudieron proponer estrategias de afrontamiento. Se advierte la necesidad de contar con nuevos estudios sobre el tema, que incluyan a los diferentes actores involucrados, con articulación intersectorial para enfrentar el fenómeno.

https://doi.org/10.1590/2177-9465-ean-2021-0250 543 downloads

Mortalidade perinatal no Brasil em 2018: análise epidemiológica segundo a classificação de Wiggleworth modificada
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Nobrega, Aglaer Alves da

; Mendes, Yluska Myrna Meneses Brandão e

; Miranda, Marina Jorge de

; Santos, Augusto César Cardoso dos

; Lobo, Andréa de Paula

; Porto, Denise Lopes

; França, Giovanny Vinícius Araújo de

Cadernos de Saúde Pública

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2022, Volume 38 Nº 1 elocation e00003121

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

Resumo: A mortalidade perinatal engloba a mortalidade fetal e a neonatal precoce (0 a 6 dias). Este estudo descreveu os óbitos perinatais ocorridos no Brasil em 2018, segundo a classificação de Wigglesworth modificada. As fontes de dados foram os Sistemas de Informações sobre Mortalidade e sobre Nascidos Vivos. Foram calculadas as taxas de mortalidade fetal e perinatal por mil nascimentos totais (nascidos vivos mais natimortos) e a taxa de mortalidade neonatal precoce por mil nascidos vivos, e comparadas usando seus respectivos intervalos de 95% de confiança (IC95%). Os óbitos perinatais foram classificados nos grupos de causas anteparto, anomalias congênitas, prematuridade, asfixia e causas específicas. Foi calculado, para cada grupo de causas, o número de óbitos por faixa de peso, além das taxas de mortalidade e os respectivos IC95%, e feita a distribuição espacial das taxas de mortalidade por Unidade da Federação (UF). Foram registrados 35.857 óbitos infantis, sendo 18.866 (52,6%) neonatais precoces; os natimortos somaram 27.009. Os óbitos perinatais totalizaram 45.875, perfazendo uma taxa de mortalidade de 15,5‰ nascimentos. A maior taxa de mortalidade (7,6‰; 7,5‰-7,7‰) foi observada no grupo anteparto, seguido da prematuridade (3,6‰; 3,6‰-3,7‰). No grupo anteparto, 14 das 27 UFs (sendo oito na Região Nordeste e quatro na Região Norte) apresentaram as taxas de mortalidade perinatal acima da nacional. A taxa de mortalidade perinatal no Brasil mostrou-se elevada, e a maioria dos óbitos poderia ser prevenida com investimento em cuidados pré-natais e ao nascimento.

Abstract: Perinatal mortality includes fetal mortality and early neonatal mortality (0 to 6 days of life). The study described perinatal deaths in Brazil in 2018 according to the modified Wigglesworth classification. The data sources were the Brazilian Mortality Information System and the Brazilian Information System on Live Births. Fetal mortality and perinatal mortality rates were calculated per 1,000 total births (live births plus stillbirths) and the early neonatal mortality rate per 1,000 live births, compared using their respective 95% confidence intervals (95%CI). Perinatal deaths were classified in groups of antepartum causes, congenital anomalies, prematurity, asphyxia, and specific causes. For each group of causes, the study calculated the number of deaths by weight group, in addition to mortality rates and respective 95%CI, besides the spatial distribution of mortality rates by state of Brazil. A total of 35,857 infant deaths were recorded, of which 18,866 (52.6%) were early neonatal deaths, while stillbirths totaled 27,009. Perinatal deaths totaled 45,875, for a mortality rate of 15.5‰ births. The highest mortality rate (7.6‰; 7.5‰-7.7‰) was observed in the antepartum group, followed by prematurity (3.6‰; 3.6‰-3.7‰). In the antepartum group, 14 of the 27 states (eight of which in the Northeast and four in the North) presented perinatal mortality rates above the national rate. Perinatal mortality in Brazil was high, and most deaths could have been prevented with investment in prenatal and childbirth care.

Resumen: La mortalidad perinatal engloba la mortalidad fetal y neonatal precoz (0 a 6 días). Este estudio describió los óbitos perinatales ocurridos en Brasil en 2018, según la clasificación de Wigglesworth modificada. Las fuentes de datos fueron los Sistemas de Información sobre Mortalidad y sobre Nacidos Vivos. Se calcularon las tasas de mortalidad fetal y perinatal por 1.000 nacimientos totales (nacidos vivos más mortinatos) y la tasa de mortalidad neonatal precoz por 1.000 nacidos vivos, y se compararon usando sus respectivos intervalos de 95% de confianza (IC95%). Los óbitos perinatales se clasificaron en los grupos de causas: anteparto, anomalías congénitas, prematuridad, asfixia y causas específicas. Se calculó, para cada grupo de causas, el número de óbitos por franja de peso, además de las tasas de mortalidad y los respectivos IC95%, y se realizó la distribución espacial de las tasas de mortalidad por Unidad de la Federación (UF). Se registraron 35.857 óbitos infantiles, siendo 18.866 (52,6%) neonatales precoces; los mortinatos sumaron 27.009. Los óbitos perinatales totalizaron 45.875, ascendiendo a una tasa de mortalidad de un 15,5‰ nacimientos. La mayor tasa de mortalidad (7,6‰; 7,5‰-7,7‰) se observó en el grupo anteparto, seguido de la prematuridad (3,6‰; 3,6‰-3,7‰). En el grupo anteparto, 14 de las 27 UFs (estando ocho en la región Nordeste y cuatro en la región Norte) presentaron tasas de mortalidad perinatal por encima de la nacional. La tasa de mortalidad perinatal en Brasil se mostró elevada y la mayoría de los óbitos podría ser prevenido con inversión en cuidados prenatales y en el nacimiento.

https://doi.org/10.1590/0102-311x00003121

10.

Mortalidade perinatal no Brasil em 2018: análise epidemiológica segundo a classificação de Wiggleworth modificada
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Nobrega, Aglaer Alves da

; Mendes, Yluska Myrna Meneses Brandão e

; Miranda, Marina Jorge de

; Santos, Augusto César Cardoso dos

; Lobo, Andréa de Paula

; Porto, Denise Lopes

; França, Giovanny Vinícius Araújo de

Cadernos de Saúde Pública

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2022, Volume 38 Nº 1 elocation e00003121

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

https://doi.org/10.1590/0102-311x00003121

11.

Chronic type 2 reaction possibly triggered by an asymptomatic Bartonella henselae infection in a leprosy patient
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Santos, Luciene Silva dos

; Drummond, Marina Rovani

; França, Andrea Fernandes Eloy da Costa

; Pavan, Maria Helena Postal

; Stelini, Rafael Fantelli

; Cintra, Maria Letícia

; Souza, Elemir Macedo de

; Velho, Paulo Eduardo Neves Ferreira

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e17

Resumo: En | Texto: En | PDF: En

ABSTRACT As leprosy and leprosy reactions are the most prevalent infectious cause of physical disability, it is important to commit efforts to better understand these chronic reactions. Infections, even when asymptomatic, can trigger leprosy reactions and Bartonella spp. in turn, can cause chronic infections. We presented a case of a 51-year-old man who was admitted presenting with chronic type 2 leprosy reactions. He had a lepromatous form of leprosy that was histologically diagnosed six months after the onset of signs and symptoms compatible with a chronic type 2 reaction. He reported a history of a previous hepatitis B diagnosis. During a 24-month multidrug therapy (MDT), chronic reactions were partially controlled with prednisone and thalidomide. Thirty-three months following the leprosy treatment, he still experienced chronic reactions, and whole bacilli as well as globi were found on a new skin biopsy. Since coinfections can trigger type 2 reactions and the patient had close contact with animals and ticks, we investigated the presence of a Bartonella sp. infection. Bartonella henselae DNA was detected in a skin fragment obtained before the beginning of the leprosy retreatment. However, even after six months of a second leprosy MDT, he continued to experience type 2 chronic reactions. He was admitted to the hospital to undergo an intravenous antibiotic therapy for 14 days and then complete the treatment per os for ten more weeks. Leprosy reactions improved following the treatment for B. henselae. After completing the MDT treatment, he has been accompanied for sixty months with no signs of leprosy or leprosy reactions. The asymptomatic infection by B. henselaein this patient was considered the putative trigger of chronic leprosy reactions and leprosy relapse.

https://doi.org/10.1590/s1678-9946202264017

12.

Low frequency of SARS-CoV2 infection in daycare centers during the reopening of school activities in the Southeast’s poor area of Brazil
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Soares, Graciela dos Santos

; Morais, Lucas Vinicius

; Silva, Kevin Cézar Nascimento

; Ferreira, Elaine Moura

; Shio, Marina Tiemi

; Romano, Camila Malta

; Conde, Carla Regiani

; Sabino, Ester Cerdeira

; França, Carolina Nunes

; Nali, Luiz Henrique

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e46

Resumo: En | Texto: En | PDF: En

ABSTRACT SARS-Cov2 has already infected over 482 million people and caused more than 6.1 million deaths. The beginning of the pandemic has led the health authorities of several countries to adopt non-pharmacological preventive measures such as daycare closures. The reopening took place when the country had the highest rates of infection and mortality (mainly due to the gamma variant (P.1) outbreak) and the beginning of the vaccination program. Therefore, we aimed to investigate the prevalence of SARS-CoV2 in daycare after educational activities resumed. The study was conducted in seven childcare facilities. Swab samples from the nasopharynx were collected from children and staff members. The viral RNA was obtained through PureLink RNA extraction kit purification and SARS-CoV2 presence was detected using the All plex SARS-CoV2 kit. The study population included 201 participants, including daycare workers and children. The average age of the workers and children is 40 and 3 years old, respectively. Among the children, 47.5% are female and among the workers, 91.4%. One (0.5%) test came out positive for the presence of SARS-CoV-2, which was from a sample of an asymptomatic childcare worker, and no secondary infections were detected. Considering that the return to daycare activities occurred during a period with a high number of deaths and a lack of vaccines throughout the country, the small number of cases indicates the effectiveness of the several preventive measures used by daycare centers in preventing SARS-CoV2 transmission.

https://doi.org/10.1590/s1678-9946202264046

13.

Crianças e adolescentes quilombolas apresentam alta prevalência de defeitos de desenvolvimento do esmalte
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França, Thalita Karenyne Xavier Silva

; Lima, Marina de Deus Moura de

; Lima, Cacilda Castelo Branco

; Moura, Marcoeli Silva de

; Lopes, Teresinha Soares Pereira

; Moura, Joyce Samandra Silva de

; Moura, Lúcia de Fátima Almeida de Deus

Ciência & Saúde Coletiva

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Jul 2021, Volume 26 Nº 7 Páginas 2889 - 2898

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

Resumo Dentes com defeitos de desenvolvimento do esmalte (DDE) apresentam porosidades e/ou irregularidades que os tornam suscetíveis a acúmulo de biofilme e predisposição à cárie e doenças periodontais. O objetivo deste artigo é determinar a prevalência de DDE e fatores associados em crianças e adolescentes residentes em comunidade quilombola. A população foi censitária e composta por indivíduos na faixa etária de 3 a 14 anos. Os responsáveis responderam a questionário contendo dados socioeconômicos demográficos e histórico de agravos durante a gravidez e infância. Foi aplicado o Índice DDE modificado. Foram realizadas análise descritiva e regressão de Poisson com variância robusta (p<0,05). Foram examinados 406 indivíduos. A prevalência de DDE foi de 80,5%, sendo que em dentes decíduos foi de 42,2% e permanentes 61,1%. Houve associação entre DDE e maior idade da criança (RP=1,09; IC95%=1,01-1,17), uso de antibiótico na gravidez (RP=1,14; IC95%=1,07-1,22) e relato de desnutrição durante a primeira infância (RP=1,12; IC95%=1,03-1,22). A prevalência de DDE em crianças e adolecentes da comunidade quilombola foi alta. E os fatores associados foram maior idade da criança, uso de antibióticos na gravidez e desnutrição durante a primeira infância.

Abstract Teeth with developmental defects of enamel (DDE) have porous and/or uneven enamel, making them more susceptible to the build-up of oral biofilm and development of caries and periodontal diseases. The aim of this cross-sectional study was to determine the prevalence of DDE and associated factors among children and adolescents living in a Quilombola community in the Northeast of Brazil. The study population was census-based and comprised individuals aged three to 14 years. The children’s parents/guardians answered a questionnaire devised to collect information on socioeconomic and demographic characteristics, health problems during pregnancy and illnesses during early childhood. DDE was diagnosed using the modified DDE index. The data were analyzed using descriptive statistics and Poisson regression with robust standard errors (p<0.05). A total of 406 individuals were examined. DDE prevalence was 80.5%: 42.2% in deciduous teeth and 61.1% in permanent teeth. There was an association between presence of DDE and age (PR=1.09, 95% CI=1.01-1.17), use of antibiotics during pregnancy (PR=1.14, 95% CI=1.07-1.22) and reported malnutrition during early childhood (PR=1.12; 95% CI=1.03-1.22). The findings reveal high prevalence of DDE among children and adolescents living in the Quilombola community. Associated factors were older age, use of antibiotics during pregnancy and malnutrition during early childhood.

https://doi.org/10.1590/1413-81232021267.12762019 332 downloads

14.

Is rituximab effective for systemic sclerosis? A systematic review and meta-analysis
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Caldas, Marina Maria Vieira de Figueiredo

; Azevedo, Kesley Pablo Morais de

; Nunes, Ana Clara de França

; Oliveira, Victor Hugo de

; Pimenta, Isac Davidson Santiago Fernandes

; Araújo, Isabela Dantas Torres de

; Bezerra Neto, Francisco Alves

; Oliveira, Ana Katherine da Silveira Gonçalves de

; Piuvezam, Grasiela

Advances in Rheumatology

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2021, Volume 61 elocation 15

Resumo: En | Texto: En | PDF: En

Abstract Background: Systemic sclerosis (SSc) Is a clinically complex and challenging disease, that leads to skin fibrosis. Its most frequent complication is interstitial lung disease (ILD), which leads to a worse prognosis. In this situation, cyclophosphamide is considered the gold standard for its treatment, despite the controversies regarding its efficacy and toxicity. However, studies using rituximab (RTX) have shown that this drug may be a promising therapeutic option. Objectives: This paper objective was to analyze the scientific evidence on the RTX effects on SSc. Methods: A systematic review (SR) was performed including clinical trials (CTs) on the use of RTX in SSc, published up to May 2020. The studies were identified through systematic searches in bibliographic databases using a predefined search strategy. The following databases were used: PUBMED, SCOPUS, SCIELO, LILACS, SCIENCE DIRECT, WEB OF SCIENCE, COCHRANE, WHOLIS, PAHO and EMBASE. Also, a manual search was performed. The methodological quality of the studies was determined using Jadad scale, Risk of Bias Tool (RoB 2.0) and Risk of Bias in Non-Randomized Studies - of Interventions tool (ROBINS-I). A meta-analysis of the randomized CTs was performed, using Review Manager. Results: Ten CTs were included in this SR. Of these, three were randomized and seven were non-randomized. Five showed a statistically significant improvement in forced vital capacity (FVC) at some time during follow-up. Regarding the skin, eight studies showed statistically significant improvements according toa the modified Rodnan skin score. The meta-analysis found positive effects of RTX in SSc, with a statistical significance for lung disease. Conclusion: Rituximab is a promising strategy for the SSc-associated ILD and cutaneous fibrosis treatment. PROSPERO registration number: CRD42019132018.

https://doi.org/10.1186/s42358-021-00170-y 190 downloads

15.

Extraction of bioactive compounds from juçara pulp (Euterpe edulis M.) is affected by ultrasonic power and temperature
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Madalão, Marina Carvalho Martins

; Lima, Emília Maria França

; Benincá, Daiane Bonizioli

; Saraiva, Sérgio Henriques

; Carvalho, Raquel Vieira de

; Silva, Pollyanna Ibrahim

Ciência e Agrotecnologia

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2021, Volume 45 elocation e024820

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

RESUMO A extração de antocianinas e compostos fenólicos de frutas e vegetais pode ser realizada usando tecnologias emergentes, como o ultrassom. O objetivo deste estudo foi avaliar a influência da temperatura e da potência ultrassônica na extração de antocianinas, compostos fenólicos e capacidade antioxidante dos extratos da polpa de juçara (Euterpe edulisM.), além de realizar a caracterização da mesma. A extração dos compostos bioativos foi realizada em banho ultrassônico (25 kHz) com variação da temperatura (25, 32, 39, 46, 53 °C) e potência ultrassônica (0, 360, 900 W). A polpa de juçara apresentou alto teor de antocianinas e fenólicos totais (298,86 ± 27,68 mg de cianidina-3-glicosídeo/100 g e 1226,39 ± 21,08 mg AGE/100 g em base úmida, respectivamente). Cianidina-3-rutinosídeo foi a principal antocianina presente no extrato, seguida pela cianidina-3-glicosídeo, identificadas e quantificadas por meio de cromatografia líquida de alta eficiência. Com relação aos ensaios de extração, para obtenção de extratos ricos em antocianinas e compostos fenólicos, sugere-se que o procedimento seja realizado a 25 °C sem aplicação de ondas ultrassônicas. Porém, para obter extratos com excelente capacidade antioxidante, deve-se utilizar potência ultrassônica de 360 W a uma frequência de 25 kHz e temperatura de 25 ºC.

ABSTRACT Anthocyanins and phenolic compounds from fruits and vegetables can be extracted using emerging technologies such as ultrasound-assisted extraction. This study aimed to investigate the effect of temperature and ultrasonic power on the extraction of anthocyanins, phenolic compounds from the extracts of juçara pulp (Euterpe edulis M.). We also determined the antioxidant capacity of the extract and determined characteristics of the pulp. Bioactive compounds were extracted in an ultrasonic bath (25 kHz) at various temperatures (25, 32, 39, 46, 53 °C) and ultrasonic power (0, 360, 900 W). Juçara pulp had high total anthocyanin and phenolic content (298.86 ±27.68 mg cyanidin-3-glucoside/100 g and 1226.39 ±21.08 mg GAE/100 g on a wet basis, respectively). Cyanidin-3-rutinoside was the major anthocyanin in the extract, followed by cyanidin-3-glucoside, which were identified and quantified by high-performance liquid chromatography. For obtaining extracts rich in anthocyanins and phenolic compounds, we suggest that the extraction process should be performed at 25 °C without the application of ultrasonic waves. However, to obtain extracts with outstanding antioxidant capacity, an ultrasonic power of 360 W at a frequency of 25 kHz and a temperature of 25 °C should be used.

https://doi.org/10.1590/1413-7054202145024820 574 downloads

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