Abstract Objective This study aimed to review literature from the past five years, focusing on the use of educational videos as a guidance tool for parents and guardians of children with lip and palate clefts. Source of data Conducted between April and July 2022, this integrative literature review was framed around the question: 'What is the evidence regarding the use of videos in health education for parents/guardians of children with cleft lip and palate? PICO strategy was used to develop the research. A literature search was undertaken across PubMed, Web of Science, Scopus, and the Virtual Health Library databases. Of the eight articles included in this review, four were sourced from the PubMed database, with three published in 2021. Summary of the findings The findings indicated that YouTube videos were moderately satisfactory and met the needs of parents or legal guardians to a partial extent. The majority of the videos analyzed in this review were characterized by a moderate level of informational content. One study particularly underscored that the content of these videos only partially satisfies the requirements of the parents or legal guardians of the children. Conclusions Nevertheless, such videos are considered viable alternatives for health education, offering numerous benefits yet facing challenges, primarily due to the scarcity of information on orofacial malformations. years clefts 2022 question What parentsguardians research Science Scopus databases database 2021 extent Nevertheless challenges malformations 202 20 2

ABSTRACT Introduction Chemotherapy and radiation therapy are considered standard treatments for stage II seminoma patients; however, these therapies are associated with long-term toxicities. Recently, retroperitoneal lymph node dissection has emerged as an alternative strategy, and the first three phase II trials were published in 2023 with promising results. The present study conducted a systematic review and meta-analysis to evaluate this surgery as an alternative treatment for stage IIA/B seminoma patients. Purpose Seminomas are the most common testicular tumors, often affecting young adult males. Standard treatments for stage II seminomas include chemotherapy and radiation therapy, but these therapies are associated with long-term toxicities. Thus, identifying alternative strategies is paramount. Herein, we conducted a systematic review and meta-analysis to appraise the efficacy and safety of retroperitoneal lymph node dissection (RPLND) for treating this condition. Methods We systematically searched the PubMed, Embase, and Cochrane databases for studies evaluating RPLND as a primary treatment for stage II A/B seminomas. Using a random-effects model, single proportion and means and pooled 2-year recurrence-free survival rates with hazard rates and 95% CI were calculated. Results Seven studies were included, comprising 331 males with stage II seminomas. In the pooled analysis, the recurrence rate was 17.69% (95% CI 12.31–24.75), and the 2-year RFS rate was 81% (95% CI 0.77–0.86). The complication rate was 9.16% (95% CI 6.16–13.42), the Clavien–Dindo > 2 complication rate was 8.83% (95% CI 5.76–13.31), and the retrograde ejaculation rate was 7.01% (95% CI 3.54–13.40). The median operative time was 174.68 min (95% CI 122.17–249.76 min), median blood loss was 105.91 mL (95% CI 46.89–239.22 mL), and patients with no evidence of lymph node involvement ranged from 0–16%. Conclusions Primary RPLNDs for treating stage IIA/B seminomas have favorable RFS rates, with low complication and recurrence rates. These findings provide evidence that this surgery is a viable alternative therapy for these patients. however longterm long term toxicities Recently strategy 202 results metaanalysis meta analysis IIAB IIA B tumors Thus paramount Herein (RPLND condition PubMed Embase AB A randomeffects random effects model 2year year recurrencefree free 95 calculated included 33 1769 17 69 17.69 (95 12.31–24.75, 12312475 12.31–24.75 , 12 31 24 75 12.31–24.75) 81 0.77–0.86. 077086 0.77–0.86 . 0 77 86 0.77–0.86) 916 9 16 9.16 6.16–13.42, 6161342 6.16–13.42 6 13 42 6.16–13.42) ClavienDindo Clavien Dindo 883 8 83 8.83 5.76–13.31, 5761331 5.76–13.31 5 76 5.76–13.31) 701 7 01 7.01 3.54–13.40. 3541340 3.54–13.40 3 54 40 3.54–13.40) 17468 174 68 174.6 1221724976 122 249 122.17–249.7 min, min) 10591 105 91 105.9 468923922 46 89 239 22 46.89–239.2 mL, mL) 016 0–16% 20 176 1 17.6 (9 1231247 12.31–24.7 07708 0.77–0.8 9.1 616134 6.16–13.4 4 88 8.8 576133 5.76–13.3 70 7.0 354134 3.54–13.4 1746 174. 122172497 122.17–249. 1059 10 105. 46892392 23 46.89–239. 0–16 17. ( 123124 12.31–24. 0770 0.77–0. 9. 61613 6.16–13. 8. 57613 5.76–13. 7. 35413 3.54–13. 12217249 122.17–249 4689239 46.89–239 0–1 12312 12.31–24 077 0.77–0 6161 6.16–13 5761 5.76–13 3541 3.54–13 1221724 122.17–24 468923 46.89–23 0– 1231 12.31–2 07 0.77– 616 6.16–1 576 5.76–1 354 3.54–1 122172 122.17–2 46892 46.89–2 123 12.31– 0.77 61 6.16– 57 5.76– 35 3.54– 12217 122.17– 4689 46.89– 12.31 0.7 6.16 5.76 3.54 1221 122.17 468 46.89 12.3 0. 6.1 5.7 3.5 122.1 46.8 12. 6. 5. 3. 122. 46.

Abstract Urban parks are not only important for the wellbeing of the human population, but are also widely considered to be potentially important sites for the conservation of biodiversity. However, they may offer risk parasitic infections, such as schistosomiasis and fascioliasis, which are both transmitted by freshwater snails. The present study investigated the occurrence of freshwater gastropods in urban parks of the Brazilian city of Rio de Janeiro, and their possible infection by helminths of medical-veterinary importance. Gastropods were collected from six parks (2021 - 2022) and examined for the presence of larval helminths. In all, 12 gastropod species from different families were collected: Ampullariidae, Assimineidae, Burnupidae, Lymnaeidae, Physidae, Planorbidae, Succineidae, and Thiaridae. The parasitological examination revealed cercaria of three types in five snail species, with the Pleurolophocerca cercariae type in Melanoides tuberculata (the most abundant species), Echinostoma cercariae in Physella acuta and Pomacea maculata, and Virgulate cercariae, in Pomacea sp. and Pomacea maculata. None of the Biomphalaria tenagophila and Pseudosuccinea columella (the most frequent species) specimens were parasitized by Schistosoma mansoni or Fasciola hepatica, respectively. Even so, some parks may represent a considerable potential risk for transmission of both Schistosoma mansoni and Fasciola hepatica, given the presence of these gastropod vectors and the frequent contact of visitors with the waterbodies. population biodiversity However infections fascioliasis snails Janeiro medicalveterinary medical veterinary importance 2021 (202 2022 all 1 Ampullariidae Assimineidae Burnupidae Lymnaeidae Physidae Planorbidae Succineidae Thiaridae , maculata sp hepatica respectively so waterbodies 202 (20 20 (2 2 (

This work describes the first chemical study on the metabolic profile of three geopropolis samples from Melipona fulva, M. compressipes, and M. paraensis collected in the Amazonian region. The samples were submitted to solvent extractions. The silylated hexane extracts were submitted to GC-MS analysis and tentatively identified mainly the presence of triterpenes, steroids, fatty acids, and alcohols. The chemical profile of M. fulva of and M. compressipes geopropolis are similar. However, cholesterol, triacontanol, and palmitic acid are the main compounds in M. fulva; in M. compressipes, palmitic acid, linoleic acid, and oleic acid are predominant. The chemical profile of the M. paraensis sample is entirely different once more than 60% of the extract comprises lupenone and triacontanol. The CHCl3 soluble fraction of the MeOH extract of the M. paraensis geopropolis was submitted to chromatographic techniques, and it afforded cycloartenol, 24-methylene-cycloartenol, lupeol, α- and β-amirins, and 7-O-methylaromadendrin. The MeOH extract of this sample presents antimicrobial activities against strains of Streptococcus mutans, S. sobrinus, and S. aureus (MIC of 15.6-62.5 µg mL−1 and MBC of 62.5-1000 µg mL−1). The M. fulva and M. compressipes geopropolis were not active in this test. M region extractions GCMS GC MS triterpenes steroids acids alcohols similar However cholesterol triacontanol predominant 60 CHCl techniques cycloartenol 24methylenecycloartenol, 24methylenecycloartenol methylenecycloartenol 24 methylene 24-methylene-cycloartenol lupeol α βamirins, βamirins β amirins, amirins β-amirins 7Omethylaromadendrin. 7Omethylaromadendrin Omethylaromadendrin 7 O methylaromadendrin. methylaromadendrin 7-O-methylaromadendrin mutans S sobrinus MIC 15.662.5 156625 15.6 62.5 15 6 62 5 15.6-62. mL1 mL 1 mL− 62.51000 6251000 1000 62.5-100 mL−1. . mL−1) test 2 662 15.662. 15662 156 15. 625 62. 15.6-62 51000 62.5100 625100 100 62.5-10 66 15.662 1566 15.6-6 5100 62.510 62510 10 62.5-1 15.66 15.6- 510 62.51 6251 62.5- 51

Resumo Antecedentes A disfunção olfatória (DO) é uma manifestação frequente da doença do coronavírus 2019 (COVID-19). A apolipoproteína E (APOE) é uma proteína que interage com o receptor da enzima conversora de angiotensina, essencial para a entrada viral na célula. Publicações anteriores sugeriram um possível papel da APOE na gravidade da COVID-19. Até onde sabemos, nenhuma publicação encontrou associações significativas entre a gravidade dessa doença, DO e polimorfismos da APOE (E2, E3 e E4). Objetivo Analisar a epidemiologia da DO e sua relação com os polimorfismos do gene APOE em uma coorte de pacientes com COVID longa. Métodos Um estudo de coorte prospectiva com pacientes acompanhados em ambulatório neurológico pós-COVID, com DO sendo definida como uma redução subjetiva da função olfativa após a infecção e a DO persistente sendo definida quando a queixa durou mais de 3 meses após a resolução da infecção por COVID-19. Este estudo transversal é parte de uma pesquisa maior com dados anteriormente relatados, focando na performance cognitiva dos pacientes. Resultados Foram selecionados 221 pacientes para esse estudo, dos quais 186 haviam coletado amostras de sangue para genotipagem APOE. O grupo DO persistente foi mais jovem e apresentou menor taxa de internação na fase aguda da doença (p < 0,001). Além disso, a frequência do alelo E4 da APOE foi menor nesse grupo (p = 0,035). Este estudo avaliou a DO em uma população com COVID longa. Na literatura atual sobre essa doença, a anosmia está associada a melhores desfechos clínicos e o alelo E4 está associado a piores desfechos. Conclusão Nosso estudo acrescenta novas informações a essas correlações, sugerindo a APOE E4 como um fator de proteção para DO. (DO 201 COVID19. COVID19 19 . (COVID-19) (APOE angiotensina célula 19. COVID-19 sabemos E2, E2 (E2 E4. E4) longa pósCOVID, pósCOVID pós COVID, pós-COVID relatados 22 18 p 0,001. 0001 0,001 0 001 0,001) disso 0,035. 0035 0,035 035 0,035) correlações 20 COVID1 1 (COVID-19 COVID-1 (E 2 000 0,00 00 003 0,03 03 (COVID-1 COVID- 0,0 (COVID- 0, (COVID

Abstract Background Olfactory dysfunction (OD) represents a frequent manifestation of the coronavirus disease 2019 (COVID-19). Apolipoprotein E (APOE) is a protein that interacts with the angiotensin-converting enzyme receptor, essential for viral entry into the cell. Previous publications have suggested a possible role of APOE in COVID-19 severity. As far as we know, no publications found significant associations between this disease's severity, OD, and APOE polymorphisms (E2, E3, and E4). Objective To analyze the epidemiology of OD and its relationship with APOE polymorphisms in a cohort of Long-COVID patients. Methods We conducted a prospective cohort study with patients followed in a post-COVID neurological outpatient clinic, with OD being defined as a subjective reduction of olfactory function after infection, and persistent OD being defined when the complaint lasted more than 3 months after the COVID-19 infection resolution. This cross-sectional study is part of a large research with previously reported data focusing on the cognitive performance of our sample. Results The final sample comprised 221 patients, among whom 186 collected blood samples for APOE genotyping. The persistent OD group was younger and had a lower hospitalization rate during the acute phase of the disease (p < 0.001). Furthermore, the APOE variant E4 allele frequency was lower in this group (p = 0.035). This study evaluated OD in an outpatient population with COVID-19. In the current literature on this disease, anosmia is associated with better clinical outcomes and the E4 allele is associated with worse outcomes. Conclusion Our study provides new information to these correlations, suggesting APOE E4 as a protective factor for OD. (OD 201 COVID19. COVID19 COVID 19 . (COVID-19) (APOE angiotensinconverting angiotensin converting receptor cell COVID-1 severity know diseases s E2, E2 (E2 E3 E4. E4) LongCOVID Long postCOVID post clinic resolution crosssectional cross sectional 22 18 genotyping p 0.001. 0001 0.001 0 001 0.001) Furthermore 0.035. 0035 0.035 035 0.035) 19. correlations 20 COVID1 1 (COVID-19 COVID- (E 2 000 0.00 00 003 0.03 03 (COVID-1 0.0 (COVID- 0. (COVID

Abstract Background There are few studies related to Coronavirus Disease 2019 (COVID-19) on the prevalence and nature of pain symptoms after hospital discharge, especially in individuals who develop moderate to severe disease forms. Therefore, this study aimed to evaluate the presence of chronic pain in patients discharged after hospitalization for COVID-19, and the relationship between the presence of chronic pain and intensive care stay, demographics, and risk factors for the worst Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) outcome. Methods A cross-sectional observational study was carried out on patients with COVID-19 who recovered after hospitalization. Patients were recruited at the least 3 months after discharge and their hospital's health files were prospected. The variables evaluated were demographics, the severity of SARS-CoV-2 infection (considering the need for intensive care), and the presence of chronic pain. The results were shown in a descriptive manner, and multivariate analysis expressed as Odds Ratios (ORs) and respective Confidence Intervals (CIs) for the outcomes studied. Statistical significance was set at p < 0.05. Results Of 242 individuals included, 77 (31.8%) reported chronic pain related to COVID-19, with no correlation with the severity of infection. Female sex and obesity were associated with a higher risk for chronic pain with ORs of 2.69 (Confidence Interval [95% CI 1.4 to 5.0]) and 3.02 (95% CI 1.5 to 5.9). The limbs were the most affected areas of the body. Conclusion Chronic pain is common among COVID-19 survivors treated in hospital environments. Female sex and obesity are risk factors for its occurrence. 201 COVID19 COVID 19 (COVID-19 forms Therefore COVID19, 19, stay demographics SARSCoV2 SARSCoV SARS CoV (SARS-CoV-2 outcome crosssectional cross sectional COVID-1 hospitals s prospected SARS-CoV- considering care, , care) manner (ORs CIs (CIs studied 005 0 05 0.05 24 included 7 31.8% 318 31 8 (31.8% 269 69 2.6 95% 95 [95 14 1 4 1. 5.0 50 5 5.0] 302 02 3.0 (95 15 5.9. 59 5.9 . 9 5.9) body environments occurrence 20 COVID1 (COVID-1 (SARS-CoV- COVID- SARS-CoV 00 0.0 31.8 (31.8 26 6 2. [9 5. 30 3. (9 (COVID- (SARS-CoV 0. 31. (31. [ ( (COVID (31 (3

ABSTRACT Objective To investigate the relationship between the levels of adipokines and other endocrine biomarkers and patient outcomes in hospitalized patients with COVID-19. Methods In a prospective study that included 213 subjects with COVID-19 admitted to the intensive care unit, we measured the levels of cortisol, C-peptide, glucagon-like peptide-1, insulin, peptide YY, ghrelin, leptin, and resistin.; their contributions to patient clustering, disease severity, and predicting in-hospital mortality were analyzed. Results Cortisol, resistin, leptin, insulin, and ghrelin levels significantly differed between severity groups, as defined by the World Health Organization severity scale. Additionally, lower ghrelin and higher cortisol levels were associated with mortality. Adding biomarkers to the clinical predictors of mortality significantly improved accuracy in determining prognosis. Phenotyping of subjects based on plasma biomarker levels yielded two different phenotypes that were associated with disease severity, but not mortality. Conclusion As a single biomarker, only cortisol was independently associated with mortality; however, metabolic biomarkers could improve mortality prediction when added to clinical parameters. Metabolic biomarker phenotypes were differentially distributed according to COVID-19 severity but were not associated with mortality. COVID19. COVID19 COVID 19. 19 21 COVID-1 unit Cpeptide, Cpeptide C peptide, C-peptide glucagonlike glucagon like peptide1, peptide1 1, 1 peptide-1 insulin YY leptin resistin. resistin clustering inhospital hospital analyzed Cortisol groups scale Additionally prognosis however parameters COVID1 2 COVID- peptide-

RESUMO Objetivo Investigar a relação entre os níveis de adipocinas e outros biomarcadores endócrinos e os desfechos em pacientes hospitalizados com COVID-19. Métodos Estudo prospectivo que incluiu 213 indivíduos com COVID-19 internados na unidade de terapia intensiva, em que foram medidos os níveis de cortisol, peptídeo-C, peptídeo-1 semelhante ao glucagon, insulina, peptídeo YY, grelina, leptina e resistina; analisamos suas contribuições para o agrupamento de pacientes, gravidade da doença e previsão de mortalidade hospitalar. Resultados Os níveis de cortisol, resistina, leptina, insulina e grelina diferiram significativamente entre os grupos por gravidade, conforme definido pela escala de gravidade da Organização Mundial da Saúde. Além disso, níveis mais baixos de grelina e mais altos de cortisol foram associados à mortalidade. A adição de biomarcadores aos preditores clínicos de mortalidade melhorou significativamente a precisão na determinação do prognóstico. A fenotipagem de indivíduos com base nos níveis de biomarcadores plasmáticos produziu dois fenótipos diferentes, que foram associados à gravidade da doença, mas não à mortalidade. Conclusão Como único biomarcador, apenas o cortisol foi independentemente associado à mortalidade; no entanto, os biomarcadores metabólicos podem melhorar a previsão de mortalidade quando associados a parâmetros clínicos. Os fenótipos dos biomarcadores metabólicos foram distribuídos diferencialmente, conforme a gravidade da COVID-19, mas não foram associados à mortalidade. COVID19. COVID19 COVID 19. 19 21 COVID-1 intensiva peptídeoC, peptídeoC C, C peptídeo-C peptídeo1 1 peptídeo- glucagon YY resistina hospitalar Saúde disso prognóstico diferentes biomarcador entanto diferencialmente COVID19, 19, COVID1 2 COVID-

ABSTRACT BACKGROUND AND OBJECTIVES: Spine diseases have a high annual prevalence and are the main causes of years lived with disability and chronic pain. Among the postoperative analgesic control options, patient-controlled analgesia (PCA) and multimodal analgesia (MMA) have shown good clinical results. This meta-analysis seeks new evidence to help in the treatment of acute postoperative pain in patients undergoing spinal surgery. CONTENTS: The following databases were used: Cochrane Central Register of Controlled Trials, Medline and Embase. Studies that compared two post-surgical analgesic interventions were included; MMA and PCA. The parameters evaluated were: analgesic effect; opioid consumption; length of hospital stay; and adverse effects. Registration of the systematic review protocol: (PROSPERO CRD42023446627). There was no statistical difference when assessing analgesic improvement comparing MMA to PCA (MD -0.12 [-0.41, 0.17] 95%CI with p=0.69). There was a statistical difference, with lower opioid consumption in MMA compared to PCA (MD -3.04 [-3.69, -2.39] 95%CI with p=0.0002). Statistically significant difference regarding length of hospital stay in favor of MMA (MD -13.17 [-16.98, -9.36] 95%CI with p=0.00001), and significantly lower incidence of nausea and vomiting in patients undergoing MMA in compared to PCA (OR 0.26 [0.11, -0.64] 95%CI with p=0.003). CONCLUSION: MMA was equivalent to PCA in the treatment of acute postoperative spinal pain, with the significant clinical advantage and safety of lower amounts of infused opioids, shorter hospital stay and lower incidence of adverse effects. OBJECTIVES options patientcontrolled patient controlled (PCA (MMA results metaanalysis meta analysis surgery CONTENTS used Trials Embase postsurgical post surgical included effect effects protocol PROSPERO CRD42023446627. CRD42023446627 CRD . CRD42023446627) MD 0.12 012 0 12 -0.1 0.41, 041 41 [-0.41 0.17 017 17 95CI CI 95 p=0.69. p069 p p=0.69 69 p=0.69) 3.04 304 3 04 -3.0 3.69, 369 [-3.69 2.39 239 2 39 -2.39 p=0.0002. p00002 p=0.0002 0002 p=0.0002) 13.17 1317 13 -13.1 16.98, 1698 16 98 [-16.98 9.36 936 9 36 -9.36 p=0.00001, p000001 p=0.00001 , 00001 p=0.00001) OR 026 26 0.2 0.11, 011 11 [0.11 0.64 064 64 -0.64 p=0.003. p0003 p=0.003 003 p=0.003) CONCLUSION opioids CRD4202344662 0.1 01 1 -0. 0.41 4 [-0.4 p06 p=0.6 6 3.0 30 -3. 3.69 [-3.6 2.3 23 -2.3 p0000 p=0.000 000 13.1 131 -13. 16.98 169 [-16.9 9.3 93 -9.3 p00000 p=0.0000 0000 02 0. 0.11 [0.1 0.6 06 -0.6 p000 p=0.00 00 CRD420234466 -0 0.4 [-0. p0 p=0. 3. -3 3.6 [-3. 2. -2. 13. -13 16.9 [-16. 9. -9. [0. p00 p=0.0 CRD42023446 - [-0 p=0 [-3 -2 -1 16. [-16 -9 [0 CRD4202344 [- p= [-1 [ CRD420234 CRD42023 CRD4202 CRD420 CRD42 CRD4

RESUMO JUSTIFICATIVA E OBJETIVOS: As doenças da coluna apresentam alta prevalência anual e são as principais causas de anos vividos com incapacidade e de cronificação da dor. Dentre as opções de controle analgésico pós-operatória, a analgesia controlada pelo paciente (ACP) e a analgesia multimodal (AMM) apresentam bons resultados clínicos. O objetivo deste estudo foi buscar novas evidências que auxiliem no tratamento da dor aguda no pós-operatório do paciente submetido à cirurgia da coluna. CONTEÚDO: As bases de dados utilizadas: Cochrane Central Register of Controlled Trials, Medline e Embase. Foram incluídos estudos que compararam duas intervenções analgésicas pós-cirúrgicas; AMM e ACP. Os parâmetros avaliados foram: efeito analgésico; consumo de opioide; tempo de internação hospitalar e efeitos adversos. Registro do protocolo de revisão sistemática: (PROSPERO CRD42023446627). Não houve diferença estatística quando avaliadas a melhora analgésica comparando a AMM à ACP (MD -0,12 [-0,41, 0,17] 95%CI com p=0,69). Houve diferença estatística, com menor consumo de opioide na AMM em comparação à ACP (MD -3,04 [-3,69, -2,39] 95%IC com p=0,0002). Diferença estatística significativa com relação ao tempo de permanência hospitalar a favor da AMM (MD -13,17 [-16,98, -9,36] 95%IC com p=0,00001), e incidência significativamente menor de náuseas e vômitos nos pacientes submetidos a AMM em comparação a ACP (OR 0,26 [0,11, -0,64] 95%IC com p=0,003). CONCLUSÃO: A AMM foi equivalente à ACP no tratamento da dor aguda pós-operatória da coluna, com a significativa vantagem clínica e a segurança de menores quantidades de opioides infundidos, menor tempo de internação hospitalar e menor incidência de efeitos adversos. OBJETIVOS pósoperatória, pósoperatória pós operatória, operatória (ACP (AMM clínicos pósoperatório operatório CONTEÚDO utilizadas Trials Embase póscirúrgicas cirúrgicas pós-cirúrgicas foram adversos sistemática PROSPERO CRD42023446627. CRD42023446627 CRD . CRD42023446627) MD 0,12 012 0 12 -0,1 0,41, 041 41 [-0,41 0,17 017 17 95CI CI 95 p=0,69. p069 p p=0,69 69 p=0,69) 3,04 304 3 04 -3,0 3,69, 369 [-3,69 2,39 239 2 39 -2,39 95IC IC p=0,0002. p00002 p=0,0002 0002 p=0,0002) 13,17 1317 13 -13,1 16,98, 1698 16 98 [-16,98 9,36 936 9 36 -9,36 p=0,00001, p000001 p=0,00001 , 00001 p=0,00001) OR 026 26 0,2 0,11, 011 11 [0,11 0,64 064 64 -0,64 p=0,003. p0003 p=0,003 003 p=0,003) CONCLUSÃO infundidos CRD4202344662 0,1 01 1 -0, 0,41 4 [-0,4 p06 p=0,6 6 3,0 30 -3, 3,69 [-3,6 2,3 23 -2,3 p0000 p=0,000 000 13,1 131 -13, 16,98 169 [-16,9 9,3 93 -9,3 p00000 p=0,0000 0000 02 0, 0,11 [0,1 0,6 06 -0,6 p000 p=0,00 00 CRD420234466 -0 0,4 [-0, p0 p=0, 3, -3 3,6 [-3, 2, -2, 13, -13 16,9 [-16, 9, -9, [0, p00 p=0,0 CRD42023446 - [-0 p=0 [-3 -2 -1 16, [-16 -9 [0 CRD4202344 [- p= [-1 [ CRD420234 CRD42023 CRD4202 CRD420 CRD42 CRD4

Resumo Fundamento: A cardiomiopatia associada à lipodistrofia parcial (LP) ainda não foi bem descrita. Objetivo: Caracterizar a morfologia e a função cardíaca na LP. Métodos: Pacientes com LP e controles foram avaliados prospectivamente por ecocardiografia transtorácica e ecocardiografia por speckle-tracking (Strain Longitudinal Global, SLG). A relação entre as variáveis ecocardiográficas e o diagnóstico de LP foi testada com modelos de regressão, considerando o efeito da pressão arterial sistólica (PAS). Adotou-se um nível de significância de 5%. Resultados: Vinte e nove pacientes com LP foram comparados com 17 controles. Eles não se diferiram quanto à idade (p=0,94), sexo ou índice de massa corporal (p= 0,05). Os pacientes com LP apresentaram PAS estatisticamente mais alta (p=0,02) em comparação aos controles. Ainda, os pacientes com LP apresentaram maior dimensão do átrio (37,3 ± 4,4 vs. 32,1 ± 4,3 mm, p= 0,001) e maior volume atrial (30,2 ± 7,2 vs. 24,9 ± 9,0 mL/m2, p=0,02), massa do Ventrículo Esquerdo (VE) (79,3 ± 17,4 vs. 67,1 ± 19,4; p=0,02), e parâmetros sistólicos reduzidos do VE (E’ lateral, p= 0,001) (E’ septal, p= 0,001), (razão E/E’, p= 0,02). A fração de ejeção do VE (64,7 ± 4,6 vs. 62,2 ± 4,4 %, p = 0,08) e o SLG não foram estatisticamente diferentes entre os grupos (-17,1±2,7 vs-18.0 ± 2,0%, p= 0,25). Observou-se uma reação positiva do átrio esquerdo (β 5,6; p<0,001), espessura da parede posterior (β 1,3; p=0,011), E’ lateral (β -3,5; p=0,002) e E’ septal (β -3,2; p<0,001) com o diagnóstico de LP, mesmo após o ajuste para a PAS. Conclusão: Os pacientes com LP apresentam hipertrofia do VE, aumento do átrio esquerdo, e disfunção diastólica do VE apesar de fração de ejeção do VE e SLG preservados. Os parâmetros ecocardiográficos estão relacionados com o diagnóstico de LP, independentemente da PAS. Fundamento (LP descrita Objetivo Métodos speckletracking speckle tracking Strain Global SLG. . SLG) regressão (PAS) Adotouse Adotou 5 5% Resultados 1 p=0,94, p094 p=0,94 , 0 94 (p=0,94) (p 0,05. 005 0,05 05 0,05) p=0,02 p002 02 (p=0,02 Ainda 37,3 373 37 3 (37, 44 4 4, vs 321 32 32, 43 mm 0,001 0001 001 30,2 302 30 2 (30, 72 7 7, 249 24 9 24, 90 9, mLm2 mLm mL m2 m mL/m2 p=0,02, p=0,02) (VE 79,3 793 79 (79, 174 17, 671 67 67, 19,4 194 19 E (E 0,001, razão E/E, EE E/E E/E’ 0,02. 002 0,02 0,02) 64,7 647 64 (64, 46 6 622 62 62, % 0,08 008 08 17,1±2,7 17127 (-17,1±2, vs18.0 vs180 18.0 18 vs-18. 20 2,0% 0,25. 025 0,25 25 0,25) Observouse Observou β 5,6 56 p<0,001, p0001 p<0,001 1,3 13 p=0,011, p0011 p=0,011 011 p=0,011) 3,5 35 -3,5 p=0,002 p0002 3,2 -3,2 Conclusão preservados (PAS p09 p=0,9 (p=0,94 00 0,0 p=0,0 p00 (p=0,0 37, (37 0,00 000 30, (30 mL/m 79, (79 19, 64, (64 17,1±2, 1712 (-17,1±2 vs18 vs18. 180 18. vs-18 2,0 0,2 5, p000 p<0,00 1, p001 p=0,01 01 3, -3, p=0,00 p0 p=0, (p=0,9 0, (p=0, (3 (7 (6 17,1±2 171 (-17,1± vs1 vs-1 2, p<0,0 -3 p=0 (p=0 ( 17,1± (-17,1 vs- p<0, - 17,1 (-17, p<0 (-17 p< (-1 (-

Abstract Background: Cardiomyopathy associated with partial lipodystrophy (PL) has not been well described yet. Objective: To characterize cardiac morphology and function in PL. Methods: Patients with familial PL and controls were prospectively assessed by transthoracic echocardiography and with speckle-tracking echocardiography (global longitudinal strain, GLS). The relationship between echocardiographic variables and PL diagnosis was tested with regression models, considering the effect of systolic blood pressure (SBP). Significance level of 5% was adopted. Results: Twenty-nine patients with PL were compared to 17 controls. They did not differ in age (p=0.94), gender or body mass index (p= 0.05). Patients with PL had statistically higher SBP (p=0.02) than controls. Also, PL patients had higher left atrial dimension (37.3 ± 4.4 vs. 32.1 ± 4.3 mm, p= 0.001) and left atrial (30.2 ± 7.2 vs. 24.9 ± 9.0 mL/m2,p=0.02), left ventricular (LV) mass (79.3 ± 17.4 vs. 67.1 ± 19.4, p=0.02), and reduced diastolic LV parameters (E’ lateral, p= 0.001) (E’ septal, p= 0.001), (E/E’ ratio, p= 0.02). LV ejection fraction (64.7 ± 4.6 vs. 62.2 ± 4.4 %, p= 0.08) and GLS were not statistically different between groups (-17.1 ± 2.7 vs. -18.0 ± 2.0 %, p= 0.25). There was a positive relationship of left atrium (β 5.6, p<0.001), posterior wall thickness, (β 1.3, p=0.011), E’ lateral (β -3.5, p=0.002) and E’ septal (β -3.2, p<0.001) with PL diagnosis, even after adjusted for SBP. Conclusion: LP patients have LV hypertrophy, left atrial enlargement, and LV diastolic dysfunction although preserved LVEF and GLS. Echocardiographic parameters are related to PL diagnosis independent of SBP. Background (PL yet Objective Methods speckletracking speckle tracking global strain . GLS) models (SBP) 5 adopted Results Twentynine Twenty nine 1 p=0.94, p094 p p=0.94 , 0 94 (p=0.94) (p 0.05. 005 0.05 05 0.05) p=0.02 p002 02 (p=0.02 Also 37.3 373 37 3 (37. 44 4 4. vs 321 32 32. 43 mm 0.001 0001 001 30.2 302 30 2 (30. 72 7 7. 249 24 9 24. 90 9. mL/m2,p=0.02, mLm2p002 mLmp mL/m2,p=0.02 mL m2 m mL/m2,p=0.02) (LV 79.3 793 79 (79. 174 17. 671 67 67. 194 19 19.4 p=0.02, p=0.02) E (E 0.001, E/E EE (E/E ratio 0.02. 002 0.02 0.02) 64.7 647 64 (64. 46 6 622 62 62. % 0.08 008 08 17.1 171 (-17. 27 2. 18.0 180 18 -18. 20 0.25. 025 0.25 25 0.25) β 56 5.6 p<0.001, p0001 p<0.001 thickness 13 1.3 p=0.011, p0011 p=0.011 011 p=0.011) 3.5, 35 -3.5 p=0.002 p0002 3.2, -3.2 Conclusion hypertrophy enlargement (SBP p09 p=0.9 (p=0.94 00 0.0 p=0.0 p00 (p=0.0 37. (37 0.00 000 30. (30 mLm mLm2p00 mL/m2,p=0.0 79. (79 19. 64. (64 (-17 18. -18 0.2 5. p000 p<0.00 1. p001 p=0.01 01 3.5 -3. p=0.00 3.2 p0 p=0. (p=0.9 0. (p=0. (3 mLm2p0 mL/m2,p=0. (7 (6 (-1 -1 p<0.0 3. -3 p=0 (p=0 ( mLm2p mL/m2,p=0 (- - p<0. mL/m2,p= p<0 mL/m2,p p<

ABSTRACT Fungi of the genus Pyricularia have a wide range of host plants and are capable of infecting more than 50 species of grasses, causing the blast disease, with damage to the ears. Species of the forage signal grass (Urochloa spp.) can be hosts of this genus of fungus and can be an important source of inoculum of the pathogen for other agricultural crops affected by blast, especially wheat. The objective of this study was to determine the reaction of nine cultivars of Urochloa to the pathogens Pyricularia oryzae Triticum lineage (PoTl), P. pennisetigena, P. urashimae, and P. grisea. The virulence of seven races of PoTl to signal grass cultivars was also evaluated. There was variation in the pathogenicity and virulence of Pyricularia species and PoTl races in different signal grass cultivars. The cultivars Ipyporã, BRS Tupi, and Xaraés were the most resistant to the different blast pathogen species and PoTl races. Therefore, it is recommended to cultivate these varieties in areas adjacent to wheat or in crop-livestock integration. 5 grasses disease ears spp. spp PoTl, , (PoTl) P pennisetigena urashimae grisea evaluated Ipyporã Tupi Therefore croplivestock crop livestock integration (PoTl

RESUMO Os fungos do gênero Pyricularia possuem ampla gama de plantas hospedeiras e são capazes de infectar mais de 50 espécies de gramíneas, causando a doença brusone, com danos às espigas. Espécies da forrageira braquiária (Urochloa spp.) podem ser hospedeiras deste gênero de fungo e podem ser importante fonte de inóculo do patógeno para outras culturas agrícolas afetadas pela brusone, especialmente o trigo. O objetivo deste estudo foi determinar a reação de nove cultivares de Urochloa aos patógenos Pyricularia oryzae linhagem Triticum (PoT1), P. pennisetigena, P. urashimae e P. grisea. Foi avaliado também a virulência de sete raças de PoTl á cultivares de braquiária. Houve variação na patogenicidade e virulência das espécies de Pyricularia e raças de PoTl em diferentes cultivares de braquiária. As cultivares Ipyporã, BRS Tupi e Xaraés foram as mais resistentes às diferentes espécies de patógenos da brusone, e raças de PoTl. Portanto, recomenda-se o cultivo dessas variedades em áreas adjacentes às de trigo ou na integração lavoura-pecuária. 5 gramíneas brusone espigas spp. spp PoT1, PoT1 PoT , (PoT1) P pennisetigena grisea Ipyporã Portanto recomendase recomenda se lavourapecuária. lavourapecuária lavoura pecuária. pecuária lavoura-pecuária (PoT1 (PoT

ABSTRACT Introduction: The academic literature on deliberative systems suggests exploring the connections between deliberative forums and other components of the political system and society. This article investigates the participation of governmental actors and civil society in councils and conferences addressing public policies on human rights in the state of Minas Gerais, Brazil. The objectives are twofold: to propose a theoretical framework for examining deliberative subsystems and to identify the connectors in a multilevel network consisting of human rights councils and conferences. Materials and methods: We adopted a methodology centered on subsystem theory, prioritizing the dynamics of deliberation arenas and the synergy between councils at local and state levels. We reinterpreted the concept of subsystem to develop an empirical model that incorporates its thematic dimension. To examine the interconnections between councils and conferences, we employed an analytical approach known as two mode network analysis, also referred to as affiliation network analysis, situated in the domain of Social Network Analysis. Results: Our findings suggest a high level of integration within the subsystem. In contrast to prior studies, we found that civil society actors, alongside governmental agents, significantly contribute to interconnecting various arenas within the subsystem. This finding underlines the functional specialization of liaison agents within the context of the deliberation system. Discussion: Our findings offer a twofold contribution to the existing literature. Firstly, we present an innovative theoretical model for analyzing deliberative systems. Secondly, we recommend the use of multilevel network analysis as a robust tool for identifying connections between multiple arenas. Introduction Gerais Brazil methods theory levels dimension Analysis Results studies Discussion Firstly Secondly

RESUMO Introdução: A literatura sobre sistemas deliberativos recomenda investigar as conexões dos fóruns deliberativos com outras partes do sistema político e da sociedade. O artigo analisa a participação de atores governamentais e da sociedade civil em conselhos e conferências de políticas públicas sobre direitos humanos no estado de Minas Gerais, Brasil. Os objetivos são dois: propor um modelo teórico para estudar subsistemas deliberativos; e identificar os conectores de uma rede multinível composta por conselhos e conferências de Direitos Humanos. Materiais e métodos: Adotamos uma metodologia centrada na teoria de subsistemas, priorizando a dinâmica das arenas de deliberação e a sinergia entre conselhos em âmbitos local e estadual. Reinterpretamos o conceito de subsistema e desenvolvemos um modelo empírico que incorpora sua dimensão temática. Para examinar as interligações entre conselhos e conferências, recorremos a uma abordagem analítica conhecida como análise de redes de dois modos, também referida como análise de redes de afiliação, situada no domínio da Análise de Redes Sociais. Resultados: Os achados sugerem que o subsistema é altamente integrado. Contrastando com pesquisas anteriores, notamos que, paralelamente à relevância dos agentes governamentais na interligação das arenas, os participantes da sociedade civil desempenham um papel preponderante na articulação das diferentes áreas que constituem o subsistema. Este resultado destaca a especialização funcional dos agentes de ligação no contexto do sistema de deliberação. Discussão: Nossas descobertas contribuem em dois aspectos fundamentais para a literatura existente. Primeiramente, introduzimos um modelo teórico inovador para a análise de sistemas deliberativos. Em segundo lugar, recomendamos a utilização da análise de rede multinível como uma ferramenta eficaz para identificar as conexões entre múltiplas arenas. Introdução Gerais Brasil Humanos métodos estadual temática modos afiliação Sociais Resultados integrado anteriores Discussão existente Primeiramente lugar

Abstract FioAntar, FIOCRUZ’s research project in Antarctica, is based on the One Health approach. FioAntar aims to generate relevant information that will help reduce the risk of future pandemics and improve the search for chemical compounds and new biological molecules. After four expeditions to Antarctica under the scope of PROANTAR, Fiocruz has identified Influenza H11N2 virus in environmental fecal samples, as well as Histoplasma capsulatum and Bacillus cereus in soil samples. In addition, in a prospective virome analysis from different lakes in the South Shetland Islands, six viral orders were described, supporting future research related to the biodiversity and viral ecology in this extreme ecosystem. Our findings of environmental pathogens of public health importance are a warning about the urgency of establishing a surveillance agenda on zoonoses in Antarctica due to the imminent risks that ongoing environmental and climate changes impose on human health across the planet. FioAntar strives to establish a comprehensive surveillance program across Antarctica, monitoring circulation of pathogens with the potential to transcend continent boundaries, thereby mitigating potential spread. For Fiocruz, Antarctica signifies a new frontier, teeming with opportunities to explore novel techniques, refine established methodologies, and cultivate invaluable knowledge. FIOCRUZs FIOCRUZ s approach molecules PROANTAR HN H N H11N samples addition Islands described ecosystem planet boundaries spread frontier techniques methodologies knowledge

RESUMO O manejo eficaz de florestas perturbadas requer um conhecimento adequado da dinâmica florestal. Neste estudo, avaliamos a mudança de uma floresta manejada em 18 parcelas permanentes de 1 hectare localizadas na floresta tropical de terra firme no leste da Amazônia (Brasil, Paragominas). Todos os indivíduos com diâmetro à altura do peito (DAP) ≥ 20 cm foram avaliados em duas avaliações separadas realizadas em 2006 e 2016. Os resultados indicam que, dez anos após a exploração, a floresta manejada apresenta um desequilíbrio nas taxas de recrutamento (1,54% ao ano) e mortalidade (2,23% ao ano), sugerindo que a floresta ainda está em processo de recuperação estrutural. No entanto, a biomassa mostrou um aumento após a exploração, atingindo 28,49 toneladas por hectare. As características das mudanças indicam que a floresta está em um processo silvigenético impulsionado pela exploração madeireira. Além disso, observamos que a floresta permanece ativa e possui potencial suficiente para uma nova produção de madeira no final do ciclo de corte, considerando as mesmas espécies e tamanhos de árvores. florestal estudo Brasil, Brasil (Brasil Paragominas. Paragominas . Paragominas) DAP (DAP 2 200 2016 1,54% 154 54 (1,54 ano 2,23% 223 23 (2,23 ano, , estrutural entanto 2849 28 49 28,4 madeireira disso corte árvores 201 1,54 15 5 (1,5 2,23 22 (2,2 284 4 28, 1,5 (1, 2,2 (2, 1, (1 2, (2 (

ABSTRACT The effective management of disturbed forests requires adequate knowledge of forest dynamics. In this study, we assessed the changes in a managed forest using 18 permanent 1 ha plots located in a ‘terra firme’ tropical rainforest in the Eastern Amazon (Paragominas, Brazil). All individuals with a diameter at breast height (DBH) ≥ 20 cm were evaluated in two separate assessments conducted in 2006 and 2016. The results show that, ten years after logging, the managed forest exhibits an imbalance between recruitment (1.54% per year) and mortality (2.23% per year) rates, indicating that it is still in the process of recovering its structure. Nevertheless, biomass tended to increase after logging (28.49 tons per hectare). The characteristics of these changes suggest that the forest is undergoing a silvigenetic process driven by the effects of logging. Furthermore, our observations indicate that the forest remains active and has sufficient potential for new timber production at the end of the cutting cycle, considering the same species and tree sizes. dynamics study terra firme Paragominas, Paragominas (Paragominas Brazil. Brazil . Brazil) DBH (DBH 2 200 2016 1.54% 154 54 (1.54 year 2.23% 223 23 (2.23 rates structure Nevertheless 28.49 2849 28 49 (28.4 hectare. hectare hectare) Furthermore cycle sizes 201 1.54 15 5 (1.5 2.23 22 (2.2 28.4 284 4 (28. 1.5 (1. 2.2 (2. 28. (28 1. (1 2. (2 (

Resumo A determinação acurada do consumo individual é um parâmetro importante para avaliação do valor nutritivo da dieta e permite o fornecimento adequado de alimentos, conforme as exigências nutricionais de cada animal. Quando há impossibilidade da sua mensuração pelo método direto, o consumo pode ser calculado a partir da produção fecal estimada por indicadores e pela digestibilidade in vitro da matéria seca (DIVMS) da dieta. Foi objetivo deste estudo avaliar os indicadores externos dióxido de titânio (TiO2) e hidroxifenilpropano enriquecido e modificado (LIPE®) nas estimativas de consumo de matéria seca (MS). Foram utilizadas quatro vacas multíparas Holandês × Gir com média de 60 dias em lactação e 488 kg de peso corporal. Os animais foram alojados em estábulo tipo free stall e alimentados com dietas à base de silagem de cana-de-açúcar suplementada com concentrado composto de milho moído, farelo de algodão e 0%, 5%, 10% e 15% de caroço de algodão (base da MS). Adotou-se delineamento quadrado latino 4 x 4. O consumo foi determinado pela razão entre a produção fecal estimada pelos indicadores e pela DIVMS da dieta, sendo as fezes coletadas diretamente na ampola retal, duas vezes por dia, por um período de sete dias. Não houve diferença (P>0,05) nos consumos de MS estimados pelos indicadores TiO2 e LIPE® (10,3 vs. 12,1; 11,1 vs. 12,5; 10,2 vs. 12,9; e 12,7 vs. 10,9 kg/vaca/dia em relação ao consumo mensurado, para as dietas com 0%, 5%, 10% e 15% de inclusão do caroço de algodão, respectivamente). Os indicadores externos LIPE® e TiO2 mostraram-se adequados para estimar o consumo de MS das vacas. Independente da dieta oferecida, ambos mostraram que podem ser utilizados em substituição ao indicador externo óxido crômico, pois, as estimativas de consumo estimadas por eles não diferiram do consumo mensurado no cocho. alimentos animal direto (DIVMS TiO (TiO2 LIPE (LIPE® MS. . (MS) 6 48 corporal canadeaçúcar cana açúcar moído 0 0% 5 5% 10 15 MS) Adotouse Adotou se retal dia P>0,05 P005 P 05 (P>0,05 10,3 103 3 (10, vs 12,1 121 12 1 111 11 11, 12,5 125 102 2 10, 12,9 129 9 127 7 12, 109 kgvacadia vaca respectivamente. respectivamente respectivamente) mostraramse oferecida crômico pois cocho (TiO (LIPE (MS P>0,0 P00 (P>0,0 (10 P>0, P0 (P>0, (1 P>0 (P>0 ( P> (P> (P

Abstract The accurate determination of individual dry matter intake (DMI) is an important parameter for evaluating the nutritional value of a diet and allows for an adequate supply of food according to the nutritional requirements of each animal. When it is not possible to measure this parameter using a direct method, the DMI can be estimated based on faecal production markers and the in vitro digestibility of dry matter (IVDMD) of the diet. The objective of this study was to evaluate the effects of the external marker titanium dioxide (TiO2) and enriched and modified hydroxyphenylpropane (LIPE®) on DMI. Four multiparous Holstein × Gyr cows with an average of 60 days in milk and 488 kg of body weight were used. The animals were housed in a free stall barn and fed diets based on sugarcane silage supplemented with concentrate composed of ground corn, cottonseed meal and 0%, 5%, 10% and 15% whole cottonseed on a dry matter (DM) basis. A 4 x 4 Latin square design was adopted. The DMI was determined by the ratio between the faecal production estimated by the markers and the IVDMD of the diet, with faeces collected by rectal grabbing twice a day for a period of seven days. There was no difference (P>0.05) in the DMI estimated by the external markers TiO2 and LIPE® (10.3 vs. 12.1; 11.1 vs. 12.5; 10.2 vs. 12.9; and 12.7 vs. 10.9 kg/cow/day in relation to the measured DMI for diets with 0%, 5%, 10% and 15% inclusion of whole cottonseed, respectively). The external markers LIPE® and TiO2 proved to be suitable for estimating cow DMI. Regardless of the diet offered, both external markers can be used to replace the external marker chromic oxide, as the DMI estimated by them did not differ from the DMI measured in the trough. (DMI animal method (IVDMD TiO (TiO2 LIPE (LIPE® 6 48 corn 0 0% 5 5% 10 15 DM (DM basis adopted P>0.05 P005 P 05 (P>0.05 10.3 103 3 (10. vs 12.1 121 12 1 111 11 11. 12.5 125 102 2 10. 12.9 129 9 127 7 12. 109 kgcowday respectively. respectively . respectively) offered oxide trough (TiO (LIPE P>0.0 P00 (P>0.0 (10 P>0. P0 (P>0. (1 P>0 (P>0 ( P> (P> (P

The aim of this article is to discuss exclusion, prejudice and the invisibility of homeless people at odds with the right to health. Using the grounded theory method and symbolic interactionism, the study was conducted with 36 participants living in municipalities in the midwest region of the state of Minas Gerais, Brazil. The findings reveal institutional exclusion of homeless people and patient prejudice against these people in health services. Furthermore, lack of planning of primary care actions jeopardizes timely comprehensive care and maintains exclusion. The study further underscores the critical role of social support networks in addressing the invisibility of these individuals and achieving greater resolution through intersectoral actions. It highlights that healthcare for people experiencing homelessness often arises from an exacerbation or illness, thus undermining the significance of intersectoral collaboration and jeopardizing the guarantee of equitable access to healthcare without prejudice.

El objetivo fue discutir la exclusión, el prejuicio y la invisibilidad de personas sin hogar en desacuerdo al derecho a la salud. Estudio delineado por la Teoría Fundamentada en los Datos e Interaccionismo Simbólico, con 36 participantes de municipios de la región centro-oeste del Estado de Minas Gerais, Brasil. Pone en evidencia la exclusión institucional de las personas sin hogar, prejuicios de usuarios al estar con estas personas en el espacio de la unidad de salud, la falta de planificación de las acciones de la Atención Primaria inviabiliza el cuidado integral y oportuno y mantiene la exclusión. El estudio también resalta el papel crucial de las redes de apoyo social para superar la invisibilidad de estas personas y lograr una mayor resolución mediante acciones intersectoriales. Se considera, como resultado de este estudio, que la atención a la salud de las personas en situación de calle se produce principalmente en respuesta a una enfermedad o un empeoramiento de la salud, lo que refuta la relevancia de las acciones intersectoriales y compromete la garantía de acceso equitativo a la atención sanitaria, sin prejuicios.

Objetivou-se discutir a exclusão, o preconceito e a invisibilidade de pessoas em situação de rua em desacordo ao direito à saúde. Trata-se de um estudo delineado pela Teoria Fundamentada nos Dados e Interacionismo Simbólico, com 36 participantes de municípios da região centro-oeste de Minas Gerais, Brasil, que evidencia a exclusão institucional das pessoas em situação de rua e preconceitos de usuários ao estar com essas pessoas no espaço da unidade de saúde. A falta de planejamento das ações da Atenção Primária inviabiliza o cuidado integral e oportuno e mantém a exclusão. A pesquisa também enfatiza a importância das redes de apoio social na superação das invisibilidades dessas pessoas e maior resolutividade com ações intersetoriais. Considera-se, como resultados deste estudo, que a atenção à saúde das pessoas em situação de rua ocorre mediante um agravo ou adoecimento, refutando a relevância das ações intersetoriais e comprometendo a garantia de acesso equânime à saúde, sem preconceitos.