Introduction: Papillary carcinomas are the most prevalent and least aggressive thyroid carcinomas (PTC). In some cases, the diagnosis is doubtfull and the prognosis is poor. The search for tissue biomarkers that ensure both the diagnosis for indeterminate cases and the prognosis, identifying the most aggressive cases, has been studied in recent decades. Objective: To review the literature in search of cyclin D1 as a marker of papillary thyroid carcinomas and multinodular goiters and evaluate whether its expression correlates with the clinicopathological characteristics of papillary thyroid carcinomas. Methods: Narrative review carried out by collecting information for reading and analysis from online research on virtual platforms. Initially, a search was carried out from MESH descriptors related to the topic, using the following terms: “papillary thyroid carcinoma, cyclin D1, immunohistochemistry, diagnosis, prognosis.” with AND or OR search, considering the title and/or abstract and those chosen were read in full. Results: The search included 77 articles that were compiled in this review. Conclusion: Cyclin D1 was expressed in the vast majority of PTCs, with diffuse distribution being predominant. There was no correlation between its expression and any clinicopathological characteristic of PTC.

Racional - Os carcinomas papilíferos são os mais prevalentes e menos agressivos de tireoide (CPT). Em alguns casos, o diagnóstico é duvidoso e o prognóstico ruim. A busca de biomarcadores teciduais que permitam assegurar tanto o diagnóstico para casos indeterminados, quanto o prognóstico, identificando os casos de maior agressividade, têm sido estudadas nas últimas décadas. Objetivo: Revisar na literatura na busca da ciclina D1 como marcador dos carcinomas papilíferos de tireoide e nos bócios multinodulares, e avaliar se a expressão dela apresenta correlação com as características clínico-patológicas dos carcinomas papilíferos de tireoide. Métodos: Revisão narrativa feita colhendo informações para leitura e análise a partir de pesquisa online em platoformas virtuais. Inicialmente foi realizada busca por descritores DECs relacionados ao tema, utilizando os seguintes termos: “carcinoma papilífero de tireoide, ciclina D1, imunoistoquímica, diagnóstico, prognóstico.” com busca AND ou OR, considerando o título e/ou resumo e os escolhidos foram lidos na íntegra. Resultados: A busca incluiu 77 artigos que foram compilados nesta revisão.  Conclusão: A ciclina D1 foi expressa na grande maioria dos CPT sendo a distribuição difusa predominante. Não houve correlação entre a expressão dela com qualquer característica clinicopatológica dos CPT.

Resumen El uso de psicofármacos es frecuente en adultos con discapacidad intelectual, a menudo por conductas desafiantes en ausencia de diagnóstico de trastorno mental. Investigaciones previas cuestionan la eficacia de estos tratamientos a falta de una enfermedad psiquiátrica, y destacan sus efectos secundarios. El objetivo de esta investigación es analizar el uso de psicofármacos en función del diagnóstico de enfermedad mental y conducta desafiante, así como la distribución de la población según el uso de psicofármacos en 569 adultos con discapacidad intelectual que presentan enfermedad mental o conductas desafiantes. Los datos acerca de la elevada prescripción de psicofármacos y, especialmente, de antipsicóticos alertan sobre la necesidad de una profunda revisión de la práctica clínica que permita reducir el uso de esta medicación en el tratamiento de la conducta y los trastornos mentales en esta población, para garantizar una atención de calidad y el respeto de los derechos de estas personas.

Abstract The use of psychotropic drugs in adults with an intellectual disability is frequent, often for defiant conduct due to the lack of a diagnosis of a mental disorder. Previous research has questioned the efficacy of such treatments in the absence of a psychiatric illness, and the stress has been on the side effects. The objective of this research is to analyze the use of psychotropic drugs based on the diagnosis of mental illness and behavioral disorders, as well as the distribution of the sample according to the use of psychotropic drugs in 569 adults with an intellectual disability who also suffer a mental illness and/or defiant conduct. Our data about the high prescription of psychotropic drugs and especially antipsychotics, warns of the need for a profound review of the clinical practice that would allow a reduction in the use of psychotropic drugs in the treatment of mental disorders and behaviour in the said collective, so as to guarantee quality mental health care for these persons and respect for their rights.

ABSTRACT. Subjective cognitive decline is defined as a self-perceived cognitive decline but with normal performance in neuropsychological assessments. Objective: To verify the evolution of patients diagnosed with subjective cognitive decline compared to the cognitively normal group without any concern. Methods: This is a follow-up study based on data analysis from the Tremembé epidemiologic study, in Brazil. The 211 individuals classified as cognitively normal and 174 diagnosed as having subjective cognitive decline at baseline were invited to participate. Results: After a median follow-up time of five years, 108 subjective cognitive decline participants (62.0%) were reassessed. Of these, 58 (53.7%) kept this diagnosis, whereas 14 individuals (12.9%) progressed to mild cognitive impairment and 5 (4.6%) to dementia. In the cognitively normal group, 107 (50.7%) were reassessed, of which 51 (47.7%) were still classified likewise, 6 (5.6%) evolved to mild cognitive impairment and 9 (8.4%) to dementia. The presence of cognitive decline had a significant association with increasing age and depression symptoms. Considering the total number of baseline participants in each group: the subjective cognitive decline group showed higher percentage of mild cognitive impairment (p=0.022) and no difference was found in progression to dementia (p=0.468) between the groups after follow-up assessment. Conclusion: Most subjective cognitive decline participants at baseline kept their cognitive complaint at follow-up and this group progressed more to mild cognitive impairment than the other group. No difference in the progression to dementia was found, despite the higher incidence of dementia in the cognitively normal group. ABSTRACT selfperceived self perceived assessments Objective concern Methods followup follow up Brazil 21 17 participate Results years 10 62.0% 620 62 0 (62.0% reassessed these 53.7% 537 53 7 (53.7% diagnosis 1 12.9% 129 12 (12.9% 4.6% 46 4 (4.6% 50.7% 507 50 (50.7% 47.7% 477 47 (47.7% likewise 5.6% 56 (5.6% 8.4% 84 8 (8.4% symptoms p=0.022 p0022 p 022 (p=0.022 p=0.468 p0468 468 (p=0.468 assessment Conclusion 2 62.0 (62.0 53.7 (53.7 12.9 (12.9 4.6 (4.6 50.7 (50.7 47.7 (47.7 5.6 (5.6 8.4 (8.4 p=0.02 p002 02 (p=0.02 p=0.46 p046 (p=0.46 62. (62. 53. (53. 12. (12. 4. (4. 50. (50. 47. (47. 5. (5. 8. (8. p=0.0 p00 (p=0.0 p=0.4 p04 (p=0.4 (62 (53 (12 (4 (50 (47 (5 (8 p=0. p0 (p=0. (6 (1 ( p=0 (p=0 p= (p= (p

RESUMO. O declínio cognitivo subjetivo (DCS) é definido como autopercepção de declínio cognitivo, mas com desempenho normal nas avaliações neuropsicológicas. Objetivo: O objetivo foi verificar a evolução dos pacientes diagnosticados com DCS em relação ao grupo cognitiva mente normal (CN), sem qualquer queixa. Métodos: Trata-se de um estudo de seguimento baseado na análise de dados do estudo epidemiológico de Tremembé, Brasil. Os 211 indivíduos classificados como CN e os 174 diagnosticados como DCS na fase inicial do estudo foram convidados a participar. Resultados: Após o tempo médio de seguimento de cinco anos, 108 participantes da DCS (62,0%) foram reavaliados. Deles, 58 (53,7%) mantiveram o diagnóstico de DCS, enquanto 14 (12,9%) evoluíram para comprometimento cognitivo leve (CCL) e cinco (4,6%) para demência. No grupo CN, 107 (50,7%) foram reavaliados, dos quais 51 (47,7%) ainda foram classificados como CN, seis (5,6%) evoluíram para CCL e nove (8,4%) para demência. A presença de declínio cognitivo teve associação significativa com o aumento da idade e com sintomas de depressão. Considerando-se o número total de participantes da fase inicial do estudo de cada grupo: o grupo DCS apresentou maior percentual de CCL (p=0,022) e não houve diferença na progressão para demência (p=0,468) entre ambos os grupos após a avaliação de seguimento. Conclusão: A maioria dos participantes DCS da fase inicial do estudo manteve sua queixa cognitiva no seguimento, e esse grupo progrediu mais para CCL. Não foi encontrada diferença na progressão para demência, apesar da maior incidência de demência no grupo CN. RESUMO (DCS neuropsicológicas Objetivo , (CN) Métodos Tratase Trata se Tremembé Brasil 21 17 participar Resultados anos 10 62,0% 620 62 0 (62,0% reavaliados Deles 5 53,7% 537 53 7 (53,7% 1 12,9% 129 12 9 (12,9% (CCL 4,6% 46 4 6 (4,6% 50,7% 507 50 (50,7% 47,7% 477 47 (47,7% 5,6% 56 (5,6% 8,4% 84 8 (8,4% depressão Considerandose Considerando p=0,022 p0022 p 022 (p=0,022 p=0,468 p0468 468 (p=0,468 Conclusão (CN 2 62,0 (62,0 53,7 (53,7 12,9 (12,9 4,6 (4,6 50,7 (50,7 47,7 (47,7 5,6 (5,6 8,4 (8,4 p=0,02 p002 02 (p=0,02 p=0,46 p046 (p=0,46 62, (62, 53, (53, 12, (12, 4, (4, 50, (50, 47, (47, 5, (5, 8, (8, p=0,0 p00 (p=0,0 p=0,4 p04 (p=0,4 (62 (53 (12 (4 (50 (47 (5 (8 p=0, p0 (p=0, (6 (1 ( p=0 (p=0 p= (p= (p

ABSTRACT Introduction: Congenital heart diseases (CHDs) constitute the most prevalent congenital pathology, and they are a consequence of structural and functional abnormalities during fetal development. The etiology of CHD involves the interaction of genetic and environmental factors. Fetal cardiac surgery aims at preventing natural pathways of CHD in utero, mitigating progression to more complex abnormalities. The goal of this review was to demonstrate the benefits and risks of fetal interventions in the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with an intact ventricular septum, but also critical aortic stenosis and hypoplastic left heart syndrome. Methods: Original and relevant articles were selected by meta-aggregation to perform a qualitative analysis of fetal cardiac interventions for pulmonary stenosis and critical aortic stenosis. The Joanna Briggs Institute’s Qualitative Assessment and Review Instrument (or JBI-QARI) was used for data quality appraisal. Results: Of 61 potential articles, 13 were selected, and nine were finally included. Discussion: The present review demonstrated that fetal cardiac surgery increases right ventricular growth and hemodynamic flow in pulmonary stenosis, whereas in critical aortic stenosis it enables growth of the left ventricle and increases left ventricular pressure. However, it has a high complication rate, along with considerable morbidity and mortality. Conclusion: The benefits of fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis are well-described in the literature; however, there is a significant risk of complications which can be reduced by the surgeon’s technical expertise and well-structured hospital facilities. Introduction CHDs (CHDs pathology development factors utero septum syndrome Methods metaaggregation meta aggregation Institutes Institute s or JBIQARI JBI QARI JBI-QARI appraisal Results 6 1 included Discussion pressure However rate mortality Conclusion welldescribed well described literature however surgeons surgeon wellstructured structured facilities

ABSTRACT Introduction: Congenital heart diseases (CHDs) constitute the most prevalent congenital pathology, and they are a consequence of structural and functional abnormalities during fetal development. The etiology of CHD involves the interaction of genetic and environmental factors. Fetal cardiac surgery aims at preventing natural pathways of CHD in utero, mitigating progression to more complex abnormalities. The goal of this review was to demonstrate the benefits and risks of fetal interventions in the two most prevalent CHDs, pulmonary stenosis and pulmonary atresia with an intact ventricular septum, but also critical aortic stenosis and hypoplastic left heart syndrome. Methods: Original and relevant articles were selected by meta-aggregation to perform a qualitative analysis of fetal cardiac interventions for pulmonary stenosis and critical aortic stenosis. The Joanna Briggs Institute’s Qualitative Assessment and Review Instrument (or JBI-QARI) was used for data quality appraisal. Results: Of 61 potential articles, 13 were selected, and nine were finally included. Discussion: The present review demonstrated that fetal cardiac surgery increases right ventricular growth and hemodynamic flow in pulmonary stenosis, whereas in critical aortic stenosis it enables growth of the left ventricle and increases left ventricular pressure. However, it has a high complication rate, along with considerable morbidity and mortality. Conclusion: The benefits of fetal cardiac surgery for pulmonary stenosis and critical aortic stenosis are well-described in the literature; however, there is a significant risk of complications which can be reduced by the surgeon’s technical expertise and well-structured hospital facilities.

Resumo Objetivos: compreender as implicações psicossociais vivenciadas por pais cuidadores, decorrentes do cuidado do filho com fissura de lábio e/ou palato associada à síndrome. Métodos: estudo transversal, qualitativo, norteado pela diretriz Consolidated Criteria for Reporting Qualitative Research, realizado entre janeiro e maio de 2019. A coleta de dados realizou-se através de entrevista semiestruturada, que foi audiograda e transcrita na íntegra. Utilizou-se como referencial metodológico a Análise de Conteúdo Temática e como referencial teórico, o Interacionismo Simbólico. Resultados: participaram 16 pais cuidadores. Foram elencadas quatro categorias: implicações diante do diagnóstico e início do tratamento, implicações relacionadas às questões financeiras e de atividades remuneradas, implicações relacionadas ao processo de cuidar e implicações referentes ao acesso aos recursos de saúde. Conclusão: percebeu-se que as implicações psicossociais vivenciadas por esses cuidadores informais são multifacetadas e complexas, e conhece-las viabilizará o planejamento e a implementação de ações que contribuam, além do processo reabilitador das crianças, à saúde e qualidade de vida daqueles que cuidam.

Abstract Objectives: to understand the psychosocial implications experienced by caregiving parents, resulting from the care of the child with cleft lip and/or palate associated with the syndrome. Methods: a cross-sectional and qualitative study, guided by the Consolidated Criteria for Reporting Qualitative Research tool, carried out between January and May 2019. Data collection was carried out through semi-structured interviews that were audio-recorded and transcribed in full. Thematic content analysis was used as the methodological framework and Symbolic Interactionism as the theoretical framework. Results: the participants were 16 caregiving parents. Four categories were listed: implications for diagnosis and treatment initiation, implications for financial issues and paid activities, implications for the care process, and implications for access to health resources. Conclusion: it was found that psychosocial implications experienced by these informal caregivers are multifaceted and complex, and that knowing them will enable planning and implementation of actions that contribute, in addition to the children's rehabilitation process, to the health and quality of life of those who care.

ABSTRACT Systemic lupus erythematosus and ANCA-associated vasculitis overlap syndrome is rare and complex. Moreover, the mechanisms that explain the interaction between these two conditions are still unclear. The authors describe the case of a patient who had myeloperoxidase ANCA-associated vasculitis as the initial diagnosis, with biopsy-proven pauci-immune crescentic glomerulonephritis, attaining complete remission after immunosuppression. Five years later, Systemic Lupus Erythematosus was diagnosed and a second kidney biopsy showed a pattern of lupus nephritis class III. While on immunosuppression treatment, the patient developed a progressive elevation of liver enzymes and was later diagnosed with primary biliary cholangitis. It seems that in this case, the overlap of Systemic Lupus Erythematosus and ANCA-associated vasculitis may be part of a poliautoimmune syndrome suggested by association with a third autoimmune disease.

Objective: To describe the agreement between the immunization data of the Juarez System and the information in the vaccination booklet and vaccination coverage in children aged 12 to 24 months. Methods: Descriptive study to assess the vaccination status at 12 and 24 months of age of children born in 2015 and registered in the Juarez System. The levels of agreement between the Juarez System data and the information in the vaccination booklet were verified. Results: 429 children were included. it was found that the agreement varied between 84.06 and 99.06%. The coverage (vaccine survey) for each vaccine ranged from 86% to 100% and for the complete schedule, 77.1% (12 months) and 68.8% (24 months). The spatial distributions of vaccine coverage ranged from 28% to 100%. Conclusion: excellent agreement between the data, high vaccination coverage, but heterogeneity in their spatial distributions.

Objetivo: Descrever a concordância entre os dados de imunização do Sistema Juarez e as informações da caderneta de vacinação e as coberturas vacinais em crianças de 12 a 24 meses. Métodos: Estudo descritivo, para avaliar a situação vacinal aos 12 e 24 meses de idade de crianças nascidas em 2015 e registradas no Sistema Juarez. Foram verificados os níveis de concordância entre os dados do Sistema Juarez e as informações da caderneta de vacinação. Resultados: Foram incluídas 429 crianças. Verificou-se que a concordância variou entre 84,06 e 99,06%. As coberturas no inquérito vacinal para cada vacina variaram de 86 a 100%; e para o esquema completo, de 77,1 (12 meses) a 68,8% (24 meses). As distribuições espaciais da cobertura vacinal foram de 28 a 100%. Conclusão: Observou-se ótima concordância entre os dados, com altas coberturas vacinais, muito embora heterogeneidade em suas distribuições espaciais.

Resumo: A evolução da população rural e de animais de algumas raças autóctones portuguesas tem demonstrado níveis de regressão preocupantes, com consequências ambientais e ecológicas, na gestão e no ordenamento do território e na sua sustentabilidade, nomeadamente, no que se refere à dimensão socioeconómica e à própria coesão territorial. Neste trabalho, tendo por base entrevistas realizadas a criadores, empresas e associações que se dedicam à criação e proteção da raça de equídeos Garrana, usada para diversos fins, pretende-se identificar os benefícios da adoção de um sistema de exploração que inclua o Garrano destacando, também, as suas principais debilidades. A abordagem será desenvolvida atendendo às dimensões ambiental, económica e social da sustentabilidade. Os resultados evidenciam a importância destes animais, não apenas enquanto património genético vivo, mas também ao nível da defesa da floresta contra incêndios, concretamente, no controlo de biomassa combustível. No entanto, será necessária a definição de uma estratégia concertada que permita valorizar o seu contributo na economia das explorações ou empresas, o que deverá refletir-se no acréscimo do bem-estar da população, na estabilização do efetivo animal e na sustentabilidade do território.

Abstract: The evolution of the rural population and livestock of some Portuguese native breeds has shown worrying levels of regression, with environmental and ecological consequences, in the management and planning of the territory and its sustainability, namely regarding the socio-economic dimension and territorial cohesion itself. Based on interviews with breeders, companies, and associations dedicated to the breeding and protection of the Garrano horse breed, used for various purposes, this paper aims to identify the benefits of adopting a production system that includes Garrano, highlighting also its main weaknesses. The approach will be developed taking into account the environmental, economic, and social dimensions of sustainability. The results show the important role of these animals, not only as a living genetic heritage but also in terms of the protection of forests against fires, regarding the control of fuel biomass. However, a concerted strategy will need to be devised to enhance its contribution to the economy of farms or enterprises. This should be reflected in the increase of the welfare of the population, the stabilization of the animal herd, and the sustainability of the territory.

Resumo Objetivo: Descrever a concordância entre os dados de imunização do Sistema Juarez e as informações da caderneta de vacinação e as coberturas vacinais em crianças de 12 a 24 meses. Métodos: Estudo descritivo, para avaliar a situação vacinal aos 12 e 24 meses de idade de crianças nascidas em 2015 e registradas no Sistema Juarez. Foram verificados os níveis de concordância entre os dados do Sistema Juarez e as informações da caderneta de vacinação. Resultados: Foram incluídas 429 crianças. Verificou-se que a concordância variou entre 84,1 e 99,1%. As coberturas no inquérito vacinal para cada vacina variaram de 86,1 a 100%; e para o esquema completo, de 77,1 (12 meses) a 68,8% (24 meses). As distribuições espaciais da cobertura vacinal foram de 28 a 100%. Conclusão: Observou-se ótima concordância entre os dados, com altas coberturas vacinais, muito embora heterogeneidade em suas distribuições espaciais.

Abstract Objective: To describe agreement between the Juarez System immunization data and information in vaccination record booklets and vaccination coverage in children aged 12 to 24 months. Methods: This was a descriptive study to assess the vaccination status at 12 and 24 months of age of children born in 2015 and recorded on the Juarez System. The levels of agreement between the Juarez System data and the information in vaccination record booklets were verified. Results: 429 children were included. It was found that agreement ranged between 84.1% and 99.1%. The vaccine survey found that coverage for each vaccine ranged from 86.01% to 100% and for the full schedule, from 77.1% (12 months) to 68.8% (24 months). The spatial distributions of vaccine coverage ranged from 28% to 100%. Conclusion: There was excellent agreement between the data, with high vaccination coverage, but heterogeneity in their spatial distributions.

Resumen Objetivo: Describir la concordancia entre los datos de vacunación del Sistema Juárez y la información de la cartilla de vacunación y cobertura vacunal en niños de 12 a 24 meses. Métodos: Estudio descriptivo para evaluar el estado de vacunación a los 12 y 24 meses de edad de los niños nacidos en 2015 e inscritos en el Sistema Juárez. Se verificaron los niveles de concordancia entre los datos del Sistema Juárez y la información del carné de vacunación. Resultados: Se incluyeron 429 niños. Se encontró que la concordancia varió entre 84,1 y 99,1%. La cobertura (encuesta de vacunas) para cada vacuna varió de 86% a 100% y para el esquema completo, 77,1% (12 meses) y 68,8% (24 meses). Las distribuciones espaciales de la cobertura vacunal oscilaron entre el 28% y el 100%. Conclusión: excelente concordancia entre los datos, alta cobertura de vacunación, pero heterogeneidad en sus distribuciones espaciales.

Resumo Objetivo: Descrever a concordância entre os dados de imunização do Sistema Juarez e as informações da caderneta de vacinação e as coberturas vacinais em crianças de 12 a 24 meses. Métodos: Estudo descritivo, para avaliar a situação vacinal aos 12 e 24 meses de idade de crianças nascidas em 2015 e registradas no Sistema Juarez. Foram verificados os níveis de concordância entre os dados do Sistema Juarez e as informações da caderneta de vacinação. Resultados: Foram incluídas 429 crianças. Verificou-se que a concordância variou entre 84,1 e 99,1%. As coberturas no inquérito vacinal para cada vacina variaram de 86,1 a 100%; e para o esquema completo, de 77,1 (12 meses) a 68,8% (24 meses). As distribuições espaciais da cobertura vacinal foram de 28 a 100%. Conclusão: Observou-se ótima concordância entre os dados, com altas coberturas vacinais, muito embora heterogeneidade em suas distribuições espaciais.

Abstract Objective: To describe agreement between the Juarez System immunization data and information in vaccination record booklets and vaccination coverage in children aged 12 to 24 months. Methods: This was a descriptive study to assess the vaccination status at 12 and 24 months of age of children born in 2015 and recorded on the Juarez System. The levels of agreement between the Juarez System data and the information in vaccination record booklets were verified. Results: 429 children were included. It was found that agreement ranged between 84.1% and 99.1%. The vaccine survey found that coverage for each vaccine ranged from 86.01% to 100% and for the full schedule, from 77.1% (12 months) to 68.8% (24 months). The spatial distributions of vaccine coverage ranged from 28% to 100%. Conclusion: There was excellent agreement between the data, with high vaccination coverage, but heterogeneity in their spatial distributions.

Resumen Objetivo: Describir la concordancia entre los datos de vacunación del Sistema Juárez y la información de la cartilla de vacunación y cobertura vacunal en niños de 12 a 24 meses. Métodos: Estudio descriptivo para evaluar el estado de vacunación a los 12 y 24 meses de edad de los niños nacidos en 2015 e inscritos en el Sistema Juárez. Se verificaron los niveles de concordancia entre los datos del Sistema Juárez y la información del carné de vacunación. Resultados: Se incluyeron 429 niños. Se encontró que la concordancia varió entre 84,1 y 99,1%. La cobertura (encuesta de vacunas) para cada vacuna varió de 86% a 100% y para el esquema completo, 77,1% (12 meses) y 68,8% (24 meses). Las distribuciones espaciales de la cobertura vacunal oscilaron entre el 28% y el 100%. Conclusión: excelente concordancia entre los datos, alta cobertura de vacunación, pero heterogeneidad en sus distribuciones espaciales.

RESUMO Objetivos: identificar os fatores relacionados à utilização do coping religioso entre cuidadores informais. Métodos: trata-se de uma revisão integrativa da literatura, realizada por meio de busca eletrônica nas bases de dados LILACS, PubMed, Scopus, Web of Science e CINAHL, além da Biblioteca Virtual de Saúde e SciELO. Foram selecionados artigos primários nos idiomas inglês, português e espanhol, por meio dos descritores: Coping Behavior, Caregivers, Spirituality e Religion, que foram combinados entre si e com seus respectivos sinônimos. Não se estabeleceu limite temporal para as publicações. Resultados: foram selecionados nove artigos. Evidenciou-se que os fatores relacionados ao uso do coping religioso em cuidadores informais incluíram: possuir idade avançada, vivenciar situações traumáticas, apresentar sobrecarga, ser cônjuge ou mãe, cuidar de indivíduos hospitalizados, com doença crônica e com alto grau de dependência. Conclusões: osfatores relacionados à utilização do coping religioso são multifacetados e envolvem aspectos físicos, psicológicos, psicossociais e situacionais.

ABSTRACT Objectives: to identify the factors related to the use of religious coping in informal caregivers. Methods: integrative literature review carried out through a search in the databases LILACS, PubMed, Scopus, Web of Science, and CINAHL, in addition to the Virtual Health Library and SciELO. The study selected primary articles in English, Portuguese, and Spanish, using the descriptors Coping Behavior, Caregivers, Spirituality, and Religion, which were combined with each other and with synonyms. There was no time limit for the publications. Results: nine articles were selected. Factors related to the use of religious coping in informal caregivers included: having an advanced age, experiencing traumatic situations, being under overload, being a spouse or mother, caring for hospitalized individuals, or for those with chronic diseases and high degrees of dependence. Conclusions: the factors related to the use of religious coping are multifaceted and involve physical, psychological, psychosocial, and situational aspects.

RESUMEN Objetivos: identificar factores relacionados a la utilización del coping religioso entre cuidadores informales. Métodos: se trata de revisión integrativa de la literatura, realizada por búsqueda electrónica en las bases de datos LILACS, PubMed, Scopus, Web of Science y CINAHL, además de la Biblioteca Virtual de Salud y SciELO. Seleccionados artículos primarios en los idiomas inglés, portugués y español, por medio de los descriptores: Coping Behavior, Caregivers, Spirituality y Religion, que han combinados entre si y con sus respectivos sinónimos. No se estableció límite temporal para las publicaciones. Resultados: seleccionados nueve artículos. Evidenció que los factores relacionados al uso del coping religioso en cuidadores informales incluyeron: poseer edad avanzada, experimentar situaciones traumáticas, presentar sobrecarga, ser cónyuge o madre, cuidar de indivíduos hospitalizados, con enfermedad crónica y con alto grado de dependencia. Conclusiones: factores relacionados a la utilización del coping religioso son multifacetados y envuelven aspectos físicos, psicológicos, psicosociales y situacionales.

ABSTRACT Introduction: SARS-CoV-2 is the causal agent of COVID-19, which has already become a pandemic that plagues the world with significant mortality rates, whose clinical-epidemiological characteristics are still surrounded by various scientific gaps. Objective: To characterize clinically and epidemiologically COVID-19 cases in Holguín. Method: Observational descriptive study of COVID-19 pandemic in the province. The 92 cases confirmed by PCR were characterized, taking into account the epidemiological variables of age, sex, place of origin, presence of symptoms at diagnosis, opportunity at admission and main symptoms; in addition, the incidence and fatality rates were determined. Results: Male sex predominated; the most affected age group was the one between 50 and 59 years; the most affected municipalities were Holguín, Gibara and Banes; the main symptoms at the beginning of the disease were cough, fever, runny nose and odynophagia, but more than half of the cases were asymptomatic at the time of diagnosis and they did not present secondary cases; less than a third of the cases were admitted in the first days after the symptoms started, which influenced their subsequent evolution and convalescence. Conclusions: COVID-19 is a highly contagious respiratory disease that must be adequately cared for in order to reduce its lethality and for which the epidemiological control of each suspected case takes on great importance.

RESUMEN Introducción: El SARS- CoV-2 es el agente causal de la COVID-19 la cual ya se ha convertido en una pandemia que azota al mundo con significativas tasas de mortalidad, cuyas características clínico epidemiológicas están rodeadas aún por diversos vacíos científicos. Objetivo: Caracterizar clínica y epidemiológicamente los casos de COVID-19 en Holguín. Método: Estudio observacional descriptivo de la pandemia COVID-19 en la provincia. Se caracterizaron los 92 casos que fueron confirmados por PCR, atendiendo a las variables epidemiológicas de edad, sexo, lugar de procedencia, presencia de síntomas al diagnóstico, oportunidad en el ingreso y principales síntomas; además se determinó la tasa de incidencia y de letalidad. Resultados: Predominó el sexo masculino; el grupo de edades más afectado fue el comprendido entre los 50 y 59 años; los municipios más incidentes fueron Holguín, Gibara y Banes; los principales síntomas al inicio de la enfermedad fueron tos, fiebre, secreción nasal y odinofagia, pero más de la mitad de los casos se encontraban asintomáticos en el momento del diagnóstico y no presentaron casos secundarios; menos de un tercio de los casos se ingresó en los primeros días de iniciados los síntomas, lo que influyó en su posterior evolución y convalecencia. Conclusiones: La COVID-19 es una enfermedad de transmisión respiratoria altamente contagiosa que debe ser atendida adecuadamente para disminuir su letalidad y donde el control epidemiológico de cada caso sospechoso, cobra gran importancia.

ABSTRACT Introduction: That the world is ravaged by a pandemic is not new, as every so often a new disease affects humans. The accumulated experiences prove that the capability to face up to these situations rises exponentially, according to preparedness and organization of the country prior to the event. Objectives: To describe the main epidemics that occurred in Cuba and the confrontation with Covid 19 at the Clinical Surgical Hospital Lucía Iñiguez Landín. Methods: The historical-logical method was used on the particular history of some epidemic diseases in Cuba; a documentary review was carried out, as well as interviews with directors of that institution to perform job evaluation. Results: Smallpox, measles and yellow fever caused numerous epidemics during the 16th, 17th and 18th centuries, with high mortality; in the 19th century, malaria was added and isolated epidemics such as dengue fever, in 1828 and cholera, in 1833, were characterized as relevant. In the neocolonial period, some of the diseases that occurred were: yellow fever until 1909, malaria, smallpox, diphtheria, scarlet fever, typhoid fever, benign influenza, chickenpox, leprosy and bubonic plague until 1915; after 1959, dengue, HIV, influenza A H1N1, cholera and, at the moment, SARS-CoV2. Conclusions: For centuries, Cuba has had to fight against some diseases that affect the whole world and have reached the island,or are typical of the tropical area where we live; at every historical moment, morbidity and mortality have been the result of the prevailing system, scientific development, strength of the health system and preparation in the fight against epidemics.

RESUMEN Introducción: Que el mundo se vea asolado por una pandemia no es nuevo, ya que cada cierto tiempo una nueva enfermedad afecta a los humanos. Las experiencias acumuladas demuestran que la capacidad para hacer frente a estas situaciones se eleva exponencialmente, según se prepare y organice el país antes del desarrollo del evento. Objetivos: Describir las principales epidemias ocurridas en Cuba y el enfrentamiento a la Covid-19 en el Hospital Clínico Quirúrgico Lucía íñiguez Landín. Métodos: Se utilizó el método histórico-lógico sobre la historia particular de algunas enfermedades epidémicas en Cuba, se realizó una revisión documental, así como entrevistas a directivos de esa institución para realizar la valoración del trabajo. Resultados: La viruela, el sarampión y la fiebre amarilla causaron numerosas epidemias durante los siglos XVI, XVII y XVIII, con alta mortalidad; en el siglo XIX se añade el paludismo y se caracterizan como epidemias aisladas relevantes la del dengue de 1828 y la de cólera de 1833. En el período neocolonial, entre las enfermedades que ocurrieron, están la fiebre amarilla hasta 1909, paludismo, viruela, difteria, escarlatina, fiebre tifoidea, gripe benigna, varicela, lepra, peste bubónica hasta 1915 y en la etapa después de 1959, dengue, VIH, influenza A H1N1, cólera y ahora el SARS-CoV2. Conclusiones: Cuba durante siglos ha tenido que combatir contra algunas enfermedades que afectan al mundo entero y han llegado a la isla o son típicas de la zona tropical donde se vive; en cada momento histórico la morbimortalidad ha sido el resultado del sistema imperante, el desarrollo científico, la fortaleza del sistema de salud y la preparación en la lucha antiepidémica.

Apresentamos o caso de uma mulher de 24 anos com queixas de dor abdominal, diarreia sanguinolenta e perda ponderal com 3 meses de evolução. Uma colonoscopia de ambulatório revelou, de forma descontínua, úlceras sugestivas de doença de Crohn (DC). Também a histologia era sugestiva de DC. Contudo, após admissão no nosso hospital, uma radiografia de tórax evidenciou cavitações pulmonares. A tomografia computorizada sugeriu o diagnóstico de tuberculose (TB) pulmonar ativa. Por esse motivo, foram realizadas broncofibroscopia, endoscopia digestiva alta e colonoscopia total com ileoscopia. A pesquisa de bacilos ácido-álcool resistentes foi positiva não só no lavado broncoalveolar e no suco gástrico, mas também nas biópsias do cólon. Verificou-se uma resolução completa das queixas gastrointestinais 2 semanas após iniciar antibacilares.

We present the case of a 24-year-old woman with complaints of abdominal pain, bloody diarrhea, and weight loss for 3 months. An outpatient colonoscopy revealed scattered ulcers, suggestive of Crohn’s disease (CD). Histopathology also favored the diagnosis of CD. However, after admission to our hospital for further investigation, a chest radiograph revealed pulmonary cavitations. A computed tomography scan suggested the diagnosis of active pulmonary tuberculosis (TB). Therefore, a bronchofibroscopy, a total colonoscopy with ileoscopy, and an upper endoscopy were performed. Not only were acid-fast bacilli present in both bronchoalveolar lavage fluid and gastric juice, but also in colonic biopsies. A complete resolution of gastrointestinal symptoms was achieved 2 weeks after starting anti-TB drugs.