Abstract Objective: This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM). Data sources: Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction. Studies selection: RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy. Data collection: Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author. Data synthesis: Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=−0.85; 95% CI=−1.59 to −0.10), dryness (MD=−0.62; 95% CI=−1.12 to −0.12) and burning (MD= −0.64; 95% CI=−1.28 to −0.01) decreased. No serious adverse effects were reported. Conclusion: CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management. Objective metaanalysis meta analysis (RCTs GSM. . (GSM) sources 202 PubMed Embase Scopus Science CENTRAL CINAHL www.trialscentral.org, wwwtrialscentralorg www trialscentral org (www.trialscentral.org www.controlledtrials.com, wwwcontrolledtrialscom www.controlled trials.com, com www.controlled-trials.com clinicaltrials.gov, clinicaltrialsgov clinicaltrials.gov , clinicaltrials gov clinicaltrials.gov) restriction selection CO2laser COlaser CO2 CO Er YAGlaser YAG YAG-laser sham therapy, therapy) collection abstract fulltext full text articles consensus author synthesis 514 participants (VHI MD=2.21 MD221 MD 2 21 (MD=2.21 95 CI125 CI 1 25 CI=1.2 3.16, 316 3.16 3 16 3.16) MD=−0.85 MD085 0 85 (MD=−0.85 CI159 59 CI=−1.5 −0.10, 010 −0.10 10 −0.10) MD=−0.62 MD062 62 (MD=−0.62 CI112 12 CI=−1.1 −0.12 012 MD= (MD −0.64 064 64 CI128 28 CI=−1.2 −0.01 001 01 decreased reported Conclusion shamlaser. shamlaser laser. sham-laser However low management (GSM 20 www.trialscentral.org controlledtrials www.controlledtrials.com wwwcontrolled trialscom trials.com 51 MD=2.2 MD22 (MD=2.2 9 CI12 CI=1. 31 3.1 MD=−0.8 MD08 8 (MD=−0.8 CI15 5 CI=−1. −0.1 MD=−0.6 MD06 6 (MD=−0.6 CI11 −0.6 06 −0.0 00 MD=2. MD2 (MD=2. CI1 CI=1 3. MD=−0. MD0 (MD=−0. CI=−1 −0. MD=2 (MD=2 CI= MD=−0 (MD=−0 CI=− −0 MD=− (MD=− −

ABSTRACT Purpose: This study evaluated the prevalence of complications in the postoperative period of esophagogastric oncological surgeries. Methods: We conducted a retrospective cross-sectional study, adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. The study size implied 163 patients who underwent surgical treatment for esophageal and gastric cancer and experienced postoperative complications between January 2018 and December 2022. These patients were treated at the Liga Norte Riograndense Contra o Câncer, a high-complexity oncology center and a reference for cancer treatment in Northeast Brazil. Results: The prevalence found was 88.3%. The most prevalent complications were Clavien-Dindo I and II, and infection was the most common. According to our statistics analysis, hypoalbuminemia showed a positive correspondence with the occurrence of postoperative complications (odds ratio = 8.60; 95% confidence interval 1.35–54.64, p = 0.0358). Conclusions: Postoperative complications of gastroesophageal surgeries increase patient morbidity and mortality. Purpose Methods crosssectional cross sectional STROBE (STROBE guidelines 16 201 2022 Câncer highcomplexity high complexity Brazil Results 883 88 3 88.3% ClavienDindo Clavien Dindo II common analysis odds 8.60 860 8 60 95 1355464 1 35 54 64 1.35–54.64 0.0358. 00358 0.0358 . 0 0358 0.0358) Conclusions mortality 20 202 88.3 8.6 86 6 9 135546 5 1.35–54.6 0035 0.035 035 2 88. 8. 13554 1.35–54. 003 0.03 03 1355 1.35–54 00 0.0 135 1.35–5 0. 13 1.35– 1.35 1.3 1.

ABSTRACT Purpose: To compare robotic versus laparoscopic colectomies in colon cancer patients in general complications. Methods: Nine databases were searched for randomized controlled trials (RCT) investigating patients with colon cancer, submitted to robotic surgery (RS) compared to a laparoscopic (LC) approach. The risk of bias was assessed using RoB 2.0 tool, and certainty of the evidence was evaluated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Data synthesis was performed using the software R. The meta-analysis of the included studies was carried out using the fixed-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis. Results: A total of four studies were used with 293 patients. Three studies were used in this comparative LC vs. RS when evaluating infection rates on surgical wound sites. The odds ratio (OR) appeared to be slightly favorable to LC (OR = 3.05; 95% confidence interval–95%CI 0.78–11.96). In the hospitalization rates analysis, two randomized controlled trials were used, and the mean differences slightly favored the RS (MD = -0.54; 95%CI -2.28–1.19). GRADE evaluation detected a serious risk of bias due to RCT format and RoB-2 concurred. Conclusion: Both types of procedures seem to have their own benefits, risks, and limitations. They seem close to equal in terms of postsurgical infection and hospitalization. Purpose complications Methods (RCT (RS (LC approach 20 2 0 2. tool Recommendations Assessment GRADE. . (GRADE) R metaanalysis meta analysis fixedeffects fixed effects DerSimonian Laird. Laird Laird) I Results 29 vs sites OR 3.05 305 3 05 95 interval95CI intervalCI interval CI 0.78–11.96. 0781196 0.78–11.96 78 11 96 0.78–11.96) MD 0.54 054 54 -0.54 95CI 2.28–1.19. 228119 2.28–1.19 28 1 19 -2.28–1.19) RoB2 RoB- concurred Conclusion benefits risks limitations (GRADE 3.0 30 9 078119 0.78–11.9 7 0.5 5 -0.5 22811 2.28–1.1 -2.28–1.19 3. 07811 0.78–11. 0. -0. 2281 2.28–1. -2.28–1.1 0781 0.78–11 -0 228 2.28–1 -2.28–1. 078 0.78–1 - 22 2.28– -2.28–1 07 0.78– 2.28 -2.28– 0.78 2.2 -2.28 0.7 -2.2 -2. -2

Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients. efficacy safety miscarriage PubMed Scopus Embase Science Library clinicaltrials.gov clinicaltrialsgov clinicaltrials gov (clinicaltrials.gov articles words 4 2022 applied 67 6 7 6/ included 8087 8 087 8,08 screened V51 V 5 V.5. Collaboration Oxford Kingdom. Kingdom . Kingdom) outcomes OR 95 CI (CI study test I statistic MVA, , (MVA) 0.16 016 0 16 95CI 0.07–0.36. 007036 0.07–0.36 07 36 0.07–0.36) 3.00 300 00 1.96–4.59, 196459 1.96–4.59 96 59 1.96–4.59) 0.65 065 65 0.52–0.80. 052080 0.52–0.80 52 80 0.52–0.80) treatments 202 808 08 8,0 V5 V.5 9 (MVA 0.1 01 00703 0.07–0.3 3.0 30 19645 1.96–4.5 0.6 06 05208 0.52–0.8 20 8, V. 0. 0070 0.07–0. 3. 1964 1.96–4. 0520 0.52–0. 2 007 0.07–0 196 1.96–4 052 0.52–0 0.07– 19 1.96– 05 0.52– 0.07 1.96 0.52 0.0 1.9 0.5 1.

Resumo Objetivo Avaliar a eficácia, segurança e aceitabilidade do misoprostol no tratamento do aborto incompleto. Fontes de dados Os bancos de dados PubMed, Scopus, Embase, Web of Science, Cochrane Library e bancos de dados de Ensaios Clínicos (clinicaltrials.gov) foram pesquisados para os artigos relevantes, e estratégias de busca foram desenvolvidas usando uma combinação de termos temáticos de Medical Subject Headings e palavras de texto. A última pesquisa foi realizada em 4 de julho de 2022. Nenhuma restrição de idioma foi aplicada. Seleção dos estudos Foram incluídos ensaios clínicos randomizados com pacientes com idade gestacional até 6/7 semanas com diagnóstico de aborto incompleto e que foram manejadas com pelo menos um dos três tipos de tratamento estudados. Um total de 8.087 estudos foram selecionados. Coleta de dados Os dados foram sintetizados usando o pacote estatístico Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). Para resultados dicotômicos, o odds ratio (OR, na sigla em inglês) e o intervalo de confiança (IC) de 95% foram derivados para cada estudo. A heterogeneidade entre os resultados do ensaio foi avaliada usando o teste padrão, estatística I2. Síntese dos dados Ao comparar misoprostol com aspiração a vácuo médico (MVA, na sigla em inglês), a taxa de aborto completo foi maior no grupo MVA (OR = 0,16; IC95% = 0,07–0,36). Hemorragia ou sangramento intenso foi mais comum no grupo do misoprostol (OR = 3,00; 95%CI = 1,96–4,59), mas a dor após o tratamento foi mais comum em pacientes tratados com MVA (OR = 0,65; 95%CI = 0,52–0,80). Não foram observadas diferenças estatisticamente significativas na aceitabilidade geral dos tratamentos. Conclusão O misoprostol tem se mostrado uma opção segura e com boa aceitação pelos pacientes. eficácia PubMed Scopus Embase Science clinicaltrials.gov clinicaltrialsgov clinicaltrials gov (clinicaltrials.gov relevantes texto 2022 aplicada 67 6 7 6/ estudados 8087 8 087 8.08 selecionados V51 V 5 1 V.5. The Collaboration Oxford Kingdom. Kingdom . Kingdom) dicotômicos OR, OR inglês IC (IC 95 estudo padrão I2 I MVA, (MVA inglês, , 0,16 016 0 16 IC95 0,07–0,36. 007036 0,07–0,36 07 36 0,07–0,36) 3,00 300 3 00 95CI CI 1,96–4,59, 196459 1,96–4,59 96 59 1,96–4,59) 0,65 065 65 0,52–0,80. 052080 0,52–0,80 52 80 0,52–0,80) tratamentos 202 808 08 8.0 V5 V.5 9 0,1 01 IC9 00703 0,07–0,3 3,0 30 19645 1,96–4,5 0,6 06 05208 0,52–0,8 20 8. V. 0, 0070 0,07–0, 3, 1964 1,96–4, 0520 0,52–0, 2 007 0,07–0 196 1,96–4 052 0,52–0 0,07– 19 1,96– 05 0,52– 0,07 1,96 0,52 0,0 1,9 0,5 1,

SUMMARY OBJECTIVE: The objective of this study was to determine adverse maternal and perinatal outcomes in pregnant women with hypertensive disorders of pregnancy. METHODS: An analytical cross-sectional study was conducted on women admitted with hypertensive disorders of pregnancies to a university maternity hospital from August 2020 to August 2022. Data were collected using a pretested structured questionnaire. Variables associated with adverse maternal and perinatal outcomes were compared using multivariable binomial regression. RESULTS: Of 501 women with pregnancies, 2, 35, 14, and 49% had eclampsia, preeclampsia, chronic hypertension, and gestational hypertension, respectively. Women with preeclampsia/eclampsia had significantly higher risks of cesarean section (79.4 vs. 65%; adjusted RR, 2,139; 95%CI, 1,386–3,302; p=0.001) and preterm delivery at <34 weeks’ gestation (20.5 vs. 6%; adjusted RR, 2.5; 95%CI, 1.19–5.25; p=0.01) than those of women with chronic/gestational hypertension. Risks of prolonged maternal hospitalization (43.9 vs. 27.1%), neonatal intensive care unit admission (30.7 vs. 19.8%), and perinatal mortality (23.5 vs. 11.2%) were higher among women with preeclampsia/eclampsia. CONCLUSIONS: Women with preeclampsia/eclampsia had a higher risk of adverse maternal and neonatal outcomes than those with chronic or gestational hypertension. This major maternity care center requires strategies for preventing and managing preeclampsia/eclampsia to improve pregnancy outcomes. OBJECTIVE METHODS crosssectional cross sectional 202 2022 questionnaire regression RESULTS 50 2 35 14 49 eclampsia preeclampsia hypertension respectively preeclampsiaeclampsia 79.4 794 79 4 (79. vs 65% 65 RR 2,139 2139 139 95CI CI 95 95%CI 1,386–3,302 13863302 1 386 3 302 p=0.001 p0001 p 0 001 34 <3 weeks 20.5 205 20 5 (20. 6% 6 2.5 25 1.19–5.25 119525 19 p=0.01 p001 01 chronicgestational 43.9 439 43 9 (43. 27.1%, 271 27.1% , 27 27.1%) 30.7 307 30 7 (30. 19.8%, 198 19.8% 8 19.8%) 23.5 235 23 (23. 11.2% 112 11 CONCLUSIONS 79. (79 2,13 213 13 1,386–3,30 1386330 38 p=0.00 p000 00 < 20. (20 2. 1.19–5.2 11952 p=0.0 p00 43. (43 27.1 30. (30 19.8 23. (23 11.2 (7 2,1 21 1,386–3,3 138633 (2 1.19–5. 1195 p=0. p0 (4 27. (3 19. 11. ( 1,386–3, 13863 1.19–5 119 p=0 1,386–3 1386 1.19– p= 1,386– 138 1.19 1,386 1.1 1,38 1. 1,3 1,

ABSTRACT Objective: to trace the clinical and epidemiological profile of penile cancer in Rio Grande do Norte/Brazil and relate them to data published in the literature. Methods: a cross-sectional study was conducted with 94 patients diagnosed with penile cancer in 2011-2018, treated at the Liga Norte Riograndense Contra o Cancer. Results: all patients were diagnosed with squamous cell carcinoma, mainly aged over 50 years, from the states interior, brown, illiterate, or with incomplete primary education. At diagnosis, 68% of patients were classified as having tumors =T2, and 30% had lymph node involvement. Distant metastases were detected in 2.1% of patients at diagnosis. Most patients received the diagnosis in the initial phase of the disease, but 20.2% were diagnosed in stage IV. Partial penectomy was the most performed surgery, and 10% of patients relapsed, mainly in the lymph nodes (87.5%). The mean follow-up of the patients was 18 months, with an estimated overall survival at five years of 59.1%. However, 25% of patients were followed up for up to 3 months, losing follow-up. Conclusion: the State of Rio Grande do Norte has a high incidence of penile cancer with a high frequency of locally advanced tumors at diagnosis and in younger patients younger than 50. Furthermore, socioeconomic factors interfere with early diagnosis and hinder access to specialized services. Objective NorteBrazil Brazil literature Methods crosssectional cross sectional 9 20112018, 20112018 2011 2018, 2018 2011-2018 Cancer Results carcinoma 5 interior brown illiterate education 68 T2 T =T2 30 involvement 21 2 1 2.1 disease 202 20 20.2 IV surgery 10 relapsed 87.5%. 875 87.5% . 87 (87.5%) followup follow months 591 59 59.1% However 25 followup. up. Conclusion Furthermore services 2011201 201 2011-201 6 =T 2. 20. 87.5 8 (87.5% 59.1 201120 2011-20 87. (87.5 59. 20112 2011-2 (87. 2011- (87 (8 (

RESUMO Objetivo: traçar o perfil clínico e epidemiológico do câncer de pênis no Rio Grande do Norte/Brazil e relacioná-los com dados publicados na literatura. Métodos: realizou-se estudo transversal de 94 pacientes diagnosticados com câncer de pênis no período de 2011-2018, tratados na Liga Norte Riograndense Contra o Câncer. Resultados: todos os pacientes foram diagnosticados com carcinoma espinocelular, principalmente com idade acima dos 50 anos, provenientes do interior do estado, pardos, analfabetos ou com ensino fundamental incompleto. Ao diagnóstico, 68% dos pacientes foram classificados com tumores =T2 e 30% possuiam envolvimento linfonodal. Metástases à distância foram detectadas em 2,1% dos pacientes ao diagnóstico. A maioria dos pacientes recebeu o diagnóstico na fase inicial da doença, mas 20,2% foram diagnosticados em estádio IV. Penectomia parcial foi a cirurgia mais realizada e 10% dos pacientes recidivaram, principalmente para linfonodos (87,5%). A média de seguimento dos pacientes foi de 18 meses, apresentando estimativa de sobrevida global em 5 anos de 59,1%. No entanto, 25% dos pacientes foram acompanhados por até 3 meses, perdendo o seguimento. Conclusão: o Estado do Rio Grande do Norte apresenta elevada incidência de câncer de pênis com alta frequência de tumores localmente avançados ao diagnóstico, assim como em pacientes mais jovens, menores que 50 anos de idade. Outrossim, o fator socioeconômico interfere no diagnóstico precoce e dificulta o acesso a serviços especializados. . Objetivo NorteBrazil Brazil relacionálos relacioná los literatura Métodos realizouse realizou se 9 20112018, 20112018 2011 2018, 2018 2011-2018 Câncer Resultados espinocelular estado pardos incompleto 68 T2 T =T 30 linfonodal 21 2 1 2,1 doença 202 20 20,2 IV 10 recidivaram 87,5%. 875 87,5% 87 (87,5%) meses 591 59 59,1% entanto 25 Conclusão jovens Outrossim especializados 2011201 201 2011-201 6 2, 20, 87,5 8 (87,5% 59,1 201120 2011-20 87, (87,5 59, 20112 2011-2 (87, 2011- (87 (8 (

SUMMARY OBJECTIVE: The aim of this study was to evaluate and compare Maternal Near Miss prevalence and outcomes before and during the coronavirus disease 2019 pandemic. METHODS: This retrospective study was carried out in a university maternity hospital of high complexity. The population was divided into two groups: G1, 1 year before the coronavirus disease 2019 pandemic period (August 2018–July 2019) and G2, 1 year during the pandemic period (August 2020–July 2021). All pregnant/postpartum women hospitalized up to 42 days after the end of pregnancy/childbirth were included, and pregnant women who were admitted with coronavirus disease 2019/flu symptoms were excluded. The association of variables with “Maternal Near Miss” was estimated using logistic regression. RESULTS: A total of 568 women from G1 and 349 women from G2 fulfilled the Maternal Near Miss criteria. The prevalence of Maternal Near Miss in pre-pandemic was 144.1/1,000 live births and during the pandemic was 78.5/1,000 live births. In the analysis adjusted for G1, the factors of days of hospitalization (PR: 1.02, CI: 1.0–1.0, p<0.05), pre-eclampsia (PR: 0.41, CI: 1.4–2.2, p<0.05), and sepsis/severe systemic infection (PR: 1.79, CI: 0.3–0.4, p<0.05) were crucial for women with the Maternal Near Miss condition to have a greater chance of being admitted to the intensive care unit. In G2, low education (PR: 0.45, CI: 0.2–0.9, p<0.05), eclampsia (PR: 5.28, CI: 3.6–7.6, p<0.05), and use of blood products (PR: 6.48, CI: 4.7–8.8, p<0.05) increased the risk of admission to the intensive care unit. CONCLUSION: During the pandemic, there was a lower prevalence of Maternal Near Miss in high-risk pregnancies, fewer hospitalizations, and more deaths compared to the non-pandemic period. OBJECTIVE 201 METHODS complexity groups G August 2018July July 2018 2020July 2020 2021. 2021 . 2021) pregnantpostpartum postpartum 4 pregnancychildbirth pregnancy childbirth included 2019flu flu excluded regression RESULTS 56 34 criteria prepandemic pre 14411000 144 000 144.1/1,00 7851000 78 5 78.5/1,00 PR (PR 102 02 1.02 CI 1010 0 1.0–1.0 p<0.05, p005 p p<0.05 , 05 preeclampsia 041 41 0.41 1422 2 1.4–2.2 sepsissevere sepsis severe 179 79 1.79 0304 3 0.3–0.4 unit 045 45 0.45 0209 9 0.2–0.9 528 28 5.28 3676 6 7 3.6–7.6 648 48 6.48 4788 8 4.7–8.8 CONCLUSION highrisk pregnancies hospitalizations nonpandemic non 20 202 1441100 14 00 144.1/1,0 785100 78.5/1,0 10 1.0 101 1.0–1. p00 p<0.0 04 0.4 142 1.4–2. 17 1.7 030 0.3–0. 020 0.2–0. 52 5.2 367 3.6–7. 64 6.4 478 4.7–8. 144110 144.1/1, 78510 78.5/1, 1. 1.0–1 p0 p<0. 0. 1.4–2 03 0.3–0 0.2–0 5. 36 3.6–7 6. 47 4.7–8 14411 144.1/1 7851 78.5/1 1.0– p<0 1.4– 0.3– 0.2– 3.6– 4.7– 1441 144.1/ 785 78.5/ p< 1.4 0.3 0.2 3.6 4.7 144.1 78.5 3. 4. 144. 78.

Abstract This article aims to discuss the subject of ethics in the context of public organizations, built on two main pillars: the Brazilian Federal Constitution and the legal framework of the Ethics Management System of the Federal Executive Power. To carry out their duties, public servants, in addition to technical qualifications, need political and ethical skills. This article is the result of a research that had the following objectives: to understand the meanings of ethics and public ethics for public servants and to identify the importance and difficulties for the exercise of ethics in the work process developed. This is an exploratory research using a qualitative approach. Information collection was carried out with semi-structured interviews, and the data collected analyzed by content analysis, in the thematic analysis mode. The research results supported reflections to help future decisions related to the studied topic, considering the objective of disseminating the importance of complying with the ethical precepts that should underpin the performance of public servants. The conclusive arguments support the need for a broad discussion of the topic of “Ethics” within the public reach and the urgency to promote postures aimed at improving relationships, reinforcing critical and reflective thoughts in the work process based on ethical imperatives. organizations pillars Power duties qualifications skills objectives developed approach semistructured semi structured interviews mode “Ethics relationships imperatives

Resumo O presente artigo aborda o tema da ética no contexto das organizações públicas, edificada em dois grandes pilares: a Constituição Federal Brasileira e o marco legal do Sistema de Gestão da Ética do Poder Executivo Federal. Para o exercício das funções, os servidores, além da qualificação técnica, necessitam de competências políticas e éticas. Este trabalho é resultante de pesquisa que teve como objetivos: compreender os sentidos da ética e da ética pública para servidores públicos e identificar a importância e as dificuldades para o exercício da ética no processo de trabalho desenvolvido. Trata-se de uma pesquisa exploratória com utilização de abordagem qualitativa. A coleta de dados foi realizada por meio de entrevista semiestruturada e os dados coletados foram analisados por meio da análise de conteúdo, na modalidade de análise temática. Os resultados da pesquisa subsidiaram reflexões para auxiliar futuras decisões relacionadas ao tema estudado, tendo em vista o intuito de disseminar a importância do cumprimento dos preceitos éticos que devem alicerçar a atuação dos servidores. Os argumentos conclusivos reforçam a necessidade de uma ampla discussão do tema “Ética” dentro da esfera pública e a urgência em fomentar posturas que visem à melhoria das relações, cimentando pensamentos críticos e reflexivos no processo de trabalho com base em imperativos éticos. públicas pilares funções técnica éticas objetivos desenvolvido Tratase Trata se qualitativa conteúdo temática estudado “Ética relações

Resumo O presente artigo aborda o tema da ética no contexto das organizações públicas, edificada em dois grandes pilares: a Constituição Federal Brasileira e o marco legal do Sistema de Gestão da Ética do Poder Executivo Federal. Para o exercício das funções, os servidores, além da qualificação técnica, necessitam de competências políticas e éticas. Este trabalho é resultante de pesquisa que teve como objetivos: compreender os sentidos da ética e da ética pública para servidores públicos e identificar a importância e as dificuldades para o exercício da ética no processo de trabalho desenvolvido. Trata-se de uma pesquisa exploratória com utilização de abordagem qualitativa. A coleta de dados foi realizada por meio de entrevista semiestruturada e os dados coletados foram analisados por meio da análise de conteúdo, na modalidade de análise temática. Os resultados da pesquisa subsidiaram reflexões para auxiliar futuras decisões relacionadas ao tema estudado, tendo em vista o intuito de disseminar a importância do cumprimento dos preceitos éticos que devem alicerçar a atuação dos servidores. Os argumentos conclusivos reforçam a necessidade de uma ampla discussão do tema “Ética” dentro da esfera pública e a urgência em fomentar posturas que visem à melhoria das relações, cimentando pensamentos críticos e reflexivos no processo de trabalho com base em imperativos éticos.

Abstract This article aims to discuss the subject of ethics in the context of public organizations, built on two main pillars: the Brazilian Federal Constitution and the legal framework of the Ethics Management System of the Federal Executive Power. To carry out their duties, public servants, in addition to technical qualifications, need political and ethical skills. This article is the result of a research that had the following objectives: to understand the meanings of ethics and public ethics for public servants and to identify the importance and difficulties for the exercise of ethics in the work process developed. This is an exploratory research using a qualitative approach. Information collection was carried out with semi-structured interviews, and the data collected analyzed by content analysis, in the thematic analysis mode. The research results supported reflections to help future decisions related to the studied topic, considering the objective of disseminating the importance of complying with the ethical precepts that should underpin the performance of public servants. The conclusive arguments support the need for a broad discussion of the topic of “Ethics” within the public reach and the urgency to promote postures aimed at improving relationships, reinforcing critical and reflective thoughts in the work process based on ethical imperatives.

SUMMARY OBJECTIVE: To evaluate the sexual function of women in the puerperal period after a postpartum pelvic floor musculature training program. We also sought to evaluate correlations between sexual dysfunction in the women and their delivery type and compare the frequency of sexual dysfunction and the quality of resumed sexual function following vaginal and cesarean deliveries. METHODS: This clinical study included an intervention, carried out between July and December 2019, in which data were collected about 28 rooming-in women at a Maternity School. Data were divided into vaginal delivery and cesarean delivery. Sexual function was evaluated by the Female Sexual Function Index and the International Consultation on Incontinence Questionnaire-Short Form to assess the Incontinence Urinary and qualifies urinary loss. The intervention consisted of a muscle training exercise program. ANOVA tests were used to establish differences between groups. RESULTS: There was an improvement in all outcomes, but there was no time versus group interaction. Improvement in sexual function was observed (p<0.001), the impact of urinary incontinence on quality of life (p<0.001), and pressure of the muscles of pelvic floor muscles (p<0.001) over time. There was no time versus group interaction for sexual function (p=0.87), the impact of urinary incontinence on quality of life (p=0.88), and pressure of the pelvic floor muscles (p=0.66). CONCLUSIONS: Pelvic floor muscle exercise programs seem to be a very promising strategy concerning improving sexual activity among puerperal patients.

SUMMARY BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can affect the nervous system, triggering problems such as the Guillain-Barre Syndrome (GBS), an association that can bring complications to the patient. OBJECTIVE: This scoping review aimed to clarify the clinical features and analyze patients with GBS associated with SARS-CoV-2 infection, looking at morbidity, mortality, and neurological outcomes. SEARCH STRATEGY: The search was conducted through Medline, Web of Science, Embase, CINAHAL, Latin-American and Caribbean Literature in Health Sciences (LILACS), clinicaltrials.gov, SCOPUS, and the Cochrane Central Register of Controlled Trials. SELECTION CRITERIA: Observational studies, published after 2019, describe patients with GBS associated with SARS-CoV-2 infection. There were no language restrictions while selecting the studies. DATA COLLECTION AND ANALYSIS: Three authors, Kleyton Santos de Medeiros, Luíza Thomé de Araújo Macêdo, and Wederson Farias de Souza, independently screened the search results using titles and abstracts. Duplicate studies were excluded. The same authors then went through the entire text to determine whether the studies met the inclusion criteria. Discrepancies were resolved by other reviewers, Ana Paula Ferreira Costa, Ayane Cristine Sarmento, and Ana Katherine Gonçalves. Finally, the selection of the studies was summarized in a PRISMA flow diagram. MAIN RESULTS: Main manifestations were fever, coughing, dyspnea, sore throat, ageusia, anosmia, and respiratory failure, in addition to paresthesia of the upper and lower limbs, tetraparesis, facial diplegia, areflexia, asthenia, mastoid pain, acute ataxia, fatigue, numbness, swallowing disorder, and moderate low back pain. CONCLUSION: Coronavirus disease 2019 (COVID-19) can trigger the GBS, despite the few studies on this topic. Patients had clinical manifestations of COVID-19 infection and neurological manifestations characterizing GBS.

SUMMARY BACKGROUND: Although much has been studied about the SARS-Cov-2 virus, its effects, and the effectiveness of possible treatments, little is known about its interaction with other infectious diseases. OBJECTIVE: The aim is to study its clinical features and morbidity, and mortality outcomes of COVID-19 patients with HIV/AIDS coinfection. DATA SOURCES: MEDLINE, Web of Science, Embase, CINAHL, LILACS, Scopus, ClinicalTrials.gov, and Cochrane. STUDY ELIGIBILITY CRITERIA: Atudies in any language, published after 2019, were describing COVID-19 patients with HIV/AIDS. STUDY APPRAISAL: JBI Levels of Evidence, Joanna Briggs Institute. SYNTHESIS METHODS: As shown in the PRISMA flow diagram, two authors separately screened the search results from the obtained titles and abstracts. RESULTS: Chest CT was observed in patients with pneumonia by SARS-CoV-2 with findings of multiple ground-glass opacities (GGO) in the lungs, there is a need for supplemental oxygenation. One patient developed encephalopathy and complicated tonic-clonic seizures; four patients were transplanted (two, liver; two, kidneys), one patient developed severe SARS-CoV-2 pneumonia and 30 patients died (mortality rate, 11%). CONCLUSION: HIV did not show any relevance directly with the occurrence of COVID-19. Some studies suggest that HIV-1 infection through induction levels of IFN-I, may to some extent, stop the apparent SARS-CoV-2 infection, thus leading to undetectable RNA. Moreover, some authors suggest retroviral therapy routinely used to control HIV infection could be used to prevent COVID-19 infection.

ABSTRACT Objective: propose steps for patient safety based on the analysis of risks in mobile emergency care from nurses’ perspective. Method: quantitative and descriptive study. Intentional sample consisting of 23 nurses. The photographic research method was used to identify the risks for patient safety in a Mobile Emergency Care Service in a city in Rio Grande do Norte (Brazil). The data were collected between March and June 2012 and organized in five phases: collection of pictures from safe and non-safe situations; selection of pictures based on the image quality; selection of pictures by experts on the theme; random selection of ten images; and application of picture analysis tool by the professionals. Content analysis and descriptive analysis were used. Results: the risks appointed in the study were: difficulties to store equipment and material; particularities of work in mobile emergency care; risk of infection; risk of traumas; and medication administration difficulties. Based on this information and confrontations with the literature, ten steps were suggested towards patient safety in emergency care, focused on the needs to reduce the risks presented. Conclusion: the risk analysis and the intervention proposal towards patient safety favor the quality of health care, with benefits in the following spheres: patient, team, equipment, professional and environment. These should be developed in accordance with the needs of each service.

RESUMEN Objetivo: proponer los pasos a seguir para la seguridad del paciente a partir del análisis de los riesgos en la atención pre-hospitalaria móvil y bajo la óptica de los enfermeros. Método: estudio cuantitativo, y descriptivo. Muestra intencional compuesta por 23 enfermeros. Se utilizó el método de investigación fotográfica para identificar los riesgos para la seguridad del paciente en un Servicio de Atención Móvil de Urgencia de una ciudad del estado de Rio Grande do Norte. La recolección se realizó de Marzo a Junio del 2012 y se organizó en cinco etapas: obtención de las fotos de situaciones de seguridad y sin seguridad, selección de fotos por la cualidad de imagen, selección de fotos por los peritos en la temática, selección de diez imágenes de forma aleatoria y aplicación del instrumento de análisis de las fotos por los profesionales. Se usó el análisis del contenido y el análisis descriptivo. Resultados: los riesgos mencionados en el estudio fueron las dificultades en el acondicionamiento de equipamientos y materiales, especificidades del trabajo en la atención pre-hospitalaria móvil, riesgo de infección, riesgo de traumas y dificultades en la administración de medicamentos. A partir de estas informaciones y cotejos con la literatura fueron sugeridos diez pasos a seguir para la seguridad del paciente en la atención pre-hospitalaria relacionados con las necesidades de reducción de los riesgos presentados. Conclusión: el análisis de riesgos y propuesta de intervenciones para la seguridad del paciente favorece la cualidad de la atención en la salud y con beneficios en las áreas paciente, equipo, profesional y ambiente. Se sugiere que sean desarrolladas de acuerdo con las necesidades de cada servicio.

RESUMO Objetivo: propor passos para a segurança do paciente a partir da análise dos riscos no atendimento pré-hospitalar móvel sob a ótica dos enfermeiros. Método: estudo quantitativo, e descritivo. Amostra intencional, composta por 23 enfermeiros. Utilizou-se o método de pesquisa fotográfica para identificar os riscos à segurança do paciente em um Serviço de Atendimento Móvel de Urgência de uma cidade do Rio Grande do Norte. A coleta foi realizada de março a junho de 2012 e organizada em cinco etapas: obtenção das fotos de situações de segurança e não segurança; seleção de fotos pela qualidade de imagem; seleção de fotos pelos experts da temática; seleção de dez imagens de modo aleatório; e aplicação do instrumento de análise das fotos pelos profissionais. Foi utilizada a análise de conteúdo e análise descritiva. Resultados: os riscos apontados no estudo foram: dificuldades no acondicionamento de equipamentos e materiais; especificidades do trabalho no atendimento pré-hospitalar móvel; risco de infecção; risco de traumas; e dificuldades na administração de medicamentos. A partir dessas informações e confrontos com a literatura, foram sugeridos dez passos para a segurança do paciente no atendimento pré-hospitalar, voltados às necessidades de redução dos riscos apresentados. Conclusão: a análise de riscos e proposta de intervenções para a segurança do paciente favorecem a qualidade do atendimento em saúde, com benefícios na esfera: paciente, equipe, profissional e ambiente. Sugere-se que sejam desenvolvidas de acordo com as necessidades de cada serviço.

RESUMO Objetivo: propor passos para a segurança do paciente a partir da análise dos riscos no atendimento pré-hospitalar móvel sob a ótica dos enfermeiros. Método: estudo quantitativo, e descritivo. Amostra intencional, composta por 23 enfermeiros. Utilizou-se o método de pesquisa fotográfica para identificar os riscos à segurança do paciente em um Serviço de Atendimento Móvel de Urgência de uma cidade do Rio Grande do Norte. A coleta foi realizada de março a junho de 2012 e organizada em cinco etapas: obtenção das fotos de situações de segurança e não segurança; seleção de fotos pela qualidade de imagem; seleção de fotos pelos experts da temática; seleção de dez imagens de modo aleatório; e aplicação do instrumento de análise das fotos pelos profissionais. Foi utilizada a análise de conteúdo e análise descritiva. Resultados: os riscos apontados no estudo foram: dificuldades no acondicionamento de equipamentos e materiais; especificidades do trabalho no atendimento pré-hospitalar móvel; risco de infecção; risco de traumas; e dificuldades na administração de medicamentos. A partir dessas informações e confrontos com a literatura, foram sugeridos dez passos para a segurança do paciente no atendimento pré-hospitalar, voltados às necessidades de redução dos riscos apresentados. Conclusão: a análise de riscos e proposta de intervenções para a segurança do paciente favorecem a qualidade do atendimento em saúde, com benefícios na esfera: paciente, equipe, profissional e ambiente. Sugere-se que sejam desenvolvidas de acordo com as necessidades de cada serviço.

ABSTRACT Objective: propose steps for patient safety based on the analysis of risks in mobile emergency care from nurses’ perspective. Method: quantitative and descriptive study. Intentional sample consisting of 23 nurses. The photographic research method was used to identify the risks for patient safety in a Mobile Emergency Care Service in a city in Rio Grande do Norte (Brazil). The data were collected between March and June 2012 and organized in five phases: collection of pictures from safe and non-safe situations; selection of pictures based on the image quality; selection of pictures by experts on the theme; random selection of ten images; and application of picture analysis tool by the professionals. Content analysis and descriptive analysis were used. Results: the risks appointed in the study were: difficulties to store equipment and material; particularities of work in mobile emergency care; risk of infection; risk of traumas; and medication administration difficulties. Based on this information and confrontations with the literature, ten steps were suggested towards patient safety in emergency care, focused on the needs to reduce the risks presented. Conclusion: the risk analysis and the intervention proposal towards patient safety favor the quality of health care, with benefits in the following spheres: patient, team, equipment, professional and environment. These should be developed in accordance with the needs of each service.

RESUMEN Objetivo: proponer los pasos a seguir para la seguridad del paciente a partir del análisis de los riesgos en la atención pre-hospitalaria móvil y bajo la óptica de los enfermeros. Método: estudio cuantitativo, y descriptivo. Muestra intencional compuesta por 23 enfermeros. Se utilizó el método de investigación fotográfica para identificar los riesgos para la seguridad del paciente en un Servicio de Atención Móvil de Urgencia de una ciudad del estado de Rio Grande do Norte. La recolección se realizó de Marzo a Junio del 2012 y se organizó en cinco etapas: obtención de las fotos de situaciones de seguridad y sin seguridad, selección de fotos por la cualidad de imagen, selección de fotos por los peritos en la temática, selección de diez imágenes de forma aleatoria y aplicación del instrumento de análisis de las fotos por los profesionales. Se usó el análisis del contenido y el análisis descriptivo. Resultados: los riesgos mencionados en el estudio fueron las dificultades en el acondicionamiento de equipamientos y materiales, especificidades del trabajo en la atención pre-hospitalaria móvil, riesgo de infección, riesgo de traumas y dificultades en la administración de medicamentos. A partir de estas informaciones y cotejos con la literatura fueron sugeridos diez pasos a seguir para la seguridad del paciente en la atención pre-hospitalaria relacionados con las necesidades de reducción de los riesgos presentados. Conclusión: el análisis de riesgos y propuesta de intervenciones para la seguridad del paciente favorece la cualidad de la atención en la salud y con beneficios en las áreas paciente, equipo, profesional y ambiente. Se sugiere que sean desarrolladas de acuerdo con las necesidades de cada servicio.