Resumo Enquadramento: A ventilação não invasiva (VNI) constitui uma estratégia terapêutica à pessoa com insuficiência respiratória aguda (IRA). Objetivo: Analisar a relação entre as variáveis sociodemográficas e clínicas, das pessoas internadas na medicina interna, e a adaptação e complicações da VNI. Metodologia: Estudo observacional retrospetivo de coorte, com amostra de 239 pessoas. A colheita de dados foi efetuada através de registos eletrónicos no SClínico, utilizando um guia de extração de dados. Resultados: Verificou-se que 25,1% das pessoas estavam inadaptadas à VNI, associando-se significativamente com a alimentação oral, confusão e uso de contenção mecânica. As complicações verificaram-se em 33,5% da amostra, sendo as mais frequentes secreções, lesão no nariz e vómitos. Constatou-se uma associação estatisticamente significativa entre o número de complicações e pessoas alimentadas por sonda nasogástrica (SNG), confusas, com medidas de contenção mecânica e a utilizarem máscara oro-nasal. Conclusão: A vigilância da pessoa submetida a VNI deve ser assegurada por uma equipa de enfermagem especializada. Devem ser implementados protocolos conducentes à prevenção de complicações e promotores de adaptabilidade à VNI.

Abstract Background: Non-invasive ventilation is a therapeutic strategy for patients with acute respiratory failure. Objective: To analyze the relationship between the sociodemographic and clinical variables of patients hospitalized in internal medicine services and the adaptation to and complications of non-invasive ventilation. Methodology: A retrospective observational cohort study was carried out with a sample of 239 patients. Data were collected from electronic records in the information system SClínico, using a data extraction guide. Results: A total of 25.1% of the participants did not adapt to non-invasive ventilation, and this was significantly associated with oral feeding, confusion, and the use of mechanical restraint measures. Complications occurred in 33.5% of the sample. The most frequent complications were secretions, nasal injuries, and vomiting. There was a statistically significant association between the number of complications and patients fed by nasogastric tube, confused, with mechanical restraint measures, and wearing an oronasal mask. Conclusion: The monitoring of patients on non-invasive ventilation should be carried out by a specialized nursing team. Protocols should be implemented to prevent complications and promote patient adaptation to non-invasive ventilation.

Resumen Marco contextual: La ventilación no invasiva (VNI) es una estrategia terapéutica para las personas con insuficiencia respiratoria aguda (IRA). Objetivo: Analizar la relación entre las variables sociodemográficas y clínicas de las personas ingresadas en medicina interna y la adaptación y complicaciones de la VNI. Metodología: Estudio observacional retrospectivo de cohortes con una muestra de 239 personas. Los datos se recogieron a través de registros electrónicos en SClínico, mediante una guía de extracción de datos. Resultados: Se observó que el 25,1% de las personas no eran aptas para la VNI, lo que se asoció significativamente con la alimentación oral, la confusión y el uso de contención mecánica. Se produjeron complicaciones en el 33,5% de la muestra, y las más frecuentes fueron secreciones, lesiones en la nariz y vómitos. Se encontró una asociación estadísticamente significativa entre el número de complicaciones y las personas alimentadas por sonda nasogástrica (SNG), confusas, con medidas de contención mecánica y que utilizaban mascarilla oronasal. Conclusión: La persona sometida a VNI debe ser controlada por un equipo de enfermería especializado. Deben aplicarse protocolos para prevenir complicaciones y favorecer la adaptabilidad a la VNI.

Abstract Background: Loneliness and social isolation are significant public health issues. Family nurses play a vital role in identifying and preventing these phenomena and designing interventions to address them. Objective: To evaluate the impact of non-face-to-face follow-up consultations with family nurses on social isolation, quality of life, and disease self-management of older adults living alone in the community. Methodology: This pre-experimental study utilizes a one-group pretest-posttest design on a sample of 24 older adult patients. The Lubben Social Network Scale-6 (LSNS-6), the World Health Organization Quality of Life Group (WHOQOL) - OLD scale, and the Portuguese Version of the Therapeutic Self-Care Scale were used for data collection. Results: Following the intervention, patients’ satisfaction with the family nurse’s follow-up improved (p < 0.001). Additionally, there was a 33.3% increase in self-care management and a reduction in the risk of social isolation (45.8% to 33.3%). Although not statistically significant, there was also an increase in the global score of the quality of life variable. Conclusion: The non-face-to-face telenursing consultations positively affected the older adult patients’ satisfaction with the family nurse’s contact and follow-up, reduced social isolation, and improved self-care activities.

Resumo Enquadramento: A solidão e/ou isolamento social (IS) representa um problema de saúde pública. Os enfermeiros de família (EF), têm um papel crucial na prevenção, identificação e intervenção dos mesmos. Objetivo: Avaliar o impacte do acompanhamento por consulta não presencial do EF no IS, qualidade de vida (QdV) e autogestão da doença de pessoas idosas (PI) a viver só na comunidade. Metodologia: Estudo pré-experimental com desenho pré e pós, com 24 PI. Utilizou-se na recolha de dados: a escala breve de redes sociais de Lubben, a escala World Health Organization Quality of Life Group e o instrumento de autocuidado terapêutico. Resultados: Após a intervenção verificou-se uma melhoria no acompanhamento pelo EF (p < 0,001), um aumento de 33,3% na gestão do autocuidado e redução do risco de IS (45,8% para 33,3%). Na QdV houve um aumento no score global, contudo não estatisticamente significativo. Conclusão: O acompanhamento por consulta não presencial do EF teve efeito positivo no contacto e acompanhamento pelo EF, mitigação do IS e na melhoria de atividades de autocuidado.

Resumen Marco contextual: La soledad o el aislamiento social (IS) constituyen un problema de salud pública. Los enfermeros de familia (EF) desempeñan un papel crucial en la prevención, identificación e intervención en estos problemas. Objetivo: Evaluar el impacto del seguimiento mediante consulta no presencial del EF en el IS, la calidad de vida (QdV) y la autogestión de la enfermedad en personas mayores (PI) que viven solas en la comunidad. Metodología: Estudio preexperimental con diseño previo y posterior, con 24 PI. Para la recogida de datos se utilizó la escala breve de redes sociales de Lubben, la escala World Health Organization Quality of Life Group y el instrumento de autocuidado terapéutico. Resultados: Tras la intervención, se produjo una mejora de la supervisión por parte de los EF (p < 0,001), un aumento del 33,3% en la gestión del autocuidado y la reducción del riesgo de IS (45,8% para 33,3%). En la QdV hubo un aumento de la puntuación global, pero no fue estadísticamente significativo. Conclusión: El seguimiento mediante consulta no presencial con el EF tuvo un efecto positivo en el contacto y acompañamiento por parte del EF, la reducción del IS y la mejora de las actividades de autocuidado.

Resumo: O objetivo deste estudo foi investigar possíveis correlações entre competências socioemocionais, adaptabilidade de carreira e autoeficácia na transição escola-trabalho. A amostra foi composta por 505 jovens aprendizes com idades entre 14 e 24 anos, sendo 39,4 % do sexo masculino (n = 199), 60,6 % do sexo feminino (n = 306), participantes de um programa de aprendizagem. Foram utilizados quatro instrumentos aplicados online: Instrumento para Avaliação de Competências Socioemocionais (SENNA 2.0), Escala de Adaptabilidade de Carreira (EAC), Escala de Autoeficácia na Transição Escola-Trabalho (AETBR), Questionário de Identificação e Critério de Classificação Econômica Brasil. Foram realizadas análises fatoriais confirmatórias, de confiabilidade, descritivas e correlações r de Pearson. Os resultados indicam correlações importantes entre todas as variáveis, exceto entre as competências socioemocionais, amabilidade e engajamento com os outros. Os resultados da AETT-BR e da EAC mostram relação entre confiança e adaptação. Os achados mostram implicações para as práticas e pistas para novas investigações.

Resumen: El objetivo de este estudio fue investigar posibles correlaciones entre competencias socioemocionales, adaptabilidad de carrera y autoeficacia, en la transición escuela-trabajo. La muestra estuvo compuesta por 505 jóvenes participantes de un programa de aprendizaje con edades entre 14 y 24 años, siendo 39.4 % del sexo masculino (n = 199) y 60.6 % del sexo femenino (n = 306). Se utilizaron cuatro instrumentos aplicados online: Instrumento para Evaluación de Competencias Socioemocionales (SENNA 2.0), Escala de Adaptabilidad de Carrera (EAC), Escala de Autoeficacia en la Transición Escuela-Trabajo (AETBR) y Cuestionario de Identificación y Criterio de Clasificación Económica Brasil. Se realizaron análisis factoriales confirmatorios de confiabilidad y descriptivos y correlaciones r de Pearson. Los resultados indicaron correlaciones importantes entre todas las variables, excepto entre las competencias socioemocionales, amabilidad y compromiso con los otros. Los resultados de la AETT-BR y de la EAC mostraron relación entre confianza y adaptación. Los hallazgos muestran implicaciones para las prácticas e indicios para realizar nuevas investigaciones.

Abstract: The aim of this study was to investigate possible correlations between socioemotional competencies, career adaptability and self-efficacy in the school-work transition. The sample consisted of 505 young apprentices aged between 14 and 24, 39.4 % male (n = 199), 60.6 % female (n = 306), participating in an apprenticeship program. Four online instruments were used: the Socio-Emotional Skills Assessment Tool (SENNA 2.0), the Career Adaptability Scale (CAT), the Self-Efficacy Scale for the School-Work Transition (AETT-BR), the Identification Questionnaire and the Brazil Economic Classification Criterion. Confirmatory factor analysis, reliability analysis, descriptive analysis and Pearson's r correlations were carried out. The results indicate significant correlations between all the variables, except for socioemotional competencies, kindness and engagement with others. The results of the AETT-BR and CAT show a relationship between trust and adaptation. The findings show implications for practice and avenues for further research.

Resumo Fundamento Análises em grandes registros apontam desfechos desfavoráveis para mulheres submetidas à cirurgia de revascularização do miocárdio (CRM), enquanto estudos randomizados sofrem com a falta de representatividade. Objetivo Comparar os resultados hospitalares ajustados entre homens e mulheres submetidos à CRM. Métodos Entre julho de 2017 e junho de 2019, 3991 pacientes foram submetidos à CRM primária isolada, tanto de forma eletiva como de urgência, em 5 hospitais de estado de São Paulo, Brasil. Para equilibrar as diferenças entre homens e mulheres, as populações foram ajustadas utilizando o Propensity Score Matching. Os desfechos considerados para análise foram os utilizados pelo STS Adult Database. As análises foram conduzidas no software R, considerando significância valores de p < 0,05. Resultados Após o Propensity Score Matching (1:1), cada grupo incluiu 1089 pacientes. Em relação às variáveis intraoperatórias os homens apresentaram maior tempo de CEC (p<0,001), tempo cirúrgico (p<0,001), número de anastomoses distais (p<0,001) e uso de enxertos arteriais. Em relação aos desfechos as mulheres apresentaram maior incidência de infecção de ferida profunda (p=0,006), tempo prolongado na Unidade de Terapia Intensiva (p=0,002), maior necessidade do uso de balão intraórtico (p=0,04), maior taxa de transfusão sanguínea (p<0,001), maior readmissão hospitalar em até 30 dias após a cirurgia (p=0,002) e maior taxa de óbitos (p=0,03). Conclusões Apesar dos homens terem apresentado um maior tempo de CEC, maior número de enxertos arteriais e maior número de anastomoses distais, os resultados imediatos após CRM foram piores em mulheres. CRM, , (CRM) representatividade 201 2019 399 isolada urgência Paulo Brasil Database R 005 0 05 0,05 11, 11 1 (1:1) 108 p<0,001, p0001 p<0,001 001 (p<0,001 p=0,006, p0006 p=0,006 006 (p=0,006) p=0,002, p0002 p=0,002 002 p=0,04, p004 p=0,04 04 (p=0,04) 3 (p=0,002 p=0,03. p003 p=0,03 . 03 (p=0,03) (CRM 20 39 00 0,0 (1:1 10 p000 p<0,00 (p<0,00 p=0,00 (p=0,006 p00 p=0,0 (p=0,04 (p=0,00 (p=0,03 2 0, (1: p<0,0 (p<0,0 p0 p=0, (p=0,0 (1 p<0, (p<0, p=0 (p=0, ( p<0 (p<0 p= (p=0 p< (p< (p= (p

Abstract Background Analyses of extensive registries indicate adverse outcomes for women undergoing coronary artery bypass grafting (CABG) surgery, while randomized studies often lack representativeness. Objective To compare adjusted hospital outcomes between men and women undergoing CABG. Methods From July 2017 to June 2019, 3991 patients underwent primary isolated CABG, both electively and urgently, in 5 hospitals in the state of São Paulo, Brazil. To mitigate demographic differences between men and women, populations were adjusted using propensity score matching (PSM). The outcomes considered for analysis were those used by the STS Adult Database. The analyses were performed using R software, with a significance set at p<0.05. Results After PSM (1:1), each group included 1089 patients. Regarding intraoperative variables, men exhibited longer cardiopulmonary bypass (CPB) time (p<0.001), surgical time (p<0.001), a higher number of distal anastomoses (p<0.001), and increased use of arterial grafts. Regarding outcomes, women had a higher incidence of deep sternal wound infection (p=0.006), prolonged Intensive Care Unit stay (p=0.002), increased need for an intra-aortic balloon pump (p=0.04), higher blood transfusion rates (p<0.001), higher 30-day hospital readmission rates after surgery (p=0.002) and higher mortality rate (p=0.03). Conclusions Although men had longer CPB times, a greater number of arterial grafts, and a greater number of distal anastomoses, immediate results after CABG were poorer in women. (CABG representativeness 201 2019 399 urgently Paulo Brazil PSM. . (PSM) Database software p005 p 0 05 p<0.05 11, 11 1 , (1:1) 108 variables (CPB p<0.001, p0001 p<0.001 001 (p<0.001) grafts p=0.006, p0006 p=0.006 006 (p=0.006) p=0.002, p0002 p=0.002 002 intraaortic intra aortic p=0.04, p004 p=0.04 04 (p=0.04) 30day day 30 (p=0.002 p=0.03. p003 p=0.03 03 (p=0.03) times 20 39 (PSM p00 p<0.0 (1:1 10 p000 p<0.00 00 (p<0.001 p=0.00 (p=0.006 p=0.0 (p=0.04 3 (p=0.00 (p=0.03 2 p0 p<0. (1: (p<0.00 p=0. (p=0.0 p<0 (1 (p<0.0 p=0 (p=0. p< ( (p<0. p= (p=0 (p<0 (p= (p< (p

Abstract This research seeks to delve into the dynamics of participation within news platforms curated by non-professional journalists residing in inland Portugal. Through an exploratory study, two initiatives originating from communities located in the country’s inland areas are analysed: Vela Notícias, in the Centre region, and Jornal da Aldeia, in the Alentejo region. These initiatives serve as empirical objects illustrating a phenomenon that reflects the shift away from traditional media, the community’s eagerness to disseminate locally pertinent knowledge, and the citizens’ yearning for social and cultural representation. Both initiatives have emerged in ageing and sparsely populated regions, with fewer than 1,000 inhabitants, according to the 2021 Census (Instituto Nacional de Estatística, 2021). To understand and address these concerns, alongside a thorough review of pertinent literature, semi-structured interviews were conducted as a methodological approach involving participants engaged in information production for the two community media outlets. The significance of this study lies in unravelling the intricacies of proximity communication dynamics spearheaded by non-journalist citizens. The residents of both parishes actively contribute to content creation, topic selection, editing, and distribution of the newspapers. Production operates outside the norms of journalistic selection, filtering, and hierarchy. Nevertheless, interviewees exhibit keen interest and confidence in the published information. The motivation for participation stems from a desire to share common values and cultural connections, fostering a sense of belonging and social responsibility.

Resumo Esta pesquisa tem como objetivo compreender as dinâmicas de participação presentes em veículos informativos produzidos por cidadãos não-jornalistas, no interior de Portugal. A partir de um estudo exploratório, são analisadas duas iniciativas desenvolvidas por comunidades localizadas no interior do país, o Vela Notícias, na região Centro, e o Jornal da Aldeia, na região do Alentejo. Estas são entendidas como objetos empíricos de um fenómeno que reflete o distanciamento e os constrangimentos dos média tradicionais, o desejo das populações destes territórios de partilharem conhecimento de interesse local e a necessidade de os cidadãos se sentirem representados social e culturalmente. As duas iniciativas surgiram em regiões desertificadas, com menos de 1.000 habitantes, e envelhecidas, segundo os Censos 2021 (Instituto Nacional de Estatística, 2021). A fim de compreender e discutir tais questões, além da revisão da literatura pertinente ao tema, realizaram-se entrevistas semiestruturadas, como procedimento metodológico, aos participantes envolvidos na produção informativa dos dois média comunitários. A importância do estudo consiste em compreender dinâmicas comunicacionais de proximidade que envolvem cidadãos não-jornalistas. Os cidadãos das duas freguesias participam na criação de conteúdos, na escolha dos assuntos, na edição e na distribuição dos periódicos. A produção não está submetida às lógicas de seleção, filtragem e hierarquização jornalísticas. Ainda assim, os entrevistados demonstram interesse e confiança nas informações publicadas. O interesse em participar relaciona-se com o desejo de partilha de valores comuns e vínculos culturais, que contam ainda com o sentimento de pertença e de responsabilidade social.

ABSTRACT The use of residues resulting from the processing of agricultural products is an widely studied topic, which is justified by the need to reduce costs and by the search for productive sustainability, which has as one of its principles the full use production, reducing waste and therefore increasing the amount of products extracted per unit of area. Residual seeds, resulting from the production of fruit pulps, are rich in nutrients and with the potential to be further improved by the application of germination, increasing the protein content and the content of bioactive compounds. However, in the germination process, the product acquires a high water content, requiring immediate drying and control of the water adsorption kinetics after dehydration. Therefore, the objective of this study was to determine the water adsorption isotherms of germinated seeds flours from pumpkins of three varieties at temperatures of 15, 25 and 35 °C, to obtain the most appropriate mathematical model to describe the hygroscopic behavior and to determine the thermodynamic properties of water adsorption, through the values of the integral isosteric heat, differential entropy, differential enthalpy and Gibbs free energy for the studied conditions. The GAB and Peleg models fit the experimental data well. With increasing water activity, there was a reduction in isosteric heat and entropy. The enthalpy-entropy compensation theory was confirmed. Gibbs free energy was negative for all temperatures, increasing with increasing equilibrium water content, demonstrating that it is a spontaneous process. topic sustainability area pulps compounds However process dehydration Therefore 15 2 3 C °C entropy conditions well activity enthalpyentropy confirmed 1

ABSTRACT BACKGROUND: Down syndrome (DS) is a non-rare genetic condition that affects approximately 1 in every 800 live births worldwide. Further, it is associated with comorbidities, anatomical alterations of the respiratory tract, and immunological dysfunctions that make individuals more susceptible to respiratory infections. OBJECTIVE: To systematize the current scientific knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among individuals with DS. DESIGN AND SETTING: This integrative review was conducted at the Universidade Federal de São Carlos, São Paulo, Brazil. METHODS: This review was conducted in the following databases: the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), PubMed, and Web of Science, using MeSH descriptors. The search included English or Portuguese studies published between January 1, 2020, and October 14, 2022. RESULTS: A total of 55 articles from 24 countries were selected, comprising 21 case-control or cohort studies, 23 case reports or series, and 11 narrative reviews or opinion studies. The articles were grouped into five categories: previous comorbidities, coronavirus disease 2019 (COVID-19) clinical features and evolution, cytokine storm and interleukins, living in institutions as a risk factor, and behavioral actions as a protective factor against SARS-CoV-2 infection. CONCLUSION: Individuals with DS are more susceptible to COVID-19 infection due to variables such as previous comorbidities, immunological factors, and their habitable environments. These aspects confer a higher risk of infection and an unfavorable clinical course. The precise pathways involved in the pathophysiology of COVID-19 in individuals with DS are not clear, thus requiring further studies. SYSTEMATIC REVIEW REGISTRATION: The Open Science Framework registered the research protocol (https://osf.io/jyb97/). BACKGROUND (DS nonrare non rare 80 worldwide Further comorbidities tract infections OBJECTIVE SARSCoV2 SARSCoV SARS CoV (SARS-CoV-2 SETTING Carlos Paulo Brazil METHODS databases Biblioteca Saúde BVS, BVS , BVS) PubMed descriptors 2020 14 2022 RESULTS 5 selected casecontrol control series categories 201 COVID19 COVID 19 (COVID-19 evolution interleukins SARS-CoV- CONCLUSION COVID-1 factors environments course clear REGISTRATION https//osf.io/jyb97/. httpsosfiojyb97 httpsosfiojyb https //osf.io/jyb97/ . osf io jyb97 jyb (https://osf.io/jyb97/) 8 (SARS-CoV- 202 20 COVID1 (COVID-1 SARS-CoV COVID- https//osf.io/jyb97/ httpsosfiojyb9 osfiojyb97 osfiojyb //osf.io/jyb97 jyb9 (https://osf.io/jyb97/ (SARS-CoV (COVID- https//osf.io/jyb97 osfiojyb9 //osf.io/jyb9 (https://osf.io/jyb97 (COVID https//osf.io/jyb9 //osf.io/jyb (https://osf.io/jyb9 https//osf.io/jyb (https://osf.io/jyb

RESUMO Objetivo Comparar a sucção infantil em bebês com e sem anquiloglossia usando um sensor de pressão controlado por microprocessador acoplado a uma chupeta. Método Cinquenta e cinco lactentes de 0 a 2 meses de idade foram submetidos ao exame clínico de anquiloglossia, em seguida foi oferecido uma chupeta de silicone conectada ao dispositivo de aquisição de pressão e a atividade de sucção foi registrada. Assim, obtivemos dados sobre a frequência de sucções dentro de um período de sucções, a duração média da sucção, a duração da rajada, o número de sucções por rajada, a amplitude máxima das sucções por rajada e o intervalo entre rajadas. O teste t não pareado foi utilizado para comparações entre os grupos. Resultados A principal diferença dos recém-nascidos com anquiloglossia em relação aos do grupo controle é que eles realizam rajadas mais longas durante a atividade de sucção. Conclusão A duração mais longa das rajadas é provavelmente uma estratégia compensatória e pode estar por trás da dor relatada pelas mães durante a amamentação. Portanto, propomos um método para quantificar objetivamente alguns parâmetros da sucção infantil e demonstramos seu uso para auxiliar na avaliação da anquiloglossia. registrada Assim grupos recémnascidos recém nascidos amamentação Portanto

ABSTRACT Purpose Compare infant suction in babies with and without ankyloglossia using a microprocessor-controlled pressure sensor coupled to a pacifier. Methods Fifty-five infants from 0 to 2 months of age underwent clinical examination for ankyloglossia, after which they were offered a silicone pacifier connected to the pressure acquisition device and suction activity was recorded. Thus, we extracted the frequency of sucks within a burst, the average suck duration, the burst duration, the number of sucks per burst, the maximum amplitude of sucks per burst and the inter-burst interval. Results The key difference in newborns with ankyloglossia in relation to control was that they perform longer bursts of suction activity. Conclusion The longer burst durations are likely a compensatory strategy and may underlie the pain reported by mothers during breastfeeding. We therefore propose a method for objectively quantifying some parameters of infant suction capacity and demonstrate its use in assisting the evaluation of ankyloglossia. microprocessorcontrolled microprocessor controlled Fiftyfive Fifty five recorded Thus duration interburst inter interval breastfeeding

Con el avance de la tecnología, el aprendizaje en teleconsultas pasó a formar parte de la graduación médica actual. Esta investigación presenta las representaciones de un grupo de alumnos de un curso de medicina localizado en la capital del estado de São Paulo sobre sus experiencias con la realización de teleconsultas sincronizadas supervisadas durante una pasantía realizada en un ambulatorio escuela, durante el segundo trimestre de 2021. Se traba de una investigación cualitativa que utilizó el software IRaMuTeQ® y Análisis de Contenido. Estos alumnos puntúan obstáculos para la utilización de las teleconsultas, destacando preocupaciones con la humanización, seguridad de la persona atendida y calidad de la consulta, pero visualizan potencialidades tales como la facilidad de acceso y la comodidad. Reconocen la importancia de la práctica durante su graduación en un mundo cada vez más tecnológico, pero presentan inquietudes relacionadas a la pérdida del examen físico y a la mercantilización de la medicina.

Com o avançar da tecnologia, passou a fazer parte da graduação médica atual o aprendizado em teleconsultas. Esta pesquisa apresenta as representações de um grupo de alunos de um curso de Medicina localizado na capital do estado de São Paulo sobre suas experiências com a realização de teleconsultas síncronas supervisionadas durante estágio realizado em um ambulatório-escola, durante o segundo semestre de 2021. Trata-se de pesquisa qualitativa que utilizou o software IRaMuTeQ® e “Análise do Conteúdo”. Esses educandos pontuam entraves para a utilização das teleconsultas, destacando preocupações com a humanização, segurança da pessoa atendida e qualidade da consulta, mas visualizam potencialidades tais como a facilidade de acesso e a comodidade. Reconhecem a importância da prática durante sua Graduação em um mundo cada vez mais tecnológico, mas trazem inquietações relacionadas à perda do exame físico e à mercantilização da Medicina.

With the progress of technology, teleconsultation has become part of medical degree courses. This article presents the representations of a group of medical students from a university in the capital of the state of São Paulo regarding their experiences with supervised synchronous teleconsultations during an internship in a teaching clinic in the second semester of 2021. We conducted a qualitative study using the software IRaMuTeQ® and content analysis. The students highlighted barriers to the use of teleconsultation, emphasizing concerns with humanization, patient safety and consultation quality, but also perceived strengths such as ease of access and convenience. They recognize the importance of practice on the degree course in an ever more technological world, but raise concerns about the lack of physical examination and the commodification of medicine.

Os hábitos de consumo de refeições específicas têm sido abordados em diversos estudos, no entanto, a avaliação dos padrões refeições tem recebido menos atenção. O objetivo deste estudo foi descrever os padrões de refeições da população brasileira. Um desenho amostral complexo foi utilizado para selecionar os 46.164 indivíduos de ≥ 10 anos examinados no Inquérito Nacional de Alimentação de 2017-2018. O consumo alimentar foi avaliado por meio de dois recordatórios de 24 horas não consecutivos, aplicados durante um período de uma semana. A análise exploratória de dados foi utilizada para determinar os padrões de refeições, ou seja, como os indivíduos combinam as principais refeições (café da manhã, almoço, jantar) e lanches (manhã, tarde, noite) ao longo do dia. Os padrões de refeições mais frequentes foram três refeições principais + um lanche, conforme relatado por 25,1% dos indivíduos, e três refeições principais + dois lanches (24,6%). Outros padrões de refeições identificados foram: três refeições principais + três lanches (18,5%); três refeições principais e nenhum lanche (10,9%); uma ou duas refeições principais + dois lanches (7,4%); uma ou duas refeições principais + um lanche (6,9%); uma ou duas refeições principais + três lanches (4,2%); e uma ou duas refeições principais e nenhum lanche (2,3%). Os padrões de refeições variaram de acordo com o sexo e a faixa etária, e nos dias típicos em comparação com os atípicos de consumo alimentar. Verificou-se que oito padrões caracterizaram o consumo diário de refeições no Brasil. Além disso, cerca de 80% da população realizava três refeições principais diárias e cerca de 13% reportaram não lanchar. A caracterização dos padrões de refeições é importante para adequar e direcionar ações de promoção da saúde.

The habit of eating specific meals has been addressed in several studies, but the evaluation of meal patterns has received less attention. This study aimed to describe the meal patterns of the Brazilian population. A complex sampling design was used to select the 46,164 ≥ 10-year-old individuals examined in the Brazilian National Dietary Survey. Food consumption was assessed by two non-consecutive 24-hour recalls applied throughout a one-week period. The exploratory data analysis approach was used to determine the meal patterns, i.e., how individuals combined the main meals (breakfast, lunch, dinner) and snacks (morning, afternoon, evening/night) throughout the day. The most common meal patterns were three main meals + one snack, reported by 25.1% of the individuals, and three main meals + two snacks (24.6%). Other meal patterns identified were: three main meals + three snacks (18.5%); three main meals and no snacks (10.9%); one or two main meals + two snacks (7.4%); one or two main meals + one snack (6.9%); one or two main meals + three snacks (4.2%); and one or two main meals and no snacks (2.3%). Meal patterns varied according to gender and age group, and on typical versus atypical food consumption days. We found that eight patterns characterized the daily meal consumption in Brazil. Furthermore, around 80% of the population had three main meals every day and about 13% did not report having any snacks. The characterization of meal habits is important for tailoring and targeting health promotion actions.

Los hábitos alimenticios específicos se han abordado en varios estudios, sin embargo, poco se sabe sobre la evaluación de los patrones de alimentación. El objetivo de este estudio fue describir el patrón de alimentación de la población brasileña. Se utilizó un diseño de muestra complejo para seleccionar a 46.164 individuos de ≥ 10 años quienes participaron en la Encuesta Nacional de Alimentación 2017-2018. El consumo alimentario se evaluó mediante dos registros de 24 horas no consecutivos, aplicados durante una semana. Para determinar el patrón de alimentación, se aplicó el análisis exploratorio, es decir, cómo las personas combinan las comidas principales (desayuno, almuerzo, cena) y las meriendas (mañana, tarde, noche) a lo largo del día. Los patrones de alimentación más frecuentes fueron tres comidas principales + una merienda según informan el 25,1% de los individuos, y tres comidas principales + dos meriendas (24,6%). Otros patrones identificados destacaron tres comidas principales + tres meriendas (18,5%); tres comidas principales sin merienda (10,9%); una o dos comidas principales + dos meriendas (7,4%); una o dos comidas principales + una merienda (6,9%); una o dos comidas principales + tres meriendas (4,2%); y una o dos comidas principales sin merienda (2,3%). Los patrones de alimentación tuvieron una variación según el sexo y el grupo de edad, y en días típicos en comparación con los atípicos de consumo de alimentos. Se encontró que ocho patrones caracterizan el consumo diario de comidas en Brasil. Por lo tanto, aproximadamente el 80% de la población tienen tres comidas principales al día y aproximadamente el 13% informan que no tienen merienda. Es importante caracterizar los patrones de alimentación para adaptar y orientar las acciones de promoción de la salud.

Resumo Objetivo: Estabelecer protocolo para realização de autópsias minimamente invasivas (AMIs) na detecção de óbitos por arboviroses e relatar dados preliminares desse protocolo no Ceará, Brasil. Métodos: Médicos patologistas foram treinados em AMI. Resultados: Estabeleceu-se protocolo para AMI, definindo-se critérios para amostras a serem coletadas, suas formas de armazenamento e diagnóstico, segundo o tipo de amostra biológica; em três meses, foram realizadas 43 AMIs, das quais 21 (48,8%) chegaram ao Serviço de Verificação de Óbito (SVO) com hipótese diagnóstica de alguma arbovirose e sete (16,3%) foram confirmados (seis de chikungunya; uma de dengue); também foram confirmados casos de covid-19 (n = 9), tuberculose (n = 5), meningite (n = 4), criptococose (n = 1), doença de Creutzfeldt-Jakob (n = 1), neoplasia de mama (n = 1) e raiva humana (n = 1). Conclusão: O protocolo implantado permitiu a captação de um maior número de óbitos suspeitos de arboviroses, além da confirmação de outras patologias de interesse da vigilância.

Abstract Objective: To create a protocol for performing minimally invasive autopsies (MIA) in detecting deaths from arboviruses and report preliminary data from its application in Ceará state, Brazil. Methods: Training was provided to medical pathologists on MIA. Results: A protocol was established for performing MIA, defining criteria for sample collection, storage methods, and diagnoses to be carried out according to the type of biological sample; 43 MIAs were performed in three months. Of these, 21 (48.8%) arrived at the Death Verification Service (SVO) with arboviruses as a diagnostic hypothesis, and seven (16.3%) were confirmed (six chikungunya cases and one dengue case); cases of COVID-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), cryptococcosis (n = 1), Creutzfeldt-Jakob disease (n = 1), breast cancer (n = 1), and human rabies (n = 1) were also confirmed. Conclusion: The protocol implemented enabled identification of a larger number of suspected arbovirus-related deaths, as well as confirmation of other diseases of interest for surveillance.

Resumen Objetivo: Estabelecer un protocolo utilizado para la realización de autopsias mínimamente invasivas (AMI) para la detección de muertes por arbovirus y presentar datos preliminares de este protocolo en Ceará, Brasil. Métodos: Se llevó a cabo la capacitación de médicos patólogos en AMI. Resultados: Se estableció un protocolo para la realización de AMI, que define los criterios para la toma de muestras, métodos de almacenamiento y diagnóstico; en tres meses se realizaron 43 AMI; de estas, 21 (48,8%) llegaron al Servicio de Verificación de Óbito (SVO) con una hipótesis diagnóstica de alguna arbovirosis y siete (16,3%) fueron confirmadas (seis casos de chikungunya y uno de dengue); también se confirmaron casos de Covid-19 (n = 9), tuberculosis (n = 5), meningitis (n = 4), criptococosis (n = 1), enfermedad de Creutzfeldt-Jakob (n = 1), neoplasia de mama (n = 1) y rabia humana (n = 1). Conclusión: El protocolo implementado permitió la identificación de un mayor número de muertes sospechosas de arbovirus, además de la confirmación de otras patologías de interés.

ABSTRACT The global reemergence of measles in 2018–2019 reinforces the relevance of high-coverage immunization to maintain the disease elimination. During an outbreak in the Sao Paulo State in 2019, several measles cases were reported in individuals who were adequately vaccinated according to the current immunization schedule recommends. This study aimed to assess measles IgG antibody seropositivity and titers in previously vaccinated adults. A cross-sectional study was conducted at CRIE-HC-FMUSP (Sao Paulo, Brazil) in 2019. It included healthy adults who had received two or more Measles-Mumps-Rubella vaccines (MMR) and excluded individuals with immunocompromising conditions. Measles IgG antibodies were measured and compared by ELISA (Euroimmun®) and chemiluminescence (LIASON®). The association of seropositivity and titers with variables of interest (age, sex, profession, previous measles, number of measles-containing vaccine doses, interval between MMR doses, and time elapsed since the last MMR dose) was analyzed. A total of 162 participants were evaluated, predominantly young (median age 30 years), women (69.8%) and healthcare professionals (61.7%). The median interval between MMR doses was 13.2 years, and the median time since the last dose was 10.4 years. The seropositivity rate was 32.7% by ELISA and 75.3% by CLIA, and a strong positive correlation was found between the tests. Multivariate analyses revealed that age and time since the last dose were independently associated with positivity. Despite being a single-center evaluation, our results suggest that measles seropositivity may be lower than expected in adequately immunized adults. Seropositivity was higher among older individuals and those with a shorter time since the last MMR vaccine dose. 20182019 2018 2019 2018–201 highcoverage high coverage elimination recommends crosssectional cross sectional CRIEHCFMUSP CRIE HC FMUSP Brazil MeaslesMumpsRubella Mumps Rubella (MMR conditions Euroimmun® Euroimmun (Euroimmun® LIASON®. LIASON LIASON® . (LIASON®) age, (age sex profession measlescontaining containing analyzed 16 evaluated 3 years , years) 69.8% 698 69 8 (69.8% 61.7%. 617 61.7% 61 7 (61.7%) 132 13 2 13. 104 10 4 10. 327 32 32.7 753 75 75.3 CLIA tests positivity singlecenter single center evaluation 2018201 201 2018–20 (Euroimmun (LIASON® 1 69.8 6 (69.8 61.7 (61.7% 32. 75. 201820 20 2018–2 (LIASON 69. (69. 61. (61.7 20182 2018– (69 (61. (6 (61 (

ABSTRACT This study aimed to determine the antibiotic profile of microorganisms isolated from urine samples of patients with community urine tract infections (UTI) admitted to the University Hospital of the Federal University of Sao Carlos to support an appropriate local empirical treatment. A retrospective cross-sectional study was conducted from October 2018 to October 2020. Data from 1,528 positive urine cultures for bacterial pathogens and antibiograms were tabulated. Bacterial species prevalence and their resistance profile were analyzed and compared by sex and age. For Gram-negative fermenting bacteria, resistance rates were compared between patients with previous hospitalization and the total of infections caused by this group. For comparisons, the Chi-square test was performed, using Fisher’s exact test when necessary (BioEstat program, adopting p ≤ 0.05). A multivariate analysis was applied to assess the effect of the studied variables in predicting multidrug resistance. Infections were more prevalent in women and older adults. Gram-negative bacteria represented 90.44% of total cultures. In both sexes, E. coli prevalence was significantly higher in adults compared with older adults (p < 0.0001). For several antibiotics, resistance rates were higher in the older adults compared with other ages and in patients with Gram-negative fermenting infections and previous hospitalization compared with the total of infections by this group of bacteria. The closer to the hospitalization, the higher the number of antibiotics with superior resistance rates. Resistance rates for aminoglycosides, carbapenems, ceftazidime, nitrofurantoin, piperacillin+tazobactam, and fosfomycin were less than 20%, considered adequate for empirical treatment. Only hospitalization in the previous 90 days was statistically significant in predicting infections by multidrug-resistant bacteria. UTI (UTI treatment crosssectional cross sectional 201 2020 1528 1 528 1,52 tabulated age Gramnegative Gram negative comparisons Chisquare Chi square performed Fishers Fisher s BioEstat program 0.05. 005 0.05 . 0 05 0.05) 9044 44 90.44 sexes E 0.0001. 00001 0.0001 0001 0.0001) aminoglycosides carbapenems ceftazidime nitrofurantoin piperacillintazobactam piperacillin tazobactam piperacillin+tazobactam 20 20% 9 multidrugresistant resistant 202 152 52 1,5 00 0.0 904 4 90.4 0000 0.000 000 2 15 5 1, 0. 90. 0.00

ABSTRACT This study aimed to assess an alkaline protease supplemented in diets with and without crude protein (CP) reduction on performance, apparent total tract digestibility (ATTD), blood parameters, and carcass and meat traits in growing-finishing pigs. Forty male pigs (26.2±1.2 kg) were randomly allocated into one of five treatments: negative control (NC, 2% and 1% reduction of CP in grower and finisher phases, respectively, no protease); NC150: NC + 150 mg protease kg−1 diet; NC300: NC + 300 mg protease kg−1 diet; PC: positive control (no CP reduction and protease); and PC300: PC + 300 mg protease kg−1 diet, with eight replicates of one pig/pen. Pigs fed NC showed greater average daily feed intake (ADFI) than pigs fed NC300 or PC and lower ADFI compared to pigs fed NC150. Pigs fed PC had lower ADFI than those fed PC300. Greater average daily gain and gain to feed ratio (G:F) were observed in pigs on NC compared with those on NC300 or NC150 and NC300, respectively. Pigs fed PC showed better G:F than pigs fed PC300. Lower coefficients of ATTD (CTTAD) of dry and organic matter (OM), digestible dry matter (DDM), digestible organic matter (DOM), and digestible protein were observed in growing II pigs fed NC compared with pigs fed NC150 or NC300. Pigs fed NC showed a lower DP compared with PC or NC150. Positive control group showed increased digestible protein compared with NC. Finishing II pigs fed NC showed lower DDM, DOM, CTTAD of OM, and gross energy than pigs fed NC150 or NC300. Pigs fed PC showed greater albumin concentration compared with pigs fed PC300 in finishing II. Pigs fed NC and PC300 showed greater luminosity in the l. thoracis muscle than pigs fed PC. A greater color score was evidenced in the l. thoracis in pigs fed PC compared with pigs fed PC300. The dietary supplementation of isolated alkaline protease and CP-reduced diets improves ATTD without supporting pig performance. (CP performance ATTD, , (ATTD) parameters growingfinishing 26.2±1.2 26212 26 2 1 (26.2±1. kg treatments NC, (NC phases respectively protease) 15 kg1 kg− diet 30 pigpen pen pig/pen (ADFI NC30 GF G F (G:F NC15 (CTTAD OM (OM) DDM (DDM) DOM (DOM) PC30 l CPreduced reduced (ATTD 26.2±1. 2621 (26.2±1 3 NC3 NC1 (OM (DDM (DOM PC3 26.2±1 262 (26.2± 26.2± (26.2 26.2 (26. 26. (26 (2 (