Abstract Introduction. Although Chagas disease causes high levels of morbidity, the muscle function and tolerance to physical activity in Chagas disease patients are still not completely understood. Objective. To compare health-related fitness of patient groups with acute Chagas disease versus chronic Chagas disease. Materials and methods. We conducted a cross-sectional study involving 18 patients. The data were obtained from patient's records, and functional capacity was measured with the six-minute walk test, the peripheral muscle strength with handgrip strength, and respiratory muscle strength using the maximum inspiratory pressure and the maximum expiratory pressure. Results. The 18 patients were divided in two groups: acute Chagas disease (n=9) and chronic Chagas disease (n=9). The distance walked in the six-minute walk test was lower than the predicted distance walked in both groups (p < 0.0001). The maximum expiratory pressure was lower than the predicted one (p = 0.005), and statistically significant for chronic Chagas disease patients (p = 0.02). Heart rate increased faster in the chronic Chagas disease group within the first two minutes of the six-minute walk test (p = 0.04). The sixminute walk test in the acute Chagas disease group presented a strong correlation with peripheral muscle strength (p = 0.012) and maximum inspiratory pressure (p = 0.0142), while in the chronic Chagas disease group, only peripheral muscle strength and maximum inspiratory pressure were correlated (p = 0.0259). Conclusion. The results suggest lowered functional capacity and reduced respiratory and peripheral muscle strength in patients with Chagas disease, although no differences were observed between groups. The early increase in heart rate during exercise in the chronic Chagas disease group implies a greater myocardial overload.

Resumen Introducción. Aunque la enfermedad de Chagas causa gran morbilidad, la función muscular y la tolerancia a la actividad física de estos pacientes aún no se comprenden por completo. Objetivos. Comparar el estado físico relacionado con la salud de pacientes con enfermedad de Chagas aguda versus crónica de Chagas. Materiales y métodos. Se hizo un estudio transversal que incluyó 18 pacientes. La información se obtuvo de los registros de los pacientes. La capacidad funcional se evaluó con la prueba de la caminata de seis minutos, se determinó la fuerza de prensión manual para evaluar los músculos periféricos y se estableció la fuerza de los músculos respiratorios mediante presión inspiratoria máxima y la presión espiratoria máxima. Resultados. Se evaluaron 18 pacientes, nueve con enfermedad de Chagas aguda y nueve con enfermedad de Chagas crónica. La distancia recorrida en la prueba de caminata de seis minutos fue menor que la distancia recorrida predicha en ambos grupos (p < 0,0001). La presión espiratoria máxima fue más baja de lo previsto (forma aguda: p = 0,005; forma crónica: p = 0,02). La frecuencia cardíaca aumentó más rápido en el grupo con enfermedad de Chagas crónica dentro de los primeros dos minutos de la caminata (p = 0,04). La distancia recorrida en el grupo con la forma aguda se correlacionó con la fuerza de prensión manual (p = 0,01) y la presión inspiratoria máxima (p = 0,01). En el grupo con la enfermedad crónica, solo hubo correlación entre la fuerza de presión manual y la presión inspiratoria máxima (p = 0,02). Conclusiones. Los resultados sugirieren disminución de la capacidad funcional y de la fuerza muscular respiratoria y periférica, aunque sin diferencias entre ambos grupos. El aumento de la frecuencia cardiaca en el grupo con enfermedad de Chagas crónica sugiere una mayor sobrecarga miocárdica.

ABSTRACT Introduction: Protocols for obtaining the maximum threshold pressure have been applied with limited precision to evaluate inspiratory muscle endurance. In this sense, new protocols are needed to allow more reliable measurements. The purpose of the present study was to compare a new incremental ramp load protocol for the evaluation of inspiratory muscle endurance with the most used protocol in healthy individuals. Methods: This was a prospective cross-sectional study carried out in a single center. Ninety-two healthy individuals (43 men [22 ± 3 years] and 49 women [22 ± 3 years]) were randomly allocated to perform: (i) incremental ramp load protocol and (ii) incremental step loading protocol. The sustained pressure threshold (or maximum threshold pressure), maximum threshold pressure/dynamic strength index ratio, time until task failure, as well as difference between the mean heart rate of the last five minutes of baseline and the peak heart rate of the last 30 seconds of each protocol were measured. Results: Incremental ramp load protocol with small increases in the load and starting from minimum values of strength index was able to evaluate the inspiratory muscle endurance through the maximum threshold pressure of healthy individuals. Conclusion: The present study suggests that the incremental ramp load protocol is able to measure maximum threshold pressure in a more thorough way, with less progression and greater accuracy in the load stratification compared to the limited incremental step loading protocol and with a safe and expected cardiovascular response in healthy individuals. Introduction sense measurements Methods crosssectional cross sectional center Ninetytwo Ninety two 43 (4 22 [2 years 4 perform i (i ii (ii or pressure, , pressure) pressuredynamic dynamic ratio failure measured Results Conclusion way ( 2 [

Abstract Objectives: to evaluate the association between intimate partner physical violence (IPPV) and inadequate gestational weight gain (GWG). Methods: cross-sectional study composed of 554 women who attended four Basic Health Units in the city of Rio de Janeiro between 2005 and 2009. The GWG was calculated through the difference between the final weight of pregnancy and pre-gestational weight. For the measurement of IPPV, the Portuguese version of the Conflict Tactics Scales (CTS-1) was used. Data analysis was based on multinomial logistic regression models, estimating odds ratios and respective 95% confidence intervals for associations between the variables of interest. Results: the prevalence of minor and severe IPPV was 31.6% and 16.3%, respectively. Almost two-thirds of the women had insufficient or excessive GWG. After adjusting the model, it was observed that the presence of IPPV increased by 1.66 (CI95%=1.05-2.64) times the chances of insufficient GWG, compared to couples who did not experience this type of violence. Concerning the excessive GWG, the associations with IPPV were not statistically significant. Conclusion: women who experience IPPV in their relationships are more likely to have insufficient GWG during pregnancy. From this perspective, prenatal care becomes an essential service for screening domestic violence and its possible repercussions. Objectives (IPPV . (GWG) Methods crosssectional cross sectional 55 200 2009 pregestational pre CTS1 CTS 1 (CTS-1 used models 95 interest Results 316 31 6 31.6 163 16 3 16.3% respectively twothirds two thirds model 166 66 1.6 CI95%=1.052.64 CI95105264 CI CI95%=1.05 2.64 CI95 05 2 64 (CI95%=1.05-2.64 significant Conclusion perspective repercussions (GWG 5 20 (CTS- 9 31. 16.3 1. 052 CI95%=1.052.6 CI9510526 CI95105 CI95%=1.0 264 2.6 CI9 0 (CI95%=1.05-2.6 (CTS 16. CI95%=1.052. CI951052 CI9510 CI95%=1. 26 2. (CI95%=1.05-2. CI95%=1.052 CI951 CI95%=1 (CI95%=1.05-2 CI95%= (CI95%=1.05- CI95% (CI95%=1.05 (CI95%=1.0 (CI95%=1. (CI95%=1 (CI95%= (CI95% (CI95 (CI9 (CI

Resumo Objetivos: avaliar a associação entre violência física entre parceiros íntimos (VFPI) e o ganho de peso gestacional (GPG) inadequado. Métodos: estudo seccional composto por 554 mulheres que compareceram a quatro Unidades Básicas de Saúde do município do Rio de Janeiro, entre 2005 e 2009. O GPG foi calculado através da diferença entre o peso final da gestação e o peso pré-gestacional. Para a mensuração da VFPI foi utilizada a versão em português da Conflict Tactics Scales (CTS-1). A análise dos dados se baseou em modelos de regressão logística multinomial, estimando-se razões de chance e respectivos intervalos de 95% de confiança para as associações entre as variáveis de interesse. Resultados: a prevalência de VFPI menor e grave foi 31,6% e 16,3%, respectivamente. Quase dois terços das mulheres apresentaram GPG insuficiente ou excessivo. Após o ajuste do modelo, observou-se que a presença de VFPI aumentou em 1,66 (IC95%=1,05-2,64) vezes as chances de GPG insuficiente, em comparação aos casais que não vivenciaram este tipo de violência. Em relação ao GPG excessivo as associações com VFPI não foram estatisticamente significantes. Conclusões: mulheres que vivenciam a VFPI têm maiores chances de apresentarem GPG insuficiente. Nessa perspectiva, o pré-natal passa a ser um serviço fundamental para o rastreamento de violência doméstica e suas possíveis repercussões. Objetivos (VFPI (GPG inadequado Métodos 55 Janeiro 200 2009 prégestacional. prégestacional pré gestacional. pré-gestacional CTS1. CTS1 CTS 1 . (CTS-1) multinomial estimandose estimando 95 interesse Resultados 316 31 6 31,6 163 16 3 16,3% respectivamente modelo observouse observou 166 66 1,6 IC95%=1,052,64 IC95105264 IC IC95%=1,05 2,64 IC95 05 2 64 (IC95%=1,05-2,64 significantes Conclusões perspectiva prénatal natal repercussões 5 20 (CTS-1 9 31, 16,3 1, 052 IC95%=1,052,6 IC9510526 IC95105 IC95%=1,0 264 2,6 IC9 0 (IC95%=1,05-2,6 (CTS- 16, IC95%=1,052, IC951052 IC9510 IC95%=1, 26 2, (IC95%=1,05-2, (CTS IC95%=1,052 IC951 IC95%=1 (IC95%=1,05-2 IC95%= (IC95%=1,05- IC95% (IC95%=1,05 (IC95%=1,0 (IC95%=1, (IC95%=1 (IC95%= (IC95% (IC95 (IC9 (IC

Abstract Background The food environment can influence food and beverage choice by the population and their nutritional status. Objective To characterize the food environment of campuses at the Federal University of Rio de Janeiro. Method A cross-sectional study of food and beverage establishments within the university was carried out. The assessment of the food environment was performed with the application of an instrument to collect information: type, food or preparations, mode, characteristics, menu and nutritional information, promotions, advertisements, availability of food or drinks, variety, and price. The observed foods and preparations, the presence of an approach such as nutritional information, advertisements, and promotions were classified as facilitators/barriers for healthy eating, according to the Food Guide for the Brazilian Population. Results Of the 5 establishments that participated, 4 were commercial and 1 was a university restaurant (RU). All establishments accepted cash and cards, and most had a menu and price. None had nutritional information. The supply of fruits and vegetables was found in 4 establishments. The availability of artificial sweetener was found in all locations. A wide variety of candies (8 ± 7.1), soft drinks (9 ± 3.7), chocolate (8 ± 7.1), salted biscuits (8 ± 12.3), and sweets (7 ± 9.1) were observed. Fruits had a higher average price, R$3.83, when compared to savory foods, R$ 2.85, and biscuits, R$ 1.50. Conclusion The university food environment presented a greater offer of unhealthy foods, presenting barriers to the promotion of more appropriate eating practices. status Janeiro crosssectional cross sectional out information type preparations mode characteristics advertisements price facilitatorsbarriers facilitators Population participated RU. RU . (RU) cards locations 8 ( 7.1, 71 7.1 , 7 7.1) 9 3.7, 37 3.7 3 3.7) 12.3, 123 12.3 12 12.3) 9.1 91 R383 R 83 R$3.83 285 2 85 2.85 150 50 1.50 practices (RU 7. 3. 12. 9. R38 R$3.8 28 2.8 15 1.5 R3 R$3. 2. 1. R$3

Resumo Introdução O ambiente alimentar pode influenciar as escolhas alimentares e de bebidas pela população e seu estado nutricional. Objetivo Caracterizar o ambiente alimentar dos campi de universidade federal do Rio de Janeiro. Método Estudo transversal com estabelecimentos que comercializavam alimentos e bebidas dentro dos campi da universidade. A avaliação do ambiente alimentar foi realizada com a aplicação de um instrumento para coleta das informações: tipo de estabelecimento, alimentos/preparações, modalidade, características, cardápio e informações nutricionais, promoções, propagandas, disponibilidade de alimentos/bebidas, variedade e preço. Os alimentos e preparações observados, a presença de estratégias como informação nutricional, propagandas e promoções foram classificados em facilitadores/ barreiras para alimentação saudável, de acordo com o Guia Alimentar para a População Brasileira. Resultados Participaram do estudo cinco estabelecimentos, quatro eram comerciais e um o restaurante universitário (RU). Todos os estabelecimentos aceitavam dinheiro e cartão, havia cardápio e preço na maioria. Nenhum apresentava informação nutricional. A oferta de frutas/hortaliças foi encontrada em quatro estabelecimentos. A disponibilidade de edulcorante artificial foi encontrada em todos os locais. Observou-se grande variedade de balas (8 ± 7,1), refrigerantes (9 ± 3,7), chocolate (8 ± 7,1), biscoito salgado (8 ± 12,3) e doce (7 ± 9,1). Frutas apresentaram preço médio superior, R$ 3,83, quando comparadas aos salgados, R$ 2,85 e biscoitos, R$ 1,50. Conclusão O ambiente alimentar universitário apresentou maior oferta de alimentos não saudáveis, apresentando barreiras na promoção de práticas alimentares mais adequadas. nutricional Janeiro estabelecimento alimentospreparações alimentos/preparações modalidade características nutricionais alimentosbebidas alimentos/bebidas observados facilitadores saudável Brasileira RU. RU . (RU) cartão maioria frutashortaliças frutas hortaliças locais Observouse Observou se 8 ( 7,1, 71 7,1 , 7 1 7,1) 9 3,7, 37 3,7 3 3,7) 12,3 123 12 9,1. 91 9,1 9,1) superior R 383 83 3,83 salgados 285 2 85 2,8 biscoitos 150 50 1,50 saudáveis adequadas (RU 7, 3, 12, 9, 38 3,8 28 2, 15 5 1,5 1,

ABSTRACT Children have an increased likelihood of becoming carriers of the chronic hepatitis B virus. A total of 1,381 children and adolescents were assessed in five municipalities of Maranhao State, Brazil, for detection of anti-HBc, HBsAg and anti-HBs serologic markers and sociodemographic and behavioral features. Among those who were HBsAg negative and anti-HBc negative, the proportion of anti-HBs positives was calculated after the individuals had completed the vaccination schedule. The robust variance of the Poisson’s regression model was used in order to have adjusted tables and calculate the prevalence ratio. Multivariate analysis was performed to identify the factors associated with the prevalence of anti-HBc with or without HBsAg and the vaccine response. It was observed that 163 children were anti-HBc positive and nine individuals were HBsAg positive. The factors associated with the infection were: municipality of residence (residing in Morros municipality or Humberto de Campos municipality), residence in a rural area, aged between 13 and 15 years old, and illicit drug use. The percentage of individuals who were anti-HBc negative and received all three doses of the vaccine was 48.5%. Among these, only 276 (38.9%) had antibodies at protective concentrations. In an adjusted analysis, Morros municipality presented an increased positivity of vaccine response (p < 0.001), and the age ranging between 6 and 10 years old presented a reduced frequency of response. This study reveals a high prevalence of current and past HBV infection within the targeted age group which, in addition to the low vaccination coverage and serological responses, raises concerns about the management of prevention measures, especially the quality of vaccination in these locations. virus 1381 1 381 1,38 State Brazil antiHBc, antiHBc anti HBc, HBc antiHBs HBs features schedule Poissons Poisson s ratio 16 residing municipality, , municipality) area use 485 48 5 48.5% 27 38.9% 389 38 9 (38.9% concentrations p 0.001, 0001 0.001 0 001 0.001) which responses measures locations 138 1,3 4 48.5 2 38.9 3 (38.9 000 0.00 00 1, 48. 38. (38. 0.0 (38 0. (3 (

ABSTRACT. An experiment was conducted to evaluate the effect of diets with reduced energy level content, supplemented with carbohydrase, on broiler performance and the coefficient of metabolizability of nutrients. A total of 720 one-day-old male Cobb-500 chicks were distributed in a completely randomized design, with six treatments, eight repetitions of 15 birds each. The treatments were: (1) a positive control, basal diet to meet the requirements of broiler chickens (PC); (2) a negative control, basal diet with a reduction of 80 kcal kg-1 (NC); (3) NC + alphagalactosydase; (4) NC + xylanase; (5) NC + xylanase and alphagalactosydase, and (6) NC + enzymatic blend (alphagalactosydase, xylanase, pectinase and amylase). The nutrient digestibility was not improved by use of enzymes. At 7 days of age, the broilers which were fed diets supplemented with enzymes showed a lower feed intake (FI) and better feed conversion ratio (FCR) than the broilers fed on PC. Both the NC and enzymatic blend resulted in a worse performance of the broilers at 21, 35 and 42 days old. The use of alphagalactosydase and xylanase, isolated or in combination, in a corn-soybean meal-based diet is effective in improving the growth performance of broilers fed energy-reduced diets. ABSTRACT content carbohydrase nutrients 72 onedayold one day old Cobb500 Cobb 500 Cobb-50 design 1 each (1 control PC (PC) 2 (2 8 kg1 kg kg- (NC) 3 (3 4 (4 5 (5 6 (6 (alphagalactosydase amylase. amylase . amylase) age FI (FI FCR (FCR 21 combination cornsoybean corn soybean mealbased meal based energyreduced Cobb50 50 Cobb-5 ( (PC (NC Cobb5 Cobb-

Abstract The incorrect disposal of medicines and their environmental impact has been related to the health medicalization and the improper use of medication by society. In this sense, it is very important to know the profile of drug disposal for foster health policies. The aim was to identify the profile of disposal of medicines by the population, including the cost perspective. This is an inquiry descriptive study that began in September 2019. Medicine disposal health education program was carried out over six months in two University pharmacies. A questionnaire for sociodemographic and discarded medicines data collection was applied. Logistic regression analysis for variables association of correct disposal and the chi-square and t-student analysis for comparison between disposal programs were performed for a level of 5% and test power of 80%. Medicines weighed 23.3 kg and 28.5 kg, with the cost variation from US$ 13.5 to US$ 16.1 until the final treatment. The correct disposal was strongly associated with the disposal reason (p=0.013), source of information (p=0.006), prescription (p=0.03), form of use (p=0.01), acquisition source (p=0.001), cost with medication (p=0.0001), education (p=0.028) and age (p=0.05). The correct medicine disposal was associated with important features of the community related to education health. society sense policies population perspective 2019 pharmacies applied chisquare chi square tstudent t student 5 80 80% 233 23 3 23. 285 28 28. US 135 13 13. 161 16 1 16. treatment p=0.013, p0013 p p=0.013 , 0 013 (p=0.013) p=0.006, p0006 p=0.006 006 (p=0.006) p=0.03, p003 p=0.03 03 (p=0.03) p=0.01, p001 p=0.01 01 (p=0.01) p=0.001, p0001 p=0.001 001 (p=0.001) p=0.0001, p00001 p=0.0001 0001 (p=0.0001) p=0.028 p0028 028 (p=0.028 p=0.05. p005 p=0.05 . 05 (p=0.05) 201 8 2 (p=0.013 p000 p=0.00 00 (p=0.006 p00 p=0.0 (p=0.03 (p=0.01 (p=0.001 p0000 p=0.000 000 (p=0.0001 p=0.02 p002 02 (p=0.02 (p=0.05 20 (p=0.00 p0 p=0. (p=0.0 (p=0.000 p=0 (p=0. p= (p=0 (p= (p

ABSTRACT Objective: To determine the relationship between psoriasis, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triodothyronine (FT3), thyroid peroxidase antibodies (TPOAb), and subclinical thyroid dysfunctions in middle-aged and older adults. Materials and methods: Cross-sectional analyses included a self-reported medical diagnosis of psoriasis and thyroid function from the 3rd visit (2017-2019) of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). TSH, FT4, and FT3 levels were analyzed as continuous variables and quintiles, and TPOAb positivity and subclinical hypothyroidism as a yes/no variable. Logistic regression models were built as crude and adjusted by main confounders (age, sex, education level, race/ethnicity, and smoking). Results: From 9,649 participants (52.3% women; 59.2 ± 8.7 years old), the prevalence of psoriasis was 2.8% (n = 270). TSH, FT4, TPOAb positivity, and subclinical hypothyroidism were not associated with psoriasis in the main analyses. In the stratified analysis, our findings showed positive associations of the lowest (OR = 2.01; 95% CI 1.05-3.84; p = 0.036) and the highest (OR = 2.13; 95% CI 1.12-4.05; p = 0.022) quintiles of FT4 and a protective association of TPOAb positivity (OR = 0.43; 95% CI 0.19-0.98; p = 0.046) with prevalent psoriasis in women. In the logistic regression for FT3, participants in the 1st quintile showed a statistically significant association with psoriasis for the whole sample (OR = 1.66; 95% CI 1.11-2.46; p = 0.013) and for men (OR = 2.25; 95% CI 1.25-4.04; p = 0.007) in the sex-stratified analysis. Conclusions: The present study showed that the association of FT4 levels with psoriasis are different according to sex, with a possible U-shaped curve in women but not in men. Although there were some associations of FT3 with psoriasis, they may be a consequence of non-thyroidal illness syndrome. Further prospective data may clarify the association of thyroid function and psoriasis. Objective thyroidstimulating stimulating TSH , (TSH) FT (FT4) (FT3) TPOAb, (TPOAb) middleaged middle aged adults methods Crosssectional Cross sectional selfreported self reported rd 20172019 2017 2019 (2017-2019 ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) yesno yes no variable age, age (age sex level raceethnicity race ethnicity race/ethnicity smoking. smoking smoking) Results 9649 9 649 9,64 52.3% 523 52 3 (52.3 592 59 2 59. 87 8 7 8. old, old old) 28 2.8 n 270. 270 270) analysis OR 2.01 201 01 95 1.053.84 105384 1.05 3.84 1 05 84 1.05-3.84 0.036 0036 0 036 2.13 213 13 1.124.05 112405 1.12 4.05 12 4 1.12-4.05 0.022 0022 022 0.43 043 43 0.190.98 019098 0.19 0.98 19 98 0.19-0.98 0.046 0046 046 st 1.66 166 66 1.112.46 111246 1.11 2.46 11 46 1.11-2.46 0.013 0013 013 2.25 225 25 1.254.04 125404 1.25 4.04 04 1.25-4.04 0.007 0007 007 sexstratified Conclusions Ushaped U shaped nonthyroidal non thyroidal syndrome (TSH (FT4 (FT3 (TPOAb 2017201 (2017-201 (ELSA-Brasil 964 64 9,6 52.3 5 (52. 2. 27 2.0 20 053 1.053.8 10538 105 1.0 384 3.8 1.05-3.8 0.03 003 03 2.1 21 124 1.124.0 11240 112 1.1 405 4.0 1.12-4.0 0.02 002 02 0.4 190 0.190.9 01909 019 0.1 098 0.9 0.19-0.9 0.04 004 1.6 16 6 1.112.4 11124 111 246 2.4 1.11-2.4 0.01 001 2.2 22 254 1.254.0 12540 125 1.2 404 1.25-4.0 0.00 000 00 (FT 201720 (2017-20 96 9, 52. (52 1.053. 1053 10 1. 38 3. 1.05-3. 0.0 1.124. 1124 40 4. 1.12-4. 0. 0.190. 0190 09 0.19-0. 1.112. 1112 24 1.11-2. 1.254. 1254 1.25-4. 20172 (2017-2 (5 1.053 1.05-3 1.124 1.12-4 0.190 0.19-0 1.112 1.11-2 1.254 1.25-4 (2017- ( 1.05- 1.12- 0.19- 1.11- 1.25- (2017 (201 (20 (2

RESUMEN Objetivo: Evaluar la relación entre los síntomas psicopatológicos y el perfil social, clínico y ocupacional de las enfermeras en la región amazónica de Brasil durante la pandemia de COVID-19. Métodos: Se llevó a cabo un estudio descriptivo transversal en línea en 2020 con la participación de 261 enfermeras. Se utilizó la Escala de Evaluación de Síntomas-40. Resultados: Se encontró una asociación significativa entre la presencia de condiciones preexistentes antes de la pandemia y el psicoticismo (p=0,044). Experimentar restricciones y/o violencia en el trabajo durante la pandemia se asoció con la somatización (p=0,025), y las horas de trabajo se relacionaron con la ansiedad (p=0,025). En general, las enfermeras presentaron predominantemente síntomas relacionados con el miedo (33,7%), la tensión (34,5%) y la sensación de que algo no está bien en la mente (22,6%). Conclusiones: Se observó una asociación significativa entre las horas de trabajo y los síntomas de ansiedad, así como entre la experiencia de restricciones y/o violencia laboral durante la pandemia de COVID-19 y los síntomas de somatización. Además, se encontró una asociación entre las condiciones preexistentes y los síntomas de psicoticismo relacionados con COVID-19. Objetivo social COVID19. COVID19 COVID 19. 19 Métodos 202 26 Síntomas40. Síntomas40 Síntomas 40. 40 Síntomas-40 Resultados p=0,044. p0044 p p=0,044 . 0 044 (p=0,044) yo o p=0,025, p0025 p=0,025 , 025 (p=0,025) p=0,025. general 33,7%, 337 33,7% 33 7 (33,7%) 34,5% 345 34 5 (34,5% 22,6%. 226 22,6% 22 6 (22,6%) Conclusiones COVID-1 Además COVID1 1 20 2 Síntomas4 4 Síntomas-4 p004 p=0,04 04 (p=0,044 p002 p=0,02 02 (p=0,025 33,7 3 (33,7% 34,5 (34,5 22,6 (22,6% COVID- Síntomas- p00 p=0,0 (p=0,04 (p=0,02 33, (33,7 34, (34, 22, (22,6 p0 p=0, (p=0,0 (33, (34 (22, p=0 (p=0, (33 (3 (22 p= (p=0 ( (2 (p= (p

ABSTRACT Objective: To assess the relationship between psychopathological symptoms and the social, clinical, and occupational profile of nurses in the Amazon region of Brazil during the COVID-19 pandemic. Methods: A descriptive cross-sectional online study was conducted in 2020 with 261 nurses. The Symptom Assessment Scale-40 was utilized. Results: The presence of pre-existing conditions before the pandemic was associated with psychotism (p=0.044). Experiencing constraints and/or violence at work during the pandemic was associated with somatization (p=0.025), and working hours were associated with anxiety (p=0.025). Nurses predominantly exhibited symptoms related to fear (33.7%), tension (34.5%), and a sense that something is wrong in the mind (22.6%). Conclusions: A significant association was observed between working hours and anxiety symptoms, the experience of constraints and/or violence at work during the COVID-19 pandemic and somatization symptoms, as well as between pre-existing conditions and psychotism symptoms related to COVID-19. Objective social clinical COVID19 COVID 19 COVID-1 Methods crosssectional cross sectional 202 26 Scale40 Scale 40 Scale-4 utilized Results preexisting pre existing p=0.044. p0044 p p=0.044 . 0 044 (p=0.044) andor or p=0.025, p0025 p=0.025 , 025 (p=0.025) p=0.025. 33.7%, 337 33.7% 33 7 (33.7%) 34.5%, 345 34.5% 34 5 (34.5%) 22.6%. 226 22.6% 22 6 (22.6%) Conclusions COVID19. 19. COVID1 1 COVID- 20 2 Scale4 4 Scale- p004 p=0.04 04 (p=0.044 p002 p=0.02 02 (p=0.025 33.7 3 (33.7% 34.5 (34.5% 22.6 (22.6% p00 p=0.0 (p=0.04 (p=0.02 33. (33.7 34. (34.5 22. (22.6 p0 p=0. (p=0.0 (33. (34. (22. p=0 (p=0. (33 (34 (22 p= (p=0 (3 (2 (p= ( (p

RESUMO Objetivo: Avaliar a relação entre sintomas psicopatológicos e o perfil social, clínico e laboral dos enfermeiros da região Amazônica do Brasil durante a pandemia de COVID-19. Métodos: Realizou-se um estudo descritivo de corte transversal online com 261 enfermeiros em 2020. Utilizou-se a Escala de Avaliação de Sintomas-40. Resultados: A presença de doenças preexistentes à pandemia associou-se ao psicoticismo (p=0,044). Ter sofrido constrangimentos e/ou violências no trabalho durante a pandemia associou-se à somatização (p=0,025), e a carga horária de trabalho associou-se à ansiedade (p=0,025). Os enfermeiros manifestaram principalmente sintomas relacionados ao medo (33,7%), tensão (34,5%) e sensação de que algo está errado na mente (22,6%). Conclusões: Foi observada uma associação significativa entre a carga horária de trabalho e sintomas de ansiedade, o sofrimento de constrangimentos e/ou violências durante o trabalho no contexto da pandemia de COVID-19 e sintomas de somatização, bem como entre doenças preexistentes à COVID-19 e sintomas de psicoticismo. Objetivo social COVID19. COVID19 COVID 19. 19 Métodos Realizouse Realizou se 26 2020 Utilizouse Utilizou Sintomas40. Sintomas40 Sintomas 40. 40 Sintomas-40 Resultados associouse associou p=0,044. p0044 p p=0,044 . 0 044 (p=0,044) eou ou p=0,025, p0025 p=0,025 , 025 (p=0,025) p=0,025. 33,7%, 337 33,7% 33 7 (33,7%) 34,5% 345 34 5 (34,5% 22,6%. 226 22,6% 22 6 (22,6%) Conclusões COVID-1 COVID1 1 2 202 Sintomas4 4 Sintomas-4 p004 p=0,04 04 (p=0,044 p002 p=0,02 02 (p=0,025 33,7 3 (33,7% 34,5 (34,5 22,6 (22,6% COVID- 20 Sintomas- p00 p=0,0 (p=0,04 (p=0,02 33, (33,7 34, (34, 22, (22,6 p0 p=0, (p=0,0 (33, (34 (22, p=0 (p=0, (33 (3 (22 p= (p=0 ( (2 (p= (p

BACKGROUND The parasite Giardia duodenalis infects a wide range of vertebrate hosts, including domestic and wild animals as well as humans. Giardia is genotyped into eight assemblages (A-H). Zoonotic assemblages A and B have already been identified in humans and wild and domestic animals (non-human primates and cats) from Brazilian Amazon and in the world. Due to its zoonotic/zooanthroponotic nature, surveillance initiatives and the definition of Giardia assemblages are important in order to characterise the epidemiological scenario and to implement further control measures. OBJECTIVES Determine assemblages of G. duodenalis in sloths from the Brazilian Amazon Region. METHODS Faecal parasitological examination of sloths from Amazonas State. Polymerase chain reaction (PCR) targeting the beta giardin (BG), and genes from multilocus sequence typing (MLST) scheme, amplicon sequencing and phylogenetic analysis. FINDINGS Here, we identified, by microscopy, Giardia in two northern sloths (Bradypus tridactylus). These two samples were submitted to molecular assays and it was revealed that both were infected by G. duodenalis assemblage A. Phylogenetic analysis showed that they belong to assemblage A within sequences from humans and wild and domestic animals. CONCLUSION Therefore, besides showing, by the first time, the current presence of this parasite in sloths, our findings reveals that this wild animal species would be part of the zoonotic/zooanthroponotic scenario of this parasite in the Brazilian Amazon. hosts AH. AH H . (A-H) nonhuman non human cats world zoonoticzooanthroponotic zoonotic zooanthroponotic nature measures G Region State PCR (PCR BG, BG , (BG) MLST (MLST scheme Here microscopy Bradypus tridactylus. tridactylus tridactylus) Therefore showing time (A-H (BG

Abstract Introduction: The association of diabetes with subclinical thyroid diseases may increase the risk of cardiovascular diseases. We analyzed the association of subclinical hypothyroidism, diabetes, and both diseases with carotid Intima-Media Thickness (cIMT) as a surrogate maker for early cardiovascular disease in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: Cross-sectional analysis with data from the 3rd visit (2017‒2019). Linear regression models were used to evaluate the association of subclinical hypothyroidism, diabetes and of both diseases with a cIMT presented as Beta (95% Confidence Interval – 95% CI) without adjustment, with adjustment for sociodemographic variables (Model 1) and multivariable adjustment (Model 1 more cardiovascular risk factors). We also used logistic regression models to analyze the Odds Ratio (OR) and 95% CI for the association of both diseases using cIMT > P75%. Results: After the exclusion of patients with previous cardiovascular disease, 5,077 participants with no diseases, 1578 with diabetes, 662 with subclinical hypothyroidism, and 234 with both diseases were included in the analysis. Linear regression models showed an association of cIMT with only diabetes (β = 0.019; 95% CI 0.012 to 0.027; p < 0.0001) and subclinical hypothyroidism more diabetes (β = 0.03; 95% CI 0.010‒0.047, p < 0.0001). The logistic regression model reported an association between diabetes and CIMT higher than P75% (OR = 1.49, 95% CI 1.30‒1.71). No interaction between diabetes and subclinical hypothyroidism was detected using cIMT respectively as a continuous (p = 0.29) or as a categorical variable (p = 0.92). Discussion: Diabetes was associated with higher cIMT values. However, no additive effect of subclinical hypothyroidism associated with diabetes over cIMT was detected. Introduction IntimaMedia Intima Media (cIMT ELSABrasil. ELSABrasil ELSA Brasil . (ELSA-Brasil) Methods Crosssectional Cross sectional rd 2017‒2019. 20172019 2017‒2019 2017 2019 (2017‒2019) 95 (95 Model factors. factors factors) OR P75 P Results 5077 5 077 5,07 157 66 23 β 0.019 0019 0 019 0012 012 0.01 0.027 0027 027 0.0001 00001 0001 0.03 003 03 00100047 010 047 0.010‒0.047 0.0001. 149 49 1.49 1.30‒1.71. 130171 1.30‒1.71 30 71 1.30‒1.71) 0.29 029 29 0.92. 092 0.92 92 0.92) Discussion values However (ELSA-Brasil 2017201 2017‒201 201 (2017‒2019 9 (9 P7 507 07 5,0 15 6 2 001 01 0.0 0.02 002 02 0.000 0000 000 00 0010004 04 0.010‒0.04 14 4 1.4 13017 1.30‒1.7 3 7 0.2 09 0.9 201720 2017‒20 20 (2017‒201 ( 50 5, 0. 0.00 001000 0.010‒0.0 1. 1301 1.30‒1. 20172 2017‒2 (2017‒20 00100 0.010‒0. 130 1.30‒1 2017‒ (2017‒2 0010 0.010‒0 13 1.30‒ (2017‒ 0.010‒ 1.30 (2017 0.010 1.3 (201 (20 (2

Resumo O Nordeste Brasileiro (NEB) apresenta, como característica marcante, a irregularidade em acumulados de precipitações, o que é decorrência de vários fatores, tais como as características ambientais e de sistemas atmosféricos. Análises estatísticas adequadas são necessárias para ter conhecimento dos níveis de retorno da precipitação em uma região e são muito importantes para auxiliar ações para prevenção de desastres naturais causados por chuvas máximas. O objetivo dessa pesquisa consistiu em apresentar os níveis de retorno da precipitação máxima diária (PMD) em todo o estado da Paraíba, o qual está localizado na NEB. O conjunto de dados foi composto por 238 estações pluviométricas, abrangendo o período de 1994 a 2020. Para a modelagem estatística foi ajustada a distribuição Gumbel, por meio do método da máxima verossimilhança. Os resultados indicaram que o Sertão Paraibano apresentou as maiores estimadas da PMD nos meses de janeiro a março, com volumes superiores a 75 mm. A Mata Paraibana apresentou as maiores estimativas da PMD nos meses de abril a junho, com valores superiores a 125 mm no mês de junho em regiões litorâneas. As informações obtidas sobre os níveis de retorno da PMD são relevantes e podem ser de grande auxílio na implementação de políticas públicas, visando a diminuição dos impactos causados pelas chuvas intensas.

Abstract Brazilian Northeast (NEB) presents, as a striking feature, the irregularity in rainfall accumulations, which is due to several factors, such as environmental characteristics and atmospheric systems. Adequate statistical analyzes are necessary to have knowledge of the return levels of precipitation in a region and are very important to assist actions to prevent natural disasters caused by maximum rainfall. The objective of this research was to present the levels of return of maximum daily rainfall in the entire state of Paraíba, which is located in the NEB. The dataset consisted of 238 rainfall stations, covering the period from 1994 to 2020. In the statistical modeling, the Gumbel distribution was adjusted using the maximum likelihood method. The results indicated that Sertão Paraibano presented the highest estimated PMD in the months from January to March, with volumes greater than 75 mm. Mata Paraibana presented the highest PMD estimates in the months from April to June, with values greater than 125 mm in the month of June in coastal regions. The information obtained on the levels of return of maximum daily rainfall is relevant and can be of great help in the implementation of public policies, aimed at reducing the impacts caused by intense rains.

Objective: To analyze the time series of colorectal cancer (CRC) mortality, according to sex and age group, in Mato Grosso, Brazil, from 2000 to 2019. Methods: Ecological time series study, with standardized mortality rates by CRC (C18 to C21), of residents in Mato Grosso. Information on deaths was provided by the Mato Grosso State Department of Health, and comprise the Mortality Information System, and demographic information obtained from the Brazilian Institute of Geography and Statistics. For the analysis of the temporal trend, the joinpoint regression analysis was used. Results: A total of 2,406 deaths from CRC were identified in Mato Grosso in the period 2000 to 2019. The highest rates were found among the age groups from 60 to 79 years. For men, there was an increasing trend in mortality rates due to CRC for almost all age groups, with the exception of those aged 40 to 49 years and those aged 80 years or more. For women, there was a significant increase in the age groups from 50 to 59 years and 80 years or more. Conclusion: The results of the study showed an increase in mortality rates from CRC in the state of Mato Grosso, from 2000 to 2019, in certain age groups of both sexes, but especially for men. Knowledge about the evolution of mortality can provide data on the epidemiological situation of cancer at the local level and, thus, contribute to the development of actions to control and prevent this disease.

Objetivo: Analisar a tendência temporal da mortalidade por câncer colorretal (CCR) segundo sexo e faixa etária, em Mato Grosso, Brasil, de 2000 a 2019. Métodos: Estudo ecológico de série temporal das taxas ajustadas de mortalidade pelo CCR (C18 a C21), de residentes de Mato Grosso. As informações sobre os óbitos foram fornecidas pela Secretaria de Estado de Saúde de Mato Grosso, e compõem o Sistema de Informações sobre Mortalidade, e as informações demográficas obtidas do Instituto Brasileiro de Geografia e Estatística. Para análise da tendência temporal foi empregada a análise de regressão por joinpoint. Resultados: Foram identificados 2.406 óbitos por CCR em Mato Grosso no período de 2000 a 2019. As maiores taxas foram encontradas entre as faixas etárias de 60 a 79 anos. Para os homens, evidenciou-se tendência crescente das taxas de mortalidade por CCR para quase todas as faixas etárias, com exceção da de 40 a 49 anos e a de 80 anos ou mais. Para as mulheres houve aumento significativo nas faixas etárias de 50 a 59 anos e de 80 anos ou mais. Conclusão: Os resultados do estudo mostraram aumento das taxas de mortalidade por CCR no estado do Mato Grosso, no período de 2000 a 2019, em determinadas faixas etárias de ambos os sexos, mas sobretudo para os homens. O conhecimento sobre a evolução da mortalidade pode oferecer dados da situação epidemiológica do câncer em nível local e, assim, contribuir na elaboração de ações de controle e prevenção deste agravo.

Abstract The insertion of Pharmaceutical Care in Primary Health Care (PHC) improves patients’ clinical outcomes and quality of life. Pharmacotherapeutic follow-up can contribute to the management of chronic diseases such as diabetes, promoting better glycemic control and adherence to therapy. This study aimed to assess the Drug-therapy Problems (DTPs) and Pharmacist Interventions (PIs) on the pharmacotherapeutic management in patients with type 2 diabetes mellitus (T2DM) in a community pharmacy. A quantitative, retrospective, and cross-sectional study was conducted in a Pharmaceutical Care Program within the PHC in Juiz de Fora (Minas Gerais, Brazil). Inclusion criteria were patients with T2DM above 18, who attended at least three pharmaceutical consultations between July 2016 and October 2018 and presented two or more glycated hemoglobin tests. The study group (n = 17) was largely composed of women (65%), elderly (76%), sedentary (72%), and obese people (52%). The resolution was achieved in 79% of the DTPs identified (n = 115). Most of DTPs were related to administration and adherence to pharmacotherapy (46%). 60% of the 437 PIs involved the provision of information and counseling. In other words, accessible interventions lead to high resolvability. Therefore, clinical actuation of pharmacists could improve the prognosis in diabetes treatment.

Este estudo de série temporal analisou a prevalência de atividade física para lazer e transporte na população adulta brasileira em uma série histórica de uma década. Foram analisadas informações de 512.969 adultos entrevistados pelo Vigitel entre 2010 e 2019. Os indivíduos que relataram praticar pelo menos 150 minutos/semana de atividade física moderada ou pelo menos 75 minutos/semana de atividade física vigorosa foram considerados ativos durante seu lazer. Os indivíduos que relataram caminhar ou andar de bicicleta para/do trabalho, curso ou escola por pelo menos 30 minutos/dia (equivalente a pelo menos 150 minutos/semana de atividade física moderada) foram considerados ativos durante seu transporte. A prevalência de atividade física para lazer e transporte foi calculada anualmente e estratificada por sexo, faixa etária, escolaridade e cor da pele/raça. Modelo de regressão segmentada foi aplicado para analisar a série temporal. Foram calculadas as mudanças percentuais anuais e as mudanças médias anuais. Com o tempo, a prevalência de atividade física para o lazer aumentou e a prevalência de atividade física para o transporte diminuiu. A maior prevalência de atividade física para lazer foi observada entre homens, jovens e pessoas com Ensino Médio completo. Idosos, pessoas com Ensino Médio e brancos apresentaram a menor prevalência de transporte ativo. Formuladores de políticas devem propor estratégias que incentivem e facilitem a atividade física para o lazer em mulheres, indivíduos com idade ≥ 35 anos e pessoas com baixa escolaridade (< 12 anos), e atividade física para transporte entre idosos (≥ 60 anos), aqueles com Ensino Médio completo (≥ 12 anos) e pessoas brancas.

This time-series study examined a 10-year historical series of the physical activity prevalence for leisure and transportation in the Brazilian adult population. Information from 512,969 adults interviewed from the Vigitel between 2010 and 2019 was analyzed. Individuals who reported practicing at least 150 minutes/week of moderate-intensity physical activity or at least 75 minutes/week of vigorous-intensity physical activity were considered active during leisure time. Individuals who reported walking or cycling to/from work, course, or school at least 30 minutes/day, equivalent to at least 150 minutes/week of moderate-intensity physical activity, were considered active during transportation. The prevalence of physical activity for leisure and transportation was calculated annually and stratified by sex, age group, schooling, and race/skin color. The segmented regression model was applied to analyze the time series. Annual percent change and average annual percent change were calculated. Over time, the prevalence of physical activity for leisure increased, and the prevalence of physical activity for transportation decreased. The highest prevalence of physical activity for leisure was observed among males, young individuals, and those with high education. Older adults, those with high education, and white people presented the lowest prevalence of active transport. Policymakers should propose strategies that encourage and facilitate physical activity for leisure in women, individuals aged ≥ 35 years, and those with less education (< 12 years), and physical activity for transportation among older adults (≥ 60 years), those with high education (≥ 12 years), and white people.

Este estudio de serie temporal analizó la prevalencia de la actividad física para el ocio y el transporte en la población adulta brasileña en una serie histórica de una década. Se analizaron las informaciones de 512.969 adultos, entrevistados por Vigitel entre 2010 y 2019. Las personas que informaron practicar al menos 150 minutos/semana de actividad física moderada o al menos 75 minutos/semana de actividad física vigorosa se consideraron activas durante su tiempo libre. Las personas que informaron caminar o andar en bicicleta al/desde el trabajo, curso o escuela por al menos 30 minutos/día (equivalente al menos a 150 minutos/semana de actividad física moderada) se consideraron activas durante su transporte. La prevalencia de la actividad física para el ocio y el transporte se calculó anualmente y se estratificó por sexo, grupo de edad, escolaridad y color de piel/raza. Se aplicó un modelo de regresión segmentada para analizar la serie temporal. Se calcularon las variaciones porcentuales anuales y las variaciones porcentuales medias anuales. Con el paso del tiempo, la prevalencia de la actividad física para el ocio tuvo un aumento y una reducción para el transporte. La mayor prevalencia de actividad física para el ocio se observó entre hombres, jóvenes y personas con educación secundaria. Los ancianos, las personas con educación secundaria y los blancos tuvieron una prevalencia más baja en el transporte activo. Los formuladores de políticas deben proponer estrategias de fomento a la actividad física para el ocio en mujeres, personas ≥ 35 años y personas con baja escolaridad (< 12 años), y la actividad física para el transporte entre los ancianos (≥ 60 años), aquellos con educación secundaria (≥ 12 años) y personas blancas.