Selenium-containing compounds exhibit diverse biological activities, such as antioxidative, anti-inflammatory, and cancer preventive effects. Using Caenorhabditis elegans as a model organism, we assessed the toxicity, neuroprotective, antioxidant properties, and impact on longevity of 11 selenoacetylenes. Their toxicity and bioactivities varied based on molecular structure. Selenoacetylenes with butyl substituents were toxic to Galleria mellonella larvae. The presence of but-3-in-2-ol radical increased antiprotozoal activity against Tetrahymena pyriformis. Compared to the positive control (Nimitz® EC), selenoacetylenes were less toxic to nematode worms and eggs. Selenoacetylenes significantly reduced amyloid beta (Aβ) paralysis in C. elegans CL4176 worms, increased longevity by 18 to 22%, along with improving survival after oxidative or thermal stress. Galantamine, showed inferior results. These findings enhance our understanding of selenoacetylenes on neuroprotection, antioxidant activity, and longevity in C. elegans. Future mammalian studies will further elucidate mechanisms and explore the potential therapeutic use of selenoacetylenes in treating Alzheimer’s disease and longevity. Seleniumcontaining Selenium containing activities antioxidative antiinflammatory, antiinflammatory anti inflammatory, inflammatory anti-inflammatory effects organism neuroprotective properties 1 structure larvae but3in2ol butinol but 3 2 ol pyriformis Nimitz® Nimitz (Nimitz EC, EC , EC) eggs Aβ (Aβ C CL CL417 22 22% stress Galantamine results neuroprotection Alzheimers Alzheimer s CL41 CL4

Abstract This article aims to explore the perception of pregnant women regarding collective prenatal care facilitated by educational technology, in the light of complexity thinking. Qualitative, exploratory and descriptive study conducted between August and November 2022. The participants were 19 pregnant women from a Family Health Strategy in the central region of the State of Rio Grande do Sul. Data were collected through individual interviews following prenatal meetings and analyzed using thematic analysis. The analysis of the data revealed three thematic axes: Prenatal care: the necessary reconnection of knowledge; Collective prenatal care: collaborative (re)construction of experiences and practices; and Educational technology: tool to foster self-reflection and self-knowledge. Collective prenatal care, facilitated by educational technology, can promote better practices in the pregnancy-postpartum journey by creating collaborative and shared environments for knowledge construction and enabling autonomous and informed decision-making.

Resumo O objetivo deste artigo é conhecer a percepção de gestantes sobre o pré-natal coletivo mediado por tecnologia educativa, à luz do pensamento da complexidade. Pesquisa qualitativa, exploratória e descritiva realizada entre os meses de agosto e novembro de 2022. Participaram da pesquisa 19 gestantes de uma Estratégia de Saúde da Família da região central do Rio Grande do Sul. Os dados foram coletados por meio de entrevista individual, após encontros de pré-natal e analisados pela técnica de análise temática. Dos dados analisados resultaram três eixos temáticos: Assistência pré-natal: a necessária religação de saberes; Pré-natal coletivo: (re)construção colaborativa de vivências e práticas; e Tecnologia educacional: ferramenta indutora de autorreflexão e autoconhecimento. O pré-natal coletivo, mediado por tecnologia educativa, é capaz de induzir melhores práticas no percurso gravídico-puerperal pelo fomento de espaços colaborativos e compartilhados de construção do conhecimento e pela tomada de decisões autônomas e responsáveis.

Abstract This article aims to estimate the underreporting of violence against women (VAW) in the Notifiable Diseases Information System (SINAN), based on data from the National Survey of Health (NSH), in Brazil and subnational units (SU). This work was an ecological study using SINAN and NSH, both from 2019. In SINAN, reports of sexual, physical, and psychological VAW, aged 18 years or older, were selected. In the NSH, women of the same age group who reported psychological, physical, or sexual violence, and who had sought health care due to consequences of the violence were selected. SINAN underreporting was calculated in reference to the NSH’s estimated population, for Brazil and each SU. Underreporting of VAW in Brazil was 98.5%, 75.9%, and 89.4% for psychological, physical, and sexual violence, respectively. The North and Northeast states presented the lowest reporting rates among the states. VAW in Brazil is highly underreported by the health sector, showing the need for adequate training of health professionals to recognize situations of violence and raise awareness of the importance of reporting.

Resumo O objetivo do artigo é estimar a subnotificação da violência contra as mulheres (VCM) no Sistema de Informação de Agravos de Notificação (SINAN) a partir de dados da Pesquisa Nacional de Saúde (PNS), para o Brasil e as unidades federadas (UF). Estudo ecológico utilizando o SINAN e a PNS, ambos do ano de 2019. No SINAN, foram selecionadas as notificações de casos de violências sexual, física e psicológica contra mulheres com idade igual ou superior a 18 anos. Na PNS, foram selecionadas as mulheres da mesma faixa etária com relato de violência psicológica, física ou sexual que tenham procurado atendimento em saúde em razão de consequência relacionada à violência vivida. Calculou-se a subnotificação do SINAN a partir da estimativa da população da PNS para o Brasil e cada UF. A subnotificação de VCM no Brasil foi de 98,5%, 75,9% e 89,4% para as violências psicológica, física e sexual, respectivamente. Os estados do Norte e Nordeste apresentaram os menores índices de notificação entre as UF. A VCM no Brasil apresenta grande subnotificação no setor saúde, demonstrando a necessidade de capacitação dos profissionais de saúde para o reconhecimento de situações de violência e conscientização da importância da notificação.

Abstract This article aims to explore the perception of pregnant women regarding collective prenatal care facilitated by educational technology, in the light of complexity thinking. Qualitative, exploratory and descriptive study conducted between August and November 2022. The participants were 19 pregnant women from a Family Health Strategy in the central region of the State of Rio Grande do Sul. Data were collected through individual interviews following prenatal meetings and analyzed using thematic analysis. The analysis of the data revealed three thematic axes: Prenatal care: the necessary reconnection of knowledge; Collective prenatal care: collaborative (re)construction of experiences and practices; and Educational technology: tool to foster self-reflection and self-knowledge. Collective prenatal care, facilitated by educational technology, can promote better practices in the pregnancy-postpartum journey by creating collaborative and shared environments for knowledge construction and enabling autonomous and informed decision-making.

Resumo O objetivo deste artigo é conhecer a percepção de gestantes sobre o pré-natal coletivo mediado por tecnologia educativa, à luz do pensamento da complexidade. Pesquisa qualitativa, exploratória e descritiva realizada entre os meses de agosto e novembro de 2022. Participaram da pesquisa 19 gestantes de uma Estratégia de Saúde da Família da região central do Rio Grande do Sul. Os dados foram coletados por meio de entrevista individual, após encontros de pré-natal e analisados pela técnica de análise temática. Dos dados analisados resultaram três eixos temáticos: Assistência pré-natal: a necessária religação de saberes; Pré-natal coletivo: (re)construção colaborativa de vivências e práticas; e Tecnologia educacional: ferramenta indutora de autorreflexão e autoconhecimento. O pré-natal coletivo, mediado por tecnologia educativa, é capaz de induzir melhores práticas no percurso gravídico-puerperal pelo fomento de espaços colaborativos e compartilhados de construção do conhecimento e pela tomada de decisões autônomas e responsáveis.

Resumo O objetivo deste artigo é conhecer a percepção de gestantes sobre o pré-natal coletivo mediado por tecnologia educativa, à luz do pensamento da complexidade. Pesquisa qualitativa, exploratória e descritiva realizada entre os meses de agosto e novembro de 2022. Participaram da pesquisa 19 gestantes de uma Estratégia de Saúde da Família da região central do Rio Grande do Sul. Os dados foram coletados por meio de entrevista individual, após encontros de pré-natal e analisados pela técnica de análise temática. Dos dados analisados resultaram três eixos temáticos: Assistência pré-natal: a necessária religação de saberes; Pré-natal coletivo: (re)construção colaborativa de vivências e práticas; e Tecnologia educacional: ferramenta indutora de autorreflexão e autoconhecimento. O pré-natal coletivo, mediado por tecnologia educativa, é capaz de induzir melhores práticas no percurso gravídico-puerperal pelo fomento de espaços colaborativos e compartilhados de construção do conhecimento e pela tomada de decisões autônomas e responsáveis. prénatal pré natal educativa complexidade qualitativa 2022 1 Sul individual temática temáticos saberes Prénatal Pré reconstrução re educacional autoconhecimento gravídicopuerperal gravídico puerperal responsáveis 202 20 2

Abstract This article aims to explore the perception of pregnant women regarding collective prenatal care facilitated by educational technology, in the light of complexity thinking. Qualitative, exploratory and descriptive study conducted between August and November 2022. The participants were 19 pregnant women from a Family Health Strategy in the central region of the State of Rio Grande do Sul. Data were collected through individual interviews following prenatal meetings and analyzed using thematic analysis. The analysis of the data revealed three thematic axes: Prenatal care: the necessary reconnection of knowledge; Collective prenatal care: collaborative (re)construction of experiences and practices; and Educational technology: tool to foster self-reflection and self-knowledge. Collective prenatal care, facilitated by educational technology, can promote better practices in the pregnancy-postpartum journey by creating collaborative and shared environments for knowledge construction and enabling autonomous and informed decision-making. technology thinking Qualitative 2022 1 Sul axes reconstruction re selfreflection self reflection selfknowledge. selfknowledge knowledge. self-knowledge pregnancypostpartum pregnancy postpartum decisionmaking. decisionmaking decision making. making decision-making 202 20 2

Resumo O objetivo do artigo é estimar a subnotificação da violência contra as mulheres (VCM) no Sistema de Informação de Agravos de Notificação (SINAN) a partir de dados da Pesquisa Nacional de Saúde (PNS), para o Brasil e as unidades federadas (UF). Estudo ecológico utilizando o SINAN e a PNS, ambos do ano de 2019. No SINAN, foram selecionadas as notificações de casos de violências sexual, física e psicológica contra mulheres com idade igual ou superior a 18 anos. Na PNS, foram selecionadas as mulheres da mesma faixa etária com relato de violência psicológica, física ou sexual que tenham procurado atendimento em saúde em razão de consequência relacionada à violência vivida. Calculou-se a subnotificação do SINAN a partir da estimativa da população da PNS para o Brasil e cada UF. A subnotificação de VCM no Brasil foi de 98,5%, 75,9% e 89,4% para as violências psicológica, física e sexual, respectivamente. Os estados do Norte e Nordeste apresentaram os menores índices de notificação entre as UF. A VCM no Brasil apresenta grande subnotificação no setor saúde, demonstrando a necessidade de capacitação dos profissionais de saúde para o reconhecimento de situações de violência e conscientização da importância da notificação. (VCM (SINAN , (PNS) UF . (UF) 2019 1 anos vivida Calculouse Calculou se 985 98 5 98,5% 759 75 9 75,9 894 89 4 89,4 respectivamente (PNS (UF 201 98,5 7 75, 8 89, 20 98, 2

Abstract This article aims to estimate the underreporting of violence against women (VAW) in the Notifiable Diseases Information System (SINAN), based on data from the National Survey of Health (NSH), in Brazil and subnational units (SU). This work was an ecological study using SINAN and NSH, both from 2019. In SINAN, reports of sexual, physical, and psychological VAW, aged 18 years or older, were selected. In the NSH, women of the same age group who reported psychological, physical, or sexual violence, and who had sought health care due to consequences of the violence were selected. SINAN underreporting was calculated in reference to the NSH’s estimated population, for Brazil and each SU. Underreporting of VAW in Brazil was 98.5%, 75.9%, and 89.4% for psychological, physical, and sexual violence, respectively. The North and Northeast states presented the lowest reporting rates among the states. VAW in Brazil is highly underreported by the health sector, showing the need for adequate training of health professionals to recognize situations of violence and raise awareness of the importance of reporting. (VAW , (SINAN) NSH (NSH) SU . (SU) 2019 physical 1 older selected NSHs s population 985 98 5 98.5% 759 75 9 75.9% 894 89 4 89.4 respectively sector (SINAN (NSH (SU 201 98.5 7 75.9 8 89. 20 98. 75. 2

RESUMO Objetivos: conhecer a percepção da equipe de enfermagem sobre cuidado prestado às gestantes com transtornos mentais internadas em uma unidade de internação hospitalar psiquiátrica. Métodos: Pesquisa Convergente Assistencial realizada entre agosto e dezembro de 2021, por meio de entrevista semiestruturada com 25 profissionais de enfermagem de uma Unidade Psiquiátrica de um Hospital de referência do Sul do Brasil. Resultado: os dados organizados e analisados resultaram em duas categorias temáticas: Cuidado tecnicista, genérico e impessoal; e Da impessoalidade à singularidade do cuidado em enfermagem. Assegurar um cuidado singular às gestantes com transtornos mentais significa atribuir-lhes significado de existência e conduzir o cuidado, a partir de uma perspectiva multidimensional e continuada. Considerações Finais: o cuidado de enfermagem às gestantes, em situação de internação psiquiátrica, demanda contínua qualificação profissional, tecnologias interativas e de apoio ao processo de enfermagem, além da promoção de um cuidado singular e multidimensional. Objetivos psiquiátrica Métodos 2021 2 Brasil Resultado temáticas tecnicista impessoal atribuirlhes atribuir lhes continuada Finais profissional 202 20

ABSTRACT Objectives: to understand the nursing team’s perception in relation to the care provided to pregnant women with mental disorders admitted to a psychiatric hospital unit. Methods: Convergent Care Research carried out between August and December 2021, through semi-structured interviews with 25 nursing professionals from a Psychiatric Unit from a reference Hospital in Southern Brazil. Results: the organized and analyzed data resulted in two thematic categories: Technical, generic and impersonal care; and From impersonality to the singularity of nursing care. Ensuring unique care for pregnant women with mental disorders means giving them a meaning of existence and providing care from a multidimensional and continuous perspective. Final Considerations: nursing care for pregnant women in psychiatric hospitalization requires continuous professional qualification, interactive technologies and support for the nursing process, in addition to promoting singular and multidimensional care. Objectives teams team s unit Methods 2021 semistructured semi structured 2 Brazil Results categories Technical perspective Considerations qualification process 202 20

RESUMEN Objetivos: conocer la percepción del equipo de enfermería sobre los cuidados prestados a las mujeres embarazadas con trastornos mentales ingresadas en una unidad de hospitalización psiquiátrica. Métodos: se trata de una Investigación Convergente Asistencial realizada entre agosto y diciembre de 2021 mediante entrevista semiestructurada entre 25 profesionales de enfermería de una Unidad Psiquiátrica de un Hospital referencia del Sur de Brasil. Resultados: los datos organizados y analizados dieron lugar a dos categorías temáticas: Cuidados técnicos, genéricos e impersonales; y De la impersonalidad a la singularidad en los cuidados de enfermería. Garantizar un cuidado singular y continuo, desde una perspectiva multidimensional, le brinda un sentido a la existencia de las gestantes con trastornos mentales. Consideraciones Finales: los cuidados de enfermería para mujeres embarazadas en hospitalización psiquiátrica requieren una cualificación profesional continua, tecnologías interactivas y apoyo al proceso de enfermería, así como la promoción de cuidados singulares y multidimensionales. Objetivos Métodos 202 2 Brasil Resultados temáticas técnicos impersonales continuo multidimensional Finales continua multidimensionales 20

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos. Objetivo COVID19 COVID 19 COVID-1 Brasil Métodos especialistas metodologistas baseouse baseou se eou GRADE ADOLOPMENT eCOVID19 eCOVID e-COVID-1 RecMap Resultados Chegaramse Chegaram 2 baricitinibe invasiva anticoagulantes tromboembolismo imdevimabe bacteriana hidroxicloroquina convalescente ritonavir rendesivir Conclusão COVID19, 19, condicional usados recursos COVID1 1 COVID- eCOVID1 e-COVID- e-COVID

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy. Objective COVID19 COVID 19 COVID-1 Brazil Methods Experts methodologists guideline andor ADOLOPMENT eCOVID19 eCOVID e e-COVID-1 platform Results Twentyone Twenty one generated authorization imdevimab infection hydroxychloroquine plasma colchicine made Conclusion recommended recommendation evidencebased economy COVID1 1 COVID- eCOVID1 e-COVID- e-COVID

Resumo Fundamento A intolerância ao exercício pós-COVID-19 não é bem entendida. O teste de esforço cardiopulmonar (TECP) pode identificar as limitações ao exercício subjacentes. Objetivos Avaliar a etiologia e a magnitude da intolerância ao exercício em sujeitos pós-COVID-19. Métodos Estudo de coorte que avaliou sujeitos com níveis de gravidades diferentes da doença COVID-19 e um grupo de controle selecionado por pareamento por escores de propensão. Em uma amostra seleta com TECP anterior à infecção viral disponível, foram realizadas comparações antes e depois. O nível de significância foi de 5% em toda a análise. Resultados Foram avaliados cento e quarenta e dois sujeitos com COVID-19 (idade mediana: 43 anos, 57% do sexo masculino), com níveis de gravidade de doença diferentes (60% leve, 21% moderada, 19% grave). O TECP foi realizado 11,5 (7,0, 21,2) semanas após o aparecimento da doença, com as limitações ao exercício sendo atribuídas aos sistemas muscular periférico (92%), pulmonar (6%), e cardiovascular (2%). Menor valor mediano do consumo de oxigênio pico percentual foi observado no subgrupo com níveis graves de doença (72,2%) em comparação com os controles (91,6%). O consumo de oxigênio foi diferente entre os grupos com diferentes níveis de gravidade de doença e o controle no pico e nos limiares ventilatórios. Inversamente, os equivalentes ventilatórios, a inclinação da eficiência do consumo de oxigênio, e o pico do pulso de oxigênio foram semelhantes. A análise do subgrupo de 42 sujeitos com TECP prévio revelou uma redução significativa no pico de velocidade da esteira no subgrupo com nível leve de doença, e no consumo de oxigênio no pico e nos limiares ventilatórios nos subgrupos com níveis moderado/grave. Por outro lado, os equivalentes ventilatórios, a inclinação da eficiência do consumo de oxigênio e o pico do pulso de oxigênio não apresentaram alterações significativas. Conclusões A fadiga do músculo periférico foi a etiologia de limitação de exercício mais comum em pacientes pós-COVID-19 independentemente da gravidade da doença. Os dados sugerem que o tratamento deve enfatizar programas de reabilitação abrangentes, incluindo componentes aeróbicos e de fortalecimento muscular. pósCOVID19 pósCOVID pós COVID 19 pós-COVID-1 entendida (TECP subjacentes pósCOVID19. 19. COVID19 COVID-1 propensão disponível depois 5 idade mediana 4 anos 57 masculino, masculino , masculino) 60% 60 (60 21 moderada grave. grave . grave) 115 11 11, 7,0, 70 7 0 (7,0 21,2 212 2 92%, 92 92% (92%) 6%, 6 6% (6%) 2%. 2% (2%) 72,2% 722 72 (72,2% 91,6%. 916 91,6% 91 (91,6%) Inversamente semelhantes moderadograve moderado moderado/grave lado significativas abrangentes pósCOVID1 1 pós-COVID- COVID1 COVID- (6 7,0 (7, 21, 9 (92% (6% (2% 72,2 (72,2 91,6 (91,6% pós-COVID ( 7, (7 (92 (2 72, (72, 91, (91,6 (9 (72 (91, (91

Abstract Background Post-COVID-19 exercise intolerance is poorly understood. Cardiopulmonary exercise testing (CPET) can identify the underlying exercise limitations. Objectives To evaluate the source and magnitude of exercise intolerance in post-COVID-19 subjects. Methods Cohort study assessing subjects with different COVID-19 illness severities and a control group selected by propensity score matching. In a selected sample with CPET prior to viral infection, before and after comparisons were performed. Level of significance was 5% in the entire analysis. Results One hundred forty-four subjects with COVID-19 were assessed (median age: 43.0 years, 57% male), with different illness severities (60% mild, 21% moderate, 19% severe). CPET was performed 11.5 (7.0, 21.2) weeks after disease onset, with exercise limitations being attributed to the peripheral muscle (92%), and the pulmonary (6%), and cardiovascular (2%) systems. Lower median percent-predicted peak oxygen uptake was observed in the severe subgroup (72.2%) as compared to the controls (91.6%). Oxygen uptake differed among illness severities and controls at peak and ventilatory thresholds. Conversely, ventilatory equivalents, oxygen uptake efficiency slope, and peak oxygen pulse were similar. Subgroup analysis of 42 subjects with prior CPET revealed significant reduction in only peak treadmill speed in the mild subgroup and in oxygen uptake at peak and ventilatory thresholds in the moderate/severe subgroup. By contrast, ventilatory equivalents, oxygen uptake efficiency slope, and peak oxygen pulse did not change significantly. Conclusions Peripheral muscle fatigue was the most common exercise limitation etiology in post-COVID-19 patients regardless of the illness severity. Data suggest that treatment should emphasize comprehensive rehabilitation programs, including aerobic and muscle strengthening components. PostCOVID19 PostCOVID Post COVID 19 Post-COVID-1 understood (CPET postCOVID19 postCOVID post post-COVID-1 COVID19 COVID-1 matching infection 5 fortyfour forty four age 430 43 0 43. years 57 male, male , male) 60% 60 (60 21 moderate severe. . severe) 115 11 11. 7.0, 70 7 (7.0 21.2 212 2 onset 92%, 92 92% (92%) 6%, 6 6% (6%) 2% (2% systems percentpredicted percent predicted 72.2% 722 72 (72.2% 91.6%. 916 91.6% 91 (91.6%) Conversely equivalents slope similar 4 moderatesevere contrast significantly severity programs components PostCOVID1 1 Post-COVID- postCOVID1 post-COVID- COVID1 COVID- (6 7.0 (7. 21. 9 (92% (6% (2 72.2 (72.2 91.6 (91.6% Post-COVID post-COVID ( 7. (7 (92 72. (72. 91. (91.6 (9 (72 (91. (91

Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for many diseases; however, it can induce complications such as Oral Mucositis (OM) and Graft-versus-Host Disease (GVHD). The neutrophil-lymphocyte ratio (NLR) is a peripheral biomarker of systemic inflammation and an independent prognostic factor for several inflammatory diseases. Aim This study aimed to evaluate the association of NLR with OM and GVHD in patients undergoing allogeneic HSCT. Methods Patients who underwent allogeneic HSCT at the Bone Marrow Transplant Service of the Hospital de Clínicas Complex of the Federal University of Paraná were included in the study. Socio-demographic data and blood counts were collected from patients’ medical records. The NLR was calculated and associated with OM and GVHD. Results 45 patients were included in the study. Although NLR was higher in patients with OM and oral GVHD, no statistical difference was observed, and no relationship between OM and GVHD with NLR could be stated. Conclusion Although both OM and GVHD are associated with an inflammatory response as well as the immune system, it was not associated with NLR. Further investigation considering other variables related to HSCT might find possible associations, as it could favor patient management and prevention. (HSCT diseases however (OM GraftversusHost Graft versus Host . (GVHD) neutrophillymphocyte neutrophil lymphocyte (NLR Sociodemographic Socio demographic records 4 observed stated system associations prevention (GVHD

RESUMO Objetivos: Há diversas terapias sendo utilizadas ou propostas para a COVID-19, muitas carecendo de apropriada avaliação de efetividade e segurança. O propósito deste documento é elaborar recomendações para subsidiar decisões sobre o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: Um grupo de 27 membros, formado por especialistas, representantes do Ministério da Saúde e metodologistas, integra essa diretriz. Foi utilizado o método de elaboração de diretrizes rápidas, tomando por base a adoção e/ou a adaptação de recomendações a partir de diretrizes internacionais existentes (GRADE ADOLOPMENT), apoiadas pela plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Foram geradas 16 recomendações. Entre elas, estão recomendações fortes para o uso de corticosteroides em pacientes em uso de oxigênio suplementar, para o uso de anticoagulantes em doses de profilaxia para tromboembolismo e para não uso de antibacterianos nos pacientes sem suspeita de infecção bacteriana. Não foi possível fazer uma recomendação quanto à utilização do tocilizumabe em pacientes hospitalizados com COVID-19 em uso de oxigênio, pelas incertezas na disponibilidade e de acesso ao medicamento. Foi feita recomendação para não usar azitromicina, casirivimabe + imdevimabe, cloroquina, colchicina, hidroxicloroquina, ivermectina, lopinavir/ ritonavir, plasma convalescente e rendesivir. Conclusão: Até o momento, poucas terapias se provaram efetivas no tratamento do paciente hospitalizado com COVID-19, sendo recomendados apenas corticosteroides e profilaxia para tromboembolismo. Diversos medicamentos foram considerados ineficazes, devendo ser descartados, de forma a oferecer o melhor tratamento pelos princípios da medicina baseada em evidências e promover economia de recursos não eficazes.

ABSTRACT Objective: Several therapies are being used or proposed for COVID-19, and many lack appropriate evaluations of their effectiveness and safety. The purpose of this document is to develop recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: A group of 27 experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Sixteen recommendations were generated. They include strong recommendations for the use of corticosteroids in patients using supplemental oxygen, the use of anticoagulants at prophylactic doses to prevent thromboembolism and the nonuse of antibiotics in patients without suspected bacterial infection. It was not possible to make a recommendation regarding the use of tocilizumab in patients hospitalized with COVID-19 using oxygen due to uncertainties regarding the availability of and access to the drug. Strong recommendations against the use of hydroxychloroquine, convalescent plasma, colchicine, lopinavir + ritonavir and antibiotics in patients without suspected bacterial infection and also conditional recommendations against the use of casirivimab + imdevimab, ivermectin and rendesivir were made. Conclusion: To date, few therapies have proven effective in the treatment of hospitalized patients with COVID-19, and only corticosteroids and prophylaxis for thromboembolism are recommended. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and promote economical resource use.

Abstract INTRODUCTION Epidemiological surveys revealed that Brazil has a high burden of oral diseases. However, no prior study has reported estimates of untreated dental caries, periodontitis, and edentulism over a three-decade period. The objective of this study is to report the trends of prevalence, incidence, and years-lived with disability (YLDs) due to untreated dental caries in primary and permanent teeth, periodontitis, and edentulism in Brazil between 1990 and 2019. METHODS Estimates of prevalence, incidence, and YLDs due to dental caries in primary and permanent teeth, periodontitis, and edentulism were produced for Brazil, by sex and age, between 1990 and 2019, using Dismod-MR 2.1, as part of the Global Burden of Disease Study 2019 (GBD 2019). Trends of oral disorders were analyzed using generalized linear regression models applying the Prais-Winsten method. RESULTS Almost 100 million Brazilians presented at least one oral disorder in 2019, which was equivalent to a prevalence of 45.3%. All oral diseases combined ranked eighth among all causes of disability, causing more than 970,000 YLDs. Untreated dental caries in primary teeth were estimated to affect 13.5 million children, and untreated dental caries in permanent teeth affected more than 52 million people. Periodontitis affected 29.5 million people, and edentulism affected almost 22 million. The generalized linear regression models revealed a trend of stability of oral disorders between 1990 and 2019. CONCLUSIONS The burden of oral diseases in Brazil is extremely high. Oral disorders, edentulism in particular, caused disability at levels that are comparable to other important chronic diseases.

ABSTRACT Background Several therapies have been used or proposed for the treatment of COVID-19, although their effectiveness and safety have not been properly evaluated. The purpose of this document is to provide recommendations to support decisions about the drug treatment of outpatients with COVID-19 in Brazil. Methods A panel consisting of experts from different clinical fields, representatives of the Brazilian Ministry of Health, and methodologists (37 members in total) was responsible for preparing these guidelines. A rapid guideline development method was used, based on the adoption and/or adaptation of recommendations from existing international guidelines combined with additional structured searches for primary studies and new recommendations whenever necessary (GRADE-ADOLOPMENT). The rating of quality of evidence and the drafting of recommendations followed the GRADE method. Results Ten technologies were evaluated, and 10 recommendations were prepared. Recommendations were made against the use of anticoagulants, azithromycin, budesonide, colchicine, corticosteroids, hydroxychloroquine/chloroquine alone or combined with azithromycin, ivermectin, nitazoxanide, and convalescent plasma. It was not possible to make a recommendation regarding the use of monoclonal antibodies in outpatients, as their benefit is uncertain and their cost is high, with limitations of availability and implementation. Conclusion To date, few therapies have demonstrated effectiveness in the treatment of outpatients with COVID-19. Recommendations are restricted to what should not be used, in order to provide the best treatment according to the principles of evidence-based medicine and to promote resource savings by aboiding ineffective treatments.

ABSTRACT This prospective cohort study aims to analyze the surveillance of COVID-19 at a single hematopoietic stem cell transplantation (HSCT) center in Brazil, in 29 patients undergoing allogeneic HSCT and 57 healthcare workers (nurses and dentists), through viral shedding of SARS-CoV-2 in saliva and plasma and seroprevalence of anti-SARS-CoV-2 IgG. In addition, we report two cases with prolonged persistent detection of SARS-CoV-2 without seroconversion. The sample collection was performed seven times for patients and five times for healthcare workers. Only two patients tested positive for SARS-CoV-2 in their saliva and plasma samples (6.9%) without seroconversion. All healthcare workers were asymptomatic and none tested positive. Two patients (6.9%) and four nurses (8%) had positive serology. No dentists had positive viral detection or positive serology. Our results reflect a low prevalence of positive RT-PCR and seroprevalence of SARS-CoV-2 in patients and healthcare workers at a single HSCT center. Results have also corroborated how the rigorous protocols adopted in transplant centers were even more strengthened in this pandemic scenario.