ABSTRACT Introduction: Rituximab (RTX) is a therapeutic option in pediatric difficult-to-treat idiopathic nephrotic syndrome (NS). We aimed to assess the efficacy and safety of RTX use in these patients. Method: A retrospective study of all patients with idiopathic NS treated with RTX was conducted in a pediatric nephrology division of a tertiary hospital. Demographic, anthropometric, clinical and analytical data were collected prior to treatment and at 6, 12, and 24 months. Results: Sixteen patients were included (11 males), with a median (25th–75th percentile, P25–P75) age at diagnosis of 2 (2.0–2.8) years. Fifteen were steroid-sensitive and 1 was steroid-resistant and sensitive to cyclosporine. The median age at administration of RTX was 10 (6.3–14.0) years. Throughout a median follow-up time of 2.5 (1.0–3.0) years, 6 (37.5%) patients achieved partial remission and 7 (43.8%) had no relapses and were not taking any immunosuppressants at the 24-month follow-up visit. Regarding complications, 1 patient presented persistent hypogammaglobulinemia. Compared with the 12-month period before RTX, there was a decrease in the median number of relapses at 6 and 12 months [3 (3.0–4.0) vs 0 (0–0.8) and 0.50 (0–1.0), respectively; p = 0.001] and in the daily steroids dose (mg/kg/day) at 6, 12, and 24 months [0.29 (0.15–0.67)vs [0.10 (0.07–0.13); p = 0.001], [0.12 (0.05–0.22); p = 0.005] and [0.07(0.04–0.18); p = 0.021]], respectively. There was also a reduction in the median BMI z score at 24 months [2.11 (0.45–3.70) vs. 2.93 (2.01–3.98); p = 0.049]. Conclusion: Our results confirm the efficacy and safety of RTX use in pediatric idiopathic NS and highlight its’ potential cardiometabolic benefits.

Resumo Introdução: Rituximabe (RTX) é uma opção terapêutica na síndrome nefrótica (SN) idiopática pediátrica de difícil tratamento. Visamos avaliar eficácia e segurança do uso de RTX nestes pacientes. Método: Realizou-se estudo retrospectivo de todos os pacientes com SN idiopática tratados com RTX, em uma unidade de nefrologia pediátrica de um hospital terciário. Dados demográficos, antropométricos, clínicos e analíticos foram coletados antes do tratamento e aos 6, 12 e 24 meses. Resultados: Incluímos 16 pacientes (11 do sexo masculino), com idade mediana (percentil 25–75, P25–P75) de 2 (2,0–2,8) anos ao diagnóstico. Quinze eram sensíveis a esteroides, e 1 resistente a esteroides e sensível à ciclosporina.A idade mediana na administração do RTX foi 10 (6,3–14,0) anos. Durante um tempo mediano de acompanhamento de 2,5(1,0–3,0) anos, 6 (37,5%) pacientes alcançaram remissão parcial e 7 (43,8%) não tiveram recidivas e não estavam tomando imunossupressor no acompanhamento aos 24 meses. Quanto às complicações,1 paciente apresentou hipogamaglobulinemia persistente. Comparado ao período de12 meses anterior ao RTX, houve diminuição no número mediano de recidivas em 6 e 12 meses [3 (3,0–4,0) vs 0 (0–0,8) e 0,50 (0–1,0), respectivamente; p = 0,001] e na dose diária de esteroides (mg/kg/dia) aos 6, 12 e 24 meses [0,29 (0,15–0,67) >vs [0,10 (0,07–0,13); p = 0,001], [0,12 (0,05–0,22); p = 0,005] e [0,07 (0,04–0,18); p = 0,021], respectivamente. Houve também redução na mediana do escore z do IMC aos 24 meses [2,11 (0,45–3,70) vs 2,93 (2,01–3,98);p = 0,049]. Conclusões: Nossos resultados confirmam a eficácia e segurança do uso de RTX em SN idiopática pediátrica, destacando seus potenciais benefícios cardiometabólicos.

Abstract Leptophlebiidae is the second most diverse family within Ephemeroptera, with species distributed across various States in Brazil, but with gaps in distribution records in others. Currently, nine species of Leptophlebiidae are recorded for the state of Piauí. Based on this information gap, the objective of this study was to present an updated species list of the family Leptophlebiidae new occurrence records and distributional sites for the state of Piauí, Brazil. By analyzing 447 specimens, we have significantly expanded our knowledge about the distribution of Leptophlebiidae species in the state of Piauí, increasing the recorded species from nine to 17. We have also added new occurrence records for six species and, for the first time, documented the presence of four genera. It is important to highlight that there is still an extensive area within the Cerrado and Brazilian semiarid regions where the occurrence of Ephemeroptera is unknown, confirming that the diversity in this area is underestimated and that knowledge of Ephemeroptera species and their distributions can expand with increased sampling efforts in the coming years, reducing the Linnean and Wallacean shortfall regarding this group. Our results also demonstrate the urgent need for inventories in the southern part of the state of Piauí, particularly in the sub-basins of the middle and upper Parnaíba river, which are considered suitable for monoculture expansion in Brazil.

Resumo Leptophlebiidae é a segunda família mais diversa de Ephemeroptera, com espécies distribuídas em vários estados do Brasil, mas com lacunas no registro de distribuição em outros. Por exemplo, no estado do Piauí tem registrado apenas nove espécies de Leptophlebiidae. Baseada nessa lacuna de informação, o objetivo deste estudo foi apresentar uma lista atualizada de espécies da família Leptophlebiidae, novos registros de ocorrência e sítios de distribuição para o estado do Piauí, Brasil. Ao analisar 447 exemplares, ampliamos significativamente nosso conhecimento sobre a distribuição das espécies de Leptophlebiidae no estado do Piauí, aumentando o número de espécies registradas de nove para 17. Também adicionamos novos registros de ocorrência para seis espécies e, pela primeira vez, documentamos a presença de quatro gêneros. Destacamos que ainda existe uma extensa área do Cerrado e semiárido brasileiro que se desconhece a ocorrência de Ephemeroptera, confirmando que a diversidade nessa área é subestimada e que o conhecimento sobre as espécies de Ephemeroptera e suas distribuições podem se expandir com o aumento do esforço amostral nos próximos anos, diminuindo as lacunas Lineana e Wallaceana sobre esse grupo. Nossos resultados também demonstram a necessidade emergencial de inventários no sul do Estado do Piauí, principalmente nas sub-bacias do médio e alto rio Parnaíba que é considerado adequado para a expansão da monocultura no Brasil.

Abstract The Very High Gravity (VHG) fermentation is a technology that can lead to a reduction in waste generation, a reduction in energy consumption and GHG emissions and several technical, economic, and environmental advantages. Having, as a limiting factor, yeast tolerance to the most diverse stressors in the fermentation medium. To overcome this limitation, the aim of the work was to verify the potential protective effect of silica (+A) on Saccharomyces cerevisiae (Ethanol Red®) submitted to VHG fermentation. Initially, an adaptive test to VHG fermentation was carried out, with 5 cell recycles in musts from sugar cane syrup. Each recycle was subjected to the treatments, in quadruplicate: T1C (control) - Wort without silica supplementation; T2S100- Wort with supplementation of 100 mg L-1 of silica and T3S300- Wort with supplementation of 300 mg L -1 of silica. As a result, the T3S300 treatment in the adaptive test, showed viability of 77.5 to 81.55%; biomass production from 8.1 to 10.0 g L-1; yield from 90.0 to 95.3% and productivity from 7.3 to 10.9 mL L-1h-1. In conclusion, the treatment of the wort with silica (+A) (100 and 300 mg L-1) has an effect protector on yeast and may present positive responses in VHG fermentations.

Abstract The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

RESUMO: Considerando a necessidade de terapias alternativas para a mastite bovina, uma inflamação, normalmente de causa infecciosa, de alta prevalência e de alto impacto econômico nas fazendas leiteiras, avaliou-se a eficácia antimicrobiana, in vivo, de uma formulação intramamária à base de polipirrol (PPy) solúvel, um polímero condutor promissor para aplicações biomédicas, especialmente como potente antibacteriano. Neste ensaio, quartos mamários de vacas holandesas sadias (n = 8) foram inoculados com Staphylococcus aureus e tratados, por via intramamária, com formulação experimental à base de PPy solúvel (5%) e com formulação comercial à base de sulfato de gentamicina. O efeito desses tratamentos foi avaliado com a realização de lactoculturas, da Contagem Bacteriana Total (TBC), da Contagem de Células Somáticas (SCC) e da análise da composição do leite das amostras obtidas de quartos mamários, em sete momentos experimentais. Avaliação hematológica dos animais também foi realizada. A aplicação intramamária de três doses da formulação experimental à base de PPy solúvel resultou em maiores log/mL da TBC e da SCC quando comparadas ao grupo controle positivo e ao grupo que recebeu sulfato de gentamicina. A administração da formulação experimental não induziu alterações na composição do leite e nos parâmetros hematológicos. Alguns fatores farmacocinéticos e farmacodinâmicos do PPy solúvel podem ser atribuídos a ineficácia antimicrobiana da pomada experimental. Outras pesquisas devem ser realizados em prol do desenvolvimento de formulações que permitam a atuação antibacteriana do PPy solúvel no ambiente intramamário de vacas leiteiras.

ABSTRACT: Given the need for alternative therapies for bovine mastitis, an infectious disease of high prevalence and significant economic impact in dairy farms, this study evaluated the in vivo antimicrobial efficacy of an intramammary formulation based on soluble polypyrrole (PPy), a promising conductive polymer for biomedical applications, especially as an effective antimicrobial agent. In this assay, mammary quarters of healthy Holstein Friesian cows (n = 8) were inoculated with Staphylococcus aureus and treated, via the intramammary route, with an experimental formulation based on soluble PPy (5%) and a commercial formulation based on gentamicin sulfate. The effect of these treatments was evaluated based on milk cultures, Total Bacterial Count (TBC), Somatic Cell Count (SCC), and milk composition analysis of mammary quarter samples in seven experimental moments. In addition, hematological evaluations of the animals were also performed. The intramammary application of three levels of the experimental formulation based on soluble PPy resulted in higher log/mL of the TBC and SCC compared to a positive control group and a group that received gentamicin sulfate. The experimental formulation did not induce changes in milk composition or in hematological parameters. Certain factors related to pharmacokinetics, such as the type of carrier used in the formulation and the pharmacodynamics of soluble PPy, may have contributed to the antimicrobial ineffectiveness of the experimental formulation. The results of this study neither define nor decrease the antimicrobial potential of soluble PPy. Further research is required to develop formulations that enable the antibacterial action of soluble PPy in the intramammary environment of dairy cows.

Abstract With the growing number of occupational therapists working at the Unified Social Assistance System (SUAS) in Brazil, there has been an increasing need for education processes focusing on the critical development of professional practice in this field. From this education demand, a project was created in October 2020: “Communities of Practice in Occupational Therapy at SUAS: professional planning and construction of strategies” aiming to promote the exchange of knowledge and experiences between occupational therapists working in social assistance. This study aims to present the work possibilities and limits at SUAS from the point of view of occupational therapists who work at its units and who participated in the Community of Practice, analyzing whether and how their professional actions have been related to the social occupational therapy theoretical-methodological framework. To this end, all the recording material produced in the two project cycles from October 2020 to July 2021 was revisited. The collected information was organized in a table that grouped the themes found. Data analysis revealed two main aspects that allow the correlation of the professionals’ actions with the social occupational therapy theoretical-methodological framework, namely, the necessary interpretation of the inseparability between micro- and macro-social factors for the development of work and the professional and political dimensions of the occupational-therapeutic actions. In both debates, the social occupational therapy theoretical-methodological framework has been the guiding thread of the process, enabling a social reading and a greater understanding of technical-professional purposes within the scope of social assistance.

Resumo Com o crescente número de terapeutas ocupacionais atuantes no Sistema Único de Assistência Social (SUAS), amplia-se a necessidade por processos formativos que desenvolvam criticamente a atuação profissional neste campo. A partir desta demanda formativa foi criado, em outubro de 2020, um projeto de extensão intitulado “Comunidade de práticas em terapia ocupacional no SUAS: articulação profissional e construção de estratégias”, com o intuito de promover trocas de conhecimento e experiências entre terapeutas ocupacionais trabalhadoras em unidades socioassistenciais. Neste artigo se apresentam as possibilidades e os limites do trabalho no SUAS sob o ponto de vista de terapeutas ocupacionais que nele atuam e que foram participantes da Comunidade de Práticas, analisando se e como suas ações profissionais têm se relacionado com a fundamentação teórico-metodológica da terapia ocupacional social. Para isso, foi revisitado todo o material de registro produzido nos dois ciclos do projeto, efetivados de outubro de 2020 a julho de 2021. As informações extraídas das atas foram organizadas em um quadro que agrupou as temáticas encontradas. A análise dos dados revelou dois principais aspectos que possibilitam a correlação das ações das profissionais com a fundamentação teórico-metodológica da terapia ocupacional social, sendo: a necessária leitura acerca da indissociabilidade entre os fatores micro e macrossociais para o desenvolvimento do trabalho e a dimensão técnico-política da atuação terapêutico-ocupacional. Em ambos os debates a fundamentação teórico-metodológica da terapia ocupacional social foi e tem sido o fio condutor do processo, possibilitando uma leitura social e maior apropriação das finalidades técnico-profissionais no âmbito da assistência social.

ABSTRACT The objective of this study was to evaluate the association of polymorphisms in the diacylglycerol acyltransferase ( DGAT ) and leptin ( LEP ) genes with the performance, carcass characteristics, meat quality, and lipid profile of Nellore cattle. A total of 100 intact male Nelore cattle were used to analyze the performance, carcass, physicochemical and centesimal composition, and fatty acid profile of beef. To identify the polymorphisms, the PCR–single-strand conformation polymorphism (SSCP) technique was applied to genomic DNA extracted from muscle tissue. The SSCP technique revealed the presence of four band patterns for the DGAT gene (AC, AD, AE and BB) with five alleles (A, B, C, D and E). For the LEP gene, five band patterns (AA, AB, AC, BB and BC) with three alleles (A, B and C) were observed. For the LEP gene, the AB genotype was associated with higher backfat thickness and ribs weight, while the BB genotype was associated with lower ribs yield; higher hindquarter yield was associated with AC and BB genotypes. Higher contents of C17:0, C18:0 and lower contents of C18:2ω6C, total polyunsaturated fatty acids, total ω6 and ratio of polyunsaturated and saturated fatty acids (PUFA/SFA) were verified for the AC genotype of the LEP gene. The AC and AA genotypes of the LEP gene were associated with higher means of C15:0 and C18:1ω9t. For the DGAT gene, the highest C24:0 content was associated with the AE genotype and the lowest with the AD and BB genotypes. Polymorphisms in the DGAT and LEP genes influence carcass parameters and the lipid profile of the meat of Nellore cattle.

RESUMO Objetivou-se com este estudo avaliar a associação do polimorfismo dos genes da Diacilglicerol Aciltransferase ( DGAT) e Leptina – (L EP ) em relação ao desempenho, características de carcaça, qualidade de carne e perfil lipídico de bovinos Nelore. Para o estudo, foram utilizados um total de 100 bovinos nelores machos inteiros e avaliado os parâmetros de desempenho, composição da carcaça, composição físico-química, centesimal e perfil lipídico da carne. Para identificação dos polimorfismos foi utilizada a técnica de PCR-SSCP a partir da extração do DNA genômico do tecido muscular. A técnica de SSCP revelou a presença de quatro padrões de banda para o gene DGAT (AC, AD, AE e BB) com cinco alelos (A, B, C, D e E) e, para o gene LEP foram verificados cinco padrões de bandas (AA, AB, AC, BB e BC) com três alelos (A, B e C). Para o gene LEP, o genótipo AB foi associado a maior espessura de gordura subcutânea e peso do corte ponta de agulha, enquanto o genótipo BB foi associado a menor rendimento do corte ponta de agulha; maior rendimento do corte traseiro foi associado aos genótipos AC e BB. Maiores teores de C17:0, C18:0 e menores de C18: 2ω6C, total de ácidos graxos poli-insaturados, total de ω6 e a relação de ácidos graxos poli-insaturados e saturados (POL/SAT) foram verificados para o genótipo AC do gene LEP. Os genótipos AC e AA do gene LEP foram associados a maiores médias de C15:0 e C18:1ω9t. Para o gene DGAT, os maiores teores de C24:0 foram associados o genótipo AE e o menores aos genótipos AD e BB. A ocorrência de polimorfismo nos genes DGAT e LEP revelaram influência destes sobre parâmetros de carcaça e perfil lipídico da carne de bovinos Nelore.

Abstract Objectives: to evaluate the reliability of information available on popular websites, in other words, websites aimed lay pregnant women, about absolute and relative indications for cesarean sections. Methods: this was a descriptive/comparative study based on the popular websites most likely to be visited by lay pregnant women and that contained information about indications for absolute and relative cesarean sections. Cohen’s Kappa index of agreement was used to analyze the reliability degree on the indications for cesarean sections presented on the websites and the scientific evidence. Results: there was a higher prevalence (62.63%) of information on the indications for cesarean sections that did not mention whether the indication was absolute or relative, and of these indications, 40.74% were not indications for cesarean sections. Low agreement was also observed among websites and the scientific evidence when the website mentioned the indication for cesarean section was absolute or relative. Conclusion: this study showed that the reliability of the information on absolute and relative indications for cesarean sections available in popular websites is questionable.

Resumo Objetivos: avaliar a confiabilidade das informações disponíveis em sites populares, ou seja, sites voltados para gestantes leigas, sobre indicações absolutas e relativas de cesarianas. Métodos: estudo descritivo/comparativo, baseado nos sites populares mais prováveis de serem visitados por gestantes leigas e que traziam informações sobre as indicações de cesarianas absolutas e relativas. Para analisar o grau de confiabilidade das indicações de cesarianas apresentadas pelos sites e a evidência cientifica, foi realizado o índice de concordância de Kappa de Cohen. Resultados: houve maior prevalência (62,63%) de informações de indicações de cesarianas que não mencionavam se a indicação apresentada era absoluta ou relativa, sendo que destas, 40,74% não eram indicações de cesarianas. Observou-se, concordância baixa entre os sites e a evidência cientifica quando o site mencionava que a indicação de cesariana era absoluta ou relativa. Conclusão: este estudo demonstrou que a confiabilidade das informações acerca das indicações absolutas e relativas de cesarianas disponíveis em sites populares é questionável

ABSTRACT Objectives: to describe the epidemiological profile of suspected, confirmed, and probable cases of monkeypox in the state of Minas Gerais, Brazil. Methods: a descriptive, retrospective study of reported suspected, confirmed, and probable cases of monkeypox infection in the state of Minas Gerais, Brazil. The study period was from the first notification, on June 11, to September 7, 2022. Results: a total of 759 suspected, confirmed, and probable cases of monkeypox infection were reported, with 35.44% suspected, 53.75% confirmed, and 10.81% probable cases, respectively. As for the coexisting diseases within confirmed cases, 38.79% were related to people living with human immunodeficiency virus, and 13.74% had some active sexually transmitted infection. Regarding the evolution of confirmed cases, 47.43% were cured. Conclusions: the results contribute to greater knowledge and control of the infection by allowing better disease management and care offered in health services.

RESUMEN Objetivos: describir perfil epidemiológico de casos sospechosos, confirmados y probables por viruela símica en Minas Gerais, Brasil. Métodos: estudio descriptivo, retrospectivo, con casos notificados sospechosos, confirmados y probables de infección por viruela símica en el estado de Minas Gerais, Brasil. El período del estudio fue desde la primera notificación, en 11 de junio, hasta 7 de septiembre de 2022. Resultados: fueron notificados 759 casos sospechosos, confirmados y probables de infección por viruela símica, siendo, respectivamente, 35,44% sospechosos, 53,75% confirmados y 10,81% probables. Cuanto a las enfermedades coexistentes en los casos confirmados, 38,79% referidos a personas viviendo con virus de la inmunodeficiencia humana, y 13,74% poseían alguna infección sexualmente transmisible activa. Sobre la evolución de casos confirmados, 47,43% evolucionaron para la cura. Conclusiones: los resultados contribuyen para mayor conocimiento y control de la infección, auxiliando en la mejor gestión de la enfermedad y cuidado ofrecidos en los servicios de salud.

RESUMO Objetivos: descrever o perfil epidemiológico dos casos suspeitos, confirmados e prováveis por monkeypox no estado de Minas Gerais, Brasil. Métodos: estudo descritivo, retrospectivo, com os casos notificados suspeitos, confirmados e prováveis de infecção pelo monkeypox no estado de Minas Gerais, Brasil. O período do estudo foi desde a primeira notificação, em 11 de junho, até 7 de setembro de 2022. Resultados: foram notificados 759 casos suspeitos, confirmados e prováveis de infecção pelo monkeypox, sendo, respectivamente, 35,44% suspeitos, 53,75% confirmados e 10,81% prováveis. Quanto às doenças coexistentes nos casos confirmados, 38,79% referiam-se a pessoas vivendo com vírus da imunodeficiência humana, e 13,74% possuíam alguma infecção sexualmente transmissível ativa. Sobre a evolução dos casos confirmados, 47,43% evoluíram para a cura. Conclusões: os resultados contribuem para maior conhecimento e controle da infecção, de modo a auxiliar no melhor gerenciamento da doença e cuidado ofertados nos serviços de saúde.

ABSTRACT Objective: To assess the repercussions of SARS-CoV-2 infection (suspected or confirmed) and the context of the pandemic on the birth route and humanized assistance during childbirth. Method: Cross-sectional epidemiological study, nested within a cohort and comparative with the research “Birth in Belo Horizonte: Survey on Childbirth and Delivery”.The medical records of three reference maternity hospitals in Belo Horizonte were assessed, with a final sample of 1,682 pregnant women, in the months of May, June and July 2020. A descriptive analysis was carried out, with absolute and relative frequency, and a comparative one, with a Pearson’s chi-square test. Results: It was observed that 2.02% of pregnant women were infected with SARS-CoV-2.Before the pandemic, out of a total of 390 pregnant women, 74.10% gave birth vaginally.During a pandemic, among infected women, 51.61% gave birth via cesarean section and 48,39% via vaginal delivery;among uninfected, 26.99% cesarean sections and 73.01% vaginaldeliveries. Conclusion: There was an increase in the percentage of cesarean sections and a possible influence of the pandemic on the rates of indication of cesarean sections at the time of admission to the maternity ward.

RESUMEN Objetivo: Evaluar las repercusiones de la infección por SARS-CoV-2 (sospechosa o confirmada) y el contexto de la pandemia en la vía del parto y la asistencia humanizada durante el parto. Método: Estudio epidemiológico transversal, anidado en una cohorte y comparativo con la investigación “Nacimiento en Belo Horizonte: Encuesta sobre Parto y Parto”.Se enviaron los prontuarios de tres maternidades de referencia en Belo Horizonte, con una muestra final de 1.682 gestantes, en los meses de mayo, junio y julio de 2020. Se realizó un análisis descriptivo, con frecuencia absoluta y relativa, y comparativo. uno, con una prueba de Chi, cuadrado de Pearson. Resultados: Tenga en cuenta que el 2,02% de las mujeres embarazadas estaban infectadas con SARS-CoV-2.Antes de la pandemia, en un total de 390 gestantes, el 74,10% daba a luz por vía vaginal.Durante una pandemia, entre las mujeres infectadas, el 51,61% dio a luz por cesárea y el 48,39% por parto vaginal;en las no infectadas, 26,99% cesáreas y 73,01% vaginales. Conclusión: Hubo un aumento en el porcentaje de cesáreas y una posible influencia de la pandemia en las tasas de indicación de cesáreas al momento del ingreso a la sala de maternidad.

RESUMO Objetivo: Avaliar as repercussões da infecção por SARS-CoV-2 (suspeita ou confirmada) e do contexto da pandemia na via de nascimento e na assistência humanizada ao parto. Método: Estudo epidemiológico transversal, aninhado a uma coorte e comparativo com a pesquisa “Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento”. Avaliou-se prontuários de três maternidades-referência em Belo Horizonte, com amostra final de 1.682 parturientes, nos meses de maio, junho e julho de 2020. Realizou-se análise descritiva, com frequência absoluta e relativa, e comparativa, com teste Qui-quadrado de Pearson. Resultados: Observou-se que, 2,02% das gestantes estavam infectadas por SARS-CoV-2. Antes da pandemia, em um total de 390 gestantes, 74,10% pariram via vaginal. Durante a pandemia, nas mulheres infectadas, 51,61% pariram pela via cesariana e 48,39% pela vaginal; nas não infectadas, 26,99% cesarianas e 73,01% vaginais. Conclusão: Observou-se aumento percentual de cesarianas e possível influência da pandemia nas taxas de indicação de cesarianas no momento da admissão na maternidade.

Abstract Objectives: To measure Quality of Life (QoL) and costs of Heart Failure (HF) outpatients in Brazil as an introduction to the Value-Based Health Care (VBHC) concept. Materials and methods: Cross-sectional study, patients with HF, with ejection fraction <50%, were recruited from three hospitals in Brazil. Two QoL (36-Item Short Form Survey [SF-36] and Minnesota Living with Heart Failure Questionnaire [MLHFQ]) and two anxiety/depression questionnaires were applied. SF-36 scores were stratified by domains. Treatment costs were calculated using the Time-Driven Activity-Based Costing (TDABC) method. Results were stratified by NYHA functional class and sex. Results: From October 2018 to January 2021, 198 patients were recruited, and the median MLHFQ (49.5 [IQR 21.0, 69.0]) and SF-36 scores demonstrated poor QoL, worse at higher NYHA classes. A third of patients had moderate/severe depression and anxiety symptoms, and women had higher anxiety scores. Mean costs of outpatient follow-up were US$ 215 ± 238 for NYHA I patients, US$ 296 ± 399 for NYHA II and US$ 667 ± 1012 for NYHA III/IV. Lab/exam costs represented 30% of the costs in NYHA I, and 74% in NYHA III/IV (US $ 63.26 vs. US$ 491.05). Conclusion: Patients with HF in Brazil have poor QoL and high treatment costs; both worsen as the NYHA classification increases. It seems that HF has a greater impact on the mental health of women. Costs increase mostly related to lab/exams. Accurate and crossed information about QoL and costs is essential to drive care and reimbursement strategies based on value.

Abstract Objective: To compare the Rapid Shallow Breathing Index (RSBI) obtained by the ventilometer and from mechanical ventilation parameters. Methods: Randomized crossover trial, including 33 intubated patients, on mechanical ventilation for at least 24 hours, undergoing spontaneous breathing test. Patients were submitted to the measurement of RSBI by four methods: disconnected from the ventilator through the ventilometer; in Pressure Support Ventilation (PSV) mode at a pressure of 7 cm H2O; in Continuous Positive Airway Pressure (CPAP) mode at a pressure of 5 cmH2O with flow trigger; in CPAP mode at a pressure of 5 cmH2O with pressure trigger. Results: No significant difference was detected between the RSBI obtained by the ventilometer and in the CPAP mode with flow and pressure triggers, however, in the PSV mode, the values were lower than in the other measurements (p < 0.001). By selecting patients from the sample with higher RSBI (≥ 80 cycles.min−1.L−1), the value of the index obtained by the ventilometer was higher than that obtained in the three options of ventilation methods. Conclusion: The RSBI obtained in the CPAP mode at a pressure of 5 cmH2O, in both triggers types, did not differ from that measured by the ventilometer; it is, therefore, an alternative when obtaining it from mechanical ventilation parameters is necessary. However, in the presence of borderline values, the RSBI measured by ventilometer is recommended, as in this method the values are significantly higher than in the three ventilation modalities investigated.

Abstract The management of drainage and urban rainwater management in Brazil and in the world faces numerous challenges in order to be sustainable. When dealing with sustainability, it is important to relate the aspects: of social, environmental and economic, known as the sustainability tripod. Compensatory urban drainage techniques, through infiltration or detention and increasing the evapotranspiration rate, have the potential to reduce: the amount of rainwater runoff; flow peaks; vulnerability of urban areas to flooding; contamination of water courses. It is important that, even with all these benefits, such technologies are associated with such aspects. In this context, this systematic review article (SR) was developed, which aimed to identify trends in the use of sustainable drainage technologies adopted in Brazil and in the world, relating them to aspects of sustainability. For that, a systematic review (SR) was carried out in which the following were identified: trends in the adoption of technologies for sustainable drainage in the world and in Brazil; and the terms used and related to technologies for sustainable drainage. It was also observed, both in Brazil and in the world, that the approach to the theme begins with the technological aspect involving the implementation, life cycle and maintenance of sustainable technologies and, in sequence, the environmental, economic and social aspects unfold in this order, but which are not done in an integral way. It was possible to characterize an important knowledge gap. tripod techniques rate reduce runoff peaks flooding courses benefits context SR (SR developed identified observed implementation sequence way gap

Abstract Fabry disease (FD) is an X-linked lysosomal storage disorder characterized by reduced or absent activity of the enzyme α-galactosidase A. Due to systemic accumulation of glycolipids, FD phenotype is diverse, and diagnosis may be challenging. Clinical manifestations include small fiber neuropathy, renal dysfunction, cardiac involvement, cerebrovascular disease, among others. In the present study, we describe biopsy proven small fiber neuropathy and subclinical cardiac involvement in two cousins diagnosed with FD secondary to a recently described pathogenic variant, highlighting the importance of diagnostic tools to document organ damage and allow early treatment. (FD Xlinked X linked αgalactosidase α galactosidase A glycolipids diverse challenging dysfunction others study variant treatment

Resumo Introdução Instrumentos que busquem conhecer os motivos que propiciam as escolhas alimentares em adolescentes são inexistentes no Brasil até o momento. O Food Choice Questionnaire (FCQ) para adolescentes é um questionário de fácil aplicação e que pode ser utilizado não somente em pesquisas, mas também nos serviços de atenção à saúde. Objetivo Descrever as etapas iniciais - validade de face e de conteúdo - do processo de tradução e adaptação transcultural do FCQ para adolescentes da versão em espanhol para o português do Brasil. Método Trata-se de um estudo metodológico de tradução e adaptação transcultural, em conformidade com as normas internacionais para tradução de instrumentos para validação. Foram seguidas quatro etapas: tradução, retradução, avaliação por comitê de especialistas e dois pré-testes, que foram realizados com adolescentes com idades entre 14 e 19 anos. Resultados Os itens e o título do instrumento foram traduzidos para o português. Alguns itens necessitaram de ajustes para melhor compreensão do público-alvo. O tempo médio de aplicação foi de sete minutos. Um item foi eliminado do questionário e modificou-se a escala de resposta para melhor adequação do instrumento. Conclusão O processo inicial de tradução e adaptação transcultural do Questionário de Escolhas Alimentares para Adolescentes Brasileiros (FCQ-A-BR) atestou as validades de face e conteúdo. No entanto, faz-se necessária a complementação das análises psicométricas, para utilização do instrumento, caso elas se mostrem satisfatórias.

Abstract Background Instruments that seek to find out the reasons that lead to food choices among adolescents are not yet available in Brazil so far. The Food Choice Questionnaire (FCQ) for adolescents is a simple questionnaire that can be used not only in research, but also in healthcare. Objective To describe the initial steps - face and content validity - of the process of translation and cross-cultural adaptation of the FCQ for adolescents from the Spanish version into Brazilian Portuguese. Method This is a methodological study of translation and cross-cultural adaptation, in accordance with international standards for translation of instruments for validation. Four steps were followed: translation, back-translation, evaluation by an expert committee and two pre-tests, which were carried out with adolescents aged between 14 and 19 years. Results The items and the instrument title were translated to Portuguese. Some items needed adjustments to better understand the target audience. The average application time was seven minutes. One item was eliminated from the questionnaire and the response scale was modified to better suit the instrument. Conclusion The initial process of translation and cross-cultural adaptation of the Food Choice Questionnaire for Brazilian Adolescents (FCQ-A-BR) attested to the face and content validity. However, it is necessary to complement the psychometric analyses, to use the instrument, if they are satisfactory.