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Food allergy is a pathological condition caused by a disruption of oral tolerance. This condition leads to a pro-inflammatory environment that culminates in symptoms that varies from abdominal pain to anaphylaxis and death. The gold standard treatment consists of removing the food that triggers the allergy from diet. However, this conduct can cause nutritional impairment and social restrictions. Therefore, the need for new treatment strategies is notorious. In this context, probiotics are investigated due to their immunomodulatory mechanisms. Therefore, the objective of the present work is to investigate the probiotic potential of a mixture of four probiotic strains (Probiatop®) in an in vivo model of food allergy to ovalbumin (OVA). Our results demonstrated that oral administration of Probiatop® attenuated weight loss and diminished significantly anti-OVA IgE and IgG1 levels. Furthermore, it mitigated proximal jejunum injury, neutrophil recruitment and local IL17 levels. In addition, the probiotic mixture modulated positively the gut microbiota composition by decreasing the levels and frequency of Staphylococcus and yeast. In summary, our data suggest that Probiatop® has the potential to alleviate important symptoms of IgE-mediated food allergy, suggesting its probiotic potential as an adjuvant in the treatment of ovalbumin food allergy.
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INTRODUCTION: Mental health professionals, teachers, families, and public administrators are concerned about suicide rates among young people, particularly in the university context. For every ten college students worldwide, three attempt suicide in their lifetime, and two experience suicidal ideation. Reducing these rates requires interventions that recognize the problem in terms of risk factors and protective factors. OBJECTIVE: The general aim of the study was to map the protective factors for suicide among college students, as perceived by them, mental health professionals, and coordinators of undergraduate courses in a public university in the North of Brazil. METHODS: The study followed an exploratory, mixed-method design. Data were collected through interviews and the application of a questionnaire with 54 participants, including college students (n = 20), mental health professionals (n = 22), and course coordinators (n = 12). Data were analyzed using Content Analysis and simple descriptive statistics. RESULTS: The findings show that the protective factors for suicide most cited among the three groups were social support, strengthening of internal resources, institutional support, and finding meaning about the change to enter the university. Although the three audiences did not converge, the protective factors also frequently reported were psychological treatment, leisure activities, religious engagement, medical treatment, civic engagement, employability, opportunities for social ascension offered by the university, and quality family relationships. CONCLUSION: It is suggested that these protective factors are considered when formulating policies to promote mental health and suicide prevention in the university environment.
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BACKGROUND: Evidence suggests that semi-facial respirators provide protection against contamination in high-risk environments, although the COVID-19 pandemic called for greater protection and viral inactivation capacity. Thus, the aim of this study was to investigate the efficacy of a novel semi-facial respirator containing chitosan nanoparticles, compared with a conventional N95 respirator on the incidence of laboratory-confirmed SARS-CoV-2 in healthcare professionals. The secondary outcomes were influenza infection, usability and comfort. METHODS: Randomized controlled trial within a large public hospital (reference for COVID-19 patients) carried out between March 2021 and June 2023. We included 230 healthcare professionals exposed to SARS-Cov-2 and influenza, working in emergency departments, hospital wards, and intensive care units. Participants were assessed at baseline, after 10 days, and 21 days of follow-up. Researchers, participants, and outcome assessors were blinded to the allocated groups. Outcomes were analyzed by bivariate and multivariate comparisons using logistic regression. Crude (cOR) and adjusted odds ratios (aOR) were estimated, followed by 95% confidence intervals (CIs 95%). We adopted intention-to-treat (ITT) and complete-case (CC) analyses. RESULTS: Baseline characteristics were considered homogeneous between groups, and usability and comfort were reported as excellent in both groups. Non-significant differences were found for all outcomes, both in the ITT and CC analyses. The incidence of COVID-19 and influenza were, respectively, cOR: 0.96 [CI95%: 0.21-4.42] and cOR: 1.25 [CI95%: 0.34-4.62]; and aOR: 1.08 [CI95%: 0.21-5.47] and aOR: 1.11 [CI95%: 0.17-7.01]. CONCLUSIONS: We found that the incidence of SARS-Cov-2 and influenza infections were similar between the new respirator compared to the conventional respirator. Furthermore, we observed that usability and comfort were similar and considered excellent for both respirators. TRIAL REGISTRATION: Clinicaltrials.gov (NCT04490200, 29/07/2020).
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COVID-19 , Quitosano , Personal de Salud , Nanopartículas , SARS-CoV-2 , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Femenino , Masculino , Adulto , Incidencia , Persona de Mediana Edad , Dispositivos de Protección Respiratoria , Gripe Humana/prevención & control , Gripe Humana/epidemiología , Respiradores N95 , Estudios de FactibilidadRESUMEN
BACKGROUND/OBJECTIVES: Evidence indicates that persistent transgressive behaviors often begin early in development and increase around age twelve, and warns that children who exhibit transgressive behaviors in childhood or early adolescence tend to develop criminal behaviors in adulthood which makes childhood a critical unit of analysis for timely intervention. The study examines risk and protective factors in childhood related to illegal behavior, through the perspective of developmental criminology. The observation of risk and protective factors in early stages allows us to design interventions that prevent social adjustment problems in children from becoming more complex by maintaining the transgression of social norms over time. Factors identified by developmental criminology can be organized according to ecological systems theory and discussed in relation to previous criminological studies. METHODS: Using a systematic review based on the PRISMA method, the study identifies 24 updated developmental criminology articles that study early protective factors between birth and age twelve. RESULT: Risk factors at the individual level include biological, socioemotional, behavioral, symptomatic aspects and adverse life experiences. Individual protective factors include cognitive, socioemotional, and personality development aspects. Risk factors at an interpersonal and contextual level are related to family, school, peers, socioeconomic situation and governance. CONCLUSIONS: This review highlights the importance of recognizing risk and protective factors in child development, contemplating interventions at multiple levels where an articulation between the various institutions involved in child care is possible.
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O estudo tem como objetivo analisar os fatores associados ao uso adequado dos Equipamentos de Proteção Individual (EPI) pelos trabalhadores da Atenção Primária à Saúde (APS). Estudo transversal, realizado no Brasil, em ambiente virtual entre os meses de agosto/2020 e março/2021. Para a coleta de dados utilizou-se o instrumento validado "E.P.I. - APS COVID-19". Foram utilizados testes qui-quadrado ou exato de Fisher, razão de prevalência, Intervalo de Confiança de 95% e regressão de Poisson com significância p≤0,005. Pesquisa aprovada pelo Comitê de Ética em Pesquisa com Seres Humanos. Participaram da pesquisa 455 trabalhadores. Os trabalhadores com 37 anos ou mais apresentaram prevalência de 1,59 vezes maior para uso adequado de óculos/protetor facial, 1,39 vezes maior para máscara N95 e 1,23 vezes maior para a higienização correta das mãos. O uso de luvas apresentou uma prevalência 35% maior para os trabalhadores com carga horária ≤ 40 horas. A faixa etária 37 anos ou mais foi associada ao uso de máscara N95 (RP=1,107) e a higiene das mãos (RP=1,075). A carga horária ≤ 40 horas foi associada ao uso de luvas (RP=0,846). Conclui-se que são fatores associados ao uso adequado de EPI a faixa etária 37 anos ou mais e a carga horária ≤ 40 horas.
This study aims to analyze the factors associated with the proper use of Personal Protective Equipment (PPE) by Primary Health Care (PHC) workers. Cross-sectional study, carried out in Brazil, in a virtual environment between August/2020 and March/2021. For data collection, the validated instrument "P.P.E. - PHC COVID-19" was used. Chi-square or Fisher's exact tests, prevalence ratio, 95% confidence interval, and Poisson regression with p≤0.005 significance were used. The research was approved by the Ethics Committee for Research with Human Beings and 455 workers participated in the survey. Workers aged 37 years or older had a prevalence of 1.59 times higher for proper use of glasses/face shields, 1.39 times higher for N95 masks, and 1.23 times higher for correct hand hygiene. The use of gloves showed a 35% higher prevalence for workers with working hours of ≤ 40 hours. The age group 37 years or older was associated with the use of N95 masks (PR=1.107) and hand hygiene (PR=1.075). Working hours of ≤ 40 hours were associated with the use of gloves (PR=0.846). It is concluded that the factors associated with the proper use of PPE are age group 37 years or older and working hours of ≤ 40 hours.
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Atención Primaria de Salud , Equipo de Protección Personal , COVID-19RESUMEN
Objectives. The main objective of this study was to evaluate mean propulsive velocity (MPV), mean propulsive force (MPF) and mean propulsive power (MPP) in elite police officers under LOADED and UNLOADED conditions. The study also investigated the association of body composition and strength levels under the same load conditions. Methods. Twenty-one men from an elite unit in Brazil participated in the study, performing Smith machine half squats and an agility test. Dual energy X-ray absorptiometry measured body composition; a linear encoder measured MPV, MPF and MPP during the half squats; and a manual chronometer registered agility test performance. Results. The results showed that wearing and carrying occupational loads did not alter the squat exercise's MPP, MPV and MPF but reduced the performance of relative MPP and agility (p < 0.05). The results also showed that MPP had a higher association with force (i.e., MPF and one-repetition maximum [1RM]) than velocity (i.e., MPV and agility) under the LOADED condition (p < 0.05). Among the body composition variables, only lean body mass was associated with MPP under the LOADED condition (p < 0.05). Conclusion. These findings suggest that load carriage does not reduce absolute mechanical power output, but reduces the relative MPP and agility in military police officers.
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Numerous natural antioxidants commonly found in our daily diet have demonstrated significant benefits for human health and various diseases by counteracting the impact of reactive oxygen and nitrogen species. Their chemical properties enable a range of biological actions, including antihypertensive, antimicrobial, anti-inflammatory, anti-fibrotic, and anticancer effects. Despite promising outcomes from preclinical studies, ongoing debate persists regarding their reproducibility in human clinical models. This controversy largely stems from a lack of understanding of the pharmacokinetic properties of these compounds, coupled with the predominant focus on monotherapies in research, neglecting potential synergistic effects arising from combining different antioxidants. This study aims to provide an updated overview of natural antioxidants, operating under the hypothesis that a multitherapeutic approach surpasses monotherapy in efficacy. Additionally, this study underscores the importance of integrating these antioxidants into the daily diet, as they have the potential to prevent the onset and progression of various diseases. To reinforce this perspective, clinical findings pertaining to the treatment and prevention of non-alcoholic fatty liver disease and conditions associated with ischemia and reperfusion phenomena, including myocardial infarction, postoperative atrial fibrillation, and stroke, are presented as key references.
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Objective: Intimate partner violence (IPV) is a major public health problem in Latin America. The present study investigates the protective factors that contribute to minimizing the risk of exposure to IPV analyzing different variables in a sample of Chilean women victims of IPV. Methods: We used data from the Cicatrices Foundation, a nonprofit Chilean organization providing psychological support to IPV victims. Relevant variables for IPV prevention were identified analyzing a database containing all the information reported by victims during a structured interview. A final sample of 444 women suffering IPV was used in the present study. Results: Logistic regression analysis was calculated in order to make predictions related to IPV protective factors, showing that having a support network (OR = 2.85), treatment compliance (OR = 2.05) and being younger (OR = 0.95) increased the probability of not living with the aggressor. Another logistic regression analysis was calculated in order to predict IPV victims´ health taking medication intake as an indicator. A significant association was observed between this variable and working outside (p = 0.002) and between mediation intake and age (p < 0.001), with an OR of 1.987 and 0.93, respectively. Working outside and being younger were identified as protective factors against consuming medication. Conclusion: To the best of our knowledge, this is one of the first studies conducted in Chile on the prevention of IPV in a sample of victims seeking for help. Our results will contribute to guide policy makers, researchers and other women in the prevention of potential risks for IPV.
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Objetivo: Analisar as evidências sobre o efeito dos agentes tópicos empregados para a prevenção da radiodermatite em pacientes com câncer. Método: Revisão sistemática de estudos clínicos randomizados duplos-cegos construída conforme recomendações do Joanna Briggs Institute e busca nas bases de dados MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase, Scopus, além da literatura cinzenta. Utilizaram-se a ferramenta de avaliação crítica do JBI para ensaios clínicos randomizados para avaliar a possibilidade de viés, o Grading of Recommendations, Assessment, Development and Evaluation para a qualidade das evidências e o Gradepro® para recomendá-las. Resultados: Selecionaram-se 13 estudos que avaliaram diferentes agentes tópicos para prevenir a radiodermatite, a saber: corticosteroides, de ação antioxidante e fitoterápicos. A qualidade metodológica de cada estudo foi apropriada, mas a qualidade da evidência gerada pela reunião deles foi baixa, independentemente do tipo de agente tópico empregado, sugerindo que a confiança no seu efeito é limitada e tornando a força de recomendação fraca. Conclusão: Alguns agentes tópicos mostraram-se promissores para a prevenção de radiodermatite, mas as evidências aqui reunidas sobre a eficácia deles não permitem indicar seu uso para a prevenção de radiodermatite em pacientes com câncer. (AU)
Objective: To analyze the evidence on the effect of topical agents to prevent radiodermatitis in cancer patients. Methods: Systematic review of double-blind randomized clinical studies built according to JBI recommendations and search in the databases MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase and Scopus, in addition to the Gray Literature. The JBI critical assessment tool for randomized clinical trials was used to assess the possibility of bias, GRADE for the quality of evidence, and Gradepro® to recommend them. Results: Thirteen studies were selected that evaluated different topical agents to prevent radiodermatitis, namely: corticosteroids, with antioxidant action and herbal medicines. The methodological quality of each study was appropriate. Still, the quality of evidence generated by pooling them was low, regardless of the type of topical agent employed, suggesting that confidence in its effect is limited and weakening the strength of the recommendation. Conclusions: Some topical agents have shown promise for the prevention of radiodermatitis, but the evidence gathered here about their effectiveness does not indicate their use for the prevention of radiodermatitis in cancer patients. (AU)
Objetivo: Analizar la evidencia sobre el efecto de los agentes tópicos utilizados para la prevención de la radiodermatitis en pacientes con cáncer. Método: Revisión sistemática de estudios clínicos aleatorizados, doble ciego, elaborados según las recomendaciones del JBI y buscados en MEDLINE/PubMed, CINAHL, LILACS, Web of Science, Embase y Scopus, además de literatura gris. Se utilizó la herramienta de evaluación crítica JBI para ensayos clínicos aleatorios para evaluar la posibilidad de sesgo, GRADE para la calidad de la evidencia y Gradepro® para recomendarla. Resultados: Se seleccionaron trece estudios que evaluaron diferentes agentes tópicos para prevenir la radiodermatitis, a saber: corticosteroides, con acción antioxidante y fitoterapia. La calidad metodológica de cada estudio fue apropiada, pero la calidad de la evidencia generada al combinarlos fue baja, independientemente del tipo de agente tópico empleado, lo que sugiere que la confianza en su efecto es limitada y debilita la fuerza de la recomendación. Conclusión: Algunos agentes tópicos se han mostrado prometedores para la prevención de la radiodermatitis, pero la evidencia aquí reunida sobre su eficacia no nos permite indicar su uso para la prevención de la radiodermatitis en pacientes con cáncer. (AU)
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Humanos , Masculino , Femenino , Radiodermatitis/prevención & control , Radioterapia , EstomaterapiaRESUMEN
Resumen La gratitud ha sido considerada como un factor protector de diferentes enfermedades mentales y proporciona a los individuos mayores sentimientos de connotación positiva hacia la vida, lo que favorece al bienestar de las personas, pero poco se ha explorado su relación con la satisfacción con la vida y la resiliencia. Por lo tanto, el objetivo de la presente investigación es identificar si existe relación entre la gratitud, la resiliencia y la satisfacción con la vida, y compararlas según el sexo e ingresos económicos en adultos colombianos. Para ello se realizó un estudio cuantitativo, no experimental, con alcance correlacional. Se aplicaron los cuestionarios Cuestionario de Gratitud (G-20), Escala de Resiliencia Connor-Davidson (CD-RISC 10) y Escala de Satisfacción con la Vida (SWLS) en una muestra de 1099 participantes de nacionalidad colombiana, 123 hombres, 971 mujeres y 5 otros. Sus edades oscilaban entre los 19 y 67 años, y recibían en su mayoría mensualmente entre 400000COP y 900 000 COP (96.06USD-218.07USD). Los resultados mostraron altos niveles de gratitud, resiliencia y satisfacción con la vida, a nivel comparativo no se encontraron diferencias entre hombres y mujeres, los participantes con mayores ingresos económicos presentaron mayores niveles de gratitud y satisfacción con la vida en comparación de aquellos con menores ingresos, y finalmente se hallaron correlaciones fuertes y positivas entre la gratitud, resiliencia y satisfacción con la vida. En conclusión, puede contemplarse a la gratitud como un aspecto favorable para la salud, la calidad de vida y el mejoramiento de otras condiciones psicológicas.
Abstract Gratitude has been considered a protective factor against various mental illnesses, providing individuals with heightened positive feelings towards life, thereby promoting well-being. However, little exploration has been conducted on its relationship with life satisfaction and resilience. Therefore, the objective of this research was to identify whether there is a relationship between gratitude, resilience, and life satisfaction and to compare these factors based on gender and income among Colombian adults. A quantitative, non-experimental study with correlational scope was conducted. The Gratitude Questionnaire (G-20), Connor-Davidson Resilience Scale (CD-RISC 10), and Satisfaction with Life Scale (SWLS) were administered to a sample of 1099 Colombian partici-pants, including 123 men, 971 women, and 5 others. Participants ranged in age from 19 to 67 years, with the majority earning monthly incomes between 400,000 COP-900,000 COP (96.06 USD-218.07 USD). The results revealed high levels of gratitude, resilience, and life satisfaction. Comparatively, no differences were found between men and women. Participants with higher incomes exhibited greater levels of gratitude and life satisfaction compared to those with lower incomes. Furthermore, strong positive correlations were found between gratitude, resilience, and life satisfaction. In conclusion, gratitude can be considered a favorable aspect for health, quality of life, and the improvement of other psychological conditions
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Mother-infant bonding is influenced by several risk and protective factors, and the literature has investigated the relationships between these factors independently. This study aimed to verify the interrelationships of some of these factors and how they influence mother-infant bonding in Brazil. In this study, 361 mothers participated, and the outcome variable of mother-infant bonding was assessed using the Postpartum Bonding Questionnaire (PBQ). Multivariate regression analysis was performed using a hierarchical model with three blocks structured according to the influence exerted on mother-infant bonding. The PBQ's factor scores were estimated and used in the subsequent analyses to decrease measurement error. The variable "violence experienced by mothers" was statistically significant for explaining the second block model but not significant for the third block. Network analysis was performed after multiple regression, showing that the violence experienced by mothers does not directly influence mother-infant bonding but rather is mediated by postpartum depression. This explains why violence is not significant in the hierarchical multiple regression when maternal depression is added to the model. This study's strengths lie in its utilization of PBQ factor scores and network analysis, enabling the estimation of conditional relationships among variables. This approach provides deeper insights into factors affecting mother-infant bonding.
Varios factores de riesgo y de protección ejercen influencia sobre la unión afectiva madreinfante; la literatura disponible ha investigado las relaciones entre estos factores de una manera independiente. Este estudio se propuso verificar las interrelaciones de algunos de estos factores y cómo ellos influyen en la unión afectiva madreinfante. Se consultó un total de 361 madres y el variable resultado de afectividad madreinfante se evaluó por medio del Cuestionario de Afectividad de Postparto (PBQ). Se llevaron a cabo análisis de regresión multivariados usando un modelo jerárquico con tres estructuras de bloques de acuerdo con la influencia ejercida sobre la unión afectiva madreinfante. Se estimaron y usaron los puntajes de factores del PBQ en los análisis subsecuentes para disminuir el error en la medida. La variable "violencia experimentada por las madres" fue estadísticamente significativa para explicar el segundo modelo de bloque, pero no significativa para el tercer bloque. Se llevó a cabo un análisis de interrelaciones después de la regresión múltiple, demostrando que la violencia experimentada por las madres no influye directamente la afectividad madreinfante, sino que la misma es mediada por la depresión posterior al parto. Esto explica por qué la violencia no es significativa en la jerárquica regresión múltiple cuando la depresión materna se le agrega al modelo. Entre los puntos fuertes de este estudio se incluye el uso de los puntajes de factores del PBQ y el análisis de interrelaciones, lo cual permitió que se estimaran las relaciones condicionales existente dentro del grupo de variables, aportando una mayor comprensión de algunos factores que interfieren en la unión afectiva madreinfante.
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Depresión Posparto , Relaciones Madre-Hijo , Madres , Apego a Objetos , Humanos , Depresión Posparto/psicología , Relaciones Madre-Hijo/psicología , Femenino , Adulto , Madres/psicología , Lactante , Brasil , Adulto Joven , Encuestas y Cuestionarios , Violencia/psicología , MasculinoRESUMEN
We report the feasibility of a combined approach of very low low tidal volume (VT) and mild therapeutic hypothermia (MTH) to decrease the ventilatory load in a severe COVID-19-related acute respiratory distress syndrome (ARDS) cohort. Inclusion criteria was patients ≥18-years-old, severe COVID-19-related ARDS, driving pressure ∆P >15 cmH2O despite low-VT strategy, and extracorporeal therapies not available. MTH was induced with a surface cooling device aiming at 34°C. MTH was maintained for 72 h, followed by rewarming of 1°C per day. Data were shown in median (interquartile range, 25%-75%). Mixed effects analysis and Dunnett's test were used for comparisons. Seven patients were reported. Ventilatory load decreased during the first 24 h, minute ventilation (VE) decreased from 173 (170-192) to 152 (137-170) mL/kg/min (P = 0.007), and mechanical power (MP) decreased from 37 (31-40) to 29 (26-34) J/min (P = 0.03). At the end of the MTH period, the VT, P, and plateau pressure remained consistently close to 3.9 mL/kg predicted body weight, 12 and 26 cmH2O, respectively. A combined strategy of MTH and ultraprotective mechanical ventilation (MV) decreased VE and MP in severe COVID-19-related ARDS. The decreasing of ventilatory load may allow maintaining MV within safety thresholds.
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BACKGROUND: Depression is a significant global disability, and early adverse experiences (EAE) represent consistent risk factors in children. However, protective factors play a vital role in promoting healthy development and mitigating these risks. METHODS: We conducted a thorough literature search on Pubmed, APA, Emcare, and EMBASE from 1946 to August 25, 2023. We included longitudinal studies analyzing protective factors for depressive symptoms in high-risk children or adolescents, excluding cross-sectional studies, reviews, and pre-clinical studies. OUTCOMES: Our analysis comprised 29 studies with 62,405 participants, identifying 38 protective factors. Positive individual characteristics, family factors, peer relationships, school-related aspects, neighborhood characteristics and intrinsic religiosity were associated with reduced depressive outcomes. INTERPRETATION: These findings have important implications for developing preventive strategies in this population. Addressing protective factors can contribute to preventing depression and enhancing mental well-being across the lifespan.
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BACKGROUND: Major depressive disorder (MDD) is a global concern due to its widespread prevalence and morbidity. Identifying protective factors in high-risk individuals, including those with a familial predisposition, maltreatment history, and socio-economic vulnerabilities, is crucial. METHODS: We assessed a high-risk subsample within a young adult population cohort (n = 791; mean age = 31.94 [SD = 2.18]) across three waves. Using multiple regression models to analyse higher education, feeling supported, spirituality, psychotherapy access, higher socioeconomic status, involvement in activities, cohabitation, and family unity in Waves 1 and 2, and their association with MDD resilience at Wave 3. RESULTS: In the high-risk group, MDD incidence was 13.7% (n=24). Paternal support had a protective effect on MDD incidence (OR = 0.366; 95% CI [0.137 to 0.955], p = 0.040) and suicidal attempt risk (OR = 0.380; 95% CI [0.150 to 0.956], p = 0.038). Higher resilience scores were also protective (OR = 0.975; 95% CI [0.953 to 0.997], p = 0.030), correlating with reduced BDI (r = 0.0484; B = -0.2202; 95% CI [-0.3572 to -0.0738]; p = 0.003) and MADRS scores (r = 0.0485; B = -0.2204; 95% CI [-0.3574 to -0.0741]; p = 0.003). CONCLUSIONS: Our paper emphasizes reorienting the MDD approach, focusing on positive prevention strategies. It highlights fathers' crucial role in family-based interventions and promoting resilience in high-risk populations.
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OBJECTIVES: To calculate the direct cost of personal protective equipment (PPE) used during the COVID-19 pandemic from the perspective of a Brazilian tertiary public hospital. METHODS: We evaluated the cost of PPE during the pandemic to the cost before (2021 vs 2019, respectively) using the microcosting method. Cost estimates were converted into US dollars in 2023, taking inflation into account and using purchasing power parity conversion rates. Our expenses included gloves, disposable gowns, head coverings, masks, N95 respirators, and eye protection. The number of PPE used was determined by the hospital's usual protocol, the total number of hospitalized patients, and the number of days of hospitalization. We used the following variables for uncertainty analysis: PPE adherence, an interquartile range of median length of hospitalization, and variance in the cost of each PPE. RESULTS: In 2021, 26 618 individuals were hospitalized compared with 31 948 in 2019. The median length of stay was 6 and 4 days, respectively. The total and per-patient direct cost of PPE were projected to be 2 939 935.47 US dollar (USD) and 110.45 USD, respectively, during the pandemic, and 1 570 124.08 USD and 49.15 USD, respectively, before the pandemic. The individual cost of PPE was the most influential cost variable. CONCLUSIONS: According to the hospital's perspective, the total estimated direct cost of PPE during the COVID-19 pandemic was nearly twice as high as the previous year. This difference might be explained by the 3-fold increase in PPE in the treatment of patients with COVID-19 compared with patients without isolation precautions.
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COVID-19 , Equipo de Protección Personal , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , COVID-19/economía , Equipo de Protección Personal/economía , Equipo de Protección Personal/estadística & datos numéricos , Brasil/epidemiología , SARS-CoV-2 , Pandemias/economía , Pandemias/prevención & control , Centros de Atención Terciaria/economía , Centros de Atención Terciaria/estadística & datos numéricos , Hospitalización/economía , Hospitalización/estadística & datos numéricosRESUMEN
Aim: In a population profile corrected for sociodemographic factors, the aim of this study was to examine sociodemographic the protective effect of a phthalocyanine-derived mouthwash (APD) before infection with SARS-CoV-2, in addition to analyzing the survival of the at-risk population and the confirmed diagnosis of COVID-19. Methods: For individuals from the Uru municipality, a structured questionnaire consisting of two parts was completed before the distribution of APD. Subsequently, subjects received two bottles containing 600 mL of APD and were instructed to rinse/gargle with 3 mL of the solution 3 to 5 times per day for 1 min for 2 months. Data were obtained from the electronic system of the municipal health center, organized in a spreadsheet, and analyzed using multiple linear regression and Cox regression analysis. Results: The study included 995 participants with the following sociodemographic data: 98/995 individuals (p<0.002) who did not complete high school used the APD 66.30 times more than did individuals with higher education. The results in terms of survival were meaningful in relation to the duration of APD use. The protective factor for COVID-19 was 14.1%. Conclusion: Daily use of a solution containing phthalocyanine derivatives provided a higher protection factor against COVID-19 infection, predominantly in individuals without a school-completion certificate.
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Immune checkpoint pathways, i.e., coinhibitory pathways expressed as feedback following immune activation, are crucial for controlling an excessive immune response. Cytotoxic T lymphocyte antigen-4 (CTLA-4) and programmed cell death protein-1 (PD-1) are the central classical checkpoint inhibitory (CPI) molecules used for the control of neoplasms and some infectious diseases, including some fungal infections. As the immunosuppression of severe paracoccidioidomycosis (PCM), a chronic granulomatous fungal disease, was shown to be associated with the expression of coinhibitory molecules, we hypothesized that the inhibition of CTLA-4 and PD-1 could have a beneficial effect on pulmonary PCM. To this end, C57BL/6 mice were infected with Paracoccidioides brasiliensis yeasts and treated with monoclonal antibodies (mAbs) α-CTLA-4, α-PD-1, control IgG, or PBS. We verified that blockade of CTLA-4 and PD-1 reduced the fungal load in the lungs and fungal dissemination to the liver and spleen and decreased the size of pulmonary lesions, resulting in increased survival of mice. Compared with PBS-treated infected mice, significantly increased levels of many pro- and anti-inflammatory cytokines were observed in the lungs of α-CTLA-4-treated mice, but a drastic reduction in the liver was observed following PD-1 blockade. In the lungs of α-CPI and IgG-treated mice, there were no changes in the frequency of inflammatory leukocytes, but a significant reduction in the total number of these cells was observed. Compared with PBS-treated controls, α-CPI- and IgG-treated mice exhibited reduced pulmonary infiltration of several myeloid cell subpopulations and decreased expression of costimulatory molecules. In addition, a decreased number of CD4+ and CD8+ T cells but sustained numbers of Th1, Th2, and Th17 T cells were detected. An expressive reduction in several Treg subpopulations and their maturation and suppressive molecules, in addition to reduced numbers of Treg, TCD4+, and TCD8+ cells expressing costimulatory and coinhibitory molecules of immunity, were also detected. The novel cellular and humoral profiles established in the lungs of α-CTLA-4 and α-PD-1-treated mice but not in control IgG-treated mice were more efficient at controlling fungal growth and dissemination without causing increased tissue pathology due to excessive inflammation. This is the first study demonstrating the efficacy of CPI blockade in the treatment of pulmonary PCM, and further studies combining the use of immunotherapy with antifungal drugs are encouraged.
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Paracoccidioidomicosis , Ratones , Animales , Antígeno CTLA-4 , Receptor de Muerte Celular Programada 1 , Ratones Endogámicos C57BL , Gravedad del Paciente , Inmunoglobulina GRESUMEN
BACKGROUND: An increase in the workload and use of personal protective equipment by healthcare workers was observed during the COVID-19 pandemic. Due to the connections between craniocervical structures, symptoms such as neck pain and temporomandibular symptoms could be influenced by the use of PPE. AIMS: To assess the prevalence of craniocervical pain, sleep quality, physical activity, and depressive symptoms and relationship among craniocervical symptoms in healthcare workers before and during the COVID-19 pandemic in Brazil. DESIGN: Cross-sectional study. PARTICIPANTS: Healthcare workers. SETTINGS: An online questionnaire included a self-report of craniocervical pain intensity [orofacial pain, neck pain, and headache (Numerical Rating Scale)], sleep quality (Pittsburgh Sleep Quality Index), depressive symptoms (Patient Health Questionnaire two items) and physical activity (self-report). METHODS: The sample analysis was performed by descriptive statistics, the paired t-test was used to compare symptoms intensity before and during the pandemic. The relationship between dependent and independent samples was assessed through McNemar test, Pearson's chi-squared test, and Student's independent t-test. A value of p < .05 was adopted as statistical significance. RESULTS: Overall, 147 participants replied the questionnaires. Headache, neck pain, and orofacial pain complaints increased during the pandemic in healthcare workers (p < 0.001). Craniocervical pain was correlated with poor sleep quality, probable depression, and physical activity during the pandemic (p < 0.05). CONCLUSION: Healthcare workers self-reported more craniocervical pain during the COVID-19 pandemic compared to before the pandemic. In addition, poor sleep quality, depressive symptoms, and physical inactivity were associated with craniocervical symptoms during this period.
Asunto(s)
COVID-19 , Depresión , Ejercicio Físico , Personal de Salud , Dolor de Cuello , Calidad del Sueño , Humanos , COVID-19/epidemiología , COVID-19/psicología , Masculino , Estudios Transversales , Femenino , Personal de Salud/estadística & datos numéricos , Personal de Salud/psicología , Brasil/epidemiología , Adulto , Depresión/epidemiología , Depresión/psicología , Dolor de Cuello/epidemiología , Dolor de Cuello/psicología , Encuestas y Cuestionarios , Ejercicio Físico/psicología , Persona de Mediana Edad , Pandemias , Cefalea/epidemiología , Cefalea/psicología , Autoinforme , SARS-CoV-2 , Equipo de Protección Personal/estadística & datos numéricos , PrevalenciaRESUMEN
Background: Most people recover from COVID-19, however, between 5 to 20% have experienced new, recurring, or continuous health problems four or more weeks after being infected, a phenomenon called Long COVID, and whose reasons for its manifestation are incipient. Our objective was to analyse the risk and protective factors for Long COVID in Brazilian adults participating in the CUME Study. Methods: The CUME Study is a prospective cohort conducted with graduates from federal universities in the State of Minas Gerais, Brazil. In this study, 390 participants who answered the baseline questionnaire in 2016 and the third follow-up questionnaire in 2022 (which contained a block of questions about occurrence of COVID-19 and Long COVID) were included. The diagnosis of Long COVID was based on self-reporting of persistence of signs and symptoms of COVID-19 between 30 days and 6 months after remission of the disease. To estimate the risk and protective factors for Long COVID, a hierarchical multivariate statistical analysis was conducted using the Poisson regression technique. Results: Long COVID was observed in 48.9% of the participants. The following characteristics were identified as risk factors for the outcome: female sex (RR = 1.56; 95% CI = 1.22-1.99); prior diagnosis of hypertension (RR = 1.46; 95% CI = 1.19-1.80); having contracted COVID-19 in the first (RR =1.38; 95% CI = 1.07-1.79) or in the second waves (RR = 1.33; 95% CI = 1.07-1.65) of the pandemic period; and having presented three or more signs and symptoms during the acute phase of COVID-19 (RR = 2.99; 95% CI = 1.08-8.24). On the other hand, having a doctoral/postdoctoral educational level (RR = 0.69; 95% CI = 0.50-0.94) was identified as a protective factor for the outcome. Conclusion: Health system managers and healthcare professionals should be aware of the socioeconomic profile and disease history of patients who have had COVID-19 because women, people with a prior diagnosis of hypertension, and those who manifested multiple signs and symptoms of COVID-19 during the acute phase of the disease were at greater risk of developing Long COVID.
RESUMEN
Introducción: Las infecciones de transmisión sexual (ITS) se adquieren principalmente por el contacto sexual y pueden afectar a personas de cualquier edad, sin embargo los adolescentes son el grupo etario más afectado, por tanto es probable que sus conductas sean más de riesgo que protectoras. Objetivo: El objetivo de la investigación es determinar la relación entre el nivel de educación sexual y el conocimiento sobre ITS y las conductas de riesgo y protectoras en los jóvenes. Método: Investigación de diseño analítico, estudio de tipo descriptivo, transversal con datos de tipo cuantitativos, con una muestra de 130 hombres y mujeres, considerando 10 personas por edad desde los 18 a los 30 años. Resultados: No existe relación estadísticamente significativa entre la educación sexual y las conductas de riesgo y/o protectores (p > 0,05), ni tampoco entre la educación sexual y el uso del preservativo, tanto interno como externo (p > 0,05). Conclusión: A pesar de tener educación sexual, no todas las personas utilizan de forma frecuente los anticonceptivos de barrera y principalmente es sorprendente el poco uso del condón de vagina en la población en general, siendo las personas de orientación heterosexual las que lo utilizan menos.
Introduction: Sexually transmitted infections (STIs) are mainly acquired through sexual contact and can affect people of any age; however, adolescents are the most affected age group, therefore, it is likely that their behaviors are more risky than protective. Objective: The objective of the research is to determine the relationship between the level of sexual education and knowledge about STIs and risk and protective behaviors in young people. Method: Analytical design research, descriptive, cross-sectional study with quantitative data, with a sample of 130 men and women, considering 10 people by age from 18 to 30 years. Results: There is no statistically significant relationship between sexual education and risk and/or protective behaviors (p > 0.05) nor between sexual education and condom use, both internal and external (p > 0.05). Conclusion: Despite having sexual education, not all people use frequently barrier contraceptives and, mainly, the little use of the vaginal condom in the general population is surprising, with people of heterosexual orientation being those that use it less.