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BACKGROUND: Patients with immune-mediated rheumatic diseases (IMRDs) have been prioritized for COVID-19 vaccination to mitigate the infection severity risks. Patients with rheumatoid arthritis (RA) are at a high risk of severe COVID-19 outcomes, especially those under immunosuppression or with associated comorbidities. However, few studies have assessed the safety of the COVID-19 vaccine in patients with RA. OBJECTIVE: To evaluate the safety of vaccines against SARS-CoV-2 in patients with RA. METHODS: This data are from the study "Safety and Efficacy on COVID-19 Vaccine in Rheumatic Diseases," a Brazilian multicentric prospective phase IV study to evaluate COVID-19 vaccine in IMRDs in Brazil. Adverse events (AEs) in patients with RA of all centers were assessed after two doses of ChAdOx1 (Oxford/AstraZeneca) or CoronaVac (Sinovac/Butantan). Stratification of postvaccination AEs was performed using a diary, filled out daily and returned at the end of 28 days for each dose. RESULTS: A total of 188 patients with RA were include, 90% female. CoronaVac was used in 109 patients and ChAdOx1 in 79. Only mild AEs were observed, mainly after the first dose. The most common AEs after the first dose were pain at the injection (46,7%), headache (39,4%), arthralgia (39,4%), myalgia (30,5%) and fatigue (26,6%), and ChAdOx1 had a higher frequency of pain at the injection (66% vs 32 %, p < 0.001) arthralgia (62% vs 22%, p < 0.001) and myalgia (45% vs 20%, p < 0.001) compared to CoronaVac. The more common AEs after the second dose were pain at the injection (37%), arthralgia (31%), myalgia (23%), headache (21%) and fatigue (18%). Arthralgia (41,4% vs 25%, p = 0.02) and pain at injection (51,4% vs 27%, p = 0.001) were more common with ChAdOx1. No serious AEs were related. With Regard to RA activity level, no significant difference was observed between the three time periods for both COVID-19 vaccines. CONCLUSION: In the comparison between the two immunizers in patients with RA, local reactions and musculoskeletal symptoms were more frequent with ChAdOx1 than with CoronaVac, especially after the first dose. In summary, the AE occurred mainly after the first dose, and were mild, like previous data from others immunizing agents in patients with rheumatoid arthritis. Vaccination did not worsen the degree of disease activity.

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BACKGROUND: The Breakthrough Series model uses learning sessions (LS) to promote education, professional development and quality improvement (QI) in healthcare. Staff divergences regarding prior knowledge, previous experience, preferences and motivations make selecting which pedagogic strategies to use in LS a challenge. AIM: We aimed to assess new active-learning strategies: two educational games, a card game and an escape room-type game, for training in healthcare-associated infection prevention. METHODS: This descriptive case study evaluated the performance of educational strategies during a Collaborative to reduce healthcare-associated infections in Brazilian intensive care units (ICUs). A post-intervention survey was voluntarily offered to all participants in LS activities. RESULTS: Seven regional 2-day LS were held between October and December 2022 (six for adult ICUs and one for paediatric/neonatal ICUs). Of 194 institutions participating in a nationwide QI initiative, 193 (99.4%) participated in these activities, totalling 850 healthcare professionals. From these, 641 participants responded to the survey (75.4%). The post-intervention survey showed that the participants responded positively to the educational activities. CONCLUSION: The participants perceived the various pedagogical strategies positively, which shows the value of a broad and diverse educational approach, customised to local settings and including game-based activities, to enhance learning among healthcare professionals.

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OBJECTIVE: To investigate the clinicopathological significance and prognosis of the expression of the anterior gradient 3 (AGR3) protein in women with breast cancer. DATA SOURCES: The PubMed, CINAHL, EMBASE, Scopus, and Web of Science databases were searched for studies published in English and without restrictions regarding the year of publication. The search terms were: breast cancer AND anterior gradient 3 OR AGR3 expression. STUDY SELECTION: We included observational or interventional studies, studies on AGR3 protein expression by immunohistochemistry, and studies on invasive breast cancer. Case reports, studies with animals, and reviews were excluded. In total, 4 studies were included, containing 713 cases of breast cancer. DATA COLLECTION: Data were extracted on clinicopathological characteristics and survival. A meta-analysis of the prevalence of AGR3 expression was performed according to the clinicopathological characteristics, hazard ratios (HRs), and overall survival and disease-free survival. DATA SYNTHESIS: The expression of AGR3 was found in 62% of the cases, and it was associated with histological grade II, positivity of estrogen and progesterone receptors, low expression of ki67, recurrence or distant metastasis, and lumen subtypes. In patients with low and intermediate histological grades, AGR3 expression was associated with worse overall survival (HR: 2.39; 95% confidence interval [95%CI]: 0.628-4.159; p = 0.008) and worse disease-free survival (HR: 3.856; 95%CI: 1.026-6.686; p = 0.008). CONCLUSION: The AGR3 protein may be a biomarker for the early detection of breast cancer and predict prognosis in luminal subtypes. In addition, in patients with low and intermediate histological grades, AGR3 protein expression may indicate an unfavorable prognosis in relation to survival.

OBJETIVO: Investigar o significado clinicopatológico e prognóstico da expressão da proteína anterior gradient 3 (AGR3) em mulheres com câncer de mama. FONTES DE DADOS: Utilizamos as bases de dados PubMed, CINAHL, EMBASE, Scopus e Web of Science para pesquisar estudos em inglês, sem restrições quanto ao ano de publicação. Os termos buscados foram: breast cancer AND anterior gradient 3 OR AGR3 expression. SELEçãO DOS ESTUDOS: Foram incluídos estudos observacionais ou intervencionais, estudos sobre a expressão da proteína AGR3 por imuno-histoquímica, e estudos sobre câncer de mama invasivo. Excluíram-se relatos de casos, estudos com animais e revisões. Quatro estudos foram selecionados, que continham 713 casos de câncer de mama. COLETA DE DADOS: Foram extraídos dados relativos a características clinicopatológicas e sobrevida. A metanálise da prevalência da expressão de AGR3 foi realizada conforme as características clinicopatológicas, razões de risco (RRs) e sobrevida global (SG) e sobrevida livre de doença (SLD). SíNTESE DOS DADOS: Encontrou-se expressão de AGR3 em 62% dos casos, que se associou com grau histológico II, positividade de receptores de estrogênio e progesterona, baixa expressão de ki67, recorrência ou metástase à distância e subtipos luminais. Em pacientes com graus histológicos baixo e intermediário, a expressão de AGR3 conferiu pior SG (RR: 2,39; intervalo de confiança de 95% [IC95%]: 0,628­4,159; p = 0,008) e pior SLD (RR: 3,856; IC95%: 1,026­6,686; p = 0,008). CONCLUSãO: A AGR3 pode ser um biomarcador para a detecção precoce do câncer de mama e predizer o prognóstico em subtipos luminais. Em graus histológicos baixo e intermediário, a expressão da proteína AGR3 pode indicar um prognóstico desfavorável em relação à sobrevida.

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Abstract Objective To investigate the clinicopathological significance and prognosis of the expression of the anterior gradient 3 (AGR3) protein in women with breast cancer. Data Sources The PubMed, CINAHL, EMBASE, Scopus, and Web of Science databases were searched for studies published in English and without restrictions regarding the year of publication. The search terms were: breast cancer AND anterior gradient 3 OR AGR3 expression. Study Selection We included observational or interventional studies, studies on AGR3 protein expression by immunohistochemistry, and studies on invasive breast cancer. Case reports, studies with animals, and reviews were excluded. In total, 4 studies were included, containing 713 cases of breast cancer. Data Collection Data were extracted on clinicopathological characteristics and survival. A meta-analysis of the prevalence of AGR3 expression was performed according to the clinicopathological characteristics, hazard ratios (HRs), and overall survival and disease-free survival. Data Synthesis The expression of AGR3 was found in 62% of the cases, and it was associated with histological grade II, positivity of estrogen and progesterone receptors, low expression of ki67, recurrence or distant metastasis, and lumen subtypes. In patients with low and intermediate histological grades, AGR3 expression was associated with worse overall survival (HR: 2.39; 95% confidence interval [95%CI]: 0.628-4.159; p= 0.008) and worse disease-free survival (HR: 3.856; 95%CI: 1.026-6.686; p= 0.008). Conclusion The AGR3 protein may be a biomarker for the early detection of breast cancer and predict prognosis in luminal subtypes. In addition, in patients with low and intermediate histological grades, AGR3 protein expression may indicate an unfavorable prognosis in relation to survival.

Resumo Objetivo Investigar o significado clinicopatológico e prognóstico da expressão da proteína anterior gradient 3 (AGR3) em mulheres com câncer de mama. Fontes de Dados Utilizamos as bases de dados PubMed, CINAHL, EMBASE, Scopus e Web of Science para pesquisar estudos em inglês, sem restrições quanto ao ano de publicação. Os termos buscados foram: breast cancer AND anterior gradient 3 OR AGR3 expression. Seleção dos Estudos Foram incluídos estudos observacionais ou intervencionais, estudos sobre a expressão da proteína AGR3 por imuno-histoquímica, e estudos sobre câncer de mama invasivo. Excluíram-se relatos de casos, estudos com animais e revisões. Quatro estudos foram selecionados, que continham 713 casos de câncer de mama. Coleta de Dados Foram extraídos dados relativos a características clinicopatológicas e sobrevida. A metanálise da prevalência da expressão de AGR3 foi realizada conforme as características clinicopatológicas, razões de risco (RRs) e sobrevida global (SG) e sobrevida livre de doença (SLD). Síntese dos Dados Encontrou-se expressão de AGR3 em 62% dos casos, que se associou com grau histológico II, positividade de receptores de estrogênio e progesterona, baixa expressão de ki67, recorrência ou metástase à distância e subtipos luminais. Em pacientes com graus histológicos baixo e intermediário, a expressão de AGR3 conferiu pior SG (RR: 2,39; intervalo de confiança de 95% [IC95%]: 0,628-4,159; p= 0,008) e pior SLD (RR: 3,856; IC95%: 1,026-6,686; p= 0,008). Conclusão A AGR3 pode ser um biomarcador para a detecção precoce do câncer de mama e predizer o prognóstico em subtipos luminais. Em graus histológicos baixo e intermediário, a expressão da proteína AGR3 pode indicar um prognóstico desfavorável em relação à sobrevida.

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ABSTRACT Spinal Muscular Atrophy (SMA) is a neurodegenerative disease that impairs motor function, justifying the help of a caregiver. This study aimed to analyze the impact of the motor function of individuals with SMA on caregiver burden. This is a cross-sectional study of 32 individuals with SMA and 27 caregivers, carried out in a rehabilitation center, using the identification questionnaire, anamnesis and sociodemographic profile, Motor Function Measurement Scale and Burden Interview. Motor function and caregiver burden were compared between SMA types using the analysis of covariance (ANCOVA) and correlated using Pearson's correlation test. Individuals with SMA type I had greater impairment of motor function when compared to types II and III, and individuals with type III had better scores in all domains of motor function. No correlation was observed between motor function and caregiver burden: however, most caregivers presented some level of burden, especially those from mild to moderate. Moderate to severe burden was found in caregivers with SMA in a considerable prevalence, which requires care and attention from health professionals.

RESUMEN La atrofia muscular espinal (AME) es una enfermedad neurodegenerativa que provoca un deterioro de la función motora, por lo que requiere la asistencia de cuidadores. El objetivo de este estudio fue analizar el impacto de la función motora de los individuos con AME en la carga de sus cuidadores. Se trata de un estudio transversal, realizado en un centro de rehabilitación con 32 individuos con AME y 27 cuidadores, utilizando como metodología el cuestionario de identificación, anamnesis y perfil sociodemográfico, la escala de medida de la función motora y la entrevista de carga. La función motora y la carga de los cuidadores se compararon entre los tipos de AME mediante el análisis de covarianza (Ancova) y se correlacionaron mediante la prueba de correlación de Pearson. Los individuos con AME tipo I tuvieron un mayor deterioro de la función motora en comparación con los tipos II y III, y los individuos de tipo III obtuvieron mejores puntuaciones en todos los dominios de la función motora. No se encontró correlación entre la función motora y la carga del cuidador, pero la mayoría de los cuidadores tenían algún nivel de carga, en particular de leve a moderada. Se encontró una carga de moderada a grave en los cuidadores con AME con una prevalencia considerable, lo que requiere cuidados y atención por parte de los profesionales de la salud.

RESUMO Atrofia muscular espinhal (AME) é uma doença neurodegenerativa que provoca comprometimento na função motora, justificando o auxílio de cuidador. O objetivo deste estudo foi analisar o impacto da função motora de indivíduos com AME na sobrecarga de seus cuidadores. Trata-se de um estudo transversal realizado em um centro de reabilitação com 32 indivíduos portadores de AME e 27 cuidadores, utilizando como metodologia o questionário de identificação, anamnese e perfil sociodemográfico, a escala da medida da função motora e Burden Interview. A função motora e a sobrecarga do cuidador foram comparadas entre os tipos de AME por meio da Análise da Covariância (Ancova) e correlacionadas pelo teste de correlação de Pearson. Os indivíduos com AME tipo I apresentaram maior comprometimento da função motora quando comparado entre os tipos II e III, e indivíduos tipo III apresentaram melhores escores em todos os domínios da função motora. Não foi percebida correlação entre função motora e sobrecarga de cuidador, entretanto encontramos a maior parte dos cuidadores apresentando algum nível de sobrecarga, com destaque ao de leve a moderado. A sobrecarga moderada a severa foi encontrada nos cuidadores com AME em uma prevalência considerável, o que requer cuidado e atenção dos profissionais de saúde.

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Congenital microcephaly is caused by a multitude of drivers affecting maternal−fetal health during pregnancy. It is a rare outcome in high-income industrial countries where microcephaly rates are in the range of 0.3−0.9 per 1000 newborns. Prevalence of microcephaly varies considerably across developing countries and can go as high as 58 cases per 1000 live births in pregnancies exposed to infection by Zika virus (ZIKV). Not only ZIKV-infected pregnancies, but other drivers can modulate the occurrence and severity of this outcome. Here, we sought to test the ZIKV−microcephaly association vs. competing hypotheses using a meta-analysis with 8341 microcephaly cases pooled from 10,250,994 newborns in the Americas, Africa, and Asia. Analysis of risk ratios (RR) showed teratogens the most likely microcephaly-associated risk factor (RR = 3.43; 95%-CI 2.69−4.38; p-value < 0.0001), while the statistical significance of the ZIKV−microcephaly association was marginal (RR = 2.12; 95%-CI 1.01−4.48; p-value = 0.048). Other congenital infections showed strong but variable associations with microcephaly (RR = 15.24; 95%-CI 1.74−133.70; p-value = 0.014). Microcephaly cases were associated with impoverished socioeconomic settings, but this association was statistically non-significant (RR = 2.75; 95%-CI 0.55−13.78; p-value = 0.22). The marginal ZIKV−microcephaly association and statistical significance of the competing hypotheses suggest maternal ZIKV infection might not be a cause of microcephaly alone.

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This study aimed to investigate the effects of Malay apple (MA) on the glycaemic response, lipid metabolism and liver health of rats fed a normal- or high-fat diet. Male Wistar rats were initially randomized into two groups: normal-fat diet (NF, n = 16) and high-fat diet (HF, n = 16) for three weeks. Then, they were subdivided into: normal-fat diet (NF, n = 8); normal-fat diet supplemented with MA (NFMA, n = 8); high-fat diet (HF, n = 8); high-fat diet supplemented with MA (HFMA, n = 8), continuing for another three weeks with their respective diets. Simultaneously, the supplemented groups received MA (400 mg/kg body weight) via gavage. MA contains anthocyanins (26.59 mg/100 g), catechin (2.55 ± 0.33 mg/100 g) and gallic acid (1.07 ± 0.20 mg/100 g) as the main phenolics. MA had a low-key effect on insulin and glucose tolerance, however decreased serum lipids and protected the liver from steatosis induced by the high-fat diet. HFMA rats showed changes in the fatty acid composition of the liver and faeces and decreased liver cholesterol levels (20.5%); as well as increased faecal excretion of fat (98%), cholesterol (10.5%) and bile acids (42.2%) when comparing to HF. MA supplementation reduced food and fat intake in HFMA in the last two weeks of the experiment, which may also have influenced these results. Our results suggest that MA was not able to improve glycaemic parameters, however, had hepatoprotective effect and minimizes changes in lipid metabolism caused by high-fat diet intake, which can relate mainly to the phenolic compounds present in this fruit.

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A series of coumarin derivatives and isosteres were synthesized from the reaction of triflic intermediates with phenylboronic acids, terminal alkynes, and organozinc compounds through palladium-catalyzed cross-coupling reactions. The in vitro cytotoxic effect of the compounds was evaluated against two non-small cell lung carcinoma (NSCLC) cell lines (A-549 and H2170) and a normal cell line (NIH-3T3) using cisplatin as a reference drug. Additionally, the effects of the most promising coumarin derivative (9f) in reversing the epithelial-to-mesenchymal transition (EMT) in IL-1ß-stimulated A549 cells and in inhibiting the EMT-associated migratory ability in A549 cells were also evaluated. 9f had the greatest cytotoxic effect (CC50 = 7.1 ± 0.8 and 3.3 ± 0.5 µM, respectively against A549 and H2170 cells) and CC50 value of 25.8 µM for NIH-3T3 cells. 9f inhibited the IL-1ß-induced EMT in epithelial cells by inhibiting the F-actin reorganization, attenuating changes in the actin cytoskeleton reorganization, and downregulating vimentin in A549 cells stimulated by IL-1ß. Treatment of A549 cells with 9f at 7 µM for 24 h significantly reduced the migration of IL-1ß-stimulated cells, which is a phenomenon confirmed by qualitative assessment of the wound closure. Taken together, our findings suggest that coumarin derivatives, especially compound 9f, may become a promising candidate for lung cancer therapy, especially in lung cancer promoted by NSCLC cell lines.

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Although gastroschisis is often diagnosed by prenatal ultrasound, there is still a gap in the literature about which prenatal ultrasound markers can predict complex gastroschisis. This systematic review and meta-analysis aimed to investigate the ultrasound markers that characterize complex gastroschisis. A systematic review of the literature was conducted according to the guidelines of PRISMA. The protocol was registered (PROSPERO ID CRD42020211685). Meta-analysis was displayed graphically on Forest plots, which estimate prevalence rates and risk ratios, with 95% confidence intervals, using STATA version 15.0. The combined prevalence of intestinal complications in fetuses with complex gastroschisis was 27.0%, with a higher prevalence of atresia (about 48%), followed by necrosis (about 25%). The prevalence of deaths in newborns with complex gastroschisis was 15.0%. The predictive ultrasound markers for complex gastroschisis were intraabdominal bowel dilatation (IABD) (RR 3.01, 95% CI 2.22 to 4.07; I2 = 15.7%), extra-abdominal bowel dilatation (EABD) (RR 1.55, 95% CI 1.01 to 2.39; I2 = 77.1%), and polyhydramnios (RR 3.81, 95% CI 2.09 to 6.95; I2 = 0.0%). This review identified that IABD, EABD, and polyhydramnios were considered predictive ultrasound markers for complex gastroschisis. However, evidence regarding gestational age at the time of diagnosis is needed.

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Rheumatoid arthritis, arthrosis and gout, among other chronic inflammatory diseases are public health problems and represent major therapeutic challenges. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most prescribed clinical treatments, despite their severe side effects and their exclusive action in improving symptoms, without effectively promoting the cure. However, recent advances in the fields of pharmacology, medicinal chemistry, and chemoinformatics have provided valuable information and opportunities for development of new anti-inflammatory drug candidates. For drug design and discovery, thiophene derivatives are privileged structures. Thiophene-based compounds, like the commercial drugs Tinoridine and Tiaprofenic acid, are known for their anti-inflammatory properties. The present review provides an update on the role of thiophene-based derivatives in inflammation. Studies on mechanisms of action, interactions with receptors (especially against cyclooxygenase (COX) and lipoxygenase (LOX)), and structure-activity relationships are also presented and discussed. The results demonstrate the importance of thiophene-based compounds as privileged structures for the design and discovery of novel anti-inflammatory agents. The studies reveal important structural characteristics. The presence of carboxylic acids, esters, amines, and amides, as well as methyl and methoxy groups, has been frequently described, and highlights the importance of these groups for anti-inflammatory activity and biological target recognition, especially for inhibition of COX and LOX enzymes.

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O objetivo do estudo foi verificar a influência do estímulo visual e posicionamento dos membros superiores no controle postural ortostático e avaliar o efeito do sexo e idade nas respostas posturais de crianças e adolescentes. Estudo transversal, com amostra de 84 participantes com idade entre 11 e 14 anos, ambos os sexos (55 meninas), de escola pública de Goiânia (GO). Além do exame físico, o controle postural foi avaliado na posição ortostática pela baropodometria computadorizada em três condições: olhos abertos, olhos fechados e olhos abertos com ombros a 90° de abdução. A ausência do estímulo visual gerou maior instabilidade postural em comparação à condição de olhos abertos. Em relação as diferenças existentes entre os sexos, foi observado que as meninas tiveram menores valores de deslocamento anteroposterior e área da elipse que os meninos. Comparando-se os olhos abertos e fechados, as meninas apresentaram maiores valores na área da elipse e os meninos nos deslocamentos anteroposterior e látero-lateral. Ao analisar o efeito da idade foi observado que o grupo com 13 e 14 anos apresentou maiores valores em todas as variáveis analisadas. A ausência do estímulo visual aumentou os valores da área da elipse no grupo com 11 e 12 e dos deslocamentos no grupo com 13 e 14 anos. Não foi verificado efeito interativo entre sexo e idade. Na condição de abdução dos membros superiores não houve diferença no controle postural. Conclui-se que a ausência do estímulo visual foi mais impactante na manutenção do controle postural ortostático em crianças e adolescentes em relação as outras condições avaliadas, existindo diferença entre os sexos e a idade, em que os meninos e o grupo com 13 e 14 anos realizaram mais ajustes para manter o controle postural. (AU)

The aim of this study was to verify the influence of visual stimulus and positioning of the upper limbs in the orthostatic postural control, and to assess the effects of gender and age in the postural responses of children and adolescents. This was a transversal study involving 84 participants (of which 55 were girls) from public schools in Goiania (GO - Brazil) with age between 11 and 14 years. Besides physical examination, the participants' postural control was assessed in the orthostatic position by computerized baropodometry in three different conditions: eyes-open, eyes-closed, and eyes-open with shoulders at 90º abduction. The absence of visual stimulus generated more postural instability in relation to the eyes-open condition. Regarding gender differences, the girls had lower anteroposterior and ellipse area displacement than boys. Comparing the eyes-open and eyes-closed conditions, the girls presented higher values in the ellipse area and the boys presented higher values in the anteroposterior and laterolateral displacements. Analyzing the effect of age, the participants between 13 and 14 years old presented higher values in all variables. The absence of visual stimulus increased the values of the ellipse area in the participants between 11 and 12 years of age and the values of displacements in the participants between 13 and 14 years of age. Interactive effect between genders and age has not been verified. There were no postural control differences in the upper limbs abduction condition. Conclusion: The absence of visual stimulus was more impacting in the support of orthostatic postural control in children and adolescents than the other conditions assessed; the boys and the participants between 13 and 14 years of age made more adjustments in order to maintain postural control. (AU)

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RESUMO O objetivo deste estudo foi avaliar o perfil de formação e produção científica do fisioterapeuta pesquisador brasileiro. Trata-se de um estudo transversal, realizado por meio de levantamento dos currículos profissionais cadastrados na Plataforma Lattes do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), atualizados nos últimos 5 anos. As principais variáveis analisadas foram sexo, distribuição dos fisioterapeutas pelo Brasil, tipo de instituição de graduação, local de atuação, formação complementar, produções científicas e participação em eventos. Foram encontrados 47.741 currículos, dos quais 17.864 estavam dentro dos critérios de seleção da pesquisa e foram analisados. Predominaram fisioterapeutas do sexo feminino (75,5%) e da região Sudeste (35%). A maioria é graduada em instituições privadas (75%), realizou pós-graduação lato sensu (61,4%) e trabalhou em universidades (30%). Existem diferenças entre os sexos com relação às produções, os eventos e a formação complementar, com o melhor desempenho do sexo masculino (p<0,001) - os graduados em instituição pública têm mais produções, eventos e atividades de formação complementar (p<0,001). Os profissionais graduados em instituições privadas, porém, realizam mais cursos de pós-graduação lato sensu (p=0,05). Conclui-se, portanto, que a maioria dos fisioterapeutas pesquisadores do Brasil é do sexo feminino, graduada na região Sudeste, formada em instituições privadas, realizou pós-graduação lato sensu e trabalha em universidades. Apesar da maioria feminina, os profissionais do sexo masculino e os formados em instituições públicas apresentam maior quantidade de produções, participações em eventos e formações complementares.

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ABSTRACT To evaluate the academic background and scientific productions' profile of researcher physiotherapists in Brazil. The study was cross-sectional in design and performed by analyzing the professional resumes that have been updated within the last 5 years in the Lattes Platform of the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq). The main variables analyzed were sex, geographical distribution, kind of undergraduate institution, working location, complementary training, scientific production, and participation in events. The analysis was carried out on 17,864 curricula which were within the selection criteria, out of a total of 47,741. There was a predominance of female therapists (75.5%) and therapists from the southeast region (35%). Most have completed their undergraduate degree in private institutions (75%) and graduate programs (61.4%), and work at universities (30%). Males perform better (p<0.001) in scientific productions, participation in events, and complementary training activities. Graduates from public institutions have more scientific productions, events, and complementary training activities (p<0.001). However, professionals that have completed their undergraduate degree in private institutions do graduate programs the most (p=0.05). Most researcher physical therapists in Brazil are females, have completed their undergraduate degrees in the Southeast region and in private institutions, have completed graduate programs and work in universities. Despite the female predominance, male professionals and those therapists who have completed their undergraduate degree from public institutions have a greater amount of scientific productions, participation in events and complementary degrees.

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This is a case of medulloepithelioma in a 14-year-old mixed breed gelding horse, presenting a large abnormal mass of tissue involving the entire extension of the right eye. Ophthalmic examination showed deformation and swelling of the eye. The animal showed signs of pain on palpation of the organ, but the specific examination of the systems did not reveal any other changes. Due to the extension of the apparently neoplastic mass and the discomfort experienced by the animal, transpalpebral enucleation procedure was decided. The excised tissue was sent for histopathological analysis, wherein a neoplastic proliferation of neuroectodermal cells was noted. The neoplasm was poorly delimited, unencapsulated, infiltrative, sustained by moderate fibrovascular stroma, and formed cords and rosettes with cells arranged in palisades around the luminal structures (Flexner-Wintersteiner rosettes), suggestive of medulloepithelioma. The immunohistochemical profile was also performed, confirming the diagnosis. The neoplastic cells were immunolabeled to vimentin, S100 protein (S100), and specific neuro enolase (NSE), but not for pan cytokeratin (AE1AE3), glial fibrillary acidic protein (GFAP), and cytokeratin 8/18 (CK8/18). Five months postoperatively, the animal was healthy, without any relapse or evidence of metastasis.(AU)

Esse é um caso de meduloepitelioma em um equino sem raça definida, castrado, de 14 anos de idade, que chegou ao atendimento apresentando grande massa de tecido envolvendo toda a extensão do olho direito. No exame oftálmico, foi observada deformação e aumento de volume ocular. O animal manifestou sinais de dor na palpação do órgão, mas o exame específico dos sistemas não revelou demais alterações. Devido à extensão da massa aparentemente neoplásica e o desconforto experimentado pelo equino foi decidida a realização da enucleação transpalpebral. O tecido excisado foi enviado para exame histopatológico, no qual observou-se proliferação neoplásica de células neuroectodérmicas, de forma mal delimitada, não encapsulada, infiltrativa, sustentada por estroma fibrovascular moderado, e formação de cordões e rosetas, com células dispostas em paliçadas ao redor de estruturas luminais (rosetas de Flexner-Wintersteiner), sugestivo de meduloepitelioma. O perfil imunohistoquímico também foi realizado, confirmando o diagnóstico. As células neoplásicas foram imunomarcadas para vimentina, proteína S100 (S100) e neuro enolase específica (NSE), mas não para pan citoqueratina (AE1AE3), proteína glial fibrilar ácida (GFAP) e citoqueratina 8/18 (CK8 / 18). Após cinco meses da realização do procedimento cirúrgico o animal apresentava-se saudável, sem recidiva ou evidência de metástase.(AU)

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OBJECTIVE: To analyze the frequency, profile, and additional variables associated with the prescription of potentially inappropriate medications (PIM) to older adults in primary care, and evaluate physicians' knowledge about these medications. METHODS: A cross-sectional study was conducted based on data from patient records for the period of January 2014 to December 2017 in a city located in the state of Minas Gerais. The frequency of PIM use was evaluated based on the 2019 Beers-Fick criteria. Physician knowledge was evaluated using a validated questionnaire as a primary data source. RESULTS: In a sample of 423 older adults, 75.89% (n = 321) used at least one PIM, the most common of which were medications used to treat central nervous system disorders (48.00%; n = 203). Most participants were female (62.41%; n = 264) and 70 years or older (69.50%; n = 294). When presented with clinical cases illustrating common situations in the management of older patients, 53.33% of physicians (n = 8) answered four or five questions correctly out of a possible seven; 13.33% (n = 2) answered six questions correctly; and 33.33% (n = 5) obtained three correct answers or fewer. CONCLUSIONS: These findings showed a high frequency of PIM use among older adults treated in Primary Health Care settings, with medications used in the treatment of central nervous system disorders. Our results highlight the importance of continuing education for health professionals and improved assessments of the medication available in the Unified Health System (Sistema Único de Saúde; SUS) for use in older adults, especially those taking multiple medications.

OBJETIVOS: Analisar a frequência, o perfil e os fatores associados à prescrição de medicamentos potencialmente inapropriados (MPI) aos idosos na Atenção Primária à Saúde, além de avaliar o conhecimento dos médicos sobre esses medicamentos. METODOLOGIA: Trata-se de um estudo transversal, cujas informações foram coletadas de prontuários dos pacientes, referentes ao período de janeiro de 2014 a dezembro de 2017, em um município localizado no estado de Minas Gerais. Para análise da frequência de uso de MPI, utilizou-se o critério Beers-Fick de 2019. Para avaliação do conhecimento médico, utilizou-se uma fonte primária de informação, um questionário validado. RESULTADOS: Dos 423 idosos, 75,89% (n=321) utilizavam pelo menos um MPI e a classe mais utilizada foi do sistema nervoso central (48,00%; n=203). Houve maior prevalência no sexo feminino (62,41%; n=264) e em idosos com idade ≥70 anos (69,50%; n=294). Em relação aos casos clínicos apresentados para avaliar o conhecimento dos médicos referentes às situações comuns no cuidado à saúde do idoso, 53,33% (n=8) acertaram quatro ou cinco questões das sete existentes, enquanto 13,33% (n=2) responderam corretamente a seis perguntas e 33,33% (n=5) obtiveram três ou menos acertos. CONCLUSÕES: Os resultados evidenciaram alta taxa de prescrição de MPI entre os idosos da Atenção Primária à Saúde, destacando-se os medicamentos que são destinados ao tratamento de doenças do sistema nervoso central. Ressalta-se a importância da educação continuada desses profissionais de saúde e a melhor avaliação de medicamentos incorporados ao Sistema Único de Saúde (SUS) e destinados à população geriátrica, sobretudo o idoso polimedicado.

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ABSTRACT: This is a case of medulloepithelioma in a 14-year-old mixed breed gelding horse, presenting a large abnormal mass of tissue involving the entire extension of the right eye. Ophthalmic examination showed deformation and swelling of the eye. The animal showed signs of pain on palpation of the organ, but the specific examination of the systems did not reveal any other changes. Due to the extension of the apparently neoplastic mass and the discomfort experienced by the animal, transpalpebral enucleation procedure was decided. The excised tissue was sent for histopathological analysis, wherein a neoplastic proliferation of neuroectodermal cells was noted. The neoplasm was poorly delimited, unencapsulated, infiltrative, sustained by moderate fibrovascular stroma, and formed cords and rosettes with cells arranged in palisades around the luminal structures (Flexner-Wintersteiner rosettes), suggestive of medulloepithelioma. The immunohistochemical profile was also performed, confirming the diagnosis. The neoplastic cells were immunolabeled to vimentin, S100 protein (S100), and specific neuro enolase (NSE), but not for pan cytokeratin (AE1AE3), glial fibrillary acidic protein (GFAP), and cytokeratin 8/18 (CK8/18). Five months postoperatively, the animal was healthy, without any relapse or evidence of metastasis.

RESUMO: Esse é um caso de meduloepitelioma em um equino sem raça definida, castrado, de 14 anos de idade, que chegou ao atendimento apresentando grande massa de tecido envolvendo toda a extensão do olho direito. No exame oftálmico, foi observada deformação e aumento de volume ocular. O animal manifestou sinais de dor na palpação do órgão, mas o exame específico dos sistemas não revelou demais alterações. Devido à extensão da massa aparentemente neoplásica e o desconforto experimentado pelo equino foi decidida a realização da enucleação transpalpebral. O tecido excisado foi enviado para exame histopatológico, no qual observou-se proliferação neoplásica de células neuroectodérmicas, de forma mal delimitada, não encapsulada, infiltrativa, sustentada por estroma fibrovascular moderado, e formação de cordões e rosetas, com células dispostas em paliçadas ao redor de estruturas luminais (rosetas de Flexner-Wintersteiner), sugestivo de meduloepitelioma. O perfil imunohistoquímico também foi realizado, confirmando o diagnóstico. As células neoplásicas foram imunomarcadas para vimentina, proteína S100 (S100) e neuro enolase específica (NSE), mas não para pan citoqueratina (AE1AE3), proteína glial fibrilar ácida (GFAP) e citoqueratina 8/18 (CK8 / 18). Após cinco meses da realização do procedimento cirúrgico o animal apresentava-se saudável, sem recidiva ou evidência de metástase.

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INTRODUCTION AND OBJECTIVES: The incidence of Postoperative Nausea and Vomiting (PONV) after video cholecystectomy is high. Progress in pharmacological PONV prophylaxis includes a new generation of 5-HT3 antagonists. This study aims to assess the effect of the 5-HT3 antagonist in postanesthetic antiemetic management of patients submitted to laparoscopic cholecystectomy with total intravenous anesthesia. METHODS: Sixty individuals who underwent video cholecystectomy were randomized into three groups of 20 individuals according to the treatment administered: 0.125 mg of palonosetron (Group 1); 4 mg of ondansetron associated with 4 mg of dexamethasone (Group 2); 4 mg of dexamethasone (Group 3). General intravenous anesthesia was performed with propofol, remifentanil and rocuronium. The group to which the participant belonged was concealed from the investigator who assessed drug effect. PONV was assessed using the Rhodes Scale at 12 and 24 hours after surgery. Rescue medication was 0.655 to 1.5 mg of droperidol. RESULTS: Group 1 presented a lower incidence of PONV and required less rescue medication in the first postoperative hour. There was no significant difference among the three groups regarding PONV incidence in the first 12 postoperative hours. Groups 1 and 2 were superior to Group 3 regarding the control of PONV from 12 to 24 hours, and after rescue medication from 12 to 24 hours. Group 1 showed significantly superior nausea control in the first 12 postoperative hours. CONCLUSIONS: The present study showed evidence that palonosetron is superior to the drugs compared regarding a protracted antiemetic effect and less requirement of rescue drugs, mainly related to its ability to completely inhibit the uncomfortable symptom of nausea.

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Abstract Introduction and objectives: The incidence of Postoperative Nausea and Vomiting (PONV) after video cholecystectomy is high. Progress in pharmacological PONV prophylaxis includes a new generation of 5-HT3 antagonists. This study aims to assess the effect of the 5-HT3 antagonist in postanesthetic antiemetic management of patients submitted to laparoscopic cholecystectomy with total intravenous anesthesia. Methods: Sixty individuals who underwent video cholecystectomy were randomized into three groups of 20 individuals according to the treatment administered: 0.125 mg of palonosetron (Group 1); 4 mg of ondansetron associated with 4 mg of dexamethasone (Group 2); 4 mg of dexamethasone (Group 3). General intravenous anesthesia was performed with propofol, remifentanil and rocuronium. The group to which the participant belonged was concealed from the investigator who assessed drug effect. PONV was assessed using the Rhodes Scale at 12 and 24 hours after surgery. Rescue medication was 0.655 to 1.5 mg of droperidol. Results: Group 1 presented a lower incidence of PONV and required less rescue medication in the first postoperative hour. There was no significant difference among the three groups regarding PONV incidence in the first 12 postoperative hours. Groups 1 and 2 were superior to Group 3 regarding the control of PONV from 12 to 24 hours, and after rescue medication from 12 to 24 hours. Group 1 showed significantly superior nausea control in the first 12 postoperative hours. Conclusions: The present study showed evidence that palonosetron is superior to the drugs compared regarding a protracted antiemetic effect and less requirement of rescue drugs, mainly related to its ability to completely inhibit the uncomfortable symptom of nausea.

Resumo Justificativa e objetivo: Náuseas e Vômitos no Pós-Operatório (NVPO) têm alta incidência após videocolecistectomia. Avanços na profilaxia farmacológica de NVPO incluem a nova geração de antagonista 5-HT3. O objetivo deste estudo foi avaliar o efeito do antagonista 5-HT3 no controle antiemético pós-anestésico em videocolecistectomia com anestesia venosa total. Método: Estudo realizado no HC-UFU (Hospital Terciário). Sessenta indivíduos submetidos a videocolecistectomia foram randomizados em três grupos de igual número, sendo administrados 0,125 mg de palonosetrona (Grupo 1); 4 mg de ondasetrona e 4 mg de dexametasona (Grupo 2); ou 4 mg de dexametasona (Grupo 3). A anestesia geral venosa foi realizada com propofol, remifentanil e rocurônio. O avaliador do efeito da droga desconhecia o grupo ao qual o indivíduo pertencia. NVPO foi avaliada aplicando a Escala de Rhodes após 12 e 24 horas do término da cirurgia. Para resgate terapêutico, foi estabelecido 0,655−1,5 mg de droperidol. Resultado: Observou-se no Grupo 1 menor incidência de NVPO e de resgate terapêutico na primeira hora de PO. Não foi observada diferença significativa entre os três grupos com relação a ocorrência de NVPO nas primeiras 12 horas de pós-operatório. Os grupos 1 e 2 foram superiores ao Grupo 3 no que se refere ao controle de NVPO de 12 a 24 horas e após o resgate de 12−24 horas. Observou-se que o controle de náuseas nas primeiras 12 horas de pós-operatório do Grupo 1 foi significantemente superior. Conclusão: O presente estudo mostrou evidências da superioridade da palonosetrona às demais drogas empregadas no que se refere ao efeito antiemético prolongado e menor necessidade de resgate, principalmente na capacidade de inibir completamente o desconfortável sintoma de náusea.

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AIMS: Verify the presence of the single nucleotide polymorphisms rs1800012 of the collagen I (COL1A1) and rs1800255 of the collagen III (COL3A1) genes and their association with pelvic organ prolapse (POP) in Brazilian women and to determine risk factors for POP. METHODS: We assessed 826 postmenopausal women divided into POP (stages III and IV) and control groups (stages 0 and I) by examination and peripheral blood sample collection. DNA sequences of interest were analyzed by real-time reverse-transcriptase polymerase chain reaction. We used logistic regression analyses, recessive and codominance models of inheritance, and P < .05 for significance. RESULTS: Six-hundred and thirty-four postmenopausal women were included: 348 (54.8%) POP cases and 286 (45.1%) controls. The frequencies of GG, GA, and AA genotypes for COL1A1 were 69.12%, 20.24%, and 10.59% in POP group and 71.79%, 20%, and 8.21% in controls; GG, GT, and TT for COL3A1 were 37.54%, 59.53%, and 2.93% in POP group and 36.24%, 60.14%, and 3.62% in controls. There were no genotypic or allelic association with POP phenotype that link both SNPs rs1800012 and rs1800255 to increased risk of POP. Vaginal delivery (odds ratio [OR] = 13; 95% confidence interval [CI] [4.00-47.08]), POP family history (OR = 3.1; 95% CI [1.49-6.50]), diabetes mellitus (OR = 2.3; 95% CI [1.08-5.21]), number of pregnancies (OR = 1.2; 95% CI [1.05-1.36]), and age (OR = 1.1; 95% CI [1.09-1.19]), were variables of increased risk for POP (P < .05 for all). CONCLUSION: Our study suggests lack of association between DNA polymorphisms rs1800012 of COL1A1 and rs1800255 of COL3A1 with advanced POP. Vaginal delivery, POP family history, diabetes mellitus, number of pregnancies, and age are risk factors for POP.

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This study aimed to verify the action of edible chitosan-citric acid (CHI-CA) coating to control Colletotrichum gloeosporioides and maintain quality parameters of fresh-cut guava. Chitosan was obtained from Litopenaeus vannamei shells using high temperature and short exposure times. The minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC) of CHI-CA against C. gloeosporioides were determined by macrodilutions at 28 °C/120 h in the absence/presence of CHI-CA (0-10 mg/mL). Scanning electron microscopy was used to evaluate morphological changes in the fungus. Guava slices were coated with CHI-CA (MIC) or 5 mg/mL glycerol (control). Rot incidence and physicochemical, physical, and microbiological factors were determined at 0, 3, 7, and 14 days at 24 °C and 4 °C. Chitosan presented typical structural characterization, 64% deacetylation, and a molecular weight of 1.6 × 104 g/mol. CHI-CA exhibited MIC and MFC values of 5 mg/mL and 10 mg/mL, respectively, and promoted changes in the morphology and cell surface of fungal spores. The fresh-cut guava coated with CHI-CA maintained quality parameters during storage and preserved their sensorial characteristics. Therefore, the use of CHI-CA as a coating is a promising strategy for improving postharvest quality of fresh-cut fruits.

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OBJECTIVE: To evaluate the frequency of structural congenital anomalies (CAs) in the midwest of Brazil and its association with maternal risk factors. METHODS: This was a prospective, observational, case-control study based on a hospital population. Pregnant women attended at a fetal medicine service in Brazil were analyzed in the period from October 2014 to February 2016.A total of 357 pregnant women were included, 223 of whom had fetuses with structural anomalies (group case), and 134 of whom had structurally normal fetuses (control group). The clinical history was made previous to prenatal consultation, and the diagnosis of the structural CA was performed through ultrasound. RESULTS: A frequency of 64.27% (n = 223) of pregnant women with fetuses with structural anomalies was observed. The most frequent structural CAs were those of the central nervous system (30.94%), followed by anomalies of the genitourinary system (23.80%), and, finally, by multiple CAs (16.60%). The background of previous children with CAs (odds ratio [OR]: 3.85; p = 0.022), family history (OR: 6.03; p = < 0.001), and consanguinity between the progenitors (OR: 4.43; p = 0.034) influenced the occurrence of structural CA. CONCLUSION: The most frequent CAs are those of the central nervous system, followed by those of the genitourinary system, and then multiple anomalies. The maternal risk factors that may have influenced the occurrence of structural CA were previous children with CA, family history, and consanguinity among the parents.

OBJETIVO: Avaliar a frequência de anomalias congênitas (ACs) estruturais no centro-oeste brasileiro e a associação com fatores de risco maternos. MéTODOS: Estudo prospectivo, observacional, caso-controle, baseado em uma população hospitalar. Foram analisadas gestantes atendidas em um serviço de medicina fetal no Brasil, no período de outubro de 2014 a fevereiro de 2016. Foram analisadas 357 gestantes, dentre as quais 223 tiveram fetos com ACs estruturais (grupo controle) e 134 tiveram fetos estruturalmente normais (grupo controle). A história clínica foi feita antes da consulta de pré-natal, e o diagnóstico da AC estrutural foi realizado por ultrassonografia. RESULTADOS: Observou-se uma frequência de 64,27% (n = 223) de gestantes com fetos com ACs estruturais. As ACs estruturais mais frequentes foram as do sistema nervoso central (30,94%), seguidas das anomalias do sistema gênito-urinário (23,80%), e, por fim, das ACs múltiplas (16,60%). Antecedentes de crianças com AC (razão de probabiliade [RP]: 3,85; p = 0,022), antecedentes familiares (RP: 6,03; p = < 0,001), e consanguinidade entre os grupos progenitores (RP: 4,43; p = 0,034) influenciaram a ocorrência de AC estrutural. CONCLUSãO: As ACs mais frequentes foram as do sistema nervoso central, as do sistema gênito-urinário, e as ACs múltiplas. Os fatores de risco maternos que podem ter influenciado a ocorrência de AC estrutural foram antecedentes de crianças com AC, história familiar, e a consanguinidade entre os pais.

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