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ABSTRACT Objective: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0-12 years during the strict period of social isolation. Methods: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. Results: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60-3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17-2.24); social distancing considered as "easy" (OR 1.67; 95%CI 1.20-2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08-3.45). Conclusions: This study indicates that the family context can influence children's QOL, especially during the COVID-19 pandemic and home environment reorganization.
RESUMO Objetivo: Investigar os fatores contextuais associados à qualidade de vida (QV) de crianças brasileiras de zero a 12 anos, em momento de ápice de distanciamento social. Métodos: Estudo observacional, transversal, online, de julho a setembro de 2020, com questionário sobre fatores do contexto familiar associados à QV e Inventário Pediátrico sobre QV — PedsQL™. A análise dos dados foi feita por de regressão logística multinomial. Resultados: A amostra foi de 849 crianças, na maioria da Região Sul (75%), brancas (83%), com desenvolvimento típico (79%), sedentárias (68%), com uso de telas (85%) em tempo >3h/dia (44%). As mães eram as cuidadoras principais (90%). Foram significativamente associadas a escores mais elevados de QV: a condição de saúde típica (odds ratio — OR 2,38; intervalo de confiança de 95% — IC95% 1,60-3,55), o tempo de tela ≤2h/dia (OR 1,62; IC95% 1,17-2,24), o distanciamento social considerado "fácil" (OR 1,67; IC95% 1,20-2,32) e a família afirmar estimular a criança (OR 1,93; IC95% 1,08-3,45). Conclusões: Este estudo mostra que o contexto familiar pode influenciar a QV de crianças, especialmente no período de pandemia e de reorganização do ambiente domiciliar.
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ABSTRACT Purpose: To describe the epidemiological and clinical profile of hospitalized patients with retinoblastoma in Brazil. Methods: Using data from the Hospital Cancer Registry of the Instituto Nacional de Câncer, patients with the morphological codes of retinoblastoma who were diagnosed between 2000 to 2018, aged 0-19 years, and followed up in registered hospitals (analytical cases) were selected. The relative and absolute frequencies of demographic, clinical, diagnostic, therapeutic, and outcome variables were described. Hospital performance indicators were calculated and compared between hospitals qualified and not qualified to treat pediatric oncology cases and between hospitals with different case volumes (<20, 20-75, >75 cases). Results: Of the 2,269 identified analytical cases from 86 institutions, 48% were from the Southeast, 54% were male, and 66% were aged <4 years. The proportion of missing data (NA) was too high for several variables. Approximately 84% of the patients were from the public health system, 40% had a positive family history, and 88% had unilateral involvement. The first treatment included surgery in 58.3% of the patients (NA=2), Approximately 36.6% of these patients achieved complete remission, 10.8% achieved partial remission, and 12.7% died (NA=59%). Hospital performance indicators were within the target in >90% of the patients. The median time between the first appointment and diagnosis (6 days, interquartile range [IQR] 1-14) was significantly lower and the median time to death was longer (343 days, IQR, 212-539) in high-volume hospitals (>75 cases) than in medium- and low-volume hospitals. Conclusions: Despite the high proportion of missing data, we found that the delay in diagnosis is due to prehospital factors. Additionally, there is a need for educational programs for healthcare professionals and families that emphasize early identification and referral to specialized centers. Future studies should focus on the impact of Hospital Cancer Registry data completeness on outcomes, causes of delay in diagnosis, regional inequalities, and barriers to accessing specialized services.
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The present study aimed to investigate the moderating effect of perceived punishment on the relationship between the Dark Triad personality traits and corruption in Brazil (N = 118) and the United Kingdom (N = 130). Participants answered the Dark Triad Dirty Dozen Scale, as well as measures of corruption and perceived punishment. It was found that punishment predicts corruption in both countries. Regarding the Dark Triad traits, a relationship between Machiavellianism and corruption was identified in Brazil and the United Kingdom, although an interaction with punishment was identified only in Brazil. Moreover, psychopathy had no relationship with corruption or punishment in either country. A direct relationship was found only in Brazil on narcissism, although the interaction term was significant in both countries. In general, it was identified that perceived punishment and the dark triad traits contribute to the understanding of corruption, despite some differences in the results between Brazil and the United Kingdom.
O presente estudo tem como objetivo investigar o papel moderador da percepção de punição na relação entre Tríade Sombria da personalidade e corrupção no Brasil (N = 118) e no Reino Unido (N = 130). Participantes responderam à Escala Dark Triad Dirty Dozen, bem como a medidas de corrupção e percepção de punição. Foi encontrado que a punição prediz a corrupção em ambos os países. Em relação à Tríade Sombria, o relacionamento entre maquiavelismo e corrupção foi identificado no Brasil e no Reino Unido, embora a interação com a punição tenha sido identificada apenas no Brasil. Adicionalmente, a psicopatia não teve relação com a corrupção ou com a punição em nenhum dos países. Um efeito direto do narcisismo foi encontrado apenas no Brasil, apesar do termo de interação ter sido significativo em ambos os países. De forma geral, foi identificado que a percepção de punição e a tríade sombria contribuíram com a compreensão da corrupção, apesar de algumas diferenças nos resultados entre Brasil e Reino Unido.
El presente estudio tuvo como objetivo investigar el efecto moderador del castigo percibido sobre la relación entre los rasgos de personalidad de la tríada oscura y la corrupción en Brasil (N = 118) y en el Reino Unido (N = 130). Los participantes respondieron a la Escala de la Docena Sucia de la Triada Oscura, así como a medidas de corrupción y castigo percibido. Se encontró que el castigo predice la corrupción en ambos países. En cuanto a los rasgos de la tríada oscura, se identificó una relación entre el maquiavelismo y la corrupción en Brasil y en el Reino Unido, aunque se identificó una interacción con el castigo solo en Brasil. Además, la psicopatía no tuvo relación con la corrupción o el castigo en ninguno de los dos países. Se encontró una relación directa solo en Brasil con el narcisismo, aunque la interacción fue significativa en ambos países. En general, se identificó que el castigo percibido y los rasgos de la tríada oscura contribuyen a la comprensión de la corrupción, a pesar de algunas diferencias en los resultados entre Brasil y el Reino Unido.
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The novel HLA-B*18:37:03 allele, first described in a potential bone marrow donor from Brazil.
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Alelos , Éxons , Humanos , Sequência de Bases , Transplante de Medula Óssea , Brasil , Teste de Histocompatibilidade , Antígeno HLA-B18/genética , Antígeno HLA-B18/imunologia , Alinhamento de Sequência , Análise de Sequência de DNA , Doadores de TecidosRESUMO
INTRODUCTION: Adolescents represent an important demographic percentage in the studied population and in Emergency Departments (ED). It is imperative that health professionals and services are prepared to address this population. This work aims to characterize adolescents at the ED of a Brazilian private tertiary hospital. METHODS: The study was an observational, retrospective longitudinal cohort that included 37,450 visits of patients aged 10 to 21 years of age, between January 2018 and June 2022 in the ED of a private tertiary hospital. The study evaluated the reason for the consultation, diagnosis, need for hospitalization, the medical professional responsible for the care, severity, and paying source of care. RESULTS: 53.7% were female. Mean age was 16.2y for girls and 15.6y for boys (p < 0.005). The most common complaints were flu-like symptoms (17.4%), sore throat (8.2%), fever (6.7%) and limb trauma (6.3%). Flu-like symptoms were the main consultations caused in all age groups and genders. 36.8% were attended by a general practitioner, 35.8% by a pediatrician, 15.1% by orthopedics and 5.6% by surgeons. The hospitalization rate was 5.5%. There was a strong correlation between age and hospitalization rate (correlation coefficient [r = 0.93]; p < 0.001). The most prevalent diagnoses in hospitalizations were acute abdomen (12.7%) and trauma (9.4%). 78.2% of the consultations were classified as "not urgent". There was a strong correlation between age and severity (r = 0.86; p < 0.001). 92.7% of the consultations were paid by medical insurance. CONCLUSION: In this study, flu-like symptoms were the single main reason for adolescents to search for immediate health care, in every age subgroup and gender, but represented a small risk for hospital admission. Limb trauma was more common in younger male teenagers. Acute abdominal pain and trauma were the most frequent causes of hospital admissions. There was a significant and strong correlation between age and both admission rate and severity.
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Serviço Hospitalar de Emergência , Hospitalização , Centros de Atenção Terciária , Humanos , Adolescente , Masculino , Feminino , Brasil/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos , Criança , Hospitalização/estatística & dados numéricos , Adulto Jovem , Hospitais Privados/estatística & dados numéricos , Estudos LongitudinaisRESUMO
We report acute Oropouche virus infections in 2 previously healthy women from a nonendemic region of Brazil outside the Amazon Basin. Infections rapidly progressed to hemorrhagic manifestations and fatal outcomes in 4-5 days. These cases highlight the critical need for enhanced surveillance to clarify epidemiology of this neglected disease.
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Infecções por Bunyaviridae , Orthobunyavirus , Humanos , Brasil/epidemiologia , Feminino , Infecções por Bunyaviridae/epidemiologia , Evolução Fatal , Adulto , Pessoa de Meia-IdadeRESUMO
To analyze the distribution and factors associated with lack of knowledge about the human papillomavirus (HPV) vaccine among Brazilian adolescents.Cross-sectional study using the 2019 National School Health Survey among 17,805 Brazilian students of public and private schools, aged 13-17 years. The outcome variable was "lack of knowledge about the HPV vaccine" and the explanatory variables were sociodemographic, behaviors, knowledge, and health conditions. Logistic regression model was used to calculate Odds Ratio (OR) and 95% confidence intervals (95%CI). Spatial analysis techniques were used to determine the formation of clusters in the federated units with similar proportions of adolescents who were unaware of the vaccine. The lack of knowledge about the HPV vaccine was reported by 45.54% of Brazilian students. There was a higher chance of lack of knowledge having had sexual intercourse (OR 1.43; 95% CI 1.20-1.70); attending public school (OR 1.72; 95%CI 1.47-2.02) and located in the Northeast Region (OR 1.35; 95%CI 1.08-1.69). The lower chance of lack of knowledge were female gender (OR 0.41; 95% CI 0.35-0.48), higher maternal education (OR 0.62; 95% CI 0.50-0.77) self-rated health as Poor/very poor (OR 0.64; 95% CI 0.49-0.86) and receiving contraceptive counseling (OR 0.77; 95% CI 0.65-0.91). The proportion of lack of knowledge about the HPV vaccine was higher with the formation of High-High spatial clusters in the states of Maranhão, Piauí, and Pernambuco. Sociodemographic, health, and behavioral conditions and knowledge of students, as well as school characteristics, were associated with lack of knowledge about the HPV vaccine. A higher frequency of lack of knowledge about the HPV vaccine among adolescents was found in the states of the Northeastern Region.
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Introduction: Sexually transmitted infections (STIs) cause considerable morbidity worldwide and, depending on the specific pathogen, may lead to serious complications in the female reproductive tract. Incarcerated women are particularly vulnerable to health problems with a disproportionate high rate of STIs, including infections with human papillomavirus (HPV). Methods: Here, cervical swab samples collected from 299 women (18 to 64 years) living in one of the women's prisons of São Paulo, Brazil were submitted for liquid-based cytology to determine the prevalence of precancerous lesions. Furthermore, direct detection of 30 genital HPV genotypes (18 high-risk and 12 low-risk types) and 11 additional STIs (Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex virus 1 and 2, Haemophilus ducreyi, Mycoplasma genitalium and hominis, Treponema pallidum, Trichomonas vaginalis, Ureaplasma parvum and urealyticum) were performed by molecular typing using two PCR-based DNA microarray systems, i.e., EUROArray HPV and EUROArray STI (EUROIMMUN), respectively. Results: The overall prevalence of cytological abnormalities was 5.8%, including five women with low-grade and five women with high-grade squamous intraepithelial lesions. The overall prevalence of HPV was 62.2, and 87.1% of the HPV-positive women were infected with oncogenic high-risk (HR) HPV types. HPV types 16 (24.1%), 33 and 52 (both 10.4%) were the most frequently detected. The prevalence of the other STIs was 72.8%. Up to four different pathogens were found in the infected women, the most frequent being Ureaplasma parvum (45.3%), Mycoplasma hominis (36.2%) and Trichomonas vaginalis (24.8%). Conclusion: The high number of HR-HPV infections and other STIs described here highlights the fact that the Brazilian female prison population requires more attention in the country's health policies. The implementation of screening programs and treatment measures might contribute to a decrease in the incidence of STIs and cervical cancer in this vulnerable population. However, for such measures to be effective, further studies are needed to investigate the best practice to get more women to engage in in-prison prevention programs, e.g., through offering further sexual health education and self-sampling.
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Papillomavirus Humano , Infecções por Papillomavirus , Prisioneiros , Infecções Sexualmente Transmissíveis , Adolescente , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Brasil/epidemiologia , Colo do Útero/patologia , Colo do Útero/microbiologia , Colo do Útero/virologia , Papillomavirus Humano/genética , Papillomavirus Humano/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Prevalência , Prisioneiros/estatística & dados numéricos , Estudos Retrospectivos , Infecções Sexualmente Transmissíveis/epidemiologia , Infecções Sexualmente Transmissíveis/microbiologiaRESUMO
Refugees usually face a disproportionate burden of infectious diseases. Recently, Brazil has experienced an influx of refugees which demands the need for scaling up public health efforts to address the challenges. The research sought to study the burden and risk factors associated with infectious diseases among refugees received in the city of Porto Alegre. This was a cross-sectional study of 261 newly arrived refugees. The study sample was predominantly composed of Venezuelans (50.6%) and Haitians (44%), male (146: 56.7%), single (30.7%), with an average age of 33.38 (± 7.30) years. The average schooling was 10.42 (± 2.09) years. Diseases with the highest prevalence were influenza, whooping cough, diphtheria, and tuberculosis. There was significant association between the country of origin and presence of symptoms for infectious and contagious diseases, which warrants targeted interventions for reducing the incidence of these diseases among refugees in Brazil.
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Doenças Transmissíveis , Difteria , Influenza Humana , Refugiados , Humanos , Estudos Transversais , Masculino , Refugiados/estatística & dados numéricos , Adulto , Feminino , Brasil/epidemiologia , Fatores de Risco , Doenças Transmissíveis/epidemiologia , Influenza Humana/epidemiologia , Difteria/epidemiologia , Adulto Jovem , Tuberculose/epidemiologia , Coqueluche/epidemiologia , Coqueluche/prevenção & controle , Prevalência , Campos de Refugiados , Pessoa de Meia-Idade , Haiti/epidemiologia , Haiti/etnologia , Efeitos Psicossociais da Doença , AdolescenteRESUMO
BACKGROUND: A new paradigm has been discussed regarding the impact of economic cycles on the mortality pattern from specific causes. These causes are called deaths of despair, and they selectively impact specific demographic groups. Also, low- and middle-income countries are most affected due to their economic and social instability. In this sense, the objective of study was to compare the magnitude of disparity in deaths from despair according to sex, age, and race in Brazil. METHODS: We performed Poisson regression modeling to estimate the magnitude of the association between sex, age group, race, and deaths from despair. Also, we estimated the relationship of time as a proxy of economic crisis phase and deaths of despair. RESULTS: We found an association between mortality from despair and male sex (PR = 6.15, 95%CI 6.09-6.22); emphasis on the age groups from 40 to 49 years old (PR = 2.45, 95% CI 2.41-2.48) and 50 to 59 years old (PR = 2.39, 95% CI 2.36-2.43); and brown (PR = 1.21, 95% CI 1.20-1.22) and black race (PR = 1.36, 95% CI 1.34-1.37). CONCLUSIONS: The present study preliminarily presents the effect of the economic crisis and mortality in the population, with demographic differences. Association with race was opposite to that verified in the original study in the USA, which suggests that this variable should be analyzed in the light of structural context.
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OBJECTIVES: An integrative taxonomic description of Aponurus laguncula (Lecithasteridae), a digenean parasitic species of Chaetodipterus faber (Acanthuriformes) from Brazilian Southeast, is provided. Morphological techniques, as whole mounted slides, histology and scanning electron microscopy, and molecular analyses supported that integrative description. METHODS: Fifteen digenean specimens were stained in hydrochloric carmine and mounted on permanent slides. Two specimens were stained in hematoxylin and eosin following histological routine processing. Four parasites were dehydrated through a graded ethanol series, critical point dried with carbon dioxide and coated with gold to scanning electron microscopy analysis. Sequence of the large ribosomal subunit (28S rDNA) gene was generated and used to construct a phylogeny based on maximum likelihood and Bayesian inference analyses. RESULTS: Morphological description and morphometric data obtained in present study were in accordance with previous studies of the species. Use of another morphological techniques, as scanning electron microscopy and histology, corroborated the observed features of whole mounted slides. Also, they provided a better observation of previous reported characteristics and new features reporting, such as an elongated hermaphroditic duct, a smooth tegument and cells that compose the prostatic gland. The molecular sequence obtained in the present study formed a robust clade with available sequences of species of Aponurus. CONCLUSIONS: The integrative taxonomic approach successfully combined morphological observations, including both previously reported features and new descriptions from histological and electron microscopy analyses, with molecular data to identify these specimens as A. laguncula. Moreover, the detailed characterization of structures, such as the gonads in A. laguncula, that would be challenging to analyze using a single technique, was possible. Further molecular studies with less conserved genetic markers should be conducted to understand phylogenetic relationships between Aponurus species.
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Doenças dos Peixes , Microscopia Eletrônica de Varredura , Filogenia , Trematódeos , Infecções por Trematódeos , Animais , Brasil , Doenças dos Peixes/parasitologia , Trematódeos/genética , Trematódeos/classificação , Trematódeos/isolamento & purificação , Trematódeos/ultraestrutura , Trematódeos/anatomia & histologia , Microscopia Eletrônica de Varredura/veterinária , Infecções por Trematódeos/veterinária , Infecções por Trematódeos/parasitologia , RNA Ribossômico 28S/genética , Peixes/parasitologia , DNA Ribossômico/genética , DNA de Helmintos/genéticaRESUMO
OBJECTIVES: To investigate the effects of a Brazil nut-enriched diet on the wall thickness and the left ventricular chamber diameter of the heart, and lipid peroxidation in a CKD-induced model. METHODS: Male Wistar rats at 12 weeks of age were divided into two groups (n=16/group): the Nx group, which underwent 5/6 nephrectomy, and the Sham group, as a control. After 5 weeks, the groups were subdivided according to diet (n=8/group): the Nx and Sham groups received a control diet; the Nx5% and Sham5% groups received a diet enriched with 5â¯% Brazil nuts for 8 weeks. The left ventricular thickening and chamber diameter were determined. Plasma biochemical parameters were evaluated. Analysis of thiobarbituric acid reactive substances (TBARS) and antioxidant enzyme activity was performed in the plasma and the left ventricle (LV). LV mRNA expression of nuclear factor-kappa B (NF-κB) and nuclear factor erythroid 2-related factor 2 (Nrf2) was evaluated by reverse transcription-polymerase chain reaction. RESULTS: The Nx5% group showed a remodeled LV wall with decreased thickness compared to the Nx group (p=0.016). Furthermore, LV TBARS concentration was reduced in the Nx5% group (p=0.0064). In addition, the Nx5% group showed an increase in plasma GPx activity (p=0.0431). No significant results were found concerning the LV mRNA expression of NF-κB and Nrf2 genes. CONCLUSIONS: A Brazil nut-enriched diet decreased LV thickness and LV TBARS concentration and increased GPx activity in a 5/6 nephrectomy experimental model, making it a promising adjuvant therapy to improve antioxidant status and cardiovascular outcomes in chronic kidney disease.
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Mycoplasma hyopneumoniae is the causative bacterium of porcine enzootic pneumonia and one of the primary etiologic agents of the porcine respiratory disease complex. Most Brazilian commercial pig farms are positive for this pathogen. However, the prevalence of the pathogen in backyard pig farms has not been described, to our knowledge. Therefore, we aimed to determine the prevalence of M. hyopneumoniae in backyard pig farms in the state of Paraná, Brazil. In January-March 2020, we collected 585 serum samples from pigs in 187 non-vaccinated herds. We tested the sera with an indirect ELISA for anti-M. hyopneumoniae antibodies and found that 182 of 585 (31.1%) samples were positive, and were found in 109 of 187 (58.3%) herds assessed.
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Anticorpos Antibacterianos , Mycoplasma hyopneumoniae , Pneumonia Suína Micoplasmática , Animais , Brasil/epidemiologia , Suínos , Mycoplasma hyopneumoniae/imunologia , Mycoplasma hyopneumoniae/isolamento & purificação , Anticorpos Antibacterianos/sangue , Pneumonia Suína Micoplasmática/epidemiologia , Pneumonia Suína Micoplasmática/microbiologia , Ensaio de Imunoadsorção Enzimática/veterinária , Prevalência , Estudos Soroepidemiológicos , Doenças dos Suínos/microbiologia , Doenças dos Suínos/epidemiologiaRESUMO
The novel HLA-DQB1*06:02:62 allele, first described in an individual from Brazil.
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Alelos , Éxons , Cadeias beta de HLA-DQ , Humanos , Cadeias beta de HLA-DQ/genética , Análise de Sequência de DNA/métodos , Teste de Histocompatibilidade/métodos , Brasil , Sequenciamento de Nucleotídeos em Larga Escala/métodos , Códon , Sequência de BasesRESUMO
Abstract Background Neurofibromatosis type 1 (NF1) is a rare genetic disorder with a wide range of clinical manifestations, notably neurocutaneous features, that can lead to emotional and physical consequences. Objectives This study assessed the influence of sociodemographic factors and clinical features of the disease on the quality of life of Brazilian individuals with NF1. Methods This is a descriptive cross-sectional study. Data were collected from 101 individuals with NF1 using the Brazilian version of the Impact of NF1 on Quality of Life Questionnaire (INF1-QoL), a form with information on sociodemographic characteristics, and an NF1 visibility self-evaluation scale. The relationship between variables was evaluated through statistical testing, and the significance level was defined as 0.05. Results The study included 101 adults with NF1 aged 18 to 59 years, with a mean age of 35.54 years (±9.63) and a female predominance (n = 84, 83.17%). The mean total INF1-QoL score was 10.62 (±5.63), with a median of 10, minimum value of 0, and maximum of 31 points. Two characteristics of the participants were significantly associated with the quality of life: educational level (p = 0.003) and familial history of NF1 (p = 0.019). There was a statistically significant correlation between the INF1-QoL score and the degree of disease visibility (rho = 0.218; p = 0.028). Study limitations Cross-sectional study, conducted with a convenience sample and using self-reported measures. Conclusions The findings support the significant impact of NF1 on quality of life. The authors recommend multidisciplinary follow-up for patients, with adherence to anticipatory clinical care measures, adequate pain control, psychological assistance, and genetic counseling.
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Abstract This article aims to examine the effects of weekend admission on in-hospital mortality for patients with acute myocardial infarction (AMI) in Brazil. Information from the Hospital Information System of the Unified Health System (SIH/SUS) of urgently admitted patients diagnosed with acute myocardial infarction (AMI) between 2008 and 2018 was used, made available through the Hospital Admission Authorization (AIH). Multivariable logistic regression models, controlling for observable patient characteristics, hospital characteristics and year and hospital-fixed effects, were used. The results were consistent with the existence of the weekend effect. For the model adjusted with the inclusion of all controls, the chance of death observed for individuals hospitalized on the weekend is 14% higher. Our results indicated that there is probably an important variation in the quality of hospital care depending on the day the patient is hospitalized. Weekend admissions were associated with in-hospital AMI mortality in Brazil. Future research should analyze the possible channels behind the weekend effect to support public policies that can effectively make healthcare equitable.
Resumo O objetivo deste artigo é examinar os efeitos da internação no final de semana na mortalidade hospitalar de pacientes com infarto agudo do miocárdio (IAM) no Brasil. Foram utilizadas informações do Sistema de Informação Hospitalar do Sistema Único de Saúde (SIH/SUS) de pacientes internados em urgência com diagnóstico de infarto agudo do miocárdio (IAM) entre 2008 e 2018, disponibilizados por meio da Autorização de Internação Hospitalar (AIH). Foram usados modelos de regressão logística multivariada, controlando as características observáveis do paciente, características do hospital e efeitos fixos de ano e hospital. Os resultados foram consistentes com a existência do efeito fim de semana. Para o modelo ajustado com a inclusão de todos os controles, a chance de óbito observada para indivíduos internados no final de semana é 14% maior. Nossos resultados indicaram que provavelmente existe uma variação importante na qualidade da assistência hospitalar dependendo do dia em que o paciente fica internado. Internações em finais de semana foram associadas à mortalidade por IAM intra-hospitalar no Brasil. Pesquisas futuras devem analisar os possíveis canais por trás do weekend effect para subsidiar políticas públicas que possam efetivamente tornar o atendimento equitativo.
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Resumo O objetivo deste estudo foi identificar indicadores de desigualdades sociais associados à mortalidade por neoplasias na população adulta brasileira. Utilizou-se como método a revisão de escopo, estabelecendo-se a pergunta norteadora: qual o efeito das desigualdades sociais na mortalidade por neoplasias na população adulta brasileira? Foram identificados 567 trabalhos, sendo 22 considerados elegíveis. Identificou-se uma diversidade de indicadores, como o Índice de Desenvolvimento Humano e o Índice de Gini, entre outros, que avaliaram primordialmente diferenças de renda, escolarização, desenvolvimento humano e vulnerabilidade. Não foi estabelecido um único padrão de associação entre os indicadores e as diferentes neoplasias, assim como não se identificou um indicador único capaz de explicar o efeito da desigualdade social em todos os níveis de área e por óbitos por todos os tipos de neoplasias, mas identificou-se que a mortalidade é influenciada pelas desigualdades sociais e que o estudo dos indicadores proporciona definir qual melhor explica os óbitos. Essa revisão destaca importantes lacunas referentes ao uso de indicadores sociais não modificáveis, à análise de pequenas áreas e ao uso limitado de indicadores multidimensionais.
Abstract The objective of this study was to identify indicators of social inequalities associated with mortality from neoplasms in the Brazilian adult population. A scoping review method was used, establishing the guiding question: What is the effect of social inequalities on mortality from neoplasms in the Brazilian adult population? A total of 567 papers were identified, 22 of which were considered eligible. A variety of indicators were identified, such as the Human Development Index and the Gini Index, which primarily assessed differences in income, schooling, human development and vulnerability. A single pattern of association between the indicators and the different neoplasms was not established, nor was a single indicator capable of explaining the effect of social inequality at all levels of territorial area and by deaths from all types of neoplasms identified. It is known that mortality is influenced by social inequalities and that the study of indicators provides an opportunity to define which best explains deaths. This review highlights important gaps regarding the use of non-modifiable social indicators, analysis of small geographical areas, and limited use of multidimensional indicators.
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OBJECTIVES: To evaluate the impact of COVID-19 pandemics on clinical and surgical practice, educational activities, health and lifestyle behavior of Brazilian urology residents after 1 year of socio-economic restrictions. MATERIALS AND METHODS: An electronic survey was e-mailed to all postgraduate (PG) students registered by the Brazilian Society of Urology. The survey inclu-ded an assessment of socio-demographic, clinical practice, educational, health-related and behavior parameters. We also evaluated which subareas of urology were predominantly affected. A similar survey was adapted and sent to the directors of all urology residency programs. RESULTS: COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. Urology residents reported >50% decrease in multiple surgical modalities. We highlight kidney transplantation surgeries (66.2%), minor surgeries (62.3%), endoscopic surgeries (42.6%) and reconstructive surgeries (38.8%). This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. Furthermore, PG students faced stressful situations that caused worsening of mental and physical health, such as getting redirected to assistance of COVID-19 patients (66.9%), and high rate of infection by SARS-CoV-2 (58.2%). CONCLUSIONS: The COVID-19 pandemic has severely impacted the clinical, surgical, and educational activities of urology residents in Brazil. This could represent a critical skills gap that residents may face beyond the COVID-19 pandemic. PG students faced stressful situations that caused worsening of mental and physical health such as redirection to assistance of COVID-19 patients, concern about their own contamination and of family members.
Assuntos
COVID-19 , Internato e Residência , Pandemias , Urologia , COVID-19/epidemiologia , Humanos , Internato e Residência/estatística & dados numéricos , Urologia/educação , Brasil/epidemiologia , Masculino , Feminino , Inquéritos e Questionários , Adulto , SARS-CoV-2 , Procedimentos Cirúrgicos Urológicos/educação , Procedimentos Cirúrgicos Urológicos/estatística & dados numéricos , Educação de Pós-Graduação em MedicinaRESUMO
Eugenia flavescens is a species cultivated in Brazil for food purposes. Given the potential application of essential oils from plants of the genus Eugenia, this study was carried out to investigate the chemical composition, acute toxicity, antioxidant, antinociceptive, gastroprotective activities, and possible mechanisms of action of the essential oil from the leaves of E. flavescens (EOEf). The EOEf was extracted by hydrodistillation, and the chemical composition was obtained using gas chromatography-mass spectrometry. The antioxidant activity was evaluated, as well as the acute toxicity and the antinociceptive and anti-inflammatory effects in mice. In addition, the gastroprotective effect was investigated using an acute gastric lesion model, considering possible mechanisms of action. The major components found in the EOEf were guaiol (19.97%), germacrene B (12.53%), bicyclogermacrene (11.11%), and E-caryophyllene (7.53%). The EOEf did not cause signs of toxicity in the acute oral toxicity test and showed in vitro antioxidant activity with IC50 ranging from 247.29 to 472.39 µg/mL in the tests ABTS and DPPH. In the nociceptive test, EOEf showed a 72.05% reduction in nociception at a dose of 100 mg/kg. In evaluating the anti-inflammatory effect, the essential oil inhibited paw edema by 95.50% and 97.69% at doses of 50 and 100 mg/kg. The results showed that EOEf has a gastroprotective effect, acting through the sulfhydryl compounds (-SH), nitric oxide (NO), and synthesis PGE2 pathways. The results suggested that EOEf is a promising source of constituents with antioxidant, antinociceptive, anti-inflammatory, and gastroprotective properties with application in the food and pharmaceutical industries.