Effect of maxillary advancement on velopharyngeal function in cleft lip and palate: 20 years of experience.

This retrospective study aimed to investigate the impact of orthognathic surgery with maxillary advancement (MA) on the velopharyngeal function (VF) in individuals with cleft lip and palate (CLP). The study included 651 patients with repaired CLP, both sexes, aged over 18 years who underwent MA alone or in combination with nasal procedures and/or mandibular osteotomy, operated between 2000 and 2019. The main outcome measures were nasalance (nasal text-NT and oral text-OT) and velopharyngeal orifice area measurement (VA), determined by nasometry and pressure-flow technique, respectively. Preoperatively, mean nasalance scores for NT and OT indicated normality, and VA demonstrated borderline-inadequate velopharyngeal closure in all patients. Following MA, a significant increase in nasalance scores for NT and OT occurred (p < 0.001), revealing hypernasality in those undergoing MA combined with nasal procedure (MAN, N = 191), bimaxillary orthognathic surgery with nasal procedure (BON, N = 227) and bimaxillary orthognathic surgery (BO, N = 151). Conversely, nasalance scores remained within the normal range for those undergoing isolated maxillary advancement (IMA, N = 82). VA exhibited a significant increase leading to the classification of VF as inadequate in the BON and MAN groups. Overall, MA contributed to VF deterioration, resulting in the appearance of hypernasality and increased VA, particularly when combined with nasal procedures.

Intravenous Line Labels For High-Alert Drugs Administered To Critically Ill Patients: A Simulated Experimental Assessment.

AIMS AND OBJECTIVES: Evaluate the effect of IV line labels on nurses' identification of high-alert medications in a simulated scenario of multiple infusions for critically ill patients. DESIGN: Randomised crossover simulation experimental study. METHODS: A study was conducted on 29 nurses working in intensive care for over 6 months. They were given two critical scenarios in a simulated environment, one with labels and the other without labels, involving multiple intravenous infusions. The nurses had to identify the medications infused into the critical patients' intravenous lines and disconnect a specific line. The data were collected and analysed to evaluate the errors made by the nurses in identifying and disconnecting the medications and the time they spent carrying out the tasks. The Wilcoxon test was used to analyse the variation in outcome before and after the intervention. RESULTS: Approximately one-third of the study participants incorrectly identified the intravenous lines in both scenarios. There was no significant difference in the average number of errors between the scenarios with and without labels. However, the time taken to perform the tasks in the scenario with labels was 1 min less than in the scenario without labels, suggesting a potential efficiency gain. CONCLUSIONS: The labels on the intravenous lines allowed for quick drug identification and disconnection. The professionals performed similarly in correctly recognising the high-alert medication intravenous lines, in the scenarios with or without labels. RELEVANCE TO CLINICAL PRACTICE: The label can be used as a technology to prevent misidentification of high-alert medications administered to critically ill patients through intravenous lines, thereby enhancing medication safety in healthcare institutions. No Public Contribution.

Mapa de evidências - Efetividade de estratégias de promoção da saúde em escolas / Effectiveness of health promotion strategies in schools

DESTAQUES ● Este mapa de evidências apresenta resultados de efetividade de intervenções realizadas em escolas, recuperadas da literatura científica global. ● Foram incluídos 217 revisões sistemáticas (RS) e 3 estudos primários que avaliaram os efeitos de treze ações relativas à Promoção da Saúde em Escolas. ● Quanto à qualidade metodológica, as RS foram assim classificadas: 9 de confiança alta, 14 moderada, 16 baixa e 178 criticamente baixas. ● As intervenções foram categorizadas segundo as ações previstas no Programa Saúde na Escola (PSE): 1) Combate ao Aedes aegypti; 2) Promoção da atividade física; 3) Promoção da cidadania ; 4) Prevenção da Covid-19; 5) Promoção de direitos sexuais e reprodutivos; 6) Controle de doenças negligenciadas; 7) Ações de saúde auditiva; 8) Ações de saúde bucal; 9) Ações de saúde ocular; 10) Promoção da alimentação saudável; 11) Monitoramento da situação vacinal; 12) Prevenção e uso de substâncias e 13) Prevenção de violências e acidentes.

HIGHLIGHTS ● This evidence map presents results on the effectiveness of interventions carried out in schools, retrieved from the global scientific literature. ● A total of 217 systematic reviews (SRs) and 3 primary studies that evaluated the effects of thirteen actions related to Health Promotion in Schools were included. ● Regarding methodological quality, the SRs were classified as follows: 9 with high confidence, 14 moderate, 16 low and 178 critically low. ● The interventions were categorized according to the actions provided for in the Brazilian School Health Program (PSE): 1) Combating Aedes aegypti; 2) Promoting physical activity; 3) Promoting citizenship; 4) Preventing Covid-19; 5) Promoting sexual and reproductive rights; 6) Controlling neglected diseases; 7) Hearing health actions; 8) Oral health actions; 9) Eye health actions; 10) Promoting healthy eating; 11) Monitoring vaccination status; 12) Prevention and use of substances and 13) Prevention of violence and accidents.

[Evidence for Health Promotion in Brazil: report on a rapid response serviceEvidencia para la promoción de la salud en Brasil: informe sobre un servicio de respuesta rápida]. / Evidências para a Promoção da Saúde no Brasil: relato de um serviço de resposta rápida.

Objective: Present the experience of a rapid response service to support decision-making in health systems. Methodology: Description of the processes and results of a service that produces rapid reviews and evidence maps to support decision-making under the National Health Promotion Policy, as well as the authors' perception of the work process. Results: The rapid response service started in 2020. By December 2023, 54 rapid reviews and five evidence maps had been produced, covering nine health promotion topics. These products were developed in 14 stages by a team made up of a coordinator, supervisors, proofreaders, and a librarian. The development of rapid responses involved a knowledge translation process, with continuous interactions between the requesting teams and production teams. Establishing effective communication was a critical factor in delivering products on time and in line with the needs of decision-makers and their supporters. Conclusion: Rapid response services can help improve the use of evidence for decision-making in health policies and health systems.

Objetivo: Presentación de la experiencia de un servicio de respuesta rápida para brindar apoyo a la toma de decisiones en materia de salud. Método: Se describen los procesos y resultados de un servicio de elaboración de revisiones rápidas y mapas de evidencia para brindar apoyo a la toma de decisiones en el marco de la Política Nacional de Promoción de la Salud, así como la percepción de los autores sobre el proceso de trabajo. Resultados: El servicio de respuesta rápida se inició en el 2020. Hasta diciembre del 2023, se habían elaborado 54 revisiones rápidas y cinco mapas de evidencia, que abarcaban nueve temas de promoción de la salud. Estos productos fueron elaborados en 14 etapas por un equipo formado por un coordinador, varios supervisores y revisores y un bibliotecario. La elaboración de respuestas rápidas fue un proceso de traducción del conocimiento e implicó una interacción continua entre los equipos solicitantes y el equipo de elaboración. El establecimiento de una comunicación eficaz fue un factor decisivo para entregar los productos a tiempo y en consonancia con las necesidades de los responsables de la toma de decisiones y su personal de apoyo. Conclusión: Los servicios de respuesta rápida pueden ayudar a mejorar el uso de evidencia en la toma de decisiones relacionadas con las políticas y los sistemas de salud.

Quesito raça/cor: qualidade do preenchimento dos Sistemas de Informação em Saúde / Race/color issue: quality of filling out Health Information Systems

Contexto - A Política Nacional de Saúde Integral da População Negra (PNSIPN) foi instituída em 2009, com o objetivo de "promover a saúde integral da população negra, priorizando a redução das desigualdades étnico-raciais, o combate ao racismo e à discriminação nas instituições e nos serviços do SUS". Entre as pessoas em vulnerabilidade por questões étnico-raciais, a população negra e a indígena estão entre as que sofrem com diversas iniquidades em saúde ocasionadas por barreiras estruturais e cotidianas que incidem negativamente nos indicadores de saúde. Diante do panorama iniciado pela PNSIPN, foram estabelecidos indicadores para o monitoramento da implementação e o desenvolvimento do Guia de Implementação do Quesito Raça/Cor/Etnia. Pergunta - Qual é o grau de qualidade do preenchimento do quesito raça/cor nos sistemas de registro de dados administrativos da saúde? Métodos - As buscas foram realizadas em julho de 2024 nas bases de dados BVS - Biblioteca Virtual em Saúde e Google Acadêmico. Foram utilizados os filtros temporais (2019 a 2024). O processo de seleção de estudos recuperados foi realizado em duplicidade e de modo independente. Resultados - De 1.340 registros recuperados nas buscas, 27 estudos foram incluídos. Os resultados são apresentados de acordo com os sistemas de informação analisados.

Context - The National Policy for Comprehensive Health of the Black Population (PNSIPN) was established in 2009, with the objective of "promoting the comprehensive health of the black population, prioritizing the reduction of ethnic-racial inequalities, combating racism and discrimination in SUS institutions and services". Among people vulnerable due to ethnic-racial issues, the black and indigenous populations are among those who suffer from various health inequities caused by structural and daily barriers that negatively impact health indicators. Given the panorama initiated by the PNSIPN, indicators were established to monitor the implementation and develop the Implementation Guide for the Race/Color/Ethnicity Question. Question - What is the degree of quality of filling out the race/color question in the administrative health data registration systems? Methods - The searches were carried out in July 2024 in the BVS - Virtual Health Library and Google Scholar databases. Time filters were used (2019 to 2024). The selection process of retrieved studies was carried out in duplicate and independently. Results - Of 1,340 records retrieved in the searches, 27 studies were included. The results are presented according to the information systems analyzed.

NutriSUS: biodisponibilidade de micronutrientes em pó para crianças / NutriSUS: bioavailability of powdered micronutrients for children

Contexto - Para promover o crescimento e o desenvolvimento saudáveis das crianças é necessária uma alimentação adequada desde o início da vida. No entanto, muitas crianças vivem em famílias em situação de insegurança alimentar. Garantir a biodisponibilidade adequada dos micronutrientes é essencial para a eficácia de intervenções nutricionais, especialmente em programas de suplementação destinados a atender populações vulnerabilizadas. Pergunta - Quais são as evidências sobre a biodisponibilidade de cada micronutriente da fórmula dos sachês de Micronutrientes em Pó - NutriSUS para crianças de 6 a 24 meses? Métodos - As buscas por estudos foram realizadas em julho de 2024 nas bases de dados Pubmed, Embase e LILACS - Literatura Latino-Americano e do Caribe de Informação em Ciências da Saúde. Nesta revisão rápida, apenas a seleção de estudos foi realizada em duplicidade e de modo independente. Resultados - As buscas resultaram em 1.805 registros recuperados. Após seleção por leitura de títulos e resumos, 15 estudos elegíveis foram lidos na íntegra, dos quais cinco foram incluídos. Os desfechos analisados referem-se principalmente à absorção do ferro.

Context - To promote healthy growth and development in children, adequate nutrition is necessary from the beginning of life. However, many children live in families experiencing food insecurity. Ensuring adequate bioavailability of micronutrients is essential for the effectiveness of nutritional interventions, especially in supplementation programs aimed at serving vulnerable populations. Question - What is the evidence on the bioavailability of each micronutrient in the formula of the Micronutrient Powder sachets - NutriSUS for children aged 6 to 24 months? Methods - Searches for studies were conducted in July 2024 in the Pubmed, Embase and LILACS databases - Latin American and Caribbean Literature on Health Sciences Information. In this rapid review, only the selection of studies was performed in duplicate and independently. Results - The searches resulted in 1,805 retrieved records. After selection by reading titles and abstracts, 15 eligible studies were read in full, of which five were included. The outcomes analyzed mainly refer to iron absorption.

Research evidence communication for policy-makers: a rapid scoping review on frameworks, guidance and tools, and barriers and facilitators.

BACKGROUND: Communication is a multifaceted process, ranging from linear, one-way approaches, such as transmitting a simple message, to continuous exchanges and feedback loops among stakeholders. In particular the COVID-19 pandemic underscored the critical need for timely, effective and credible evidence communication to increase awareness, levels of trust, and evidence uptake in policy and practice. However, whether to improve policy responses in crises or address more commonplace societal challenges, comprehensive guidance on evidence communication to decision-makers in health policies and systems remains limited. Our objective was to identify and systematize the global evidence on frameworks, guidance and tools supporting effective communication of research evidence to facilitate knowledge translation and evidence-informed policy-making processes, while also addressing barriers and facilitators. METHODS: We conducted a rapid scoping review following the Joanna Briggs Manual. Literature searches were performed across eight indexed databases and two sources of grey literature, without language or time restrictions. The methodological quality of included studies was assessed, and a narrative-interpretative synthesis was applied to present the findings. RESULTS: We identified 16 documents presenting either complete frameworks or framework components, including guidance and tools, aimed at supporting evidence communication for policy development. These frameworks outlined strategies, theoretical models, barriers and facilitators, as well as insights into policy-makers' perspectives, communication needs, and preferences. Three primary evidence communication strategies, comprising eleven sub-strategies, emerged: "Health information packaging", "Targeting and tailoring messages to the audience", and "Combined communication strategies". Based on the documented barriers and facilitators at micro, meso and macro levels, critical factors for successful communication of evidence to policy-makers were identified. CONCLUSIONS: Effective communication is indispensable for facilitating knowledge translation and evidence-informed policy-making. Nonetheless gaps persist in frameworks designed to enhance research communication to policy-makers, particularly regarding the effectiveness of multiple communication strategies. To advance in this field, the development of comprehensive frameworks incorporating implementation strategies is warranted. Additionally, barriers and facilitators to implementing effective communication must be recognized and addressed taking diverse contexts into consideration. Registration https://zenodo.org/record/5578550.

Micronutrientes em pó: efetividade das estratégias de fortificação da alimentação de crianças menores de cinco anos / Powdered micronutrients: effectiveness of food fortification strategies for children under five years of age

Contexto - A alimentação inadequada nos primeiros anos de vida está associada à morbimortalidade de crianças, representada por doenças infecciosas, afecções respiratórias, cárie dental, desnutrição, excesso de peso e carências específicas de micronutrientes como de ferro, zinco e vitamina A. O Estudo Nacional de Alimentação e Nutrição Infantil (ENANI), realizado em 2019 com crianças brasileiras de até 5 anos, mostrou uma redução na prevalência de anemia de 20,9%, em 2006, para 10,1%, em 2019, com diferenças entre as regiões brasileiras. Evidências indicam que o fornecimento de alimentos complementares fortificados a crianças dos 6 aos 23 meses podem reduzir a anemia em 43% e aumentar as concentrações de hemoglobina de forma significativa. Pergunta - Qual é a efetividade das estratégias de fortificação de micronutrientes em pó (MNP) implementadas na alimentação de crianças de 6 meses até 59 meses? Métodos - As buscas por revisões sistemáticas (RS) foram realizadas em abril de 2024 nas bases de dados Lilacs - Literatura Latino-Americana e do Caribe em Ciências da Saúde, Pubmed, Embase e Epistemonikos. Nesta revisão rápida, apenas a seleção de estudos foi realizada em duplicidade e de modo independente. Resultados - As buscas resultaram em 109 registros recuperados. Após seleção por leitura de títulos e resumos, 17 RS elegíveis foram lidas na íntegra, das quais quatro foram incluídas. Os achados foram organizados de acordo com grupos de desfechos avaliados nos estudos: anemia e seus indicadores, estado nutricional, níveis séricos de micronutrientes, eventos adversos.

Context - Inadequate nutrition in the first years of life is associated with morbidity and mortality in children, represented by infectious diseases, respiratory conditions, dental caries, malnutrition, overweight and specific deficiencies of micronutrients such as iron, zinc and vitamin A. The National Study of Child Feeding and Nutrition (ENANI), carried out in 2019 with Brazilian children up to 5 years old, showed a reduction in the prevalence of anemia from 20.9%, in 2006, to 10.1%, in 2019, with differences between Brazilian regions. Evidence indicates that providing fortified complementary foods to children aged 6 to 23 months can reduce anemia by 43% and significantly increase hemoglobin concentrations. Question - How effective are the strategies for fortifying powdered micronutrients (MNP) implemented in the diets of children aged 6 months to 59 months? Methods - Searches for systematic reviews (SRs) were conducted in April 2024 in the databases Lilacs - Latin American and Caribbean Literature in Health Sciences, Pubmed, Embase and Epistemonikos. In this rapid review, only the selection of studies was performed in duplicate and independently. Results - The searches resulted in 109 retrieved records. After selection by reading titles and abstracts, 17 eligible SRs were read in full, of which four were included. The findings were organized according to groups of outcomes evaluated in the studies: anemia and its indicators, nutritional status, serum micronutrient levels, adverse events.

Caffeine Consumption and Interaction with ADORA2A, CYP1A2 and NOS1 Variants Do Not Influence Age at Onset of Machado-Joseph Disease.

BACKGROUND: The age at onset (AO) of Machado-Joseph disease (SCA3/MJD), a disorder due to an expanded CAG repeat (CAGexp) in ATXN3, is quite variable and the role of environmental factors is still unknown. Caffeine was associated with protective effects against other neurodegenerative diseases, and against SCA3/MJD in transgenic mouse models. We aimed to evaluate whether caffeine consumption and its interaction with variants of caffeine signaling/metabolization genes impact the AO of this disease. METHODS: a questionnaire on caffeine consumption was applied to adult patients and unrelated controls living in Rio Grande do Sul, Brazil. AO and CAGexp were previously determined. SNPs rs5751876 (ADORA2A), rs2298383 (ADORA2A), rs762551 (CYP1A2) and rs478597 (NOS1) were genotyped. AO of subgroups were compared, adjusting the CAGexp to 75 repeats (p < 0.05). RESULTS: 171/179 cases and 98/100 controls consumed caffeine. Cases with high and low caffeine consumption (more or less than 314.5 mg of caffeine/day) had mean (SD) AO of 35.05 (11.44) and 35.43 (10.08) years (p = 0.40). The mean (SD) AO of the subgroups produced by the presence or absence of caffeine-enhancing alleles in ADORA2A (T allele at rs5751876 and rs2298383), CYP1A2 (C allele) and NOS1 (C allele) were all similar (p between 0.069 and 0.516). DISCUSSION: Caffeine consumption was not related to changes in the AO of SCA3/MJD, either alone or in interaction with protective genotypes at ADORA2A, CYP1A2 and NOS1.

Mortalidade materna e near miss no contexto de iniquidades em saúde / Maternal mortality and near miss in the context of health inequities

Contexto - As mortes maternas, em sua maioria, são consideradas evitáveis. Near miss materno, situação de uma mulher que quase morreu devido a uma complicação materna grave, é um critério relacionado à prevenção de mortes maternas. Ambas podem ser afetadas por iniquidades em saúde. Nesse sentido, o objetivo desta revisão rápida foi identificar como as iniquidades em saúde influenciam as taxas de mortes maternas e de near miss. Pergunta - Quais são as evidências sobre as taxas de mortalidade materna e near miss no contexto de iniquidades em saúde? Métodos - As buscas de estudos primários e secundários foram realizadas em 22 de abril de 2024 nas bases de dados Lilacs - Literatura Latino-Americana e do Caribe em Ciências da Saúde (via Biblioteca Virtual em Saúde - BVS), Pubmed e Epistemonikos. A seleção de estudos foi realizada em duplicidade e de modo independente. Apenas as revisões sistemáticas foram avaliadas quanto à qualidade metodológica. Resultados - De 360 registros recuperados nas buscas, 19 estudos foram incluídos. Os estudos se referem a dados especialmente dos Estados Unidos, com foco em mulheres negras. Apenas dois estudos abordam o contexto brasileiro. Os achados foram agrupados em duas categorias: (i) iniquidades em saúde e mortalidade materna; (ii) iniquidades em saúde e near miss.

Context - Most maternal deaths are considered preventable. Maternal near miss, a situation in which a woman almost died due to a serious maternal complication, is a criterion related to the prevention of maternal deaths. Both can be affected by health inequities. In this sense, the objective of this rapid review was to identify how health inequities influence the rates of maternal deaths and near miss. Question - What is the evidence on maternal mortality and near miss rates in the context of health inequities? Methods - Searches for primary and secondary studies were carried out on April 22, 2024 in the databases Lilacs - Latin American and Caribbean Literature in Health Sciences (via the Virtual Health Library - VHL), Pubmed and Epistemonikos. Study selection was performed in duplicate and independently. Only systematic reviews were assessed for methodological quality. Results - Of 360 records retrieved in the searches, 19 studies were included. The studies refer to data especially from the United States, with a focus on black women. Only two studies address the Brazilian context. The findings were grouped into two categories: (i) health inequities and maternal mortality; (ii) health inequities and near miss.

From the Gut to the Brain: Is Microbiota a New Paradigm in Parkinson's Disease Treatment?

Parkinson's disease (PD) is recognized as the second most prevalent primary chronic neurodegenerative disorder of the central nervous system. Clinically, PD is characterized as a movement disorder, exhibiting an incidence and mortality rate that is increasing faster than any other neurological condition. In recent years, there has been a growing interest concerning the role of the gut microbiota in the etiology and pathophysiology of PD. The establishment of a brain-gut microbiota axis is now real, with evidence denoting a bidirectional communication between the brain and the gut microbiota through metabolic, immune, neuronal, and endocrine mechanisms and pathways. Among these, the vagus nerve represents the most direct form of communication between the brain and the gut. Given the potential interactions between bacteria and drugs, it has been observed that the therapies for PD can have an impact on the composition of the microbiota. Therefore, in the scope of the present review, we will discuss the current understanding of gut microbiota on PD and whether this may be a new paradigm for treating this devastating disease.

Vigilância Alimentar e Nutricional na Atenção Primária à Saúde / Food and Nutrition Surveillance in Primary Health Care

Contexto - A Vigilância Alimentar e Nutricional (VAN) consiste em uma ferramenta que auxilia a promoção de saúde em relação a informações sobre alimentação, nutrição e seus determinantes na população. Devido à sua importância para organização da atenção nutricional e garantia da segurança alimentar e nutricional, é necessário conhecer estratégias para o aumento da cobertura e execução das ações na Atenção Primária à Saúde. Pergunta - Quais estratégias foram implementadas para aumentar a cobertura da Vigilância Alimentar e Nutricional e avaliação do consumo alimentar na Atenção Primária à Saúde? Métodos - As buscas de estudos primários e secundários foram realizadas em dezembro de 2023 nas bases de dados da Biblioteca Virtual em Saúde, Biblioteca Digital Brasileira de Teses e Dissertações e Google Acadêmico. Apenas a seleção de estudos foi realizada em duplicidade e de modo independente. Resultados - De 266 registros recuperados nas buscas, 10 estudos foram incluídos. Os estudos se referem a dados do país, de alguns estados ou de regiões e municípios. De modo geral, os achados apontam para uma baixa cobertura no registro de dados.

Context - Food and Nutrition Surveillance (VAN) is a tool that helps promote health in relation to information on food, nutrition and their determinants in the population. Due to its importance for organizing nutritional care and ensuring food and nutritional security, it is necessary to know strategies for increasing coverage and implementing actions in Primary Health Care. Question - What strategies have been implemented to increase the coverage of Food and Nutrition Surveillance and assessment of food consumption in Primary Health Care? Methods - Searches for primary and secondary studies were carried out in December 2023 in the databases of the Virtual Health Library, the Brazilian Digital Library of Theses and Dissertations and Google Scholar. Only the selection of studies was carried out in duplicate and independently. Results - Of 266 records retrieved in the searches, 10 studies were included. The studies refer to data from the country, some states or regions and municipalities. Overall, the findings point to low coverage in data recording.

Vigilância Alimentar e Nutricional de populações em vulnerabilidade social: desafios para a implementação / Food and Nutrition Surveillance of Socially Vulnerable Populations: Implementation Challenges

Contexto - A Vigilância Alimentar e Nutricional (VAN), é uma forma de avaliação contínua relacionada à alimentação e nutrição da população e aos seus fatores de risco. Os dados consolidados da VAN podem auxiliar na análise e discussão de casos, na elaboração de estratégias e critérios de vulnerabilidade e na tomada de decisões no âmbito da Atenção Primária à Saúde. Pergunta - Quais são os desafios para a implementação da Vigilância Alimentar e Nutricional de populações em vulnerabilidade social na Atenção Primária à Saúde? Métodos - As buscas de estudos foram realizadas em março de 2024, nas bases de dados Medline (via PubMed), Literatura Latino Americana e do Caribe - LILACS (via Biblioteca Virtual em Saúde - BVS), Biblioteca Digital Brasileira de Teses e Dissertações (BDTD). Utilizando atalhos de revisão rápida, apenas a seleção de estudos foi realizada em duplicata e de modo independente. Não foi realizada a avaliação da qualidade metodológica dos estudos incluídos. Resultados - De 325 registros identificados nas buscas das bases de dados, 3 estudos foram incluídos. Os estudos analisaram os desafios relacionados aos beneficiários do Programa Bolsa Família e do Programa de Atenção aos Desnutridos e Gestantes em Risco Nutricional.

Context - Food and Nutrition Surveillance (VAN) is a form of continuous assessment related to the population's diet and nutrition and their risk factors. Consolidated VAN data can assist in the analysis and discussion of cases, in the development of vulnerability strategies and criteria, and in decision-making within the scope of Primary Health Care. Question - What are the challenges for the implementation of Food and Nutrition Surveillance of socially vulnerable populations in Primary Health Care? Methods - The searches for studies were carried out in March 2024, in the Medline databases (via PubMed), Latin American and Caribbean Literature - LILACS (via Virtual Health Library - BVS), and Brazilian Digital Library of Theses and Dissertations (BDTD). Using rapid review shortcuts, only the selection of studies was carried out in duplicate and independently. The methodological quality of the included studies was not assessed. Results - Of 325 records identified in the database searches, 3 studies were included. The studies analyzed the challenges related to beneficiaries of the Bolsa Família Program and the Care Program for Malnourished and Pregnant Women at Nutritional Risk.

Racismo sistêmico: efeitos sobre as iniquidades e disparidades em saúde / Systemic racism: effects on health inequities and disparities

Contexto - O racismo sistêmico, também denominado racismo institucional ou racismo estrutural, propicia um olhar que vai além das manifestações conscientes de racismo e discriminação racial. O racismo institucional atua nas instituições sociais, contribuindo para a naturalização e reprodução da hierarquia racial. Esse conceito é de grande relevância para o avanço das políticas públicas, para a garantia de direitos e de equidade na atenção à saúde. Há décadas, estudiosos vêm chamando a atenção para as iniquidades em saúde como consequência de questões étnico-raciais. Pergunta - Quais são os efeitos do racismo sistêmico sobre as iniquidades ou disparidades em saúde? Métodos - As buscas foram realizadas em março de 2024 nas bases de dados Lilacs - Literatura Latino-Americana e do Caribe em Ciências da Saúde e Index Psicologia (via Biblioteca Virtual em Saúde - BVS), Pubmed, Epistemonikos, incluindo os termos DeCS, MeSH e seus sinônimos. Apenas o processo de seleção de estudos recuperados foi realizado em duplicidade e de modo independente. A avaliação da qualidade metodológica das RS foi realizada por meio da ferramenta AMSTAR 2. Resultados - De 261 registros recuperados nas buscas, 10 estudos foram incluídos, sendo a maioria relativa à população dos Estados Unidos e apenas um estudo brasileiro. Os resultados são apresentados de acordo com as seguintes condições de saúde: câncer (4 revisões); psicose (1 revisão); saúde materna (4 revisões); alimentação e nutrição (1 revisão); autoavaliação de saúde (1 estudo transversal). Os desfechos analisados nos estudos referem-se aos efeitos das questões étnico-raciais sobre carga da doença, implicações no diagnóstico e no acesso a tratamentos, sobrevida, entre outros.

Context - Systemic racism, also called institutional racism or structural racism, provides a perspective that goes beyond conscious manifestations of racism and racial discrimination. Institutional racism acts in social institutions, contributing to the naturalization and reproduction of racial hierarchy. This concept is of great relevance for the advancement of public policies, for guaranteeing rights and equity in health care. For decades, scholars have been drawing attention to health inequities as a consequence of ethnic-racial issues. Question - What are the effects of systemic racism on health inequities or disparities? Methods - The searches were conducted in March 2024 in the databases Lilacs - Latin American and Caribbean Literature in Health Sciences and Index Psicologia (via Virtual Health Library - BVS), Pubmed, Epistemonikos, including the terms DeCS, MeSH and their synonyms. Only the process of selecting retrieved studies was carried out in duplicate and independently. The methodological quality of the SRs was assessed using the AMSTAR 2 tool. Results - Of the 261 records retrieved in the searches, 10 studies were included, the majority of which were related to the United States population and only one was a Brazilian study. The results are presented according to the following health conditions: cancer (4 reviews); psychosis (1 review); maternal health (4 reviews); diet and nutrition (1 review); self-rated health (1 cross-sectional study). The outcomes analyzed in the studies refer to the effects of ethnic-racial issues on the burden of disease, implications for diagnosis and access to treatments, survival, among others.

Mapa de evidências - Estratégias para o cuidado de pessoas com diabetes mellitus tipo 2, hipertensão arterial sistêmica ou obesidade / Evidence map - Strategies for the care of people with type 2 diabetes mellitus, systemic arterial hypertension or obesity

DESTAQUES ● Este mapa de evidências tem como objetivo apresentar estratégias que podem ser efetivas para o cuidado de pessoas com diabetes, hipertensão ou obesidade. ● Foram incluídas 93 revisões sistemáticas, cujos estudos primários foram realizados em sua maioria (65,1%) na América do Norte, Ásia e Europa. ● As intervenções foram classificadas em 5 categorias e 26 subcategorias. Observouse maior frequência da categoria "Teleconsulta/eHealth" e da subcategoria "cuidado assistencial". ● Os desfechos analisados foram classificados em clínicos e não clínicos. Desfechos clínicos foram relatados em 53 revisões sistemáticas, com destaque para a pressão arterial. Desfechos não clínicos foram relatados em 51 revisões sistemáticas, com destaque para a adesão ao tratamento farmacológico. ● As cinco categorias de intervenções - Teleconsulta/eHealth, Educação, Automonitoramento/autogerenciamento, Tratamento farmacológico, Serviço de saúde - apresentaram efeito positivo ou potencialmente positivo acima de 50% para os desfechos avaliados.

HIGHLIGHTS ● This evidence map aims to present strategies that may be effective for the care of people with diabetes, hypertension or obesity. ● 93 systematic reviews were included, the majority of whose primary studies were carried out (65.1%) in North America, Asia and Europe. ● Interventions were classified into 5 categories and 26 subcategories. There was a greater frequency of the "Teleconsultation/eHealth" category and the "assistance care" subcategory. ● The analyzed outcomes were classified as clinical and non-clinical. Clinical outcomes were reported in 53 systematic reviews, with emphasis on blood pressure. Non-clinical outcomes were reported in 51 systematic reviews, with emphasis on adherence to pharmacological treatment. ● The five categories of interventions - Teleconsultation/eHealth, Education, Self-monitoring/self-management, Pharmacological treatment, Health service - showed a positive or potentially positive effect above 50% for the evaluated outcomes.

Glial-restricted precursors stimulate endogenous cytogenesis and effectively recover emotional deficits in a model of cytogenesis ablation.

Adult cytogenesis, the continuous generation of newly-born neurons (neurogenesis) and glial cells (gliogenesis) throughout life, is highly impaired in several neuropsychiatric disorders, such as Major Depressive Disorder (MDD), impacting negatively on cognitive and emotional domains. Despite playing a critical role in brain homeostasis, the importance of gliogenesis has been overlooked, both in healthy and diseased states. To examine the role of newly formed glia, we transplanted Glial Restricted Precursors (GRPs) into the adult hippocampal dentate gyrus (DG), or injected their secreted factors (secretome), into a previously validated transgenic GFAP-tk rat line, in which cytogenesis is transiently compromised. We explored the long-term effects of both treatments on physiological and behavioral outcomes. Grafted GRPs reversed anxiety-like deficits and demonstrated an antidepressant-like effect, while the secretome promoted recovery of only anxiety-like behavior. Furthermore, GRPs elicited a recovery of neurogenic and gliogenic levels in the ventral DG, highlighting the unique involvement of these cells in the regulation of brain cytogenesis. Both GRPs and their secretome induced significant alterations in the DG proteome, directly influencing proteins and pathways related to cytogenesis, regulation of neural plasticity and neuronal development. With this work, we demonstrate a valuable and specific contribution of glial progenitors to normalizing gliogenic levels, rescuing neurogenesis and, importantly, promoting recovery of emotional deficits characteristic of disorders such as MDD.

Effects of sodium dodecylbenzene sulfonate (SDBS) on zebrafish (Danio rerio) gills and blood.

Sodium dodecylbenzene sulfonate (SDBS) is an important surfactant used as a cleaning agent and industrial additive to remove unwanted chemicals which have been detected in the aquatic environment. The aim of this study was to examine the toxicological potential of SDBS on the gills of adult male zebrafish (Danio rerio) exposed to this chemical. For the 96 hr acute exposure, fish were divided into three groups: control, 0.25 mg/L, and 0.5 mg/L of SDBS. After the experiment, morphophysiological analyses (gill histopathology and histochemistry), oxidative stress (determination of gill activities of superoxide dismutase (SOD) and catalase (CAT)), and hematological analyses (leukocyte differentiation) were conducted. Data demonstrated that SDBS at both tested concentrations altered the histopathological index and initiated circulatory disturbances, as well as adverse, progressive, and immunological changes in the gills. In the 0.5 mg/L group, SOD activity decreased significantly, but CAT activity was not altered. Prominent blood changes observed in this group were neutrophilia and lymphocytosis. The number of mucous and chloride cells increased significantly in both groups. Taken together, our findings demonstrated that exposure of D. rerio to SDBS, even for 96 hr, produced adverse morphological and hematological effects associated with a reduction in SOD activity. Our findings indicate that exposure of aquatic species to the anionic surfactant SDBS may lead to adverse consequences associated with oxidative stress. Therefore, this study highlights the risks that this substance may pose to aquatic ecosystems and emphasizes the need for further investigations and strict regulations on its disposal.

Atividade física para crianças e adolescentes: barreiras e facilitadores da implementação / Physical activity for children and adolescents: barriers and facilitators of implementation

Contexto - A atividade física (AF), por meio de uma prática regular, contribui para reduzir os riscos à saúde, controlar doenças cardíacas, diabetes tipo 2, câncer, e outras doenças e melhorar a qualidade de vida das pessoas. De acordo com a Organização Mundial da Saúde, até 5 milhões de mortes por ano poderiam ser evitadas no mundo se a população fosse mais ativa. No entanto, a influência de fatores individuais, coletivos, ambientais, culturais, econômicos e políticos podem contribuir ou prejudicar a prática de AF. Pergunta - Quais são as barreiras e os facilitadores para a implementação da atividade física na promoção da saúde de crianças e adolescentes na Atenção Primária à Saúde (APS)? Métodos - As buscas dos estudos foram realizadas em dezembro de 2023 nas bases de dados Medline (via PubMed), Literatura Latino-americana e do Caribe em Ciências da Saúde (Lilacs) via Biblioteca Virtual em Saúde (BVS), Google Acadêmico e Biblioteca Digital Brasileira de Teses e Dissertações (BDTD). Apenas o processo de seleção de estudos recuperados foi realizado em duplicidade e de modo independente. Resultados - De 1030 registros identificados, cinco estudos foram incluídos, três qualitativos, um quanti-qualitativo e uma revisão de literatura. Os resultados são apresentados em categorias de facilitadores e barreiras relacionados aos usuários, profissionais e serviços de saúde.

Context - Physical activity (PA), through regular practice, helps reduce health risks, control heart disease, type 2 diabetes, cancer, and other diseases, and improve people's quality of life. According to the World Health Organization, up to 5 million deaths per year could be avoided worldwide if the population were more active. However, the influence of individual, collective, environmental, cultural, economic, and political factors can contribute to or hinder the practice of PA. Question - What are the barriers and facilitators for the implementation of physical activity in promoting the health of children and adolescents in Primary Health Care (PHC)? Methods - The searches for studies were carried out in December 2023 in the Medline databases (via PubMed), Latin American and Caribbean Literature in Health Sciences (Lilacs) via the Virtual Health Library (BVS), Google Scholar, and the Brazilian Digital Library of Theses and Dissertations (BDTD). Only the selection process of retrieved studies was carried out in duplicate and independently. Results - Of 1030 records identified, five studies were included, three qualitative, one quantitative-qualitative and one literature review. The results are presented in categories of facilitators and barriers related to users, professionals and health services.

Práticas corporais e atividade física para mulheres gestantes e puérperas: efeitos na saúde / Body practices and physical activity for pregnant and postpartum women: health effects

Contexto - As práticas corporais e atividade física (PCAF) contribuem para reduzir os riscos à saúde e melhorar a qualidade de vida das pessoas. Entre gestantes e puérperas a AF pode trazer benefícios para a saúde da mulher e do bebê, além de reduzir riscos e complicações relacionados à gravidez. Pergunta - Quais são os efeitos das práticas corporais e/ou atividade física para a promoção da saúde de gestantes e puérperas na Atenção Primária à Saúde (APS)? Métodos - As buscas de revisões sistemáticas (RS) foram realizadas em dezembro de 2023 nas bases de dados da Biblioteca Virtual em Saúde, Pubmed, Embase e Health Systems Evidence. Apenas os processos de seleção de estudos recuperados e de avaliação da qualidade metodológica das RS (AMSTAR 2) foram realizados em duplicidade e de modo independente. Resultados - De 193 registros recuperados nas buscas, 36 RS foram incluídas. Os resultados são apresentados de acordo com os períodos de realização da AF: gravidez, perinatal e pós-parto. De modo geral, observaram-se benefícios para os seguintes desfechos: ➔ Dor, dor pélvica e dor lombar (9 RS) ➔ Qualidade de vida (5 RS); ➔ Sintomas depressivos e de ansiedade (4 RS) ➔ Complicações na gravidez, parto e pós-parto (4 RS) ➔ Medidas antropométricas (3 RS) ➔ Capacidade funcional e fadiga (2 RS) Considerações finais - A maioria dos resultados indica efeitos positivos relacionados à prática de PCAF para a promoção da saúde de gestantes e puérperas no contexto da APS. No entanto, deve-se observar que as RS foram classificadas em qualidade criticamente baixa (13 RS), baixa (2 RS) e alta (1 RS). Além disso, há grande variedade quanto às modalidades, à frequência e à duração das intervenções.

Context - Body practices and physical activity (PCAF) contribute to reducing health risks and improving people's quality of life. Among pregnant and postpartum women, PA can bring benefits to the health of women and babies, in addition to reducing risks and complications related to pregnancy. Question - What are the effects of body practices and/or physical activity for promoting the health of pregnant and postpartum women in Primary Health Care (PHC)? Methods - Searches for systematic reviews (SRs) were carried out in December 2023 in the databases of the Virtual Health Library, Pubmed, Embase, and Health Systems Evidence. Only the processes of selection of retrieved studies and assessment of the methodological quality of the SRs (AMSTAR 2) were performed in duplicate and independently. Results - Of 193 records retrieved in the searches, 36 SRs were included. The results are presented according to the periods of PA performance: pregnancy, perinatal, and postpartum. In general, benefits were observed for the following outcomes: ➔ Pain, pelvic pain and low back pain (9 SR) ➔ Quality of life (5 SR); ➔ Depressive and anxiety symptoms (4 SR) ➔ Complications during pregnancy, childbirth and postpartum (4 SR) ➔ Anthropometric measurements (3 SR) ➔ Functional capacity and fatigue (2 SR) Final considerations - Most results indicate positive effects related to the practice of PCAF for promoting the health of pregnant and postpartum women in the context of PHC. However, it should be noted that the SR were classified as critically low (13 SR), low (2 SR) and high (1 SR) quality. In addition, there is great variety in terms of the modalities, frequency and duration of the interventions.

Correlation between peripheral endothelial function, oxygen consumption and ventilatory efficiency in heart transplantation recipients.

BACKGROUND: Endothelial dysfunction and peak oxygen uptake (VO2peak) are also predictors of increased risk of cardiovascular events in heart transplantation (HTx) recipients. The preservation of endothelial function may contribute to exercise tolerance. OBJECTIVE: To investigate the correlation between peripheral endothelial function and exercise tolerance through VO2peak and ventilation to carbon dioxide production slope (VE / VCO2 slope) in HTx recipients. METHODS: A pilot cross-sectional study was conducted with adult individuals aged 18-65 years, HTx ≥ six months after surgery, who had a stable medical condition and no changes over the last three months of immunosuppressive treatment. The patients underwent an assessment of endothelial function through PAT (EndoPAT-2000®) and performed a cardiopulmonary exercise test (CPET). RESULTS: A total of 41% of the studied population presented endothelial dysfunction. The individuals were divided into two groups: the endothelial dysfunction (GED; n=9) group and the normal endothelial function (GNEF; n=13) group according to the logarithm of the reactive hyperemia index (LnRHI). There was a positive and moderate correlation between the LnRHI and VO2 peak (r=0.659, p=0.013) and a negative and moderate correlation between the LnRHI and VE/VCO2 slope (r= -0.686, p= 0.009) in the GNEF. However, no significant correlations were found in the GED. CONCLUSION: The results showed that the preservation of peripheral endothelial function is significantly correlated with an increase in exercise tolerance in individuals after HTx. These findings bring important considerations for cardiovascular risk prevention and emphasize that therapeutic strategies with physical training programs must be implemented early.