Cerebral Venous Thrombosis in Pediatric Age: Risk Factors and Prognosis.

INTRODUCTION: Cerebral venous thrombosis (CVT) is a rare but potentially fatal disease in pediatric age with an important morbimortality. In adults several factors have been associated with worse outcomes, however there are still few studies in children. This study aims to identify risk factors associated with clinical manifestations and long-term sequelae in pediatric CVT. METHODS: Retrospective analysis of pediatric inpatients admitted to a tertiary-care hospital due to CVT between 2008 and 2020. RESULTS: Fifty-four children were included, 56% male, median age of 6.5 years (9 months-17.3 years). Permanent risk factors were identified in 13 patients (malignancy, 8; hematologic condition, 5) and transient risk factors in 47, including head and neck infections (57%) and head trauma (15%). Multiple venous sinuses involvement was present in 65% and the deep venous system was affected in four patients. Seventeen percent had intracranial hemorrhage and 9% cerebral infarction. Sixty-four percent of patients with multiple venous sinuses involvement presented with severe clinical manifestations: impaired consciousness, intracranial hypertension, acute symptomatic seizures or focal deficits. Regarding long-term prognosis, six patients had major sequelae: epilepsy (n = 3), sensory motor deficits (n = 2), and cognitive impairment (n = 3). Permanent risk factors were associated with severe clinical manifestations (p = 0.043). Cerebral infarction and intracranial hemorrhage were associated with major sequelae (p = 0.006 and p = 0.03, respectively, adjusted for age and sex). CONCLUSION: Permanent risk factors, involvement of multiple venous sinuses, intracranial hemorrhage, and cerebral infarction, were related to worse prognosis. Detection and early management of risk factors may limit CVT extension and reduce its morbimortality.

Inorganic contamination in roadkill birds in Northeast Brazil / Contaminação inorgânica em aves atropeladas no Nordeste do Brasil

Abstract Wildlife roadkill surveys in Brazil often focus on birds, as they are one of the main groups affected by road accidents. In addition roadkill, anthropogenic litter also contributes to a significant number of bird fatalities every year. The present study aimed to investigate the stomach contents and possible contamination by inorganic material of birds killed on a federal highway that crosses the Serra de Itabaiana National Park in the state of Sergipe, Brazil. Monitoring and data collection were carried out from January to June 2022, with a motorcycle at an average speed of 60 km/h. The collected animals were transported to the Institute of Technology and Research, located at the Tiradentes University, Sergipe, Brazil, and a plastic material was identified. The plastic material found was subjected to Fourier Transform Infrared Spectroscopy (FTIR), which showed a similar wavenumber to a polymer in the polypropylene chain, very common in plastic packaging. The presence of plastics and metals in the intestinal contents of Caracara plancus and Crotophaga ani is noteworthy, as they have a greater tendency to ingest plastics due to their generalist diet. Plastic contamination in Progne chalybea and Nyctidromus albicollis probably occurred through bioaccumulation, from the consumption of insects contaminated by microplastics.

Resumo As pesquisas sobre atropelamentos de animais silvestres no Brasil geralmente se concentram nas aves, pois elas são um dos principais grupos afetados por acidentes rodoviários. Além dos atropelamentos, o lixo antropogênico também contribui para um número significativo de mortes de aves todos os anos. O presente estudo teve como objetivo investigar o conteúdo estomacal e possível contaminação por material inorgânico de aves atropeladas em uma rodovia federal que atravessa o Parque Nacional da Serra de Itabaiana, no estado de Sergipe, Brasil. O monitoramento e a coleta de dados foram realizados no período de janeiro a junho de 2022, com uma motocicleta a uma velocidade média de 60 km/h. Os animais coletados foram transportados para o Instituto de Tecnologia e Pesquisa situado na Universidade Tiradentes, Sergipe, Brasil, onde foi identificado um material plástico. O material plástico encontrado foi submetido à espectroscopia no infravermelho com transformada de Fourier (FTIR), que mostrou número de onda semelhante a um polímero da cadeia do polipropileno, muito comum em embalagens plásticas. Chama a atenção a presença de plásticos e metais no conteúdo intestinal de Caracara plancus e Crotophaga ani, pois apresentam maior tendência à ingestão de plásticos devido à dieta generalista. A contaminação plástica em Progne chalybea e Nyctidromus albicollis provavelmente ocorreu por bioacumulação, a partir do consumo de insetos contaminados por microplásticos.

Microcotylidae (Monogena) parasites of snappers (Perciformes: Lutjanidae) collected from the northeast coast of Brazil.

Monogeneans are a diverse group of flatworms, being ectoparasites of marine and freshwater fish, with great morphological and ecological variety. Analyzes of monogenetics in fish with great habitat diversity such as snappers are scarce in the literature, which already emphasizes the need for an update in this regard. The presente study found, morphologically characterized and mapped the geographic distribution and in known hosts the species Microcotyloides incisa and Microcotyloides impudicus, describing the first occurrence of these monogeneans for South America and in new hosts. The survey of hosts in the literature shows that M. incisa seems to have a greater Affinity with congener species of Lutjanidae and fish from other families, which may indicate a preference or specificity for fish of this family because they are congeners of their host type. The introduction of these parasites into South American waters may have occurred due to the migratory behavior of snappers, which are well distributed along the Mexican coast, where the parasites are usually reported. Here, we also bring the first occurrence of M. incisa for Lutjanus analis and Lutjanus jocu and M. impudicus for Ocyurus chrysurus and Lutjanus synagris, helping in the mapping and distribution of these monogenetic species in the Americas.

Child Neurology: Anti-Hu Encephalitis in an Adolescent With a Mediastinal Seminoma.

Anti-Hu antibodies are associated with autoimmune syndromes, mainly limbic encephalitis, encephalomyelitis, and painful sensory polyneuropathy (Denny-Brown). We report the case of a 15-year-old boy presenting with epilepsia partialis continua (EPC) found to have a right middle frontal gyrus brain lesion without atrophy or contralateral involvement. After partial resection, neuropathology revealed neuronal loss, reactive gliosis and astrocytosis, and perivascular mononuclear inflammatory infiltrate and features of neuronophagia resembling Rasmussen encephalitis. Suboptimal response to antiseizure drugs and surgery prompted further workup with identification of positive serum anti-Hu antibodies and a mediastinal seminoma. The patient was treated with immunotherapy including steroids, IV immunoglobulin, azathioprine, rituximab, plasmapheresis, and mediastinal lesion resection. However, he continued to experience EPC and psychomotor impairment along with left hemiparesis and dysarthria. Given clinical progression with failure to respond to immunotherapy and antiseizure polytherapy, hemispherotomy was attempted and seizure freedom achieved. A review of the literature found only 16 cases of neurologic presentations associated with anti-Hu antibodies in children, confirming the rarity of EPC in these cases. Thus, this report provides a new observation of germ cell mediastinal tumor associated with anti-Hu antibodies in children, broadening the spectrum of anti-Hu-associated neurologic disorders in children and highlighting the importance of considering antineuronal antibody testing in children presenting with EPC and brain lesions suggestive of Rasmussen encephalitis.

The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations.

Physician-Patient communication (PPC) has been linked to patient adjustment outcomes. However, conflicting results have been reported and previous systematic reviews showed some methodological weaknesses. It has also been suggested that PPC is related to physicians' own adjustment outcomes. This systematic review aims to explore and synthesize the associations between PPC and both patient and physician adjustment outcomes. A systematic search was conducted primarily in five databases and 11.488 non-duplicated articles were identified. Forty-five studies met the eligibility criteria and data extraction was performed for sample characteristics, PPC measurement, adjustment outcomes under examination and main outcomes. The observed results showed that the majority of the included studies were cross-sectional, assessed PPC by proxy-report and reported an overall positive association with patients' adjustment outcomes. None of the studies examined the association between PPC and physicians' adjustment outcomes. Thirty-three studies were meta-analyzed and showed a positive and significant association between PPC and patients' adjustment outcomes (r = .16). Due to the small number of studies included in the meta-analysis, the heterogeneity was high. Subgroup analysis could not identify sources for heterogeneity. Research on the associations between PPC and physicians' own adjustment outcomes is warranted. Future studies should be rigorous in defining clear PPC definitions, directionality of communication processes, and study design.

Successful Treatment of a Child With Epileptic Encephalopathy With Spike-Wave Activation in Sleep and GRIN2A Variant Using Sulthiame.

Epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS) and developmental EE-SWAS (DEE-SWAS) are characterized by variable combinations of cognitive, language, behavioral, and/or motor regression associated with continuous or near-continuous diffuse spike-and-wave complexes during sleep. Glutamate ionotropic receptor NMDA type subunit 2A (GRIN2A) variants have been associated with EE-SWAS. It encodes the most relevant GluN2 subunit of the N-methyl-D-aspartate receptor (NMDAR). Sulthiame reduces NMDAR-mediated neuronal excitability and has been progressively used as monotherapy in self-limited epilepsy with centrotemporal spikes (SeLECTS) or as add-ontherapy in EE-SWAS/DEE-SWAS. A five-year-old female, with family history of epilepsy, was initially diagnosed with SeLECTS and medicated with valproic acid (VPA). One year later, she presented a focal to bilateral tonic-clonic seizure during sleep and learning difficulty. The electroencephalogram revealed continuous spike-and-wave during sleep leading to the diagnosis of EE-SWAS. Prednisolone was effective, but there was repeated recurrence after its discontinuation and associated adverse effects. As an alternative, sulthiame was added to VPA. Four years later, she remains clinically stable. Genetic testing revealed a GRIN2A missense variant, C.3228C>A (p.Asn1076Lys). Sulthiame appeared effective in this recurrent EE-SWAS child, who presented a GRIN2A missense variant with possible NMDAR gain-of-function and adverse effects of corticosteroids. Functional studies​​​​​​​ of GRIN2A variants might become a future tool for individualized therapies.

Cuidados intensivos de enfermagem ao idoso com delirium: um protocolo de revisão de escopo / Intensive nursing care to older adults with delirium: a protocol of scoping review

OBJETIVO: explorar sistematicamente a literatura quanto aos cuidados de enfermagem prestados aos idosos internados com delirium, em unidades de terapia intensiva, sejam eles para prevenção, sejam eles para manejo do delirium. MÉTODO: protocolo de revisão de escopo, estruturado pelas recomendações do Manual do Instituto Joanna Briggs, utilizando as seguintes bases de dados: PubMed via MEDLINE, Scopus, Embase, Web of Science e Google Scholar. A bibliografia encontrada será organizada através do gerenciador EndNote. Após a exclusão dos estudos duplicados, as citações serão transferidas para o software Rayyan. Em seguida, será iniciada a triagem das referências por dois pesquisadores independentes. O processo da seleção de estudos será exibido no fluxograma adaptado do Checklist PRISMA-ScR. Os dados serão extraídos dos estudos através de uma planilha desenvolvida no programa Microsoft Excel pelos próprios autores, avaliando e interpretando as informações de acordo com o objetivo proposto. Os dados serão organizados em tabelas, quadros e fluxogramas, com discussão narrativa.

OBJECTIVE: to systematically explore the literature regarding the nursing care provided to the older adult hospitalized with delirium in intensive care units for the prevention or management of delirium. METHOD: scoping review protocol, structured by the recommendations of the Joanna Briggs Institute manual, utilizing the following database: MEDLINE via PubMed, Scopus, Embase, Web of Science, and Google Scholar. We will organize the citations found through the EndNote manager. After the exclusion of duplicated studies, we will transfer the citations to the Rayyan software. Afterward, two independent researchers will begin the screening of titles / abstracts. We will present the selection process of studies in the Checklist PRISMA-ScR adopted flowchart. The authors will extract the data of the studies through a spreadsheet developed in the Microsoft Excel, evaluating and interpreting the information according to the objective of the study. We will organize the data in charts, tables, and flowcharts with a narrative discussion.

Tecnologias educacionais utilizadas pelo enfermeiro junto ao idoso em hemodiálise: um protocolo de revisão de escopo / Educational technologies used by the nurse with the elderly on hemodialysis: a scoping review protocol

OBJETIVO: Mapear as tecnologias educacionais utilizadas pelo enfermeiro no cuidado ao idoso em hemodiálise. MÉTODO: Trata-se de um protocolo de revisão de escopo desenvolvido com base nas recomendações do Manual do Instituto Joanna Briggs e registrado na Open Science Framework: https://osf.io/9qfge. A busca pelos artigos será realizada nas bases de dados Medline/PubMed, Scopus, Web of Science, Embase, LILACS, BDENF, CINAHL e Google Scholar. Serão considerados elegíveis os estudos que respondam à pergunta de pesquisa "Quais são as tecnologias educacionais utilizadas pelo enfermeiro ao idoso em hemodiálise?". Dois revisores atuarão de maneira independente para promover a seleção dos artigos. O software Rayyan será utilizado como ferramenta para auxiliar no arquivamento dos documentos. As listas de referências dos artigos selecionados também serão consultadas. Caso haja divergências entre os revisores, um terceiro revisor fará a apreciação para resolver as discordâncias. Para a síntese e extração dos dados, os autores utilizarão um formulário previamente elaborado. A apresentação dos resultados será feita por meio de quadros, fluxogramas, resumo e discussão narrativa.

OBJECTIVE: To identify the educational technologies used by nurses in the care of the elderly on hemodialysis. METHOD: This is a scoping review protocol developed based on the recommendations of the Joanna Briggs Institute Manual and registered with the Open Science Framework: https://osf.io/9qfge. Articles will be searched in Medline/PubMed, Scopus, Web of Science, Embase, LILACS, BDENF, CINAHL, and Google Scholar databases. Studies that answer the research question, "What educational technologies are used by nurses working with the elderly in hemodialysis?" will be considered eligible. Two reviewers will work independently to select articles. Rayyan software will be used as a tool to assist in document archiving. The reference lists of the selected articles will also be consulted. A third reviewer will assess the disagreement in case of disagreement between the reviewers. For data synthesis and extraction, the authors will use a pre-designed form. The results will be presented in tables, flowcharts, summaries, and narrative discussions.

Motor stereotypies in autism spectrum disorder: Clinical randomized study and classification proposal.

LAY ABSTRACT: Motor stereotypies are one of the most frequent features in children with a diagnosis of autism spectrum disorder. They may disrupt children's functioning and development and be a potential source of stress for families. Several factors, including sex, age, cognitive ability, and severity of autism spectrum disorder, may influence the presence and intensity of stereotypies. The present study aimed to identify the prevalence of motor stereotypies in a group of children with autism spectrum disorder. In addition, it sought to investigate whether sex, age, cognitive ability, verbal language, neurological comorbidities, and severity of autism spectrum disorder were associated with an increased probability and higher number, duration, and variability of stereotypies. A total of 134 participants aged 2.3-17.6 years underwent a clinical protocol with standardized video-recorded sessions. Stereotypies were identified and classified by two independent evaluators. The prevalence of stereotypies was 56.7%, and a total of 1198 motor stereotypies were captured. Children who were younger, nonverbal, and had higher severity of autism spectrum disorder had an increased probability of presenting stereotypies. Being nonverbal or having higher severity of autism spectrum disorder was also associated with presenting a higher number of stereotypies. Children with developmental delay, intellectual disability, or epilepsy displayed longer stereotypies, and children with developmental delay or intellectual disability additionally presented more diverse stereotypies. As part of the study, the authors present a clinical classification model, a glossary, and video samples of motor stereotypies. The findings of this study suggest that children who are younger, nonverbal, have lower cognitive ability, and have higher severity of autism spectrum disorder may have a higher burden of stereotypies. Earlier intervention and monitoring of these children have the potential to improve their long-term outcomes.

Phlebotominae Fauna (Diptera: Psychodidae) and the Spatial Distribution of Species in Sergipe, Brazil.

Some sand fly species are the vectors responsible for the transmission of Leishmania spp. (Kinetoplastida: Trypanosomatidae), the etiological agent of leishmaniasis, and in the state of Sergipe, the two main forms of the disease (visceral and cutaneous) are recorded. Few works show information about the species that form the Phlebotominae fauna in Sergipe. This study aimed to update and determine how they are distributed throughout the state. The study used data from surveys about phlebotomines in Sergipe, from the Program of Surveillance and Control of Visceral Leishmaniasis, carried out by the Central Public Health Laboratory of Sergipe, from 2008 to 2018, along with review and original data from 2022. The commentary on this information was developed with focus on the species that can be vectors for the disease. Sergipe has, up to now, 27 registered species of phlebotomines from 12 genera, 15 of them are of sanitary relevance. Twenty two of these species are in the mesoregion East, 19 in the Agreste, and 11 in the Sertão of Sergipe. The species with the greatest distribution was Evandromyia lenti (Mangabeira, 1938), present in 74.6% of the municipalities of Sergipe, followed by Lutzomyia longipalpis (Lutz & Neiva, 1912), the main vector of the etiological agent of visceral leishmaniasis in Brazil, present in 68% of the municipalities studied. This study expands the number and distribution of species recorded in the state. This information can contribute to disease containment plans and support health education actions aimed at the control of leishmaniasis in Sergipe.

Exploring factors associated with complete mental health of pregnant women during the COVID-19 pandemic.

OBJECTIVE: To explore a wide range of factors associated with complete mental health (i.e., positive mental health - the presence of flourishing, and the absence of mental illness - depressive and anxious symptoms) among Portuguese pregnant women, during the COVID-19 pandemic. DESIGN: Quantitative cross-sectional study. SETTING: Data were collected through an online survey placed on social media websites targeting pregnant Portuguese adult women between October 2020 and April 2021. PARTICIPANTS: The sample comprised 207 pregnant women. RESULTS: A multivariate logistic regression model showed that higher levels of self-compassion and higher engagement in mindful self-care practices increased the likelihood of reporting complete mental health during pregnancy. CONCLUSIONS: Promoting self-compassion and mindful self-care may be particularly important in pregnant women, as these psychological factors appear to contribute to complete mental health during COVID-19 pandemic. IMPLICATIONS FOR PRACTICE: The COVID-19 pandemic represented a demanding period for pregnant women. Our findings highlight that targeting the promotion of self-compassion and mindful self-care practices during stressful periods could significantly contribute to their overall mental health.

Conhecimento de pacientes com câncer sobre cuidados paliativos: estudo bibliométrico / Knowledge of patients with cancer about palliative care: a bibliometric study / Conocimiento de los pacientes con cáncer sobre cuidados paliativos: un estudio bibliométrico

Resumo Esta pesquisa busca caracterizar os indicadores bibliométricos acerca do conhecimento de pacientes com câncer sobre cuidados paliativos. Por meio da associação dos descritores " patient ", " palliative care ", " knowledge " e " neoplasm " encontrou-se baixa taxa de publicação, com tendência a elevação, além de rede de conexão limitada entre os autores. Os países asiáticos foram os que mais publicaram, mas observou-se nível de conhecimento limitado sobre o tema, pois há forte associação com cuidados de fim de vida, destinados apenas a pacientes com câncer, internados em hospital e sem cura. Este estudo permitiu mapear os principais indicadores bibliométricos a respeito do conhecimento de pacientes com câncer sobre os cuidados paliativos, sendo perceptível o crescimento de publicações sobre o tema, mas ainda com baixa quantidade total. Evidencia-se, assim, a necessidade de mais publicações para a obtenção de maior entendimento sobre o tema.

Abstract This research seeks to characterize the bibliometric indicators regarding cancer patients's knowledge about palliative care. Bibliographic search associating the descriptors " patient, " " palliative care, " " knowledge " and " neoplasm " found low publication ratio and limited conexion among authors. Asian countries account for most publications, but the level of knowledge on the topic was limited given its strong association with end-of-life care aimed at hospitalized cancer patients without possibility of cure. Mapping the main bibliometric indicators on knowledge about palliative care pointed out the need for further publications on the topic to provide better understanding.

Resumen Este estudio tiene como objetivo caracterizar los indicadores bibliométricos de conocimiento de los pacientes con cáncer sobre cuidados paliativos. A partir de la asociación entre las palabras clave " patient ", " palliative care ", " knowledge " y " neoplasm ", se constató una baja tasa de publicación, con tendencia al alza, así como una limitada red de conexiones entre autores. Los países asiáticos fueron los que más publicaron, aunque el nivel de conocimientos sobre el tema era limitado, ya que lo asocian a los cuidados al final de la vida, destinados únicamente a los pacientes oncológicos, hospitalizados y no curados. Este estudio permitió trazar los principales indicadores bibliométricos sobre el conocimiento de los cuidados paliativos por parte de los pacientes con cáncer, y se observó que hubo un aumento de las publicaciones sobre el tema, aunque el número total sigue siendo bajo. Esto pone de manifiesto la necesidad de más publicaciones para conocer mejor el tema.

Lesões bucais em idosos usuários de prótese dentária: uma revisão de escopo / Oral lesions in elderly dental prosthesis wearers: a scoping review / Lesiones orales en usuarios de prótesis dentales de edad avanzada: una revisión de alcance

Objetivo: Mapear as evidências científicas disponíveis acerca das lesões bucais prevalentes em idosos que fazem uso de próteses dentárias. Métodos: Trata-se de uma revisão de escopo na qual os estudos foram selecionados em abril de 2022, a partir de buscas nas bases Cochrane, Lilacs, PubMed, Scopus e Web of Science. Incluíram-se estudos publicados de 1997 a 2021 e não houve restrição de idioma. Resultados: Foram incluídos 18 artigos, sendo dezesseis (88,9%) estudos transversais e dois (11,1%) estudos de coorte, de diferentes países. A estomatite protética foi a lesão mais prevalente nos idosos na maior parte dos achados, seguida por úlceras, queilite angular, hiperplasias e candidíase eritematosa. Conclusões: Os estudos analisados apontam uma maior ocorrência da estomatite protética em mulheres, sendo o uso de próteses removíveis mais propício a lesões. Sugere-se que outros protocolos de pesquisa sejam desenvolvidos a fim de evidenciar novos achados sobre a temática, em diferentes regiões. (AU).

Objective: To identify the scientific evidence available on the prevalent oral lesions in the elderly who use dental prostheses. Methods: This is a scoping review in which studies were selected in April 2022, from searches in Cochrane, Lilacs, PubMed, Scopus and Web of Science databases. Studies published from 1997 to 2021 were included, and there was no language restriction. Results: Eighteen articles were included, of which sixteen (88.9%) were cross-sectional studies and two (11.1%) were cohort studies, from different countries. Prosthetic stomatitis was the most prevalent lesion in the elderly in most findings, followed by ulcers, angular cheilitis, hyperplasia and erythematous candidiasis. Conclusions: The studies analyzed point to a higher occurrence of prosthetic stomatitis in women, with the use of removable prostheses being more prone to lesions. It is suggested that other research protocols be developed in order to highlight new findings on the subject in different regions. (AU).

Objetivo: Mapear la evidencia científica disponible sobre las lesiones orales prevalentes en los ancianos que utilizan prótesis dentales. Métodos: Se trata de una revisión de la investigación en la que los estudios fueron seleccionados en abril de 2022, a partir de búsquedas en las bases Cochrane, Lilacs, PubMed, Scopus y Web of Science. Se incluyeron los estudios publicados entre 1997 y 2021 y no hubo restricción de idioma. Resultados: Se incluyeron dieciocho artículos, de los cuales dieciséis (88,9%) eran estudios transversales y dos (11,1%) eran estudios de cohortes, procedentes de diferentes países. La estomatitis fue la lesión más prevalente en los ancianos en la mayoría de los hallazgos, seguida de las úlceras, la queilitis angular, la hiperplasia y la candidiasis eritematosa. Conclusiones: Los estudios analizados señalan una mayor ocurrencia de estomatitis protésica en las mujeres, siendo el uso de prótesis removibles más propenso a las lesiones. Se sugiere que se desarrollen otros protocolos de investigación con el fin de evidenciar nuevos hallazgos sobre el tema, en diferentes regiones. (AU).

Demandas e utilização de serviços de saúde entre imigrantes de uma região metropolitana do nordeste do Brasil / Demandas y uso de servicios de salud entre inmigrantes de uma región metropolitana del noreste de Brasil / Demands and use of health services among immigrants from a metropolitan region in northeastern Brazil

Resumo Objetivo analisar as demandas e a utilização dos serviços de saúde por imigrantes na Região Metropolitana de Aracaju, Sergipe. Método recrutaram-se, pelo método bola de neve, 186 imigrantes, alocados em clusters relacionados à renda per capita do país de origem e países da América Latina ou não. Utilizou-se questionário auto aplicado sobre as condições e práticas de saúde. Resultados imigrantes de países com renda baixa e média baixa (IMB) são mais jovens, com menor tempo de permanência no Brasil, possuem ensino fundamental/médio, exercem atividade laboral sem carteira de trabalho assinada e renda de até um salário mínimo (p<0,05). Imigrantes da América Latina (IAL) possuem aproximadamente duas vezes mais chances de ter alguma doença crônica não transmissível (DCNT), comparados aos imigrantes de outros países (IOP). A idade e o tempo de permanência no Brasil influenciam na autoavaliação da saúde, na busca por serviços de saúde e ter alguma DCNT (p<0,05). O Sistema Único de Saúde foi o mais buscado tanto na chegada ao Brasil quanto nos últimos 12 meses, principalmente pelos IMB e IAL (p<0,05). Conclusão e implicações para a prática observaram-se diferenças dentro dos subgrupos de imigrantes, principalmente em termos de padrões de utilização, ressaltando a importância da competência transcultural na assistência.

Resumen Objetivo fueron analizadas las demandas y el uso de los servicios de salud por los inmigrantes en la Región Metropolitana de Aracaju, Sergipe. Método fueron reclutados, mediante el método bola de nieve, 186 inmigrantes y se dividieron en agrupación es según la renta per cápita del país de origen y continente. Se utilizó un cuestionario auto aplicado sobre condiciones y prácticas de salud. Resultados los inmigrantes de países de renta baja y media baja (IMB) son más jóvenes, han pasado menos tiempo en Brasil, tien en educación primaria/secundaria, trabajan sin contrato formal y tienen una renta de hasta 1 mínimo salario (p<0,05). Los inmigrantes de Latinoamérica (LAI) tienen aproximadamente el doble de probabilidades de tener una enfermedad crónica no transmisible (ENT) em comparación con inmigrantes de otros países (IOP). La edad y el tiempo de permanencia en Brasil influyen en la autoevaluación de la salud, la búsqueda de servicios de salud y el tener algunas ENT (p<0,05). El Sistema Único de Salud (Sistema Único de Saúde) fue el más buscado tanto a su llegada a Brasil como en los últimos 12 meses, principalmente por el IMB y la IAL (p<0,05). Conclusión e implicaciones para la práctica se observaron diferencias dentro de los subgrupos de inmigrantes, principalmente en términos de sus patrones de uso, resaltando la importancia de la competencia intercultural em la asistencia.

Abstract Objective This study aimed to analyze the demands and use of health services by international migratory clusters in the metropolitan region of Aracaju, Sergipe. Method A total of 186 immigrants were recruited, and divided into clusters according to the country of origin and continent. An epidemiological questionnaire on health conditions and care-related. Results Low and low middle income country immigrants (LMI) are younger, with lower length of stay in Brazil, elementary education, working without a formal contract, with an income of up to 1 minimum wage (p<0.05). Latin America immigrants (LAI) are approximately twice as likely to have some Chronic noncommunicable disease (NCDs), compared to other country immigrants (OCI). Age and length of stay in Brazil influence self-rated health, search for health services and having some NCDs (p<0.05). The Unified Health System (Sistema Único de Saúde) was the most sought after both on arrival in Brazil and in the last 12 months, mainly by LMI and LAI (p<0.05). Conclusion and implications for practice Differences were observed within immigrant subgroups, mainly in terms of their use patterns and the importance for cross-cultural competence in health care.

Small Molecules Targeting SARS-CoV-2 Spike Glycoprotein Receptor-Binding Domain.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the coronavirus disease 2019 (COVID-19) pandemic. Several variants of SARS-CoV-2 have emerged worldwide. These variants show different transmissibility infectivity due to mutations in the viral spike (S) glycoprotein that interacts with the human angiotensin-converting enzyme 2 (hACE2) receptor and facilitates viral entry into target cells. Despite the effective SARS-CoV-2 vaccines, we still need to identify selective antivirals, and the S glycoprotein is a key target to neutralize the virus. We hypothesize that small molecules could disrupt the interaction of S glycoprotein with hACE2 and inhibit viral entry. We analyzed the S glycoprotein-hACE2 complex structure (PDB: 7DF4) and created models for different viral variants using visual molecular dynamics (VMD) and molecular operating environment (MOE) programs. Moreover, we started the hits search by performing structure-based molecular docking virtual screening of commercially available small molecules against S glycoprotein models using OEDocking FRED-4.0.0.0 software. The FRED-4.0.0.0 Chemguass4 scoring function was used to rank the small molecules based on their affinities. The best candidate compounds were purchased and tested using a standard SARS-CoV-2 pseudotyped cell-based bioassay to investigate their antiviral activity. Three of these compounds, alone or in combination, showed antiviral selectivity. These small molecules may lead to an effective antiviral treatment or serve as probes to better understand the biology of SARS-CoV-2.

Sintomas e compreensões de mulheres na menopausa em área metropolitana do Nordeste brasileiro: estudo quantiqualitativo / Symptoms and understandings of women in menopause in a metropolitan area of brazilian northeast: a quanti-qualitative study

Avaliar como as mulheres em área metropolitana do Nordeste brasileiro sentem e compreendem a menopausa. Estudo misto, com 417 mulheres de 40 a 60 anos no qual se utilizou um roteiro de questões socioeconômicas, ginecológicas/obstétricas, morbidades, medicações e sexualidade, além do Female Sexual Function Index e Menopause Rating Scale. A menopausa, constatada em 56,6% das mulheres com média de idade de 50,4±5,7 anos, teve sintomatologia associada severa (falta de ar, suor, calor e ansiedade); 52,5% apresentaram dúvidas ou falta de conhecimento sobre a menopausa, e 44,6%, redução na função sexual, que se correlacionou negativamente com a idade (r= -0,208; p<0,001). A disfunção sexual é quase duas vezes maior nas mulheres em menopausa do que naquelas em pré menopausa (OR=1,81; p=0,036). A sexualidade das mulheres com dificuldades ou disfunções sexuais por causa da menopausa pode estar permeada por inibições emocionais e psicológicas.

To evaluate what women feel and how they understand the menopause period in a metropolitan area of the Brazilian Northeast. A mixed study with 417 women aged 40 to 60 years that used a script of socioeconomic, gynecological/obstetrical, morbidity, medication, and sexuality questions, as well as the Female Sexual Function Index and Menopause Rating Scales. Menopause, observed in 56.6% of women with a mean age of 50.4±5.7 years, had severe associated symptoms (shortness of breath, sweat, heat and anxiety); 52.5% had doubts or lack of knowledge about menopause, and 44.6%, reduction in sexual function, which correlated negatively with age (r= -0.208; p<0.001). Sexual dysfunction is almost twice as high in menopausal women as in premenopausal women (OR=1.81; p=0.036). The sexuality of women with sexual issues or dysfunctions due to menopause may be permeated by emotional and psychological inhibitions.