Morbidity trend and space-time clusters of COVID-19 occurrence in children and adolescents.

OBJECTIVE: To analyze the morbidity trend and space-time distribution clusters of confirmed COVID-19 cases in children and adolescents. METHOD: An ecological study of COVID-19 cases confirmed in the Information System from 2020 to 2022 in the age group from 0 to 19 years old, residents in Mato Grosso municipalities, Brazilian Midwest region. A trend analysis of the monthly morbidity rate of cases/100,000 inhabitants was used, following Prais-Winsten's regression. A space-time distribution of the Bayesian incidence rate per 100,000 inhabitants was performed, in addition to a space-time scan to identify high-risk clusters. RESULTS: Of all 79,592 COVID-19 cases studied, 51.6% were in females and 44.21% in people aged 15-19 years old. The mean monthly rate was 265.87 cases per 100,000 inhabitants, with a stationary trend in the period analyzed (Monthly Percentage Variation [MPV]) = 12.15; CI95%[MPV]: -0.73;26.70). The morbidity rate due to COVID-19 was higher in the female gender (283.14/100,000 inhabitants) and in the age group from 15 to 19 years old (485.90/100,000 inhabitants). An increasing trend was observed with a greater monthly time variation of 14.42% (CI95%[MPV]: 1.28;29.28)] among those aged from 10 to 14 years old. The primary cluster, which was also the one with the highest Relative Risk (RR = 5,16, p-value = 0.001), included 19 municipalities located in the North health macro-region. CONCLUSION: The findings indicated a monthly stationary trend in the study population, an increase in the age group from 10 to 14 years old, and areas at a higher risk for the disease in the North health macro-region of the state.

Prenatal Androgen Excess Induces Multigenerational Effects on Female and Male Descendants.

Background: It is still unelucidated how hormonal alterations affect developing organisms and their descendants. Particularly, the effects of androgen levels are of clinical relevance as they are usually high in women with Polycystic Ovary Syndrome (PCOS). Moreover, it is still unknown how androgens may affect males' health and their descendants. Objectives: We aimed to evaluate the multigenerational effect of prenatal androgen excess until a second generation at early developmental stages considering both maternal and paternal effects. Design And Methods: This is an animal model study. Female rats (F0) were exposed to androgens during pregnancy by injections of 1 mg of testosterone to obtain prenatally hyperandrogenized (PH) animals (F1), leading to a well-known animal model that resembles PCOS features. A control (C) group was obtained by vehicle injections. The PH-F1 animals were crossed with C males (m) or females (f) and C animals were also mated, thus obtaining 3 different mating groups: Cf × Cm, PHf × Cm, Cf × PHm and their offspring (F2). Results: F1-PHf presented altered glucose metabolism and lipid profile compared to F1-C females. In addition, F1-PHf showed an increased time to mating with control males compared to the C group. At gestational day 14, we found alterations in glucose and total cholesterol serum levels and in the placental size of the pregnant F1-PHf and Cf mated to F1-PHm. The F2 offspring resulting from F1-PH mothers or fathers showed alterations in their growth, size, and glucose metabolism up to early post-natal development in a sex-dependent manner, being the females born to F1-PHf the most affected ones. Conclusion: androgen exposure during intrauterine life leads to programing effects in females and males that affect offspring health in a sex-dependent manner, at least up-to a second generation. In addition, this study suggests paternally mediated effects on the F2 offspring development.

Protein arginine methyltransferase 1 regulates B cell fate after positive selection in the germinal center in mice.

Positively selected germinal center B cells (GCBC) can either resume proliferation and somatic hypermutation or differentiate. The mechanisms dictating these alternative cell fates are incompletely understood. We show that the protein arginine methyltransferase 1 (Prmt1) is upregulated in murine GCBC by Myc and mTORC-dependent signaling after positive selection. Deleting Prmt1 in activated B cells compromises antibody affinity maturation by hampering proliferation and GCBC light zone to dark zone cycling. Prmt1 deficiency also results in enhanced memory B cell generation and plasma cell differentiation, albeit the quality of these cells is compromised by the GCBC defects. We further demonstrate that Prmt1 intrinsically limits plasma cell differentiation, a function co-opted by B cell lymphoma (BCL) cells. Consistently, PRMT1 expression in BCL correlates with poor disease outcome, depends on MYC and mTORC1 activity, is required for cell proliferation, and prevents differentiation. Collectively, these data identify PRMT1 as a determinant of normal and cancerous mature B cell proliferation and differentiation balance.

Organizational factors and safe food handling by food service workers: a scoping review protocol.

OBJECTIVE: The objective of this scoping review is to explore and map the scientific evidence on organizational factors related to safe food handling by food service workers to prevent foodborne disease. INTRODUCTION: According to the World Health Organization, more than 600 million people become ill each year due to foodborne diseases. Improper food handling is one of the main causes of such diseases. Despite the growing literature on safe food handling, many studies focus on assessing and discussing cognitive variables, such as food safety knowledge. This indicates a need to study this topic from a new perspective, for example, through its organizational factors. INCLUSION CRITERIA: The review will include quantitative and qualitative studies on food handlers (ie, individuals who have direct or indirect contact with food during their professional duties) working in food services (ie, institutional or commercial establishments). Food handlers involved in industrial processing, planting, harvesting, or working on the street (street food) or in the home will be excluded. Eligible studies will explore the organizational factors of safe food handling that influence employee behavior regarding food production. METHODS: This review will use the JBI methodology for scoping reviews to identify published and unpublished studies in all languages, with no date limit. The following databases will be searched: Scopus, CINAHL, Embase, Web of Science, MEDLINE, PsycINFO, and Food Science and Technology Abstracts. A structured search for gray literature will also be conducted. Titles, abstracts, and full texts of articles will be screened by 2 independent reviewers for inclusion, with discrepancies resolved by a third reviewer. Data will be extracted using a standardized form. The results will be summarized in tabular or graphical format, accompanied by a narrative summary. KEY DETAILS OF THIS REVIEW PROJECT ARE AVAILABLE IN OPEN SCIENCE FRAMEWORK: https://osf.io/hxfe4.

Intrauterine androgen exposure impairs gonadal adipose tissue functions of adult female rats.

Prenatal androgen exposure induces fetal programming leading to alterations in offspring health and phenotypes that resemble those seen in women with Polycystic Ovary Syndrome. It has been described that prenatal androgenization affects the reproductive axis and leads to metabolic and endocrine disorders. Adipose tissue plays a crucial role in all these functions and is susceptible to programming effects. Particularly, gonadal adipose tissue is involved in reproductive functions, so dysfunctions in this tissue could be related to fertility alterations. We aimed to investigate the extent to which prenatal hyperandrogenization is able to alter the functionality of gonadal adipose tissue in female adult rats, including lipid metabolism, adipokines expression, and de novo synthesis of steroids. Pregnant rats were treated with 1 mg of testosterone from day 16 to day 19 of pregnancy, and female offspring were followed until 90 days of age, when they were euthanized. The prenatally hyperandrogenized (PH) female offspring displayed two phenotypes: irregular ovulatory (PHiov) and anovulatory (PHanov). Regarding lipid metabolism, both PH groups displayed disruptions in the main lipid pathways with altered levels of triglyceride and increased lipid peroxidation levels. In addition, we found that Peroxisome Proliferator-Activated Receptors (PPARs) alpha protein expression was decreased in both PH phenotypes (p < 0.05), but no changes were found in PPARγ protein levels. Furthermore, regarding adipokines, no changes were found in Leptin and Adiponectin protein levels, but Chemerin protein levels were decreased in the PHiov group (p < 0.05). Regarding de novo synthesis of steroids, the PHanov group showed increased protein levels of Cyp17a1 and Cyp19, while the PHiov group only showed decreased protein levels of Cyp19 (p < 0.05). These results suggest that prenatal androgen exposure affects females' gonadal adipose tissue in adulthood, disturbing different lipid pathways, Chemerin expression, and de novo synthesis of steroids.

Primary health care essential and derivative attributes in children and adolescents with leprosy / Atributos esenciales y derivados de la atención primaria de la salud en niños y adolescentes con lepra / Atributos essenciais e derivados da atenção primária à saúde em crianças e adolescentes com hanseníase

ABSTRACT Objective: to assess the presence and extension of Primary Health Care essential and derivative attributes in the assistance provided to children and adolescents with leprosy. Method: a cross-sectional study of an evaluative nature, with a quantitative approach. The information was obtained through interviews with nurses and physicians (n=37) working at Primary Health Care units in the care of children and adolescents with leprosy in the municipality of Parauapebas, Pará, Brazil, between October 2021 and February 2022. Mean, minimum, maximum and standard deviation values were used in the descriptive analyses, as well as the Levene test, Student's t-test. Pearson's Correlation Coefficient and a 5% confidence level. Results: 45.9% of the study participants had attended up to two training programs in leprosy care and 32.4% were trained in minors with the disease. When analyzing the mean values of each attribute, low orientation of the service provided and lower values of the general mean were observed in the analysis of attributes related to Access and Continued Care (score 3.4, SD±1.3; and score 3.8, SD±1.7 respectively). There was a regular positive correlation in most of the evaluated attributes and a significant strong positive correlation between care coordination and Professional/Community Orientation: r=0.601 and r=0.651, respectively. Conclusion: there is evidence of weaknesses in health care for children and adolescents with leprosy related to low service orientation; however, qualification in Care coordination exerts a positive influence on Professional orientation and Community orientation with an impact on service surveillance.

RESUMEN Objetivo: evaluar la presencia y la extensión de los atributos esenciales y derivados de la Atención Primaria de la Salud en la asistencia de niños y adolescentes con lepra. Método: estudio transversal, de naturaleza evaluativa y enfoque cuantitativo. Toda la información se obtuvo por medio de entrevistas realizadas entre octubre de 2021 y febrero de 2022 con enfermeros e médicos (n=37) que trabajan en unidades de Atención Primaria de la Salud en la asistencia de niños y adolescentes con lepra del municipio de Parauapebas, Pará, Brasil. En los análisis descriptivos se utilizaron los valores de media, mínimo, máximo y desvío estándar, además de las pruebas de Levene y t de Student, el Coeficiente de Correlación de Pearson y nivel de confianza del 5%. Resultados: el 45,9% de los participantes del estudio había asistido a un máximo de dos programas de capacitación en la atención de enfermos de lepra y el 32,4% se había capacitado en menores de edad que sufren el problema. Al analizar las medias de los valores de cada atributo, se observó escasa orientación del servicio prestado y valores inferiores a la media general en el análisis de los atributos relacionados con Acceso y Asistencia continuada (puntuación de 3,4; DE±1,3; y 3,8 DE±1,7 respectivamente). Se observó una correlación positiva regular en la mayoría de los atributos evaluados y una fuerte correlación y significativa entre Coordinación de la asistencia y Orientación profesional/comunitaria: r=0,601 y r=0,651, respectivamente. Conclusión: se detecta evidencia de debilidades en la atención de la salud en niños y adolescentes con lepra relacionadas a la escasa orientación del servicio; sin embargo, la calificación en la Coordinación de la asistencia ejerce una influencia positiva positivamente sobre la Orientación profesional y la Orientación comunitaria, con un efecto en la vigilancia de los servicios.

RESUMO Objetivo: avaliar a presença e extensão dos atributos essenciais e derivados da Atenção Primária à Saúde no atendimento à criança e ao adolescente com hanseníase. Método: estudo transversal, de natureza avaliativa, com abordagem quantitativa. As informações foram obtidas por meio de entrevistas com enfermeiros e médicos (n=37) atuantes em unidades da atenção primária à saúde no atendimento à criança e ao adolescente com hanseníase no município de Parauapebas, Pará, Brasil, entre os meses de outubro de 2021 a fevereiro de 2022. Utilizou-se nas análises descritivas os valores de média, mínimo, máximo e desvio padrão, e os testes de Levene, Teste t- Student e Coeficiente de Correlação de Pearson e nível de confiança de 5%. Resultados: dos participantes do estudo, 45,9% possuíam até dois treinamentos em cuidados com hanseníase e 32,4% com capacitação em menores com o agravo. Ao analisar as médias dos valores de cada atributo, observou-se baixa orientação do serviço prestado e valores inferiores da média geral na análise dos atributos relativos ao Acesso e Atendimento continuado (score 3,4; DP±1,3 e 3,8 DP±1,7 respectivamente). Observou-se correlação positiva regular na maioria dos atributos avaliados e correlação positiva forte significativa entre coordenação do cuidado com Orientação Profissional/Comunitária, respectivamente (r= 0,601) e (r= 0,651). Conclusão: há evidências de fragilidades nos cuidados de saúde em crianças e adolescentes com hanseníase relacionados à baixa orientação do serviço, contudo, a qualificação na Coordenação do Cuidado influencia positivamente na Orientação Profissional e na Orientação Comunitária com impacto na vigilância dos serviços.

Therapeutic Potential of Photosynthetic Microorganisms for Visceral Leishmaniasis: An Immunological Analysis.

New therapeutic strategies for visceral leishmaniasis (VL) have been studied, and the development of an immunotherapeutic agent that modulates the host's immune response is necessary. The aim of this study was to evaluate in vitro the bioactive extracts of photosynthetic microorganisms (PMs) for their leishmanicidal/leishmanistatic and immunomodulatory potentials. Bioactive extracts from PMs (Arthrospira platensis and Dunaliella tertiolecta) were obtained by sonication. Reference drugs, miltefosine (MTF) and N-methylglucamine antimoniate (SbV), were also evaluated. The selectivity index (SI) of treatments was determined by assays of inhibitory concentration (IC50) in Leishmania infantum cells and cytotoxic concentrations (CC50) in human peripheral blood mononuclear cells by the MTT method. The immune response was evaluated in healthy human cells by the production of cytokines and nitric oxide (NO) and the gene expression of Tbx21, GATA3, RORc, and FOXP3, using four concentrations (CC50, ½ CC50, » CC50, and IC50) for in-vitro stimulation. Based on the data obtained, we observed that the extracts of D. tertiolecta (SI = 4.7) and A. platensis (SI = 3.8) presented better results when compared to SbV (SI = 2.1). When analyzing the immune response results, we identified that the extracts of PMs stimulated the production of cytokines of the Th1 profile more than the reference drugs. The extracts also demonstrated the ability to stimulate NO synthesis. Regarding gene expression, in all concentrations of A. platensis extracts, we found a balance between the Th1/Th2 profile, with the average expression of the Tbx21 gene more than the GATA3 in the highest concentration (CC50). Regarding the extract of D. tertiolecta, we can observe that, in the lowest concentrations, a balance between all the genes was present, with the average expression of the GATA3 gene being lower than the others. The best result was found in the ½ CC50 concentration, stimulating a balanced positive expression between the Th1×Th17×Treg profiles, with a negative expression of GATA3. Thus, PM extracts showed promising results, presenting low toxicity, leishmanicidal/leishmanistatic activity, and induction of the immune response, which could be potential therapeutic candidates for VL.

Social school contacts of multibacillary leprosy cases in children living in the hyperendemic region of the Midwest of Brazil

Abstract Objective: To analyze the prevalence of Mycobacterium leprae detection and the associated factors among social contacts in the school environment of multibacillary cases living in a hyperendemic municipality of the state of Mato Grosso. Methods: Cross-sectional study with 236 social contacts of multibacillary leprosy from public schools and residents in Cuiabá (Mato Grosso) in 2018. The sources of information were interviews and nasal swab tests for molecular analysis by polymerase chain reaction - PCR. For the prevalence ratio estimates, crude and adjusted analyses were performed using robust Poisson regression and their respective confidence intervals (95% CI). The ArcGIS 9.1 software was used for the geographic distribution analyses. Results: The prevalence of detection of M. leprae in social contacts was 14%. A total of 63.6% of the schools surveyed had 5.1% to 50% of the social contacts of leprosy with positive PCR. The analysis of the geographic distribution in the neighborhoods showed a high prevalence of infection, being higher than 50% in some localities. The highest proportion of positive results occurred in the northern region of the city and from a precarious socioeconomic class. Conclusion: The results showed a high prevalence of detection of M. leprae among social contacts in areas with poor socioeconomic conditions. In these regions, there is a greater risk of

Preeclampsia among women with COVID-19 during pregnancy and its impact on maternal and perinatal outcomes: Results from a national multicenter study on COVID in Brazil, the REBRACO initiative.

OBJECTIVE: To evaluate the prevalence of preeclampsia among cases of COVID-19 infection during pregnancy and the association between both conditions, in a multicenter cohort of Brazilian women with respiratory symptoms. STUDY DESIGN: Ancillary analysis of the Brazilian Network of COVID-19 in Obstetrics (REBRACO) study. We performed a nested case-control analysis selecting all women with COVID-19 and compared outcomes between women with and without PE. MAIN OUTCOMES: Maternal, gestational, and clinical characteristics and perinatal outcomes. MEASURES: Prevalence ratio (PR) and its 95%CI for each of the predictors and outcomes. RESULTS: A total of 203 women were included: 21 (10.3%) in PE group and 182 (89.7%) in non-PE group. Preeclampsia was not different among women with and without COVID-19 (10.3% vs 13.1%, p-value = 0.41), neither complication such as eclampsia and HELLP syndrome. Chronic hypertension (33.4%) (p < 0.01) and obesity (60.0%) (p = 0.03) were the most frequent comorbidities in PE group, and they were significantly more frequent in this group. Women with PE had more cesarean section (RR 5.54 [1.33 - 23.14]) and their neonates were more frequently admitted to neonatal intensive care unit (PR 2.46[1.06 - 5.69]), most likely due to preterm-birth-related complications. CONCLUSION: The prevalence of PE among women with COVID-19 infection during pregnancy was around 10%; women with COVID-19 and a history of chronic hypertension or obesity are more likely to have preeclampsia. Cesarean section is increased among women with PE and COVID-19, with increased rates of neonatal admission to intensive care units, mostly due to prematurity.

Resistência das populações de Aedes (Stegomyia) aegypti (Linnaeus, 1762) (Insecta, Diptera, Culicidae) aos inseticidas utilizados para o controle: estado da arte do conhecimento / Resistance of Aedes (Stegomyia) aegypti (Linnaeus, 1762) (Insecta, Diptera, Culicidae) populations to insecticides used for control: art state of knowledge

Introdução: cerca de quatro bilhões de pessoas residem em áreas com risco de dengue, uma arbovirose transmitida pelo mosquito Aedes (Stegomyia) aegypti (Linnaeus, 1762) (Insecta, Diptera, Culicidae). Na tentativa de combater esse vetor e reduzir a disseminação da dengue, o meio de controle vetorial frequentemente utilizado são os inseticidas. Entretanto, o uso indiscriminado destes no controle do mosquito está relacionado aos mecanismos de resistência desse vetor. Objetivo: mapear as evidências científicas relacionadas à resistência do mosquito A. aegypti aos inseticidas utilizados para o controle populacional. Metodologia: revisão de escopo, segundo metodologia Instituto Joana Briggs, em bases de dados indexadas: PubMed, Embase, CINAHL, Web of Science, SCOPUS e Biblioteca Virtual em Saúde. Através do mnemônico PCC (população, conceito e contexto), elaborou-se a estratégia de busca utilizando descritores do Decs e Mesh. Resultados: foram encontrados 1.631 estudos sobre a temática. Após critérios de elegibilidade e seleção, foram incluídos 30 estudos específicos sobre resistência do Aedes aegypti a inseticidas foram incluídos na revisão. A maior parte tratou de forma experimental e 28 (93,3%) estudos trabalharam o controle químico. Em relação à resistência a inseticidas, em 20 estudos (66,6%) constatou-se resistência metabólica e em 9 (30%) a resistência mediada pela alteração da variabilidade genética. Os estudos que observaram mutação não deixam claro se a mutação gênica é especificamente devido à ação mutagênica aos inseticidas. Conclusões:o A. aegypti desenvolve adaptações que lhe conferem resistência aos inseticidas, sendo que esses mecanismos de resistência estão relacionados à variabilidade genética e a adaptações metabólicas, que são transmitidas a seus descendentes ao longo das gerações. Assim, torna-se necessário um avanço nos estudos visando não apenas identificar e explicar os mecanismos de resistência, mas encontrar meios alternativos de manejo que possam controlar o inseto sem ocasionar resistência aos mesmos.

Introduction: about four billion people live in areas at risk of dengue, an arbovirus transmitted by the Aedes (Stegomyia) aegypti (Linnaeus, 1762) (Insecta, Diptera, Culicidae). To combat this vector and reduce the spread of dengue, the means of vector control often used are insecticides. However, their indiscriminate use in mosquito control is related to the resistance mechanisms of this vector. Objective: to map the scientific evidence related to the resistance of the Aedes aegypti mosquito to the insecticides used to control dengue. Methodology: scope review, according to the Joana Briggs Institute methodology, in indexed databases: PubMed, Embase, CINAHL, Web of Science, SCOPUS and Virtual Health Library. Using the mnemonic PCC (population, concept and context), a search strategy was developed using Decs and Mesh descriptors. Results: 1,631 studies on the subject were found. After eligibility and selection criteria, 30 specific studies on Aedes aegypti resistance to insecticide were included in the review . Most treated experimentally and 28 (93.3%) studies worked on chemical control. Regarding the resistance to insecticide, in 20 studies (66.6%) there was found metabolic resistance and in 9 (30%) resistance mediated by modification on the genetic variability. Studies that have looked at mutation do not make it clear whether the gene mutation is specifically due to mutagenic action of insecticides. Conclusions: Aedes aegypti develops adaptations that gives them resistance to insecticides, and these resistance mechanisms are related to genetic variability and to metabolic adaptations, which are transmitted to its descendants over generations. Thus, it is necessary to perform advance in studies aiming not only to identify and explain the resistance mechanisms, but to find alternative means of management that can control the insect without causing resistance to them.

Social school contacts of multibacillary leprosy cases in children living in the hyperendemic region of the Midwest of Brazil.

OBJECTIVE: To analyze the prevalence of Mycobacterium leprae detection and the associated factors among social contacts in the school environment of multibacillary cases living in a hyperendemic municipality of the state of Mato Grosso. METHODS: Cross-sectional study with 236 social contacts of multibacillary leprosy from public schools and residents in Cuiabá (Mato Grosso) in 2018. The sources of information were interviews and nasal swab tests for molecular analysis by polymerase chain reaction - PCR. For the prevalence ratio estimates, crude and adjusted analyses were performed using robust Poisson regression and their respective confidence intervals (95% CI). The ArcGIS 9.1 software was used for the geographic distribution analyses. RESULTS: The prevalence of detection of M. leprae in social contacts was 14%. A total of 63.6% of the schools surveyed had 5.1% to 50% of the social contacts of leprosy with positive PCR. The analysis of the geographic distribution in the neighborhoods showed a high prevalence of infection, being higher than 50% in some localities. The highest proportion of positive results occurred in the northern region of the city and from a precarious socioeconomic class. CONCLUSION: The results showed a high prevalence of detection of M. leprae among social contacts in areas with poor socioeconomic conditions. In these regions, there is a greater risk of infection and of getting sick.

Fetal programming by androgen excess impairs liver lipid content and PPARg expression in adult rats.

It is known that prenatal hyperandrogenization induces alterations since early stages of life, contributing to the development of polycystic ovary syndrome affecting the reproductive axis and the metabolic status, thus promoting others associated disorders, such as dyslipidemia, insulin resistance, liver dysfunction, and even steatosis. In this study, we aimed to evaluate the effect of fetal programming by androgen excess on the hepatic lipid content and metabolic mediators at adult life. Pregnant rats were hyperandrogenized with daily subcutaneous injections of 1 mg of free testosterone from days 16 to 19 of pregnancy. The prenatally hyperandrogenized (PH) female offspring displayed two phenotypes: irregular ovulatory phenotype (PHiov) and anovulatory phenotype (PHanov), with different metabolic and endocrine features. We evaluated the liver lipid content and the main aspect of the balance between fatty acid (FA) synthesis and oxidation. We investigated the status of the peroxisomal proliferator-activated receptors (PPARs) alpha and gamma, which act as lipid mediators, and the adipokine chemerin, one marker of liver alterations. We found that prenatal hyperandrogenization altered the liver lipid profile with increased FAs levels in the PHanov phenotype and decreased cholesterol content in the PHiov phenotype. FA metabolism was also disturbed, including decreased mRNA and protein PPARgamma levels and impaired gene expression of the main enzymes involved in lipid metabolism. Moreover, we found low chemerin protein levels in both PH phenotypes. In conclusion, these data suggest that prenatal hyperandrogenization exerts a negative effect on the liver and alters lipid content and metabolic mediators' expression at adult age.

Viralizando Lygia Clark: sopros para contagiar de encanto a experiência do cuidado / Viralizing Lygia Clark: breaths to contaminate with enchantment the experience of care

RESUMO Esta escrita é desdobramento de um percurso investigativo comum das autoras a partir da obra da artista brasileira Lygia Clark, especialmente no que tange às interfaces arte-vida, arte-clínica, arte-política, implicadas em suas obras e proposições. Temos a psicologia e a dança como territórios profissionais-existenciais de partida e nos interessamos pelas experiências tecidas em uma trama transdisciplinar. No ano de centenário da artista, 2020, acordamos a memória inscrita no corpo da trajetória de Lygia Clark nos indagando sobre as possíveis contribuições de seu legado na contemporaneidade. Compreendemos que a violência colonial, que insiste nos tempos de agora, incide sobre o corpo, anestesiando sua dimensão sensível e absorvendo sua dimensão criadora, e se estabelece por meio de uma política de desencantamento da vida. O movimento de produção de saúde, que a trajetória de Lygia inspira, faz-nos afirmar seu percurso como possibilidade de ativação da dimensão sensível do corpo e de restauração do sentido de encanto. Por meio da partilha de algumas memórias de experimentações que foram criadas no contágio com a sua obra, desejamos criar sopros que liberem sentidos à aventura do viver e teçam espaços de ativação de uma saúde poética.

ABSTRACT This writing is an unfolding of a common investigative path of the authors based on the work of Brazilian artist Lygia Clark, especially concerning the interfaces art-life, clinical art, and political art involved in her works and propositions. We have psychology and dance as professional-existential starting territories and we are interested in the experiences woven through a transdisciplinary plot. In the artist's centennial year, 2020, we awoke the memory inscribed in the body of Lygia Clark's trajectory, asking ourselves about the possible contributions of her legacy in contemporary times. We understand that colonial violence, which insists on these time, affects the body, anesthetizing its sensitive dimension and absorbing its creative dimension, and is established through a policy of disenchantment with life. The movement of health production, which Lygia's path inspires, makes us affirm her path as a possibility of activating the sensitive dimension of the body and restoring the sense of enchantment. By sharing some memories of experiments that were created in contagion with Lygia's work, we want to create breaths that release meanings to the adventure of living and weave spaces for activating poetic health.

Leprosy patients quality of life: a scoping review.

OBJECTIVE: To explore the scientific evidence regarding the leprosy patients quality of life. METHOD: Scoping review according to the Joanna Briggs Institute methodology, with articles indexed in PubMed, Cochrane, LILACS, Embase, CINAHL, Scopus, Web of Science, PsyINFO, INFOLEP, and Google Scholar databases, published in full in Portuguese, English, or Spanish. RESULTS: Seventy-four studies were identified, with 71 of quantitative approach and 3 with a mixed method. There was a predominance of studies published in Brazil (58.1%), with an adult population, (97.3%) and recruited in reference centers for the treatment of leprosy (52.7%). There was greater use of the WHOQOL-bref (50%) and SF-36 (18.9%) instruments to assess quality of life. The study showed that the greatest impairment in quality of life was related to the delay in the diagnosis of the disease, to leprosy reactions, physical disabilities, neuropathic pain, and stigma. CONCLUSION: Most studies were developed in endemic countries, with adults, and based on observational studies, and the worst scores obtained were associated with physical domain impairment.

Prenatal testosterone exposure induces insulin resistance, uterine oxidative stress and pro-inflammatory status in rats.

Prenatal androgen excess is considered one of the main causes of the development of polycystic ovary syndrome. In this study, we investigated the effect of prenatal hyperandrogenization (PH) on the physiology of the adult uterine tissue using a murine model of fetal programming caused by androgen excess in adult female rats. Pregnant rats were hyperandrogenized with testosterone and female offspring were studied when adult. Our results showed that PH leads to hyperglycemia and hyperinsulinemia. Consequently, PH developed insulin resistance and a systemic inflammatory state reflected by increased C-reactive protein. In the uterine tissue, levels of PPAR gamma-an important metabolic sensor in the endometrium-were found to be impaired. Moreover, PH induced a pro-inflammatory and an unbalanced oxidative state in the uterus reflected by increased COX-2, lipid peroxidation, and NF-κB. In summary, our results revealed that PH leads to a compromised metabolic state likely consequence of fetal reprogramming.

Factors associated with leprosy in children contacts of notified adults in an endemic region of Midwest Brazil / Fatores associados à hanseníase em crianças contatos de adultos notificados em umaregião endêmica do Centro-Oeste do Brasil

Abstract Objectives: To analyze the factors associated with leprosy in children who were intradomiciliary contacts of notified adults with the disease in an endemic municipality in Mato Grosso, Brazil. Method: Case-control study with 204 children under 15 years of age, living in an endemic municipality. Cases (n = 40) were considered as the children with leprosy registered at the National Information System of Notifiable Diseases in 2014 and 2015, who were intradomiciliary contacts of at least one adult diagnosed with the disease in the family, and as a control group (n = 164) of children living within a radius of up to 100 m of the notified cases. Data were obtained through medical file analysis, interviews, and blood samples for anti-PGL-I serological test by the ELISA method. The binary logistic regression technique was used, with p ≤ 0.05. Results: After adjustments, the following were associated with leprosy: age (95% CI: 1.24-9.39, p = 0.018), area of residence (95% CI: 1.11-6.09, p = 0.027), waste disposal (95% CI: 1.91-27.98, p = 0.004), family history of the disease (95% CI: 3.41-22.50, p = 0.000), and time of residence (95% CI: 1.45-7.78, p = 0.005). Conclusion: Factors associated with the disease indicate greater vulnerability of children aged 8-14 years, associated with living conditions and time of residence, as well as the family history of the disease.

Resumo Objetivos: Analisar os fatores associados à hanseníase em crianças contatos intradomiciliares de adultos notificados com a doença em município endêmico, Mato Grosso, Brasil. Método: Estudo caso-controle com 204 menores de 15 anos residentes em um município endêmico. Consideraram-se casos (n = 40) crianças registradas com hanseníase no Sistema Nacional de Agravos de Notificação em 2014 e 2015 e que eram contatos intradomiciliares de pelo menos um adulto diagnosticado com a doença na família e como grupo controle (n = 164) crianças residentes a um raio de 100 metros dos casos notificados. Os dados foram obtidos por meio de análise de prontuários, entrevistas e coleta de amostras de sangue para investigação sorológica do anti-PGL-I pelo método Elisa. Usou-se a técnica de regressão logística binária e p ≤ 0,05. Resultados: Mostraram-se associados à hanseníase após ajustes: idade (IC 95%: 1,24-9,39; p = 0,018), zona de residência (IC 95%: 1,11-6,09; p = 0,027), destino de lixo (IC 95%: 1,91-27,98; p = 0,004), história da doença na família (IC 95%: 3,41-22,50; p = 0,000) e tempo de moradia (IC 95%: 1,45-7,78; p = 0,005). Conclusão: Os fatores associados à doença indicam maior vulnerabilidade em menores de 8 a 14 anos, ligadas as condições e ao tempo de moradia, bem como a história da doença na família.

Prenatal androgen exposure affects ovarian lipid metabolism and steroid biosynthesis in rats.

Prenatal androgen exposure affects reproductive functions and has been proposed as an underlying cause of polycystic ovary syndrome (PCOS). In this study, we aimed to investigate the impact of prenatal androgen exposure on ovarian lipid metabolism and to deepen our understanding of steroidogenesis regulation during adulthood. Pregnant rats were hyperandrogenized with testosterone and female offspring were studied when adult. This treatment leads to two different phenotypes: irregular ovulatory and anovulatory animals. Our results showed that prenatally hyperandrogenized (PH) animals displayed altered lipid and hormonal profile together with alterations in steroidogenesis and ovarian lipid metabolism. Moreover, PH animals showed alterations in the PPARg system, impaired mRNA levels of cholesterol receptors (Ldlr and Srb1) and decreased expression of the rate-limiting enzyme of de novo cholesterol production (Hmgcr). Anovulatory PH animals presented an increase of ovarian cholesteryl esters levels and lipid peroxidation index. Together with alterations in cholesterol metabolism, we found an impairment of the steroidogenic pathway in PH animals in a phenotype-specific manner. Regarding fatty acid metabolism, our results showed, in PH animals, an altered expression of Srebp1 and Atgl, which are involved in fatty acid metabolism and triglycerides hydrolysis, respectively. In conclusion, fatty acid and cholesterol metabolism, which are key players in steroidogenesis acting as a source of energy and substrate for steroid production, were affected in animals exposed to androgens during gestation. These results suggest that prenatal androgen exposure leads to long-term effects that affect ovary lipid metabolism and ovarian steroid formation from the very first steps.

[Acceptability of chemoprophylaxis in an endemic area for leprosy: the PEP-Hans Brazil Project]. / Aceitabilidade da quimioprofilaxia em área endêmica para a hanseníase: projeto PEP-Hans Brasil.

The aim was to analyze the acceptability of chemoprophylaxis with single-dose rifampicin (PEP) in contacts, index leprosy cases, and health professionals and related factors that can influence adherence. A qualitative content analysis study was performed after application of semi-structured interviews according to the protocol proposed in the LPEP program (2016) drafted at Alta Floresta, Mato Grosso State, Brazil, in July 2016. Study participants included individuals with leprosy, contacts, and health professionals. The QRS NVivo software version 10 was used. A total of 80 individuals were contacted, including 54 (67%) contacts, 11 (14%) index cases, and 15 (19%) health professionals. 94% of the contacts (51/54) took PEP. Three PEP categories were identified: understanding, acceptance, and expectation towards the intervention. Understanding proved to be related to care by the health team. Acceptance (or lack thereof) of the medication was related to fear, trust, and protection, the strategy's operability, self-esteem, and insecurity regarding the intervention. Expectation towards the intervention was related to wellbeing, prevention of the disease, sequelae, decrease in public expenditures, and expanded access. Participants acknowledged the relevance of the PEP strategy based on the possibility of interrupting the transmission chain, reduction in new cases, and improved quality of life. Insecurity in taking the medication and the possibility of the disease manifesting itself had a negative influence on acceptance of PEP, while prior information on the PEP strategy helped strengthen trust in the health professionals and the medication's acceptance.

O objetivo deste artigo foi analisar a aceitabilidade da quimioprofilaxia com rifampicina em dose única (PEP) entre os contatos, casos índices de hanseníase e profissionais da saúde e fatores relacionados que possam influenciar na adesão. Realizou-se um estudo qualitativo de análise de conteúdo após aplicação de entrevistas semiestruturadas segundo protocolo proposto no programa LPEP (2016), realizado em Alta Floresta, Mato Grosso, Brasil, em julho de 2016. Participaram do estudo indivíduos notificados com hanseníase, contatos e profissionais da saúde. Utilizou-se o software QRS NVivo versão 10. Foram contatados 80 indivíduos, sendo 54 (67%) contatos, 11 (14%) casos índices e 15 (19%) profissionais de saúde. Dentre os contatos, 94% (51/54) tomaram PEP. Foram identificadas 3 categorias quanto à PEP: compreensão, aceitação e expectativa da intervenção. A compreensão se mostrou relacionada ao cuidado da equipe de saúde. Aceitar ou não a medicação revelou-se relacionada ao medo, confiança e proteção, operacionalidade da estratégia, autoestima e insegurança quanto à intervenção. A expectativa da intervenção relacionou-se ao bem-estar, prevenção da doença e de sequelas, diminuição de gastos públicos e ampliação do acesso. Houve reconhecimento da relevância da estratégia PEP pela possibilidade de interrupção da cadeia de transmissão, diminuição de casos novos e melhora na qualidade de vida. A insegurança em tomar a medicação e de a doença se manifestar influenciaram negativamente à aceitação da PEP; por outro lado, as informações prévias sobre a estratégia PEP contribuíram para o fortalecimento da confiança nos profissionais de saúde e para a aceitabilidade da medicação.

El objetivo fue analizar la aceptabilidad de la quimioprofilaxis con rifampicina en dosis única (PEP) entre los contactos, casos índices de hanseniasis y profesionales de salud, así como los factores relacionados que puedan influenciar en la adhesión al tratamiento. Se realizó un estudio cualitativo de análisis de contenido, tras la realización de entrevistas semiestructuradas, según el protocolo propuesto en el programa LPEP (2016), realizado en Alta Floresta, Mato Grosso, Brasil, en julio de 2016. Participaron en el estudio individuos diagnosticados con hanseniasis, contactos y profesionales de la salud. Se utilizó el software QRS NVivo versión 10. Se contactó con 80 individuos, siendo 54 (67%) contactos, 11 (14%) casos índices y 15 (19%) profesionales de salud. Entre los contactos 94% (51/54) tomaron PEP. Se identificaron 3 categorías respecto a la PEP: comprensión, aceptación y expectativa de intervención. La comprensión estuvo relacionada con el cuidado del equipo de salud. El aceptar o no la medicación estuvo relacionado con el miedo, confianza y protección, operatividad de la estrategia, autoestima e inseguridad de la intervención. La expectativa de la intervención estuvo relacionada con el bienestar, prevención de la enfermedad, así como secuelas, disminución de gasto público y ampliación del acceso. Existió un reconocimiento de la relevancia de la estrategia PEP por la posibilidad de interrupción de la cadena de transmisión, disminución de casos nuevos y mejora en la calidad de vida. La inseguridad en tomar la medicación y de que la enfermedad se manifestara influenciaron negativamente en la aceptación de la PEP, por otro lado, la información previa sobre la estrategia PEP contribuyó al fortalecimiento de la confianza en los profesionales de salud y a la aceptabilidad de la medicación.