The role of the visceral adiposity index in the assessment of metabolic syndrome of polycystic ovary syndrome patients: a new anthropometric index.

PURPOSE: Polycystic ovary syndrome (PCOS) is a common endocrine disorder often linked to metabolic syndrome (MS), raising the risk of cardiovascular disease and type II diabetes. Certain indicators, such as the lipid accumulation product (LAP) and homeostatic model assessment for insulin resistance (HOMA-IR), can predict MS in PCOS patients. This study aimed to assess the predictive power of the visceral adiposity index (VAI) in comparison to LAP and HOMA-IR as predictors of MS in PCOS patients. METHODS: In this cross-sectional observational study, data from 317 diagnosed PCOS women were analyzed. VAI, LAP, and HOMA-IR were computed as indexes. Participants were categorized into two groups for index accuracy comparison: PCOS patients with and without MS. The data were assessed using a ROC curve. RESULTS: Among PCOS women with MS, 92.3% had abnormal VAI results, 94.5% had abnormal LAP results, and only 50.5% had abnormal HOMA-IR results. Conversely, the majority of PCOS women without MS had normal HOMA-IR (64.6%). When comparing these indexes using the ROC curve, VAI displayed the highest accuracy, followed by LAP and HOMA-IR. CONCLUSION: The VAI index proved to be a superior predictor of metabolic MS in PCOS women when compared to other indexes.

Patients with longstanding pPatients with longstanding psoriatic arthritis can achieve DAPSA remission or low disease activity and it correlates to better functional outcomes: results from a Latin-American real-life cohort.

BACKGROUND: Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. OBJECTIVES: To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ - 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. METHODS: This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. RESULTS: Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16-0.6795% CI p = 0.002) and RR 0.96 (0.93-0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12-2.6095%CI p = 0.013)]. CONCLUSIONS: In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.

Patients with longstanding psoriatic arthritis can achieve DAPSA remission or low disease activity and it correlates to better functional outcomes: results from a Latin-American real-life cohort

Abstract Background Patients with psoriatic arthritis (PsA) experience reduced physical function and impaired quality of life. Better patient-reported functional outcomes are found when lower disease activity is achieved. Objectives To evaluate the variation of physical function by HAQ-DI over time in PsA patients treated with standard therapy in a real-life setting: to verify predictors of achieving a minimum clinically important difference (MCID) in function by HAQ-DI (ΔHAQ-DI ≤ − 0.35) and to measure the impact of achieving REM/LDA on long-term function by HAQ-DI. Methods This is a longitudinal analysis of a real-life retrospective cohort. Data from PsA patients with at least 4 years of follow-up in the PsA clinic from 2011 to 2019 were extracted from electronic medical records. The variations of physical function by HAQ-DI and disease activity by DAPSA over time were calculated. A multivariate hierarchical regression model was applied to verify predictors of MCID in HAQ-DI. A comparison of HAQ-DI variation between patients with DAPSA REM, LDA, moderate and high disease activity was made using the generalized estimating equation model (GEE), adjusted by Bonferroni test. The Spearman correlation method was applied to verify the correlation of ΔDAPSA and ΔHAQ-DI over time. Statistical analysis was performed in SPSS program version 21.0. Results Seventy-three patients were included in the analysis. Physical function measured by HAQ-DI was determined by PsA disease activity measured by DAPSA (p < 0.000). A moderate and statistically significant correlation between ΔDAPSA and ΔHAQ-DI was observed (rs = 0.60; p < 0.001). Only patients in DAPSA REM demonstrated a constant decline in HAQ-DI scores during the follow-up. White ethnicity and older age at baseline were predictors for not achieving MCID in HAQ-DI [RR 0.33 (0.16-0.6795% CI p = 0.002) and RR 0.96 (0.93-0.9895% CI p < 0.000), respectively, while higher scores of HAQ-DI at baseline were predictors of achieving MCID [RR 1.71 (1.12-2.6095%CI p = 0.013)]. Conclusion In PsA, patients who maintained DAPSA REM/LDA over time had better long-term functional outcomes. Higher HAQ-DI scores at baseline, non-white ethnicity and younger age were predictors for achieving a clinical meaningful improvement of HAQ-DI.

Glycosyltransferase 8 domain-containing protein 1 (GLT8D1) is a UDP-dependent galactosyltransferase.

Glycosyltransferases (GTs) are enzymes that catalyze the formation of glycosidic bonds and hundreds of GTs have been identified so far in humans. Glycosyltransferase 8 domain-containing protein 1 (GLT8D1) has been associated with central nervous system diseases and cancer. However, evidence on its enzymatic properties, including its substrates, has been scarcely described. In this paper, we have produced and purified recombinant secretory GLT8D1. The enzyme was found to be N-glycosylated. Differential scanning fluorimetry was employed to analyze the stabilization of GLT8D1 by Mn2+ and nucleotides, revealing UDP as the most stabilizing nucleotide scaffold. GLT8D1 displayed glycosyltransferase activity from UDP-galactose onto N-acetylgalactosamine but with a low efficiency. Modeling of the structure revealed similarities with other GT-A fold enzymes in CAZy family GT8 and glycosyltransferases in other families with galactosyl-, glucosyl-, and xylosyltransferase activities, each with retaining catalytic mechanisms. Our study provides novel structural and functional insights into the properties of GLT8D1 with implications in pathological processes.

American Thyroid Association and Thyroid Imaging Reporting and Data System developed by the American College of Radiology: which one is better at predicting malignancy risk?

OBJECTIVE: The aim of this study was to compare the capacity of American Thyroid Association and Thyroid Imaging Reporting and Data System developed by the American College of Radiology in predicting malignancy risk of thyroid nodules and to verify which one is better at avoiding unnecessary fine needle aspiration. METHODS: This was a cross-sectional study with 565 thyroid nodules, followed at a tertiary care hospital, in an iodine-replete area. Those were classified as American Thyroid Association and Thyroid Imaging Reporting and Data System developed by the American College of Radiology systems and stratified according to the Bethesda classification of fine needle aspiration. The values of sensibility, specificity, positive predictive value, and negative predictive value accuracy were calculated. Also, the percentage of unnecessary biopsies was presented. RESULTS: The mean age of the individuals was 58.2±13.5 [26-90] years for benign nodules and 41.7±15.6 [23-66] years for malignant nodules (p=0.002). Regarding gender, 92.6% (n=150) of the individuals with benign nodules and 85.7% (n=06) with malignant nodules were females (p=0.601). For American Thyroid Association, 90.9% of sensibility, 51.4% of specificity, 52.6% of accuracy, 10.2% of positive predictive value, and 98.9% of negative predictive value were found. For Thyroid Imaging Reporting and Data System developed by the American College of Radiology, 90.9% of sensibility, 49.7% of specificity, 52.1% of accuracy, 9.9% of positive predictive value, and 98.9% of negative predictive value were found. .Notably, 12.3% of unnecessary fine needle aspiration were found in American Thyroid Association and 44.4% were found in Thyroid Imaging Reporting and Data System developed by the American College of Radiology. CONCLUSION: Both Thyroid Imaging Reporting and Data System developed by the American College of Radiology and American Thyroid Association are able to predict the malignancy risk of thyroid nodules. Thyroid Imaging Reporting and Data System developed by the American College of Radiology was better at avoiding unnecessary fine needle aspiration.

Detection of Equus caballus Papillomavirus in Equine Aural Plaque Samples.

Aural plaques have been linked to Equus caballus papillomavirus (EcPV). Ten types of EcPVs have already been described; however, only EcPVs 1, 3, 4, 5, and 6 have been observed in association with aural plaques. Accordingly, the objective of this study was to evaluate the presence of EcPVs in equine aural plaque samples. A total of 29 aural plaque samples (from 15 horses) were collected and assessed for the presence of the DNA of these EcPVs by PCR. Additionally, 108 aural plaque samples used in previous research were evaluated for the presence of EcPVs 8 and 9. Previously described primers were used for PCR to detect EcPVs 1 to 8, and specific primers were designed for EcPV 9. Minigenes were synthesized and used as a positive control in the PCRs for the undetected EcPVs. EcPVs 2, 7, 8, and 9 were not detected in any of the evaluated samples, suggesting that these viral types are not involved in the etiology of the equine aural plaque in Brazil. EcPV 6 was the most prevalent (81%), followed by EcPVs 3 (72%), 4 (63%) and 5 (47%), which reinforces the idea that these viruses play an important role in the etiology of the equine aural plaque in Brazil.

In vitro and in vivo susceptibility to sulfadiazine and pyrimethamine of Toxoplasma gondii strains isolated from Brazilian free wild birds.

Little is known about the existence of drug-resistant Toxoplasma gondii strains and their possible impact on clinic outcomes. To expand our knowledge about the existence of natural variations on drug susceptibility of T. gondii strains in Brazil, we evaluated the in vitro and in vivo susceptibility to sulfadiazine (SDZ) and pyrimethamine (PYR) of three atypical strains (Wild2, Wild3, and Wild4) isolated from free-living wild birds. In vitro susceptibility assay showed that the three strains were equally susceptible to SDZ and PYR but variations in the susceptibility were observed to SDZ plus PYR treatment. Variations in the proliferation rates in vitro and spontaneous conversion to bradyzoites were also accessed for all strains. Wild2 showed a lower cystogenesis capacity compared to Wild3 and Wild4. The in vivo analysis showed that while Wild3 was highly susceptible to all SDZ and PYR doses, and their combination, Wild2 and Wild4 showed low susceptibility to the lower doses of SDZ or PYR. Interestingly, Wild2 presented low susceptibility to the higher doses of SDZ, PYR and their combination. Our results suggest that the variability in treatment response by T. gondii isolates could possibly be related not only to drug resistance but also to the strain cystogenesis capacity.

Adrenal incidentaloma: Do patients with apparently nonfunctioning mass or autonomous cortisol secretion have similar or different clinical and metabolic features?

OBJECTIVE: Although there is growing evidence associating nonfunctioning adrenal incidentalomas (NFAI) with cardiovascular risk factors, there are limited data whether NFAI and autonomous cortisol secretion (ACS) groups have similar or different clinical and metabolic features. The aim of this study is to compare cardiometabolic clinic parameters among patients with ACS and NFAI, as well as controls. DESIGN: Cross-sectional study. PATIENTS: Eighty nine NFAI, 58 ACS and 64 controls were evaluated. MEASUREMENTS: Diagnosis of NFAI (1 mg dexamethasone suppression test [1 mg-DST] ≤50 nmol/L [≤1.8 µg/dl]) and ACS (1 mg-DST > 50 nmol/L [> 1.8 µg/dl]) was established according to current guidelines. The control group was selected based on a normal adrenal imaging exam. RESULTS: There were no differences between groups regarding age, gender, ethnicity, menopause or body mass index. Patients with adrenal incidentaloma presented higher frequency of hypertension (74.1 vs. 57.8%; p = .02), resistant hypertension (45.4 vs. 9.4%; p < .001), dyslipidemia (80.1 vs. 63.9%; p = .01), as well as metabolic syndrome (84.2 vs. 61.7%; p = .001) compared to the controls, respectively. NFAI and ACS patients presented similar frequency of arterial hypertension (70.8 vs. 79.3%) and resistant hypertension (41.3 vs. 51.1%), dyslipidemia (79.3 vs. 81.5%) and metabolic syndrome (83.3 vs. 85.7%); also, levels of HbA1c were similar between the groups. Binary logistic regression showed that NFAI (p = .004) and ACS (p = .001) were independent predictors for resistant hypertension (p = .003); also, ACS was an independent predictor for metabolic syndrome (p = .04). CONCLUSIONS: NFAI and ACS presented a higher frequency of cardiometabolic morbidities in comparison with individuals with normal adrenal glands. Additionally, we demonstrated that both ACS and NFAI groups have similar cardiometabolic conditions.

American Thyroid Association and Thyroid Imaging Reporting and Data System developed by the American College of Radiology: which one is better at predicting malignancy risk?

SUMMARY OBJECTIVE: The aim of this study was to compare the capacity of American Thyroid Association and Thyroid Imaging Reporting and Data System developed by the American College of Radiology in predicting malignancy risk of thyroid nodules and to verify which one is better at avoiding unnecessary fine needle aspiration. METHODS: This was a cross-sectional study with 565 thyroid nodules, followed at a tertiary care hospital, in an iodine-replete area. Those were classified as American Thyroid Association and Thyroid Imaging Reporting and Data System developed by the American College of Radiology systems and stratified according to the Bethesda classification of fine needle aspiration. The values of sensibility, specificity, positive predictive value, and negative predictive value accuracy were calculated. Also, the percentage of unnecessary biopsies was presented. RESULTS: The mean age of the individuals was 58.2±13.5 [26-90] years for benign nodules and 41.7±15.6 [23-66] years for malignant nodules (p=0.002). Regarding gender, 92.6% (n=150) of the individuals with benign nodules and 85.7% (n=06) with malignant nodules were females (p=0.601). For American Thyroid Association, 90.9% of sensibility, 51.4% of specificity, 52.6% of accuracy, 10.2% of positive predictive value, and 98.9% of negative predictive value were found. For Thyroid Imaging Reporting and Data System developed by the American College of Radiology, 90.9% of sensibility, 49.7% of specificity, 52.1% of accuracy, 9.9% of positive predictive value, and 98.9% of negative predictive value were found. .Notably, 12.3% of unnecessary fine needle aspiration were found in American Thyroid Association and 44.4% were found in Thyroid Imaging Reporting and Data System developed by the American College of Radiology. CONCLUSION: Both Thyroid Imaging Reporting and Data System developed by the American College of Radiology and American Thyroid Association are able to predict the malignancy risk of thyroid nodules. Thyroid Imaging Reporting and Data System developed by the American College of Radiology was better at avoiding unnecessary fine needle aspiration.

Análise de preditores de risco cumulativo para a gagueira persistente: percepção familiar e quantidade de rupturas da fala / Analysis of cumulative risk predictors for persistent stuttering: family perception and amount of speech disruptions

RESUMO Objetivo Pesquisar duas variáveis independentes consideradas como possíveis preditores de risco cumulativo para a gagueira persistente (GP): percepção familiar da gagueira e quantidade de rupturas da fala. Método Participaram 452 crianças, com idade entre 3 a 11:11 anos, de ambos os gêneros, divididos em 4 grupos: grupo 1 (GGQ), 158 crianças com percentual de rupturas gagas ≥3% e queixa familiar de gagueira; grupo 2 (GGS), 42 crianças com percentual de rupturas gagas ≥3% e sem queixa familiar de gagueira; grupo 3 (FQ), 94 crianças com percentual de rupturas gagas ≤2.9% com queixa familiar de gagueira e grupo 4 (FS), 158 crianças com percentual de rupturas gagas ≤2.9 sem queixa familiar de gagueira. Resultados Para o grupo GGQ há relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala típicas da gagueira e houve predominância de crianças do sexo masculino. Para o grupo GGS não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FQ não houve relação significante entre a queixa familiar de gagueira e quantidade de rupturas de fala. Para o grupo FS houve relação significante entre a ausência de queixa familiar de gagueira e a reduzida quantidade de rupturas de fala. Conclusão O percentual de rupturas ≥3% é um indicador de risco para a GP. A queixa familiar de rupturas do tipo repetições pode ser um indicador de risco para a GP. A queixa familiar de gagueira, isoladamente, não deve ser considerada como indicador de GP.

ABSTRACT Purpose To investigate two independent variables considered as two possible predictors of cumulative risk for persistent stuttering: family perception of stuttering and amount of speech disruptions. Methods Participants were 452 children, aged 3 to 11:11 years, male and female, divided into 4 groups: group 1 (SCG), composed of 158 children who presented a percentage of stuttered speech disruptions ≥ 3% and family complaint of stuttering; group 2 (SWCG), 42 children who presented percentage of stuttered speech disruptions ≥ 3% and without family complaint of stuttering; group 3 (FCG), 94 children who presented percentage of stuttered speech disruptions ≤ 2. 9% with family complaints of stuttering and group 4 (FWCG), 158 children who presented a percentage of stuttered speech disruptions ≤ 2.9 without family complaints of stuttering. Results For the SCG group, there was a significant relationship between family complaints of stuttering and the number of speech disruptions typical of stuttering. In this group, there was a predominance of male children. For the SWCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FCG group, there was no significant relationship between family complaints of stuttering and the number of speech disruptions. For the FWCG group, there was a significant relation between the absence of a family complaint of stuttering and the reduced number of speech disruptions. Conclusion The percentage of speech disruptions ≥ 3% is a risk indicator for persistent stuttering. The percentage of speech disruptions ≤ 2.9% associated with syllable and sound repetitions can be a risk indicator for persistent stuttering. Family complaints of syllable and sound repetitions may be a risk indicator for persistent stuttering. Family complaints of stuttering alone should not be considered an indicator of persistent stuttering.

Perfil epidemiológico, risco de agravamento e óbito por COVID-19 em cardiopatas no Brasil / Epidemiological profile, risk of worsening and death by COVID-19 in patients with heart disease in Brazil / Perfil epidemiológico, riesgo de empeoramiento y muerte por COVID-19 en pacientes con cardiopatía en Brasil

Objetivo:traçar o perfil epidemiológico de cardiopatas que contraíram COVID-19 no primeiro ano pandêmico. Método:estudo observacional, do tipo coorte retrospectiva. Foram incluídos cardiopatas com resultado de PCR positivo, de março a dezembro de 2020. Excluíram-se os registros com dados incompletos para as variáveis analisadas. Na análise bivariada, foram calculadas as razões de prevalência (com IC 95%) como medida de associação entre a variável dependente (cardiopatia) e as variáveis independentes (idade, sexo, escolaridade e zona de residência) empregando-se o teste do χ2de Mantel Haenszel. Resultados:identificou-se associação com significância estatística em relação às variáveis faixa etária, sexo e escolaridade. O maior risco de ocorrer desfecho desfavorável, foi para a faixa etária acima de 70 anos (59,97%), seguido do intervalo de idade de 60 a 69 anos (38,31%), sexo masculino (45,28%) e escolaridade para o nível superior. Conclusão:evidenciou-se que os cardiopatas requerem maiores cuidados após o diagnóstico da doença, especialmente pelo fato deste grupo apresentar um maior índice de mortalidade.

Objective:to establish the epidemiological profile of patients with heart disease who contracted COVID-19 in the first pandemic year. Method:observational, retrospective cohort study. Patients with heart disease with positive PCR results from March to December 2020 were included. Records with incomplete data for the variables analyzed were excluded. In the bivariate analysis, the prevalence ratios (with CI 95%) were calculated as a measure of association between the dependent variable (cardiopathy) and the independent variables (age, sex, education and area of residence) using the χ2 test of Mantel Haenszel. Results:an association with statistical significance was identified in relation to the variables age, sex and education. The highest risk of an unfavorable outcome was for the age group over 70 years old (59.97%), followed by the age range from 60 to 69 years old (38.31%), male sex (45.28%) and schooling to higher level. Conclusion:it was evidenced that patients with heart disease require greater care after the diagnosis of the disease, especially because this group has a higher mortality rate.

Objetivo:establecer el perfil epidemiológico de los pacientes con cardiopatías que contrajeron COVID-19 en el primer año de pandemia. Método:estudio observacional de cohortes retrospectivo. Se incluyeron pacientes con cardiopatías con PCR positiva de marzo a diciembre de 2020. Se excluyeron los registros con datos incompletos para las variables analizadas. En el análisis bivariado se calcularon las razones de prevalencia (con IC 95%) como medida de asociación entre la variable dependiente (cardiopatía) y las variables independientes (edad, sexo, escolaridad y zona de residencia) mediante la prueba de χ2 de Mantel Haenszel. Resultados:se identificó una asociación con significancia estadística en relación a las variables edad, sexo y escolaridad. El mayor riesgo dedesenlace desfavorable fue para el grupo de edad de más de 70 años (59,97%), seguido del rango de edad de 60 a 69 años (38,31%), sexo masculino (45,28%) y nivel de escolaridad superior. Conclusión:se evidenció que los pacientes con cardiopatía requieren mayor cuidado luego del diagnóstico de la enfermedad, sobre todo porque este grupo presenta una mayor tasa de mortalidad.

Validation of a permanent health education workshop on nutrition, physical activity and bodily practices / Validação de oficina de educação permanente em alimentação, atividade física e práticas corporais

This study aims to describe the development and validation of a permanent health education work-shop protocol for professional qualification in promoting adequate and healthy eating and physical activity and bodily practices for professionals working in Primary Health Care. The protocol de-velopment was based on the following theoretical references: Brazilian Dietary Guidelines, Brazil-ian Physical Activity Guidelines, Interprofessional Collaborative Practice, and Critical-Reflective Methodology (MCR); and it was proposed with 6 modules, totaling 30 hours of qualification. The protocol was evaluated in two panels of experts for content validation, which assessed aspects of clar-ity, relevance, and representativeness. The Content Validity Index (CVI), considering adequate the activities that scored CVI>0.8; and the proportion of theoretical representativeness in each activity were calculated. All 32 activities in the protocol have been validated for clarity and relevance, and the representativeness obtained results consistent with the objectives of each module. The represent-ativeness of MCR in the protocol as a whole was of 86.25%. The workshop activities protocol was evaluated as adequate for the proposed objective, considering its theoretical framework and its target audience. This is the first validated permanent education workshop to work in combination the Bra-zilian Dietary Guidelines and the Brazilian Physical Activity Guidelines, and it can be applied to the qualification of professionals in Primary Health Care throughout Brazil

O objetivo deste trabalho é descrever o desenvolvimento e validação de conteúdo de um protocolo de oficina de educação permanente em saúde para a qualificação profissional em promoção da alimentação adequada e saudável e da atividade física e práticas corporais voltado aos profissionais atuantes na Atenção Primária à Saúde. O desenvolvimento do protocolo utilizou como referenciais teóricos o Guia Alimentar para a Popu-lação Brasileira, o Guia de Atividade Física para a População Brasileira, a Prática Colaborativa Interpro-fissional e a Metodologia Crítico-Reflexiva (MCR); e foi definido com seis módulos presenciais, totalizando 30 horas de qualificação. O protocolo foi avaliado nos aspectos de clareza, pertinência e representatividade, em dois painéis de juízes para validação de conteúdo. Foram calculados o Índice de Validade de Conteúdo (IVC), considerando adequadas as atividades que pontuaram IVC>0,8; e o percentual de representatividade dos referenciais teóricos em cada atividade. Todas as 32 atividades do protocolo foram validadas para clareza e pertinência; e a representatividade obteve resultados condizentes com os objetivos de cada módulo. A repre-sentatividade da MCR no protocolo como um todo foi de 86,25%. As atividades da oficina foram avaliadas como adequadas ao objetivo proposto, considerando seu referencial teórico e seu público-alvo. Esta é a pri-meira oficina de educação permanente em saúde validada a trabalhar em formação combinada com o Guia Alimentar e o Guia de Atividade Física para a População Brasileira, e pode ser aplicada para a qualificação de profissionais da Atenção Primária à Saúde em todo Brasil

Desenvolvimento e validação de conteúdo de uma qualificação combinada em alimentação saudável e atividade física para profissionais da Atenção Primária à Saúde / Development and content validation of a combined qualification in healthy eating and physical activity for Primary Health Care professionals

Introdução - O excesso de peso, caracterizado como uma condição crônica e multifatorial, apresenta prevalência crescente no Brasil e exige ações de prevenção e controle que sejam intersetoriais e multidisciplinares. Dentre seus determinantes proximais, destacam-se a prática insuficiente de atividade física e o distanciamento de práticas alimentares adequadas e saudáveis. A qualificação dos profissionais atuantes na Atenção Primária à Saúde por meio da educação permanente é etapa fundamental para o enfrentamento do quadro epidemiológico atual. Objetivo - Descrever o processo de desenvolvimento e validação de conteúdo de um protocolo de oficina de educação permanente em saúde para a qualificação em promoção da alimentação adequada e saudável e da atividade física e práticas corporais voltada aos profissionais atuantes na Atenção Primária à Saúde. Métodos - O desenvolvimento do protocolo utilizou como referenciais teóricos o Guia Alimentar para a População Brasileira, o Guia de Atividade Física para a População Brasileira, a Prática Colaborativa Interprofissional e a Metodologia Crítico-Reflexiva (MCR). Foram definidos seis módulos presenciais, totalizando 30 horas de qualificação. A oficina é apresentada textualmente em um protocolo, sendo cada atividade constituída por uma breve apresentação, duração total, material necessário, objetivos, descrição da atividade e resultados esperados. A validação de conteúdo foi realizada em dois painéis de juízes, em que especialistas avaliaram e atribuíram notas aos aspectos de clareza, pertinência e representatividade do protocolo de oficina. Foram calculados o Índice de Validade de Conteúdo (IVC), considerando adequadas as atividades que pontuaram IVC>0,8; e o percentual de representatividade dos referenciais teóricos em cada atividade. Os comentários e notas dos especialistas foram apreciados e as atividades sofreram modificações a fim de melhorar os aspectos apontados. Posteriormente, o protocolo foi revisado sob a ótica do estigma da obesidade por dois especialistas que não participaram dos painéis de juízes. Resultados - Todas as 32 atividades do protocolo foram validadas para clareza e pertinência, sendo o IVC médio do protocolo igual a 0,98. A representatividade obteve resultados condizentes com os objetivos de cada módulo, e o protocolo como um todo teve representatividade da MCR de 86,25%. A revisão sob a ótica do estigma da obesidade apontou 28 sugestões voltadas a recomendações para a equipe executora e inclusão de objetivos e resultados, permitindo que o protocolo da oficina não estimule ou reforce comportamentos estigmatizantes em relação à obesidade, mas sem alterações no conteúdo validado. Conclusão - As atividades da oficina foram avaliadas como adequadas ao objetivo proposto, considerando seu referencial teórico e seu público-alvo. Esta é a primeira oficina de educação permanente em saúde validada a trabalhar em qualificação combinada com o Guia Alimentar para a População Brasileira e o Guia de Atividade Física para a População Brasileira, e pode ser aplicada para a qualificação de profissionais da Atenção Primária à Saúde no contexto do Sistema Único de Saúde.

Introduction Overweight, characterized as a chronic and multifactorial condition, has an increasing prevalence in Brazil and requires prevention and control actions that are intersectoral and multidisciplinary. Among its proximal determinants, the insufficient practice of physical activity and the distancing from adequate and healthy eating practices stand out. The workforce qualification in Primary Health Care through permanent education is a fundamental step to face the current epidemiological situation. Objective To describe the process of development and content validity of a workshop protocol for permanent health education for professional qualification in adequate and healthy eating and in physical activity and bodily practices aimed at professionals working in Primary Health Care. Methods - The protocol development used as theoretical references the Brazilian Dietary Guidelines, the Brazilian Physical Activity Guidelines, Interprofessional Collaborative Practice and Critical-Reflexive Methodology (CRM). Six face-to-face modules were defined, totaling 30 hours of training. The workshop is presented in writing in a protocol, with each activity consisting of a brief presentation, total duration, necessary material, objectives, description of the activity and expected results. Content validity was carried out in two panels of judges, in which experts evaluated and assigned grades to aspects of clarity, relevance and representativeness of the workshop protocol. The Content Validity Index (CVI), considering adequate the activities that scored CVI>0.8; and the proportion of theoretical representativeness in each activity were calculated. The experts' comments and notes were assessed and the activities underwent modifications to improve the aspects which were pointed out. Subsequently, the protocol underwent a review from the standpoint of the stigma of obesity by two experts who did not participate in the panel of judges. Results - All 32 activities were validated for clarity and relevance, with an average CVI of 0.98. The percentage of theoretical representativeness obtained results consistent with the objectives of each module, and average theoretical representation of CRM in the protocol as a whole was of 86.25%. The review from the perspective of obesity stigma pointed out 28 suggestions aimed at recommendations for the executing team and inclusion of objectives and results, allowing the workshop protocol not to encourage or reinforce stigmatizing behaviors in relation to obesity, but without changes in the validated content. Conclusion - The workshop activities were evaluated as adequate for the proposed objective, considering its theoretical framework and its target audience. This is the first validated professional qualification workshop to work jointly with the Brazilian Dietary Guidelines and the Brazilian Physical Activity Guidelines, and can be applied to the qualification of Primary Health Care professionals in the context of the Unified Health System.

Desenvolvimento e avaliação de infográfico animado: medicação segura em saúde da criança / Development and assessment of animated infographic: safe medication for children's health

Resumo Objetivo Desenvolver e avaliar um infográfico animado como recurso didático para o ensino de medicação segura em saúde da criança. Métodos Trata-se de estudo metodológico composto pela criação de um infográfico animado sobre medicação segura em saúde da criança para estudantes do ensino superior de enfermagem. O desenvolvimento desta tecnologia digital educacional seguiu quatro etapas: planejamento, produção, implementação e avaliação. O critério para avaliação foi concordância superior a 90%, analisada por meio do Índice de Validade de Conteúdo.Resultados: A versão final do infográfico animado possui 37 telas, as quais apresentam as metas do 3º Desafio da Organização Mundial de Saúde, os eventos adversos, fatores de risco do público-alvo e, por fim, as recomendações sobre boas práticas na administração segura de medicamentos em saúde da criança. O infográfico foi avaliado por 13 especialistas e obteve-se concordância entre todos os itens superior a 90%. Conclusão O infográfico animado foi considerado um recurso educacional válido, que poderá favorecer o processo de ensino aprendizagem de estudantes de enfermagem no que tange à conduta de boas práticas na administração de medicação na área da saúde da criança.

Resumen Objetivo Desarrollar y evaluar un infográfico animado como recurso didáctico para la enseñanza de medicación segura para la salud de los niños. Métodos Se trata de estudio metodológico compuesto por la creación de un infográfico animado sobre medicación segura para la salud del niño para estudiantes de la enseñanza superior en enfermería. El desarrollo de esta tecnología digital educativa siguió cuatro etapas: planificación, producción, implementación y evaluación. El criterio para la evaluación fue la coincidencia superior al 90 %, analizada por medio del Índice de Validez de Contenido.Resultados: La versión final del infográfico animado cuenta con 37 pantallas que presentan las metas del 3er Desafío de la Organización Mundial de Salud, los eventos adversos, factores de riesgo del público destinatario y, por fin, las recomendaciones sobre buenas prácticas en la administración segura de medicamentos para la salud para los niños. El infográfico fue evaluado por 13 especialistas y se obtuvo la coincidencia entre todos los ítems superior al 90 %. Conclusión El infográfico animado fue considerado como un recurso educativo válido, que podrá favorecer el proceso de enseñanza y aprendizaje de estudiantes de enfermería en lo que se refiere a la conducta de buenas prácticas en la administración de medicación en el área de la salud de los niños.

Abstract Objective To develop and assess an animated infographic as a teaching resource for teaching safe medication in children's health. Methods This is a methodological study consisting of the creation of an animated infographic about safe medication in children's health for students in higher education in nursing. The development of this digital educational technology followed four stages: planning, production, implementation and assessment. The criterion for assessment was greater than 90% agreement, analyzed using the Content Validity Index. Results The final version has 37 screens, which present the goals of the 3rdChallenge of the World Health Organization, adverse events, risk factors for the target audience and, finally, recommendations on good practices in safe medication administration in children's health. The infographic was assessed by 13 experts and there was an agreement between all items greater than 90%. Conclusion The animated infographic was considered a valid educational resource, which could favor the teaching-learning process of nursing students regarding the conduct of good practices in medication administration in children's health.

Evaluation of temporary cement to prevent bacterial contamination of the root canal after pulpectomy / Avaliação da capacidade do cemento temporário prevenir a contaminação bacteriana do canal após pulpectomia

ABSTRACT To evaluate the ability of temporary cement (TC) and gutta-percha sticks (GP) to prevent bacterial contamination of the root canal through the coronal seal after pulpectomy. Eighty artificial primary maxillary central incisors were selected and randomly divided into 2 groups: TC (n = 40) and GP (n = 40). Endodontic access, rotary instrumentation, root canal filling, and coronal sealing were performed according to group allocation. The root canal opening was seeded with S. mutans and E. faecalis. Both groups were subdivided into 5 experimental time points (24, 48, 72, 96, and 120 hours), with 8 specimens per time-point group: 5 in which both root canal filling and coronal sealing were performed (with either TC or GP) and 3 controls (coronal sealing alone, without root canal filling). All specimens were incubated in an anaerobic jar at 37°C, and bacterial contamination was assessed in a spectrophotometer. ANOVA (t-test) was used to compare contamination and the Kruskal-Wallis test to compare filling scores between the experimental groups. A significant difference was observed in sealing in the first 24 hours between GP and controls (p = 0.046). There was no significant difference in the filling pattern between canals sealed with TC versus GP. Specimens sealed with GP showed less contamination than controls in the first 24 hours. At later time points, neither GP nor TC were effective at controlling bacterial contamination; both failed to provide adequate coronal sealing.

RESUMO Avaliar a capacidade do obturador provisório (OP) e da gutapercha em bastão (GP) de prevenir a contaminação bacteriana dos condutos radiculares. Foram selecionados 80 incisivos centrais superiores decíduos artificiais que foram divididos aleatoriamente em 2 grupos: OP (n = 40) e GP (n = 40). Foi realizado acesso endodôntico, instrumentação rotatória, preenchimento do canal radicular e selamento coronário conforme os grupos. Foi feita a semeadura de S.mutans e E. faecalis na entrada do canal radicular. Ambos os grupos foram subdivididos em 5 tempos experimentais (24, 48, 72, 96 e 120 horas), com 8 espécimes por tempo experimental: 5 submetidos a preenchimento do canal radicular e selamento coronário (com OP ou GP) e 3 controles (apenas selamento coronário, sem preenchimento do canal). Todos os espécimes foram incubados em jarras de anaerobiose a 37°C e a contaminação bacteriana foi avaliada em espectrofotômetro. Utilizou-se ANOVA (teste t) para a comparação da contaminação e o teste de Kruskal-Wallis para a comparação dos escores da obturação entre os grupos experimentais. Foi observada diferença significativa no selamento nas primeiras 24 horas entre GP e controles (p = 0,046). Não houve diferença estatisticamente significativa no padrão de preenchimento entre os canais selados com OP versus GP. Os espécimes selados com GP apresentaram menor contaminação do que os controles nas primeiras 24 horas. Nos demais tempos experimentais, tanto GP quanto OP não foram eficientes no controle da contaminação bacteriana; ambos apresentaram falha no selamento coronário.

Ensaio clínico de tratamento - em três modalidades - para crianças com distúrbios da fluência e gagueira / Treatment clinical trial - three types - for children with fluency disorders and stuttering

RESUMO Objetivo Delinear um ensaio clínico de tratamento - em três modalidades - que verificasse se os tramentos testados para a gagueira crônica do desenvolvimento (GCD) apresentam indicadores que permitam reunir informações para a continuidade da sua aplicação, estabelecendo uma relação benefício-risco eficaz e segura. Método Para a realização do estudo foram analisadas 252 crianças, com idades entre 2 e 12 anos, que realizaram avaliação e tratamento para a GCD. Dentre as crianças atendidas, 93 cumpriram todos os critérios de elegibilidade. Após a obtenção dos escores de risco para GCD (Protocolo de Risco para a Gagueira do Desenvolvimento) todas as crianças foram avaliadas segundo seu perfil da fluência e grau de gravidade da gagueira. Foram aplicados os tratamentos para GCD: Programa Verde; Programa Amarelo e Programa Vermelho. A determinação do tratamento mais indicado para cada criança foi baseada na análise do grau de risco para a GCD. Resultados Todos os programas terapeuticos apresentaram resultados de melhora pós-tratamento consistentes nos segmentos analisados com exceção de: repetição de palavras; prolongamentos no final das palavras e intrusão de sons/segmentos. Conclusão Os programas terapêuticos testados - verde, amarelo e vermelho - foram eficientes para a ampla maioria dos participantes. A intervenção direta, aplicada no Programa Vermelho, foi altamente eficiente para a promoção da fala fluente, indicando que para os casos com maior índice de cronicidade a aplicação de técnicas específicas é indicada.

ABSTRACT Purpose To present a treatment clinical trial, involving three types of treatment for chronic developmental stuttering (CDS), to verify whether they present indicators and sufficient information to establish an effective and safe benefit-risk relationship. Methods The study included 252 children between 2 and 12 years old, who underwent assessment and treatment for CDS. Among the selected children, 93 met the established inclusion criteria. After obtaining the scores for the risk of CDS (Protocol for the Risk of Developmental Stuttering), all children were assessed according to their fluency profile and the severity level of stuttering. The children underwent treatment for CDS Green, Yellow and Red Programs. The treatment chosen for each child was based on the analysis of the risk for CDS. Results All therapeutic programs presented positive results in the post-treatment assessment considering the analyzed parameters, with the exception of word repetition, sound prolongation at the end of words, and intrusion of sounds/word segments. Conclusion The tested therapeutic programs - green, yellow, and red - were efficient for most of the participants. The direct intervention used in the Red Program was highly efficient in promoting fluent speech. This result suggests that for most of the patients with a higher risk of developing the chronic form of stuttering, the use of specific fluency promotion techniques is indicated.

Inserção das lutas na educação física escolar da cidade de Muriaé-MG / Insertion of fights in school physical education in the city of Muriaé-MG / Inserción de las luchas en la educación física escolar de la ciudad de Muriaé-Mg

O objetivo deste trabalho foi verificar se os professores de Educação Física escolar utilizam o conteúdo Lutas em suas aulas na cidade de Muriaé - MG. Participaram da pesquisa sete professores de educação física de escolas públicas e privadas. Foi aplicada uma entrevista semiestruturada e os dados foram analisados através da Análise de Conteúdo. Observou-se que apenas dois professores desenvolvem o conteúdo lutas em suas aulas. Falta de preparo e conhecimento foram apontados como os principais motivos para a não abordagem desse conteúdo nas aulas. Concluiu-se que as lutas ainda são pouco utilizadas nas aulas de Educação Física escolar e que a formação de professores é um ponto chave para a solução dessa defasagem (AU).

The objective was to verify if teachers of Physical Education at school use the content Fight in their classes in the city of Muriaé - MG. Seven physical education teachers from public and private schools participated in the research. A semi-structured interview was applied and the data were analyzed through Content Analysis. It was observed that only two teachers develop the content fights in their classes. Lack of preparation and knowledge were pointed out as the main reasons for not addressing this content in class. It was concluded that the struggles are still little used in school Physical Education classes, and that the training of teachers is a key point for the solution of this gap (AU).

El objetivo fue verificar si los profesores de Educación Física en la escuela utilizan el contenido Lucha en sus clases en la ciudad de Muriaé - MG. En la investigación participaron siete profesores de educación física de escuelas públicas y privadas. Se aplicó una entrevista semiestructurada y los datos se analizaron mediante Análisis de Contenido. Se observó que solo dos docentes desarrollan las luchas de contenido en sus clases. La falta de preparación y conocimiento fueron señalados como los principales motivos para no abordar este contenido en clase. Se concluyó que las luchas aún son poco utilizadas en las clases de Educación Física escolar, y que la formación de los docentes es un punto clave para la solución de esta brecha (AU).

Hyperextension of the head versus cervical vertebrae morphology in mouth and nasal breathers: a preliminary study

Objective: This study aimed to compare through cone-beam computed tomography (CBCT) the morphology of the cervical vertebrae atlas (C1) and axis (C2) in mouth breathers (MB) and nose breathers (NB), correlating them with the head and neck postures of the two groups. Materials and Methods: CBCT images of 36 subjects aged 11 to 22 years were evaluated using the InVivo Dental 5.1 (Anatomage, San Jose, California) software. The following measurements were used to assess C1 and C2 morphology: posterior height, anterior height, length, and volume. The craniocervical angle (NSL/OPT) was used to evaluate head posture concerning the neck. Results: The posterior height, length, and volume of C1 and C2 were lower in the MB group, but only the posterior size was significantly shorter than the NB group (C1, p=0.01 / C2, =0.05). Mouth breathers also showed a considerably higher craniocervical angle (p=0.04). Spearman test showed a significant positive correlation between C1 and C2 length and craniocervical angle (C1, =0.629, p=0.005 / C2, =0.665, p=0.003). Conclusion: The mouth breathers showed an increased craniocervical angle and decreased posterior height of the C1 vertebra concerning nasal breathers. The hyperextension of the head present is positively correlated with the length of the vertebra.

Objetivo: Este estudo teve como objetivo comparar por meio da tomografia computadorizada de feixe cônico (TCFC) a morfologia do atlas das vértebras cervicais (C1) e do eixo (C2) em respiradores orais (MB) e nasais (RN), correlacionando-os com a cabeça e posturas do pescoço dos dois grupos. Materiais e Métodos: Imagens de CBCT de 36 indivíduos com idades entre 11 e 22 anos foram avaliadas usando o software InVivo Dental 5.1 (Anatomage, San Jose, Califórnia). As seguintes medidas foram usadas para avaliar a morfologia de C1 e C2: altura posterior, altura anterior, comprimento e volume. O ângulo craniocervical (NSL/OPT) foi utilizado para avaliar a postura da cabeça em relação ao pescoço. Resultados: A altura posterior, comprimento e volume de C1 e C2 foram menores no grupo MB, mas apenas o tamanho posterior foi significativamente menor que o grupo RN (C1, p=0,01 / C2, =0,05). Os respiradores orais também apresentaram um ângulo craniocervical consideravelmente maior (p=0,04). O teste de Spearman mostrou correlação positiva significativa entre comprimento de C1 e C2 e ângulo craniocervical (C1, =0,629, p=0,005 / C2, =0,665, p=0,003). Conclusão: Os respiradores orais apresentaram aumento do ângulo craniocervical e diminuição da altura posterior da vértebra C1 em relação aos respiradores nasais. A hiperextensão da cabeça presente está positivamente correlacionada com o comprimento da vértebra.