Deactivation of cardiac implantable electronic devices in palliative patients: When and how.

Cardiac implantable electronic devices have transformed medicine as they improve quality of life and prevent premature death. In palliative care settings, deactivation of these devices must be discussed, particularly at end-of-life. In terminally ill patients it is consensual to recommend implantable cardioverter defibrillator deactivation once shocks are frequent and painful. Concerning pacemakers, the decision to deactivate is controversial and it usually is not an option at patients' end-of-life, since in pacing-dependent patients, such low heart rates might induce symptoms of bradycardia, with no impact on survival. Regarding cardiac resynchronization therapy, deactivation is not recommended as it can worsen symptoms. Left ventricular assistance device deactivation at end-of-life is a well-accepted practice, since it has the benefit of ending the physical burden associated with the device. Advance care planning should be encouraged and patients should be informed that deactivation is possible.

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio.

Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

Robotic and Plastic Surgery: actuality and prospects for the near future, a scoping review.

OBJECTIVE: This work aims to review the existing use of robotics in plastic surgery. METHODS: A meticulous selection process identified 22 articles relevant to this scoping review. RESULTS: The literature on the use of robotics in plastic surgery is sparse. Nonetheless, this review highlights emerging benefits in microsurgery, breast reconstruction, and transoral surgery. CONCLUSION: This scoping review identifies critical articles reporting the emerging use of robotics in plastic surgery. While the scientific medical community has yet to extensively document its use, the available evidence suggests a promising future for robotics in this field.

Doxycycline reversal of amphetamine-induced mania-like behavior is related to adjusting brain monoamine abnormalities and antioxidant effects in primary hippocampal neurons.

Mania is associated with disturbed dopaminergic transmission in frontotemporal regions. D-amphetamine (AMPH) causes increased extracellular DA levels, considered an acknowledged mania model in rodents. Doxycycline (DOXY) is a second-generation tetracycline with promising neuroprotective properties. Here, we tested the hypothesis that DOXY alone or combined with Lithium (Li) could reverse AMPH-induced mania-like behavioral alterations in mice by the modulation of monoamine levels in brain areas related to mood regulation, as well as cytoprotective and antioxidant effects in hippocampal neurons. Male Swiss mice received AMPH or saline intraperitoneal (IP) injections for 14 days. Between days 8-14, mice receive further IP doses of DOXY, Li, or their combination. For in vitro studies, we exposed hippocampal neurons to DOXY in the presence or absence of AMPH. DOXY alone or combined with Li reversed AMPH-induced risk-taking behavior and hyperlocomotion. DOXY also reversed AMPH-induced hippocampal and striatal hyperdopaminergia. In AMPH-exposed hippocampal neurons, DOXY alone and combined with Li presented cytoprotective and antioxidant effects, while DOXY+Li also increased the expression of phospho-Ser133-CREB. Our results add novel evidence for DOXY's ability to reverse mania-like features while revealing that antidopaminergic activity in some brain areas, such as the hippocampus and striatum, as well as hippocampal cytoprotective effects may account for this drug's antimanic action. This study provides additional rationale for designing clinical trials investigating its potential as a mood stabilizer agent.

Molecular Verification of Trichophyton in the Brazilian URM Culture Collection.

Trichophyton species cause dermatophytosis in humans, with a high, worldwide frequency of reports and important public health relevance. We evaluated 61 Trichophyton strains from different sources deposited in the University Recife Mycology (URM) culture collection of the Universidade Federal de Pernambuco, Brazil. Strains were phenotypically identified and confirmed by sequencing Internal Transcribed Spacers rDNA and partial beta-tubulin 2-exon. Additionally, we evaluated their susceptibility to terbinafine and itraconazole. Physiological analyses included urease activity and growth in casein medium. Phenotypic methods allowed the reliable identification of T. rubrum only, whereas, for other species, molecular methods were mandatory. All Trichophyton species exhibited susceptibility profiles to itraconazole (0.04-5.33 µg/mL) and terbinafine (0.17-3.33 µg/mL). Our analyses revealed a heterogeneous distribution of T. mentagrophytes, which does not support the current distribution within the species complex of T. mentagrophytes and its genotypes.

Common mental disorders in Brazilian adolescents: association with school characteristics, consumption of ultra-processed foods and waist-to-height ratio / Transtornos mentais comuns em adolescentes brasileiros: associação com características escolares, consumo de alimentos ultraprocessados e razão cintura/estatura / Trastornos mentales comunes en adolescentes brasileños: asociación con características escolares, consumo de alimentos ultraprocesados y relación cintura/estatura

Abstract: Half of all mental health problems diagnosed in adulthood have their onset before or during adolescence, especially common mental disorders (CMD). Thus, it is relevant to study the factors associated with these disorders. This study aimed to investigate the association of school characteristics, consumption of ultra-processed foods, and waist-to-height ratio with the presence of CMD in Brazilian adolescents. This is a school-based, cross-sectional study that analyzed data from 71,553 Brazilian adolescents aged 12-17 years. The prevalence of CMD in these adolescents was 17.1% (cut-off point 5 for the General Health Questionnaire-12). Associations were estimated using multilevel logistic models, with the presence of CMD as the dependent variable. The final model, adjusted for non-modifiable individual variables, modifiable individual variables and family characteristics, identified a positive association between private-funded schools (OR = 1.10; 95%CI: 1.07-1.14), advertisements for ultra-processed foods (OR = 1.13; 95%CI: 1.09-1.17), the second to fourth quartiles of ultra-processed food intake and waist-to-height ratio (OR = 2.26; 95%CI: 2.03-2.52). This study demonstrated that the private-funded schools , the presence of ultra-processed food advertisements, the consumption of ultra-processed food, and an increased waist-to-height ratio are risk factors for CMD in Brazilian adolescents.

Resumo: Metade de todos os problemas de saúde mental diagnosticados na idade adulta têm seu início antes ou durante a adolescência, especialmente os transtornos mentais comuns (TMC). Desta maneira, é importante estudar os fatores associados a estes transtornos. Este estudo objetiva investigar a associação entre características escolares, consumo de alimentos ultraprocessados e razão cintura/estatura com a presença de TMC em adolescentes brasileiros. Trata-se de um estudo transversal de base escolar que analisou dados de 71.553 adolescentes brasileiros de 12-17 anos. A prevalência de TMC nesses adolescentes foi de 17,1% (ponto de corte 5 para o Questionário de Saúde Geral - GHQ-12). As associações foram estimadas por meio de modelos logísticos multiníveis, tendo como variável dependente a presença de TMC. O modelo final, ajustado para variáveis individuais não modificáveis, variáveis individuais modificáveis e características familiares, identificou uma associação positiva entre dependência administrativa privada (OR = 1,1; IC95%: 1,07-1,14), presença de propaganda de alimentos ultraprocessados (OR = 1,13; IC95%: 1,09-1,17), segundo a quarto quartis de consumo de alimentos ultraprocessados e razão cintura/estatura (OR = 2,26; IC95%: 2,03-2,52). Este estudo demonstrou que a dependência administrativa privada da escola, a presença de propagandas de alimentos ultraprocessados, o consumo de alimentos ultraprocessados e o aumento da razão cintura/estatura são fatores de risco para TMC em adolescentes brasileiros.

Resumen: La mitad de todos los problemas de salud mental diagnosticados en la edad adulta empiezan antes o durante la adolescencia, sobre todo los trastornos mentales comunes (TMC). Así, es importante estudiar los factores asociados a estos trastornos. El objetivo de este estudio es investigar la asociación entre las características escolares, el consumo de alimentos ultraprocesados y la proporción cintura/estatura y la presencia de TMC en adolescentes brasileños. Se trata de un estudio transversal de base escolar que analizó datos de 71.553 adolescentes brasileños de 12 a 17 años. La prevalencia de TMC en estos adolescentes fue del 17,1% (punto de corte 5 para el Cuestionario General de Salud - GHQ-12). Se estimaron las asociaciones a través de modelos logísticos multinivel, con la presencia de TMC como variable dependiente. El modelo final, ajustado para variables individuales no modificables, variables individuales modificables y características familiares, identificó una asociación positiva entre la dependencia administrativa privada (OR = 1,10; IC95%: 1,07-1,14), la presencia de publicidad de alimentos ultraprocesados (OR = 1,13; IC95%: 1,09-1,17), segundo al cuarto cuartil de consumo de alimentos ultraprocesados y la proporción cintura/estatura (OR = 2,26; IC95%: 2,03-2,52). Este estudio demostró que la dependencia administrativa privada de la escuela, la presencia de publicidades de alimentos ultraprocesados, el consumo de alimentos ultraprocesados y el aumento de la proporción cintura/estatura son factores de riesgo para trastornos mentales comunes en adolescentes brasileños.

Robotic and Plastic Surgery: actuality and prospects for the near future, a scoping review

ABSTRACT Objective This work aims to review the existing use of robotics in plastic surgery. Methods A meticulous selection process identified 22 articles relevant to this scoping review. Results The literature on the use of robotics in plastic surgery is sparse. Nonetheless, this review highlights emerging benefits in microsurgery, breast reconstruction, and transoral surgery. Conclusion This scoping review identifies critical articles reporting the emerging use of robotics in plastic surgery. While the scientific medical community has yet to extensively document its use, the available evidence suggests a promising future for robotics in this field.

Construção de um aplicativo: promoção à saúde do idoso com incapacidade e dor lombar / Building an app: promoting the health of elderly people with disabilities and low back pain

Introdução: A incapacidade funcional e o desempenho físico são definidos pela dificuldade ou necessidade de ajuda para o indivíduo executar tarefas diárias, podendo repercutir na capacidade adaptativa das atividades diárias, tanto nas suas capacidades físicas quanto mentais. O processo de envelhecimento acarreta incapacidade funcional, comprometendo a qualidade de vida. Objetivo geral: Construir um aplicativo em saúde com foco na saúde do idoso com incapacidade na lombar. Métodos: Trata-se de um estudo do tipo construção de um aplicativo, desenvolvido durante o período de agosto de 2021 a maio de 2022 em Fortaleza-CE, na página https://fabricadeaplicativos.com.br e será disponibilizado com um instrumento composto pelo índice de Oswestry 2.0 de Incapacidade. Resultados: Telas explicativas para download e acesso ao aplicativo desenvolvido para facilitar o alcance de informações relevantes aos idosos que sofrem limitações no seu dia a dia, provenientes do processo de envelhecimento. Conclusão: Tendo visto que existem poucos estudos e aplicativos sobre esse assunto, se faz necessário a criação de um aplicativo voltado ao tema.(AU)

Introduction: Functional disability and physical performance are defined by the difficulty or need for help for the individual to perform daily tasks. It can have repercussions on the adaptive capacity of daily activities, both in their physical and mental capacities. The aging process causes functional disability, thus compromising quality of life. General objective: To build a health application focused on the health of the elderly with disabilities in the lumbar. Methods: This is a study of the type of construction of an application, developed during the period from August 2021 to May 2022 in Fortaleza-Ceará, on page https://fabricadeaplicativos.com.br and will be made available with an instrument composed of the Oswestry 2.0 Disability Index. Results: Explanatory screens for download and access to the application that was developed to facilitate the reach of relevant information to the elderly who suffer limitations in their day-to-day coming from the aging process. Conclusion: Having seen that there are few studies and applications on this subject, it is necessary to create an application focused on the subject.(AU)

Introducción: La discapacidad funcional y el rendimiento físico se definen por la dificultad o necesidad de ayuda del individuo para realizar las tareas diarias, lo que puede repercutir en la capacidad adaptativa de las actividades diarias, tanto en sus capacidades físicas como mentales. El proceso de envejecimiento conduce a una discapacidad funcional, comprometiendo la calidad de vida. Objetivo general: Construir una aplicación de salud centrada en la salud de personas mayores con discapacidad lumbar. Métodos: Se trata de un estudio del tipo constructivo de una aplicación, desarrollado durante el período de agosto de 2021 a mayo de 2022 en Fortaleza-CE, en la página https://fabricadeaplicativos.com.br y estará disponible con un instrumento compuesto. por el Índice de Discapacidad Oswestry 2.0. Resultados: Pantallas explicativas de descarga y acceso a la aplicación desarrollada para facilitar el acceso a información relevante a personas mayores que sufren limitaciones en su vida diaria, derivadas del proceso de envejecimiento. Conclusión: Dado que existen pocos estudios y aplicaciones sobre este tema, es necesario crear una aplicación enfocada en el tema.(AU)

Fatores associados à depressão e ansiedade em nutricionistas na pandemia por COVID-19 / Factors associated with depression and anxiety in nutritionists in the COVID-19 pandemic

O objetivo foi investigar os fatores associados à depressão e/ou ansiedade em nutricionistas durante a pandemia por COVID-19. Estudo transversal com aplicação das escalas GAD-7 e PHQ-9. Dos 1.018 participantes 60,2% manifestaram rastreio positivo para depressão e/ou ansiedade, com maior força de associação para conflitos muito frequentes nas relações (OR = 11,11; IC95% 6,61;18,67), uso de medicação para dor (OR = 7,42; IC95% 4,67;11,79) e pensar sempre sobre a pandemia (OR = 6,5; IC95% 4,14;10,32). Não estar em tratamento psicoterápico (OR = 0,39; IC95% 0,27;0,560) e não estar em uso de medicamento psicotrópico (OR = 0,40; IC95% 0,26;0,60) foram associados a menores chances de rastreio positivo. O estudo resulta em conhecimento epidemiológico aplicável a ações de vigilância, prevenção e controle da ansiedade e depressão entre nutricionistas.

The objective was to investigate the factors associated with depression and/or anxiety and depression in nutritionists during the COVID-19 pandemic. Cross-sectional study with the application of the GAD-7 and PHQ-9 scales. 1,018 participated, of which 60.2% showed positive screening for depression and/or anxiety, with a greater strength of association for very frequent conflicts in relationships (OR = 11.11; 95%CI 6.61;18.67), use of pain medication (OR = 7.42; 95%CI 4.67;11.79) and always thinking about the pandemic (OR = 6.5; 95%CI 4.14;10.32). Not being under psychotherapeutic treatment (OR = 0.39; 95%CI 0.27;0.560) and not using psychotropic medication (OR = 0.40; 95%CI 0.26;0.60) were associated with lower odds of positive screening. This study results in epidemiological knowledge applicable to surveillance, prevention and control of anxiety and depression among nutritionists.

Female Reproductive Health - study of an egg donor population.

OBJECTIVE: Infertility is one of the most significant reproductive health issues addressed with medically assisted procreation. This study looked into a potential correlation between the number of mature oocytes harvested and donor biological characteristics in order to propose an anti-Müllerian hormone (AMH) cutoff level to optimize the selection of candidates for gamete donation. METHODS: The donors were healthy women included in the Public Gamete Bank between 2011 and 2021. Their results can be used as a national indicator of fertility. RESULTS: We found that women with higher AMH levels had more antral follicles and oocytes harvested. As age increased, the number of oocytes harvested decreased. The suggested AMH cutoff level for successful donation was 1.12 ng/mL. CONCLUSIONS: The analysis of the reproductive health of Public Gamete Bank donors allows the standardization of AMH cutoff values at a national level, since the same laboratory techniques were employed consistently across medical centers. The study also allowed insight into the factors that compromise donation success. If adopted, a more rigorous selection of donor candidates would increase the success rate of egg donations.

The association between multiple cardiovascular risk factors and overweight in Brazilian adolescents: an analysis based on the grade of membership.

The aim of the current research is to analyze the coexistence of modifiable risk behaviors for cardiovascular disease (CVD) in 12-to-17-year-old adolescents living in Brazil and their influence on overweight. National, cross-sectional, school-based epidemiological study focused on estimating the prevalence of cardiovascular risk factors and metabolic syndrome in 12 to 17 year old adolescents enrolled in public and private schools in Brazilian counties accounting for more than 100 thousand inhabitants. The grade of membership method was used to identify the coexistence of risk factors among adolescents. The analytical sample comprised 71,552 adolescents. According to the two herein generated profiles, adolescents classified under Profile 2 have shown behaviors such as smoking, alcohol consumption and diet rich in Ultra-processed food intake ≥ 80% of the percentage of total caloric value. In addition, adolescents presenting CVD risk profile have shown increased likelihood of being overweight. The study has found coexistence of risk factors for CVD in Brazilian adolescents, with emphasis on tobacco smoking and alcoholic beverage intake. In addition, it heads towards the analysis of the association between CVD risk factors and health outcomes, such as overweight.

The association between multiple cardiovascular risk factors and overweight in Brazilian adolescents: an analysis based on the grade of membership / A associação entre múltiplos fatores de risco cardiovascular e o excesso de peso em adolescentes brasileiros: uma análise baseada no grade of membership

Abstract The aim of the current research is to analyze the coexistence of modifiable risk behaviors for cardiovascular disease (CVD) in 12-to-17-year-old adolescents living in Brazil and their influence on overweight. National, cross-sectional, school-based epidemiological study focused on estimating the prevalence of cardiovascular risk factors and metabolic syndrome in 12 to 17 year old adolescents enrolled in public and private schools in Brazilian counties accounting for more than 100 thousand inhabitants. The grade of membership method was used to identify the coexistence of risk factors among adolescents. The analytical sample comprised 71,552 adolescents. According to the two herein generated profiles, adolescents classified under Profile 2 have shown behaviors such as smoking, alcohol consumption and diet rich in Ultra-processed food intake ≥ 80% of the percentage of total caloric value. In addition, adolescents presenting CVD risk profile have shown increased likelihood of being overweight. The study has found coexistence of risk factors for CVD in Brazilian adolescents, with emphasis on tobacco smoking and alcoholic beverage intake. In addition, it heads towards the analysis of the association between CVD risk factors and health outcomes, such as overweight.

Resumo O objetivo desta pesquisa é analisar a coexistência de comportamentos de risco modificáveis para doenças cardiovasculares (DCV) em adolescentes de 12 a 17 anos residentes no Brasil e sua influência no excesso de peso. Estudo epidemiológico nacional, transversal, de base escolar, com foco em estimar a prevalência de fatores de risco cardiovascular e síndrome metabólica em adolescentes de 12 a 17 anos matriculados em escolas públicas e privadas de municípios brasileiros que somam mais de 100 mil habitantes. O grade of membership foi utilizado para identificar a coexistência de fatores de risco entre os adolescentes. A amostra analítica foi composta por 71.552 adolescentes. De acordo com os dois perfis gerados, os adolescentes classificados no Perfil 2 mostraram comportamentos como fumar, consumo de álcool e dieta rica em alimentos ultraprocessados ≥ 80% da porcentagem do valor calórico total. Além disso, adolescentes com perfil de risco para DCV mostraram maior probabilidade de apresentar excesso de peso. O estudo encontrou coexistência de fatores de risco para DCV em adolescentes brasileiros, com destaque para tabagismo e consumo de bebidas alcoólicas. Além disso, demonstra associação entre fatores de risco para DCV e desfechos de saúde, como o excesso de peso.

Approach to vaccination in systemic lupus erythematosus on biological treatment.

In recent years, treat-to-target strategy and early intervention strategies with immunosuppressive agents have attempted to improve the prognosis and outcome in patients with autoimmune inflammatory rheumatic diseases. However, infectious complications due to side effects of medication remain a major concern in routine practice. In this regard, vaccine immunity and vaccination programmes are of the utmost importance in patients with systemic lupus erythematosus (SLE) in terms of morbidity and mortality. Encouragingly, research investigations have increased exponentially, both in monitoring the vaccines efficacy, and in determining the immune response while patients are on immunosuppression., However, in this biological era in rheumatology, relatively little data have been published investigating these parameters in those receiving biological agents, therefore, no definitive consensus about a vaccination policy for patients with SLE is currently available. In this review, we aim to address what is established about vaccinating patients with SLE on biological agents and discuss potential problems.

Constant testing for Pestivirus in cell lines reveals different routes of contamination.

Pestivirus can contaminate cell cultures and sera and cause serious problems that evolve the integrity of studies, confidence in diagnostic results, and safety of human and animal vaccines. Contaminations by Pestivirus and other viruses may occur at any time and regular assays of monitoring in cell cultures and your supplies are necessary. This study aimed to analyze the phylogeny of Pestivirus detected from cell cultures, calf serum, and standard strains of three laboratories in Brazil that carry out frequent tests for the monitoring of cellular contaminations. These samples were submitted to phylogenetic analysis to understand the genetic relationship between contaminants occurring in these facilities. As result, the Pestivirus found in samples were Bovine viral diarrhea virus (BVDV-1 and BVDV-2), Hobi-like viruses (often named BVDV-3), and Classical swine fever virus (CSFV), and the phylogenetic analysis help us to infer at three possible routes of contamination in this work.

Hospitalizations for ambulatory care-sensitive conditions in children, Rondônia, Brazil, 2008-2019. / Internações por condições sensíveis à atenção primária em crianças, Rondônia, Brasil, 2008-2019.

This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

Health-related quality of life in children with cerebral palsy associated with congenital Zika infection.

OBJECTIVE: To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection. METHODS: Cross-sectional study of a consecutive series of children, followed in a referral multicentric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables. RESULTS: The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3. CONCLUSIONS: Among children with cerebral palsy (CP) related to congenital Zika syndrome, the quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population.

Internações por condições sensíveis à atenção primária em crianças, Rondônia, Brasil, 2008-2019 / Hospitalizations for ambulatory care-sensitive conditions in children, Rondônia, Brazil, 2008-2019

Resumo Objetivou-se caracterizar o perfil de internações de crianças na rede pública dos 52 municípios do estado de Rondônia, Brasil, no período de 2008 a 2019. Trata-se de um estudo de série temporal do tipo ecológico, com dados secundários do Sistema de Informações Hospitalares. A tendência anual das internações foi apresentada por faixa etária e regional de saúde. Foi realizada regressão linear aplicando a técnica de Prais-Winsten no pacote estatístico Stata, versão 11.0. As internações por doenças gastrointestinais tiveram declínio em todas as faixas etárias, assim como pelas doenças previníveis por imunizantes entre 1 a 9 anos. As internações por doenças de pele e tecido subcutâneo foram crescentes em todas as idades, as epilepsias em idades de 1 a 9 anos e pelas doenças relacionadas ao parto e puerpério foi crescente. As regiões de saúde apresentaram perfil de internações variável, com tendência estável nas regiões Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, Vale do Jamari; e em declínio nas regiões Central e Zona da Mata. As elevadas taxas de internações por condições sensíveis à atenção primária em crianças refletem a pouca efetividade das estratégias e dos investimentos na esfera da atenção primária no estado.

Abstract This study aimed to define the profile of hospitalizations of children in public hospitals of 52 municipalities of the state of Rondônia, Brazil. We performed an ecological time series study using secondary data provided by the Hospital Information System. The annual trend of Hospitalizations was presented by age group and health region. Linear regression was performed using the Prais-Winsten technique of the statistical package Stata, version 11.0. Hospitalizations for gastrointestinal diseases were found to be decreasing in all age groups, just as those for vaccine-preventable diseases in children aged between 1 and 9 years. Hospitalizations for skin and subcutaneous tissue diseases were increasing in all ages, as well as those caused by epilepsies in children aged 1 to 9 and those caused by diseases related to childbirth and puerperium. Health regions showed a varied hospitalization profile. A stable trend was found in the Cone Sul, Madeira-Mamoré, Café, Vale do Guaporé, and Vale do Jamari regions, whereas a declining trend was found in the Central and Zona da Mata regions. The high rates of hospitalizations for ambulatory care-sensitive conditions in children show how inefficient strategies and investments in primary care have been in the state of Acre, Brazil.

Quantification of in vitro replication kinetics of Alagoas vesiculovirus isolates by digital droplet RT-PCR.

Vesicular stomatitis caused by Alagoas vesiculovirus (VSAV) has generated disease outbreaks in Brazil, mainly in the northeast region. Phylogenetic studies divide the isolates into three distinct genotypes (A, B, and C). However, there is no description of how this genetic divergence reflects on the phenotype of VSAV isolates such as in vitro replication fitness. Therefore, the objective of this work was to evaluate the ability of three distinct genotypes of Brazilian isolates of VSAV to grow in different cell-culture lines (BHK-21, Vero, and NCI-H1299). Quantification of viral RNA was performed using RT-PCR digital droplet from supernatant of cell culture collected every 4 h for a period of 24 h of viral growth in three different cell lines (BHK-21, Vero, and NCI-H1299). It was observed that the genotype C isolate has the lowest replication efficiency among the three analyzed viruses, without major changes in the copies of viral RNA over the entire time of the study.

Leishmania infantum NTPDase1 and NTPDase2 play an important role in infection and nitric oxide production in macrophages.

Leishmania infantum, the causative agent of American Visceral Leishmaniasis (VL), is known for its ability to modulate the host immune response to its own favor. Ecto-nucleoside triphosphate diphosphohydrolase (ENTPDase) represents a family of enzymes that hydrolyze nucleotides and are involved in nucleotide-dependent biological processes. L. infantum has two ENTPDases, namely LiNTPDase1 and LiNTPDase2. Here, we used genetic tools to overexpress or abolish the expression of LiNTPDase1 and -2 to assess their role in parasite growth in culture and macrophage infection. While LiNTPDase1 or 2-overexpressing clones showed no morphological or growth changes in promastigotes, LiNTPDase2 overexpression increased macrophage adhesion and infection by 50% and 30%, respectively. The individual LiNTPDase1 and 2 knockout mutants showed lag in growth profile, which was reversed by the addition of adenine and guanine to the culture media. Moreover, the morphology of the knockout mutants even in supplemented media was changed to an amastigote-like form. The double knockout of both genes was lethal and a mechanism of compensation of deletion of one isoform was detected in these mutants. Correspondingly, the absence of LiNTPDase1 or LiNTPDase2 led to a dramatic reduction in in vitro infection (∼90%). Interestingly, nitric oxide production was decreased in both knockout mutants during infection, which suggests that both LiNTPDases can inhibit macrophage responses against the parasite. Overall, our results show important roles of LiNTPDase1 and -2 concerning in vitro macrophage infection and reinforce their use as potential targets to control Leishmania infections.