Association between sedentary behavior, diet and nutritional status in adolescents: baseline results from the LONCAAFS Study.

The aim of the present study was to analyze the relationship between time spent engaged in sedentary behaviors, type of diet, and overweight in adolescents. A cross-sectional study using data from the Longitudinal Study on Sedentary Behavior, Physical Activity, Eating Habits, and Health of Adolescents - LONCAAFS Study. A total of 1,438 adolescents (10 to 14 years old) from public schools in the city of João Pessoa, Brazil, participated in the study. To evaluate the combined effects of excessive time in sedentary behavior and consumption from two food groups: Convenience and Prudent on overweight, we performed multiple logistic regression analyses, adjusted for energy, level of physical activity, sex, and age. Excessive time in sedentary behavior increased the chance of adolescents being overweight by 37% (OR = 1.37; 95%CI: 1.04-1.80). This chance increased to 43% when the adolescents were simultaneously engaged in excessive sedentary behavior and had high consumption of the Convenience food group (OR = 1.43; 95%CI: 1.05-1.94) and increased to 39% on those who engaged in excessive sedentary behavior and had low consumption of foods from the Prudent (OR = 1.39; 95%CI: 1.04-1.84). Excessive sedentary behavior is associated with being overweight and the chance increases with the consumption of convenient foods.

Perspectives of FTIR as Promising Tool for Pathogen Diagnosis, Sanitary and Welfare Monitoring in Animal Experimentation Models: A Review Based on Pertinent Literature.

Currently, there is a wide application in the literature of the use of the Fourier Transform Infrared Spectroscopy (FTIR) technique. This basic tool has also proven to be efficient for detecting molecules associated with hosts and pathogens in infections, as well as other molecules present in humans and animals' biological samples. However, there is a crisis in science data reproducibility. This crisis can also be observed in data from experimental animal models (EAMs). When it comes to rodents, a major challenge is to carry out sanitary monitoring, which is currently expensive and requires a large volume of biological samples, generating ethical, legal, and psychological conflicts for professionals and researchers. We carried out a survey of data from the relevant literature on the use of this technique in different diagnostic protocols and combined the data with the aim of presenting the technique as a promising tool for use in EAM. Since FTIR can detect molecules associated with different diseases and has advantages such as the low volume of samples required, low cost, sustainability, and provides diagnostic tests with high specificity and sensitivity, we believe that the technique is highly promising for the sanitary and stress and the detection of molecules of interest of infectious or non-infectious origin.

The High Capacity of Brazilian Aedes aegypti Populations to Transmit a Locally Circulating Lineage of Chikungunya Virus.

The incidence of chikungunya has dramatically surged worldwide in recent decades, imposing an expanding burden on public health. In recent years, South America, particularly Brazil, has experienced outbreaks that have ravaged populations following the rapid dissemination of the chikungunya virus (CHIKV), which was first detected in 2014. The primary vector for CHIKV transmission is the urban mosquito species Aedes aegypti, which is highly prevalent throughout Brazil. However, the impact of the locally circulating CHIKV genotypes and specific combinations of local mosquito populations on vector competence remains unexplored. Here, we experimentally analyzed and compared the infectivity and transmissibility of the CHIKV-ECSA lineage recently isolated in Brazil among four Ae. aegypti populations collected from different regions of the country. When exposed to CHIKV-infected AG129 mice for blood feeding, all the mosquito populations displayed high infection rates and dissemination efficiency. Furthermore, we observed that all the populations were highly efficient in transmitting CHIKV to a vertebrate host (naïve AG129 mice) as early as eight days post-infection. These results demonstrate the high capacity of Brazilian Ae. aegypti populations to transmit the locally circulating CHIKV-ECSA lineage. This observation could help to explain the high prevalence of the CHIKV-ECSA lineage over the Asian lineage, which was also detected in Brazil in 2014. However, further studies comparing both lineages are necessary to gain a better understanding of the vector's importance in the epidemiology of CHIKV in the Americas.

Macrophage migration inhibitory factor favors Neospora caninum infection in mice.

Neospora caninum is a protozoan parasite with worldwide incidence, acting as a major cause of reproductive failures in ruminants and neuromuscular symptoms in dogs. Macrophage Migration Inhibitory Factor (MIF) is produced by several cell types and exhibits a central role in immune responses against intracellular pathogens. The present study aimed to comprehend the role of MIF in the relationship between N. caninum and its host. We used in vivo, in vitro and ex vivo experiments in a model of infection based on genetically deficient mice to analyze the infection kinetics and inflammatory markers. MIF production was measured in response to N. caninum during the acute and chronic phases of the infection. While Mif-/- mice survived lethal doses of NcLiv tachyzoites, sublethal infections in these mice showed that parasite burden was controlled in target tissues, alongside with reduced inflammatory infiltrates detected in lung and brain sections. TNF was increased at the initial site of the infection in genetically deficient mice and the MIF-dependent reduction was confirmed in vitro with macrophages and ex vivo with primed spleen cells. In sum, MIF negatively regulated host immunity against N. caninum, favoring disease progression.

Neofunctionalization driven by positive selection led to the retention of the loqs2 gene encoding an Aedes specific dsRNA binding protein.

BACKGROUND: Mosquito borne viruses, such as dengue, Zika, yellow fever and Chikungunya, cause millions of infections every year. These viruses are mostly transmitted by two urban-adapted mosquito species, Aedes aegypti and Aedes albopictus. Although mechanistic understanding remains largely unknown, Aedes mosquitoes may have unique adaptations that lower the impact of viral infection. Recently, we reported the identification of an Aedes specific double-stranded RNA binding protein (dsRBP), named Loqs2, that is involved in the control of infection by dengue and Zika viruses in mosquitoes. Preliminary analyses suggested that the loqs2 gene is a paralog of loquacious (loqs) and r2d2, two co-factors of the RNA interference (RNAi) pathway, a major antiviral mechanism in insects. RESULTS: Here we analyzed the origin and evolution of loqs2. Our data suggest that loqs2 originated from two independent duplications of the first double-stranded RNA binding domain of loqs that occurred before the origin of the Aedes Stegomyia subgenus, around 31 million years ago. We show that the loqs2 gene is evolving under relaxed purifying selection at a faster pace than loqs, with evidence of neofunctionalization driven by positive selection. Accordingly, we observed that Loqs2 is localized mainly in the nucleus, different from R2D2 and both isoforms of Loqs that are cytoplasmic. In contrast to r2d2 and loqs, loqs2 expression is stage- and tissue-specific, restricted mostly to reproductive tissues in adult Ae. aegypti and Ae. albopictus. Transgenic mosquitoes engineered to express loqs2 ubiquitously undergo developmental arrest at larval stages that correlates with massive dysregulation of gene expression without major effects on microRNAs or other endogenous small RNAs, classically associated with RNA interference. CONCLUSIONS: Our results uncover the peculiar origin and neofunctionalization of loqs2 driven by positive selection. This study shows an example of unique adaptations in Aedes mosquitoes that could ultimately help explain their effectiveness as virus vectors.

Potential of piperine for neuroprotection in sepsis-associated encephalopathy.

AIMS: Sepsis-associated encephalopathy (SAE) is a common complication that increases mortality and leads to long-term cognitive impairment in sepsis survivors. However, no specific or effective therapy has been identified for this complication. Piperine is an alkaloid known for its anti-inflammatory, antioxidant, and neuroprotective properties, which are important characteristics for treatment of SAE. The objective of this study was to evaluate the neuroprotective effect of piperine on SAE in C57BL/6 mice that underwent cecum ligation and perforation surgery (CLP). MAIN METHODS: C57BL/6 male mice were randomly assigned to groups that underwent SHAM surgery or CLP. Mice in the CLP group were treated with piperine at doses of 20 or 40 mg/kg for short- (5 days) or long-term (10 days) periods after CLP. KEY FINDINGS: Our results revealed that untreated septic animals exhibited increased concentrations of IL-6, TNF, VEGF, MMP-9, TBARS, and NLRP3, and decreased levels of BDNF, sulfhydryl groups, and catalase in the short term. Additionally, the levels of carbonylated proteins and degenerated neuronal cells were increased at both time points. Furthermore, short-term and visuospatial memories were impaired. Piperine treatment reduced MMP-9 activity in the short term and decreased the levels of carbonylated proteins and degenerated neuronal cells in the long term. It also lowered IL-6 and TBARS levels at both time points evaluated. Moreover, piperine increased short-term catalase and long-term BDNF factor levels and improved memory at both time points. SIGNIFICANCE: In conclusion, our data demonstrate that piperine exerts a neuroprotective effect on SAE in animals that have undergone CLP.

Ileal inflammation is reduced due to treatment with a metalloprotease from BmooMP-α-I snake venom in an experimental model of Toxoplasma gondii infection.

The selection process for advanced therapies in patients with inflammatory bowel diseases (IBDs) must prioritize safety, especially when considering new biologic agents or oral molecule modulators. In C57BL/6 mice, oral infection with Toxoplasma gondii induces intestinal inflammation through excessive tumor necrosis factor (TNF) production, making TNF neutralization a potential therapeutic intervention. Considering this, the present study aimed to evaluate the therapeutic effects of BmooMP-α-I, a snake venom metalloprotease isolated from Bothrops moojeni, which could promote TNF hydrolysis, in treating T. gondii-induced ileitis. The results showed that C57BL/6 mice orally infected with 50 cysts of T. gondii from the Me49 strain and treated with BmooMP-α-I exhibited prolonged survival and improved morbidity scores. Additionally, the treatment ameliorated both the macroscopic and microscopic aspects of the intestine, reduced macrophage influx, and decreased the production of inflammatory mediators by mesenteric lymph node cells. These findings provide compelling experimental evidence supporting the ability of BmooMP-α-I to alleviate ileal inflammation. Considering that the currently available therapeutic protocols are not completely effective and often result in side effects, the exploration of alternative strategies involving novel therapeutic agents, as demonstrated in this study, has the potential to significantly enhance the quality of life for patients suffering from inflammatory bowel diseases.

Lessons learned from over a decade of data audits in international observational HIV cohorts in Latin America and East Africa.

Introduction: Routine patient care data are increasingly used for biomedical research, but such "secondary use" data have known limitations, including their quality. When leveraging routine care data for observational research, developing audit protocols that can maximize informational return and minimize costs is paramount. Methods: For more than a decade, the Latin America and East Africa regions of the International epidemiology Databases to Evaluate AIDS (IeDEA) consortium have been auditing the observational data drawn from participating human immunodeficiency virus clinics. Since our earliest audits, where external auditors used paper forms to record audit findings from paper medical records, we have streamlined our protocols to obtain more efficient and informative audits that keep up with advancing technology while reducing travel obligations and associated costs. Results: We present five key lessons learned from conducting data audits of secondary-use data from resource-limited settings for more than 10 years and share eight recommendations for other consortia looking to implement data quality initiatives. Conclusion: After completing multiple audit cycles in both the Latin America and East Africa regions of the IeDEA consortium, we have established a rich reference for data quality in our cohorts, as well as large, audited analytical datasets that can be used to answer important clinical questions with confidence. By sharing our audit processes and how they have been adapted over time, we hope that others can develop protocols informed by our lessons learned from more than a decade of experience in these large, diverse cohorts.

High capacity of Brazilian Aedes aegypti populations to transmit a locally circulating lineage of Chikungunya virus.

The global incidence of chikungunya has surged in recent decades, with South America, particularly Brazil, experiencing devastating outbreaks. The primary vector for transmitting CHIKV in urban areas is the mosquito species Aedes aegypti, which is very abundant in Brazil. However, little is known about the impact of locally circulating CHIKV genotypes and specific combinations of mosquito populations on vector competence. In this study, we analyzed and compared the infectivity and transmissibility of a recently isolated CHIKV-ECSA lineage from Brazil among four Ae. aegypti populations collected from different regions of the country. When exposed to CHIKV-infected mice for blood feeding, all mosquito populations showed high infection rates and dissemination efficiency. Moreover, using a mouse model to assess transmission rates in a manner that better mirrors natural cycles, we observed that these populations exhibit highly efficient transmission rates of CHIKV-ECSA. Our findings underscore the robust capability of Brazilian Ae. aegypti populations to transmit the locally circulating CHIKV-ECSA lineage, potentially explaining its higher prevalence compared to the Asian lineage also introduced in Brazil.

Dermatite de contato pigmentada por cosmético / Pigmented cosmetic contact dermatitis

A dermatite de contato pigmentada se destaca por sua raridade, sendo associada a inúmeros alérgenos cosméticos e têxteis. Acomete predominantemente mulheres de meia idade e fototipos altos. O teste de contato é imprescindível para a identificação do agente causal. O tratamento indicado consiste no afastamento do agente causal, no uso de fotoprotetores, clareadores tópicos e, por vezes, procedimentos dermatológicos abrasivos. Relatamos um caso de dermatite de contato pigmentada por cosmético motivado pela exuberância clínica e desfecho satisfatório, ressaltando a importância da suspeição diagnóstica e do manejo adequado impactando neste desfecho.

Pigmented contact dermatitis is a rare condition associated with numerous cosmetic and textile allergens. It predominantly affects middle-aged women with high phototypes. The patch test is essential to identify the causative agent. Treatment includes removal of the causative agent, sunscreen use, administration of topical bleaching agents, and occasionally abrasive dermatologic procedures. We report a case of pigmented cosmetic contact dermatitis motivated by its clinical exuberance and satisfactory outcome, emphasizing the importance of diagnostic suspicion and adequate management impacting this outcome.

Euterpe oleracea Mart. (Açai) seed extract improves physical performance in old rats by restoring vascular function and oxidative status and activating mitochondrial muscle biogenesis.

OBJECTIVES: Alterations in cardiovascular and skeletal muscle function are hallmarks of ageing that lead to exercise intolerance. We aimed to examine whether the treatment with Euterpe oleracea Mart. seed extract (ASE) associated with exercise training improves aerobic exercise performance by promoting healthy ageing in the elderly. METHODS: Male Wistar rats were divided into five groups: Young (3 months), Old (18 months), Old+ASE (ASE 200 mg/kg/day), Old+Training (exercise training 30 min/day; 5 days/week) and Old+Training+ASE, for 4 weeks. KEY FINDINGS: ASE treatment increased the exercise time and the running distance concerning the initial maximal treadmill stress test (MTST) in the Old+Training+ASE group. Exercise training or ASE treatment restored the aorta oxidative damage and antioxidant defence. It reduced the acetylcholine (ACh)-induced vasodilation in the aorta of old animals to the same values as the young and improved hypertension. Only the association of both strategies restored the ACh-induced vasodilation in mesentery arteries. Remarkably, exercise training associated with ASE increased the antioxidant defence, nitrite levels and expression of the mitochondrial SIRT-1, PGC1α in soleus muscle homogenates. CONCLUSIONS: ASE treatment associated with exercise training contributes to better exercise performance and tolerance in ageing by improving vascular function, oxidative stress and activating the muscle SIRT-1/PGC-1α pathway.

Sobrecarga da equipe de enfermagem e o risco de eventos adversos / Nursing team overload and the risk of adverse events

Objetivo: Analisar os elementos relacionados a sobrecarga de trabalho da equipe de enfermagem que podem influenciar na ocorrência de eventos adversos e comprometer a segurança do paciente. Método: Estudo descritivo, quantitativo, realizado em um Hospital público do Distrito Federal, com aplicação de um questionário semiestruturado, com total de 92 participantes.Resultado: A maioria dos participantes eram técnicos de enfermagem do sexo feminino, com tempo de atuação superior a 10 anos, com carga horária semanal de 40 horas, e apenas 1 vínculo empregatício. O cooperativismo entre os colegas foi notório, e a grande maioria afirmou haver sobrecarga de serviço na unidade e que essa, por sua vez, afeta a segurança do paciente. Conclusão: A sobrecarga dos profissionais potencializada pela insuficiência de recursos humanos e materiais, alta demanda de pacientes e deficiência nos sistemas organizacionais institucionais, resultam em uma assistência deficiente com aumento do risco de eventos adversos.(AU)

Objective: To Analyze Elements Related to the workload of the nursing team that influence the occurrence of adverse events and compromise patient safety. Method: Descriptive, quantitative study, carried out in a public hospital in the Federal District, with the application of a semi-structured questionnaire, with a total of 92 participants. Result: Most participants were female nursing technicians, with more than 10 years of experience, with a weekly workload of 40 hours, andonly 1 employment relationship.Cooperativism Among Colleagues Was Notorious, and the vast majority stated that there was a service overload in the unit and that this, in turn, affects patient safety. Conclusion: The overload professionals, enhanced by insufficient human and material resources, high demand from patients and deficiencies in institutional organizational systems, result in poor assistance with an increased risk of adverse events.(AU)

Objetivo: Analizar elementos relacionados conla carga de trabajodel equipo de enfermería que pueden influir enlaocurrencia de eventos adversos y comprometer laseguridaddel paciente. Método: Estudio descriptivo, cuantitativo, realizado enun hospital público del Distrito Federal, conlaaplicación de uncuestionariosemiestructurado, conun total de 92 participantes. Resultado: La mayoría de los participantes eran técnicos de enfermeríadel sexo femenino, con más de 10 años de experiencia, con carga horaria semanal de 40 horas y sólo 1 vínculo laboral. El cooperativismo entre loscompañerosfuenotorio, y lagranmayoríaafirmó que había sobrecarga de serviciosenlaunidad y que eso, a su vez, afectalaseguridaddel paciente. Conclusión: La sobrecarga de profesionales, potenciada por lainsuficiencia de recursos humanos y materiales, la alta demanda de los pacientes y lasdeficienciasenlos sistemas organizativos institucionales, resultanen una mala asistenciaconunmayorriesgo de eventos adversos(AU)

Autocuidado para higiene oral em adultos e idosos no campo da enfermagem: protocolo de revisão de escopo / Self-care for oral hygiene in adults and older adults in the field of nursing: a scoping review protocol

OBJETIVO: Mapear evidências disponíveis sobre os antecedentes, atributos e consequentes do autocuidado para higiene oral de adultos e idosos, no campo da enfermagem. MÉTODO: Conduzido conforme a metodologia do Joanna Briggs Institute. Como critério de elegibilidade, serão utilizados a população de adultos e idosos, o conceito de autocuidado para a higiene oral e o contexto dos ambientes de cuidado de enfermagem. Na estratégia de busca, serão pesquisadas palavras relevantes em título e resumo, inicialmente em duas bases, que auxiliará na estratégia final de busca para todas as bases e, por fim, serão consultadas as referências dos estudos incluídos. As bases consultadas serão: Medline/Pubmed, CINAHL, Scopus, LILACS, Web of Science (WOS) e IBECS. Para busca de literatura cinzenta, serão utilizados os Catálogos de Teses e Dissertações da CAPES e a base OpenGrey. Os resultados serão redigidos de acordo com o Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist.

OBJECTIVE: To map available evidence on the antecedents, attributes, and consequences of self-care for oral hygiene in adults and older adults in the nursing field. METHOD: The study will be conducted according to the Joanna Briggs Institute's methodology. As eligibility criteria, the population of adults and older adults, the concept of self-care for oral hygiene, and the context of nursing care environments will be used. In the search strategy, relevant words will be searched in the titles and abstracts, initially in two databases, which will help achieve the final search strategy for all databases, and, finally, the references of the included studies will be consulted. The databases consulted will be Medline/Pubmed, CINAHL, Scopus, LILACS, Web of Science (WOS), and IBECS. The grey literature search will include the CAPES thesis, dissertation bank, and OpenGrey database. The results will be reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews.

Mosquito vector competence for dengue is modulated by insect-specific viruses.

Aedes aegypti and A. albopictus mosquitoes are the main vectors for dengue virus (DENV) and other arboviruses, including Zika virus (ZIKV). Understanding the factors that affect transmission of arboviruses from mosquitoes to humans is a priority because it could inform public health and targeted interventions. Reasoning that interactions among viruses in the vector insect might affect transmission, we analysed the viromes of 815 urban Aedes mosquitoes collected from 12 countries worldwide. Two mosquito-specific viruses, Phasi Charoen-like virus (PCLV) and Humaita Tubiacanga virus (HTV), were the most abundant in A. aegypti worldwide. Spatiotemporal analyses of virus circulation in an endemic urban area revealed a 200% increase in chances of having DENV in wild A. aegypti mosquitoes when both HTV and PCLV were present. Using a mouse model in the laboratory, we showed that the presence of HTV and PCLV increased the ability of mosquitoes to transmit DENV and ZIKV to a vertebrate host. By transcriptomic analysis, we found that in DENV-infected mosquitoes, HTV and PCLV block the downregulation of histone H4, which we identify as an important proviral host factor in vivo.

Swallowing outcome to speech therapy intervention in resistant hypertensive patients with obstructive sleep apnea.

PURPOSE: To evaluate (i) the outcome of swallowing therapy program on the rehabilitation of oropharyngeal dysphagia in resistant hypertensive patients with obstructive sleep apnea (OSA) and (ii) the association between the clinical and anthropometric characteristics of these individuals and this outcome. METHODS: This was a prospective interventional study in which resistant hypertensives diagnosed with OSA by polysomnography and dysphagia by fiberoptic endoscopic evaluation of swallowing (FESS) participated. All participants underwent a FEES and assessment of the risk of dysphagia (Eating Assessment Tool, EAT-10) and swallowing-related quality of life (Swal-QoL) before and after the intervention. The therapeutic program was performed daily by the participants, with weekly speech-therapist supervision for eight weeks, including the following strategies: Masako, chin tuck against resistance, and expiratory muscle training. RESULTS: A total of 26 (78.8%) of the participants exhibited improvement in the degree of dysphagia in the intervention outcome. After the intervention, there was a statistically significant improvement in the level of penetration-aspiration (p = 0.007), the degree of pharyngeal residue (p = 0.001), the site of onset of the pharyngeal phase (p = 0.001), and the severity of dysphagia (p = 0.001) compared to before intervention. The EAT-10 score was 2 (0-6) before and 0 (0-3) after intervention (p = 0.023). Swal-QoL had a score on the symptom frequency domain of 92.8 (75-100) before and 98.2 (87.5-100) after intervention (p = 0.002). CONCLUSIONS: Resistant hypertensive patients with OSA showed improved swallowing performance after swallowing therapy program.

Acompanhamento Fisioterapêutico após Tratamento Cirúrgico do Câncer de Mama por Teleconsulta: Percepção e Adesão das Pacientes / Physiotherapeutic Follow-up after Surgery for Breast Cancer Treatment by Telehealth: Patients' Perception and Adherence / Seguimiento Fisioterapéutico Posquirúrgico para el Tratamiento del Cáncer de Mama por Teleconsulta: Percepción y Adherencia de las Pacientes

Introdução: O serviço de fisioterapia do Hospital do Câncer III do Instituto Nacional de Câncer (HCIII/INCA) inseriu as teleconsultas em suas atividades assistenciais para o acompanhamento das pacientes submetidas ao tratamento cirúrgico do câncer de mama durante a pandemia. Objetivo: Avaliar a percepção das pacientes quanto aos atendimentos por teleconsulta no HCIII/INCA, além da compreensão e da adesão quanto às orientações fisioterapêuticas domiciliares no pós-operatório de câncer de mama. Método: Estudo observacional, de abordagem qualiquantitativa, no qual foram incluídas pacientes submetidas ao tratamento cirúrgico do câncer de mama, de março a maio de 2020, que realizaram teleconsultas com a fisioterapia. Foi utilizado um questionário com perguntas semiestruturadas e uma pergunta aberta sobre teleconsulta. Resultados: Foram incluídas 129 mulheres, 81,4% referiram conforto com as teleconsultas, 72,1% sentiram-se muito seguras e 71,3% sentiram-se satisfeitas com esse tipo de atendimento. Quanto às orientações fisioterapêuticas fornecidas, 89,1% das pacientes relataram que as entenderam e 66,7% que as seguiram totalmente; 63,6% realizaram os exercícios de membros superiores diariamente. Quanto à questão qualitativa, as pacientes relataram que a teleconsulta foi necessária, válida e importante por evitar a exposição ao vírus no período da pandemia, além de evitar os deslocamentos até a instituição, a economia de tempo e de dinheiro. Conclusão: A modalidade de teleconsulta nas avaliações da fisioterapia pós-cirurgia do câncer de mama geraram percepções de segurança, conforto e satisfação, tendo boa compreensão e adesão tanto das orientações fornecidas quanto da prática de exercícios domiciliares

Introduction: The physiotherapy service at the Cancer Hospital III of the National Cancer Institute (HCIII/INCA) has included telehealth in its care activities for monitoring patients undergoing surgical treatment for breast cancer during the pandemic. Objective: To evaluate the perception of patients about telehealth at HCIII/INCA, in addition to understanding and adherence to home physiotherapeutic guidelines in the postoperative breast cancer period. Method: Observational, qualitative and quantitative approach study, which included patients who received surgical treatment for breast cancer from March to May 2020 and attended physiotherapy telehealth. A semi-structured questionnaire with an open question about telehealth was utilized. Results: 129 women were included, 81.4% reported comfort with telehealth, 72.1% felt very safe and 71.3% felt satisfied with this type of service. Regarding physiotherapeutic guidelines provided, 89.1% of the patients claimed they understood the content, 66.7% followed them completely and 63.6% performed daily upper limb exercises. In relation to the quality, the patients reported that telehealth was necessary, valid and important to avoid exposure to the virus during the pandemic, in addition to being cost-effective, time-saving and avoiding trips to the institution. Conclusion: The modality of telehealth as evaluated by physiotherapy after breast cancer surgery generated a feeling of security, comfort and satisfaction, with good understanding and adherence to the guidelines and practice of home exercises

Introducción: El servicio de fisioterapia del Hospital Oncológico III del Instituto Nacional del Cáncer (HCIII/INCA) ha incluido la teleconsulta en su actividad asistencial para el seguimiento de las pacientes sometidas a tratamiento quirúrgico por cáncer de mama durante la pandemia. Objetivo: Evaluar la percepción de las pacientes sobre la teleconsulta en el HCIII/INCA, además de su comprensión y adherencia a las pautas de fisioterapia domiciliaria en el posoperatorio de cáncer de mama. Método: Estudio observacional, con abordaje cualitativa y cuantitativa, que incluyó pacientes que se sometieron a tratamiento quirúrgico por cáncer de mama, de marzo a mayo de 2020, a quienes se les realizó teleconsultas con fisioterapia. Se utilizó un cuestionario con preguntas semiestructuradas y una pregunta abierta sobre teleconsulta. Resultados: Se incluyeron 129 mujeres, el 81,4% refirió comodidad con las teleconsultas, el 72,1% se sintió muy segura y el 71,3% se sintió satisfecha con este tipo de atención. En cuanto a las pautas fisioterapéuticas brindadas, el 89,1% de las pacientes reportó que las entendían y el 66,7% que las seguía completamente; el 63,6% realizaba ejercicios de miembros superiores diariamente. En cuanto a la pregunta cualitativa, las pacientes relataron que la teleconsulta fue necesaria, válida e importante para evitar la exposición al virus durante el período de pandemia, además de evitar desplazamientos a la institución, ahorrando tiempo y dinero. Conclusión: La modalidad de teleconsulta en las evaluaciones de fisioterapia después de la cirugía de cáncer de mama generó percepciones de seguridad, comodidad y satisfacción, con buena comprensión y adherencia tanto a las orientaciones brindadas como a la práctica de ejercicios domiciliarios

Culturas infantis nas fotografias do parque Violeta Dória Lins (décadas de 1940 a 1960) / Children's culture in photographs of Violeta Dória Lins playground (from 1940's to 1960's) / La cultura infantil en las fotografías del parque Violeta Dória Lins (décadas 1940 a 1960)

O Parque Infantil Violeta Dória Lins foi inaugurado em 1940, em Campinas, como parte de um projeto mais amplo que tinha como finalidade educar e cuidar de crianças. Nesses parques, as intenções educativas evidenciavam o papel da arquitetura e da natureza. O objetivo deste trabalho é compreender as culturas infantis nas produções materiais e simbólicas produzidas para as crianças que frequentaram parques infantis entre as décadas de 1940 e 1960 na cidade de Campinas. Para essa investigação, foram selecionadas fotografias do acervo da instituição, bem como do Museu da Imagem e do Som de Campinas. A análise evidenciou que havia dois padrões de fotografias armazenados. Um empenhado na exibição das estruturas edificadas; outro, das práticas educativas que envolviam as crianças. Concluímos que as particularidades do projeto educacional dos Parques Infantis representavam possibilidades profícuas para a produção de culturas infantis, a partir da valorização do contato com a natureza e de um programa pedagógico voltado para atividades artísticas, trabalhos manuais, jogos e brincadeiras. (AU)

The Violeta Dória Lins Playground was inaugurated in 1940, in Campinas, as part of a larger project to educate and care for children. In these parks, the educational intentions highlighted the role of architecture and nature. This paper aims to understand children's cultures in the material and symbolic productions produced for the children who frequented playgrounds between the 1940s and 1960s in Campinas. For this investigation, photographs were selected from the institution's collection and the Museum of Image and Sound of Campinas. The analysis showed that there were two patterns of stored photographs, one committed to the display of the built structures, the other to the educational practices involving children. We conclude that the particularities of the educational project of the Playgrounds represented fruitful possibilities for the production of children's cultures, from the appreciation of the contact with nature and a pedagogical program focused on artistic activities, crafts, games, and play. (AU)

El Parque Infantil Violeta Dória Lins fue inaugurado en 1940, en Campinas, como parte de un proyecto más amplio destinado a la educación y el cuidado de los niños. En estos parques, las intenciones educativas estaban vinculadas a la arquitectura y la naturaleza. El objetivo de este trabajo es comprender las culturas infantiles en las producciones materiales y simbólicas producidas para los niños que asistían a los parques infantiles entre las décadas de 1940 y 1960 en la ciudad de Campinas. Las fotografías fueron seleccionadas de la colección de la institución, así como del Museu da Imagem e do Som. El análisis mostró que había dos corrientes de fotografías, una comprometida con la exhibición de las estructuras construidas y la otra, con las prácticas educativas. Concluimos que las particularidades del proyecto educativo de los Parques Infantiles representaron posibilidades fructíferas para la producción de culturas infantiles, a partir de la valoración del contacto con la naturaleza y en un programa pedagógico centrado en actividades artísticas, trabajos manuales, juegos y actividades lúdicas. (AU)

Validação do conteúdo da história em quadrinho "Tenho diabetes e agora?" / Validation of the content of the comic strip "I have diabetes and what now?"

RESUMO Objetivo analisar as evidências de validade de conteúdo da história em quadrinho "Tenho diabetes e agora?". Métodos pesquisa metodológica na produção de tecnologia em saúde no formato de história em quadrinhos para apoio a familiares e crianças internadas, com diagnóstico de Diabetes Mellitus tipo 1. Após elaboração da tecnologia educativa, ocorreu a etapa de validação do conteúdo com seis crianças e sete familiares, na qual se aplicou a escala Likert, com indicadores analisados por meio do Índice de Validade de Conteúdo. Resultados a tecnologia educativa apresentou bons índices de validação conforme avaliação das crianças (0,833) e familiares (1,000). Conclusão as crianças se identificaram com o personagem da historinha e concordaram ser uma ferramenta para o entendimento da doença, e os familiares afirmaram ser oportuno propagar a tecnologia em outros serviços de saúde. Contribuições para a prática há situações que permeiam aspectos relacionados ao cuidado com crianças com diabetes, portanto, a história em quadrinhos poderá contribuir para a qualidade da assistência multiprofissional a essa população acometida pelo Diabetes Mellitus.

ABSTRACT Objective to analyze the evidence of content validity of the comic strip "I have diabetes, what now?" Methods methodological research into the production of health technology in the form of a comic book to support family members and hospitalized children diagnosed with type 1 diabetes mellitus. After developing the educational technology, the content was validated with six children and seven family members using a Likert scale, with indicators analyzed using the Content Validity Index. Results the educational technology showed good validation indices according to the evaluation of the children (0.833) and family members (1.000). Conclusion the children identified with the character in the story and agreed that it was a tool for understanding the disease, and family members said that it would be useful to disseminate the technology in other health services. Contributions to practice there are situations that permeate aspects related to the care of children with diabetes, so the comic book could contribute to the quality of multi-professional care for this population affected by Diabetes Mellitus.

The direct and indirect costs of cardiovascular diseases in Brazil.

OBJECTIVE: To evaluate the direct and indirect costs of cardiovascular diseases (such as coronary heart disease and stroke) by sex and age group, attributed to the excessive consumption of salt, saturated fat and trans fat in Brazil. MATERIALS AND METHODS: The data for estimating the Population Attributable Fraction (PAF) corresponding to the consumption of salt, saturated fat and trans-fat were obtained from the Household Budget Survey 2017-2018. The calculation of direct costs for cardiovascular diseases (CVD) was made from the accounting sum of costs with hospitalizations and outpatient care found in the National Health System (Hospital Information System and Outpatient Information System), from 2017 to 2019, including the costs of treatment, such as medical consultations, medical procedures, and drugs. Regarding the indirect costs, they were measured by the loss of human capital, given the premature death, resulting in loss of productivity. To define the attributable costs, they were multiplied by the PAF. RESULTS: Higher burden of CVD attributable to the consumption of salt, saturated fat and trans fat were observed in younger individuals, which progressively decreased with advancing age, but still generated economic costs in the order of US$ 7.18 billion, in addition to 1.53 million productive years of life lost (YLL) to premature death, if considering salt as an inducer. Although attributable burden of CVD is higher among younger individuals, the highest costs are associated with males aged 45 to 74 years old for direct costs and 45 to 64 years old for indirect costs. CONCLUSION: The attributable fractions to consumption of salt are the ones that cause the most effects on CVD, followed by saturated fat and trans fat, with direct and indirect costs being higher for males.

Fiberoptic endoscopic evaluation of swallowing and the Brazilian version of the Eating Assessment Tool-10 in resistant hypertensive patients with obstructive sleep apnea

Abstract Objective: The aim of this study was to describe the prevalence and characteristics of OD through Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and the Eating Assessment Tool-10 (EAT-10) in hypertensive patients with OSA, as well as to describe the sensitivity of EAT-10 for the detection of OD in this population. Methods: This study included a convenience sample in which 85 resistant hypertensive patients diagnosed with OSA in an university hospital participated. Participants were subjected to the EAT-10 (index test) and FEES (reference standard). Results: The median EAT-10 score was 2 (0-5.5). According to the FEES, 27 participants did not have dysphagia, 42 had mild dysphagia and 16 had mild to moderate dysphagia. The sensitivity of the EAT-10 was 70.7% (95% CI: 57.3-81.9) at a cutoff score ≤1, with a discriminatory power of 67.4% (p = 0.005). The most prevalent symptom in this population was "food stuck in the throat", while the most prevalent signs were delayed initiation of the pharyngeal phase of swallowing, premature bolus spillage and pharyngeal residue. Conclusion: In our study, the cutoff score for the EAT-10 for screening for OD in this population was ≥ 1. In conclusion, this population presented a high prevalence of dysphagia detected in FEES and its severity is associated with higher EAT-10 scores.