Longitudinal neuropsychological performance of post-stroke adults with and without rehabilitation.

This study compared the neuropsychological performance of two post-stroke groups, one undergoing rehabilitation and the other not receiving any intervention, on the acute and chronic stroke phases, and explored sociodemographic and neurological variables associated with changes in performance over time. Sixty-three adults underwent neuropsychological assessment with the Cognitive Screening Instrument (TRIACOG) less than thirty days after having a stroke and were reassessed three to six months after stroke. Thirty-eight participants did not undertake rehabilitation and twenty-five did physiotherapy and/or speech therapy between the two time points. The frequency of cognitive deficits (between groups) and the range of cognitive assessment scores over time (between and within groups) were analyzed. There was a significant decrease in the frequency of neuropsychological deficits and improvement on neuropsychological assessment scores over time only in the group undergoing rehabilitation. Severity of the neurological condition, years of education and being in rehabilitation explained the longitudinal changes in several cognitive domains measured by TRIACOG. Engaging in rehabilitation within three to six months post-stroke is crucial for enhancing the recovery of neuropsychological deficits. Cognitive screening instruments like TRIACOG can be used by health professionals to identify stroke-related neuropsychological changes and plan interventions.

Genomic surveillance and serological profile of SARS-CoV-2 variants circulating in Macaé and nearby cities, southeastern Brazil.

Introduction: A characteristic of the COVID-19 pandemic has been the sequential emergence and global dissemination of SARS-CoV-2 variants, noted for their enhanced transmission efficiency. These variants with mutations in the Spike glycoprotein (S-glycoprotein), which interacts with ACE2 receptors in human cells is critical for infection, affects the transmissibility of the virus, which is a matter of great concern for public health. Objective: This research analyses the effects these variants on a cohort of vaccinated and naturally infected individuals from the cities of Macaé-RJ, Rio das Ostras-RJ, and Campos dos Goytacazes-RJ, Brazil, from March 2021 to March 2023. Methods: This investigation encompasses the Alpha (B.1.1.7), Gamma (P.1), Delta (B.1.617.2, B.1.671.3), and Omicron (BQ.1, BQ.1.1 sublines, and BF.7) variants, focusing on their genomic surveillance and implications for the disease's epidemiology. The experimental analysis included a control group (vaccinated and uninfected subjects), and an infected group (post-vaccinated subjects). Samples from nasopharyngeal swabs underwent viral detection via RT-qPCR for diagnosis confirmation. RNase H-dependent RT-qPCR (rhAmp-PCR) and third-generation sequencing were used to detect SARS-CoV-2 variants. Anti-S-glycoprotein immunoglobulins were also evaluated for vaccinated infected and noninfected volunteers. Symptoms from infected individuals were compiled in order to reveal patterns of clinical signs associated with viral infection. Results: The study included 289 participants, with infections identified by Gamma (n = 44), Delta (n = 189), and Omicron (n = 56) variants. The prevalent symptoms among the naturally infected participants were cough, fever, sore throat, headache, and runny nose. For Omicron, cognitive symptoms such as memory loss and concentration issues were reported. Interestingly, the infected vaccinated group had higher anti-S-glycoprotein IgM production (n = 28, 0.2833 ± 0.09768 OD) compared to the uninfected vaccinated group (n = 14, 0.1035 ± 0.03625 OD). Conversely, anti-S-glycoprotein IgG production was higher in the control group (n = 12, 1.770 ± 0.1393 OD) than in the infected vaccinated group (n = 26, 1.391 ± 0.1563 OD). Conclusion: This comprehensive study enables monitoring of predominant variants and their correlation with clinical cases, providing valuable insights for public health. Our research group continues to survey circulating variants, contributing to the global understanding of the pandemic.

Associação entre parâmetros do sono e atividade física em corredores durante a pandemia de COVID-19 / Association between sleep parameters and physical activity in runners during the COVID-19 pandemic

Determinar associação entre qualidade do sono (QS), sonolência diurna excessiva (SDE) e a atividade física (AF) em corredores de rua durante a pandemia deCOVID-19. Em86 voluntários, as seguintes variáveis foram avaliadas: QS (pelo Índice de Qualidade do Sono de Pittsburgh, ESE (pelaEscala de Sonolência de Epworth) e a AF (pelo aplicativo Google Fit®).Utilizou-se o teste de correlação de Pearson ou teste de correlação de Spearman. A análise de regressão linear simples foi realizada entre as variáveis que apresentaram correlação. Consideraram-se significantes os valores de p<0,05. Houve correlação entre a SDE e a contagem de passos, bem como entre a SDE e a AF. Verificou-se associação entre a SDE e a AF, mas não entre a QS e a AF.

To determine the association between sleep quality (SQ), excessive daytime sleepiness (EDS) and physical activity (PA) in amateur street runners during the COVID-19pandemic. Eighty-six volunteers were evaluated, and the analyzed variables were: SQ (By Pittsburgh Sleep Quality Index), EDS (By Epworth Sleepiness Scale), and PA (By the Google Fit® app). The data was collected remotely, via email, using Google Forms. Pearson correlation test or Spearman correlation test was used for data correlation. Simple linear regression analysis was performed between variables that showed correlation. P values < 0.05 were considered significant. There was a correlation between EDS and step count [r (p) = 0.219 (0.042)], and only an association between PA and EDS was observed. Based on the results, an association was found between EDS and PA. However, no association was found between SQ and PA.

Old but still good: genetic diversity of ancient pecan genotypes from southern Brazil.

Pecan [Carya illinoinensis (Wangenh.) K. Koch] is a crop fruit native to the USA and Mexico currently cultivated in several countries, including Brazil, Uruguay, Argentina, Chile, Peru, China, South Africa, and Australia. Supported by the increasing consumption and market prices, the interest in the cultivation of this fruit crop is strongly growing around the world. In this study, AFLP and S-SAP markers were employed to characterize the genetic diversity of ancient accessions of pecan from southern Brazil. The evaluated plants were selected and preserved by the farmers and are remnants of the first introduction of seedlings from the U.S.A into southern Brazil aiming at developing research towards establishing commercial orchards. High levels of genetic diversity were estimated, suggesting that these plants have an important genetic background for the establishment of a germplasm collection with a wide genetic basis, for the development of breeding programs for this fruit crop. Cluster analysis of the genetic datasets revealed some correlation between the nuts' morphometric traits and genetic markers. Such correlation should be further exploited. These ancient genotypes must be evaluated for other agronomic traits of interest and included in core collections of pecans.

Seaweeds and Corals from the Brazilian Coast: Review on Biotechnological Potential and Environmental Aspects.

Brazil has a megadiversity that includes marine species that are distributed along 800 km of shoreline. This biodiversity status holds promising biotechnological potential. Marine organisms are important sources of novel chemical species, with applications in the pharmaceutical, cosmetic, chemical, and nutraceutical fields. However, ecological pressures derived from anthropogenic actions, including the bioaccumulation of potentially toxic elements and microplastics, impact promising species. This review describes the current status of the biotechnological and environmental aspects of seaweeds and corals from the Brazilian coast, including publications from the last 5 years (from January 2018 to December 2022). The search was conducted in the main public databases (PubChem, PubMed, Science Direct, and Google Scholar) and in the Espacenet database (European Patent Office-EPO) and the Brazilian National Property Institute (INPI). Bioprospecting studies were reported for seventy-one seaweed species and fifteen corals, but few targeted the isolation of compounds. The antioxidant potential was the most investigated biological activity. Despite being potential sources of macro- and microelements, there is a literature gap regarding the presence of potentially toxic elements and other emergent contaminants, such as microplastics, in seaweeds and corals from the Brazilian coast.

Word Reading and Spelling Processing and Acquired Dyslexia post Unilateral Stroke.

This study investigates the performance of adults with cerebrovascular lesion in the right hemisphere (RHL) or left hemisphere (LHL) in word reading (TLPP) and spelling (TEPP) tasks based on the dual-route models. A total of 85 adults were assessed, divided into three groups: 10 with RHL, 15 with LHL, and 60 neurologically healthy ones. The performance of the three groups was compared in terms of the characteristics of the words (regularity, frequency, and length) and pseudowords (length), error types, and psycholinguistic effects. A cluster analysis was performed to investigate the profiles of the reading. The LHL group showed lower scores in reading and spelling tasks of words and pseudowords, as well as a higher frequency of errors. Four LHL cases were found to have an acquired dyslexia profile. This study highlights that the tasks developed in Brazil are in accordance with theoretical models of written language, and the results point to the heterogeneous performance of the cases with acquired dyslexia.

Respiratory system impedance in different decubitus evaluated by impulse oscillometry in individuals with obesity.

BACKGROUND AND OBJECTIVE: The body posture can influence gas exchange, respiratory mechanics, and mucociliary clearance and different positions can be used as a therapeutic strategy to improve in gas exchange and can also help physiotherapists to assist patients who have difficult or restrictions to stay seated or the ones who stay in the same position for a long period. The objective of this study was to evaluate the effect of different positions on respiratory system impedance in obese and eutrophic subjects, using Impulse Oscillometry System (IOS). METHODS: The IOS parameters were evaluated in seated (Se), right lateral decubitus (RL), left lateral decubitus (LL), and supine (Su). RESULTS: Sixty two volunteers were allocated in obese group (OG) or eutrophic group (EG) according to BMI. In seated position, OG showed higher impedance than EG for R5: 0.55 (0.31; 0.93) and 0.33 (0.24; 0.52); R20: 0.39 (0.23; 0.54) and 0.32 (0.03; 0.41); R5-R20: 0.13 (0.02; 0.47) and 0.01 (-0.08; 0.27); X5: -0.20 (-0.51; 0.16) and -0,10 (-0.016; -0.04); Fres: 20.59 (11.54; 36.45 and 10.69 (7.56; 24.7) (p<0.05) and the impedance were higher in the Su for both groups. Compared to Se, there were differences with Su (R5, R5-20, X5), with RL (R20), and with LL (R5, R20) for OG; and with Su (R5, R5-20, X5, Fres), with RL and LL (X5) for EG. Compared to Su, there were differences with RL and LL (R5-20, X5) for OG; and with RL (R5, R5-20, X5, Fres), and LL (R5-20, X5, Fres) for EG. There were no differences between RL and LL for OG and EG. CONCLUSION: The respiratory system impedance is increased in OG, with greater contribution of peripheral resistance. The higher values of resistance and reactance were obtained in the supine position, in both groups, with lower differences obtained in the right and left lateral decubitus.

Mineral and Trace Elements in Nutritious Flours: Total Contents, In Vitro Bioaccessibility and Contribution to Dietary Intake.

The consumption of fruits, vegetables, and cereals in the form of flour has been an alternative for the intake of nutrients, currently seen in a society that seeks a healthier diet. Thus, the assessment of total contents and bioaccessibility is important to better understand the actual intake of nutrients or contaminants present in foods. The objective of this study was to determine the total content and estimate the bioaccessible fraction of Cu, Fe, and Zn in nutritious flours by inductively coupled plasma optical emission spectrometry (ICP OES) after microwave acid digestion. Bioaccessibility was assessed using the in vitro method, taking into account the entire gastrointestinal tract (Unified Bioaccessibility Method (UBM)). The following concentration ranges, in µg g-1, were found: Ca (341-6275), K (2984-13,953), P (476-6110), Na (< 0.39-2995), Fe (1.4-167), Cu (< 0.01-59.6), and Zn (< 0.07-30.3). Principal component analysis (PCA) and hierarchical cluster analysis (HCA) showed a tendency towards the formation of three groups. The bioaccessible fractions for Cu, Fe, and Zn were considered low, ranging from 0.96 to 40% in the gastrointestinal phase and from 4.1 to 100% in the gastric phase.

The long-term dynamics of serum antibodies against SARS-CoV-2.

Objective: To analyze the long-term dynamics of antibodies against SARS-CoV-2 and understand the impact of age, gender, and viral load on patients' immunological response. Methods: Serum samples were obtained from 231 COVID-19 positive patients from Macaé, in Rio de Janeiro state, in Brazil, from June 2020 until January 2021. The production of IgA, IgM, IgG, and IgE against S glycoprotein was analyzed using the S-UFRJ assay, taking into account the age, gender, and viral load. Results: Analysis of antibody production over 7 months revealed that IgA positivity gradually decreased after the first month. Additionally, the highest percentage of IgM positivity occurred in the first month (97% of patients), and declined after this period, while IgG positivity remained homogeneous for all 7 months. The same analysis for IgE revealed that almost all samples were negative. The comparison of antibody production between genders showed no significant difference. Regarding the age factor and antibody production, patients aged ≥60 years produced almost twice more IgA than younger ones (17-39 years old). Finally, a relationship between viral load and antibody production was observed only for older patients. Conclusions: Our work provides an overview of long-term production of antibodies against SARS-CoV-2, suggesting prolonged production of IgA and IgM antibodies for 3 months and continued IgG production for over 7 months. In addition, it identified a correlation between viral load and IgM titers in the older group and, finally, different IgA production between the age groups.

Schools reopening and the COVID-19 pandemic: a case study from Macaé, Rio de Janeiro, Brazil.

Since the first reported case of COVID-19 in Brazil, the public and private educational system started to close. Up to November 2020, scientific discussions about the return of schooling activities have been rarely performed by the national scientific community and police-makers. The great delay of school returning in Brazil contrasts with successful international strategies of school reopening worldwide and seems counterintuitive with the reopening of non-essential activities. Here, important issues to be considered before and during school reopening are reviewed and discussed. COVID-19 testing is essential to avoid disease spreading, but high cost of individual RT-qPCRs impairs an extensive testing strategy for school returning. To reduce costs and increase the speed of diagnosis, we tested the efficiency of a pooled-sample PCR strategy in a cohort of the educational staff in the city of Macaé/RJ, finding five asymptomatic individuals (0,66%) among the 754 people tested. Thus, a polled-sample PCR testing strategy of the educational staff might prevent infection spreading in schools at a reasonable cost. We discuss how our test strategy could be coupled with internationally recognized safety rules to allow for a safe school return and how countries from different world regions are dealing with educational activities during COVID-19 pandemic.

Laparoscopy assisted abomasal cannulation in cadavers of bovine fetuses.

BACKGROUND: Due to the complexity of ruminant digestion, cannulation of organs of the digestive tract has been carried out in order to advance the understanding of digestive physiology, nutrient degradability, gastrointestinal diseases and biotechnological research. The abomasal cannulation is interesting for nutritional studies, especially in suckling calves, to obtain fluid and abomasal content, evaluation of abomasal flow and function, and infusion of nutrients and drugs when it is intended to reach high concentrations in the organ. Conventionally, access and cannulation of digestive organs of ruminants has been performed by laparotomy, a method often criticized and classified as cruel by some sectors related to ethics and animal welfare. The aim of this present study is to describe and standardize a minimally invasive by laparoscopy assisted abomasal cannulation in bovine fetuses (cadavers), which had been previously slaughtered by accident and would be discarded in local slaughterhouses. RESULTS: The abomasal cannulation technique was feasible, simple and did not present major difficulties. The surgical time for cannulation of the abomasum, from the insertion of the trocars to the completion of the technique with fixation of the organ to the abdominal wall, ranged from 9 to 27 min, with an average of 15.5 ± 6.62 min. CONCLUSIONS: The Laproscopic assisted abomasal cannulation in bovine fetuses was feasible and safe with minimal tissue injury to the abdominal wall and with short surgical time. More studies in the clinical routine related to minimally invasive abomasal content collection, abomasopexy and abomasotomy are required in order to demonstrate its impact and importance in bovine clinic.

Multielement determination (essential and potentially toxic elements) in eye shadows exposed to consumption in Brazil using ICP OES.

Worldwide, cosmetics (especially eye shadows) are widely consumed and have a great impact on the economy. The aim of this study was to determine the multielement composition, focusing on essential and potentially toxic elements, in cosmetics (eye shadow) exposed to consumption in Brazil. Concentrations of 17 elements (Al, As, Ba, Cd, Co, Cr, Cu, Mn, Mo, Ni, Pb, Sb, Se, Sr, Ti, V and Zn) were determined in samples (produced in China and Brazil) using a sequential optical emission spectrometer with inductively coupled plasma (ICP OES) after acid digestion, assisted by a closed digester block (6 mL of HNO3 + 2 mL of H2O2 + 1 mL of Triton ×-100 + 1 mL of ultrapure water). The method was validated by linearity, precision, accuracy, limits of detection (LoD) and quantification (LoQ). The elements were quantified (in µg g-1): Al (852-21,900), Ba (3.47-104), Cd (1.70-6.93), Cr (< 8.53-66.6), Cu (< 0.480-14.5), Mn (92.20-1,190), Ni (< 4.23-40.7), Pb (< 2.16-5.06), Sb (1.10-10.5), Sr (0.760-46.0), Ti (32.0-440), V (< 0.85-1.7) and Zn (24.90-2,600). As, Co, Mo and Se in all the investigated samples were found to be below the LoQ values of ICP OES. In this study, regardless of sample compositions and origins (Brazilian or Chinese), high levels of Al, Cd, Cr, Cu, Mn, Ni, Pb, Sb, Ti, V and Zn were observed, exceeding the recommended maximum tolerable limits, according to Brazilian and global legislations, which may present potential risks to human health and the environment.

Effect of losartan potassium, metformin hydrochloride, and simvastatin on in vitro bioaccessibility of Cu, Fe, Mn, and Zn in oat flour from Brazil.

BACKGROUND: The simultaneous administration of drugs with food can compromise the bioaccessibility and absorption of nutrients. The objective of this study was to evaluate the influence of the use of losartan potassium (LP), metformin hydrochloride (MH), and simvastatin (S) on the in vitro bioaccessibility of micronutrients (Cu, Fe, Mn, and Zn) in oat flour from Bahia, Brazil. METHODS: The experimental procedure consisted of the in vitro extraction of the bioaccessible fraction of Cu, Fe, Mn, and Zn in oat flour-with and without LP (50 mg), MH (500 mg), and S (20 mg)-using the unified bioaccessibility method (UBM), simulating the conditions of the gastrointestinal tract. For decomposition of the samples (oat flour and residue), a digester block with a closed system was used. To determine the total content (flour and residual fraction) and bioaccessible micronutrients, inductively coupled plasma optical emission spectrometry (ICP OES) was used. RESULTS: The bioaccessible contents (µg g-1) without the addition of drugs were: Cu 5.86 ± 0.21, Fe 32.80 ± 1.32, Mn 87.90 ± 1.90, and Zn 30.33 ± 2.05, with bioaccessibility ranging from 31.5 % for Fe to 99 % for Mn. The in vitro extraction method was validated by mass balance with recovery values from 89.78 % for Cu to 101.94 % for Mn. The range of bioaccessible contents (µg g-1) were: Cu (<4.14), Fe (32.10 ± 0.20-54.10 ± 2.03), Mn (81.40 ± 0.93-93.22 ± 0.80), and Zn (<10.80-29.11 ± 2.20). The estimation of the bioaccessibility of Cu, Mn, and Zn in oat flour were compromised in the presence of LP, MH, and S (p < 0.05). CONCLUSION: Chemical interactions can occur between drugs and micronutrients. Taken together, our results highlight that LP, MH, and S can interfere with the bioaccessibility of Cu, Fe, Mn, and Zn in oat flour in patients who use these drugs, suggesting its rational use in further investigations.

Correlation among clinical, functional and morphological indexes of the respiratory system in non-cystic fibrosis bronchiectasis patients.

BACKGROUND: Non-cystic fibrosis bronchiectasis (NCFB) is a heterogeneous disease, which assessment and severity can't be defined by one particular instrument but using a multidimensional score. Thus, in additional to traditional methods, alternative tools have been developed to assist these patients' evaluation. OBJECTIVE: To correlate functional and morphological indexes with severity and dyspnea in NCFB patients, focusing on the correlation between the impulse oscillometry system (IOS) and the quantitative analysis of computed tomography (CT). METHODS: Clinically stable NCFB patients, between 18 and 80 years old were submitted to clinical, functional and morphological evaluations assessed by Bronchiectasis Severity Index (BSI) and Medical Research Council (MRC) scale; spirometry and IOS; and subjective and quantitative Chest CT scans analysis, respectively. RESULTS: This study included 38 patients. The best correlations obtained between functional and morphological airway indexes were: resistance at 5 Hz-R5 and the normalized thickness of bronchial walls-Pi10 (r = 0.57), and the mean forced expiratory flow (FEF25-75%) and CT score (r = -0.39). BSI as well as MRC showed higher correlations with the quantitative automated analysis of CT (BSI and Pi10: r = 0.41; MRC and Pi10: r = 0.35) than with subjective CT score (BSI and CT score: r = 0.41; MRC and CT score: r = 0.15); and moderate and weak correlations were obtained on both functional airway indexes (BSI and peripheral airways resistance - R5-R20: r = 0.53; BSI and forced expiratory volume at the first second-FEV1: R = -0,64; MRC and R5-R20: r = 0.42; and MRC and VEF1: r = -0.45). CONCLUSION: In NCFB patients, compartmentalized methods for assessing the respiratory system (IOS and the automated quantitative CT analysis) have a good correlation with severity and dyspnea.

Increased airway resistance can be related to the decrease in the functional capacity in obese women.

BACKGROUND AND OBJECTIVE: Obesity can increase the airways resistance, mainly in the periphery, leading to dyspnea perception that can impair the functional capacity. This study aimed to analyze if airways resistance could be related to the walking capacity of women with morbid obesity. METHODS: Thirty-seven women with grade III obesity in preoperative bariatric surgery were evaluated using the spirometry test, impulse oscillometry system (IOS), and six-minute walk test (6MWT). Additionally, data about their daily dyspnea perception and physical activity level were collected. RESULTS: Variables of the spirometry test did not detect ventilator disorders. Compared to the predicted values, the IOS identified significant increase in airways resistance (kPa/L/s) (R5: 0.36 (0.34; 0.36) and 0.53 (0.47; 0.61); R20: 0.30 (0.28; 0.30) and 0.41 (0.35; 0.45); R5-20: 0.06 (0.06; 0.06) and 0.14 (0.10; 0.15); X5: -0.03 (-0.04; -0.01) and -0.20 (-0.27; -0.18), respectively). The distance walked in the 6MWT, 491.4±60.4m was significantly correlated to R5 (rho = -0.41, p = 0.01), R5-20 (rho = -0.52, p = 0.001), and X5 (rho = 0.54, p = 0.0006). CONCLUSION: The IOS is able to identify changes in airway resistance even before the onset of symptoms. When evaluated by IOS women with severe obesity and normal spirometry exhibited central and peripheral airways obstruction. The correlations between the IOS and six-minute walk distance suggest that increased peripheral airways resistance could be related to worsening functional capacity.

Effects of physical therapy with neuromuscular electrical stimulation in acute and late septic shock patients: A randomised crossover clinical trial.

BACKGROUND: Patients with sepsis and immobility in the intensive care unit are associated with muscle weakness, and early mobilisation can counteract it. However, during septic shock, mobilisation is often delayed due to the severity of the illness. Neuromuscular electrical stimulation (NMES) may be an alternative to mobilise these patients early. This study aims to identify whether NMES performed within the first 72 hours of septic shock diagnosis or later is safe from a metabolic perspective. METHODS: This is the analysis of two randomised controlled crossover studies. Patients with acute septic shock (within the first 72 hours of diagnosis) and sepsis and septic shock in the late phase (after 72 hours of diagnosis) were eligible. Patients were submitted in a random order to the intervention protocol (dorsal decubitus position with the lower limbs raised and NMES) and control (dorsal decubitus position with the lower limbs raised without NMES). The patients were allocated in group 1 (intervention and control) or group 2 (control and intervention) with a wash-out period of 4 to 6 hours. Metabolic variables were evaluated by indirect calorimetry. RESULTS: Sixteen patients were analysed in the acute septic shock study and 21 in the late sepsis/septic shock study. There were no significant differences between Oxygen Consumption (VO2) values in the acute phase of septic shock when the baseline period, intervention, and control protocols were compared (186.59 ± 46.10; 183.64 ± 41.39; 188.97 ± 44.88, p>0.05- expressed in mL/Kg/min). The same was observed when the VO2 values in the late phase were compared (224.22 ± 53.09; 226.20 ± 49.64; 226.79 ± 58.25, p>0.05). The other metabolic variables followed the same pattern, with no significant differences between the protocols. When metabolic variables were compared between acute to late phase, significant differences were observed (p<0.05). CONCLUSIONS: As metabolic rates in septic shock patients had no increase during NMES, either in the first 72 hours of diagnosis or later, NMES can be considered safe from a metabolic viewpoint, even despite the higher metabolic demand in the acute phase of shock. TRIAL REGISTRATION: NCT03193164; NCT03815994. Registered on June 5, 2017; November 13, 2018 (clinicaltrials.gov/).

Professional attitudes towards suicidal behavior in primary health care: a quasi-experimental study / Actitudes profesionales en relación a las conductas suicidas en la atención primaria de la salu: un estudio cuasi-experimental / Atitudes profissionais em relação ao comportamento suicida na atenção primária à saúde: um estudo quase-experimental

ABSTRACT Objective: to analyze the attitudes of health professionals working in Primary Health Care before and after participating in workshops about how to approach people with suicidal behavior. Method: a before-and-after quantitative and quasi-experimental study, conducted in a municipality in the inland of the state of São Paulo from August to September 2019. The sample consisted of 34 workers who answered a Sociodemographic Questionnaire and the Questionnaire on Attitudes towards Suicidal Behavior, applied before and after three workshops on how to approach people with suicidal behavior in the Primary Health Care context. The data were analyzed by means of the Wilcoxon and McNemar tests, considering p<0.05. Results: a statistically significant difference was identified before and after the workshops regarding professional ability (p=0.011), negative feelings towards the patient (p=0.025) and without a category (p=0.006), evidencing the effectiveness of the workshops on how to approach people with suicidal behavior for management and care professionals working in Primary Health Care. Conclusion: the short-term results observed after the workshops point to a change in the professionals' conception and management in relation to people with suicidal behavior. Permanent and continuous training strategies as spaces for learning, reflection and action are fundamental to qualify the approach to people with suicidal behavior.

RESUMEN Objetivo: analizar las actitudes de los profesionales de la salud que trabajan en Atención Primaria antes y después de participar en talleres sobre el enfoque en relación a personas que presentan conductas suicidas. Método: estudio de carácter cuantitativo y cuasi-experimental del tipo antes y después, realizado en un municipio del interior del estado de San Pablo de agosto a septiembre de 2019. La muestra estuvo compuesta por 34 trabajadores que respondieron un Cuestionario Sociodemográfico y el Cuestionario sobre Actitudes en Relación a las Conductas Suicidas, aplicados tanto antes como después de asistir a tres talleres sobre cómo tratar a personas con conductas suicidas en el contexto de la Atención Primaria de la Salud. Los dados se analizaron por medio de las pruebas de Wilcoxon y McNemar, considerando p<0,05. Resultados: se identificó una diferencia estadísticamente significativa antes y después de los talleres en lo que se refiere a la capacidad profesional (p=0,011), a sentimientos negativos en relación al paciente (p=0,025) y a ninguna categoría específica (p=0,006), evidenciando así la efectividad de los talleres sobre cómo tratar a personas con conductas suicidas destinados a profesionales de gestión y atención en el contexto de la Atención Primaria de la Salud. Conclusión: los resultados a corto plazo que se observaron después de los talleres señalan un cambio en la concepción y el manejo de los profesionales frente a personas que presentan conductas suicidas. Estrategias permanentes y sostenidas en el tiempo como espacios de aprendizaje, reflexión y acción son fundamentales para cualificar debidamente la forma de atender a personas con conductas suicidas.

RESUMO Objetivo: analisar as atitudes dos profissionais de saúde da Atenção Primária à Saúde antes e após a participação de oficinas acerca da abordagem em relação à pessoa com comportamento suicida. Método: estudo de natureza quantitativa e quase-experimental do tipo antes e depois, realizado em município do interior do estado de São Paulo de agosto a setembro de 2019. A amostra foi composta por 34 trabalhadores que responderam a um Questionário Sociodemográfico e ao Questionário sobre Atitudes em Relação ao Comportamento Suicida, aplicados antes e após a realização de três oficinas sobre abordagem à pessoa com comportamento suicida no contexto da Atenção Primária à Saúde. Os dados foram analisados por meio dos testes de Wilcoxon e McNemar, considerando p<0,05. Resultados: identificou-se diferença estatisticamente significativa antes e após as oficinas no que se refere à capacidade profissional (p=0,011), sentimentos negativos em relação ao paciente (p=0,025) e sem categoria (p=0,006), evidenciando a efetividade das oficinas sobre a abordagem da pessoa com comportamento suicida para os profissionais da gestão e do cuidado na Atenção Primária à Saúde. Conclusão: os resultados a curto prazo, observados após oficinas, apontam para uma mudança na concepção e no manejo dos profissionais frente à pessoa com comportamento suicida. Estratégias permanentes e continuadas de formação como espaços de aprendizagem, reflexão e ação são fundamentais para qualificar a abordagem à pessoa com comportamento suicida.

Molecular testing and analysis of disease spreading during the emergence of COVID-19 in Macaé, the Brazilian National Capital of Oil.

The Brazilian strategy to overcome the spread of COVID-19 has been particularly criticized due to the lack of a national coordinating effort and an appropriate testing program. Here, a successful approach to control the spread of COVID-19 transmission is described by the engagement of public (university and governance) and private sectors (hospitals and oil companies) in Macaé, state of Rio de Janeiro, Brazil, a city known as the National Oil Capital. In 2020 between the 17th and 38th epidemiological week, over two percent of the 206,728 citizens were subjected to symptom analysis and RT-qPCR testing by the Federal University of Rio de Janeiro, with positive individuals being notified up to 48 h after swab collection. Geocodification and spatial cluster analysis were used to limit COVID-19 spreading in Macaé. Within the first semester after the outbreak of COVID-19 in Brazil, Macaé recorded 1.8% of fatalities associated with COVID-19 up to the 38th epidemiological week, which was at least five times lower than the state capital (10.6%). Overall, considering the successful experience of this joint effort of private and public engagement in Macaé, our data suggest that the development of a similar strategy countrywise could have contributed to a better control of the COVID-19 spread in Brazil. Quarantine decree by the local administration, comprehensive molecular testing coupled to scientific analysis of COVID-19 spreading, prevented the catastrophic consequences of the pandemic as seen in other populous cities within the state of Rio de Janeiro and elsewhere in Brazil.

Effects of Controlled Voluntary Increase in the Ventilatory Demand on Respiratory System Resistance in Healthy and Non-Cystic Fibrosis Bronchiectasis Subjects: A Cross-Sectional Study / Efectos del aumento voluntario y controlado de la demanda ventilatoria en la resistencia del sistema respiratorio en sujetos sanos y en pacientes con bronquiectasias no debidas a fibrosis quística: un estudio transversal

Introduction: Bronchiectasis patients may present a reduced functional capacity due to an increase in the ventilatory demand during exercise. Objective: To evaluate the effects of controlled voluntary hyperinflation and increased respiratory rate on the mechanics of the respiratory system, simulating what happens during exercise, in bronchiectasis and healthy subjects. Methods: Bronchiectasis (n=30) and healthy (n=16) subjects were evaluated by impulse oscillometry (IOS) during a baseline condition, and in controlled conditions with baseline (b) tidal volume (V) and hyperinflation (H), with respiratory rates at 30(R30) and 40(R40) bpm, in a random order. The mixed effects and a significance level at 0.05 were used for comparisons. Results: Resistance at 5Hz (R5), and at minus 20Hz (R5–R20), in kPa/L/s, were higher in subjects with bronchiectasis in all experimental conditions (p<0.05). For the bronchiectasis group, R5 and R5-20 increased with R increase at V (VRb versus VR30 and VR40; VR30 versus VR40; R5, R20 and R5-20 increased with R increase at H (HRb versus HR40; HR30 versus HR40). For the same R, there was a decrease with H compared to V (HRb versus VR30 and VR40; and HR30 versus VR30 and VR40). For the healthy group, only R20 showed differences (HR30 versus HR40; HR40 versus VR40). Conclusion: The tachypnea increases the resistance and reactance of the respiratory system in bronchiectasis patients, and the voluntary hyperinflation caused attenuates this increase. These results can guide the development of strategies to reduce the limitation of physical activity in patients with bronchiectasis. (AU)

Introducción: Los pacientes con bronquiectasias pueden presentar una capacidad funcional reducida debido a un aumento en la demanda ventilatoria durante el ejercicio. Objetivo: Evaluar los efectos de la hiperinsuflación voluntaria y controlada y el aumento de la frecuencia respiratoria en la mecánica del sistema respiratorio, simulando lo que sucede durante el ejercicio, en sujetos sanos y en pacientes con bronquiectasias. Métodos: Se evaluó a sujetos con bronquiectasia (n=30) y sujetos sanos (n=16) mediante la oscilometría de impulso (IOS) en situación basal, y en condiciones controladas con basal (b), volumen corriente (V) e hiperinsuflación (H), con frecuencias respiratorias a 30 (R30) y 40 (R40) bpm, en orden aleatorio. Para las comparaciones se utilizaron el modelo de efectos mixtos y un nivel de significación de 0,05. Resultados: La resistencia a 5Hz (R5) y la diferencia con 20Hz (R5-R20), medida en kPa/l/s, fue mayor en sujetos con bronquiectasias en todas las condiciones experimentales (p<0,05). Para el grupo de bronquiectasias, R5 y R5-R20 aumentaron con el aumento de R en V (VRb versus VR30 y VR40; VR30 versus VR40; R5, R20 y R5-R20 aumentaron con el aumento de R en H (HRb versus HR40; HR30 versus HR40. Para el mismo R, hubo una disminución de H en comparación con V (HRb versus VR30 y VR40; y HR30 versus VR30 y VR40). Para el grupo sano, solo R20 mostró diferencias (HR30 versus HR40; HR40 versus VR40). Conclusión: La taquipnea aumenta la resistencia y la reactancia del sistema respiratorio en pacientes con bronquiectasias, y la hiperinsuflación voluntaria generada atenúa este aumento. Estos resultados pueden guiar el desarrollo de estrategias para reducir la limitación de la actividad física en pacientes con bronquiectasia. (AU)

Evaluation of multielement/proximate composition and bioactive phenolics contents of unconventional edible plants from Brazil using multivariate analysis techniques.

Unconventional edible plants (UEP) are potential supplementary sources of minerals and bioactive compounds. However, there is still a gap in the literature on UEP composition. In this study, the multielement/proximate composition of ten UEP from Brazil was evaluated by ICP OES. Furthermore, phenolic bioactives were quantified by HPLC-UV-DAD. The UEP showed high moisture content (84.85-95.27%) and elements (in mg Kg-1): Al (122-657), Ca (145-14,229), Cu (8.3-18.81), Fe (177-586), K (12.46-34.50%), Mg (157-1,552), Mn (16.85-84.96), Na (1,107-23,775), P (2,535-6,127), Si (189-1,695), Sr (25.56-104.63) and Zn (0.3-72.31). Nine phenolic bioactive compounds (1-2,147) and three flavonoids (1-2,042 mg Kg-1) were determined. PCA and HCA grouped samples (Java ginseng, Coriander, Spearmint and Indian borage) rich in minerals. Spearmint showed high levels of transcinamic acid, kaempferol and quercetin. This study contributes to the scientific development and use of UEP.