Identification of key neuronal mechanisms triggered by dimethyl fumarate in SH-SY5Y human neuroblastoma cells through a metabolomic approach.

Dimethyl fumarate (DMF) is an old drug used for psoriasis treatment that has recently been repurposed to treat relapse-remitting multiple sclerosis, mostly due to its neuro- and immunomodulatory actions. However, mining of a pharmacovigilance database recently ranked DMF as the second pharmaceutical most associated with cognitive adverse events. To our best knowledge, the signaling mechanisms underlying its therapeutic and neurotoxic outcomes remain mostly undisclosed. This work thus represents the first-hand assessment of DMF-induced metabolic changes in undifferentiated SH-SY5Y human neuroblastoma cells, through an untargeted metabolomic approach using gas chromatography-mass spectrometry (GC-MS). The endometabolome was analyzed following 24 h and 96 h of exposure to two pharmacologically relevant DMF concentrations (0.1 and 10 µM). None of these conditions significantly reduced metabolic activity (MTT reduction assay). Our data showed that 24 h-exposure to DMF at both concentrations tested mainly affected metabolic pathways involved in mitochondrial activity (e.g., citric acid cycle, de novo triacylglycerol biosynthesis), and the synthesis of catecholamines and serotonin by changing the levels of their respective precursors, namely phenylalanine (0.68-fold decrease for 10 µM DMF vs vehicle), and tryptophan (1.36-fold increase for 0.1 µM DMF vs vehicle). Interestingly, taurine, whose levels can be modulated via Nrf2 signaling (DMF's primary target), emerged as a key mediator of DMF's neuronal action, displaying a 3.86-fold increase and 0.27-fold decrease for 10 µM DMF at 24 h and 96 h, respectively. A 96 h-exposure to DMF seemed to mainly trigger pathways associated with glucose production (e.g., gluconeogenesis, glucose-alanine cycle, malate-aspartate shuttle), possibly related to the metabolism of DMF into monomethyl fumarate and its further conversion into glucose via activation of the citric acid cycle. Overall, our data contribute to improving the understanding of the events associated with neuronal exposure to DMF.

The influence of the Great Recession on perinatal health-an ecological study on the trend changes and regional differences in Portugal.

Background: Few studies examine the relationship between socioeconomic factors and trends in mortality in high-income European countries. Due to the lack of regional-level data, most recent studies on social inequality in Portugal do not investigate regional differences. This study analyses time trends and regional disparities in the evolution of perinatal mortality (PMR) and infant mortality (IMR) associated with demographic and socioeconomic indicators following Portugal's 2008 economic and financial crisis. Methods: Associations were assessed using generalised linear models. A Poisson joinpoint regression model was applied to identify relevant PMR and IMR changes between 2000 and 2018. Country regional disparities were analysed using Mixed Effect Multilevel models. Findings: IMR and PMR significantly decreased in the pre-crisis period but not in the post-crisis period. The significant differences between regions in IMR and PMR in 2000 were followed by a different evolution of regional IMR after 2008. PMR and IMR were not significantly associated with socioeconomic indicators. A significant positive association with maternal age at first birth was identified. Interpretation: Results confirm the influence of the crisis on PMR and IMR trends in Portugal, taking into account recurring associations between macroeconomic cycles, variations in mortality trends, macroeconomic volatility, and stagnation of IMR and PMR. Regional inequalities confirm the internal variability of the crisis influence and persistent spatial inequalities affecting IMR patterns. Funding: FCT, under the Institute of Public Health of the University of Porto (ISPUP)-EPIUnit (UIDB/04750/2020) and ITR (LA/P/0064/2020), Maastricht University's external PhD programme under the Care and Public Health Research Institute (CAPHRI), and the RECAP preterm project (grant agreement no 733280).

Enhancing the Longevity and Functionality of Ti-Ag Dry Electrodes for Remote Biomedical Applications: A Comprehensive Study.

This study aims to evaluate the lifespan of Ti-Ag dry electrodes prepared using flexible polytetrafluoroethylene (PTFE) substrates. Following previous studies, the electrodes were designed to be integrated into wearables for remote electromyography (EMG) monitoring and electrical stimulation (FES) therapy. Four types of Ti-Ag electrodes were prepared by DC magnetron sputtering, using a pure-Ti target doped with a growing number of Ag pellets. After extensive characterization of their chemical composition and (micro)structural evolution, the Ti-Ag electrodes were immersed in an artificial sweat solution (standard ISO-3160-2) at 37 °C with constant stirring. Results revealed that all the Ti-Ag electrodes maintained their integrity and functionality for 24 h. Although there was a notable increase in electrical resistivity beyond this timeframe, the acquisition and transmission of (bio)signals remained viable for electrodes with Ag/Ti ratios below 0.23. However, electrodes with higher Ag content (Ag/Ti = 0.31) became insulators after 7 days of immersion due to excessive Ag release into the sweat solution. This study concludes that higher Ag/Ti atomic ratios result in heightened corrosion processes on the electrode's surface, consequently diminishing their lifespan despite the advantages of incorporating Ag into their composition. This research highlights the critical importance of evaluating electrode longevity, especially in remote biomedical applications like smart wearables, where electrode performance over time is crucial for reliable and sustained monitoring and stimulation.

Using Digital Tools to Study the Health of Adults Born Preterm at a Large Scale: e-Cohort Pilot Study.

BACKGROUND: Preterm birth is a global health concern. Its adverse consequences may persist throughout the life course, exerting a potentially heavy burden on families, health systems, and societies. In high-income countries, the first children who benefited from improved care are now adults entering middle age. However, there is a clear gap in the knowledge regarding the long-term outcomes of individuals born preterm. OBJECTIVE: This study aimed to assess the feasibility of recruiting and following up an e-cohort of adults born preterm worldwide and provide estimations of participation, characteristics of participants, the acceptability of questions, and the quality of data collected. METHODS: We implemented a prospective, open, observational, and international e-cohort pilot study (Health of Adult People Born Preterm-an e-Cohort Pilot Study [HAPP-e]). Inclusion criteria were being an adult (aged ≥18 years), born preterm (<37 weeks of gestation), having internet access and an email address, and understanding at least 1 of the available languages. A large, multifaceted, and multilingual communication strategy was established. Between December 2019 and June 2021, inclusion and repeated data collection were performed using a secured web platform. We provided descriptive statistics regarding participation in the e-cohort, namely, the number of persons who registered on the platform, signed the consent form, initiated and completed the baseline questionnaire, and initiated and completed the follow-up questionnaire. We also described the main characteristics of the HAPP-e participants and provided an assessment of the quality of the data and the acceptability of sensitive questions. RESULTS: As of December 31, 2020, a total of 1004 persons had registered on the platform, leading to 527 accounts with a confirmed email and 333 signed consent forms. A total of 333 participants initiated the baseline questionnaire. All participants were invited to follow-up, and 35.7% (119/333) consented to participate, of whom 97.5% (116/119) initiated the follow-up questionnaire. Completion rates were very high both at baseline (296/333, 88.9%) and at follow-up (112/116, 96.6%). This sample of adults born preterm in 34 countries covered a wide range of sociodemographic and health characteristics. The gestational age at birth ranged from 23+6 to 36+6 weeks (median 32, IQR 29-35 weeks). Only 2.1% (7/333) of the participants had previously participated in a cohort of individuals born preterm. Women (252/333, 75.7%) and highly educated participants (235/327, 71.9%) were also overrepresented. Good quality data were collected thanks to validation controls implemented on the web platform. The acceptability of potentially sensitive questions was excellent, as very few participants chose the "I prefer not to say" option when available. CONCLUSIONS: Although we identified room for improvement in specific procedures, this pilot study confirmed the great potential for recruiting a large and diverse sample of adults born preterm worldwide, thereby advancing research on adults born preterm.

Rehabilitation and release of confiscated songbirds into the wild: A pilot study.

Songbirds are currently the most prevalent animals in illegal trafficking in Brazil and other countries, so they are often confiscated, and this poses legal, ethical, and conservation challenges. Returning them to nature requires complex and expensive management, a topic that is sparingly addressed in the literature. Here, we described the processes and costs associated with an attempt to rehabilitate and release confiscated songbirds into the wild. A total of 1,721 songbirds of several species were quarantined, rehabilitated, and released, primarily on two farms located within their typical geographical distribution. Health assessments were performed on samples from 370 birds. Serology revealed no antibodies against Newcastle disease, and Salmonella spp. cultures were negative. Real-time polymerase chain reactions detected M. gallisepticum in samples from seven birds. Atoxoplasma spp. and Acuaria spp. infections, sepsis, and trauma were the top causes of bird death. About 6% of the released birds were recaptured, within an average period of 249 days after release, and at a mean distance of 2,397 meters from the release sites. The majority of these birds were found with free-living mates within or close to fragments of transitional ecoregions with native or cultivated grasslands, and native groves/forests, and shrublands. However, eucalyptus plantations with rich understory regeneration provided a suitable environment for the released forest species to settle, since they were recaptured during the defense of these sites. Over half of the recaptured birds presented behavioral profiles with both dominant and tame traits. Birds with dominant traits are more likely to settle in habitats and face the live decoys during fieldwork, whereas birds with tame characteristics tend to accept close contact with humans. Ultramarine grosbeak (Cyanoloxia brissonii), the least common species among those released, at the release sites showed an almost 2-fold recapture rate in the shortest mean distances from the release sites. This suggests less territory competition, perhaps a major factor of bird re-establishment here. The total per-bird cost was USD 57. Our findings suggested suitable survival and re-establishment of confiscated songbirds in the wild, when managed as we describe.

A Semi-Automatic Method for the Quantification of Astrocyte Number and Branching in Bulk Immunohistochemistry Images.

Immunohistochemical staining of cell and molecular targets in brain samples is a powerful tool that can provide valuable information on neurological mechanisms. However, post-processing of photomicrographs acquired after 3,3'-Diaminobenzidine (DAB) staining is particularly challenging due to the complexity associated with the size, samples number, analyzed targets, image quality, and even the subjectivity inherent to the analysis by different users. Conventionally, this analysis relies on the manual quantification of distinct parameters (e.g., the number and size of cells and the number and length of cell branching) in a large set of images. These represent extremely time-consuming and complex tasks, defaulting the processing of high amounts of information. Here we describe an improved semi-automatic method to quantify glial fibrillary acidic protein (GFAP)-labelled astrocytes in immunohistochemistry images of rat brains, at magnifications as low as 20×. This method is a straightforward adaptation of the Young & Morrison method, using ImageJ's plugin Skeletonize, coupled with intuitive data processing in datasheet-based software. It allows swifter and more efficient post-processing of brain tissue samples, regarding astrocyte size and number quantification, the total area occupied, as well as astrocyte branching and branch length (indicators of astrocyte activation), thus contributing to better understand the possible inflammatory response developed by astrocytes.

Effects of High-Fat and High-Fat High-Sugar Diets in the Anxiety, Learning and Memory, and in the Hippocampus Neurogenesis and Neuroinflammation of Aged Rats.

High-caloric diets induce several deleterious alterations in the human body, including the brain. However, information on the effects of these diets on the elderly brain is scarce. Therefore, we studied the effects of 2 months of treatment with high-fat (HF) and high-fat-high-sugar (HFHS) diets on aged male Wistar rats at 18 months. Anxiety levels were analyzed using the open-field and plus-maze tests, while learning and memory processes were analyzed using the Morris water maze test. We also analyzed neurogenesis using doublecortin (DCX) and neuroinflammation using glial fibrillary acidic protein (GFAP). In aged rats, the HFHS diet impaired spatial learning, memory, and working memory and increased anxiety levels, associated with a reduction in the number of DCX cells and an increase in GFAP cells in the hippocampus. In contrast, the effects of the HF diet were lighter, impairing spatial memory and working memory, and associated with a reduction in DCX cells in the hippocampus. Thus, our results suggest that aged rats are highly susceptible to high-caloric diets, even if they only started in the elderly, with an impact on cognition and emotions. Furthermore, diets rich in saturated fats and sugar are more detrimental to aged rats than high-fat diets are.

Unlocking the secrets of saliva: the promising potential of salivary biomarkers for evaluating crack use / Desvendando os segredos da saliva: o potencial promissor dos biomarcadores salivares para avaliar o uso de crack

The forthcoming letter will encompass the following highlights: Crack cocaine use involves smoking a highly addictive form of cocaine, which is a significant concern in Brazil, particularly in urban areas. This addiction is linked to various health problems, including cardiovascular issues, sexually transmitted infections (STIs) like AIDS and syphilis, tuberculosis, and a notable increase in mortality, largely due to violent causes. Furthermore, crack cocaine users are particularly vulnerable to dental caries, gingival inflammation, oral mucosa lesions, and xerostomia (AU)

A próxima carta incluirá os seguintes destaques: O uso de crack envolve fumar uma forma altamente viciante da cocaína, o que é uma preocupação significativa no Brasil, especialmente em áreas urbanas. Esta dependência está ligada a vários problemas de saúde, incluindo problemas cardiovasculares, infecções sexualmente transmissíveis (IST), como a AIDS e a sífilis, a tuberculose e um aumento notável da mortalidade, devido, em grande parte, a causas violentas. Além disso, os usuários de crack são particularmente vulneráveis a cáries dentárias, inflamação gengival, lesões na mucosa oral e xerostomia (AU)

Global frequency and epidemiological profile of electronic cigarette users: a systematic review.

OBJECTIVE: Electronic cigarette (e-cigarette) use is growing significantly worldwide, especially among young people. This product has been associated with renormalizing smoking and hindering quit attempts in smokers. Moreover, among nonsmokers, it can lead to subsequent cigarette smoking and nicotine dependence. The present study aimed to assess the epidemiological profile of e-cigarette users worldwide. STUDY DESIGN: A systematic review was performed using 3 main electronic databases (Medline/PubMed, SCOPUS, and EMBASE). Studies were independently assessed by 2 reviewers based on established eligibility criteria. The risk of bias was assessed using the MAStARI critical appraisal instrument. RESULTS: From 4,496 records, 43 were included. Among the 1,238,392 participants, 132,786 (10.72%) were e-cigarette users. The age range with the highest percentage of e-cigarette users was 18-24 years old, with 40,989 (30.86%) males, 34,875 (26.26%) females, and 33.6% being current cigarette smokers. The highest prevalence of users was 52.88% in Croatia and 49.62% in New Zealand. Other possible correlations were observed with e-cigarette use, such as a high level of education. CONCLUSION: Overall, e-cigarette users tended to be male young adults with a higher level of education. The highest prevalence of use was found in Croatia. This systematic review provides valuable information to improve the development of appropriate intervention strategies targeting e-cigarette users for more accurate anti-smoking actions.

Antimicrobial TiN-Ag Coatings in Leather Insole for Diabetic Foot.

This work reports on TiN-Ag antimicrobial coatings deposited by d.c. magnetron sputtering on leather used for insoles on the footwear industry, studies involving the antimicrobial properties of Ag-based functionalized leathers by sputtering techniques are shown. The X-ray diffraction (XRD) results suggested the presence of crystalline fcc-TiN phase for the sample without silver, and also a fcc-Ag phase in the samples containing silver. According to the Scanning Electron Microscopy (SEM) analysis, the coatings were homogeneous and dispersed Ag clusters were detected on the surface of samples with silver content above 8 at. %. The Inductively coupled plasma-optical emission spectrometry (ICP-OES) analysis showed that the ionization of silver over time depends on the morphology of the coatings. The samples did not present cytotoxicity and only samples with incorporated silver presented antibacterial and antifungal activity, highlighting the potential of the TiN-Ag insole coatings for diseases such as diabetic foot.

Increased interaction and procedural flexibility favoured participation: Study across European cohorts of preterm born individuals.

OBJECTIVE: To understand participation and attrition phenomena variability in European cohorts of individuals born preterm through in-depth exploration of the interplay of situational elements involved. METHODS: Multi-situated qualitative design, using focus groups, semi-structured interviews and collaborative visual methodology with a purposive sample of adults born preterm, parents and professionals (n = 124) from eight cohorts in seven European countries. RESULTS: Most cohort participants were motivated by altruism/solidarity and gratitude/sense of duty to reciprocate (only absent in adults aged 19 - 21), followed by expectation of direct benefit to one's health and knowledge amongst participating adults. Common deterrents were perceived failure in reciprocity as in insufficient/inadequate interaction and information sharing, and postal questionnaires. Combining multipurpose, flexible strategies for contact and assessment, reminders, face-to-face and shorter periodicity and not simply adding retention strategies or financial incentives favoured participation. Professionals' main challenges entailed resources, funding and, European societal changes related to communication and geopolitical environment. CONCLUSION: Retention would benefit from tailoring inclusive strategies throughout the cohorts' life cycle and consistent promotion of reciprocal altruistic research goals. Investing in regular interaction, flexibility in procedures, participant involvement and return of results can help mitigate attrition as well as considering mothers as main facilitators to participating children and impaired adults.

Clinical and diagnostic aspects of Fabry disease management: a narrative review with a particular focus on Brazilian experts' perspectives

ABSTRACT Research on the genetics, epidemiology, and clinical manifestations of Fabry disease (FD) has increased significantly in recent years. However, some relevant clinical questions still need to be answered to develop better approaches to patient management. This review focuses on answering specific questions raised by Brazilian experts based on their experience in diagnosing and managing patients with FD. The questions are as follows: What is the role of globotriaosylsphingosine in diagnosis? How does one proceed with the diagnosis if there is a variant of unknown significance? What are the earliest and most reliable markers of renal, cardiac, and neurological impairment? What is the prevalence of FD in patients with cryptogenic stroke? What is the average delay in diagnosis in patients with FD? Based on these questions, our objective was to highlight epidemiological, diagnostic, and clinical aspects relating to the literature in the FD field.

Crassicaudiasis in three geographically and chronologically distant Cuvier's beaked whales (Ziphius cavirostris) stranded off Brazil.

The Cuvier's beaked whale (CBW; Ziphius cavirostris) is a cosmopolitan marine mammal found in deep tropical and temperate waters of all oceans. CBW strandings have been recorded sporadically in Brazil; however, there is lack of information available regarding their causes of stranding and/or death. Herein, we report the epidemiologic, pathologic, morphologic parasitologic features and molecular identification of arterial and renal crassicaudiasis by Crassicauda sp. in three geographically and chronologically distant CBW stranded off Brazil. CBW-1 was an adult male stranded dead in Rio Grande do Sul State. CBW-2 was an adult female that stranded alive in Sergipe State and died shortly after. CBW-3 was and adult male that stranded dead in Santa Catarina State. The most relevant pathologic findings in these three CBW were severe, chronic proliferative mesenteric and caudal aortic endarteritis and chronic granulomatous and fibrosing interstitial nephritis with renicular atrophy and loss, and numerous intralesional Crassicauda sp. nematodes. Furthermore, CBW-1 had concomitant gram-negative bacterial pneumonia and pulmonary and hepatic thromboembolism. Morphologic analysis of renal adult nematodes identified Crassicauda sp. in the three CBW. Molecular analyses targeting the 18S and ITS-2 ribosomal loci of renal nematodes in CBW-2 and CBW-3 identified C. anthonyi. It is believed that severe arterial and renal crassicaudiasis likely resulted or contributed significantly to morbidity and death of these animals. These results expand the known geographical range of occurrence of crassicaudiasis in CBW. Specifically, the present study provides the first accounts of arterial and renal crassicaudiasis in CBW off the southern hemisphere, specifically in CBW off Brazil, and to the authors' knowledge, it is the first record of C. anthonyi in the southern Atlantic Ocean.

Perceptions of secondary school teachers towards school expulsion of pregnant adolescents at Igunga District, Tanzania-a qualitative study.

BACKGROUND: In Tanzania, adolescent pregnancy results in a denial of the girl's fundamental right to education. School expulsion of pregnant adolescents is a common practice exercised by teachers in this country for decades. This study aimed to explore the perceptions and feelings of secondary school teachers towards this practice. METHODS: The study used a qualitative approach comprising focus groups and individual semistructured interviews with a purposive sample of sixteen teachers and nine headmasters (n = 25) from nine secondary schools of the rural Igunga district, in Tabora region, Tanzania. Data was collected in March to June 2017 and submitted to thematic analysis. RESULTS: Though most participants were not satisfied with the practice, their role on the expulsion of pregnant students was perceived as mandatory by law and regulations. Main argument in favor was its deterrent effect, yet the review of schools' registries did not sustain that perception. Stigma and fear of contamination added a relevant contribution to its implementation. Conflicting feelings among teachers were also disclosed. CONCLUSION: This study was of most value to understand current perceptions and feelings of those who exercise the practice of banning pregnant adolescents from school in Tanzania, while having identified some of the cultural and social believes acting as influential factors in its pervasiveness. International and national human rights organizations should increase their efforts and campaigns in order to strength social awareness of the benefit of females' education to society as a whole and of adopting policies and practices in support of their equal right to education.

Operação especial de barreiras sanitárias para enfrentamento do vírus sars-cov-2, Bahia, 2020 / Special operation of sanitary barrier to combat the sars-cov-2 virus, Bahia, 2020 / Operativo especial de barrera sanitaria para combatir el virus sars-cov-2, Bahía, 2020

A pandemia do novo coronavírus se apresenta como um dos maiores desafios sanitários do século 21. O primeiro caso confirmado no Brasil foi registrado no dia 25 de fevereiro de 2020, em São Paulo, e na Bahia, em 6 de março de 2020. Em função da Emergência de Saúde Pública de Importância Internacional (ESPII), a Secretaria da Saúde do Estado da Bahia (Sesab) desenvolveu o Projeto de Operação Especial de Vigilância Sanitária, em articulação com a Agência Nacional de Vigilância Sanitária (Anvisa), em um período de 90 dias. Este trabalho tem como objetivo descrever as ações de controle e mitigação da epidemia de Covid-19 no estado da Bahia, mediante a realização de barreiras sanitárias nos principais aeroportos, rodoviárias e nas rodovias intermunicipais de maior fluxo de veículos, com desenvolvimento de atividades de educação e comunicação em saúde para viajantes e trabalhadores. Trata-se de um estudo descritivo, com uso da técnica da observação participante, cujas atividades foram centradas na avaliação do risco sanitário, visando o controle e a mitigação da epidemia de Covid-19 no estado da Bahia. As barreiras sanitárias nos principais pontos de entrada do estado contribuíram para detecção e notificação de casos suspeitos para Covid-19, bem como para refrear a introdução e disseminação do vírus SARS-CoV-2 em determinados territórios. Considera-se as barreiras sanitárias uma estratégia relevante, visto que podem contribuir na implementação de ações de vigilância relacionadas às pessoas em trânsito (viajantes e trabalhadores), de modo a minimizar e/ou reduzir o avanço da epidemia em sua fase inicial no território baiano.

The pandemic of the new coronavirus is one of the greatest health challenges of the 21st century. The first confirmed case in Brazil occurred on February 25, 2020 in the municipality of São Paulo and on March 6, 2020 in the state of Bahia. Due to the Public Health Emergency of International Concern (PHEIC), the Health Department of the State of Bahia (Sesab) developed the Special Health Surveillance Operation Project, in conjunction with the Brazilian Health Regulatory Agency (Anvisa), for 90 days. This study aims to describe the actions to control and mitigate the Covid-19 epidemic in the state of Bahia, by the implementation of sanitary barriers in the main airports, highways and intercity highways with the highest flow of vehicles, with the development of education and training activities. health communication for travelers and workers. This is a descriptive study, using the technique of participant observation, whose activities were centered on the assessment of health risk, aiming at the control and mitigation of the Covid-19 epidemic in the state of Bahia. Sanitary barriers at the main points of entry of the state contributed to the detection and notification of suspected cases for Covid-19, and to curb the introduction and spread of the SARS-CoV-2 virus in certain territories. Sanitary barriers are considered a relevant strategy, since they can contribute to the implementation of surveillance actions related to people in transit (travelers and workers), to minimize and/or reduce the spread of the epidemic in Bahia, in its phase initial.

La pandemia del nuevo coronavirus se presenta como uno de los mayores desafíos sanitarios del siglo XXI. El primer caso confirmado en Brasil ocurrió el 25 de febrero de 2020 en São Paulo y, en Bahía, el 6 de marzo de 2020. Debido a la Emergencia de Salud Pública de Importancia Internacional (ESPII), la Secretaría de Salud del Estado de Bahía (Sesab) desarrolló el Proyecto Operativo Especial de Vigilancia Sanitaria, en conjunto con la Agencia Nacional de Vigilancia Sanitaria (Anvisa), por un período de 90 días. Este trabajo tiene como objetivo describir las acciones para controlar y mitigar la epidemia del covid-19 en el estado de Bahía, por medio de la implementación de barreras sanitarias en los principales aeropuertos, carreteras y carreteras interurbanas con mayor flujo de vehículos en el estado, con el desarrollo de actividades formativas y de comunicación sanitaria para viajeros y trabajadores. Este es un estudio descriptivo, utilizando la técnica de observación participante, cuyas actividades se centraron en la evaluación de riesgos para la salud, con el objetivo de controlar y mitigar la epidemia del covid-19 en el estado de Bahía. Las barreras sanitarias en los principales puntos de entrada del estado contribuyeron a la detección y notificación de casos sospechosos del covid-19, así como a frenar la introducción y propagación del virus SARS-CoV-2 en ciertos territorios. Las barreras sanitarias se consideran una estrategia relevante, ya que pueden contribuir a la implementación de acciones de vigilancia relacionadas con las personas en tránsito (viajeros y trabajadores), con el fin de minimizar y/o reducir el avance de la epidemia en ese territorio, en su fase inicial.

Violência obstétrica: experiência da equipe multidisciplinar em saúde / Obstetric violence: experience of a multidisciplinary health team / Violencia obstétrica: experiencia de un equipo multidisciplinario de Salud

Objetivo: Descrever a compreensão, a experiência e as proposições da equipe multidisciplinar em saúde em relação à violência obstétrica. Método: Estudo qualitativo, descritivo, desenvolvido em maternidade pública do interior paulista. Entrevistaram-se 43 participantes profissionais de diversas categorias. Coleta de dados realizada por meio de entrevista semiestruturada. Dados analisados e fundamentados na Análise de Conteúdo de Bardin, modalidade temática. Resultados: Emergiram a partir das falas transcritas as categorias: 1 ­ Desconhecimento da violência obstétrica; 2 - Relato sobre violência obstétrica; 3 - Práticas de violência obstétrica; 4 - Necessidade de capacitações sobre violência obstétrica; 5 - Necessidade da inserção de enfermeiras obstetras; 6 ­ Necessidade de reestruturação física e inserção de quarto para Pré-parto, Parto e Pós-parto (PPP). Conclusão: Alguns participantes demonstraram desconhecimento sobre o tema. Ressalta-se a importância do conhecimento da equipe de saúde sobre a violência obstétrica, para que possam identificar, intervir e prestar assistência humanizada. A violência obstétrica é favorecida por falta de reestruturação do ambiente e de materiais, escassez de recursos humanos e sobrecarga de trabalho dos profissionais envolvidos. Considera-se oportuna a promoção de capacitações que aproximem os profissionais de saúde de condutas baseadas em evidências científicas.(AU)

Objective: To describe a multidisciplinary health team's understanding, experience, and propositions regarding obstetric violence. Method: A qualitative, descriptive study was carried out in a public maternity hospital in the countryside of São Paulo. Forty-three professionals from different categories were interviewed. Data collection was performed through semi-structured interviews. The data analysis was based on Bardin's Content Analysis framework. Results: From the transcribed speeches, the following categories emerged: 1 ­ Unfamiliarity with obstetric violence; 2 - Obstetric violence reports; 3 - Obstetric violence practices; 4 -Need for training on obstetric violence; 5 - Need for insertion of obstetric nurses; 6 ­ Need for physical restructuring and insertion of prepartum, delivery, and postpartum (PDP) rooms. Conclusion: Some participants demonstrated ignorance about the topic. The importance of the health team's knowledge about obstetric violence is highlighted to identify, intervene, and provide humanized care. Obstetric violence is favored by the lack of restructuring of the environment and materials, shortage of human resources, and work overload of professionals. It is considered opportune to promote training to help health professionals adopt evidence-based conducts.(AU)

Objetivo: Describir el entendimiento, la experiencia y las propuestas de un equipo de salud multidisciplinario sobre la violencia obstétrica. Método: Se realizó un estudio descriptivo cualitativo en una maternidad pública del interior de São Paulo. Se entrevistó a 43 profesionales de diferentes categorías. La recolección de datos se realizó mediante entrevistas semiestructuradas. El análisis de datos se basó en el marco de análisis de contenido de Bardin. Resultados: De los discursos transcritos surgieron las siguientes categorías: 1 - Desconocimiento de la violencia obstétrica; 2 - Informes de violencia obstétrica; 3 - Prácticas de violencia obstétrica; 4 -Necesidad de formación sobre violencia obstétrica; 5 - Necesidad de inserción de enfermeras obstétricas; 6 - Necesidad de reestructuración física e inserción de salas de preparto, parto y posparto (PPP). Conclusión: Algunos participantes demostraron desconocimiento sobre el tema. Se destaca la importancia del conocimiento del equipo de salud sobre la violencia obstétrica, para que pueda identificar, intervenir y brindar atención humanizada. La violencia obstétrica se ve favorecida por la falta de reestructuración del entorno y materiales, escasez de recursos humanos y sobrecarga de trabajo de los profesionales. Se considera oportuno promover la formación para ayudar a los profesionales de salud a adoptar conductas basadas en evidencia.(AU)

Rare mutations in ATL3, SPTLC2 and SCN9A explaining hereditary sensory neuropathy and congenital insensitivity to pain in a Brazilian cohort.

Hereditary sensory neuropathies (HSN) are a group of rare neurological disorders with heterogeneous clinical and genetic characteristics. Although at least 17 different genes have already been associated with HSN, the epidemiology of the disorder in Brazil is still unknown. Performing whole genome sequencing (WGS) in 23 unrelated Brazilian families diagnosed with HSN, we detected pathogenic variants in ATL3, SPTLC2, and SCN9A in 12 patients belonging to five unrelated families. Clinical features associated with heterozygous mutations in ATL3 (c.575A > G; p.(Tyr192Cys)) and SPTLC2 (c.529A > G; p.(Asn177Asp)) were sensory deficits, neuropathic pain, and recurrent ulcerations. Presenting as congenital insensitivity to pain, three unrelated probands carried biallelic loss-of-function mutations in SCN9A. The so far undescribed stop mutation c.2106G > A (p.(Trp702Ter)) and the likewise novel splicing variant c.3319-1G > A were found in compound-heterozygosity with, respectively, the known pathogenic variants c.2908G > T (p.Trp970Ter) and c.2690G > A (p.Glu897Ter). In total, we identified pathogenic mutations in 21.7% of our families, which suggests that most of the cases could be explained by yet to be discovered genes or unusual alleles. Our study represents the first mutational screen in a Brazilian HSN cohort, enabling additional insights for genotype-phenotype correlations, reducing misdiagnoses, and providing early treatment considerations.