Prevalence of trachoma in indigenous and non-indigenous areas, Northeastern Brazil, 2019-2021.

Objective: To estimate the prevalence of trachoma in indigenous and non-indigenous populations in selected areas of the state of Maranhão, in northeastern Brazil. Methods: This was a population-based survey with probabilistic sampling. For the diagnosis of trachoma, external ocular examination was performed using head magnifying loupes, at 2.5X magnification. The prevalence of trachomatous inflammation - follicular (TF) in children aged 1-9 years and the prevalence of trachomatous trichiasis (TT) in the population aged ≥15 years were estimated. Relative frequencies of sociodemographic and environmental characteristics were obtained. Results: The study included 7 971 individuals, 3 429 from non-indigenous populations and 4 542 from indigenous populations. The prevalence of TF in non-indigenous and indigenous populations was 0.1% and 2.9%, respectively, and the prevalence of TT among indigenous populations was 0.1%. Conclusions: The prevalence of TF and TT in the two evaluation units in the state of Maranhão were within the limits recommended for the elimination of trachoma as a public health problem. However, the prevalence of TF was higher in the indigenous evaluation unit, indicating a greater vulnerability of this population to the disease. The prevalence of TF of below 5.0% implies a reduction in transmission, which may have resulted from improved socioeconomic conditions and/or the implementation of the World Health Organization SAFE strategy.

Brain volumetry from CT-scan endocasts of three neotropical carnivores.

Studies on brain anatomy can clarify specific evolutionary and behavioural aspects of wild animals. The rich diversity in a broad range of habitats makes carnivorans especially eligible for studying the relations between the brain form and behaviour, cognitive, sensorial and motor traits. This study compared the brain's contour and total and segmented brain volumetry in three species of neotropical carnivorans. CT images of 17 skulls of three species were acquired: Conepatus chinga (n = 6), Galictis cuja (n = 6) and Lontra longicaudis (n = 5). Three-dimensional endocasts allowed for estimating the brain's total and segmented volumes (olfactory bulb, rostral cerebrum, caudal cerebrum and cerebellum/brain stem). The average volume percentage of the segments was compared interspecifically and intraspecifically between the sexes. The otter has a notably more complex gyrification, typical for semiaquatic carnivorans. Proportionally, the olfactory bulb was significantly larger in hog-nosed skunks, possibly due to a better sense of smell for capturing insects. The proportional volumes of the rostral cerebrum, caudal cerebrum and cerebellum/brain stem segments did not differ between these species. Social behaviour traits and tactile, motor and balance skills were probably not sufficiently distinct to reflect differences in the brain segments analysed in these three species.

Coronary anatomy in neotropical carnivores: A comparative analysis.

This study aims to investigate the anatomy of coronary arteries and their primary branches in neotropical carnivores, given the functional significance of coronary circulation and the limited existing descriptions in this order. For this purpose, coronary arteries were dissected, and their branches were counted in 74 hearts from 20 species belonging to five families: Canidae, Mustelidae, Procyonidae, Mephitidae, and Felidae. In all specimens of the suborder Caniformia, the subsinuosal interventricular branch originated at the end of the circumflex branch of the left coronary artery (LCA). In contrast, in all hearts of Felidae specimens, the subsinuosal branch was derived from the right coronary artery. Among the 50 neotropical specimens of the suborder Caniformia, 13.1 ± 5.2 ventricular branches originated from the LCA and only 4.6 ± 1.4 from the right (p < 0.0001), characterizing a consistent left dominance. However, in the 24 specimens of the Felidae family, 10.5 ± 4.0 ventricular branches were found originating from the LCA and 10.4 ± 3.4 from the right, with no difference between the means (p = 0.82), defining a balanced pattern. It is suggested that the type of coronary circulation may correlate with the phylogeny of carnivorans.

Sexual behavior and self-declaration of sexual orientation among people 18-64 years in Brazil: results from the Knowledge, Attitudes, and Practices survey, 2013 and the National Health Survey, 2019.

BACKGROUND: Population surveys involving the monitoring of high-risk sexual behavior have been recognized as important public health tools to control the HIV epidemic and other sexually transmitted infections (STIs). METHODS: Using data from the Knowledge, Attitudes, and Practices survey (PCAP-2013) and from the National Health Survey (PNS-2019), indicators of sexual behavior were compared according to sociodemographic characteristics among individuals aged 18-64 years, including size (%) estimates of men who have sex with men (MSM) and women who have sex with women (WSW). Specifically, the PNS-2019 prevalence estimates of homosexual, bisexual, heterosexual males and females were compared with those from the PCAP-2013. To compare PCAP and PNS proportional distributions, the Pearson's chi-square test, adjusted by the Rao-Scott's correction, was applied. RESULTS: Size (%) estimates of MSM and WSW obtained by direct questions from the PCAP-2013, showed higher homosexuality prevalence estimates than those resulting from the PNS-2019 self-declared sexual orientation. Significant differences were found between the MSM proportions according to the PCAP-2013 (3.7%; 95% CI 3.1-4.4%) and to the PNS-2019 (2.2%; 95% CI 1.9-2.5), and between the WSW proportions (4.6%; 95% CI 4.0-5.4%) and (2.1%; 95% CI 1.8-2.4), respectively. Results from both surveys showed MSM and WSW prevalence estimates increase with educational level, decrease with age, and is larger among people who do not live with partner, live in urban areas and in state capitals. Regarding condom use at last sexual intercourse, no differences between the PCAP-2013 and the PNS-2019 estimates were found at the national level, but significant improvements were found for MSM, people aged 18-24 and 25-34 years, and individuals not living with a partner. CONCLUSIONS: The underestimation of MSM and WSW prevalence by self-declared sexual orientation suggests that sexual minorities face many difficulties related to disclosing their sexuality and reinforces the importance of developing public health interventions for changing population attitudes and promoting sexual orientation disclosure. Moreover, the low use of condoms in both surveys (PCAP-2013 and PNS-2019) carried out 6 years apart highlights the need of public policies to expand prevention strategies for HIV infection and other STIs.

Cohort study of hospitalized patients with COVID-19 at Brazilian tertiary-care hospital: Occurrence of adverse events and mortality.

INTRODUCTION: Patients hospitalized with COVID-19 are often submitted to invasive procedures and they are at risk for hospital-associated adverse events. OBJECTIVES: To evaluate the epidemiological and clinical aspects of patients hospitalized with COVID-19; the occurrence of adverse events and the risk factors for mortality. METHOD: Cohort study that included adult patients hospitalized with a diagnosis of SARSCoV-2 infection, at the tertiary University Hospital of UNICAMP from March 2020 to March 2021. Patients were identified through the hospital epidemiological surveillance system and followed until discharge or death. Descriptive, comparative, and logistic regression analysis was performed. RESULTS: 650 adult patients were included. The main adverse events identified were nosocomial infections (31.5%), renal failure (33.8%), thromboembolic and vascular events (12.6%). Mortality was higher among those with bloodstream infections (30.2% vs. 8.6%; p < 0.0001), ventilator-associated pneumonia (VAP, 52.5% vs. 12.3%; p < 0.0001), catheter associated urinary infection (27.3% vs. 7.2%; p < 0.0001); thromboembolic and vascular events (23.0% vs. 9.9%; p < 0.0001) and renal failure (81.3% vs. 20.9%; p < 0.0001). Klebsiella pneumoniae (15.6%), Pseudomonas aeruginosa (14.4%), Enterococcus faecalis (8.6%) were the most isolated bacteria. Logistic regression analysis identified age, (RR = 1.03; 95% CI 1.02 to 1.05); ICU admission (RR = 3.06; 95% CI 1.59 to 5.87), vasoactive drug use (RR = 3.1; 95% CI 1.79 to 4.82); renal failure (RR = 7.76; 95% CI 4.54 to 13.26); and VAP (RR = 2.2; 95% CI 1.23 to 3.96), independently associated with mortality. CONCLUSION: adverse events have an important impact on the evolution of patients with COVID-19, reinforcing the need for optimized prevention and control measures as an essential part of care for these patients.

Linear CT-scan measurements of cerebral ventricles in senile Poodle dogs.

Breed traits seem to influence the dimensions of the cerebral ventricles in dogs. The ratios between the ventricles and the brain are crucial diagnostic criteria for suspected canine cognitive dysfunction (CCD). This study aimed to establish linear computed tomography (CT)-scan measurements of the cerebral ventricles in 55 Poodle dogs aged >7 years. To this end, cross-sectional CT images were evaluated. The measurements in the whole sample were: height of the right ventricle, 6.0 ± 1.6 mm; height of the left ventricle, 5.8 ± 1.6 mm; width of the right ventricle, 6.9 ± 1.4 mm; width of the left ventricle, 7.0 ± 1.3 mm; height of the third ventricle, 3.4 ± 0.8 mm; height of the right cerebral hemisphere, 39.5 ± 2.0 mm; and height of the left cerebral hemisphere, 40.2 ± 2.6 mm. The average ventricular measurements were higher in dogs older than 11 years (p < 0.05). However, the average ratio of the ventricle height to the height of the brain did not reveal differences between age groups, sex, or antimeres. In addition, none of the images showed fused lateral ventricles. Thus, these data can assist in interpreting ventricle size in senile Poodle dogs (aged >7 years).

Características raciais parecem influenciar as dimensões dos ventrículos cerebrais em cães. As proporções entre os ventrículos e o cérebro são cruciais para os casos suspeitos de disfunção cognitiva canina (DCC). Este estudo objetivou estabelecer medidas lineares dos ventrículos cerebrais de 55 cães da raça Poodle com idade acima de sete anos. Para tal, foram avaliadas imagens de cortes transversais obtidas por tomografia computadorizada. As medidas na amostragem total foram: altura do ventrículo direito 6,0 ± 1,6 mm, altura do ventrículo esquerdo 5,8 ± 1,6 mm, largura do ventrículo direito 6,9 ± 1,4 mm, largura do ventrículo esquerdo 7.0 ± 1,3 mm, altura do terceiro ventrículo 3,4 ± 0,8 mm, altura do hemisfério cerebral direito 39,5 ± 2,0 mm e altura do hemisfério cerebral esquerdo 40,2 ± 2,6 mm. As médias das medidas ventriculares foram maiores em cães acima de 11 anos de idade (p < 0,05). Contudo, a relação entre altura ventricular e altura cerebral não revelou diferenças entre grupos etários, sexo ou antímeros. Além disso, nenhuma imagem revelou ventrículos fusionados. Assim, os dados do presente estudo podem auxiliar na interpretação das dimensões ventriculares em cães da raça Poodle acima dos sete anos de idade.

Population Prevalence of Trachoma in Nine Rural Non-Indigenous Evaluation Units of Brazil.

PURPOSE: To assess the contemporary prevalence of trachoma in Brazil's non-indigenous population, surveys of those thought to be at greatest risk of disease were conducted. METHODS: Rural census tracts of non-indigenous population from nine mesoregions were selected to compose the survey evaluation units (EUs) by considering previously endemic municipalities at greatest risk of trachoma. In each of the nine EUs, we conducted a population-based prevalence survey. Every resident of selected households aged ≥1 year was examined for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT). Additionally, data were collected on household-level access to water, sanitation, hygiene (WASH) and education. RESULTS: A total of 27,962 individuals were examined across nine EUs. The age-adjusted TF prevalence in 1-9-year-olds was <5% in each EU. The age- and gender-adjusted prevalence of TT unknown to the health system in ≥15-year-olds was <0.2% in eight EUs; in one EU, it was 0.22%. The median number of households surveyed per EU with access to an improved drinking water source within a 30-minute roundtrip of the house was 66%. School attendance was >99% of surveyed children. CONCLUSIONS: The prevalence of TF was well below the target for elimination as a public health problem in all EUs. Because EUs surveyed were selected to represent the highest-risk non-indigenous areas of the country, TF prevalence is unlikely to be ≥5% in non-indigenous populations elsewhere. In one EU, the prevalence of TT was above the target threshold for elimination. Further investigation and possibly improvement in TT surgical provision are required in that EU.

Health vulnerabilities in female sex workers in Brazil, 2016.

Female sex workers (FSW) suffer stigma and discrimination that negatively impact their physical and mental health and affect access to health care services. This paper aims to describe selected health indicators among FSW in 12 Brazilian cities in 2016. Brazilian cross-sectional Biological Behavioral Surveillance Survey was conducted in 2016 among 4328 FSW recruited by respondent-driven sampling. The sample weighing was inversely proportional to participant's network sizes and the seeds were excluded from the analysis. Health indicators were estimated with 95% confidence interval and included indicators of health status, symptoms of depression, antenatal care, pap smear coverage, signs and symptoms of sexually transmitted infection, contraception and regular condom use, number of births and children alive per women, human immunodeficiency virus and syphilis testing, usual source of care, and perception of discrimination. Most participants self-rated their health as very good/good (65.8%) and 27.7% were positively screened for major depressive disorder episode on Patient Health Questionnaire-2. Antenatal coverage was 85.8% and 62.3% of FSW had access to pap smear exam in the past 3 years. A total of 67.0% of FSW were using some contraceptive method at the time of the study. Male condom was the most common method (37.1%), followed by oral pill (28.9%). A total of 22.5% FSW had never been tested for HIV and the main reasons were "not feeling at risk" (40.4%) and "being afraid or ashamed" (34.0%). The vast majority of FSW used Brazilian National Health System as their usual source of health care (90.2%). Approximately one-fifth of the participants felt discriminated against or were treated worse for being FSW (21.4%) and only 24.3% disclose their sex work status in health services. The vulnerability of FSW is expressed in all health indicators. Indicators of health status, antenatal care, pap smear coverage, and contraception were worse than in the Brazilian population, and point out to the importance of increase FSW's access to health care services. Also, stigma and discrimination emerged as an important barrier to FSW's health care in all dimensions and need to be struggled.

Brachial plexus formation in Jaguarundi (Puma yagouaroundi).

Puma yagouaroundi is a wild felid with wide distribution on the American continent. This paper aims to describe the origin and motor distribution of the nerves of the brachial plexus of P. yagouaroundi and compare the findings with the available descriptions for the Carnivora order. Fourteen brachial plexuses of specimens collected dead on highways were dissected (five males and two females). In most cases (57%), the brachial plexus originated from the ventral spinal branches of C5, C6, C7, C8 and T1. The C7 branch was the one that most contributed to the formation of the plexus nerves (57.7%). Among all dissected nerves, 23.6% were unisegmental and 76.4% plurisegmental. The radial nerve was the thickest and innervated the largest number of muscles, while the caudal pectoral nerve showed the most varied formation. Intraspecific polymorphisms occurred in the plexus, although the distribution of the nerves to the muscles had an evident constancy among the individuals. Due to the similarities, locoregional blocking techniques may consider the same anatomical landmarks stipulated for domestic cats. Comparison with the descriptions of other carnivorans allows speculating a polymorphism at the plexus origin, in contrast to the conservative innervation of the muscles in the order Carnivora.

Cross-validation of four different survey methods used to estimate illicit cigarette consumption in Brazil.

OBJECTIVE: To cross-validate estimates of the size of the illicit cigarette trade based on the results of four different survey methods. METHODS: In 2018/2019, four non-industry-funded, large-scale studies were conducted in selected Brazilian cities: packs discarded in household garbage/PDG (1 city), packs littered in the streets/PLS (5 cities), a phone survey of tobacco users' purchase behaviors/VIGITEL (5 cities), and a face-to-face household survey of tobacco users' purchase behaviors/FTF-household (2 cities). The proportions of illicit cigarettes consumed were based on the price paid by smokers in their last purchase (VIGITEL or FTF-household) and/or direct observation of brand names and health warnings (PDG, PLS or FTF-household). RESULTS: Based on PLS, the share of packs that avoided taxation ranged from 30.4% (95% CI 25.6% to 35.7%) in Rio de Janeiro to 70.1% (95% CI 64.6% to 75.0%) in Campo Grande; and PDG conducted in Rio de Janeiro found an even lower proportion point estimate of illicit cigarette use (26.8%, 95% CI 25.1% to 28.6%). In FTF-household, the share of illicit cigarette consumption based on the self-reported price ranged from 29.1% (95% CI 22.4% to 35.7%) in Rio de Janeiro to 37.5% (95% CI 31.2% to 43.7%) in São Paulo, while estimates based on pack observation ranged from 29.9% (95% CI 23.3% to 36.5%) in Rio de Janeiro to 40.7% (95% CI 34.3% to 47.0%) in São Paulo. For all cities, VIGITEL presented the lowest levels of illicit consumption, and most illicit brands were produced in Paraguay. CONCLUSIONS: Small differences in the estimated levels of illicit trade across methods were found, except for the phone survey. The cross-validation of estimates from independent studies is important to help effectively implement tobacco excise tax policy in Brazil and other low-income and middle-income countries.

Associations of Sociodemographic Factors and Health Behaviors with the Emotional Well-Being of Adolescents during the COVID-19 Pandemic in Brazil.

This cross-sectional study utilizes data from a nationwide web-based survey aimed to identify the factors affecting the emotional well-being of Brazilian adolescents aged 12-17 during the period of school closures and confinement. Data collection took place from 27 June to 17 September 2020. We used the "virtual snowball" sampling method, and students from private and public schools were included. A total of 9470 adolescents were analyzed. A hierarchical logistic regression model was used to find the factors associated with reporting at least two of three self-reported problems-sadness, irritability, and sleep problems. The main proximal factor was loneliness (AdjOR = 8.12 p < 0.001). Problems related to school closures also played an important role. Regular intake of fruits and vegetables, as well as physical activity, demonstrated a positive influence on emotional well-being, while excessive screen time (AdjOR = 2.05, p < 0.001) and alcohol consumption negatively affected outcomes (AdjOR = 1.73, p < 0.001). As for distal variables, less affluent adolescents were the most affected, and males reported fewer emotional problems than females. Uncertainty regarding the disease in a context of socioeconomic vulnerability, together with rises in unhealthy behaviors and isolation from their immediate social circles, have negatively affected adolescents' emotional status throughout the COVID-19 pandemic.

Evolutionary history or function? Which preponderates in the expression of the muscle mass of the thoracic limb in wild carnivorans?

Thoracic limbs are extremely versatile and exhibit informative characteristics about habits of the Carnivora order in the wild. Despite this relevance, comparative studies with quantitative variables on thoracic limb muscles are still scarce in carnivorans. The aims of this study were to measure the mass of the intrinsic muscles of the thoracic limb of neotropical species of the Carnivora order and to establish comparative conjectures. For this purpose, 39 thoracic limbs of 10 neotropical carnivorans species were dissected. The mass of each muscle was measured on a digital scale, muscles were grouped by function, and the mass average percentage that each functional group of muscles occupied in the thoracic limb was calculated. The data of the present study was added to that available in the literature for 22 other carnivoran species. Three groups of species were considered: Canidae, Musteloidea, and Feliformia. Comparatively, the eight canid species included in this analyses concentrate muscle mass proximally in the thoracic limb to prioritize essential cursoriality. The nine musteloids had more muscle mass in the distal muscles due to the demand for versatility and manual strength, and the 14 Feliformia species exhibited an intermediate trend. The analysis of clusters revealed a great overlap of the percentage distribution of muscle mass with the phylogeny previously established for carnivorans. It could be verified that the distribution of muscle masses meets the demand of the locomotor habits of the species up to a certain level, from which phylogeny begins to limit morphological adaptations.

Os membros torácicos são extremamente versáteis e exibem características informativas sobre os hábitos das espécies da ordem Carnivora em vida livre. A despeito desta relevência, estudos comparativos com variéveis quantitativas dos músculos do membro torácico são escassos em carnívoros. Os objetivos deste estudo foram aferir a massa dos músculos intrínsecos do membro torácico de espécies neotropicais da ordem Carnivora e estabelecer conjecturas comparativas. Para este fim, foram dissecados 39 membros torácicos de dez espécies de carnívoros neotropicais. A massa de cada músculo foi mensurada em uma balança digital, os músculos foram agrupados por função e calculou-se a massa percentual média a que cada grupo funcional de músculos correspondia no membro torácico. Os dados do presente estudo foram analisados conjuntamente às informações disponíveis na literatura para outras 22 espécies da ordem Carnivora. Três grupos de espécies foram considerados: Canidae, Musteloidea e Feliformia. Comparativamente, as oito espécies de canídeos incluídas nesta análise demonstraram concentração de massa muscular mais proximalmente no membro torácico em razão dos hábitos essencialmente cursoriais. As nove espécies da superfamília Musteloidea exibiram mais massa nos músculos distais devido à maior demanda por versatilidade e força manual. As 14 espécies da subordem Feliformia apresentaram um padrão intermediário. A análise de clusters revelou nítida sobreposição entre o percentual de distribuição da massa muscular com a filogenia previamente estabelecida para a ordem Carnivora. Verificou-se que a distribuição da massa dos músculos atende à demanda dos hábitos locomotores das espécies até um certo nível, a partir do qual a filogenia começa a limitar as adaptações morfológicas.

Anatomical variations in cervical vertebrae in two species of neotropical canids: What is the meaning?

Anatomical variation in wild canids is rarely described. Altered shapes, uni- or bilaterally situated, were observed in ventral laminae of C6 and/or in C7 vertebral body of two fox species: Lycalopex gymnocercus and Cerdocyon thous. The specimens were young adults, collected dead on highways in southern Brazil. Deformities were considered anatomical variations because apparently there was no interference in function. The occurrence of such variations in two related species from the same area can suggest an environmental common cause rather than genetic issues. Future studies may deepen the understanding between cause and effect of these vertebral deformities in wild canids.

Web Data Mining: Validity of Data from Google Earth for Food Retail Evaluation.

To overcome the challenge of obtaining accurate data on community food retail, we developed an innovative tool to automatically capture food retail data from Google Earth (GE). The proposed method is relevant to non-commercial use or scholarly purposes. We aimed to test the validity of web sources data for the assessment of community food retail environment by comparison to ground-truth observations (gold standard). A secondary aim was to test whether validity differs by type of food outlet and socioeconomic status (SES). The study area included a sample of 300 census tracts stratified by SES in two of the largest cities in Brazil, Rio de Janeiro and Belo Horizonte. The GE web service was used to develop a tool for automatic acquisition of food retail data through the generation of a regular grid of points. To test its validity, this data was compared with the ground-truth data. Compared to the 856 outlets identified in 285 census tracts by the ground-truth method, the GE interface identified 731 outlets. In both cities, the GE interface scored moderate to excellent compared to the ground-truth data across all of the validity measures: sensitivity, specificity, positive predictive value, negative predictive value and accuracy (ranging from 66.3 to 100%). The validity did not differ by SES strata. Supermarkets, convenience stores and restaurants yielded better results than other store types. To our knowledge, this research is the first to investigate using GE as a tool to capture community food retail data. Our results suggest that the GE interface could be used to measure the community food environment. Validity was satisfactory for different SES areas and types of outlets.

Social distancing, feeling of sadness and lifestyles of the Brazilian population during the COVID-19 pandemic / Distanciamento social, sentimento de tristeza e estilos de vida da população brasileira durante a pandemia de COVID-19

The COVID-19 pandemic has had biopsychosocial impacts on individual and collective health. The aim of the study was to analyze adherence to social distance, the repercussions on mood and changes in the lifestyles of the Brazilian adult population during the beginning of the COVID-19 pandemic. This is a cross-sectional study with adult individuals living in Brazil (n = 45,161) who participated in the virtual health survey ConVid - Behavior Survey, from April 24 to May 24, 2020. Data collection was performed via web, using a self-administered questionnaire. The prevalence and 95% confidence interval of the studied variables were calculated. Of the sample studied, only 1.5% led normal lives, without any social restrictions and 75% stayed at home, of which 15% stayed strictly at home. The frequent feelings of sadness or depression (35.5%), isolation (41.2%) and anxiety (41.3%) were reported by a large part of the studied population. It was found that 17% of participants reported increased consumption of alcoholic beverages and 34% of smokers increased the number of cigarettes. There was an increase in the consumption of unhealthy foods and a reduction in the practice of physical activity in the period studied. It was concluded that there was a high adherence to social distance and an increase in feelings of sadness, depression and anxiety, as well as an increase in the consumption of unhealthy foods, use of alcoholic beverages and cigarettes and a reduction in the practice of physical activity. These changes are worrying and can result in damage to individual and collective health in the medium and long term.

A pandemia de COVID-19 acarretou impactos biopsicossociais à saúde individual e coletiva. O objetivo do estudo foi analisar a adesão ao distanciamento social, as repercussões no estado de ânimo e mudanças nos estilos de vida da população adulta brasileira durante o início da pandemia da COVID-19. Trata-se de estudo transversal com indivíduos adultos residentes no Brasil (n = 45.161) que participaram do inquérito de saúde virtual ConVid - Pesquisa de Comportamentos, no período de 24 de abril a 24 de maio de 2020. A coleta de dados foi realizada via web, utilizando-se de um questionário autopreenchido. Foram calculadas as prevalências e intervalo de 95% de confiança das variáveis estudadas. Da amostra estudada, apenas 1,5% levou vida normal, sem nenhuma restrição social e 75% ficaram em casa, sendo que destes 15% ficaram rigorosamente em casa. Os sentimentos frequentes de tristeza ou depressão (35,5%), isolamento (41,2%) e ansiedade (41,3%) foram reportados por grande parte da população estudada. Verificou-se 17% dos participantes reportaram aumento do consumo de bebidas alcoólicas e de 34% dos fumantes aumentaram o número de cigarros. Observou-se aumento no consumo de alimentos não saudáveis e redução da prática de atividade física no período estudado. Conclui-se que houve elevada adesão ao distanciamento social e aumento dos sentimentos de tristeza, depressão e ansiedade, bem como aumento de consumo de alimentos não saudáveis, uso de bebidas alcóolicas e cigarros e redução da prática de atividade física. Essas mudanças são preocupantes e podem resultar em danos à saúde individual e coletiva a médio e longo prazo.  

Nationwide vitamin D status in older Brazilian adults and its determinants: The Brazilian Longitudinal Study of Aging (ELSI).

Little is known about vitamin D status in older adults in South America, where exposures to ultra-violet radiation are high. We examined the distribution of serum 25-hydroxyvitamin D (25OHD) concentration and its determinants in a nationally representative sample of Brazilians aged 50 years and older. Explanatory variables included environment and individuals' characteristics from the ELSI baseline survey (2015-16). Among the 2,264 participants (mean age = 62.6 years), the geometric mean of 25OHD concentration was 66.8 nmol/L. The prevalence of vitamin D deficiency (< 30 nmol/L) and insufficiency (< 50 nmol/L) were 1.7% (95% CI 1.0, 2.8) and 16% (95% CI 12, 20), respectively. Mean concentrations were lower in those geographical regions situated at lower latitudes. Those at the oldest age, women, self-classified as Black and Brown, living in urban areas and current smokers were more likely to have vitamin D insufficiency, independent of each other and other relevant factors. In contrast, individuals who eat fish regularly were considerably less likely to present lower concentration. Based on these findings it is possible to estimate that about 875,000 older Brazilians have vitamin D deficiency and 7.5 million its insufficiency.

Anatomical background of ovine kidney for use as animal model: analysis of arterial segmentation, proportional volume of each segment and arterial injury after cranial pole partial nephrectomy.

OBJECTIVE: To study the arterial segments of ovine kidney, present a proportional volume analysis of each kidney arterial segment, and analyze arterial injuries caused by simulated partial nephrectomy of cranial pole. MATERIALS AND METHODS: Forty-eight ovine kidneys injected with polyester resin into the renal arteries and collecting system were used in this study. Eighteen kidneys were used to study the arterial segments and the proportional volume of each renal segment. Other 30 kidneys were submitted to superior pole resection at a distance of 1.0cm, 0.5cm, or exactly at the cranial hilar edge, just before the resin hardening. These endocasts were used to evaluate the arterial injuries caused by these different resection planes. RESULTS: Ovine renal artery divided into two (ventral and dorsal) or three segmental arteries. Dorsal segment presented higher proportional volume than ventral segment. For kidneys with three segments, the third segment was on the caudal region (caudo-ventral or caudo-dorsal segment) and presented the lowest proportional volume. None of the resected kidneys (at 1.0, 0.5 or at the cranial hilar edge) presented injury of arterial branches that irrigate non-resected region. CONCLUSION: The segmental distribution of renal artery, the proportional volume of each segment and arterial injuries after cranial pole resection in ovine kidneys are different from what is observed in human kidneys. Meanwhile, ovine kidneys show a primary segmental division on anterior and posterior, as in humans, but different from swine. These anatomical characteristics should be considered when using ovine as animal models for renal experimental and/or training procedures.

Digit innervation of the thoracic limb of Criollo horses: Anatomical description and consequences to perineural blocks.

Criollo horse breeding is an important economic activity in South America. Because of their athletic performance, these animals tend to show great incidence of musculoskeletal disorders, many of them diagnosed by means of perineural blocks. However, incorrect interpretation of these blocks may be due to anatomical differences in nerve distribution. The objective of this study was to describe the innervation of the digit region of thoracic limbs in Criollo horses, in order to improve the interpretation of tests for claudication diagnosis based on nerve block. Thirty thoracic limbs from Criollo horses were dissected. It could be observed that in 90% of the limbs, dorsal branches of the palmar nerve originated proximally to the proximal sesamoid bone. In 93% of the cases, the palmar digital nerve and the dorsal branches communicated; in 87% of the cases, communication between branches of the dorsal branch was observed; and in 27% (8/30) of the limbs, the palmar metacarpal nerve and the dorsal branch presented communications. None of the specimens showed complete symmetry in the distribution of nerves in contralateral limbs. The high frequency of communication between the nerves may be a particularity of the Criollo breed that may interfere with the interpretation of perineural blocks. Based on the anatomical position, it may be inferred that divergent results in Criollo horses may occur when abaxial sesamoid nerve block is used. Palmar digital nerve block may be less influenced by these variations, provided it is performed as distal as possible from the ungular cartilage.

Clavicle in Carnivorans: A Forgotten Bone.

The clavicle is a bone whose development is related to the versatility of the thoracic limbs in mammals. Studies with vestigial structures are scarce and controversial, especially in the order Carnivora. The objective of this study was to verify the presence and to investigate the shape and constitution of the clavicle in neotropical carnivores. In order to do this, 108 cadavers of 19 different species were collected dead on highways and were analyzed. The clavicles were submitted to dissections, longitudinal length measurements, radiographs, histological sections and, in some cases, diaphanization. Sixteen of the 19 species had clavicles in both sides, being significantly larger (P < 0.05) and distinctly more radiopaque in the felids than in the other families. There were no macro or microscopic evidence of clavicle in the specimens of Nasua nasua (n = 6), Conepatus semistriatus (n = 2), and Conepatus chinga (n = 1). The clavicle of the males of Lycalopex gymnocercus, Galictis cuja, and Leopardus geoffroyi was significantly larger (P < 0.05). The predominating contour of the clavicles was a thin stick with cranial convexity. The histological sections demonstrated compact bone consisting of trabecula and lamellae filled by bone marrow and different levels of occupation by chondroid matrix. It can be proposed the clavicles of the order Carnivora, although vestigial and rarely absent, have their presence, constitution and shape more associated with the phylogenetic proximity and evolutionary history of the species than to the variety of movements the thoracic limbs perform in free-living conditions. Anat Rec, 2019. © 2019 American Association for Anatomy Anat Rec, 303:1831-1841, 2020. © 2019 American Association for Anatomy.

Prevalence of arterial hypertension in Brazilian adults and its associated factors and activity limitations: a cross-sectional study.

BACKGROUND: Hypertension is a serious global public health problem that affects a large part of the Brazilian adult population and can cause limitations and losses of quality of life. OBJECTIVE: The objective of this study was to analyze the association of hypertension and its correlated limitations, with sociodemographic and epidemiological factors. DESIGN AND SETTING: Cross-sectional study analyzing information on 44,271 adults (30 years or older) from the Brazilian National Health Survey of 2013. METHODS: The prevalence of hypertension and the degree of limitation of the patients' activities associated with hypertension, according to sociodemographic characteristics, anthropometric measurements and lifestyles, were calculated for both sexes. To analyze the strength of association, bivariate and multivariate Poisson regression were used. RESULTS: Hypertension was the most prevalent risk factor among Brazilian adults aged 30 years or older (40.7%). It was strongly associated with the aging process (prevalence ratio, PR 3.51), obesity (PR 1.73), heart disease (PR 1.67) and stroke (PR 1.86). Furthermore, limitations associated with hypertension were more prevalent among those with comorbidities from noncommunicable diseases relating to hypertension complications (stroke PR 1.47; heart disease PR 1.69) and with incomplete elementary education (PR 1.19). CONCLUSIONS: This study showed sociodemographic inequality in the prevalence of hypertension, especially in the population with some degree of limitation associated with hypertension. It showed that improvements in access to primary care services for controlling hypertension at its initial stages are essential in order to avoid comorbidities of greater severity and limitations and losses of quality of life, especially among socially disadvantaged people.