Ciclo de palestras online "de férias com o PET": um relato de experiência / Online lecture series on vacation with PET: an experience report

As constantes transformações tecnológicas dos últimos anos têm refletido diretamente sobre o cenário da educação, com a popularização do ensino em meio digital, especialmente após a pandemia do COVID-19. Diante disso, surgiu a proposta de um ciclo de palestras online pelo grupo que compõe o Programa de Educação Tutorial (PET) Odontologia, do Instituto de Saúde de Nova Friburgo. O objetivo do evento foi oferecer conteúdo atualizado, de interesse dos participantes, abordando temas nem sempre são contemplados na grade curricular, contando com convidados externos à instituição. Após a seleção dos temas e a escolha dos palestrantes, iniciou-se a organização e divulgação do evento, utilizando ferramentas online gratuitas. O ciclo de palestras contou com sete apresentações, abrangendo áreas como Odontogeriatria, Dentística, Harmonização Orofacial, Gestão e Empreendedorismo, Emergências Médicas e Estomatologia. Durante os cursos, os participantes tiveram a oportunidade de esclarecer suas dúvidas, tornando a experiência interativa. Como instrumento de feedback, os participantes foram convidados a preencher um formulário de avaliação. O evento teve uma média de 73 participantes, os quais demonstraram estar satisfeitos com a qualidade dos temas abordados. Pode-se concluir que a proposta de um ciclo de palestras online é viável, dissemina o conhecimento, proporciona oportunidades de aprendizado e contribui para a consolidação do senso crítico-reflexivo. Para os membros do PET Odontologia, a experiência destacou a importância do ensino-aprendizado de excelência, contínuo e permanente, bem como a utilização de métodos alternativos que podem inovar o processo de formação acadêmica.

The constant technological transformations in recent years have directly impacted the education landscape, with the popularization of online teaching, especially after the COVID-19 pandemic. In light of this, a proposal for an online lecture series emerged from the group that comprises the Tutorial Education Program (PET) at the Nova Friburgo Institute of Health (ISNF). The aim of the event was to offer updated content, of interest to participants, covering topics not always included in the curriculum and featuring external guests to the institution. After selecting the topics and choosing the speakers, the organization and promotion of the event began, using free online tools. The lecture series consisted of seven presentations, covering areas such as Geriatric Dentistry, Restorative Dentistry, Orofacial Harmonization, Management and Entrepreneurship, Medical Emergencies, and Stomatology. Throughout the courses, participants had the opportunity to clarify their doubts, making the experience interactive. As a feedback tool, participants were invited to fill out an evaluation form. The event had an average of 73 participants, who expressed satisfaction with the quality of the topics covered. It could be concluded that the proposal for an online lecture series is feasible, disseminates knowledge, provides learning opportunities, and contributes to the consolidation of critical-reflexive thinking. For PET Dentistry members, the experience highlighted the importance of continuous and excellent teaching and learning, as well as the use of alternative methods that can innovate the academic training process.

Calidad de vida relacionada con la salud y los estados de ánimo en estudiantes de instituciones educativas de Antioquia, Colombia / Quality of life related to the health and mood states of students in educational institutions from Antioquia, Colombia / Qualidade de vida relacionada à saúde e ao humor em estudantes de instituições de ensino em Antioquia, Colômbia

Introducción: La calidad de vida relacionada con la salud (CVRS) y los estados de ánimo son indicadores cruciales del bienestar en adolescentes, pero su relación con estudiantes de Antioquia, Colombia, no ha sido ampliamente estudiada. Objetivo: Determinar la CVRS y los estados de ánimo en escolares de Antioquia-Colombia. Materiales y métodos: Estudio transversal con 1957 escolares de 9 a 20 años. Se aplicaron mediciones de CVRS, ansiedad, depresión, hostilidad y alegría, actividad física, comportamiento sedentario, apoyo social de padres y nivel socioeconómico. Resultados: La calidad de vida alta (CVA) es más elevada en hombres, personas con alegría, estudiantes con apoyo de padres, activos físicamente y personas de nivel socioeconómico alto y medio. AL aumentar un año de edad, disminuye en un 15 % la CVA, y al aumentar la depresión, la ansiedad y el comportamiento sedentario disminuye la CVA. Además, los niveles de depresión y ansiedad son mayores en mujeres, estudiantes mayores, sin apoyo de los padres y personas sedentarias. Conclusiones: La CVRS se asocia con estados de ánimo, actividad física, comportamiento sedentario y apoyo de los padres; mientras que los estados de ánimo se asocian con el sexo, el apoyo de los padres, la CVS y el sedentarismo.

Introduction: Even though health-related quality of life (HRQL) and mood states are key indicators of the well-being of adolescents, their relationship has not been analyzed in students from Antioquia, Colombia. Objective: To determine HRQL and mood states in schoolchildren from Antioquia. Materials and methods: A cross-sectional study was conducted on 1,957 schoolchildren and adolescents aged between 9 and 20 years. Measurements of HRQL, anxiety, depression, hostility and happiness, physical activity, sedentary behavior, parental social support, and socioeconomic status were applied. Results: A high quality of life (HQL) was observed more frequently in male participants, students with parental support, physically active, and those belonging to medium and high socioeconomic status. HQL decreased 15% as their age increased by one year. Also, HQL was reduced when depression, anxiety, and sedentary behavior increased. Furthermore, depression and anxiety levels were higher in women, older students, as well as in those without parental control and with sedentary behavior. Conclusions: HRQL is associated with mood states, physical activity, sedentary behavior, and parental support. In contrast, mood states are related to gender, parental support, HQL, and sedentary lifestyle.

Introdução: A qualidade de vida relacionada à saúde (CVRS) e os estados de humor são indicadores cruciais de bem-estar em adolescentes, mas sua relação com estudantes de Antioquia, Colômbia, não foi amplamente estudada. Objetivo: Determinar a CVRS e os estados de humor em escolares de Antioquia-Colômbia. Materiais e métodos: Estudo transversal com 1.957 escolares de 9 a 20 anos. Foram aplicadas medidas de QVRS, ansiedade, depressão, hostilidade e felicidade, atividade física, comportamento sedentário, apoio social dos pais e nível socioeconômico. Resultados: A alta qualidade de vida (CVA) é maior em homens, pessoas com alegria, estudantes com apoio parental, fisicamente ativos e pessoas de nível socioeconômico alto e médio. À medida que a idade aumenta em um ano, diminui em 15% o CVA, e ao aumentar a depressão, a ansiedade e o comportamento sedentário aumentam, o CVA diminui. Além disso, os níveis de depressão e ansiedade são mais elevados nas mulheres, nos estudantes mais velhos, sem apoio dos pais e nas pessoas sedentárias. Conclusões: A QVRS está associada a estados de humor, atividade física, comportamento sedentário e apoio parental; enquanto os estados de humor estão associados ao sexo, apoio parental, CVS e estilo de vida sedentário.

Desafios e mudanças no processo de trabalho das equipes de saúde da família no cenário pandêmico: relato de experiência / Challenges and changes in the work process of family health teams in the pandemic scenario: experience report

O presente estudo tem por objetivo realizar um relato de experiência demonstrando a percepção de discentes do curso de odontologia na sua participação na prática da atenção primária à saúde (APS), vivenciadas em um cenário pandêmico e com base no combate a enfrentamentos e desafios impostos no processo de trabalho das equipes de saúde da família. Este estudo trata - se de relato de experiência, de caráter descritivo e retrospectivo, associado à uma pesquisa bibliográfica para que trousse o embasamento teórico necessário para a descrição do relato de experiência vivenciado. No decorrer da pandemia, a Equipe de saúde da família exerceu importante papel e atuou na linha de prevenção e controle desta, sendo uma das maiores ferramentas de apoio. Na odontologia, a atuação da equipe de saúde bucal devido a fatores de risco inerentes à esta modalidade de ocupação, ficou limitada em seu exercício. O conhecimento de muitos dos profissionais da rede pública foi colocado em questão, assim como sua vivência, limitações e o medo de contrair a doença. Os profissionais da equipe de saúde, mostraram que o trabalho interprofissional e um bom relacionamento aumentou o incentivo e a responsabilidade de equipe.

This study aims to carry out an experience report demonstrating the perception of students of the dentistry course in their participation in the practice of primary health care (PHC), experienced in a pandemic scenario and based on the fight against confrontations and challenges imposed on the work process of family health teams. This study is an experience report, descriptive and retrospective, associated with bibliographical research to bring the necessary theoretical basis for the description of the lived experience report. During the pandemic, the Family Health Team played an important role and acted in the line of prevention and control of this, being one of the greatest support tools. In dentistry, the performance of the oral health team, due to risk factors inherent to this type of occupation, was limited in its exercise. The knowledge of many public health professionals was questioned, as well as their experience, limitations and fear of contracting the disease. Health team professionals showed that interprofessional work and a good relationship increased team incentive and responsibility.

Children and adolescents with sickle cell disease: characteristics and use of medicinal plants / Crianças e adolescentes com doença falciforme: características e uso de plantas medicinais

ABSTRACT Objective: The aim of this study was to describe the epidemiological characteristics of pediatric patients with sickle cell disease (SCD) and evaluate the use of medicinal plants in these patients concomitantly with their drug treatment. Methods: This is a review of the medical records of pediatric patients at a public institution with tertiary care. The selection criterion was to be a child or adolescent with SCD undergoing pediatric follow-up at this outpatient clinic. In the medical records of the patients selected, records of the use of plants for medicinal purposes were sought. Results: In total, 154 records (100% of total active patients followed in this clinic) were reviewed: 99 children and 55 adolescents. The predominant genotype was SS (58.4%), followed by SC (29.2%). The use of at least one medication for SCD was reported in 95.5% of the medical records. The use of medicinal plants was reported by 70.1% of patients, with 276 citations in the medical records referring to 64 different types of plants. Six plants were used for the treatment of SCD, the main one being Lemonvine/Ora-pro-nóbis (Pereskia aculeata). The use of medicinal plants was reported for flu-like symptoms and/or COVID-19 (both for prevention and treatment) by 60.5% of the citations, with 35 different plants reported for this use, exclusively or not. This use was followed by pain symptoms (14.2% of citations). Conclusions: The majority of patients in this study use both conventional and traditional/complementary/alternative medicine, highlighting the need for more studies in the area, with a special focus on patient safety.

RESUMO Objetivo: Descrever as características epidemiológicas de pacientes pediátricos com doença falciforme (DF) e avaliar o uso de plantas medicinais concomitantemente ao tratamento medicamentoso. Métodos: Realizou-se revisão de prontuários de pacientes pediátricos de uma instituição pública com nível de atendimento terciário; o critério de seleção foi ser criança ou adolescente com DF em acompanhamento pediátrico neste ambulatório. Nos prontuários dos pacientes selecionados foi procurado o registro do uso de plantas com finalidades medicinais. Resultados: Foram revisados 154 prontuários (100% dos pacientes ativos desse ambulatório): 99 crianças e 55 adolescentes. O genótipo predominante foi SS (58,4%), seguido do SC (29,2%). O uso de ao menos uma medicação para a DF foi relatada em 95,5% dos prontuários. Em 70,1% dos prontuários havia o relato do uso de plantas medicinais, em 276 citações, sendo 64 plantas citadas ao todo; destas, seis espécies foram citadas para o tratamento da doença de base (DF), sendo "ora-pro-nobis" (Pereskia aculeata) a principal. Das 276 citações de plantas medicinais nos prontuários, 60,5% incluíram o uso de plantas medicinais em sintomas gripais e/ou COVID-19 (tanto prevenção quanto tratamento), sendo relatadas 35 para este uso, exclusivamente ou não. Essa foi a principal finalidade de uso encontrada nos prontuários dos pacientes, seguida do uso para sintomas de dor (14,2% das citações). Conclusões: Notou-se que a maioria dos pacientes avaliados faz uso da medicina convencional, aliada à tradicional/ complementar/ alternativa, o que leva à necessidade de mais estudos nessas áreas, especialmente na pediatria, visando principalmente à segurança do paciente.

Brazilian children's quality of life during the COVID-19 pandemic: analysis of contextual factors and dimensions / Qualidade de vida de crianças brasileiras durante a pandemia de COVID-19: análise de fatores e dimensões contextuais

ABSTRACT Objective: The aim of this study was to investigate the contextual factors associated with the quality of life (QOL) of Brazilian children aged 0-12 years during the strict period of social isolation. Methods: This observational cross-sectional study was conducted between July and September 2020 using an online questionnaire on QOL-related family factors and the Pediatric Quality of Life Inventory (PedsQL™). Results were analyzed by multinomial logistic regression analysis. Results: The sample had 849 children, mostly from the South Region of Brazil (75%), white (83%), with typical development (79%), sedentary (68%), using screen (85%) for >3 h/day (44%). Their mothers were their main caregivers (90%). The following variables were significantly associated with high scores of QOL: typical health status (OR 2.38; 95%CI 1.60-3.55; screen time ≤2 h/day (OR 1.62; 95%CI 1.17-2.24); social distancing considered as "easy" (OR 1.67; 95%CI 1.20-2.32), and stimulation of the child by the family (OR 1.93; 95%CI 1.08-3.45). Conclusions: This study indicates that the family context can influence children's QOL, especially during the COVID-19 pandemic and home environment reorganization.

RESUMO Objetivo: Investigar os fatores contextuais associados à qualidade de vida (QV) de crianças brasileiras de zero a 12 anos, em momento de ápice de distanciamento social. Métodos: Estudo observacional, transversal, online, de julho a setembro de 2020, com questionário sobre fatores do contexto familiar associados à QV e Inventário Pediátrico sobre QV — PedsQL™. A análise dos dados foi feita por de regressão logística multinomial. Resultados: A amostra foi de 849 crianças, na maioria da Região Sul (75%), brancas (83%), com desenvolvimento típico (79%), sedentárias (68%), com uso de telas (85%) em tempo >3h/dia (44%). As mães eram as cuidadoras principais (90%). Foram significativamente associadas a escores mais elevados de QV: a condição de saúde típica (odds ratio — OR 2,38; intervalo de confiança de 95% — IC95% 1,60-3,55), o tempo de tela ≤2h/dia (OR 1,62; IC95% 1,17-2,24), o distanciamento social considerado "fácil" (OR 1,67; IC95% 1,20-2,32) e a família afirmar estimular a criança (OR 1,93; IC95% 1,08-3,45). Conclusões: Este estudo mostra que o contexto familiar pode influenciar a QV de crianças, especialmente no período de pandemia e de reorganização do ambiente domiciliar.

Neutralizing antibodies in milk and blood of lactating women vaccinated for SARS-CoV-2: a systematic review / Anticorpos neutralizantes no leite e no sangue de lactantes vacinadas para SARS-CoV-2: uma revisão sistemática

ABSTRACT Objective: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. Data source: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. Data synthesis: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. Conclusions: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.

RESUMO Objetivo: Comparar a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite materno e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Fontes de dados: Foi efetuado registro no International Prospective Register of Systematic Reviews — PROSPERO (CRD42021287554) e foram seguidas as diretrizes do Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Foram elegíveis estudos de coorte, caso-controle e transversais que avaliaram anticorpos contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e tiveram como grupo controle lactantes não vacinadas. Utilizaram-se os Descritores em Ciências da Saúde (DeCs), Medical Subject Heading (MeSH) e Emtree para as bases Biblioteca Virtual em Saúde (BVS), Medical Literature Analysis and Retrieval System Online (Medline/PubMed) e Embase, respectivamente. Na Web of Science e Scopus foi feita adaptação da estratégia. Não foram estabelecid as restrições quanto ao período de publicação e idioma. Síntese dos dados: As buscas identificaram 233 registros. Foram excluídos 128 duplicados e 101 fora dos critérios de inclusão, e quatro estudos de coorte foram elegíveis. As lactantes vacinadas com Pfizer-BioNTech e Moderna apresentaram anticorpos contra SARS-CoV-2 no sangue e no leite materno. Conclusões: As mulheres lactantes vacinadas apresentaram níveis mais elevados de imunoglobulina G (IgG) e A (IgA) no soro e no leite materno em comparação com as mulheres não vacinadas.

Systematic review on molecular detection of congenital and neonatal infections caused by TORCH and SARS-CoV-2 in newborns' cerebrospinal fluid / Revisáo sistemática sobre deteção molecular de infecções congênitas e neonatais causadas por TORCH e SARS-CoV-2 no líquido cefalorraquidiano de recém-nascidos

ABSTRACT Objective: To verify the use and identify advantages of molecular methods for congenital infections diagnosis in cerebrospinal fluid of neonates. Data source: The review was registered in the International Prospective Register of Systematic Reviews (PROSPERO), under CRD42021274210. The literature search was performed in databases: PubMed, Virtual Health Library/ Latin American and Caribbean Center on Health Sciences Information (VHL/BIREME), Scopus, Web of Science, Excerpta Medica database (EMBASE), Cochrane, ProQuest, and EBSCOhost. The search was carried out from August to October 2021 and updated in December 2022, respecting the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The selection sequence was: 1) Duplicate title removal; 2) Examination of titles and abstracts; 3) Full-text retrieval of potentially relevant reports; and 4) Evaluation of the full text according to eligibility criteria by two independent authors. Inclusion criteria considered randomized and non-randomized control trials, longitudinal, cross-sectional, and peer-reviewed studies in humans, published in English, Spanish, Italian, and Portuguese, with newborns up to 28 days old who had congenital neuroinfections by toxoplasmosis, rubella, cytomegalovirus, herpes simplex (TORCH), and others such as Treponema pallidum, Zika, parvovirus B-19, varicella zoster, Epstein-Barr, and SARS-CoV2, diagnosed by polymerase chain reaction (PCR). Two evaluators extracted the following information: author, year of publication, nationality, subjects, study type, methods, results, and conclusion. Data synthesis: The most studied pathogen was herpes simplex. Several articles reported only nonspecific initial symptoms, motivating the collection of cerebrospinal fluid and performing PCR for etiological investigation. Conclusions: Molecular methods are effective to detect pathogen genomes in cerebrospinal fluid, which can impact clinical evolution and neurological prognosis.

RESUMO Objetivo: Verificar a utilização e identificar as vantagens dos métodos moleculares para diagnóstico de infecções congênitas no líquido cefalorraquidiano de neonatos. Fontes de dados: A revisão foi registrada na base PROSPERO (International Prospective Register of Systematic Reviews) sob CRD42021274210. A busca bibliográfica foi realizada nas bases de dados PubMed, Biblioteca Virtual em Saúde/ Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde (BVS/BIREME), Scopus, Web of Science, Excerpta Medica database (EMBASE), Cochrane, ProQuest, e EBSCOhost. A busca foi feita no período de agosto a outubro de 2021 e atualizada em dezembro de 2022, respeitando as orientações do Preferred Reporting Items for Systematic Reviews e Meta-Analyises (PRISMA). A sequência da seleção dos estudos foi: 1) Remoção de duplicatas; 2) Exame de títulos e resumos; 3) Recuperação dos textos completos potencialmente relevantes; e 4) Avaliação do texto completo conforme critérios de elegibilidade por dois autores independentes. O critério de inclusão considerou ensaios clínicos randomizados e não randomizados, estudos longitudinais, transversais, revisados por pares, estudos em humanos, publicados em inglês, espanhol, italiano e português, com recém-nascidos de até 28 dias que sofreram neuroinfecções congênitas pelos agentes toxoplasmose, rubéola, citomegalovírus, herpes simples (TORCH), e outros como Treponema pallidum, Zika, parvovírus B-19, varicela zoster, Epstein-Barr, e SARS-CoV-2, diagnosticadas por reação em cadeia de polimerase (PCR). Dois avaliadores extraíram as seguintes informações: autor, ano de publicação, nacionalidade, sujeitos, tipo de estudo, métodos, resultados e conclusão. Síntese dos dados: O patógeno mais estudado foi Herpes Simples. Muitos artigos relataram somente sintomas iniciais inespecíficos, motivando a coleta de líquido cefalorraquidiano e realização da PCR para investigação etiológica. Conclusões: Os métodos moleculares são eficazes para detectar o genoma do patógeno no líquido cefalorraquidiano, o que pode impactar na evolução clínica e no prognóstico neurológico.

Acute kidney injury: a post-COVID-19 complication in children and adolescents / Lesão renal aguda: uma complicação pós-COVID-19 em crianças e adolescentes

ABSTRACT Objective: To describe cases of acute kidney injury (AKI) in children diagnosed with COVID-19, associated risk factors, clinical aspects and outcome of cases. Methods: Retrospective study, carried out in a pediatric hospital between March 2020 and September 2021, with patients with COVID-19 who were diagnosed with AKI, studying information present in medical records such as comorbidities, age, gender and use of nephrotoxic medications. Results: We studied 40 cases, and male individuals were significantly more affected (62.5%; p=0.025). AKI was a severe complication of COVID-19 infection, with 100% of the sample requiring admission to the Intensive Care Unit and 22.5% dying. The most prevalent comorbidities analyzed in this study were epilepsy, cerebral palsy and heart disease. Most patients were classified according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria as KDIGO 1 (42.5%), and required orotracheal intubation (67.5%). The frequency of use of nephrotoxic medications and need for dialysis was low, with percentages of 35 and 17.5%, respectively. Among the children who died, 70.4% had some comorbidity and 88.8% received invasive ventilation. Conclusions: AKI in children with COVID-19 infection is associated with severe conditions. Despite the severity, most patients were discharged alive from the hospital.

RESUMO Objetivo: Descrever casos de lesão renal aguda (LRA) em crianças diagnosticadas com COVID-19, associando fatores de risco, aspectos clínicos e evolução dos casos. Métodos: Estudo retrospectivo, realizado em hospital pediátrico entre março de 2020 e setembro de 2021, com pacientes com COVID-19 diagnosticados com LRA, que examinou informações presentes em prontuários como comorbidades, idade, sexo e uso de medicações nefrotóxicas. Resultados: Foram estudados 40 casos, sendo o sexo masculino significativamente mais acometido (62,5%; p=0,025). A LRA foi uma complicação grave da infecção por COVID-19, com 100% da amostra necessitando de internação na Unidade de Terapia Intensiva e 22,5% indo a óbito. As comorbidades mais prevalentes analisadas neste estudo foram epilepsia, paralisia cerebral e cardiopatia. A maioria dos pacientes foi classificada pelos critérios Kidney Disease: Improving Global Outcomes (KDIGO) como KDIGO 1 (42,5%) e necessitou de intubação orotraqueal (67,5%). A frequência de uso de medicamentos nefrotóxicos e necessidade de diálise foi baixa, com percentuais de 35 e 17,5%, respectivamente. Entre as crianças que faleceram, 70,4% apresentavam alguma comorbidade e 88,8% receberam ventilação invasiva. Conclusões: A LRA em crianças com infecção por COVID-19 está associada a quadros graves, apesar de a maior parte dos pacientes ter recebido alta hospitalar.

Post-COVID-19 dry eye negatively impacts the patient's quality of life

ABSTRACT Purpose: To describe the ophthalmological findings of dry eye disease and its relation to the quality of life of COVID-19 survivors. Methods: COVID-19 survivors who had previously been hospitalized at Hospital das Clínicas de Ribeirão Preto complex underwent an ophthalmological evaluation, which included a dry eye disease questionnaire, break-up time, fluorescein staining, and Schirmer test. We collected the presenting and best-corrected visual acuity, sociodemographic data, personal medical history, and scores from a self-reported quality of life questionnaire (WHOQOL-bref). According to the severity of the acute phase of the disease, the patients were classified into mild-to-moderate, severe, and critical groups. Results: Ninety-five patients (190 eyes) were evaluated 100 ± 44 days after the onset of COVID-19 symptoms. Of these, 83 patients (87.3%) completed the WHOQOL-bref questionnaire. Ten patients (12.0%) had mild-to-moderate COVID-19, 41 (49.4%) had severe COVID-19, and 32 (38.6%) had critical COVID-19. The median best-corrected visual acuity was logMAR 0 (0-1). Approximately 26.3% patients had a history of dry eye disease or severe dry eye symptoms (frequent or constant ocular dryness and irritation). There was an association between the proportion of patients with dry eye disease and the quality of life (p=0.014) and health (p=0.001). Furthermore, there was a significant trend between the proportion of patients with dry eye disease and how they rated their health and quality of life (p=0.0004 and 0.0027, respectively. Conclusions: There is a significant negative correlation between the proportion of patients with dry eye disease and their self-reported quality of life.

Orientações publicadas on-line nos três níveis de gestão para as Redes de Atenção Psicossocial brasileiras na Covid-19 / Online guidance for the three levels of management of psychosocial care networks in Brazil during the Covid-19 pandemic / Orientaciones publicadas online en los tres niveles de gestión para las Redes de Atención Psicosocial brasileñas durante la Covid-19

A presente análise documental tem como objetivo debater as orientações publicadas on-line em sites oficiais para guiar as respostas das Redes de Atenção Psicossocial (Raps) do Sistema Único de Saúde (SUS) do Brasil diante da emergência de Saúde Pública causada pela Covid-19. Baseia-se na análise de materiais publicados on-line entre 6/2/20 e 31/8/21 nos níveis federal e estadual e em todas as capitais do país. Combina essa análise documental com orientações e publicações de entidades internacionais a fim de refletir sobre os desafios, acertos, erros e omissões das orientações dadas para as Raps no país durante o início do período pandêmico. Conclui que as orientações, apesar de existentes formalmente, foram pouco articuladas e integradas dentro das próprias redes, com outros setores e com desafios preexistentes, conforme preconizado pela comunidade internacional.

This article discusses guidance published on official websites regarding the response of the Brazilian National Health System (SUS) psychosocial care networks (RAPS) to the public health emergency caused by Covid-19. The discussion draws on the analysis of online materials published between 06/02/20 and 31/08/21 at state and federal level across all the country's state capitals. We compare the results of the document analysis with guidance published by international organizations to reflect on the challenges, successes, mistakes and omissions in the guidance given to the RAPS at the beginning of the pandemic. It is concluded that, despite being formal, the guidance was poorly coordinated and integrated into the networks and with other sectors and pre-existing challenges, as recommended by the international community.

El presente análisis documental tiene el objetivo de debatir las orientaciones publicadas online en páginas web oficiales para guiar las respuestas de las Redes de Atención Psicosociales (RAPS) del Sistema Brasileño de Salud (SUS) ante la emergencia de salud pública causada por la Covid-19. Se basa en el análisis de materiales publicados online entre el 06/02/20 y el 31/08/21 en las esferas de la federación y de los estados en todas las capitales del país. Combina este análisis documental con orientaciones y publicaciones de entidades internacionales para reflexionar sobre los desafíos, aciertos, errores y omisiones de las orientaciones dadas para las RAPS en el país durante el inicio del período pandémico. Concluye que las orientaciones, a pesar de existentes formalmente, fueron poco articuladas e integradas dentro de las propias redes con otros sectores y con desafíos preexistentes, conforme lo determina la comunidad internacional.

Aspects of general, mental, and auditory health among nursing team members of a public hospital affected by Covid-19 / Aspectos de saúde geral, mental e auditiva de trabalhadores da equipe de enfermagem de um hospital público acometidos pela Covid-19

ABSTRACT Purpose: to analyze possible impacts on the general, mental and hearing health of nursing workers affected by the COVID-19 virus. Methods: an exploratory, cross-sectional study, carried out with nursing professionals from a public hospital in Southern Brazil, who answered a questionnaire on general and auditory symptoms after COVID-19 infection, and the Oldenburg Burnout Inventory (OLBI). Statistical analysis was performed using the Chi-square test of independence, the ANOVA test with Tukey's post-test and Pearson's Linear Correlation, with a p-value of 5%. Results: 52 workers participated (17 nurses, 30 technicians, five aides). The symptoms of headache, loss of smell and taste, fatigue and muscle pain were reported by more than 75% of workers; 80.8% either had already been classified as burnout (40.4%) or featured high scores for exhaustion or work disengagement (40.4%), with a correlation with the symptoms of cough (p=0.0327) and fever (p=0.0235); 44.23% had auditory symptoms, with dizziness/vertigo reported by 34.6% and tinnitus by 13.5%, although without correlation with burnout levels (p=0.4250). Conclusion: there were impacts on the general, mental and hearing health of nursing workers who were diagnosed with COVID-19, mainly cough and fever, burnout, tinnitus and dizziness.

RESUMO Objetivo: analisar possíveis impactos à saúde geral, mental e auditiva de trabalhadores da enfermagem acometidos pelo vírus da COVID-19. Métodos: estudo exploratório, transversal, realizado com profissionais da enfermagem de um hospital público da região Sul do Brasil, que responderam a um questionário sobre sintomas gerais e auditivos após a infecção pela COVID-19 e o Oldenburg Burnout Inventory (OLBI). A análise estatística foi realizada com a aplicação do teste do Qui-quadrado de independência, do teste ANOVA com pós-teste de Tukey e da Correlação Linear de Pearson, com p-valor em 5%. Resultados: participaram 52 trabalhadores (17 enfermeiros, 30 técnicos, cinco auxiliares). Os sintomas de cefaleia, perda do olfato e do paladar, cansaço e dores musculares foram referidos por mais de 75% dos trabalhadores; 80,8% ou já estão classificados com burnout (40,4%) ou já apresentam escores altos para exaustão ou para distanciamento do trabalho (40,4%), havendo correlação com os sintomas tosse (p = 0,0327) e febre (p=0,0235); 44,23% apresentaram sintomas auditivos, sendo a tontura/vertigem referida por 34,6% e zumbido por 13,5%, embora sem correlação com os níveis de burnout (p=0.4250). Conclusão: houve impactos na saúde geral, mental e auditiva dos trabalhadores da enfermagem que foram diagnosticados com COVID-19, principalmente tosse e febre, burnout, zumbido e tontura.

Exploring adolescent suicide attempts before and during the coronavirus disease 2019 pandemic: a cross-sectional study / Um olhar às tentativas de suicídio antes e durante a pandemia da doença do coronavírus 2019: estudo transversal

ABSTRACT Objective: The objective of this study was to analyze suicide attempts in adolescents treated in the emergency department before and during the coronavirus disease 2019 pandemic. Methods: This cross-sectional, documentary, and retrospective study assessed the medical records of adolescents treated for suicide attempts in two emergency rooms linked to a teaching hospital in São Paulo, Brazil. Data were collected from the pre-pandemic period (between January 1, 2015, and March 10, 2020) and the pandemic period (between March 11, 2020, and May 5, 2023), characterizing the adolescents, risk factors for suicide attempts during the pandemic, and treatment. Data were subjected to descriptive and inferential analyses, including association tests and trend analysis, with a p-value of <0.05 considered statistically significant. The national ethical guidelines were followed. Results: Data on 140 suicide attempts were collected, of which 54 occurred during the pandemic. The trend in these cases remained stable (p>0.05). We observed an association between adolescents who had completed high school and cases during the pandemic, with a previous mental disorder diagnosis and pre-pandemic cases, and a higher number of suicide attempt notifications to the Brazilian epidemiological surveillance system during the pandemic period (p<0.05). Feelings of loneliness were the most prevalent risk factor during the pandemic. Conclusions: The COVID-19 pandemic did not show an influence on the number of suicide attempt cases in adolescents. However, it was observed that the cases during this period were not related to previous mental disorder diagnoses, as seen in the pre-pandemic period, which may suggest that other risk factors were associated with suicide attempt cases during the pandemic.

RESUMO Objetivo: Analisar as tentativas de suicídio em adolescentes atendidos em um departamento de urgência e emergência antes da pandemia da COVID-19 e durante seu curso. Métodos: Estudo transversal, documental e retrospectivo, conduzido com prontuários de adolescentes atendidos por tentativa de suicídio, em dois prontos-socorros vinculados a um hospital escola no município de São Paulo, Brasil. Foram coletados dados do período pré-pandêmico (entre 1o de janeiro de 2015 e 10 de março de 2020) e período pandêmico (entre 11 de março de 2020 e 5 de maio de 2023), com a caracterização do adolescente, dos fatores de risco à tentativa de suicídio na pandemia e do atendimento. Os dados foram submetidos a análise descritiva e inferencial, com testes de associação e análise de tendência, considerando-se o valor de p<0,05 como diferença estatística. Respeitaram-se as diretrizes éticas nacionais. Resultados: Foram coletados dados de 140 atendimentos de tentativa de suicídio, dos quais 54 ocorreram no período pandêmico. A tendência de atendimentos mostrou-se estacionária (p>0,05). Observou-se associação entre os adolescentes que estudaram até o ensino médio e os atendimentos na pandemia; ter um diagnóstico de transtorno mental prévio e o atendimento pré-pandêmico; e o maior número de notificações de tentativa de suicídio para o sistema de vigilância epidemiológico brasileiro no período pandêmico (p<0,05). A sensação de solidão destacou-se como fator de risco pandêmico mais prevalente. Conclusões: A pandemia da COVID-19 não mostrou influência nos atendimentos de tentativa de suicídio em adolescentes. Todavia, observou-se que os casos neste período não tiveram relação com o diagnóstico de transtorno mental prévio, como visto no período pré-pandêmico, o que pode sugerir que outros fatores de risco estiveram associados aos casos de tentativa de suicídio durante a pandemia.

How did previously obese children and adolescents behave during the SARS-CoV-2 pandemic in relation to weight gain? / Como crianças e adolescentes previamente obesos se comportaram durante a pandemia de SARS-CoV-2 com relação ao ganho de peso?

ABSTRACT Objective: The objective of this study was to analyze the implications of social contingency measures and interruption of outpatient follow-up on weight gain in children and adolescents with a previous diagnosis of obesity. Methods: This is an observational study with data from electronic medical records of children and adolescents followed up at a specialized outpatient clinic from 2019 to 2023. Weight gain, height, BMI variation, BMI z-score, laboratory tests, and associated comorbidities were analyzed. The data were computed and analyzed using the Statistical Package for the Social Sciences (SPSS), and the results were considered statistically significant when p<0.05. Results: There was a weight gain of approximately 17.66% in the total set of participants, corresponding to a median increase of 14 kg. When analyzing between genders, we observed an approximate increase of 21.38% in body weight for men, while for women, it was 21.45%. Conclusions: The COVID-19 pandemic has led to significant weight gain among previously obese children and adolescents in follow-up at a specialized outpatient clinic.

RESUMO Objetivo: Analisar as implicações das medidas de contingenciamento social e interrupção do acompanhamento ambulatorial sobre o ganho de peso de crianças e adolescentes com diagnóstico prévio de obesidade. Métodos: Estudo observacional com dados proveniente de prontuários eletrônicos de crianças e adolescentes acompanhadas no Ambulatório de Obesidade na Criança e no Adolescente do Hospital de Clínicas da Universidade Estadual de Campinas, no período de 2019 a 2023. Analisaram-se ganho ponderal, altura, variação do índice de massa corporal (IMC), escore Z de IMC, exames laboratoriais e comorbidade associadas. Os dados foram computados e analisados pelo programa StatisticalPackage for the Social Sciences (SPSS). Os resultados foram considerados estatisticamente significativos quando p<0,05. Resultados: Constatou-se aumento ponderal de aproximadamente 17,6% no conjunto total de participantes, correspondendo ao acréscimo mediano de 14 kg. Ao analisarmos os gêneros, observamos elevação aproximada de 21,38% no peso corporal do sexo masculino, enquanto a do sexo feminino foi de 21,4%. Conclusões: A pandemia de COVID-19 levou a ganho peso significante entre crianças e adolescentes previamente obesos, que estavam em seguimento em ambulatório especializado.

Advancement in SARS-CoV-2 diagnosis: A new and stable electrochemical biosensor for genomic RNA detection.

Coronavirus disease (COVID-19) is caused by infection with the SARS-CoV-2 virus, having already caused more than seven million deaths worldwide. Conventional techniques for SARS-CoV-2 detection have limitations, as high cost, low specificity, and longer analysis time, among others. Biosensors emerge as a necessary alternative to overcome the difficulties of current diagnostics. This paper reports a sensor platform where silver-doped zinc oxide nanomaterial (Ag:ZnONp) was used onto carbon screen-printed electrode and ethidium bromide as indicator for development of a specific electrochemical genosensor for COVID-19. This genosensor demonstrated good linearity between the concentrations of 5.62 × 104-5.62 copies/mL and a detection limit of 5 copies/mL with gRNA in patient's samples, with a response time within 30 min. Molecular modeling and morphological analysis are in agreement with obtained electrochemical results. Additional techniques such as AFM, SEM, and EIS were conducted to characterize the morphological and electrochemical properties of the biosensor's surface. The biosensor was also capable of detecting the target presence in spiked samples and demonstrated a stability of 60 days, higher than other similar biosensors for SARS-CoV-2.

Clinical and Nutritional Aspects and Outcomes of Covid-19 in Cancer and Non-Cancer Pediatric Patients.

The SARS-CoV-2 virus has been the subject of study by several researchers worldwide since 2020; however, there are points to be clarified. This study aimed to analyze the clinical and nutritional aspects of hospitalized cancer and non-cancer pediatric patients and the association with COVID-19 outcomes. This is a cohort study of hospitalized children and adolescents with a laboratory diagnosis of COVID-19. Patients were assessed according to the presence or absence of previous oncological diseases. Sociodemographic, clinical and nutritional data were investigated during the course of the infection. Outcomes included Intensive Care Unit (ICU) admission, longer length of stay (14 days), criticality, and death. Oncological disease was found in 16 (19.3%) patients, most of whom had B-type acute lymphoid leukemia. In Poisson regression, adjusted for age and comorbidity, an association was found between oncological disease and length of stay ≥14 days (RR 4.30; 95% CI 1.46 - 15.6; p = 0.013), COVID-19 criticality (RR 3.82; 95% CI 1.66 - 30.9; p = 0.010) and death (RR 3.42; 95% CI 0.94 - 9.96; p = 0.035). The research revealed that cancer patients had longer hospital stays, were more likely to have the severe form of COVID-19, and had a 3.42 times greater risk of dying.

Profile of female survivors of sexual violence in the first 6 months of the COVID-19 quarantine in the city of Campinas, Brazil: A cross-sectional retrospective study.

OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

A Population-Based Epidemiologic Study of Symptomatic SARS-CoV-2 Infections and Fatalities in Brazilian Children over 3 Years.

OBJECTIVE: To provide a comprehensive overview of the epidemiologic characteristics, outcomes, and risk factors of COVID-19-related deaths in children and adolescents in Brazil. STUDY DESIGN: We conducted a population-based, retrospective cohort study that included all patients aged <18 years with laboratory-confirmed, symptomatic SARS-CoV-2 infection as registered in official Brazilian national surveillance systems for COVID-19 between February 2020 and February 2023. The primary outcome was COVID-19-related deaths. Odds ratios (ORs) of risk factors associated with death were estimated using multivariable logistic regression. RESULTS: Over a 3-year period, 2 855 704 pediatric patients with symptomatic SARS-CoV-2 infection were registered in Brazil. Of these, 59 179 (2.1%) were hospitalized, 13 844 (0.48%) were admitted to the intensive care unit, and 4943 (0.17%) received mechanical ventilation. A total of 4740 (0.17%) patients had fatal outcomes. The case fatality rate increased to 7.9% among patients who required hospitalization; 2102 (44.3%) patients who died did not receive advanced critical support. Notably, 2 (65%, 95% CI 58-71) or 3 doses (86%, 95% CI 81-89) of the vaccine provided strong protection against death. The following adjusted covariates were significantly associated with increased odds of death: age (0-4 and 11-17 years), ethnicity (Brown and Indigenous), region (Northeast or North), dyspnea, nosocomial infection, and comorbidities. Conversely, living in the South or Central-West regions, admission in the later period of the pandemic, and receiving a vaccine were all associated with protection against death. CONCLUSIONS: Our findings suggest that a complex interplay between individual factors and social inequities has shaped the impact of COVID-19 on Brazilian children and adolescents.

Trends in the Diagnosis of Pediatric Venous Thromboembolism and Arterial Ischemic Stroke during the COVID-19 Pandemic: An Administrative Database Study.

OBJECTIVE: To investigate trends in the diagnosis of venous thromboembolism (VTE) and arterial ischemic stroke (AIS), and examine the use of pharmacological thromboprophylaxis during the COVID-19 pandemic. STUDY DESIGN: This retrospective cohort study used the Pediatric Health Information Systems database to investigate patients admitted to a participating hospital between January 1, 2018, and December 31, 2021. International Classification of Diseases, 10th edition codes were used to identify VTE, AIS, and COVID-19. Pharmacy billing codes were used to investigate pharmacological thromboprophylaxis use. RESULTS: 1 759 701 unique patients underwent 2 234 135 inpatient admissions. Rate of VTE increased from 84 cases per 10 000 admissions in 2018-2019 to 108 cases per 10 000 admissions in 2020-2021, representing a 28.6% increase (P < .001). In contrast, the rate of AIS remained stable through the study period. When compared with 2018-2019, children diagnosed with VTE during 2020-2021 had longer hospitalizations and were more likely to be admitted to the intensive care unit. When analysis was limited to 2020-2021, a diagnosis code of COVID-19 was associated with a 1.35-fold (95% CI: 1.24-1.45) increase in the odds of VTE diagnosis, but not AIS. Use of pharmacologic thromboprophylaxis increased from 1.5% of hospitalizations in 2018-2019 to 3.0% of hospitalizations in 2020-2021 (P < .001). When evaluating thromboprophylaxis during 2020-2021, a diagnosis code for COVID-19 was associated with an 11-fold (95% CI: 10.86-11.49; P < .001) increase in the utilization of pharmacological thromboprophylaxis. CONCLUSIONS: This study found an increase in the rate of VTE among hospitalized children during the pandemic. A diagnosis of COVID-19 was associated with a modest increase in odds of VTE diagnosis, which occurred despite increased use of pharmacological thromboprophylaxis.

Disputes over the figures of the COVID-19 pandemic: Epistemic diversity, dissemination of science, and political opposition.

The health policies imposed by multiple national governments after the emergence of SARS-CoV-2 were publicly justified by official figures on the deaths that the new virus would have caused and could cause in the future. At the same time, however, groups of people from different countries expressed their scepticism about those figures. Although they were categorised as 'anti-science', 'spreaders of misinformation' or 'conspiracy theorists' in some media, many of those sceptics claimed to be based on scientific evidence. This article qualitatively analyses a sample of the content published by sceptics on their social media between 2020 and 2022. More specifically, it examines the shared documents supposedly coming from the scientific community. We find very diverse content ranging from unsubstantiated assumptions to documents produced by prestigious scientists inviting questions about the fatality rates, the mathematical models anticipating millions of deaths, and the real numbers of people who died from COVID-19. The disputes surrounding the official figures lead us to a reflection about the relationship between, epistemic diversity, the dissemination of science, censorship, and new forms of political opposition. We also touch upon the nature and ethics of scientific controversy in times of a 'war' against 'misinformation'.