Perfil lipídico e fatores de risco para doenças cardiovasculares em idosos acompanhados na atenção primária à saúde / Lipid profile and risk factors for cardiovascular diseases in older people seen in primary health care / Perfil lipídico y factores de riesgo de enfermedades cardiovasculares en ancianos seguidos en la atención primaria de salud

Introdução: As dislipidemias estão entre os fatores de riscos mais importantes para o desenvolvimento de doenças cardiovasculares (DCV), além de estarem relacionadas a outras patologias que predispõem às DCV. Em função da elevada prevalência e da incidência de complicações associadas à cronicidade da doença, as dislipidemias representam elevados custos ao setor da saúde e da previdência social. Diante disso, ressalta-se a importância do Sistema Único de Saúde, representado pela Atenção Primária à Saúde (APS), em prover práticas de prevenção, diagnóstico e acompanhamento dos pacientes dislipidêmicos, a fim de desonerar o sistema financeiro e promover o envelhecimento saudável. Objetivo: Descrever a prevalência de perfil lipídico alterado entre os idosos. Além disso, pretendeu-se caracterizar a amostra quanto aos aspectos sociodemográficos, de saúde e de comportamento, bem como analisar os fatores associados à distribuição do perfil lipídico alterado e às características da amostra. Métodos: Estudo transversal com dados secundários, obtidos de agosto de 2021 a julho de 2022, tendo como população pacientes idosos em acompanhamento na APS do município de Marau (RS). Todos os dados foram coletados dos prontuários eletrônicos da rede de APS e, após dupla digitação e validação dos dados, a amostra foi caracterizada por meio de estatística descritiva. Foi calculada a prevalência de perfil lipídico alterado com intervalo de confiança de 95% (IC95%) e foi verificada sua distribuição conforme as variáveis de exposição, empregando-se o teste do χ2 e admitindo-se erro tipo I de 5%. Resultados: A prevalência de dislipidemia proporcional entre os sexos foi maior no feminino (33%). A cor de pele predominante foi a branca (76,7%). Cerca de 20% dos pacientes apresentavam colesterol total, colesterol HDL-c e triglicerídeos alterados, enquanto cerca de 15% apresentavam o colesterol HDL-c anormal. Constatou-se que os pacientes dislipidêmicos apresentam mais diabetes e hipertensão em relação aos não dislipidêmicos, ocorrendo a sinergia de fatores de risco para as DCV. Conclusões: A caracterização exercida neste estudo serve de base científica para a compreensão da realidade local e, também, para o direcionamento de políticas públicas na atenção primária que atuem de forma efetiva na prevenção e no controle das dislipidemias e demais fatores de risco cardiovascular.

Introduction: Dyslipidemias are among the most important risk factors for the development of cardiovascular diseases (CVD), in addition to being related to other pathologies that predispose to CVD. Because of the high prevalence and incidence of complications associated with the chronicity of the disease, dyslipidemias represent high costs for the health and social security sector. This highlights the importance of the Unified Health System, represented by primary health care (PHC), in providing prevention, diagnosis and follow-up practices for dyslipidemic patients to relieve the financial system and promote healthy aging. Objective: The study aimed to describe the prevalence of altered lipid profile among older people. In addition, we sought to characterize the sample in terms of sociodemographic, health and behavioral aspects, as well as to analyze the factors associated with the distribution of the altered lipid profile and the characteristics of the sample. Methods: We conducted a cross-sectional study with secondary data, from August 2021 to July 2022, with older patients being followed up at the PHC in the city of Marau (RS) as the study population. All data were collected from the electronic medical records of the PHC network, and after double-typing and validation, the sample was characterized using descriptive statistics. The prevalence of altered lipid profile was determined with a 95% confidence interval (95%CI), and its distribution was verified according to the exposure variables, using the chi-square test and a type I error of 5%. Results: The prevalence of proportional dyslipidemia between sexes was higher in females (33%). The predominant skin color was white (76.7%). About 20% of the patients had altered total cholesterol, HDL-C and triglycerides, while about 15% had abnormal HDL-C. It was found that more dyslipidemic patients had diabetes and hypertension than non-dyslipidemic patients, with a synergy of risk factors for CVD. Conclusions: The characterization carried out in this study serves as a scientific basis for understanding the local reality and also for directing public policies in PHC that act effectively in the prevention and control of dyslipidemia and other cardiovascular risk factors.

Introducción: las dislipidemias se encuentran entre los factores de riesgo más importantes para el desarrollo de enfermedades cardiovasculares (ECV), además de estar relacionadas con otras patologías que predisponen a ECV. Debido a la alta prevalencia e incidencia de complicaciones asociadas a la cronicidad de la enfermedad, las dislipidemias representan altos costos para los sectores de salud y seguridad social. Frente a eso, se destaca la importancia del Sistema Único de Salud, representado por la Atención Primaria de Salud (APS), en la provisión de prácticas de prevención, diagnóstico y seguimiento de pacientes dislipidémicos, con el fin de descongestionar el sistema financiero y promover el envejecimiento saludable. Objetivo: El estudio tiene como objetivo describir la prevalencia del perfil lipídico alterado entre los ancianos. Además, se pretende caracterizar la muestra en cuanto a aspectos sociodemográficos, de salud y conductuales, así como analizar los factores asociados a la distribución del perfil lipídico alterado y las características de la muestra. Métodos: estudio transversal con datos secundarios, de agosto de 2021 a julio de 2022, con pacientes ancianos en seguimiento en la APS del municipio de Marau (RS) como población. Todos los datos fueron recolectados de la historia clínica electrónica de la red de la APS y, luego de doble digitación y validación, la muestra fue caracterizada mediante estadística descriptiva. Se calculó la prevalencia de perfil lipídico alterado con un intervalo de confianza del 95% (IC95%) y se verificó su distribución según las variables de exposición, utilizando la prueba de chi-cuadrado y admitiendo un error tipo I del 5%. Resultados: la prevalencia de dislipidemia proporcional entre sexos fue mayor en el sexo femenino (33%). El color de piel predominante fue el blanco (76,7%). Alrededor del 20% de los pacientes tenían colesterol total, colesterol HDL-C y triglicéridos alterados, mientras que alrededor del 15% tenían colesterol HDL-C anormal. Se encontró que los pacientes dislipidémicos tienen más diabetes e hipertensión que los pacientes no dislipidémicos, con una sinergia de factores de riesgo para ECV. Conclusiones: la caracterización realizada en este estudio sirve de base científica para comprender la realidad local y también para orientar políticas públicas en atención primaria que actúen de manera efectiva en la prevención y control de la dislipidemia y otros factores de riesgo cardiovascular.

Prevalência de Influenza A, vírus sincicial respiratório eSARS-CoV-2 em pacientes com síndrome respiratóriaaguda grave em Passo Fundo, Rio Grande do Sul / Prevalence of Influenza A, respiratory syncytial virus andSARS-CoV-2 in patients with severe acute respiratorysyndrome in Passo Fundo, Rio Grande do Sul

A síndrome respiratória aguda grave (SRAG) é caracterizada por sintomas de febre alta, tosse e dispneia, e, na maioria dos casos, relacionada a uma quantidade reduzida de agentes infecciosos. O objetivo foi avaliar a prevalência dos vírus respiratórios Influenza A (FluA), vírus sincicial respiratório (RSV) e do novo coronavírus (SARS-CoV-2) em pacientes com internação hospitalar por SRAG. Estudo transversal, com pacientes em internação hospitalar com SRAG entre novembro de 2021 e maio de 2022. Dados sociodemográficos e clínicos e amostras da nasofaringe foram coletados/as, as quais foram submetidas à extração de RNA e testadas quanto à positividade para Influenza A, RSV e SARS-CoV-2 por meio da técnica de PCR em tempo real pelo método SYBR Green. Foram incluídos 42 pacientes, sendo 59,5% do sexo feminino, 57,1% idosos, 54,8% com ensino fundamental. A maior parte dos pacientes reportou hábito tabagista prévio ou atual (54,8%), não etilista (73,8%) e 83,3% deles apresentavam alguma comorbidade, sendo hipertensão arterial sistêmica e diabetes mellitus tipo 2 as mais prevalentes. Um total de 10,5% dos pacientes testou positivo para FluA, nenhuma amostra positiva para RSV e 76,3% positivos para SARS-CoV-2. Na população estudada, SRAG com agravo hospitalar foi observado em maior proporção, em mulheres, idosos e pessoas com comorbidades, embora sem significância estatística, sendo o novo coronavírus o agente etiológico mais relacionado, o que evidencia a patogenicidade desse agente e suas consequências ainda são evidentes após quase 2 anos de período pandêmico.

Severe acute respiratory syndrome (SARS) is characterized by symptoms of high fever, cough and dyspnea, and is in most cases related to a reduced amount of infectious agents. The objective was to assess the prevalence of respiratory viruses Influenza A (FluA), respiratory syncytial virus (RSV) and the new coronavirus (SARS-CoV-2) in patients hospitalized for SARS. Cross-sectional study, with patients hospitalized with SARS between November 2021 and May 2022. Sociodemographic and clinical data and nasopharyngeal samples were collected, which were subjected to RNA extraction and tested for positivity for Influenza A, RSV and SARS-CoV-2 using the real-time PCR technique using the SYBR Green method. 42 patients were included, 59.5% female, 57.1% elderly, 54.8% with primary education. Most patients reported previous or current smoking habits (54.8%), non-drinkers (73.8) and 83.3% of them had some comorbidity, with systemic arterial hypertension and type 2 diabetes mellitus being the most prevalent. A total of 10.5% of patients tested positive for FluA, no samples positive for RSV, and 76.3% positive for SARS-CoV-2. In the studied population, SARS with hospital injury was observed more frequently in women and the elderly, with associated comorbidities, with the new coronavirus being the most related etiological agent, which shows, although not statistically significant, that the pathogenicity of this agent and its consequences are still evident after almost 2 years of period pandemic.

Vulnerabilidade social na população idosa usuária da Atenção Primária à Saúde de um município do Rio Grande do Sul / Social vulnerability of the older population using PrimaryHealth Care in a municipality of Rio Grande do Sul

O envelhecimento populacional, realidade no Brasil, é um processo fisiológico acompanhado por diversos fatores que podem aumentar a vulnerabilidade dessa população. O objetivo do presente estudo foi caracterizar uma amostra de idosos usuários da Atenção Primária à Saúde quanto aos fatores sociodemográficos, aspectos de saúde e hábitos de vida, associados à prevalência de vulnerabilidade social, de acordo com variáveis preditoras. Os dados foram coletados por meio de aplicação de questionário e posteriormente digitados, validados e analisados por meio de estatística descritiva. Foram entrevistados 403 idosos, com maioria composta pelo sexo feminino, idade entre 60-69 anos, da cor branca, que possuem companheiro, cursaram o ensino fundamental, que praticam atividade física, não fumam ou bebem, não exercem atividade remunerada, com renda per capita mensal menor ou igual a 1 salário mínimo, que residem com 2 pessoas e que possuem 3 ou mais doenças crônicas não transmissíveis. A prevalência de vulnerabilidade social, dada pela ausência de cônjuge, baixa escolaridade e baixa renda, foi de 51% e variou em função do sexo (56,7% em mulheres; p=0,01), mas não variou em função da idade (p=0,30) e da cor da pele (p=0,07). A maior vulnerabilidade social em idosas é decorrente da maior longevidade, associada muitas vezes à ausência de companheiro, bem como pelas históricas desvantagens educacionais, que culminam em baixa escolaridade, e dificuldades financeiras, como menor renda, em comparação aos homens.

Ageing population, a reality in Brazil, is a physiological process accompanied by several factors that can increase the vulnerability of this population. The objective of the present study was to characterize a sample of older population users of the urban network of Primary Health Care regarding sociodemographic factors, health aspects and lifestyle habits, associated with the prevalence of social vulnerability, in accordance with predictor's variables. Data were collected through questionnaire application and later typed, validated and analyzed using descriptive statistics. We interviewed 403 elderly, with a majority composed of females, aged 60-69 years, white, who have a partner, attended elementary school, who practice physical activity, do not smoke or drink, do not perform paid activity, with per capita monthly income less than or equal to 1 minimum wage, who live with 2 people and who have 3 or more chronic non-communicable diseases. The prevalence of social vulnerability, given by the absence of spouse, low schooling and low income, was 51% and varied according to gender (56.7% in women; p=0.01), but did not vary according to age (p=0.30) and skin color (p=0.07). The greater social vulnerability in the old women is due to greater longevity, often associated with the absence of a partner, as well as historical educational, with low educational level, and income disadvantages, as lower income, compared to men.

Association Between Active Commuting and Cardiometabolic Diseases in Primary Health Care Users

Abstract Background Although active commuting is inversely related to cardiovascular disease risk factors, these associations are unknown among Brazilian primary health care users. Objective To investigate the association between active commuting to daily activities and the prevalence of cardiometabolic diseases. Methods This cross-sectional study, conducted between May and August 2019, included primary health care users from all 34 primary health care centers in Passo Fundo, a city in southern Brazil. Cardiometabolic diseases (type 2 diabetes, hypertension, hypercholesterolemia, hypertriglyceridemia, cardiovascular diseases, and overweight/obesity) were measured by self-reported medical diagnosis using a questionnaire. Active commuting was analyzed dichotomously: daily commuting on foot or by bicycle was considered active, while daily commuting by car, motorcycle, or bus was considered passive. To determine the association between cardiometabolic diseases and active commuting, crude and adjusted prevalence ratios (PR) were estimated using Poisson regression, considering p <0.05 significant. Results The sample consisted of 1443 patients. There was an inverse association between active commuting and type 2 diabetes (PR: 0.59; 95% CI [Confidence Interval]: 0.39-0.90) and overweight/obesity (PR: 0.83: 95% CI: 0.71-0.98). Conclusion A lower prevalence of type 2 diabetes and obesity/overweight was observed in people who actively commute. These findings indicate that changes in urban infrastructure to enable safe active commuting will positively impact the health of the population.

Prevalência de diabetes mellitustipo 2 em usuários da Atenção Primária àSaúdee fatores associados / Prevalence of type 2 diabetes mellitus in users of Primary Health Care and associated factors

O diabetes mellitus tipo 2 (DM2) é uma patologia crônica que cresceu mundialmente. Quando mal controlado, pode acarretar ao seu portador diversas complicações, comprometendo, assim, a sua qualidade de vida. O presente trabalho teve como objetivo estimar a prevalência e os fatores associados à diabetes mellitus tipo 2 (DM2) em usuários da Atenção Primária à Saúde (APS). Trata-se de um estudo transversal realizado de maio a agosto de 2019. A estatística compreendeu o cálculo da prevalência de DM2, es eu intervalo de confiança foi de 95% (IC95). Para verificação dos fatores ajustados, foram calculadas as Razões de Prevalência (RP), brutas e ajustadas. A amostra foi de 1.365 usuários, com prevalência do desfecho de9% (IC95 8-11), sendo esta maior entre idosos (RP=2,21; IC95 1,50-3,26), hipertensos (RP= 3,02; IC95 1,90-4,81), pessoas com hipertrigliceridemia (RP=2,38; IC95 1,67-3,38), polimedicados (RP=2,91; IC95 1,82-4,67) e que não praticavam atividade física (RP=1,71; IC95 1,04-2,79) e menor entre aqueles que não exerciam atividade remunerada (RP=0,39; IC95 0,22-0,70) e com costume de pesquisar sobre saúde na internet (RP=0,51; IC95 0,30-0,88). Os achados obtidos nesse estudo destacam a imprescindibilidade à promoção de ações inovadoras com novas formas de atenção primária.

Type 2 diabetes mellitus (DM2) is a chronic pathology that has grown worldwide. If poorly controlled, it can cause several complications to the patient, thus compromising their quality of life. The present study aimed to estimate the prevalence and factors associated with type 2 Diabetes mellitus (DM2) in users of Primary Health Care (PHC). This is a cross-sectional study carried out from May to August 2019. The statistics comprised the calculation of the prevalence of DM2, and its 95% confidence interval (95% CI). To check the adjusted factors, gross and adjusted Prevalence Ratios (PR) were calculated. Thesample consisted of 1,365 users, with a 9% prevalence of the outcome (CI95 8-11), which was higher among the elderly (PR = 2.21; CI95 1.50-3.26), hypertensive patients (PR = 3.02; CI95 1.90-4.81), with hypertriglyceridemia (PR = 2.38; CI95 1.67-3.38), polymedicates (PR = 2.91; CI95 1.82-4.67) and that did not practice physical activity (PR = 1.71; CI95 1.04-2.79) and lower, among those who did not engage in paid activity (PR = 0.39; CI95 0.22-0.70) and with the habit of researching on health on the internet (PR = 0.51; 95% CI 0.30-0.88). The findings obtained in this study the need to promote innovative actions with new forms of primary care is highlighted.

Realização de medidas preventivas contra SARS-CoV-2/Covid-19: um estudo transversal em Passo Fundo, RS / Preventive measures against SARS-CoV-2/Covid-19: a cross-sectional study in Passo Fundo, RS

Resumo Introdução O SARS-CoV-2, responsável pela pandemia de COVID-19, apresenta alta transmissibilidade, principalmente por gotículas respiratórias de pessoas sintomáticas, aperto de mãos ou objetos e superfícies contaminadas, o que eleva a importância da adoção de medidas de redução da transmissibilidade no coletivo. Objetivo Avaliar a prevalência e os fatores associados à realização de medidas preventivas contra SARS-CoV-2/Covid-19. Método Estudo transversal, tipo Web Survey, realizado em Passo Fundo, RS. Coleta de dados on-line com indivíduos de 18 anos ou mais, avaliando aspectos sociodemográficos, de saúde, comportamento e conhecimento sobre o vírus. Desfecho definido como realização de no mínimo oito de nove medidas recomendadas pelo Ministério da Saúde. Estatística descritiva, cálculo de prevalência e razões de prevalência (RP) brutas e ajustadas. Resultados Amostra com 920 participantes, 68% de prevalência do desfecho, associada a mulheres (RP = 1,26; IC = 1,10-1,45), idosos (RP = 1,50; IC = 1,43-1,58), indivíduos que trabalham (RP = 1,09; IC=1,07-1,11), profissionais/estudantes da saúde (RP = 1,12; IC = 1,07-1,17), com 4 ou mais pessoas no domicílio (RP = 0,84; IC = 0,75-0,94) e medo da contaminação (RP = 1,20; IC = 1,17-1,22), do grupo de risco (RP = 0,94; IC = 0,91-0,96), com sinais/sintomas na última semana (RP = 0,83; IC = 0,72-0,96), não fumantes (RP = 1,10; IC = 1,01-1,20) e com conhecimento sobre sinais/sintomas (RP = 1,04; IC = 1,03-1,05), quando procurar atendimento (RP = 1,07; IC = 1,06-1,08) e formas de transmissão (RP = 1,03; IC = 1,00-1,06). Frequência de medidas preventivas variou de 98,5% (evitar aglomerações) a 60,9% (não compartilhar objetos de uso pessoal). Conclusão Mais da metade aderiu às medidas de prevenção, que podem ser reforçadas especialmente entre jovens, homens, do grupo de risco e com conhecimento insuficiente sobre a doença.

Abstract Background SARS-CoV-2, responsible for the COVID-19 pandemic, has high transmissibility, mainly through respiratory droplets from symptomatic people, hand shaking or contaminated objects and surfaces, which raises the importance of adopting measures to reduce transmissibility among individuals in community. Objective To assess the prevalence and factors associated with preventive measures against SARS-CoV-2 / Covid-19. Method This is a Web Survey, cross-sectional study carried out in Passo Fundo, RS. Online data collection with individuals 18 years old or more. Outcome defined as performance of at least eight out of nine measures recommended by the Ministry of Health. Calculation of prevalence, gross and adjusted prevalence ratios (PR). Results Sample of 920 participants, with 68% prevalence of the outcome, associated with women (PR = 1.26; C I= 1.10-1.45), elderly (PR = 1.50; CI=1.43-1.58), working individuals (PR = 1.09; CI = 1.07-1.11), health professionals / students (PR = 1.12; CI = 1.07-1.17), with 4 or more people in the household (PR = 0.84; CI = 0.75-0.94) and fear of contamination (PR = 1.20; CI = 1.17-1.22), belonging to the risk group (PR = 0.94; CI=0.91-0.96), with signs / symptoms in the last week (PR = 0.83; CI =0 .72-0.96), non-smokers (PR = 1.10; CI = 1.01-1.20) and, with knowledge about signs / symptoms (PR = 1.04; CI = 1.03-1.05), when seeking care (PR = 1.07 ; CI = 1.06-1.08) and forms of transmission (PR = 1.03; CI = 1.00-1.06). The frequency of preventive measures ranged from 98.5% (avoiding crowds) to 60.9% (not sharing personal items). Conclusion More than half have adhered to preventive measures, which can be strengthened especially among youth, men, the group at risk and with insufficient knowledge of the disease.

Tentativa de suicídio: prevalência e fatores associados entre usuários da Atenção Primária à Saúde / Suicide attempt: prevalence and associated factors among users of Primary Health Care

OBJETIVO: Estimar a prevalência de tentativa de suicídio entre usuários da Atenção Primária à Saúde (APS) e verificar fatores associados. MÉTODOS: Estudo transversal realizado com indivíduos de 18 anos ou mais, atendidos na rede urbana da APS de Passo Fundo, Rio Grande do Sul. Foi calculada a prevalência do desfecho, com intervalo de confiança de 95% (IC95), além das Razões de Prevalência (RPs) brutas e ajustadas para verificação dos fatores associados. RESULTADOS: Amostra de 1.443 indivíduos, prevalência da tentativa de suicídio de 9% (IC95 8%-11%), com maior probabilidade em mulheres (RP = 3,01; IC95 1,54-5,86), 18-59 anos (RP = 2,15; IC95 1,38-3,34), sem cônjuge (RP = 1,82; IC95 1,09-3,03), com duas ou mais doenças crônicas não transmissíveis (RP = 1,54; IC95 1,08-2,18), diagnóstico de HIV/AIDS (RP = 3,02; IC95 1,30-7,02), de depressão (RP = 2,69; IC95 1,83-3,96), história familiar de tentativa de suicídio (RP = 1,99; IC95 1,50-2,63) e insônia (RP = 1,46; IC95 1,05-2,02). Observou-se tendência linear inversamente proporcional em relação à escolaridade, com redução de 42% na probabilidade do desfecho entre os participantes com ensino superior (RP = 0,58; IC95 0,39-0,86). CONCLUSÕES: Constataram-se alta prevalência de tentativa de suicídio, em comparação à média nacional, e associação com idade adulta, sexo feminino, menor escolaridade, ausência de cônjuge, diagnóstico de doenças crônicas, insônia e história familiar de suicídio.

OBJECTIVE: To estimate the prevalence of attempted suicide among Primary Health Care (PHC) users and to verify the associated factors. METHODS: Cross-sectional study, performed with individuals aged ≥ 18 years, assisted in the urban PHC services in Passo Fundo, Rio Grande do Sul, Brazil. The prevalence of the outcome was calculated, with a confidence interval of 95% (95% CI), in addition to the crude and adjusted Prevalence Ratios (PR) to verify the associated factors. RESULTS: Sample of 1,443 individuals, 9% prevalence of attempted suicide (95% CI 8%-11%), most likely in women (PR = 3.01; 95% CI 1.54-5.86), 18-59 years (PR = 2.15; 95% CI 1.38-3.34), individuals without a spouse (PR = 1.82; 95% CI 1.09-3.03), with two or more chronic non-communicable diseases (PR = 1.54; 95% CI 1.08-2.18), diagnosis of HIV/AIDS (PR = 3.02; 95% CI 1.30-7.02) and of depression (PR = 2.69; 95% CI 1.83-3.96), family history of attempted suicide (PR = 1.99; 95% CI 1.50-2.63) and insomnia (PR = 1.46; 95% CI 1.05-2.02). An inversely proportional linear trend was observed in relation to education, with a 42% reduction in the probability of the outcome among participants with higher education (PR = 0.58; 95% CI 0.39-0.86). CONCLUSIONS: There was a high prevalence of attempted suicide compared to the national average and association with adult age, female gender, lower education level, absence of a partner, diagnosis of chronic diseases, insomnia and family history of suicide.

Automedicação em usuários da Atenção Primária à Saúde: motivadores e fatores associados / Self-medication in users of Primary Health Care: motivators and associated factors

Introdução: a automedicação pode aliviar sintomas e doenças agudas por um menor custo. Entretanto, esse consumo de medicamentos por conta própria e sem orientação adequada pode acarretar prejuízos como terapêuticas inadequadas, intoxicações e dependência. Objetivo: estimar a prevalência, os motivadores e os fatores associados à automedicação em adultos e idosos atendidos na Atenção Primária à Saúde (APS). Métodos: estudo transversal realizado de maio a agosto de 2019. A estatística compreendeu o cálculo da prevalência de automedicação, com período recordatório de 30 dias e seu intervalo de confiança de 95% (IC 95%). Para verificação dos fatores ajustados, foram calculadas as Razões de Prevalência (RP), brutas e ajustadas. Resultados: a amostra foi de 1.365 usuários, com prevalência do desfecho de 55% (IC 95%: 53-58), sendo esta maior em mulheres (RP=1,33; IC 95%: 1,17-1,52), adultos (RP=1,27; IC 95%: 1,14-1,41) e naqueles com 12 anos ou mais de estudo (RP=1,22; IC 95%: 1,09-1,37). Os principais motivadores foram dor (89%), gripe, resfriado e dor de garganta (18,9%) e febre (6,9%). Conclusão: verificou-se prevalência importante de automedicação, especialmente em mulheres, jovens e com maior escolaridade. Considerando os riscos, destaca-se a necessidade de políticas públicas para prevenir o uso indiscriminado de medicamentos.

Introduction: self-medication can relieve symptoms and diseases at a lower cost. However, this can lead to losses such as inappropriate therapies, intoxications and dependence. Objective: to estimate the prevalence, motivators and factors associated with self-medication in adults and the elderly treated in Primary Health Care. Methods: cross-sectional study carried out from May to August 2019. The statistics comprised the calculation of the prevalence of self-medication, with a recall period of 30 days and its 95% confidence interval (95% CI). In order to check the adjusted factors, crude and adjusted Prevalence Ratios (PR) were calculated. Results: the sample consisted of 1,365 users, with an outcome prevalence of 55% (95% CI: 53-58), which was higher in women (PR = 1.33; 95% CI: 1.17-1.52), adults (PR = 1.27; 95% CI: 1.14-1.41) and in those with 12 or more years of study (PR = 1.22; 95% CI: 1.09-1.37). The main motivators were pain (89%), flu, cold and sore throat (18.9%) and fever (6.9%). Conclusion: there was an important prevalence of self-medication, especially in women, young people and those with higher education. Considering the risks, the need for public policies to prevent the indiscriminate use of medicines is highlighted.

Percepção do medo de ser contaminado pelo novo coronavírus / Perception of fear of being infected by the new coronavirus

RESUMO Objetivo: Avaliar a prevalência e os fatores associados à percepção do medo de ser contaminado pelo novo coronavírus. Métodos: Estudo transversal realizado em Passo Fundo, Rio Grande do Sul, com indivíduos de ambos os sexos e 18 ou mais anos de idade. Coleta on-line de dados sociodemográficos, de saúde, de comportamento e de conhecimento acerca do vírus. Análise estatística descritiva e cálculo de prevalência e de razões de prevalência (RP) brutas e ajustadas. Resultados: Amostrados 920 participantes, com 64% de prevalência de medo de contaminação, sendo maior em indivíduos que trabalham (RP = 1,10; IC95 1,02-1,20), com idosos no domicílio (RP = 1,18; IC95 1,17-1,19), percepção negativa da saúde (RP = 1,15; IC95 1,02-1,31), avaliação de elevado risco de contaminação (RP = 1,30; IC95 1,23-1,38), com no mínimo um dos principais sinais/sintomas na semana anterior (RP = 1,12; IC95 1,11-1,13), que realizam maior número de medidas preventivas (RP = 1,27; IC95 1,15-1,40), vacinados contra a gripe (RP = 1,08; IC95 1,07-1,10) e que sabem que pertencem ao grupo de risco (RP = 1,17; IC95 1,14-1,19). Menor probabilidade do desfecho observada em idosos (RP = 0,74; IC95 0,60-0,91), profissionais ou estudantes da saúde (RP = 0,82; IC95 0,81-0,83) e em não fumantes (RP = 0,86; IC95 0,79-0,94). Conclusões: Observou-se elevada proporção de medo entre os participantes, especialmente entre aqueles que se percebem sob maior risco. Considerando o importante papel do medo na saúde mental das pessoas, os achados indicam a importância de intensificar ações educativas e informativas, visando ampliar o esclarecimento da população e reduzir os impactos da pandemia nesse aspecto.

ABSTRACT Objective: To assess the prevalence and factors associated with the perception of fear of being infected by the new coronavirus. Methods: Cross-sectional study carried out in Passo Fundo, Rio Grande do Sul, with individuals of both sexes and 18 years of age or older. Online data collection of sociodemographic, health and behavior characteristics as well as knowledge about the virus. Descriptive statistical analysis and calculation of prevalence and crude and adjusted prevalence ratios (PR). Results: Nine hundred and twenty participants were sampled, with a 64% prevalence of fear of contamination, being higher in working individuals (PR = 1.10; CI95 1.02-1.20), with elderly people at home (PR = 1.18; CI95 1.17-1.19), negative perception of health (PR = 1.15; CI95 1.02-1.31), assessment of high risk of contamination (PR = 1.30; CI95 1.23-1,38), with at least one of the main signs/symptoms in the previous week (PR = 1.12; CI95 1.11-1.13), who perform a greater number of preventive measures (PR = 1.27; CI95 1,15-1.40), vaccinated against influenza (PR = 1.08; CI95 1.07-1.10) and who know that they belong to the risk group (PR = 1.17; CI95 1.14-1,19). Lower probability of outcome observed in the elderly (PR = 0.74; CI95 0.60-0.91), health professionals or students (PR = 0.82; CI95 0.81-0.83) and in non-smokers (PR = 0.86; CI95 0.79-0.94). Conclusions: There was a high proportion of fear among the participants, especially among those who perceive themselves to be at greater risk. Considering the important role of fear in people's mental health, the findings indicate the importance of intensifying educational and informational actions, aiming to expand the clarification of the population and reduce the impacts of the pandemic in this regard.

Viral diversity of Rhipicephalus microplus parasitizing cattle in southern Brazil.

Ticks are ectoparasites spread worldwide and are well known as vectors of many viruses of great importance to human and animal health. However, the viral diversity in ticks is still poorly understood, particularly in South America. Here we characterized the viral diversity present in Rhipicephalus microplus parasitizing cattle in the southern region of Brazil using metagenomics. Our study revealed the presence of viruses that had not been previously described in the region, including lihan tick virus (Phenuiviridae family) and wuhan tick virus 2 (Chuviridae family), as well as expands the biogeography of jingmen tick virus (Flaviviridae family) in Brazil. Also, we described three novel tymoviruses (Tymovirales order), named guarapuava tymovirus-like 1 to 3. We described the genomic and phylogenetic characterization of these viruses. Our study sheds light on the viral diversity of Rhipicephalus microplus in South America, and also expands the biogeography of tick viruses that were previously described only in Asia.

Revalidation and genetic characterization of new members of Group C (Orthobunyavirus genus, Peribunyaviridae family) isolated in the Americas.

Group C serogroup includes members of the Orthobunyavirus genus (family Peribunyaviridae) and comprises 15 arboviruses that can be associated with febrile illness in humans. Although previous studies described the genome characterization of Group C orthobunyavirus, there is a gap in genomic information about the other viruses in this group. Therefore, in this study, complete genomes of members of Group C serogroup were sequenced or re-sequenced and used for genetic characterization, as well as to understand their phylogenetic and evolutionary aspects. Thus, our study reported the genomes of three new members in Group C virus (Apeu strain BeAn848, Itaqui strain BeAn12797 and Nepuyo strain BeAn10709), as well as re-sequencing of original strains of five members: Caraparu (strain BeAn3994), Madrid (strain BT4075), Murucutu (strain BeAn974), Oriboca (strain BeAn17), and Marituba (strain BeAn15). These viruses presented a typical genomic organization related to members of the Orthobunyavirus genus. Interestingly, all viruses of this serogroup showed an open reading frame (ORF) that encodes the putative nonstructural NSs protein that precedes the nucleoprotein ORF, an unprecedented fact in Group C virus. Also, we confirmed the presence of natural reassortment events. This study expands the genomic information of Group C viruses, as well as revalidates the genomic organization of viruses that were previously reported.

Novel Parvoviruses from Wild and Domestic Animals in Brazil Provide New Insights into Parvovirus Distribution and Diversity.

Parvoviruses (family Parvoviridae) are small, single-stranded DNA viruses. Many parvoviral pathogens of medical, veterinary and ecological importance have been identified. In this study, we used high-throughput sequencing (HTS) to investigate the diversity of parvoviruses infecting wild and domestic animals in Brazil. We identified 21 parvovirus sequences (including twelve nearly complete genomes and nine partial genomes) in samples derived from rodents, bats, opossums, birds and cattle in Pernambuco, São Paulo, Paraná and Rio Grande do Sul states. These sequences were investigated using phylogenetic and distance-based approaches and were thereby classified into eight parvovirus species (six of which have not been described previously), representing six distinct genera in the subfamily Parvovirinae. Our findings extend the known biogeographic range of previously characterized parvovirus species and the known host range of three parvovirus genera (Dependovirus, Aveparvovirus and Tetraparvovirus). Moreover, our investigation provides a window into the ecological dynamics of parvovirus infections in vertebrates, revealing that many parvovirus genera contain well-defined sub-lineages that circulate widely throughout the world within particular taxonomic groups of hosts.

Genomic characterization and evolution of Tacaiuma orthobunyavirus (Peribunyaviridae family) isolated in Brazil.

Tacaiuma virus (TCMV) is antigenically characterized as a member of the Anopheles A complex in the Orthobunyavirus genus, Peribunyaviridae family (Bunyavirales order). Clinically, the TCMV infection is characterized by acute febrile illness with myalgia and arthralgia lasting three to five days. However, the genomic and evolutionary aspect of this virus has not been elucidated. In this study, we described the complete coding sequences of three segments of two TCMV strains isolated in Brazil and three complete coding sequences of the small segment of three TCMV strains. All the strains sequenced in this study showed the typical genomic organization of orthobunyaviruses that infect vertebrates, except for the absence of the open reading frame that encodes the well-described non-structural small protein. This study presents the genomic and evolutionary characterization of TCMV strains and would be helpful for diagnostic purposes and epidemiology.

Characterization of the Gamboa Virus Serogroup (Orthobunyavirus Genus, Peribunyaviridae Family).

Comprehensive comparative phylogenetic analyses were performed on 17 Gamboa serogroup viruses (GAMSVs) from distinct geographic regions in the Americas and other representative members of the genus Orthobunyavirus (Peribunyaviridae), based on small (S), medium (M), and large (L) open reading frame full-length and partial sequences. Genome characterization showed that the GAMSVs divide into four clades or genotypes. The GAMSVs have a genetic organization similar to other orthobunyaviruses, except that they have a larger NSm protein than other orthobunyaviruses. A serosurvey for Gamboa virus antibodies was performed in plasma from birds, other wild animals, and humans living around the Tucuruí hydroelectric dam in Pará state, northern Brazil, a known focus of GAMSV activity. Newborn chicks (Gallus gallus domesticus) were experimentally infected with a GAMSV, and the pathogenesis is described. Histopathological changes were primarily in the lungs and liver. Also, a review of the ecology of the GAMSVs in the Americas is included. In sum, this study presents the genomic and evolutionary characterization of the Gamboa group and the potential model of pathogenesis, which would be helpful for diagnostic purposes, epidemiology, and immunopathogenesis studies.

The Potential for Reassortment between Oropouche and Schmallenberg Orthobunyaviruses.

A number of viruses within the Peribunyaviridae family are naturally occurring reassortants, a common phenomenon for segmented viruses. Using a minigenome-reporter and virus-like particle (VLP) production assay, we have accessed the potential of Oropouche virus (OROV), Schmallenberg virus (SBV), and other orthobunyaviruses within the Simbu serogroup to reassort. We found that the untranslated region (UTR) in the medium segment is a potential contributing factor for reassortment by the tested viruses. We demonstrate that for promoter activity to occur it was essential that the viral RNA polymerase (L) and nucleocapsid (N) proteins were from the same virus, reinforcing the hypothesis that the large and small segments that encode these proteins segregate together during genome reassortment. Our results indicate that, given the right epidemiological setting, reassortment between SBV and OROV would potentially be feasible and could contribute to the emergence of a new Simbu virus.

Characterization of the Bujaru, frijoles and Tapara antigenic complexes into the sandfly fever group and two unclassified phleboviruses from Brazil.

The genus Phlebovirus includes the sandfly fever viruses and tick-transmitted uukuviruses. Sandfly fever group viruses have been isolated from various vertebrate species and from phlebotomines and occasionally alternative arthropods, e.g. mosquitoes, or ceratopogonids of the genus Culicoides. Uukuniemi serogroup viruses have been isolated from various vertebrate species and from ticks. Despite the public health importance of some viruses of the genus, the genomic diversity of phleboviruses that could be incriminated as causative of human or veterinary diseases remains underestimated. Here we describe the nearly complete sequences and genomic characterization of two phleboviruses belonging to the Bujaru antigenic complex: the prototype species and the Munguba virus. Furthermore, six previously unclassified phleboviruses isolated in Brazil were also sequenced and characterized: Ambe, Anhanga, Joa, Uriurana, Urucuri and Tapara viruses. The results of the phylogenetic analysis indicated that these viruses group with viruses of three antigenic complexes (Bujaru, Tapara and frijoles clades), with two unclassified phleboviruses. We also performed genomic reassortment analysis and confirmed that there were no events for the viruses described in this study, but we found a new potential reassortment in Medjerda Valley virus, which contains S and L segments of Arbia virus, and probably a unique M segment, both viruses circulate in the same geographic region, indicating these two isolates represent two distinct viruses. This study provides insights into the genetic diversity, classification and evolution of phleboviruses.

Oropouche Virus: Clinical, Epidemiological, and Molecular Aspects of a Neglected Orthobunyavirus.

AbstractOropouche virus (OROV) is an important cause of arboviral illness in Latin American countries, more specifically in the Amazon region of Brazil, Venezuela and Peru, as well as in other countries such as Panama. In the past decades, the clinical, epidemiological, pathological, and molecular aspects of OROV have been published and provide the basis for a better understanding of this important human pathogen. Here, we describe the milestones in a comprehensive review of OROV epidemiology, pathogenesis, and molecular biology, including a description of the first isolation of the virus, the outbreaks during the past six decades, clinical aspects of OROV infection, diagnostic methods, genome and genetic traits, evolution, and viral dispersal.

Oropouche virus is detected in peripheral blood leukocytes from patients.

Oropouche virus (OROV) is a frequent cause of arboviral febrile disease in the Amazon. The present report describes studies done in two patients, one of them; the first OROV human case acquired outside of the Amazon, which have revealed for the first time the presence of OROV in peripheral blood leukocytes. This novel finding raises important issues regarding pathogenesis of human infections and may offer a new tool, for the rapid diagnosis of this neglected infection. J. Med. Virol. 89:1108-1111, 2017. © 2017 Wiley Periodicals, Inc.

Complete genome sequence of Piry vesiculovirus.

Piry virus (PIRYV) is a rhabdovirus (genus Vesiculovirus) and is described as a possible human pathogen, originally isolated from a Philander opossum trapped in Para State, Northern Brazil. This study describes the complete full coding sequence and the genetic characterization of PIRYV. The genome sequence reveals that PIRYV has a typical vesiculovirus-like organization, encoding the five genes typical of the genus. Phylogenetic analysis confirmed that PIRYV is most closely related to Perinet virus and clustered in the same clade as Chandipura and Isfahan vesiculoviruses.

Molecular characterization of Capim and Enseada orthobunyaviruses.

Capim and Enseada viruses are members of the genus Orthobunyavirus isolated from mosquitoes and mammals in Brazil. Despite seroprevalence studies indicating human infections in Latin America, these viruses remain relatively unknown and unstudied. In order to better understand the genetic and evolutionary relationships among orthobunyaviruses, we sequenced the three genomic segments of Capim and Enseada orthobunyaviruses. Based on phylogenetic analysis, we demonstrated that these viruses depicted two new distinct clades, one represented by Enseada and another composed of Capim virus. In general, the genome organization and genetic traits of these viruses are similar to other orthobunyaviruses however, the open reading frame (ORF) of the putative nonstructural NSs protein of Enseada orthobunyavirus precedes the nucleocapsid ORF. Overall, our study provides details on the molecular characteristics of the prototype species of two groups within the Orthobunyavirus genus, revealing novel features into the genetic diversity and evolution of this genus.