Gastroenterological Manifestations of Immunoglobulin G Subclass 4-Related Disease-Epidemiology, Clinical Manifestations, Diagnosis and Treatment.

Despite causing high morbidity, IgG4-related disease (IgG4-RD) and its gastroenterological manifestations lack better and greater theoretical contributions. Therefore, the objective of this work was to evaluate the clinical-epidemiological, diagnostic and treatment aspects of the gastrointestinal manifestations of this disease. A systematic review was carried out using the PubMed, Scopus and Embase databases between January 2012 and March 2023 with the following descriptors: "Immunoglobulin G4-Related Disease" (MeSH) AND #2 "Gastrointestinal Tract" (MeSH). Our data collection grouped a total of 3607 patients from mostly epidemiological cohort studies and cross-sectional follow-ups. In the subgroup analysis, IgG4-RD was associated with male gender, with an estimated prevalence between 54% and 80%. In our findings, the prevalence by topography was presented in the following ranges: lacrimal glands (17-57%); salivary glands (28-72%); pancreas (19-60%); biliary tract (5-40%); retroperitoneal cavity (9-43%). Longitudinal studies are needed to better map the natural history of the gastrointestinal manifestations of IgG4-RD and enable the formulation of individualized treatments.

The Impact of the COVID-19 Pandemic on the Mental Health of Teachers and Its Possible Risk Factors: A Systematic Review.

(1) Objective: The objective was to analyze the development of psychiatric pathologies/burnout syndrome and their possible risk factors in teachers in the context of the COVID-19 pandemic. (2) Methods: A qualitative systematic review was carried out, according to the PRISMA protocol, in the PubMed, Scopus, and Web of Science databases using a combination of the following descriptors [MeSH]: "mental health", "mental disorders'', "covid-19" and "school teachers''. Articles selected were written in English, Portuguese and Spanish, published between November 2019 and December 2022. (3) Results: The most common psychiatric pathologies were generalized anxiety disorders and depression. Burnout syndrome was also quite prevalent. Of the 776 articles identified, 42 were selected after applying the eligibility criteria. Although there is variability among the analyzed studies, the risk factors most correlated with increased morbidity in teachers were: (i) being female; (ii) age below the fifth decade of life; (iii) pre-existence of chronic or psychiatric illnesses before the pandemic; (iv) difficulty in adapting to the distance education model; (v) family/work conflicts; (vi) negative symptoms caused by the pandemic. (4) Conclusions: Therefore, the COVID-19 impact on mental health appears to be more common in female teachers in their fifth decade of life and with pre-existing psychiatric comorbidities. However, prospective studies are needed to better map this situation.

COVID-19, mental health and Indigenous populations in Brazil: The epidemic beyond the pandemic.

The aim of this paper was to report on factors contributing to the deterioration of the mental health of Indigenous populations (IP) in Brazil. Five factors seem to have a direct impact on the mental health of IP in Brazil: (1) The absence of public policies; (2) Intellectual production; (3) Psychiatric medical care for remote areas (e.g., telemedicine) aimed at promoting the mental health of Brazil's IP, which causes a huge gap in the process of assistance and social, psychological, economic and cultural valorization of native peoples; (4) The dissemination of fake news, which exposed, above all, older IP to risk behaviors in the pandemic, such as refusal of vaccination; and (5) The violence carried out on IP lands due to economic interests with mining/agribusiness.

"Between the cross and the sword": Brazilian children face an influenza epidemic while still dealing with the COVID-19 pandemic.

The Influenza activity remained at inter-seasonal levels; however, influenza A(H3N2) detections continue to increase in Brazil, Chile, Paraguay, and Uruguay. Most of the activity and rising trend of A(H3N2) detections are recorded in Brazil. A bulletin issued by the Oswaldo Cruz Foundation (Fiocruz) reported significant presence of the influenza A virus, both in children and in the adult population, among cases of SARS-Cov-2.This situation is worrying, as vaccination campaigns were hampered by the COVID-19 pandemic.

Hesitation regarding the COVID-19 vaccine among medical students in Brazil

SUMMARY OBJECTIVE: This study aims to know the main determinants of hesitation to the vaccine against COVID-19 mentioned by medical students in Brazil. METHODS: A cross-sectional study with 250 students who answered the online questionnaire between December 18, 2020 and January 8, 2021. RESULTS: Most students (84%) mentioned the intention to take anti-COVID vaccine and 14% were hesitant. Information provided by governments (59.2%), the pharmaceutical industry (54.4%), and the press (51.6%) were the items that most generated vaccine hesitation. CONCLUSION: In the context of the COVID-19, vaccine hesitation is an additional concern because adherence to vaccination is a recurring challenge. The category of contextual influences predominated among the main determinants of anti-COVID vaccine hesitation expressed by medical students in Brazil, disfavoring vaccine adherence in this public.

Risk factors for physical disability due to leprosy: a case-control study / Fatores de risco para a deficiência física decorrente da hanseníase: estudo de caso-controle

ABSTRACT Background The main consequence of leprosy is physical disability. Objective To identify risk factors of physical disabilities due to leprosy. Method Case-control study carried out at the Notifiable Diseases Information System - Leprosy in the 9th Regional Health District of the state of Paraíba, Brazil, between 2001 and 2014. Cases were individuals who presented degree of physical disability 1 or 2 at diagnosis or discharge; and controls included individuals with degree of physical disability 0 also at diagnosis and discharge. A 1:1 (case:control) proportion was used. Data were analyzed using the Epi Info and BioEstat software packages. Results The following cases and controls (428 each) at risk for physical disability were analyzed: aged ≥15 years (96.5%, OR=0.33, p<0.01), males (59.3%, OR=1.82, p<0.01), low education level (70.4%, OR=2.66, p<0.01), multibacillary classification (72.9%, OR=9.29; p< 0.01), number of lesions ≥5 (34.3%, OR=0.18, p<0.01), and number of nerves affected ≥1 (12.6%, OR=0.05; p<0.01). Late diagnosis, missing/inadequately filled data, absence/non-registration of dermato-neurological evaluation, and low control of contacts were observed. Conclusion The need for active surveillance and early detection of leprosy cases and contacts is highlighted.

RESUMO Introdução A principal consequência da hanseníase é a deficiência física. Objetivo Identificar fatores de risco para deficiências físicas decorrentes da hanseníase. Método Estudo de caso-controle, realizado no Sistema de Informação de Agravos de Notificação de hanseníase entre 2001 e 2014, presente na 9ª Regional de Saúde da Paraíba. Os casos foram associados às pessoas que apresentaram grau de incapacidade física 1 ou 2 no diagnóstico ou na alta; bem como controles com grau de incapacidade física 0, tanto no diagnóstico quanto na alta. A proporção foi um caso para um controle. Os dados foram analisados nos programas Epi Info e BioEstat. Resultados Foram analisados 428 casos e 428 controles com risco para incapacidade física para pessoas maiores de 15 anos (96,5%; OR = 0,33; p <0,01), gênero masculino (59,3%; OR = 1,82; p < 0,01), baixa escolaridade (70,4%; OR = 2,66; p < 0,01), classificação multibacilar (72,9%; OR = 9,29; p < 0,01), lesões maiores ou iguais a cinco (34,3%; OR = 0,18; p < 0,01) e nervos afetados maiores que um (12,6%; OR = 0,05; p < 0.01). Observou-se diagnóstico tardio, falta/inadequação no preenchimento dos dados, ausência/não registro da avaliação dermatoneurológica e baixo controle dos comunicantes. Conclusão Ressalta-se a necessidade da vigilância ativa e detecção precoce dos casos e contatos.

Hesitation regarding the COVID-19 vaccine among medical students in Brazil.

OBJECTIVE: This study aims to know the main determinants of hesitation to the vaccine against COVID-19 mentioned by medical students in Brazil. METHODS: A cross-sectional study with 250 students who answered the online questionnaire between December 18, 2020 and January 8, 2021. RESULTS: Most students (84%) mentioned the intention to take anti-COVID vaccine and 14% were hesitant. Information provided by governments (59.2%), the pharmaceutical industry (54.4%), and the press (51.6%) were the items that most generated vaccine hesitation. CONCLUSION: In the context of the COVID-19, vaccine hesitation is an additional concern because adherence to vaccination is a recurring challenge. The category of contextual influences predominated among the main determinants of anti-COVID vaccine hesitation expressed by medical students in Brazil, disfavoring vaccine adherence in this public.

Epidemiology and Etiopathogeny of COVID-19.

Despite the recent announcement of the new pathogenic coronavirus to man, SARS-CoV2, a large number of publications are presented to the scientific community. An organized and systematic review of the epidemiological, etiological, and pathogenic factors of COVID-19 is presented. This is a systematic review using the databases MEDLINE, EMBASE, Web of Science, SCIELO; the descriptors coronavirus, SARS-CoV-2, etiology, epidemiology, pathophysiology, pathogenesis, COVID-19, with publications from December 2019 to January 2021, resulting in more than 800 publications and 210 selected. The data suggest that COVID-19 is associated with SAR-CoV-2 infection, with the transmission of contagion by fomites, salivary droplets, and other forms, such as vertical and fecal-oral. The bat and other vertebrates appear to be reservoirs and part of the transmission chain. The virus uses cell receptors to infect human cells, especially ACE2, like other coronaviruses. Heat shock proteins have different roles in the infection, sometimes facilitating it, sometimes participating in more severe conditions, when not serving as a therapeutic target. The available data allow us to conclude that COVID-19 is a pandemic viral disease, behaving as a challenge for public health worldwide, determining aggressive conditions with a high mortality rate in patients with risk factors, without treatment, but with the recent availability of the first vaccines.

Influenza A/H1N1 e COVID-19 no Brasil: impactos e diferenças epidemiológicas / Influenza A/H1N1 and COVID-19 in Brazil: epidemiological impacts and diferences / Influenza A/H1N1 y COVID-19 en Brasil: impactos epidemiológicos y diferencias

Justificativa e Objetivos: Em 2009, o Brasil enfrentou a pandemia de influenza A/H1N1pdm09 que infectou, pelo menos, 50 mil pessoas. Em 2020, enfrenta outra pandemia causada pelo vírus SARS-Cov-2 (COVID-19). Por se tratar de uma doença nova, há muita especulação sobre a mesma, assim como comparação com outros cenários, muitas vezes com base em informações falsas. Este estudo compara os impactos e diferenças epidemiológicas da Influenza A/H1N1 e COVID-19 no Brasil. Métodos: Estudo quantitativo, descritivo, epidemiológico, de base documental, cujos dados foram coletados nas plataformas de informação do Ministério da Saúde do Brasil e da Organização Mundial da Saúde, além de artigos científicos. Os dados sobre Influenza A/H1N1 referem-se ao ano de 2009 e os de COVID-19 ao período de março a 30 de abril de 2020. Resultados: Constata-se que no Brasil, em apenas dois meses, o número de casos da COVID-19 (85.380) já ultrapassou o total de casos de influenza A/H1N1pdm09 (50.482) ocorridos em todo o ano de 2009 e provocou o triplo de óbitos. Portanto, a COVID-19 apresenta-se de forma mais severa, dada as proporções alcançadas em letalidade, pela falta de vacina e tratamento específico dos casos. Conclusão: A pandemia da COVID-19 é mais impactante para o Brasil que a pandemia da influenza A/H1N1pdm09.(AU)

Background and Objectives: In 2009, Brazil faced the influenza A/H1N1pdm09 pandemic that infected at least 50 thousand people. In 2020, it faces another pandemic caused by the SARS-Cov-2 virus (COVID-19). Because it is a new disease, there is much speculation about it and comparison with other scenarios, often based on fake news. This study compares the impacts and epidemiological differences of Influenza A / H1N1 and COVID-19 in Brazil. Methods: Quantitative, descriptive, epidemiological study, based on documents, whose data were collected on the information platforms of the Ministry of Health of Brazil and the World Health Organization, in addition to scientific articles. The data on Influenza A/H1N1 refer to the year 2009 and the data on COVID-19 to the period from March to April 30, 2020. Results: It appears that in Brazil, in just two months the number of cases of COVID-19 (85,380) has already exceeded the total cases of influenza A/H1N1pdm09 (50,482) that occurred in the whole year of 2009 and caused a triple of deaths. Therefore, COVID-19 presents itself more severely, given the proportions reached in lethality, due to the lack of vaccine and specific treatment of cases. Conclusion: The COVID-19 pandemic is more impactful for Brazil than the influenza A/H1N1pdm09 pandemic.(AU)

Justificación y Objetivos: En 2009, Brasil se enfrentó a la pandemia de influenza A / H1N1pdm09 que infectó al menos a 50,000 personas. En 2020, se enfrenta a otra pandemia causada por el virus SARS-Cov-2 (COVID-19). Como se trata de una enfermedad nueva, se especula mucho y se compara con otros escenarios, a menudo basados en información falsa. Este estudio compara los impactos y las diferencias epidemiológicas de la Influenza A / H1N1 y COVID-19 en Brasil. Métodos: Estudio epidemiológico cuantitativo, descriptivo, basado en documentos, cuyos datos fueron recolectados en las plataformas de información del Ministerio de Salud de Brasil y de la Organización Mundial de la Salud, además de artículos científicos. Los datos sobre Influenza A / H1N1 se refieren al año 2009 y los datos sobre COVID-19 al período de marzo al 30 de abril de 2020. Resultados: Parece que en Brasil, en solo dos meses, el número de casos de COVID-19 (85,380) ya excedió el número total de casos de influenza A / H1N1pdm09 (50,482) que ocurrieron en todo el año de 2009 y causaron un triple de muertes. Por lo tanto, COVID-19 se presenta más severamente, dadas las proporciones alcanzadas en la letalidad, debido a la falta de vacuna y al tratamiento específico de los casos. Conclusión: La pandemia de COVID-19 es más impactante para Brasil que la pandemia de influenza A / H1N1pdm09.(AU)

Effects of quarantine on mental health of populations affected by Covid-19.

BACKGROUND: To prevent the spread of the The novel coronavirus (2019-nCOV), some classic public health measures are being taken, such as social distancing and quarantine METHOD: Studies were identified using large-circulation international journals found in two electronic databases: Scopus and Embase. RESULTS: The prolonged confinement is evidently related to psychological damage, considering that individuals would be subjected to stressors for a longer period of time . In some cases, these psychic losses lasted for many months after the end of this confinement CONCLUSIONS: It is necessary to develop and implement actions to minimize the population psychological distress in meeting the needs of the communities affected by COVID-19 Thus, as it occurred in China, it is necessary that the other affected nations promote the publication of regulations that guide the implementation of mental health services and the allocation of resources, in order to ensure that individuals are monitored by competent professionals, thus reducing the psychological damage that can be motivated by the social isolation period during the quarantine.

Do medical interns feel prepared to work in the COVID-19 pandemic?

OBJECTIVE To learn about the perceptions of medical internship students about the early conclusion of the course and their preparation to act in the fight against COVID-19. METHODS An online questionnaire was applied with questions about the socioeconomic profile and the object of investigation. The data were analyzed using the Bioestat 5.0 software. RESULTS 111 students participated, most of whom (61.3%) were male, aged 20 to 25 years (80.2%), of Catholic religion (57.5%), and attending the 2nd year of internship (50.5%). A small portion (22.5%) reported being in total social isolation. The majority (57.5%) considered themselves unprepared to act in the fight against the pandemic, and 86.8% of the students believe that the early conclusion of the course will contribute to the fight against COVID-19 in the country. CONCLUSION This scenario points to the urgency of measures that provide, to recent graduates, timely technical preparation, safe work conditions, and emotional support even at the beginning of their professional career, leading them to competent, dignified and healthy work, during and after the pandemic.

Do medical interns feel prepared to work in the COVID-19 pandemic?

SUMMARY OBJECTIVE To learn about the perceptions of medical internship students about the early conclusion of the course and their preparation to act in the fight against COVID-19. METHODS An online questionnaire was applied with questions about the socioeconomic profile and the object of investigation. The data were analyzed using the Bioestat 5.0 software. RESULTS 111 students participated, most of whom (61.3%) were male, aged 20 to 25 years (80.2%), of Catholic religion (57.5%), and attending the 2nd year of internship (50.5%). A small portion (22.5%) reported being in total social isolation. The majority (57.5%) considered themselves unprepared to act in the fight against the pandemic, and 86.8% of the students believe that the early conclusion of the course will contribute to the fight against COVID-19 in the country. CONCLUSION This scenario points to the urgency of measures that provide, to recent graduates, timely technical preparation, safe work conditions, and emotional support even at the beginning of their professional career, leading them to competent, dignified and healthy work, during and after the pandemic.

RESUMO OBJETIVO Conhecer as percepções de estudantes do internato médico sobre formatura antecipada e preparo para trabalhar no combate à pandemia da Covid-19. MÉTODOS Aplicou-se questionário on-line com questões sobre o perfil socioeconômico e o objeto de investigação. Os dados foram analisados pelo software Bioestat 5.0. RESULTADOS Participaram 111 estudantes, a maioria (61,3%) do sexo masculino, na faixa etária de 20 a 25 anos (80,2%), de religião católica (57,5%) e cursando o 2o ano do internato (50,5%). Pequena parcela (22,5%) informou estar em isolamento social total. A maioria (57,5%) se sente despreparada para atuar no combate à pandemia, e 86,8% consideram que a formatura antecipada contribuirá para o enfrentamento da Covid-19 no País. CONCLUSÃO Este panorama remete à urgência de medidas que propiciem, aos recém-graduados, preparo técnico oportuno, condições de trabalho seguras e suporte emocional já neste início de carreira profissional, conduzindo-os ao trabalho competente, digno e saudável, durante e após a pandemia.

New record and extended geographical distribution of Aedes fluviatilis (Lutz, 1904) in Ceará, northeastern Brazil.

INTRODUCTION: Aedes fluviatilis(Lutz, 1904) is considered a potential vector of yellow fever and dengue viruses and is naturally infected by Wolbachia. METHODS: In March 2018, during a field activity in the municipality of Saboeiro, 163 mosquito larvae were collected in a dammed area of the Jaguaribe River. RESULTS: Of the larvae collected, 143 (87.7%) were identified asAe. fluviatilis. CONCLUSIONS: We report the first documentation of Ae. fluviatilis in the municipality of Saboeiro, northeastern Brazil. It is important to conduct additional entomological surveys to characterize the local Culicidae fauna. Ignoring the presence and dispersion of this vector could be a public health risk.

Análise dos resultados do teste de papanicolaou entre usuárias da atenção primária: estudo transversal / Analysis of the results of the papanicolaou test among primary care users: a cross-sectional study

Objetivo: Identificar os resultados do teste de Papanicolaou correlacionando-os com o início da atividade sexual e o número de parceiros de mulheres. Metodologia: Estudo transversal com mulheres que realizaram o teste de Papanicolaou. Na análise dos dados, consideraram-se os resultados dos exames normais e alterados, por meio do teste não paramétrico Kruskal- Wallis. As médias das variáveis foram comparadas entre o grupo normal e cada infecção, por meio do teste t de Student. Resultados: Foi identificada prevalência de infecções genitais em 25,5%, com índice por Gardnerella vaginalis de 49% e por Candida spp de 38%. A idade do início da atividade sexual e o número de parceiros sugeriram associação com as infecções genitais. Conclusão: Deve-se realizar a educação em saúde e o teste de Papanicolaou para a prevenção primária e secundária de infecções sexualmente transmissíveis.

Objective: To identify the results of the Papanicolaou test and correlate them with the beginning of sexual activity and the number of partners of women. Methodology: Cross-sectional study with women who made the Papanicolaou test. In the analysis of the data, consider the results of the normal and altered exams using the Kruskal-Wallis non-parametric test. The averages of the variables were compared between the normal group and each infection, using Student’s t test. Results: The prevalence of genital infections was identified in 25.5%, with a index by Gardnerella vaginalis of 49% and by Candida spp of 38%. The age of beginning of sexual activity and the number of partners suggested association with the genital infections. Conclusion: Must be performed the health education and the Papanicolaou test for primary and secondary prevention of sexually transmitted infections.

Objetivo: Identificar los resultados de la prueba de Papanicolaou correlacionándolos con el inicio de la actividad sexual y el número de parejas de mujeres. Métodos: Estudio transversal con mujeres que realizaron la prueba de Papanicolaou. En el análisis de los datos, se consideraron los resultados de los exámenes normales y alterados, por medio del test no paramétrico Kruskal-Wallis. Las medias de las variables fueron comparadas entre el grupo normal y cada infección, por medio del test t de Student. Resultados: Se identificó prevalencia de infecciones genitales en el 25,5%, con índice por Gardnerella vaginalis del 49% y por Candida spp del 38%. La edad del inicio de la actividad sexual y el número de parejas sugieren asociación con las infecciones genitales. Conclusión: Se debe realizar la educación en salud y la prueba de Papanicolaou para la prevención primaria y secundaria de infecciones de transmisión sexual.

New record and extended geographical distribution of Aedes fluviatilis (Lutz, 1904) in Ceará, northeastern Brazil

Abstract INTRODUCTION Aedes fluviatilis(Lutz, 1904) is considered a potential vector of yellow fever and dengue viruses and is naturally infected by Wolbachia. METHODS In March 2018, during a field activity in the municipality of Saboeiro, 163 mosquito larvae were collected in a dammed area of the Jaguaribe River. RESULTS Of the larvae collected, 143 (87.7%) were identified asAe. fluviatilis. CONCLUSIONS We report the first documentation of Ae. fluviatilis in the municipality of Saboeiro, northeastern Brazil. It is important to conduct additional entomological surveys to characterize the local Culicidae fauna. Ignoring the presence and dispersion of this vector could be a public health risk.

Influência da publicidade na automedicação na população de um município brasileiro de médio porte / Influence of advertising in self-medication among the population of a brazilian midsize town

Introdução: A automedicação é uma prática que, feita de forma arbitrária, traz riscos reais à saúde da população. Entretanto, seus fatores contributivos, sobretudo a influência da propaganda no consumo de fármacos, não tem uma correlação bem estabelecida na literatura. Objetivos: Estimar a prevalência da automedicação e avaliar a influência da propaganda nesse hábito. Método: estudo transversal, quantitativo, no município de Crato, Ceará, Brasil, com amostra de 104 pessoas. Resultados: 67% da amostra praticava automedicação. Destas, 80% conheciam os riscos para a prática. Uma parcela de 67,6% dos praticantes revelou ser influenciada pela propaganda para a escolha do medicamento e, entre eles, a taxa de automedicação foi de 1,6x maior (p=0,004). O sexo, a idade e a renda não exerceram influência sobre a referida prática (p>0,05). Conclusões: A prevalência de automedicação entre os participantes é elevada, o que denota uma necessidade real de se repensar as normas regimentais de publicidade, assim como desperta e sugere para o impacto que campanhas publicitárias bem elaboradas podem ter no público em geral, configurando uma potencial ferramenta de saúde pública.

Introduction: DSelf-medication is a practice that, when carried out in an arbitrary way, brings real risks to the health of the population. However, its contributory factors, especially the influence of advertising on drug consumption, do not have a well-established correlation. Objectives: To estimate the prevalence of self-medication and to evaluate the influence of advertising on such habit. Method: A cross-sectional and quantitative study was carried out in the city of Crato, Ceará, Brazil, with a sample of 104 people. Results: It was evidenced that 67% of the sample practiced self-medication, of which 80% knew the risks to practice. A portion of 67.6% of practitioners was shown to be influenced by the advertising for drug choice, and among these the selfmedication rate was 1.6x higher (p = 0.004). Sex, age and income exerted no influence the practice (p> 0.05). Conclusion: The prevalence of self-medication among the participants is high, which indicates a real need to rethink the regimental norms of publicity, as well as awakens and suggests that the impact of well-designed advertising campaigns can have on the general public, making up a potential public health tool.