Toxoplasma gondii and Neospora caninum in invasive wild boars (Sus scrofa) and hunting dogs from Brazil.

The wild boar, an impactful invasive species in Brazil, is subject to population control activities, which often include the use of hunting dogs. Hunters commonly consume wild boar meat, which is also used to feed their dogs, posing a risk of Toxoplasma gondii infection for humans and both T. gondii and Neospora caninum for dogs. The study aimed to investigate the prevalence of infection in wild boars (n = 127) and hunting dogs (n = 73) from São Paulo, Rio Grande do Sul, and Paraná states. We employed histopathological, serological (indirect fluorescent antibody test), and molecular techniques (endpoint polymerase chain reaction). Histopathology slides of wild boar tissue (central nervous system, heart, skeletal muscle, liver, spleen, kidney, gastrointestinal tract, pancreas, lymph nodes, and thyroid) sections revealed no T. gondii or N. caninum cysts (0/47). Antibodies anti-T. gondii were detected in 35/108 (32.4%) and anti-N. caninum in 45/108 (41.7%) wild boars. Only 2/18 (11.1%) wild boar tissue homogenate samples tested positive for T. gondii on endpoint PCR. Hunting dogs showed antibodies against T. gondii in 62/73 (85%) and against N. caninum in 31/73 (42%). The presence of antibodies against T. gondii and N. caninum in wild boars and hunting dogs, along with T. gondii DNA detection in wild boars, indicates the circulation of these parasites. Educating hunters on preventing these foodborne diseases, including zoonotic risks, is crucial.

Seroprevalence and risk factors for Neospora caninum and Toxoplasma gondii in dairy cattle from São Paulo State, Brazil.

Neospora caninum is a major cause of reproductive loss in cattle worldwide as it leads to abortion and animal repositioning. Although Toxoplasma gondii does not cause a reproductive problem in cattle, consuming raw or uncooked beef poses the risk of transmission. This study aimed to evaluate the occurrence of anti-N. caninum and anti-T. gondii antibodies in dairy cattle in the West and Northwest regions of São Paulo State, Brazil. A total of 653 serum samples from dairy cows were analyzed using an indirect immunofluorescence assay (IFA). Epidemiological data from the farms were associated with the serological results of the animals by logistic regression based on the presence of antibodies. The frequencies of the antibodies against N. caninum and T. gondii were 41.6% (272/653) and 11.5% (75/653), respectively. A statistically significant association was observed between: the serum anti-N. caninum antibodies and breed, history of food supplementation for calves, introduction of outside animals that later presented reproductive problems, and history of reproductive problems by the trimester of gestation. The present study highlights the importance of neosporosis in dairy cattle in the study regions and that the inclusion of this parasite in the investigation of animals with reproductive disorders is important.

Cannabinoid products for pain management: recommendations from the São Paulo State Society of Anesthesiology.

There is growing interest in using cannabinoids across various clinical scenarios, including pain medicine, leading to the disregard of regulatory protocols in some countries. Legislation has been implemented in Brazil, specifically in the state of São Paulo, permitting the distribution of cannabinoid products by health authorities for clinical purposes, free of charge for patients, upon professional prescription. Thus, it is imperative to assess the existing evidence regarding the efficacy and safety of these products in pain management. In light of this, the São Paulo State Society of Anesthesiology (SAESP) established a task force to conduct a narrative review on the topic using the Delphi method, requiring a minimum agreement of 60% among panelists. The study concluded that cannabinoid products could potentially serve as adjuncts in pain management but stressed the importance of judicious prescription. Nevertheless, this review advises against their use for acute pain and cancer-related pain. In other clinical scenarios, established treatments should take precedence, particularly when clinical protocols are available, such as in neuropathic pain. Only patients exhibiting poor therapeutic responses to established protocols or demonstrating intolerance to recommended management may be considered as potential candidates for cannabinoids, which should be prescribed by physicians experienced in handling these substances. Special attention should be given to individual patient characteristics and the likelihood of drug interactions.

Impact of Cuminaldehyde and Indomethacin Co-Administration on Inflammatory Responses in MIA-Induced Osteoarthritis in Rats.

Osteoarthritis (OA) remains a chronic incurable condition, presenting substantial challenges in treatment. This study explores a novel strategy by investigating the concurrent use of cuminaldehyde, a natural compound, with indomethacin in animal models of MIA-induced OA. Our results demonstrate that the co-administration of cuminaldehyde and indomethacin does indeed produce a superior effect when compared to these compounds individually, significantly enhancing therapeutic outcomes. This effect is evidenced by a marked reduction in pro-inflammatory cytokines IL-6 and IFN-γ, alongside a significant increase in the anti-inflammatory cytokine IL-10, compared to treatments with each compound alone. Radiographic analyses further confirm the preservation of joint integrity and a reduction in osteoarthritic damage, highlighting the association's efficacy in cartilage-reducing damage. These findings suggests that the association of cuminaldehyde and indomethacin not only slows OA progression but also offers enhanced cartilage-reducing damage and fosters the production of protective cytokines. This study underscores the potential benefits of integrating natural products with pharmaceuticals in OA management and stresses the importance of further research to fully understand the mechanisms underlying the observed potentiated effects.

Toxoplasma gondii infection in European brown hares (Lepus europaeus) in Brazil.

Toxoplasmosis is a worldwide zoonosis that affects warm-blooded animals, including humans. Wild animals can act as intermediate hosts of this pathogen; thus, this study aims to detect Toxoplasma gondii infection in invasive European brown hares in Brazil. For this, 72 wild European brown hares were captured from July 2020 to June 2022 in three Brazilian states: São Paulo, Paraná, and Rio Grande do Sul. The diagnostic of Toxoplasma gondii infection was performed by bioassay in mouse, histopathology in Hematoxylin-Eosin-stained tissue sections (brain, liver, lungs, kidneys, and small intestine), serology by IFAT, and molecular techniques by conventional PCR and qPCR. The combined prevalence of the different diagnostic methods was 51.4% (37/72, CI= 40.1 - 62.6 %), and there was no statistical difference between sexes, age range, or geographical region of the hosts. Mouse bioassay was the technique that detected more positive hares. To our knowledge, this is the first confirmation of Toxoplasma gondii infection in invasive European brown hares in Brazil. These animals act as reservoirs and potential infection source for carnivores and other wild and domestic animals, including humans, thus contributing to perpetuate the disease cycle in São Paulo, Paraná, and Rio Grande do Sul States. Research such as the present study is necessary to raise awareness about the role of animals in the disease cycle.

Essential oil of oregano (Origanum vulgare L.) reduces infection and proliferation of Toxoplasma gondii in BeWo cells with induction of autophagy and death of tachyzoites through a mechanism similar to necrosis.

Toxoplasmosis poses a global health threat, ranging from asymptomatic cases to severe, potentially fatal manifestations, especially in immunocompromised individuals and congenital transmission. Prior research suggests that oregano essential oil (OEO) exhibits diverse biological effects, including antiparasitic activity against Toxoplasma gondii. Given concerns about current treatments, exploring new compounds is important. This study was to assess the toxicity of OEO on BeWo cells and T. gondii tachyzoites, as well as to evaluate its effectiveness in in vitro infection models and determine its direct action on free tachyzoites. OEO toxicity on BeWo cells and T. gondii tachyzoites was assessed by MTT and trypan blue methods, determining cytotoxic concentration (CC50), inhibitory concentration (IC50), and selectivity index (SI). Infection and proliferation indices were analyzed. Direct assessments of the parasite included reactive oxygen species (ROS) levels, mitochondrial membrane potential, necrosis, and apoptosis, as well as electron microscopy. Oregano oil exhibited low cytotoxicity on BeWo cells (CC50: 114.8 µg/mL ± 0.01) and reduced parasite viability (IC50 12.5 ± 0.06 µg/mL), demonstrating 9.18 times greater selectivity for parasites than BeWo cells. OEO treatment significantly decreased intracellular proliferation in infected cells by 84% after 24 h with 50 µg/mL. Mechanistic investigations revealed increased ROS levels, mitochondrial depolarization, and lipid droplet formation, linked to autophagy induction and plasma membrane permeabilization. These alterations, observed through electron microscopy, suggested a necrotic process confirmed by propidium iodide labeling. OEO treatment demonstrated anti-T. gondii action through cellular and metabolic change while maintaining low toxicity to trophoblastic cells.

The effect of low dose intra-articular S(+) ketamine on osteoarthritis in rats: an experimental study.

BACKGROUND: This study aimed to investigate the analgesic impact of S(+)-ketamine on pain behavior and synovial inflammation in an osteoarthritis (OA) model. METHODS: Animals were grouped as follows: OA-Saline (n = 24) and OA-Ketamine (n = 24), OA induced via intra-articular sodium monoiodoacetate (MIA); a Non-OA group (n = 24) served as the control. On the 7th day post OA induction, animals received either saline or S(+)-ketamine (0.5 mg.kg-1). Behavioral and histopathological assessments were conducted up to day 28. RESULTS: S(+)-ketamine reduced allodynia from day 7 to 28 and hyperalgesia from day 10 to 28. It notably alleviated weight distribution deficits from day 10 until the end of the study. Significant walking improvement was observed on day 14 in S(+)-ketamine-treated rats. Starting on day 14, OA groups showed grip force decline, which was countered by S(+)-ketamine on day 21. However, S(+)-ketamine did not diminish synovial inflammation. CONCLUSION: Low Intra-articular (IA) doses of S(+)-ketamine reduced MIA-induced OA pain but did not reverse synovial histopathological changes. IRB APPROVAL NUMBER: 23115 012030/2009-05.

Polymeric Nanoparticles Enable mRNA Transfection and Its Translation in Intervertebral Disc and Human Joint Cells, Except for M1 Macrophages.

Chronic lower back pain caused by intervertebral disc degeneration and osteoarthritis (OA) are highly prevalent chronic diseases. Although pain management and surgery can alleviate symptoms, no disease-modifying treatments are available. mRNA delivery could halt inflammation and degeneration and induce regeneration by overexpressing anti-inflammatory cytokines or growth factors involved in cartilage regeneration. Here, we investigated poly(amidoamine)-based polymeric nanoparticles to deliver mRNA to human joint and intervertebral disc cells. Human OA chondrocytes, human nucleus pulposus (NP) cells, human annulus fibrosus (AF) cells, fibroblast-like synoviocytes (FLS) and M1-like macrophages were cultured and transfected with uncoated or PGA-PEG-coated nanoparticles loaded with EGFP-encoding mRNA. Cell viability and transfection efficiency were analyzed for all cell types. Nanoparticle internalization was investigated in FLS and M1-like macrophages. No significant decrease in cell viability was observed in most conditions. Only macrophages showed a dose-dependent reduction of viability. Transfection with either nanoparticle version resulted in EGFP expression in NP cells, AF cells, OA chondrocytes and FLS. Macrophages showed internalization of nanoparticles by particle-cell co-localization, but no detectable expression of EGFP. Taken together, our data show that poly (amidoamine)-based nanoparticles can be used for mRNA delivery into cells of the human joint and intervertebral disc, indicating its potential future use as an mRNA delivery system in OA and IVDD, except for macrophages.

Pain as a disease in the new International Classification of Diseases (ICD-11): Latin American expert consensus.

Aims: Pain diagnoses in the 10th version of the International Classification of Diseases (ICD-10) did not adequately support the current management of pain. Therefore, we aimed to review the new 11th revision (ICD-11) in order to analyze its usefulness for the management, coding, research and education of chronic pain from a Latin American perspective. Methods: The Latin American Federation of Associations for the Study of Pain convened a meeting of pain experts in Lima, Peru. Pain specialists from 14 Latin American countries attended the consensus meeting. Results: In ICD-11, chronic pain is defined as pain that persists or recurs longer than 3 months and is subdivided into seven categories: chronic primary pain and six types of chronic secondary pain. Chronic primary pain is now considered a disease in itself, and not a mere symptom of an underlying disease. Conclusion: The novel definition and classification of chronic pain in ICD-11 is helpful for better medical care, research and health statistics. ICD-11 will improve chronic pain management in Latin American countries, for both the pain specialist and the primary care physician.

Chronic pain is one of the most frequent reasons for medical consultation in Latin America. In the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10), chronic pain was not adequately defined and individual pain diagnoses were poorly defined. For the first time in Latin America, a meeting of pain experts analyzed and reviewed the 11th version of the International Classification of Diseases (ICD-11), when the Latin America Federation of Associations for the Study of Pain organized a meeting of experts from 14 Latin American countries. In ICD-11, chronic pain is recognized as a biopsychosocial phenomenon and defined as pain that continues or returns for more than 3 months. It is split into seven types: chronic primary pain and six types of chronic secondary pain. In ICD-11, chronic primary pain is now considered a disease in itself, not a mere manifestation of other disease. Our article is the first to address the problems, challenges and benefits of using ICD-11 from a Latin American perspective. It will help to facilitate and disseminate the use of this new classification of chronic pain. This will improve chronic pain treatment, statistics, research and development of better health strategies for pain management in Latin America.

The effect of low dose intra-articular S(+) ketamine on osteoarthritis in rats: an experimental study

Abstract Background: This study aimed to investigate the analgesic impact of S(+)-ketamine on pain behavior and synovial inflammation in an osteoarthritis (OA) model. Methods: Animals were grouped as follows: OA-Saline (n = 24) and OA-Ketamine (n = 24), OA induced via intra-articular sodium monoiodoacetate (MIA); a Non-OA group (n = 24) served as the control. On the 7th day post OA induction, animals received either saline or S(+)-ketamine (0.5 mg.kg-1). Behavioral and histopathological assessments were conducted up to day 28. Results: S(+)-ketamine reduced allodynia from day 7 to 28 and hyperalgesia from day 10 to 28. It notably alleviated weight distribution deficits from day 10 until the end of the study. Significant walking improvement was observed on day 14 in S(+)-ketamine-treated rats. Starting on day 14, OA groups showed grip force decline, which was countered by S(+)-ketamine on day 21. However, S(+)-ketamine did not diminish synovial inflammation. Conclusion: Low Intra-articular (IA) doses of S(+)-ketamine reduced MIA-induced OA pain but did not reverse synovial histopathological changes. IRB approval number: 23115 012030/2009-05.

Seroprevalence and risk factors for Neospora caninum and Toxoplasma gondii in dairy cattle from São Paulo State, Brazil / Soroprevalência e fatores de risco para Neospora caninum e Toxoplasma gondii em bovinos leiteiros do Estado de São Paulo

Abstract Neospora caninum is a major cause of reproductive loss in cattle worldwide as it leads to abortion and animal repositioning. Although Toxoplasma gondii does not cause a reproductive problem in cattle, consuming raw or uncooked beef poses the risk of transmission. This study aimed to evaluate the occurrence of anti-N. caninum and anti-T. gondii antibodies in dairy cattle in the West and Northwest regions of São Paulo State, Brazil. A total of 653 serum samples from dairy cows were analyzed using an indirect immunofluorescence assay (IFA). Epidemiological data from the farms were associated with the serological results of the animals by logistic regression based on the presence of antibodies. The frequencies of the antibodies against N. caninum and T. gondii were 41.6% (272/653) and 11.5% (75/653), respectively. A statistically significant association was observed between: the serum anti-N. caninum antibodies and breed, history of food supplementation for calves, introduction of outside animals that later presented reproductive problems, and history of reproductive problems by the trimester of gestation. The present study highlights the importance of neosporosis in dairy cattle in the study regions and that the inclusion of this parasite in the investigation of animals with reproductive disorders is important.

Resumo Neospora caninum é uma das principais causas de perda reprodutiva em bovinos em todo o mundo, pois leva ao aborto e ao reposicionamento animal. Embora o Toxoplasma gondii não cause problemas reprodutivos em bovinos, o consumo de carne bovina crua ou não cozida apresenta risco de transmissão. Este estudo teve como objetivo avaliar a ocorrência de anticorpos anti-N. caninum e anti-T. gondii em bovinos leiteiros nas regiões Oeste e Noroeste do Estado de São Paulo, Brasil. Um total de 653 amostras de soro de bovinos leiteiros, foi analisado utilizando-se o ensaio de imunofluorescência indireta (IFI). Os dados epidemiológicos das propriedades foram associados aos resultados sorológicos dos animais por meio de regressão logística. As frequências dos anticorpos contra N. caninum e T. gondii foram 41,6% (272/653) e 11,5% (75/653), respectivamente. Foi observada associação estatisticamente significativa entre: soropositividade para N. caninum e raça, histórico de suplementação alimentar para bezerros, introdução de animais externos que, posteriormente, apresentaram problemas reprodutivos e histórico de problemas reprodutivos no segundo trimestre de gestação. O presente estudo destaca a importância da neosporose em bovinos leiteiros, nas regiões de estudo, e a inclusão deste parasita na investigação de animais com distúrbios reprodutivos é fundamental.

Molecular characterization and epidemiology of Toxoplasma gondii isolates from free-range chickens in the southwest region of Goiás: new genotypes.

The purpose of this study was to isolate Toxoplasma gondii from tissues of free-range chickens in the southwestern region of Goiás, to detect and molecularly characterize the genetic material of the parasite, and to determine the seroprevalence of the protozoan parasite in these animals. A seroprevalence of T. gondii antibodies of 76% (19/25) was found among the chickens, while genetic material from their tissues was detected in 56% (14/25). A total of 14 isolates was obtained in the bioassay, ten of which were considered acute, eight were considered isolates of high virulence lethal to mice, and four of low virulence, considered non-lethal but with the ability to chronify the infection. Seven of the ten isolates showed significant morphometric differences from the RH strain, in terms of nucleus-complex-apical distance, length and width. Genotyping of the acute isolates was performed by RFLP-PCR, using 11 genetic markers: SAG1, SAG2 (3'SAG2 and 5'SAG2), alt.SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and APICO. The results were compared and classified according to the genotypes listed on the ToxoDB Platform, where different profiles were observed indicating the presence of two known genotypes (#7 and #63) and five new genotypes (NEW 3, NEW4, NEW5, NEW6, NEW 7). The results showed high seroprevalence, isolation rate, molecular detection and genotypic variations of T. gondii in free-range chickens in the southwestern region of Goiás.

Molecular characterization of Cryptosporidium in ruminants and observation of natural infection by Cryptosporidium andersoni in sheep from Paraná, Brazil.

The aim of this study was to identify Cryptosporidium species found in cattle and sheep in Paraná, southern region of Brazil. Individual fecal samples from 458 bovines and 101 sheep were submitted for molecular analysis by PCR and nested PCR using specific primers for sequences of the 18S ribosomal unit (rRNA). Positive samples were analyzed using restriction fragment length polymorphism (RFLP), followed by genetic sequencing for species confirmation. The occurrence of Cryptosporidium was 11.27% (63/559). The highest occurrence was detected in lambs (12/59, 20.33%). From the 63 positive samples, it was possible to identify the species in 58 of them by RFLP and genetic sequencing. Five species of Cryptosporidium were identified: Cryptosporidium andersoni, Cryptosporidium bovis, Cryptosporidium ryanae, Cryptosporidium xiaoi, and Cryptosporidium parvum. The most prevalent species was C. andersoni (41.38%) and the least predominant was C. parvum (10.34%). The most abundant species of Cryptosporidium in dairy calves were C. andersoni (11/25) and C. ryanae (6/25). Of the 17 positive sheep, nine (52.94%) were infected with C. andersoni. This finding is the first report on the occurrence of C. andersoni in naturally infected sheep in Brazil and the first observation of a high absolute occurrence of this Cryptosporidium species in sheep.

Recent advances in the treatment of pain in endometriosis: A bibliometric analysis of experimental models.

Background and Aim: Treatment of endometriosis involves pain relief which is achieved through the administration of analgesics and non-steroidal anti-inflammatory drugs, with or without the addition of hormone therapy. At present, studies investigating endometriosis pain management using experimental rat models and the use of medications are scarce. Therefore, this study aimed to systematically evaluate research trends and critical points in the field of endometriosis pain management using experimental models. Materials and Methods: A total of 30 publications related to this topic that were published from 2012 to 2022 were retrieved from various databases, including Web of Science, Scopus, PubMed, Embase, and CINAHL, using appropriate English keywords. The quality of the publications was evaluated using impact metrics, productivity, term density mapping, and author network. Results: The average publication rate was three articles per year, reaching its peak in 2021 at five articles per year. The United States and China were found to be the most productive countries, with 12 and 10 publications per year, respectively. The field of medicine (37.0%) was the most abundant, although the H-index was relatively low (13:13). Term density mapping involved the search of 542 keywords, of which 35 were selected, with only 8 exhibiting significant density. Conclusion: In the past decade, there has been a shortage of publications that have addressed pain in endometriosis in experimental models and, within this context the majority of the production and publication in this field has been performed by the United States and China. After performing this bibliometric review, it can be inferred that more research is required in this field, to develop new approaches and treatments for endometriotic pain.

SEROLOGICAL SURVEY FOR SELECTED PATHOGENS IN FREE-RANGING COUGARS (PUMA CONCOLOR) IN SÃO PAULO, BRAZIL.

This study performed a serological assay to assess the exposure of free-ranging cougars (Puma concolor) to four selected infectious agents, including Toxoplasma gondii, Leptospira spp., the feline immunodeficiency virus (FIV), and the feline leukemia virus (FeLV). Serum samples were collected from 27 free-ranging cougars along the Tietê River Basin, in the central region of the State of São Paulo, Brazil. The presence of antibodies against T. gondii was detected in 59.3% (16/27) of the serum samples through the modified agglutination test (MAT-t), which was the most prevalent agent. The microscopic agglutination technique (MAT-1) was used to investigate the occurrence of anti-Leptospira spp. antibodies, showing that 11.1% (3/27) of the sampled cougars were seropositive. The only serovar detected was Djasiman (L. interrogans). A commercial enzyme-linked immunosorbent assay (ELISA) licensed for use in domestic felines was used to investigate the occurrence of retroviruses. The ELISA test kits detected a prevalence of 11.1% (3/27) of FIV antibodies, while none of the samples tested showed any evidence of FeLV antigen. These results suggest that free-ranging cougars are exposed to potentially pathogenic agents. This study presented the first recorded occurrence of the serovar Djasiman in P. concolor.

The value of the International Association for the Study of Pain to developing countries.

ABSTRACT: Since it was founded, the International Association for the Study of Pain (IASP) has been at the forefront of improving pain research, education, and effective pain management in both developed and developing countries. As IASP activities progressed, major differences between the practice of pain management, education, and research in developed countries compared with developing countries were identified. This led to areas of focus by IASP that included pain education to address poor knowledge of pain assessment and treatment, prioritization of pain management by governments and official national legislation and programs, and availability of pain treatments (especially potent analgesics). A few pioneering IASP members from developing countries in the early years encouraged more multidisciplinary professionals to join IASP and attend conferences. Inauguration of national and regional chapters was also encouraged, and regular continuing medical education programs were held, especially on topics from IASP conferences and global pain events. Many IASP chapters in developing countries have established collaborations with groups from developed countries, whereas IASP also implemented other innovative approaches including the developing countries working group, educational grants, pain camps, and multidisciplinary pain hubs with toolkits to develop pain experts for regions in the developing world. Thus, the influence of IASP in many developing countries has had a multiplier effect on the progress made in effective pain management, education, and research. Nonetheless, challenges remain and include better integration of pain management, education, and research in national health systems and academic programs for health professionals.

A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic.

OBJECTIVE: To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo. METHODS: Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period. RESULTS: A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency. CONCLUSION: The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.

OBJETIVO: Analisar o impacto pandemia de COVID-19 sobre a residência de ginecologia e obstetrícia do Estado de São Paulo. MéTODOS: Estudo transversal desenvolvido por representantes dos residentes da Associação de Ginecologia e Obstetrícia do Estado de São Paulo (SOGESP). Foram coletados dados de questionários aplicados aos residentes de ginecologia e obstetrícia cadastrados no site da SOGESP em fevereiro de 2022. Os entrevistados responderam sobre repercussões da pandemia sobre a residência médica e se tiveram suporte técnico e psicológico durante o período. RESULTADOS: Foram levantados 247 questionários de residentes de ginecologia e obstetrícia. Os residentes apresentaram idade de 28,3 ± 3 anos, sendo a maioria do sexo feminino (88,4%). O deslocamento para "covidários" foi referido por 62,34% dos avaliados, porém somente 35,6% referiram equipamento de proteção individual completamente adequado e apenas 7,7% referiram instrução completa teórica e técnica para o suporte destes pacientes. Quase a totalidade dos entrevistados afirmou que o setor de ginecologia foi o mais afetado. A maioria dos entrevistados considerou que o os residentes do segundo ano foram os que tiveram maior prejuízo, sendo que mais da metade dos residentes do 1° e 2° ano afirmou ter desejado desistir da residência durante a pandemia. Mais de 80% dos residentes referiram aulas teóricas e/ou apresentação de artigos online, reforçando o fato de que as atividades virtuais ganharam um espaço maior dentro da residência médica. CONCLUSãO: A pandemia impactou nas residências em maior proporção nos ambulatórios e cirurgias ginecológicas, interferindo também sobre o desejo do médico de seguir com o programa.

A Study of the Current Scenario of the Obstetrics and Gynecology Residency during the COVID-19 Pandemic / Um estudo do cenário atual da residência em obstetrícia e ginecologia durante a pandemia de COVID-19

Abstract Objective To analyze the impact of the COVID-19 pandemic on the residency of gynecology and obstetrics in São Paulo. Methods Cross-sectional study developed by representatives of residents of the Association of Gynecology and Obstetrics of the State of São Paulo (SOGESP, in the Portuguese acronym). Data were collected from questionnaires applied to gynecology and obstetrics residents registered on the SOGESP website in February 2022. The interviewees answered about the repercussions of the pandemic on medical residency and whether they had technical and psychological support during the period. Results A total of 247 questionnaires were collected from residents of gynecology and obstetrics. The residents had an age of 28.3 ± 3 years old, and most of them were female (88.4%). The displacement to COVID care was reported by 62.34% of the students, but only 35.6% reported completely adequate personal protective equipment and only 7.7% reported complete theoretical and technical instruction to support these patients. Almost all of the interviewees stated that the gynecology sector was the most affected. The majority of the interviewees considered that the second-year residents had the greatest loss, and more than half of the residents in the 1st and 2nd year said they wished to give up their residency during the pandemic. More than 80% of the residents reported online theoretical classes and/or presentation of articles, reinforcing the fact that virtual activities gained a greater space within the medical residency. Conclusion The pandemic impacted the residency in greater proportion in outpatient clinics and gynecological surgeries, also interfering with the physician's desire to continue with the program.

Resumo Objetivo Analisar o impacto pandemia de COVID-19 sobre a residência de ginecologia e obstetrícia do Estado de São Paulo. Métodos Estudo transversal desenvolvido por representantes dos residentes da Associação de Ginecologia e Obstetrícia do Estado de São Paulo (SOGESP). Foram coletados dados de questionários aplicados aos residentes de ginecologia e obstetrícia cadastrados no site da SOGESP em fevereiro de 2022. Os entrevistados responderam sobre repercussões da pandemia sobre a residência médica e se tiveram suporte técnico e psicológico durante o período. Resultados Foram levantados 247 questionários de residentes de ginecologia e obstetrícia. Os residentes apresentaram idade de 28,3 ± 3 anos, sendo a maioria do sexo feminino (88,4%). O deslocamento para "covidários" foi referido por 62,34% dos avaliados, porém somente 35,6% referiram equipamento de proteção individual completamente adequado e apenas 7,7% referiram instrução completa teórica e técnica para o suporte destes pacientes. Quase a totalidade dos entrevistados afirmou que o setor de ginecologia foi o mais afetado. A maioria dos entrevistados considerou que o os residentes do segundo ano foram os que tiveram maior prejuízo, sendo que mais da metade dos residentes do 1° e 2° ano afirmou ter desejado desistir da residência durante a pandemia. Mais de 80% dos residentes referiram aulas teóricas e/ou apresentação de artigos online, reforçando o fato de que as atividades virtuais ganharam um espaço maior dentro da residência médica. Conclusão A pandemia impactou nas residências em maior proporção nos ambulatórios e cirurgias ginecológicas, interferindo também sobre o desejo do médico de seguir com o programa.

Prejudice impairing quality of life in sickle cell disease patients in a developing country: faces of suffering

ABSTRACT Introduction: The perception of prejudice against, and stigmatization of, sickle cell disease (SCD) leads the patient to perceive a different treatment, due to the disease stigma and maybe related to a worse quality of life (QoL). Objectives: Describe and evaluate the perception of the prejudice against the disease and its impact on the quality of life of patients with sickle cell disease. Methods: This is a cross-sectional study conducted between March 2019 and February 2020, with patients diagnosed with SCD. Patients were questioned about the perception of prejudice in any kind of situation, choosing between "Yes" or "No", not differentiating situations related to prejudice. To assess the QoL and impact of the disease, the volunteers answered a version of the SF-36 questionnaire translated and validated into Brazilian Portuguese. Results: In this study, 113 patients with SCD were followed up, 92% were classified as HbSS and the rest, divided between HbSC and HbS-β-0. Regarding the SF-36, the worst scores were in the summary of the physical components (mean 48.19 ± 21.51) and the physical aspect had the lowest mean (30.75 ± €42.65). When questioned if they had already perceived any kind of prejudice, including the SCD, 32.74% answered "Yes". For this comparison, there was a significant difference in the summary of the physical and mental components, with worse QoL for those who had already suffered prejudice. Conclusion: Patients diagnosed with SCD who reported perception of prejudice had statistically significant worse QoL, revealing the negative impact, that might lead to sadness and social isolation.