Factors associated to mortality in children with critical COVID-19 and multisystem inflammatory syndrome in a resource-poor setting.

SARS-CoV-2 infection in children is usually asymptomatic/mild. However, some patients may develop critical forms. We aimed to describe characteristics and evaluate the factors associated to in-hospital mortality of patients with critical COVID-19/MIS-C in the Amazonian region. This multicenter prospective cohort included critically ill children (1 mo-18 years old), with confirmed COVID-19/MIS-C admitted to 3 tertiary Pediatric Intensive Care Units (PICU) in the Brazilian Amazon, between April/2020 and May/2023. The main outcome was in-hospital mortality and were evaluated using a multivariable Cox proportional regression. We adjusted the model for pediatric risk of mortality score version IV (PRISMIV) score and age/comorbidity. 266 patients were assessed with 187 in the severe COVID-19 group, 79 included in the MIS-C group. In the severe COVID-19 group 108 (57.8%) were male, median age was 23 months, 95 (50.8%) were up to 2 years of age. Forty-two (22.5%) patients in this group died during follow-up in a median time of 11 days (IQR, 2-28). In the MIS-C group, 56 (70.9%) were male, median age was 23 months and median follow-up was 162 days (range, 3-202). Death occurred in 17 (21.5%) patients with a median death time of 7 (IQR, 4-13) days. The mortality was associated with higher levels of Vasoactive Inotropic-Score (VIS), presence of acute respiratory distress syndrome (ARDS), higher levels of Erythrocyte Sedimentation Rate, (ESR) and thrombocytopenia. Critically ill patients with severe COVID-19 and MIS-C from the Brazilian Amazon showed a high mortality rate, within 12 days of hospitalization.

Efectos de azúcares totales sustitutos de sacarosa en la salud bucal. Revisión bibliográfica / Effects of sucrose substitute total sugars on oral health. Bibliographic review

Se realizó una revisión bibliográfica sobre los efectos de azúcares totales sustitutos de sacarosa sobre el estado de salud bucal. Los artículos científicos fueron localizados en bases de datos científicas digitales: Scopus, PubMed, Web Of Science y Ovid. Las fuentes empleadas son de libre acceso, 49 de los manuscritos fueron descartados, quedando 23. El 43,5% de los artículos mostraban resultados de ensayos clínicos sobre las gomas de mascar con xilitol, el 39,1% acerca de otros compuestos (stevia, magnolia, eritritol, fostato de calcio), el 13% revisiones narrativas y el 4,4% metaanálisis. Las gomas de mascar hechas con sustitutos de sacarosa estimulan la producción salival, neutralizan y elevan su pH, reconociéndosele su función promotora de salud bucal en varias publicaciones científicas. Los efectos anticariogénicos del xilitol están establecidos en diversos estudios. No existen suficientes estudios sobre los efectos de las sustancias: stevia, d-tagatosa, magnolia, eritritol y fostato de calcio.

A bibliographic review was carried out on the effects of sucrose substitute total sugars on the state of oral health. The scientific articles were in the following digital scientific databases: Scopus, PubMed, Web of Science and Ovid. The sources used were freely accessible, 49 of the manuscripts gotten by the search were discarded and 23 were used. 43.5% of the articles inclu-ded showed results of clinical trials on chewing gums with xylitol, 39.1% about other com-pounds (stevia, magnolia, erythritol, calcium phosphate), 13% narrative reviews and the 4.4% meta-analysis. Chewing gums made with sucrose substitutes stimulate salivary production, neutralize and raise its pH. That is why, its role in promoting oral health is recognized in several scientific publications. The anticariogenic effects of xylitol were established in various studies. There were not enough studies on the effects of the substances: stevia, d-tagatose, magnolia, erythritol and calcium phosphate

Caracteristicas del enfoque global en la dependencia al teléfono móvil en adolescentes de la Unidad Educativa Adventista Miraflores / Characteristics of the global approach to mobile phone dependence in adolescents of the Miraflores Adventist Educational Unit

La presente investigación tiene como propósito determinar las características del enfoque global en la dependencia al teléfono móvil en adolescentes, entendiendo el concepto de dependencia como el uso constante del celular estableciéndose una relación muy cercana con el teléfono más que con cualquier otro objeto o persona.

Multisystem Inflammatory Syndrome Associated With Coronavirus Disease in Children: A Multi-centered Study in Belém, Pará, Brazil.

We described the characteristics of 11 children with pediatric multisystem inflammatory syndrome-temporally associated with SARS-CoV-2. The main clinical indications for hospital admission were vasogenic toxic shock (n = 2), Kawasaki disease (n = 4), and Kawasaki disease shock syndrome (n = 5). The echocardiography findings were abnormal in 63% of cases. All patients had 2 or more organ dysfunctions, and the mortality rate was 18%.

Design, Synthesis and Antileishmanial Activity of Naphthotriazolyl-4- Oxoquinolines.

BACKGROUND: Leishmaniasis is a neglected public health problem caused by several protozoanspecies of the genus Leishmania. The therapeutic arsenal for treating leishmaniasis is quite limited, raising concerns about the occurrence of resistant strains. Furthermore, most of these drugs were developed more than 70 years ago and suffer from poor efficacy and safety and are not well adapted to the needs of patients. Therefore, research on novel natural or synthetic compounds with antiparasitic activity is urgently needed. In this paper, we evaluated the effect and the mechanism of action of naphthotriazolyl-4-oxoquinolines on promastigotes and intracellular amastigotes of Leishmania amazonensis. MATERIALS AND METHODS: The naphthotriazolyl-4-oxoquinoline derivatives were obtained in good to moderate yields via the [3+2] cycloaddition reaction between 1,4-naphtoquinone and azido-4- oxoquinoline derivatives. HMPA at 100°C was established as the best solvent and temperature condition for this reaction. The structures of the compounds were confirmed by spectral analyses (infrared spectroscopy, one- and two-dimensional ¹H and ¹³C NMR spectroscopy, and high-resolution mass spectrometry). The compounds exhibited promising activities with IC50 values ranging from 0.7 to 2.0 µM against intracellular amastigotes of Leishmania amazonensis. The most selective compound was the Npentyl- substituted derivative, which showed a Selectivity Index (SI) of 8.6, making it less toxic than pentamidine (SI 4.5). RESULTS: Our results demonstrated that all compounds, except the N-propyl-substituted derivative, induce ROS production by parasites early in the culture. As a proof of concept, we demonstrated that the most selective compound was able to interfere with sterol biosynthesis in L. amazonensis. CONCLUSION: The naphthotriazolyl-4-oxoquinoline derivatives were obtained in good to moderate yields. These conjugates have potent in vitro antileishmanial activity involving at least two different mechanisms of action, making them promising lead compounds for the development of new therapeutic alternatives for leishmaniasis.

A Novel Naphthotriazolyl-4-oxoquinoline Derivative that Selectively Controls Breast Cancer Cells Survival Through the Induction of Apoptosis.

BACKGROUND: Breast cancer is a major cause of death among women worldwide. Treatment for breast cancer involves the surgical removal of cancer tissue, followed by chemotherapy. Although the treatment is efficient, especially when the cancer is detected early, recurrence is common and is often resistant to the previous treatment. Therefore, a constant search for efficient and novel drugs for the treatment of breast cancer is mandatory. Recently, triazole derivatives have shown promising effects against different types of cancer, revealing these molecules as putative anticancer drugs. EXPERIMENTAL: We have synthesized a series of naphthotriazolyl-4-oxoquinoline derivatives and tested their activity against a human breast cancer cell line. Among the compounds tested, we identified a molecule that killed the human breast cancer cell line MCF-7 with minimal effects on its noncancer counterpart, MCF10A. This effect was seen after 24 hours of treatment and persisted for additional 24 hours after treatment withdrawal. After 1 hour of treatment, the compound, here named 12c, promoted a decrease in cell glucose consumption and lactate production. Moreover, the cells treated with 12c for 1 hour showed diminished intracellular ATP levels with unaltered mitochondrial potential and increased reactive oxygen species production. Additionally, apoptosis was triggered after treatment with the drug for 1 hour. All of these effects are only observed with MCF-7 cells, and not MCF10A. These data show that 12c has selective activity against breast cancer cells and is a potential candidate for a novel anticancer drug. RESULTS AND CONCLUSION: The naphthotriazolyl-4-oxoquinoline derivatives were obtained in good to moderate yields, and one of them, 12c, exhibited strong and selective antitumor properties. The antitumor mechanism involves inhibition of glycolysis, diminished intracellular ATP levels, induction of ROS production and triggering of apoptosis. These effects are all selective for cancer cells, since noncancer cells are unaffected, and these effects can only be attributed to the whole molecule, as different pharmacophoric groups did not reproduce these effects.

Performance of soybean cultivars at different doses of base fertilization on Brachiaria decumbens straw / Desempenho de cultivares de soja em diferentes doses de adubação de base sobre palhada de Brachiaria decumbens

The deployment of soybean under no-tillage in degraded pasture has been a trivial practice, and the efficient and rational use of fertilizers is a decisive to its economic viability factor. The objective was to evaluate the agronomic performance of six cultivars subjected to doses of basic fertilization with NPK and straw grown on Brachiaria decumbens. The experiment was conducted in the experimental area of the State University of Mato Grosso do Sul, Unit Aquidauna. The experimental design was a randomized block design in split plot design with four replications. The plots consisted of six soybean cultivars (NA 5909 RR, M SOY 7908 RR, BMX Magna RR, BRS 245 RR, SYN 3358 RR, BMX Potência RR) and the subplots of five doses of NPK (0, 50, 100, 200 and 400 kg ha-1). Were evaluated plant height, first pod height, number of ramifications per plant, mass of 1000 grains and grain yield. Increased doses of fertilizer caused a linear increase in all variables in all cultivars, being recommended for degraded pastures base fertilization with 400 kg ha-1 of NPK. The varieties BMX Power RR 3358 and RR SYN showed higher mass of 1000 grains and consequently higher grain yield.

A implantação da cultura da soja sob plantio direto em pastagem degradada vem sendo uma prática trivial, e o uso eficiente e racional de fertilizantes é um fator decisivo para a sua viabilidade econômica. O objetivo foi avaliar o desempenho agronômico de seis cultivares submetidas a doses adubação de base com NPK e cultivadas sobre palhada de Brachiaria decumbens. O experimento foi conduzido na área experimental da Universidade Estadual de Mato Grosso do Sul, Unidade de Aquidauana (UEMS/UUA). O delineamento experimental foi em blocos casualizados em esquema parcelas subdivididas, com quatro repetições. As parcelas foram constituídas de seis cultivares de soja (NA 5909 RR, M SOY 7908 RR, BMX Magna RR, BRS 245 RR, SYN 3358 RR, BMX Potência RR) e as subparcelas por cinco doses de NPK (0, 50, 100, 200 e 400 kg ha-1). Foram avaliados a altura da planta, altura da primeira vagem, número de ramificações por planta, massa de 1000 grãos e produtividade de grãos. O aumento das doses de fertilizante causou um incremento linear em todas as variáveis avaliadas em todas cultivares avaliadas, sendo recomendada para pastagens degradadas à adubação de base com 400 kg ha-1 de NPK. As variedades BMX Potencia RR e SYN 3358 RR apresentaram maior massa de 1000 grãos e, consequentemente, maior produtividade de grãos.

Curricular intersections of university extension and teaching in Physical Therapy programs / Intersecções curriculares da extensão universitária com o ensino nos cursos de Fisioterapia

Introduction University extension can be a vehicle for social change and aid in the education of university students; however, it is important to study how it is inserted in university programs so that educational actions and policies can be planned more adequately. Objectives To study the insertion of extension activities in undergraduate physical therapy curricula in Brazilian federal universities. Method Documentary research conducted by accessing files available on the Internet. Data were analyzed quantitatively in the form of numbers and percentages. We examined documents from 22 of the 29 federal universities that offered physical therapy programs. Results University extension takes the form of complementary academic activities together with other options such as participating in conferences, specific training courses and working as a teaching assistant. Undergraduate physical therapy courses have a 4,000h to 4,925h course load, of which 0.72% to 8.9% are dedicated to extension activities. Conclusion The data indicate that the insertion of extension activities in undergraduate physical therapy programs offered by Brazilian federal universities needs to be reassessed according to recommended policies and guidelines. .

Introdução A Extensão Universitária pode ser um veículo de modificação social e de aprendizado para os acadêmicos; portanto, o estudo de sua inserção nos cursos pode contribuir para o planejamento de ações e políticas educacionais. Objetivo Estudar a inserção de atividades de Extensão Universitária nos currículos dos cursos de graduação em Fisioterapia das universidades federais brasileiras. Método Foi realizada uma pesquisa documental, buscando arquivos disponibilizados na internet. Os dados foram analisados quantitativamente por meio de números brutos e porcentagens. Estudou-se documentos de 22 das 29 universidades federais que oferecem cursos de Fisioterapia. Resultados Verificou-se que as atividades de extensão são inseridas na forma de atividades acadêmicas complementares, em conjunto com atividades como participação em congressos, monitorias e cursos de aperfeiçoamento. A carga horária total dos cursos de graduação em Fisioterapia varia de 4.000h a 4.925h, e a porcentagem aproveitada para a extensão varia de 0,72% a 8,98%. Conclusão Os dados mostram que a inserção da extensão nos cursos federais de Fisioterapia necessita ser repensada segundo as políticas e diretrizes preconizadas. .

Utilización terapéutica de la criocirugía en el melanoma extensivo superficial (spreading) / Therapeutic use of cryosurgery in the spreading superficial melanoma

Se presenta la siguiente revisión bibliográfica, orientada a los colegas médicos, en la práctica general, con la finalidad de obtener un acertado diagnóstico en la evaluación de una lesión tumoral pigmentada, así como describir modalidades terapéuticas existentes para el tratamiento del melanoma superficial de Spreading. Y entre éstos, una prácticamente inusual, como lo es la técnica crioquirúrgica que escapa de los lineamientos convencionales, como son, los que a continuación se menciona: quimioterapia, radioterapia, exsición local, exsición con margen de seguridad, exsición con linfadenectomía, exsición radical, etc. Hay ensayos terapéuticos como: el uso del DNCB (dinitroclorobenzeno), para prueba de sensibilidad de la piel que nos permita valorar el pronóstico del melanoma maligno; si disminuye la sensibilidad, indica malignidad avanzada. Se ha usado el DTIC, Imadozole dicarboxamida más la BCG como prueba terapéutica, así como el uso del corynebacterium-parvum en pacientes post-quirúrgicos, por el riesgo de recurrencia. Debemos mencionar también los ensayos terapéuticos con el antiestrógeno tamoxifeno.

The following bibliographic revision is presented, oriented to the colleagues in general practice with the aim to obtain a correct diagnosis in the assessment of a pigmented tumorous lesion as well as to describe existing therapeutic methods for treatment of spreading superficial melanoma, and among them, one that is practically unusual as it is the cryosurgical technique which is out of the conventional directions as those we mention next: chemotherapy, radio therapy, local excision, excision with margin of safety, excision with lymphadenectomy, radical excision, etc. There are therapeutic trails such as: use of DNCB (dinitrichlorobenzene), as a sensitivity test that allows us to value the prognosis of the malignant melanoma; if sensitivity lessens, I means advanced malignancy. DTIC, Imidazole dicarboxamida has been used, plus BCG as a therapeutic test, as well as corynebacterium-parvum in post-surgical patients, because of the recurrence risk. We must also mention the therapeutic trials with the anti-estrogen tamoxiphene.

Perfil de adolescentes grávidas, internadas em dois hospitais públicos / Profile of pregnant teenagers, hospitalized in two public hospitals

A gravidez em adolescentes constitui assunto de importância biopsicossocial e caracteriza-se pela complexidade das ações de saúde necessárias para a adequada solução dos problemas específicos da gestação em idade precoce. A casuística é constituída de 638 adolescentes grávidas atendidas em dois hospitais públicos situados na cidade de São Paulo. Eram procedentes, em sua maioria, da região Sudeste, com baixo nível de escolaridade, convivendo em estado conjugal não-regularizado e sem ocupação profissional. Referiram ter recebido orientação sexual 46,68 por cento das jovens, porém, a não-utilização de métodos contraceptivos (79,83 por cento) resultou, para a maioria das adolescentes, em gravidez não-planejada (75,96 por cento). Ainda assim, aproximadamente 20 por cento das adolescentes eram multíparas. As informações acerca da sexualidade foram, segundo as jovens, obtidas em ambiente escolar (43,79 por cento). O acompanhamento pré-natal, em média, foi considerado insuficiente. A perspectiva de vida dessas adolescentes não é das mais promissoras em vista de, apenas, 2,61 por cento delas estarem empregadas e, ao mesmo tempo, inseridas em ambiente educacional.

Gravidez em adolescentes: o papel da escola pública / Teenage pregnancy: the role of the public school

A erotização social tem levado nossos jovens a se lançarem cada vez mais precocemente na vida sexual. Resultante desta prática computamos o aumento de gestações em adolescentes. Foram sujeitos neste trabalho 362 gestantes e/ou puérperas menores de 18 anos, internadas entre novembro de 1996 e novembro de 1997, em hospital público de São Paulo. Todas responderam a questionário que abrangia: dados pessoais, gestacionais e projetos de vida. A maioria possuía escolaridade até 5ª série do Ensino Fundamental, renda familiar de 3 a 5 salários mínimos, encontrando-se fora da escola e do mercado de trabalho e não tendo recebido orientação sexual. A análise da pesquisa possibilita a conclusão de que a escola pública não vem desempenhando o seu papel social, no que diz respeito à orientação sexual dos jovens. As raras escolas que trabalham com orientação sexual geralmente a realizam tardiamente e com estratégias que não favorecem a transformação das mesmas em ações preventivas. Para se garantir que um número maior de adolescentes recebessem alguma orientação sobre sexualidade, as escolas deveriam fazê-la de maneira contínua e antes da 4ª série do Ensino Fundamental (AU)

Gravidez em adolescentes: o papel da escola pública / Teenage pregnancy: the role of the public school

A erotização social tem levado nossos jovens a se lançarem cada vez mais precocemente na vida sexual. Resultante desta prática computamos o aumento de gestações em adolescentes. Foram sujeitos neste trabalho 362 gestantes e/ou puérperas menores de 18 anos, internadas entre novembro de 1996 e novembro de 1997, em hospital público de São Paulo. Todas responderam a questionário que abrangia: dados pessoais, gestacionais e projetos de vida. A maioria possuía escolaridade até 5ª série do Ensino Fundamental, renda familiar de 3 a 5 salários mínimos, encontrando-se fora da escola e do mercado de trabalho e não tendo recebido orientação sexual. A análise da pesquisa possibilita a conclusão de que a escola pública não vem desempenhando o seu papel social, no que diz respeito à orientação sexual dos jovens. As raras escolas que trabalham com orientação sexual geralmente a realizam tardiamente e com estratégias que não favorecem a transformação das mesmas em ações preventivas. Para se garantir que um número maior de adolescentes recebessem alguma orientação sobre sexualidade, as escolas deveriam fazê-la de maneira contínua e antes da 4ª série do Ensino Fundamental