Body fat predicts urinary tract infection in kidney transplant recipients: a prospective cohort study.

BACKGROUND: The association between obesity and infectious diseases is increasingly reported in the literature. There are scarce studies on the association between obesity and urinary tract infection after kidney transplantation (KTx). These studies defined obesity based on body mass index, and their results were conflicting. The present study aimed to evaluate this association using bioelectrical impedance analysis for body composition evaluation, and obesity definition. METHODS: A single-center cohort study was conducted. Demographic, clinical, anthropometric, and laboratory data were collected at KTx admission, and bioelectrical impedance analysis was performed to measure the visceral fat area, waist circumference, and total fat mass. The occurrence of urinary tract infection (symptomatic bacteriuria and/or histological evidence of pyelonephritis) was evaluated within three months after KTx. RESULTS: Seventy-seven patients were included in the cohort, and 67 were included in the final analysis. Urinary tract infection was diagnosed in 23.9% of the transplanted patients. Waist circumference (HR: 1.053; 95% CI 1.005-1.104; p = 0.032), visceral fat area (HR: 1.015; 95% CI 1.003-1.027; p = 0.014), and total fat mass (HR: 1.075; 95% CI 1.008-1.146; p = 0.028) were associated with urinary tract infection occurrence after KTx, using Cox regression models. Patients with high waist circumference (above 102 cm for men and above 88 cm for women) had a 4.7 times higher risk of a urinary tract infection than those with normal waist circumference (HR: 4.726; 95% CI 1.267-17.630; p = 0.021). Kaplan-Meier curves showed that patients with high waist circumference, high visceral fat area, and high total fat mass had more urinary tract infections (Log-rank test p = 0.014, p = 0.020, and p = 0.018, respectively). Body mass index was not able to predict urinary tract infection in the study sample. CONCLUSIONS: Waist circumference, visceral fat area, and total fat mass, assessed by bioelectrical impedance analysis, were predictors of urinary tract infection risk within the first three months after KTx.

Standardization of Semi-Quantitative Dot Blotting Assay-Application in the Diagnosis, Follow-Up, and Relapse of Paracoccidioidomycosis.

INTRODUCTION: This study standardized a semi-quantitative dot blotting assay (DB) and a quantitative real-time polymerase chain reaction (qPCR) to detect specific antibodies for Paracoccidioides brasiliensis and its DNA in PCM patients. METHODOLOGY: We evaluated 42 confirmed PCM patients upon admission using a serological double agar gel immunodiffusion test (DID), DB, and molecular tests (qPCR in total blood). The control groups included 42 healthy individuals and 37 patients with other infectious diseases. The serological progress during treatment was evaluated in eight patients, and there was a relapse diagnosis in ten patients using the Pb B.339 strain antigen. The cut-off points for the serological tests were determined by a receiver operator characteristic curve. RESULTS: The DB and DID tests showed similar accuracy, but the DB identified lower antibody concentrations. Cross-reactions were absent in the DB assay. In the relapse diagnoses, DB exhibited much higher sensitivity (90%) than DID (30%). CONCLUSIONS: A DB assay is easier and faster than a DID test to be performed; DB and DID tests show the same accuracy, while blood qPCR is not recommended in the diagnosis at the time of admission; cross-reactions were not observed with other systemic diseases; DB and DID tests are useful for treatment monitoring PCM patients; and a DB assay is the choice for diagnosing relapse. These findings support the introduction of semi-quantitative DB assays in clinical laboratories.

Rapid Classification of Serum from Patients with Paracoccidioidomycosis Using Infrared Spectroscopy, Univariate Statistics, and Linear Discriminant Analysis (LDA).

Paracoccidioidomycosis (PCM) is a systemic mycosis that is diagnosed by visualizing the fungus in clinical samples or by other methods, like serological techniques. However, all PCM diagnostic methods have limitations. The aim of this study was to develop a diagnostic tool for PCM based on Fourier transform infrared (FTIR) spectroscopy. A total of 224 serum samples were included: 132 from PCM patients and 92 constituting the control group (50 from healthy blood donors and 42 from patients with other systemic mycoses). Samples were analyzed by attenuated total reflection (ATR) and a t-test was performed to find differences in the spectra of the two groups. The wavenumbers that had p < 0.05 had their diagnostic potential evaluated using receiver operating characteristic (ROC) curves. The spectral region with the lowest p value was used for variable selection through principal component analysis (PCA). The selected variables were used in a linear discriminant analysis (LDA). In univariate analysis, the ROC curves with the best performance were obtained in the region 1551-1095 cm-1. The wavenumber that had the highest AUC value was 1264 cm-1, achieving a sensitivity of 97.73%, specificity of 76.01%, and accuracy of 94.22%. The total separation of groups was obtained in the PCA performed with a spectral range of 1551-1095 cm-1. LDA performed with the eight wavenumbers with the greatest weight from the group discrimination in the PCA obtained 100% accuracy. The methodology proposed here is simple, fast, and highly accurate, proving its potential to be applied in the diagnosis of PCM. The proposed method is more accurate than the currently known diagnostic methods, which is particularly relevant for a neglected tropical mycosis such as paracoccidioidomycosis.

Experiencias del adulto mayor en tiempos de pandemia de Covid-19 / Experiences of the elderly in times of the Covid-19 pandemic

Objetivo principal: Comprender la experiencia del adulto mayor ante la pandemia por Covid-19. Metodología: Estudio cualitativo fenomenológico interpretativo, realizado con adultos mayores sin deterioro cognitivo de la ciudad de San Luis Potosí. Muestra determinada a partir de la saturación de datos. Se utilizó entrevista fenomenológica y análisis desde el abordaje de Max Van Manen. Resultados principales: En el análisis se identificaron las categorías: distintas formas de expresión del miedo, tejiendo lazos de ayuda durante el confinamiento por Covid-19, el circulo social como fuente de confirmación de los medios de comunicación, la incomodidad ante el uso de las medidas de protección personal, sufrimiento por las consecuencias económicas del Covid-19, la espiritualidad en tiempo de pandemia y las pérdidas del Covid-19. Conclusión principal: se identifica un estado de precariedad al vivir con miedo que condiciona un estado de sufrimiento mental.(AU)

Objective: Understand the experience of the elderly in the face of the Covid-19 infodemic. Methods: Qualitative interpretative phenomenological study, conducted with older adults without cognitive impairment in the city of San Luis Potosi. Sample determined from data saturation. Phenomenological interview and analysis from Max Van Manen's approach were used. Results: The analysis identified the following categories: different forms of expression of fear, weaving ties of help during Covid-19 confinement, the social circle as a source of confirmation from the media, discomfort with the use of personal protective measures, suffering due to the economic consequences of Covid-19, spirituality in times of pandemic and losses of Covid-19. Conclusions: a state of precariousness is identified by living in fear that conditions a state of mental suffering.(AU)

A Study on the Epidemiological-Molecular Role of Staphylococcus aureus Strains in the Development of Ventilator-Associated Pneumonia in a Tertiary Hospital in Brazil.

This study aimed to explore the molecular epidemiology of Staphylococcus aureus isolated from patients on mechanical ventilation and the participation of virulence factors in the development of ventilator-associated pneumonia (VAP). A prospective cohort study was conducted on patients under mechanical ventilation, with periodic visits for the collection of tracheal aspirates and clinical data. The S. aureus isolates were analyzed regarding resistance profile, virulence, expression of protein A and alpha-toxin using Western blot, clonal profile using PFGE, sequence type using MLST, and characterization and quantification of phenol-soluble modulins. Among the 270 patients in the study, 51 S. aureus strains were isolated from 47 patients. The incidence density of S. aureus and MRSA VAP was 2.35/1000 and 1.96/1000 ventilator days, respectively; of these, 45% (n = 5) were resistant to oxacillin, with 100% (n = 5) harboring SCCmec types II and IV. The most frequent among the tested virulence factors were icaA, hla, and hld. The clonal profile showed a predominance of sequence types originating from the community. Risk factors for VAP were the presence of solid tumors and the sea gene. In conclusion, patient-related risk factors, together with microbiological factors, are involved in the development of S. aureus VAP, which is caused by the patient's own strains.

COVID-19 Infodemic and Impacts on the Mental Health of Older People: Cross-sectional Multicenter Survey Study.

BACKGROUND: The COVID-19 pandemic received widespread media coverage due to its novelty, an early lack of data, and the rapid rise in deaths and cases. This excessive coverage created a secondary "infodemic" that was considered to be a serious public and mental health problem by the World Health Organization and the international scientific community. The infodemic particularly affected older individuals, specifically those who are vulnerable to misinformation due to political positions, low interpretive and critical analysis capacity, and limited technical-scientific knowledge. Thus, it is important to understand older people's reaction to COVID-19 information disseminated by the media and the effect on their lives and mental health. OBJECTIVE: We aimed to describe the profile of exposure to COVID-19 information among older Brazilian individuals and the impact on their mental health, perceived stress, and the presence of generalized anxiety disorder (GAD). METHODS: This cross-sectional, exploratory study surveyed 3307 older Brazilians via the web, social networks, and email between July 2020 and March 2021. Descriptive analysis and bivariate analysis were performed to estimate associations of interest. RESULTS: Major proportions of the 3307 participants were aged 60 to 64 years (n=1285, 38.9%), female (n=2250, 68.4%), and married (n=1835, 55.5%) and self-identified as White (n=2364, 71.5%). Only 295 (8.9%) had never started or completed a basic education. COVID-19 information was mainly accessed on television (n=2680, 81.1%) and social networks (n=1943, 58.8%). Television exposure was ≥3 hours in 1301 (39.3%) participants, social network use was 2 to 5 hours in 1084 (32.8%) participants, and radio exposure was ≥1 hour in 1223 (37%) participants. Frequency of exposure to social networks was significantly associated with perceived stress (P=.04) and GAD (P=.01). A Bonferroni post hoc test revealed significantly different perceived stress in participants who were exposed to social networks for 1 hour (P=.04) and those who had no exposure (P=.04). A crude linear regression showed that "some" social media use (P=.02) and 1 hour of exposure to social media (P<.001) were associated with perceived stress. Adjusting for sociodemographic variables revealed no associations with this outcome variable. In a crude logistic regression, some social media use (P<.001) and 2 to 5 hours of exposure to social media (P=.03) were associated with GAD. Adjusting for the indicated variables showed that some social network use (P<.001) and 1 hour (P=.04) and 2 to 5 hours (P=.03) of exposure to social media were associated with GAD. CONCLUSIONS: Older people, especially women, were often exposed to COVID-19-related information through television and social networks; this affected their mental health, specifically GAD and stress. Thus, the impact of the infodemic should be considered during anamnesis for older people, so that they can share their feelings about it and receive appropriate psychosocial care.

Desenvolvimento de um protótipo de software baseado na caderneta de saúde da pessoa idosa / Development of a software prototype based on the health booklet of the elderly person / Desarrollo de un prototipo de software basado en la cartilla de salud de la persona mayor

RESUMO: Objetivo: descrever o desenvolvimento de um protótipo de software baseado na Caderneta de Saúde da Pessoa Idosa, utilizando a Avaliação Heurística para análise de sua usabilidade. Método: pesquisa aplicada de desenvolvimento tecnológico, utilizando a Avaliação Heurística de Nielsen como forma de realizar a análise de usabilidade, iniciada em novembro de 2021 em Juiz de Fora e São João Del Rei. Resultados: o protótipo inicial conta com 5 telas, que contêm alguns dados relevantes para o cuidado em saúde da pessoa idosa, como idade, comorbidades e histórico de alergias. Os idosos conseguirão fazer a edição dos dados pessoais, mas somente os profissionais conseguirão incluir os dados de saúde dos pacientes, com o objetivo de torná-los mais fidedignos. Conclusão: a utilização deste aplicativo contribuirá para atualizar e avançar com o uso de tecnologias voltadas para o cuidado em saúde, e que trará benefícios para os sistemas de saúde e para os usuários.

ABSTRACT Objective: to describe the development of a software prototype based on the Health Booklet for the Elderly, using Heuristic Evaluation to analyze its usability. Method: applied technological development research, using Nielsen's Heuristic Evaluation as a way of carrying out usability analysis, which began in November 2021 in Juiz de Fora and São João Del Rei. Results: the initial prototype has 5 screens, which contain some relevant data for the health care of the elderly, such as age, comorbidities, and history of allergies. The elderly will be able to edit their personal data, but only professionals will be able to include the patient's health data, with the aim of making it more reliable. Conclusion: The use of this application will help to update and advance the use of technologies aimed at health care and will bring benefits to health systems and users.

RESUMEN Objetivo: describir el desarrollo de un prototipo de software basado en la Cartilla de Salud de la Persona Mayor, utilizando la Evaluación Heurística para analizar su usabilidad. Método: investigación aplicada de desarrollo tecnológico, utilizando la Evaluación Heurística de Nielsen como medio para realizar el análisis de usabilidad, iniciada en noviembre de 2021 en Juiz de Fora y São João Del Rei. Resultados: el prototipo inicial cuenta con 5 pantallas, que contienen algunos datos relevantes para el cuidado de la salud de las personas mayores, como la edad, las comorbilidades y el historial de alergias. Los ancianos podrán editar sus datos personales, pero sólo los profesionales podrán incluir los datos de salud del paciente, con el objetivo de hacerlo más fiable. Conclusión: El uso de esta aplicación contribuirá a actualizar y avanzar en el uso de las tecnologías destinadas a la atención sanitaria, y aportará beneficios a los sistemas de salud y a los usuarios.

Reproducibility of double agar gel immunodiffusion test using stored serum and plasma from paracoccidioidomycosis patients.

Background: Serological evaluation performed by double agar gel immunodiffusion test (DID) is used for diagnosis, evaluation of severity, management of paracoccidioidomycosis patients, and development of new clinical studies. For these reasons, the Botucatu Medical School of UNESP maintains a serum bank at the Experimental Research Unit with patient clinical data. This study aimed to evaluate the influence of the freeze-thaw cycle and different blood matrices on the titration of circulating antibodies. Methods: The study included 207 patients with confirmed (etiology-demonstrated) or probable (serology-demonstrated) paracoccidioidomycosis, and DID was performed with culture filtrate from Paracoccidioides brasiliensis B339 as antigen. First experiment: the antibody levels were determined in serum samples from 160 patients with the chronic form and 20 with the acute/subacute form, stored at -80oC for more than six months. Second experiment: titers of 81 samples of serum and plasma with ethylenediaminetetraacetic acid (EDTA) or heparin, from 27 patients, were compared according to matrix and effect of storage at -20oC for up to six months. Differences of titers higher than one dilution were considered discordant. Results: First experiment: test and retest presented concordant results in serum stored for up to three years, and discordant titers in low incidence in storage for four to six years but high incidence when stored for more than six years, including conversion from reagent test to non-reagent retest. Second experiment: serum, plasma-EDTA and plasma-heparin samples showed concordant titers, presenting direct correlation, with no interference of storage for up to six months. Conclusions: Storage at -80oC for up to six years has no or little influence on the serum titers determined by DID, permitting its safe use in studies depending on this parameter. The concordant titrations in different blood matrices demonstrated that the plasma can be used for immunodiffusion test in paracoccidioidomycosis, with stability for at least six months after storage at -20oC.

Infodemia de COVID-19 e estresse percebido em idosos que utilizam as mídias sociais / COVID-19 infodemic and perceived stress in elderly people who use social media

Objetivo: Analisar a relação entre infodemia de COVID-19 e estresse percebido em idosos que utilizam as mídias sociais. Métodos: Estudo transversal por web-based survey, 470 idosos respondentes a questões sociodemográficas, de exposição a informações sobre COVID-19, e sinais e sintomas associados ao sofrimento psíquico. Variável de desfecho avaliada pela Escala de Estresse Percebido e pontuação média segundo variáveis independentes comparada por teste t, análise de variância ou correlação de Pearson e construído modelo final por regressão linear múltipla. Resultados: As variáveis significativas no modelo final (p < 0,05) foram: exposição pela TV (β = -0,144; IC95 porcent= -11,195 - -1,609); exposição pelas redes sociais (β = -0,175; IC95 porcent= -8,117 - -0,837); rastreio positivo para sofrimento psíquico devido à exposição a informações sobre COVID-19 (β = -0,380; IC95 porcent= -16,033 - -8,975). Conclusão: A infodemia pode potencializar o estresse em idosos, demandando cuidados específicos para essa população e o fortalecimento de sua rede social(AU)

Objective: To analyze the relationship between COVID-19 infodemic and perceived stress in elderly people who use social media. Methods: Cross-sectional study using a web-based survey, 470 aged respondents to sociodemographic questions, exposure to information about COVID-19, and signs and symptoms associated with psychological distress. Outcome variable evaluated by the Perceived Stress Scale and mean score according to independent variables compared by t-test, analysis of variance or Pearson's correlation and final model constructed by multiple linear regression. Results: The significant variables in the final model (p < 0.05) were: TV exposure (β = -0.144; 95percentCI= -11.195 - -1.609); exposure through social networks (β = -0.175; CI95percent = -8.117 - -0.837); positive screening for psychological distress due to exposure to information about COVID-19 (β = -0.380; 95percentCI= -16.033 - -8.975). Conclusion: infodemic can increase stress in the elderly, demanding specific care for this population and the strengthening of their social network(AU)

Objetivo: Analizar la relación entre la infodemia de COVID-19 y el estrés percibido en ancianos usuarios de redes sociales. Métodos: Estudio transversal mediante una encuesta basada en la web; 470 ancianos que respondieron preguntas sociodemográficas, exposición a la información sobre la COVID-19 y los signos y síntomas asociados con la angustia psicológica. La variable se evaluó por la escala de estrés percibido y la puntuación media según las variables independientes, comparadas por t-test, análisis de variación o correlación de Pearson y el modelo final construido por regresión lineal múltiple. Resultados: Las variables significativas en el modelo final (p < 0,05) fueron: exposición a la televisión (β = -0,144; IC95 por ciento = -11,195 - -1,609); exposición a través de redes sociales (β = -0,175; IC95 por ciento = -8,117 - -0,837); cribado positivo de malestar psicológico por exposición a información sobre la COVID-19 (β = -0,380; IC95 por ciento= -16,033 - -8,975). Conclusiones: La infodemia puede aumentar el estrés en los ancianos, lo que exige cuidados específicos para esa población y el fortalecimiento de su red social(AU)

Implementação de Prontuário Eletrônico por profissionais médicos e enfermeiros da Atenção Primária à Saúde / Implementation of Electronic Medical Records by physicians and nurses in Primary Health Care

Objetivo: Avaliar a implementação o Prontuário Eletrônico do Cidadão da estratégia e-SUS na Atenção Primária a Saúde pelos médicos e enfermeiros de duas macrorregiões de saúde de Minas Gerais. Métodos: Estudo de método misto explanatório sequencial quanti-qualitativo. A coleta de dados ocorreu por meio de um formulário online. Foi construída uma matriz de análise e julgamento para avaliar e ponderar as questões avaliativas no instrumento de coleta. Resultados: De maneira geral, o grau de implementação de cada uma das funcionalidades (assistenciais e gerenciais) foi classificado como não adequado, mas há diferença quando se compara as profissões. Os dados mostram que a medicina quando comparada com a enfermagem tem a utilização do prontuário com escore menor, indicando que médicos informaram usar menos o prontuário eletrônico do que os enfermeiros. Conclusões: Apesar dos grandes esforços governamentais para expandir a implantação do prontuário eletrônico, sua implementação, de forma geral, ainda não é adequada. Dessa forma, a utilização do prontuário eletrônico como potencial qualificador de dados em saúde deve ser estimulada em direção à gestão e coordenação do cuidado(AU)

Objective: To evaluate the implementation of the Electronic Citizen's Record of the e-SUS strategy in Primary Health Care by physicians and nurses from two health macro-regions in Minas Gerais. Methods: Estudio de método mixto explicativo secuencial cuantitativo-cualitativo. Data collection took place through an online form. An analysis and judgment matrix were built to evaluate and weigh the evaluative questions in the collection instrument. Results: In general, the degree of implementation of each of the functionalities (assistance and management) was classified as not adequate, but there is a difference when comparing the professions. The data show that medicine, when compared to nursing, uses the medical record with a lower score, indicating that physicians reported using the electronic medical record less than nurses. Conclusions: Despite major government efforts to expand the implementation of electronic medical records, its implementation, in general, is still not adequate. Thus, the use of electronic medical records as a potential qualifier of health data should be encouraged towards the management and coordination of care(AU)

Objetivo: Evaluar la implementación del Registro Ciudadano Electrónico de la estrategia e-SUS en la Atención Primaria de Salud por médicos y enfermeros de dos macrorregiones de salud de Minas Gerais. Métodos: La recolección de datos se realizó a través de un formulario en línea, se construyó una matriz de análisis y juicio para evaluar y ponderar las preguntas evaluativas del instrumento de recolección. Resultados: En general, el grado de implantación de cada una de las funcionalidades (asistencia y gestión) fue catalogado como no adecuado, pero hay diferencias, al comparar las profesiones. Los datos muestran que la medicina, en comparación con la enfermería, utiliza la historia clínica con una puntuación más baja, lo que indica que los médicos utilizan menos la historia clínica electrónica que las enfermeras. Conclusiones: A pesar de los grandes esfuerzos gubernamentales por ampliar la implementación de la historia clínica electrónica, su implementación, en general aún no es adecuada. Por lo tanto, se debe fomentar el uso de la historia clínica electrónica como potencial calificador de datos de salud para la gestión y coordinación de la atención(AU)

Modelagem de sistema especialista para avaliação multidimensional de pessoas idosas / Expert system modeling for the multidimensional evaluation of aged people / Diseño de un sistema experto para la evaluación multidimensional del adulto mayor

RESUMO Objetivo: descrever a modelagem de um Sistema Especialista para Avaliação Multidimensional de pessoas idosas. Método: realizado no período de abril de 2021 a setembro de 2022, sendo conduzido por pesquisadores de universidades do interior de Minas Gerais - Brasil. Percorreu-se pelas etapas: revisão de literatura, levantamento dos requisitos para o Sistema, modelagem e implementação. Resultados: o Sistema possibilita avaliação dos aspectos físico, psicossocial e funcional, identifica as necessidades geriátrico-gerontológicas e as classifica de acordo com níveis de gravidade, além de oferecer sugestões de intervenções terapêuticas. As informações geradas podem ser compartilhadas por meio de mensageiros instantâneos através de aplicativos, dando base para o desenvolvimento de um painel de monitoramento das pessoas idosas assistidas no município. Conclusão: o Sistema se apresenta como uma solução tecnológica dada a importância da avaliação multidimensional da pessoa idosa no âmbito do cuidado a essa população e a carência de soluções tecnológicas para realizar a avaliação.

ABSTRACT Objective: to describe the modeling of an Expert System for the Multidimensional Evaluation of aged people. Method: the study was carried out from April 2021 to September 2022 by researchers from universities in the inland of Minas Gerais - Brazil. The following stages were conducted: literature review; survey of the System requirements; modeling; and implementation. Results: the System makes it possible to assess the physical, psychosocial and functional aspects; it identifies the geriatric-gerontological needs and classifies them according to severity levels, in addition to offering suggestions for therapeutic interventions. The diverse information generated can be shared through instant messengers via apps, providing the basis for the development of a monitoring panel for aged people assisted in the municipality. Conclusion: the System presents itself as a technological solution given the importance of the multidimensional evaluation of aged people within the scope of care for this population segment and the lack of technological solutions to carry out the assessment.

RESUMEN Objetivo: describir el diseño de un Sistema Experto para la Evaluación Multidimensional del adulto mayor. Método: estudio realizado, de abril de 2021 a septiembre de 2022, por investigadores de universidades del interior de Minas Gerais, Brasil. Pasó por los pasos: revisión de la literatura, relevamiento de los requisitos del Sistema, diseño e implementación. Resultados: el Sistema permite evaluar aspectos físicos, psicosociales y funcionales, identifica necesidades geriátrico-gerontológicas y las clasifica según el nivel de gravedad, además ofrece sugerencias de intervenciones terapéuticas. La información generada podrá ser compartida a través de mensajería instantánea mediante aplicaciones, y sentará las bases para el desarrollo de un panel de seguimiento de los adultos mayores atendidos en el municipio. Conclusión: el Sistema es una solución tecnológica dada la importancia que tiene la evaluación multidimensional del adulto mayor en el ámbito de la atención de esta población y la falta de soluciones tecnológicas para realizar la evaluación.

A infodemia COVID-19 à luz da teoria da complexidade de Edgar Morin: um estudo de reflexão

Objetivo: Refletir sobre a infodemia da COVID-19 sob a luz da Teoria da Complexidade de Edgar Morin e seus três principais principios, a saber o princípio dialógico, da recursão organizacional e hologramático. Metodologia: Trata-se de ensaio teórico de caráter reflexivo da literatura acerca da infodemia de COVID-19 sob a luz da Teoria da Complexidade de Edgar Morin. Resultados: Interrelacionando o princípio dialógico com a infodemia, pode-se refletir sobre a relação da ambivalência complexa entre a desinformação e informações validadas cientificamente e dos diversos conteúdos dissipados nos meios de comunicação. Ressalta-se que é necessário realizar uma síntese coerente e confiável sobre os conteúdos abordados e amplamente difundidos. A infodemia de COVID-19 submerge de uma intenção que ocorre nas entrelinhas dos meios de comunicação, e nessa intencionalidade há participação direta da sociedade. Compreende-se que a desinformação se amplia na medida em que a produção de conteúdo aumenta, nesse sentido, a desinformação produz a infodemia que, consequentemente, é produzida também pela desinformação. É possível refletir sobre a infodemia através da noção de que está pode influenciar e ser influenciada pelo todo, envolvendo assim, questões que atravessam a saúde pública, a economia, a política, ao mesmo tempo que é fomentada e influenciada por esses eixos específicos. Considerações finais: Os princípios do pensamento complexo, constituem-se como elementos que auxiliam a compreensão do fenômeno infodemia sua influência no contexto informacional. Espera-se que este estudo reflexivo possa contribuir para que sejam mitigadas as repercussões da infodemia no cotidiano dos usuários das redes de informação.

Objective: To reflect on the COVID-19 infodemic in the light of Edgar Morin's Complexity Theory and its three main principles, namely the dialogic principle, organizational and hologrammatic recursion. Methodology: This is a theoretical essay with a reflective character of the literature on the COVID-19 infodemic in the light of Edgar Morin's Complexity Theory. Result: Interrelating the dialogic principle with the infodemic, one can reflect on the relationship of the complex ambivalence between disinformation and scientifically validated information and the various contents dissipated in the media. It is noteworthy that it is necessary to carry out a coherent and reliable synthesis of the contents covered and widely disseminated. The COVID-19 infodemic is submerged in an intention that occurs between the lines of the media, and in this intention, there is direct participation by society. It is understood that disinformation increases as the production of content increases, in this sense, disinformation produces the infodemic which, consequently, is also produced by disinformation. It is possible to reflect on the infodemic through the notion that it can influence and be influenced by the whole, thus involving issues that cross public health, the economy, politics, at the same time that it is fostered and influenced by these specific axes. Final considerations: the principles of complex thinking are elements that help the understanding of the infodemic phenomenon and its influence in the informational context. It is hoped that this reflective study can contribute to mitigate the repercussions of the infodemic in the daily lives of users of information networks.

Objetivo: Reflexionar sobre la infodemia de la COVID-19 a la luz de la Teoría de la Complejidad de Edgar Morin y sus tres principios fundamentales, a saber, el principio dialógico, el organizativo y el hologramático de la recursividad. Metodología: Se trata de un ensayo teórico con carácter reflexivo de la literatura sobre la infodemia del COVID-19 a la luz de la Teoría de la Complejidad de Edgar Morin. Resultados: Interrelacionando el principio dialógico con la infodemia, se puede reflexionar sobre la relación de la compleja ambivalencia entre la desinformación y la información científicamente validada y los diversos contenidos disipados en los medios. Cabe destacar que es necesario realizar una síntesis coherente y confiable de los contenidos abordados y ampliamente difundidos. La infodemia del COVID-19 está sumergida en una intención que se da entre líneas mediáticas y en esa intención hay una participación directa de la sociedad. Se entiende que la desinformación se expande a medida que aumenta la producción de contenidos. En ese sentido, la desinformación produce la infodemia que, en consecuencia, también es producida por la desinformación. Es posible reflexionar sobre la infodemia a partir de la noción de que puede influir y ser influenciada por el conjunto, involucrando así cuestiones que cruzan la salud pública, la economía, la política, al tiempo que es fomentada e influenciada por estos ejes específicos. Consideraciones finales: Los principios del pensamiento complejo son elementos que ayudan a la comprensión del fenómeno infodémico y su influencia en el contexto informacional. Se espera que este estudio reflexivo pueda contribuir a mitigar las repercusiones de la infodemia en la cotidianidad de los usuarios de las redes de información.

Estratégias de enfrentamento contra a infodemia utilizadas pelos adultos e idosos: uma revisão de escopo

O objetivo desse estudo é mapear a produção científica sobre as estratégias propostas e/ou utilizadas para o enfrentamento a infodemias com foco à preservação da saúde adultos e idosos no contexto da Pandemia de COVID-19. Trata-se de uma revisão de escopo, desenvolvida com a metodologia do Joanna Briggs Institute (JBI), que incluiu 27 artigos. Esses artigos foram analisados de acordo com tipo de estudo, estratégias de enfrentamento utilizadas, principais resultados e limitações dos estudos. As estratégias de enfrentamento encontradas contra a infodemia foram divididas entre estratégias de enfrentamento utilizadas pelos adultos e idosos e sugestões de estratégia de autores contra a infodemia. Conhecer essas novas ferramentas de enfrentamento utilizadas pelos adultos e idosos são essenciais para o desenvolvimento de novas estratégias e aprimoramento das que já estão disponíveis, já que foram encontrados poucos artigos específicos sobre o tema. Sendo assim, sugere-se estudos futuros com artigos mais robustos que preencham as lacunas encontradas.

The objective of this study is to map the scientific production on the strategies proposed and/or used to face infodemics with a focus on preserving the health of adults and the elderly in the context of the COVID-19 Pandemic. This is a Scope review, developed using the Joanna Briggs Institute (JBI) methodology, which included 27 articles. These articles were analyzed according to the type of study, coping strategies used, main results and limitations of the studies. The coping strategies found against the infodemic were divided into coping strategies used by adults and the elderly and authors' suggested strategy against the infodemic. Knowing these new coping tools used by adults and the elderly is essential for the development of new strategies and improvement of those that are already available, since few specific articles on the subject were found. Therefore, future studies are suggested with more robust articles that fill in the gaps found.

El objetivo de este estudio es mapear la producción científica sobre las estrategias propuestas y/o utilizadas para enfrentar las infodemias con enfoque en la preservación de la salud de los adultos y ancianos en el contexto de la Pandemia del COVID-19. Esta es una revisión de alcance, desarrollada utilizando la metodología del Instituto Joanna Briggs (JBI), que incluyó 27 artículos. Estos artículos fueron analizados según el tipo de estudio, estrategias de afrontamiento utilizadas, principales resultados y limitaciones de los estudios. Las estrategias de afrontamiento encontradas frente a la infodemia se dividieron en estrategias de afrontamiento utilizadas por adultos y ancianos y estrategia sugerida por los autores frente a la infodemia. Conocer estas nuevas herramientas de afrontamiento utilizadas por adultos y ancianos es fundamental para el desarrollo de nuevas estrategias y mejora de las ya disponibles, ya que se encontraron pocos artículos específicos sobre el tema. Por lo tanto, se sugieren futuros estudios con artículos más robustos que llenen los vacíos encontrados.

Avaliação multidimensional de pessoas idosas na Atenção Primária à Saúde: uma revisão de escopo / Multidimensional geriatric assessment in primary care: a scoping review

Resumo Objetivo mapear as publicações referentes à avaliação multidimensional de pessoas idosas no contexto da Atenção Primária à Saúde. Método Trata-se de uma revisão de escopo desenvolvida utilizando a metodologia Resultados foi incluída uma amostra total de 19 evidências para análise qualitativa, de variados delineamentos, com predominância do tipo transversal e em sua maioria na língua inglesa. Verificaram-se três dimensões que compõem a avaliação; instrumentos desenvolvidos aplicáveis à Atenção Primária; dois tipos de tecnologias da informação utilizadas para instrumentalizar a avaliação e achados relevantes sobre a prática. Conclusão esta revisão encontrou propostas de ferramentas construídas a partir de diversos instrumentos existentes. Devem ser criadas estratégias para atender aos idosos de forma rápida e factível. Foram verificados domínios prevalentes presentes nos instrumentos, constituindo-se como importantes quando se pensa em avaliar amplamente e de forma específica a população idosa.

Abstract Objective to map the publications on multidimensional geriatric assessment in the primary care setting. Method A scoping review using the Joanna Briggs Institute methodology was carried out on the databases Web of Science, Scopus, Medical Literature Analysis and Retrieval System Online (MEDLINE) and Literatura Latino Americana e do Caribe em Ciencias da Saude (LILACS). The studies addressed the population of older people aged ≥60 years, the concept of multidimensional assessment and the primary care setting. Results a total sample of 19 publications was included for qualitative analysis. The studies selected were of different designs (predominantly cross-sectional) and most were in English. The evaluation comprised three dimensions; instruments developed applicable to primary care; two types of information technologies used to support the evaluation; and the relevant findings about the practice. Conclusion this review identified tools that were based on several existing instruments. Strategies should be tailored for assessing older individuals in a quick feasible manner. Specific domains were commonly present in the instruments, considered important for providing a comprehensive assessment tailored for the older population.

A scoping study of pulmonary paracoccidioidomycosis: severity classification based on radiographic and tomographic evaluation.

The lungs have great importance in patients with paracoccidioidomycosis since they are the portal of entry for the infecting fungi, the site of quiescent foci, and one of the most frequently affected organs. Although they have been the subject of many studies with different approaches, the severity classification of the pulmonary involvement, using imaging procedures, has not been carried out yet. This study aimed to classify the active and the residual pulmonary damage using radiographic and tomographic evaluations, according to the area involved and types of lesions.

Transtornos mentais em crianças no contexto de saúde da família / Trastornos mentales en niños en el contexto de salud familiar / Mental disorders in children in thecontextof family Health

Descrever os transtornos mentais dos tipos emocionais e comportamentais em crianças de 2 a 6 anos, segundo a avaliação dos pais/responsáveis. Método: Delineamento transversal, em uma escola da área de abrangência de uma equipe de Saúde da Família no município da Região Ampliada Oeste de Minas Gerais. Aplicou-se um questionário socio demográfico e o Inventário dos Comportamentos de Crianças (CBCL). Resultado: Observou-se o predomínio no sexo masculino da desordem reatividade emocional (39,3%) e o menor índice em problemas com o sono (9%). No sexo feminino as desordens depressão (34,2%) e complicações somáticas (34,2%) são as mais frequentes, sendo a timidez/isolamento (2,85) a menos frequente. Conclusão: A descoberta precoce de transtornos mentais em crianças pode auxiliar no delineamento de cuidados e políticas e o enfermeiro exerce papel importante neste contexto.

Objective: To describe mental disorders of emotional and behavioral types in children aged 2 to 6 years, according to the assessment of parents/guardians. Method: Cross-sectional design, in a school in the catchment area of a Family Health team in the municipality of the Extended West Region of Minas Gerais. A sociodemographic questionnaire and the Children's Behavior Inventory (CBCL) were applied. Results: There was a predominance of emotional reactivity disorder in males (39.3%) and a lower rate of sleep problems (9%). In females, depression (34.2%) and somatic complications (34.2%) are the most frequent, with shyness/isolation (2.85) being the least frequent. Conclusion: The early discovery of mental disorders in children can help design care and policies, and nurses play an important role in this context.

Objetivo: Describir los trastornos mentales de tipo emocional y conductual en niños de 2 a 6 años, según la valoración de los padres/tutores. Método: Diseño transversal, en una escuela de la zona de influencia de un equipo de Salud de la Familia en el municipio de la Región Oeste Extendido de Minas Gerais. Se aplicó un cuestionario sociodemográfico y el Inventario de Conducta Infantil (CBCL). Resultados: Predominó el trastorno de reactividad emocional en el sexo masculino (39,3%) y una menor tasa de problemas de sueño (9%). En el sexo femenino, la depresión (34,2%) y las complicaciones somáticas (34,2%) son las más frecuentes, siendo la timidez/aislamiento (2,85) las menos frecuentes. Conclusión: El descubrimiento temprano de los trastornos mentales en los niños puede ayudar a diseñar cuidados y políticas, y las enfermeras juegan un papel importante en este contexto.

A saúde mental dos profissionais de enfermagem frente à pandemia do COVID-19: Revisão de literatura / La salud mental de los profesionales de enfermería frente a la pandemia del COVID-19: Revisión de la literatura / The mental health of nursing professionals against the COVID-19 pandemic: Literature review

Objetivo:analisar a saúde mental dos profissionais de enfermagem frente à pandemia do COVID-19. Método:trata-se de uma revisão integrativa, realizadaem 2021,através da questão norteadora: "Qual o impacto da pandemia da Covid-19 na saúde mental dos profissionais de enfermagem?". Para a coleta de dados, foram utilizados bases de dados como LILACS, MEDLINE, SCIELO e BDENF, com auxilio dos Descritores em Ciências da Saúde (DeCS), obedecendo alguns critérios de inclusão para a seleção dos estudos, sendoas buscas realizadas entre os meses de maio a agosto de 2021, com intervalo de revisão de 2019 a 2021. Resultado:elaborou-se uma matriz de síntese dos artigos selecionados, para análise dos dados.Conclusão: destaca-se que esses profissionais estão mais suceptivéis a desenvolverem transtornos mentais, visto que a todo tempo lidam com situações causadoras de um alto nível de estresse e ansiedade, além da necessidade de tomada de decisão de maneira rápida(AU)

Objective: to analyze the mental health of nursing professionals in the face of the COVID-19 pandemic. Method: this is an integrative review, carried out in 2021, through the guiding question: "What is the impact of the Covid-19 pandemic on the mental health of nursing professionals?". For data collection, databases such as LILACS, MEDLINE, SCIELO and BDENF were used, with the help of the Health Sciences Descriptors (DeCS), following some inclusion criteria for the selection of studies, and the searches were carried out between the months from May to August 2021, with a review interval from 2019 to 2021. Result: a synthesis matrix of selected articles was prepared for data analysis. Conclusion: it is noteworthy that these professionals are more susceptible to developing mental disorders, as they constantly deal with situations that cause a high level of stress and anxiety, in addition to the need for quick decision-making.(AU)

Objetivo: analizar la salud mental de los profesionales de enfermería frente a la pandemia de COVID-19. Método: tratar- a partir de una revisión integradora, realizada en 2021, a través de la pregunta orientadora: "Cuál es el impacto de la pandemia del Covid-19 en la salud mental de los profesionales de enfermería?". Para la recolección de datos se utilizan bases de datos como LILACS, MEDLINE, SCIELO y BDENF, con ayuda de los Descriptores de Ciencias de la Salud (DeCS), obedeciendo a unos criterios de inclusión para la selección de estudios, realizándose las búsquedas entre los meses de mayo a agosto de 2021, con un intervalo de revisión de 2019 a 2021. Resultado: se elaboró ​​una matriz resumen de los artículos seleccionados para el análisis de datos que estos profesionales son más propensos a desarrollar trastornos mentales, ya que se ocupan de situaciones que provocan un alto nivel de estrés y ansiedad, además de la necesidad de una rápida toma de decisiones.(AU)

Using infrared spectroscopy of serum and chemometrics for diagnosis of paracoccidioidomycosis.

Paracoccidioidomycosis (PCM) is a systemic granulomatous mycosis endemic to Latin America, whose etiologic agents are fungi of the genus Paracoccidioides. PCM is usually diagnosed by microscopic observation of the fungus in biological samples, combined or not with other techniques such as serological methods. However, all currently used diagnostic methods have limitations. The objective of this study was to develop a method based on Fourier transform infrared spectroscopy (FTIR) and chemometric analysis for PCM diagnosis. We included 224 serum samples: 132 PCM sera, 24 aspergillosis sera, 10 cryptococcosis sera, 8 histoplasmosis sera, and 50 sera from healthy blood donors. Samples were analyzed by attenuated total reflection (ATR), and chemometric analyses including exploratory analysis through principal component analysis (PCA) and a classification method (PCM and non-PCM) through orthogonal partial least squares discriminant analysis (OPLS-DA). The spectra were similar, with the main bands up to approximately 1652 cm-1 and 1543 cm-1 (amide I and amide II bands). This same region was mainly responsible for the partial separation of the samples in PCA. The OPLS-DA model correctly classified all serum samples with only one latent variable, with a determination coefficient (R²) higher than 0.999 for both the calibration set and prediction set. Sensitivity and specificity were 100% for both sets, showing better performance than the reference diagnostic methods. Therefore, the use of FTIR/ATR together with OPLS-DA modeling proved to be a promising method for PCM diagnosis.