Simultaneity of health-related behaviors and food insecurity among pregnant women.

The researchers aimed through this cross-sectional study to explore the co-occurrence of health-related behaviors and their association with food insecurity in pregnant women. The investigated behaviors include smoking, alcohol consumption, non-regular consumption of fruit, and physical inactivity among 605 participants. Our findings reveal that women experiencing food insecurity exhibit a higher prevalence of simultaneous engagement in specific health behaviors. Specifically, the co-occurrence of alcohol consumption and non-regular fruit consumption is elevated, as is the co-occurrence of smoking, alcohol consumption, and physical inactivity, and alcohol consumption, regular fruit consumption, and physical inactivity. The implications of these findings underscore the need for targeted interventions addressing both food insecurity and clustered health behaviors during pregnancy.

The 2021 World Health Organization classification of gliomas: an imaging approach.

The purpose of this pictorial essay is to describe the recommendations of the 2021 World Health Organization classification for adult-type and pediatric-type gliomas and to discuss the main modifications in relation to the previous (2016) classification, exemplified by imaging, histological, and molecular findings in nine patients followed at our institutions. In recent years, molecular biomarkers have gained importance in the diagnosis and classification of gliomas, mainly because they have been shown to correlate with the biological behavior and prognosis of such tumors. It is important for neuroradiologists to familiarize themselves with this new classification of central nervous system tumors, so that they can use this knowledge in evaluating and reporting the imaging examinations of patients with glioma.

O propósito deste ensaio iconográfico é descrever e discutir as novas recomendações da Organização Mundial da Saúde de 2021, referente aos gliomas dos tipos adulto e infantil, e suas principais diferenças com a classificação anterior (2016), exemplificadas com imagens de nove casos de pacientes atendidos nas nossas instituições. Recentemente, há uma crescente significância dos marcadores moleculares no diagnóstico e classificação dos gliomas e tumores do sistema nervoso central, principalmente pela correlação com o comportamento biológico e o prognóstico. É importante que os neurorradiologistas estejam familiarizados com a nova classificação dos tumores do sistema nervoso central para a prática clínica, na avaliação e emissão de laudos e opiniões nas imagens dos pacientes com gliomas.

Evaluation of acute toxicity and in vitro antitumor activity of a novel doxorubicin-loaded folate-coated pH-sensitive liposome.

Doxorubicin (DOX) loaded liposomes have been used and studied in the last decades due to the significant decrease in DOX induced cardiac and systemic toxicity relative to administration of free drug. Therefore, new strategies are sought to improve DOX delivery and antitumor activity, while avoiding side effects. Recently, folate-coated pH-sensitive liposomes (SpHL-Fol) have been studied as a tool to enhance cellular uptake and antitumor activity of paclitaxel and DOX in breast cancer cells expressing folate receptor (FR+). However, the elucidation of folate functionalization relevance in DOX-loaded SpHL (SpHL-DOX-Fol) in different cell types (MDA-MB-231, MCF-7, and A549), as well as, the complete safety evaluation, is necessary. To achieve these objectives, SpHL-DOX-Fol was prepared and characterized as previously described. Antitumor activity and acute toxicity were evaluated in vivo through direct comparison of free DOX verses SpHL-DOX, a well-known formulation to reduce DOX cardiotoxicity. The obtained data are crucial to support future translational research. Liposomes showed long-term stability, suitable for biological use. Cellular uptake, cytotoxicity, and percentage of migration inhibition were significantly higher for MDA-MB-231 (FR+) treated with SpHL-DOX-Fol. In addition, SpHL-DOX-Fol demonstrated a decrease in the systemic toxic effects of DOX, mainly in renal and cardiac parameters evaluation, even using a higher dose (20 mg/kg). Collectively these data build the foundation of support demonstrating that SpHL-DOX-Fol could be considered a promising drug delivery strategy for the treatment of FR+ breast tumors.

Trajectory of blood pressure levels and weight gain in pregnant women: A group-based approach.

BACKGROUND AND OBJECTIVES: Morbidities associated with increased blood pressure levels during pregnancy represent one of the main causes of maternal mortality. The objective was to identify patterns of systolic blood pressure (SPB) trajectory in pregnant women undergoing prenatal care at the Unified Health System, and associations with weight gain trajectory, demographic, obstetric, anthropometric data, and health related behaviors. METHODS AND RESULTS: Cohort study with pregnant women using the public health services in Brazil. Data were collected through questionnaires and medical records. Trajectory patterns of SBP and weight gain were identified by a group-based trajectory model. For trajectory analysis, 460 women had SBP information available, totaling 2839 measurements, with an average of 6.2 measurements during pregnancy. Three SBP trajectory patterns were identified and classified as "Group 1" (48.0%), with a mean of 103 mmHg (95% CI 102.5-103.7 mmHg), "Group 2" (42.7%) with a mean of 114 mmHg (95% CI 113.7-114.9 mmHg), and "Group 3" (9.1%) with the highest mean SBP value of 130 mmHg (95% CI 128.8-131.5 mmHg). It was observed that regardless of the weight gain trajectory group, women classified in the group with the highest SBP had the highest SBP levels. The probability of being classified in Group 3 was higher among women with higher education, who started pregnancy presenting obesity, and who were using antihypertensive drugs. CONCLUSION: The probability of belonging to groups with a greater trajectory of SBP during pregnancy was associated with obesity, education, and hypertension under treatment.

The 2021 World Health Organization classification of gliomas: an imaging approach / Nova classificação das neoplasias gliais segundo a Organização Mundial da Saúde 2021, com enfoque radiológico

Abstract The purpose of this pictorial essay is to describe the recommendations of the 2021 World Health Organization classification for adult-type and pediatric-type gliomas and to discuss the main modifications in relation to the previous (2016) classification, exemplified by imaging, histological, and molecular findings in nine patients followed at our institutions. In recent years, molecular biomarkers have gained importance in the diagnosis and classification of gliomas, mainly because they have been shown to correlate with the biological behavior and prognosis of such tumors. It is important for neuroradiologists to familiarize themselves with this new classification of central nervous system tumors, so that they can use this knowledge in evaluating and reporting the imaging examinations of patients with glioma.

Resumo O propósito deste ensaio iconográfico é descrever e discutir as novas recomendações da Organização Mundial da Saúde de 2021, referente aos gliomas dos tipos adulto e infantil, e suas principais diferenças com a classificação anterior (2016), exemplificadas com imagens de nove casos de pacientes atendidos nas nossas instituições. Recentemente, há uma crescente significância dos marcadores moleculares no diagnóstico e classificação dos gliomas e tumores do sistema nervoso central, principalmente pela correlação com o comportamento biológico e o prognóstico. É importante que os neurorradiologistas estejam familiarizados com a nova classificação dos tumores do sistema nervoso central para a prática clínica, na avaliação e emissão de laudos e opiniões nas imagens dos pacientes com gliomas.

ICU Nursing Team Mental Health in The Face of the COVID-19 Pandemic: An Integrative Review / Saúde mental da equipe de enfermagem intensivista ante a pandemia da covid-19: revisão integrativa / Salud mental de los profesionales de enfermería intensivistas ante la pandemia de la COVID-19: revisión integradora

Introduction: During the COVID-19 pandemic, health professionals were at an increased risk of developing psychological conditions, especially in Intensive Care Units. A gap is verified in the knowledge about ICU Nursing teams' mental health in the care provided to patients affected by COVID-19. Objective: To review the literature to identify the mental health conditions of ICU Nursing professionals during the COVID-19 pandemic. Materials and method: This is an integrative literature review with data collection from January to April 2022 in the Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus Content Overview and Web of Science databases. The following descriptors were listed: "Intensive Care Units," "COVID-19," "Mental Health," and "Nurse." The materials included were studies produced since 2020, available in full in the Spanish, English and Portuguese languages, and which answered the research question. Search and selection of the articles were the duty of two duly trained researchers, who worked independently through peer discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations were followed. Results: From a sample of 16 articles, it was observed that the critical care of COVID-19 patients affected Nursing professionals' mental health with an emphasis on depression, anxiety, stress and fear. This was associated with a lack of evidence-based training, scarcity of human and physical resources, work overload and insufficient work experience. Conclusions: ICU Nursing professionals are mentally shaken; therefore, it is imperative to implement policies, strategies and methods to improve the psychological conditions of these professionals, to ensure the quality of services.

Introdução: durante a pandemia da covid-19, os profissionais de saúde apresentaram risco aumentado para o desenvolvimento de afecções psíquicas, especialmente na unidade de terapia intensiva. Verifica-se lacuna de conhecimento sobre a saúde mental da equipe de enfermagem intensivista no atendimento aos pacientes acometidos pela covid-19. Objetivo: identificar, na literatura científica, as condições da saúde mental do profissional de enfermagem intensivista durante a pandemia da covid-19. Materiais e método: esta é uma revisão integrativa da literatura; a coleta de dados ocorreu de janeiro a abril de 2022 nas fontes de dados Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus Content Overview e Web of Science. Elencaram-se os seguintes descritores: "Intensive Care Units", "Covid 19", "Mental Health", "Nurse". Incluíram-se estudos produzidos desde 2020, disponíveis na íntegra, em espanhol, inglês e português, e que respondessem à questão de pesquisa. A busca e seleção dos artigos foram executadas por dois pesquisadores treinados, de modo independente, mediante discussão por pares. As recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses foram seguidas. Resultados: a partir de uma amostra de 16 artigos, observou-se que o cuidado crítico de pacientes com covid-19 afetou a saúde mental dos profissionais de enfermagem com destaque para depressão, ansiedade, estresse e medo. Isso se associou à falta de tratamento baseado em evidências, à carência de recursos humanos e físicos, à sobrecarga de trabalho e às experiências de trabalho insuficientes. Conclusões: os profissionais de enfermagem intensivistas estão mentalmente abalados; portanto, é imperativa a implantação de políticas, estratégias e métodos para melhorar as condições psicológicas desses profissionais, para, assim, garantir a qualidade nos serviços.

Introducción: durante la pandemia de la covid-19, los profesionales de la salud han presentado riesgo aumentado para el desarrollo de afecciones psíquicas, especialmente en la unidad de terapia intensiva. Se encuentra vacío de conocimiento acerca de la salud mental de los profesionales de enfermería intensivistas en la atención a los pacientes acometidos por la covid-19. Objetivo: identificar, en la literatura científica, las condiciones de la salud mental del profesional de enfermería intensivista durante la pandemia de la covid-19. Materiales y método: se trata de una revisión integradora de la literatura; la recolección de datos ocurrió de enero a abril de 2022 en las fuentes de dados Embase, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus Content Overview y Web of Science. Se han relacionado los siguientes descriptores: "Intensive Care Units", "Covid 19", "Mental Health", "Nurse". Se han incluido estudios producidos desde el 2020, disponibles de forma integral, en español, inglés y portugués, y que atendieran a la pregunta de investigación. La búsqueda y selección de los artículos se ejecutaron por dos investigadores capacitados, de modo independiente, mediante discusión por pares. Se siguieron las recomendaciones del Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Resultados: desde una amuestra de 16 artículos, se ha observado que la atención crítica a pacientes con covid-19 ha afectado la salud mental de los profesionales de enfermería con énfasis para depresión, ansiedad, estrés y miedo. Lo anterior se asocia a la falta de tratamiento basado en evidencia, la carencia de recursos humanos y físico, la sobrecarga de trabajo y las experiencias de trabajo insuficientes. Conclusiones: los profesionales de enfermería intensivistas están mentalmente debilitados; por lo tanto, urge la implantación de políticas, estrategias y métodos para mejorar las condiciones psicológicas de estos profesionales para, así, asegurar la calidad en los servicios.

Patterns of energy balance-related behaviors and food insecurity in pregnant women.

The behaviors related to caloric balance during pregnancy can lead to short- and long-term repercussion over the life course. This study aimed to identify patterns of energy balance-related behavior (EBRB) and its association with food insecurity (FI) in pregnant women. Cross-sectional, with pregnant women undergoing prenatal care in public health units in Colombo, Brazil, in 2018/2019. EBRB patterns were identified by factor analysis, and the scores were compared according to FI levels (mild and moderate/severe (M/S) through quantile regression. Four EBRB patterns were identified among 535 pregnant women: Factor 1- household/caregiving activities, exercise/sport, and physical inactivity; Factor 2 - fruits and vegetables; Factor 3 - paid work and commuting; Factor 4 - soda and sweetened beverage, sweets, and goodies. After adjusted analyses, women with mild FI presented higher scores for Factor 1 and lower scores for Factor 3. Higher scores for Factor 4 (p25) were observed among women with mild FI in simultaneous quantile regression. M/S FI was associated with lower scores for Factor 3 (p75). Mixed patterns with factors negatively and positively associated with energy balance were identified among pregnant women with FI.

Patterns of energy balance-related behaviors and food insecurity in pregnant women / Padrões de comportamentos relacionados ao balanço de energia corporal e insegurança alimentar em gestantes

Abstract The behaviors related to caloric balance during pregnancy can lead to short- and long-term repercussion over the life course. This study aimed to identify patterns of energy balance-related behavior (EBRB) and its association with food insecurity (FI) in pregnant women. Cross-sectional, with pregnant women undergoing prenatal care in public health units in Colombo, Brazil, in 2018/2019. EBRB patterns were identified by factor analysis, and the scores were compared according to FI levels (mild and moderate/severe (M/S) through quantile regression. Four EBRB patterns were identified among 535 pregnant women: Factor 1- household/caregiving activities, exercise/sport, and physical inactivity; Factor 2 - fruits and vegetables; Factor 3 - paid work and commuting; Factor 4 - soda and sweetened beverage, sweets, and goodies. After adjusted analyses, women with mild FI presented higher scores for Factor 1 and lower scores for Factor 3. Higher scores for Factor 4 (p25) were observed among women with mild FI in simultaneous quantile regression. M/S FI was associated with lower scores for Factor 3 (p75). Mixed patterns with factors negatively and positively associated with energy balance were identified among pregnant women with FI.

Resumo Os comportamentos relacionados ao balanço de energia corporal (CRBEC) durante a gestação podem estar associados às repercussões de curto e longo prazo. Este estudo objetivou identificar os padrões de CRBEC e sua associação com a insegurança alimentar (IA) em gestantes. Estudo transversal com mulheres em acompanhamento pré-natal em unidades públicas de saúde de Colombo (PR), Brasil em 2018/2019. Padrões de CRBEC foram identificados por análise fatorial e os escores foram comparados de acordo com os níveis de IA (IA leve, IA moderada/grave (M/G) por meio de regressão quantílica. Quatro padrões de CRBEC foram identificados entre 535 gestantes: Fator 1- atividades domésticas/cuidados, exercícios/esporte e inatividade física; Fator 2- frutas e vegetais; Fator 3 - trabalho remunerado e deslocamento; Fator 4 - refrigerantes e bebidas açucaradas, doces e guloseimas. Após análise ajustada as mulheres com IA leve apresentaram maiores escores para o Fator 1 e menores escores para o Fator 3. Maiores escores foram observados entre as mulheres com IA leve no Fator 4 (p25) na regressão quantílica simultânea. IA M/G foi associada a escores mais baixos para o Fator 3 (p75). Padrões mistos com fatores negativa e positivamente associados ao balanço de energia foram identificados entre as gestantes com IA.

Fish Oil - Omega-3 Exerts Protective Effect in Oxidative Stress and Liver Dysfunctions Resulting from Experimental Sepsis.

Background: Sepsis is a severe global health problem, with high morbidity and mortality. In sepsis, one of the main affected organs is the liver. Hepatic alterations characterize a negative prognostic. Omega-3 fatty acids (ω3), eicosapentaenoic acid, and docosahexaenoic acid, are part of the main families of polyunsaturated fatty acids. ω3 has been used in studies as sepsis treatment and as a treatment for non-alcoholic liver disease. Aim: We aimed to evaluate the effects of treatment with fish oil (FO) rich in ω3 on liver changes and damage resulting from experimental sepsis. Methodology: A model of severe sepsis in Wistar rats was used. Oxidative stress in the liver tissue was evaluated by means of tests of thiobarbituric acid reactive substances, 2,7-dihydrodichlorofluorescein diacetate , catalase, and glutathione peroxidase, in the serum TBARS, DCF, thiols and, to assess liver dysfunction, alanine aminotransferase and aspartate aminotransferase. Hepatic tissue damage was evaluated using H&E histology. Results: In assessments of oxidative stress in liver tissue, a protective effect was observed in the tests of TBARS, DCF, CAT, and GPx, when compared the sepsis versus sepsis+ω3 groups. Regarding the oxidative stress in serum, a protective effect of treatment with ω3 was observed in the TBARS, DCF, and thiols assays, in the comparison between the sepsis and sepsis+ω3 groups. ω3 had also a beneficial effect on biochemical parameters in serum in the analysis of ALT, creatinine, urea, and lactate, observed in the comparison between the sepsis and sepsis+ω3 groups. Conclusion: The results suggest ω3 as a liver protector during sepsis with an antioxidant effect, alleviating injuries and dysfunctions.

Genetic polymorphisms of TNF-α, IL-6, and IL-10 in female elderly patients with chronic temporomandibular disorder pain.

AIM: To verify the association of the TNF-α, IL-6, and IL-10 polymorphisms with chronic temporomandibular disorder pain development in female elderly patients. METHODS: Participants were evaluated according to Diagnostic Criteria for Temporomandibular Disorders. The genomic DNA was extracted from blood according to the Salting Out method followed by a quantification using the NanoDrop spectrophotometer. The -308G/A TNF-α polymorphism analysis was performed by the polymerase chain reaction-restriction fragment length polymorphism technique, the determination of -174G/C IL-6 polymorphism was performed by polymerase chain reaction, and the evaluation of the -1082A/G IL-10 polymorphism was carried out by polymerase chain reaction- allele-specific amplification. Data were analyzed using the BioEstat 5.3 software. RESULTS: The -308G/A TNF-α polymorphism showed a significant difference when genotypes of cases with chronic temporomandibular disorder pain and controls were compared (p = .025). There was a lack of association regarding the -174G/C IL-6 polymorphism (p = .286) however, a positive association between the -1082A/G IL-10 polymorphism with chronic temporomandibular disorder was observed (p = .020). CONCLUSION: The analyzed data of elderly subjects support the possible involvement of the GA genotype of the -308G/A TNF-α and the AA genotype of the -1082A/G IL-10 polymorphisms in the pathogenesis of chronic temporomandibular disorder pain.

Trajectory Patterns of Gestational Weight Gain.

OBJECTIVE: To identify gestational weight gain trajectories and their association with demographic, obstetric, and anthropometric characteristics. METHOD: Information of 599 pregnant women undergoing prenatal care in public health units was collected through questionnaires and medical records, resulting in 4,272 measures of body weight. Group-based trajectory models were applied to identify patterns of gestational weight gain. RESULTS: The average gestational weight gain at 40 weeks was 14.1 kg (95%CI: 13.2, 15.0). Three different trajectory groups were identified: low (9.9%), intermediate (66.4%), and high (23.7%). Pregnant women who smoked and those classified above IOM's weight gain recommendations were more likely to be classified in the group with a high weight gain trajectory; while those with pre-pregnancy overweight or obesity, and with greater parity were more likely to be categorized in the low weight gain trajectory. After adjusting for other variables in the model, parity remained significantly associated with gestational weight gain (ß: 0.88; 95%CI: 0.27, 0.73). In the multilevel model, weight gain remained different among the categories of group-based trajectory, even after adjustment for other investigated variables for intermediate (ß: 2.94; 95%CI: 2.32, 3.58) and high (ß: 5.88; 95%CI: 5.09, 6.66) gestational weight gain trajectory groups. CONCLUSIONS: Behavioral, obstetric, and anthropometric characteristics determined the belonging to groups with a high or low trajectory of gestational weight gain. The findings contribute to a better understanding of patterns of gestational weight gain in middle-income women groups.

Componentes do diagnóstico de enfermagem estilo de vida sedentário em universitários: revisão integrativa da literatura / Components of the nursing diagnosis sedentary lifestyle in college students: integrative literature review / Componentes del diagnóstico de enfermería estilo de vida sedentario en estudiantes universitarios: revisión bibliográfica integradora

O estilo de vida sedentário envolve um gasto energético similar aos valores basais em repouso, sendo prejudicial à saúde. Dessa forma, o presente estudo objetiva sintetizar o conhecimento produzido sobre indicadores clínicos, fatores causais e relações clínicas entre os indicadores e os fatores causais do diagnóstico de enfermagem estilo de vida sedentário em estudantes universitários. Trata-se de uma revisão integrativa da literatura, realizada no mês de novembro de 2022. As fontes de dados consultadas foram: Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed e Web of Science. A amostra foi composta por dez artigos. Em relação aos estudos incluídos, todos eram internacionais, publicados em sua maioria no ano de 2021 (30%) e escritos na língua inglesa (90%). O principal indicador clínico encontrado foi atividade física menor que a recomendada. Quanto aos fatores causais, encontrou-se tempo de tela excessivo, tempo de atividade física insuficiente, falta de tempo para se exercitar, tempo sentado prolongado, atividades sedentárias educacionais e socialização sedentária. As relações clínicas encontradas foram excesso de adiposidade, sono prejudicado e saúde mental prejudicada. Conclui-se que a literatura referente aos indicadores clínicos, fatores causais e relações clínicas do diagnóstico estudado é limitada, necessitando de pesquisas que possam preencher as lacunas de conhecimento.

The sedentary lifestyle involves an energy expenditure similar to the basal values at rest, being harmful to health. Thus, this study aims to synthesize the knowledge produced on clinical indicators, causal factors, and clinical relationships between the indicators and causal factors of the nursing diagnosis sedentary lifestyle in college students. This is an integrative literature review, conducted in November 2022. The data sources consulted were: Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed, and Web of Science. The sample was composed of ten articles. Regarding the studies included, all were international, published mostly in the year 2021 (30%) and written in English (90%). The main clinical indicator found was physical activity lower than recommended. As for causal factors, excessive screen time, insufficient physical activity time, lack of time to exercise, prolonged sitting time, sedentary educational activities, and sedentary socialization were found. The clinical relationships found were excessive adiposity, impaired sleep, and impaired mental health. It is concluded that the literature regarding the clinical indicators, causal factors, and clinical relationships of the diagnosis studied is limited, necessitating research that can fill the gaps in knowledge.

El sedentarismo implica un gasto energético similar a los valores basales en reposo, siendo perjudicial para la salud. Por lo tanto, este estudio tiene como objetivo sintetizar los conocimientos producidos sobre los indicadores clínicos, factores causales y las relaciones clínicas entre los indicadores y factores causales del diagnóstico de enfermería estilo de vida sedentario en estudiantes universitarios. Se trata de una revisión bibliográfica integradora, realizada en noviembre de 2022. Las fuentes de datos consultadas fueron: Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed y Web of Science. La muestra estuvo compuesta por diez artículos. En cuanto a los estudios incluidos, todos eran internacionales, publicados en su mayoría en el año 2021 (30%) y escritos en inglés (90%). El principal indicador clínico encontrado fue una actividad física inferior a la recomendada. En cuanto a los factores causales, se encontraron el tiempo excesivo frente a la pantalla, el tiempo insuficiente de actividad física, la falta de tiempo para hacer ejercicio, el tiempo prolongado sentado, las actividades educativas sedentarias y la socialización sedentaria. Las relaciones clínicas encontradas fueron la adiposidad excesiva, la alteración del sueño y la alteración de la salud mental. Se concluye que la literatura relativa a los indicadores clínicos, factores causales y relaciones clínicas del diagnóstico estudiado es limitada, siendo necesaria la realización de investigaciones que puedan colmar las lagunas de conocimiento.

Cobertura vacinal: uma análise comparativa entre os estados da região nordeste do Brasil com ênfase no estado do Maranhão / Vaccination coverage: a comparative analysis between the states of the northeast region of Brazil with emphasis on the state of Maranhão / Cobertura de vacunación: un análisis comparativo entre los estados de la región nordeste de Brasil con énfasis en el estado de Maranhão

Introdução: Devido à escassez de pesquisas voltadas para a situação da cobertura vacinal no Nordeste, sobretudo no Maranhão, apresenta-se a necessidade de realizar uma análise comparativa entre os estados da região nordeste do Brasil. Objetivo: Analisar a cobertura vacinal entre os estados na Região Nordeste do Brasil entre 2017 a 2021, por meio da análise de dados secundários provenientes de sistemas de informação em saúde. Metodologia: trata-se de estudo ecológico de série temporal, com uso de dados secundários provenientes de sistemas de informação em saúde. Foi realizado por meio da coleta de dados disponibilizados pelo TABNET do Departamento de Informação e Informática do SUS (DATASUS), referentes ao período entre 2017 e 2021, nos estados da Região Nordeste do Brasil. Resultados: No período de 2017 a 2021 a cobertura vacinal na Região Nordeste do Brasil foi de 64,48%, sendo uma das piores do país, perdendo apenas para Região Norte (63,30%). Cabe salientar que a média no país em todo o período analisado foi de 68,57%, estando bem abaixo do ideal (entorno de 90% a 95% a depender do imunizante). E entre os anos de 2019 a 2020 houve um declínio de 12,05% e em 2021 14,87% da cobertura vacinal na região nordeste do país. Conclusão: Este estudo permitiu realizar uma análise comparativa entre os estados da região nordeste do Brasil com ênfase no estado do maranhão quanto à cobertura vacinal, onde foi observado que, o estado do Maranhão apresenta umas das menores taxas de vacinação em comparação com outros estados da região nordeste.

Introduction: Due to the lack of research focused on the situation of vaccination coverage in the Northeast, especially in Maranhão, there is a need to carry out a comparative analysis between the states of the northeast region of Brazil. Objective: To analyze vaccination coverage among states in the Northeast Region of Brazil between 2017 and 2021, through the analysis of secondary data from health information systems. Methodology: this is an ecological time series study, using secondary data from health information systems. It was carried out by collecting data provided by the TABNET of the Department of Information and Informatics of the SUS (DATASUS), referring to the period between 2017 and 2021, in the states of the Northeast Region of Brazil. Results: In the period from 2017 to 2021, vaccination coverage in the Northeast Region of Brazil was 64.48%, being one of the worst in the country, second only to the North Region (63.30%). It should be noted that the average in the country throughout the analyzed period was 68.57%, well below the ideal (around 90% to 95% depending on the immunizer). And between the years 2019 to 2020 there was a decline of 12.05% and in 2021 14.87% of vaccination coverage in the northeast region of the country. Conclusion: This study made it possible to carry out a comparative analysis between the states of the northeast region of Brazil, with emphasis on the state of maranhão regarding vaccination coverage, where it was observed that the state of Maranhão has one of the lowest vaccination rates compared to other states in the region. northeast region.

Introducción: Debido a la falta de investigaciones centradas en la situación de las coberturas de vacunación en el Nordeste, especialmente en Maranhão, surge la necesidad de realizar un análisis comparativo entre los estados de la región Nordeste de Brasil. Objetivo: Analizar las coberturas de vacunación entre los estados de la Región Nordeste de Brasil entre 2017 y 2021, a través del análisis de datos secundarios de los sistemas de información en salud. Metodología: se trata de un estudio de series temporales ecológicas, utilizando datos secundarios de los sistemas de información en salud. Fue realizado a partir de la recopilación de datos facilitados por el TABNET del Departamento de Información e Informática del SUS (DATASUS), referentes al período comprendido entre 2017 y 2021, en los estados de la Región Nordeste de Brasil. Resultados: En el período de 2017 a 2021, la cobertura de vacunación en la Región Nordeste de Brasil fue del 64,48%, siendo una de las peores del país, superada solo por la Región Norte (63,30%). Cabe señalar que el promedio en el país durante todo el período analizado fue de 68,57%, muy por debajo del ideal (alrededor de 90% a 95% dependiendo del inmunizador). Y entre los años 2019 a 2020 hubo un descenso de 12,05% y en 2021 de 14,87% de las coberturas de vacunación en la región nororiental del país. región nordeste. PALABRAS CLAVE: Cobertura de Vacunación; Vacunas; Enfermedades Prevenibles por Vacunas.

Sobrepeso e obesidade entre mulheres e associação com características demográficas e obstétricas entre usuárias de uma unidade de saúde especializada / Overweight and obesity between women and association with demographic and obstetric characteristics among users of a specialized health unit

Resumo Introdução O excesso de peso é um fator de risco para doenças crônicas. Objetivo Estimar a prevalência de sobrepeso e obesidade, e investigar sua associação com variáveis demográficas, socioeconômicas e reprodutivas e com comportamentos relacionados à saúde entre mulheres usuárias de unidade de atenção especializada. Método Estudo transversal com mulheres em atendimento por mastologista. O estado nutricional foi classificado por meio do índice de massa corporal. Foram utilizados modelos de regressão logística multinomial brutos e ajustados, com estimativa de razões de chance (RC) e intervalos de confiança de 95% (IC95%). A eutrofia foi considerada como categoria de referência. Resultados Participaram 182 mulheres com média de idade de 51 anos. A prevalência de sobrepeso foi de 34,1% (IC95% 27,1-41,0) e de obesidade foi de 31,8% (IC95% 25,0-38,7). Apresentaram maiores chances de obesidade as mulheres: com 60 anos ou mais, que exerciam atividade remunerada, que tiveram menarca antes dos 13 anos e com três ou mais gestações. Após análise ajustada, permaneceram associadas à maior chance de obesidade a menarca antes dos 13 anos (RC 4,40; IC95% 1,76-10,99) e três ou mais gestações (RC 8,50; IC95% 2,14-33,70). Conclusão Verificou-se elevada prevalência de sobrepeso e obesidade entre as participantes, associada às características reprodutivas.

Abstract Background Overweight is a risk factor for chronic diseases. Objective To estimate the prevalence of overweight and obesity and to investigate its association with demographic, socioeconomic, reproductive and health behaviors related among women users of specialized care units. Method Cross-sectional study with women in care by a mastologist. Nutritional status was classified by Body Mass Index (BMI). Gross and adjusted multinomial logistic regression models were used, to estimate an Odds Ratios (OR) and 95% Confidence Intervals (95% CI). Eutrophy was considered as a reference category. Results 182 women with a mean age of 51 years. The prevalence of overweight was 34.1% (CI 95% 27.1-41.0) and obesity was 31.8% (CI 95% 25.0-38.7). Women were more likely to be obese: 60 years of age or older, who were gainfully employed, who had menarche before age 13, and with three or more pregnancies. After adjusted analysis, they remained associated with a greater chance of the development of obesity to menarche before 13 years (OR 4.40 CI 95% 1.76-10.99) and three or more pregnancies (OR 8.50 CI 95% 2.14-33.70). Conclusion There was a high prevalence of overweight and obesity among the participants, associated with reproductive characteristics.

Efetividade da simulação virtual no ensino de enfermagem para aprender o raciocínio clínico: uma revisão integrativa / Effectiveness of virtual simulation in nursing teaching to learn clinical reasoning: an integrative review / Eficacia de la simulación virtual en la enseñanza de enfermería para el aprendizaje del razonamiento clínico: una revisión integradora

Introdução: Nas duas últimas décadas, os meios de ensino vêm mudando na área da saúde, no qual o ensino tradicional já não é capaz de suprir as necessidades atuais. Assim, a simulação virtual passou a ter um papel fundamental na educação superior de enfermagem, sendo um meio ativo de aprendizado. Objetivo: Analisar na literatura científica a efetividade da simulação virtual no ensino de enfermagem. Metodologia: Trata-se de uma pesquisa bibliográfica do tipo revisão integrativa da literatura. Resultados: 10 artigos foram incluídos nesta revisão, a maior parte com abordagem quantitativa dos dados, publicados no ano de 2021, todos estavam na língua inglesa, houve predomínio de estudos realizados na Coreia do Sul e Estados Unidos, sendo a maioria estudos transversais em que todos os estudos recomendavam (grau de recomendação "A") o uso da simulação virtual para o ensino de enfermagem. Conclusão: A simulação virtual no ensino de enfermagem tem potencial para melhorar a retenção do conhecimento e o raciocínio clínico numa fase inicial e ao longo do tempo, e aumenta a satisfação com a experiência de aprendizagem entre os estudantes de enfermagem.

Introduction: In the last two decades, the means of teaching have been changing in the health area, in which traditional teaching is no longer able to meet current needs. Thus, virtual simulation began to play a fundamental role in higher education in nursing, being an active means of learning. Objective: To analyze the effectiveness of virtual simulation in nursing education in the scientific literature. Methodology: This is a bibliographic research of the integrative literature review type. Results: 10 articles were included in this review, most with a quantitative approach to the data, published in the year 2021, all were in English, there was a predominance of studies carried out in South Korea and the United States, most of which were cross-sectional studies in which all studies recommended (degree of recommendation "A") the use of virtual simulation for teaching nursing. Conclusion: Virtual simulation in nursing education has the potential to improve knowledge retention and clinical reasoning at an early stage and over time, and increases satisfaction with the learning experience among nursing students.

Introducción: En las últimas dos décadas, las formas de enseñanza han ido cambiando en el área de la salud, en la que la enseñanza tradicional ya no es capaz de suplir las necesidades actuales. Así, la simulación virtual pasó a jugar un papel fundamental en la educación superior en enfermería, siendo un medio activo de aprendizaje. Objetivo: Analizar la efectividad de la simulación virtual en la educación de enfermería en la literatura científica. Metodología: Se trata de una investigación bibliográfica del tipo revisión integradora de literatura. Resultados: se incluyeron en esta revisión 10 artículos, la mayoría con enfoque cuantitativo de los datos, publicados en el año 2021, todos en inglés, hubo predominio de estudios realizados en Corea del Sur y Estados Unidos, la mayoría de los cuales fueron transversales -estudios seccionales en los que todos los estudios recomendaron (grado de recomendación "A") el uso de simulación virtual para la enseñanza de enfermería. Conclusión: La simulación virtual en la educación de enfermería tiene el potencial de mejorar la retención de conocimientos y el razonamiento clínico en una etapa temprana y con el tiempo, y aumenta la satisfacción con la experiencia de aprendizaje entre los estudiantes de enfermería.

Intention of breastfeeding and association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women / Intenção de amamentar e associação com características sociodemográficas, obstétricas e experiência com o aleitamento materno entre mulheres grávidas

Abstract Objectives: to estimate the intention of breastfeeding (IBF) duration and its association with sociodemographic, obstetric characteristics and experience with breastfeeding among pregnant women undergoing prenatal care. Methods: cross-sectional study, with pregnant women undergoing prenatal care in public health services in Colombo, Paraná, Brazil. The duration of IBF was questioned to pregnant women. Negative binomial Poisson regression with robust variance adjustment allowed estimating crude and adjusted prevalence ratios (PR), and 95% confidence intervals (CI95%) of the association between IBF duration and exposure variables. Results: among the participating pregnant women (n = 604), 7.9% reported having IBF for less than six months, 28.0% from six to 11 months, 38.3% from 12 to 23 and 25.9% for 24 months or more. The mean IBF time was 13.5 ± 8.4 and median of 12 months. Pregnant women with moderate food insecurity (PR=1.34; CI95%=1.04-1.73), multiparous women (PR=1.13; CI95%=1.00-1.26), and who reported having been breastfed as babies (PR=1.19; CI95%=1.02-1.40) had a longer IBF time. Conclusions: food security situation, primiparity and exposure to breastfeeding in childhood are determinants of IBF during pregnancy.

Resumo Objetivos: estimar o tempo de intenção de amamentar (IA) e sua associação com características sociodemográficas, obstétricas e experiência com amamentação entre gestantes em acompanhamento pré-natal. Métodos: estudo transversal com gestantes em serviços públicos de saúde em Colombo, Paraná. O tempo de IA foi questionado às gestantes. Regressão de Poisson binomial negativa com ajuste robusto da variância permitiu estimar razões de prevalência (RP) brutas e ajustadas, e intervalos de confiança de 95% (IC95%) da associação entre tempo de IA e variáveis de exposição. Resultados: dentre as gestantes (n = 604), 7,9% afirmaram IA por menos de 6 meses, 28,0% de 6 a 11 meses, 38,3% de 12 a 23 e 25,9% por 24 meses ou mais. O tempo médio de IA foi de 13,5 ± 8,4 e mediana de 12 meses. Gestantes em insegurança alimentar moderada (RP=1,34; IC95%=1,04-1,73), multíparas (RP=1,13; IC95%=1,00-1,26), e que referiram terem sido amamentadas quando bebês (RP=1,19; IC95%=1,02-1,40) apresentaram maior tempo de IA. Conclusões: situação de segurança alimentar, primiparidade e exposição ao aleitamento materno na infância são determinantes da IA na gestação.

In Vitro and In Vivo Effect of pH-Sensitive PLGA-TPGS-Based Hybrid Nanoparticles Loaded with Doxorubicin for Breast Cancer Therapy.

Doxorubicin (DOX) is an antineoplastic agent clinically employed for treating breast cancer patients. Despite its effectiveness, its inherent adverse toxic side effects often limit its clinical application. To overcome these drawbacks, lipid-polymer hybrid nanoparticles (LPNP) arise as promising nanoplatforms that combine the advantages of both liposomes and polymeric nanoparticles into a single delivery system. Alpha-tocopherol succinate (TS) is a derivative of vitamin E that shows potent anticancer mechanisms, and it is an interesting approach as adjuvant. In this study, we designed a pH-sensitive PLGA-polymer-core/TPGS-lipid-shell hybrid nanoparticle, loaded with DOX and TS (LPNP_TS-DOX). Nanoparticles were physicochemically and morphologically characterized. Cytotoxicity studies, migration assay, and cellular uptake were performed in 4T1, MCF-7, and MDA-MB-231 cell lines. Antitumor activity in vivo was evaluated in 4T1 breast tumor-bearing mice. In vitro studies showed a significant reduction in cell viability, cell migration, and an increase in cellular uptake for the 4T1 cell line compared to free DOX. In vivo antitumor activity showed that LPNP-TS-DOX was more effective in controlling tumor growth than other treatments. The high cellular internalization and the pH-triggered payload release of DOX lead to the increased accumulation of the drugs in the tumor area, along with the synergic combination with TS, culminating in greater antitumor efficacy. These data support LPNP-TS-DOX as a promising drug delivery system for breast cancer treatment.

Irinotecan-Loaded Polymeric Micelles as a Promising Alternative to Enhance Antitumor Efficacy in Colorectal Cancer Therapy.

Colorectal cancer has been considered a worldwide public health problem since current treatments are often ineffective. Irinotecan is a frontline chemotherapeutic agent that has dose-limiting side effects that compromise its therapeutic potential. Therefore, it is necessary to develop a novel, targeted drug delivery system with high therapeutic efficacy and an improved safety profile. Here, micellar formulations composed of 1,2-distearoyl-sn-glycero-3-phosphoethanolamine-N-[methoxy(polyethyleneglycol)-2000] (DSPE-mPEG2k) containing irinotecan were proposed as a strategy for colorectal cancer therapy. Firstly, the irinotecan-loaded micelles were prepared using the solvent evaporation method. Then, micelles were characterized in terms of size, polydispersity, zeta potential, entrapment efficiency, and release kinetics. Cytotoxicity and in vivo antitumor activity were evaluated. The micelles showed size around 13 nm, zeta potential near neutral (-0.5 mV), and encapsulation efficiency around 68.5% (irinotecan 3 mg/mL) with a sustained drug release within the first 8 h. The micelles were evaluated in a CT26 tumor animal model showing inhibition of tumor growth (89%) higher than free drug (68.7%). Body weight variation, hemolytic activity, hematological, and biochemical data showed that, at the dose of 7.5 mg/kg, the irinotecan-loaded micelles have low toxicity. In summary, our findings provide evidence that DSPE-mPEG2k micelles could be considered potential carriers for future irinotecan delivery and their possible therapeutic application against colorectal cancer.

Recent advances in point of care testing for COVID-19 detection.

The World Health Organizations declaration of the COVID-19 pandemic was a milestone for the scientific community. The high transmission rate and the huge number of deaths, along with the lack of knowledge about the virus and the evolution of the disease, stimulated a relentless search for diagnostic tests, treatments, and vaccines. The main challenges were the differential diagnosis of COVID-19 and the development of specific, rapid, and sensitive tests that could reach all people. RT-PCR remains the gold standard for diagnosing COVID-19. However, new methods, such as other molecular techniques and immunoassays emerged. Also, the need for accessible tests with quick results boosted the development of point of care tests (POCT) that are fast, and automated, with high precision and accuracy. This assay reduces the dependence on laboratory conditions and mass testing of the population, dispersing the pressure regarding screening and detection. This review summarizes the advances in the diagnostic field since the pandemic started, emphasizing various laboratory techniques for detecting COVID-19. We reviewed the main existing diagnostic methods, as well as POCT under development, starting with RT-PCR detection, but also exploring other nucleic acid techniques, such as digital PCR, loop-mediated isothermal amplification-based assay (RT-LAMP), clustered regularly interspaced short palindromic repeats (CRISPR), and next-generation sequencing (NGS), and immunoassay tests, and nanoparticle-based biosensors, developed as portable instruments for the rapid standard diagnosis of COVID-19.

Assistência à saúde do homem transgênero durante o ciclo gravídico puerperal: Uma revisão integrativa / Atención a la salud de hombres transgénero durante el ciclo del embarazo puerperal: Una revisión integrativa / Health care for transgender men during the puerperal pregnancy cycle: An integrative review

Objetivo: Identificar a produção científica acerca da assistência à saúde do homem transgênero durante o ciclo gravídico puerperal. Método: Foi realizada uma revisão integrativa da literatura, em abril de 2022, nas bases de dados: Scopus, Web of Science, PubMed Central, Embase e Literatura Latino-Americana e do Caribe em Ciências da Saúde, sem delimitação de intervalo temporal para a pesquisa. Resultados: Após aplicação dos critérios de elegibilidade, nove artigos foram incluídos na amostra final. A maior parte dos estudos foi publicada nos anos de 2020 (22,2%) e 2015 (22,2%), prevaleceram os estudos transversais (44,4%) e todos estavam escritos na língua inglesa. Conclusão: O estudo da literatura evidenciou que a assistência à saúde dos homens transgênero engloba diversos desafios como a falta de competência profissional, receio de receber tratamento transfóbico, ausência de orientações e escassez de evidências científicas para as necessidades de saúde desse público. (AU)

Objective: To identify the scientific production on health care for transgender men during the pregnancy-puerperal cycle. Method: An integrative literature review was carried out, in April 2022, in the following databases: Scopus, Web of Science, PubMed Central, Embase and Latin American and Caribbean Literature on Health Sciences, without delimitation of time interval for research. Results: After applying the eligibility criteria, nine articles were included in the final sample. Most of the studies were published in 2020 (22.2%) and 2015 (22.2%), cross-sectional studies prevailed (44.4%) and all were written in English. Conclusion: The study of the literature showed that the health care of transgender men encompasses several challenges such as lack of professional competence, fear of receiving transphobic treatment, lack of guidelines and scarcity of scientific evidence for the health needs of this public (AU)

Objetivo: Identificar la producción científica sobre la atención a la salud de hombres transgénero durante el ciclo embarazo-puerperio. Método: Se realizó una revisión integrativa de la literatura, en abril de 2022, en las siguientes bases de datos: Scopus, Web of Science, PubMed Central, Embase y Latin American and Caribbean Literature on Health Sciences, sin delimitación de intervalos de tiempo para la investigación. Resultados: Después de aplicar los criterios de elegibilidad, se incluyeron nueve artículos en la muestra final. La mayoría de los estudios se publicaron en 2020 (22,2%) y 2015 (22,2%), prevalecieron los estudios transversales (44,4%) y todos estaban escritos en inglés. Conclusión: El estudio de la literatura mostró que la atención a la salud de los hombres transgénero engloba varios desafíos, como la falta de competencia profesional, el miedo a recibir un tratamiento transfóbico, la falta de directrices y la escasez de evidencia científica para las necesidades de salud de este público (AU)