Mapping the Silent Threat: A Comprehensive Analysis of Chagas Disease Occurrence in Riverside Communities in the Western Amazon.

Chagas disease (CD) is a typical tropical illness caused by Trypanosoma cruzi. The objective of this study was to assess the prevalence of Chagas disease in communities in two states of the Brazilian Amazon. Data collection occurred in July in the Alto Juruá region of Acre and in December in the communities of Humaitá, Amazonas, in 2019. A total of 477 participants were included in the study. In the communities of Alto Juruá, triatomine collections and analyses of T. cruzi infection were also carried out. All confirmed cases were found in the state of Acre, resulting in a total prevalence of 1.67. Of these eight cases, seven underwent ECG, all of which were concluded as normal by the physician team's cardiologists. Seventeen triatomine bugs, all belonging to the Rhodnius genus, were captured. The natural infection rate by T. cruzi was 25% in the Nova Cintra community and 66.67% in the Boca do Moa community (Alto Juruá). This research found that more than 1% of the studied population exhibited positive serological results for Chagas disease in the riverine communities during the study period, representing a small portion of cases among those who have not yet been diagnosed.

Telemedicine for diagnosis or treatment during Covid-19: systematic review

OBJECTIVE: To describe the use of telemedicine by health professionals for diagnosis or treatment of patients during the Covid-19 pandemic. METHOD: This is a systematic literature review of observational studies. Five databases were used. The assessment of the studies methodological quality occurred individually among the revisors and the Joanna Briggs Institute (JBI) tool was used. RESULTS: The reviewers selected 22 articles from 6,180 works. The services provided through telemedicine were consultation/screening, consultation/follow-up or monitoring, test reports, medication prescriptions and case discussions. The technological resources used were platforms using video and telephone (audio and video). The use of telemedicine made it possible to reduce their exposure to Covid-19, reduce social panic and anxiety, quickly medical specialties access and the possibility of access to diagnosis and treatment of patients with chronic and acute diseases. CONCLUSION: Telemedicine can be an important tool in healthcare, keeping patients and healthcare professionals safe during the Covid-19 pandemic.

First report of Rhodnius stali Lent, Jurberg & Galvão, 1993 (Hemiptera: Reduviidae: Triatominae), vector of Trypanosoma cruzi (TcI) and Trypanosoma rangeli (TrA), in Rondônia, Southwestern Brazilian Amazonia.

Triatomines are hematophagous insects of epidemiological importance as they are vectors of Chagas disease. The first report of Rhodnius stali Lent, Jurberg & Galvão, 1993 in Rondônia, Brazil, is described. The insects were captured on palm trees of the genus Oenocarpus sp. Two adult male specimens of R. stali were identified and were found to be infected with Trypanosoma cruzi and Trypanosoma rangeli. The confirmation of this Rhodnius species in Rondônia increases the number of triatomines from nine to ten species in this state.

Analysis of strength and electromyographic activity of lower limbs of individuals with down syndrome assisted in physiotherapy and hippotherapy.

INTRODUCTION: one of the characteristics of Down Syndrome (DS) is muscle hypotonia. Different therapeutic approaches have a positive influence, between them Physiotherapy applications with different therapeutic approaches such as Hippotherapy have a positive effect on the physical health and quality of live of individuals with DS. OBJECTIVE: to evaluate the effects of both treatments on the strength and electromyographic activity of the lower limbs of children and adolescents with DS. METHODS: fourteen individuals, aged between 10 and 18 years, participated in two groups: Physiotherapy group (n = 5) and Hippotherapy group (n = 9). Thirty interventions were performed for each type of therapy, once a week, lasting 30 min. Pre and post-interventions, the 30-Second Chair Stand Test (30s-CST) was used to assess the strength of the lower limbs and the surface electromyography equipment (EMG 800RF) to assess the lower limb myoelectric activity. RESULTS: there was a reduction in the post-intervention electromyographic values for both treatments (p˂0.001), with significantly less myoelectric activity in Hippotherapy compared to Physiotherapy for all evaluated muscles (p˂0.001) and a significant increase in muscle strength for the Hippotherapy, post-intervention group (p = 0.0007). CONCLUSION: Physiotherapy and Hippotherapy are interventions that promote positive changes in the myoelectric activities of individuals with DS. However, only hippotherapy promoted an increase in strength of the lower limbs.

Describing Trends in Maternal Mortality in the State of São Paulo, Brazil, from 2009 to 2019.

BACKGROUND: Maternal mortality is a significant public health concern, with varying impacts across different regions in Brazil, particularly affecting women from lower-income social classes with limited access to social resources. The aim of this study is to describe the trends in maternal mortality in São Paulo, Brazil, from 2009 to 2019. MATERIALS AND METHODS: This study employed an ecological approach utilizing a time-series design to examine maternal deaths. Secondary data from the Mortality Information System (SIM) and the Live Births Information System (SINASC) from 2009 to 2019 were utilized. The analysis included all maternal deaths among women aged 10 to 49 years residing in the state of São Paulo. Time-series data for maternal mortality ratios were constructed for the seven regions within São Paulo State. Joinpoint regression analysis was applied to characterize the maternal mortality ratio. The study estimated the annual percentage variation, the average annual percentage variation, and their respective 95% confidence intervals. RESULTS: In São Paulo, a total of 3075 maternal deaths were reported, resulting in a mortality ratio of 45.9 deaths per 100,000 live births. The leading causes of maternal death were eclampsia (7.13%), gestational hypertension (6.09%), and postpartum hemorrhage (5.89%). The analysis of the annual percentage change in the maternal mortality ratio for São Paulo State and its six clusters showed stationarity. CONCLUSIONS: The assessment of the maternal mortality ratio in the state of São Paulo, Greater São Paulo, and Baixada Santista revealed an increase in the maternal death ratio over the studied period.

Occurrence of triatomines in public spaces: An atypical case in the Southwestern Brazilian Amazon.

BACKGROUND: Triatomines infest atypical public spaces in the Western Amazon. METHODS: Frequent visitors to these spaces captured the insects in the state of Acre, Brazil (Rio Branco and Cruzeiro do Sul). RESULTS: Six insects were found in a penitentiary, a church, a school, a university, a hospital, and a health center. Five of the insects were adults (three positive for Trypanosoma cruzi) and one was a nymph. CONCLUSIONS: This is the first report of triatomine occurrence in schools or churches. These data are important for implementing surveillance strategies and alerting individuals about possible changes in Chagas disease transmission dynamics.

Occurrence of triatomines in public spaces: An atypical case in the Southwestern Brazilian Amazon

ABSTRACT Background: Triatomines infest atypical public spaces in the Western Amazon. Methods: Frequent visitors to these spaces captured the insects in the state of Acre, Brazil (Rio Branco and Cruzeiro do Sul). Results: Six insects were found in a penitentiary, a church, a school, a university, a hospital, and a health center. Five of the insects were adults (three positive for Trypanosoma cruzi) and one was a nymph. Conclusions: This is the first report of triatomine occurrence in schools or churches. These data are important for implementing surveillance strategies and alerting individuals about possible changes in Chagas disease transmission dynamics.

First report of Rhodnius montenegrensis (Hemiptera: Reduviidae: Triatominae) in Bolivia.

BACKGROUND: The subfamily Triatominae, which comprises 157 species, carries the protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. This short communication reports for the first time the occurrence of Rhodnius montenegrensis in Bolivia. METHODS: Active searches were carried out on palm trees of the genus Oenocarpus in Beni district, Bolivia. RESULTS: Fifteen R. montenegrensis specimens were collected from a rural area of the Beni district, Bolivia, and tested positive for T. cruzi. CONCLUSIONS: This new report expands the geographic distribution of the species in Latin America. Due to their ability to transmit trypanosomatids, the species deserves the attention of vector control programs.

Analysis of Trunk Neuromuscular Activation During Equine-Assisted Therapy in Older Adults.

The three-dimensional movement of the horse in physical therapy is a valuable kinesio-therapeutic phenomenon that simultaneously affects several body systems, including particularly the neuromuscular system. However, the effects of equine-assisted services (EAS) on neuromuscular activation patterns in older adults have not been thoroughly investigated. In this study, we evaluated the impact of a 10-weeks EAS program on trunk muscles in older adults who used a saddle and placed their feet in stirrups for the first 15 minutes and out of stirrups for the remaining 15 minutes of 30-minute EAS sessions. We gathered electromyographic (EMG) data of the trunk muscles five times each on the first, fifth, and 10th sessions: pre-EAS and post-EAS on a stationary horse and at 1-minute, 15-minutes, and 30-minutes on a horse in motion. Participants were 20 adults, aged 60-79 years. We analyzed normalized EMG data with 5 (session time) by 3 (session number) analyses of variance (ANOVAs) with repeated measures and with Bonferroni's testing (p ≤ .05). There was a significant difference over the number of interventions for the right thoracic paravertebral muscle (p = .025) and session time effect for the left trapezius (p = .042), right thoracic paravertebral (p < .001), right and left multifidus (p < .001), and right and left rectus abdominis muscles (p < .001). Thus, trunk muscles in older adults showed complex neuromuscular activation synchronized with the horse's movement, which was influenced by session time and number of interventions. The practical implication of these findings is that EAS can reduce fall risk among elderly adults of both sexes.

COVID-19 in the municipalities of Botucatu and Serrana, São Paulo, Brazil, the effects of lethality and mortality / COVID-19 nos municípios de Botucatu e Serrana, São Paulo, Brasil, os efeitos da letalidade e mortalidade

Introduction: In 2019, the proliferation of a virus identified as SARS-CoV-2 emerged in the city of Wuhan, a district in China, quickly spread throughout the world, gaining pandemic status and less than 1 year, its repercussions and magnitude caused scientists, governments and society to adopt severe measures to combat this disease. Objective: To analyze mortality, incidence and mortality from COVID-19 in the municipalities of Botucatu and Serrana, São Paulo, Brazil. Methods: This is an ecological study with a time series design with secondary data. All registered cases and deaths registered by COVID-19 from April 2020 to August 2021 in the municipalities of Botucatu and Serrana, São Paulo, Brazil were considered. The incidence, mortality and lethality rate were used. The monthly and/or weekly percentage variation and their respective 95% confidence intervals were estimated.Results: It identified that 12.88% of the residents of the city of Botucatu were infected with COVID-19 and 8.61% of the population of the municipality of Serrana was infected. There was a stationary trend of mortality and incidence in the period between April 2020 and May 2021 and decreasing in both sexes in the mortality rate in the municipality of Serrana, in the city of Botucatu there was a trend of increasing mortality and incidence in the same period observed. Conclusion: The mass vaccination strategy of citizens in the cities of Botucatu and Serrana present robust data to consider that immunization has a decreasing effect on the number of cases and deaths from COVID-19, which effectively contributes to fighting the pandemic and reduces the contamination and progression of the disease to more severe cases.

Introdução: em 2019, surgiu na cidade de Wuhan, um distrito na região da China a proliferação com a infecção de um vírus identificado como SARS-CoV-2, rapidamente espalhou-se pelo mundo ganhando status de pandemia em menos de 1 ano, suas repercussões e magnitude fizeram que os cientistas, governos e sociedade adotarem medidas severas para o combate a esta enfermidade. Objetivo: analisar a mortalidade, incidência e letalidade por COVID-19 nos municípios de Botucatu e Serrana, São Paulo, Brasil. Método: trata-se de um estudo ecológico com delineamento de série temporal com dados secundários. Foram consideradas todos os casos registrados e óbitos registrados por COVID-19 no período de abril de 2020 a agosto de 2021, nos municípios de Botucatu e Serrana, São Paulo, Brasil. Foi utilizado a taxa de incidência, mortalidade e letalidade. Estimou-se a variação percentual mensal e/ou semanal e seus respectivos intervalos de 95% de confiança. Resultados: identificou que e 12,88% dos munícipes da cidade de Botucatu foram infectados com COVID-19 e 8,61% da população do município de Serrana foi infectada. Observou-se uma tendência estacionária de mortalidade e incidência no período entre abril 2020 a maio 2021 e decrescente em ambos os sexos na taxa de letalidade no município de Serrana, na cidade de Botucatu houve tendência de mortalidade e incidência crescentes no mesmo período observado. Conclusão: a estratégia de vacinação em massa dos munícipes das cidades de Botucatu e Serrana apresentam dados robustos para considerar que a imunização tem efeito de queda no número de casos e óbitos por COVID-19, o que contribui efetivamente no combate a pandemia e reduz a contaminação e evolução da doença para casos mais graves.

Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review

ABSTRACT Introduction: Early mobilization of patients in the postoperative period of cardiac surgery who are hospitalized in the intensive care unit (ICU) is a practice that has a positive impact. Methods: This is a systematic review of studies published until September 2020 in the Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase, Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library Online (or SciELO), and Latin American and Caribbean Health Sciences Literature (or LILACS) databases. Randomized clinical trials describing mobilization protocols performed early in ICU patients after cardiac surgery were included. Results: According to the eligibility criteria, only 14 of the 1,128 articles found were included in the analysis. Early mobilization protocols were initiated in the immediate postoperative period or first postoperative day. The resources and technics used were progressive mobilization, cycle ergometer, early bed activities, walking protocols, resistance exercise, and virtual reality. Intensity of the mobilization activities was determined using the Borg scale and heart rate. Conclusion: Early mobilization protocols are generalist (not individual), and low-intensity exercises are used, through progressive mobilization, with two daily physical therapy sessions, during 10 to 30 minutes.

Early Mobilization Prescription in Patients Undergoing Cardiac Surgery: Systematic Review.

INTRODUCTION: Early mobilization of patients in the postoperative period of cardiac surgery who are hospitalized in the intensive care unit (ICU) is a practice that has a positive impact. METHODS: This is a systematic review of studies published until September 2020 in the Medical Literature Analysis and Retrieval System Online (or MEDLINE®), Embase, Physiotherapy Evidence Database (or PEDro), Scientific Electronic Library Online (or SciELO), and Latin American and Caribbean Health Sciences Literature (or LILACS) databases. Randomized clinical trials describing mobilization protocols performed early in ICU patients after cardiac surgery were included. RESULTS: According to the eligibility criteria, only 14 of the 1,128 articles found were included in the analysis. Early mobilization protocols were initiated in the immediate postoperative period or first postoperative day. The resources and technics used were progressive mobilization, cycle ergometer, early bed activities, walking protocols, resistance exercise, and virtual reality. Intensity of the mobilization activities was determined using the Borg scale and heart rate. CONCLUSION: Early mobilization protocols are generalist (not individual), and low-intensity exercises are used, through progressive mobilization, with two daily physical therapy sessions, during 10 to 30 minutes.

Vaccine coverage and measles incidence in Northern Brazil / Cobertura vacinal e incidência de sarampo na Região Norte do Brasil

Introduction: measles is an immunopreventable viral disease, acute exanthematous and extremely transmissible. Infection occurs directly, from person to person, through respiratory secretions. The measles vaccine is low-cost and effective, but measles still affects around 40 million people worldwide and is responsible for at least 800,000 deaths, mainly in developing countries.Objective: to analyze vaccination coverage and measles incidence in Northern Brazil.Methods: this is an ecological study. Secondary data were used regarding vaccination coverage of the viral double, viral triple and viral tetra and incidence of measles in residents in the States of the Northern Region, Brazil, from 2010 to 2018.Results: confirmed measles cases in 2010 to 2018 in the Northern region of Brazil it registered 10,249, were reported in Amazonas (95.65%), Roraima (3.53%), Pará (0.80%) and Rondônia (0.02%). Outbreaks of measles cases in the Northern Region were reported in 2018, the highest incidence rate was in Amazonas with 237.7. Vaccination coverage in the North Region varied between the lowest rate in 2013 with 56.88% and the highest vaccination coverage achieved in 2010, with 104.02%.Conclusion: it was possible to observe a reduction in vaccination coverage during the study period, not reaching the percentage recommended by the Ministry of Health and increasing the incidence of measles in the Northern Region of Brazil and these indicators are important to determine the strategies to be carried out by the National Program for Immunization and Epidemiological Surveillance.

Introdução: o sarampo é uma doença viral imunoprevenível, exantematosa aguda e extremamente transmissível. A infecção ocorre de forma direta, de pessoa a pessoa, por meio das secreções respiratórias. A vacina contra o sarampo é de baixo custo e efetiva, porém o sarampo ainda acomete cerca de 40 milhões de pessoas no mundo e é responsável por pelo menos 800 mil mortes, principalmente em países em desenvolvimento.Objetivo: analisar a cobertura vacinal e incidência de sarampo na Região Norte do Brasil.Método: trata-se de um estudo ecológico. Utilizou-se dados secundários referente a cobertura vacinal da dupla viral, tríplice viral e tetra viral e incidência de sarampo em residentes nos Estados da Região Norte, Brasil, no período de 2010 a 2018.Resultados: os casos confirmados de sarampo em 2010 a 2018 na região Norte do Brasil registrou 10.249, foram notificados no Amazonas (95,65%), Roraima (3,53%), Pará (0,80%) e Rondônia (0,02%). Os surtos de casos de sarampo na Região Norte foram notificados no ano de 2018, a maior taxa de incidência foi no Amazonas com 237,7. A cobertura vacinal da Região Norte variou entre o menor índice em 2013 com 56,88% e a maior cobertura vacinal alcançada em 2010, com 104,02%.Conclusão: foi possível observar uma redução da cobertura vacinal no período de estudo, não atingindo o percentual preconizado pelo Ministério da Saúde e aumentando a incidência de sarampo na Região Norte do Brasil e estes indicadores são importantes para determinar as estratégias a serem realizadas pelo Programa de Imunização e Vigilância Epidemiológica.

First report of Rhodnius montenegrensis (Hemiptera: Reduviidae: Triatominae) in Bolivia

ABSTRACT Background: The subfamily Triatominae, which comprises 157 species, carries the protozoan Trypanosoma cruzi, the etiological agent of Chagas disease. This short communication reports for the first time the occurrence of Rhodnius montenegrensis in Bolivia. Methods: Active searches were carried out on palm trees of the genus Oenocarpus in Beni district, Bolivia. Results: Fifteen R. montenegrensis specimens were collected from a rural area of the Beni district, Bolivia, and tested positive for T. cruzi. Conclusions: This new report expands the geographic distribution of the species in Latin America. Due to their ability to transmit trypanosomatids, the species deserves the attention of vector control programs.

COVID-19 mortality and lethality in the state of Pará, legal Amazon, Brazil / Mortalidade e letalidate da COVID-19 no Estado do Pará, Amazônia legal, Brasil

INTRODUCTION: the growth of coronavirus indices in the North region highlights the region's historical social inequalities and the problems in accessing citizenship. OBJECTIVE: to analyze the mortality and lethality of COVID-19 in the state of Pará, Brazil. METHODS: this is an ecological study with a time series design of secondary data. All registered cases and deaths reported by COVID-19 in the period from March 2020 to June 2021, in the state of Pará, Brazil, were considered. The incidence and mortality and lethality rates were used. The daily percentage variation and their respective 95% confidence intervals were estimated. RESULTS: the total number of confirmed cases and deaths from COVID-19 in the state of Pará was 552,937 and 15,469, respectively, from March 2020 to June 2021. Incidence and mortality rates from March 2020 to June 2021 were, respectively, 6,407.9 and 179.3 per 100,000 inhabitants and the lethality was 43.3. Regarding the analysis of the daily trend of rates in the period from March 2020 to June 2021, both mortality and incidence increased. CONCLUSION: it was found that the behavior of the trend of rates in the first wave was increasing in the incidence of confirmed cases and the lethality decreasing, and in the second wave, the mortality and lethality rates were increasing.

INTRODUÇÃO: o crescimento dos índices do coronavírus na região Norte evidencia as desigualdades sociais históricas da região e os problemas no acesso à cidadania. OBJETIVO: analisar a mortalidade e letalidade da COVID-19 no estado do Pará, Brasil. MÉTODO: trata-se de um estudo ecológico com delineamento de série temporal de dados secundários. Foram consideradas todos os casos registrados e óbitos notificados por COVID-19 no período de março de 2020 a junho de 2021, no estado do Pará, Brasil. Foi utilizado a taxa de incidência, mortalidade e letalidade. Estimou-se a variação percentual diário e seus respectivos intervalos de 95% de confiança. RESULTADO: o total de casos confirmados e óbitos por COVID-19 no estado do Pará foi de 552.937 e 15.469, respectivamente, no período de março de 2020 a junho de 2021. As taxas de incidência e mortalidade do período de março de 2020 a junho de 2021 foram, respectivamente, 6.407,9 e 179,3 por 100.000 habitantes e a letalidade foi 43,3. Com relação à análise de tendência diária das taxas no período de março de 2020 a junho de 2021 tanto a mortalidade quanto a incidência foram crescentes. CONCLUSÃO: constatou-se que o comportamento da tendência das taxas na primeira onda foi crescente na incidência de casos confirmados e a letalidade decrescente e, na segunda onda, as taxas de mortalidade e letalidade foram crescentes.

Evolution of mortality and lethality due to COVID-19 in the State of Roraima, Brazil, from march 2020 to july 2021 / Evolução da mortalidade e letalidade da COVID-19 no Estado de Roraima no período de março de 2020 a julho de 2021

INTRODUCTION: the context of the Covid-19 pandemic in the Brazilian North region is worrying. There is a lack of resources for Public Health, a low human development index, and poverty indicators above the national average OBJECTIVE: to analyze mortality and lethality from COVID-19 in the State of Roraima, Brazil METHODS: this is an ecological time-series study of secondary data on COVID-19 in Roraima, Northern Brazil, from March 2020 to July 2021. The incidence, mortality, and lethality rates due to COVID-19 were calculated. The Prais-Winsten regression model was used to calculate the time series trends. Trends were classified as increasing, decreasing, or stationary. The trend was considered static when the p-value was not significant (p>0.05 RESULTS: in the state of Roraima, from March 2020 to July 2021, there were 123,125 cases and 1,903 accumulated deaths due to COVID-19. The first wave (March 2020 to October 2021) of COVID-19 recorded the incidence rate (2,995.30 new cases per 100,000 inhabitants - July 2020) and mortality (56.32 deaths per 100,000 inhabitants - June 2020) higher lethality. However, in the second wave (November 2020 to July 2021), the highest lethality rate was observed (3.47% - February 2021). It was observed that during the first wave, the incidence rate of COVID-19 showed increasing trends. During this period, the mortality rate had a stationary tendency (p>0.05) and the percentage lethality with a decreasing trend (p<0.05). During the second wave, there was a more aggravating scenario for lethality, which changed from a daily reduction rate of 0.90% to stationary trends CONCLUSION: the pandemic in the state of Roraima is not yet under control, so it is necessary to strengthen strategies to mitigate the spread of the pandemic in the region and prevent the formation of new waves

INTRODUÇÃO: o contexto da pandemia da Covid-19 na região Norte é preocupante, visto que há falta de recursos para a Saúde Pública, baixo índice de desenvolvimento humano e indicadores de pobreza acima da média nacional OBJETIVO: analisar a letalidade e mortalidade por COVID-19 no Estado de Roraima, Brasil MÉTODO: trata-se de um estudo ecológico de séries temporais de dados secundários sobre a COVID-19 no estado de Roraima, região Norte do Brasil, no período de março de 2020 a julho de 2021. Foram calculadas as taxas de incidência, mortalidade e letalidade por COVID-19. Utilizou-se o modelo de regressão de Prais-Winsten para calcular as taxas de construção de séries temporais. As taxas foram classificadas como crescentes, decrescentes ou estacionárias. A tendência foi considerada estacionária quando o p-valor não foi significativo, (p>0,05 RESULTADOS: no estado de Roraima, durante o período de março de 2020 a julho de 2021, houve um total de 123.125 casos e 1.903 óbitos acumulados devido a COVID-19. A primeira onda (março de 2020 a outubro de 2021) da COVID-19 foi registrada a taxa de incidência (2.995,30 novos casos por 100.000 habitantes - julho de 2020) e de mortalidade (56,32 óbitos por 100.000 habitantes - junho de 2020) letalidade mais elevada. Entretanto, foi na segunda onda (novembro de 2020 a julho de 2021) que foi observada a taxa de letalidade mais elevada (3,47% - fevereiro de 2021). Observou-se que durante a primeira onda, a taxa de incidência da COVID-19 apresentou tendências crescentes. Neste período, a taxa de mortalidade encontrava-se com tendência estacionária (p>0,05) e a letalidade percentual com tendência decrescente (p<0,05). Durante a segunda onda, observou-se um cenário mais agravante para a letalidade, que transitou de uma taxa de redução diária de 0,90%, para tendências estacionárias CONCLUSÃO: a pandemia no estado de Roraima ainda não está controlada, assim faz-se necessário o fortalecimento de estratégias para mitigar o avanço da pandemia na região e evitar a formação de novas ondas

Perinatal Mortality Analysis in Espírito Santo, Brazil, 2008 to 2017.

This is an ecological and time-series study using secondary data on perinatal mortality and its components from 2008 to 2017 in Espírito Santo, Brazil. The data were collected from the Mortality Information System (SIM) and Live Births Information System (SINASC) of the Unified Health System Informatics Department (DATASUS) in June 2019. The perinatal mortality rate (×1000 total births) was calculated. Time series were constructed from the perinatal mortality rate for the regions and Espírito Santo. To analyze the trend, the Prais-Winsten model was used. From 2008 to 2017 there were 8132 perinatal deaths (4939 fetal and 3193 early neonatal) out of a total of 542,802 births, a perinatal mortality rate of 15.0/1000 total births. The fetal/early neonatal ratio was 1.5:1, with a strong positive correlation early neonatal mortality rate, perinatal mortality rate, r (9) = 0.8893, with a significance level of p = 0.000574. The presence of differences in trends by health region was observed. Risk factors that stood out were as follows: mother's age ranging between 10 and 19 or 40 and 49 years old, with no education, a gestational age between 22 and 36 weeks, triple and double pregnancy, and a birth weight below 2499 g. Among the causes of death, 49.70% of deaths were concentrated in category of the tenth edition of the International Classification of Diseases, fetuses and newborns affected by maternal factors and complications of pregnancy, labor, and delivery (P00-P04), and 11.03% were in the category of intrauterine hypoxia and birth asphyxia (P20-P21), both related to proper care during pregnancy and childbirth. We observed a slow reduction in the perinatal mortality rate in the state of Espírito Santo from 2008 to 2017.

Diretrizes de prática clínica para o tratamento da Covid-19 no Brasil: uma revisão sistemática / Clinical practice guidelines for the treatment of Covid-19 in Brazil: A systematic review / Guías de práctica clínica para el tratamiento de la enfermedad por Covid-19 en Brasil: revisión sistemática

Resumo Introdução A Coronavirus Disease-2019 é uma doença infectocontagiosa que afeta o sistema respiratório, que surgiu na China e logo se espalhou pelo mundo. Objetivo Avaliar a qualidade metodológica e transparência das Diretrizes de Prática Clínica brasileiras para o tratamento da Coronavirus Disease-2019. Materiais e Métodos Trata-se de uma revisão sistemática realizada em 2020 nas fontes de dados: MEDLINE (via PubMed), EMBASE, Scopus e Literatura Latino-Americana e do Caribe em Ciências da Saúde, National Guideline Clearinghouse e Guidelines International Network, e sites do Ministério da Saúde do Brasil, Sociedades Médicas Brasileiras, Conselhos de Medicina, Conselho Federal de Enfermagem e Conselho Federal de Fisioterapia. A avaliação da qualidade metodológica e da transparência das diretrizes ocorreu por meio do instrumento Appraisal of Guidelines for Research & Evaluation, versão II, realizada por quatro autores. Resultados Foram encontradas 33 diretrizes, das quais foram incluídas 14 para análise. Somente uma diretriz apresentou pontuações acima de 60% em todos os domínios. Entre os seis domínios, três apresentaram maiores pontuações: Escopo e finalidade, Envolvimento das partes interessadas e Clareza da apresentação. Discussão Apesar da fragilidade metodológica, os autores se preocuparam em apresentar as recomendações de forma clara e concisa, através de informações-chave e opções terapêuticas que facilitam a tomada de decisão. Conclusão As diretrizes brasileiras apresentaram baixa qualidade metodológica, em que somente uma diretriz foi recomendada e classificada com alta qualidade e transparência metodológica.

Abstract Introduction Coronavirus disease (Covid-19) is an infectious disease affecting the respiratory tract, which emerged in China and spread rapidly throughout the world. Objective To evaluate the methodological quality and transparency of Brazilian clinical practice guidelines for the treatment of coronavirus disease (Covid-19). Materials and Methods A systematic review was conducted in 2020 on Medline (via PubMed), Embase, Scopus, LILACS, National Guideline Clearinghouse and Guidelines International Network databases, in addition to online searches on the Brazilian Ministry of Health, Brazilian Medical Association, Federal Council of Medicine, Federal Council of Nursing and Federal Council of Physical Therapy websites. The methodological quality and transparency of the guidelines were assessed using the second version of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument developed by four authors. Results 33 guidelines were found of which 14 were included in the analysis. There was only one guideline that scored above 60% in all domains. Among the six domains, higher scores were found in the following three domains: scope and objective, stakeholder involvement and clarity of presentation. Discussion Despite methodological weakness found, the authors were keen to provide clear and concise recommendations through key information and therapeutic options to facilitate decision making. Conclusions Brazilian clinical practice guidelines were found to be of poor methodological quality, from which only one guideline was recommended and classified as to be of high methodological quality and transparency.

Resumen Introducción La enfermedad por coronavirus (Covid-19) es una patología infecciosa que afecta al sistema respiratorio, la cual se originó en China y se extendió rápidamente por todo el mundo. Objetivo Evaluar la calidad metodológica y la transparencia de las guías de práctica clínica brasileñas para el tratamiento de la enfermedad por coronavirus (Covid-19). Materiales y métodos Se realizó una revisión sistemática en 2020 en las bases de datos Medline (vía PubMed), Embase, Scopus, LILACS, National Guideline Clearinghouse y Guidelines International Network, además de consultas en los sitios web del Ministerio de Salud de Brasil, Asociación Médicas Brasileña, Consejo Federal de Medicina, Consejo Federal de Enfermería y Consejo Federal de Fisioterapia. La evaluación de la calidad metodológica y la transparencia de las guías se realizó con el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE), segunda versión realizada por cuatro autores. Resultados Se encontraron 33 guías, de las que se incluyeron 14 en el análisis. Hubo una sola guía que obtuvo una puntuación superior al 60% en todos los dominios. Entre los seis dominios, se presentaron puntuaciones más altas en los siguientes tres dominios: alcance y objetivo, participación de las partes interesadas y claridad de la presentación. Discusión A pesar de la fragilidad metodológica, los autores se interesaron por presentar las recomendaciones de forma clara y concisa a través de información clave y opciones terapéuticas que faciliten la toma de decisiones. Conclusión Las guías de práctica clínica brasileñas mostraron tener una baja calidad metodológica, de las que solamente una guía fue recomendada y clasificada como de alta calidad y transparencia metodológica.

Diretrizes de prática clínica para o tratamento da Covid-19 no Brasil: uma revisão sistemática / Clinical practice guidelines for the treatment of Covid-19 in Brazil: A systematic review

Introdução: A Coronavirus Disease-2019 é uma doença infectocontagiosa que afeta o sistema respiratório, que surgiu na China e logo se espalhou pelo mundo. Objetivo: Avaliar a qualidade metodológica e transparência das Diretrizes de Prática Clínica brasileiras para o tratamento da Coronavirus Disease-2019. Materiais e Métodos: Trata-se de uma revisão sistemática realizada em 2020 nas fontes de dados: MEDLINE (via PubMed), EMBASE, Scopus e Literatura Latino-Americana e do Caribe em Ciências da Saúde, National Guideline Clearinghouse e Guidelines International Network, e sites do Ministério da Saúde do Brasil, Sociedades Médicas Brasileiras, Conselhos de Medicina, Conselho Federal de Enfermagem e Conselho Federal de Fisioterapia. A avaliação da qualidade metodológica e da transparência das diretrizes ocorreu por meio do instrumento Appraisal of Guidelines for Research & Evaluation, versão II, realizada por quatro autores. Resultados: Foram encontradas 33 diretrizes, das quais foram incluídas 14 para análise. Somente uma diretriz apresentou pontuações acima de 60% em todos os domínios. Entre os seis domínios, três apresentaram maiores pontuações: Escopo e finalidade, Envolvimento das partes interessadas e Clareza da apresentação. Discussão: Apesar da fragilidade metodológica, os autores se preocuparam em apresentar as recomendações de forma clara e concisa, através de informações-chave e opções terapêuticas que facilitam a tomada de decisão. Conclusão: As diretrizes brasileiras apresentaram baixa qualidade metodológica, em que somente uma diretriz foi recomendada e classificada com alta qualidade e transparência metodológica.

Introduction: Coronavirus disease (Covid-19) is an infectious disease affecting the respiratory tract, which emerged in China and spread rapidly throughout the world. Objective: To evaluate the methodological quality and transparency of Brazilian clinical practice guidelines for the treatment of coronavirus disease (Covid-19). Materials and Methods: A systematic review was conducted in 2020 on Medline (via PubMed), Embase, Scopus, LILACS, National Guideline Clearinghouse and Guidelines International Network databases, in addition to online searches on the Brazilian Ministry of Health, Brazilian Medical Association, Federal Council of Medicine, Federal Council of Nursing and Federal Council of Physical Therapy websites. The methodological quality and transparency of the guidelines were assessed using the second version of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument developed by four authors. Results: 33 guidelines were found of which 14 were included in the analysis. There was only one guideline that scored above 60% in all domains. Among the six domains, higher scores were found in the following three domains: scope and objective, stakeholder involvement and clarity of presentation. Discussion: Despite methodological weakness found, the authors were keen to provide clear and concise recommendations through key information and therapeutic options to facilitate decision making. Conclusions: Brazilian clinical practice guidelines were found to be of poor methodological quality, from which only one guideline was recommended and classified as to be of high methodological quality and transparency.

Introducción: La enfermedad por coronavirus (Covid-19) es una patología infecciosa que afecta al sistema respiratorio, la cual se originó en China y se extendió rápidamente por todo el mundo. Objetivo: Evaluar la calidad metodológica y la transparencia de las guías de práctica clínica brasileñas para el tratamiento de la enfermedad por coronavirus (Covid-19). Materiales y métodos: Se realizó una revisión sistemática en 2020 en las bases de datos Medline (vía PubMed), Embase, Scopus, LILACS, National Guideline Clearinghouse y Guidelines International Network, además de consultas en los sitios web del Ministerio de Salud de Brasil, Asociación Médicas Brasileña, Consejo Federal de Medicina, Consejo Federal de Enfermería y Consejo Federal de Fisioterapia. La evaluación de la calidad metodológica y la transparencia de las guías se realizó con el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE), segunda versión realizada por cuatro autores. Resultados: Se encontraron 33 guías, de las que se incluyeron 14 en el análisis. Hubo una sola guía que obtuvo una puntuación superior al 60% en todos los dominios. Entre los seis dominios, se presentaron puntuaciones más altas en los siguientes tres dominios: alcance y objetivo, participación de las partes interesadas y claridad de la presentación. Discusión: A pesar de la fragilidad metodológica, los autores se interesaron por presentar las recomendaciones de forma clara y concisa a través de información clave y opciones terapéuticas que faciliten la toma de decisiones. Conclusión: Las guías de práctica clínica brasileñas mostraron tener una baja calidad metodológica, de las que solamente una guía fue recomendada y clasificada como de alta calidad y transparencia metodológica.

Chagas Disease in the Western Brazilian Amazon: Epidemiological Overview from 2007 to 2018 / Doença de Chagas na Amazônia Ocidental Brasileira: panorama epidemiológico no período de 2007 a 2018

INTRODUCTION: Chagas disease (CD) is a disease caused by the protozoan flagellates of the Kinetoplastid order Trypanosoma cruzi. Approximately 8,000,000 people are infected worldwide, mainly in Latin America, causing disabilities and more than 10,000 deaths per year OBJECTIVE: This study aimed to describe the epidemiological panorama of CD in the Western Brazilian Amazon from 2007 to 2018. METHODS: In this ecological study, secondary data regarding the confirmed cases of T. cruzi infection in the states of Acre, Amazonas, Rondônia, and Roraima were collected from the Single Health System Notification Information System of the Department of Informatics of the Single Health System and were analyzed. The data were used to characterize the epidemiological profile of T. cruzi infection and to determine the frequency of infection in Western Amazonia. RESULTS: A total of 184 cases of CD were reported in Western Amazonia, and the highest number of cases was reported in the states of Amazonas and Acre. CONCLUSION: The epidemiological panorama of the Western Brazilian Amazon from 2007 to 2018 includes a greater number of cases of T. cruzi infection in men aged 20-39 years and those living in rural areas. Oral transmission was prevalent in the region during the study, and the highest number of cases was reported in the months of April and December. Epidemiological data are an important resource for understanding the dynamics of CD and the main aspects related to the health-disease process.

INTRODUÇÃO: A doença de Chagas (DC) é uma enfermidade causada pelo protozoário flagelado da ordem Kinetoplastida denominado Trypanosoma cruzi. Estima-se que oito milhões de pessoas estejam infectadas em todo o mundo, principalmente na América Latina, causando incapacidades e mais de dez mil mortes por ano. OBJETIVO: Descrever o panorama epidemiológico da doença de Chagas na Amazônia Ocidental brasileira no período de 2007 a 2018. MÉTODO: Trata-se de um estudo ecológico e com coleta e análise de dados referentes aos casos confirmados de infecção por T. cruzi nos estados do Acre, Amazonas, Rondônia e Roraima, por meio de fontes secundárias oriundos do Sistema de Informação de Agravos de Notificação do Sistema Único de Saúde (SINAN) do Departamento de Informática do Sistema Único de Saúde (DATASUS). Os dados foram utilizados para caracterizar o perfil epidemiológico dos infectados por T. cruzi e determinar a frequência da infecção na Amazônia Ocidental RESULTADOS: Houve a notificação de 184 casos de doença de Chagas na Amazônia Ocidental com mais registros nos estados do Amazonas e Acre. CONCLUSÃO: O panorama epidemiológico da Amazônia Ocidental Brasileira no período de 2007 a 2018, compreende uma maior quantidade de casos em indivíduos do sexo masculino, na faixa etária dos 20-39 anos, e provenientes de zona rural. A forma de contágio prevalente na região durante o estudo foi a oral e a maior sazonalidade compreendeu os meses de abril e dezembro. Dados epidemiológicos são um importante recurso para a compreensão da dinâmica da DC e os principais aspectos relacionados no processo saúde-doença.