Magnolol derivatives as specific and noncytotoxic inhibitors of breast cancer resistance protein (BCRP/ABCG2).

The breast cancer resistance protein (BCRP/ABCG2) transporter mediates the efflux of numerous antineoplastic drugs, playing a central role in multidrug resistance related to cancer. The absence of successful clinical trials using specific ABCG2 inhibitors reveals the urge to identify new compounds to attend this critical demand. In this work, a series of 13 magnolol derivatives was tested as ABCG2 inhibitors. Only two compounds, derivatives 10 and 11, showed partial and complete ABCG2 inhibitory effect, respectively. This inhibition was selective toward ABCG2, since none of the 13 compounds inhibited neither P-glycoprotein nor MRP1. Both inhibitors (10 and 11) were not transported by ABCG2 and demonstrated a low cytotoxic profile even at high concentrations (up to 100 µM). 11 emerged as the most promising compound of the series, considering the ratio between cytotoxicity (IG50) and ABCG2 inhibition potency (IC50), showing a therapeutic ratio (TR) higher than observed for 10 (10.5 versus 1.6, respectively). This derivative showed a substrate-independent and a mixed type of inhibition. The effect of compound 11 on the ABCG2 ATPase activity and thermostability revealed allosteric protein changes. This compound did not affect the expression levels of ABCG2 and increased the binding of the conformational-sensitive antibody 5D3. A docking study showed that 11 did not share the same binding site with ABCG2 substrate mitoxantrone. Finally, 11 could revert the chemoresistance to SN-38 mediated by ABCG2.

Effects of anodal transcranial direct current stimulation over motor cortex on resting-state brain activity in the early subacute stroke phase: A power spectral density analysis.

INTRODUCTION: Despite promising results, the effects of transcranial direct current stimulation (tDCS) in the early stages of stroke and its impact on brain activity have been poorly studied. Therefore, this study aimed to investigate the effect of tDCS applied over the ipsilesional motor cortex on resting-state brain activity in the early subacute phase of stroke. METHODS: This is a pilot, randomized, double-blind, proof-of-concept study. The patients with stroke were randomly assigned into two groups: anodal tDCS (A-tDCS) or sham tDCS (S-tDCS). For A-tDCS, the anode was placed over the ipsilesional motor cortex, while the cathode was placed over the left or right supraorbital area (Fp2 for left stroke or Fp1 for right stroke). For the real stimulation, a constant current of 1.0 mA was delivered for 20 min and then ramped down linearly for 30 s, maintaining a resistance below 10 kΩ. For the sham stimulation, the stimulator was turned on, and the current intensity was gradually increased for 30 s, tapered off over 30 s, and maintained for 30 min without stimulation. Each stimulation was performed for three consecutive sessions with an interval of 1 h between them. The primary outcome was spectral electroencephalography (EEG) analysis based on the Power Spectral Density (PSD) determined by EEG records of areas F3, F4, C3, C4, P3, and P4. Brain Vision Analyzer software processed the signals, EEG power spectral density (PSD) was calculated before and after stimulation, and alpha, beta, delta, and theta power were analyzed. The secondary outcomes included hemodynamic variables based on the difference between baseline (D0) and post-intervention session (D1) values of systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), respiratory rate (RR) and peripheral oxygen saturation (SPO2). Mann-Whitney test was used to compare position measurements of two independent samples; Fisher's exact test was used to compare two proportions; paired Wilcoxon signed-rank test was used to compare the median differences in the within-group comparison, and Spearman correlations matrix among spectral power analysis between EEG bands was performed to verify consistency of occurrence of oscillations. Statistical significance was set at P < 0.05. RESULTS: An increase in PSD in the alpha frequency in the P4 region was observed after the intervention in the A-tDCS group, as compared to the placebo group (before = 6.13; after = 10.45; p < 0.05). In the beta frequency, an increase in PSD was observed in P4 (before = 4.40; after = 6.79; p < 0.05) and C4 (before = 4.43; after = 6.94; p < 0.05) after intervention in the A-tDCS group. There was a reduction in PSD at delta frequency in C3 (before = 293.8; after = 58.6; p < 0.05) after intervention in the A-tDCS group. In addition, it was observed a strong relationship between alpha and theta power in the A-tDCS group before and after intervention. However, the sham group showed correlations between more power bands (alpha and theta, alpha and delta, and delta and theta) after intervention. There was no difference in hemodynamic variables between the intra- (before and after stimulation) and inter-groups (mean difference). CONCLUSION: Anodal tDCS over the ipsilesional motor cortex had significant effects on the brain electrical activity in the early subacute stroke phase, increasing alpha and beta wave activities in sensorimotor regions while reducing slow delta wave activity in motor regions. These findings highlight the potential of anodal tDCS as a therapeutic intervention in the early stroke phase.

Chemical Properties, Ruminal Fermentation, Gas Production and Digestibility of Silages Composed of Spineless Cactus and Tropical Forage Plants for Sheep Feeding.

The aim was to evaluate the chemical composition, carbohydrates, protein fractionation and in vitro gas production of silages composed of spineless cactus and tropical forages and their effect on sheep performance. Treatments consisted of silages: corn silage (CS), spineless cactus silage (SCS), spineless cactus + gliricidia (SCG), spineless cactus + buffel grass silage (SCBG) and spineless cactus + pornunça (SCP). Silos were opened 60 days after ensiling, and analyses were carried out. The digestibility test lasted for 36 days, with eight animals per treatment. A completely randomized design was adopted. Considering carbohydrate fractionation, CS, SCS and SCBG silages had higher total carbohydrate content (p = 0.001). The SCS silage presented a higher A + B1 fraction (p = 0.001). The SCBG and SCG silages showed a higher B2 fraction (p < 0.0001) compared to the CS and SCS silages. The SCBG and SCP silages presented a higher C fraction (p = 0.001). For protein fractionation, the SCP and SCG silages showed higher crude protein contents (p = 0.001). The CS and SCS silages showed a higher A fraction (p = 0.001). The SCBG silage presented a higher B1 + B2 fraction (p = 0.001). The SCG silage showed a higher B3 fraction (p = 0.006) compared to SCBG silage. The SCS and SCP silages showed a higher C fraction (p = 0.001). Exclusive SCS silage showed higher in vitro dry matter digestibility (p = 0.001), dry matter degradability (p = 0.001) and total gas production (p = 0.001). The use of the SCBG, SCP and SCG silages to feed sheep increased the dry matter intake (p < 0.001). Sheep fed the SCG silage showed greater dry matter and crude protein digestibility compared to the sheep fed the CS, SCS and SCP silages (p = 0.002). There was a higher water intake (p < 0.001) with the use of the SCS and SCG silages to feed the sheep. The SCP and SCG silages provided a greater intake (p < 0.001) and excretion (p < 0.001) of nitrogen by the animals. Although there were no differences between the treatments for daily gains, lambs that received the spineless cactus-based silage associated with tropical forages showed higher gains (160-190 g/day) than lambs that received CS silage (130 g/day). Thus, the use of spineless cactus associated with buffelgrass, pornunça and gliricidia to prepare mixed silages (60:40) to feed sheep has potential use to feed sheep, with positive effects on nutrient degradation and increases in dry matter intake. Under experimental conditions, we recommend the exclusive use of spineless cactus silage associated with buffel grass, pornunça and gliricidia in feeding sheep in semi-arid regions, as it provides nutrients, water and greater daily gains compared to corn silage.

Sleep assessment in adults with Down syndrome: correlation between functionality and polysomnographic findings.

BACKGROUND: Sleep disorders have a negative impact on health, being associated with neurocognitive problems, cardiovascular diseases and obesity, influencing children's development and learning. OBJECTIVE: To assess the sleep pattern of people with Down syndrome (DS) and correlate changes with functionality and behavior. METHODS: A cross-sectional study was conducted to evaluate the sleep pattern in adults with DS > 18 years old. Twenty-two participants were assessed using the Pittsburgh Sleep Quality Index, the Functional Independence Measure and the Strengths and Difficulties Questionnaire, and the 11 who presented indications of disorders by the screening questionnaires were referred to polysomnography. Statistical tests were performed using a significance level of 5%, including sample normality tests and correlation tests (sleep and functionality). RESULTS: Impairment in sleep architecture was found due to an increase in the rate of awakenings in 100% of the participants, a decrease in the number of slow waves, and a high prevalence of sleep disordered breathing (SDB), with higher averages in the Apnea and Hypopnea Index (AHI) in the group. There was a negative correlation between sleep quality and global functionality (p = 0.011) and the motor (p = 0.074), cognitive (p = 0.010), and personal care (p = 0.072) dimensions in the group. Global and hyperactivity behavior changes were related to worse sleep quality (p = 0.072; p = 0.015, respectively). CONCLUSION: There is an impairment in the sleep quality of adults with DS, with an increase in the rate of awakenings, a decrease in the number of slow waves, and a high prevalence of SDB affecting this population in the functional and behavioral aspects.

ANTECEDENTES: Os distúrbios de sono têm impacto negativo na saúde, estando associados a problemas neurocognitivos, doenças cardiovasculares e obesidade, influenciando no desenvolvimento e aprendizado. OBJETIVO: Avaliar o padrão de sono de pessoas com síndrome de Down (SD) e correlacionar as alterações com a funcionalidade e comportamento. MéTODOS: Foi realizado um estudo transversal para avaliação do padrão de sono em adultos com SD > 18 anos. Foram avaliados 22 participantes, através do Índice de Qualidade do Sono de Pittsburgh, da Medida de Independência Funcional e do Questionaário de Capacidades e Dificuldades. Os 11 participantes que apresentaram indicativos de presença de distúrbios pelos questionários de triagem foram indicados a polissonografia. Os testes estatísticos foram realizados com nível de significância de 5%, incluindo testes de normalidade e testes de correlação (sono e funcionalidade). RESULTADOS: Foi encontrado prejuízo na arquitetura de sono pelo aumento do índice de despertares em 100% dos participantes, diminuição na quantidade de ondas lentas, e alta prevalência de distúrbio respiratório do sono (DRS), com maiores médias nos Índices de Apneia e Hipopneia (IAH). Houve correlação negativa entre a qualidade de sono e a funcionalidade global (p = 0,011), e as dimensões motora (p = 0,074), cognitiva (p = 0,010) e cuidados pessoais (p = 0,072). As alterações de comportamento global e comportamentos de hiperatividade foram relacionados à pior qualidade do sono (p = 0,072; p = 0,015, respectivamente). CONCLUSãO: Existe prejuízo na qualidade de sono de adultos com SD, com aumento de índice de despertares, diminuição na quantidade de ondas lentas, e alta prevalência de DRS, afetando essa população nos aspectos funcionais e comportamentais.

Sleep assessment in adults with Down syndrome: correlation between functionality and polysomnographic findings / Avaliação do sono de adultos com síndrome de Down: correlações entre funcionalidade e achados polissonográficos

Abstract Background Sleep disorders have a negative impact on health, being associated with neurocognitive problems, cardiovascular diseases and obesity, influencing children's development and learning. Objective To assess the sleep pattern of people with Down syndrome (DS) and correlate changes with functionality and behavior. Methods A cross-sectional study was conducted to evaluate the sleep pattern in adults with DS > 18 years old. Twenty-two participants were assessed using the Pittsburgh Sleep Quality Index, the Functional Independence Measure and the Strengths and Difficulties Questionnaire, and the 11 who presented indications of disorders by the screening questionnaires were referred to polysomnography. Statistical tests were performed using a significance level of 5%, including sample normality tests and correlation tests (sleep and functionality). Results Impairment in sleep architecture was found due to an increase in the rate of awakenings in 100% of the participants, a decrease in the number of slow waves, and a high prevalence of sleep disordered breathing (SDB), with higher averages in the Apnea and Hypopnea Index (AHI) in the group. There was a negative correlation between sleep quality and global functionality (p= 0.011) and the motor (p= 0.074), cognitive (p= 0.010), and personal care (p= 0.072) dimensions in the group. Global and hyperactivity behavior changes were related to worse sleep quality (p= 0.072; p= 0.015, respectively). Conclusion There is an impairment in the sleep quality of adults with DS, with an increase in the rate of awakenings, a decrease in the number of slow waves, and a high prevalence of SDB affecting this population in the functional and behavioral aspects.

Resumo Antecedentes Os distúrbios de sono têm impacto negativo na saúde, estando associados a problemas neurocognitivos, doenças cardiovasculares e obesidade, influenciando no desenvolvimento e aprendizado. Objetivo Avaliar o padrão de sono de pessoas com síndrome de Down (SD) e correlacionar as alterações com a funcionalidade e comportamento. Métodos Foi realizado um estudo transversal para avaliação do padrão de sono em adultos com SD > 18 anos. Foram avaliados 22 participantes, através do Índice de Qualidade do Sono de Pittsburgh, da Medida de Independência Funcional e do Questionaário de Capacidades e Dificuldades. Os 11 participantes que apresentaram indicativos de presença de distúrbios pelos questionários de triagem foram indicados a polissonografia. Os testes estatísticos foram realizados com nível de significância de 5%, incluindo testes de normalidade e testes de correlação (sono e funcionalidade). Resultados Foi encontrado prejuízo na arquitetura de sono pelo aumento do índice de despertares em 100% dos participantes, diminuição na quantidade de ondas lentas, e alta prevalência de distúrbio respiratório do sono (DRS), com maiores médias nos Índices de Apneia e Hipopneia (IAH). Houve correlação negativa entre a qualidade de sono e a funcionalidade global (p= 0,011), e as dimensões motora (p= 0,074), cognitiva (p= 0,010) e cuidados pessoais (p= 0,072). As alterações de comportamento global e comportamentos de hiperatividade foram relacionados à pior qualidade do sono (p= 0,072; p= 0,015, respectivamente). Conclusão Existe prejuízo na qualidade de sono de adultos com SD, com aumento de índice de despertares, diminuição na quantidade de ondas lentas, e alta prevalência de DRS, afetando essa população nos aspectos funcionais e comportamentais.

Uso de Ivermectina e Atazanavir no tratamento da Covid-19: uma revisão de escopo / Use of Ivermectin and Atazanavir in the treatment of Covid-19: a scoping review / Uso de Ivermectina y Atazanavir en el tratamiento de Covid-19: una revisión de alcance

Objetivo: Examinar e mapear as evidências científicas sobre a eficácia do uso de ivermectina e atazanavir no tratamento de COVID-19. Metodologia: Scoping Review, baseado nos procedimentos recomendados pelo Instituto Joanna Briggs. Estabeleceu-se a pergunta norteadora: "Quais são as evidências científicas sobre o uso de ivermectina e atazanavir no tratamento de pacientes com sintomas leves de COVID-19?". Foram realizadas buscas em seis bases de dados nacionais e internacionais, sobre trabalhos publicados até dezembro de 2022. Dos 357 estudos encontrados, 22 foram selecionados para leitura na íntegra, resultando em uma amostra final de 11 estudos analisados. Resultados: As 11 publicações analisadas foram publicadas de 2020 a 2022 durante período pandêmico, de âmbito nacional e internacional com delineamento de estudos experimentais, do tipo ensaio clínico com randomização. Apenas 03 estudos (25%) testaram o atazanavir como intervenção conjugada a outras drogas, não evidenciando melhorias significativas em relação ao seu uso. Já no tratamento com Ivermectina, dos oito (75%) estudos que a testaram, apenas três (37,5%) recomendaram seu uso e cinco (62,5%) não suportam seu uso para tratamento de COVID-19 leve. O tempo de resolução dos sintomas variou de 8 a 10 dias nos braços tratados com ivermectina e em média 07 dias no tratamento com atazanavir. Não se detectou eventos adversos graves relacionados ao uso das duas drogas. Conclusão: As evidências que recomendavam o uso de ivermectina datam do início do período pandêmico, 2020, mas posteriormente, com a realização de ensaios clínicos robustos e controlados, novas evidências não suportam o uso de ivermectina e atazanavir no tratamento de COVID-19 leve mostrando que não houve diferença no tempo de resolução dos sintomas, na taxa de mortalidade, taxa de internação na UTI e tempo de hospitalização.

Objective: To examine and map the scientific evidence on the effectiveness of using ivermectin and atazanavir in the treatment of COVID-19. Methodology: Scoping Review, based on the procedures recommended by the Joanna Briggs Institute. The guiding question was established, "What is the scientific evidence on the use of ivermectin and atazanavir in the treatment of patients with mild symptoms of COVID-19?" Searches were conducted in six national and international databases on papers published until December 2022. Of the 357 studies found, 22 were selected for reading in full, resulting in a final sample of 11 studies analyzed. Results: The 11 publications analyzed were published from 2020 to 2022 during pandemic period, of national and international scope with experimental study design, of clinical trial type with randomization. Only 03 studies (25%) tested atazanavir as a combined intervention with other drugs, showing no significant improvements in relation to its use. As for the treatment with Ivermectin, of the eight (75%) studies that tested it, only three (37.5%) recommended its use and five (62.5%) did not support its use for treating mild COVID-19. The time to symptom resolution ranged from 8 to 10 days in the ivermectin-treated arms and on average 07 days in the atazanavir treatment. No serious adverse events related to the use of the two drugs were detected. Conclusion: evidence recommending the use of ivermectin dates back to the beginning of the pandemic period, 2020, but subsequently, with robust controlled clinical trials, new evidence does not support the use of ivermectin and atazanavir in the treatment of mild COVID-19 showing that there was no difference in time to symptom resolution, mortality rate, ICU admission rate, and length of hospital stay.

Objetivo: Examinar y mapear la evidencia científica sobre la eficacia del uso de ivermectina y atazanavir en el tratamiento de COVID-19. Metodología: Scoping Review, basada en los procedimientos recomendados por el Instituto Joanna Briggs. La pregunta guía era: "¿Cuál es la evidencia científica sobre el uso de ivermectina y atazanavir en el tratamiento de pacientes con síntomas leves de COVID-19? Se realizaron búsquedas en seis bases de datos nacionales e internacionales, en artículos publicados hasta diciembre de 2022. De los 357 estudios encontrados, se seleccionaron 22 para su lectura completa, lo que dio lugar a una muestra final de 11 estudios analizados. Resultados: Las 11 publicaciones analizadas fueron publicadas entre 2020 y 2022 durante el periodo pandémico, de ámbito nacional e internacional con diseño de estudio experimental, de tipo ensayo clínico con aleatorización. Apenas 03 estudios (25%) probaron el atazanavir como intervención combinada con otras drogas, sin evidenciar mejoras significativas en relación con su uso. En cuanto al tratamiento con Ivermectina, de los ocho (75%) estudios que la probaron, sólo tres (37,5%) recomendaron su uso y cinco (62,5%) no apoyaron su uso para tratar la COVID-19 leve. El tiempo transcurrido hasta la resolución de los síntomas osciló entre 8 y 10 días en los brazos tratados con ivermectina y una media de 07 días en el tratamiento con atazanavir. No se detectaron acontecimientos adversos graves relacionados con el uso de los dos fármacos. Conclusión: las pruebas que recomiendan el uso de ivermectina se remontan al inicio del periodo pandémico, 2020, pero posteriormente, con ensayos clínicos controlados sólidos, las nuevas pruebas no apoyan el uso de ivermectina y atazanavir en el tratamiento de la COVID-19 leve, lo que demuestra que no hubo diferencias en el tiempo hasta la resolución de los síntomas, la tasa de mortalidad, la tasa de ingreso en la UCI y la duración de la estancia hospitalaria.

Structural and molecular characterization of lopinavir and ivermectin as breast cancer resistance protein (BCRP/ABCG2) inhibitors.

A current clinical challenge in cancer is multidrug resistance (MDR) mediated by ABC transporters. Breast cancer resistance protein (BCRP) or ABCG2 transporter is one of the most important ABC transporters implicated in MDR and the use of inhibitors is a promising approach to overcome the resistance in cancer. This study aimed to characterize the molecular mechanism of ABCG2 inhibitors identified by a repurposing drug strategy using antiviral, anti-inflammatory and antiparasitic agents. Lopinavir and ivermectin can be considered as pan-inhibitors of ABC transporters, since both compounds inhibited ABCG2, P-glycoprotein and MRP1. They inhibited ABCG2 activity showing IC50 values of 25.5 and 23.4 µM, respectively. These drugs were highly cytotoxic and not transported by ABCG2. Additionally, these drugs increased the 5D3 antibody binding and did not affect the mRNA and protein expression levels. Cell-based analysis of the type of inhibition suggested a non-competitive inhibition, which was further corroborated by in silico approaches of molecular docking and molecular dynamics simulations. These results showed an overlap of the lopinavir and ivermectin binding sites on ABCG2, mainly interacting with E446 residue. However, the substrate mitoxantrone occupies a different site, binding to the F436 region, closer to the L554/L555 plug. In conclusion, these results revealed the mechanistic basis of lopinavir and ivermectin interaction with ABCG2. See also the Graphical abstract(Fig. 1).

Correlation of family functionality and burden of informal caregivers of hospitalized older adults.

AIM: to analyze the relationship between family functionality and burden of informal caregivers of hospitalized older people. METHODS: this is a cross-sectional study conducted with 98 informal caregivers of hospitalized older people in an inpatient unit of a large hospital in São Carlos, São Paulo. For data collection were used questionnaires to sociodemographic and care context characterization, to evaluate burden and family functionality. Descriptive analyzes and Spearman's correlation coefficient were used. RESULTS: female caregivers predominated, who took care of their parents and had no training. Approximately 59.8% of caregivers had good family functionality and 49.5% scored for mild to moderate burden. There was a negative correlation, moderate magnitude, between family functionality and burden (p<0,001). The higher the burden score, the lower the family functionality score and vice versa. CONCLUSION: caregivers with high burden had worse family functionality. Therefore, nurses need to identify such conditions early and implement assertive interventions so that the family functions as a therapeutic resource.

Use of artificial intelligence as an instrument of evaluation after stroke: a scoping review based on international classification of functioning, disability and health concept.

INTRODUCTION: To understand the current practices in stroke evaluation, the main clinical decision support system and artificial intelligence (AI) technologies need to be understood to assist the therapist in obtaining better insights about impairments and level of activity and participation in persons with stroke during rehabilitation. METHODS: This scoping review maps the use of AI for the functional evaluation of persons with stroke; the context involves any setting of rehabilitation. Data were extracted from CENTRAL, MEDLINE, EMBASE, LILACS, CINAHL, PEDRO Web of Science, IEEE Xplore, AAAI Publications, ACM Digital Library, MathSciNet, and arXiv up to January 2021. The data obtained from the literature review were summarized in a single dataset in which each reference paper was considered as an instance, and the study characteristics were considered as attributes. The attributes used for the multiple correspondence analysis were publication year, study type, sample size, age, stroke phase, stroke type, functional status, AI type, and AI function. RESULTS: Forty-four studies were included. The analysis showed that spasticity analysis based on ML techniques was used for the cases of stroke with moderate functional status. The techniques of deep learning and pressure sensors were used for gait analysis. Machine learning techniques and algorithms were used for upper limb and reaching analyses. The inertial measurement unit technique was applied in studies where the functional status was between mild and severe. The fuzzy logic technique was used for activity classifiers. CONCLUSION: The prevailing research themes demonstrated the growing utility of AI algorithms for stroke evaluation.

Correlation of family functionality and burden of informal caregivers of hospitalized older adults / Correlación de funcionalidad familiar y sobrecarga de cuidadores informales de ancianos hospitalizados / Correlação da funcionalidade familiar e sobrecarga de cuidadores informais de idosos hospitalizados

ABSTRACT Aim to analyze the relationship between family functionality and burden of informal caregivers of hospitalized older people. Methods this is a cross-sectional study conducted with 98 informal caregivers of hospitalized older people in an inpatient unit of a large hospital in São Carlos, São Paulo. For data collection were used questionnaires to sociodemographic and care context characterization, to evaluate burden and family functionality. Descriptive analyzes and Spearman's correlation coefficient were used. Results female caregivers predominated, who took care of their parents and had no training. Approximately 59.8% of caregivers had good family functionality and 49.5% scored for mild to moderate burden. There was a negative correlation, moderate magnitude, between family functionality and burden (p<0,001). The higher the burden score, the lower the family functionality score and vice versa. Conclusion caregivers with high burden had worse family functionality. Therefore, nurses need to identify such conditions early and implement assertive interventions so that the family functions as a therapeutic resource.

RESUMEN Objetivo analizar la relación entre la funcionalidad familiar y la sobrecarga de los cuidadores informales de ancianos hospitalizados. Métodos estudio transversal realizado con 98 cuidadores informales de ancianos hospitalizados en una unidad de internación de un gran hospital de São Carlos, São Paulo. Para la recolección de datos, se utilizaron cuestionarios para caracterizar sociodemográficos y contexto de atención, para evaluar la sobrecarga y funcionalidad familiar. Se realizaron análisis descriptivos y coeficiente de correlación de Spearman. Resultados predominaban las cuidadoras femeninas, que cuidaban a sus padres y carecían de formación. Acerca de 59,8% de los cuidadores mostró una buena funcionalidad familiar y 49,5% puntuó por sobrecarga leve a moderada. Hubo una correlación negativa, de magnitud moderada, entre funcionalidad familiar y sobrecarga (p <0,001). Cuanto mayor puntuación de carga, menor puntuación de funcionalidad familiar y viceversa Conclusión los cuidadores con alta carga tenían peor funcionalidad familiar. Por lo tanto, las enfermeras necesitan identificar estas condiciones de manera temprana e implementar intervenciones asertivas para que la familia pueda funcionar como un recurso terapéutico.

RESUMO Objetivo analisar a relação entre funcionalidade familiar e sobrecarga de cuidadores informais de idosos hospitalizados. Método estudo transversal, quantitativo, realizado com 98 cuidadores informais de idosos hospitalizados em São Carlos, São Paulo. Para a coleta de dados, foram utilizados questionários para caracterização sociodemográfica e do contexto de cuidado, para avaliação da sobrecarga e da funcionalidade familiar. Foram usadas análises descritivas e coeficiente de correlação de Spearman. Resultados predominaram cuidadores do sexo feminino, que cuidavam de seus progenitores e não possuíam capacitação. Aproximadamente 59,8% deles apresentaram boa funcionalidade familiar, e 49,5%, sobrecarga leve a moderada. Houve correlação negativa, de moderada magnitude, entre funcionalidade familiar e sobrecarga (p<0,001). Quanto maior o escore de sobrecarga, menor o escore de funcionalidade familiar e vice-versa. Conclusão cuidadores com alta sobrecarga apresentaram pior funcionalidade familiar. Diante disso, enfermeiros precisam identificar precocemente tais condições e implementar intervenções assertivas para que a família funcione como um recurso terapêutico.

Parenting practices and the child's eating behavior / Prácticas parentales y comportamiento alimentario del niño / Práticas parentais e comportamento alimentar da criança

ABSTRACT Objective: to investigate the association between the parenting practices and the child's eating behavior. Method: a cross-sectional study, conducted with 368 children aged from one to five years old, registered in the Family Health Strategy units of the urban area of the municipality of Divinópolis-MG. An anthropometric assessment was performed to classify the children's nutritional status. Information was collected from January to September 2019 referring to demographic and socioeconomic data, as well as to lifestyle, health status, diabetes, parenting practices, and children's eating behavior. The child's eating behavior was assessed by means of a food frequency questionnaire, where the daily consumption of ultra-processed foods was estimated. Multiple linear regression was used to assess the association between parenting practices and the child's eating behavior, with a significance level of 5%. Results: greater consumption of ultra-processed foods was identified when the parents used physical force (p<0.018), reward for eating (p<0.002), and food restriction (p<0.011) practices. A negative association with the consumption of ultra-processed foods was evidenced when the parents provided guidance for healthy eating (p<0.006), authoritative monitoring (p<0.017), and positive reinforcement of the children's behavior that is considered adequate (p<0.046). Conclusion: the results of this study evidenced that the parenting practices were associated with the children's eating behavior. Therefore, research studies on the determinants of this behavior are recommended.

RESUMEN Objetivo: evaluar la asociación entre las prácticas parentales y el comportamiento alimentario del niño. Método: estudio transversal, realizado con 368 niños de uno a cinco años de edad, registrados en las unidades de Estrategia de Salud Familiar de la zona urbana del municipio de Divinópolis-MG. Se realizó una evaluación antropométrica de enero a septiembre de 2019 para clasificar el estado nutricional de los niños. Se recolectó información referente a datos demográficos y socioeconómicos, sobre estilo de vida, estado de salud, relacionados con dietas, prácticas parentales y comportamiento alimentario de los niños. El comportamiento alimentario del niño se evaluó por medio del cuestionario de frecuencia alimentaria, donde se estimó el consumo diario de alimentos ultra procesados. Se empleó regresión lineal múltiple para evaluar la asociación entre las prácticas parentales y el comportamiento alimentario del niño, con un nivel de significancia del 5%. Resultados: se identificó un mayor consumo de alimentos ultra procesados cuando los padres empleaban prácticas de fuerza física (p<0,018), recompensas para comer (p<0,002) y restricción alimentaria (p<0,011). Se hizo evidente una asociación negativa con el consumo de alimentos ultra procesados cuando los padres ofrecían pautas de orientación para una alimentación saludable (p<0,006), control con autoridad (p<0,017) y refuerzo positivo del comportamiento infantil considerado adecuado (p<0,046). Conclusión: los resultados de este estudio evidenciaron que las prácticas parentales están asociadas con el comportamiento alimentario de los niños. En consecuencia, se recomienda realizar estudios de investigación acerca de los determinantes de dicho comportamiento.

RESUMO Objetivo: avaliar a associação entre as práticas parentais e comportamento alimentar da criança. Método: estudo transversal, realizado com 368 crianças de um a cinco anos de idade, cadastradas nas Estratégias de Saúde da Família da zona urbana do município de Divinópolis-MG. Realizou-se avaliação antropométrica para classificação do estado nutricional das crianças. Coletaram-se informações de janeiro a setembro de 2019 referentes a dados demográficos, socioeconômicos, estilo de vida, estado de saúde, dietéticos, práticas parentais e comportamento alimentar das crianças. O comportamento alimentar da criança foi avaliado por meio do questionário de frequência alimentar, onde se estimou o consumo diário de alimentos ultraprocessados. Regressão linear múltipla foi usada para avaliar a associação de práticas parentais e comportamento alimentar da criança, com um nível de significância de 5%. Resultados: identificou-se um maior consumo de alimentos ultraprocessados quando os pais realizavam práticas de força física (p<0,018), recompensa para comer (p<0,002) e restrição alimentar (p<0,011). Associação negativa com o consumo de ultraprocessados foi evidenciada quando os pais realizavam orientação para alimentação saudável (p<0,006), monitoramento autoritativo (p<0,017) e reforço positivo ao comportamento infantil considerado adequado (p<0,046). Conclusão: os resultados deste estudo evidenciaram que práticas parentais associam-se ao comportamento alimentar das crianças. Portanto, recomendam-se investigações acerca dos determinantes desse comportamento.

Comportamento dos pais e comportamento alimentar da criança: Revisão Sistemática / Influencia familiar en la conducta alimentaria en niños: Revisión Sistemática / Family influence on children's eating behavior: A Systematic Review

Introdução: O tema comportamento alimentar tem tido destaque na atualidade em função da implicação deste sobre a determinação de doenças crônicas. São escassos estudos nacionais sobre os determinantes do comportamento alimentar infantil, especialmente no que tange as práticas parentais. Objetivo: identificar a relação entre o comportamento dos pais durante a refeição e comportamento alimentar da criança. Materiais e Métodos: Revisão sistemática da literatura baseada na estratégia PECOS e no PRISMA. Realizou-se a pesquisa nas bases de dados Lilacs, MEDLINE e IBECS, com artigos publicados entre 2013 e 2018. Vinte e três estudos compuseram a presente revisão. Resultados: Dos estudos, 83% permitiram observar diretamente as práticas parentais durante a refeição, encontrando associação estatisticamente significativa entre o uso de pressão para alimentar pelos pais e alimentação seletiva pela criança. Dentre os estudos, 17% mostraram que o comportamento alimentar dos pais interfere no comportamento alimentar das crianças, tornando-os similares. A maioria dos artigos são internacionais, sendo apenas um realizado no Brasil. Discussão: O ambiente familiar pode ser considerado um importante formador do comportamento e estilo de vida das crianças. Acredita-se que o contexto familiar contribui para preferências, rejeições e comportamentos alimentares. As crianças aprendem não apenas vivenciando suas próprias experiências, mas observado aos outros. Conclusão: Os dados resultantes desta revisão sistemática permitem evidenciar que as práticas parentais utilizadas pelos pais podem determinar o comportamento alimentar de crianças. Estudos nacionais sobre o comportamento alimentar infantil são imperativos, visando uma maior elucidação sobre o tema e ampliando os fatores relacionados.

Introduction: Eating behavior has increasingly gained relevance in recent times given its incidence in identifying chronic diseases. In addition, few studies have been conducted nationwide on the determinants of eating behavior in children, particularly those related to parental feeding practices. Objective: To identify the relationship between parental feeding practices and children's eating behavior. Materials and Methods: A systematic literature review was conducted on PICO and PRISMA strategies. The research was conducted using the LILACS, MEDLINE and IBECS databases, involving articles published between 2013 and 2018. A total of 23 studies make up this review. Results: 83% of the studies allowed direct observation of parental mealtime practices resulting in a statistically significant association between parental pressure to eat and selective eating in children. 17% of the studies suggested that parental feeding practices interfere with children's eating behavior, which makes them very similar. Most of the articles have been published worldwide with only one being conducted in Brazil. Discussion: Family settings are considered to contribute to eating preferences, refusals and behaviors. Children learn not only by living their own experiences but also by observing others. Conclusion: The data obtained from this systematic review demonstrate that parental feeding practices can determine eating behavior in children. Further national research on children's eating behavior is essential to better understand and explore its determinants.

Introducción: La conducta alimentaria ha venido ganando relevancia recientemente debido a su incidencia en la identificación de enfermedades crónicas. Asimismo, se han realizado muy pocos estudios a nivel nacional sobre los factores determinantes de la conducta alimentaria en niños, especialmente lo relacionado con las prácticas de alimentación de los padres. Objetivo: Identificar la relación entre las prácticas de los padres a la hora de comer y la conducta alimentaria del niño. Materiales y Métodos: Se realizó una revisión sistemática de la literatura basada en las estrategias PICO y PRISMA. La investigación se realizó en las bases de datos LILACS, MEDLINE e IBECS, con artículos publicados entre 2013 y 2018. 23 estudios componen en total la presente revisión. Resultados: En el 83 % de los estudios se permitió observar directamente las prácticas de los padres durante las comidas y se encontró una asociación estadísticamente significativa entre el uso de la presión para dar de comer por parte de los padres y la alimentación selectiva en los niños. Entre los estudios, el 17 % demostró que el comportamiento alimenticio de los padres interfiere con la conducta alimentaria de los niños, lo que los vuelve muy similares. La mayoría de los artículos se han publicado internacionalmente y solo uno ha sido realizado en Brasil. Discusión: El entorno familiar puede considerarse un importante formador del comportamiento y del estilo de vida de los niños. Se considera que el contexto familiar contribuye a las preferencias, rechazos y conductas alimentarias. Los niños aprenden no solo viviendo sus propias experiencias, sino también observando las de los demás. Conclusión: Los datos obtenidos en esta revisión sistemática demuestran que las prácticas parentales pueden determinar la conducta alimentaria en niños. A fin de comprender mejor esta temática y profundizar en sus factores asociados, es fundamental llevar a cabo más estudios a nivel nacional sobre la conducta alimentaria en los niños.

Men's health care: construction and validation of a tool for nursing consultation.

OBJECTIVES: to elaborate and validate a data collection tool for nursing consultation with men in the context of Primary Health Care. METHOD: a methodological study developed in four stages. The first one consisted in tool elaboration, using databases and the Dorothea Orem's theoretical model. In the second and third stages, content validation and tool appearance by 23 nurse judges took place. The Concordance Index was used for assessment. In the fourth stage, a pilot test was carried out with 20 men using Primary Health Care. RESULTS: of the 145 indicators prepared, organized and submitted to validation process, items with the Concordance Index <0.80 were excluded. The final tool consisted of 156 items. An overall 0.88 Concordance Index calculation was obtained. CONCLUSIONS: the final tool presented content validity for data collection with men in Primary Health Care.

Maternal endotoxemia induces renal collagen deposition in adult offspring: Role of NADPH oxidase/TGF-ß1/MMP-2 signaling pathway.

Maternal endotoxemia has been shown to increase renal collagen deposition in the offspring. Renal fibrosis is a hallmark of progressive chronic kidney disease. It was investigated whether maternal reactive oxygen species (ROS) leads to renal fibrosis or exacerbates unilateral ureteral obstruction (UUO)-induced renal fibrosis in the offspring of dams treated with lipopolysaccharide (LPS). Furthermore, it was studied the role of matrix metalloproteinases (MMPs) in these changes. Adults Wistar rats were obtained from dams submitted to LPS administration through the third part of gestation. To evaluate the role of maternal ROS, part of the dams received α-tocopherol simultaneously with LPS. Part of the offspring in each group was submitted to UUO at adulthood when sub-groups were treated with NADPH oxidase inhibitor, apocynin. Maternal LPS administration increased proteinuria, systolic arterial pressure and renal collagen deposition in adult offspring. LPS offspring rats also presented higher MMP-2 activity in parallel to a decreased renal cortical TIMP-2 content. These changes were correlated to increased amounts of TGF-ß1 and NOX2. Maternal α-tocopherol treatment prevented collagen deposition and reduced arterial pressure in adult offspring. α-Tocopherol also inhibited maternal endotoxemia-induced changes in TGF-ß1/NOX2/MMP-2 signaling. UUO led to increased collagen deposition in the contralateral kidneys of LPS offspring, which was correlated to increased NADPH oxidase activity and prevented by NADPH oxidase inhibition. In summary, maternal endotoxemia led to alterations in the TGF-ß1/NOX2/MMP-2 signaling pathway in renal tissue concomitant with collagen deposition, therefore contributing to hypertension in adult offspring.

Association between self-reported sleep bruxism and temporomandibular disorder in undergraduate students from Brazil.

Objective: To evaluate the association between self-reported sleep bruxism and temporomandibular disorder in undergraduate students from Brazil. Methods: Descriptive, cross-sectional study with a quantitative approach, carried out on 600 undergraduate students of a faculty from Brazil. The Fonseca's Anamnestic Index and the Research Diagnostic Criteria for Temporomandibular Disorder-axis II were used. Results: Of the 600 students, women (63%), aged ≤23 years old (60.7%) and economy class C (48.5%) prevailed. Regarding sex, women were the most affected (67.9%) by TMD; 82% of the students who reported sleep bruxism had TMD, equivalent to 5.28 times the chance of developing temporomandibular disorder. Conclusion: Perceived sleep bruxism and TMD had a high prevalence among undergraduate students, with a statistically significant association. However, it is not possible to establish a cause-effect relationship between the two pathologies based only on questionnaires, so further studies are needed to demonstrate this association.

Perfil epidemiológico das fissuras labiopalatais de crianças atendidas em um centro de referência paranaense / Perfil epidemiológico de las hendiduras labiopalatinas en niños tratados en un centro de referencia en Paraná / Epidemiological profile of labiopalatine clefts in children cared for at a reference center in Paraná

Objetivo: analisar o perfil epidemiológico das fissuras labiopalatais de crianças atendidas em um centro de atenção e pesquisa em anomalias craniofaciais. Método: estudo epidemiológico, documental, transversal, que avaliou 116 crianças, com idade de zero a até 12 anos incompletos, com fissura labial e/ou palatina atendidas em um centro de referência do oeste do Paraná de fevereiro de 2013 a fevereiro de 2017 Resultados: houve predominância de pacientes do sexo masculino (n=67; 57,8%), residentes em Cascavel (n=58; 50%), com mais que 5 anos no momento da primeira consulta (n=41; 35,3%). As fissuras mais frequentes eram de extensão completa (n=56; 50,9%), do tipo labiopalatina (n=50; 43,1%) e unilaterais à esquerda (n=35; 44,3%). Conclusões: os dados obtidos estão de acordo com os achados da literatura e evidenciam a necessidade de medidas que viabilizem o acesso precoce das crianças fissuradas ao referido serviço especializado.

Objective: to analyze the epidemiological profile of labiopalatine clefts in children cared for at a care and research center on craniofacial anomalies. Method: this is an epidemiological, documentary and cross-sectional study that assessed 116 children, aged from 0 to 12 incomplete years, with labial and/or palatine cleft cared for at a reference center in western Paraná from February 2013 to February 2017 Results: there was a predominance of male patients (n=67; 57.8%), living in Cascavel (n=58; 50%) and over five years old at the time of the first consultation (n=41; 35.3%). The most frequent clefts were typified as: complete extension (n=56; 50.9%), labiopalatine (n=50; 43.1%) and left-sided unilateral (n=35; 44.3%). Conclusions: the acquired data are in accordance with the findings of the pertinent literature and show the need for measures that enable the early access of cleft children to this specialized service.

Objetivo: analizar el perfil epidemiológico de las hendiduras labiopalatinas en niños tratados en un centro de atención e investigación sobre anomalías craneofaciales. Método: estudio epidemiológico, documental, transversal que evaluó a 116 niños, de 0 a 12 años de edad, con labio leporino y/o palatino, tratados en un centro de referencia en el oeste de Paraná desde febrero de 2013 hasta febrero de 2017 Resultados: hubo un predominio de pacientes masculinos (n=67; 57.8%), residentes en Cascavel (n=58; 50%) y mayores de 5 años en el momento de la primera consulta (n=41; 35.3%). Las fisuras más frecuentes fueron de extensión completa (n=56; 50,9%), del tipo labiopalatino (n=50; 43,1%) y unilaterales a la izquierda (n=35; 44,3%). Conclusiones: los datos obtenidos están en línea con los hallazgos de la literatura y muestran la necesidad de medidas que permitan el acceso temprano de los niños con hendiduras a ese servicio especializado.

Men's health care: construction and validation of a tool for nursing consultation / Atención de salud del hombre: construcción y validación de instrumento para consulta de enfermería / Atenção à saúde do homem: construção e validação de instrumento para consulta de enfermagem

ABSTRACT Objectives: to elaborate and validate a data collection tool for nursing consultation with men in the context of Primary Health Care. Method: a methodological study developed in four stages. The first one consisted in tool elaboration, using databases and the Dorothea Orem's theoretical model. In the second and third stages, content validation and tool appearance by 23 nurse judges took place. The Concordance Index was used for assessment. In the fourth stage, a pilot test was carried out with 20 men using Primary Health Care. Results: of the 145 indicators prepared, organized and submitted to validation process, items with the Concordance Index <0.80 were excluded. The final tool consisted of 156 items. An overall 0.88 Concordance Index calculation was obtained. Conclusions: the final tool presented content validity for data collection with men in Primary Health Care.

RESUMEN Objetivos: elaborar y validar un instrumento de recolección de datos para consultas de enfermería con hombres en el contexto de la Atención Primaria de Salud. Métodos: estudio metodológico desarrollado en cuatro etapas. El primero consistió en la elaboración del instrumento, utilizando las bases de datos y el modelo teórico de Dorothea Orem. En la segunda y tercera etapas, se llevó a cabo la validación del contenido y la apariencia del instrumento por 23 enfermeras jueces. El índice de concordancia se utilizó para la evaluación. En la cuarta etapa, se llevó a cabo una prueba piloto con 20 hombres utilizando la Atención Primaria de Salud. Resultados: de los 145 indicadores preparados, organizados y presentados al proceso de validación, se excluyeron los ítems con índice de concordancia <0,80. El instrumento final consistió en 156 ítems. Se obtuvo un cálculo global de índice de concordancia de 0,88. Conclusiones: el instrumento final presentó la validez de contenido para la recopilación de datos con hombres en el contexto de la Atención Primaria de Salud.

RESUMO Objetivos: elaborar e validar um instrumento de coleta de dados para consulta de enfermagem junto ao homem no contexto da Atenção Primária à Saúde. Métodos: estudo metodológico, desenvolvido em quatro etapas. A primeira consistiu na elaboração do instrumento, utilizando-se bases de dados e o modelo teórico de Dorothea Orem. Na segunda e terceira etapas, ocorreu a validação de conteúdo e aparência do instrumento por 23 juízes enfermeiros. Para avaliação, foi utilizado o Índice de Concordância. Na quarta etapa, foi realizado o teste piloto com 20 homens usuários da Atenção Primária à Saúde. Resultados: dos 145 indicadores elaborados, organizados e submetidos ao processo de validação, foram excluídos os itens com Índice de Concordância menor que 0,80. O instrumento final foi composto por 156 itens. Obteve-se o cálculo de Índice de Concordância global de 0,88. Conclusões: o instrumento final apresentou validade de conteúdo para a coleta de dados junto a homens no contexto da Atenção Primária à Saúde.

Experiências de cuidadores nos cuidados paliativos e redes de suporte / Experiences of caregivers in the palliative care and support networks

Objetivo: compreender as experiências vivenciadas por cuidadores familiares de pacientes elegíveis para cuidados paliativos. Método: estudo qualitativo, descritivo e exploratório, fundamentado na fenomenologia social. Entrevistaram-se 20 cuidadores cadastrados na atenção primária à saúde. Realizou-se a coleta de dados por meio de entrevista fenomenológica e interpretada através das fases de descrição, redução e compreensão. utilizou-se a técnica de Análise de Conteúdo na modalidade Análise Ttemática categorial, com o auxílio do programa ATLAS TI 7. Resultados: identificaram-se as categorias: Redes de apoio ao familiar cuidador; Dinâmicas e rotinas diárias de cuidados prestados pelo familiar; Sobrecargas físicas e mentais do cuidador familiar. Conclusão: vivenciaram-se pelos cuidadores importantes mudanças em suas rotinas diárias, o que acabou por ocasionar uma sobrecarga física e mental aos mesmos, levando à necessidade de redes de apoio formais e informais para estes cuidados. Observou-se a inexistência de uma rede de apoio formal aos cuidadores e a falta de treinamento e orientação suficientes para realização do cuidado junto a seu familiar. Ressalta-se a importância da atuação dos equipamentos da APS, por meio do apoio às necessidades biopsicossociais destes cuidadores.(AU)

Recidiva de ameloblastoma após tratamento conservador: relato de caso / Recovery of ameloblastoma after conservative treatment. Case report

O ameloblastoma é um tumor benigno, de crescimento lento, localmente invasivo e apresenta altas taxas de recidiva. O tratamento dos ameloblastomas encontra várias abordagens cirúrgicas, desde as mais conservadoras,chegando às mais radicais. O melhor tratamento ainda é um assunto muito controvérsio na literatura, mas vários aspectos devem ser analisados como: tipo histopatológico das lesões, idade dos pacientes, região anatômica envolvida, estágio de desenvolvimento dos tumores e taxas de recorrências. A decisão de tratamento deve ser feita de acordo com aspectos individual. As abordagens conservadoras como enucleação, curetagem, osteotomia periférica e uso de crioterapia ou solução de Carnoy, geralmente são indicadas em tratamento de ameloblastomas das variedades menos agressivas, como unicística, ou em tratamento deste tumor em crianças. Mas essa modalidade de tratamento, apesar do alto risco de recidiva, vem sendo melhor estudada pelos cirurgiões, pois pode postergar um tratamento mais agressivo como um Hemimandibulectomia. Resultando em um período de maior qualidade de vida para o paciente.

Recovery of ameloblastoma after conservative treatment. Case report Ameloblastoma is a benign, slow-growing, locally invasive tumor with a high relapse rate. The treatment of ameloblastomas is found in several guidelines, from the most conservative to the most radical. The same is still a controversial subject in the literature, but the main forms of treatment are: histopathological type of lesions, age of patients, anatomical region involved, stage of tumor development and rates of recurrence. The decision to treat should be made according to individual issues. Conservative approaches such as enucleation, curettage, peripheral osteoporosis and the use of cryotherapy or Carnoy's solution are generally more indicated in the treatment of ameloblastomas in less aggressive forms, such as unicystic, or in the treatment of this tumor in children. But this modality of treatment, despite the high risk of relapse, may be a little more studied for surgeons, because it may be faster as a Hemimandibulectomy. It resulted in a period of higher quality of life for the patient.

Avaliação da aplicabilidade de um instrumento para monitorar a ocorrência da tuberculose resistente às drogas na Coordenadoria Regional de Saúde Leste de São Paulo (SP) / Evaluation of the applicability of an instrument to monitor the occurrence of drug-resistant tuberculosis at Eastern Health Regional Coordination in Sao Paulo

Introdução: A tuberculose droga resistente continua sendo um problema de saúde pública grave e crescente. Dentre as medidas recomendadas para o seu controle, destacam-se o envolvimento de todos os profissionais e serviços de saúde no tratamento e a implementação de um sistema de monitoramento ativo dos casos. Objetivos: descrever o perfil epidemiológico da tuberculose droga resistente na Coordenadoria Regional de Saúde Leste de São Paulo, no período de 01 de janeiro de 2007 a 31 de dezembro de 2016 e analisar a percepção dos profissionais da saúde sobre o conteúdo e a aplicabilidade de um instrumento (MonitoraTBDR) para o monitoramento dos casos na Atenção Básica. Metodologia: trata-se de um estudo exploratório, de caráter aplicado, de abordagem quali-quantitativa, sendo entrevistados 24 profissionais de serviços de saúde e realizada a análise de conteúdo. Resultados: 208 pacientes, 63,5% homens, 45,7% brancos, 82,2% entre 20 e 59 anos, 31,3% com 8 a 11 anos de estudo, 56,7% empregados, 51% procedentes do estado de São Paulo; 93,3% com forma clínica pulmonar, 51,8% primária, 52,4% monorresistentes, 41,8% multirresistentes, 4,4% polirresistentes e 1,4% Extensively Drug-Resistant, 61,1% com alta por cura; 23,6% eram alcoolistas, 21,2% usuários de drogas, 18,8% tinham HIV, 11,1% diabetes, 5,8% eram tabagistas; 75% sem informação da modalidade do tratamento, 18,2% dos contatos foram examinados e 6,4% adoeceram. A maior parte do conteúdo do instrumento MonitoraTBDR foi classificada como clara, pertinente, precisa, relevante e suficiente. O instrumento foi avaliado como viável para o monitoramento dos casos, no entanto foram constadas algumas limitações para sua aplicação, como a obtenção de algumas informações pela dificuldade de comunicação com o serviço de referência e o dispêndio de tempo para consultar várias fontes de dados. Conclusões: o MonitoraTBDR é uma ferramenta viável, que facilitará o monitoramento da tuberculose droga resistente, principalmente se for instituído um sistema informatizado integrado que envolva todos os serviços responsáveis pelo paciente. Além disso, constituir um instrumento de apoio à assistência de enfermagem poderá favorecer a adesão ao tratamento.

Introduction: Drug-resistant tuberculosis remains a serious and growing public health problem. Among the measures recommended for its control, the involvement of all health professionals and services in the treatment and the implementation of an active case monitoring system stands out. Objectives: to describe the epidemiological profile of drug-resistant tuberculosis in the Regional Health Coordination East of São Paulo, from January 1st, 2007 to December 31st, 2016, and to analyze the perception of health professionals about the content and applicability of an instrument (MonitoraTBDR) to monitor cases in Primary Care. Methodology: it is an exploratory study, of an applied character, of a qualitative-quantitative approach, 24 professionals of health services hav been interviewed and carried out the analysis of content. Results: 208 patients, 63.5% men, 45.7% white, 82.2% between 20 and 59 years, 31.3% with 8 to 11 years of schooling, 56.7% employed, 51% from the state from São Paulo; 93.3% were clinically pulmonary diagnosis, 51.8% were primary, 52.4% were monoresistant, 41.8% were multiresistant, 4.4% were polyresistant and 1.4% extensively Drug-Resistant, 61.1% with hospital discharge due to healing ; 23.6% were alcoholics, 21.2% were drug users, 18.8% had HIV, 11.1% were diabetics, 5.8% were smokers; 75% without information on the treatment modality, 18.2% of the contacts were examined and 6.4% became ill. Most of the content of the MonitoraTBDR instrument was classified as clear, relevant, accurate, relevant and sufficient. The instrument was evaluated as feasible for the monitoring of the cases, however some limitations were found for its application, such as obtaining some information due to the difficulty of communication with the referral service and the time spent in consulting several data sources. Conclusions: MonitoraTBDR is a viable tool that will facilitate the monitoring of drug-resistant tuberculosis, especially if an integrated computerized system is established, that involves all services in charge of the patient. In addition, establishing an instrument to support nursing care may increase adherence to treatment.