Circulating MicroRNAs as Specific Biomarkers in Atrial Fibrillation: A Meta-Analysis.

Atrial fibrillation (AF) is the most frequently occurring supraventricular arrhythmia. Although microRNAs (miRNAs) have been associated with AF pathogenesis, standard protocols for quantifying and selecting specific miRNAs for clinical use as biomarkers should be optimized. In this study, we evaluated the clinical application of miRNAs as biomarkers for the prognosis and diagnosis of AF. Literature searches were conducted on PubMed, Cochrane Library, and EMBASE. We included prospective or retrospective observational studies that had been published as of 14 February 2022; our main objective was to analyze the relationship between circulating miRNAs and AF. The data were extracted using the descriptors "Atrial fibrillation AND miRNA", "Atrial fibrillation AND diagnostic AND miRNA", and "Atrial fibrillation AND prognosis AND miRNA". No filters were applied for period delimitation, type of publication, or language. Studies using samples isolated from blood plasma and TaqMan and RT-qPCR for detecting and quantifying miRNAs were selected, and those that used atrial tissue samples were excluded. We identified 272 articles and excluded 102 duplicated articles. Two authors independently read the titles and abstracts of 170 out of 272 articles and selected 56 potential articles, 6 of which were selected for final review. Our analysis revealed a significant association between AF and miR-4798 [OR = 1.90 (95% CI 1.45-2.47)], AF and miRNA-133a [2.77 (2.73-2.82)], AF and miRNA-150 [3.77 (1.50-9.46); I2 = 70%], AF and miRNA-21 [2.23 (1.20-4.17); I2 = 99%], AF and hsa-miRNA4443 [2.32 (2.20-2.44)], and AF and miR-20a-5p [3.67 (1.42-9.49)]. The association between miRNAs and AF showed an OR of 2.51 [95% CI 1.99-3.16; I2 = 99%]. Our meta-analysis demonstrated that circulating miRNAs are potential biomarkers of AF, as they exhibit stable expression post-sample collection. In addition to regulating cellular processes, such as proliferation, differentiation, development, and cell death, miRNAs were found to be linked to arrhythmia development.

Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy. / Reanimação cardiopulmonar para leigos: avaliação de vídeos sob a perspectiva do letramento digital em saúde.

OBJECTIVE: to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy. METHOD: a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed. RESULTS: of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation. CONCLUSION: no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.

An In Silico Analysis Identified FZD9 as a Potential Prognostic Biomarker in Triple-Negative Breast Cancer Patients.

OBJECTIVE: Breast cancer (BC) is the main cause of cancer-related deaths in women across the world. It can be classified into different subtypes, including triple-negative (TN), which is characterized by the absence of hormone receptors for estrogen and progesterone and the lack of the human epidermal growth factor receptor 2. These tumors have high heterogeneity, acquire therapeutic resistance, and have no established target-driven treatment yet. The identification of differentially expressed genes in TN breast tumors and the in silico validation of their prognostic role in these tumors. MATERIALS AND METHODS: We employed a microarray dataset and, by using the GEO2R tool, we identified a list of differentially expressed genes. The in silico validation was conducted using several online platforms including the KM Plotter, cBioPortal, bc-GenExMiner, Prognoscan, and Roc Plotter. RESULTS: We observed that FZD9 was among the top differentially expressed genes in a cohort of patients with different TNBC subtypes. The FZD9 expression was significantly different in TN breast tumors than in non-TN (nTN) breast tumors (p<0.0001), and the basal TN subtype showed the highest levels (p<0.0001). In addition, the FZD9 levels were significantly inversely and positively proportional (p<0.0001) to estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2 clinical parameters. The high levels of FZD9 were associated with worse overall survival (p=0.007), relapse-free survival (p=5.8e-05), and worse survival in patients who received chemotherapy (p=3.2e-05; 0.007). CONCLUSION: Our cumulative results demonstrated that FZD9 plays an important role in TNBC and may be a potential prognostic biomarker. Nevertheless, further in vitro and in vivo assays are necessary to confirm our findings and to strengthen the evidences about the mechanisms by which FZD9 functions in these tumors.

Helicobacter pylori virulence dupA gene: risk factor or protective factor?

Helicobacter pylori is the etiological agent of chronic gastritis, peptic ulcer, and gastric cancer. The duodenal ulcer-promoting gene dupA, which is located in the plasticity region of the H. pylori genome, is homologous to the virB gene which encodes a type IV secretion protein in Agrobacterium tumefaciens. Studies have shown associations between H. pylori dupA-positive strains and gastroduodenal diseases. However, whether dupA acts as a risk factor or protective factor in these diseases remains unclear. Therefore, in this study, we aimed to verify the presence of the dupA gene in infectious H. pylori strains in the Brazilian mid-west and to investigate its association with the clinical outcomes of patients with dyspepsia. Additionally, the phylogenetic origin of the strains was determined. Gastric biopsies from 117 patients with dyspepsia were analyzed using histological and molecular techniques. The hpx gene (16S rRNA) was used to screen for H. pylori infection, and positive samples were then subjected to dupA gene detection and sequencing. The estimated prevalence of H. pylori infection was 64.1%, with the dupA gene being detected in a high proportion of infectious strains (70.7%). Furthermore, a risk analysis revealed that for women, a dupA-positive H. pylori infection increased the chance of developing gastritis by twofold. The partial dupA sequences from isolated infectious strains in this work are similar to those of strains isolated in westerns countries. This study provides useful insights for understanding the role of the H. pylori dupA gene in disease development.

Major mutations in the NS3 gene region of hepatitis C virus related to the resistance to direct acting antiviral drugs: a systematic review.

Hepatitis C virus (HCV) remains a global public health problem with high prevalence rates and chronicity of infection. Present work aimed to describe the main mutations in the NS3 region of the HCV genome related to the resistance of patients to the currently available direct-acting antivirals (DAAs). To guide the study description, the preferred items in the PRISMA protocol for systematic review were used. The data collected were HCV genotypes and subtypes and mutations in HCV NS3, general and stratified by continent. The 10 papers selected for this systematic review reported studies in seven countries, on three continents, and generated data of 2937 patients. The most frequent HCV subtype was 1a. Prevalence of genotypes suggested that there were few demographic regions reached by the studies, since there were regional variations in the type of genotypes reported in the available bibliographies. Of the total study population, 35.3% (n = 1037) had mutations in the NS3 gene region of HCV, suggesting a high rate of resistance to DAAs and a low sustained virologic response among those who used some therapeutic option. Ten major mutations were identified: Q80K, V170I, S122G, V36L, T54S, D168Q, A156S, Q80G, S122R, and V55A. The Q80K mutation was the highlight of the study, appearing not only with greater representativity (61.6%) but also as the only one described in the three continents analyzed. This systematic review reinforces the need to carry out more studies of detection of these mutations to fill in all information gaps that might help in optimization of treatment.

The FTO rs9939609 polymorphism and obesity risk in teens: Evidence-based meta-analysis.

OBJECTIVE: This meta-analysis aims evaluate the association of the polymorphism rs9939609 of FTO with the risk of obesity among children and adolescents, based on the assessment of four genetic models: codominant, dominant, recessive alleles model. METHODS: Case-control studies, published between the years 2011-2015, were selected from tree available databases (PubMed, Scopus and Web of Science) and were analysed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Thirteen studies were included totalling 15,613 participants, divided into 7311 cases and 8302 controls. RESULTS: The FTO rs9939609 polymorphism was significantly associated with increased risk of obesity in children and adolescents for homozygous genotypes AA and heterozygous AT (TT vs. AT+AA: OR=0.723, 95% CI 0.629 to 0.832; p<0.0001). CONCLUSION: This meta-analysis shows that the FTO rs9939609 polymorphism in the gene is a risk factor for obesity in children and adolescents with the presence of the A allele, both homozygous genotype AA situation, as heterozygous AT.

Association between polymorphisms in the genes encoding toll-like receptors and dectin-1 and susceptibility to invasive aspergillosis: a systematic review.

Invasive aspergillosis is a common fungal infection in immunocompromised individuals. Some studies have shown that toll-like receptor and dectin-1 genetic polymorphisms may alter signaling pathways, thus increasing an individual's susceptibility to invasive aspergillosis. We investigated the pertinent literature to determine whether polymorphisms in the genes encoding toll-like receptors and dectin-1 increase the susceptibility to invasive aspergillosis. This study systematically reviewed the literature using the databases PubMed/PMC, Scopus, and Web of Science using the keywords invasive aspergillosis, polymorphism, Toll-like, and Dectin-1. From the initial search, 415 studies were found and according to our inclusion and exclusion criteria, eight studies were selected. Several studies described single-nucleotide polymorphisms (SNPs) that are associated with a greater susceptibility to invasive aspergillosis. These SNPs were found in the genes that encode toll-like receptors 1, 3, 4, and 5 and the gene that encodes dectin-1; upon activation, both cellular receptors initiate a signaling cascade that can result in the production of cytokines and chemokines. Thus, our literature review uncovered a significant association between polymorphisms in the genes that encode toll-like receptors and dectin-1 and invasive aspergillosis. More studies should be performed to better understand the relationship between toll-like receptor and dectin-1 genetic polymorphisms and invasive aspergillosis susceptibility.

GENOTYPE ASSOCIATION GSTM1 NULL AND GASTRIC CANCER: EVIDENCE-BASED META-ANALYSIS.

BACKGROUND: Gastric cancer is the fourth most common cancer in men and the sixth among women, except for non-melanoma skin tumors, in Brazil. Epidemiological evidences reveal the multifactorial etiology of this cancer, highlighting risk factors such as: infection by the bacterium Helicobacter pylori, advanced age, smoking, chronic alcohol abuse, eating habits and genetic polymorphisms. Considering the context of genetic polymorphisms, there is the absence of the GSTM1 gene. The lack of GSTM1 function to detoxify xenobiotics and promote defense against oxidative stress leads to increased DNA damage, promoting gastric carcinogenesis. This process is multifactorial and the development of gastric cancer results from a complex interaction of these variables. OBJECTIVE: The aim of this study was to investigate the association of GSTM1 null polymorphism in the pathogenesis of gastric cancer. METHODS: A meta-analysis was conducted from 70 articles collected in SciELO and PubMed databases, between September 2015 and July 2016. In order to evaluate a possible association, we used the odds ratio (OR) and confidence interval of 95% (CI 95%). To assess the heterogeneity of the studies was used the chi-square test. Statistical analysis was performed using the BioEstat® 5.3. RESULTS: This study included 70 studies of case-control, including 28,549 individuals, which were assessed for the null polymorphism of the GSTM1 gene, and of which 11,208 (39.26%) were cases and 17,341 (60.74%) were controls. The final analysis showed that the presence of the GSTM1 gene acts as a protective factor against the development of gastric cancer (OR=0.788; 95%CI 0.725-0.857; P<0.0001). Positive statistical association was found in Asia (OR=0.736; 95%CI 0.670-0.809; P<0.0001) and Eurasia (OR=0.671; 95%CI 0.456-0.988; P=0.05). However, statistically significant data was not obtained in Europe (OR=1.033; 95%CI 0.873-1.222; P=0.705) and America (OR=0.866; 95%CI 0.549-1.364; P=0.534). Therefore, the results can not be deduced around the world. CONCLUSION: This meta-analysis concluded that the presence of the GSTM1 gene is a protector for the emergence of gastric cancer, especially in Asian countries, but this result was not found in Europe and America.

Human papillomavirus in oral cavity and oropharynx carcinomas in the central region of Brazil.

INTRODUCTION: Molecular studies about carcinomas of the oral cavity and oropharynx demonstrate the presence of human papilomavirus genome in these tumors, reinforcing the participation of human papilomavirus in oral carcinogenesis. OBJECTIVES: This study aimed to determine the prevalence of human papilomavirus and genotype distribution of HPV16 and HPV18 in oral cavity and oropharynx carcinomas, as well as their association with clinical characteristics of the tumors. METHODS: This is a retrospective study, with clinical data collected from 82 patients. Human papilomavirus detection was conducted on specimens of oral cavity and oropharynx carcinomas included in paraffin blocks. Patients were assisted in a cancer reference center, in the central region of Brazil, between 2005 and 2007. Polymerase chain reaction was used for the detection and genotyping of human papilomavirus. RESULTS: Among the patients evaluated, 78% were male. The average age of the group was about 58 years. Risk factors, such as smoking (78%) and alcohol consumption (70.8%) were recorded for the group. HPV DNA was detected in 21 cases (25.6%; 95% confidence interval 16.9-36.6) of which 33.3% were HPV16 and 14.3% were HPV18. The presence of lymph node metastases and registered deaths were less frequent in human papilomavirus positive tumors, suggesting a better prognosis for these cases; however, the differences between the groups were not statistically significant. CONCLUSION: The results obtained in the present study, with respect to the presence of the high-risk HPV16 and HPV18 genotypes, highlight the importance of human papilomavirus vaccination in the control of oral cavity and oropharynx carcinomas.

Fatores associados a ansiedade, depressão e estresse em estudantes de Medicina na pandemia da Covid-19 / Factors associated with anxiety, depression and stress in medical students in the Covid-19 pandemic

Resumo: Introdução: O curso de Medicina apresenta alta prevalência de transtornos mentais, e essa situação é agravada com a pandemia da Covid-19. Objetivo: Assim, o objetivo deste estudo foi analisar os fatores associados aos sintomas de ansiedade, depressão e estresse em estudantes de Medicina durante o período pandêmico. Método: Trata-se de um estudo transversal analítico com abordagem quantitativa. Foram aplicados dois questionários: um sobre dados sociodemográficos, pessoais e acadêmicos, e a DASS-21. Resultado: Investigou-se uma amostra de 274 estudantes de Medicina. A maioria dos participantes era do sexo feminino (63,5%) com idade que variava de 21 a 25 anos (58,4%). Dos entrevistados, 40,1% raramente encontraram os amigos. A maior parte estava insatisfeita com o rendimento acadêmico (79,9%) e acusou piora na qualidade de vida (54,7%). Em relação aos dados sociodemográficos, foi evidenciada uma incidência muito maior de depressão, ansiedade e estresse em estudantes do sexo feminino (p < 0,0001). No que diz respeito aos dados pessoais e clínicos, os estudantes que já tinham doença psiquiátrica apresentaram mais comumente ansiedade, estresse e depressão (p < 0,0001), e aqueles já faziam terapias psicológicas tiveram o mesmo resultado (p < 0,0001). Quanto aos aspectos acadêmicos, no grupo que referiu já ter pensado em abandonar o curso, houve maior incidência de depressão, ansiedade e estresse (p < 0,0001), bem como quem referiu piora na qualidade de vida durante a pandemia teve depressão, ansiedade e estresse com maior frequência (p < 0,0001). Conclusão: Este estudo evidenciou aspectos sociodemográficos, pessoais e acadêmicos, e, consequentemente, os fatores que estiveram associados a maiores níveis de ansiedade, depressão e estresse em estudantes de Medicina durante a pandemia da Covid-19. Tendo em vista o impacto da pandemia na saúde mental dos estudantes, é essencial a adoção de medidas e programas específicos que visem à diminuição e à prevenção dos transtornos psíquicos no ambiente estudantil.

Abstract: Introduction: Medical school reports a high prevalence of mental disorders, and this situation has been aggravated by the Covid-19 pandemic. Thus, the aim of this study was to analyze the factors associated with symptoms of anxiety, depression, and stress in medical students during the pandemic. Methods: This is an analytical cross-sectional study with a quantitative approach. Two questionnaires were applied, the first on sociodemographic, personal, and academic data and the second on the DASS-21 Scale Results: A sample of 274 medical students was investigated. Most participants were female (63.5%) and aged between 21 and 25 years (58.4%). Of those interviewed, 40.1% rarely meet up with friends. Most were dissatisfied with their academic performance (79.9%) and reported a worsening in their quality of life (54.7%). Regarding sociodemographic data, a much higher incidence of depression, anxiety and stress was evidenced in female students (p<0.0001). Considering the personal and clinical data, students who had previously suffered psychiatric illness were more likely to present anxiety, stress and depression (p<0.0001), with the same result reported by those who were already undergoing psychological therapies (p<0.0001). As for academic aspects, in the group that reported having thought about leaving the course, there was a higher incidence of depression, anxiety and stress (p<0.0001), and those who reported a declining quality of life during the pandemic suffered from depression, anxiety and stress more frequently (p<0.0001). Conclusion: This study demonstrated sociodemographic, personal and academic aspects and, consequently, the factors that were associated with higher levels of anxiety, depression and stress in medical students during the Covid-19 pandemic. In view of the impact of the pandemic on the mental health of students, it is essential to adopt specific measures and programs aimed at reducing and preventing mental disorders in the student environment.

Reanimação cardiopulmonar para leigos: avaliação de vídeos sob a perspectiva do letramento digital em saúde / Cardiopulmonary resuscitation for lay people: Evaluation of videos from the perspective of digital health literacy / Reanimación cardiopulmonar para legos: evaluación de videos desde la perspectiva de la alfabetización digital en salud

Resumo Objetivo: analisar indicadores de qualidade e conteúdo técnico dos vídeos postados na plataforma YouTube, para leigos, sobre reanimação cardiopulmonar em adultos e sua produção audiovisual quanto aos princípios do letramento digital em saúde. Método: estudo descritivo, exploratório, que selecionou vídeos gravados entre dezembro de 2015 e abril de 2021. Foram analisados por indicadores da produção de material audiovisual, considerando as diretrizes da American Heart Association e os princípios do letramento digital em saúde. Foi realizada estatística descritiva e inferencial. Resultados: dos 121 vídeos analisados, 26 não atenderam qualquer indicador sobre ressuscitação cardiopulmonar; quatro atingiram 81% de conformidade; oito vídeos, 79%; nove vídeos, 69% e 74 vídeos de seis a 63%. De acordo com os princípios do letramento digital em saúde, um vídeo atendeu 85% dos indicadores; 81 vídeos atenderam de 50 a 80% e 39 vídeos, de 10 a 49%. Foi identificada correlação positiva entre letramento e ressuscitação cardiopulmonar. Conclusão: nenhum vídeo apresentou 100% de conformidade com as diretrizes da American Heart Association. A falta de mecanismos de fiscalização e controle sobre conteúdos relacionados à saúde permite a publicação de vídeos equivocados, que têm sido utilizados como aprendizado pelas pessoas e podem perder o maior objetivo que é salvar vidas.

Abstract Objective: to analyze the quality indicators and technical content of the videos for lay people posted on the YouTube platform, on cardiopulmonary resuscitation in adults and their audiovisual production regarding the principles of digital health literacy. Method: a descriptive and exploratory study, which selected videos recorded between December 2015 and April 2021. They were analyzed by indicators of the production of audiovisual material, considering the American Heart Association guidelines and the principles of digital health literacy. Descriptive and inferential statistics were performed. Results: of the 121 videos analyzed, 26 did not comply with any indicator on cardiopulmonary resuscitation, four reached 81% compliance, eight videos reached 79%, nine reached 69% and 74 videos, from 6% to 63%. According to the principles of digital health literacy, one video met 85% of the indicators, 81 met from 50% to 80% and 39, from 10% to 49%. A positive correlation was identified between literacy and cardiopulmonary resuscitation. Conclusion: no video presented 100% compliance with the American Heart Association guidelines. The absence of mechanisms for supervision and control over health-related contents allows for the posting of mistaken videos, which have been used as a learning method by people and can thus miss their greatest goal: save lives.

Resumen Objetivo: analizar los indicadores de calidad y contenido técnico de los videos publicados en la plataforma YouTube, para legos, sobre reanimación cardiopulmonar en adultos y su producción audiovisual según los principios de la alfabetización digital en salud. Método: estudio descriptivo, exploratorio, que seleccionó videos grabados entre diciembre de 2015 y abril de 2021. Fueron analizados en función de los indicadores de producción de material audiovisual, considerando las directrices de la American Heart Association y los principios de la alfabetización digital en salud. Se realizó estadística descriptiva e inferencial. Resultados: de los 121 videos analizados, 26 no cumplieron con ninguno de los indicadores de reanimación cardiopulmonar; cuatro lograron un 81% de conformidad; ocho videos, 79%; nueve videos, 69% y 74 videos de seis a 63%. De acuerdo con los principios de la alfabetización digital en salud, un video cumplió con el 85% de los indicadores; 81 videos cumplieron del 50 al 80% y 39 videos del 10 al 49%. Se identificó una correlación positiva entre la alfabetización y la reanimación cardiopulmonar. Conclusión: ningún video cumplió el 100% de las directrices de la American Heart Association. La falta de mecanismos de supervisión y control sobre los contenidos relacionados con la salud permite la publicación de videos erróneos, que han sido utilizados como experiencia de aprendizaje por las personas y es probable que no cumplan con el principal objetivo, que es salvar vidas.

Functional health literacy and knowledge of renal patients on pre-dialytic treatment. / Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico.

OBJECTIVE:: to analyze the functional health literacy (FHL), i.e., understanding and knowledge about chronic renal disease of 60 patients in pre-dialytic treatment. METHOD:: this is a cross-sectional study. FHL was measured by B-TOFHLA; and the knowledge, by questionnaire. Pearson correlation and Chi-square tests were carried out as well as linear regression models. RESULTS:: all respondents presented inadequate FHL, and most showed insufficient knowledge about the disease and treatment. Low schooling was a predictive factor for worst FHL scores. Insufficient knowledge was related to age and compromised cognition. CONCLUSION:: although association between predictive variables has not been found, limited capability to obtain and use health-related information and insufficient knowledge about their own condition and treatment can contribute to worse outcomes for CKD. Appropriate intervention strategies are necessary to deal with limited FHL and also greater knowledge and ability of professionals to deal with the matter.

Comprehension of the education handout and health literacy of pacemaker users.

Objective: To verify the comprehension of the education handout and the level of Functional Health Literacy of individuals with cardiac pacemaker (PM) and whether there is correlation between the comprehension and Functional Health Literacy (FHL). Method: Cross-sectional study with 63 individuals with PM who answered to comprehension tests of the handout, literacy assessment (SAHLPA-50) and cognition (MMSE). Measurements of dispersion, Pearson correlation and multiple linear regression were calculated. Results: Most women, study time ≤ 9 years, 66.21 (average age) presented no cognitive changes. An adequate literacy level was evidenced in 50.8% individuals with PM and satisfactory comprehension of the handout. No correlation was identified between FHL, handout comprehension, age, years of study and cognition. Conclusion: The handout comprehension assessed by individuals with appropriate FHL indicated that it can be a printed material suitable for use, aiming to improve care process and knowledge of individuals with PM.

Objetivo: Verificar a legibilidade de prospecto facilitador da aprendizagem e o nível de Letramento Funcional em Saúde de indivíduos com marcapasso cardíaco (MP) e se há correlação entre a legibilidade e Letramento Funcional em Saúde (LFS). Método: Estudo transversal com 63 indivíduos com MP, que responderam testes de legibilidade do prospecto, de avaliação do letramento (SAHLPA-50) e cognição (MEEM). Foram calculadas medidas de dispersão, correlação de Pearson e regressão linear múltipla. Resultados: Maioria mulheres, tempo de estudo ≤ 9 anos, idade média de 66,21 anos, sem alteração cognitiva. Evidenciado nível adequado de letramento em 50,8% dos indivíduos com MP e legibilidade satisfatória do prospecto. Não foi identificada correlação entre LFS, legibilidade do prospecto, idade, anos de estudo e cognição. Conclusão: A legibilidade do prospecto avaliada por indivíduos com adequado LFS indicou que pode ser um impresso educativo apropriado para uso, visando aprimorar o processo de cuidar e o conhecimento dos indivíduos com MP.

Características Sócio-comportamentais, o Conhecimento Sobre o Exame Citopatológico e os Resultados Citológicos de Usuárias do Serviço Único de Saúde / Socio-behavioral characteristics, Knowledge about the Cytopathological Examination and the Cytological Results of Users of the Unique Health Service

Objetivos: Analisar, por meio de estudo de coorte transversal, a associação entre as características sociodemográficas-comportamentais, o conhecimento sobre o exame citopatológico e o resultado citológico das mulheres atendidas no Centro de Saúde da Família (CSF) da Vila Mutirão, em Goiânia, Goiás. Métodos: As pacientes incluídas no estudo atendidas responderam um questionário sobre o conhecimento a respeito do exame citopatológico, características sociodemográficas e comportamentais. Os dados coletados foram inseridos em um banco de dados no Microsoft® Excel 2010 e utilizado o Software R i386 versão 3.6.3. Para validação das associações foi utilizado o teste do Qui-quadrado (x²), com nível de significância de 5% (p<0,05). Resultados: Das 64 participantes, 96,8% possuem escolaridade até o ensino fundamental. Dessas, 65,5% afirmam ser pardas, a maioria com renda familiar menor que dois salários mínimos, indicando 53,1%. Cerca de 78,0% possuem vida sexualmente ativa, sendo 54,7% iniciado após os 16 anos, 49,2% apresentavam mais de dois parceiros sexuais. Sobre o conhecimento do citopatológico, 93,8% tem o conhecimento, entretanto 89,9% não o realizam na periodicidade adequada. A microbiota lactobacilar foi a mais frequente com 60,93%. Mulheres que faziam uso de cigarros há mais de 10 anos tiveram maior frequência de microbiota não lactobacilar no exame citopatológico com significante associação (p=0,0065). Conclusões: O estudo reforça a importância da necessidade de criação estratégica de medidas educativas e de saúde pública, além de programas de educação sexual e sobre a importância da realização do exame citopatológico e sua periodicidade.

Avaliação das crenças parentais no cuidado domiciliar do recém-nascido prematuro / Evaluation of parental beliefs in the home care of premature newborn / Evaluación de las creencias de los padres en el cuidado domiciliaria del recién nacido prematuro

Objetivo: Avaliar as crenças que norteiam o cuidar do recém-nascido prematuro em domicílio, na perspectiva da mãe cuidadora. Método: Trata-se de um estudo descritivo com abordagem qualitativa. Foram realizadas 30 entrevistadas semiestruturadas com mães que tiveram filhos prematuros. Para a análise dos discursos apreendidos nas entrevistas foi utilizada a Teoria Fundamentada nos Dados. Resultados: As mães de recém-nascidos prematuros apresentaram baixa renda, pouco acesso ao sistema de saúde e eram moradoras de áreas consideradas geográfica e economicamente menos favorecidas. Evidenciou-se que as mães apresentaram medo e insegurança ao cuidar dos seus filhos e não receberam apoio da Estratégia Saúde da Família. Conclusão: As mães do estudo relataram grande interferência na adoção das práticas parentais no domicílio, principalmente da avó e não se sentem preparadas para cuidar do filho prematuro, em casa, por sentirem medo de realizar os cuidados. (AU)

Objective: To evaluate the beliefs that guide the care of the premature newborn at home from the perspective of the caregiving mother. Methods: This is a descriptive study with a qualitative approach. 30 semi-structured interviewees were carried out with mothers who had premature children. The Grounded Theory was used to analyze the speeches seized in the interviews. Results: It was evidenced that the mothers of premature newborns had low income, little access to the health system and lived in areas considered geographically and economically less favored. It was evident that mothers were afraid and insecure when taking care of their children and did not receive support from the Family Health Strategy. Conclusion: The mothers of the study reported great interference in the adoption of parenting practices at home, especially the grandmother and they do not feel prepared to take care of the premature child at home, because they are afraid to perform the care. (AU)

Objetivo: Evaluar las creencias que guían el cuidado del recién nacido prematuro en el hogar desde la perspectiva de la madre que cuida. Métodos: Este es un estudio transversal con un enfoque cualitativo. Se realizaron 30 entrevistados semiestructurados con madres que tuvieron hijos prematuros. The Grounded Theory se utilizó para analizar los discursos incautados en las entrevistas. Resultados: Se evidenció que las madres de recién nacidos prematuros tenían bajos ingresos, poco acceso al sistema de salud y vivían en áreas consideradas geográficamente y económicamente menos favorecidas. Era evidente que las madres tenían miedo e inseguridad al cuidar a sus hijos y no recibían apoyo de la Estrategia Salud Familiar. Conclusión: Las madres del estudio informaron una gran interferencia en la adopción de prácticas parentales en el hogar, especialmente la abuela, y no se sienten preparadas para cuidar al niño prematuro en casa, porque tienen miedo de realizar el cuidado. (AU)

Avaliação da qualidade de vida em pacientes idosos antes e após a cirurgia de catarata / Quality of life assessment in elderly patients before and after cataract surgery

RESUMO Objetivo: Avaliar a qualidade de vida de pacientes idosos antes e após de se submeterem à cirurgia de catarata. Métodos: Estudo longitudinal analítico com abordagem quantitativa. A coleta de dados se deu em duas etapas (antes da cirurgia de catarata e 2 meses após o procedimento), tendo sido aplicados dois questionários, sendo um sociodemográfico e o outro o World Health Organization Quality of Life OLD. Recorreu-se à estatística descritiva e aos testes estatísticos t de Student, análise de variância, de Mann-Whitney e de Kruskal-Wallis. Resultados: Participaram da pesquisa 34 idosos, sendo 15 (44,1%) até 69 anos de idade e 19 (55,9%) com mais de 69 anos. Identificou-se decréscimo nos escores do Funcionamento do Sensório nos idosos que não tinham atividade de lazer (p=0,0006), não praticavam atividade física (p=0,0023) e não utilizavam a internet (p=0,0010). No domínio Atividades Passadas, Presentes e Futuras, identificou-se aumento do escore nos idosos que não tinham atividade de lazer (p=0,0258), não praticavam atividade física (p=0,0303), afirmaram ter outros problemas de saúde (p=0,0372) e referiram ter boa saúde (p=0,0298). Já no domínio Participação Social, houve aumento do escore nos idosos que não tinham atividade de lazer (p=0,0068), não praticavam atividade física (p=0,0033) e afirmaram ter saúde regular (p=0,0102). Conclusão: Evidenciaram-se decréscimo no Funcionamento do Sensório e aumento nas Atividades Passadas, Presentes e Futuras e na Participação Social.

ABSTRACT Objective: To evaluate quality of life of elderly patients before and after cataract surgery. Methods: A longitudinal analytical study with quantitative approach. Data collection was performed in two stages (before cataract surgery and 2 months after the procedure), when two questionnaires were used - a sociodemographic and the World Health Organization Quality of Life (WHOQLD). Descriptive statistics and Student's t test, analysis of variance, Mann-Whitney and Kruskal-Wallis tests were employed. Results: A total of 34 elderly individuals participated in the research, 15 (44.1%) aged up to 69 years and 19 (55.9%) over 69 years. A decrease in the Sensory Functioning scores was identified in those who had no leisure activity (p=0.0006), did not exercise (p=0.0023) and did not use the internet (p=0.0010). In the domain Past, Present and Future Activities, an increase in the score was observed in the elderly who had no leisure activity (p=0.0258), did not exercise (p=0.0303), reported having other health problems (p=0.0372), and in those who reported having good health status (p=0.0298). In the Social Participation domain, there was an increase in the score of the elderly who had no leisure activity (p=0.0068), did not exercise (p=0.0033), and of those who reported having regular health status (p=0.0102). Conclusion: There was a decrease in Sensory Functioning scores and an increase in the domains Past, Present and Future Activities, as well as Social Participation.

Polymorphisms of the vitamin D receptor gene in Crohn's disease / Polimorfismos do gene do receptor de vitamina D na doença de Crohn

Introduction: Crohn's disease (CD) and ulcerative colitis (UC) are chronic inflammatory conditions of the gastrointestinal tract. Studies have shown that polymorphisms of the vitamin D receptor (VDR) gene may help elucidate the pathogenesis of CD. Objectives: To analyze the role of VDR gene polymorphisms (ApaI, BsmI, FokI, and TaqI) in the development of CD. Methods: The present study is a systematic review with meta-analysis. a total of 50 articles in English and Portuguese published from 2000 to 2020 were selected from 3 databases. The relationship between CD and the VDR gene was addressed in 16 articles. Results: The TaqI polymorphism was analyzed in 3,689 patients and 4,645 control subjects (odds ratio [OR]=0.948; 95% confidence interval [95%CI]=0.851-1.056; p=0.3467). The ApaI polymorphism was studied in 3,406 patients and 4,415 control subjects (OR=1,033; 95%CI=0.854-1.250; p=0.7356). For FokI polymorphism, there were 2,998 patients and 4,146 control subjects (OR=0.965; 95%CI=0.734-1.267; p=0.7958). Lastly, the BsmI polymorphism was analyzed in 2,981 patients and 4,477 control subjects (OR=1,272; 95%CI=0.748-2.161; p=0.3743). Conclusion: These four VDR gene polymorphisms were not associated with CD. Therefore, further studies with larger samples are required to corroborate or rectify the conclusions from the present meta-analysis. (AU)

Introdução: A doença de Crohn (DC) e a retocolite ulcerativa (RU) são condições inflamatórias crônicas do trato gastrointestinal. Estudos indicam que os polimorfismos do gene do receptor de vitamina D (RVD) são promissores para a patogênese da DC. Objetivos: Avaliar papel dos os polimorfismos do gene do RVD (ApaI, BsmI, FokI e TaqI) no desenvolvimento da DC. Métodos: Trata-se de uma revisão sistemática com metanálise. Foram identificados 50 artigos em inglês e português publicados entre 2000 a 2020 em 3 bases de dados. Destes, foram selecionados 16 artigos que contemplavama relação entre a DC e o genedo RVD. Resultados: Para o polimorfismo TaqI, a amostra foi composta por 3.689 pacientes e 4.645 controles (razão de probabilidade [RP]=0,948; intervalo de confiança de 95% [IC95%]=0,851-1,056; p=0,3467). Para o polimorfismo ApaI, 3.406 pacientes e 4.415 controles (RP=1,033; IC95%=0,854-1,250; p=0,7356). Para o polimorfismo FokI, 2.998 pacientes e 4.146 controles (RP=0,965; IC95%=0,734-1,267; p=0,7958). E, para o polimorfismo BsmI, 2.981 pacientes e 4.477 controles (RP =1,272; IC95%=0,748-2,161; p=0,3743). Conclusão: Esses quatro polimorfismos do gene do RVD não apresentaram associação coma DC. Logo, sugere-se a realização de mais estudos com amostras maiores a fimde corroborar ou retificar a conclusão desta metanálise. (AU)

Avaliação dos níveis de ansiedade e seus fatores associados em estudantes internos de Medicina / Evaluation of anxiety levels and their associated factors in medical interns

Resumo: Introdução: O período do internato para um estudante de Medicina é complexo e demanda atenção das escolas médicas em relação à saúde mental desses médicos em formação. Objetivo: Este estudo teve como objetivo avaliar os fatores associados aos níveis de ansiedade em estudantes internos de Medicina. Método: Trata-se de um estudo transversal analítico com abordagem quantitativa. Aplicaram-se dois questionários: um com dados sociodemográficos, pessoais e clínicos, e o Inventário de Ansiedade de Beck (BAI). Resultados: Foram incluídos na pesquisa 140 estudantes internos de um curso de Medicina. A maioria tinha até 24 anos (67,9%) e 70,7% eram do sexo feminino. Dos participantes, 54,2% eram solteiros, 31% eram adeptos de uma religião e 68,3% moravam com familiares. Na comparação dos aspectos sociodemográficos com os níveis de ansiedade, identificou-se, no sexo feminino, uma frequência bem maior de ansiedade leve e moderada do que no sexo masculino (p = 0,0133). Aspectos pessoais e clínicos comparados com os níveis de ansiedade mostraram uma frequência maior de ansiedade em estudantes que afirmaram realizar terapia psiquiátrica ou psicológica (p = 0,0110). Ter insônia esteve relacionado com ansiedade de moderada a severa (p < 0,0001). A utilização de substâncias que alteram o sono foi associada com maior frequência a todos os níveis de ansiedade (p = 0,0099). A satisfação com o rendimento acadêmico teve menor relação com os níveis de ansiedade (p = 0,0017). Entretanto, maiores frequências de ansiedade de moderada a severa e ansiedade severa foram encontradas nos alunos que afirmaram ter pensado em abandonar o curso de Medicina (p = 0,0239). Conclusão: O presente estudo revelou os aspectos sociodemográficos, pessoais e clínicos, e, consequentemente, os fatores de risco que estão mais associados ao nível de ansiedade em estudantes internos de Medicina. Ademais, expõem-se as consequências que os níveis de ansiedade podem provocar em um indivíduo, sendo imprescindível a adoção de medidas para combater e prevenir o desenvolvimento de sintomas ansiosos.

Abstract: Introduction: The internship period for a medical student is complex and demands attention from medical schools regarding the mental health of these trainee doctors. Objective: Accordingly, the aim of this study was to assess factors associated with anxiety levels among medical interns. Method: A cross-sectional analytical study with a quantitative approach. Two questionnaires were applied, one with sociodemographic, personal and clinical data and the other consisting of the Beck Anxiety Inventory (BAI) Results: 140 medical students were included in the research. Most of the students were 24 years old or under (67.9%); 70.7% were female. The majority were single (54.2%), and lived with family members (68.3%), while 31% reported having a religion. When correlating sociodemographic aspects to levels of anxiety, a much higher frequency of females with mild and moderate anxiety was identified than that of males (p = 0.0133). Personal and clinical aspects compared to the levels of anxiety showed a higher frequency of anxiety in all levels of students who claimed to undergo psychiatric or psychological therapy (p = 0.0110). Suffering from insomnia is related to moderate to severe anxiety (p <0.0001). Using substances that alter sleep is related to a higher frequency of students at all levels of anxiety (p = 0.0099). Satisfaction with academic performance is less related to anxiety levels (p = 0.0017). However, higher frequency in students with moderate to severe and severe anxiety were found in those who reported having already contemplated leaving medical school (p = 0.0239). Conclusion: This study revealed the sociodemographic, personal and clinical aspects and, consequently, the risk factors that are most frequently associated to anxiety in medical interns. Furthermore, it exposes the consequences that the variable levels of anxiety can have on an individual, and it is essential to adopt measures to combat and prevent the development of anxiety symptoms.

Acústicas bioquímicas semi-automatizadas por processamento de imagem Dipstick com base em arduino / Biochemical semi-automated acoustics by Dipstick image processing based on arduino

Apesar da ampla disponibilidade de dispositivos para leitura de tiras reativas para análise de urina, falhas potenciais persistem na rotina baseada na interpretação humana. O objetivo deste estudo foi desenvolver e avaliar o desempenho de um dispositivo baseado em Arduino para a leitura semi-automática de parâmetros de fitas reativas. O parâmetro glicose de um modelo de tira reativa comercial foi analisado pelo sistema, que prevê a concentração do analito submetendo a cor observada na tira a um modelo de regressão, ajustado a um banco de dados de padrões de cores. O sistema foi avaliado através da leitura de 80 tiras com 16 amostras de concentrações aleatórias de glicose. O menor coeficiente de variação após cinco leituras replicadas foi de 4,5% e o mais alto foi de 16,6% (MSE = 68,7 mg / dL; r = 0,979). O dispositivo apresentou resultados satisfatórios mais baixos custos. Para torná-lo útil na rotina laboratorial, seriam necessárias novas experiências com outros parâmetros e outras classes de tiras reativas para análise de urina.

Although many devices are available to read urinalysis reactive strips, potential failure, based on human interpretation, persists in routine tasks. Current study develops and evaluates the performance of an Arduino-based device for the semi-automated reading of reactive strip parameters. The glucose parameter of a commercial reactive strip model was analyzed by the system, which predicts analyte concentration by submitting the color observed in the strip to a regression model, adjusted to a database of color patterns. The system was assessed by reading of 80 strips with 16 samples of random glucose concentrations. The lowest coefficient of variation after five replicated readings was 4.5% and the highest was 16.6% (MSE=68.7 mg/dL; r=0.979). The device featured satisfactory results plus low costs. To make it useful in the laboratory routine, further experiments with other parameters and other classes of urinalysis reactive strips would be necessary.

Evaluation of breastfeeding self-effectiveness and its associated factors in puerperal women assisted at a public health system in Brazil / Avaliação da autoeficácia para amamentação e seus fatores associados em puérperas assistidas no sistema público de saúde no Brasil

Abstract Objectives: evaluate breastfeeding self-efficacy and its associated factors in puerperal women assisted at a public health system in Brazil. Methods: it is a cross-sectional analytical study, with convenience sampling and two instruments: sociodemographic, personal and clinical, and Breastfeeding Self-Efficacy Scale (BSES-SF), applied to puerperal women in a puerperal outpatient clinic at two public maternity hospitals in Goiânia/GO, from September to November 2019. Inclusion criteria: mothers in puerperal period, age above 18 years, children born at term and on exclusive breastfeeding. Exclusion criteria: report depression and premature wean. Results: 128puerperal women were interviewed. The average age was 26.7 (± 5.9) years old. The levels of self-efficacy were high (95.3%) and no puerperal had a low level. The variables with statistical significance were: experience in breastfeeding (p= 0.0312), not having received information on breastfeeding during pregnancy (p=0.0292), did not receive other milk at the maternity (p=0.0380), did not feel pain while breastfeeding (p=0.0242), being able to breastfeed on demand (p=0.0124), presence of breast engorgement (p=0.0207), presenting protruding nipples (p=0.0427). Conclusions: clinical and personal aspects were identified as risk factors for early weaning. This can provide information for the training ofprofessionals and structuring the interventions in health services, with a view in preventing these risks.

Resumo Objetivos: avaliar a autoeficácia da amamentação e seus fatores associados em puérperas atendidas no sistema público de saúde. Métodos: estudo transversal analítico, com amostragem por conveniência e dois instrumentos: sociodemográfico, pessoal e clínico, e Escala de Autoeficácia em Amamentação, aplicada a puérperas em um ambulatório de acompanhamento puerperal de duas maternidades públicas de Goiânia/GO, de setembro a novembro de 2019. Critérios de inclusão: mães no período puerperal, idade acima de 18 anos, filhos nascidos a termo e em aleitamento materno exclusivo. Critérios de exclusão: autorrelato de depressão e desmame prematuro. Resultados: foram entrevistadas 128 puérperas. A média de idade foi de 26,7 (± 5,9). Os níveis de autoeficácia foram altos (95,3%) e nenhuma puérpera obteve nível baixo. As variáveis com significância estatística foram: experiência em amamentar (p = 0,0312), não ter recebido informações sobre aleitamento materno durante a gravidez (p = 0,0292), não ter recebido outro leite na maternidade (p = 0,0380), não sentindo dor durante a amamentação (p = 0,0242), sendo amamentada sob demanda (p = 0,0124), presença de ingurgitamento mamário (p = 0,0207), apresentando mamilos salientes (p = 0,0427). Conclusões: foram identificados aspectos clínicos e pessoais como fatores de risco para o desmame precoce. Isso pode fornecer informações para a formação de profissionais e a estruturação de intervenções nos serviços de saúde, visando a prevenção desses riscos.