Barriers to research in family medicine-interviews with Portuguese family physician researchers.

BACKGROUND: There is a need for a deeper understanding of the barriers to research in family medicine (FM) and to consider the perceptions and perspectives of professionals. Our study aims to provide a strategic view for research capacity building in FM. We included the perspective of family physician researchers (FPR) on the existing barriers to investigation in this context. OBJECTIVES: To understand and characterize the barriers to research in FM (personal and structural), from the perspective of Portuguese family physicians who are researchers. METHODS: A qualitative study, of phenomenological nature, was performed, through the conduction of semi-structured interviews with FPR, from 2019 to 2022. Data analysis and thematic coding were done on MAxQDA®, with inductive and deductive approaches, until data saturation was reached. RESULTS: A total of 12 family physicians/researchers were interviewed. Seven main themes were identified as barriers to research: time, professional valorization, funding, ethics committees, infrastructure, management/institutions, and participants. Each theme is divided into subthemes that make it possible to assess how a barrier can affect researchers in performing research activities. CONCLUSION: Our study highlights the identification of 7 main barriers. Structuring them into sub-themes not only improved the organization of our results but also provided robust support for the next phase, namely the application of a survey with the aim of gaining a deeper insight into the repercussions that these barriers to FPR have at a national level. This research is crucial to laying the foundations for a policy document that offers well-defined and tailored recommendations to address the barriers we have uncovered.

Dual Drug Repurposing: The Example of Saracatinib.

Saracatinib (AZD0530) is a dual Src/Abl inhibitor initially developed by AstraZeneca for cancer treatment; however, data from 2006 to 2024 reveal that this drug has been tested not only for cancer treatment, but also for the treatment of other diseases. Despite the promising pre-clinical results and the tolerability shown in phase I trials, where a maximum tolerated dose of 175 mg was defined, phase II clinical data demonstrated a low therapeutic action against several cancers and an elevated rate of adverse effects. Recently, pre-clinical research aimed at reducing the toxic effects and enhancing the therapeutic performance of saracatinib using nanoparticles and different pharmacological combinations has shown promising results. Concomitantly, saracatinib was repurposed to treat Alzheimer's disease, targeting Fyn. It showed great clinical results and required a lower daily dose than that defined for cancer treatment, 125 mg and 175 mg, respectively. In addition to Alzheimer's disease, this Src inhibitor has also been studied in relation to other health conditions such as pulmonary and liver fibrosis and even for analgesic and anti-allergic functions. Although saracatinib is still not approved by the Food and Drug Administration (FDA), the large number of alternative uses for saracatinib and the elevated number of pre-clinical and clinical trials performed suggest the huge potential of this drug for the treatment of different kinds of diseases.

Strategies for research capacity building by family physicians in primary healthcare: a scoping review protocol.

INTRODUCTION: The qualities of primary healthcare (PHC) make it a very relevant environment for research; however, there is still work to be done to enhance the research capabilities of family physicians in healthcare units. Considering there is no ongoing review that specifically addresses this objective, the proposed goal of this scoping review is to determine the depth of the literature on the current strategies that support research capacity building among family physicians in the context of PHC. METHODS AND ANALYSIS: The scoping review will include studies from PubMed, Scopus, Web of Science, Cochrane Library and grey literature, published from 2008 to 2023, that address strategies to promote research capacity building among family physicians in the context of PHC. Only studies published in English, Portuguese or Spanish will be considered. All study designs, including quantitative, qualitative and mixed-methods studies, will be eligible for inclusion. The literature search will be performed from January to March of 2024 and data charting will employ a descriptive-analytical method, systematically summarising study objectives, methodologies, findings and implications. This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols and the review will employ the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. ETHICS AND DISSEMINATION: This review does not need ethical approval. Peer-reviewed publications, policy summaries, presentations at conferences and involvement with pertinent stakeholders are all part of our outreach approach.

Hydropathic AF-2 variants in the androgen receptor gene among androgen insensitivity patients.

BACKGROUND: Androgen insensitivity syndrome (AIS) is a common condition among individuals with differences of sexual development (DSD) and results from germline allelic variants in the androgen receptor (AR) gene. Understanding the phenotypic consequences of AR allelic variants that disrupt the activation function 2 (AF2) region is essential to grasping its clinical significance. OBJECTIVES: This study aims to provide insights into the phenotypic characteristics and clinical impact of AR mutations affecting the AF2 region in AIS patients. We achieve this by reviewing reported AR variants in the AF2 region among individuals with AIS, including identifying a new phenotype associated with the c.2138T>C variant (p.Leu713Pro) in the AR gene. MATERIALS AND METHODS: We comprehensively reviewed AR variants within the AF2 region reported in AIS and applied molecular dynamics simulations to assess the impact of the p.Leu713Pro variant on protein dynamics. RESULTS: Our review of reported AR variants in the AF2 region revealed a spectrum of phenotypic outcomes in AIS patients. Molecular dynamics simulations indicated that the p.Leu713Pro variant significantly alters the local dynamics of the AR protein and disrupts the correlation and covariance between variables. DISCUSSION: The diverse phenotypic presentations observed among individuals with AR variants in the AF2 region highlight the complexity of AIS. The altered protein dynamics resulting from the p.Leu713Pro variant further emphasize the importance of the AF2 region in AR function. CONCLUSION: Our study provides valuable insights into AR mutations' phenotypic characteristics and clinical impact on the AF2 region in AIS. Moreover, the disruption of protein dynamics underscores the significance of the AF2 region in AR function and its role in the pathogenesis of AIS.

Enhancing Lung Cancer Care in Portugal: Bridging Gaps for Improved Patient Outcomes.

Lung cancer has the highest incidence and cancer-related mortality worldwide. In Portugal, it ranks as the fourth most common cancer, with nearly 6000 new cases being diagnosed every year. Lung cancer is the main cause of cancer-related death among males and the third cause of cancer-related death in females. Despite the globally accepted guidelines and recommendations for what would be the ideal path for a lung cancer patient, several challenges occur in real clinical management across the world. The recommendations emphasize the importance of adequate screening of high-risk individuals, a precise tumour biopsy, and an accurate final diagnosis to confirm the neoplastic nature of the nodule. A detailed histological classification of the lung tumour type and a comprehensive molecular characterization are of utmost importance for the selection of an efficacious and patient-directed therapeutic approach. However, in the context of the Portuguese clinical organization and the national healthcare system, there are still several gaps in the ideal pathway for a lung cancer patient, involving aspects ranging from the absence of a national lung cancer screening programme through difficulties in histological diagnosis and molecular characterization to challenges in therapeutic approaches. In this manuscript, we address the most relevant weaknesses, presenting several proposals for potential solutions to improve the management of lung cancer patients, helping to decisively improve their overall survival and quality of life.

PRRX1 silencing is required for metastatic outgrowth in melanoma and is an independent prognostic of reduced survival in patients.

Paired related homeobox 1 (PRRX1) is an inducer of epithelial-to-mesenchymal transition (EMT) in different types of cancer cells. We detected low PRRX1 expression in nevus but increased levels in primary human melanoma and cell lines carrying the BRAFV600E mutation. High expression of PRRX1 correlates with invasiveness and enrichment of genes belonging to the EMT programme. Conversely, we found that loss of PRRX1 in metastatic samples is an independent prognostic predictor of poor survival for melanoma patients. Here, we show that stable depletion of PRRX1 improves the growth of melanoma xenografts and increases the number of distant spontaneous metastases, compared to controls. We provide evidence that loss of PRRX1 counteracts the EMT phenotype, impairing the expression of other EMT-related transcription factors, causing dysregulation of the ERK and signal transducer and activator of transcription 3 (STAT3) signaling pathways, and abrogating the invasive and migratory properties of melanoma cells while triggering the up-regulation of proliferative/melanocytic genes and the expression of the neural-crest-like markers nerve growth factor receptor (NGFR; also known as neurotrophin receptor p75NTR) and neural cell adhesion molecule L1 (L1CAM). Overall, our results indicate that loss of PRRX1 triggers a switch in the invasive programme, and cells de-differentiate towards a neural crest stem cell (NCSC)-like phenotype that accounts for the metastatic aggressiveness.

The use of spirituality/religiosity by oncology nurse residents in nursing care.

OBJECTIVES: to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer. METHODS: a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0. RESULTS: participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned. FINAL CONSIDERATIONS: spirituality and religiosity are dimensions that guide oncology nurse residents' attitudes.

[Taurolidine lock in pediatric patients with intestinal failure. A practical guideline from the Spanish Society of Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP)]. / Sellado con taurolidina en el fracaso intestinal pediátrico. Guía práctica de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátrica (SEGHNP).

Introduction: Objectives: the prevention of central line-associated bloodstream infections is a critical aspect of care for patients with intestinal failure who are treated with parenteral nutrition. The use of taurolidine in this context is becoming increasingly popular, however there is a lack of standardization in its pediatric application. The objective of this work is to develop a guide to support its prescription. Methodology: the guide is based on a review of the literature and expert opinions from the Intestinal Failure Group of the SEGHNP. It was developed through a survey distributed to all its members, addressing aspects of usual practice with this lock solution. Results: this manuscript presents general recommendations concerning taurolidine indications, commercial presentations, appropriate forms of administration, use in special situations, adverse reactions, and contraindications in the pediatric population Conclusions: taurolidine is emerging as the primary lock solution used to prevent central line-associated bloodstream infections, proving to be safe and effective. This guide aims to optimize and standardize its use in pediatrics.

Introducción: Objetivo: la prevención de las infecciones asociadas a catéter ocupa un papel fundamental en los cuidados del paciente en situación de fracaso intestinal en tratamiento con nutrición parenteral. El empleo del sellado del catéter con taurolidina con ese fin se ha generalizado sin que exista una estandarización sobre su uso en población pediátrica. El objetivo de este trabajo es elaborar una guía clínica que sirva de apoyo en su utilización. Métodos: la guía se basa en una revisión de la literatura y en la opinión de expertos del Grupo de Trabajo de Fracaso Intestinal de la SEGHNP recogida a través de una encuesta realizada a todos sus integrantes sobre aspectos de la práctica habitual con este sellado. Resultados: este manuscrito expone unas recomendaciones en cuanto a las indicaciones, presentaciones comerciales disponibles, forma adecuada de administración, uso en situaciones especiales, reacciones adversas y contraindicaciones de la taurolidina en población pediátrica. Conclusiones: el sellado con taurolidina para la prevención de la infección asociada a catéter venoso central se ha mostrado como un tratamiento eficaz y seguro. La presente guía pretender optimizar y homogeneizar su uso en pediatría.

Clinical Impact of Supplementation with Pasteurized Donor Human Milk by High-Temperature Short-Time Method versus Holder Method in Extremely Low Birth Weight Infants: A Multicentre Randomized Controlled Trial.

Nosocomial infections are a frequent and serious problem in extremely low birth weight (ELBW) infants. Donor human milk (DHM) is the best alternative for feeding these babies when mother's own milk (MOM) is not available. Recently, a patented prototype of a High-Temperature Short-Time (HTST) pasteurizer adapted to a human milk bank setting showed a lesser impact on immunologic components. We designed a multicentre randomized controlled trial that investigates whether, in ELBW infants with an insufficient MOM supply, the administration of HTST pasteurized DHM reduces the incidence of confirmed catheter-associated sepsis compared to DHM pasteurized with the Holder method. From birth until 34 weeks postmenstrual age, patients included in the study received DHM, as a supplement, pasteurized by the Holder or HTST method. A total of 213 patients were randomized; 79 (HTST group) and 81 (Holder group) were included in the analysis. We found no difference in the frequency of nosocomial sepsis between the patients of the two methods-41.8% (33/79) of HTST group patients versus 45.7% (37/81) of Holder group patients, relative risk 0.91 (0.64-1.3), p = 0.62. In conclusion, when MOM is not available, supplementing during admission with DHM pasteurized by the HTST versus Holder method might not have an impact on the incidence of catheter-associated sepsis.

Implementation of a roadmap for the comprehensive diagnosis, follow-up, and research of childhood leukemias in vulnerable regions of Mexico: results from the PRONAII Strategy.

The main objective of the National Project for Research and Incidence of Childhood Leukemias is to reduce early mortality rates for these neoplasms in the vulnerable regions of Mexico. This project was conducted in the states of Oaxaca, Puebla, and Tlaxcala. A key strategy of the project is the implementation of an effective roadmap to ensure that leukemia patients are the target of maximum benefit of interdisciplinary collaboration between researchers, clinicians, surveyors, and laboratories. This strategy guarantees the comprehensive management of diagnosis and follow-up samples of pediatric patients with leukemia, centralizing, managing, and analyzing the information collected. Additionally, it allows for a precise diagnosis and monitoring of the disease through immunophenotype and measurable residual disease (MRD) studies, enhancing research and supporting informed clinical decisions for the first time in these regions through a population-based study. This initiative has significantly improved the diagnostic capacity of leukemia in girls, boys, and adolescents in the regions of Oaxaca, Puebla, and Tlaxcala, providing comprehensive, high-quality care with full coverage in the region. Likewise, it has strengthened collaboration between health institutions, researchers, and professionals in the sector, which contributes to reducing the impact of the disease on the community.

Análise das produções científicas sobre atenção integral à saúde do homem: revista Nursing brasileira / Analysis of scientific productions on comprehensive care for men's health: Brazilian Nursing magazine

Objetiva-se analisar as produções cientificas sobre a atenção integral da saúde do homem na Revista Nursing brasileira, São Paulo. Método: trata-se de uma revisão integrativa de literatura, utilizando as bases de dados LILACS e BDENF, o corte epistemológico foi de 2009 a 2019, a amostra final constituiu-se de 10 artigos. Resultados: os dados analisados foram divididos a partir de associações temáticas, em quatro categorias: acesso e acolhimento; saúde sexual e saúde reprodutiva; doenças prevalentes na população masculina e prevenção de violência e acidentes. Conclui-se que o cuidado integral a saúde do homem, e colocá-los como sujeito do cuidado, com autonomia, independência e responsabilidade social.(AU)

The objective is to analyze scientific productions on comprehensive men's health care in the Brazilian Nursing Journal, São Paulo. Method: This is an integrative literature review, using the LILACS and BDENF databases, the epistemological cut was from 2009 to 2019, the final sample consisted of 10 articles. Results: The data analyzed was divided into four categories based on thematic associations: access and reception; sexual health and reproductive health; prevalent diseases in the male population; and prevention of violence and accidents. The conclusion is that comprehensive care for men's health should place them as the subject of care, with autonomy, independence and social responsibility.(AU)

El objetivo es analizar la producción científica sobre atención integral a la salud masculina en la Revista Brasileña de Enfermería, São Paulo. Método: Se trata de una revisión bibliográfica integradora, utilizando las bases de datos LILACS y BDENF, el corte epistemológico fue de 2009 a 2019, la muestra final constó de 10 artículos. Resultados: Los datos analizados se dividieron en cuatro categorías a partir de asociaciones temáticas: acceso y acogida; salud sexual y salud reproductiva; enfermedades prevalentes en la población masculina; y prevención de violencia y accidentes. Se concluye que la atención integral a la salud del hombre debe colocarlo como sujeto de cuidados, con autonomía, independencia y responsabilidad social.(AU)

The use of spirituality/religiosity by oncology nurse residents in nursing care / El uso de la espiritualidad/religiosidad por parte del enfermero residente de oncología en la atención de enfermería / O uso da espiritualidade/religiosidade por enfermeiros residentes em oncologia na assistência de enfermagem

ABSTRACT Objectives: to analyze the use of spirituality/religiosity by oncology nurse residents in caring for patients with cancer. Methods: a census, descriptive, sectional study, with 46 nurse residents from three public hospitals in Rio de Janeiro. Data collection took place between August 2020 and January 2021, using a sociodemographic questionnaire, including a question about the use of spirituality/ religiosity to deal with work situations. Descriptive analysis was carried out using SPSS software version 22.0. Results: participants stated that they use religiosity/spirituality in work situations related to patients or themselves. In relation to patients, death was the most mentioned situation among professionals, and for themselves, everyday situations and emotional vulnerability were the most mentioned. Final Considerations: spirituality and religiosity are dimensions that guide oncology nurse residents' attitudes.

RESUMEN Objetivos: analizar el uso de la espiritualidad/religiosidad por parte de enfermeras residentes de oncología en el cuidado del paciente con cáncer. Métodos: estudio censal, descriptivo, seccional, con 46 enfermeros residentes de tres hospitales públicos de Río de Janeiro. La recolección de datos se realizó entre agosto de 2020 y enero de 2021, mediante un cuestionario sociodemográfico, que incluía una pregunta sobre el uso de la espiritualidad/religiosidad para afrontar situaciones laborales. El análisis descriptivo se realizó mediante el software SPSS, versión 22.0. Resultados: los participantes afirmaron utilizar la religiosidad/espiritualidad en situaciones laborales relacionadas con el cliente o con ellos mismos. En relación al cliente, la muerte fue la situación más mencionada entre los profesionales, y para usted, las situaciones cotidianas y su vulnerabilidad emocional fueron las más mencionadas. Consideraciones Finales: espiritualidad y religiosidad son dimensiones que orientan las actitudes de los enfermeros residentes en oncología.

RESUMO Objetivos: analisar o uso da espiritualidade/religiosidade por enfermeiros residentes em oncologia na assistência ao paciente oncológico. Métodos: estudo censitário, descritivo, do tipo seccional, com 46 enfermeiros residentes de três hospitais públicos do Rio de Janeiro. A coleta de dados ocorreu entre agosto de 2020 e janeiro de 2021, utilizando um questionário sociodemográfico, incluindo uma pergunta acerca do uso da espiritualidade/religiosidade para lidar com situações do trabalho. A análise descritiva foi realizada por meio do software SPSS, versão 22.0. Resultados: os participantes afirmaram fazer uso da religiosidade/espiritualidade em situações de trabalho relacionadas ao cliente ou a si próprio. Em relação ao cliente, a morte foi a situação mais referida entre os profissionais, e para si, as situações do dia a dia e sua vulnerabilidade emocional foram as mais referidas. Considerações Finais: a espiritualidade e a religiosidade são dimensões que guiam as atitudes dos enfermeiros residentes em oncologia.

Impactos da Covid-19 em uma Unidade de Tratamento Oncológico: Percepção dos Enfermeiros na Perspectiva da Teoria das Representações Sociais / Impacts of Covid-19 in an Oncology Treatment Unit: Nurses' Perception from the Perspective of the Theory of Social Representations / Impactos del Covid-19 en una Unidad de Tratamiento Oncológico: la Percepción de los Enfermeros desde la Perspectiva de la Teoría de las Representaciones Sociales

Introdução: O novo coronavírus SARS-CoV-2, causa principal da covid-19, foi identificado em dezembro de 2019 em Wuhan, na China. Desde então, espalhou-se pelo mundo e infectou milhares de pessoas. Serviços de saúde ficaram sobrecarregados com o atendimento de pacientes acometidos pela infecção. A enfermagem neste contexto é a categoria profissional que permanece mais tempo assistindo ao paciente. Diante desses fatos, é importante apresentar as opiniões, vivências e percepções dos enfermeiros atuantes na pandemia. Objetivo: Identificar, na perspectiva de enfermeiros, os impactos da covid-19 em seu cotidiano de trabalho no cuidado às pessoas diagnosticadas com câncer. Método: Estudo descritivo qualitativo baseado na teoria das representações sociais. O cenário do estudo ocorreu em uma instituição pública federal, referência no atendimento ao câncer, com 25 enfermeiros. Os dados foram coletados por meio da técnica de entrevista semiestruturada e de um questionário sociodemográfico. A análise dos dados foi realizada pela técnica de análise de conteúdo temática. Resultados: Participaram da pesquisa 22 enfermeiras (88%) com atuação na área oncológica de oito a 30 anos. A análise resultou em quatro categorias centrais: conceitos atribuídos pelos enfermeiros à covid-19; impactos da pandemia no cotidiano dos profissionais; impactos da pandemia na instituição; e impactos da pandemia em pessoas com câncer. Conclusão: Diante de um evento pandêmico, os enfermeiros foram essenciais para o enfrentamento da covid-19. Percebeu-se que as mudanças na rotina da instituição, o uso de equipamentos de proteção individual (EPI), a redução do número de leitos e o índice de absenteísmo afetaram tanto a vida do profissional quanto a do paciente

Introduction: The new coronavirus SARS-CoV-2 the main cause of the COVID-19, was identified in December 2019 in Wuhan, China. Since then the virus has spread around the world and infected millions of people. Healthcare services have become overwhelmed with the care of patients affected by the infection. Nursing is the health professional who stays longer with the patients. Given these facts, it is essential to know the opinions, experiences, knowledge and perception of nurses while providing care to patients during the pandemic. Objective: Identify, from the perspective of nurses, the impacts of COVID-19 on their daily work in caring for individuals diagnosed with cancer. Method: Descriptive, qualitative approach study based on the theory of social representation. The study scenario was a reference federal public institution in cancer care with 25 nurses. Data were collected through a semi-structured interview technique and a sociodemographic questionnaire. Data analysis was performed using the thematic content analysis technique. Results: The participants were 22 female nurses (88%), with between eight and 30 years of experience in oncology. The analysis resulted in 4 core categories: concepts attributed by nurses to COVID-19; impacts of the pandemic on the daily lives of professionals, impacts of the pandemic on the institution and impacts of the pandemic on oncology patients. Conclusion: Even in a pandemic scenario, the nurses were essential to deal with COVID-19. Changes of the institution routine, the use of personal protective equipment (PPE), reduction of beds and absenteeism affected the lives of professionals and patients

Introducción: El nuevo coronavirus SARS-CoV-2, causa principal del COVID-19, fue identificado en diciembre de 2019 en Wuhan, China. Desde entonces, el virus se ha propagado por todo el mundo y ha infectado a millones de personas. Los servicios sanitarios fueron desbordados por la atención a los pacientes afectados por la infección. La enfermería es la clase profesional sanitaria que permanece más tiempo con los pacientes. Ante estos hechos, es fundamental presentar las opiniones, experiencias, conocimientos y percepción de los enfermeros durante la asistencia a los pacientes durante la pandemia. Objetivo: Identificar, desde la perspectiva de los enfermeros, los impactos del COVID-19 en su trabajo diario en el cuidado de personas diagnosticadas con cáncer. Método: Estudio descriptivo con enfoque cualitativo basado en la teoría de la representación social. El escenario de estudio fue en una institución pública federal de referencia en atención al cáncer, con 25 enfermeros. Los datos fueron recolectados a través de la técnica de entrevista semiestructurada y un cuestionario sociodemográfico. El análisis de los datos se realizó mediante la técnica de análisis de contenido temático. Resultados: Participaron del estudio 22 enfermeras (88%), con experiencia en el campo de la oncología entre ocho y 30 años. El análisis resultó en cuatro categorías centrales: conceptos atribuidos por los enfermeros al COVID-19; impactos de la pandemia en la vida diaria de los profesionales, impactos de la pandemia en la institución e impactos de la pandemia en los pacientes de oncología. Conclusión: Con este estudio se pudo comprobar que incluso ante un evento pandémico, los enfermeros fueron profesionales esenciales para enfrentar el COVID-19. Se percibió que los cambios en la rutina de la institución, el uso de equipos de protección personal (EPP), la reducción del número de camas y el índice de ausentismo, afectaron tanto la vida del profesional como la del paciente

Pesquisas cadastradas por enfermeiros no registro brasileiro de ensaios clínicos / Research registered by nurses in the brazilian registry of clinical trials / Investigación registrada por enfermeros en el registro brasileño de ensayos clínicos

Objetivo: Caracterizar os estudos de intervenção cadastrados por enfermeiros no Registro Brasileiro de Ensaios Clínicos. Métodos: Estudo descritivo, com abordagem quantitativa, realizado mediante acesso virtual ao Registro Brasileiro de Ensaios Clínicos, para busca dos estudos cadastrados na plataforma. Após leitura dos 3350 resumos disponíveis, os 320 cadastrados por enfermeiros foram selecionados para compor a amostra. Foi realizada a análise descritiva, no software R. Resultados: Foram encontrados estudos registrados entre 2010 e 2019, dos quais 49,7% localizavam-se na região Sudeste, 49,3% cadastrados por doutores, 46,3% filiados a universidades federais. A área da enfermagem mais estudada (18,8%) tratou-se de saúde do adulto, 72,9% possuíam dois braços, 53,1% com recrutamento concluído, 50,3% realizados com cegamento e o tipo de intervenções mais estudado (21,9%) foi a educativa. Conclusão: A maioria dos estudos de intervenção cadastrados por enfermeiros no Registro Brasileiro de Ensaios Clínicos testaram intervenções educativas, em adultos, possuíram cegamento e foram randomizados. (AU)

Objective: To characterize the intervention studies registered by nurses in the Brazilian Registry of Clinical Trials. Methods: Descriptive study, with quantitative approach, carried out through virtual access to the Brazilian Registry of Clinical Trials, to search for the studies registered on the platform. After reading the 3350 abstracts available, the 320 registered by nurses were selected to make up the sample. Descriptive analysis was performed in the software R. Results: Studies registered between 2010 and 2019 were found, of which 49.7% were in the Southeast region, 49.3% registered by doctors, 46.3% affiliated to federal universities. The most studied nursing area (18.8%) it was adult health, 72.9% had two arms, 53.1% with completed recruitment, 50.3% performed blinding and the most studied type of interventions (21.9%) was the educational. Conclusion: Most intervention studies registered by nurses in the Brazilian Registry of Clinical Trials tested educational interventions in adults, blinded and randomized. (AU)

Objetivo: Caracterizar los estudios de intervención registrados por enfermeros en el Registro Brasileño de Ensayos Clínicos. Métodos: Estudio descriptivo, con enfoque cuantitativo, realizado a través del acceso virtual al Registro Brasileño de Ensayos Clínicos, para buscar estudios registrados en la plataforma. Después de leer los 3350 resúmenes disponibles, los 320 registrados por enfermeros fueron seleccionados para componer la muestra. Se realizó análisis descriptivo en el software R. Resultados: Se encontraron estudios registrados entre 2010 y 2019, de los cuales el 49,7% se ubicaron en la región Sudeste, el 49,3% fueron registrados por médicos, el 46,3% fueron afiliados a universidades federales. El área de enfermería más estudiada (18,8 %) fue la salud del adulto, el 72,9 % tenía dos brazos, el 53,1 % había completado el reclutamiento, el 50,3 % estaba cegada y el tipo de intervenciones más estudiadas (21,9 %) fue la educativa. Conclusión: La mayoría de los estudios de intervención registrados por enfermeros en el Registro Brasileño de Ensayos Clínicos probaron intervenciones educativas en adultos, fueron ciegos y aleatorizados. (AU)

Chikungunya virus infection in the southernmost state of Brazil was characterised by self-limited transmission (2017-2019) and a larger 2021 outbreak

BACKGROUND Chikungunya is a mosquito-borne virus that has been causing large outbreaks in the Americas since 2014. In Brazil, Asian-Caribbean (AC) and East-Central-South-African (ECSA) genotypes have been detected and lead to large outbreaks in several Brazilian states. In Rio Grande do Sul (RS), the southernmost state of Brazil, the first cases were reported in 2016. OBJECTIVES AND METHODS We employed genome sequencing and epidemiological investigation to characterise the Chikungunya fever (CHIKF) burden in RS between 2017-2021. FINDINGS We detected an increasing CHIKF burden linked to travel associated introductions and communitary transmission of distinct lineages of the ECSA genotype during this period. MAIN CONCLUSIONS Until 2020, CHIKV introductions were most travel associated and transmission was limited. Then, in 2021, the largest outbreak occurred in the state associated with the introduction of a new ECSA lineage. CHIKV outbreaks are likely to occur in the near future due to abundant competent vectors and a susceptible population, exposing more than 11 million inhabitants to an increasing infection risk.

Pacientes com Câncer e suas Representações Sociais sobre a Doença: Impactos e Enfrentamentos do Diagnóstico / Cancer Patients and their Social Representations about the Disease: Impacts and Confrontations of the Diagnosis / Pacientes con Cáncer y sus Representaciones Sociales sobre la Enfermedad: Impactos y Confrontaciones del Diagnóstico

Introdução: O diagnóstico de câncer atinge diversos aspectos, como emocionais, de relacionamento, espirituais e financeiros, tornando-o um importante problema de saúde pública mundialmente. Objetivo: Analisar a estrutura das representações sociais do câncer para pacientes oncológicos hospitalizados adultos e apontar sua relação com aspectos do cotidiano de enfrentamento do diagnóstico e do adoecimento por essa patologia. Método: De natureza qualitativa, descritiva e exploratória, embasado na Teoria das Representações Sociais. O cenário foi um hospital federal de câncer, no município do Rio de Janeiro, com 111 participantes vivendo o adoecimento oncológico. Foram coletadas as evocações livres ao termo indutor "câncer" e aplicado o questionário para caracterização dos pacientes. A análise se deu por intermédio do software EVOC 2005. Resultados: Participantes, majoritariamente homens (69,3%), com ensino fundamental (57,6%). Apresentaram-se como provável núcleo central: doença, tristeza e morte. O conhecimento reificado do câncer ocorreu por meio da palavra "doençaË®. Reconhece-se o predomínio de elementos negativos, ainda que hajam alguns positivos como tratamento, cura e Deus na representação do grupo. A doença em voga carreia estigma, tornando o enfrentamento um processo doloroso e triste. Conclusão: É possível observar o pesar de estar com câncer na visão dos pacientes, ao passo que a esperança existe e os move em direção à cura. Identifica-se a necessidade de o profissional enfermeiro dar enfoque no que diz respeito à dimensão espiritual e religiosa em seu cuidado, entendendo o indivíduo como um ser único e complexo que demanda cuidados individuais.

Introduction: The diagnosis of cancer affects several aspects, whether emotional, relationships, spiritual and financial, making it an important public health problem worldwide. Objective: To analyze the structure of social representations of cancer for adult hospitalized cancer patients and reveal its relations with daily aspects of coping with the diagnosis and sickening by this pathology. Method: Qualitative, descriptive and exploratory based in the Theory of Social Representations. The scenario was a federal cancer hospital in the city of Rio de Janeiro, with 111 participants living the oncological sickening. Free evocations related to the inducing term "cancer" were collected and a questionnaire was applied to characterize the patients. The EVOC 2005 software was utilized for the analyses. Results: Mostly male participants (69.3%), with elementary education (57.6%) appeared as probable core nucleus: disease, sadness and death. The reified knowledge of cancer is given through the word "diseaseË®. The predominance of negative elements is recognized, although there are some positive ones such as treatment, cure and God in the representation of the group. The current disease carries stigma, making coping a painful and sad process. Conclusion: It is possible to detect the regret the patients express for being with cancer, while hope exists and moves them towards the cure. It is identified the need for the nurse to focus on the spiritual and religious dimensions during the caring process, understanding the individual as a unique and complex being that demands centered care

Introducción: El diagnóstico de cáncer incide en diversos aspectos, ya sean emocionales, relacionales, espirituales y económicos, convirtiéndolo en un importante problema de salud pública a nivel mundial. Objetivo: Analizar la estructura de las representaciones sociales del cáncer en pacientes adultos con cáncer hospitalizados y señalar su relación con aspectos cotidianos del afrontamiento del diagnóstico y la enfermedad por esta patología. Método: Cualitativo, descriptivo y exploratorio, basado en la Teoría de las Representaciones Sociales. El escenario fue un hospital federal de cáncer, en la ciudad de Río de Janeiro, 111 participantes viviendo enfermarse de cáncer. Se recogieron evocaciones gratuitas del término inductor "cáncer" y se aplicó un cuestionario para caracterizar a los pacientes. El análisis se realizó mediante el software EVOC 2005. Resultados: Mayoritariamente varones (69,3%), con educación básica (57,6%). Aparecen como un probable núcleo central: enfermedad, tristeza y muerte. El conocimiento cosificado del cáncer se da a través de la palabra "enfermedadË®. Se reconoce el predominio de elementos negativos, aunque existen algunos positivos como el tratamiento, la cura y Dios en la representación del grupo. La enfermedad actual conlleva un estigma, lo que hace que el afrontamiento sea un proceso doloroso y triste. Conclusión: Es posible observar el arrepentimiento de estar con cáncer en la mirada de los pacientes, mientras existe la esperanza y los mueve hacia la cura. Identifica la necesidad del profesional de enfermería de centrarse en la dimensión espiritual y religiosa en su cuidado, entendiendo al individuo como un ser único y complejo que demanda cuidados individuales

Epidemiological investigation reveals local transmission of SARS-CoV-2 lineage P. 1 in Southern Brazil / Investigação epidemiológica revela transmissão local da variante P. 1 do SARS-CoV-2 no Sul do Brasil / Una investigación epidemiológica revela la transmisión local de la variante P. 1 del SARS-CoV-2 en el sur de Brasil

Since its detection in December of 2020, the SARS-CoV2 lineage P.1, descendent of B.1.1.28 lineage, has been identified in several places in Brazil and abroad. This Variant of Concern was considered highly prevalent in Northern Brazil and now is rapidly widening its geographical range. Here, we present epidemiological and genomic information of the first case of P1 lineage in Rio Grande do Sul state, in a patient without reported travel history and a tracked transmission chain. These findings occurred in a tourist destination representing an important hub receiving tourists from diverse places.(AU)

Desde a sua detecção em dezembro de 2020, a linhagem P.1 do SARS-CoV2, descendente da linhagem B.1.1.28, foi identificada em diversos locais no Brasil e no mundo. Essa variante de preocupação era considerada altamente frequente no Norte do Brasil e agora está ampliando rapidamente sua distribuição geográfica. Aqui, apresentamos informações epidemiológicas e genômicas do primeiro caso da linhagem P.1 no Rio Grande do Sul em um paciente sem histórico de viagens relatado e com cadeia de transmissão identificada. Esses achados ocorreram em um destino turístico que representa um importante pólo de recepção de turistas de diversas localidades.(AU)

Desde su detección en diciembre de 2020, del linaje P.1 del SARS-CoV2, derivada de la B.1.1.28, hay sido ampliamente identificada en Brasil y en todo el mundo. Esta variante preocupante es muy frecuente en el norte de Brasil y ahora está ampliando rápidamente su distribución geográfica. Aquí, presentamos información epidemiológica y genómica del primer caso de P.1 en Rio Grande do Sul en un paciente sin antecedentes de viaje y con una cadena de transmisión identificada. Estos datos se han obtenido en un destino turístico que representa un importante centro de acogida de turistas de diferentes lugares.(AU)

Estenosis esofágica congénita. La sospecha diagnóstica se inicia desde Atención Primaria / Esophageal congenital stenosis. The diagnostic suspect is started from Primary Care

La estenosis esofágica congénita es una malformación rara que ocurre debido a la separación incompleta del esófago y del sistema respiratorio. Generalmente cursa con vómitos persistentes que suelen debutar o exacerbarse con la introducción de la alimentación complementaria y con ello de los alimentos sólidos. Dados los síntomas de presentación, la sospecha diagnóstica se puede realizar desde las consultas de Pediatría de Atención Primaria. El diagnóstico se realiza mediante una endoscopia digestiva alta que mostrará normalidad de la mucosa y un tránsito digestivo. Existe controversia en cuanto al tratamiento de elección, prefiriéndose el tratamiento conservador mediante dilataciones endoscópicas de inicio

Esophageal congenital stenosis is an unusual type of malformation that occurs due to incomplete division of the esophagus and respiratory system. Generally, it shows up with persistent vomiting that tends to debut or exacerbate with the introduction of complementary feeding and solid foods. A high degree of suspicion is necessary for diagnosis from Primary Care pediatricians. A high digestive endoscopy with normal mucosa and a digestive transit confirm the diagnosis. There is controversy regarding the treatment of choice, conservative treatment is preferred by initial endoscopic dilations

Practices for the prevention of sexually transmitted infections among university students / Prácticas para la prevención de infecciones de transmisión sexual entre estudiantes universitarios / Práticas de prevenção de infecções sexualmente transmissíveis entre estudantes universitários

ABSTRACT Objective: to analyze the sexual practices adopted by university students for the prevention of Sexually Transmitted Infections Method: a quantitative, descriptive and cross-sectional study, conducted in 2016, at a private university in the municipality of Rio de Janeiro, Brazil. A convenience sample was selected, stratified by gender, of 768 students who answered a self-administered questionnaire, structured with variables of sociodemographic characterization and related to knowledge about sexually transmitted infections, sexual practices, prevention practices and care with sexual health. In the analysis, descriptive statistics, chi-square tests and analysis of variance were used, with a significance level of 5%. Results: most of the university students ‒ 654 (85.16%) ‒ had an active sex life and 480 (62.54%) did not use condoms in all their sexual encounters. Among the participants, 509 (84.83%) said they had sexual intercourse with a steady partner, of which 224 (44.01%) used a condom. In the investigated group, 313 (47.86%) had relationships with casual partners, with 199 (63.58%) reporting having used a condom. Among the participants, 174 (26.61%) had their sexual practices classified as adequate/satisfactory. Conclusion: the findings show that the university students investigated present a risk behavior for Sexually Transmitted Infections due to inadequate/unsatisfactory sexual practices. Health education actions should consider cultural and individual aspects of the group in order to encourage reflection on practices for the prevention of sexually transmitted diseases.

RESUMEN Objetivo: analizar las prácticas sexuales adoptadas por estudiantes universitarios para prevenir Infecciones de Transmisión Sexual. Método: estudio cuantitativo, descriptivo y transversal, realizado en el año 2016 en una universidad privada del municipio de Río de Janeiro, Brasil. Ajustada por conveniencia y estratificada por sexo, la muestra estuvo compuesta por 768 estudiantes que respondieron un cuestionario autoaplicado, estructurado con variables de caracterización sociodemográfica y relacionadas con el conocimiento sobre infecciones de transmisión sexual, prácticas sexuales, prácticas de prevención y cuidados con la salud sexual. En el análisis se empleó la estadística descriptiva, pruebas de Chi-cuadrado y análisis de variancia, con un nivel de significancia del 5%. Resultados: la mayoría de los universitarios ‒ 654 (85,16%) ‒ tenía una vida sexual activa y 480 (62,54%) no usaban preservativo en todos sus encuentros sexuales. Entre los participantes, 509 (84,83%) afirmaron tener relaciones sexuales con una pareja fija y, de ellos, 224 (44,01%) utilizaban preservativo. En el grupo investigado, 313 (47,86%) tuvieron relaciones con parejas casuales, y 199 (63,58%) declararon haber usado preservativo. Entre los participantes, las prácticas sexuales de 174 (26,61%) de ellos se clasificaron como adecuadas/satisfactorias. Conclusión: las conclusiones del estudio evidencian que los universitarios investigados presentan un comportamiento de riesgo para contraer Infecciones de Transmisión Sexual como resultado de prácticas sexuales inadecuadas/insatisfactorias. Las medidas de educación en salud deben considerar aspectos culturales e individuales del grupo para favorecer la reflexión sobre las prácticas de prevención de enfermedades de transmisión sexual.

RESUMO Objetivo: analisar as práticas sexuais adotadas por estudantes universitários para prevenção de Infecções Sexualmente Transmissíveis Método: estudo quantitativo, descritivo e transversal, realizado em 2016, em uma universidade privada no município do Rio de Janeiro, Brasil. Selecionou-se amostra por conveniência, estratificada por sexo, de 768 estudantes que responderam a um questionário autoaplicado, estruturado com variáveis de caracterização sociodemográfica e relacionadas ao conhecimento sobre infecções sexualmente transmissíveis, práticas sexuais, práticas de prevenção e cuidados com a saúde sexual. Na análise, empregou-se a estatística descritiva, testes de quiquadrado e análise de variância, com nível de significância de 5%. Resultados: a maioria dos universitários ‒ 654(85,16%) ‒ tinha vida sexual ativa e 480(62,54%) não fazia uso do preservativo em todos os intercursos sexuais. Entre os participantes, 509(84,83%) afirmaram ter relação sexual com parceiro fixo, dos quais 224(44,01%) utilizaram o preservativo. No grupo investigado, 313(47,86%) tiveram relações com parceiros casuais, sendo que 199 (63,58%) informaram ter usado o preservativo. Entre os participantes, 174(26,61%) tiveram suas práticas sexuais classificadas como adequadas/satisfatórias. Conclusão: os achados evidenciam que os universitários investigados apresentam um comportamento de risco para Infecções Sexualmente Transmissíveis decorrente de práticas sexuais inadequadas/insatisfatórias. Ações de educação em saúde devem considerar aspectos culturais e individuais do grupo para favorecer a reflexão sobre as práticas de prevenção de doenças transmitidas pelo sexo.