ANÁLISE DA CAPACIDADE FUNCIONAL E SUA ASSOCIAÇÃO COM CARACTERÍSTICAS SOCIODEMOGRÁFICAS, DOENÇAS E HÁBITOS DE MULHERES RESIDENTES EM PERIFERIA

Objective of this study was to estimate functional capacity and analyze the association with sociodemographic characteristics, lifestyle habits, morbidity, multimorbidity and falls among elderly women living in a periphery of the city of São Paulo. A cross-sectional study of simple random sampling was carried out, whose study population consisted of 174 women (≥60 years of age) registered and a Unidade Básica de Saúde - (UBS) Jardim Rincão, city of São Paulo, Brazil, were randomly selected in the period of August to December 2015. Descriptive and inferential statistics were performed based on sociodemographic variables, life habits, chronic disease, physical activity and self-assessment of functional capacity. The results show a high prevalence of insufficient functional capacity in the population studied, 81.0%. After crude and adjusted logistic regression analysis, no statistical differences were observed in the analyzed variables p>0.05. Thus, the study revealed that sociodemographic variables, life habits, chronic diseases have no effect on the functional capacity of elderly women living in a periphery. Therefore, comprehensive health care actions for the elderly need to be carried out, combining incentives for research in areas of social vulnerability and actions planned to improve disabling conditions.El objetivo de este estudio fue estimar la capacidad funcional y analizar la asociación con características sociodemográficas, hábitos de vida, morbilidad, multimorbilidad y caídas entre ancianas residentes en una periferia de la ciudad de São Paulo. Se realizó un estudio transversal de muestreo aleatorio simple, cuya población de estudio estuvo constituida por 174 mujeres (≥60 años) registradas y una Unidade Básica de Saúde - (UBS) Jardim Rincão, ciudad de São Paulo, Brasil, fueron seleccionadas aleatoriamente seleccionados en el período de agosto a diciembre de 2015. Se realizó estadística descriptiva e inferencial a partir de variables sociodemográficas, hábitos de vida, enfermedad crónica, actividad física y autoevaluación de la capacidad funcional. Los resultados muestran una alta prevalencia de capacidad funcional insuficiente en la población estudiada, 81,0%. Después del análisis de regresión logística cruda y ajustada, no se observaron diferencias estadísticas en las variables analizadas p>0,05. Así, el estudio reveló que las variables sociodemográficas, los hábitos de vida, las enfermedades crónicas no tienen efecto sobre la capacidad funcional de las ancianas que viven en la periferia. Por lo tanto, es necesario realizar acciones de atención integral a la salud de las personas mayores, combinando incentivos a la investigación en áreas de vulnerabilidad social y acciones planificadas para mejorar las condiciones de discapacidad.O objetivo deste estudo foi estimar a capacidade funcional e analisar a associação com as características sociodemográficas, hábitos de vida, morbidade, multimorbidade e quedas entre mulheres idosas residentes em uma periferia do município de São Paulo. Foi realizado um estudo transversal de amostragem aleatória simples cuja população estudada foi de 174 mulheres (≥60 anos de idade) cadastradas e uma Unidade Básica de Saúde – (UBS) Jardim Rincão do município de São Paulo foram selecionadas de maneira aleatória no período de agosto a dezembro de 2015. Foram executadas estatísticas descritivas e inferenciais a partir de variáveis sociodemográficas, hábitos de vida, doença crônica, atividade física e autoavaliação da capacidade funcional. Os resultados evidenciam elevada prevalência de capacidade funcional insuficiente na população estudada 81,0%. Após análise de regressão logística bruta e ajustada, não foram observadas diferenças estatísticas nas variáveis analisadas p>0,05. Assim, o estudo revelou que variáveis sociodemográficas, hábitos de vida, doenças crônicas não possuem efeito sobre a capacidade funcional de idosas residentes de uma periferia. Portanto, ações de atenção integral à saúde das idosas precisam ser efetivadas, aliando o incentivo à pesquisa em áreas de vulnerabilidade social e às ações planejadas para melhorar as condições incapacitantes

CLÍNICA E DIAGNÓSTICO DAS INFECÇÕES PELOS VÍRUS HERPES GESTACIONAL E NEONATAL

O herpes genital é uma doença infectocontagiosa, sexualmente transmitida, tendo como agente etiológico duas cepas diferentes do vírus de herpes simples (HSV), o tipo 1 (HSV-1) e o tipo 2 (HSV-2). Esses vírus são filogeneticamente semelhantes, mas apresentam diferenças genotípicas bem definidas. Produzem uma primoinfecção aguda, seguida da latência viral nos gânglios sensoriais com episódios de recidiva de características variadas, sempre acompanhada da destruição irreversível da célula hospedeira infectada. A infecção de herpes genital, também denominada de Penfigóide gestacional, está associada a aborto espontâneo, prematuridade, herpes congênito e neonatal, que pode ser fatal ou acarretar sequelas graves para o bebê, como: catarata, atrofia óptica, retardamento psicomotor e perda auditiva

Influence of sweeteners in the biodistribution of radiopharmaceutical and laboratory tests in rats

This study aimed to evaluate the effect of supplementation of sucralose and fructose on the metabolism of adolescent rats. Eighteen male Wistar rats were divided into 3 groups: control group (GC), fructose group (GF) treated with 50 mg/kg of fructose, and sucralose group (GS) receiving 50 mg/kg of sucralose for 24 days. The weight and feed intake were measured weekly. At the end of the experiment, some biochemical parameters, histopathology of the liver and biodistribution of the radiotracer 99mTc-sodium phytate in liver and blood were analyzed. The GF showed higher body weight only in the first week compared with GS and GC (p<0.05). Histopathology and % ATI/g radiotracer 99mTc-sodium phytate in liver and blood were not different between the groups. The GF showed higher values of aspartate aminotransferase activity, bilirubin, alkaline phosphatase activity and gamma glutamyl transferase activity, compared with the other groups (GC and GS) (p<0.05). Activity of alanine aminotransferase and albumin level of GF were higher than GS (p<0.05). For other parameters, no statistical difference was observed. It was concluded that the use of fructose during the experiment was able to alter hepatic enzymes, but on the other hands, the use of sucralose caused no change.Keywords: Sucralose, fructose, adolescent rats, radiopharmaceutica

Fatores de risco para o desenvolvimento de pseudoartrose: uma revisão integrativa

Introduction: Pseudarthrosis is a complication that occurs in the process of consolidation of the fractured bone, being caused, above all, by mechanical instability, deficient vascularization and inadequate or late treatment. Therefore, the objective of this study was to discuss the risk factors that permeate this clinical scenario, in order to aim for an improvement in patient’s quality of life and prevent such situation. Methodology: This is an integrative literature review. The Health Sciences Descriptors platform (DeCS/MeSH) was used, using the descriptors “pseudoarthrosis” and “risk factors” in both Portuguese and English. Therefore, a search was carried out in the databases: Pubmed, Lilacs and Scielo. A total of 363 articles were obtained. The inclusion criteria are articles from the last 5 years that answer the research question and are in Portuguese, English or Spanish, with 14 articles being included to build this research. Results: An increase in cases of pseudarthrosis was observed when related to infections, and social determinants were relevant in the complications of cases. Comorbidities proved to be possible post-surgical complications and there was a relationship between spinal deformity in adults, pseudarthrosis and nail fracture. There were also interferences from surgical techniques and the possibility of a pseudarthrosis outcome. Conclusion: Therefore, it was possible to realize that there are several risk factors for pseudarthrosis. Faced with multifactorial causes, it is necessary to understand each patient's condition, seeking to improve quality of life, in order to mitigate factors that predispose to the development of pseudarthrosis.Introdução: A pseudoartrose é uma complicação que ocorre no processo de consolidação do osso fraturado, sendo causada, sobretudo, por instabilidade mecânica, vascularização deficiente e tratamento inadequado ou tardio. Portanto, o objetivo deste estudo foi discutir os fatores de risco que permeiam tal cenário clínico, a fim de almejar melhora na qualidade de vida dos pacientes e prevenir tal quadro. Metodologia: Trata-se de uma revisão integrativa de literatura. Foi utilizada a plataforma de Descritores em Ciências da Saúde (DeCS/MeSH), utilizando os descritores “pseudoartrose” e “fatores de risco” tanto na língua portuguesa, quanto na língua inglesa. Assim, foi feita uma pesquisa nas bases de dados: Pubmed, Lilacs e Scielo.Foram obtidos um total de 363 artigos. Os critérios de inclusão são os artigos dos últimos 5 anos que respondem à pergunta de pesquisa e são de língua portuguesa, inglesa ou espanhola, sendo incluídos 14 artigos para construir essa pesquisa. Resultados: Observou-se aumento dos casos de pseudoartrose quando relacionados a infecções, bem como os determinantes sociais mostraram-se relevantes nas complicações dos casos.  As comorbidades se mostraram como possíveis complicadores no pós-cirúrgico e houve relação entre deformidade da coluna vertebral em adultos, pseudoartrose e a fratura de haste. Verificou-se também, interferências das técnicas cirúrgicas e possibilidade de desfecho em pseudoartrose. Conclusão: Logo, foi possível perceber que existem diversos fatores de risco para a pseudoartrose. Diante de causas multifatoriais, é necessário entender o quadro de cada paciente, buscando melhora da qualidade de vida, a fim de mitigar fatores que predisponham ao desenvolvimento da pseudoartrose

Consultas neurológicas e diagnósticos em um grande hospital universitário dedicado a COVID-19

Background: More than one-third of COVID-19 patients present neurological symptomsranging from anosmia to stroke and encephalopathy. Furthermore, pre-existingneurological conditions may require special treatment and may be associated with worseoutcomes. Notwithstanding, the role of neurologists in COVID-19 is probablyunderrecognized. Objective: The aim of this study was to report the reasons forrequesting neurological consultations by internists and intensivists in a COVID-19-dedicated hospital. Methods: This retrospective study was carried out at Hospital dasClínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil, a 900-bedCOVID-19 dedicated center (including 300 intensive care unit beds). COVID-19 diagnosiswas confirmed by SARS-CoV-2-RT-PCR in nasal swabs. All inpatient neurologyconsultations between March 23rd and May 23rd, 2020 were analyzed. Neurologistsperformed the neurological exam, assessed all available data to diagnose theneurological condition, and requested additional tests deemed necessary. Difficultdiagnoses were established in consensus meetings. After diagnosis, neurologists wereinvolved in the treatment. Results: Neurological consultations were requested for 89 outof 1,208 (7.4%) inpatient COVID admissions during that period. Main neurologicaldiagnoses included: encephalopathy (44.4%), stroke (16.7%), previous neurologicaldiseases (9.0%), seizures (9.0%), neuromuscular disorders (5.6%), other acute brainlesions (3.4%), and other mild nonspecific symptoms (11.2%). Conclusions: Mostneurological consultations in a COVID-19-dedicated hospital were requested for severeconditions that could have an impact on the outcome. First-line doctors should be able torecognize neurological symptoms; neurologists are important members of the medicalteam in COVID-19 hospital care.Introdução: Mais de um terço dos pacientes com COVID-19 apresentam sintomasneurológicos que variam de anosmia a AVC e encefalopatia. Além disso, doençasneurológicas prévias podem exigir tratamento especial e estar associadas a pioresdesfechos. Não obstante, o papel dos neurologistas na COVID-19 é provavelmentepouco reconhecido. Objetivo: O objetivo deste estudo foi relatar os motivos para solicitarconsultas neurológicas por clínicos e intensivistas em um hospital dedicado à COVID-19. Métodos: Estudo retrospectivo realizado no Hospital das Clínicas da Faculdade deMedicina da Universidade de São Paulo, Brasil, um centro dedicado à COVID-19 com900 leitos (incluindo 300 leitos para unidades de terapia intensiva). O diagnóstico deCOVID-19 foi confirmado por SARS-CoV-2-RT-PCR em swabs nasais. Todas asinterconsultas de neurologia hospitalar entre 23 de março e 23 de maio de 2020 foramanalisadas. Os neurologistas realizaram o exame neurológico, avaliaram todos os dadosdisponíveis para diagnosticar a patologia neurológica e solicitaram exames adicionaisconforme necessidade. Diagnósticos difíceis foram estabelecidos em reuniões deconsenso. Após o diagnóstico, os neurologistas participaram da condução dos casos.Resultados: Foram solicitadas consultas neurológicas para 89 de 1.208 (7,4%) empacientes internados por COVID-19 durante o período. Os principais diagnósticosneurológicos incluíram: encefalopatia (44,4%), acidente vascular cerebral (16,7%),doenças neurológicas prévias (9,0%), crises epilépticas (9,0%), transtornosneuromusculares (5,6%), outras lesões encefálicas agudas (3,4%) e outros sintomasleves inespecíficos (11,2%). Conclusões: A maioria das consultas neurológicas em umhospital dedicado à COVID-19 foi solicitada para condições graves que poderiam afetaro desfecho clínico. Os médicos na linha de frente devem ser capazes de reconhecersintomas neurológicos. Os neurologistas são membros importantes da equipe médica noatendimento hospitalar à COVID-19

Água de beber: a filtração doméstica e a difusão do filtro de água em São Paulo

This work studies the advent and diffusion of water filter usage in São Paulo State, during the 20th Century. The water filter, a set of two terracotta vessels equipped with a filtering device, was a product of the ceramics industry, one of the first to be developed in São Paulo. This research shows that in São Paulo at the end of 19th and beginning of 20th Centuries, with the growth of cities and rapid urbanisation, a concern about the quality of water increased due to serious public health hazards, mainly epidemics caused by the consumption of unhealthy drinking water. Despite the existence of an incipient market of domestic equipment for water filtration, these were imported and of limited usage. From the 1910's, ceramics companies, owned by Portuguese and Italian immigrants, started installing filtering devices in terracotta vessels, launching the water filter set. It caught on and became the main domestic filtering equipment after the 1930's, when several companies specialized in this kind of product and started catering for the national market, such as Filtros Salus (from São Paulo city), Pozzani (Jundiaí) and Stéfani (Jaboticabal). Studying the advent and diffusion of the water filter entails knowledge about one of the first consumer goods of the Brazilian industry and, at the same time, knowledge about the history of the ways in which the Brazilian population obtained water to drink.Este artigo trata do processo de surgimento e difusão do uso do filtro de água no Estado de São Paulo, ao longo do século XX. O filtro de água, conjunto de dois recipientes de argila equipado com vela filtrante, é um produto da indústria cerâmica, uma das primeiras a se desenvolver em São Paulo. A pesquisa mostra que, em São Paulo, no final do século XIX e início do XX, com o aumento da urbanização e o crescimento das cidades, a preocupação com a qualidade da água que se consumia ganhou importância em virtude de graves problemas de saúde pública principalmente epidemias causadas por águas impróprias para beber. Embora já existisse um incipiente mercado de equipamentos domésticos de filtração da água, eles eram ainda importados e de uso restrito. A partir da década de 1910, empresas cerâmicas, de imigrantes portugueses e italianos, passaram a acoplar velas filtrantes a recipientes de argila, dando origem ao filtro de água. Depois dos anos de 1930, o filtro difundiu-se e tornou-se o principal equipamento de filtração doméstica, quando diversas empresas, como Filtros Salus (São Paulo-SP), Pozzani (Jundiaí-SP) e Stéfani (Jaboticabal-SP), especializaram-se nesse produto e passaram a atender ao mercado nacional. Estudar o surgimento e a difusão do filtro de água significa conhecer um dos primeiros bens de consumo da indústria brasileira e, ao mesmo tempo, a história de como a população obtém água para beber

High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.World Health OrganizationRevisión por pare

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio