Imagine your perfect park: how would it be? A qualitative study on the preferences, barriers and facilitators of green spaces' use by adolescents in a southern European urban context

Os espaços verdes são elementos essenciais das cidades. Estes espaços contribuem significativamente para a saúde e bem-estar dos adolescentes no meio urbano, constituindo modos de intervenção custo-efetiva para a redução das iniquidades em saúde e a transformação de cidades resilientes às alterações climáticas. No que concerne o planeamento e design dos espaços verdes urbanos, as necessidades e interesses dos adolescentes tendem a ser negligenciados. Foi objetivo deste estudo identificar facilitadores, barreiras e promotores de uso de espaços verdes urbanos pelos adolescentes da Área Metropolitana do Porto. Foi realizado um estudo qualitativo com recolha de dados através de grupos focais. Os participantes foram selecionados da coorte Geração XXI (G21) e foram estratificados de acordo com estatuto socioeconómico. Os dados foram analisados tematicamente, usando-se uma abordagem dedutivo-indutiva. A proximidade e multifuncionalidade dos espaços verdes urbanos foram os facilitadores de uso mais citados pelos adolescentes; enquanto que elevada pressão de visitantes, falta de vegetação e falta de manutenção foram identificados como importantes barreiras. Os adolescentes destacaram a necessidade de aumentar em número e tamanho os espaços verdes na Área Metropolitana do Porto, potenciando simultaneamente a sua multifuncionalidade através da provisão de equipamentos.Green spaces are an essential element in cities. They can significantly contribute to adolescents' health and wellbeing in the urban setting, being at the same time a cost-effective intervention to reduce health inequities and contributing to climate-resilient cities. Adolescents needs and desires regarding the planning and design of urban green spaces tend to be neglected. We aimed to identify facilitators, barriers and promoters of use of urban green spaces by adolescents in the Porto Metropolitan Area. A focus group design was used. Participants were selected from the Generation XXI cohort (G21) and were stratified according to their socioeconomic status. Data were analyzed thematically using a deductive-inductive approach. Proximity and multifunctionality of urban green spaces were the most cited facilitators of use, by adolescents; whilst high visitors' pressure, lack of vegetation and lack of maintenance were identified as important barriers. Adolescents enhance the need to increase the number and size of urban green spaces in the Porto Metropolitan Aera, while potentiating their multifunctionality by means of equipment provision

ABDOMINOPLASTIA EM PACIENTE PÓS-BARIÁTRICO: ESTUDO DE CASO

Com o aumento do número de cirurgias bariátricas, decorrente da alta prevalência de obesos no Brasil, são visíveis as consequências decorrentes da perda ponderal como flacidez de pele e hérnias incisionais. A abdominoplastia em âncora é a melhor indicação por proporcionar resultados mais satisfatórios quanto à estética e a melhor qualidade de vida para o paciente. Objetivos: O objetivo desse trabalho é o estudo de uma situação específica, a abdominoplastia em âncora realizada em um paciente pos bariátrico com quadro de hérnia incisional volumosa supra umbilical. Metodologia: O estudo de caso foi realizado a partir de dados recolhidos utilizando diversos meios (ações diretas e indiretas, entrevistas, fotos, resultados de exames, entre outros), aliados a construção de embasamento teórico a partir de principais sites de artigos científicos e uso do prontuário médico, com termo de consentimento assinado pelo paciente. Conclusão: A abdominoplastia em ancora é uma ótima opção para tratamento da flacidez de pele em pacientes pós bariátrico. A associação com outros profissionais da área médica como o cirurgião geral, para tratamento concomitante da hérnia incional, trouxe melhores resultados estéticos e melhorou a qualidade de vida do paciente

Effect of High vs Low Doses of Chloroquine Diphosphate as Adjunctive Therapy for Patients Hospitalized With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection: A Randomized Clinical Trial.

There is no specific antiviral therapy recommended for coronavirus disease 2019 (COVID-19). In vitro studies indicate that the antiviral effect of chloroquine diphosphate (CQ) requires a high concentration of the drug.To evaluate the safety and efficacy of 2 CQ dosages in patients with severe COVID-19. This parallel, double-masked, randomized, phase IIb clinical trial with 81 adult patients who were hospitalized with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was conducted from March 23 to April 5, 2020, at a tertiary care facility in Manaus, Brazilian Amazon. - Patients were allocated to receive high-dosage CQ (ie, 600 mg CQ twice daily for 10 days) or low-dosage CQ (ie, 450 mg twice daily on day 1 and once daily for 4 days). - Label: Main Outcomes and Measures Primary outcome was reduction in lethality by at least 50% in the high-dosage group compared with the low-dosage group. Data presented here refer primarily to safety and lethality outcomes during treatment on day 13. Secondary end points included participant clinical status, laboratory examinations, and electrocardiogram results. Outcomes will be presented to day 28. Viral respiratory secretion RNA detection was performed on days 0 and 4. Out of a predefined sample size of 440 patients, 81 were enrolled (41 [50.6%] to high-dosage group and 40 [49.4%] to low-dosage group). Enrolled patients had a mean (SD) age of 51.1 (13.9) years, and most (60 [75.3%]) were men. Older age (mean [SD] age, 54.7 [13.7] years vs 47.4 [13.3] years) and more heart disease (5 of 28 [17.9%] vs 0) were seen in the high-dose group. Viral RNA was detected in 31 of 40 (77.5%) and 31 of 41 (75.6%) patients in the low-dosage and high-dosage groups, respectively. Lethality until day 13 was 39.0% in the high-dosage group (16 of 41) and 15.0% in the low-dosage group (6 of 40). The high-dosage group presented more instance of QTc interval greater than 500 milliseconds (7 of 37 [18.9%]) compared with the low-dosage group (4 of 36 [11.1%]). Respiratory secretion at day 4 was negative in only 6 of 27 patients (22.2%). - Label: Conclusions and Relevance The preliminary findings of this study suggest that the higher CQ dosage should not be recommended for critically ill patients with COVID-19 because of its potential safety hazards, especially when taken concurrently with azithromycin and oseltamivir. These findings cannot be extrapolated to patients with nonsevere COVID-19

COVID-19 outcomes in people living with HIV: Peering through the waves

Objective: To evaluate clinical characteristics and outcomes of COVID-19 patients infected with HIV, and to compare with a paired sample without HIV infection. Methods: This is a substudy of a Brazilian multicentric cohort that comprised two periods (2020 and 2021). Data was obtained through the retrospective review of medical records. Primary outcomes were admission to the intensive care unit, invasive mechanical ventilation, and death. Patients with HIV and controls were matched for age, sex, number of comorbidities, and hospital of origin using the technique of propensity score matching (up to 4:1). They were compared using the Chi-Square or Fisher's Exact tests for categorical variables and the Wilcoxon for numerical variables. Results: Throughout the study, 17,101 COVID-19 patients were hospitalized, and 130 (0.76%) of those were infected with HIV. The median age was 54 (IQR: 43.0;64.0) years in 2020 and 53 (IQR: 46.0;63.5) years in 2021, with a predominance of females in both periods. People Living with HIV (PLHIV) and their controls showed similar prevalence for admission to the ICU and invasive mechanical ventilation requirement in the two periods, with no significant differences. In 2020, in-hospital mortality was higher in the PLHIV compared to the controls (27.9% vs. 17.7%; p = 0.049), but there was no difference in mortality between groups in 2021 (25.0% vs. 25.1%; p > 0.999). Conclusions: Our results reiterate that PLHIV were at higher risk of COVID-19 mortality in the early stages of the pandemic, however, this finding did not sustain in 2021, when the mortality rate is similar to the control group

Lazer da pessoa idosa

Trata-se de dinamica para estimulo do lazer da pessoa idosa, apresentando os locais que disponibilizam atividades na área de abrangencia da Unidade de Saúde Ouvidor Pardinho. As contribuições dessa atividade para os idosos é de que eles consigam identificar dentro do seu território atividades tanto do lazer na esfera privada como pública e também reconhecer e identificar os seus direitos.Trata-se de dinamica para estimulo do lazer da pessoa idosa, apresentando os locais que disponibilizam atividades na área de abrangencia da Unidade de Saúde Ouvidor Pardinh