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Social isolation is extremely important to minimize the effects of a pandemic. Latin American (LA) countries have similar socioeconomic characteristics and health system infrastructures. These countries face difficulties to deal with the COVID-19 pandemic and some of them had very high death rates. Government stringency index (GSI) of twelve LA countries was gathered from the Oxford COVID-19 Government Response Tracker (OxCGRT) project. GSI was calculated considering nine metrics such as school and work closures, stay-at-home requirements, among others types of social distancing and isolation measures. Population data from the United Nations Population Fund and number of deaths data was collected from the dashboard of the World Health Organization (WHO). We performed an analysis of the period March-December using a mixed linear model approach. Peru, Brazil, Chile, Bolivia, Colombia, Argentina and Ecuador had the highest death rates with an increasing trend over time, while Suriname, Venezuela, Uruguay, Paraguay and Guyana had the lowest ones, which remained steady. GSI in most countries followed the same pattern during the analyzed months. i.e., high indices at the beginning of the pandemic and lower ones in the last evaluated months, while the number of deaths increased over the whole period. Almost no country kept its GSI high for much time, especially from October to December. Time and GSI as well as their interaction were highly significant. As their interaction increases, death rate decreases. In conclusion, our statistical model explains and substantiates the need for maintaining social distancing and isolation measures over time during the pandemic.

Fanny Helena Martins Salles,1 Pedro San Martin Soares,1 Carolina David Wiener,1 Thaise Campos Mondin,1 Paula Moraes da Silva,1 Karen Jansen,1–3 Luciano Dias de Mattos Souza,1 Ricardo Azevedo da Silva,1 Jean Pierre Oses1–3 1Translational Science on Brain Disorders, Department of Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil; 2Translational Psychiatry Program, 3Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) Medical School, Houston, TX, USA Abstract: Nerve growth factor (NGF) is an important member of the neurotrophin family and its alteration has been associated with psychiatric disorders. Functionality consists of the activities that an individual can perform, as well as their social participation, which is an important factor in analyzing the carrier living conditions of subjects with psychiatric suffering. Several studies have evaluated functionality in bipolar disorder; however, no studies have evaluated the functionality in other mental disorders. There are also few studies investigating the association between functionality and the biological bases of mental disorders. This study aimed to evaluate the serum NGF levels in psychiatric patients and to verify a possible association between the serum neurotrophic levels and functionality. This was a cross-sectional study with a convenient sample obtained from the Public Mental Health Service from the south of Brazil. The final sample was composed of 286 patients enrolled from July 2013 to October 2014. Data was collected using a sociodemographic questionnaire, and the diagnosis was confirmed using the Mini International Neuropsychiatric Interview (M.I.N.I) and a Functioning Assessment Short Test. The serum NGF levels were determined using the enzyme-linked immunosorbent assay method. Statistical analyses were performed using IBM SPSS Statistic 21.0 software. NGF serum levels were increased significantly in patients with obsessive–compulsive disorder compared with patients with no obsessive–compulsive disorder (P=0.015). An increase in serum NGF levels in generalized anxiety disorder patients was observed compared with patients with no generalized anxiety disorder (P=0.047). NGF was negatively associated with autonomy (P=0.024, r=–0.136), work (P=0.040, r=–0.124), and cognition (P=0.024, r=–0.137), thereby showing that changes in serum levels of NGF are associated with functionality in mental disorders. Keywords: NGF, mental disorders, functional impairment

Augusto Duarte Faria,1 Luciano Dias de Mattos Souza,2 Taiane de Azevedo Cardoso,2 Karen Amaral Tavares Pinheiro,2 Ricardo Tavares Pinheiro,2 Ricardo Azevedo da Silva,2 Karen Jansen21Department of Clinical and Health Psychology, Universidade Federal do Rio Grande – FURG, Rio Grande, RS, Brazil; 2Health and Behavior Postgraduate Program, Universidade Católica de Pelotas – UCPEL, Pelotas, RS, BrazilIntroduction: Changes in biological rhythm are among the various characteristics of bipolar disorder, and have long been associated with the functional impairment of the disease. There are only a few viable options of psychosocial interventions that deal with this specific topic; one of them is psychoeducation, a model that, although it has been used by practitioners for some time, only recently have studies shown its efficacy in clinical practice.Aim: To assess if patients undergoing psychosocial intervention in addition to a pharmacological treatment have better regulation of their biological rhythm than those only using medication.Method: This study is a randomized clinical trial that compares a standard medication intervention to an intervention combined with drugs and psychoeducation. The evaluation of the biological rhythm was made using the Biological Rhythm Interview of Assessment in Neuropsychiatry, an 18-item scale divided in four areas (sleep, activity, social rhythm, and eating pattern). The combined intervention consisted of medication and a short-term psychoeducation model summarized in a protocol of six individual sessions of 1 hour each.Results: The sample consisted of 61 patients with bipolar II disorder, but during the study, there were 14 losses to follow-up. Therefore, the final sample consisted of 45 individuals (26 for standard intervention and 19 for combined). The results showed that, in this sample and time period evaluated, the combined treatment of medication and psychoeducation had no statistically significant impact on the regulation of biological rhythm when compared to standard pharmacological treatment.Conclusion: Although the changes in biological rhythm were not statistically significant during the time period evaluated in this study, it is noteworthy that the trajectory of the score showed a trend towards improvement, which may indicate a positive impact on treatment, though it may take a longer time than expected.Keywords: neuropsychiatry, melatonin, depression, mania, lithium

Rodrigo Augusto da Silva,1 André Luis Shinohara,2 Denise Carleto Andia,1 Ariadne Letra,3 Regina Célia Peres,1 Ana Paula de Souza11Department of Morphology, Piracicaba Dental School, State University of Campinas, 2Oral Biology Program, Bauru Dental School, State University of São Paulo, São Paulo, Brazil; 3Department of Endodontics and Center for Craniofacial Research, School of Dentistry, University of Texas Health Science Center, Houston, TX, USAAbstract: Single nucleotide polymorphisms are genome variations that can be used as population-specific markers to infer genetic background and population origin. The Brazilian population is highly admixed due to immigration from several other populations. In particular, the state of São Paulo is recognized for the presence of Japanese individuals who seem likely to have contributed to a substantial proportion of ancestry in the modern Brazilian population. In the present study, we analyzed allele and genotype frequencies and associations of the –418G>C (rs8179090) single nucleotide polymorphism in the TIMP2 gene promoter in Brazilian and Japanese subjects, as well as in Japanese descendants from southeastern Brazil. The allele and genotype frequency analyses among groups demonstrated statistical significance (PC single nucleotide polymorphism of the TIMP2 gene, have a high probability of being Japanese or Japanese descendants. In addition to other genetic polymorphisms, the −418G>C TIMP2 polymorphism could be a population marker to assist in predicting Japanese ancestry, both in Japanese individuals and in admixed populations.Keywords: Brazilian, Japanese, polymorphism, allele, TIMP2

Pediatric care is fundamental to preventing several diseases during the early years of childhood. Early medical care and having at least nine checkups in the first year of life are the ideal in pediatric care. It is essential to periodically assess whether or not these goals are being met. In 1994, a cross-sectional study was carried out using three-stage cluster sampling to measure coverage of pediatric care and factors associated with that care among children in the city of Sao Luis, in the state of Maranhao, Brazil. For data collection, a standardized questionnaire was used with the mother of the child or another person responsible for the child. The percentage of those refusing to participate or who were absent was 7%. This work analyzes data concerning 290 children between 1 and 23 months of age. The coverage estimates and 95% confidence intervals took into consideration possible effects of the study design. Cox's regression, modified for cross-sectional studies, was used to estimate adjusted relative risks. Pediatric care coverage for the population studied was 80%. The children had an average of 7.8 checkups in the first year; 44% of the children had six or fewer checkups during the first year of life, well below the recommended number. Eighty-one percent of the children were seen in the Brazilian public health care system (Sistema Unico de Saude, SUS), and only 15% used health insurance. After adjusting for confounding factors, the factors "greater number of siblings at home" and "father with four or fewer years of schooling" were associated with not having checkups. After adjustment, family income was not associated with the number of checkups. Encouraging educational activities and perhaps also family planning programs are important strategies for increasing the coverage of pediatric care in the city of Sao Luis.

The aim of this study was to assess the immediate effect of bilateral talocrural joint manipulation on the postural balance of healthy subjects. Ninety healthy subjects (21 males and 69 females) were included in this study. The mean age, height and body weight of the subjects were 22.21 years, 165.1 cm and 62.58 Kg, respectively. Following collection of anthropometric data, the subjects were allocated randomly into an experimental group (receiving real talocrural joint manipulation), a placebo group and a control group. Before and after manipulation, the subjects performed two postural balance tasks, inquiet standing position (eyes open and eyes closed) on a force platform. The stabilometric data were recorded for 60 seconds in each condition. Sway area, medio-lateral (ML) and anteroposterior (AP) velocities and median frequency were calculated from the center of pressure (COP) displacements. The results showed that in the experimental group the COP sway velocity decreased in both directions of movement (AP and ML) and in both visual tasks (eyes open and eyes closed). In general, the placebo and control groups had similar postural balance across balance parameterss. Significant effect of the bilateral talocrural joint manipulation was found on main balance parameter like COP velocity in the anteroposterior and mediolateral directions. These results have some much implications for manual therapy rehabilitation of individuals with ankle instability.

Foi realizado inquérito domiciliar do tipo transversal abrangendo crianças menores de cinco anos residentes em 3 áreas da ilha de São Luís (Brasil): Vila Palmeira, Anjo da Guarda e São José de Ribamar. Aplicou-se um questionário onde se perguntou à mãe ou à pessoa responsável pela criança sobre a presença de diarréia nas duas últimas semanas. Foram realizados dois estudos censitários (maio de 1986 e 1989) e quatro amostragens sazonais (novembro de 1986, 1987 e 1988 e maio de 1989). A prevalência de diarréia foi maior em maio de 1986 e novembro de 1987; São José de Ribamar foi o local de maior prevalência; a distribuição dos casos por idade mostrou maior prevalência entre crianças de 6 a 11 meses e de 1 a 2 anos de idade; a prevalência da diarréia foi maior nas famílias que tinham como destino dos dejetos a maré e fossa negra; que se abasteciam de água de poço descoberto, nas famílias cujos pais eram desempregados e nas que depositavam o lixo na maré. A diarréia foi a principal causa de morte nos dois estudos censitários; a taxa de mortalidade infantil em maio de 1986 foi, respectivamente, de 44,0 por mil em menores de um ano e 12,8 por mil em menores de cinco anos; em maio de 1989 foi de 7,9 por mil e 4,9 por mil. As reduções na morbidade e mortalidade infantil por diarréia aguda entre 1986 e 1989 foram estatisticamente significantes.

Abdominal ultrasonography was performed on eight children and four adults with acute schistosomiasis mansoni, 12 chronically infected patients, and 12 noninfected individuals from the endemic area, who were paired by age and sex with the acute group. In all acute patients, lymphadenomegaly as well as liver and spleen enlargement were detected. Lymph nodes surrounding the portal vein and the hepatic artery in the hepatic hilus were visualized. In the children, the right lobe of the liver was statistically significantly larger in the acute group than in the noninfected group. The portal and splenic vein diameters were significantly larger in children with acute schistosomiasis than in the chronically infected and negative control groups. The left hepatic lobe and a longitudinal scan of the spleen in acute adult patients were statistically significantly larger than in the chronically infected and negative control groups. Ultrasonography is shown to be a useful tool for the differential diagnosis of acute schistosomiasis mansoni.

This work is part of the clinical nutritional evaluation of the "Health Diagnostic in the Polonoroeste Survey, 1983". With the objective of evaluating the nutritional status of the population in the area of Polonoroeste a Nutritional Inquiry was done in 7 cities of the State of Mato Grosso. The inquiry included a study of alimentary habits, anthropometric studies and a clinical evaluation of the nutritional status of children between 3 and 72 months of age. We examined 585 children selected as proposed by the SANCHES & CARVALHEIRO sampling method modified by MEIRELLES and SANCHES and the clinical-nutritional evaluation was made according to JELLIEFE. Clinical evidence of proteic-energetic malnutrition was registered in 6.6% of the children, anemia in 9.7% and goiter in 2.7%. There was correlation of the anemia with intestinal parasitoses observed in the same sample by another team of the same project. O estudo do exame clínico-nutricional é parte do Inquérito Nutricional, realizado no "Diagnóstico em Saúde do Polonoroeste-MT em 1983". No intuito de reconhecer a situação nutricional da população da região em estudo, o grupo do Inquérito Nutricional procedeu ao estudo do Consumo Alimentar das famílias, ao estudo dos dados antropométricos e de sinais clínico-nutricionais de crianças na faixa etária de 3 a 72 meses. Foram examinadas 585 crianças da amostra como proposta por SANCHES & CARVALHEIRO7 adaptado por MEIRELLES e SANCHES. O exame clínico-nutricional foi realizado segundo a metodologia recomendada por JELLIFFE4. Foram encontrados sinais clínicos sugestivos de carência nutricional em 6,6% das crianças; sinais de anemia em 9,7% e de bócio em 2,7%. Não foi possível definir com precisão outros quadros carenciais.

Realizou-se o estudo do estado nutricional através da antropometria com o objetivo de descrever a prevalência e a forma da Desnutrição Protéico-Energética em seis cidades da região do Polonoroeste. O exame antropométrico foi aplicado em um grupo de 573 crianças de 3 a 72 meses de idade, de ambos os sexos. Para o tratamento dos dados coletados utilizou-se as classificações propostas por GOMEZ e por WATERLOW, sendo ainda realizada a distribuição do peso e a altura por faixas de percentis. A prevalência de desnutrição encontrada, segundo a classificação de GOMEZ, foi de 51,0%, sendo que o maior percentual foi constatado na cidade de Jauru (79,2%) e o menor na cidade de Araputanga (31,3%). Quanto à forma de desnutrição a de maior prevalência foi a desnutrição pregressa, mostrando com isso um comprometimento acentuado da estatura, confirmado através da distribuição por percentis. A study of the nutritional state through anthropometry was made in order to describe the prevalence and the protein-energetic undernutrition form within six cities of Polonoroeste/MT area. The anthropometric test was done over a group of 573 children from 3 to 72 months old, of both sex. For the manipulation of the collected data, the classification proposed by GOMEZ and WATERLOW was used, being still done the distribution of weight and height in percentage ranges. Following GOMEZ classification the undernutrition prevalence met was of 51%, being that the highest percentage found was in the city of Jauru (79.2%) and the lowest in Araputanga city (31.3%). As for the undernutrition form, the highest prevalence was the past undernutrition showing an accentuated compromise of the height confirmed through the percentage distribution.