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Abstract Background Dexamethasone-cyclophosphamide pulse (DCP) and dexamethasone pulse (DP) have been successfully used to treat pemphigus, but DCP/DP outcomes comparing pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are scarce. Objective To compare DCP/DP outcomes in a Brazilian cohort of PV and PF patients according to demographic and clinical data. Methods Retrospective analytical cohort study, reviewing medical charts of PV and PF patients (for DCP/DP Phases I‒IV consult Pasricha et al.16‒18). Results 37 PV and 41 PF patients non responsive to usual treatments were included similarly for DCP or DP therapy. Disease duration was longer among PF before DCP/DP prescription (p < 0.001); PF required a higher number of monthly pulses to acquire remission in Phase I (median 10 and 6 pulses, respectively; p = 0.005). DCP/DP outcomes were similar in both groups: remission in 37.8% of PV and 34.1% of PF after completed DCP/DP cycles following a median of 13 months (1-56 months follow-up); failure occurred in 13.5% of PV and 14.6% of PF in Phase I; relapse in 13.5% of PV and 12.2% of PF, and dropout in 27% of PV and 24.4% of PF in Phases II to IV. Mild side effects were documented. Study limitations The severity of PV and PF disease was not assessed by score indexes. Conclusions PV and PF patients presented similar DCP/DP outcomes. DCP/DP should be initiated earlier in PF patients due to the longer duration of their disease in order to decrease the number of pulses and the duration of Phase I to acquire remission.

Abstract Background Basal cell carcinoma (BCC) dermoscopy is key to lower the biopsy threshold of suspicious lesions. There is a scarcity of published data on the dermoscopy of very small BCC (≤3 mm) and its differences from larger BCCs. Objective To describe and compare dermoscopic features of BCCs measuring ≤3 mm, with those from 3 to 10 mm. Methods An analytical cross-sectional study, included biopsy-proven BCCs that had dermoscopic photographic images, between January 2017 and December 2022 in a Skin Cancer Center in Medellín, Colombia. Demographic, clinic-pathological and dermoscopic features were compared between very small BCCs (vsBCCs) and a reference group. Results A total of 326 BCCs in 196 patients were included, of whom 60% were male. The most common Fitzpatrick phototype was III. vsBCCs accounted for 25% of the lesions (81/326). Face and neck were the most frequent locations (53%), especially in very small tumors. The nodular type was more common in very small tumors than in larger lesions, the superficial type was less frequent, and aggressive types were equally prevalent in both groups. On dermoscopy, very small tumors were statistically more likely to present pigmented structures than reference lesions, especially blue-gray dots (67% vs. 54%), vessels were less frequent, particularly short-fine telangiectasias (SFT) (52% vs. 66%), as were other structures such as shiny white structures (SWS), ulceration, micro-erosions, and scales. Study limitations Latin-American sample, lacks information on dark phototypes Conclusions Pigmented structures, especially blue-gray dots, were most common in vsBCCs when compared to larger lesions; SFT, SWS and other findings were less prevalent.

Abstract This publication is an update of the “Consensus on the therapeutic management of atopic dermatitis - Brazilian Society of Dermatology” published in 2019, considering the novel, targeted-oriented systemic therapies for atopic dermatitis. The initial recommendations of the current consensus for systemic treatment of patients with atopic dermatitis were based on a recent review of scientific published data and a consensus was reached after voting. The Brazilian Society of Dermatology invited 31 experts from all regions of Brazil and 2 international experts on atopic dermatitis who fully contributed to the process. The methods included an e-Delphi study to avoid bias, a literature search and a final consensus meeting. The authors added novel approved drugs in Brazil and the indication for phototherapy and systemic therapy for AD. The therapeutical response to systemic treatment is hereby reported in a suitable form for clinical practice and is also part of this updated manuscript.

RESUMO Este artigo tem por objetivo analisar a implementação das estratégias de adaptação às mudanças climáticas e gestão de desastres na cidade de São Paulo, estabelecidas a partir da Lei Municipal n.14.933/2009 até o ano de 2019. O objeto do estudo foi a análise da efetividade do quadro legal dessa política, sua articulação com outras normas relevantes e com o direito ambiental e como vem sendo construída sua governança. Foram analisadas questões como a abordagem do risco e da vulnerabilidade; as estratégias quanto aos desastres; a existência de uma adaptação sustentável e a articulação dessas políticas a outras normas urbanísticas, assim como a atuação do Comitê de Mudança do Clima e Ecoeconomia. As conclusões mostraram avanços e dificuldades específicos da implementação das estratégias e a importância do Comitê como espaço de articulação, suas limitações e aspectos para o aperfeiçoamento de sua institucionalização.

Abstract Objective To perform a systematic review and meta-analysis of studies on maternal, fetal, and neonatal outcomes of women with singleton pregnancies, after spontaneous conception, and with the diagnosis of amniotic sludge before 37 weeks of gestational age. Data Sources We conducted a search on the PubMed, Cochrane, Bireme, and Theses databases until June 2022. Selection of Studies Using the keywords intra-amniotic sludge or fluid sludge or echogenic particles, we found 263 articles, 132 of which were duplicates, and 70 were discarded because they did not meet the inclusion criteria. Data Collection The articles retrieved were analyzed by 2 reviewers; 61 were selected for full-text analysis, 18 were included for a qualitative analysis, and 14, for a quantitative analysis. Data Synthesis Among the maternal outcomes analyzed, there was an increased risk of preterm labor (95% confidence interval [95%CI]: 1.45–2.03), premature rupture of ovular membranes (95%CI: 1.99–3.79), and clinical (95%CI: 1.41–6.19) and histological chorioamnionitis (95%CI: 1.75–3.12). Regarding the fetal outcomes, there was a significant increase in the risk of morbidity (95%CI: 1.80–3.17), mortality (95%CI: 1.14–18.57), admission to the Neonatal Intensive Care Unit (NICU; 95%CI: 1.17–1.95), and neonatal sepsis (95%CI: 2.29–7.55). Conclusion The results of the present study indicate that the presence of amniotic sludge is a risk marker for preterm delivery. Despite the heterogeneity of the studies analyzed, even in patients with other risk factors for prematurity, such as short cervix and previous preterm delivery, the presence of amniotic sludge increases the risk of premature labor. Moreover, antibiotic therapy seems to be a treatment for amniotic sludge, and it may prolong pregnancy.

Planarians are known for their ability to regenerate missing body parts. However, little is known about the regeneration ability of land planarians, especially regarding Neotropical species. Herein, we investigated the regeneration in the Neotropical land planarian Luteostriata abundans. Specimens were cut in two at different points along the body and monitored for 50 days. Larger and anterior pieces survived more than smaller posterior pieces. Anterior pieces that retained the pharynx continued to feed normally as intact animals, while posterior pieces that retained the pharynx lost its function temporarily. The growth rate was similar amongst all pieces across 50 days. Anterior mouthless pieces regenerated the pharynx and mouth significantly faster than posterior mouthless pieces. After 50 days, the relative position of the mouth along the body reached values close to intact animals in all regenerating pieces. In general, anterior pieces showed higher survival and regenerated faster than posterior fragments, which agrees with observations with other planarian species. However, surviving posterior pieces were able to retain the proportions of intact animals as well. Our results suggest that L. abundans has a good regenerative capacity similar to many freshwater planarians.

O artigo tem como objetivo compreender como a abordagem histórica é mobilizada na produção acadêmica de Magda Soares. Busca, nessa direção, com base, especialmente, em um corpus de quatro publicações, identificar as questões de pesquisa, as tendências historiográficas, a perspectiva epistemológica, as fontes e seu tratamento, as justificativas para a construção desse olhar e os resultados dos estudos. A análise indica que a História é mobilizada em três dimensões: a rememoração, o apoio à argumentação na discussão de problemas contemporâneos e como fazer historiográfico propriamente dito. As contribuições dos referidos estudos da autora se concentram nos campos da história da escolarização, das disciplinas escolares e do livro didático, e da história do letramento. A posição epistemológica por ela privilegiada apresentava-se coerente com sua atuação em pesquisa, divulgação científica e ação educacional, ao estabelecer relações entre os fenômenos estudados e as práticas sociais, culturais e políticas mais amplas.

O esgoto contém grande diversidade de microrganismos, incluindo patógenos como os vírus, sendo, portanto, um meio propício para identificação da circulação de doenças infectocontagiosas – técnica conhecida como wastewater-based epidemiology (WBE). A WBE se mostra uma poderosa ferramenta de saúde pública para rastrear e sinalizar a situação epidemiológica da população, visto que as partículas virais do SARS-CoV-2 podem ser expelidas nas fezes e urina dos contaminados antes mesmo do surgimento de sintomas e do diagnóstico clínico de COVID-19. Este estudo apresenta uma revisão de literatura sobre a presença de SARS-CoV-2 e outros vírus no esgoto doméstico e as possibilidades de remoção em estações de tratamento de esgoto (ETEs) convencionais e avançadas, bem como as técnicas de concentração e detecção em amostras ambientais. Ao final do artigo, foi apresentada uma análise econômica da aplicabilidade da WBE como instrumento de predição epidemiológica da COVID-19 em um município brasileiro.

Objective: To investigate the relationship between anticholinergic load (ACL) and self-perceived general health in adults in a medium-sized municipality in southern Brazil. Methods: This cross-sectional study was based on 2015 data from a medium-sized municipality in southern Brazil. All respondents aged 44 years or older who reported using drugs in the 2 weeks before the interview were included (n = 662). The Anticholinergic Drug Scale was used to measure the ACL. Self-perceived health was categorized as positive self-perception (PSP) or negative self-perception (NSP). Crude and adjusted Poisson regression analyses were conducted to investigate the association between ACL and self-perceived health. Results: NSP was found in 50.91% of 662 respondents. Significant ACL, older age, lower economic status, lower education, polypharmacy, and depression correlated with a higher frequency of NSP. Individuals with significant ACL had a prevalence of NSP of 1.27 (95% confidence interval: 1.02 - 1.58), and each additional ACL level represented a 6.10% higher chance of worse self-perceived health, regardless of confounding factors. Conclusions: An association was found between significant ACL and NSP, with an effect dependent on ACL level.

Abstract: The Brazilian Strategy for the Prevention and Care of Childhood Obesity (PROTEJA) aims to implement a set of actions to prevent obesity in Brazil. As such, this qualitative and descriptive documentary study presents the Strategy’s stages of the operational design, general proposal, evaluation and monitoring conducted by the Brazilian Ministry of Health’s technical coordination. After analyzing the epidemiological data on children and the existing policies aimed at obesity prevention, and reviewing the scientific literature and recommendations, PROTEJA was formulated and approved by the Brazilian Ministry of Health, and 1,320 municipalities committed to implementing 20 essential and 5 complementary actions, from 41, including some structural to improve environments. Coordinated by the Brazilian Ministry of Health in partnership with subnational governments and universities, the Strategy also relies on a local team for implementation support, as well as implementation and impact evaluations. Actions will be monitored annually, and the indicators will impact financial incentives. As a strong, evidence-based and innovative strategy aiming to promote healthy environments in cities, PROTEJA has the potential to open a path to childhood obesity reversal, as well as add to the implementation science and contribute to the development and improvement of public policies for obesity prevention; however, its implementation remains a challenge.

RESUMO Este artigo analisou a dinâmica do processo conferencista adotado na X Conferência Municipal de Saúde de Belo Horizonte. A metodologia utilizada foi a qualitativa, com o uso da técnica de análise de conteúdo. A X Conferência cumpriu a etapa local, realizando cerca de 150 conferências locais, e a distrital, com a realização de nove conferências distritais. Como insumo, as conferências contaram com os documentos apresentados pela: Gestão, Plenária de Usuários e dos Trabalhadores. O processo conferencista, ao transitar documentos para discussão e formulação das políticas, pode ser tomado como referência na construção coletiva das políticas municipais de saúde.

Abstract Background Pesticides, mainly organophosphates (OP), have been related to increased risk of pemphigus vulgaris (PV) and pemphigus foliaceus (PF), nevertheless, their measurement has not been determined in pemphigus patients. Objective To evaluate pesticide exposure and pesticide measurement, comparing PV, PF and control groups in Southeastern Brazil. Methods Information about urban or rural residency and exposure to pesticides at the onset of pemphigus was assessed by questionnaire interview; hair samples from the scalp of PV, PF, and controls were tested for OP and organochlorines (OC) by gas-phase chromatography coupled to mass spectrometry. Results The minority of PV (2 [7.1%] of 28) and PF (7 [18%] of 39), but none of the 48 controls, informed living in rural areas at the onset of pemphigus (p = 0.2853). PV (33.3%), PF (38.5%), and controls (20%) informed exposure to pesticides (p = 0.186). Twenty-one (14.8%) of 142 individuals tested positive for OP and/or OC: PV (2 [6.3%] of 32) and PF (11 [25.6%] of 43) had similar pesticides contamination as controls (8 [11.9%] of 67) (p = 0.4928; p = 0.0753, respectively), but PF presented higher contamination than PV (p = 0.034). PV did not present any positivity for OP. Three (7%) PF tested positive for both OP and OC. Some PF tested positive for three or four OP, mainly diazinon and dichlorvos. Study limitation Lack of data for some controls. Conclusion Although the frequency of PV and PF patients exposed to pesticides was similar, pesticides were more frequently detected in hair samples from PF compared to PV. The cause-effect relationship still needs to be determined.

Com base nas entrevistas realizadas com duas feministas que têm suas trajetórias envolvidas, ao mesmo tempo, com a academia e com a política institucional, buscamos traçar uma cartografia de mulheres argentinas que estiveram e estão dentro do campo político, que abrange desde a militância feminista até as candidaturas e os mandatos para cargos públicos, passando pelo vínculo com partidos políticos. No momento em que este artigo é escrito, Dora Barrancos é assessora direta do presidente da Argentina, Alberto Fernández, e já foi candidata a senadora. Fernanda Gil Lozano é diretora do Centro Internacional para a Promoção de Direitos Humanos da UNESCO no país, e já foi deputada federal. As visões amplas e as experiências políticas dessas mulheres, ao serem narradas, abrem possibilidades de reflexão sobre a conformação do campo político argentino em termos de gênero e raça, a partir de suas percepções sobre as mulheres políticas nas arenas compostas pela esquerda, mas também pela direita argentina. Quais são os lugares dessas mulheres nos seus partidos políticos? São elas apoiadas, instrumentalizadas ou invisibilizadas no sistema argentino de listas fechadas de candidatos? Estas são algumas questões sobre as quais queremos refletir.

RESUMO Os estudos sobre cinema e ditadura brasileira partem geralmente da produção fílmica do período, buscando realizar análises de conteúdo, forma e discurso. A proposta deste artigo é percorrer um trajeto pouco convencional, partindo de um catálogo como documento histórico que incentivou pesquisas sobre mulheres cineastas que dirigiram filmes durante a vigência do regime ditatorial militar brasileiro. Com esse mapeamento, torna-se possível perceber que o cinema de resistência apresenta especificidades, e é por meio delas que serão tratados, ao mesmo tempo, o apagamento e o protagonismo das mulheres nessa história. Ao transgredirem normas sociais e papéis tradicionais, por meio de suas personagens, algumas cineastas se tornaram elementos de uma política e uma estética de resistência que confrontavam tanto a ditadura quanto as normas e relações patriarcais.

In this article we will investigate the main research themes present in the dissertations developed by the students of ProfHistoria so as to identify continuities and changes in the teaching of History in Basic Education. For this, we analyzed the dissertations defended by master's students between 2016 and 2019. This article was organized in three parts: initially we presented ProfHistoria and its conception about continuing teacher education. Then, we will identify the themes that were preponderant among the works developed in this program by the master's students of the classes of 2014 and 2016. And in the third part we seek to exemplify the research clippings and the motivations of its authors in order to discuss traditions and innovations of History teaching in Brazil.