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Introdução: O envelhecimento populacional é um fenômeno universal que acarreta um aumento na prevalência de problemas de saúde característicos do idoso, em sua maioria doenças crônico-degenerativas. Os transtornos mentais e comportamentais, dentre os quais se encontram o alcoolismo e a alteração cognitiva, são apontados em alguns trabalhos como transtornos psiquiátricos frequentemente encontrados em pacientes acima de 60 anos. O alcoolismo é um problema de saúde pública e interfere na vida do sujeito nos aspectos biopsicossociais e idosos etilistas são mais vulneráveis às consequências danosas do álcool, de alterações cognitivas leves até quadros demenciais avançados. Objetivo: Realizar revisão de literatura sobre a relação do álcool e função cognitiva em idosos. Resultados: Foram identificadas pesquisas limitadas sobre substâncias psicoativas entre os idosos; de 2 a 10% dos idosos fazem uso abusivo de álcool; o alcoolismo crônico em idosos é um fator etiológico de transtornos cognitivos e há dificuldades para identificação desses casos. Discussão: O alcoolismo e o uso abusivo do álcool podem acelerar o envelhecimento cerebral e apresentar clinicamente, de forma aguda, alterações cognitivas transitórias. Nos casos de uso crônico de álcool, ocorre neurodegeneração, neurotoxicidade e comprometimento do metabolismo cerebral, causando disfunções cognitivas leves até lesões irreversíveis com quadro demencial instalado. Conclusão: A relação entre álcool e função cognitiva em idosos é complexa e desperta interesse em estudos nessa área. O termo demência alcoólica ainda é questionado. Entretanto, é um termo genérico para descrever as alterações cognitivas e comportamentais ocasionadas pelo uso crônico de álcool, com sintomas predominantemente das áreas frontais, com prejuízos na funcionalidade e na qualidade de vida. Portanto, é necessário compreender os transtornos mentais em idosos e detectá-los precocemente, para intervenção imediata e promoção de um envelhecimento saudável.

Este artigo tem como objetivo refletir sobre o projeto científico de Jean Itard (1774- 1838), médico francês do Instituto Nacional para Surdos-Mudos, em seu trabalho de reeducação de Victor, uma criança tida como “selvagem”, encontrada nas florestas próximas à cidade de Aveyron, ao sul da França. O propósito é investigar as influências deste projeto reeducativo de Itard sobre as bases epistemológicas que constituíram posteriormente o campo da Educação Especial. Para produção do texto, foi realizada uma pesquisa bibliográfica, do tipo estado da arte, tendo como fonte de dados a Biblioteca Digital Brasileira de Teses e Dissertações, com um recorte temporal compreendido entre os anos 2000 e 2023. A busca ocorreu por meio dos descritores “Jean Itard” e “Victor de Aveyron”, resultando na seleção de oito trabalhos para análise. As discussões e temáticas apresentadas foram organizadas em três categorias, a saber: inter-relações entre educação, linguagem, aprendizagem e desenvolvimento humano; psicose infantil e autismo; abordagens clínica e pedagógica da Educação Especial. As produções analisadas apontam para a complexidade da Educação Especial, dos primórdios ao contexto atual: as tendências da época de Itard eram pautadas na educação dos sentidos, método hoje considerado insuficiente para suprir as necessidades tanto do educador quanto do educando; do mesmo modo, é evidente a questão da dificuldade atual na inclusão de crianças com deficiência, pela necessidade de empreender práticas pedagógicas que respondam de forma positiva às diferenças sensoriais, cognitivas, e culturais dos estudantes, o que se configura como um imenso desafio, até mesmo para as teorias contemporâneas. O estudo conclui que a relação entre Itard e Victor suscitou profundas reflexões sobre a maneira de intervir e compreender as diferenças humanas, principalmente através do reconhecimento de que esse processo está intrinsecamente ligado ao meio sociocultural.

Abstract Objectives: to evaluate the prevalence and associated factors with acquired syphilis in pregnant women attended at the primary health care in Montes Claros-MG. Methods: a cross-sectional study carried out with pregnant women enrolled in the Estratégia Saúde da Família (Family Health Strategy) teams in Montes Claros, Minas Gerais, Brazil (2018-2019). Sociodemographic, behavioral and obstetric factors were collected through a questionnaire applied by interview. The result of the Venereal Disease Research Laboratory (VDRL) examination was evaluated. Binary logistic regression analysis was used to determine associated factors with syphilis in pregnancy. Results: the prevalence of syphilis found was 1.7% (CI95%= 1.44–1.96). Pregnant women who graduated from high school had 75% (OR = 0.25; CI95%= 0.08–0.81) less chance of having syphilis, when compared to pregnant women with elementary school. Pregnant women who used illicit drugs during pregnancy (OR = 3.47; CI95%= 1.02–11.82) and consumed alcoholic beverages during pregnancy (OR = 16.35; CI95%= 3. 81–70.20) were more likely to have the disease. Conclusion: schooling, consumption of alcohol and illicit drugs are associated with the diagnosis of syphilis in pregnant women. Therefore, educational programs and interventions are needed to address issues related to prevention, diagnosis, treatment and their risk factors, especially social determinants, and women’s reproductive health issues.

The dangers and stresses of a police officer’s career cause physical and psychological distress which in turn cause considerable challenges for the integration of professional, family, and personal life. This study focuses on the conditions that influence this articulation between the personal, family, and professional lives of Portuguese Police (PSP1) officers. A questionnaire survey was applied to 414 police officers from 11 divisions of COMETLIS.2 At the empirical level, several models were tested to assess the articulation between the professional, family, and personal lives of police officers. The results highlight the influence of having young children, elderly people or other dependents living in the family home, as well as the employee’s age, on the job’s interaction with professional life. At a professional level, the variables shift work, professional category, years of service and working away from home were identified by the officers as conditioning factors in the work-family-personal life balance. Sex differences in the articulation of professional, family, and personal life were also observed.

Abstract Objective: This meta-analysis of randomized controlled trials (RCTs) aimed to update evidence on the effectiveness and safety of laser therapy for treating genitourinary syndrome of menopause (GSM). Data sources: Manuscripts published until May 2023 were systematically searched in PubMed; Embase; Scopus; Web of Science; CENTRAL; CINAHL; and clinical trial databases (www.trialscentral.org, www.controlled-trials.com, and clinicaltrials.gov), with no language and year of publication restriction. Studies selection: RCTs with women diagnosed with GSM, and the intervention was vaginal laser therapy (CO2-laser or Er: YAG-laser) comparing with placebo (sham therapy), no treatment or vaginal estrogen therapy. Data collection: Two authors evaluated the publications for inclusion based on the title and abstract, followed by reviewing the relevant full-text articles. Disagreements during the review process were addressed by consensus, with the involvement of a third author. Data synthesis: Twelve RCTs, representing a total of 5147 participants, were included in this review. Vaginal health index (VHI) significantly improved in the carbon dioxide laser (CO2-laser) therapy group (MD=2.21; 95% CI=1.25 to 3.16), while dyspareunia (MD=−0.85; 95% CI=−1.59 to −0.10), dryness (MD=−0.62; 95% CI=−1.12 to −0.12) and burning (MD= −0.64; 95% CI=−1.28 to −0.01) decreased. No serious adverse effects were reported. Conclusion: CO2-laser increases VHI score and decreases dyspareunia, dryness and burning, especially when compared to sham-laser. However, the certainty of the evidence is low, thus preventing the recommendation of laser therapy for GSM management.

ABSTRACT Open fractures are highly incident injuries closely related to the modern life, in which accidents caused by motor vehicles or other machines impart high energy to bone tissue. Individual morbidity is represented by the functional impairment resultant of infection, nonunion, or vicious healing. In terms of public health, there are huge costs involved with the treatment of these fractures, particularly with their complications. One of the critical issues in managing open fractures is the use of antibiotics (ATB), including decisions about which specific agents to administer, duration of use, and ideal timing of the first prophylactic dose. Although recent guidelines have recommended starting antibiotic prophylaxis as soon as possible, such a recommendation appears to stem from insufficient evidence. In light of this, we conducted a systematic review, including studies that addressed the impact of the time to first antibiotic and the risk of infectious outcomes. Fourteen studies were selected, of which only four found that the early initiation of treatment with antibiotics is able to prevent infection. All studies had important risks of bias. The results indicate that this question remains open, and further prospective and methodologically sound studies are necessary in order to guide practices and health policies related to this matter. Level of Evidence II; Therapeutic Studies Investigating the Results Level of Treatment.

Abstract Objective To assess the efficacy, safety, and acceptability of misoprostol in the treatment of incomplete miscarriage. Data sources The PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Clinical Trials databases (clinicaltrials.gov) were searched for the relevant articles, and search strategies were developed using a combination of thematic Medical Subject Headings terms and text words. The last search was conducted on July 4, 2022. No language restrictions were applied. Selection of studies Randomized clinical trials with patients of gestational age up to 6/7 weeks with a diagnosis of incomplete abortion and who were managed with at least 1 of the 3 types of treatment studied were included. A total of 8,087 studies were screened. Data collection Data were synthesized using the statistical package Review Manager V.5.1 (The Cochrane Collaboration, Oxford, United Kingdom). For dichotomous outcomes, the odds ratio (OR) and 95% confidence interval (CI) were derived for each study. Heterogeneity between the trial results was evaluated using the standard test, I2 statistic. Data synthesis When comparing misoprostol with medical vacuum aspiration (MVA), the rate of complete abortion was higher in the MVA group (OR = 0.16; 95%CI = 0.07–0.36). Hemorrhage or heavy bleeding was more common in the misoprostol group (OR = 3.00; 95%CI = 1.96–4.59), but pain after treatment was more common in patients treated with MVA (OR = 0.65; 95%CI = 0.52–0.80). No statistically significant differences were observed in the general acceptability of the treatments. Conclusion Misoprostol has been determined as a safe option with good acceptance by patients.

Esse estudo investiga os ciclos de vida profissional na relação com o saber docente durante o primeiro ano de aulas remotas. O objetivo é compreender a relação com o saber docente, a partir da premissa de que havia poucas experiências, recursos e orientações que pudessem subsidiar as escolhas e as práticas docentes. Os dados foram coletados por questionário online e tratados nos softwares estatísticos Sphinx iQ2 e Minitab. As análises fundamentam-se em Charlot, Tardif, Huberman, Cavaco, Hargreaves e Fullan. As mudanças em relação à docência foram sentidas pelos professores com mais tempo de docência que precisaram reaprender o saber-fazer da prática docentes. Embora as aprendizagens e adaptações das práticas pedagógicas sejam significativas, o desejo de saber se confundiu à representação do saber, pois parecem ser resultado da urgência e das demandas externas impostas e não uma possibilidade desejável e desejada pelos professores.

Introduction The paediatric population represents a quarter of the world’s population, and like adult patients, they have also suffered immeasurably from the SARS-CoV-2 pandemic. Immunisation is an effective strategy for reducing the number of COVID-19 cases. With the advancements in vaccination for younger age groups, parents or guardians have raised doubts and questions about adverse effects and the number of doses required. Therefore, systematic reviews focusing on this population are needed to consolidate evidence that can help in decision-making and clinical practice. This protocol aims to assess the safety of COVID-19 vaccines in paediatric patients and evaluate the correlation between the number of vaccine doses and side effects.Methods and analysis We will search the PubMed, ClinicalTrials.gov, Web of Science, Embase, CINAHL, Latin American and Caribbean Health Sciences Literature, Scopus and Cochrane databases for randomised and quasi-randomised clinical trials that list the adverse effects of the COVID-19 vaccine and assess its correlation with the number of doses, without any language restrictions. Two reviewers will select the studies according to the inclusion and exclusion criteria, extract data and asses for risk of bias using the Cochrane risk-of-bias tool. The Review Software Manager (RevMan V.5.4.1) will be used to synthesise the data. We will use the Working Group’s Grading of Recommendations Assessment, Development and Evaluations to grade the strength of the evidence of the results.Ethics and dissemination Formal ethical approval is not required as no primary data are collected. This systematic review will be disseminated through a peer-reviewed publication.PROSPERO registration number CRD42023390077.

Introduction Peripheral arterial disease (PAD) is increasingly prevalent, and supervised physical exercise programmes are recommended as the first-line treatment. However, these programmes are underused. Alternative delivery models may be able to expand treatment coverage. The objective of this study was to compare a home-based exercise programme (HBEP) and a centre-based exercise (CBE) in terms of their effects on functional capacity, peripheral muscle oxygenation and quality of life in individuals with PAD.Methods and analysis This single-blind, parallel randomised clinical trial will consist of two groups: HBEP and CBE. A qualitative analysis will be carried out to investigate acceptability and satisfaction. The primary outcome will be functional capacity, assessed by the incremental shuttle walk test. Secondary outcomes will include functional capacity, assessed by a treadmill walking test; peripheral muscle oxygenation and quality of life; and self-reported functional impairment, risk factors, morbidity, level of physical activity, adherence, acceptability and satisfaction. The intervention protocols will consist of 12 weeks of intermittent walking until claudication symptoms, three times a week. Participants randomly assigned to the CBE group will participate in supervised face-to-face sessions. The HBEP group will perform exercises at home with remote supervision, monitored by a pedometer and heart rate monitor, and subjective perception of effort during each session will be recorded by participants in a training diary; follow-up will be conducted by telephone calls. Statistical analyses will follow the intention-to-treat principle. Participants allocated to the HBEP group will be interviewed about their experience of remote treatment using a qualitative approach.Ethics and dissemination Ethics approval was obtained from the Ethics Committee of the Universidade Federal de Minas Gerais. The results will be disseminated in a peer-reviewed journal and presented at international congresses. This research has the potential to improve the care of people with PAD because if home-based rehabilitation demonstrates effectiveness, it could be considered an alternative or support resource to the usual centre-based treatment models, expanding access, coverage and participation in vascular physiotherapyTrial registration https://ensaiosclinicos.gov.br/rg/RBR-97vy9n7 on 14 April 2022.

Objetivo: relatar a experiência ao levar informações sobre a onicocriptose (unha encravada). Materiais e métodos: trata-se de um relato de experiência realizado por acadêmicas do 5º período do curso de Estética e Cosmética de uma instituição de ensino superior da cidade de Montes Claros-MG. Foi realizado um monitoramento entre os voluntários usuários do Spa Escola da mesma instituição, por um questionário, com o intuito de averiguar o conhecimento sobre as patologias que acometem as unhas através da plataforma Google Forms. A partir disso, foi desenvolvida uma cartilha com informações e cuidados a fim de prevenir e cuidar da onicocriptose. Resultados: a partir desse instrumento confeccionado, espera-se levar um maior conhecimento às pessoas em geral, como para os profissionais de saúde, sobre as patologias que acometem as unhas, fazendo com que a população possa compreender as causas e tratamentos para a onicocriptose e a importância de procurar um profissional adequado. Conclusão: observou-se, com a prática, que ainda há necessidade de mais estudos sobre a onicocriptose para o maior conhecimento da população. Dessa forma, para evitar ou tratar essa condição, deve-se buscar profissionais qualificados e cuidados específicos.

The present article focuses on The Double, deliberately turning away from the literary motif that Saramago appropriates to denaturalize and expose the constructedness of dominant masculinity and its apparatuses of social and symbolic reproduction. The analysis sheds light on the functioning of several of such instruments, as dramatized in the novel: the name as original language; popular cinema; and common senses inherited from the oral tradition. The final section discusses the critical commentary that accompanies the narrative in dialog with contemporary critiques of masculine gender privilege.

PurposeThis paper reports a systematic review and meta-analysis protocol that will be used to evaluate the efficacy and safety of pembrolizumab, alone or combined with bevacizumab and other therapies, in adult women with cervical carcinoma from stage IB2 onwards.MethodsThe protocol follows PRISMA-P recommendations and was registered on PROSPERO (CRD42024531233). The search will be conducted without restrictions on language and year of publication in the following databases: Pubmed, Embase, Scopus, Web of Science, Cancerlit, The World Health Organization (WHO), International Clinical Trials Registry Platform (ICTRP) and Clinical Trials Registry Platform. Grey literature will be searched using the following sources: Clinicaltrials.gov, Google Scholar and Opengrey. Manual search will be carried out for the reference lists of eligible studies. The studies will be selected independently by two reviewers and all completed or ongoing randomized clinical trials that evaluated the efficacy and safety of pembrolizumab, used alone or combined with chemotherapy, radiotherapy, bevacizumab or surgery, in adult women diagnosed with cervical cancer, will be included. The data extraction will include population characteristics, type of treatment and main outcomes of studies. The methodological quality of the studies will be assessed using the Cochrane Risk of Bias 2.0. The certainty of the evidence will be rated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE).ConclusionsThe findings will be presented in narrative summary tables and a quantitative synthesis will be conducted using the 'meta' package of R software, version 4.3.1. This future systematic review may contribute with quality evidence for clinical decision-making on the use of pembrolizumab in women with cervical cancer.

O artigo contextualiza a condição em que as aulas remotas foram assumidas e analisa algumas mudanças das condições da prática docente com o uso de recursos digitais. Os dados foram coletados pela pesquisa "Docência e aulas remotas", tratados com os softwares Sphinx iQ2 e Minitab e analisados na perspectiva da Sociologia da Educação. Selecionou-se 203 respostas do Ensino Fundamental, das redes pública e privada. Destacam-se, como resultados, a ausência de diretrizes claras dos governos em contraponto ao esforço dos professores em conhecerem e utilizarem pedagogicamente softwares e plataformas digitais. Conclui-se que as dificuldades enfrentadas e a recomposição da forma escolar remota implicam na necessidade de estabelecer balizas próprias para avaliarmos o ano escolar de 2020.

Introduction Breast cancer survivors (BCSs) experience more severe symptoms of genitourinary syndrome of menopause (GSM) than healthy postmenopausal women. As hormonal therapy with oestrogen should be avoided in BCSs, finding an effective and safe therapy to address vaginal symptoms and sexual dysfunction is urgently needed. Physical methods may be promising alternatives for the specificities of this group of women. This review aims to evaluate the efficacy and safety of physical methods (laser and radiofrequency) for treating GSM in BCSs.Methods and analysis The PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov databases will be searched. A search strategy was developed to retrieve clinical trials that evaluate the efficacy and safety of any physical method (laser or radiofrequency) used for GSM in BCSs. No date or language restrictions will be imposed. Two authors will independently select studies by title, abstract and full text to meet the inclusion criteria. Data will be extracted, and the risk of bias will be evaluated using the Cochrane risk-of-bias tool (RoB 2). Review Manager 5.4.1 will be used for data synthesis. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the strength of the evidence.Ethics and dissemination This study reviews the published data; thus, obtaining ethical approval is unnecessary. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration number CRD42023387680.

Fertilizers and chemical pesticides supply plants’ nutritional requirements and protect them against pathogens. However, they may cause harm to the environment. Pectobacterium sp. has been reported as an endophyte with the capacity of a plant-growth promoter, especially in the control of phytopathogens. The current paper evaluates the capacity of the endophytic bacterium Pectobacterium sp. MG-60 isolated from Mikania glomerata Spreng. (Asteraceae) to antagonize phytopathogens in vitro, produce IAA, and fix nitrogen (nifH). Growth promotion assessments of bean and soybean plants under greenhouse conditions were also performed. The rate of antagonism against Sclerotinia sclerotiorum was 52.5%. The endophyte Pectobacterium sp. MG-60 produced 3.54 µg mL-1 of IAA when 5 mM L-tryptophan in the culture medium was used. Under greenhouse conditions, significant results for Pectobacterium sp. MG-60 in the growth of soybean and common bean plants were observed, especially in the height of common bean (19%) and soybean (20%), fresh weight of shoot (18.5%) and fresh weight of roots (46.8 %) of soybean plants. This is the first report on Pectobacterium isolated as an endophyte from M. glomerata with plant growth-promoting agent abilities with biotechnological potential for the agricultural field.

ABSTRACT In Brazil, all transport and storage of native forest products and by-products must be registered within the DOF (Document of Forestry Origin) system. This computerized platform exists to support control agencies in reducing the sale of forest products obtained illegally. However, this tool still shows only modest results in fulfilling its objectives, since gaps in the system allow illegal wood to be acquired and enter the system as legal wood. The objective of this study was to test whether the volumetric yield coefficient (CRV) of a sawmill on an industrial scale corresponds to the 35% established by Brazilian legislation. The focus was directed at a loophole that allows the accumulation of virtual credits in the DOF system by turning logs into lumber. For this purpose, we estimated the sawmill’s CRV and mean percentage yield of 19 commercial species used by a timber company in the Brazilian Amazon with a sample size of 90 logs. The estimated CRV was 24.6 ± 2.4, showing 9.9% uncertainty. The mean CRV differed highly significantly (p < 0.001) from that proposed by the DOF, with a 10.35% difference. Based on these results, the difference between the observed yield and that proposed by the legislation can generate the accumulation of virtual log credits. With this accumulation, managers encounter difficulties in acquiring new logging permits and, consequently, do not meet the actual demand for logs to the sawmill’s capacity.

Abstract Objective To evaluate the efficacy of the hormonal and nonhormonal approaches to symptoms of sexual dysfunction and vaginal atrophy in postmenopausal women. Data Sources We conducted a search on the PubMed, Embase, Scopus, Web of Science, SciELO, the Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, as well as on clinical trial databases. We analyzed studies published between 1996 and May 30, 2020. No language restrictions were applied. Selection of Studies We selected randomized clinical trials that evaluated the treatment of sexual dysfunction in postmenopausal women. Data Collection Three authors (ACAS, APFC, and JL) reviewed each article based on its title and abstract. Relevant data were subsequently taken from the full-text article. Any discrepancies during the review were resolved by consensus between all the listed authors. Data Synthesis A total of 55 studies were included in the systematic review. The approaches tested to treat sexual dysfunction were as follows: lubricants and moisturizers (18 studies); phytoestrogens (14 studies); dehydroepiandrosterone (DHEA; 8 studies); ospemifene (5 studies); vaginal testosterone (4 studies); pelvic floor muscle exercises (2 studies); oxytocin (2 studies); vaginal CO2 laser (2 studies); lidocaine (1 study); and vitamin E vaginal suppository (1 study). Conclusion We identified literature that lacks coherence in terms of the proposed treatments and selected outcome measures. Despite the great diversity in treatment modalities and outcome measures, the present systematic review can shed light on potential targets for the treatment, which is deemed necessary for sexual dysfunction, assuming that most randomized trials were evaluated with a low risk of bias according to the Cochrane Collaboration risk of bias tool. The present review is registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42018100488).

Peripheral acute fatigue (PAF) is defined as when the skeletal muscle is incapable of generating power. We aimed to investigate the acute effects of traditional Chinese acupuncture (TCA) and dry needling (DN) over PAF induced on the biceps brachii of untrained healthy volunteers. We conducted a randomized, single-blind controlled clinical trial. All volunteers (n = 45) underwent fatigue induction protocols repeated before and after treatment with TCA (TCA group; TCAg; n = 15), DN (DN group; DNg; n = 15), and rest (control group; Cg; n = 15). Assessments of PAF, skin temperature, and exercise time occur before and after each event: 1st fatigue induction (FI), treatment, and 2nd FI. We used repeated measures ANOVA adjusted with Bonferroni post hoc test to determine any change in tested variables (PAF-VAS, PAF-EMG, and skin temperature) at different time points compared to the baseline. Paired Samples t-test was used for the variable exercise times. All statistical tests considered’ the significance level at p ≤ 0,05. There was no difference between groups in acute fatigue recovery (p = 0.19). All intragroup analyses were significant (p ≤ 0.05) and all volunteers show a reduction in fatigue perception after treatment (p ≤ 0,05), however, exercise time did not ameliorate after TCA or DN (p > 0.77). A single session of TCA and, DN can equally reduce fatigue, temperature, and exercise time over PAF induced on biceps brachii of untrained healthy volunteers.

Objetivo: analisar o percentual de pacientes sob tratamento anti-hipertensivo que apresentam níveis de pressão arterial controlados e fatores associados. Método: estudo transversal e analítico. A seleção de pacientes ocorreu por amostragem probabilística, por conglomerados tratados de forma descritiva e analítica. Participaram do estudo 720 indivíduos. Resultados: após regressão logística, permaneceram associadas ao não controle da pressão arterial as variáveis sexo, adesão à terapia medicamentosa, história pregressa de doença cardíaca e automedicar-se. Conclusão: a prevalência de controle da pressão arterial foi de 54,3 %, as dificuldades no tratamento anti-hipertensivo relacionam-se a fatores como aspectos pessoais, ao ambiente de vida, ao acesso aos cuidados de saúde, destacando-se como variável modificável a não adesão medicamentosa. Reforça-se a necessidade de incentivo das políticas públicas para o estabelecimento de novas estratégias para abordagem dos fatores modificáveis no manejo da hipertensão.

Objetivo: Relatar a experiência de implantação da administração da penicilina G benzatina no Serviço de Assistência Especializada (SAE) e processo de matriciamento para as UBS’s da Atenção Primária à Saúde, na cidade de Montes Claros-MG, Brasil. Materiais e Métodos: Trata-se de um estudo descritivo na modalidade relato de experiência. A partir da necessidade e urgência de se estabelecer estratégias para o controle da sífilis adquirida, gestacional e congênita em Montes Claros e, para atender à recomendação do MS, a Secretaria Municipal de Saúde, por meio de uma parceria do setor de vigilância epidemiológica e da atenção primária à saúde, deu início, no ano de 2021, ao processo de implantação da administração da penicilina G benzatina nas UBS’s do município. Inicialmente, foram realizadas reuniões intersetoriais para definir a estrutura mínima para a realização do procedimento com segurança, como disponibilidade de medicações e dispositivos para uso em caso de reações adversas à medicação, cilindro e máscaras de oxigênio, entre outros. Além disso, definiu-se a necessidade de treinamento sobre atendimento de urgência pré-hospitalar e técnica ventroglútea de administração de medicação para os profissionais de saúde das equipes. Primeiramente, em setembro de 2021, como “projeto-piloto”, deu-se início às aplicações da medicação no SAE, após capacitação da equipe. Com a constatação do sucesso da implementação do serviço, em 2022, foi iniciado o processo de descentralização para as equipes de Estratégia Saúde da Família. Resultados: Até maio de 2023, cerca de 90% das unidades da Atenção Primária à Saúde encontravam-se equipadas e capacitadas para administração da medicação na região ventroglútea e para prestar atendimento de urgência até a chegada da equipe do SAMU (Serviço de Atendimento Móvel de Urgência). No entanto, por questões inerentes ao processo de trabalho e ainda por resistência e insegurança na administração da medicação, por parte de alguns profissionais, das 142 equipes, 112 (78,8%) realizam, atualmente, a administração da penicilina. Ressalta-se ainda que, até a presente data, não foi registrada a ocorrência de reações adversas graves. Conclusão: Reitera-se a importância da administração da penicilina G benzatina nas UBS’s como medida facilitadora da adesão ao tratamento da sífilis e, consequentemente, do controle da infecção. Contudo, percebem-se alguns fatores dificultadores do processo, como a rotatividade de profissionais de saúde e a necessidade de capacitações continuadas. Apesar disso, acredita-se que essa estratégia terá impacto direto sobre a redução da transmissão da infecção, especialmente da transmissão materno-fetal.

Objetivo: Relatar o processo de descentralização dos testes rápidos (TR) para as unidades da Atenção Primária à Saúde, no município de Montes Claros, MG. Materiais e Métodos: Trata-se de um estudo descritivo na modalidade relato de experiência, vivenciado pela equipe do Serviço de Assistência Especializada (SAE)–Ampliado. O processo de descentralização dos testes de IST em Montes Claros iniciou-se em 2014, precedido por várias reuniões da equipe do SAE, Vigilância Epidemiológica e Coordenação da Atenção Primária à Saúde para planejamento das ações, de acordo com as recomendações do Ministério da Saúde (MS). Inicialmente foi elaborado um plano de curso/capacitação dividido em duas etapas: 1) Teorização sobre as IST e aconselhamento; oferecida a um grupo maior de profissionais; 2) Prática sobre a técnica de coleta dos testes rápidos, realizada no CTA, em pequenos grupos. Posteriormente, a parte teórica foi substituída pelos cursos da Plataforma Telelab, por orientação do Ministério da Saúde. Durante a prática, além da avaliação da aptidão para a execução dos testes rápidos, aspectos sobre a garantia do sigilo, confidencialidade e aconselhamento eram discutidos. As capacitações seguiram um cronograma e iniciaram pelas equipes que já possuíam estrutura mínima (geladeira). Resultados: De 2014 a 2022, foram capacitados e certificados pela equipe do SAE, 100% dos enfermeiros e técnicos de enfermagem das equipes de Estratégia Saúde da Família do município. Alguns médicos também participaram da capacitação, porém em proporção bem menor. Após o período de capacitação, os testes foram dispensados através de solicitação via link, criado na plataforma google forms, distribuídos para as unidades e monitorados pela equipe do SAE através de visitas técnicas aleatórias. Atualmente, 98% das unidades de ESF realizam os TR e o aconselhamento para as IST. Conclusão: Entende-se a descentralização dos testes rápidos como uma estratégia fundamental para o controle das IST, no entanto, precisa de acompanhamento e monitoramento contínuos para manter a motivação da equipe e qualidade do serviço. Durante o processo, foram identificados fatores facilitadores da descentralização, como: sensibilidade dos profissionais em relação aos dados epidemiológicos; perspectiva de trabalho segundo princípios do SUS e da saúde da família. Entre os aspectos que dificultaram o processo estão: equipes incompletas e rotatividade de profissionais; desconfiança em relação ao teste rápido; percepção de sobrecarga de trabalho; inseguranças relacionadas ao aconselhamento e comunicação diagnóstica.

Este artigo pretende refletir sobre as mulheres e sua entrada na Educação a Distância que pode (ou não) se apresentar como uma possibilidade de acesso ao ensino superior. De modo a termos uma compreensão mais cabal sobre condições objetivas da mulher no mundo do trabalho capitalista serão evidenciados sob análise conceitual os estudos de Heleieth Saffioti (1976; 1984; 2015) e Silvia Federici (2017; 2021) aliando dados do Instituto Brasileiro de Geografia e Estatística (IBGE). Dessa forma, procura-se compreender a entrada das mulheres no ensino superior a distância, avaliando, por fim, alguns elementos do cenário pandêmico, a superintensificação dos afazeres domésticos, cuidados com familiares e o trabalho precário.

Abstract Objective: This study aimed to describe the characteristics of mothers and children assisted in a follow-up clinic for congenital syphilis and identify the factors associated with the confirmation of the diagnosis. Methods: This is a prospective study conducted from 2016 to 2019 in Montes Claros, Northern Minas Gerais, Brazil. Specific forms addressing maternal sociodemographic, behavioral, and lifestyle habit characteristics, as well as characteristics related to access to healthcare, were used. Hierarchical Poisson regression analysis was performed to define the factors associated with diagnostic confirmation, including the calculation of the prevalence ratios (PR) and respective 95% confidence intervals (95%CI). Results: A total of 200 binomials (mother-child) who attended at least one appointment as part of the follow-up after discharge from the maternity hospital were eligible for the study. The mothers were mostly young (79.0%), with a low educational level (43.0%), and black (89.5%). Nearly half of the mothers reported not having a steady sexual partner (42.5%). About a quarter attended less than six prenatal appointments (27.5%). Nearly half did not treat the disease adequately during pregnancy (24.5%). The diagnosis of congenital syphilis was confirmed for 116 children. The following factors were associated with the diagnostic confirmation after multiple analyses: low maternal educational level (PR 1.30; 95%CI 1.05–1.60), maternal risky sexual behavior (PR 1.34; 95%CI 1.07–1.66), inadequate treatment of the mother (PR 3.16; 95%CI 2.42–4.47), and lack of treatment of the partner (PR 1.44; 95%CI 1,18–1.81). Conclusions: Syphilis remains a major challenge. The results highlight the social inequities associated with congenital syphilis and the lack of proper management of pregnant women and their partners.

Comprising advanced materials like polyvinylidene fluoride (PVDF) for mechanical stability and biofouling prevention and polyvinylpyrrolidone (PVP) for hydrophilicity, membranes enable selective filtration, retaining larger particles and external contaminants in wastewater treatment. Incorporating activated carbon during manufacturing is a strategic approach to enhance membrane (AC-CO2 membrane) properties, leveraging its high surface area and adsorption capacity. This study produced mixed polymeric membranes by combining PVDF, PVP, and activated carbon (AC-CO2), using N-Methyl-2-pyrrolidone (NMP) as the solvent. These membranes were employed for the filtration of phenolic compounds, particularly phenol. In an AC-CO2 membrane formulation with 1.3 g of PVP, 1.15 g of PVDF, 8.8 mL of NMP, and 2.5 g of AC-CO2, with thickness variations of 150 µm and 300 µm, approximately 56.77% and 90.35% of 50 mg/L of phenol in model wastewater were removed within 5 min, respectively, with breakthrough occurring at 15 min. Finally, this study developed a hydrophilic membrane with alkaline characteristics and a neutral pH point of zero charge (pHPZC), establishing the feasibility of employing these membranes to treat model wastewater containing phenolic compounds. The prospect of scaling up for practical applications presents a promising avenue for future investigations.

Objetivo: Analisar nas evidências científicas quais as principais prescrições de enfermagem para a prevenção da Lesão por pressão. Métodos: Trata-se de uma Revisão Integrativa da Literatura, sendo elas divididas em seis etapas interativas e interdependentes, por meio da identificação e triagem de artigos e pesquisas. Foram analisados e selecionados artigos da BDENF, LILACS, MEDLINE, IBECS, BINACIS e LIPECS, como critério de seleção foram usados os seguintes descritores: Lesão por pressão, Enfermagem, Fatores de risco e idoso. Resultados: Foram encontrados 1,252 estudos publicados nos últimos 5 anos, com os critérios de seleção foram escolhidos 18 artigos para compor a pesquisa. A atuação e papel da enfermagem na elaboração de estratégias e planos de cuidados, ademais práticas, condutas e interação na equipe visando uma saúde holística foram pilares fundamentais para prevenção de lesão por pressão. Conclusão: O estudo, portanto, evidenciou a identificação de fatores de risco, a implementação da Sistematização da Assistência de Enfermagem e Processo de enfermagem são imprescindíveis na assistência prestada ao paciente, pois são cuidados com base científica e eficazes em um atendimento de qualidade. Onde a equipe de enfermagem por meio de uma análise crítica, consegue desenvolver um raciocínio clínico e prevenir possíveis casos de lesão por pressão.

Abstract Objectives: to characterize the profile of pregnant women and newborns accompanied at a reference center for infectious-parasitic diseases, after the exposure of T. gondii, establishing comparisons with a previous study, in the same location, ten years ago. Methods: this is a retrospective cohort study, with a follow-up of four years (2016 to 2019), using the previous study carried out from 2002 to 2010 as a comparative for the variables assessed. Mothers who presented tests suggestive of seroconversion for the disease during prenatal care and their respective concepts, followed up over a year, were included. The chi-square test was used, assuming a significance level of 5% for the comparison of the groups in the two periods. Results: during the period from 2016 to 2019, 79 binomials were studied, whereas 58 binomials were accompanied in the previous period. Comparing both periods, the findings showed lower proportions of adolescents (p

Microalgae biomass can offer several compounds beneficial to human nutrition, including lipids, proteins, minerals and pigments. In this sense, microalgae-based foods are already evident as opportunities for food research and development. Thus, the consumption of foods containing declared compounds from microalgae (e.g., omega 3/proteins) can be sold in the form of supplements and other innovative products, including chocolates and beverages. Furthermore, the production of microalgae brings advantages to global food security and reduces the impact considering environmental problems related to the expansion of food production in agricultural land. In this sense, the quality and safety of derivatives depend on good cultivation, harvesting and processing practices since unwanted organic and inorganic compounds may be present in microalgae biomass due to environmental contamination or processing steps. Moreover, this may pose a risk to human health, and it is essential for consumer protection that microalgae biomass be monitored for levels of residues and contaminants. The optimization of processes and knowledge of cultivation steps and their reagents are crucial for quality control. These aspects are discussed throughout this review, focusing on recent reports on potential microalgae-based food contaminants.

Objetivo: apresentar a experiência ao avaliar os riscos e achados em idosos durante a consulta de enfermagem, definindo diagnósticos persistentes, intervenções e implementação do plano de cuidados. Materiais e Métodos: foi realizada consulta de enfermagem com idosos, por acadêmicos de enfermagem de uma instituição de ensino superior no município Montes Claros-MG, durante as práticas de estágio, no período de setembro e outubro de 2021. Os idosos foram classificados através da ficha Índice de Vulnerabilidade Clínico-Funcional-20 (IVCF- 20). Permeou-se a consulta com anamnese e exame físico; em seguida foram definidos os diagnósticos persistentes, realizando o planejamento, aplicando as intervenções e a elaboração do plano de cuidados. Resultados: a dificuldade encontrada foi que o idoso não compareceu ao retorno. Diante disso, foi realizado vídeo chamada com os familiares, quando foram orientados detalhadamente sobre o plano de cuidado e as intervenções. Os pacientes demonstraram satisfação e interesse em colocar em prática as informações repassadas. Conclusão: a avaliação multidimensional do idoso foi de extrema importância para os acadêmicos, pois possibilitou conhecer mais sobre essa população, identificando problemas de saúde-doença, executando e avaliando cuidados que contribuam para a promoção, proteção, recuperação e reabilitação da saúde do idoso.

Objetivo: analisar a frequência de sífilis entre os usuários do Centro de Testagem e Aconselhamento de Montes Claros, Minas Gerais, e os fatores associados à infecção. Método: trata-se de um estudo transversal, com componentes descritivos e analíticos, realizado com usuários atendidos no serviço entre 2014 e 2019. Os dados foram coletados de fonte secundária, por amostragem aleatória e sistemática. Resultados: a amostra foi composta por 957 formulários de usuários e a frequência de casos de testes rápidos reagentes para sífilis foi de 11,3%, com distribuição semelhante entre os sexos. O diagnóstico da sífilis se associou de forma significativa às variáveis: situação conjugal, idade, escolaridade, quantidade de parcerias sexuais, orientação sexual e uso de drogas no último ano. Conclusão: programas de aconselhamento e testagem rápida devem ser incentivados para prevenção e diminuição das infecções sexualmente transmissíveis em Montes Claros e em todo país.

This paper evaluates the influence of water content and mixing conditions (mixing time and sequence of addition of the constituents) on the fresh state properties of lime-based materials and their impact on the hardened state properties. Higher water contents allowed an increased fluidity and lower torque, yield stress and plastic viscosity values. In turn, a longer mixing time with the aggregate caused a progressively stiffer mortar and a substantial increase in the torque, yield stress and plastic viscosity values due to the breakdown of lime agglomerates that consume part of the free water available to lubricate the mix. A longer mixing time without the aggregate caused similar trends, albeit to a much lesser extent. The water content and mixing conditions also had a major impact on the resulting porous structure of lime mortars and, thus, on their mechanical strength.

Introdução: O envelhecimento demográfico mundial determinará um número crescente de pessoas com necessidades de cuidados de longa duração, em particular nas Estruturas Residenciais para Pessoas Idosas. É difícil atrair e reter enfermeiros qualificados para estes contextos. Importa os enfermeiros supervisores deterem competências em enfermagem gerontogeriátrica, com o intuito de serem uma influência positiva para os estudantes de enfermagem. Objetivo: Analisar os fatores que influenciam as práticas de supervisão de estudantes de enfermagem, em ensino clínico, em lares de idosos, de forma a contribuir para a melhoria da qualidade das práticas de supervisão nestes ambientes. Métodos: Revisão integrativa da literatura, realizada no agregador de conteúdos da Biblioteca Virtual da Escola Superior de Enfermagem do Porto e na base de dados Trip Medical Database, numa estratégia temporal entre 2014 e outubro de 2021. Os dados foram extraídos com auxílio de uma tabela, realizando-se uma análise crítica do conteúdo. Resultados: Dos 53 artigos identificados, foram incluídos nesta revisão 9 estudos. Da síntese dos dados, emergiram os seguintes fatores: as características do estudante, o contexto ensino-aprendizagem, a relação supervisiva e o planeamento do ensino clínico. Conclusão: Importa maximizar as experiências de aprendizagem nestes contextos, pelo reconhecido potencial destes ambientes na formação inicial dos estudantes, com vista a atrair pessoal qualificado para este sector.

Abstract Background The National Immunization Program Information System (SIPNI - Sistema de Informação do Programa Nacional de Imunização) in Brazil is a technological innovation management tool that enhances the performance of managers and health professionals in the evaluation and monitoring of immunization activities. In the country, the decentralization of the System is at an advanced stage, but it still faces challenges regarding its operation and use, impacting on its results. This study aims to evaluate the deployment of SIPNI in the state of Minas Gerais, in 2017. Method Cross-section study performed in Primary Healthcare vaccination rooms in 54 municipalities in the Brazilian state of Minas Gerais, in 2017. A multidimensional questionnaire was used with nursing professionals who work in vaccination rooms, containing questions about the structure (presence of an internet-connected computer, instruction manual, software version, IT professional for technical support, trained healthcare professional, use of communication channels to obtain system information) and the process (activities performed by the staff to operate the immunization information system) of their work. Those questions refer to the components of the information system: system management, immunized-patient records, and Movement of Immunobiological. Implementation Degree (ID) was defined by a score system with different weights for each criterion, according to the importance level observed in it, with a rating of: adequate, partially adequate, inadequate and critically inadequate. For data analysis, median was used as the summary measure, and Pearson’s Chi-Squared Test was used for proportion comparison. Results Municipal SIPNI is not adequately implemented and that results mainly from the actions performed in health service units, indicating problems in the use of technology by professionals working in vaccination rooms. The structure was better evaluated than the process, presenting IDs of 70.9 and 59.5%, respectively. Insufficient internet access, inadequate use of communication channels, and lack of professional qualification were some of the identified structural issues. “Movement of Immunobiological” was the best-ranked component (ID = 68.5%), followed by “immunized patient records” (ID = 59.3%) and “SIPNI management” (ID = 50.7%). Partial performance of SIPNI is independent of population size in the municipality and of FSH coverage. Conclusions SIPNI is still an underutilized technological innovation. There are challenges that must be overcome, such as implementation of the final web version, internet connectivity, and capabilities aimed at the use of information generated by technology. Nevertheless, perspectives regarding SIPNI are positive, with functionalities to optimize activities in vaccination rooms.

ABSTRACT BACKGROUND: The thrombin generation test (TGT) has shown promise for investigation of hemorrhagic and thrombotic diseases. However, despite its potential, it still needs standardization. Moreover, few studies have established reference values for TGT parameters. In Brazil, these values have not yet been established. OBJECTIVE: To determine TGT performance and reference intervals for TGT parameters in healthy individuals. DESIGN AND SETTING: Cross-sectional study conducted among participants in the Brazilian Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). METHODS: The reference sample consisted of 620 healthy individuals. The calibrated automated thrombogram (CAT) method, under low and high tissue factor (TF) conditions, was used to assess thrombin generation. Test performance was analyzed using intra and interassay coefficients of variation (CV) and reference intervals were calculated using the nonparametric method proposed by the International Federation of Clinical Chemistry and the Clinical and Laboratory Standards Institute. RESULTS: The intraassay CV ranged from 1.4% to 2.2% and the interassay CV, 6.8% to 14.7%. The reference intervals for TGT parameters under low and high TF conditions were, respectively: lagtime: 3.0-10.3 and 1.4-3.7 min; endogenous thrombin potential (ETP): 1134.6-2517.9 and 1413.6-2658.0 nM.min; normalized ETP: 0.6-1.3 and 0.7-1.4; peak: 103.2-397.7 and 256.4-479.0 nM; normalized peak: 0.3-1.3 and 0.7-1.2; and time-to-peak: 5.6-16.0 and 3.4-6.7 min. These parameters were categorized relative to sex. Conclusion: TGT performance was adequate and the proposed reference intervals were similar to those of other studies. Our findings may be useful for consolidating the TGT, through contributing to its standardization and validation.

ObjectiveComplex regional pain syndrome (CRPS) is usually triggered by trauma or a surgical procedure, and it typically becomes an established one after an intense inflammatory process with chronic pain and edema as the main symptoms. Available treatments for CRPS have low efficacy. This study aimed to evaluate the clinical and immunoregulatory effects of omega-3 polyunsaturated fatty acid (PUFA) supplementation on paw edema and anti- and pro-inflammatory cytokines and macrophage phenotypes in the chronic post-ischemia pain (CPIP) preclinical model of CRPS-Type I.MethodsFemale Swiss mice were supplemented with omega-3, corn oil, or saline and then submitted to the CPIP model of ischemia/reperfusion (I/R) injury. Supplementation was carried out for 30 days prior to and up to 2 or 15 days after the induction of CPIP, according to experimental protocols. The supplementation protocol included 1,500 mg/kg of omega-3 or corn oil through an intragastric route (gavage). Paw edema, interleukin- (IL-) 4, IL-10, transforming growth factor-β1 (TGF-β1), monocyte chemotactic protein-1 (MCP-1), and tumor necrosis factor (TNF) were then measured in the paw skin and muscle by enzyme-linked immunosorbent assay (ELISA), and macrophage phenotypes (M1 and M2) assessed in the paw muscle by Western blotting.ResultsThe CPIP model induced an increase in paw thickness up to 72 h post-I/R. Mice supplemented with omega-3 compared to the saline group displayed reduced edema but neither altered skin IL-4 or skin and muscle TGF-β1, TNF, and MCP-1 concentrations, nor did they exhibit significantly altered muscle macrophage phenotype on the 2nd-day post-CPIP. However, omega-3 supplementation reversed the I/R-related reduction in IL-4 in the paw muscle compared to groups supplemented with saline and corn oil. Furthermore, omega-3 promoted the reduction of IL-10 levels in the paw skin, compared to animals with lesions supplemented with saline, until the 2nd-day post-CPIP. On the 15th day post-CPIP, IL-10 was significantly increased in the muscle of animals supplemented with omega-3 compared to the saline group.ConclusionThe results suggest that omega-3 PUFA supplementation has anti-inflammatory effects in the CPIP model of CRPS-Type I, significantly reducing paw edema and regulating concentrations of anti-inflammatory cytokines, including IL-4 and IL-10.

Introduction SARS-CoV-2 is responsible for a large number of global COVID-19 cases. Strategies such as social isolation, personal hygiene and frequent hand washing have been implemented; however, a protective vaccine is required to achieve sufficient herd immunity to SARS-CoV-2 infection to ultimately control the COVID-19 pandemic. To meet the urgent need for a vaccine, a reduction in the development schedule has been proposed from 10–15 years to 1–2 years. For this reason, this systematic review and meta-analysis protocol aims to compare the side effects, safety and toxicity of COVID-19 vaccines available globally, including their combinations.Methods and analysis We will select randomised controlled trial-type studies that evaluate the side effects of the COVID-19 vaccine. PubMed, Web of Science, Embase, CINAHL, PsycINFO, LILACS, SCOPUS, ClinicalTrials.gov, International Clinical Trials Registry Platform (ICTRP), medRxiv.org, biorxiv.org, preprints.org and the Cochrane Library will be searched for eligible studies until December 2021. Three reviewers will independently screen and select studies, assess methodological quality and extract data. A meta-analysis will be performed, if possible, and the Grading of Recommendations, Assessment, Development and Evaluations summary of findings will be presented.Ethics and dissemination This study will review published data, and thus it is unnecessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration number CRD42021231101.

Abstract Centrosema coriaceum Benth belongs to Fabaceae family and have few studies of biological activity and chemical composition. Thus, the aims of this work were to determine chemical profile of the ethanolic extract of C. coriaceum leaves (CCE) by UFLC-QTOF-MS and to evaluate its in vitro biological potential. CCE showed MIC value of 1000 µg/mL against Candida glabrata (fungistatic effect) and high affinity in cell envelope by increasing cell permeability in nucleotide leakage, sorbitol and ergosterol assays. CCE showed antioxidant activity in all assays performed. For the anti-inflammatory and cytotoxicity activities, CCE, at all tested concentrations, significantly inhibited the production of nitric oxide and did not decrease J774A.1 cell viability below 70%. Finally, rutin, kaempferol-3O-rutinoside, caffeic acid, and sucrose were identified in CCE by UFLC-QTOF-MS. These results suggest, for the first time, that C. coriaceum has interesting antifungal, antioxidant, and anti-inflammatory activities.

BackgroundMechanical factors are primary complications that justify early removal of a peripherally inserted central catheter, and thrombotic catheter occlusion is the most critical mechanical complication associated with loss of device functionality. Studies have investigated these factors in adult patients, but findings are not directly applicable to newborns. Therefore, systematic reviews focusing on this population are necessary for consolidated evidence to aid clinical practice.AimsThis study aims to evaluate the efficacy of intermittent heparin washing versus 0.9% sodium chloride solution for preventing occlusion in newborns with peripherally inserted central catheters.MethodsWe will use the PubMed, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, CINAHL, and Clinical Trial Databases for article search, without language or publication periods restrictions. Randomized clinical trials evaluating the use of intermittent heparin washing versus 0.9% sodium chloride solution in newborns with peripherally inserted central venous catheters will be included. The primary outcome will be peripherally inserted central catheter occlusion. Two reviewers will independently screen the studies, based on the inclusion criteria, extract the data for each included study and assess the risk of bias using the Cochrane risk of bias tool. The data will be synthesized using the Review Manager software (RevMan 5.4.1). To classify the strength of the evidence of results, we will use the Grading of Recommendations Assessment, Development and Evaluation Working Group (GRADE). The review was registered with PROSPERO (registration number CRD42021281509).Expected resultsWe expect that this study would reveal the best method for preventing catheter occlusion in newborns with peripherally inserted central catheters.

Introduction Therapeutic management of neonatal pain is essential to reduce changes in initial and subsequent development. Although glucose has been shown to be effective in relieving pain, concentrations and dosages remain to be standardised. The objective of this systematic review and meta-analysis is to identify the efficacy of glucose as an analgesic in preterm infants.Methods and analysis The Web of Science, Science Direct, Scopus, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, PubMed, Medline, Latin American and Caribbean Health Sciences Literature and Embase databases will be researched for randomised studies published until December 2021. This systematic review and meta-analysis will include studies investigating the use of glucose for pain control in premature neonates. The primary outcome will be pain relief. Three independent reviewers will select the studies and extract the data from original publications. The risk of bias was assessed using the Cochrane risk of bias tool. Data synthesis will be performed using the Review Manager software (RevMan V.5.2.3). We will evaluate heterogeneity based on I2 statistics. In addition, quantitative synthesis will be performed if the included studies are sufficiently homogeneous.Ethics and dissemination Ethical approval for the research will not be required for this systematic review. The results of this study will be published in an international journal.Trial registration number This protocol was submitted to the International Prospective Register of Systematic Reviews (PROSPERO, number CRD42021236217).

Abstract Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p

The estrogen decrease in postmenopausal women results in functional and anatomical changes in the genitourinary tract. The most prevalent and bothersome symptoms are vaginal dryness, dyspareunia, and reduced lubrication, which can significantly affect the quality of life of these women, principally those who are sexually active. Hormonal therapy with local estrogens is generally considered the “gold standard.” However, there are cases in which there are clinical concerns about its use or women opt for non-hormonal options. Thus, safe and effective non-hormonal options are needed to improve symptoms in these women. Moisturizers and lubricants are first-line therapy for breast cancer survivors.

The genitourinary syndrome in menopause can occur at different stages of life, with different causes or triggering factors, such as prolonged use of antiestrogens, chemotherapy, radiotherapy, and extensive vaginal surgeries, which can alter vascularization, hydration, collagen quality, and tissue elasticity. Despite hormonal therapy being considered the best evidenced treatment for genitourinary syndrome of menopause (GSM), there are limitations concerning the latter. Thus, alternative, complementary, or even substitutive treatments have emerged, such as energy use, promoting thermal tissue stimulation to improve tropism. Due to its practicality and feasibility, the micro ablative fractional radiofrequency (MAFRF) has gained space among these energies. It uses high-frequency electromagnetic waves and promotes thermal micro points in the superficial and deep dermis. The safety of these energies limits thermal action laterality and depth. Laterally, it is essential for an adequate regenerative effect without scarring marks or sequelae; the appropriate depth is important for stimulating the obligatory tissue repair response with the production and reorganization of collagen, elastic fibers, increased vascularization and hydration, and the consequent improvement in tropism. In gynecology, the MAFRF is used with therapeutic indication and functional improvement; it is applied to the entire length of the vaginal walls, the vulvar vestibule, urethral meatus, labia minora, clitoris prepuce, labia majora, perineum, and perianal region. The MAFRF has been proved to be an effective and safe treatment for GSM, with long-lasting effects, significantly reducing symptoms and improving vaginal tropism. This review aims to analyze the MAFRF as a non-hormonal therapeutic option for GSM.

Genitourinary syndrome of menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. Among 27–84% of women in postmenopausal are affected for symptoms of GSM, and these can unquestionably impair health, sexual function, consequently the quality of life of these women. The main signs and symptoms of GSM include, among others, burning, irritation, vulvovaginal dryness, dyspareunia, urinary symptoms of urgency, dysuria, or recurrent urinary tract infection. The diagnosis can be made through anamnesis, questionnaires, physical exams, and, sometimes, complementary exams. Objective vaginal assessment is essential and can be complemented by using the Vaginal Health Index (VHI), Vaginal Maturation Index (VMI), or vaginal pH measurement. The acknowledgment of this condition by health professionals is crucial for its identification and proper management and exclusion of other conditions that make a differential diagnosis with it.

Menopause is a physiological and progressive phenomenon secondary to decreased ovarian follicular reserve that significantly affects the genital tract. Although postmenopausal vulvovaginal atrophy primarily affects postmenopausal women, it is also seen in premenopausal women. The hypoestrogenic condition results in hormonal and anatomical changes, with the main symptoms, are dryness, burning and genital irritation, decreased lubrication, urinary urgency, dysuria, and recurrent urinary tract infections. This review aims to update hormone therapy for urogenital atrophy, both local and systemic, and discusses the importance of understanding and the need for active treatment of this condition. The main therapeutic objective is the relief of symptoms, and hormonal therapy (HT) is still the most effective choice for treating clinical manifestations, despite the side effects of its use. HT should be used in an individualized way to the needs of the women and appropriate to the stage in which she is menopausal, perimenopausal, or after menopause.