ABSTRACT: Introduction: Vaccination in populations exposed to increased risk of severe disease and death consequent to SARS-CoV-2 infection has generated a major impact on global Public Health. Certainly, the benefit has been evidenced mostly in people with chronic comorbidities, where rheumatoid arthritis (RA) plays an important role. Objective: To analyze vaccination against Sars-CoV-2 in paraguayan patients with rheumatoid arthritis (RA) during the COVID19 pandemic. Methods: A multicenter study was carried out, in which a cohort of patients with RA was analyzed cross-sectionally, during the period from October to December 2022. For the study, clinical-epidemiological and vaccination-related variables were recorded (i.e. access to vaccination, type, number of doses). A descriptive analysis of the variables was carried out with the R-4.3.2 software. Results: 568 patients were included, 84.1% were female, with an average age of 55.5±13.9 years. 88.7% (504) patients received at least one dose of SARS-CoV-2 vaccine, 85% (483) received two doses, while 60.9% (344) patients received the first booster, and 21.2% the second booster. Conclusions: In this series of Paraguayan patients with RA the percentage of vaccination against SARS-CoV-2 was higher than that registered in the general population of the country. This could be related to the priority of this population to access vaccines and the insistence of their physicians to complete the vaccination schedule.

RESUMEN: Introducción: La vacunación en poblaciones expuestas a mayor riesgo de enfermedad grave y muerte consecuentes a la infección por SARS-CoV-2, ha generado un gran impacto en la salud pública mundial. Indudablemente, el beneficio ha sido evidenciado mayormente en personas con comorbilidades crónicas, donde la artritis reumatoide (AR) juega un rol importante. Objetivo: Analizar la vacunación contra Sars-CoV-2 en pacientes paraguayos con AR, durante la pandemia COVID-19. Métodos: Se realizó un estudio multicéntrico, en el que se analizó transversalmente a una cohorte de pacientes con AR, durante el periodo de octubre a diciembre del año 2022. Para el estudio se registraron variables clínico-epidemiológicas y relacionadas con la vacunación (i.e. acceso a la vacunación, tipo, número de dosis). Se realizó un análisis descriptivo de las variables con el software R-4.3.2. Resultados: Se incluyeron 568 pacientes, 84,1% eran mujeres, con un promedio de edad de 55,5±13,9 años. El 88,7% (504) pacientes, recibieron al menos una dosis de vacuna contra SARS-CoV-2. 85% (483) recibieron dos dosis, mientras que el 60,9% (344) pacientes recibieron el primer refuerzo, y 21,2% el segundo refuerzo. Conclusiones: En esta serie de pacientes paraguayos con AR el porcentaje de vacunación contra SARS-CoV-2 fue más elevado que el registrado en la población general del país. Esto podría estar relacionado con la prioridad de esta población para acceder a las vacunas y a la insistencia de sus médicos en completar el esquema de vacunación.

Abstract The objective of the study was to evaluate the prevalence of Work-related musculoskeletal disorders (WMSDs) in administrative positions in the national office of a short-term Social Security Health Management Entity in the Plurinational State of Bolivia. The methodology corresponds to a cross-sectional study of 64 civil servants (30 men and 34 women), the collection of information was carried out through the Labor Sociodemographic Questionnaire, the Kuorinka Nordic Questionnaire, the ROSA Method, and the Clinical Histories. The results obtained indicate that 59% of the population is overweight and obese, in addition to the absence of physical activity in 61%, elements that are associated with TMEAT. The general prevalence was 68%, presenting a high risk, with female gender predominance. The compromised anatomical areas are: the neck that ranked first with 76.6%, followed by the lumbar area with a presence of 71.9%, in wrist/hand areas 50.0% present discomfort, shoulders with 42.2% and finally the elbow or forearm with 39.1%.

Resumen El estudio tuvo como objetivo evaluar la prevalencia de los trastornos musculoesqueléticos asociados con el trabajo (TMEAT) de cargos administrativos en oficina nacional de un Ente Gestor de Seguridad Social de Corto Plazo en el Estado Plurinacional de Bolivia. La metodología corresponde a un estudio transversal de 64 funcionarios (30 hombres y 34 mujeres), la recopilación de la información se realizó mediante el Cuestionario Sociodemográfico laboral, el Cuestionario Nórdico de Kuorinka, el Método ROSA, y las Historias Clínicas. Los resultados obtenidos indican que el 59% de la población, presenta sobrepeso y obesidad, además de la ausencia de actividad física en el 61%, elementos que están asociados a los TMEAT, La prevalencia general fue de 68% presentando un riesgo alto, con predominancia del género femenino. Las áreas anatómicas comprometidas son: el cuello que ocupó el primer lugar con un 76.6%, seguida del área lumbar con una presencia del 71.9%, en áreas de muñeca/mano el 50.0% presentan molestas, los hombros con el 42.2% y por último el codo o antebrazo con 39.1%.

Resumen Antecedentes: Agave potatorum es una especie endémica importante ecológica, cultural y económicamente. Poco se cultiva y sus poblaciones naturales están desapareciendo, por lo que una alternativa es la propagación por cultivo de tejidos vegetales. Preguntas: ¿Es posible regenerar nuevos individuos partiendo de estructuras somáticas? ¿Qué explante regenera más plántulas? ¿Qué combinación de reguladores del crecimiento vegetal estimula una mayor formación de brotes? Especie estudiada: Agave potatorum, semillas de Oaxaca, México. Lugar de estudio y fechas: Jardín Botánico, Instituto de Biología, UNAM, Ciudad de México, México. Desde 2020. Métodos: Semillas se desinfectaron y germinaron in vitro y ex vitro. Se cultivaron in vitro explantes de cotiledones, tallos y hojas en medio MS modificado, un mes con BAP (0-2 mg/L) combinado con 2,4-D (0-0.5 mg/L), posteriormente en MS sin reguladores del crecimiento vegetal. Las plantas obtenidas con tres o más raíces se sometieron a un proceso de aclimatización. Resultados: A dos meses de iniciados los cultivos las semillas germinaron in vitro (56.04 %) y ex vitro (31.87 %). Después de 10 meses del período de inducción, se obtuvieron 228 brotes y plántulas, 206 procedían de los tratamientos BAP 1.5-2 mg/L con 2,4-D 0.5 mg/L, con 8.1-12.5 brotes/explante de tallo y hoja. Más del 70 % de las plantas sobrevivieron en invernadero luego de dos meses. Conclusiones: Esta investigación puede contribuir a la conservación de la especie, enfrentar los efectos del cambio climático, la conservación de servicios ecosistémicos y potenciar la economía mediante un aprovechamiento sustentable de ésta y otras especies amenazadas.

Abstract Background: Agave potatorum is an endemic species of ecological, cultural and economic importance. Despite its importance and its overexploited status, it is barely cultivated and its natural populations have been disappearing, so an alternative is propagation by plant tissue culture. Questions: Is it possible to regenerate new individuals from somatic structures? From which explant do more plantlets regenerate? What combination of plant growth regulators stimulates more bud formation? Species studied: Agave potatorum, seeds from Oaxaca, Mexico Study site and dates: Botanical Garden, Institute of Biology, UNAM, Mexico City, Mexico. Since 2020 Methods: The explant culture of cotyledons, stems and leaves sections in modified MS medium was explored, one month with BAP (0-2 mg/L) combined with 2,4-D (0-0.5 mg/L). Subsequently in MS without plant growth regulators. The obtained plants with 3 or more roots underwent an acclimatization process. Results: The seeds' germination was achieved and at two months, the in vitro (56.04 %) and ex vitro (31.87 %) germination were obtained. At 10 months after the induction period, the total number of shoots and plantlets of all treatments was 228, most of them (206) were with BAP 1.5-2 mg/L with 2,4-D 0.5 mg/L promoted the regeneration of 8.1-12.5 shoots/explant of stem and leaf. More than 70 % of the plants survived in greenhouse after two months of culture. Conclusions: This investigation can contribute to the conservation of Agave potatorum, address climate change, conserve ecosystemic services, and strengthen the economy by using this and other endangered species sustainably.

RESUMO Objetivo: Verificar a prevalência e identificar os fatores associados à ausência do acompanhante de parto em mulheres no sul do Brasil. Métodos: Trata-se de um estudo transversal, realizado com 466 parturientes, pertencentes a uma coorte de mulheres da zona urbana da cidade de Pelotas, RS. Aos 18 meses pós-parto, foi aplicado um questionário estruturado com dados sociodemográficos, gestacionais e questões relacionadas ao parto. Foi realizada regressão logística para ajustes de possíveis fatores de confusão. Resultados: A prevalência da ausência de acompanhante de parto entre as mulheres foi de 22,3%. As parturientes com até 8 anos de estudo (RP=2,0 [IC95% 1,1–3,8]), que não viviam com um companheiro (RP=2,3 [IC95% 1,2–4,3]), que realizaram o pré-natal no setor público (RP=1,9 [IC95% 1,0–3,7]) e que tiveram um parto via cesárea (RP=6,0 [IC95% 2,9–12,4]) apresentaram maior probabilidade de ausência de acompanhante de parto. Conclusão: Os resultados apontam evidências relevantes para o seguimento da verificação da presença do acompanhante de parto no sul do Brasil, indicando a necessidade de melhor aproveitamento e adesão desta prática. Além disso, a lei que aprova a presença do acompanhante de parto no Brasil parece não estar sendo colocada em prática de modo integral, desrespeitando um direito das parturientes e impactando nos benefícios para a saúde materno-infantil.

ABSTRACT Objective: To verify the prevalence and identify the factors associated with the absence of birth companions among women in Southern Brazil. Methods: This is a cross-sectional study carried out with 466 parturient women in a cohort of women from the urban area of the city of Pelotas, RS. At 18 months postpartum, a structured questionnaire was applied with sociodemographic, gestational data and questions related to childbirth. Logistic regression was performed to adjust for possible confounding factors. Results: The prevalence of the absence of a birth companion among women was 22.3%. Parturient women with up to 8 schooling years (PR=2.0 [95%CI 1.1–3.8]), who did not live with a partner (PR=2.3 [95%CI 1.2–4.3]), who performed their prenatal care in the public sector (PR=1.9 [95%CI 1.0–3.7]) and who had a cesarean delivery (PR=6.0 [95%CI 2.9–12.4]) were more likely to not have had a birth companion. Conclusion: The results shows relevant evidence for the verification of the presence of a companion in Southern Brazil, indicating the need for better use and adherence to this practice. In addition, the law that approves the presence of the birth companion in Brazil does not seem to be being fully implemented, disrespecting a right of parturient women and impacting the benefits for for maternal and child health.

Abstract Objectives: this study aimed to explore a set of factors associated with lower maternal-fetal attachment (MFA) in pregnant women. Methods: this is a cross-sectional study corresponding to the second wave of a cohort study with a population-based sample of pregnant women in the South of Brazil. The maternal-fetal attachment scale (MFAS) was used to measure MFA. Bivariate analysis was performed using the t-test and ANOVA. The variables that presented p<0.20 were taken for multivariate analysis, through linear regression, in order to control possible confounding factors. Results: a total of 840 pregnant women were included. Pregnant women who had lower MFA means were those who did not live with a partner (B=-3.8 [CI95%=-6.0; -1.7]), those between the first and second trimester of pregnancy (B=-4.3 [CI95%=-5.9; -2.6]), those who did not have support from their mother during pregnancy (B=-2.4 [CI95%=-4.6; -0.2]), and those with depressive symptoms (B=-4.9 [CI95%=-7.4; -2.5]). Conclusions: the results showed that a higher MFA it is associated with an adequate support network during pregnancy, better maternal mental health, and with an advanced pregnancy. Early evaluation of MFA and effort to promote an adequate prenatal bond, focusing on maternal psychological and emotional aspects are strongly suggested.

Resumo Objetivos: explorar um conjunto de fatores associados ao menor apego materno-fetal (AMF) em gestantes. Métodos: trata-se de um estudo transversal, correspondente à segunda fase de um estudo de coorte com uma amostra de base populacional de gestantes no sul do Brasil. Foi utilizada a Escala de Apego Materno-Fetal (EAMF) para medir o AMF. A análise bivariada foi realizada através do teste t e ANOVA. As variáveis que apresentaram p<0,20 foram levadas para análise multivariada, por meio de regressão linear, a fim de controlar possíveis fatores de confusão. Resultados: foram incluídas 840 gestantes. As gestantes que apresentaram menores médias de AMF foram aquelas que não moravam com um companheiro (B=-3,8 [IC95%=-6,0; -1,7]), que estavam entre o primeiro e o segundo trimestre de gestação (B=-4,3 [IC95%=-5,9; -2,6]), que não tiveram o apoio da mãe durante a gestação (B=-2,4 [IC95%=-4,6; -0,2]) e que apresentaram sintomas depressivos (B=-4,9 [IC95%=-7,4; -2,5]). Conclusões: os resultados mostraram que um maior AMF está associado a presença de uma rede de apoio adequada na gravidez, melhor saúde mental materna e a uma gestação avançada. A avaliação precoce do AMF e a promoção de um vínculo pré-natal adequado, com foco nos aspectos psicológicos e emocionais maternos são fortemente sugeridos.

ABSTRACT Objective: To verify the prevalence and identify the factors associated with the absence of birth companions among women in Southern Brazil. Methods: This is a cross-sectional study carried out with 466 parturient women in a cohort of women from the urban area of the city of Pelotas, RS. At 18 months postpartum, a structured questionnaire was applied with sociodemographic, gestational data and questions related to childbirth. Logistic regression was performed to adjust for possible confounding factors. Results: The prevalence of the absence of a birth companion among women was 22.3%. Parturient women with up to 8 schooling years (PR=2.0 [95%CI 1.1–3.8]), who did not live with a partner (PR=2.3 [95%CI 1.2–4.3]), who performed their prenatal care in the public sector (PR=1.9 [95%CI 1.0–3.7]) and who had a cesarean delivery (PR=6.0 [95%CI 2.9–12.4]) were more likely to not have had a birth companion. Conclusion: The results shows relevant evidence for the verification of the presence of a companion in Southern Brazil, indicating the need for better use and adherence to this practice. In addition, the law that approves the presence of the birth companion in Brazil does not seem to be being fully implemented, disrespecting a right of parturient women and impacting the benefits for for maternal and child health.

RESUMO Objetivo: Verificar a prevalência e identificar os fatores associados à ausência do acompanhante de parto em mulheres no sul do Brasil. Métodos: Trata-se de um estudo transversal, realizado com 466 parturientes, pertencentes a uma coorte de mulheres da zona urbana da cidade de Pelotas, RS. Aos 18 meses pós-parto, foi aplicado um questionário estruturado com dados sociodemográficos, gestacionais e questões relacionadas ao parto. Foi realizada regressão logística para ajustes de possíveis fatores de confusão. Resultados: A prevalência da ausência de acompanhante de parto entre as mulheres foi de 22,3%. As parturientes com até 8 anos de estudo (RP=2,0 [IC95% 1,1–3,8]), que não viviam com um companheiro (RP=2,3 [IC95% 1,2–4,3]), que realizaram o pré-natal no setor público (RP=1,9 [IC95% 1,0–3,7]) e que tiveram um parto via cesárea (RP=6,0 [IC95% 2,9–12,4]) apresentaram maior probabilidade de ausência de acompanhante de parto. Conclusão: Os resultados apontam evidências relevantes para o seguimento da verificação da presença do acompanhante de parto no sul do Brasil, indicando a necessidade de melhor aproveitamento e adesão desta prática. Além disso, a lei que aprova a presença do acompanhante de parto no Brasil parece não estar sendo colocada em prática de modo integral, desrespeitando um direito das parturientes e impactando nos benefícios para a saúde materno-infantil.

ABSTRACT Obesity is currently a worldwide public health problem. It is characterized by its negative impact on multiple organs, including the liver, through the development of diseases such as non-alcoholic fatty liver disease (NAFLD), which can promote the development of hepatocellular carcinoma. This review discusses the association between obesity and the development of NAFLD, emphasizing on the importance of a preventive and interventional approach during the early stages of the disease, as well as the potential effect of some dietary bioactive compounds. In this regard, it is advisable to focus the intervention on improving BMI, through a program of physical activity, nutritional and health education, and changes in dietary patterns. The inclusion of foods rich in bioactive compounds, such as phenolic compounds, fiber and vitamins can provide an antioxidant, anti-inflammatory and anti-obesogenic effect that could hinder the progression of NAFLD and other comorbidities and complication.

RESUMEN La obesidad es actualmente un problema de salud pública a nivel mundial. Ésta se caracteriza por afectar a múltiples órganos, entre ellos el hígado, desarrollándose enfermedades como la enfermedad de hígado graso no alcohólico (EHGNA), la cual predispone al desarrollo de carcinoma hepatocelular. En esta revisión se discute la asociación entre la obesidad y la EHGNA, enfatizando un abordaje preventivo y de intervención en etapas tempranas de la enfermedad, así como los potenciales efectos de algunos compuestos bioactivos presentes en la dieta. Al respecto es recomendable centrar la intervención en mejorar el IMC, a través de un programa de actividad física, educación nutricional y de salud, y cambios en los patrones dietéticos. La inclusión de alimentos ricos en compuestos bioactivos, como los compuestos fenólicos, fibra y vitaminas pueden proveer de un efecto antioxidante, antiinflamatorio y anti-obesogénico que podrían obstaculizar la progresión de la EHGNA, y otras comorbilidades y complicaciones.

SUMMARY OBJECTIVE: A multicentric, cross-sectional study was carried out to determine the prevalence and risk factors for Coronavirus disease 2019 in medical students and residents from four universities and affiliated hospitals in Brazil. METHODS: A survey about contamination risk and symptoms was sent to all participants through email and WhatsApp. Prevalence was measured by the self-report of positive polymerase chain reaction or serological test. Univariate and multivariate analyses were performed, and odds ratio and 95% confidence interval were calculated. RESULTS: Prevalence of infection by Sars-CoV-2 was 14.9% (151/1011). The disease was more prevalent in residents and interns than in undergraduate students. Contact with an infected relative outside the hospital or with colleagues without using personal protective equipment was associated with higher contamination. Contact with patients without wearing goggles and higher weekly frequency of contact were the two factors independently associated with the infection by Coronavirus disease 2019 in the multivariate analysis. CONCLUSIONS: Medical students, interns, and residents have a higher prevalence of Coronavirus disease 2019 than the general population, in which the last two groups are significantly at higher risk. Contacting patients at a higher weekly frequency increases the risk for infection. The use of goggles should be reinforced when contacting patients.

Resumo Introdução: A endometriose é um distúrbio que pode atingir amplamente a qualidade de vida (QV) e interferir no âmbito biológico, psicológico, social, marital e familiar. Objetivo: Analisar a influência da endometriose na QV de mulheres portadoras dessa patologia. Métodos: O estudo foi realizado no período de março a abril de 2018, com dez voluntárias da Fundação Santa Casa de Misericórdia do Pará, que apresentavam diagnóstico clínico de endometriose. Aplicou-se o Questionário de Qualidade de vida em Endometriose (EHP-30), versão em português, a fim de avaliar a QV em mulheres com endometriose. Resultados: Os resultados sociodemográficos mostra-ram uma predominância de mulheres com idade entre 29 e 55 anos, sendo a maioria casada (6) e com colegial completo (5). Sete das dez voluntárias tiveram gestações. Dentre os âmbitos avaliados pelo EHP-30, o questionário central de QV relacionado à dor pélvica teve 79% dos itens comprometendo as participantes. Nos demais questionários, a vida sexual (82%) foi o índice mais afetado, seguido da vida profissional (70%) e infertilidade (58,82%). Conclusão: Nas mulheres avaliadas, os aspectos da QV mais influenciados pela dor pélvica relacionada à endometriose foram a sexualidade e a vida profissional, acarretando prejuízos biopsicossociais.

Abstract Introduction: Endometriosis is a disorder that can significantly affect quality of life (QOL) and interfere in biological, psychological, social, marital and family aspects. Objective: To analyze the influence of endometriosis on the QOL of women diagnosed with the disease. Methods: The study was carried out from March to April 2018, with 10 volunteers from the Santa Casa de Misericórdia do Pará Foundation, with a clinical diagnosis of endometriosis. The Portuguese version of the endometriosis health profile questionnaire (EHP-30) was applied in order to assess QOL in women with this pathology. Results: The sociodemographic results revealed a predominance of women aged between 29 and 55 years, most of whom were married (6) and high school graduates (5). Seven of the ten volunteers had previous pregnancies. Of the aspects evaluated in the EHP-30, 79% of the items associated with pelvic pain in the core questionnaire were present in the participants. In other questionnaires, sexual life (82%) was the most affected index, followed by professional life (70%) and infertility (58.82%). Conclusion: The aspects of QOL most impacted by pelvic pain associated with endometriosis in the women evaluated were sexuality and professional life, leading to biopsychosocial trauma.

RESUMEN: Introducción: El cáncer pediátrico provoca un cambio radical en el entorno externo e interno del niño o adolescente afectando su desarrollo y crecimiento. Objetivo: Sintetizar los hallazgos de estudios de Enfermería que publicaron resultados en la salud física, psicológica, social e inmunitaria mediante el uso de estrategias de distracción para el cuidado. Metodología: Revisión integrativa de literatura, cualitativa de alcance descriptivo y retrospectivo fundamentada en parámetros establecidos por Whittemore y Knafl con cinco etapas. Criterios de inclusión: artículos científicos con resultados en salud física, psicológica, social e inmunitaria mediante uso de la distracción desde enfermería a población pediátrica con diagnóstico oncológico, publicados en 15 bases de datos científicas, idiomas: inglés, portugués y español, entre los años 2011-2020, con nivel de evidencia según Lobiondo Nivel I, II y III, estudios con asignación al azar, con grupo control independiente y separado, basados en evaluación critica del Instituto Joanna Briggs. Resultados: Las estrategias de distracción usadas en niños y adolescentes con diagnóstico oncológico incluyeron: ejercicio, juego, masaje, música y terapias complementarias realizadas en diferentes escenarios que obtuvieron resultados significativos en la salud física, psicológica, social e inmunitaria. Conclusiones: Con el uso de la distracción en el ámbito hospitalario o no hospitalario se logran beneficios en la salud demostrando ser intervención innovadora e importante para el cuidado de enfermería en población pediátrica oncológica.

ABSTRACT: Introduction: pediatric cancer causes a radical change in the external and internal environment of the child or adolescent affecting their development and growth. Objective: to synthesize the findings of nursing studies that published results in physical, psychological, social and immune health through the use of distraction strategies for care. Methodology: integrative literature review, qualitative descriptive and retrospective based on parameters established by Whittemore and Knafl with five stages. Inclusion criteria: scientific articles with results in physical, psychological, social and immune health through the use of distraction from nursing to pediatric population with oncological diagnosis, published in 15 scientific databases, languages: English, Portuguese and Spanish, between the years 2011-2020, with level of evidence according to Lobiondo Level I, II and III, randomized studies, with independent and separate control group, based on critical evaluation of the Joanna Briggs Institute. Results: the distraction strategies used in children and adolescents with oncological diagnosis included: exercise, play, massage, music and complementary therapies performed in different scenarios that obtained significant results in physical, psychological, social and immune health. Conclusions: with the use of distraction in the hospital or non-hospital setting, health benefits are achieved, proving to be an innovative and important intervention for nursing care in the pediatric oncological population.

Abstract Introduction: Physical activity (PA) has received increasing interest as adjuvant therapy for patients with rheumatologic diseases. However, there is scarce information on PA performed by rheumatoid arthritis (RA) patients in Paraguay. Objective: To analyze the PA of patients diagnosed with RA and the factors associated with the performance of PA. Methodology: The study was cross-sectional and patients with RA were included consecutively at the time of their regular check-up with their treating rheumatologist. PA was calculated with the GPAQ (Global Physical Activity Questionnaire) and socio demographic and clinical variables were recorded to analyze their relationship with the performance of PA. Results: 187 patients were included, of whom 45.5% were not sufficiently active according to World Health Organization (WHO) recommendations. Age, sex and hypothyroidism were the variables associated with PA. Conclusion: A significant proportion of RA patients did not perform sufficient PA according to WHO recommendations in our study. This highlights the importance of analyzing the factors involved in this outcome in order to overcome them and find strategies that favor regular PA.

Resumen Introducción: La actividad física (AF) ha recibido un interés creciente como terapia adyuvante para los pacientes con enfermedades reumatológicas. Sin embargo, existe escasa información sobre la AF realizada por los pacientes con artritis reumatoide (AR) de Paraguay. Objetivo: Analizar la AF de los pacientes con diagnóstico de AR y los factores asociados a la realización de la misma. Metodología: El estudio fue transversal y los pacientes con AR fueron incluidos de forma consecutiva al momento de su control habitual con su reumatólogo tratante. La AF fue calculada con el GPAQ (Global Physical Activity Questionnaire) y se registraron variables sociodemográficas y clínicas para analizar su relación con la realización de AF. Resultados: Se incluyó a 187 pacientes, de los cuales el 45,5% no fueron suficientemente activos considerando las recomendaciones de la Organización Mundial de la Salud (OMS). La edad, el sexo y el hipotiroidismo fueron las variables asociadas a la AF. Conclusión: En nuestro estudio se observó que una proporción importante de pacientes con AR no realizó suficiente AF según las recomendaciones de la OMS. Esto resalta la importancia de analizar los factores implicados en este resultado para lograr superarlos y encontrar estrategias que favorezcan la realización de AF regular.

ABSTRACT Introduction: The use of biological therapy has been associated with an increased risk for different types of infections. In this sense, the development of strategies for prevention and treatment of infections in patients with rheumatic diseases with biological therapy is essential. Currently there is little information on the seroprevalence of Chagas disease (CD) and toxoplasmosis in patients with rheumatic diseases. Objective: To analyze the seroprevalence of CD and toxoplasmosis in patients with rheumatic diseases in plans to start BT. Methodology: Retrospective study of patients with rheumatic diseases whit criteria to start a BT in the Rheumatology Service of the IPS Central Hospital. Clinical, epidemiological, serological and treatment-related variables were recorded. The frequency of positive serology for CD and toxoplasmosis was analyzed and the association with the collected variables was studied. Results: 228 patients were included (RA = 176, Sp = 43, Collagenopathy = 9), 74.6% were women with a mean age of 46.2 years. Chagas seroprevalence was 2.9% and toxoplasmosis 63.1%. No significant associations were identified with the analyzed variables. Conclusion: The seroprevalence of toxoplasmosis and Chagas disease was similar to that described in studies of the general population of our country and the region, so it is important to always keep them in mind especially in developing countries.1Q In the present study, a reactivation of the disease after the onset of BT was not found.

RESUMEN Introducción: El uso de las terapias biológicas (TB) ha sido asociado a un mayor riesgo para el desarrollo de diferentes tipos de infecciones. En este sentido, es fundamental el desarrollo de estrategias para su prevención y tratamiento en los pacientes con enfermedades reumatológicas tratados con estos agentes. Actualmente existe escasa información sobre la seroprevalencia de la enfermedad de Chagas (EC) y de toxoplasmosis en pacientes con enfermedades reumatológicas. Objetivo: Analizar la seroprevalencia de EC y de toxoplasmosis en pacientes con enfermedades reumatológicas en planes de iniciar una TB Metodología: Estudio retrospectivo de pacientes con enfermedades reumatológicas (artritis reumatoide (AR), espondiloartritis (EspA), colagenopatías) en planes de iniciar una TB en el Servicio de Reumatología del Hospital Central del IPS. Se registraron variables clínicas, epidemiológicas, serológicas y relacionadas con el tratamiento. Se analizó la frecuencia de serología positiva para EC y toxoplasmosis y se estudió la asociación con las variables recogidas. Se consultó el registro BIOBADAGUAY para valorar la evolución clínica de los pacientes posterior al inicio de la TB. Resultados: Se incluyó a 228 pacientes (AR=176, EsP=43, Colagenopatía=9) en planes de iniciar una TB. De estos el 74,6% eran mujeres con una edad media de 46,2 ± 13,6 años. La seroprevalencia de Chagas fue de 2,9% y de toxoplasmosis 63,1%. No se observó asociación significativa con las variables analizadas. Conclusión: La seroprevalencia de toxoplasmosis y EC fue similar a lo descrito en estudios poblacionales de nuestro país y de la región, por lo que deben ser consideradas en pacientes en planes de iniciar un tratamiento inmunosupresor, sobre todo en pacientes originarios de países en vías de desarrollo. En nuestra serie de pacientes, no se ha constatado una reactivación de la enfermedad posterior al inicio de la TB.

Abstract This study aimed to evaluate the productive parameters and the concentrations of serum intestinal secretory IgA, cholesterol, LDL, and HDL of laying hens fed sorghum + soybean + canola diets with lower content of nutrients and added with a multienzyme complex (proteases, amylases, and xylanases) and a probiotic (Bacillus subtilis). A total of 180 Bovans White laying hens, between 42 and 54 wk of age, were randomly assigned to three treatments: 1) control diet; 2) low metabolizable energy diet (50 kcal/kg and 2 % of protein and methionine and lysine amino acids) + enzymes; 3) diet number two + probiotic. Productive performance results showed a significant difference (P<0.05) in egg weight between both treatments; treatment 3, added with the enzymes and probiotic, increased egg weight, compared to treatment 2. Humoral immunity, cholesterol, LDL, and HDL variables showed no statistical differences (P> 0.05) between treatments. This study demonstrates that low-nutrient (ME, protein, and lysine and methionine amino acids) diets added with a multienzyme complex and probiotic allow similar results in productive parameters compared to the control diet, and without changing intestinal immunity and levels of cholesterol, high- and low-density lipoproteins in Bovans White hens.

Resumen Se realizó un estudio con la finalidad de evaluar los parámetros productivos, concentraciones de IgA secretora intestinal, colesterol, LDL, HDL en suero, de gallinas de postura alimentadas con dietas sorgo + soya + canola con menor contenido de nutrientes adicionadas con un complejo multienzimático (proteasas, amilasas y xilanasas) y un probiótico (Bacillus subtilis). Se emplearon 180 gallinas Bovans White de 42 a 54 semanas de edad distribuidas en un diseño completamente al azar, con 3 tratamientos: 1) dieta testigo, 2) dieta reducida en energía metabolizable (50 kcal/kg y 2% de proteína y aminoácidos metionina y lisina) + enzimas, 3) dieta 2 + probiótico. Para los resultados de rendimiento productivo existió diferencia (P<0.05) en el peso de huevo con menor peso el tratamiento 2, pero con la adición de enzimas y probióticos, se incrementó. Para las variables inmunidad humoral, colesterol, LDL y HDL, no se observó diferencia estadística (P>0.05) entre tratamientos. Se puede concluir que la inclusión de enzimas y probiótico permitió reducir nutrientes (EM, proteína y aminoácidos lisina y metionina) con resultados similares en parámetros productivos respecto a la dieta testigo, y sin cambios en inmunidad intestinal, niveles de colesterol, lipoproteínas de alta y baja densidad en gallinas Bovans White.

Abstract Extreme climatic events and their hazards have strong impact on society. Urban areas in Brazil are especially vulnerable to the impact of such events due to their rapid growth and inappropriate infrastructure. Viçosa is a mid-sized city in Southeastern Brazil that has been experiencing issues associated with urban expansion and population growth since the 1960s. Thus, this study aims to identify patterns of extreme climate events in Viçosa based on daily temperature and precipitation time series (1968-2017). Homogeneity tests were carried out in order to identify breaking points in these climate variables. Climate trends were analyzed through Mann-Kendall test and their magnitude was checked based on Sen’s slope. Results have evidenced statistically significant and increasing trends in annual minimum temperature since the 1990s. Moreover, statistically significant breaking points in extreme temperature indices have shown increasing number of warm days, and decreasing number of cold nights, in both annual and seasonal analyses. Extreme climatic events have been observed more often in recent years, mainly in the number of consecutive dry days and maximum and heavy precipitation days. Based on results, Viçosa experiences warmer conditions throughout the year, whereas more (less) torrential rainfall events have been occurring during Summer (Winter).

ABSTRACT Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology that presents severe clinical manifestations and unpredictable course. It has been observed in several cohorts that this disease has a more aggressive behavior in the non-Caucasian population due to socioeconomic, demographic and genetic differences. The objective of this study was to describe the clinical-epidemiological characteristics of SLE patients included in the LUPUS-PY cohort and the current situation of the samples stored in the BIOBANCO IMID-PY. The study was based on the review of clinical histories and clinical-epidemiological questionnaires on the day of inclusion in the LUPUS-PY registry. Frequencies were calculated for the categorical variables and the means with their standard deviation for the continuous ones. A total of 83 patients with a diagnosis of SLE were included consecutively (mean age: 34.4 ± 10.0 years), 86.7% were female, 55% were from Asunción, 49.1% had basic education level, 45% received monthly a minimum salary (approximately 350 US dollars) or less. Forty six point eight percent did not perform any type of physical activity. The mean time elapsed since the onset of symptoms and the diagnosis of SLE was 9.3 ± 13.7 years, and the time of evolution of the disease until entry into the registry was 5.9 ± 6.3. Sixteen percent reported a family history of autoimmune diseases. The first manifestation of the disease more described was articular. Patients with SLE in our center have both clinical and epidemiological characteristics similar to those reported by other cohorts.

RESUMEN El lupus eritematoso sistémico (LES) es una enfermedad autoinmune, de etiología desconocida que presenta manifestaciones clínicas de gravedad y curso impredecible. Se ha observado en varias cohortes que esta enfermedad tiene un comportamiento más agresivo en la población no caucásica debido a diferencias socioeconómicas, demográficas y genéticas. El objetivo del estudio es describir las características clínico-epidemiológicas de los pacientes con LES incluidos en la cohorte LUPUS-PY y la situación actual de las muestras custodiadas en el BIOBANCO IMID-PY. Estudio basado en la revisión de historias clínicas y en los cuestionarios clínico-epidemiológicos del día de la inclusión al registro LUPUS-PY. Se calcularon las frecuencias para las variables categóricas y las medias con su desvío estándar para las continuas. Se incluyeron de forma consecutiva, 83 pacientes con diagnóstico de LES (edad media: 34,4±10,0 años), el 86,7% era del sexo femenino, el 55% provenía de Asunción, el 49,1% tenía nivel educativo básico, el 45% percibía un ingreso mensual de un sueldo mínimo (aproximadamente 350 dólares americanos) o menos. El 46,8% no realizaba ningún tipo de actividad física. La media del tiempo trascurrido desde el inicio de los síntomas y el diagnóstico del LES fue de 9,3±13,7 años y el tiempo de evolución de la enfermedad hasta el ingreso al registro fue de 5,9±6,3. El 16% refirió antecedentes familiares de enfermedades autoinmunes. La primera manifestación de la enfermedad más descripta fue la articular (45%). Los pacientes con LES de nuestro centro tienen características tanto clínicas como epidemiológicas similares a las reportadas por otras cohortes.