Abstract Objective: To evaluate sleep characteristics of parents and their children during the COVID-19 pandemic and predictors for sleep disturbances. Methods: Cross-sectional web-based study using an online survey made available for dyads of parents and their children during the 7th week of quarantine in southern Brazil. Parents' and adolescents’ sleep were characterized using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. For children aged 0-3 years parents completed the Brief Infant Sleep Questionnaire, for those aged 4-12 years the Sleep Disturbance Scale for Children. Parents also informed, subjectively, their perception about sleep habits during social distancing. Multiple regression was run to predict sleep disturbances in adults using independent variables: sex, income, education, children age, and children with sleep disturbances. Results: Data from 577 dyads showed sleep alterations in 69,8% of adults, in 58,6% of children aged 0-3 years, 33,9% in the 4-12 years range (with a predominance of disorders of initiating or maintaining sleep), and 56,6% in adolescents. Sex (female) and children with sleep disturbances were significant predictors of a sleep problem in parents (p < 0.005). Subjective perception revealed complaints related to emotional concerns such as anxiety and fear in adults and due to alterations in routine in children and adolescents. Conclusion: The present study’s data showed an increased rate of sleep problems among families during quarantine both measured by validated instruments and also based on personal perception.

Resumo Paciente do sexo masculino, 67 anos, diabético, hipertenso, foi admitido no pronto-socorro com histórico de úlcera necrótica no maléolo externo esquerdo, sem pulsos poplíteos e distais palpáveis. A ultrassonografia Doppler arterial identificou oclusão femoropoplítea, com reenchimento da artéria poplítea infragenicular e perviedade da artéria fibular. Foi realizado procedimento endovascular, com necessidade de acesso retrógrado na artéria poplítea para restabelecer o fluxo sanguíneo e realizar implante de stent poplíteo. O sucesso técnico foi alcançado e, em seguida, o paciente foi submetido ao desbridamento da ferida. No segundo dia, cerca de 48 horas de pós-operatório, o paciente apresentou quadro respiratório com tosse e dispneia. Foi submetido a uma tomografia computadorizada do tórax, que identificou opacidades em vidro fosco e broncograma aéreo bilateralmente nos pulmões, com teste de reverse transcription – polymerase chain reaction (RT-PCR) positivo para SARS-Cov-2. O paciente foi transferido para uma unidade de terapia intensiva, necessitando de ventilação mecânica. Recebeu hidroxicloroquina e azitromicina. Apesar do tratamento em suporte intensivo, o paciente morreu 4 dias após o diagnóstico de COVID-19.

Abstract A 67-year-old male diabetic patient with systemic arterial hypertension was admitted to the emergency department with a necrotic ulcer in the left external malleolus and no palpable popliteal or pedal pulses. Arterial Duplex ultrasound identified femoropopliteal occlusion, with popliteal refilling below the knee and a patent peroneal artery. An endovascular procedure was performed, requiring retrograde access to the popliteal artery to re-establish blood flow and deploy a popliteal stent. Technical success was achieved and the patient underwent debridement of the wound. Two days later, about 48 hours after the operation, the patient began to exhibit respiratory symptoms, with coughing and dyspnea. He immediately underwent a chest CT that identified ground glass opacities, the crazy-paving pattern, and bilateral air bronchogram in the lungs. A reverse transcription – polymerase chain reaction (RT-PCR) test was positive for SARS-Cov-2. The patient was moved to an intensive care unit and put on mechanical ventilation. Both hydroxychloroquine and azithromycin were administered. Despite appropriate treatment, the patient died 4 days after he was diagnosed with COVID-19.

Abstract: Background: Acne in women is often associated with anxiety and depression, and may persist from adolescence as well as manifest for the first time in adulthood. Genetic and hormonal factors contribute to its etiopathogenesis, and maintenance treatment is required, usually for years, due to its clinical evolution. Objective: To develop a guide for the clinical practice of adult female acne. Methods: A team of five experts with extensive experience in acne conducted a literature review of the main scientific evidence and met to discuss the best practices and personal experiences to develop a guide containing recommendations for the clinical practice of adult female acne. Results: The group of specialists reached consensus on the main guidelines for clinical practice, providing detailed recommendations on clinical picture, etiopathogenesis, laboratory investigation and treatment of adult female acne. Conclusion: Different from teenage acne, adult female acne presents some characteristics and multiple etiopathogenic factors that make its management more complex. This guide provides recommendations for best clinical practices and therapeutic decisions. However, the authors consider that additional studies are needed in order to provide more evidence for adult female acne to be better understood.

RESUMO O objetivo deste estudo foi desenvolver um índice de qualidade de água modificado (IQAMod), por meio de análises multivariadas, e comparar com o índice utilizado pela Companhia Ambiental do Estado de São Paulo (Cetesb) (IQACETESB), para ser aplicado no Arroio Pelotas, Rio Grande do Sul, Brasil. Foram usados dados secundários de qualidade da água superficial do Arroio Pelotas, para o sítio de amostragem GER 48, localizado no município de Pelotas, monitorados e disponibilizados pela Fundação Estadual de Proteção Ambiental Henrique Luís Roessler (FEPAM), no período entre 1997 e 2013. Entre as análises multivariadas, empregou-se a análise fatorial (AF)/análise de componentes principais (ACP). Os resultados indicaram que a ACP extraiu duas componentes principais que explicaram 100% da variância total dos dados na matriz de correlação, enquanto os escores fatoriais para o cálculo do IQAMod foram extraídos do primeiro fator, que explicou 70,6% da variância total. Concluímos que o IQAMod mostrou demanda bioquímica de oxigênio (DBO5), turbidez (TH) e sólidos totais (ST) como as variáveis de mais importância na construção do índice, diferindo do IQACETESB, que apresentou as variáveis oxigênio dissolvido (OD), coliformes termotolerantes (CT) e potencial hidrogeniônico (pH) como as de mais relevância, demonstrando assim a necessidade da calibração do IQACETESB para aplicação nesse ecossistema específico.

ABSTRACT This research aimed at developing a modified water quality index (WQIMod) by using multivariate analysis, from a comparison with the WQI used by the Environmental Company of São Paulo (Companhia Ambiental do Estado de São Paulo-Cetesb) (IQACETESB), to be applied in the Pelotas Stream, RS, Brazil. Secondary data from Pelotas Stream surface water quality were used, collected in the sampling site GER 48, located in the municipality of Pelotas, where they were monitored and provided by the State Foundation of Environmental Protection Henrique Luís Roessler (Fundação Estadual de Proteção Ambiental Henrique Luís Roessler-FEPAM) between 1997 and 2013. Among the multivariate analyses, the factor analysis/principal component analysis (PCA) was used. The results indicated that the PCA extracted two principal components, which explained 100% of the total data variance in the correlation matrix, while the factorial scores for WQIMod calculation were extracted from the first factor, which explained 70.6% of the total data variance. We concluded that the WQIMod exhibits biochemical oxygen demand (BOD5), turbidity (TH) and total solids (TS) as the most important variables for the index construction, differing from the WQICETESB, which shows the variables dissolved oxygen (DO), thermotolerant coliforms (TC) and hydrogenionic potential (pH) as the most relevant ones, indicating the need of WQICETESB calibration for applying in this specific ecosystem.

ABSTRACT This study aims to describe the prevalence, distribution, and factors associated with soil-transmitted helminthiases (STHs) in rural localities in Piaui, Brazil. Two cross-sectional surveys (n=605 subjects; 172 families) were carried out in order to obtain socio-demographic, anthropometric, spatial and parasitological data. Parasites were evaluated using Kato-Katz and centrifugal sedimentation techniques. Eggs were measured to assess infection with zoonotic Strongylida parasites. Kernel maps were constructed with Q-GIS. The prevalence of hookworm infection was 12.4% (75/605). Other helminthes found were Trichuris trichiura (n=1; 0.2%) and Hymenolepis nana (n=1; 0.2%). The hookworm positivity rate was significantly lower among subjects who had used albendazole when compared with individuals who had not used anthelmintics or had used antiprotozoal drugs in the last 6 months (8/134 [6.0%] vs. 59/415 [14.2%]; p=0.009). A total of 39/172 (22.7%) families had at least one infected member. The association between the number of dwellers and hookworm positivity in the family was present in a logistic regression multivariate model. Assessment of worm burdens showed 92.2% light, 6.2% moderate, and 1.6% heavy infections. Hookworm eggs (n=34) measured 57.2 - 75.4 µm in length and 36.4 - 44.2 µm in width (mean ± SD = 65.86 ± 4.66 µm L and 40.05 ± 1.99 µm W), commensurate with human hookworms. Hotspots suggest that transmission has a focal pattern. STHs persist in impoverished rural areas in Northeastern Brazil where currently available control strategies (mass drug administration) apparently do not allow the elimination of the infection.

Our study evaluated how the consumption of diets with low (LOW group - 0.4/1) or high (CON group - 13.6/1) omega-6/omega-3 ratio across generations (F1 and F2) can modulate liver fatty acid (FA) profile and blood biomarkers. Liver content of α-linolenic acid was higher in animals always fed with LOW diet than animals that changed from CON to LOW diet, which by your time was higher than animals always fed with CON diet. Liver saturated FA concentration decreased in both groups from F1 to F2. In conclusion, both diets were efficient in decreasing the saturated FA liver content across generations, the LOW ratio diet was more effective in reducing blood triglycerides and non-esterified fatty acids, and there was a multigenerational effect of the LOW ratio diet, improving the FA profile even when the offspring start receiving the CON diet.

ResumoAs estrobilurinas estão entre os fungicidas mais comumente utilizados no controle das doenças do trigo, isoladamente ou em misturas com fungicidas inibidores da enzima succinato desidrogenase (IDHS). As estrobilurinas são conhecidas como fungicidas inibidores da quinona oxidase ou fungicidas IQo. Por ter como alvo um único sítio de ação nas células fúngicas, o gene mitocondrial cyt b, o emprego contínuo das estrobilurinas pode representar alto risco de emergência de resistência a estes fungicidas em populações de fitopatógenos. O presente trabalho teve como objetivo testar a hipótese de que a resistência a azoxistrobina no fungo Pyricularia oryzae dotrigo resultou em resistência cruzada a piraclostrobina, outro fungicida IQo. Para testar esta hipótese, foi comparado o nível de resistência à piraclostrobina apresentado por dois grupos de isolados do fungo P. oryzae do trigo: a) sensíveis à azoxistrobina e portadores do gene cyt b não mutante (haplotipo H9) e b) resistentes à azoxistrobina e portadores da mutação G143A no gene cyt b(haplotipo H1). Fungicidas pertencentes a um mesmo grupo químico apresentam resistência cruzada. Todos os isolados de P. oryzaedo trigo sensíveis à azoxistrobina foram também sensíveis à piraclostrobina. Os isolados resistentes a azoxistrobina foram, também, resistentes à piraclostrobina, indicando que há resistência cruzada para os dois fungicidas. Entre os isolados resistentes, distinguiram-se dois grupos fenotípicos: (A) altamente resistentes e (B) resistentes. Isolados de P. oryzaecom a presença da mutação G143A no gene cyt b foram 42 vezes mais resistentes à piraclostrobina. Esses altos níveis de resistência à fungicidas IQo podem ser o resultado de elevada pressão de seleção exercida pelos anos consecutivos de aplicações de estrobilurinas para o manejo de doenças do trigo no Brasil.

ABSTRACTStrobilurins are among the fungicides that are most commonly used in the control of wheat diseases, separately or in mixtures with fungicides that inhibit the enzyme succinate dehydrogenase (SDH). Strobilurins are known as quinone oxidoreductase inhibitors or QoI fungicides. As in fungal cells they have one single site of action as target, the mitochondrial cyt b gene, the continued use of strobilurins may represent a high risk of emergence of resistance to these fungicides for plant pathogens populations. This study aimed to test the hypothesis that resistance to azoxystrobin in the wheat blast fungus Pyricularia oryzae resulted in cross-resistance to pyraclostrobin, another QoI fungicide. To test this hypothesis, we compared the level of pyraclostrobin resistance presented by two groups of P. oryzae isolates from wheat: a) sensitive to azoxystrobin and carrier of the non-mutant cyt b gene (haplotype H9), and b) resistant to azoxystrobin and carrier of the G143A mutation in the cyt b gene (H1 haplotype). Fungicides belonging to the same chemical group show cross-resistance. All P.oryzae isolates sensitive to azoxystrobin were also sensitive to pyraclostrobin. Isolates that were resistant to azoxystrobin were also resistant to pyraclostrobin, indicating cross-resistance to both fungicides. Two phenotypic groups were distinguished among the resistant isolates: (A) highly resistant and (B) resistant. P. oryzae isolates with the presence of G143A mutation in the cyt b gene were 42 times more resistant to pyraclostrobin. These high levels of resistance to QoI fungicides may be the result of high selection pressure exerted by consecutive years of strobilurin application for the management of wheat diseases in Brazil.

FUNDAMENTOS: A utilização de antifúngicos tópicos na terapêutica da onicomicose é de grande valor na prática clínica, visto que há diferentes limitações ao uso das opções terapêuticas sistêmicas. OBJETIVO: Avaliar comparativamente a eficácia e a segurança de uma formulação de esmalte de ciclopirox a 8% em dois diferentes esquemas posológicos: o esquema tradicional (3/2/1) e um esquema posológico de uso semanal. MÉTODOS: Foi realizado um estudo cego, comparativo e randomizado que incluiu 41 pacientes, divididos em dois grupos, sendo o grupo I submetido ao esquema posológico de uma vez por semana e o grupo II submetido ao esquema posológico tradicional (3/2/1). Os grupos utilizaram a medicação por 180 dias. RESULTADOS: As espécies mais frequentemente encontradas nos grupos I e II foram Trichophyton rubrum (55% e 61,9%) e Trichophyton mentagrophytes (30% e 19%). Houve tendência de maior resistência ao tratamento pelo T. mentagrophytes nos dois grupos estudados, sem predileção por sexo, idade, proporção de acometimento ungueal inicial, tempo de evolução do quadro ou número de unhas acometidas por indivíduo. Ambas as modalidades apresentaram índices significativos de cura micológica, resposta clínica e sucesso terapêutico, e não houve diferença estatisticamente significante entre os grupos I e II (p > 0,05). CONCLUSÃO: O esmalte contendo ciclopirox a 8% mostrou-se igualmente eficaz na posologia de uma vez por semana quando comparada à posologia tradicional (3/2/1), permitindo um esquema posológico mais confortável.

BACKGROUND: The use of topical antifungal agents in the treatment of onychomycosis is of great value in clinical practice as there are different limitations regarding the use of systemic treatment. OBJECTIVE: To evaluate the efficacy and safety of a nail lacquer formulation containing ciclopirox 8% in two different posologies: the traditional regimen (3/2/1) and a regimen of weekly use. METHODS: A blind, randomized, comparative trial which included 41 patients divided into 02 groups, with Group I using the nail lacquer once weekly and Group II using the traditional regimen (3/2/1). Both groups applied the medication for 06 months. RESULTS: The species most frequently found in groups I and II were Trichophyton rubrum (55% and 61.9%) and Trichophyton mentagrophytes (30% and 19%). There was a tendency to a higher level of treatment resistance by T. mentagrophytes infection in both groups, without any predilection for sex, age, proportion of the nail affected at the beginning of the study, duration of the clinical disease and quantity of nails affected per person. Both groups had significant levels of mycological cure, clinical response and therapeutic success and there was no statistically significant difference between groups I and II (p >0.05). CONCLUSION: The nail lacquer containing ciclopirox 8% was equally effective at a weekly dose when compared to the traditional dosing (3/2/1), allowing a more comfortable regimen.

Devido ao crescente número de imigrantes nos EUA, composto por latinos, brasileiros, asiáticos e africanos, observou-se um aumento no interesse dessas comunidades em obter produtos que são comuns em seus países de origem. Para atender essa demanda houve um aumento nas importações de produtos étnicos e na produção interna dessas hortaliças. A mandioca é um bom exemplo do interesse em cultivos étnicos. As importações desse produto cresceram 370% nos últimos seis anos. A Universidade de Massachusetts iniciou suas pesquisas em 1996 com culturas populares entre os imigrantes de Porto Rico e Republica Dominicana e, em 2002, com os vegetais presentes na culinária brasileira. Este trabalho sumariza as informações disponíveis atualmente em relação às necessidades dos imigrantes brasileiros em termos de hortaliças de cunho cultural, identifica as cadeias fornecedoras existentes, explica os impactos da mídia sobre o mercado étnico e descreve as práticas de aquisição de produtos específicos demandados pelos consumidores brasileiros. Pesquisas mostraram que a maioria dos imigrantes brasileiros eram provenientes do estado de Minas Gerais e devido a esse fator, as culturas escolhidas foram jiló, maxixe, taioba, abóbora e quiabo. Para a introdução dos produtos no mercado é necessário focar grande parte das atenções no marketing e divulgação. Apesar de existir uma demanda, esses vegetais não são normalmente encontrados nos mercados, sendo necessário informar onde e quais produtos estão disponíveis. O melhor meio de divulgação entre os brasileiros é através da emissora de TV Rede Globo, porém outros meios como jornais e rádios em língua portuguesa são eficientes e mais acessíveis. A exportação de produtos étnicos para os EUA é um mercado crescente, porém para entrar nesse mercado é necessário compreender a cadeia de distribuição de vegetais frescos nos EUA. Além disso, os donos das grandes cadeias de supermercados desconhecem os vegetais étnicos, sendo muitas vezes uma barreira para a comercialização dos mesmos.

Due to the growing number of immigrants in the United States, made up principally of Latinos, Asians and Africans, there has been a growing demand for products that are popular in their countries of origin. In order to meet this demand, there has been a tremendous increase in imports of agricultural products to the United States. Cassava is a good example. Imports of cassava to the US have increased 370% in the last six years. The University of Massachusetts began to evaluate vegetable crops popular among Puerto Ricans and Dominicans in 1996, and in 2002 began to evaluate crops popular among the large and growing Brazilian population in the state and region. This paper summarizes results of research on crops popular with Brazilian immigrants in the US, in addition to the evaluation of the marketing chain and impact of media outlets to promote and sell these crops. Surveys of Brazilian customers in target markets demonstrated that the majority of Brazilian immigrants in the Northeastern United States are from the state of Minas Gerais. Due to this fact, the crops chosen for research in Massachusetts were ones that were popular in this state: jiló, maxixe, taioba, abóbora and okra. In order to successfully introduce these crops into the marketplace it is critical to devote resources to promotion and marketing. In spite of their popularity among Brazilians, these vegetable crops are not normally found in the market so it is necessary to let the community know that they are available and in what locations. The most effective media outlet evaluated in this work to reach Brazilians was the television station Rede Globo International, available in the United States; however, other avenues evaluated to promote this project to Brazilians, such as Brazilian newspapers and radio programs, were also effective and less expensive. The opportunity to export agricultural products to the United States is a growing opportunity for farmers in Brazil. In order to gain access to this market it is important to understand the distribution system used for fresh produce in the United States.

O objetivo deste estudo foi descrever e comparar as pregas cutâneas triciptal (PCT) e subescapular (PCS) de acordo com características demográficas, sócio-econômicas, comportamentais e biológicas em adolescentes de Pelotas, Rio Grande do Sul, Brasil. Realizou-se um estudo transversal aninhado a uma coorte de nascimentos (N = 4.452; média de idade = 11 anos). Os desfechos foram apresentar prega cutânea maior ou igual ao percentil 90 da curva de referência do National Center for Health Statistics. A prevalência de PCT e PCS elevada foi, respectivamente, de 20,2% e 17,3% nos meninos e de 14,2% e 10,5% nas meninas. O fator mais fortemente associado com adiposidade nos meninos foi o nível econômico (p < 0,001) e entre as meninas foi o índice de massa corporal materno (p < 0,001). Baixo nível de atividade física (< 300 minutos/semana) esteve associado com PCS elevadas somente entre as meninas, enquanto que escolaridade se associou à PCT e PCS elevada somente entre os meninos. Dieta, cor da pele e comportamento sedentário não se associaram com nenhum dos desfechos. Concluiu-se que os principais preditores de adiposidade foram características maternas e sócio-econômicas. Recomendam-se investigações utilizando-se outras técnicas de composição corporal para confirmação dos achados deste estudo.

The objective of this study was to describe and compare the tricipital (TSF) and subscapular skinfold (SSF) thickness according to demographic, socioeconomic, behavioral, and biological characteristics in adolescents from Pelotas, Rio Grande do Sul State, Brazil. A cross-sectional study nested in a birth cohort (n = 4,452; mean age = 11 years) was conducted. The outcomes were defined as skinfold thickness > 90th percentile of the National Center for Health Statistics reference curve. The prevalence rates for elevated TSF and SSF were 20.2% and 17.3%, respectively, in boys and 14.2% and 10.5% in girls. The strongest factor associated with adiposity in boys was socioeconomic status (p < 0.001), whereas among girls it was maternal body mass index (p < 0.001). Low physical activity (< 300 minutes/week) was associated with elevated SSF only among girls, while schooling was associated with increased TSF and SSF only among boys. Diet, skin color, and sedentary behavior were not associated with any of the outcomes. We concluded that the main predictors of adiposity were maternal and socioeconomic characteristics. We recommend that further studies on this issue apply other methods to estimate body composition in order to confirm our results.

O objetivo deste estudo foi descrever e comparar as pregas cutâneas triciptal (PCT) e subescapular (PCS) de acordo com características demográficas, sócio-econômicas, comportamentais e biológicas em adolescentes de Pelotas, Rio Grande do Sul, Brasil. Realizou-se um estudo transversal aninhado a uma coorte de nascimentos (N = 4.452; média de idade = 11 anos). Os desfechos foram apresentar prega cutânea maior ou igual ao percentil 90 da curva de referência do National Center for Health Statistics. A prevalência de PCT e PCS elevada foi, respectivamente, de 20,2% e 17,3% nos meninos e de 14,2% e 10,5% nas meninas. O fator mais fortemente associado com adiposidade nos meninos foi o nível econômico (p < 0,001) e entre as meninas foi o índice de massa corporal materno (p < 0,001). Baixo nível de atividade física (< 300 minutos/semana) esteve associado com PCS elevadas somente entre as meninas, enquanto que escolaridade se associou à PCT e PCS elevada somente entre os meninos. Dieta, cor da pele e comportamento sedentário não se associaram com nenhum dos desfechos. Concluiu-se que os principais preditores de adiposidade foram características maternas e sócio-econômicas. Recomendam-se investigações utilizando-se outras técnicas de composição corporal para confirmação dos achados deste estudo.

The objective of this study was to describe and compare the tricipital (TSF) and subscapular skinfold (SSF) thickness according to demographic, socioeconomic, behavioral, and biological characteristics in adolescents from Pelotas, Rio Grande do Sul State, Brazil. A cross-sectional study nested in a birth cohort (n = 4,452; mean age = 11 years) was conducted. The outcomes were defined as skinfold thickness > 90th percentile of the National Center for Health Statistics reference curve. The prevalence rates for elevated TSF and SSF were 20.2% and 17.3%, respectively, in boys and 14.2% and 10.5% in girls. The strongest factor associated with adiposity in boys was socioeconomic status (p < 0.001), whereas among girls it was maternal body mass index (p < 0.001). Low physical activity (< 300 minutes/week) was associated with elevated SSF only among girls, while schooling was associated with increased TSF and SSF only among boys. Diet, skin color, and sedentary behavior were not associated with any of the outcomes. We concluded that the main predictors of adiposity were maternal and socioeconomic characteristics. We recommend that further studies on this issue apply other methods to estimate body composition in order to confirm our results.