ABSTRACT The emergence of HIV abruptly impacted health services in 1981, initially affecting restricted social groups. Currently, with the development of antiretroviral therapy, we are faced with a different disease from the one seen in the 80s, now with a chronic evolution. However, some barriers remain the same, such as the social, mental and physical impact of the diagnosis on the life of the person living with HIV. The objective of the present study was to verify the viral load, CD4+ lymphocyte count, and quality of life of people living with the human immunodeficiency virus. This was a cross-sectional observational research with a sample of 24 individuals of both sexes, with positive serology for HIV, in medical follow-up under antiretroviral treatment. A specific instrument was used to collect sociodemographic information. CD4+ count and HIV viral load results were collected from patients’ medical records. Quality of life (QoL) was assessed using the WHOQOL-HIV-BREF. Descriptive analysis was used to characterise the sample profile. Participants (46.8± 9.2 years) have completed high school (41.8%), with an income of one to three minimum wages (37.5%). They present a three-year diagnosis and CD4 lymphocyte count above 500 mm3 of blood (75%). Regarding QoL, the participants had a higher average for the physical domain (26.7± 5.3) and lower averages for the environment domains (10.9± 2.7) and social relationships (12.2± 2.8). The study concludes that the people living with HIV who participated in the study are young adults, with low income and level of education, with a low quality of life in relation to the environment and social relations domains.

RESUMO O surgimento do HIV impactou os serviços de saúde abruptamente em 1981, inicialmente afetando grupos sociais restritos. Atualmente, com o desenvolvimento da terapia antirretroviral, nos deparamos com uma doença diferente da encarada na década de 80, agora com uma evolução crônica. Todavia, algumas barreiras permanecem as mesmas, como o impacto social, mental e físico do diagnóstico na vida da pessoa que vive com HIV. O objetivo do presente estudo é verificar carga viral, contagem de linfócitos CD4+, e qualidade de vida de pessoas que vivem com o vírus da imunodeficiência humana. A presente pesquisa trata-se de um estudo observacional transversal com amostra de 24 indivíduos de ambos os sexos, com sorologia positiva para HIV, em acompanhamento médico sob tratamento antirretroviral. Foi utilizado um instrumento próprio para a coleta de informações sociodemográficas. Os resultados de contagem de CD4+ e a Carga Viral do HIV foram coletados dos prontuários médicos dos pacientes. A Qualidade de vida (QV) foi avaliada através do WHOQOL-HIV-BREF. Foi utilizada a análise descritiva para a caracterização do perfil da amostra. Os participantes (46,8± 9,2 anos) possuem ensino médio completo (41,8%), com renda de um a três salários mínimos (37,5%). Apresentam de um a três anos de diagnóstico e contagem de linfócitos CD4 acima de 500 mm3 de sangue (75%). Em relação à QV, os participantes apresentaram média mais alta para o domínio físico (26,7± 5,3) e mais baixa para os domínios de meio ambiente (10,9± 2,7) e relações sociais (12,2± 2,8). O estudo conclui que as pessoas que vivem com HIV participantes do estudo são adultos jovens, com renda e nível de escolaridade baixas, apresentam baixa qualidade de vida em relação aos domínios meio ambiente e relações sociais.

ABSTRACT Given the chronicity of HIV infection, psychosocial factors emerge as potentiators for the elevation of stress levels in PLHIV, as well as for the immunological imbalance and elevation of the viral load. The present research objective was to evaluate the stress level, TCD4+ lymphocyte count and viral load of people living with HIV undergoing ART, treated at a public university hospital. This was an observational, cross-sectional research with 25 patients (40.76 years± 9.88 years) living with HIV treated at the outpatient clinic of a public hospital in Rio de Janeiro. A sociodemographic questionnaire was used to characterise the sample. Stress was evaluated through the LIPP Stress Symptom Inventory and observed in recent laboratory tests. Stress was identified in 68% of the participants, with a predominance of physical symptoms and a resistance phase. There was a higher prevalence of stress in people with low socioeconomic status, unemployment and recent diagnosis. Lower levels of CD4+ T lymphocytes or higher viral load were not observed in people with stress.

RESUMO Diante da cronificação da infecção pelo HIV, fatores psicossociais surgem como potencializadores para elevação dos níveis de estresse nas PVHIV, bem como para o desequilíbrio imunológico e elevação da carga viral. O objetivo da presente pesquisa foi avaliar o nível de estresse, a contagem de linfócitos TCD4 + e a carga viral de pessoas vivendo com HIV submetidas a TARV, atendidas em um hospital público universitário. Tratou-se de um estudo observacional, transversal com 25 pacientes (40,76 anos± 9,88 anos) que vivem com HIV atendidos no ambulatório de um hospital público do Rio de Janeiro. Foi utilizado um questionário sociodemográfico para caracterização da amostra, o estresse foi avaliado através do Inventário de Sintomas de Stress de LIPP e observados exames laboratoriais recentes. Foi identificado estresse em 68% dos participantes, com predomínio de sintomas físicos e fase de resistência. Houve maior prevalência de estresse em pessoas com baixo nível socioeconômico, desemprego e diagnóstico recente. Não foram observados menores níveis de linfócitos TCD4 + ou maior carga viral nas pessoas com estresse.

Abstract Drag crisis has been described as a drop in the drag coefficient (Cd). This procedure was lately assessed in able-bodied cyclists in time trial position by computational fluid dynamics (CFD). Therefore, the aim of this study was to assess the phenomenon of the drag crisis by computer fluid dynamics in transradial and transtibial amputee cyclists in the upright position. A male elite-level cyclist was recruited for this research. The subject was scanned (3D geometry with a 3D Scan) with his competition bicycle, helmet, suit, and shoes. Consequently, transradial and transtibial 3D models were created editing the able-bodied 3D model. To perform the CFD analyses, a domain measuring 7 x 2.5 x 2.5 m (length, width and height, respectively) was created around each bicycle-cyclist model. The domains were meshed with more than 42 million elements. Numerical simulations by CFD were performed in fluent numerical for speeds between 1 m/s and 13 m/s, with increments of 1 m/s. The total Cd decreased with speed. It ranged from 0.84 to 0.55 in the able-bodied, 0.86 to 0.64 in the transradial and 0.90 to 0.61 in the transtibial. The drag crisis phenomenon was observed between 1m/s and 4m/s in all models.

ABSTRACT. Two experiments were carried out to evaluate the effects of protease addition to the diet of broilers at a higher level (1× or 2×) than the nutritional value proposed for the enzyme. The first experiment, 1280 day-old chicks (Cobb500®) were randomly allocated (randomized block design, 2×2+1 factorial arrangement), five treatments, eight replicates containing 32 birds/replicate. Treatments consisted: control diet without protease (CD); CD + 1× nutritional value of the enzyme (CDM1); CD + 2× nutritional value of the enzyme (CDM2); CDM1 + protease; and CDM2 + protease. The experimental period was 42 days. The mean weight (AFW), feed intake (FI), weight gain (WG), feed conversion, and carcass yield were evaluated. Significant differences were observed for AFW, WG, FI, abdominal fat yield, and feet percentage in the carcass. In the second experiment, 120 Cobb500® chicks at 14 days of age were allotted in a completely randomized design, 2×2+1 factorial arrangement, five treatments, six replicates with four birds/replicate. The treatments were consistent with the first experiment. Significant improvements in the nitrogen balance were observed for the broilers that received protease. The use of the enzyme tested is recommended with the recommended nutritional matrix, improving the zootechnical indices of broilers.

Mental disorders such as anxiety, depression, and memory loss have been described in patients with chronic Chagas disease (CD), a neglected tropical disease caused by the protozoan parasite Trypanosoma cruzi. Social, psychological, and biological stressors may take part in these processes. There is a consensus on the recognition of an acute nervous form of CD. In chronic CD patients, a neurological form is associated with immunosuppression and neurobehavioural changes as sequelae of stroke. The chronic nervous form of CD has been refuted, based on the absence of histopathological lesions and neuroinflammation; however, computed tomography shows brain atrophy. Overall, in preclinical models of chronic T. cruzi infection in the absence of neuroinflammation, behavioural disorders such as anxiety and depression, and memory loss are related to brain atrophy, parasite persistence, oxidative stress, and cytokine production in the central nervous system. Interferon-gamma (IFNγ)-bearing microglial cells are colocalised with astrocytes carrying T. cruzi amastigote forms. In vitro studies suggest that IFNγ fuels astrocyte infection by T. cruzi and implicate IFNγ-stimulated infected astrocytes as sources of TNF and nitric oxide, which may also contribute to parasite persistence in the brain tissue and promote behavioural and neurocognitive changes. Preclinical trials in chronically infected mice targeting the TNF pathway or the parasite opened paths for therapeutic approaches with a beneficial impact on depression and memory loss. Despite the path taken, replicating aspects of the chronic CD and testing therapeutic schemes in preclinical models, these findings may get lost in translation as the chronic nervous form of CD does not fulfil biomedical model requirements, as the presence of neuroinflammation, to be recognised. It is hoped that brain atrophy and behavioural and neurocognitive changes are sufficient traits to bring the attention of researchers to study the biological and molecular basis of the central nervous system commitment in chronic CD.

Résumé Dans le cadre de Music in the Community, les projets d'intervention doivent être un moteur de développement personnel et de changement social, impliquant la "fabrication" de musique de manière collaborative à travers des actes de co-création entre l'animateur et les participants. Au Portugal, les projets de ce type sont encore peu connus. Cet article vise à présenter le processus développé dans le cadre d'un projet musical avec des personnes handicapées. Encadré dans l'unité curriculaire de Projet musical d'intervention communautaire II du diplôme Musique dans la communauté de l'ESELx, le projet "En AFID je suis heureux !" a été mis en œuvre entre le 5 novembre 2020 et le 27 mai 2021 à la Fondation AFID Diferença, établie par l'Association nationale des familles pour l'intégration des personnes handicapées (AFID). Le cadre conceptuel de la méthodologie de projet a été utilisé pour concevoir et mettre en œuvre cette intervention. Le processus a abouti à la présentation de trois objets artistiques: un CD avec des créations musicales originales, un spectacle et une installation visuelle. Tout au long de ce projet, l'importance de l'écoute et de l'intervention active de tous les agents est devenue évidente. Il est urgent de diffuser et de réfléchir au rôle de ce type de projet afin que les processus de transformation puissent avoir lieu dans davantage de communautés et être significatifs en termes de bien-être maximal des personnes.

Abstract In the context of Music in the Community, intervention projects should be a driver for personal development and social change, involving collaborative music "making" through acts of co-creation between the facilitator and participants. In Portugal, projects of this kind are still little known. This article aims to present the process developed in a musical project with people with disabilities. The project " Na AFID eu sou Feliz!” was implemented between November 5, 2020, and May 27, 2021, at the Fundação AFID Diferença, established by the Associação Nacional de Famílias para a Integração de Pessoa Deficiente (AFID). The conceptual framework of the Project Methodology was adopted to design and implement this intervention. The process culminated in the presentation of three artistic objects: a CD with original musical creations, a show, and a visual installation. Throughout this project, the importance of listening and the active intervention of all agents became evident. It is urgent to disseminate and reflect on the role of this type of project so that transformation processes can take place in more communities and be meaningful in terms of people's maximum well-being.

Resumen En el ámbito de la Música en la Comunidad, los proyectos de intervención deben ser un motor de desarrollo personal y de cambio social, implicando el "hacer" música de forma colaborativa a través de actos de co-creación entre el facilitador y los participantes. En Portugal, los proyectos de este tipo son todavía poco conocidos. Este artículo pretende presentar el proceso desarrollado en un proyecto musical con personas con discapacidad. Enmarcado en la unidad curricular de Proyecto Musical de Intervención Comunitaria II de la carrera de Música en la Comunidad de la ESELx, el proyecto "En AFID soy Feliz!" fue implementado entre el 5 de noviembre de 2020 y el 27 de mayo de 2021 en la Fundación AFID Diferença, establecida por la Associação Nacional de Famílias para a Integração de Pessoa Deficiente (AFID). El marco conceptual de la Metodología de Proyectos se utilizó para diseñar y aplicar esta intervención. El proceso culminó con la presentación de tres objetos artísticos: un CD con creaciones musicales originales, un espectáculo y una instalación visual. A lo largo de este proyecto se puso de manifiesto la importancia de la escucha y la intervención activa de todos los agentes. Es urgente difundir y reflexionar sobre el papel de este tipo de proyectos para que los procesos de transformación tengan lugar en más comunidades y sean significativos en términos de máximo bienestar de las personas.

Resumo No âmbito da Música na Comunidade, os projetos de intervenção devem ser um motor de desenvolvimento pessoal e mudança social, envolvendo o “fazer” música de forma colaborativa através de atos de cocriação entre o facilitador e os participantes. Em Portugal, projetos deste teor são ainda pouco divulgados. Este artigo tem como objetivo apresentar o processo desenvolvido num projeto musical com pessoas com deficiência. Enquadrado na Unidade Curricular de Projeto Musical de Intervenção Comunitária II da Licenciatura em Música na Comunidade da Escola Superior de Educação de Lisboa (ESELx), o projeto “Na AFID eu sou Feliz!” foi implementado entre 5 de novembro de 2020 e 27 de maio de 2021 na Fundação AFID Diferença, instituída pela Associação Nacional de Famílias para a Integração de Pessoa Deficiente (AFID). Para delineamento e concretização desta intervenção foi adotada a grelha conceptual da Metodologia de Projeto. O processo culminou na apresentação de três objetos artísticos: um CD com criações musicais originais, um espetáculo e uma instalação visual. Ao longo deste projeto, constatou-se a importância da escuta e da intervenção ativa de todos os agentes. É urgente divulgar e refletir sobre o papel deste tipo de projetos para que os processos de transformação possam ter lugar em mais comunidades e sejam significativos em termos do bem-estar máximo das pessoas.

Resumen: Se realizó un estudio para evaluar la variación en el pH, la disponibilidad y las asociaciones químicas de Cd en dos Latosoles previamente contaminados, modificados con enmiendas minerales y orgánicas. Los Latosoles fueron contaminados con Cd y enmendados con vermicompost, torta de filtro de caña de azúcar, torta de palmiste, cal, roca fosfórica y zeolita. La disponibilidad de cadmio se evaluó mensualmente en las mezclas de suelo contaminadas / enmienda de suelo, empleando los extractantes DTPA y Mehlich-3 durante doce meses de incubación. Al final de este período, se realizó un procedimiento de extracción secuencial en las mezclas para identificar las formas de Cd presentes en las diversas fracciones geoquímicas. La cal inmovilizó el Cd en una extensión mayor (60%), siendo el metal transferido a las fracciones menos disponibles. El extractante Mehlich-3 tuvo una alta correlación (0.96 **) con la fracción disponible examinada por el procedimiento de extracción secuencial. En general, las enmiendas orgánicas produjeron pequeños efectos sobre el pH final de las mezclas suelo / enmiendas del suelo, en comparación con el pH inicial del suelo. Las enmiendas minerales mejoraron el pH del suelo y el efecto más pronunciado se produjo con el uso de cal.

Summary: A study was performed to evaluate the variation in pH, availability, and chemical associations of Cd in two previously contaminated Latosols amended with mineral and organic amendments. The Latosols were contaminated with Cd and amended with vermicompost, sugarcane filter cake, palm kernel pie, lime, phosphate rock, or zeolite. Cadmium availability was evaluated monthly in the contaminated soil/soil amendment mixtures with the DTPA and Mehlich-3 extractants for twelve months of incubation. At the end of this period, a sequential extraction procedure was performed in the mixtures to identify the Cd forms present in the several geochemical fractions. Lime immobilized Cd at a larger extension (60%), being the metal transferred to less available fractions. The Mehlich-3 extractant had a high correlation (0.96**) with the available fraction examined by the sequential extraction procedure. In general, organic amendments produced small effects on the final pH of soil/soil amendment mixtures as compared with the initial soil pH. Mineral amendments caused enhancement of soil pH and the most pronounced effect occurred with the use of lime.

Resumo O artigo tem por objetivo analisar as histórias de vida de portadores de doença de Chagas (DC), para evidenciar em suas narrativas elementos e possibilidades de enfrentamento dessa problemática. Causada pelo protozoário Trypanosoma cruzi, a DC combina condições de infecção assintomática e/ou de progressão para doença de acordo com determinantes biológicos e sociais e afeta 6 a 7 milhões de pessoas infectadas. No mundo anualmente 6 mil pessoas em consequência das complicações na fase crônica da DC. Realizamos um estudo qualitativo com uso da técnica de história de vida coletadas em entrevistas abertas, coletando um material riquíssimo para trabalhar o contexto da doença em múltiplas dimensões. Associamos uma escuta sensível com a necessidade das pessoas vivendo com a DC darem força à sua voz, valorizando sua própria história de vida, transformando-as em detendoras de sua história e de seu conhecimento. A visibilidade emergiu e prevaleceu, expondo a própria doença como tema central e dois subtemas gerais: suas percepções sobre a doença e a sua própria vida, no contexto da doença. Identificamos a necessidade de (re)pensar a problemática da doença de Chagas como algo visível e presente.

Abstract The scope of this article is to analyze the life histories of Chagas disease (CD) patients, searching for elements in their narratives that might present possibilities for coping with this problem. Caused by the protozoan Trypanosoma cruzi, Chagas disease combines conditions of infection and/or progression to disease, in accordance with biological and social determinants and affects around 6 to 7 million people infected with T. cruzi. More than 6,000 people die each year due to complications in the chronic CD phase. This is a qualitative study using the life history technique that was used in open interviews. We collected a wealth of material with which we can work on the context of the disease in multiple dimensions. We associate sensitive listening with the needs of people living with the CD to give strength to their voice, valuing their own life story, transforming them into masters of their history and knowledge. Visibility emerged and prevailed, exposing the disease itself as a central theme and two general sub-themes: their perceptions about the disease and their own life, in the context of the disease. We identified the need to (re)think the problem of Chagas disease as something visible and present.

Resumo O artigo tem por objetivo analisar as histórias de vida de portadores de doença de Chagas (DC), para evidenciar em suas narrativas elementos e possibilidades de enfrentamento dessa problemática. Causada pelo protozoário Trypanosoma cruzi, a DC combina condições de infecção assintomática e/ou de progressão para doença de acordo com determinantes biológicos e sociais e afeta 6 a 7 milhões de pessoas infectadas. No mundo anualmente 6 mil pessoas em consequência das complicações na fase crônica da DC. Realizamos um estudo qualitativo com uso da técnica de história de vida coletadas em entrevistas abertas, coletando um material riquíssimo para trabalhar o contexto da doença em múltiplas dimensões. Associamos uma escuta sensível com a necessidade das pessoas vivendo com a DC darem força à sua voz, valorizando sua própria história de vida, transformando-as em detendoras de sua história e de seu conhecimento. A visibilidade emergiu e prevaleceu, expondo a própria doença como tema central e dois subtemas gerais: suas percepções sobre a doença e a sua própria vida, no contexto da doença. Identificamos a necessidade de (re)pensar a problemática da doença de Chagas como algo visível e presente.

Abstract The scope of this article is to analyze the life histories of Chagas disease (CD) patients, searching for elements in their narratives that might present possibilities for coping with this problem. Caused by the protozoan Trypanosoma cruzi, Chagas disease combines conditions of infection and/or progression to disease, in accordance with biological and social determinants and affects around 6 to 7 million people infected with T. cruzi. More than 6,000 people die each year due to complications in the chronic CD phase. This is a qualitative study using the life history technique that was used in open interviews. We collected a wealth of material with which we can work on the context of the disease in multiple dimensions. We associate sensitive listening with the needs of people living with the CD to give strength to their voice, valuing their own life story, transforming them into masters of their history and knowledge. Visibility emerged and prevailed, exposing the disease itself as a central theme and two general sub-themes: their perceptions about the disease and their own life, in the context of the disease. We identified the need to (re)think the problem of Chagas disease as something visible and present.

Resumen Introducción: la enfermedad inflamatoria intestinal (EII) es una enfermedad inmunomediada, cuya incidencia en Latinoamérica ha aumentado en los últimos años. Objetivo: analizar las características demográficas y clínicas de los pacientes con EII tratados en un hospital universitario y presentar los datos epidemiológicos con respecto a otros centros en Colombia. Pacientes y métodos: estudio descriptivo de pacientes con EII (1996-2019) en el Hospital Universitario Fundación Santa Fe de Bogotá. Análisis de datos de centros de Medellín, Cali, Bogotá y Cartagena. Resultados: de 386 pacientes, 277 presentaron colitis ulcerativa (CU), 102 enfermedad de Crohn (EC) y 7 colitis no clasificable. La EII fue más frecuente en mujeres (53 %). La mortalidad fue menor de 1 %. El compromiso de la CU fue principalmente la pancolitis (42,6 %). Entre mayor la extensión de la enfermedad, más alta fue la tasa de hospitalización y cirugías (OR 3,70; p < 0,01). El 13 % de los pacientes con CU recibió biológicos. El compromiso por la EC fue principalmente ileocolónico (43,6 %) e ileal (43,6 %). El patrón clínico predominante de la EC fue estenosante (50%). El 45 % recibió biológicos y 56% cirugía. La colangitis esclerosante primaria (CEP) se encontró en 4 % de los pacientes (n = 15). Dos pacientes con CEP desarrollaron cáncer colorrectal (OR 4,18; p 0,008), mientras que 13 pacientes con CU desarrollaron cáncer de colon y 7 cambios displásicos. 3 pacientes con EC desarrollaron cáncer de colon. Conclusiones: se compararon los resultados en relación con otros centros de referencia. Encontramos tendencias similares en el comportamiento clínico y en el tratamiento de la EII, con mayores tazas de hospitalizaciones y cirugías en nuestros casos.

Abstract Introduction: Inflammatory bowel disease (IBD) is an immune-mediated disease whose incidence in Latin America has increased in recent years. Aim: To analyze the demographic and clinical characteristics of patients with IBD treated in a university hospital and present the epidemiological data compared to other centers in Colombia. Patients and methods: Descriptive study of patients with IBD (1996-2019) at the Hospital Universitario Fundación Santa Fe de Bogotá. Analysis of data from centers in Medellín, Cali, Bogotá, and Cartagena. Results: Of 386 patients, 277 presented with ulcerative colitis (UC), 102 with Crohn’s disease (CD), and seven with unclassifiable colitis. IBD was more frequent in women (53 %). Mortality was less than 1 %. The involvement of UC was mainly pancolitis (42.6 %). The greater the extent of the disease, the higher the hospitalization and surgery rates (OR 3.70, P < 0.01). Thirteen percent of patients with UC received biologics. Compromise due to CD was mainly ileocolonic (43.6 %) and ileal (43.6 %). The predominant clinical pattern of CD was structuring (50%). Forty-five percent received biologicals and 56 % surgery. Primary sclerosing cholangitis (PSC) was found in 4 % of patients (n = 15). Two patients with PSC developed colorectal cancer (OR 4.18; p 0.008), while 13 patients with UC developed colon cancer and seven dysplastic changes. Three patients with CD developed colon cancer. Conclusions: The results were compared to other reference centers. We found similar trends in the clinical behavior and treatment of IBD, with higher hospitalization and surgery rates in our cases.

ABSTRACT Chagas disease (CD) is a neglected tropical disease associated with poverty in which patients are surrounded by stigma. These factors can contribute to reducing health-related quality of life (HRQoL). Therefore, a broad discussion of HRQoL in the CD population is required. This study aimed to discuss the main findings of HRQoL in patients with CD, focusing on the association between sociodemographic and lifestyle factors, echocardiographic and functional determinants, and the effect of non-invasive interventions on HRQoL. A literature search of the MEDLINE, Web of Science, CINAHL, Scopus, and LILACS databases was performed with no data or language restrictions. Twenty-two articles were included in this meta-analysis. In general, HRQoL is worse in patients with CD than in healthy individuals, particularly in the presence of cardiovascular and/or gastrointestinal symptoms. Sex, age, functional class, level of physical activity, healthy habits, and medications received could affect HRQoL. Among the echocardiographic and functional determinants, decreased systolic function seems to negatively affect HRQoL. No association with the peak oxygen uptake was observed in the maximal tests. By contrast, well-tolerated field tests with submaximal intensities were associated with HRQoL. Both pharmaceutical care and exercise training have a positive effect on the HRQoL of patients with Chagas cardiomyopathy, and the mental component can be a prognostic marker in this population. In conclusion, assessment of HRQoL can provide important information about the health status of patients with CD, and its use in clinical practice is warranted.

Resumo A Doença de Chagas (DC) é reconhecida pela Organização Mundial da Saúde como uma das treze doenças tropicais mais negligenciadas do mundo. A autopercepção de saúde é considerada um melhor preditor de mortalidade do que medidas objetivas do estado de saúde, e o contexto em que se vive influencia esse preditor. O objetivo deste estudo foi avaliar a prevalência e os fatores individuais e contextuais associados à pior autopercepção em saúde de pacientes com DC de uma região endêmica do Brasil. É um estudo transversal multinível. Os dados individuais vêm de um corte transversal de um estudo de coorte denominado SaMi-Trop. Os dados contextuais foram coletados a partir de plataformas e sistemas de informações institucionais acessíveis ao público. A variável dependente foi a autopercepção de saúde. A análise foi realizada por meio de regressão logística binária multinível. Participaram do estudo 1.513 pacientes com DC, sendo 335 (22,1%) com pior autopercepção de saúde. Este estudo revelou a influência da organização/oferta do serviço público de saúde brasileiro e de características individuais na autopercepção de saúde de pacientes com DC.

Abstract Chagas disease (CD) is recognized by the World Health Organization as one of the thirteen most neglected tropical diseases in the world. Self-perceived health is considered a better predictor of mortality than objective measures of health status, and the context in which one lives influences this predictor. This study aimed to evaluate the prevalence and individual and contextual factors associated with poor self-rated health among CD patients from an endemic region in Brazil. It is a multilevel cross-sectional study. The individual data come from a cross-section of a cohort study named SaMi-Trop. Contextual data was collected from publicly accessible institutional information systems and platforms. The dependent variable was self-perceived health. The analysis was performed using multilevel binary logistic regression. The study included 1,513 patients with CD, where 335 (22.1%) had Poor self-rated health. This study revealed the influence of the organization/offer of the Brazilian public health service and of individual characteristics on the self-perceived health of patients with CD.

Resumo A Doença de Chagas (DC) é reconhecida pela Organização Mundial da Saúde como uma das treze doenças tropicais mais negligenciadas do mundo. A autopercepção de saúde é considerada um melhor preditor de mortalidade do que medidas objetivas do estado de saúde, e o contexto em que se vive influencia esse preditor. O objetivo deste estudo foi avaliar a prevalência e os fatores individuais e contextuais associados à pior autopercepção em saúde de pacientes com DC de uma região endêmica do Brasil. É um estudo transversal multinível. Os dados individuais vêm de um corte transversal de um estudo de coorte denominado SaMi-Trop. Os dados contextuais foram coletados a partir de plataformas e sistemas de informações institucionais acessíveis ao público. A variável dependente foi a autopercepção de saúde. A análise foi realizada por meio de regressão logística binária multinível. Participaram do estudo 1.513 pacientes com DC, sendo 335 (22,1%) com pior autopercepção de saúde. Este estudo revelou a influência da organização/oferta do serviço público de saúde brasileiro e de características individuais na autopercepção de saúde de pacientes com DC.

Abstract Chagas disease (CD) is recognized by the World Health Organization as one of the thirteen most neglected tropical diseases in the world. Self-perceived health is considered a better predictor of mortality than objective measures of health status, and the context in which one lives influences this predictor. This study aimed to evaluate the prevalence and individual and contextual factors associated with poor self-rated health among CD patients from an endemic region in Brazil. It is a multilevel cross-sectional study. The individual data come from a cross-section of a cohort study named SaMi-Trop. Contextual data was collected from publicly accessible institutional information systems and platforms. The dependent variable was self-perceived health. The analysis was performed using multilevel binary logistic regression. The study included 1,513 patients with CD, where 335 (22.1%) had Poor self-rated health. This study revealed the influence of the organization/offer of the Brazilian public health service and of individual characteristics on the self-perceived health of patients with CD.

Resumo Estimar os custos e a compatibilidade dos incentivos públicos de duas tecnologias para o tratamento da mandíbula edêntula: prótese total convencional (PTC) e overdenture retida por dois implantes (OD). Este estudo consistiu em uma avaliação econômica parcial, com abordagem “bottom-up” para o cálculo dos custos diretos. As estimativas levaram em consideração o número de consultas, proporção de materiais, equipamentos, vida útil dos instrumentais e recursos humanos. Os custos foram baseados no painel de preços do Ministério da Economia do Brasil e informações complementares foram obtidas de um painel de especialistas. Uma análise de sensibilidade foi baseada na variação de 20% dos custos. Os custos da PTC foram estimados em R$ 189,89 (cenário base) com variação entre R$ 151,91 e R$ 227,89 na análise de sensibilidade. Os custos da OD foram R$ 663,05 (variando de R$ 795,66 a R$ 530,44). O Ministério da Saúde cobre apropriadamente os custos de ambas as tecnologias nos cenários base e mais otimista. Ambas as tecnologias apresentaram custos dentro dos limites dos incentivos públicos recebidos. As tecnologias são economicamente viáveis e devem ser induzidas por políticas públicas diante do impacto positivo em vários domínios funcionais da saúde.

Abstract This study aimed to estimate cost and compatibility with public financial incentives of two technologies for treating the edentulous mandible: lower complete dentures (CD) and overdentures retained by two dental implants (OD). This study consisted of a partial economic evaluation, with a micro-costing bottom-up approach for the calculation of direct costs. The estimates involved the number of consultations, proportion of materials, equipment, instruments’ lifetime, and human resources, described in the price panel website of the Ministry of Economy in Brazil. Complementary information was obtained from a panel of experts. A sensitivity analysis was based on 20% variation. The estimated cost of a CD was R$ 189.89 (base scenario), and this varied between R$ 151.91 and R$ 227.89 according to sensibility analysis. The cost of an OD was R$ 663.05 (ranging from R$ 795.66 to R$ 530.44 - 1US=R$ 3.80/July 2019). The Ministry of Health covers appropriately the costs of the CD and OD. Both technologies showed costs that are within the limits of financial public incentives obtained by municipalities. The technologies are economically viable and should be induced through public policies due to their positive impacts on several functional domains of health.

RESUMO O objetivo do estudo é descrever o perfil de três grupos de mulheres: aparentemente saudáveis (não doentes-ND); com doenças cardiovasculares (DC); e com doenças respiratórias (DR) crônicas. A pesquisa comparou esses grupos conforme variáveis sociodemográficas (faixa etária, escolaridade, etnia e renda familiar) e dados sobre qualidade de vida (QV), segundo domínios: físico, psicológico, relações sociais e meio ambiente. Este estudo é caracterizado como quantitativo, analítico, observacional e transversal de base populacional, com informações extraídas do Inquérito de Saúde da Mulher, realizado na cidade de Uberaba-MG. Foram entrevistadas 1.387 mulheres, com o objetivo de coletar informações sobre DC, DR, idade, escolaridade, etnia e renda familiar. A QV foi estudada por meio do WHOQOL - Bref, segundo os quatro domínios. Foi realizado levantamento estatístico, descritivo e inferencial. Identificou-se que o grupo com DC é formado por mulheres com idade a partir de 50 anos e baixa escolaridade, em oposição ao grupo de mulheres com DR, que são mais jovens e possuem escolaridade superior. Quanto à QV, as mulheres com DC (31,65%) apresentaram níveis inferiores em relação às mulheres com DR (19,10%), nos domínios: físico (50,6;54,0;<0,0001), psicológico (55,1;58,7;<0,0001), relações sociais (75,8;77,2;0,0055) e meio ambiente (41,7;43,0;0,0173), valores em média. Portanto, o domínio de QV que obteve menor pontuação para todos os grupos foi o meio ambiente e as mulheres com DC apresentaram valores mais baixos, estatisticamente significativos, para todas as categorias.

ABSTRACT This study aims to describe the profile of three groups of women; apparently healthy (non-sick - NS); with cardiovascular diseases (CD); and with chronic respiratory diseases (RD). These groups were compared according to sociodemographic variables (age group, education, ethnicity, and family income) and quality of life (QoL) data, composing the domains: physical, psychological, social relations, and environment. This study is characterized as quantitative, analytical, observational, and cross-sectional population-based, with information extracted from the Women’s Health Survey, conducted in the city of Uberaba-MG. A total of 1,387 women were interviewed, and information on CD, RD, age, education, ethnicity and family income were collected. The QoL was studied using WHOQOL - BREF, according to its four domains. Descriptive and inferential statistics were performed. The CD group is composed of women aged 50 years and older and low education level, in contrast to the women of the RD group , who are younger and have higher education level. As for QoL, women with CD (31.65%) had lower levels than women with RD (19.10%), in the domains: physical (50.6;54.0;<0.0001), psychological (55.1;58.7;<0.0001), social relations (75.8;77.2;0.0055), and environment (41.7;43.0;0.0173), values on average and p, respectively. Therefore, the QoL domain that obtained the lowest score for all groups was the environment and women with CD presented lower values for all categories, which were statistically significant.

RESUMEN El objetivo del estudio es describir el perfil de tres grupos de mujeres: aparentemente sanas (no enfermas-NE); con enfermedades cardiovasculares (EC); y con enfermedades respiratorias crónicas (ER). La investigación comparó estos grupos según variables sociodemográficas (grupo de edad, escolaridad, etnia e ingresos familiares) y datos sobre calidad de vida (CV), según dominios: físico, psicológico, relaciones sociales y medio ambiente. Este estudio se caracteriza por ser cuantitativo, analítico, observacional y transversal de base poblacional, con información extraída de la Encuesta de Salud de la Mujer, realizada en la ciudad de Uberaba-MG. Se entrevistó a un total de 1.387 mujeres, con el objetivo de recopilar información sobre EC, ER, edad, escolaridad, etnia e ingresos familiares. La CV se estudió utilizando el WHOQOL - Bref, según los cuatro dominios. Se realizó encuesta estadística, descriptiva e inferencial. Se identificó que el grupo con EC está formado por mujeres con edad de 50 años o más y baja escolaridad, en contraposición al grupo de mujeres con EC, que son más jóvenes y tienen estudios superiores. En cuanto a la CV, las mujeres con EC (31,65%) presentaron niveles más bajos en comparación con las mujeres con ER (19,10%), en los siguientes dominios: físico (50,6; 54,0;<0,001), psicológico (55,1; 58,7;<0,0001), relaciones sociales (75,8;77,2;0,0055) y medio ambiente (41,7;43,0; 0,0173), valores medios. Por lo tanto, el el dominio de CV que obtuvo la puntuación más baja para todos los grupos fue el medio ambiente y las mujeres con EC presentaron valores más bajos, estadísticamente significativos, para todas las categorías.