Resumo O objetivo deste artigo é analisar a implantação do Programa de Promoção da Alimentação Adequada e Saudável na Atenção Primária à Saúde em municípios de Minas Gerais. Pesquisa de Métodos Mistos com Estratégia Incorporada Concomitante de dados. Na abordagem quantitativa utilizou-se pesquisa avaliativa na perspectiva da análise de implantação. Na abordagem qualitativa realizou-se estudo exploratório-descritivo utilizando a análise de conteúdo. Os dados qualitativos e quantitativos foram incorporados para análise a partir de sua imbricação. O Grau de Implantação do programa foi 92,5% representando uma implantação adequada. Na imbricação dos dados, a metodologia das ações propostas no programa e a realização da atividade de Educação Permanente foram pontos fortes convergentes que emergiram. Recursos Humanos insuficientes para planejamento e execução do programa e falta de cozinha para oficina culinária foram apontados como desafios. A implantação do programa foi adequada e poderá ser estendida para outros municípios brasileiros, de forma a apoiar os profissionais a estruturar intervenções de promoção da alimentação adequada e saudável na rotina de trabalho na Atenção Primária.

Abstract This article aims to analyze the implementation of an Adequate and Healthy Food Promotion Program in Primary Health Care in the municipalities of Minas Gerais. Mixed Methods Research with Data Concomitant Embedded Strategy. Evaluative research from the perspective of the implementation analysis was employed in the quantitative approach. An exploratory-descriptive study was conducted using content analysis in the qualitative approach. Qualitative and quantitative data were incorporated for analysis from their imbrication. The Program Implementation Level (IL) was 92.5%, representing an adequate implementation. The methodology of the actions proposed in the program and the implementation of Continuing Education were convergent strengths that emerged from data imbrication. The need for more human resources for planning and implementing the program and the lack of a kitchen for cooking workshops were identified as challenges. The Program’s implementation was adequate and can be extended to other Brazilian municipalities to help professionals structure interventions to promote adequate and healthy food in the Primary Care work routine.

RESUMO O Departamento de Higiene da Faculdade de Medicina de São Paulo (FMUSP), organizado com o apoio da Fundação Rockefeller, tornou-se o Instituto de Higiene, tendo a aula inaugural ministrada por Samuel Darling em 1918. A história da Entomologia de Saúde Pública confunde-se com a do próprio Instituto, que passou a ser a Faculdade de Higiene e Saúde Pública em 1945. Ainda na década de 1930, Paulo César de Azevedo Antunes e John Lane começam a organizar a Entomologia de Saúde Pública dentro da Parasitologia Médica, do então Instituto de Higiene. Durante esse período o laboratório de entomologia passou a ser reconhecido por suas pesquisas em sistemática de insetos hematófagos, bem como na ecologia, biologia e comportamento de vetores. A Coleção Entomológica de Referência (CER) originou-se naturalmente das pesquisas de Paulo César Antunes e John Lane e é um patrimônio nacional e internacional abrangendo tipos primários e secundários de espécies de insetos que apresentam interesse à saúde pública. No decorrer dos anos, consolidou-se com os esforços de Augusto Ayroza Galvão, Renato Corrêa, José Coutinho, Nelson Cerqueira, Ernesto Rabello, Oswaldo Forattini e outros. Em seus mais de oitenta anos de atividades, a CER possibilitou a formação de diversos cientistas aptos a atuar em programas de vigilância e controle de endemias associadas aos insetos vetores em toda a América Latina, além de formar taxonomistas voltados aos insetos de interesse em Saúde Pública. Pesquisadores de outros institutos brasileiros e do exterior juntaram-se ao laboratório de entomologia por conta de sua importância e das pesquisas nele desenvolvidas. A produção científica crescente possibilitou aos estudos entomológicos desenvolvidos na Faculdade de Saúde Pública (FSP) adquirirem uma visibilidade internacional, contribuindo para o desenvolvimento das ações de prevenções de doenças e controle de epidemias no país.

ABSTRACT The Department of Hygiene of the Faculty of Medicine of São Paulo (FMUSP), organized with the support of the Rockefeller Foundation, became the Institute of Hygiene, with the inaugural class taught by Samuel Darling in 1918. The history of Public Health Entomology is mixed with that of the Institute itself, which became the Faculty of Hygiene and Public Health in 1945. Still in the 1930s, Paulo César de Azevedo Antunes and John Lane organized Public Health Entomology within the Medical Parasitology area of the then Institute of Hygiene. During this period, the entomology laboratory came to be recognized for its research in the systematics of hematophagous insects, as well as in the ecology, biology and behavior of vectors. The Entomological Reference Collection (CER) originated naturally from the research of Paulo César Antunes and John Lane and is a national and international heritage covering primary and secondary types of insect species that are of interest to public health. Over the years, it has been consolidated with the efforts of Augusto Ayroza Galvão, Renato Corrêa, José Coutinho, Nelson Cerqueira, Ernesto Rabello, Oswaldo Forattini and others. In its over eighty years of activities, CER has enabled the training of several scientists able to act in programs of surveillance and control of endemic diseases associated with insect vectors throughout Latin America, in addition to training taxonomists focused on insects of interest in Public Health. Researchers from other Brazilian institutes and abroad joined the entomology laboratory because of its importance and the research developed in it. The growing scientific production made it possible for entomological studies developed at the Faculty of Public Health (FSP) to gain international visibility, contributing to the development of disease prevention and epidemic control actions in the country.

Abstract This article aims to analyze the implementation of an Adequate and Healthy Food Promotion Program in Primary Health Care in the municipalities of Minas Gerais. Mixed Methods Research with Data Concomitant Embedded Strategy. Evaluative research from the perspective of the implementation analysis was employed in the quantitative approach. An exploratory-descriptive study was conducted using content analysis in the qualitative approach. Qualitative and quantitative data were incorporated for analysis from their imbrication. The Program Implementation Level (IL) was 92.5%, representing an adequate implementation. The methodology of the actions proposed in the program and the implementation of Continuing Education were convergent strengths that emerged from data imbrication. The need for more human resources for planning and implementing the program and the lack of a kitchen for cooking workshops were identified as challenges. The Program’s implementation was adequate and can be extended to other Brazilian municipalities to help professionals structure interventions to promote adequate and healthy food in the Primary Care work routine.

Resumo O objetivo deste artigo é analisar a implantação do Programa de Promoção da Alimentação Adequada e Saudável na Atenção Primária à Saúde em municípios de Minas Gerais. Pesquisa de Métodos Mistos com Estratégia Incorporada Concomitante de dados. Na abordagem quantitativa utilizou-se pesquisa avaliativa na perspectiva da análise de implantação. Na abordagem qualitativa realizou-se estudo exploratório-descritivo utilizando a análise de conteúdo. Os dados qualitativos e quantitativos foram incorporados para análise a partir de sua imbricação. O Grau de Implantação do programa foi 92,5% representando uma implantação adequada. Na imbricação dos dados, a metodologia das ações propostas no programa e a realização da atividade de Educação Permanente foram pontos fortes convergentes que emergiram. Recursos Humanos insuficientes para planejamento e execução do programa e falta de cozinha para oficina culinária foram apontados como desafios. A implantação do programa foi adequada e poderá ser estendida para outros municípios brasileiros, de forma a apoiar os profissionais a estruturar intervenções de promoção da alimentação adequada e saudável na rotina de trabalho na Atenção Primária.

ABSTRACT The Department of Hygiene of the Faculty of Medicine of São Paulo (FMUSP), organized with the support of the Rockefeller Foundation, became the Institute of Hygiene, with the inaugural class taught by Samuel Darling in 1918. The history of Public Health Entomology is mixed with that of the Institute itself, which became the Faculty of Hygiene and Public Health in 1945. Still in the 1930s, Paulo César de Azevedo Antunes and John Lane organized Public Health Entomology within the Medical Parasitology area of the then Institute of Hygiene. During this period, the entomology laboratory came to be recognized for its research in the systematics of hematophagous insects, as well as in the ecology, biology and behavior of vectors. The Entomological Reference Collection (CER) originated naturally from the research of Paulo César Antunes and John Lane and is a national and international heritage covering primary and secondary types of insect species that are of interest to public health. Over the years, it has been consolidated with the efforts of Augusto Ayroza Galvão, Renato Corrêa, José Coutinho, Nelson Cerqueira, Ernesto Rabello, Oswaldo Forattini and others. In its over eighty years of activities, CER has enabled the training of several scientists able to act in programs of surveillance and control of endemic diseases associated with insect vectors throughout Latin America, in addition to training taxonomists focused on insects of interest in Public Health. Researchers from other Brazilian institutes and abroad joined the entomology laboratory because of its importance and the research developed in it. The growing scientific production made it possible for entomological studies developed at the Faculty of Public Health (FSP) to gain international visibility, contributing to the development of disease prevention and epidemic control actions in the country.

RESUMO O Departamento de Higiene da Faculdade de Medicina de São Paulo (FMUSP), organizado com o apoio da Fundação Rockefeller, tornou-se o Instituto de Higiene, tendo a aula inaugural ministrada por Samuel Darling em 1918. A história da Entomologia de Saúde Pública confunde-se com a do próprio Instituto, que passou a ser a Faculdade de Higiene e Saúde Pública em 1945. Ainda na década de 1930, Paulo César de Azevedo Antunes e John Lane começam a organizar a Entomologia de Saúde Pública dentro da Parasitologia Médica, do então Instituto de Higiene. Durante esse período o laboratório de entomologia passou a ser reconhecido por suas pesquisas em sistemática de insetos hematófagos, bem como na ecologia, biologia e comportamento de vetores. A Coleção Entomológica de Referência (CER) originou-se naturalmente das pesquisas de Paulo César Antunes e John Lane e é um patrimônio nacional e internacional abrangendo tipos primários e secundários de espécies de insetos que apresentam interesse à saúde pública. No decorrer dos anos, consolidou-se com os esforços de Augusto Ayroza Galvão, Renato Corrêa, José Coutinho, Nelson Cerqueira, Ernesto Rabello, Oswaldo Forattini e outros. Em seus mais de oitenta anos de atividades, a CER possibilitou a formação de diversos cientistas aptos a atuar em programas de vigilância e controle de endemias associadas aos insetos vetores em toda a América Latina, além de formar taxonomistas voltados aos insetos de interesse em Saúde Pública. Pesquisadores de outros institutos brasileiros e do exterior juntaram-se ao laboratório de entomologia por conta de sua importância e das pesquisas nele desenvolvidas. A produção científica crescente possibilitou aos estudos entomológicos desenvolvidos na Faculdade de Saúde Pública (FSP) adquirirem uma visibilidade internacional, contribuindo para o desenvolvimento das ações de prevenções de doenças e controle de epidemias no país.

ABSTRACT Acute vulvar ulcer (Lipschütz’s ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet’s syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz’s ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.

ABSTRACT Prune belly syndrome is a rare congenital disease of unknown etiology that is present in one in every 40 thousand live births, and predominantly affects males, at a ratio of 4:1. In males, it presents with anomalies in the urinary system, absence of abdominal muscles, bilateral cryptorchidism, and infertility. In women, the syndrome has variable presentations, but fertility is preserved. Searching the medical literature, we found only one case of prune belly syndrome in pregnant women. Therefore, the patient in this report is the second case. She was primiparous, 25-years-old, with no abdominal muscles, severe congenital kyphoscoliosis, and pulmonary restriction. Elective cesarean section was performed at 37 weeks of gestation due to maternal risk of uterine rupture by transverse presentation and fetal risk of intrauterine growth restriction. The pre-anesthetic approach defined that general anesthesia might have more risks for the patient due to severe maternal lung disease compared to ultrasound-guided locoregional anesthesia. During prenatal care, there were some maternal complications, such as asthma exacerbations, abdominal pain, and constipation. The newborn was born small for gestational age and this can possibly be explained by maternal restrictive lung capacity. The newborn presented with Apgar score 8/9 and tachypnea, but improved after two hours of life.

Resumo Introdução A crescente utilização de recursos de terapia intensiva neonatal para manter a vida dos recém-nascidos enfermos pode gerar estímulos dolorosos, causando sofrimento a eles. Porém, nem sempre essa dor é percebida pelos profissionais envolvidos no cuidado, embora já exista um interesse crescente por parte deles nesse sentido. Objetivo Avaliar a percepção de dor do recém-nascido por profissionais de saúde que atuam em unidade neonatal. Método Pesquisa qualitativa do tipo exploratória, realizada em um hospital de referência em cuidado neonatal de uma capital do Nordeste. Foram realizadas entrevistas semiestruturadas com todos os profissionais que atuavam na Unidade de Terapia Intensiva Neonatal e/ou na Unidade de Cuidados Intermediários em cuidado direto com o recém-nascido. Utilizou-se da análise de conteúdo na modalidade temática, e os resultados foram agrupados em categorias. Resultados Foram realizadas 36 entrevistas. Os profissionais entrevistados reconheceram que a dor neonatal foi historicamente negligenciada e que hoje as evidências científicas comprovam sua existência. Foram identificadas carência na formação no tema e fragilidade na aplicação do conhecimento na prática. Conclusão Os profissionais têm conhecimento sobre a dor neonatal, entretanto quase não utilizam os parâmetros fisiológicos e possuem pouco conhecimento sobre a literatura científica atual. O principal desafio diz respeito à necessidade de uso sistemático de escalas que garantam a avaliação da dor.

Abstract Background The increasing use of neonatal intensive care resources to maintain the lives of sick infants can generate painful stimuli and cause distress for them. However, this pain is not always perceived by the professionals involved in the care, although there is already an increasing interest on the part of the professionals involved in care. Objective To evaluate the perception of health professionals, who works in a neonatal unit related to newborn pain. Method Qualitative research of the exploratory type was carried out in a reference hospital in neonatal care of a capital of the Northeast. Semi-structured interviews were conducted with all professionals working in the Neonatal Intensive Care Unit and / or Intermediate Care Unit in direct care of the newborn. Content Analysis was used in the thematic modality and the results were grouped into categories. Results 36 interviews were conducted. The professionals interviewed acknowledged that neonatal pain was historically neglected and that scientific evidence today confirms its existence. It was identified lack in the training in the theme and fragility in the application of the knowledge in the practice. Conclusion The professionals have knowledge about neonatal pain; however they still use little physiological parameters and have little knowledge of current scientific literature. The main challenge is the need for systematic use of scales that guarantee the evaluation of pain.

Abstract The aim was of this study was to determine the current weight of evidence for the existence of specific differences between the microbiota of healthy teeth and healthy implants, or of teeth with periodontitis and implants with peri-implantitis. A systematic review was conducted according to the PRISMA statement. The MEDLINE, EMBASE and Cochrane databases were searched up to February 2018 for studies comparing microbiological data of biofilm samples collected from healthy teeth and implants or from teeth with periodontitis and implants with peri-implantitis. The weight of evidence was defined in three categories (strong, moderate and mild/some), according to the difference in number of studies showing statistically significantly higher counts and/or proportions and/or abundance and/or prevalence of microorganisms in health or in disease. Of the 132 articles identified, 8 were included. A wide range of microorganisms were present in different conditions but no microorganisms showed strong, moderate or mild/some evidence for a specific association with either teeth or implants. The results of this systematic review indicated that there is insufficient evidence in the literature to support specific differences between microorganisms colonizing teeth and implants, either in health or in disease.

Since studies show that an unfavorable environment during intrauterine development predisposes individuals to several diseases in adulthood, our objective is to assess the relation between fetal growth restriction and chronic renal disease in adults. We searched four different electronic databases through November 2017: CENTRAL, EMBASE, LILACS and MEDLINE. We selected studies with longitudinal or transversal designs associating kidney function in adulthood with low birth weight. Two reviewers evaluated the inclusion criteria and the risk of bias and extracted data from the included papers. Thirteen studies were selected for the systematic review and meta-analysis. We observed increased risks of presenting end-stage renal disease (risk ratio 1.31, 95% confidence interval: 1.17, 1.47), a lower glomerular filtration rate (ml/min) (mean difference 7.14; 95% confidence interval: -12.12, -2.16), microalbuminuria (risk ratio 1.40; 95% confidence interval: 1.28, 1.52) and a small increase in the albumin/creatinine ratio (mean difference 0.46; 95% confidence interval: 0.03, 0.90) in the low birth weight patients, compared with control group. These findings suggest that low birth weight is associated with renal dysfunction in adults.

INTRODUÇÃO: a atenção tem se concentrado na investigação da prevalência de atividade física AF em diferentes populações.OBJETIVO: analisar os fatores associados à prática de AF habitual em mulheres em regiões de Santa Catarina, Brasil.MÉTODOS: o estudo transversal obteve amostra de 2750 mulheres, com média de idade de 32,97 ± 10,9 anos. A AF foi avaliada pelo Questionário Internacional de Atividade Física IPAQ. A amostra foi dividida em seis grupos: Região Sul; Região do Vale do Itajaí; Região Norte; Região Oeste; Região Serrana e Região da Grande Florianópolis, SC, Brasil. A análise estatística foi descritiva e inferencial.RESULTADOS: aproximadamente 68,3% das mulheres foram consideradas suficientemente ativas ativas + muito ativas, destacando-se as da Região da Grande Florianópolis. Na prática de atividade moderada e moderada + vigorosa, as mulheres da Região Oeste apresentaram as maiores médias 65 ± 64; 105 ± 102 min/dia, respectivamente, e as de 20 a 32 anos apresentaram 61% de chance de serem consideradas ativas com relação às mulheres de 46 a 59 anos. Quanto ao índice de massa corporal IMC, as mulheres com peso normal das Regiões Sul e Vale do Itajaí, apresentaram 2,24 IC 95% = 1,15-4,35 e 1,76 IC 95% =1,14-2,73 vezes mais chances de serem ativas quando comparadas às mulheres acima do peso.CONCLUSÃO: as mulheres das regiões de Santa Catarina foram consideradas suficientemente ativas. A AF moderada + vigorosa foi a mais prevalente nas seis regiões estudadas.

INTRODUCTION: attention has been focused on investigating the prevalence of physical activity PA in different populations.OBJECTIVE: to analyze factors associated with the usual practice of PA in women from areas of Santa Catarina, Brazil.METHODS: the cross-sectional study enrolled a sample of 2750 women with a mean age of 32.97±10.9 years. PA was assessed by the International Physical Activity Questionnaire IPAQ. The sample was divided into six groups: Southern Region; Itajaí Valley; Northern Region; Western Region; Highlands Region and the Greater Florianópolis Region, SC, Brazil. Statistical analysis was descriptive and inferential.RESULTS: approximately 68.3% of women were considered sufficiently active active + very active, in particular the Greater Florianópolis Region, SC, Brazil. In the practice of moderate and moderate + vigorous activity, the women of Western Region presented the highest averages 65±64 min/d; 105±102 min/d, respectively, and those in the range of 20-32 years old showed 61% chance of being considered active compared with women in the range of 46-59 years old. As for the body mass index BMI, women with normal weight of the South Region and Itajaí Valley regions had 2.24 95% CI;1.15-4.35 and 1.76 95% CI; 1.14-2.73 times more chances to be active when compared to the overweight women.CONCLUSION: women in the regions of Santa Catarina were considered sufficiently active. Moderate + vigorous PA was the most prevalent in the six regions studied.

INTRODUCCIÓN: los estudios han sido dirigidos a investigar la prevalencia de actividad física AF en diferentes poblaciones.OBJETIVO: Analizar los factores asociados con la práctica habitual de actividad física en las mujeres de regiones de Santa Catarina, Brasil.MÉTODOS: este estudio transversal obtuvo muestra de 2750 mujeres con edad promedio de 32,97 ± 10,9 años. La AF se evaluó mediante el Cuestionario Internacional de Actividad Física IPAQ. La muestra fue dividida en seis grupos: Región Sur; Valle de Itajaí; Región Norte; Región Occidental; Región Montañosa y Gran Florianópolis. El análisis estadístico fue descriptivo e inferencial.RESULTADOS: aproximadamente el 68,3% de las mujeres se consideraron suficientemente activas activa + muy activa, destacando la región de la Gran Florianópolis, SC, Brasil. En la práctica de actividad moderada y moderada + vigorosa, las mujeres de la Región Occidental presentaron los promedios más altos 65 ± 64; 105 ±102 min./día, respectivamente, y las de 20 a 32 años tenían 61% de probabilidad de ser consideradas activas en comparación con las mujeres de 46 a 59 años. En cuanto el índice de masa corporal IMC, las mujeres con peso normal de las Región Sur y del Valle de Itajaí, presentaron 2,24 IC del 95%; 1,15-4,35 y 1,76 IC del 95%; 1,14-2,73 veces más probabilidades de ser activas en comparación con las mujeres con sobrepeso.CONCLUSIÓN: las mujeres en las regiones de Santa Catarina se consideraron suficientemente activas. La actividad física moderada + vigorosa fue la más prevaleciente en las seis regiones estudiadas.