A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

Resumo Introdução: Dada a multiplicidade de definições acerca do conceito de churning de recursos humanos, tomou-se como premissa, os custos associados às substituições de trabalhadores provenientes de saídas voluntárias das organizações. Tratando-se de uma temática ainda pouco explorada em Portugal, pretende-se através deste estudo expandir o quadro teórico, assim como os estudos empíricos; Objetivos; Métodos: Este estudo qualitativo visa identificar os principais precedentes do churning de recursos humanos e as medidas estratégicas aplicadas pelas organizações para o atenuar. De modo a tornar o objetivo exequível, surgiu como questão de investigação: qual a origem do churning nas organizações e quais as medidas de atenuação? Como método de recolha de dados, recorreu-se à realização de 20 entrevistas semiestruturadas a diretores de recursos humanos de vários setores de atividade, procedendo-se à sua análise através da análise de conteúdo, de forma a extrair as principais variáveis, dando enfase à elaboração de um modelo teórico e sua análise; Resultados: de forma a analisar o referido modelo, foram definidas 3 proposições às quais se procedeu à sua fundamentação, com recurso à literatura sobre a temática e à informação obtida através das entrevistas, foi possível analisar a veracidade das proposições definidas. Permitindo predizer que os precedentes de churning de recursos humanos exercem influência negativamente na ocorrência de churning de recursos humanos; as medidas de atenuação exercem influência positiva sobre o churning de recursos humanos e que as medidas de atenuação exercem influência positiva sobre os precedentes de churning de recursos humanos. Conclusões: Quanto maior for o investimento na aplicação e / ou desenvolvimento de políticas e práticas de retenção de recursos humanos, menor será a taxa de churning, logo o custo derivado das substituições de trabalhadores será reduzido.

Abstract Introduction: Given the multiplicity of definitions about the concept of human resource churning, we took as a premise, the costs associated with the replacement of workers from voluntary departures from organisations. As this is a subject that has not yet been widely explored in Portugal, this study aims to expand the theoretical framework, as well as the empirical studies; Goals; Methods: This qualitative study aims to identify the main precedents of human resource churning and the strategic measures applied by organisations to mitigate it. In order to make the objective feasible, the research question was: what is the origin of churning in organisations and what are the mitigation measures? As a data collection method, 20 semi-structured interviews were conducted with human resources directors from various sectors of activity, which were analysed through content analysis in order to extract the main variables, emphasising the development of a theoretical model and its analysis; Results: In order to analyse this model, 3 propositions were defined and proceeded to their substantiation, using the literature on the subject and the information obtained through the interviews, it was possible to analyse the veracity of the defined propositions. It was possible to predict that human resource churning precedents negatively influence the occurrence of human resource churning; that mitigation measures have a positive influence on human resource churning and that mitigation measures have a positive influence on human resource churning precedents; Conclusions: The greater the investment in the application and/or development of policies and practices of human resources retention, the lower the churning rate will be, and therefore the costs derived from the replacement of workers will be reduced.

Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods:  A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.   Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods:  A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.

Abstract Background: Real-world, primary data on the treatment of psoriasis are scarce, especially concerning the role of soluble biomarkers as outcome predictors. Objective: The authors evaluated the utility of Th1/Th17 serum cytokines along with clinical characteristics as predictors of drug survival in the treatment of psoriasis. Methods: The authors consecutively included participants with moderate to severe psoriasis who were followed up for 6 years. Baseline interferon-α, tumor necrosis factor-α, and inter-leukin (IL)-2, IL-4, IL-6, IL-10, and IL-17A were measured using a cytometric bead array; clinical data were assessed. The authors calculated hazard ratios (HRs) for drug survival using a Cox proportional hazards model. Results: The authors included 262 patients, most of whom used systemic immunosuppressants or biologics. In the multivariate model, poor quality of life measured by the Dermatology Life Quality Index (HR = 1.04; 95% CI 1.01–1.07; p = 0.012) and elevated baseline IL-6 (HR = 1.99; 95% CI 1.29–3.08; p = 0.002) were associated with treatment interruption. Study limitations: The main limitation of any cohort study is the presence of confounders that could not be detected in clinical evaluation. Conclusions: Poor quality of life and elevated baseline serum IL-6 level predicted treatment interruption in patients with moderate to severe psoriasis. Although IL-6 is not the most important mediator of the inflammatory pathway in the skin environment, it is an interesting biomarker candidate for predicting psoriasis treatment response.

Abstract Trust in institutions and democracy. The cases of young Spanish and Latin Americans This article examines data from the Jóvenes en Iberoamérica 2021 survey, coordinated by the SM Foundation of Spain, which interviewed 13,500 young people aged between 15 and 29 from Argentina, Brazil, Chile, Colombia, Ecuador, Spain, Mexico, Peru and the Dominican Republic between March 2019 and April 2020. The study aimed to measure the perception of these young people regarding the determinants of trust in relation to political and social institutions that constitute, in contemporary societies, the fundamental bases for the exercise of democratic life. The data shows, in general, a low level of trust in institutions among young people in these countries.

Resumo Confiança nas instituições e democracia. Os casos dos jovens espanhóis e latinoamericanos Este artigo examina dados da pesquisa Jóvenes en Iberoamérica 2021, coordenada pela Fundação SM da Espanha, que entrevistou 13.500 jovens com idade entre 15 e 29 anos da Argentina, Brasil, Chile, Colômbia, Equador, Espanha, México, Peru e República Dominicana entre março de 2019 e abril de 2020. O estudo teve como objetivo medir a percepção desses jovens a respeito dos determinantes da confiança em relação a instituições políticas e sociais que constituem, nas sociedades contemporâneas, as bases fundamentais para o exercício da vida democrática. Os dados mostram, em geral, um baixo nível de confiança nas instituições entre os jovens desses países.

Resumen Este artículo examina datos de la encuesta Jóvenes en Iberoamérica 2021, coordinada por la Fundación SM, de España, que entrevistó a 13.500 jóvenes de entre 15 y 29 años de Argentina, Brasil, Chile, Colombia, Ecuador, España, México, Perú y República Dominicana, entre marzo de 2019 y abril de 2020. El estudio tuvo como objetivo medir la percepción de estos jóvenes sobre los determinantes de la confianza en relación con las instituciones políticas y sociales que constituyen, en las sociedades contemporáneas, las bases fundamentales para el ejercicio de la vida democrática. Los datos muestran, en general, un bajo nivel de confianza en las instituciones entre los jóvenes de estos países.

SUMMARY BACKGROUND: Cerebrovascular accident (or stroke) and ischemic heart disease are the the major causes of death in the world. It is estimated that about 85% of strokes are ischemic in origin. Reperfusion therapy in the acute phase of ischemic stroke with a recombinant human tissue plasminogen activator is effective, but some factors influence the success of this treatment. OBJECTIVE: The aim of this study was to evaluate clinical aspects and possible determinants for reperfusion after venous thrombolysis. METHODS: This is a retrospective, cross-sectional, observational study based on a review of hospital records of inpatients diagnosed with ischemic stroke treated with intravenous thrombolysis, the main outcome being reperfusion or not. RESULTS: Data from this study revealed a predominance of females in the group of reperfused patients and males in the non-reperfused group, both maintaining moderate severity on the National Institutes of Health Stroke Scale and admission without statistical significance (p>0.18). In addition, the mean admission severity score was 13.2 for the group of reperfused patients and 14.2 for those not reperfused, and the mean ejection fraction of both groups was within normal functionality, with a mean of 0.50 for reperfused patients and 0.62 for non-reperfused patients. CONCLUSION: We found an association between successful venous chemical thrombolysis reperfusion and lower mortality in patients with acute stroke.

ABSTRACT: When applied at growing phase, lighting program aims to obtain quails with body weight and physiological maturity suitable for the beginning of laying. This study evaluated lighting programs at growing phase on performance, sexual maturity and egg quality of meat quail breeders (Coturnixcoturnix) at laying phase. From 7 to 49 days of age, 300 female meat quails were subjected to three lighting programs (natural, intermittent and continuous), with 5 replicates of 20 birds each. At 49 days of age, 240 quails were transferred to a shed, maintaining the same experimental conditions. Meat quails submitted to continuous and intermittent lighting programs had higher weight of reproductive system and lower ages for first egg production and to reach 50% of egg production (P < 0.05). Quails submitted to natural lighting had lower feed intake from 49 to 70 and 71 to 92 days of age and worse feed conversion up to 114 days of age. Continuous and intermittent lighting programs resulted in more precocious quails compared to natural lighting program. Quails submitted to natural lighting at growing phase presented lower egg production during all periods, not differing for birds submitted to continuous and intermittent programs from the second period (71 to 92 days of age). Intermittent and continuous lighting result in better feed conversion of breeding quails up to 114 days and a higher percentage of laying (49 to 136 days), reducing the number of days to produce the first egg and to reach 50% of laying, in relation to natural lighting.

RESUMO: Quando aplicado na fase de crescimento, o programa de luz visa obter codornas com peso corporal e maturidade fisiológica adequados para o início da postura. Este estudo avaliou programas de iluminação na fase de crescimento sobre o desempenho, maturidade sexual e qualidade dos ovos de codornas de corte reprodutoras (Coturnix coturnix) na fase de postura. Durante o período de sete a 49 dias de idade, 300 codornas de corte fêmeas foram submetidas a três programas de iluminação (natural, intermitente e contínuo), com cinco repetições de 20 aves cada. Aos 49 dias de idade, 240 codornas foram transferidas para um galpão, mantendo a mesma distribuição experimental e submetidas às mesmas condições. As aves submetidas aos programas de iluminação contínuo e intermitente na fase de crescimento apresentaram maiores peso relativo do sistema reprodutivo e consequentemente menores idades para produção do primeiro ovo e para atingir 50% da produção de ovos (P < 0.05). As aves que receberam apenas iluminação natural apresentaram menor consumo de ração nos períodos de 49 a 70 e 71 a 92 dias de idade e pior conversão alimentar até 114 dias de idade. Os programas de iluminação contínua e intermitente na fase de crescimento resultaram em codornas mais precoces quando comparados as aves submetidas ao programa de iluminação natural. Codornas submetidas a programa de luz natural na fase de crescimento apresentaram menor produção de ovos durante todos os períodos, não diferindo das aves submetidas a programas contínuos e intermitentes a partir do segundo período (71 a 92 dias de idade). A iluminação intermitente e contínua na fase de crescimento resulta em melhor conversão alimentar de codornas reprodutoras até 114 dias e maior percentual de postura (49 a 136 dias), reduzindo o número de dias para produzir o primeiro ovo e atingir 50% de postura, em relação a iluminação natural..

ABSTRACT Objective: To evaluate severe acute respiratory syndrome surveillance in a pediatric unit. Methods: Descriptive study of reported severe acute respiratory syndrome cases with the detection of respiratory viruses in the nasopharyngeal sample of patients hospitalized between 2013 and 2019, in a reference hospital in the Federal District, Brazil. Results: A total of 269 children had one or more viruses detected, resulting in 280 viruses, of which 152 (54%) were respiratory syncytial virus. The detection of respiratory syncytial virus was higher during the autumn-winter period. Children´s median age was 6.9 months, 156 (58%) were male, 104 (39%) had comorbidity, 197 (73%) required mechanical ventilation, 241 (90%) received antibiotics, and 146 (54%) oseltamivir. There were 19 (7%) deaths. The median time from symptom onset to sample collection was 5 days and the median time from sample collection to final results was 6 days. Conclusions: The system needs to reduce the time to deliver results so that inappropriate use of antibiotics and antivirals can be avoided. Moreover, the burden of viral pneumonia was relevant and the system must be flexible enough to include emerging viruses in order to be useful in responding to public health emergencies caused by respiratory viruses.

RESUMO Objetivo: Avaliar a vigilância da síndrome respiratória aguda grave em uma unidade pediátrica. Métodos: Estudo descritivo dos casos de síndrome respiratória aguda grave, notificados e com a detecção de vírus respiratório em amostra de nasofaringe de pacientes internados entre 2013 e 2019, em um hospital de referência do Distrito Federal. Resultados: Um total de 269 crianças tiveram algum vírus detectado, resultando em 280 vírus, sendo 152 (54%) vírus sincicial respiratório. A detecção do vírus sincicial respiratório foi maior durante o período de outono-inverno. A mediana da idade das crianças foi de 6,9 meses, 156 (58%) eram do sexo masculino, 104 (39%) tinham comorbidade, 197 (73%) necessitaram de ventilação mecânica, 241 (90%) receberam antibióticos e 146 (54%) oseltamivir. Ocorreram 19 (7%) óbitos. A mediana do tempo desde o início dos sintomas até a coleta da amostra foi de 5 dias, e do tempo da coleta até o resultado foi de 6 dias. Conclusões: O sistema necessita reduzir o tempo do resultado final para que seja possível evitar o uso inadequado de antibióticos e antivirais. Ademais, o impacto das pneumonias virais foi relevante e o sistema deve ser flexível suficiente para incluir vírus emergentes, para ser útil na resposta às emergências de saúde pública causada por vírus respiratórios.

ABSTRACT: This study evaluated the impacts of thermal processing on the chemical composition of jackfruit seeds and their toxicity. The ash content of the seeds subjected to roasting was higher (3.21%) compared to the seeds in the other treatments. However, the contents of moisture (5.29%) and protein (10.49%) were lower. The protein content showed a significant difference (P≤ 0.05) among the studied groups (10.49%). The lipid content was lower in the seeds subjected to cooking (1.13%), while the carbohydrate content showed a significant difference (P≤ 0.05) among the groups studied (54.11%). Raw seeds had the highest fiber content (25.20%). Regarding toxicity, only the cooked jackfruit seed flour showed cytotoxic potential. However, none of the samples caused irritation or vascular disorders in fertilized eggs. These results suggested that heat treatment can ensure the safety of seeds against cytotoxicity; although, it reduces the content of some macronutrients.

RESUMO: Este estudo teve como objetivo avaliar os impactos do processamento térmico na composição química das sementes de jaca sua toxicidade. O teor de cinzas das sementes submetida à torra foi maior (3,21%) em comparação com as sementes nos outros tratamentos. No entanto, os teores de umidade (5,29%) e proteínas (10,49%) foram menores. O teor de proteínas apresentou diferença significativa (P≤ 0.05) entre os grupos estudados (10,49%). O teor de lipídeos foi menor nas sementes submetidas ao cozimento (1,13%), enquanto o teor de carboidratos apresentou diferença significativa (P ≤ 0.05) entre os grupos estudados (54,11%). As sementes brutas apresentaram o maior teor de fibras (25,20%). Em relação à toxicidade, apenas a farinha de sementes de jaca cozidas apresentou potencial citotóxico, embora nenhuma das amostras tenha causado irritação ou distúrbios vasculares em ovos fecundados. Esses resultados sugerem que o tratamento térmico pode garantir a segurança das sementes frente à citotoxicidade, embora reduza o teor de alguns macronutrientes.

ABSTRACT The use of non-conventional feeds in poultry farming can reduce production costs, mainly because of its low cost, availability and chemical composition. Thus, parboiled whole rice bran (PWRB) appears as a potential use in feeding quails. Two experiments were carried out to evaluate the effects of the inclusion of PWRB in the diet of quails. In each experiment, a total of 288 seven-day-old European quails of both sexes, were distributed in a completely randomized design with six treatments and six replicates of eight quails each. The treatments consisted in the inclusion of PWRB in the proportions of 0; 5; 10; 15; 20 and 25% (first) and 0; 8; 16; 24; 32 and 40% (second). In the first experiment, a linear reduction in feed intake and weight gain was observed with the inclusion of PWRB above 5%, with no significant effect on feed conversion and carcass characteristics. However, there was no loss in the performance and carcass characteristics of quails fed with different levels of PWRB in comparison to the control group. In the second, it was observed that the inclusion of PWRB above 8% promoted a linear reduction in feed intake, weight gain and improvement in feed conversion, with no significant effect on carcass characteristics. However, quails fed 40% PWRB showed reduced intake and weight gain when compared to the control group. The use of PWRB provided an improvement in economic viability. Considering the effect on growth, PWRB can be used in the feeding of meat quails up to 32%.

Abstract Objective To assess the functional disability level and identify associated factors in people after Ischemic Cerebral Vascular Accident. Methods A prospective cohort, carried out in a reference hospital in neurology with 224 people with ischemic stroke. Data collection took place between March and October 2019. Participants were followed up during hospitalization, when sociodemographic and clinical variables were collected using specific instruments and contacted after 90 days, by telephone call, to apply the Modified Barthel Index. In the analysis, descriptive statistics and Pearson’s chi-square test were applied. Statistical significance of 5% was adopted. Results Most had some degree of functional disability (58.5%), with 29.5% having moderate dependence and 29.0% having severe dependence. The variables being female (p=0.011), time of arrival at the reference hospital greater than or equal to 4.5 hours (p=0.017), previous stroke (p=0.031), not having undergone thrombolysis (p=0.023), having high blood pressure (p=0.032) and greater severity estimated by the National Institute of Health Stroke Scale (p=0.000) were associated with a higher disability level. Conclusion Moderate to severe dependence predominated. The severity of the event, previous event, hypertension, non-submission to thrombolysis, delay in arriving at the hospital and female gender were associated with a higher functional disability level.

Resumen Objetivo Evaluar el nivel de incapacidad funcional e identificar los factores asociados en las personas después de un accidente cerebrovascular isquémico. Métodos Cohorte prospectiva, realizada en un hospital de referencia en neurología, con 224 personas con accidente cerebrovascular isquémico. La recopilación de datos se llevó a cabo entre marzo y octubre de 2019. Se acompañó a los participantes durante la internación, momento en que se recopilaron las variables sociodemográficas y clínicas mediante la utilización de instrumentos específicos, y se los contactó 90 días después, por teléfono, para aplicar el Índice de Barthel modificado. En el análisis se aplicó estadística descriptiva y la prueba χ2 de Pearson. Se adoptó significación estadística de 5 %. Resultados La mayoría presentó algún nivel de incapacidad funcional (58,5 %), de los cuales el 29,5 % presentó dependencia moderada y el 29,0 % dependencia severa o grave. Las siguientes variables fueron asociadas a un mayor nivel de incapacidad: sexo femenino (p=0,011), tiempo de llegada al hospital de referencia mayor o igual a 4,5 h (p=0,017), accidente cerebrovascular previo (p=0,031), no haber realizado trombólisis (p=0,023), tener hipertensión arterial (p=0,032) y mayor gravedad estimada por la National Institute of Health Stroke Scale (p=0,000). Conclusión Predominó la dependencia de moderada a grave. La gravedad del evento, evento previo, hipertensión, no realización de trombólisis, retraso de la llegada al hospital y sexo femenino fueron las variables asociadas a un mayor nivel de incapacidad funcional.

Resumo Objetivo Avaliar o nível de incapacidade funcional e identificar os fatores associados em pessoas após Acidente Vascular Cerebral Isquêmico. Métodos Coorte prospectiva, realizada em hospital de referência em neurologia, com 224 pessoas com acidente vascular cerebral isquêmico. A coleta de dados ocorreu entre março a outubro de 2019. Os participantes foram acompanhados durante a internação, quando as variáveis sociodemográficas e clínicas foram levantadas empregando-se instrumentos específicos e contatados após 90 dias, por ligação telefônica, para aplicação do Índice de Barthel modificado. Na análise, aplicou-se estatística descritiva e o teste Qui-quadrado de Pearson. Adotou-se significância estatística de 5%. Resultados A maioria apresentou algum grau de incapacidade funcional (58,5%), sendo que 29,5% apresentaram dependência moderada e 29,0% severa ou grave. As variáveis sexo feminino (p=0,011), tempo de chegada ao hospital de referência maior ou igual a 4,5h (p=0,017), Acidente vascular cerebral prévio (p=0,031), não ter realizado trombólise (p=0,023), ter hipertensão arterial (p=0,032) e maior gravidade estimada pela National Institute of Health Stroke Scale (p=0,000) foram associadas a maior nível de incapacidade. Conclusão Predominou a dependência de moderada a grave. A gravidade do evento, evento prévio, hipertensão, não submissão à trombólise, retardo à chegada ao hospital e sexo feminino foram associados a maior nível de incapacidade funcional.

Objective: to evaluate the association between quality of life and presence of symptoms of depression, anxiety, and stress in college students in the health area. Method: cross-sectional study that included 321 students from undergraduate courses in the health area. Quality of life was measured using the World Health Organization scale, abbreviated version, in the physical, psychological, social relations and environment domains, and symptoms were assessed by the depression, anxiety and stress scale. Multivariate analysis was performed using robust linear regression to evaluate the association between quality of life and symptoms. Results: a negative association was observed between the quality of life and depression symptoms in all domains, while anxiety symptoms showed a negative association in the environment domain, and stress symptoms had a negative association in the psychological domain. Symptom severity was unfavorably associated with quality of life, that is, the greater the symptom severity, the lower the mean scores in all domains. Conclusion: symptoms of depression, anxiety, and stress were prevalent and had a negative impact on students’ quality of life, especially in the presence of depressive symptoms. The decrease in scores was significantly associated with the severity of symptoms.

Objetivo: evaluar la asociación entre la calidad de vida y la presencia de síntomas de depresión, ansiedad y estrés en estudiantes universitarios del área de la salud. Método: estudio transversal que incluyó a 321 estudiantes de carreras del área de la salud. La calidad de vida se midió mediante la escala de la Organización Mundial de la Salud, versión abreviada, en los dominios físico, psicológico, relaciones sociales y ambiente, y los síntomas se evaluaron por la escala de depresión, ansiedad y estrés. Se realizó un análisis multivariante por medio de regresión lineal robusta para evaluar la asociación entre la calidad de vida y los síntomas presentados. Resultados: se observó una asociación negativa entre la calidad de vida y los síntomas de depresión en todos los dominios, mientras que los síntomas de ansiedad tuvieron una asociación negativa en el dominio ambiente, y los síntomas de estrés tuvieron una asociación negativa en el dominio psicológico. La gravedad de los síntomas se asoció desfavorablemente con la calidad de vida, es decir, cuanto mayor la gravedad de los síntomas, menores las puntuaciones medias en todos los dominios. Conclusión: los síntomas de depresión, ansiedad y estrés fueron prevalentes e impactaron negativamente en la calidad de vida de los estudiantes, especialmente en presencia de síntomas depresivos. Las puntuaciones disminuidas se asociaron significativamente con la gravedad de los síntomas.

Objetivo: avaliar a associação entre qualidade de vida e presença de sintomas de depressão, ansiedade e estresse em estudantes universitários da área da saúde. Método: estudo transversal que incluiu 321 estudantes de cursos de graduação da área da saúde. A qualidade de vida foi mensurada por meio da escala da Organização Mundial da Saúde, versão abreviada, nos domínios físico, psicológico, relações sociais e meio ambiente, e os sintomas avaliados pela escala de depressão, ansiedade e estresse. Foi realizada análise multivariada utilizando regressão linear robusta para avaliar a associação entre qualidade de vida e sintomas apresentados. Resultados: observou- se associação negativa entre qualidade de vida e sintomas de depressão em todos os domínios, enquanto os sintomas de ansiedade apresentaram associação negativa no domínio meio ambiente, e os sintomas de estresse tiveram associação negativa no domínio psicológico. A gravidade dos sintomas associou-se de forma desfavorável com a qualidade de vida, ou seja, quanto maior a gravidade dos sintomas, menor a média dos escores em todos os domínios. Conclusão: sintomas de depressão, ansiedade e estresse mostraram-se prevalentes e com impacto negativo na qualidade de vida dos estudantes, principalmente na presença de sintomas depressivos. A diminuição dos escores foi significativamente associada à gravidade dos sintomas.

ABSTRACT BACKGROUND AND OBJECTIVES: Delirium is an acute mental status change, with fluctuating course and high incidence in cardiac surgery (CS) post-operative (PO) period. Delirium can lead to short and long-term consequences. The aim of this study was to assess the prevalence of delirium and pain and their risk factors on the 1st PO day after CS. METHODS: This was a cross-sectional analytical research. To determine the presence of PO delirium, the Confusion Assessment Method modified for Intensive Care Unit setting (CAM-ICU) and the Richmond Agitation Sedation Scale (RASS) were used. PO pain was analyzed using the Visual Analogue Pain Scale (VAS) and the presence of neuropathic components was analyzed using the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) scale. After bedside analysis, patients were divided into Delirium (D) and Without Delirium (WD) groups. RESULTS: The total number of patients was 79. The prevalence of delirium was 16.5% (95% CI = 9.06 - 26.49%) and the mean number of comorbidities in the preoperative period was a significant risk factor for the occurrence of delirium (D =4.15±2.37 versus WD=2.96±1.78, p: 0.04). Another significant risk factor was the group older than 65 years of age, with the occurrence of delirium 1.45 times higher (PR=1.12-1.88, p: 0.0014). Regarding pain evaluation, 72.15% (95% CI 60.93 - 81.65%) reported it in the 1st PO day. CONCLUSION: The prevalence of delirium was similar to previous studies. The number of previous comorbidities and advanced age were risk factors for delirium. Pain was present predominantly over the sternotomy incision region.

RESUMO JUSTIFICATIVA E OBJETIVOS: Delirium é uma alteração aguda do estado mental, com curso flutuante e alta incidência no pós-operatório (PO) de cirurgia cardíaca (CC). O delirium pode levar a consequências a curto e longo prazo. O objetivo deste estudo foi avaliar a prevalência de delirium e dor e seus fatores de risco no 1º dia PO após CC. MÉTODOS: Trata-se de um estudo transversal analítico. Para determinar delirium no PO, foram utilizados o Confusion Assessment Method modificado para ambiente de Unidade de Terapia Intensiva (CAM-UTI) e a Richmond Agitation Sedation Scale (RASS). A dor PO foi analisada por meio da Escala Analógica Visual (EAV) e a presença de componentes neuropáticos foi analisada por meio da Escala de Avaliação de Sintomas e Sinais Neuropáticos de Leeds (LANSS). Após análise, os pacientes foram divididos nos grupos Delirium (D) e Sem Delirium (SD). RESULTADOS: Foram estudados 79 pacientes. A prevalência de delirium foi de 16,5% (IC 95%=9,06-26,49%) e o número médio de comorbidades no pré-operatório foi um fator de risco significativo para a ocorrência de delirium (D=4,15±2,37 versus SD=2,96±1,78, p: 0,04). Outro fator de risco foi o grupo com mais de 65 anos, com ocorrência de delirium 1,45 vezes maior (RP=1,12-1,88, p: 0,0014). Em relação à avaliação da dor, 72,15% (IC 95% 60,93-81,65%) a relataram no 1º dia PO. CONCLUSÃO: A prevalência de delirium foi semelhante à de estudos anteriores. O número de comorbidades prévias e a idade avançada foram fatores de risco para delirium. A dor estava presente predominantemente na região da incisão da esternotomia.

ABSTRACT Objectives: To verify the association between the ABO blood type and the risk of SARS-CoV-2 infection and COVID-19 disease severity. Methods: This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), using the 2020 PRISMA Checklist and flow diagram, and articles selected for review were analyzed using the Newcastle-Ottawa Quality Rating Scale. The research question was: "Would the ABO blood group influence the risk of infection and clinical course of patients infected with SARS-CoV-2?", The following databases were used: Embase, PubMed, Virtual Health Library (VHL), Web of Science, Science-Direct and Scopus. The protocol for this review was registered in the Prospective Register of Systematic Reviews (PROSPERO), number CRD42021245945. Results: We found 798 articles across PubMed, Embase, Scopus, Web of Science, Science Direct and Virtual Health Library and 54 articles were included in the final analysis. Among 30 studies evaluating the risk of COVID-19 infection, 21 found significant correlations with ABO blood groups, 14 of them revealing an increased risk in blood group A and 15 studies showing a decreased risk in blood group O. Most studies found no significant correlation with disease severity or mortality. Conclusion: The qualitative assessment of available information suggests that blood group A may be a risk factor for COVID-19 infection and that blood group O may have a protective effect. We were unable to determine a clear association between the ABO blood group and mortality. These conclusions are based on highly heterogenous evidence.

Abstract Timor-Leste is a country with a rich natural and cultural heritage, with great potential to develop tourism to support the country's economic development. The touristic infrastructures are deficient and the touristic attributes are deficient, so the number of visitors is relatively small. The question that arises is “How to overcome these limitations to the development of the tourism sector?”. This study sought to identify the motivations and expectations of visitors as well as their satisfaction with the Timor-Leste destination. For its implementation, primary data were collected through a questionnaire survey among visitors to Timor-Leste. The study concluded that most of the interviewees, visitors, came from Australia, followed by Portugal and that the purpose of the trip was mostly professional. The attributes constituted by the climate, tranquillity and hospitality were valued in a satisfactory or very satisfactory way by the visitors; in the group regarding direct usufruct, satisfaction and a lot of satisfaction were always superior to dissatisfaction, although with some warning signs in dissatisfaction; in prices charged, the degree of dissatisfaction was around 40%, and the quality of the infrastructures showed the greatest signs of dissatisfaction on the part of visitors. The proposals for improvement and recommendations were: not leaving litter on the beaches, improving sanitation, road conditions, tourist information and guides, accommodation and ecotourism conditions, public transport in Dili and in the Districts, entertainment, tourist attraction and traditional gastronomy.

Resumo Timor-Leste é um país com um rico património natural e cultural, com grande potencial para desenvolver o turismo para suportar o desenvolvimento económico do país. As infraestruturas turísticas são modestas e os atributos turísticos deficientes, pelo que o número de visitantes é relativamente pequeno. A questão que se coloca é “Como ultrapassar estas limitações ao desenvolvimento do setor do turismo”. Este estudo procurou identificar as motivações e expetativas dos visitantes assim como a sua satisfação com o destino Timor-Leste. Para a sua concretização, foram recolhidos dados primários através de inquérito por questionários junto de visitantes de Timor-Leste. O trabalho concluiu que a maioria dos entrevistados, visitantes, era proveniente d Austrália, logo seguida de Portuga e que a finalidade da viagem era maioritariamente profissional. Os atributos constituídos pelo clima, tranquilidade e hospitalidade foram valorizados de forma satisfatória ou muito satisfatória pelos visitantes; nos do grupo respeitante ao usufruto direto, a satisfação e a muita satisfação foram sempre superiores à insatisfação embora com alguns sinais de alerta na insatisfação, nos preços praticados, o grau de insatisfação rondou os 40%, e na qualidade das infraestruturas verificaram-se os maiores sinais de insatisfação por parte dos visitantes. As propostas de melhoria e recomendações foram: não deixar lixo nas praias, melhoria do saneamento, condições das estradas, informações e guias turísticos, condições de alojamento e de ecoturismo, transportes públicos em Díli e nos Distritos, animação, atração turística e gastronomia tradicional.