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 This article aims to characterize the language employed in educational and communications materials about STIs, HIV/AIDS and viral hepatitis produced by the Ministry of Health between 2010 and 2019, identifying elements related to health promotion and disease prevention. We conducted an exploratory descriptive study. The materials were selected by performing a systematic search of the Ministry of Health website focusing on the period 2010-2019. The materials were analyzed to determine the educational approaches adopted. The preventive, educational and personal development approaches were identified in 100% (201), 24.87% (50) and 7.96% (16) of the materials, respectively. The radical and popular education for health approaches were not observed. The almost exclusive focus on the preventive approach reveals that promoting changes in individual habits and behavior alone is not sufficient to combat and solve the problem of STIs, HIV/AIDS and viral hepatitis in Brazil.

Resumo O objetivo do artigo é caracterizar a linguagem utilizada nos materiais educativos e comunicacionais vinculados à temática das IST, do HIV/Aids e hepatites virais produzidos e veiculados pelo Ministério da Saúde no período de 2010 a 2019, identificando elementos de promoção à saúde e de prevenção de doenças. Metodologia descritiva exploratória para a caracterização da linguagem utilizada nos materiais educativos e comunicacionais sobre as IST, do HIV/Aids e hepatites virais. Para a seleção dos materiais educativos, adotou-se a estratégia de busca sistemática realizada no site do Ministério da Saúde do Brasil por um período de dez anos: de 2010 a 2019. Os materiais foram observados por meio dos enfoques educativos. O enfoque preventivo foi identificado em 100% dos materiais analisados (201). O enfoque educativo foi encontrado em 24,87% (50) dos materiais, e o enfoque de desenvolvimento pessoal foi encontrado em 7,96% (16). Os enfoques radical e da educação popular em saúde não foram observados. A atenção quase exclusiva ao enfoque preventivo revela que cuidados individuais isoladamente não são suficientes para combater e sanar o problema das IST, do HIV/Aids e das hepatites virais no Brasil.

Abstract The child and adolescent mental health policy, implemented in Brazil from the beginning of the 21st century, established the Centros de Atenção Psicossocial Infantojuvenis (CAPSi - Psychosocial Care Centers for Children and Adolescent) as strategic services to prioritize more complex cases, with emphasis on autism. This study aims to compare two sources of information on the perception family members of autistic people regarding the work carried out by CAPSi: the first was collected in a 2011 survey, which used focus groups; and the second, from the literature produced on the subject in the following 10 years. The family member’s narratives were organized into four thematic axes: perception of the effects of psychosocial care; information sharing; perception about care processes; and demands and claims. Despite the heterogeneity between the studies, the results indicated that the work of the CAPSi produces positive effects, especially regarding socialization. However, this perception is not accompanied by a better understanding of the clinical picture and care processes. The value of treatment is often attributed to the personal attitude of professionals, indicating the lack of sharing and participation by family members. These aspects should encourage the CAPSi to involve family members as partners in care, particularly valuing the transmission of the psychosocial reasoning, its strategies and direction of care.

Resumo A política de saúde mental infantojuvenil, implantada no Brasil no início do século XXI, estabeleceu os Centros de Atenção Psicossocial Infantojuvenis (CAPSi) como equipamentos estratégicos para priorizar os casos de maior complexidade, com destaque para os autistas. Este estudo visa cotejar duas fontes de informação sobre a percepção de familiares de autistas acerca do trabalho desenvolvido pelos CAPSi: a primeira foi colhida em pesquisa de 2011, que utilizou grupos focais; e a segunda, a partir da literatura produzida sobre o tema nos 10 anos seguintes. As narrativas foram organizadas em quatro eixos temáticos: percepção sobre os efeitos do trabalho psicossocial; compartilhamento de informações; percepção sobre os processos de cuidado; e demandas e reivindicações. A despeito da heterogeneidade entre os estudos, os resultados indicaram que o trabalho dos CAPSi produz efeitos positivos, principalmente em relação à socialização. Contudo, essa percepção não é acompanhada de melhor entendimento do quadro clínico e dos processos de cuidado. O valor do tratamento é frequentemente atribuído à atitude pessoal dos profissionais, indicando a ausência de compartilhamento e participação dos familiares. Esses aspectos devem instigar os CAPSi a envolver os familiares como parceiros do cuidado, dando atenção especial à transmissão da lógica psicossocial, suas estratégias e direção do cuidado.

Abstract Objective: to analyze nurses’ discourse about the potentialities in using information technologies as organizational support for the COVID-19 coping actions in Primary Health Care. Method: a qualitative and exploratory study conducted in the Family Health Strategy units from the city of João Pessoa, Paraíba, Brazil. Data collection was carried out from September to November 2021 with 26 nurses selected through the snowball technique, resorting to a semi-structured interview script. The empirical material was organized in the Atlas.ti 9 software and grounded on the theoretical-methodological contribution of Discourse Analysis, French Line. Results: three discursive blocks were evidenced: innovation based on social media; health education actions; resoluteness in organizational actions, presenting the relevance of the WhatsApp®, Instagram® and Facebook® apps as strategic resources, in order to collaborate in the Primary Health Care are with the organization of health actions against COVID-19 by nurses. Conclusion: health units have the potential to strengthen the assistance provided through digital organizational devices; however, they need political support that invests in the structure and strategies to enhance organization of the health actions.

Resumen Objetivo: analizar el discurso de los enfermeros sobre el potencial que tienen las tecnologías de la información como apoyo organizacional a las acciones en la lucha contra el COVID-19 en la Atención Primaria de Salud. Método: estudio cualitativo y exploratorio, realizado en unidades de la Estrategia Salud de la Familia, en la ciudad de João Pessoa, Paraíba, Brasil. La recolección de datos se realizó de septiembre a noviembre de 2021 con 26 enfermeros seleccionados mediante la técnica de bola de nieve, utilizando un formulario de entrevista semiestructurada. El material empírico fue organizado en el software Atlas.ti 9 y se basó en el aporte teórico-metodológico del Análisis del Discurso de la escuela francesa. Resultados: se observaron tres bloques discursivos: innovación desde las redes sociales; acciones de educación para la salud; resolutividad en las acciones organizacionales, que muestran la importancia de las aplicaciones WhatsApp®, Instagram® y Facebook® como recursos estratégicos, que colaboran en el área de Atención Primaria de Salud con la organización de las acciones de salud contra el COVID-19 que llevan a cabo los enfermeros. Conclusión: las unidades de salud tienen potencial para fortalecer la atención a través de dispositivos organizacionales digitales, pero necesitan apoyo político que invierta en la estructura y en estrategias para mejorar la organización de las acciones de salud.

Resumo Objetivo: analisar o discurso de enfermeiros acerca das potencialidades na utilização das tecnologias da informação como apoio organizacional das ações de enfrentamento da COVID-19 na Atenção Primária à Saúde. Método: estudo qualitativo e exploratório, realizado nas unidades da Estratégia Saúde da Família, na cidade de João Pessoa, Paraíba, Brasil. A coleta de dados foi realizada de setembro a novembro de 2021 com 26 enfermeiros selecionados por meio da snowball technique, utilizando-se de roteiro de entrevista semiestruturado. O material empírico foi organizado no software Atlas.ti 9 e fundamentado com base no aporte teórico-metodológico da Análise do Discurso de linha francesa. Resultados: evidenciaram-se três blocos discursivos: inovação a partir das mídias sociais; ações de educação em saúde; resolutividade nas ações organizacionais, apresentando a relevância dos aplicativos WhatsApp®, Instagram® e Facebook® como recursos estratégicos, de forma a colaborar para a área de Atenção Primária à Saúde com a organização das ações de saúde frente à COVID-19 por enfermeiros. Conclusão: as unidades de saúde possuem potencial para fortalecer a assistência por meio dos dispositivos organizacionais digitais, no entanto, necessitam de apoio político que invista na estrutura e em estratégias para potencializar a organização das ações de saúde.

RESUMO Objetivo: Analisar a evolução temporal da anemia em crianças de seis a 59 meses em Pernambuco, com base nos inquéritos populacionais de 1997, 2006 e 2016 e os fatores associados à situação em 2016. Métodos: Os estudos de campo ocorreram nos domicílios dos participantes, na Região Metropolitana do Recife, interior urbano e rural. No estudo de tendência da anemia em crianças, utilizaram-se dados da II (40,9%) e III PESNs (Pesquisa Estadual de Saúde e Nutrição) (32,8%). Os dados da IV PESN foram coletados por formulários com famílias para verificação das condições socioeconomicas e individuais, bem como registros antropométricos, peso e altura, e bioquímicos, hemoblobina. Para o estudo de tendência temporal, utilizou-se o teste de tendência de proporção; e para os fatores associados a regressão de Poisson para testes de hipóteses. Estatisticamente considerou-se significante o valor p<0,05. Resultados: A prevalência de anemia, em 2016, foi de 24,2%, expressando uma diminuição significativa na ocorrência da doença. Nas crianças de 6–23 m., houve redução da II e III para IV PESN de 63 e 55,6 para 37,7% (p<0,001), respectivamente. Em 2016, as variáveis com significância estatística para a anemia em crianças foram a hemoglobina materna, a idade da criança, a ocorrência atual ou recente de diarreia e o índice P/I. Conclusão: Entre 1997 e 2016, houve redução da anemia, demostrando uma tendência epidemiológica que pode contribuir para melhoria contínua da saúde das crianças abaixo de cinco anos em Pernambuco.

ABSTRACT Objective: To analyze the temporal evolution of anemia in children aged six to 59 months in Pernambuco, based on population surveys from 1997, 2006, and 2016 and the factors associated with the situation in 2016. Methods: The field studies took place in the participants’ households, in the Recife Metropolitan Area, as well as in the urban and rural inland. The trend study of anemia in children used data from the State Health and Nutrition Survey (Pesquisa Estadual de Saúde e Nutrição — PESN) II (40.9%) and III (32.8%). Data from PESN IV were collected using questionnaires administered to families to verify socioeconomic and individual conditions, as well as anthropometric — weight and height — and biochemical — hemoglobin — records. We adopted the test for trend in proportion for the time trend study and Poisson regression for hypothesis tests for the associated factors. Statistically significance was set at a p-value<0.05. Results: In 2016, the prevalence of anemia was 24.2%, indicating a significant reduction in disease incidence. In children aged 6–23 months, this number decreased from PENS II and III to PENS IV — 63 and 55.6 to 37.7% (p<0.001), respectively. In 2016, the statistically significant variables for anemia in children were maternal hemoglobin, child's age, current or recent case of diarrhea, and weight-for-age index Conclusion: Between 1997 and 2016, anemia rates decreased, showing an epidemiological trend that can contribute to continuously improve the health of children under five years of age in Pernambuco.

RESUMO Objetivo: Identificar as consequências do uso excessivo da tecnologia na infância. Fontes de dados: Foi realizada uma revisão sistemática nas bases de dados eletrônicas PubMed (National Library of Medicine — National Institutes of Health) e Biblioteca Virtual em Saúde (BVS) com artigos publicados de 2015 a 2020, em inglês, português e espanhol, utilizando os termos internet, child e growth and development. Síntese dos dados: Foram localizados 554 artigos, resultando em oito artigos incluídos nesta pesquisa. Os estudos foram avaliados quanto à sua qualidade metodológica pelos critérios Strengthening the Reporting of Observational Studies in Epidemiology (Strobe) e Consolidated Standards of Reporting Trials (Consort) e receberam pontuações que variaram de 17 a 22 pontos. Os artigos evidenciaram que há fatores positivos e negativos associados ao uso de tecnologias na infância, embora a maioria dos textos ressalte seu aspecto prejudicial. O uso excessivo de internet, jogos e exposição à televisão ocasionaram alterações intelectuais e da saúde mental, porém também possibilitaram o desenvolvimento psicossocial. Conclusões: Impedir o uso da internet é uma medida utópica, visto que a sociedade faz uso de tecnologias. Considerando que a internet pode trazer benefícios, mas também malefícios, são importantes a otimização do uso e a redução dos riscos, como a participação dos pais e responsáveis como moderadores dessa utilização, além da atualização dos profissionais da saúde para melhor orientá-los.

Abstract Objective: To identify the consequences of technology overuse in childhood. Data source: A systematic review was carried out in the electronic databases PubMed (National Library of Medicine of the National Institutes of Health) and BVS (Virtual Health Library), considering articles published from 2015 to 2020, in English, Portuguese and Spanish using the terms “Internet”, “Child” and “Growth and Development”. Data synthesis: 554 articles were found and 8 were included in the analysis. The studies’ methodological quality was assessed by the Strobe and Consort criteria, being scored from 17 to 22 points. The articles showed positive and negative factors associated with the use of technology in childhood, although most texts emphasize the harmful aspects. Excessive use of internet, games and exposure to television are associated with intellectual deficits and mental health issues, but can also enable psychosocial development. Conclusions: Preventing the use of the internet is a utopic measure ever since society makes use of technologies. The internet is associated with benefits as well as with harms. It is important to optimize the use of internet and reduce risks with the participation of parents and caregivers as moderators, and training of health professionals to better guide them.

RESUMO Objetivo: Analisar a ocorrência de desigualdade racial e regional na tendência temporal das prevalências de déficit de estatura e excesso de peso de crianças brasileiras menores de cinco anos ao longo dos anos de 2008–2018. Métodos: Estudo ecológico de série temporal com dados do Sistema de Vigilância Alimentar e Nutricional das prevalências de déficit de estatura e excesso de peso em crianças menores de 5 anos de acordo com raça/cor, região e ano. Para avaliar diferenças entre prevalências medianas por ano dos desfechos, realizou-se teste de Kruskal-Wallis. Análises de regressão linear foram propostas para avaliar tendências das prevalências dos desfechos ao longo dos anos. Resultados: No Brasil, as crianças pretas apresentaram tendência de crescimento do excesso de peso (β=4,611; p=0,042). Entre as crianças pretas, houve aumento ao longo dos anos do déficit de estatura no Sudeste (β=3,960; p=0,014) e queda no Sul (β=-4,654; p=0,022). No Brasil e na maioria das regiões, a prevalência mediana do déficit de estatura foi maior nas crianças pretas do que nas brancas (12,86 vs. 11,54%, p<0,001). No Sudeste e Sul, as crianças pretas também apresentaram as maiores prevalências de excesso de peso (15,48 e 15,99%, respectivamente). Conclusão: Crianças de regiões menos desenvolvidas do Brasil e pretas apresentaram maior vulnerabilidade para dupla carga de má nutrição.

ABSTRACT Objective: To analyze the occurrence of racial and regional inequality in the temporal trend of the prevalence of stunting and overweight in Brazilian children under five years of age over the years 2008–2018. Methods: An ecological time-series study with data from the Food and Nutrition Surveillance System on the prevalence of stunting and overweight in children under five years old according to race/skin color, region, and year. To assess differences between median prevalence per year of outcomes, the Kruskal-Wallis test was performed. Linear regression analyses were proposed to assess trends in the prevalence of outcomes over the years. Results: In Brazil, black children tended to be overweight (β=4.611; p=0.042). Among black children, there was an increase over the years in stunting in the Southeast (β=3.960; p=0.014) and a decrease in the South (β=-4.654; p=0.022). In Brazil and in most regions, the median prevalence of stunting was higher in black children than in white ones (12.86 vs. 11.54%, p<0.001). In the Southeast and South, black children also had the highest prevalence of overweight (15.48 and 15.99%, respectively). Conclusion: Children from less developed regions of Brazil and of black skin color/race were more vulnerable to a double burden of malnutrition.

ABSTRACT Introduction: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease. Methods: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate. Results: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001). Conclusion: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions.

ABSTRACT Introduction: Due to Brazilian population aging, prevalence of aortic stenosis, and limited number of scores in literature, it is essential to develop risk scores adapted to our reality and created in the specific context of this disease. Methods: This is an observational historical cohort study with analysis of 802 aortic stenosis patients who underwent valve replacement at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul, from 1996 to 2018. With the aid of logistic regression, a weighted risk score was constructed based on the magnitude of the coeficients β of the logistic equation. Two performance statistics were obtained: area under the receiver operating characteristic curve and the chi-square (χ2) of Hosmer-Lemeshow goodness-of-fit with Pearson’s correlation coeficient between the observed events and predicted as a model calibration estimate. Results: The risk predictors that composed the score were valve replacement surgery combined with coronary artery bypass grafting, prior renal failure, New York Heart Association class III/IV heart failure, age > 70 years, and ejection fraction < 50%. The receiver operating characteristic curve area was 0.77 (95% confidence interval: 0.72-0.82); regarding the model calibration estimated between observed/predicted mortality, Hosmer-Lemeshow test χ2 = 3,70 (P=0.594) and Pearson’s coeficient r = 0.98 (P<0.001). Conclusion: We propose the creation of a simple score, adapted to the Brazilian reality, with good performance and which can be validated in other institutions.

ABSTRACT Coordinated and harmonic (synchronous) ventricular electrical activation is essential for better left ventricular systolic function. Intraventricular conduction abnormalities, such as left bundle branch block due to artificial cardiac pacing, lead to electromechanical “dyssynchronopathy” with deleterious structural and clinical consequences. The aim of this review was to describe and improve the understanding of all the processes connecting the several mechanisms involved in the development of artificially induced ventricular dyssynchrony by cardiac pacing, most known as pacing-induced cardiomyopathy (PiCM). The chronic effect of abnormal impulse conduction and nonphysiological ectopic activation by artificial cardiac pacing is suspected to affect metabolism and myocardial perfusion, triggering regional differences in the activation/contraction processes that cause electrical and structural remodeling due to damage, inflammation, and fibrosis of the cardiac tissue. The effect of artificial cardiac pacing on ventricular function and structure can be multifactorial, and biological factors underlying PiCM could affect the time and probability of developing the condition. PiCM has not been included in the traditional classification of cardiomyopathies, which can hinder detection. This article reviews the available evidence for pacing-induced cardiovascular disease, the current understanding of its pathophysiology, and reinforces the adverse effects of right ventricular pacing, especially right ventricular pacing burden (commonly measured in percentage) and its repercussion on ventricular contraction (reflected by the impact on left ventricular systolic function). These effects might be the main defining criteria and determining mechanisms of the pathophysiology and the clinical repercussion seen on patients.

ABSTRACT Objective: To analyze the occurrence of racial and regional inequality in the temporal trend of the prevalence of stunting and overweight in Brazilian children under five years of age over the years 2008–2018. Methods: An ecological time-series study with data from the Food and Nutrition Surveillance System on the prevalence of stunting and overweight in children under five years old according to race/skin color, region, and year. To assess differences between median prevalence per year of outcomes, the Kruskal-Wallis test was performed. Linear regression analyses were proposed to assess trends in the prevalence of outcomes over the years. Results: In Brazil, black children tended to be overweight (β=4.611; p=0.042). Among black children, there was an increase over the years in stunting in the Southeast (β=3.960; p=0.014) and a decrease in the South (β=-4.654; p=0.022). In Brazil and in most regions, the median prevalence of stunting was higher in black children than in white ones (12.86 vs. 11.54%, p<0.001). In the Southeast and South, black children also had the highest prevalence of overweight (15.48 and 15.99%, respectively). Conclusion: Children from less developed regions of Brazil and of black skin color/race were more vulnerable to a double burden of malnutrition.

RESUMO Objetivo: Analisar a ocorrência de desigualdade racial e regional na tendência temporal das prevalências de déficit de estatura e excesso de peso de crianças brasileiras menores de cinco anos ao longo dos anos de 2008–2018. Métodos: Estudo ecológico de série temporal com dados do Sistema de Vigilância Alimentar e Nutricional das prevalências de déficit de estatura e excesso de peso em crianças menores de 5 anos de acordo com raça/cor, região e ano. Para avaliar diferenças entre prevalências medianas por ano dos desfechos, realizou-se teste de Kruskal-Wallis. Análises de regressão linear foram propostas para avaliar tendências das prevalências dos desfechos ao longo dos anos. Resultados: No Brasil, as crianças pretas apresentaram tendência de crescimento do excesso de peso (β=4,611; p=0,042). Entre as crianças pretas, houve aumento ao longo dos anos do déficit de estatura no Sudeste (β=3,960; p=0,014) e queda no Sul (β=-4,654; p=0,022). No Brasil e na maioria das regiões, a prevalência mediana do déficit de estatura foi maior nas crianças pretas do que nas brancas (12,86 vs. 11,54%, p<0,001). No Sudeste e Sul, as crianças pretas também apresentaram as maiores prevalências de excesso de peso (15,48 e 15,99%, respectivamente). Conclusão: Crianças de regiões menos desenvolvidas do Brasil e pretas apresentaram maior vulnerabilidade para dupla carga de má nutrição.

ABSTRACT Objective To identify the association between dietary patterns and nutritional status in adolescent freshmen at a public university in Northeastern Brazil. Methods In this cross-sectional study anthropometric variables, body composition and food intake were collected and assessed using the food frequency questionnaire. Dietary patterns were evaluated through factor analysis using the principal component extraction method. Results Two dietary patterns were identified: “Western” pattern, consisting of foods with high energy density and low nutritional value, and the “traditional Brazilian” pattern, with foods from Brazilian cuisine such as rice, beans, corn, roots and tubers, fruits, greens and vegetables. The multiple regression analysis revealed a negative association between the “traditional Brazilian” pattern and both excess weight and body fat in females. Conclusion A healthy dietary pattern with typical local cuisine foods can offer protection to health and should be encouraged.

RESUMO Objetivo Identificar a associação entre padrões alimentares e estado nutricional em adolescentes recém-ingressos em uma universidade pública do Nordeste brasileiro. Métodos Neste estudo transversal foram coletados dados antropométricos, composição corporal e consumo alimentar, verificado pelo questionário de frequência alimentar. Os padrões alimentares foram derivados através da análise fatorial pelo método de extração de componentes principais. Resultados Dois padrões alimentares foram identificados: o padrão “Ocidental”, composto por alimentos de elevada densidade energética e de baixo valor nutricional, e o padrão “tradicional brasileiro”, contendo alimentos da culinária brasileira como arroz, feijão, milho, raízes e tubérculos, frutas, verduras e legumes. A análise de regressão múltipla mostrou associação negativa entre o excesso de peso e de gordura corporal e o padrão alimentar “tradicional brasileiro” no sexo feminino. Conclusão Um padrão alimentar saudável e com alimentos típicos da culinária local pode conferir proteção à saúde, devendo ser incentivado.

ABSTRACT Objective: To analyze the temporal evolution of anemia in children aged six to 59 months in Pernambuco, based on population surveys from 1997, 2006, and 2016 and the factors associated with the situation in 2016. Methods: The field studies took place in the participants’ households, in the Recife Metropolitan Area, as well as in the urban and rural inland. The trend study of anemia in children used data from the State Health and Nutrition Survey (Pesquisa Estadual de Saúde e Nutrição — PESN) II (40.9%) and III (32.8%). Data from PESN IV were collected using questionnaires administered to families to verify socioeconomic and individual conditions, as well as anthropometric — weight and height — and biochemical — hemoglobin — records. We adopted the test for trend in proportion for the time trend study and Poisson regression for hypothesis tests for the associated factors. Statistically significance was set at a p-value<0.05. Results: In 2016, the prevalence of anemia was 24.2%, indicating a significant reduction in disease incidence. In children aged 6–23 months, this number decreased from PENS II and III to PENS IV — 63 and 55.6 to 37.7% (p<0.001), respectively. In 2016, the statistically significant variables for anemia in children were maternal hemoglobin, child's age, current or recent case of diarrhea, and weight-for-age index Conclusion: Between 1997 and 2016, anemia rates decreased, showing an epidemiological trend that can contribute to continuously improve the health of children under five years of age in Pernambuco.

RESUMO Objetivo: Analisar a evolução temporal da anemia em crianças de seis a 59 meses em Pernambuco, com base nos inquéritos populacionais de 1997, 2006 e 2016 e os fatores associados à situação em 2016. Métodos: Os estudos de campo ocorreram nos domicílios dos participantes, na Região Metropolitana do Recife, interior urbano e rural. No estudo de tendência da anemia em crianças, utilizaram-se dados da II (40,9%) e III PESNs (Pesquisa Estadual de Saúde e Nutrição) (32,8%). Os dados da IV PESN foram coletados por formulários com famílias para verificação das condições socioeconomicas e individuais, bem como registros antropométricos, peso e altura, e bioquímicos, hemoblobina. Para o estudo de tendência temporal, utilizou-se o teste de tendência de proporção; e para os fatores associados a regressão de Poisson para testes de hipóteses. Estatisticamente considerou-se significante o valor p<0,05. Resultados: A prevalência de anemia, em 2016, foi de 24,2%, expressando uma diminuição significativa na ocorrência da doença. Nas crianças de 6–23 m., houve redução da II e III para IV PESN de 63 e 55,6 para 37,7% (p<0,001), respectivamente. Em 2016, as variáveis com significância estatística para a anemia em crianças foram a hemoglobina materna, a idade da criança, a ocorrência atual ou recente de diarreia e o índice P/I. Conclusão: Entre 1997 e 2016, houve redução da anemia, demostrando uma tendência epidemiológica que pode contribuir para melhoria contínua da saúde das crianças abaixo de cinco anos em Pernambuco.

ABSTRACT Objective: To analyze the relationship between malocclusion and bullying and its impact on the well-being and quality of life of students from low social development areas. Material and Methods: This cross-sectional study included 243 schoolchildren between 10 and 17 years. Malocclusion was analyzed using Dental Aesthetic Index. Bullying and self-perception of the impact of one’s oral condition on quality of life and interpersonal relationships were assessed by questions from National Survey of Schoolchildren's Health and Child Perceptions Questionnaire 11-14 (CPQ11-14). Data were analyzed using the Spearman correlation coefficient and Mann-Whitney tests, considering groups: 10-11, 12-14 and 15-17 years. Results: No correlation was observed between malocclusion and bullying. However, in the 12-14 group, poor correlations were found between malocclusion and the CPQ11-14 (0.226) and between malocclusion and being shy/embarrassed due to oral aspects (0.298). Positive correlations were observed between bullying and the impact on the quality of life in the 10-11 (0.420) and 12-14 (0.425) groups. In the older group, a positive correlation (0.724) was observed between the concern about what others think of their oral health and the impact on their quality of life. Conclusion: There was no evidence of a relationship between malocclusion and bullying. However, the oral conditions negatively affected the interpersonal relationships and the student's quality of life.

Abstract The aim of this study was to determine the resistance of gastrointestinal nematodes in goats and sheep to the anthelmintic drugs levamisole, ivermectin, and albendazole in the metropolitan region of São Luís Island, Maranhão, Brazil. Fecal samples were collected from 150 animals across four different farms; two farms had goats, and the other two had sheep. The samples were then randomly divided into three to four groups of 10 animals: Group I: control, without treatment; Group II: ivermectin treatment; Group III: levamisole treatment; and Group IV: albendazole treatment. Stool samples were collected from the rectal ampulla one day before treatment and 10 days after anthelmintic treatment. Individual coproparasitological examinations were performed using the modified McMaster technique at the Animal Health Laboratory of the Federal Institute of Maranhão, Campus São Luís-Maracanã. The efficacies of the anthelmintic drugs against gastrointestinal nematodes in goats and sheep were: 14.28%, and 13.6% for ivermectin; 0% and 79.4% for levamisole; and 59.8% and 3.43% for albendazole, respectively Gastrointestinal nematodes demonstrated multiple anthelmintic resistance, as the percentage reduction in egg count was less than 95% and the lower limit of the confidence interval was less than 90%.

Resumo Objetivou-se determinar a resistência de nematoides gastrintestinais aos anti-helmínticos levamisol, ivermectina e albendazol em caprinos e ovinos da região metropolitana da Ilha de São Luís, Maranhão, Brasil. Foram coletadas amostras de fezes de 150 animais de quatro propriedades diferentes, sendo 2 com caprinos e 2 com ovinos, e aleatoriamente distribuídos de três a quatro grupos de 10 animais: Grupo I: grupo controle, sem tratamento. Grupo II: tratado com anti-helmíntico à base de ivermectina, administrado oralmente na dose de 200 mcg/kg; Grupo III: tratado com anti-helmíntico à base de levamisol, administrado oralmente na dose de 7,5mg/kg e Grupo IV: tratado com anti-helmíntico à base de albendazol administrado oralmente na dose de 3mg/kg. Amostras de fezes foram colhidas da ampola retal um dia antes do tratamento e 10 dias após o tratamento anti-helmíntico. Foram feitos exames coproparasitológicos individuais, pela técnica de McMaster modificada, no Laboratório de Sanidade Animal, do Instituto Federal do Maranhão (IFMA), Campus São Luís-Maracanã. A ivermectina, na espécie caprina, mostrou eficácia de 14,28%, enquanato para ovina, 13,6 e 52,2%. Considerando o levamisol na espécie caprina, não apresentou eficácia contra os nematoides gastrintestinais, enquanto para ovinos, apresentou eficácia de 79,4%. Já o albendazol, apresentou eficácia de 59,8% para caprinos, e 3,43% para ovinos. Os nematoides gastrintestinais demonstraram resistência múltipla (RAM), visto que a percentagem de redução da contagem de ovos foi inferior a 95% e o limite inferior do intervalo de confiança menor do que 90%.