Abstract Objectives: to analyze the consumption of ultra-processed food and its association with body image, physical activity, nutritional status and self-assessment on food of pregnant women enrolled in the Primary Health Care. Methods: this is a cross-sectional study carried out with pregnant women enrolled in the Family Health Strategy in the city of Montes Claros, Minas Gerais. Data were collected through a questionnaire. The dependent variable was the consumption of ultra-processed food, and the independent ones addressed body appearance, physical activity, nutritional status, self-assessment on food and food consumption. Descriptive analysis was carried out and for association of analysis, the linear regression model was used with crude and adjusted associations. Results: 1,185 pregnant women participated in the study. Caloric intake from ultra-processed food represented 32.0% of these women’s daily diet. There was an association between consumption of ultra-processed food and physical activity (β=-0.08; p<0.01), pre-gestional nutritional status (β=-0,12; p<0.01) and body image (β =0.08; p=0.01). Conclusion: the pregnant women presented high consumption of ultra-processed food. Having a negative body image, the lowest level of physical activity, and high pre-gestational nutritional status are conditions that influenced the consumption of these food.

Resumo Objetivos: analisar o consumo de alimentos ultraprocessados e sua associação com imagem corporal, atividade física, estado nutricional e autoavaliação alimentar de gestantes cadastradas na Atenção Primária à Saúde. Métodos: trata-se de um estudo transversal, realizado com gestantes cadastradas na Estratégia Saúde da Família do município de Montes Claros, Minas Gerais. Os dados foram coletados por meio de um questionário. A variável dependente foi consumo de alimentos ultraprocessados, e as independentes abordaram aspecto corporal, atividade física, estado nutricional, autoavaliação alimentar e consumo alimentar. Realizou-se análise descritiva e para análise de associação, utilizou-se o modelo de regressão linear com associações brutas e ajustadas. Resultados: participaram do estudo 1.185 gestantes. O consumo calórico proveniente dos ultraprocessados representou 32,0% da dieta diária dessas mulheres. Verificou-se associação entre consumo de ultraprocessados com atividade física (β=-0,08; p<0,01), estado nutricional pré-gestacional (β=-0,12; p<0,01) e imagem corporal (β=0,08; p=0,01). Conclusão: as gestantes apresentaram alto consumo de alimentos ultraprocessados. Ter imagem corporal negativa, menor nível de atividade física, estado nutricional pré-gestacional elevado são condições que influenciaram o consumo desses alimentos.

Resumo A Escala de Apego Materno-Fetal tem sido amplamente aplicada em pesquisas sobre a temática. Desconhecem-se investigações sobre a validade de uma versão reduzida desse instrumento no Brasil. Este estudo teve por objetivo propor uma versão abreviada da Escala de Apego Materno-Fetal e examinar suas evidências de validade e confiabilidade. Trata-se de um estudo metodológico, realizado com uma amostra de 937 gestantes no âmbito da Atenção Primária à Saúde de Montes Claros, Minas Gerais - Brasil. Obteve-se uma versão trifatorial com 15 itens, que apresentou índices satisfatórios de ajuste. As validades convergente e discriminante foram próximas do recomendado. A escala diferenciou os escores de apego segundo diferentes características da amostra. A consistência interna (α de Cronbach = 0,878) e a confiabilidade composta (> 0,70) foram apropriadas. A versão brasileira abreviada da Escala de Apego Materno-Fetal apresentou atributos psicométricos satisfatórios para aplicação a gestantes na Atenção Primária à Saúde.

Abstract The Maternal-Fetal Attachment Scale has been widely applied in research on the subject. There are no known studies that have validated a shortened version of this instrument in Brazil. This study aimed to propose a shortened version of the Maternal-Fetal Attachment Scale and examine its evidence of validity and reliability. This methodological study was carried out on a sample of 937 pregnant women in the Primary Health Care of Montes Claros, Minas Gerais - Brazil. Construct validity and reliability were measured. A trifactor version with 15 items was obtained, which presented satisfactory adjustment indexes. Convergent and discriminant validities were close to the recommended ones. The scale differentiated attachment scores according to different sample characteristics. Internal consistency (Cronbach’s α = 0.878) and composite reliability (> 0.70) were appropriate. The abbreviated Brazilian version of the Maternal-Fetal Attachment Scale presented satisfactory psychometric attributes for application to pregnant women in Primary Health Care.

Resumen La Maternal Fetal Attachment Scale es ampliamente aplicada en estudios sobre la temática. No existen investigaciones sobre la validez de una versión corta de este instrumento en Brasil. Se pretende proponer una versión corta de esta escala y examinar su validez y fiabilidad. Estudio metodológico, realizado en la Atención Primaria de Salud de Montes Claros, Minas Gerais - Brasil en una muestra de 937 mujeres embarazadas. Se midieron la validez y la fiabilidad del constructo. Se obtuvo una versión de tres factores, con 15 ítems, e índices de ajuste satisfactorios. La validez convergente y discriminante se acercó a lo recomendado. La escala diferenció las puntuaciones de vinculación según las distintas características de la muestra. La consistencia interna (α de Cronbach = 0,878) y la fiabilidad compuesta (> 0,70) fueron adecuadas. La versión corta de Maternal Fetal Attachment Scale para Brasil presentó atributos psicométricos satisfactorios para aplicarse a gestantes en Atención Primaria de Salud.

RESUMO Objetivo Avaliar a qualidade da dieta das gestantes acompanhadas pelas equipes da Estratégia da Saúde da Familia e fatores associados. Métodos Trata-se de um estudo tranversal de base populacional, realizado com 1244 gestantes entre 2018 e 2019. O Índice de Qualidade da Dieta Adaptado para Gestantes foi utilizado para mensurar a qualidade da dieta adotada pelas gestantes e associá-la a fatores de risco (sociodemográficos, obstétricos, clínicos, comportamentais, estado nutricional) durante a gravidez. Utilizou-se um modelo hierárquico composto por três blocos. Aplicou-se a regressão logística multinomial. Resultados Observou-se que a média geral do Índice de Qualidade da Dieta foi de 72,75 pontos, sendo que a média do 1º tercil foi de 56,06 pontos; a média do 2º tercil foi de 73,71 pontos e que a do 3º tercil foi de 88,51 pontos. A dieta de pior qualidade esteve relacionada a gestantes com menor escolaridade (OR=2,36; 95% IC=1,39-4,01), sedentárias (OR=1,37 95% IC=1,17-2,61), que apresentavam autopercepção negativa da alimentação (OR=2,00; 95% IC=1,45-2,76) e que faziam de três a cinco refeições ao dia (OR=1,83; 95% IC=1,26-2,77) e menos de três (OR=2,64 ; 95% IC=1,13-6,18). Conclusão O presente estudo identificou que gestantes com menor escolaridade, sedentárias e com características nutricionais inadequadas apresentaram dieta de pior qualidade.

ABSTRACT Objective To evaluate the quality of the diet of the pregnant women monitored by the Family Health Strategy teams and associated factors. Methods This is a population-based cross-sectional study, carried out with 1244 pregnant women between 2018 and 2019. The Diet Quality Index Adapted for Pregnant Women was used to measure the quality of the diet and associate it with risk factors (sociodemographic, obstetric, clinical, behavioral, nutritional status) during the pregnancy. A hierarchical model composed of three blocks was used. A multinomial logistic regression was applied. Results The general average of this Diet Quality Index was 72.75 points, the average of the 1st tercile was 56.06 points, the average of the 2nd tercile was 73.71 points and the average of the 3rd was 88.51 points. The worst diet quality was related to pregnant women with lower education (OR=2.36; 95% CI=1.39-4.01), sedentary women (OR=1.37; 95% CI=1.17-2, 61), those who had a negative self-perception of food (OR=2.00; 95% CI=1.45-2.76) and who had 3 to 5 meals a day (OR=1.83; 95% CI=1.26-2.77), and less than 3 (OR=2.64; 95% CI=1.13-6.18). Conclusion The present study identified that pregnant women with less education, sedentary, and with inadequate nutritional characteristics presented worse diet qualities.

ABSTRACT The Hepatitis C virus (HCV) infection is a public health problem. The high level of HCV replication and its lack of post-transcriptional correction mechanisms results in the emergence of viral variants and the difficulty in determining polymorphisms and variants that contain the substitutions associated with resistance towards new antivirals. The main focus of this study was to map the NS5A and NS5B polymorphisms and resistance mutations to new antiviral drugs in HCV strains genotype 1 from patients with chronic hepatitis C infection. Serum samples were collected from patients who underwent routine viral load tests at the Instituto Adolfo Lutz, Sao Paulo city, Brazil. A total of 698 and 853 samples were used for the characterization of NS5A and NS5B regions, respectively, which comprise the HCV genotypes 1a and 1b. The prevalence of resistance mutations found in the NS5A region was 6.4%, with Y93H, L31M, Q30R, and Y93N as the main resistance-associated substitutions (RAS). No NS5B-associated RAS was observed for any of the analyzed drugs. These findings support that the RAS test should be offered to individuals with poor response to double combination regimens prior to treatment initiation, thereby assisting strain vigilance and selection of effective treatment or retreatment options using DAA regimens.

ABSTRACT Surveillance strategies to detect colonization are an important tool to prevent and control the spread of microorganisms in hematopoietic stem cell transplant (HSCT) units. The aim of this study was to evaluate routine surveillance cultures for screening colonization and infection by carbapenem-resistant Enterobacteriaceae (CRE), carbapenem-resistant Pseudomonas aeruginosa (CRPa), and vancomycin-resistant enterococci (VRE). Surveillance cultures were collected (1,323 samples) from 200 patients admitted to an HSCT unit over one year; swabs were taken on admission and then weekly. We compared the positivity of cultures for each site, agent, clinical and epidemiological data according to the colonization status. Infection due to multidrug-resistant organisms (MDROs) occurred in 52 (21.5%) patients, 45 (86.5%) due to blood stream infection; 12 (23%) patients had a positive surveillance culture before the infection. Cultures of 554 (41.8%) samples were performed for CRPa, 413 (31.2%) for VRE and 356 (27%) for CRE. Of these, 179 (13.5%) were positive. Colonization by any MDRO, CRE or CRPa was associated with increased risk of infection (P < 0.05), but not with death. Previous colonization by an MDRO was a significant risk for infection by these pathogens, specially by CRE. Overall, rectal swabs had the highest positivity rate compared with other sites, oropharynx swabs were an option for CRPa, and fecal cultures showed low positivity. Although the impact of the strategy on the mortality of patients undergoing HSCT is not clear, routine VRE surveillance should be questioned with regard to patients undergoing auto-HSCT due to the additional cost and little impact on survival rates.

RESUMO: Os arbovírus são vírus que mantêm o seu ciclo de vida em ambiente silvestre. Eles são transmitidos aos hospedeiros vertebrados por dípteros hematófagos, tem caráter zoonótico podendo estabelecer um ciclo enzoótico no meio urbano, sendo que em humanos a infecção pode ter caráter encefalomiogênico a hemorrágico. Este estudo teve como objetivo relatar a ocorrência de arbovírus em mamíferos da ordem Didelphimorphia e Rodentia capturados na Amazônia. Os soros dos animais foram submetidos a testes de Inibição da Hemaglutinação utilizando um painel viral com as 19 principais espécies de arbovírus que ocorrem na Amazônia. Foram capturados 14 espécimes de mamíferos silvestres, 12 Philander opossum, 1 Didelphis marsupialis e 1 Nectomys rattus. A soropositividade para arbovírus foi observada em 57,14% (8/14) dos espécimes estudados, com soroprevalência monotípica para o vírus da Encefalite Equina do Leste (n = 1), o vírus Ilheus (n = 2) e o vírus Catu (n = 4) e quatro reações heterotípicos para Flavivírus e Orthobyavírus. Conclui-se que há manutenção e circulação de espécies de arbovírus com características enzoóticas em mamíferos silvestres da região amazônica, podendo ser hospedeiros em potenciais na transmissão da doença para humanos.

ABSTRACT: Arboviruses are viruses that maintain their life cycle in the wild and are transmitted to vertebrate hosts by hematophagous diptera. They are zoonotic and can establish an enzootic cycle in the urban areas; in humans, the infection can manifest from being encephalitogenic to hemorrhagic. This study aimed to report the occurrence of arboviruses in mammals of the order Didelphimorphia and Rodentia, captured from the Amazon. Serum samples were subjected to hemagglutination inhibition test using a viral panel of 19 species of arboviruses that are known to occur in the Amazon. Altogether, 14 wild mammals, 12 of Philander opossum, 1 of Didelphis marsupialis, and 1 of Nectomys rattus were captured. Eight of these were reported to be seropositive for arboviruses (57.14%) with monotypic seroprevalence for the Eastern Equine Encephalitis Virus (n=1), the Ilheus Virus (n=2), and the Catu virus (n=4); 4 heterotypic responses were observed for Flavivirus and Orthobunyavirus. In conclusion, several arbovirus species are in active circulation and maintenance, exhibiting enzootic characteristics in the wild mammals of the Amazon region; these animals prove to be potential hosts in the transmission of diseases to humans.

Resumo Objetivos: identificar a prevalência e os fatores associados à síndrome de burnout (SB) entre docentes da educação básica de escolas públicas de um município de médio porte. Métodos: estudo transversal analítico realizado em Minas Gerais, em 2016. Coletaram-se dados sociodemográficos e ocupacionais e aplicou-se o Cuestionário para la Evaluación del Síndrome de Quemarse por el Trabajo para avaliar a SB. A amostra (n = 745) foi probabilística por conglomerados em único estágio. Utilizou-se análise hierarquizada com regressão de Poisson. Resultados: a prevalência geral da SB foi de 13,8% (IC95%: 11,3-16,3%), com 9,0% apresentando o Perfil 1 (SB sem níveis altos de sentimento de culpa) e 4,8% o Perfil 2 (SB grave). As dimensões mais prevalentes foram “desgaste psíquico” (39,4%) e “ilusão pelo trabalho” (19,7%). A prevalência de SB foi maior entre os docentes mais jovens (RP = 1,82), sem filhos (RP = 1,45), concursados/efetivos (RP = 1,88), insatisfeitos no trabalho (RP = 3,16), com desejo de mudar de profissão (RP = 2,94) e com falta de apoio da direção escolar (RP = 2,38). Conclusão: há urgência na criação de políticas públicas de suporte aos docentes, pois os identificados com sintomas da síndrome estão em exercício funcional, o que agrava seu quadro de saúde e, por conseguinte, compromete os diversos processos da área educacional.

Abstract Objectives: to identify the associated factors and the prevalence of burnout syndrome (BS) in primary and secondary public school teachers of a medium-sized municipality. Methods: cross-sectional analytical study conducted in Minas Gerais, Brazil, in 2016. We collected sociodemographic and occupational data, and applied the Spanish Burnout Inventory [Cuestionário para la Evaluación del Síndrome de Quemarse por el Trabajo]. The sample (n = 745) was probabilistic by clusters in a single stage. We used Hierarchical analysis with Poisson regression. Results: the general prevalence of BS was 13.8% (95% CI: 11.3-16.3%), with 9.0% having Profile 1 (BS without high levels of feelings of guilt) and 4.8% Profile 2 (severe BS). The most prevalent dimensions were “psychological exhaustion” (39.4%) and “enthusiasm towards job” (19.7%). The BS prevalence was higher among younger teachers (PR = 1.82), without children (PR = 1.45), job stability insured as civil servant (PR = 1.88), with job dissatisfaction (PR = 3.16), with a desire to change professions (PR = 2.94) and lack of support from the school managers (PR = 2.38). Conclusion: there is an urgent need to develop public policies to support teachers, since those identified with BS symptoms are in work activity, which worsens their health condition and, therefore, undermines the educational processes.

Abstract Objective: To investigate the association between child’s daytime caring person and risk for higher early childhood caries (ECC) experience. Material and Methods: The sample consisted of all clinical records (census) of children (0-3 years old) attended in a public dental clinic, which contained information about caries experience and child’s daytime caring person (mother, grandmother or others). Caries experience was dichotomized as dmft ≤ 2 or dmft >2. Data were analyzed by the chi-square (α = 0.05). Binary logistic regression models were built. Results: From a total of 310 children, 19% of children had the grandmother as daytime caring person. There was no association between child’s daytime caring person and caries experience (p=0.32). Logistic regression analysis showed that low daytime caregiver schooling (OR: 5.76 95%CI 1.18-28.18; p=0.02) and child’s age (OR: 1.14 95% CI 1.09-1.19; p=0.00) were risk factors, and breastfeeding duration (> 9 months - OR: 0.38 95% CI 0.21-0.68; p=0.00), no nocturnal feeding (OR: 0.50 95% CI 0.27-0.91; p=0.02), and absence of sugar consumption between main meals (OR: 0.50 95% CI 0.28-0.89; p=0.02) were protection factors for ECC. Conclusion: A higher caries experience in early childhood is not associated to child’s daytime caring person. On the other hand, the higher caries experience is associated with low caregiver schooling and older children.

ABSTRACT Capnocytophaga is a group of facultative anaerobic gram-negative bacteria present in the oral cavity of humans, dogs and cats, as part of their normal oral flora. Here, we described two cases of bloodstream infections (BSI) caused by Capnocytophaga in neutropenic autologous hematopoietic stem cell transplantation (auto-HSCT) patients with mucositis (Grade I and Grade III) identified by Maldi-Tof. They were successfully treated with β-lactam (meropenem and piperacillin-tazobactam). The species C. sputigena was confirmed by 16S rRNA gene sequencing in one patient. The review of literature showed that C. ochraceae was the most frequent species causing BSI in auto-HSCT patients and that the patients usually presented mucositis and were neutropenic at the onset of the infection.

RESUMO Objetivo: Estimar, em uma população brasileira, a magnitude da associação entre o transtorno do espectro do autismo (TEA) e os fatores pós-natais. Métodos: Estudo de caso controle realizado com 253 indivíduos com diagnóstico do TEA e 886 sem sinais do transtorno. Foi aplicado um questionário semiestruturado e adotou-se o modelo de regressão logística múltipla na análise dos dados. Para estimar a magnitude das associações, utilizou-se a razão de chances (Odds Ratio - OR) bruta e ajustada. Resultados: Encontrou-se associação de TEA com os seguintes fatores: ter nascido com má-formação congênita (OR 4,24; intervalo de confiança de 95% - IC95% 1,92-9,34), icterícia neonatal (OR 1,43; IC95% 1,01-2,02), ausência de choro ao nascer (OR 1,97; IC95% 1,20-3,23) e episódio de convulsão na infância (OR 5,75; IC95% 3,37-9,81). A magnitude da associação foi maior nas crianças/adolescentes que tiveram duas ou mais complicações pós-natais (OR 6,39; IC95% 4,10-10,00). Conclusões: Os achados do presente estudo sugerem que má-formação, icterícia neonatal, ausência de choro ao nascer e episódios de convulsão na infância são fatores importantes a serem considerados ao estudar a etiologia do TEA.

ABSTRACT Objective: To estimate the magnitude of the association between Autism Spectrum Disorder (ASD) and postnatal factors in a Brazilian population. Methods: A case-control study was performed with 253 individuals diagnosed with ASD and 886 individuals without signs of the disorder. A semi-structured questionnaire and the multiple logistic regression model were adopted in the data analysis. To estimate the magnitude of associations, the crude and adjusted Odds Ratio (OR) was used. Results: An association with the following factors was found: having been born with congenital malformation (OR 4.24; confidence interval of 95% - 95%CI 1.92-9.34), neonatal jaundice (OR 1.43; 95%CI 1.01-2.02), absence of crying at birth and seizure episode in childhood (OR 5.75; 95%CI 3.37-9.81). The magnitude of the association was higher in the children/adolescents who had two or more postnatal complications (OR 6.39; 95%CI 4.10-10.00). Conclusions: The findings of the present study suggest that malformation, neonatal jaundice, absence of crying at birth and seizure episodes in childhood are important factors to be considered when studying the etiology of ASD.

Resumo Introdução Os exames integram o sistema de saúde e contribuem para o avanço da assistência. A sua solicitação pelos médicos deve ser realizada adequadamente, podendo ser influenciada por diferentes aspectos. Objetivo Desenvolver e validar um instrumento de avaliação de aspectos que influenciam a solicitação de exames. Método Trata-se de um estudo transversal e analítico que passou pelas seguintes etapas: 1) identificação dos aspectos que influenciam a solicitação de exames na prática médica; 2) verificação da validade aparente e validade de conteúdo; 3) verificação da validade de construto; 4) análise da confiabilidade; 5) verificação da validade discriminante, aplicada a 158 médicos de família e emergencistas no norte de Minas Gerais. Resultados O instrumento permaneceu com 36 itens, psicometricamente válidos, agrupados em cinco dimensões: particularidade pessoal do médico; estrutura e processos do sistema de saúde; características do paciente; preparo profissional; e dificuldade para a realização do exame. O instrumento apresentou validade aparente, validade de conteúdo, validade de construto, nível satisfatório de confiabilidade e validade discriminante. Conclusão O instrumento de avaliação dos aspectos que influenciam a solicitação de exames na prática médica tem a possibilidade de identificar a influência particular de cada aspecto e de cada dimensão que interfere na prática de solicitação de exames.

Abstract Background Exams are part of the health system, and they contribute to the advancement of care. The request of exams by physicians must be performed properly, and can be influenced by different aspects. Objective Develop and validate an instrument to evaluate aspects that influence the request for exams. Method This is a cross-sectional, analytical study conducted in the following steps: 1) Identification of the aspects that influence the request for exams in medical practice; 2) Verification of apparent and content validity; 3) Verification of construct validity; 4) Reliability analysis; 5) Verification of discriminant validity applied to 158 family and emergency physicians in the north of Minas Gerais state. Results The instrument was composed of 36 psychometrically valid items grouped into five dimensions: particularity of the physician, structure and processes of the health system, characteristics of the patient, professional expertise, and difficulty conducting the exam. The instrument presented apparent and content validity, construct validity, satisfactory level of reliability, and discriminant validity. Conclusion The instrument to assess aspects that influence the request of exams in medical practice can identify the particular influence of each aspect and each dimension that interferes with the practice of requesting exams.

Resumo Objetivo Estimar a prevalência de comportamentos de risco à saúde (CRS) e identificar os fatores associados. Métodos Estudo transversal com amostra aleatória de 902 acadêmicos de uma universidade pública no norte de Minas Gerais, Brasil. As variáveis analisadas foram: características sociodemográficas, acadêmicas e comportamentos de risco. Utilizou-se a Razão de Prevalência bruta e ajustada, estimadas pelo modelo de regressão de Poisson. Resultados Os CRS mais prevalentes foram: baixo consumo de frutas e verduras (98,1%), não realização de exercício aeróbio (71,2%) e uso irregular de preservativo (63,1%). As associações significativas foram: gênero masculino com consumo abusivo de bebida alcoólica (RP=1,53), drogas ilícitas (RP=2,41) e envolvimento em brigas (RP=2,12); idade até 21 anos com envolvimento em brigas (RP=2,77); estado civil com companheiro com envolvimento em brigas (RP=3,03) e uso irregular de preservativo (RP=1,59); estudantes de outras áreas de graduação com não realização de exercício aeróbio (RP=1,26); classe econômica A ou B com drogas ilícitas (RP=1,92). Conclusão Observaram-se variações nas prevalências dos CRS, com destaque para baixo consumo de frutas e verduras, e tabagismo. Os CRS mostraram-se positivamente associados ao gênero masculino, idade até 21 anos, classe econômica A ou B, estado civil com companheiro e estudantes de outras áreas de graduação.

Abstract Objectives To estimate the prevalence of health risk behaviors (HRB) and identify the factors associated with it. Methods Cross-sectional study with a random sample of 902 students, at a public university on the north of Minas Gerais, Brazil. The variables analyzed were: sociodemographic characteristics, academic and risk behaviors. It was used the crude and adjusted prevalence ratio, estimated by the Poisson model. Results HRB more prevalents: low consumption of fruits and vegetables (98.1%), non-performance of aerobic exercise (71.2%) and irregular preservative use (63.1%). The significant associations were: males with abusive consumption of alcohol (RP=1.53), illegal drugs (RP=2.41) and involvement in fights (RP=2.12); age up to 21 years with involvement in fights (RP=2.77); relashionship status with a partner with involvement in fights (RP=3.03) and irregular use of preservatives (RP=1.59); students from other academic areas with non-performance of aerobic exercise (RP=1.26); economic class A or B with illicit drugs (RP=1.92). Conclusion There were variations in the prevalence of HRB among university students, with emphasis on low fruit and vegetable consumption and smoking. HRB were positively associated with the male gender, up to 21 years, economic class A or B, marital status with partner and students from other undergraduate areas.

Resumo Fundamentos: Disfunção do ventrículo direito (VD) é observada em 30-50% dos pacientes com infarto do miocárdio na parede inferior (IM-I) e é fator preditor de mortalidade precoce. A fibrose miocárdica está associada com disfunção ventricular progressiva e prognóstico grave. Nesses pacientes, a ressonância magnética cardíaca (RMC) é um importante método de estratificação de risco. Objetivos: Avaliar a associação entre disfunção do VD e fibrose miocárdica em pacientes com IM-I por RMC. Métodos: Estudo coorte realizado em um centro de cardiologia de referência. Quarenta indivíduos com IM-I foram incluídos no estudo. RMC foi realizada durante a internação para estimar função do VD e quantificar fibrose miocárdica pela técnica de realce tardio com gadolínio (TRT). Os pacientes foram estratificados quanto à função ventricular, e características clínicas foram comparadas entre os grupos. Resultados: Quarenta pacientes foram incluídos no estudo, 75% eram homens e 43% idosos (idade ≥ 60 anos). Entre os fatores de risco cardiovasculares, hipertensão (45%) e tabagismo (33%) foram os mais prevalentes. A disfunção do VD estava presente em 33% dos pacientes. A massa de fibrose média foi 22 ± 12g nos pacientes com disfunção do VD e 15 ± 8 g nos pacientes com função ventricular preservada (p = 0,051). Conclusões: Os resultados deste estudo indicam uma possível associação entre disfunção do VD e fibrose miocárdica nos pacientes com IM-I. No entanto, outros estudos envolvendo um maior número de pacientes são necessários para confirmar nossos achados.

Abstract Background: Right ventricular dysfunction (RVD) can be found in 30-50% of patients with inferior wall myocardial infarction (I-MI) and predicts early mortality. Myocardial fibrosis is associated with progressive ventricular dysfunction and severe prognosis. In these patients, cardiovascular magnetic resonance (CMR) is an important risk stratification method. Objectives: This study sought to evaluate the association between RVD and myocardial fibrosis in patients with I-MI, using CMR. Methods: Cohort study conducted in a prominent center of cardiology. Forty individuals with I-MI were included in the study. CMR was performed during hospitalization to estimate parameters of right ventricle function and to quantify myocardial fibrosis through late gadolinium enhancement (LGE) technique. Patients were stratified by ventricular function, and clinical characteristics were compared between study groups. Results: Forty patients were included in the study, 75% were male and 43% elderly (age ≥ 60 years). Hypertension (45%) and smoking (33%) were the most prevalent cardiovascular risk factors. RVD was found in 33% of patients. Mean fibrosis mass was 22 ± 12 g in patients with RVD compared with 15 ± 8 g in patients with preserved ventricular function (p = 0.051). Conclusions: The findings of our study indicate a possible association between RVD and myocardial fibrosis in patients with I-MI. However, further studies with larger series are needed to confirm our findings.

Dentre os principais benefícios da adrenalectomia laparoscópica (AL) frente à adrenalectomia aberta (AA) destaca-se a rápida recuperação dos pacientes com diminuição do tempo de internação. O objetivo deste estudo foi comparar a adrenalectomia aberta com a adrenalectomia laparoscópica em suínos. Foram operados 32 suínos, distribuídos em quatro grupos (n=8), sendo um grupo submetido à AA e outro grupo à AL, com seus respectivos grupos controle. Foram avaliados parâmetros referentes a tempo operatório, temperatura corporal, hematócrito, intercorrências operatórias e tempo de deambulação. Não houve diferença significativa entre os tempos operatórios e de deambulação, apesar deste último ter sido maior no grupo submetido à AA. As intercorrências mais frequentes foram acidentes em alças intestinais, lesões em vasos adrenais e hematoma renal. As perdas sanguíneas não foram significativas, a hipotermia observada não apresentou repercussão clínica. A laparoscopia para adrenalectomia experimental em suínos é uma técnica confiável podendo servir como referência para o tratamento de doenças adrenais com indicações cirúrgicas em outras espécies animais. Palavras-chave: glândulas supra-renais; irrigação sanguínea; videocirurgia.

Among the main benefits of laparoscopic adrenalectomy (LA) compared to open adrenalectomy (OA) the rapid recovery of patients with decreased length of stay in hospital can be highlighted. The objective of this study was to compare the open adrenalectomy with laparoscopic adrenalectomy in swine. Thirty-two swine were operated. The animals had been divided into four groups (n = 8), one group was submitted to OA and the other to LA, together with its respective control group. Parameters were evaluated regarding operative time, body temperature, hematocrit, postoperative and intraoperative complications and time to deambulation. There was no meaningful difference between operative and deambulation times, even though the latter having been higher in the group submitted to OA. The most frequent intercurrences were in bowel, damage to adrenal vessels and renal hematoma. There were no significant blood losses, and observed hypothermia did not have any clinical impact. Laparoscopy in swine experimental adrenalectomy is a reliable technique that can serve as a reference for the surgical treatment of patients with adrenal diseases with surgical indications in other animal species.