Abstract Objective: To evaluate the behavior of VCR and VCH, per municipality and per vaccines offered at the NVC, to identify priority areas for intervention. Methods: Descriptive study of a time series, using secondary data and accompanied by a narrative review of the literature evaluating VCR and VCH. Vaccines offered to children under one year and to those aged one year in the pre-pandemic period of COVID-19 (2015 to 2019) were selected and compared to those offered during the pandemic period (2020 and 2021 ). Results and discussions: The decrease in VCR and VCH is a process that precedes the COVID-19 pandemic but was intensified during this period. In 2021, the VCR was around 70% for most vaccines. This phenomenon encompasses the entire country; however, it is more intense in the states/municipalities located in the north and northeast regions, suggesting greater difficulty in accessing health services. Conclusion: Low and heterogeneous VCR requires the adoption of practices that were previously implemented, establishing partnerships with governmental and non-governmental institutions, with adequate communication, active search for non-compliance and non-adherence to the regular vaccination program, adopting intra- and extramural vaccination strategies, to reverse the current situation and reduce the risk of recurrence of diseases that have been already controlled and eliminated.

Abstract Objective: Among the mechanisms proposed for the development of bronchopulmonary dysplasia is the increase in the pulmonary inflammatory process and oxidative stress. Thus, the control of this process may result in improvements in bronchopulmonary dysplasia-related outcomes. This study aims to analyze the current scientific evidence regarding the use of budesonide, a potent anti-inflammatory drug, associated with a pulmonary surfactant to prevent bronchopulmonary dysplasia. Methods: A systematic review of the literature was performed on the Embase and MEDLINE platforms, and studies that compared budesonide with pulmonary surfactant versus pulmonary surfactant for treating respiratory distress syndrome were included. The primary outcome was a reduction in bronchopulmonary dysplasia or death. Results: Four randomized clinical trials and two observational studies were included in this systematic review. Three of the randomized clinical trials found a reduction in bronchopulmonary dysplasia or death in the use of budesonide with the surfactant, all the other studies (1 clinical trial and 2 observational studies) found no statistical differences between the groups for the primary outcomes. The three main studies showed a reduction in the primary outcome; however, all studies showed great heterogeneity regarding the type of surfactant (poractant or beractant) and the method of administration. Conclusion: Robust clinical studies, in a heterogeneous population, using porcine surfactant associated with budesonide, with administration by a minimally invasive technique are necessary for there to be a recommendation based on scientific evidence for its widespread use.

Abstract Introduction: Chronic kidney disease, more prevalent in the elderly, is considered a public health issue worldwide. Objective: To evaluate the impact of automated, peritoneal dialysis modalities, intermittent and continuous, on the inflammatory profile of elderly people with chronic kidney disease. Methods: Prospective, cross-sectional and analytical study carried out in a dialysis clinic in Brasília - Brazil, with 74 elderly people aged 60 years or older. The patients underwent rapid Peritoneal Equilibration Test, clinical assessment, blood collection for biochemical and cytokine assessments, interleukin 6 and transforming growth factor beta 1, and answered a quality-of-life questionnaire (KDQOL-SF36). We used a 5% significance level for data analysis, associations and correlations. Results: Patients in the continuous modality had higher serum values of transforming growth factor beta 1 than those in the intermittent modality, which had higher peritoneal transforming growth factor beta 1, age and residual renal function than those in continuous mode. Interleukin 6 dosage in the peritoneum was associated with age, while serum IL-6 was associated with IL-6 in the peritoneum, time on dialysis and age. There was no association between the modality and the presence of diabetes, blood volume or nutritional status. Both modalities enable good adaptation to the dialysis treatment. Conclusion: Inflammation in automated peritoneal dialysis is mainly associated with low residual renal function, advanced age and longer time on therapy, and not to the type of dialysis performed.

Resumo Introdução: A doença renal crônica, mais prevalente em idosos, é considerada um problema de saúde pública em todo o mundo. Objetivo: Avaliar o impacto das modalidades de diálise peritoneal automatizada, intermitente e contínua, no perfil inflamatório de idosos renais crônicos. Métodos: Estudo prospectivo, transversal e analítico realizado em uma clínica de diálise em Brasília, com 74 idosos com idade igual ou maior que 60 anos. Os pacientes foram submetidos ao Teste de Equilíbrio Peritoneal rápido, avaliação clínica, coleta de sangue para avaliações bioquímicas e de citocinas, interleucina 6 e fator de crescimento transformador beta 1, e questionário de qualidade de vida (KDQOL-SF36). Foram utilizadas para análise dos dados, associações e correlações com nível de significância de 5%. Resultados: Pacientes na modalidade contínua apresentaram valores séricos do fator de crescimento transformador beta 1 maiores do que os em modalidade intermitente. Estes apresentaram fator de crescimento transformador beta 1 no peritônio, idade e função renal residual maiores do que os em modalidade contínua. A dosagem da interleucina 6 no peritônio foi associada à idade, enquanto a IL-6 sérica foi associada à IL-6 no peritônio, ao tempo em diálise e à idade. Não houve associação entre a modalidade e a presença de diabetes, volemia ou estado nutricional. Ambas as modalidades permitem boa adequação à terapia dialítica. Conclusão: A inflamação na diálise peritoneal automatizada está associada principalmente à baixa função renal residual, à idade avançada e ao maior tempo em terapia, e não à modalidade de diálise realizada.

Abstract Objective: To assess the predictive value of selected growth phenotypes for neonatal morbidity and mortality in preterm infants < 30 weeks and to compare them with INTERGROWTH-21st (IG21). Methods: Retrospective analysis of data from the Brazilian Neonatal Research Network (BNRN) database for very low birth weight (VLBW) at 20 public tertiary-care university hospitals. Outcome: the composite neonatal morbidity and mortality (CNMM) consisted of in-hospital death, oxygen use at 36 weeks, intraventricular hemorrhage grade 3 or 4, and Bell stage 2 or 3 necrotizing enterocolitis. Selected growth phenotypes: small-for-gestational-age (SGA) defined as being < 3rd (SGA3) or 10th (SGA10) percentiles of BW, and large-for-gestational-age (LGA) as being > 97th percentile of BW. Stunting as being < 3rd percentile of the length and wasting as being < 3rd percentile of BMI. Single and multiple log-binomial regression models were fitted to estimate the relative risks of CNMM, comparing them to IG21. Results: 4,072 infants were included. The adjusted relative risks of CNMM associated with selected growth phenotypes were (BNRN/IG21): 1.45 (0.92–2.31)/1.60 (1.27–2.02) for SGA; 0.90 (0.55–1.47)/1.05 (0.55–1.99) for LGA; 1.65 (1.08–2.51)/1.58 (1.28–1.96) for stunting; and 1.48 (1.02–2.17) for wasting. Agreement between the two references was variable. The growth phenotypes had good specificity (>95%) and positive predictive value (70-90%), with poor sensitivity and low negative predictive value. Conclusion: The BNRN phenotypes at birth differed markedly from the IG21 standard and showed poor accuracy in predicting adverse neonatal outcomes.

Abstract Background Literature is scarce on echocardiographic characteristics of COVID-19 patients admitted to the intensive care unit (ICU). Objectives To describe echocardiographic characteristics of ICU COVID-19 patients and associate them with clinical signals/symptoms, laboratory findings and outcomes. Methods Patients with RT-PCR-confirmed COVID-19, admitted to the ICU, who underwent echocardiography were included. Clinical characteristics associated with an abnormal echocardiogram (systolic ventricular dysfunction of any degree — left and/or right ventricle — and/or high filling pressures and/or moderate to severe pericardial effusion) were analyzed. Groups were compared using the Student’s t-test, chi-square, and logistic regression. A p < 0.05 was considered statistically significant. Results A total of 140 patients met inclusion criteria, and 74 (52.9%) had an abnormal echocardiogram. A low number of left and right ventricular systolic dysfunction was observed, and 35% of the population had a normal diastolic function. In the univariate analysis, characteristics associated with abnormal echocardiogram were age, chronic kidney disease, elevated troponin, previous heart failure, and simplified acute physiology score 3 (SAPS 3). In the regression model, troponin and SAPS3 score were independent markers of abnormal echocardiogram. An abnormal echocardiogram was associated with a higher prevalence of in-hospital death (RR 2.10; 95% CI 1.04-4.24) and orotracheal intubation (RR 2.3; 95% CI 1.14-4.78). Conclusions COVID-19 has little effect on ventricular function, but it is common to find increased filling pressures. Elevated serum troponin level and SAPS3 score were the independent markers of an abnormal echocardiogram. In addition, the prevalence of in-hospital death and need for mechanical ventilation were higher in patients with abnormal echocardiogram.

Abstract Introduction Nurses from the night shift are exposed to sleep deprivation, which is associated with circadian rhythm alteration, lifestyle changes, psychosocial stress, and, consequently, increased risk of blood pressure (BP) deregulation and hypertension. Objective To analyze risk factors associated with elevated BP levels in nursing workers. Methods A transversal, quantitative study was conducted with 172 nursing professionals of a large hospital in the state of Minas Gerais, Brazil. The following data were collected: anthropometric and BP measurements, sociodemographic characteristics, clinical variables, and lifestyle habits. Results were evaluated by bivariate analysis and logistic regression. The level of significance adopted in the statistical analysis was 5%. Results Participants’ average age was 42.7 ± 9.6 years old; 86.6% (n = 149) were female, and 20.3% (n = 35) had previous diagnosis of hypertension. Overweight and obesity (odds ratio [OR]: 2.187, 95% confidence interval [CI]: 1.060 – 4.509) and night shift (OR: 2.100, CI 95%: 1.061 – 4.158) were statistically significant (p < 0.05) for increased risk of elevated BP level. Conclusion Excessive weight and night shift were significant factors for increased BP in nursing workers.

Abstract Background The incidence of diabetes mellitus in younger adults is rising over the years. The diabetic population has an increased risk of developing heart failure, and diabetic individuals with heart failure have four times greater mortality rate. Studies results about exercise effect on left ventricular function in type 2 diabetes mellitus are heterogenous. Objective This review aimed to analyze the effects of physical exercise on left ventricular dysfunction in type 2 diabetes mellitus (T2DM). Methods Only randomized clinical trials with humans published in English were included. Inclusion criteria were studies with type 2 diabetes patients, physical exercise, control group and left ventricular function. Exclusion criteria were studies with animals, children, teenagers, elderly individuals and athletes, presence of diet intervention, and patients with type 1 diabetes, cancer, cardiac, pulmonary, or neurological diseases. Electronic databases PubMed, Web of Science, Cochrane, and Scopus were last searched in September 2021. Risk of bias was assessed by the Physiotherapy Evidence Database (PEDro) scale. Results Five studies were included, representing 314 diabetic individuals submitted to resistance and aerobic exercise training. Of the variables analyzed, physical exercise improved peak torsion (PTo), global longitudinal strain, global strain rate (GSR), time to peak untwist rate (PUTR), early diastolic filling rate (EDFR) and peak early diastolic strain rate (PEDSR). Conclusion To our knowledge, this is the first systematic review on the effects of exercise on left ventricular function in T2DM including only randomized clinical trials with humans. Physical exercise seems to improve systolic and diastolic strain, twist, and torsion. High intensity exercise was reported to be superior to moderate intensity exercise in one study. This review was limited by the small number of studies and their heterogeneity regarding exercise protocols, follow-up period, exercise supervision and left ventricular function variables analyzed. This review was registered in PROSPERO (CRD42021234964).

Abstract: The cottonseed delinting removes lint from the seed coat to improve plantability and maintain the seed’s physiological quality, therefore, this work aimed to determine the effect of delinting and neutralizers’ residual on the physiological quality of stored cottonseed by using image analysis phenotyping. The experiment was a randomized factorial design of 3 x 4 x 2 and two periods of storage evaluation (0 and 180 days). The cotton seeds were delinted at three different times (2, 4, and 10 minutes), neutralized using four distinct neutralizers (Quicklime, Hydrated lime, Filler lime, and NaOH), and there were seeds with and without neutralizer residue. The evaluations carried out were: water content, seed residual lint imaging, germination, seedling emergence, and seedling length imaging. The neutralizers Quicklime, Hydrated lime, and Filler lime do not need removal from the cotton seed coat. In storage, only the neutralizer NaOH has a high latent effect in lowering cottonseed quality, and the other neutralizers have lower physiological quality when the residue is removed. The image analysis phenotyping is efficient in identifying seedlings’ vigor.

Resumo: O deslintamento das sementes de algodão remove o linter do tegumento para melhorar a plantabilidade e manter a qualidade fisiológica da semente, por isso, este trabalho teve como objetivo determinar o efeito do deslintamento e do resíduo de neutralizantes na qualidade fisiológica de sementes de algodão armazenado por meio de fenotipagem usando análise de imagens. O experimento foi um delineamento casualizado em fatorial 3 x 4 x 2 e dois períodos de avaliação de armazenamento (0 e 180 dias). As sementes de algodão foram deslintadas em três tempos diferentes (2, 4 e 10 minutos), neutralizadas com quatro neutralizantes (Cal virgem, Calcário hidratada, Calcário filler e NaOH), e utilizou-se sementes com e sem resíduo de neutralizante. As avaliações realizadas foram: teor de água, imagem de linter residual em sementes, germinação, emergência de plântulas e imagem de comprimento de plântulas. Os neutralizantes Cal virgem, Calcário hidratado e Calcário filler não precisam ser removidos do tegumento da semente de algodão. No armazenamento, apenas o neutralizante NaOH apresenta alto efeito latente na redução da qualidade da semente de algodão, e os demais neutralizantes apresentam inferior qualidade fisiológica quando o resíduo é removido. A fenotipagem por análise de imagem é eficiente na identificação do vigor das plântulas.

Abstract Background The COVID-19 pandemic has changed food consumption. Objective Evaluate the association between metabolic phenotypes, changes in food consumption during the pandemic, and health outcomes in obese women. Methods Cross-sectional observational study including 491 women without previous diagnosis of chronic diseases, evaluated according to metabolic phenotype. During the pandemic, a subsample was re-evaluated by online questionnaires via Google Forms. Analyzed anthropometric, biochemical, and dietary data as well as health outcomes (coronary artery disease, type 2 diabetes, hypertension, dyslipidemia or death). Information on mortality was collected from the Internal Affairs Office of the State of Rio de Janeiro and the Health Department of the State of Rio de Janeiro. Statistical analysis was performed using the statistical program SPSS 21, with Mann-Whitney test, Pearson’s chi-squared, Spearman correlation, and binary logistic regression, at a significance level of 5%. Results The anthropometric, glucose, and lipid profiles showed significant differences between the metabolically healthy and metabolically unhealthy groups (p = 0.00). Before the pandemic, women in the metabolically unhealthy group had higher dietary intakes of lipids (p = 0.01), saturated fat (p = 0.01) and sodium (p = 0.04), during the pandemic, they consumed more energy (p = 0.04), lipids (p = 0.02), saturated fat (p = 0.02), proteins (p = 0.03) and sodium from ultra-processed foods (p = 0.03). Consequently, health outcomes were more prevalent in the metabolically unhealthy group (p = 0.00). Conclusion Observed that metabolically healthy women had qualitatively better food intake and fewer health outcomes throughout the study.

Abstract: Seed treatment is important for protecting seed and seedling from pests and/or pathogens. Seed treatment can be performed generally in two ways: industrial seed treatment (IST), performed by seed companies, or on-farm treatment (OFT). These treatment technologies will affect the final quality of the process. Therefore, the objective of this study was to characterize the seed quality profile of ISTs and OFTs in Brazilian agribusiness in terms of functional quality and dose application effectiveness (DAE). Seed samples treated by both processes were collected in 6 producing states of Brazil, Mato Grosso, Goiás, Paraná, Minas Gerais, São Paulo, and Santa Catarina. To evaluate the functional quality of the treatments, the coating percentage was determined by high-resolution image analysis with GroundEye® equipment, and the insecticide active ingredient DAE amount was determined with high-performance liquid chromatography (HPLC). Image analysis proved to be a promising technique to evaluate seed coating, in addition, samples treated with “on farm” technology had greater variation and heterogeneity in coating and active ingredient dose, while samples treated industrially showed greater homogeneity, uniformity, effectiveness of applied products. There was a strong positive correlation between coating with phytosanitary products and DAE in treated corn seeds, important parameters in the evaluation of the quality of the treatment.

Resumo: O tratamento de semente é importante para a proteção de sementes e plântulas contra pragas e ou patógenos. Podendo ser realizado basicamente via tratamento de sementes industrial (TSI) ou na própria fazenda “on farm” (TOF). Essas tecnologias de tratamento vão afetar a qualidade final do processo. Assim, o objetivo no trabalho foi realizar a caracterização do perfil da qualidade do TSI e TOF no agronegócio brasileiro, quanto à qualidade funcional e eficácia de aplicação de dose (EAD). Sementes tratadas em ambos os processos foram coletadas em 6 estados produtores do Brasil e avaliadas quanto à porcentagem de recobrimento por meio da análise de imagens com o equipamento GroundEye® e EAD do ingrediente ativo inseticida por meio de Cromatografia Líquida de Alta Eficiência (CLAE). A análise de imagem mostrou-se uma técnica promissora para avaliar o recobrimento de sementes, além disso, as amostras tratadas com a tecnologia “on farm” apresentaram maior variação e heterogeneidade do revestimento e da dose do ingrediente ativo, enquanto as amostras tratadas industrialmente houve maior homogeneidade, uniformidade, assertividade dos produtos aplicados. Existe forte correlação positiva entre recobrimento por produto fitossanitário e EAD em sementes tratadas de milho, parâmetros importantes na avaliação da qualidade do tratamento.

Abstract Background Dietary treatment containing fiber-rich foods may contribute to lowering weight in obese women. Objective To investigate the effect of a hypoenergetic diet combined with pumpkin seed flour (PSF) consumption on diet quality, anthropometric indices, and glucose and lipid metabolism in obese women. Methods We conducted a randomized, double-blind, placebo-controlled, 90-day clinical trial with obese women, distributed into the following two groups: hypoenergetic diet + placebo (PG) and hypoenergetic diet + pumpkin seed flour (PSFG). A total of 100 participants were included in the PSFG (n = 47) and PG (n = 53). We evaluated neck circumference (NC); waist to height ratio; conicity index; fat mass (FM); lipid profile; blood concentrations of glucose and insulin; homeostatic model assessment for insulin resistance (HOMA-IR); quantitative insulin sensitivity check index (QUICKI); and blood pressure at baseline, 30, 60, and 90 days. Dietary analysis was determined by differences between diet quality indices before and after prescribing the experimental diet. Chi-squared, Student’s t-tests and analysis for repeated measures were used, and values were considered significant at p < 0.05. Results The dietary pattern improved after 90 days in both groups. The PSFG presented lower NC (p < 0.001), FM (p = 0.010), triglycerides (TG) (p = 0.025), insulin (p = 0.003), and HOMA-IR (p = 0.018). The PG presented a lower diastolic blood pressure (p = 0.004) and low-density lipoprotein cholesterol (LDL-c) (p = 0.056). Conclusion A hypoenergetic diet combined with PSF consumption contributes to lowering NC, FM, HOMA-IR, TG, and insulin concentrations.

Abstract Metabolic syndrome (MetS) is increasing at epidemic proportions worldwide. MetS and its components are frequent among Brazilian women (41.8%). Women are affected by changes in adipose tissue distribution, lipid profile, insulin resistance (IR), and vascular remodeling during their lives. These changes result from the lack of estrogen after menopause. There have been various attempts to propose a uniform origin for the clustering of the MetS components, including genetics, IR, obesity, lifestyle, sleep disturbances, inflammation, fetal and neonatal programming, and disturbed circadian rhythm of the body functions. The proinflammatory and prothrombotic state in MetS is well-defined. Socioeconomic and lifestyle-related factors are also essential triggers of MetS, which is associated with a higher risk for coronary artery diseases (CAD) and stroke in women. Population measures in health and community medicine, such as continuing education on the importance of lifestyle change to reduce cardiovascular risks from early childhood, are fundamental strategies. Statins reduce high-sensitivity C-reactive protein blood levels and treat high cholesterol. According to the patient, hypoglycemic agents, such as dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1(GLP-1a), and sodium-glucose transport protein 2 (SGLT2) inhibitors, in addition to metformin, have their indication due to their beneficial cardiometabolic and vascular effects. Angiotensin-converting enzyme inhibitor (ACEI) and angiotensin-receptor blocker (ARB) should be the first choice to treat hypertension in postmenopausal womem. The recognition of the different gender- and age-specific risk factors, allowing for specific and targeted interventions, is fundamental, especially for women.

Abstract Introduction: Currently, two types of phenotypes have been recognized in individuals who are obese. Among the factors related to lifestyle, diet has a relevant influence, although there is no consensus regarding the role of diet in metabolic phenotypes; furthermore, diet is a strong moderator of chronic systemic inflammation. Objective: Investigate dietary inflammatory potential between metabolic phenotypes and to compare the differences between anti-inflammatory and pro-inflammatory diets in individuals with the same phenotype. Methods: This is a cross-sectional observational study that utilized the database of 533 individuals divided into 4 groups, according to metabolic phenotype and dietary inflammatory characteristic. Sociodemographic, clinical, anthropometric and biochemical characteristics were evaluated and the inflammatory index of the diet was calculated. Results: The mean Dietary Inflammatory index (DII) of the total sample was 0.974±1.02, with a maximum of 4.34 and a minimum of −1.74. In the metabolically unhealthy groups, we found a statistical difference in relation to systolic blood pressure when comparing the anti-inflammatory [median 120 (110.0-130.0)] and pro-inflammatory diets [median 130 (120.0-140.0); p = 0.022], and mean isoprostane concentrations were lower in the metabolically healthy group with anti-inflammatory diet. In regression analysis, the only variable that demonstrated a higher risk of alterations in all groups when compared to the metabolically healthy and anti-inflammatory group were isoprostane concentrations. Conclusion: We are able to conclude that an anti-inflammatory diet is associated with lower oxidative stress in metabolically healthy obese, and a pro-inflammatory diet is associated with higher systolic blood pressure values.

Abstract: The objective of this study was to assess the impact of incorporating vermiculite into germination tests for both chemically treated and untreated stored cotton seeds. To that end, two independent experiments were conducted using cotton seeds of the cultivar DP1746B2RF under chemical treatment with a mixture of fungicide, insecticides, and nematicide; and both experiments were set up in a completely randomized design with four replications. In Experiment 1, the objective was to determine the ideal water volume for moistening the vermiculite. Four water volumes were used: 1.5, 2.0, 2.5, and 3.0 times the weight of the dry vermiculite. Experiment 2 was conducted in a 2 × 2 × 2 triple factorial arrangement consisting of two substrates (germitest paper and germitest paper + vermiculite), two treatments (chemically treated seeds and untreated seeds), and two storage periods (0 and 150 days). First germination count and germination were evaluated in the two experiments. From the results found in Experiment 1, the water volume corresponding to 3.0 times the weight of the vermiculite provided the best conditions for germination. In Experiment 2, the most appropriate substrate for conducting the germination test of untreated and chemically treated cotton seeds is vermiculite, which led to rapid germination and uniform seedling development.

Resumo: Objetivou-se avaliar o efeito da inclusão da vermiculita no teste de germinação em sementes de algodão não tratadas e tratadas quimicamente. Para isso, foram conduzidos dois experimentos independentes, utilizando-se sementes de algodão da cultivar DP1746B2RF, submetidas ao tratamento químico com mistura de fungicida, inseticidas e nematicida, ambos, instalados em delineamento inteiramente casualizado com quatro repetições. No Experimento 1, objetivou-se determinar o volume de água ideal para o umedecimento da vermiculita. Foram utilizados quatro volumes de água: 1,5; 2,0; 2,5 e 3,0 vezes o peso da vermiculita seca. O Experimento 2 foi conduzido em esquema fatorial triplo 2 x 2 x 2 sendo: dois substratos (papel germitest e papel germitest + vermiculita), dois tratamentos (sementes tratadas quimicamente e sementes não tratadas) e dois períodos de armazenamento (0 e 150 dias). Avaliou-se nos dois experimentos, a primeira contagem de germinação e a germinação. Pelos resultados encontrados no Experimento 1, o volume de água correspondente a 3,0 vezes o peso da vermiculita proporcionou as melhores condições para germinação. No Experimento 2, o substrato mais apropriado para condução do teste de germinação de sementes de algodão não tratadas e tratadas quimicamente, é a vermiculita, tendo proporcionado rápida germinação e desenvolvimento uniforme das plântulas.