Abstract Objective To evaluate the lifestyle and quality of life in Brazilian children and adolescents during the COVID-19 social distancing period in 2020. Methods This cross-sectional study evaluated children and adolescents (2-18 years of age) and their parents, who voluntarily participated in an online survey. Snowball sampling was used to recruit participants during the first 6 months of the pandemic. A questionnaire was used to characterize the study population. The PedsQL 4.0 and the EUROHIS-QOL 8-item index were used to assess the quality of life (QoL) in children/adolescents and parents, respectively. Data were analyzed using SPSS 18.0 statistical program through the ANOVA with post hoc Bonferroni analysis, student's t test, and the generalized estimating equation. Results Mean screen time increased from 2h pre-pandemic to 5h during the pandemic (p <0.001), which was associated with a decline in PedSQL4.0 scores (from 75.7 ± 2.6 to 71.3 ± 13.7, p <0.001). Unhealthy eating habits increased from 11% to 34% and were associated with worse QoL scores compared with improved or unchanged eating habits during the pandemic (69.7 ± 13.3 vs 72.80 ± 13.4 vs 76.4 ± 12.6; p <0.001). Poor sleep quality increased from 9% to 31.7% and was associated with worse QoL scores compared to improved or unchanged sleep quality during the pandemic (67.3 ± 13.1 vs 74.5 ± 13.1 vs 76.8 ± 12.2; p <0.05). Physical exercise was associated with better PedSQL4.0 scores (77.5 ± 12.3 vs 72.5 ± 14.4; p <0.001). Children aged 2-4y old had the best QoLscores. Conclusions Pandemic-related social distancing promoted significant lifestyle changes in children and adolescents, increasing screen time, reducing physical activity, and worsening food and sleep quality, which resulted in worse QoL scores.

ABSTRACT Introduction: The study of comorbidity requires a multilateral approach with a view to improving the quality of care for these patients by the care system. Objectives: To explore the magnitude of the comorbidity of chronic diseases in adults admitted to hospitals. Methods: Prospective-observational-longitudinal-analytical study. Patients hospitalized in a medical clinic room or clinical patients in indiscriminate hospitalization rooms are included, Multicenter study in 42 centers, with 2 years of recruitment. Consecutive sampling. Descriptive, inferential and regression statistics. Results: 5925 recruited, male gender 50,3%, age 60,66 ± 0,25 years, main origin from the guard 73%, stay 12,61 ± 0,24 days, longer in surgical (15,45 ± 0,67 vs 11,76 ± 0,23, p < 0,00001), 23% received surgical treatment. Main educational level: complete secondary school 21,6%. Economic difficulties: 20%, mortality 9,26%, prevalence of dyslipidemia, diabetes and hypertension: 22,53%, 28,82% and 51,86% with 473 new diagnoses in said pathologies, BMI: 27,88 ± 0,65, Global Charlson 2,09 ± 0,02 and in deaths 3,84 ± 0,11. The average number of pathologies per patient was 2,14 ± 0,01 and increased with age (p value for linear regression < 0,00001). Conclusions: Hypertension, diabetes and dyslipidemia represented the most prevalent entities in the clinical hospitalization room, cardiovascular, respiratory, infectious, oncological, neurological, metabolic and nephrological diseases were independent predictors of mortality.

RESUMEN Introducción: El estudio de la comorbilidad requiere de un enfoque multilateral con vistas a mejorar la calidad de la atención de los enfermos por el sistema de atención. Objetivos: Explorar la magnitud de la comorbilidad de enfermedades crónicas en adultos internados en los hospitales. Métodos: Se realizó un estudio prospectivo-observacional-longitudinal-analítico. Se incluyeron pacientes internados en las Salas de Clínica Médica o pacientes clínicos en Salas de Internación Indiscriminada. Se realizó un estudio multicéntrico en 42 centros en un período de 2 años, con un muestreo consecutivo. Para el estudio se tuvo en cuenta la estadística descriptiva, inferencial y de regresión. Resultados: El total de pacientes en el estudio fue de 5925, masculinos con el 50,3 % de edad 60,66 ± 0,25 años. Principal procedencia desde la guardia el 73 %. La estadía hospitalaria de 12,61 ± 0,24 días, mayormente en pacientes quirúrgicos (15,45 ± 0,67 vs 11,76 ± 0,23; p < 0,00001). El 23 % recibió tratamiento quirúrgico. El principal nivel educativo: secundario completo 21,6 %. Dificultades económicas: 20 %, mortalidad 9,26 %; prevalencia de dislipemia, diabetes e hipertensión: 22,53 %; 28,82 % y 51,86 % con 473 nuevos diagnósticos, IMC: 27,88 ± 0,65, Charlson global 2,09 ± 0,02 y en óbitos 3,84 ± 0,11. La media de patologías por paciente fue de 2,14 ± 0,01 y aumentó con la edad (p valor regresión lineal < 0,00001). Conclusiones: La hipertensión, la diabetes y la dislipemia representaron las entidades más prevalentes en Salas de Internación Clínica, Las enfermedades cardiovasculares, respiratorias, infectológicas, oncológicas, neurológicas, metabólicas y nefrológicas fueron predictores independientes de mortalidad.

Abstract Introduction: Pediatric Early Warning Scores were developed as standardized clinical aides for early recognition of clinical deterioration in children. These systems improve situational awareness among professionals. A major concern is the workload increase. After implementation in the Short Stay Unit, we intended to evaluate its effectiveness in our population. Methods: We reviewed medical records of children admitted to the Short Stay Unit between July 2017 and February 2020. We developed a statistical analysis to evaluate the test performance. Results: One thousand three hundred twenty-three patients were included (median age 3.07 years-old); 5.7% were considered to have clinical deterioration (maximum score median 7.00 vs 2.00) (p<0.001). The area under the ROC curve was 0.947. Defining 4 as cut-off value, the sensitivity is 97.1% (specificity 82.7%). Conclusion: This score proved to be a good test for early identification of clinical deterioration in our population.

Resumo Introdução: Os Pediatric Early Warning Scores foram desenvolvidos como auxiliares clínicos padronizados para o reconhecimento precoce de agravamento clínico em crianças e aumentam o grau de alerta entre os profissionais. Uma das principais preocupações é o aumento da carga de trabalho. Após a implementação na Unidade de Internamento de Curta Duração, pretendemos avaliar a eficácia na nossa população. Métodos: Revimos retrospetivamente os registos médicos de crianças internadas na Unidade de Internamento de Curta Duração entre julho de 2017 e fevereiro de 2020 e executámos análise estatística do desempenho do teste. Resultados: Foram incluídos 1323 doentes (mediana das idades 3,07 anos); 5,7% agravaram clinicamente (mediana do score máximo 7,00 vs 2,00) (p <0,001). A área sob a curva ROC foi de 0,947. Utilizando 4 como valor de corte, a sensibilidade é de 97,1% (especificidade 82,7%). Conclusão: Este score é um bom teste para identificação precoce de agravamento clínico na nossa população.

ABSTRACT Introduction: Rituximab (RTX) is a therapeutic option in pediatric difficult-to-treat idiopathic nephrotic syndrome (NS). We aimed to assess the efficacy and safety of RTX use in these patients. Method: A retrospective study of all patients with idiopathic NS treated with RTX was conducted in a pediatric nephrology division of a tertiary hospital. Demographic, anthropometric, clinical and analytical data were collected prior to treatment and at 6, 12, and 24 months. Results: Sixteen patients were included (11 males), with a median (25th–75th percentile, P25–P75) age at diagnosis of 2 (2.0–2.8) years. Fifteen were steroid-sensitive and 1 was steroid-resistant and sensitive to cyclosporine. The median age at administration of RTX was 10 (6.3–14.0) years. Throughout a median follow-up time of 2.5 (1.0–3.0) years, 6 (37.5%) patients achieved partial remission and 7 (43.8%) had no relapses and were not taking any immunosuppressants at the 24-month follow-up visit. Regarding complications, 1 patient presented persistent hypogammaglobulinemia. Compared with the 12-month period before RTX, there was a decrease in the median number of relapses at 6 and 12 months [3 (3.0–4.0) vs 0 (0–0.8) and 0.50 (0–1.0), respectively; p = 0.001] and in the daily steroids dose (mg/kg/day) at 6, 12, and 24 months [0.29 (0.15–0.67)vs [0.10 (0.07–0.13); p = 0.001], [0.12 (0.05–0.22); p = 0.005] and [0.07(0.04–0.18); p = 0.021]], respectively. There was also a reduction in the median BMI z score at 24 months [2.11 (0.45–3.70) vs. 2.93 (2.01–3.98); p = 0.049]. Conclusion: Our results confirm the efficacy and safety of RTX use in pediatric idiopathic NS and highlight its’ potential cardiometabolic benefits.

Resumo Introdução: Rituximabe (RTX) é uma opção terapêutica na síndrome nefrótica (SN) idiopática pediátrica de difícil tratamento. Visamos avaliar eficácia e segurança do uso de RTX nestes pacientes. Método: Realizou-se estudo retrospectivo de todos os pacientes com SN idiopática tratados com RTX, em uma unidade de nefrologia pediátrica de um hospital terciário. Dados demográficos, antropométricos, clínicos e analíticos foram coletados antes do tratamento e aos 6, 12 e 24 meses. Resultados: Incluímos 16 pacientes (11 do sexo masculino), com idade mediana (percentil 25–75, P25–P75) de 2 (2,0–2,8) anos ao diagnóstico. Quinze eram sensíveis a esteroides, e 1 resistente a esteroides e sensível à ciclosporina.A idade mediana na administração do RTX foi 10 (6,3–14,0) anos. Durante um tempo mediano de acompanhamento de 2,5(1,0–3,0) anos, 6 (37,5%) pacientes alcançaram remissão parcial e 7 (43,8%) não tiveram recidivas e não estavam tomando imunossupressor no acompanhamento aos 24 meses. Quanto às complicações,1 paciente apresentou hipogamaglobulinemia persistente. Comparado ao período de12 meses anterior ao RTX, houve diminuição no número mediano de recidivas em 6 e 12 meses [3 (3,0–4,0) vs 0 (0–0,8) e 0,50 (0–1,0), respectivamente; p = 0,001] e na dose diária de esteroides (mg/kg/dia) aos 6, 12 e 24 meses [0,29 (0,15–0,67) >vs [0,10 (0,07–0,13); p = 0,001], [0,12 (0,05–0,22); p = 0,005] e [0,07 (0,04–0,18); p = 0,021], respectivamente. Houve também redução na mediana do escore z do IMC aos 24 meses [2,11 (0,45–3,70) vs 2,93 (2,01–3,98);p = 0,049]. Conclusões: Nossos resultados confirmam a eficácia e segurança do uso de RTX em SN idiopática pediátrica, destacando seus potenciais benefícios cardiometabólicos.

ABSTRACT Introduction: Brazil has the largest public and universal healthcare system in the world, but little is known about the outcomes of patients on hemodialysis (HD) in the country according to the source of funding for the treatment. Objective: To compare the profile and survival of patients under HD treatment funded by the Public Healthcare System (SUS) to those with private insurance. Methods: Retrospective analysis of adults undergoing HD between 2012 and 2017 in 21 dialysis centers in Brazil that provided both by the SUS and private health insurance. Participants, regardless of the paying source, received similar dialysis treatment. Data were censored after 60 months of follow-up or at the end of 2019. Results: 4,945 patients were included, 59.7% of which were financed by the SUS. Patients financed by SUS, compared to those with private insurance, were younger (58 vs. 60 years; p < 0.0001) and with a lower prevalence of diabetes (35.8% vs. 40.9%; p < 0.0001). The 60-month survival rates in these groups were 51.1% and 52.1%, respectively (p = 0.85). In the analysis of the subdistribution proportional hazard ratio by the Fine-Gray model, including adjustment for concurrent outcomes, a significant increase in the risk ratio for death was found (1.22 [95% confidence interval 1.04 to 1.43]) in patients with treatment funded by the SUS. Conclusions: Patients on HD with treatment funded by the SUS have a higher adjusted risk of death when compared to those with private insurance, despite similar dialysis treatment. Factors not directly related to dialysis therapy could explain this difference.

Resumo Introdução: O Brasil possui o maior sistema público e universal de saúde do mundo, mas pouco se sabe sobre os desfechos dos pacientes em hemodiálise (HD) no país de acordo com a fonte de financiamento do tratamento. Objetivo: Comparar o perfil e a sobrevida dos pacientes que têm o tratamento de HD custeado pelo Sistema Único de Saúde (SUS) com aqueles com convênio privado. Métodos: Análise retrospectiva dos adultos incidentes em HD entre 2012 e 2017 em 21 centros de diálise no Brasil que atendiam tanto pelo SUS quanto por convênios privados. Os participantes, independentemente da fonte pagadora, receberam tratamento dialítico semelhante. Os dados foram censurados com 60 meses de acompanhamento ou ao final de 2019. Resultados: Foram incluídos 4945 pacientes, sendo 59,7% financiados pelo SUS. Os pacientes financiados pelo SUS, em comparação aos que tinham convênio privado, eram mais jovens (58 vs 60 anos; p < 0,0001) e com menor prevalência de diabetes (35,8% vs 40,9%; p < 0,0001). As taxas de sobrevida, em 60 meses nesses grupos foram de 51,1% e 52,1%, respectivamente (p = 0,85). Na análise da razão de risco proporcional de subdistribuição pelo modelo de Fine-Gray, incluindo ajuste para desfechos concorrentes, foi encontrado um aumento significativo na razão de risco para morte (1,22 [intervalo de confiança de 95% 1,04 a 1,43]) nos pacientes com tratamento custeado pelo SUS. Conclusões: Pacientes em HD com tratamento custeado pelo SUS têm um risco ajustado de morte mais elevado do que aqueles com convênio privado, apesar do tratamento dialítico semelhante. Fatores não relacionados diretamente à terapia dialítica poderiam justificar esta diferença.

ABSTRACT In Chile, until December 31st, 2020, 12.5% of foreign residents were from Haiti. The nutritional status (NS) in pregnant women and infants is unknown; as well as the prevalence of exclusive breastfeeding (EBF) of the Haitian population residing in Chile. This study aimed to compare: (i) the NS of Haitian and Chilean pregnant women, (ii) the NS of infants, and (iii) the duration of EBF in children of Haitian and Chilean mothers. We analyzed the database of the Haitian and Chilean population attended between the years 2016-2019 at the Primary Care Health Center (CESFAM) “Los Castaños” located in the commune of La Florida. During the pregestational stage, the Haitian pregnant women had a higher prevalence of low weight compared to the Chilean pregnant women (p= 0,0003), whereas, at the end of the pregnancy, they had a higher prevalence of normal nutritional status (p= 0,0001) and a lower prevalence of obesity and a tendency at the end of pregnancy. Whereas at the end of the pregnancy, Chilean women had a higher prevalence of obesity. Regarding the nutritional status of the infants, differences were only observed in the first month of life, where 82% of Haitian infants had a normal weight compared to 24% of Chilean infants (p= 0.0001). No significant differences were observed in the prevalence of EBF up to 6 months between Haitian and Chilean infants (35.3% vs. 30%, respectively). It is important to mention that neither of the two groups of infants met the goal established by the World Health Organization (WHO) that proposes EBF for the first six months of life up to at least 50%. In conclusion, there are differences in the NE of pregnant and lactating women in both countries, while the prevalence of EBF in both groups was similar.

RESUMEN En Chile, al 31 de diciembre del 2020 un 12,5% de los extranjeros eran de nacionalidad haitiana. Se desconoce el estado nutricional (EN) en embarazadas y lactantes; así como también la prevalencia de lactancia materna exclusiva (LME) de la población haitiana en Chile. Los objetivos de este trabajo fueron comparar: (i) el EN de embarazadas haitianas y chilenas, (ii) el EN de lactantes y (iii) la duración de la LME en hijos de madres haitianas y chilenas. Para esto se analizó la base de datos de la población haitiana y chilena atendidos entre los años 2016-2019 en el Centro de Salud Familiar (CESFAM) “Los Castaños” ubicado en la comuna de La Florida. En la etapa pre-gestacional, las embarazadas haitianas presentaron mayor prevalencia de bajo peso en comparación a embarazadas chilenas (p= 0,0003), mientras que al término del embarazo presentaron una mayor prevalencia de estado nutricional normal (p= 0,0001) y menor prevalencia de obesidad (p= 0,0001). Respecto al estado nutricional de los lactantes, sólo se observaron diferencias en el primer mes de vida, donde un 82% de los lactantes haitianos tenían un EN normopeso en comparación al 24% en los lactantes chilenos (p= 0,0001). No se observaron diferencias significativas en la prevalencia de LME hasta los 6 meses entre lactantes haitianos y chilenos (35,3% vs 30%, respectivamente). Es importante mencionar que ninguno de los dos grupos de lactantes cumplió con la meta establecida por la Organización Mundial de la Salud (OMS) que propone LME en los primeros seis meses de vida hasta al menos 50%. En conclusión, se evidencian diferencias en el EN de las embarazadas y lactantes de ambos países, mientras que la prevalencia de LME en ambos grupos fue similar.

Abstract Introduction: Home parenteral nutrition (HPN) and/or home parenteral hydration (HPH) are the gold-standard treatment for patients with long-term intestinal failure (IF). The authors aimed to assess the impact of HPN/HPH on nutritional status and survival of long-term IF patients, as well as HPN/HPH-related complications. Methods: This was a retrospective study including IF patients under HPN/HPH followed in a single large tertiary Portuguese hospital. The data collected included demographics, underlying conditions, anatomical characteristics, type and duration of parenteral support, IF functional, pathophysiological, and clinical classifications, body mass index (BMI) at the beginning and end of follow-up, complications/hospitalizations, current patient status (deceased, alive with HPN/HPH, and alive without HPN/HPH), and cause of death. Survival after HPN/HPH beginning, until death or August 2021, was recorded in months. Results: Overall 13 patients were included (53.9% female, mean age 63.46 years), and 84.6% of patients presented type III IF and 15.4% type II. Short bowel syndrome caused 76.9% of IF. Nine patients received HPN and 4 HPH. Eight patients (61.5%) were underweight at the beginning of HPN/HPH. At the end of follow-up, 4 patients were alive without HPN/HPH, 4 maintained HPN/HPH, and 5 died. All patients improved their BMI (mean initial BMI 18.9 vs. 23.5 at the end, p < 0.001). Eight patients (61.5%) were hospitalized due to catheter-related complications, mainly infectious (mean hospitalization epi-sodes 2.25, mean hospital stay of 24.5 days). No deaths were related to HPN/HPH. Conclusion: HPN/HPH significantly im-proved IF patients’ BMI. HPN/HPH-related hospitalizations were common, however causing no deaths, reinforcing that HPN/HPH is an adequate and safe therapy for long-term IF patients.

Resumo Introdução: A nutrição parentérica domiciliária (NPD) e/ou a hidratação parentérica domiciliária (HPD) constituem o tratamento gold-standard para doentes com falência intestinal (FI) crónica. O objetivo do presente estudo foi avaliar o impacto da NPD/HPD no status nutricional e sobrevivência dos doentes com FI crónica, bem como as complicações relacionadas à NPD/HPD. Métodos: Estudo retrospetivo, incluindo doentes com FI sob NPD/HPD, seguidos num hospital terciário em Portugal. Informação recolhida para cada doente: dados demográficos, patologia de base, características anatómicas, tipo e duração do su-porte parentérico, classificação funcional, fisiopatológica e clínica da FI, índice de massa corporal (IMC) no início e final do seguimento, complicações/hospitalizações, estado atual do doente (falecido, vivo sob NPD/HPD e vivo sem NPD/HPD) e causa de morte. A sobrevida após início da NPD/HPD foi calculada em meses, até à data da morte ou agosto de 2021. Resultados: Incluídos 13 doentes (53.9% do sexo feminino, idade média 63.46 anos), 84.6% com FI tipo III e 15.4% com FI tipo II. A síndrome do intestino curto foi causa de 76.9% das FI. Nove doentes foram tratados com NPD e 4 com HPD. Oito doentes (61.5%) apresentavam IMC baixo no início da NPD/HPD. No final do seguimento, 4 doentes estavam vivos sem NPD/HPD, 4 mantinham NPD/HPD e 5 faleceram. Todos os doentes melhoraram significativamente o seu IMC (IMC médio no início do seguimento 18.9kg/m2 vs 23.5kg/m2 no final, p<0.001). Oito doentes (61.5%) tiveram de ser hospitalizados devido a complicações relacionadas com o cateter, sobretudo de causa infeciosa (número médio de hospitalizações por doente 2.25, duração média de internamento 24.5 dias). Não houve mortes relacionadas com a NPD/HPD. Conclusão: A NPD/HPD melhorou significativamente o IMC dos doentes com FI. As hospitalizações relacionadas com a NPD/HPD foram comuns, contudo não causaram mortes, reforçando o facto que a NPD/HPD é uma terapêutica segura e adequada para doentes com FI crónica.

Resumo Introdução: O Brasil possui o maior sistema público e universal de saúde do mundo, mas pouco se sabe sobre os desfechos dos pacientes em hemodiálise (HD) no país de acordo com a fonte de financiamento do tratamento. Objetivo: Comparar o perfil e a sobrevida dos pacientes que têm o tratamento de HD custeado pelo Sistema Único de Saúde (SUS) com aqueles com convênio privado. Métodos: Análise retrospectiva dos adultos incidentes em HD entre 2012 e 2017 em 21 centros de diálise no Brasil que atendiam tanto pelo SUS quanto por convênios privados. Os participantes, independentemente da fonte pagadora, receberam tratamento dialítico semelhante. Os dados foram censurados com 60 meses de acompanhamento ou ao final de 2019. Resultados: Foram incluídos 4945 pacientes, sendo 59,7% financiados pelo SUS. Os pacientes financiados pelo SUS, em comparação aos que tinham convênio privado, eram mais jovens (58 vs 60 anos; p < 0,0001) e com menor prevalência de diabetes (35,8% vs 40,9%; p < 0,0001). As taxas de sobrevida, em 60 meses nesses grupos foram de 51,1% e 52,1%, respectivamente (p = 0,85). Na análise da razão de risco proporcional de subdistribuição pelo modelo de Fine-Gray, incluindo ajuste para desfechos concorrentes, foi encontrado um aumento significativo na razão de risco para morte (1,22 [intervalo de confiança de 95% 1,04 a 1,43]) nos pacientes com tratamento custeado pelo SUS. Conclusões: Pacientes em HD com tratamento custeado pelo SUS têm um risco ajustado de morte mais elevado do que aqueles com convênio privado, apesar do tratamento dialítico semelhante. Fatores não relacionados diretamente à terapia dialítica poderiam justificar esta diferença.

ABSTRACT Introduction: Brazil has the largest public and universal healthcare system in the world, but little is known about the outcomes of patients on hemodialysis (HD) in the country according to the source of funding for the treatment. Objective: To compare the profile and survival of patients under HD treatment funded by the Public Healthcare System (SUS) to those with private insurance. Methods: Retrospective analysis of adults undergoing HD between 2012 and 2017 in 21 dialysis centers in Brazil that provided both by the SUS and private health insurance. Participants, regardless of the paying source, received similar dialysis treatment. Data were censored after 60 months of follow-up or at the end of 2019. Results: 4,945 patients were included, 59.7% of which were financed by the SUS. Patients financed by SUS, compared to those with private insurance, were younger (58 vs. 60 years; p < 0.0001) and with a lower prevalence of diabetes (35.8% vs. 40.9%; p < 0.0001). The 60-month survival rates in these groups were 51.1% and 52.1%, respectively (p = 0.85). In the analysis of the subdistribution proportional hazard ratio by the Fine-Gray model, including adjustment for concurrent outcomes, a significant increase in the risk ratio for death was found (1.22 [95% confidence interval 1.04 to 1.43]) in patients with treatment funded by the SUS. Conclusions: Patients on HD with treatment funded by the SUS have a higher adjusted risk of death when compared to those with private insurance, despite similar dialysis treatment. Factors not directly related to dialysis therapy could explain this difference.

RESUMO Objetivo descrever o perfil sociodemográfico dos casos notificados de violência sexual (VS) e a distribuição dos serviços de atendimento ao agravo em Minas Gerais, Brasil, 2019. Métodos estudo descritivo dos casos notificados no Sistema de Informação de Agravos de Notificação e dos serviços registrados no Cadastro Nacional dos Estabelecimentos de Saúde. Resultados foram identificadas 4.418 notificações de VS no período, correspondendo a mais de 12 notificações/dia; houve maior frequência de notificações no sexo feminino (87,0%) e entre crianças e adolescentes (72,0%); a distribuição dos serviços mostrou vazios assistenciais em quatro das 14 macrorregiões de saúde do estado; as distâncias máximas percorridas para atendimento em serviços de referência variaram de 93 a 327 km. Conclusão a escassez de serviços de atendimento a pessoas em situação de VS nas microrregiões e macrorregiões de Minas Gerais sinalizam a necessidade de planejamento de políticas públicas visando aumentar o acesso a esses serviços.

RESUMEN Objetivo describir el perfil sociodemográfico de los casos notificados de violencia sexual (VS) y la distribución de los servicios para esta condición. Métodos estudio observacional descriptivo basado en datos del Sistema de Información de Enfermedades de Declaración Obligatoria y servicios registrados en el Registro Nacional de Estabelecimientos de Salud, en Minas Gerais, Brasil, en 2019. Resultados se identificaron 4.418 notificaciones de SV que representan más de 12 notificaciones por día; los registros se centraron en el sexo femenino (87,0%), niños y adolescentes (72,0%); la distribución de los servicios mostró brechas de atención en cuatro macrorregiones entre las 14 existentes; la distancia máxima recorrida para asistencia en un servicio de referencia osciló entre 93 y 327 km. Conclusión la escasez de servicios de atención a personas en situación de SV en las micro y macro regiones, indican la necesidad de planificación de políticas públicas para ampliar el acceso.

ABSTRACT Objective to describe the sociodemographic profile of reported cases of sexual violence (SV) and the distribution of care services for this health condition in the state of Minas Gerais, Brazil, 2019. Methods this was a descriptive study of the cases of sexual violence reported on the Notifiable Health Conditions Information System and care services registered in the National Health Establishment Registry. Results a total of 4,418 notifications of SV were identified during the study period, representing more than 12 notifications per day; the majority of notifications were among females (87.0%) and among children and adolescents (72.0%); the distribution of care services showed care gaps in four of the 14 health macro-regions of the state of Minas Gerais; the maximum distances traveled to access referral services ranged from 93 to 327 km. Conclusion the scarcity of care services for people subjected to sexual violence in the micro-regions and macro-regions of Minas Gerais highlights the need for planning public policies aimed at increasing access to these services.

Abstract Persistence involves the intention to maintain efforts when faced with obstacles and challenges, in order to achieve a specific goal. The Rigid and Flexible Persistence Scale (RFPS) is a self-report measure that assesses persistence that is theoretically derived from the premises of the Dualistic Model of Passion. The aim of the present research was to adapt the RFPS to Brazilian Portuguese and to estimate its evidence of validity and reliability in the context of work. Participants were 400 professionals, 55.8% women, aged between 18 and 68 years. The results indicate that the RFPS presented validity evidence based on the content. Corresponding to the theoretical expectations, exploratory and confirmatory factor analyses demonstrated adequacy of the structure composed of two factors, explaining 75% of the data variance, with good levels of reliability. The RFPS also revealed strong invariance across gender and work conditions (in-person vs remote). Flexible persistence showed positive association with harmonious passion and occupational self-efficacy. Conversely, rigid persistence showed positive association with obsessive passion. It was observed a mediational role of occupational self-efficacy in the relationship between harmonious passion and flexible persistence. Overall, the findings suggest that the RFPS is an adequate measure of persistence in a Brazilian occupational sample.

ABSTRACT Introduction: During the SARS-CoV-2 pandemic, the high flow nasal cannula (HFNC) was used as support while waiting for the Intensive Care Unit (ICU) or as an alternative to invasive ventilation. The objective of this work is the description and analysis of the use of CNAF in our population. Objectives: Primary: Determine if HFNC prevents orotracheal intubation. Secondary: Analyze predictors of success at the start of CNAF and a descriptive analysis of the sample Materials and method: Retrospective descriptive observational study. Patients over 16 years of age positive for SARS-CoV-2, treated in Guard and ICU were included. who used CNAF between October 2020 and March 2021 Data was collected in individual forms, analyzed by an external professional. Results: The study included 72 patients (16 to 88 years old), 20 women and 52 men; 50 % of the sample avoided orotracheal intubation. Start IROX, group “success” vs. group “failure” p = 0.006. Comparison Irox.12 h group “success” vs. group “failure” p < 0.001. Comparison “Time from admission to start of CNAF” group “success” vs. group “failure” p = 0.133. Comparison “Delta IROX” group “success” vs. group “failure” p = 0.092. Conclusion: HFNC avoided orotracheal intubation in the 50 % of the cases. The initial IROX and the IROX 12 hours after the use of HFNC were statistically significant, which is a good predictor of success in this population. The date of onset of symptoms and the use of FNAF and IROX delta during the first 12 hours were not statistically significant for the success of the therapy. These data are a useful tool for generating patient selection protocols for this pathology.

RESUMEN Introducción: Durante la pandemia por SARS-CoV-2, la cánula nasal de alto flujo (CNAF) se usó como soporte en espera de Unidad de terapia intensiva (UTI) o como alternativa a la ventilación invasiva. Objetivos: Primario: Determinar si la cánula nasal de alto flujo evita la intubación orotraqueal. Secundarios: Analizar predictores de éxito al inicio de la cánula nasal de alto flujo y análisis descriptivo de la muestra. Materiales y métodos: Estudio observacional descriptivo retrospectivo. Se incluyeron pacientes mayores de 16 años positivos para SARS-CoV-2, atendidos en guardia y unidad de terapia intensiva, que utilizaron cánula nasal de alto flujo entre octubre de 2020 y marzo 2021. Se recolectaron datos en planillas individuales, analizadas por un profesional externo. Resultados: Se incluyeron en el trabajo 72 pacientes (de 16 a 88 años), 20 mujeres y 52 hombres. El 50 % de la muestra evitó la intubación orotraqueal. El IROX inicio grupo “éxito” vs. grupo “fracaso”, p = 0,006. Comparación Irox 12 h grupo “éxito” vs. grupo “fracaso” p < 0,001. Comparación “tiempo desde ingreso a inicio de cánula nasal de alto flujo” grupo “éxito” vs. grupo “fracaso”, p = 0,133. Comparación “Delta IROX” grupo “éxito” vs grupo “fracaso” p = 0,092. Conclusión: Se evitó la intubación orotraqueal en el 50 % de los casos. El IROX de inicio y el IROX a las 12 h del uso de cánula nasal de alto flujo fue estadísticamente significativo, lo que es un buen predictor del éxito en esta población. La fecha de inicio de síntomas y el uso de cánula nasal de alto flujo y el delta del IROX durante las primeras 12 h no fue estadísticamente significativo para el éxito de la terapia. Estos datos son una herramienta útil con el objeto de generar protocolos de selección de pacientes para esta patología.

ABSTRACT Introduction: During the SARS-CoV-2 pandemic, the high flow nasal cannula (HFNC) was used as support while waiting for the Intensive Care Unit (ICU) or as an alternative to invasive ventilation. The objective of this work is the description and analysis of the use of CNAF in our population. Objectives: Primary: Determine if HFNC prevents orotracheal intubation. Secondary: Analyze predictors of success at the start of CNAF and a descriptive analysis of the sample Materials and method: Retrospective descriptive observational study. Patients over 16 years of age positive for SARS-CoV-2, treated in Guard and ICU were included. who used CNAF between October 2020 and March 2021 Data was collected in individual forms, analyzed by an external professional. Results: The study included 72 patients (16 to 88 years old), 20 women and 52 men; 50 % of the sample avoided orotracheal intubation. Start IROX, group “success” vs. group “failure” p = 0.006. Comparison Irox.12 h group “success” vs. group “failure” p < 0.001. Comparison “Time from admission to start of CNAF” group “success” vs. group “failure” p = 0.133. Comparison “Delta IROX” group “success” vs. group “failure” p = 0.092. Conclusion: HFNC avoided orotracheal intubation in the 50 % of the cases. The initial IROX and the IROX 12 hours after the use of HFNC were statistically significant, which is a good predictor of success in this population. The date of onset of symptoms and the use of FNAF and IROX delta during the first 12 hours were not statistically significant for the success of the therapy. These data are a useful tool for generating patient selection protocols for this pathology.

RESUMEN Introducción: Durante la pandemia por SARS-CoV-2, la cánula nasal de alto flujo (CNAF) se usó como soporte en espera de Unidad de terapia intensiva (UTI) o como alternativa a la ventilación invasiva. Objetivos: Primario: Determinar si la cánula nasal de alto flujo evita la intubación oro traqueal. Secundarios: Analizar predictores de éxito al inicio de la cánula nasal de alto flujo y análisis descriptivo de la muestra. Materiales y métodos: Estudio observacional descriptivo retrospectivo. Se incluyeron pacientes mayores de 16 años positivos para SARS-CoV-2, atendidos en guardia y unidad de terapia intensiva, que utilizaron cánula nasal de alto flujo entre octubre de 2020 y marzo 2021. Se recolectaron datos en planillas individuales, analizadas por un profesional externo. Resultados: Se incluyeron en el trabajo 72 pacientes (de 16 a 88 años), 20 mujeres y 52 hombres. El 50 % de la muestra evitó la intubación orotraqueal. El IROX inicio grupo “éxito” vs. grupo “fracaso”, p = 0,006. Comparación Irox 12 h grupo “éxito” vs. grupo “fracaso” p < 0,001. Comparación “tiempo desde ingreso a inicio de cánula nasal de alto flujo” grupo “éxito” vs. grupo “fracaso”, p = 0,133. Comparación “Delta IROX” grupo “éxito” vs grupo “fracaso” p = 0,092. Conclusión: Se evitó la intubación orotraqueal en el 50 % de los casos. El IROX de inicio y el IROX a las 12 h del uso de cánula nasal de alto flujo fue estadísticamente significativo, lo que es un buen predictor del éxito en esta población. La fecha de inicio de síntomas y el uso de cánula nasal de alto flujo y el delta del IROX durante las pri meras 12 h no fue estadísticamente significativo para el éxito de la terapia. Estos datos son una herramienta útil con el objeto de generar protocolos de selección de pacientes para esta patología.

ABSTRACT Objective To identify the food environment healthy eating potential in the authorized food services on the campus of a Brazilian university. Methods This is an observational study carried out between March and April 2014 on a campus of a public university in Rio de Janeiro, Brazil. The elements of the food environment were evaluated using an audit instrument, containing 86 questions: availability (amount of food services and types of food offered), convenience (days and hours of operation), incentives and barriers to healthy eating (nutrition information, payment strategies and food advertisements). Preparations based on whole grains and fresh or minimally processed products were considered healthy foods; and, preparations with high caloric density, sugar-sweetened beverages, sweets, desserts, cookies, and savory snacks were considered unhealthy food. The questionnaire allowed us to calculate a score for each service, which could range from 0 to 36 points, and indicates the potential for promoting healthy eating in the establishment, with higher scores indicating a greater presence of elements that contribute to healthy eating. The different types of food service facilities were compared based on the scores (p<0.05 for statistical significance). Results Among the establishments evaluated, 24% were snack bars/cafeterias, 26%, restaurants, and 50% offered mixed services. Healthy food items were scarcely available in the establishments (fruits: 24%; vegetables: 20%; brown rice: 15%); while added-sugar beverages (98%), sweets and treats (76%) were widely offered. There was a higher frequency of advertising encouraging consumption of unhealthy items than that aimed at healthy foods (44% vs 30%). In general, the score was 13,2 points (SD=3.3) and the mean score for snack bars/cafeterias (9.3 points) was lower (p<0,05) than that of restaurants and mixed establishments (14,4 points). Conclusion On the campus assessed, the food environment had limited potential for healthy eating, since elements that did not favor healthy food choices were more frequent.

RESUMO Objetivo Identificar o potencial do ambiente alimentar para alimentação saudável em serviços permissionários no campus de uma universidade brasileira. Métodos Realizou-se um estudo observacional entre março e abril de 2014, em 54 serviços de alimentação permissionários de um campus de uma universidade pública do Rio de Janeiro, Brasil. Os elementos do ambiente alimentar foram avaliados por meio de instrumento de auditoria contendo 86 questões: disponibilidade (quantidade de serviços de alimentação e tipos de alimentos comercializados), conveniência (dias e horários de funcionamento), estímulos e barreiras para a alimentação saudável (informação nutricional, estratégias de pagamento e propagandas de alimentos). As preparações à base de cereais integrais e produtos frescos ou minimamente processados foram considerados alimentos saudáveis e aquelas com elevada densidade calórica, bebidas com adição de açúcar, doces, sobremesas, guloseimas, biscoitos e lanches salgados foram considerados não saudáveis. O questionário permitiu calcular um escore, para cada serviço, que poderia variar entre 0 a 36 pontos, e indica o potencial para promoção da alimentação saudável no estabelecimento, sendo que escores mais elevados indicam maior presença de elementos que favorecem a alimentação saudável. Os diferentes tipos de serviços de alimentação permissionários foram comparados segundo os escores (p<0,05 para significância estatística). Resultados Dos estabelecimentos avaliados, 24% eram lanchonetes/cafeterias, 26%, restaurantes e 50%, mistos. Itens saudáveis eram disponibilizados de forma incipiente nos estabelecimentos (frutas: 24%; hortaliças: 20%; arroz integral: 15%), enquanto bebidas com adição de açúcar (98%) e doces e guloseimas (76%) eram amplamente ofertados. Havia maior frequência de propagandas incentivando o consumo de itens não saudáveis do que aquelas voltadas para alimentos saudáveis (44% vs 30%). De modo geral, o escore foi de 13,2 pontos (DP=3,3) e a média do escore de lanchonetes/cafeterias (9,3 pontos) era menor (p<0,05) do que a de restaurantes e estabelecimentos mistos (14,4 pontos). Conclusão O ambiente alimentar do campus avaliado apresentou potencial limitado para a alimentação saudável, uma vez que eram mais frequentes os elementos que não favoreciam escolhas alimentares saudáveis.

Abstract Objectives To evaluate the colonization dynamics of subgingival microbiota established over six months around newly installed dental implants in periodontally healthy individuals, compared with their corresponding teeth. Methodology Seventeen healthy individuals assigned to receive single dental implants participated in the study. Subgingival biofilm was sampled from all implant sites and contralateral/ antagonist teeth on days 7, 30, 90, and 180 after implant installation. Microbiological analysis was performed using the Checkerboard DNA-DNA hybridization technique for detection of classical oral taxa and non-oral microorganisms. Significant differences were estimated by Mann-Whitney and Friedman tests, while associations between implants/teeth and target species levels were assessed by linear regression analysis (LRA). Significance level was set at 5%. Results Levels of some species were significantly higher in teeth compared to implants, respectively, at day 7 ( V.parvula , 6 × 10 5 vs 3 × 105 ; Milleri streptococci , 2 × 10 6 vs 6 × 10 5 ; Capnocytophaga spp., 2 × 10 6 vs 9 × 10 5 ; E.corrodens , 2 × 10 6 vs 5 × 10 5 ; N. mucosa , 2 × 10 6 vs 5 × 10 5 ; S.noxia , 2 × 10 6 vs 3 × 10 5 ; T.socranskii , 2 × 10 6 vs 5 × 10 5 ; H.alvei , 4 × 10 5 vs 2 × 10 5 ; and Neisseria spp., 6 × 10 5 vs 4 × 10 4 ), day 30 ( V.parvula , 5 × 10 5 vs 10 5 ; Capnocytophaga spp., 1.3 × 10 6 vs 6.8 × 10 4 ; F.periodonticum , 2 × 10 6 vs 10 6 ; S.noxia , 6 × 10 5 vs 2 × 10 5 ; H.alvei , 8 × 10 5 vs 9 × 10 4 ; and Neisseria spp., 2 × 10 5 vs 10 6 ), day 120 ( V.parvula , 8 × 10 5 vs 3 × 10 5 ; S.noxia , 2 × 10 6 vs 0; and T.socranskii , 3 × 10 5 vs 8 × 10 4 ), and day 180 ( S.enterica subsp. enterica serovar Typhi, 8 × 10 6 vs 2 × 10 6 ) (p<0.05). Implants showed significant increases over time in the levels of F.nucleatum , Gemella spp., H.pylori , P.micra , S.aureus , S.liquefaciens , and T.forsythia (p<0.05). LRA found that dental implants were negatively correlated with high levels of S. noxia and V. parvula (β=-0.5 to -0.3; p<0.05). Conclusions Early submucosal microbiota is diverse and only a few species differ between teeth and implants in the same individual. Only 7 days after implant installation, a rich microbiota can be found in the peri-implant site. After six months of evaluation, teeth and implants show similar prevalence and levels of the target species, including known and new periodontopathic species.

Abstract This exploratory study investigated whether children with dental decay were more likely to have COVID-19 than those without caries. The children underwent dental inspection and blood collection for detection of SARS-CoV-2 antibodies. Fifty-four children aged 6 to 9 years participated in the survey, which was conducted between March and June 2020 in the municipality of Ipojuca, Pernambuco, Brazil. The diagnosis of caries was performed using the dmft and DMFT indices. Parents reported signs and symptoms of sickness in their children during this period. The serology test aimed to verify the immune response of the children to coronavirus by detecting IgM/IgG antibodies. Statistical analyses were performed at P < 0.05. The majority of the children presented caries (68.5%). Of the nine children who tested positive for COVID-19 (16.7%), eight presented IgG antibodies to the virus, and only one had IgG and IgM antibodies to SARS-CoV2. Children who tested positive for SARS-CoV-2 had a higher percentage of caries lesions than those who tested negative for SARS-CoV-2 (77.8% vs 65.9%), but this difference was not statistically significant.