ABSTRACT Objective: to identify the epidemiological profile of victims who suffered sexual violence, in Anápolis - Goiás - Brazil, between the years 2017 to 2020. Methods: descriptive study of quantitative nature. Data from the notification form of sexual violence registered in the Department of Epidemiological Surveillance were used. Chi-square test was used with a significance level of 5% (p<0.05). Results: 850 cases were notified, with the peak in 2020, 82.1% were female, between the age group of two to 10 years (42.2%), brown (61.2%) and single (37.1%). The main conduct carried out after sexual violence was blood collection (21.6%); the main aggressors were the parents (20.9%), the main type of sexual violence was rape (68.7%) and the victims were mainly referred to the Guardianship Council (48.2%). Conclusion: The results point to the need to strengthen interventions to expand the social protection network for children and adolescents.

RESUMEN Objetivo: identificar el perfil epidemiológico de las víctimas que han sufrido violencia sexual, en Anápolis - Goiás - Brasil, entre los años 2017 a 2020. Método: estudio descriptivo de naturaleza cuantitativa. Se utilizaron datos de la ficha de notificación de violencia sexual registrada en el Departamento de Vigilancia Epidemiológica. Se utilizó la prueba de chi cuadrado con un nivel de significación del 5% (p<0,05). Resultados: Fueron notificados 850 casos, con el pico en 2020, siendo 82,1% mujeres, entre el grupo de edad de dos a 10 años (42,2%), morenas (61,2%) y solteras (37,1%). La principal conducta realizada después de la violencia sexual fue la extracción de sangre (21,6%); los principales agresores fueron los padres (20,9%), el principal tipo de violencia sexual fue la violación (68,7%) y las víctimas fueron encaminadas principalmente al Consejo Tutelar (48,2%). Conclusión: los resultados apuntan a la necesidad de reforzar las intervenciones para ampliar la red de protección social de niños y adolescentes.

RESUMO Objetivo: identificar o perfil epidemiológico das vítimas que sofreram violência sexual, em Anápolis - Goiás - Brasil, entre os anos 2017 a 2020. Métodos: estudo descritivo de natureza quantitativa. Foram utilizados dados da ficha de notificação de violência sexual cadastrada no Departamento de Vigilância Epidemiológica. Utilizado o teste qui-quadrado com nível de significância de 5% (p<0,05). Resultados: foram notificados 850 casos, com o pico em 2020, sendo 82,1% do sexo feminino, entre a faixa etária de dois a 10 anos (42,2%), de cor parda (61,2%) e solteira (37,1%). A principal conduta realizada após violência sexual foi a coleta de sangue (21,6%); os principais agressores foram os pais (20,9%), o tipo de violência sexual principal foi estupro (68,7%) e as vítimas foram encaminhadas, principalmente, para o Conselho tutelar (48,2%). Conclusão: os resultados apontam a necessidade de se fortalecer intervenções no sentido de ampliar a rede de proteção social às crianças e adolescentes.

ABSTRACT Stress fractures (SF) represent 10%-20% of all injuries in sport medicine. An SF occurs when abnormal and repetitive loading is applied on normal bone: The body cannot adapt quickly enough, leading to microdamage and fracture. The etiology is multifactorial with numerous risk factors involved. Diagnosis of SF can be achieved by identifying intrinsic and extrinsic factors, obtaining a good history, performing a physical exam, and ordering laboratory and imaging studies (magnetic resonance imaging is the current gold standard). Relative energy deficiency in sport (RED-S) is a known risk factor. In addition, for women, it is very important know the menstrual status to identify long periods of amenorrhea in the past and the present. Early detection is important to improve the chance of symptom resolution with conservative treatment. Common presentation involves complaints of localized pain, with or without swelling, and tenderness on palpation of bony structures that begins earlier in training and progressively worsens with activity over a 2- to 3-week period. Appropriate classification of SF based on type, location, grading, and low or high risk is critical in guiding treatment strategies and influencing the time to return to sport. Stress injuries at low-risk sites are typically managed conservatively. Studies have suggested that calcium and vitamin D supplementation might be helpful. Moreover, other treatment regimens are not well established. Understanding better the pathophysiology of SFs and the potential utility of current and future bone-active therapeutics may well yield approaches that could treat SFs more effectively.

SUMMARY OBJECTIVE: The aim of this study was to assess the inter-reliability of the Braden scale and its subscales for different patients assisted in the intensive care unit. We hypothesized that the Braden scale has low reliability in different populations. METHODS: This reliability study involved the Braden scale in intensive care unit of a hospital. A total of 200 patients were admitted to the intensive care unit in four different groups: neurological patients, sepsis, elderly, and adults affected by trauma. The Braden scale is a tool composed of six subscales for patient assessment: sensory perception, humidity, activity, mobility, nutrition, and friction. The total score was also calculated. The Braden scale was applied by two different nurses with an interval of 20–30 min between applications. RESULTS: For all populations, kappa values considered unsuitable were observed for most categories of the Braden scale, ranging from 0.06–0.25. Only for the total Braden scale score was moderate reliability identified in all groups evaluated, with intraclass correlation coefficient values ranging from 0.48–0.75. CONCLUSIONS: Braden scale is not a reliable tool to be used in the intensive care unit, and we do not recommend the use of this scale to assess the risk of developing pressure injury.

Abstract The number of deaths from COVID-19 is closely associated with multimorbidities. This study aimed to review the clinical and functional conditions of patients who recovered from COVID-19. Additionally, identify the relationship with risk factors and comorbidities. Systemic arterial hypertension (SAH) was more frequently observed in patients with severe COVID-19. Diabetes mellitus (DM) is one of the comorbidities that has contributed the most to the increase in the number of hospitalizations due to complications and the number of deaths due to infection by COVID-19. Obesity has been shown to be a risk factor for hospitalization in patients with COVID-19 under 60 years of age. Most survivors of COVID-19 suffer primarily from muscle fatigue or weakness. In addition, patients who were more seriously ill during their hospital stay have greater impairment of functional capacity, pulmonary diffusion and fatigue symptoms, and are the main target population for long-term recovery interventions. To optimize the post-hospitalization rehabilitation of patients after discharge from COVID-19, the need for multidisciplinary work in rehabilitation, the reinforcement of public policies to ensure equity in access to the public health system and training should be considered of the health team in view of the new demands and realities generated by COVID-19.

Resumo O número de mortes por COVID-19 está intimamente associado a multimorbidades. O presente estudo teve como objetivo revisar as condições clínicas e funcionais de pacientes que se recuperaram da COVID-19. Adicionalmente, identificar a relação com fatores de risco e comorbidades. A hipertensão arterial sistêmica (HAS) foi observada com mais frequência em pacientes com COVID-19 grave. O diabetes mellitus (DM) é uma das comorbidades que mais tem contribuído para o aumento do número de internações por complicações e do número de óbitos por infecção por COVID-19. A obesidade demonstrou ser um fator de risco para hospitalização em pacientes com COVID-19 com menos de 60 anos. A maioria dos sobreviventes da COVID-19 sofre principalmente de fadiga ou fraqueza muscular. Além disso, os pacientes que estiveram mais gravemente enfermos durante sua internação hospitalar apresentam maior prejuízo da capacidade funcional, pior difusão pulmonar e sintomas de fadiga, sendo assim a população-alvo para intervenções de recuperação a longo prazo.. Para otimizar a reabilitação pós-hospitalização de pacientes após alta por COVID-19, deve-se considerar a necessidade de trabalho multiprofissional na reabilitação, o reforço das políticas públicas para garantir a equidade no acesso ao sistema público de saúde e o treinamento da equipe de saúde frente às novas demandas e realidades geradas pelo COVID-19.

Resumo O número de mortes por COVID-19 está intimamente associado a multimorbidades. O presente estudo teve como objetivo revisar as condições clínicas e funcionais de pacientes que se recuperaram da COVID-19. Adicionalmente, identificar a relação com fatores de risco e comorbidades. A hipertensão arterial sistêmica (HAS) foi observada com mais frequência em pacientes com COVID-19 grave. O diabetes mellitus (DM) é uma das comorbidades que mais tem contribuído para o aumento do número de internações por complicações e do número de óbitos por infecção por COVID-19. A obesidade demonstrou ser um fator de risco para hospitalização em pacientes com COVID-19 com menos de 60 anos. A maioria dos sobreviventes da COVID-19 sofre principalmente de fadiga ou fraqueza muscular. Além disso, os pacientes que estiveram mais gravemente enfermos durante sua internação hospitalar apresentam maior prejuízo da capacidade funcional, pior difusão pulmonar e sintomas de fadiga, sendo assim a população-alvo para intervenções de recuperação a longo prazo.. Para otimizar a reabilitação pós-hospitalização de pacientes após alta por COVID-19, deve-se considerar a necessidade de trabalho multiprofissional na reabilitação, o reforço das políticas públicas para garantir a equidade no acesso ao sistema público de saúde e o treinamento da equipe de saúde frente às novas demandas e realidades geradas pelo COVID-19.

Abstract The number of deaths from COVID-19 is closely associated with multimorbidities. This study aimed to review the clinical and functional conditions of patients who recovered from COVID-19. Additionally, identify the relationship with risk factors and comorbidities. Systemic arterial hypertension (SAH) was more frequently observed in patients with severe COVID-19. Diabetes mellitus (DM) is one of the comorbidities that has contributed the most to the increase in the number of hospitalizations due to complications and the number of deaths due to infection by COVID-19. Obesity has been shown to be a risk factor for hospitalization in patients with COVID-19 under 60 years of age. Most survivors of COVID-19 suffer primarily from muscle fatigue or weakness. In addition, patients who were more seriously ill during their hospital stay have greater impairment of functional capacity, pulmonary diffusion and fatigue symptoms, and are the main target population for long-term recovery interventions. To optimize the post-hospitalization rehabilitation of patients after discharge from COVID-19, the need for multidisciplinary work in rehabilitation, the reinforcement of public policies to ensure equity in access to the public health system and training should be considered of the health team in view of the new demands and realities generated by COVID-19.

Resumo Objetivo Revelar as percepções dos profissionais de saúde sobre os desfechos do cuidado com a mulher em situação de violência conjugal. Métodos Estudo de abordagem qualitativa embasado no referencial teórico-metodológico da Teoria Fundamentada nos Dados. Para a coleta de dados, foram realizadas entrevistas com dois grupos amostrais compostos, no total, de 31 profissionais de saúde de nível superior integrantes da equipe mínima ou do Núcleo de Apoio à Saúde da Família de Unidades de Saúde da Família de um distrito sanitário localizado em uma capital do Nordeste brasileiro. Resultados A partir das narrativas das participantes da pesquisa, foram elucidados desfechos do cuidado com a mulher em situação de violência conjugal, os quais estão organizados em duas categorias representativas: Propiciando o enfrentamento da violência conjugal a partir do fortalecimento da mulher e Comprometendo o enfrentamento da violência conjugal em razão do não cuidado, sendo essa última composta por duas subcategorias intituladas Vulnerabilizando a mulher para permanência na relação abusiva e Suscetibilizando a mulher para o adoecimento/morte. Conclusão A oferta de uma assistência qualificada nos serviços impacta diretamente na vida das mulheres que vivenciam violência, seja positiva ou negativamente, uma vez que o não cuidado pode reverberar em agravamentos à saúde da mulher e resultar, inclusive, em seu óbito, enquanto que, ao prestar uma assistência acolhedora, o profissional favorece o empoderamento feminino e, assim, contribui para o enfrentamento da violência conjugal.

Abstract Objective To reveal healthcare professionals’ perceptions about the outcomes of care for women in situations of marital violence. Methods This is a qualitative approach study based on the Grounded Theory theoretical-methodological framework. For data collection, interviews were carried out with two sample groups composed, in total, of 31 higher education healthcare professionals, members of the minimum team or of Family Health Support Nucleus of Family Health Units in a health district in a capital of northeastern Brazil. Results From the participants’ narratives, outcomes of care for women in situations of marital violence were elucidated, which are organized into two representative categories: Providing marital violence tackling from women empowerment and Compromising marital violence tackling due to non-care, the latter being composed of two subcategories entitled Vulnerating women to remain in an abusive relationship and Making women susceptible to illness/death. Conclusion The offer of qualified assistance in services directly impacts the lives of women who experience violence, whether positively or negatively, since non-care can reverberate in women’s health and even result in their death. Providing a welcoming assistance, professionals favor female empowerment, thus contributing to the tackling conjugal violence.

Resumen Objetivo Revelar las percepciones de los profesionales de la salud sobre los resultados del cuidado de mujeres en situación de violencia conyugal. Métodos Estudio de enfoque cualitativo basado en el marco referencial teórico-metodológico de la teoría fundamentada en los datos. Para la recopilación de datos se realizaron encuestas con dos grupos de muestras compuestos, en total, por 31 profesionales de la salud de nivel superior integrantes del equipo mínimo o del Núcleo de Apoyo a la Salud de la Familia de Unidades de Salud de la Familia de un distrito sanitario ubicado en una capital de la región Nordeste brasileña. Resultados A partir de las narrativas de las participantes del estudio, fueron ilustrados los resultados del cuidado de mujeres en situación de violencia conyugal, y se organizaron en dos categorías representativas: Propiciar el afrontamiento a la violencia conyugal a partir del fortalecimiento de la mujer y Comprometer el afrontamiento a la violencia conyugal por causa del no cuidado, y esta última se dividió en dos subcategorías tituladas: Vulnerar a la mujer para que permanezca en la relación abusiva y Susceptibilidad de la mujer para que se enferme/muera. Conclusión Ofrecer una asistencia calificada en los servicios impacta directamente en la vida de las mujeres que sufren violencia, ya sea de forma positiva o negativa, dado que el no cuidado puede repercutir en el agravamiento de la salud de la mujer y puede, inclusive, provocar su muerte; mientras que, al proporcionar una atención acogedora, el profesional favorece el empoderamiento femenino y, de esta forma, contribuye con el afrontamiento a la violencia conyugal.

RESUMEN Bixa orellana L. es una planta nativa de Brasil, pero también está presente en otros países tropicales como Perú, Colombia, Ecuador, México, Indonesia, India y África Oriental. Es conocida popularmente como Urucum en Brasil. Esta revisión expone el potencial de los compuestos bioactivos derivados de B. orellana para tratar enfermedades debido a sus propiedades antimicrobianas y antioxidantes. Esta planta también está relacionada como un agente antiinflamatorio para el tratamiento de enfermedades pulmonares e incluso como gotas para los ojos para el enrojecimiento. Sus hojas se utilizan para el tratamiento de la mordedura de serpiente, diarrea, gonorrea, hepatitis, gastritis, diuréticos, antipiréticos y para enfermedades de la piel. Ese conocimiento popular ha fomentado la identificación de compuestos bioactivos en esa planta. Los compuestos β-criptoxantina, geranilgeraniol, luteína, procianidina B2, procianidina B3, isómero elagitanino y ácido elágico desoxihexosa inhibieron microorganismos patógenos como bacterias, hongos, protozoos y virus. En ese sentido, B. orellana es una fuente prometedora de compuestos que podrían aplicarse en la terapia antimicrobiana. Este trabajo de revisión puede ayudar a comprender e incentivar nuevas investigaciones para los descubrimientos de antimicrobianos que utilizan diferentes compuestos de B. orellana.

SUMMARY Bixa orellana L. is a native plant from Brazil, but it is also present in other tropical countries such as Peru, Colombia, Ecuador, Mexico, Indonesia, India and East Africa. It is popularly known as Urucum in Brazil. This review shows the potential of bioactive compounds derived from B. orellana to treat infectious diseases due their antimicrobial and antioxidant properties. This plant is also related as an antiinflammatory agent for treatment of pulmonary diseases, or even as eye drops for redness. Its leaves are used for treatment of snakebite, diarrhea, gonorrhea, hepatitis, gastritis, diuretic, antipyretic, and for skin disease. This popular knowledge has encouraged the identification of bioactive compounds in this plant. Compounds as β-cryptoxanthin, geranylgeraniol, lutein, procyanidin B2, procyanidin B3, ellagi tannin isomer and ellagic acid deoxyhexose have been described. These compounds inhibited pathogenic microorganisms such as bacteria, fungi, protozoan and viruses. In addition, some compounds with anti-inflammatory and antioxidant activities were also described. In this sense, B. orellana is a promising source of compounds that could be applied in antimicrobial therapy. This review work may help in the understanding and incentive of new research for antimicrobial discoveries using different B. orellana compounds.

OBJECTIVES: Ischemic stroke (IS) or transient ischemic attack (TIA) history is present in 4-17% of patients with coronary artery disease (CAD). This subgroup of patients is at high risk for both ischemic and bleeding events. The aim of this study was to determine the role of platelet aggregability, coagulation and endogenous fibrinolysis in patients with CAD and previous IS or TIA. METHODS: A prospective case-control study that included 140 stable CAD patients divided into two groups: the CASE group (those with a previous IS/TIA, n=70) and the CONTROL group (those without a previous IS/TIA, n=70). Platelet aggregability (VerifyNow Aspirin® and VerifyNow P2Y12®), coagulation (fibrinogen and thromboelastography by Reorox®) and endogenous fibrinolysis (D dimer and plasminogen activator inhibitor-1) were evaluated. RESULTS: Patients in the CASE group presented significantly higher systolic blood pressure levels (135.84±16.09 vs 123.68±16.11, p<0.01), significantly more previous CABG (25.71% vs 10%, p=0.015) and significantly higher calcium channel blocker usage (42.86% vs 24.29%, p=0.02) than those in the control group. In the adjusted models, low triglyceride values, low hemoglobin values and higher systolic blood pressure were significantly associated with previous IS/TIA (CASE group). Most importantly, platelet aggregability, coagulation and fibrinolysis tests were not independently associated with previous cerebrovascular ischemic events (CASE group). CONCLUSION: Platelet aggregability, coagulation and endogenous fibrinolysis showed similar results among CAD patients with and without previous IS/TIA. Therefore, it remains necessary to identify other targets to explain the higher bleeding risk presented by these patients.

Introduction Most studies that have evaluated the stomachs of patients with Chagas disease were performed before the discovery of Helicobacter pylori and used no control groups. This study compared the gastric features of chagasic and non-chagasic patients and assessed whether gastritis could be associated with Chagas disease. Methods Gastric biopsy samples were taken from patients who underwent endoscopy for histological analysis according to the Updated Sydney System. H. pylori infection was assessed by histology, 16S ribosomal ribonucleic acid (rRNA) polymerase chain reaction (PCR), serology and the 13C-urea breath test. Patients were considered H. pylori-negative when all of these diagnostic tests were negative. Clinical and socio-demographic data were obtained by reviewing medical records and using a questionnaire. Results The prevalence of H. pylori infection (70.3% versus 71.7%) and chronic gastritis (92.2% versus 85%) was similar in the chagasic and non-chagasic groups, respectively; such as peptic ulcer, atrophy and intestinal metaplasia. Gastritis was associated with H. pylori infection independent of Chagas disease in a log-binomial regression model. However, the chagasic H. pylori-negative patients showed a significantly higher grade of mononuclear (in the corpus) and polymorphonuclear (PMN) (in the antrum) cell infiltration. Additionally, the patients with the digestive form of Chagas disease showed a significantly lower prevalence of corpus atrophy than those with other clinical forms. Conclusions The prevalence of H. pylori infection and of gastric histological and endoscopic features was similar among the chagasic and non-chagasic patients. Additionally, this is the first controlled study to demonstrate that H. pylori is the major cause of gastritis in patients with Chagas disease.

Introduction: Polychlorinated biphenyls (PCBs), used as pesticides in agriculture, can lead to irreversible injuries in living organisms, particularly in liver. Oxidative stress has been implicated in the liver pathogenesis induced by different molecules, including PCBs. It has been demonstrated that quercetin, an antioxidant flavonoid found in the diet, exhibits a potent antioxidant effect in different liver pathologies. Objective: To evaluate oxidative stress caused by PCBs in liver and the antioxidant activity of quercetin. Methodology: We used male Wistar rats (n = 36), divided in 4 groups: control, quercetin (50 mg/kg/day), PCBs (0.4 ml/kg/day), and rats treated with both PCBs and quercetin. On day 25 blood was collected to assess liver integrity (enzymes AST, ALT and ALP), and liver samples to measure oxidative stress (TBARS), activity of antioxidant enzymes (SOD, CAT, GPx) and DNA damage (micronucleus assay), and histological damage. Results: TBARS concentration and SOD activity were significantly higher in PCBs animals as compared to the PCB group receiving quercetin. CAT and GPx decreased in PCBs and increased when quercetin was added. The histological analysis showed damage to hepatocytes in PCBs, but quercetin was able to afford protection against such damage. The micronucleus test showed there was an increase in the production of microclenucleus compared to control, and quercetin was able to reduce this effect. Conclusion: Contamination with PCBs led to increased lipid peroxidation and DNA damage, and the use of antioxidant quercetin was effective in reducing PCBs-induced liver injury.

Introducción: los bifenilospoliclonados (PCBs) son pesticidas ampliamente usados en agricultura que pueden inducir daños irreversibles particularmente en el hígado. El estrés oxidativo ha sido implicado en diversas patogénesis hepáticas, incluidas las relacionadas conPCBs. La quercetina, un flavonoide de la dieta, ha demostrado tener un potente efecto antioxidante en diversos modelos de patología hepática. Objetivo: Evaluar el estrés oxidativo hepático inducido por PCBs y la actividad antioxidante de la quercetina. Metodología: Se usaron ratas macho de raza Wistar (n = 36), divididas en cuatro grupos: control, quercetina (50 mg/kg/día), PCBs (0,4 ml/kg/día) y ratas tratadas tanto con PCBs como con quercetina. Transcurridos 25 días de tratamiento se recogieron muestras de sangre, para evaluar la integridad hepática (AST, ALT y ALP), y de tejido para cuantificar el estrés oxidativo (TBARS), actividad antioxidante (SOD, CAT, GPx), daño al DNA (ensayo de micronúcleos) y daño histológico. Resultados: la concentración de TBARS y la actividad SOD fueron significativamente mayores en los animales que recibieron PCBs que en los que recibían quercetina. La actividad de CAT y GPx se redujo con los PCBs y se incrementó al administrar quercetina. Los análisis histológicos y de micronúcleos mostraron daño hepático y al DNA respectivamente inducido por PCBs que eran revertidos con el tratamiento con quercetina. Conclusion: La contaminación con PCBs induce un incremento en la peroxidación lipídica, modificación en la actividad de enzimas antioxidantes, daño histológico y al DNA en el hígado, siendo el antioxidante quercetina es capaz de reducir dichos cambios.

Infrared spectroscopy is one of the most widely used techniques for measurement of conversion degree in dental composites. However, to obtain good quality spectra and quantitative analysis from spectral data, appropriate expertise and knowledge of the technique are mandatory. This paper presents important details to use infrared spectroscopy for determination of the conversion degree.

O câncer anal representa aproximadamente 2% dos cânceres colorretais. Nos últimos anos observa-se o aumento da incidência nos indivíduos HIV positivos. Este estudo teve como objetivo avaliar a prevalência de lesões intra-epiteliais escamosas anais (ASIL) em pacientes HIV+ procedentes de Manaus. Foram estudados 45 doentes HIV+ encontrando-se no exame histopatológico, os seguintes resultados: 15(35,7%) lesões de baixo grau, 3(7,1%) lesões de alto grau e 24(57,2%) negativos para ASIL. Houve, portanto, alta prevalência de ASIL, 42,8%. Concluímos que a prevalência de ASIL entre os pacientes HIV positivos, da amostra estudada, é muito importante, justificando-se a implantação de um programa de acompanhamento e detecção precoce, destas lesões; pois os pacientes HIV+ representam um importante grupo de risco para o desenvolvimento do câncer anal.

The anal cancer accounts approximately for 2% of the cases of colorectal cancer. In the last few years it has been observed an increase in the incidence of this disease in HIV-positive individuals. The objective of this study is to evaluate the prevalence of anal squamous intraepithelial lesions (ASIL) in HIV-positive patients which are resident in Manaus. Forty-five HIV+ patients were included in the study, from which it was collected anal mucosal tissue for biopsy under anoscopic control using widened image for histopathological exam. According to this exam, it was found the following results: 15(35,7%) low grade lesions, 3(7,1%) high grade lesions and 24 (57,2%) negative for ASIL. Therefore, there was a high prevalence of ASIL, 42,8%. We concluded that the prevalence of ASIL among HIV-positive patients, in the studied sample, is very important, justifying the implementation of a program of precocious monitoring and detection of these lesions, as the HIV+ patients represent an important risk group for the developing of anal cancer.