ABSTRACT OBJECTIVE To analyze the impact of the covid-19 pandemic on the use of primary health care services to follow-up the child growth and development in Brazil. METHOD A total of 7.9 million consultations of children (0–2 years old) across Brazil between March 2017 and May 2020 were studied. Differences between medians were analyzed using non-parametric tests, the Global Moran Index (IGM) and the Local Indicators of Spatial Association. RESULTS During the initial period of the pandemic, the median number of consultations was significantly lower than the same period in previous years, reducing more than 50%. The drop in 2020, compared to 2019, ranged from 49% to 62.2% across all regions of the country, except the South. The percentage reduction registered in 2019–2020 showed significant spatial autocorrelation (IGM = 0.20; p = 0.04), with the presence of low-low (states with reduction between 29% and 51%) and high-high (states with reduction between 55% and 69%) spatial clusters. CONCLUSION The covid-19 pandemic impacted the follow-up of child growth and development in primary health care services in Brazil, with a geographically uneven reduction.

ABSTRACT OBJECTIVE To analyze the impact of the covid-19 pandemic on the use of primary health care services to follow-up the child growth and development in Brazil. METHOD A total of 7.9 million consultations of children (0–2 years old) across Brazil between March 2017 and May 2020 were studied. Differences between medians were analyzed using non-parametric tests, the Global Moran Index (IGM) and the Local Indicators of Spatial Association. RESULTS During the initial period of the pandemic, the median number of consultations was significantly lower than the same period in previous years, reducing more than 50%. The drop in 2020, compared to 2019, ranged from 49% to 62.2% across all regions of the country, except the South. The percentage reduction registered in 2019–2020 showed significant spatial autocorrelation (IGM = 0.20; p = 0.04), with the presence of low-low (states with reduction between 29% and 51%) and high-high (states with reduction between 55% and 69%) spatial clusters. CONCLUSION The covid-19 pandemic impacted the follow-up of child growth and development in primary health care services in Brazil, with a geographically uneven reduction.

A Associação Brasileira de Sono reuniu especialistas em medicina do sono com o objetivo de desenvolver novas diretrizes no diagnóstico e tratamento das insônias. Nós consideramos quatro níveis de evidência: padrão, recomendado, opcional e não recomendado. Os tópicos abordados foram: conceito, avaliação clínica e psicossocial, indicação da polissonografia, tratamento farmacológico, terapia comportamental cognitiva, comorbidades e insônia na infância. Para o diagnóstico da insônia, foi recomendada uma avaliação psicossocial e a realização da polissonografia, enquanto que no que se refere ao tratamento, foi estabelecido como padrão a indicação da terapia comportamental cognitiva, e, quanto ao tratamento farmacológico, foi indicado o uso do zolpidem como hipnótico padrão, e sendo recomendado o zopiclone, a trazodona e a doxepina.

The Brazilian Sleep Association brought together specialists in sleep medicine, in order to develop new guidelines on the diagnosis and treatment of insomnias. The following subjects were discussed: concepts, clinical and psychosocial evaluations, recommendations for polysomnography, pharmacological treatment, behavioral and cognitive therapy, comorbidities and insomnia in children. Four levels of evidence were envisaged: standard, recommended, optional and not recommended. For diagnosing of insomnia, psychosocial and polysomnographic investigation were recommended. For non-pharmacological treatment, cognitive behavioral treatment was considered to be standard, while for pharmacological treatment, zolpidem was indicated as the standard drug because of its hypnotic profile, while zopiclone, trazodone and doxepin were recommended.

O trabalho foi realizado no Setor de Ovinocultura do Departamento de Zootecnia da Universidade Federal de Santa Maria, objetivando determinar as quantidades de osso, músculo e gordura da carcaça e o crescimento de osso e músculo da carcaça e dos diferentes cortes da mesma. Foram utilizados 22 cordeiros machos inteiros, filhos de carneiros Texel e ovelhas cruza (Texel x Ideal). Desses, quatro/oram abatidos no início do experimento (24 horas após o nascimento), e os restantes, ao desmame (45 dias de idade) e aos 28 e 33kg. Os cordeiros foram confinados em baias individuais, com suas respectivas mães, até o desmame (45 dias de idade). A determinação do crescimento dos tecidos da carcaça e de seus cortes (quarto, paleta, costela, espinhaço e pescoço) foi realizada através de equações alométricas, utilizando-se o logaritmo do peso de osso ou músculo, em função do logaritmo do peso de corpo vazio (PCV) ou peso de carcaça fria (PCF). As quantidades de osso e músculo aumentaram (P<0,05) com a elevação do peso de abate. A proporção de osso diminuiu (P<0,05) e a de músculo manteve-se constante (P>0,05) com a elevação do peso de carcaça fria. A proporção de gordura aumentou do nascimento ao desmame (P<0,05), e a partir daí, diminuiu (P<0,05). Com relação ao PCV e PCF, o tecido que primeiro se desenvolve é o ósseo (b=0,729l88 e b=0,673340), seguido pelo muscular (b=1,075728 e b=l,001403). Entre os cortes da carcaça, o crescimento ósseo e muscular da costela são mais tardios que os demais.

This experiment was developed at the Ovine Section of Animal Science Department, at Federal University of Santa Maria, Brazil- The purpose of this experiment was to determine the quantity of bone, muscle and fat of the carcass, and the growth ofbone and muscle of the carcass, and of the carcass cuts. Twenty-two intact mate lambs, sired by Texel males, from crossbreed Texel -Ideal dams were used. Four lambs were siaughtered at the beginning of the experiment (24 hours after birth) and groups of six lambs were siaughtered at weaning and when reaching 28 and 33kg. The lambs were kept in individual stalls together with their respective mothers until weaning (45 days of age). To study the growth of the carcass tissues and carcass cuts (hindquarter, shoulder, rib, backbone, neck), regression equations of the log of weight of each tissue, as a function of the log of empty body weight (EBW) or cold carcass weight (CCW) were fitted. The quantities of bone and muscle -increased (P<0.05) with the higher of siaughter weights. The proportion of bone decreased (P<0.05) and that of muscle remained constant (P>0.05) with the higher of the CCW, the proportion of fat increased from birth to weaning (P<0.05) and decreased after weaning (P<0.05). In relation to EBW and CCW, bones were early maturing (b=0.729188 and b=0.673340), followed by muscular tissue (b=1.075728 and b=1.001403). Among carcass cuts rib bone and muscle were later maturing than in other cuts.