RESUMEN Introducción y objetivos: El tratamiento de los pacientes con fibrilación auricular no valvular (FANV) que requieren implante de stents coronarios es un desafío. El objetivo del estudio fue investigar si el cierre de la orejuela izquierda (COI) podría ser una opción posible y beneficiosa para estos pacientes. Para ello, se analiza el impacto del COI más tratamiento antiagregante plaquetario (AP) en comparación con la combinación de anticoagulantes orales (ACO), incluidos los ACO directos, y tratamiento AP en los resultados a largo plazo de estos pacientes Métodos: Se analizaron los resultados de 207 pacientes con FANV sometidos consecutivamente a implante de stents coronarios. Recibieron ACO 146 pacientes (74 acenocumarol, 71 ACO de acción directa) y en 61 se realizó COI. La mediana de seguimiento fue de 35 meses. Los pacientes también recibieron tratamiento AP por prescripción de su cardiólogo. El estudio recibió la debida supervisión ética. Resultados: La edad (media: 75,7 años) y el antecedente de accidente vascular cerebral fueron similares en ambos grupos, aunque el grupo de COI presentó más características desfavorables (antecedente de enfermedad de las arterias coronarias [CHA2DS2-VASc], antecedente de hemorragias significativas [BARC ≥ 2] y HAS-BLED). La aparición de acontecimientos adversos graves (muerte, accidente vascular cerebral, accidente isquémico transitorio, hemorragia grave) y cardiovasculares graves (muerte de causa cardiaca, accidente vascular cerebral, accidente isquémico transitorio, infarto de miocardio) fue significativamente mayor en el grupo de ACO que en el de COI: 19,75 frente a 9,06% (HR = 2,18; p = 0,008) y 6,37 frente a 1,91% (HR = 3,34; p = 0,037), respectivamente. Conclusiones: La combinación de COI y tratamiento AP en pacientes con FANV conlleva mejor pronóstico clínico a largo plazo que el tratamiento con ACO y terapia AP, a pesar de las características basales desfavorables del grupo de COI.

ABSTRACT Introduction and objectives: The treatment of patients with non-valvular atrial fibrillation (NVAF) who need coronary stenting is challenging. The objective of the study was to determine whether left atrial appendage occlusion (LAAO) could be a feasible option and benefit these patients. To this end, we studied the impact of LAAO plus antiplatelet drugs vs oral anticoagulants (OAC) (including direct OAC) plus antiplatelet drugs in these patients' long-term outcomes. Methods: The results of 207 consecutive patients with NVAF who underwent coronary stenting were analyzed. A total of 146 patients were treated with OAC (75 with acenocoumarol, 71 with direct OAC) while 61 underwent LAAO. The median follow-up was 35 months. Patients also received antiplatelet therapy as prescribed by their cardiologist. The study received the proper ethical oversight. Results: Age (mean 75.7 years), and the past medical history of stroke were similar in both groups. However, the LAAO group had more unfavorable characteristics (history of coronary artery disease [CHA2DS2-VASc], and significant bleeding [BARC ≥ 2] and HAS-BLED). The occurrence of major adverse events (death, stroke/transient ischemic events, major bleeding) and major cardiovascular events (cardiac death, stroke/transient ischemic attack, and myocardial infarction) were significantly higher in the OAC group compared to the LAAO group: 19.75% vs 9.06% (HR, 2.18; P = .008) and 6.37% vs 1.91% (HR, 3.34; P = .037), respectively. Conclusions: In patients with NVAF undergoing coronary stenting, LAAO plus antiplatelet therapy produced better long-term outcomes compared to treatment with OAC plus antiplatelet therapy despite the unfavorable baseline characteristics of the LAAO group.

ABSTRACT The Caatinga biome has plant and animal species that have developed mechanisms that allow them to resist the edaphoclimatic conditions of the region. Therefore, this work identified the phytosociological composition of a fragment of caatinga forest located at the rural community of Mocambo de Baixo, in the municipality of Patos-PB, Brazil, and analyzed the potentialities of the tree component by means of a forest inventory, considering the density, frequency, dominance, cover and importance values of the tree species, and the Shannon-Weaver and the Pielou equability index values of the adult and regenerating tree communities. A total of 1402 individuals were found: 534 adult, 510 regenerating and 358 dead plants. There were 10 species, 10 genera and 06 families of adult individuals, and 08 species, 08 genera and 05 families for the regenerating plants. The most expressive botanical families of adult or regenerating plants were Apocynaceae, Euphorbiaceae and Fabaceae. Densities of 953.7 and 910.7 ind.ha-1 were found for adult and regenerant plants, respectively. The highest values of tree cover and importance were estimated for Aspidosperma pyrifolium. The Shannon- Waever and the Pielou equability index values were 1.38 and 0.60, respectively. Adult individuals were most abundant in class I for diameter (1.9 cm < D < 4.4 cm) and height (1.4 m < H < 3.4 m), and regeneranting plants were most abundant in class II (H > 1 m). The estimated volume of stacked wood averaged approximately 38 st.ha-1..

RESUMO O bioma Caatinga possui espécies vegetais e animais que desenvolveram mecanismos que as permitem resistir às condições edafoclimáticas da região. Diante disso, este trabalho identificou a composição florística de um fragmento de uma floresta de Caatinga na comunidade rural Mocambo de Baixo, município de Patos – PB, Brasil, e analisou as potencialidades do componente vegetal arbóreo através de inventário florestal, considerando os parâmetros de densidade, frequência, dominância, valor de cobertura e valor de importância das espécies arbóreas, e os índices de diversidade de Shannon-Weaver e de equabilidade de Pielou das comunidades de indivíduos adultos e regenerantes de espécies arbóreas. Foi constatado um total de 1402 indivíduos: 534 adultos, 510 regenerantes e 358 mortos. Foram verificadas 10 espécies, 10 gêneros e 06 famílias de indivíduos adultos, e 08 espécies, 08 gêneros e 05 famílias para os regenerantes. As famílias botânicas com maior expressividade entre os indivíduos adultos ou regenerantes foram Apocynaceae, Euphorbiaceae e Fabaceae. Foram encontradas densidades de 953,7 e 910,7 ind.ha-1 para adultos e regenerantes, respectivamente. Os maiores valores de cobertura e de importância foram obtidos por Aspidosperma pyrifolium. Os valores estimados para os índices de Shannon-Weaver e de equabilidade de Pielou foram 1,38 e 0,60, respectivamente. Os indivíduos adultos se concentraram na classe I de diâmetro (1,9 cm < D < 4,4 cm) e altura (1,4 m < H < 3,4 m), e entre os regenerantes, a maior quantidade foi observada na classe II (H > 1 m). O valor estimado do volume empilhado médio de madeira foi de 38 st.ha-1.

Resumen Los objetivos del estudio fueron 1) investigar que fuentes de información usaron los participantes para conocer sobre la COVID-19, 2) evaluar cuál es el nivel de conocimiento que tienen sobre COVID-19 y la atención a pacientes durante la contingencia, y 3) evaluar la percepción de seguridad sobre el regreso a actividades presenciales en la facultad. Estudio transversal. Se aplicó un cuestionario en línea (29 ítems; n=371) que exploró cada objetivo e incluyó una escala de Likert (Alfa de Cronbach de 0.778). Los datos fueron analizados con las pruebas de U de Mann Whitney y con Tau-c de Kendall. La mayoría de los participantes obtuvieron información sobre la COVID-19 a través de la Secretaría de Salud (45.28%), tuvieron un conocimiento bueno sobre las generalidades de la COVID-19 y el 59.3% tuvo un conocimiento excelente sobre la atención a pacientes. La mitad de los encuestados tuvo una percepción de inseguridad en un posible regreso a actividades en la facultad. Hubo diferencia estadística significativa para la asociación entre año escolar y grado de conocimiento (p<0.001) y entre la percepción en la seguridad en el regreso a actividades (muy inseguro, inseguro, seguro y muy seguro) y el grado escolar (P=0.000). Los participantes tuvieron buen conocimiento sobre las generalidades de la COVID-19 y sobre la atención a pacientes en situación de contingencia. La mitad de los EO sienten inseguridad sobre un posible regreso a actividades.

Abstract This study aimed: 1) to investigate sources of information used by students to learn about COVID-19, 2) to investigate levels of knowledge about COVID-19 and about conditions for the treatment of patients during the COVID-19 lockdown, and 3) to evaluate students' perceptions of safety regarding their return to in-person activities at the School of Dentistry. Dental students answered a questionnaire (29 items; n=371) that explored the aims of the study, based on a Likert scale (Cronbach's alpha, 0.778). Data were tested with the Mann-Whitney U test and Kendall's Tau-c. Dental students received information about COVID-19 from the Mexican Health Ministry as their first source (45.28%). Students had good knowledge about the main characteristics of COVID-19, and 59.3% of students had excellent knowledge about the factors relevant to dental treatment of patients. Half of the students said they felt safe regarding a possible return to in-person activities at the dental school, while the other half did not. Statistically significant differences were noted between the students' scholar year and their level of knowledge (P<0.001) and between their perception of safety (very unsafe, unsafe, safe, and very safe) and scholar year (P=0.000). Dental students had good knowledge about COVID-19 and about the dental care for patients during the lockdown. Half of the dental students felt unsafe about a possible return to in-person school activities.

Abstract BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has several mechanisms of action related to inflammatory responses, especially in individuals diagnosed with obesity. This hyperinflammatory clinical profile resulting from the association between obesity and coronavirus disease 2019 (COVID-19) may be attenuated by regular physical activity. OBJECTIVE: The aim of this study was to review the evidence on the consequences of physical inactivity and physical activity on COVID-19 in patients with obesity. DESIGN AND SETTING: Narrative review at the Bahiana School of Medicine and Public Health in Salvador, Brazil. METHODS: We searched evidence on the association of COVID-19 with physical activity and obesity using the following keywords: “covid-19,” “physical activity,” and “obesity”. The databases used were MEDLINE (PubMed), ScienceDirect, and Virtual Health Library. Studies published from 2019 to 2021 and available in Portuguese, English, and Spanish were included. The final search was conducted on September 26, 2021. RESULTS: We identified 661 studies in the database, among which 71 were considered for inclusion in the narrative review of the molecular aspects of COVID-19 and its relationship with physical activity and obesity. CONCLUSION: This literature review enabled the perception of the relationship between the molecular mechanisms of COVID-19 and obesity. Regular physical activity had various benefits for the inflammatory condition of the studied population, highlighting moderate-intensity.

Desde o lançamento da terceira versão do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-III), a psiquiatria biológica vem sistematicamente aplicando seu raciocínio classificatório a fenômenos sociais de múltiplas naturezas. Nessa perspectiva, ganha relevância o discurso do trauma, pelo qual acontecimentos de magnitude devastadora passaram a receber interpretações neurocomportamentais e foram, finalmente, reconhecidos menos por seus impactos culturais e subjetivos que pelas alterações fisiológicas que propiciam. Apoiado em revisão narrativa, este artigo procurará explorar a transição da racionalidade traumática entre o século XIX, quando o trauma fora concebido em associação ao conceito cognitivo de memória, e o século XX, quando finalmente esse fenômeno foi anexado à pesquisa neurocientífica do estresse. A pluralidade de modelos conceituais e paradigmas determinísticos pode contribuir para que a pesquisa do trauma produza protocolos de enfrentamento multifatoriais mais adequados à experiência humana do sofrimento pós-traumático.

Desde la publicación de la tercera versión del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-III), la psiquiatría biológica ha aplicado sistemáticamente su razonamiento clasificatorio a fenómenos sociales de múltiple naturaleza. Desde esta perspectiva cobra relevancia el discurso del trauma, a través del cual eventos muy devastadores pasaron a tener interpretaciones neuroconductuales y finalmente fueron reconocidos menos por sus impactos culturales y subjetivos que por los cambios fisiológicos que provocan. A partir de una revisión narrativa, este artículo busca explorar la transición del razonamiento traumático entre el siglo XIX, cuando el trauma se concibe en asociación con el concepto cognitivo de memoria, y el siglo XX, cuando este fenómeno se vincula a la investigación neurocientífica sobre estrés. La diversidad de modelos conceptuales y paradigmas deterministas puede contribuir a que la investigación del trauma produzca protocolos de afrontamiento multifactoriales más adecuados a la experiencia humana del sufrimiento postraumático.

Since the release of the third version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), biological psychiatry has been systematically applying its classification reasoning to social phenomena of many natures. From this perspective, the discourse of trauma gained relevance and events of devastating magnitude began to receive neurobehavioral interpretations until finally being recognized less for their cultural and subjective effects than for the physiological changes they cause. By a narrative review, this study aims to analyze the transition of traumatic rationality from the 19th century, when trauma was associated with the cognitive concept of memory, to the 20th century, when this phenomenon was finally attached to neuroscientific research on stress. The plurality of conceptual models and deterministic paradigms can contribute to the fact that trauma research produces multifactorial coping protocols more appropriate to the human experience of post-traumatic suffering.

Resumen En trabajos previos se desarrolló un método para la diferenciación a nivel foliar de la respuesta de plantas de banano a la marchitez por Fusarium raza 1, el cual constituye una herramienta útil para incrementar la eficiencia de la selección de la resistencia en condiciones ex vitro. El objetivo de este trabajo consistió en evaluar la resistencia a esta enfermedad en nuevos clones de banano mediante el método de evaluación mencionado. Para ello se realizaron seis momentos de evaluación; y se utilizaron diez plantas de cada línea seleccionada del clon ‘Zanzíbar’ irradiado. Los resultados evidenciaron que las plantas de las líneas evaluadas del clon ‘Zanzíbar’ irradiado indican ser materiales promisorios para el mejoramiento genético en el cultivo dirigido a la resistencia a esta enfermedad. Por otra parte, se obtuvo una respuesta a la selección en un reducido tiempo (48 horas), así como evaluar las líneas seleccionadas a partir de grandes poblaciones de plantas (60 plantas) con la exclusión de otros organismos; y el control de las condiciones ambientales que pudieran interferir en los resultados obtenidos. Sin embargo, constituye una necesidad continuar estudios adicionales en campo para confirmar la resistencia en las líneas evaluadas.

Abstract In previous works, a method was developed for the differentiation at the foliar level of the response of banana plants to Fusarium race 1 wilt, which constitutes a useful tool to increase the efficiency of resistance selection in ex vitro conditions. The objective of this work was to evaluate resistance to this disease in new banana clones using the evaluation method mentioned. For this, six moments of evaluation were made; and ten plants of each selected line of the irradiated ‘Zanzíbar’ clone were used. The results showed that the plants of the evaluated lines of the irradiated ‘Zanzíbar’ clone indicate that they are promising materials for genetic improvement in the crop aimed at resistance to this disease. On the other hand, a response to selection was obtained in a short time (48 hours), as well as evaluating the lines selected from large populations of plants (60 plants) with the exclusion of other organisms; and the control of environmental conditions that could interfere with the results obtained. However, it is necessary to continue additional studies in the field to confirm the resistance in the evaluated lines.

ABSTRACT University dropout has been the subject of intense research for it incurs social, academic, and economic losses. In this work, we investigate factors that affect freshman dropout rates in the context of Federal University of Recôncavo da Bahia. To this end, we make use of a dataset that comprises 19,452 freshmen admitted by Sistema de Seleção Unificada between 2010 and 2019 from 43 undergraduate courses. We aim at identifying associations between dropout rates and five freshmen factors: gender, age at admission, admission via quota, hometown, and Sistema de Seleção Unificada edition. To this end, we carry out exploratory data analysis and fit simple and multiple logistic regression models for each department as well as for the aggregate data. We conclude that each department has a distinct set of factors associated with dropout, requiring the adoption of policies to reduce dropout rates focused on the identified particularities.

RESUMEN La deserción de estudiantes de la educación superior ha sido objeto de estudio ya que se traduce en consecuencias sociales, económicas y académicas negativas. En este trabajo, investigamos la deserción de estudiantes de primer año en la Universidade Federal do Recôncavo da Bahia utilizando datos de 19.452 estudiantes que ingresaron a Sistema de Seleção Unificada entre 2010 y 2019, en los 43 cursos de graduación. Nuestro objetivo es identificar posibles conexiones entre la deserción y los factores: género, edad de admisión, admisión por reserva de cupos, ciudad de origen y edición de Sistema de Seleção Unificada. Para eso, ajustamos modelos de regresión logística simple y múltiple para cada uno de los centros educativos y para los datos agregados. Concluimos que cada centro educativo tiene un conjunto distinto de factores asociados a la deserción, lo que requiere la adopción de políticas de combate enfocadas en las particularidades identificadas.

RESUMO A evasão no ensino superior tem sido objeto de estudo por resultar em desperdícios social, acadêmico e econômico. Neste trabalho, investigamos a evasão de calouros no contexto da Universidade Federal do Recôncavo da Bahia utilizando dados de 19.452 estudantes ingressantes pelo Sistema de Seleção Unificada entre os anos de 2010 e 2019, compreendendo 43 cursos de graduação. Temos como objetivo identificar possíveis associações entre a evasão e os seguintes fatores: sexo, idade de ingresso, admissão por sistema de cotas, cidade de origem e edição do Sistema de Seleção Unificada. Para esse fim, realizamos uma análise descritiva e ajustamos modelos de regressão logística, simples e múltipla, para cada um dos centros de ensino e para os dados agregados. Concluímos que cada centro de ensino apresenta um conjunto distinto de fatores associados à evasão, sendo necessária a adoção de políticas de combate focalizadas nas particularidades identificadas.

Abstract Introduction Occupational therapists have consolidated their assistance in hospital settings through their work in various sectors of these institutions with diverse populations. The pediatric ward is one of the scenarios where these professionals act, providing services to hospitalized children and adolescents, as well as to their companions: their mothers. Objective To present the intervention of occupational therapists with accompanying mothers in pediatric wards and these professionals’ perception of the mothers’ contribution in this context. Method This is a descriptive, exploratory, qualitative study. 14 occupational therapists working with accompanying mothers in pediatric wards participated in this study. The data were collected through a self-administered questionnaire containing 39 questions available via Google Forms®, coded using the ATLAS.ti® 8.0 software, and analyzed by Content Analysis in its thematic modality. Results The data showed that occupational therapists assess the difficulties and needs of accompanying mothers during the hospitalization of their children, set goals that encompass the woman or the dyad, and perceive the contributions arising from their practice. The data also pointed out the models, techniques, resources, and theoretical frameworks used by these professionals in their interventions with the accompanying mothers, as well as the places made available by these institutions for this practice. Conclusion Occupational therapists fully help accompanying mothers during the hospitalization of their children. The results illustrate the occupational therapy intervention process with this population, from the evaluation, intervention, to the results observed by the professionals.

Resumo Introdução Terapeutas ocupacionais têm consolidado sua assistência nos contextos hospitalares atuando em diversos setores dessas instituições com populações diversas. A enfermaria pediátrica é um dos cenários de atuação desses profissionais, que prestam seus serviços às crianças e adolescentes hospitalizados, assim como as suas acompanhantes, as mães. Objetivos Apresentar a intervenção de terapeutas ocupacionais com mães acompanhantes em enfermaria pediátrica e a percepção desses profissionais sobre sua contribuição nesse contexto. Método Trata-se de estudo descritivo, exploratório, de abordagem qualitativa. Participaram 14 terapeutas ocupacionais que atuavam com mães acompanhantes em enfermaria pediátrica. Os dados foram coletados por meio de questionário autoaplicável contendo 39 questões disponibilizado via Google Forms®, codificados com auxílio do software ATLAS.ti® (versão 8) e analisados por análise de conteúdo na modalidade temática. Resultados Os dados apontam que as terapeutas ocupacionais avaliam as dificuldades e necessidades das mães acompanhantes durante a internação dos seus filhos, traçam objetivos que englobam a mulher ou a díade e percebem as contribuições decorrentes da sua prática. Os dados apontam ainda modelos, técnicas, recursos e referenciais teóricos utilizados pelos profissionais nas intervenções com as mães acompanhantes, além dos locais disponibilizados pelas instituições para essa prática. Conclusão Terapeutas ocupacionais auxiliam de forma integral as mães acompanhantes durante a internação dos seus filhos. Os resultados ilustram o processo de intervenção da terapia ocupacional com esse público, perpassando pela avaliação, intervenção e resultados observados pelos profissionais.

Abstract This systematic review and meta-analysis aimed to analyze the impact of the COVID-19 pandemic on dental trauma patient attendance. The study was registered in the PROSPERO system, using the CRD42021288398 protocol. Searching was performed in PubMed, Scopus, Web of Science, Embase, Lilacs, and OpenGrey databases, using the following keywords: “Tooth injuries,” “Dental trauma,” “Traumatic Dental injury,” and “COVID-19". We included observational studies evaluating dental trauma in the context of the COVID-19 pandemic. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Cross-Sectional Studies. Meta-analysis was performed in RevMan 5.4 software with Odds Ratios as a pooled measure of effect, with a 95% confidence interval, and using random-effects modeling. After applying the eligibility criteria, 32 studies were included for qualitative analysis, in which 10 were used to assess the frequency of dental trauma diagnoses in dental emergencies. Despite the decrease of visits during COVID-19, the analysis revealed no difference between the pandemic and pre-pandemic periods. Regarding the type of dental trauma, two of the studies revealed no differences for the periods before and during the pandemic. This study revealed that the COVID-19 pandemic has not impacted the frequency or type of dental trauma compared to previous periods.

Abstract The skimmed goat milk was submitted to the nanofiltration process using a volume reduction factor (VRF) equal to 2. It was verified a rapid decrease of the permeate flux at a low time, with a continuous flux, caused by the reversible resistance, which is characterized by the standard and complete blocking. The combined fouling model was evaluated, including complete pore blocking and cake filtration mechanism, which described the skimmed goat milk nanofiltration behavior. For the VRF equal to 2 was determined the total solids, protein, lactose, ash, mineral fraction content, which increased successfully with the nanofiltration process. The Power Law and Herschel-Buckley models were fitting to describe the flow behavior for retentate, which presented the higher apparent viscosity.

ABSTRACT Congenital and gestational syphilis are increasingly prevalent multisystemic infections in Brazil. This study aimed to present a case series of three children diagnosed with congenital syphilis even though their mother had unreactive treponemal tests. The VDRL (Venereal Disease Research Laboratory) titers of a 22-year-old mother with three pregnancies decreased after treatment. The mother did not have a reactive treponemal test, but all the three children were diagnosed with early congenital syphilis. This case series highlights the difficulty in diagnosing gestational and congenital syphilis in Brazil.

Since the release of the third version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III), biological psychiatry has been systematically applying its classification reasoning to social phenomena of many natures. From this perspective, the discourse of trauma gained relevance and events of devastating magnitude began to receive neurobehavioral interpretations until finally being recognized less for their cultural and subjective effects than for the physiological changes they cause. By a narrative review, this study aims to analyze the transition of traumatic rationality from the 19th century, when trauma was associated with the cognitive concept of memory, to the 20th century, when this phenomenon was finally attached to neuroscientific research on stress. The plurality of conceptual models and deterministic paradigms can contribute to the fact that trauma research produces multifactorial coping protocols more appropriate to the human experience of post-traumatic suffering.

Desde la publicación de la tercera versión del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-III), la psiquiatría biológica ha aplicado sistemáticamente su razonamiento clasificatorio a fenómenos sociales de múltiple naturaleza. Desde esta perspectiva cobra relevancia el discurso del trauma, a través del cual eventos muy devastadores pasaron a tener interpretaciones neuroconductuales y finalmente fueron reconocidos menos por sus impactos culturales y subjetivos que por los cambios fisiológicos que provocan. A partir de una revisión narrativa, este artículo busca explorar la transición del razonamiento traumático entre el siglo XIX, cuando el trauma se concibe en asociación con el concepto cognitivo de memoria, y el siglo XX, cuando este fenómeno se vincula a la investigación neurocientífica sobre estrés. La diversidad de modelos conceptuales y paradigmas deterministas puede contribuir a que la investigación del trauma produzca protocolos de afrontamiento multifactoriales más adecuados a la experiencia humana del sufrimiento postraumático.

Desde o lançamento da terceira versão do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-III), a psiquiatria biológica vem sistematicamente aplicando seu raciocínio classificatório a fenômenos sociais de múltiplas naturezas. Nessa perspectiva, ganha relevância o discurso do trauma, pelo qual acontecimentos de magnitude devastadora passaram a receber interpretações neurocomportamentais e foram, finalmente, reconhecidos menos por seus impactos culturais e subjetivos que pelas alterações fisiológicas que propiciam. Apoiado em revisão narrativa, este artigo procurará explorar a transição da racionalidade traumática entre o século XIX, quando o trauma fora concebido em associação ao conceito cognitivo de memória, e o século XX, quando finalmente esse fenômeno foi anexado à pesquisa neurocientífica do estresse. A pluralidade de modelos conceituais e paradigmas determinísticos pode contribuir para que a pesquisa do trauma produza protocolos de enfrentamento multifatoriais mais adequados à experiência humana do sofrimento pós-traumático.

ABSTRACT The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) pandemic demanded rapid diagnosis to isolate new COVID-19 cases and prevent disease transmission. Quantitative Real-Time Polymerase Chain Reaction (qRT-PCR) rapidly became the gold standard for diagnosis. However, due to the high cost and delay of the results, other types of diagnosis were implemented, such as COVID-19 Ag Rapid Tests and Reverse Transcription Technique followed by Loop-Mediated isothermal Amplification (RT-LAMP). In this work, we validated the use of RT-LAMP in saliva samples rather than nasopharyngeal swabs, as the collection is more comfortable. First, we selected 5 primer sets based on the limit of detection for SARS-CoV-2 RNA, then validated their sensitivity and specificity in patient samples. A total of 117 samples were analyzed by fluorometric RT-LAMP and compared with qRT-PCR results. Our results show that the use of a high-sensitive primer ORF1-a, together with a low-sensitive primer set Gene E (time to threshold of 22.9 and 36.4 minutes, respectively, using 200 copies of viral RNA), achieved sensitivity in purified RNA from saliva samples of 95.2% (95% CI 76.1-99.8) with 90.5% specificity (95% CI 69.6-98.8) (n = 42).As RNA purification increases the turnaround time, we tested the outcome of RT-LAMP utilizing raw saliva samples without purification. The test achieved a sensitivity of 81.8% (95% CI 59.7-94.8) and a specificity of 90.9% (95% CI 70.8-98.8). As a result, the accuracy of 92.9% (95% CI 80.5-98.5) in purified RNA-saliva samples was lowered to an acceptable level of 86.4% (95% CI 72.6-94.8) in raw saliva. Although mass vaccination has been implemented, new strains and low vaccination progress helped to spread COVID-19. This study shows that it is feasible to track new COVID-19 cases in a large population with the use of raw saliva as sample in RT-LAMP assay which yields accurate results and offers a less invasive test.

ABSTRACT Objective: to develop a care-educational technology similar to a health navigation program for men during the COVID-19 pandemic. Methods: a methodological and qualitative study of a care-educational technology of health navigation program, structured by Program Development Cycle, with 16 patient navigators and 10 professional navigators. It used reflective thematic content analysis and an adaptation model for data processing. Results: the “Fala-M@ano-COVID-19”; navigation program was developed by: I) Observation of reality, problem mapping, needs assessment: content selection, creation of domains and questions; II) Theoretical-conceptual and methodological definition, creation of product under the elaboration of care plans, based on theory, process and taxonomies by a flowchart of operationalization of actions; and III) Self-assessment: qualitative research with professional navigators. Final considerations: the technology developed, with theoretical and methodological support, allowed to derive a viable navigation program compatible with reality based on the audience’s needs.

RESUMEN Objetivo: desarrollar una tecnología cuidado-educativa similar a un programa de navegación en salud para hombres durante la pandemia de COVID-19. Métodos: estudio metodológico y cualitativo de una tecnología asistencial-educativa como un programa de navegación en salud, estructurado por el Ciclo de Desarrollo del Programa, con 16 navegandos y 10 navegadores. Se utilizó el análisis de contenido temático reflexivo y un modelo de adaptación para el procesamiento de datos. Resultados: el programa de navegación “Fala-M@ano-COVID-19”; fue desarrollado por: I) Observación de la realidad, mapeo de problemas, evaluación de necesidades: selección de contenidos, creación de dominios y preguntas; II) Definición teórico-conceptual y metodológica, creación del producto bajo la elaboración de planes de cuidados, fundamentados en teoría, proceso y taxonomías mediante un diagrama de flujo de operacionalización de acciones; y III) Autoevaluación: investigación cualitativa con navegadores. Consideraciones finales: la tecnología desarrollada, con sustento teórico y metodológico, permitió derivar un programa de navegación viable compatible con la realidad a partir de las necesidades del público.

RESUMO Objetivo: desenvolver uma tecnologia cuidativo-educacional do tipo programa de navegação em saúde para homens na pandemia de COVID-19. Métodos: estudo metodológico e qualitativo de uma tecnologia cuidativo-educacional do tipo programa de navegação em saúde, estruturado pelo Program Development Cycle, com 16 navegandos e 10 navegadores. Usou análise de conteúdo temática reflexiva e modelo de adaptação para tratamento dos dados. Resultados: o programa de navegação “Fala-M@ano-COVID-19” foi desenvolvido por: I) Observação da realidade, mapeamento do problema, levantamento das necessidades: seleção de conteúdo, criação de domínios e perguntas; II) Definição teórico-conceitual e metodológica, criação do produto sob elaboração de planos de cuidados, pautados em teoria, processo e taxonomias por um fluxograma de operacionalização das ações; e III) Autoavaliação: pesquisa qualitativa com os navegadores. Considerações finais: a tecnologia desenvolvida, com suporte teórico e metodológico, permitiu derivar um programa de navegação viável e compatível à realidade com base nas necessidades do público.

Abstract Background The high incidence of atrial arrhythmias in pulmonary hypertension (PH) might be associated with poor prognosis, and the left atrium (LA) may play a role in this. An important finding in PH studies is that LA remodeling is underestimated. Objective This study investigated LA morphology and mechanical function, as well as the susceptibility to develop arrhythmias in a monocrotaline-induced PH (MCT-PH) model. Methods Wistar rats aged 4 weeks received 50 mg/kg of MCT. Electrocardiography and histology analysis were performed to evaluate the establishment of the MCT-PH model. The tissue was mounted in an isolated organ bath to characterize the LA mechanical function Results Compared with the control group (CTRL), the MCT-PH model presented LA hypertrophy and changes in cardiac electrical activity, as evidenced by increased P wave duration, PR and QT interval in MCT-PH rats. In LA isolated from MCT-PH rats, no alteration in inotropism was observed; however, the time to peak contraction was delayed in the experimental MCT-PH group. Finally, there was no difference in arrhythmia susceptibility of LA from MCT-PH animals after the burst pacing protocol. Conclusion The morphofunctional remodeling of the LA did not lead to increased susceptibility to ex vivo arrhythmia after application of the burst pacing protocol.

Resumo Fundamento A alta incidência de arritmias atriais na hipertensão pulmonar (HP) pode estar associada a um prognóstico ruim, e o átrio esquerdo (AE) pode desempenhar um papel neste quadro. Um achado importante nos estudos de HP é que a remodelação do AE é subestimada. Objetivo Este estudo investigou a morfologia e a função mecânica do AE, bem como a suscetibilidade ao desenvolvimento de arritmias em um modelo de HP induzida por monocrotalina (HP-MCT). Métodos Ratos Wistar com 4 semanas de idade receberam 50 mg/kg de MCT. Foram realizadas análises eletrocardiográficas e histológicas para avaliar o estabelecimento do modelo de HP-MCT. O tecido foi montado em banho de órgão isolado para caracterizar a função mecânica do AE. Resultados Em comparação com o grupo controle, o modelo de HP-MCT apresentou hipertrofia do AE e alterações da atividade elétrica cardíaca, conforme evidenciadas pelo aumento da duração da onda P, PR e intervalo QT. Não foi observada alteração no inotropismo do AE isolado de ratos com HP-MCT; no entanto, o tempo para atingir a contração máxima foi atrasado. Finalmente, não observamos diferença na suscetibilidade à arritmia no AE dos ratos com HP-MCT após o protocolo de estimulação intermitente. Conclusão A remodelação morfofuncional do AE não levou ao aumento da suscetibilidade à arritmia ex vivo após a aplicação do protocolo de estimulação intermitente.