Renal osteodystrophy and clinical outcomes: a prospective cohort study / Osteodistrofia renal e desfechos clínicos: um estudo de coorte prospectivo

Abstract Introduction: Renal osteodystrophy (ROD) refers to a group of bone morphological patterns that derive from distinct pathophysiological mechanisms. Whether the ROD subtypes influence long-term outcomes is unknown. Our objective was to explore the relationship between ROD and clinical outcomes. Methods: This study is a subanalysis of the Brazilian Registry of Bone Biopsies (REBRABO). Samples from individual patients were classified as having osteitis fibrosa (OF), mixed uremic osteodystrophy (MUO), adynamic bone disease (ABD), osteomalacia (OM), normal/minor alterations, and according to turnover/mineralization/volume (TMV) system. Patients were followed for 3.4 yrs. Clinical outcomes were: bone fractures, hospitalization, major adverse cardiovascular events (MACE), and death. Results: We enrolled 275 participants, of which 248 (90%) were on dialysis. At follow-up, 28 bone fractures, 97 hospitalizations, 44 MACE, and 70 deaths were recorded. ROD subtypes were not related to outcomes. Conclusion: The incidence of clinical outcomes did not differ between the types of ROD.

Resumo Introdução: Osteodistrofia renal (OR) refere-se a um grupo de padrões morfológicos ósseos que decorrem de mecanismos fisiopatológicos distintos. É desconhecido se os subtipos de OR influenciam desfechos em longo prazo. Nosso objetivo foi explorar as relações entre OR e desfechos. Métodos: Este estudo é uma subanálise do Registro Brasileiro de Biópsias Ósseas (REBRABO). As amostras de cada paciente foram classificadas em osteíte fibrosa (OF), osteodistrofia urêmica mista (MUO), doença óssea adinâmica (ABD), osteomalácia (OM), alterações normais/menores, e pelo sistema Remodelação / Mineralização / Volume (RMV). Os pacientes foram acompanhados por 3,4 anos. Os eventos clínicos foram: fraturas ósseas, hospitalizações, eventos cardiovasculares adversos maiores (MACE), e óbito. Resultados: Analisamos 275 indivíduos, 248 (90%) deles estavam em diálise. No acompanhamento, 28 fraturas ósseas, 97 hospitalizações, 44 MACE e 70 óbitos foram registrados. Os subtipos de OR não foram relacionados aos desfechos clínicos. Conclusão: A incidência de desfechos clínicos não diferiu entre os tipos de OR.

Overview of renal osteodystrophy in Brazil: a cross-sectional study / Visão geral da osteodistrofia renal no Brasil: um estudo transversal

Abstract Introduction: The epidemiologic profile of renal osteodystrophy (ROD) is changing over time and cross-sectional studies provide essential information to improve care and health policies. The Brazilian Registry of Bone Biopsy (REBRABO) is a prospective, nationalmulticenter cohort that includes patients with chronic kidney disease (CKD) undergoing bone biopsy. REBRABO aims to provide clinical information on ROD. The main objective of this subanalysis was to describe the profile of ROD, including clinically relevant associations. Methods: From Aug/2015 to Dec/2021, 511 patients with CKD who performed bone biopsy were included in the REBRABO platform. Patients with no bone biopsy report (N = 40), GFR > 90 mL/min (N = 28), without asigned consent (N = 24), bone fragments inadequate for diagnosis (N = 23), bone biopsy indicated by a specialty other than nephrology (N = 6), and < 18 years old (N = 4) were excluded. Clinical-demographic data (e.g., age, sex, ethnicity, CKD etiology, dialysis vintage, comorbidities, symptoms, and complications related to ROD), laboratory (e.g., serum levels of total calcium, phosphate, parathormone, alkaline phosphatase, 25-hydroxyvitamin D, and hemoglobin), and ROD (e.g., histological diagnosis) were analyzed. Results: Data from 386 individuals were considered in this subanalysis of REBRABO. Mean age was 52 (42-60) years; 198 (51%) were male; 315 (82%) were on hemodialysis. Osteitis fibrosa (OF) [163 (42%)], adynamic bone disease (ABD) [96 (25%)] and mixed uremic osteodystrophy (MUO) [83 (21%)] were the most frequent diagnosis of ROD in our sample; 203 (54%) had the diagnosis of osteoporosis, 82 (56%) vascular calcification; 138 (36%) bone aluminum accumulation, and 137 (36%) iron intoxication; patients with high turnover were prone to present a higher frequency of symptoms. Conclusions: A high proportion of patients were diagnosed with OF and ABD, as well as osteoporosis, vascular calcification and clinical symptoms.

Resumo Introdução: O perfil epidemiológico da osteodistrofia renal (OR) está mudando com o tempo e estudos transversais fornecem informações essenciais para melhorar cuidados e políticas de saúde. O Registro Brasileiro de Biópsia Óssea (REBRABO) é uma coorte nacional multicêntrica prospectiva que inclui pacientes com doença renal crônica (DRC) submetidos à biópsia óssea. O REBRABO visa fornecer informações clínicas sobre OR. O principal objetivo desta subanálise foi descrever o perfil da OR, incluindo associações clinicamente relevantes. Métodos: De Ago/2015 a Dez/2021, 511 pacientes com DRC que realizaram biópsia óssea foram incluídos na plataforma REBRABO. Excluíram-se os pacientes sem laudo de biópsia óssea (N = 40), TFG > 90 mL/min (N = 28), sem consentimento assinado (N = 24), fragmentos ósseos inadequados para diagnóstico (N = 23), biópsia óssea indicada por especialidade que não a nefrologia (N = 6), e < 18 anos de idade (N = 4). Foram analisados dados clínico-demográficos (por exemplo, idade, sexo, etnia, etiologia da DRC, tempo da diálise, comorbidades, sintomas e complicações relacionadas à OR), laboratoriais (níveis séricos de cálcio total, fosfato, paratormônio, fosfatase alcalina, 25-hidroxivitamina D e hemoglobina), e OR (diagnóstico histológico). Resultados: Dados de 386 indivíduos foram considerados nesta subanálise do REBRABO. A idade média foi 52 (42-60) anos; 198 (51%) eram homens; 315 (82%) estavam em hemodiálise. Osteíte fibrosa (OF) [163 (42%)], doença óssea adinâmica (DOA) [96 (25%)] e osteodistrofia urêmica mista (OUM) [83 (21%)] foram os diagnósticos mais frequentes de OR na amostra; 203 (54%) apresentaram diagnóstico de osteoporose, 82 (56%) calcificação vascular; 138 (36%) acúmulo ósseo de alumínio, e 137 (36%) intoxicação por ferro; pacientes com remodelação óssea aumentada eram propensos a apresentar maior frequencia de sintomas. Conclusões: Uma alta proporção de pacientes foi diagnosticada com OF e DOA, assim como osteoporose, calcificação vascular e sintomas clínicos.

Jogo eletrônico: contribuições teórico-metodológicas para a formação de professores de Educação Física / Electronic games: theoretical and methodological contributions to the training of physical education teachers / Juego electrónico: aportes teóricos y metodológicos a la formación de profesores de educación física

Este estudo tem como objetivo analisar as contribuições teórico-metodológicas do jogo eletrônico para a formação de professores nos cursos de Licenciatura em Educação Física. Metodologicamente, optamos pela Hermenêutica-Dialética como método, que tem como princípio a comunicação (tratada neste estudo por meio de uma abordagem qualitativa com inserção no campo). Foi utilizada a coleta de dados, como o instrumento questionário, aplicado aos professores que tratam o conhecimento "jogo" na formação inicial em Educação Física, em uma Universidade pública. Concluímos que as contribuições teórico-metodológicas do jogo eletrônico para a formação de professores de Educação Física podem ser compreendidas em três tópicos: cultura, transposição da realidade virtual para a concreta e exergame (AU).

The purpose of this study was to analyze the theoretical and methodological contributions of electronic games to teachers training for a Physical Education Licentiate degree. As for the methodology, we chose the hermeneutics-dialectic method, which views communication as a principle and is treated in this study through a qualitative approach inserted in the field. A questionnaire for data collection was applied to teachers who dealt with game knowledge in the initial formation of Physical Education at a public university. It was concluded that the theoretical-methodological contributions of electronic games for the formation of Physical Education teachers can be understood by three topics: culture, transposition of virtual reality into concrete reality, and exergame (AU).

Este estudio tiene como objetivo analizar los aportes teóricos y metodológicos de los juegos electrónicos a la formación de profesores en los cursos de Licenciatura en Educación Física. Metodológicamente, se optó por el método hermenéutico-dialéctico, que tiene como principio la comunicación, tratado en este estudio a través de un enfoque cualitativo con inserción en el campo, utilizando el instrumento cuestionario para la recolección de datos aplicado a los docentes que abordan el conocimiento del juego en la formación en Educación Física en una universidad pública. Concluimos que los aportes teórico-metodológicos de los juegos electrónicos para la formación de estos docentes se pueden entender en tres temas: cultura, transposición de la realidad virtual al concreto y exergame (AU).

Evaluation of teaching low intensity laser in perspective dentist

Search knowledge dentist front surgeon to low intensity laser through a questionnaire. They were selected randomly in the city of Juiz de Fora and region 91 Dental Surgeons of Minas Gerais. These employees were sent during the months from July to October 2013, a standard form printed with questions about laser education assessment of low intensity. Of the 91 participants, 42 (46.2%) were female and 49 (53.8%) were male. Fifty-seven (62.6%) had dental public institution of higher education; 32 (35.2%) attended a private institution and 2 (2.2%) did not report this data. Eighty-nine dentists reported the time of graduation, and this varied with a minimum of 1 year and a maximum of 38 years of training, the average being 11 years and this is the standard deviation of 10.7. The age of these professionals is on average thirty-five years, ranging from twenty-two years to sixty-five years of age and the standard deviation of this is 10.8. The distribution according to academic title was: 35 dentists (38.5%) had a degree in dentistry; 13 (14.3%) were specialists; 14 (15.4%) had master's and 4 (4.4%) doctorate. 25 (27.5%) did not report the academic title. The most relevant mentioned specialties were general practitioner, endodontics and implantology. We can conclude that the Juiz de Fora dentist - MG and region makes little use of laser therapy and this is mainly due to little knowledge acquired at the undergraduate and graduate education.

Urgent care frequency of the assessment carried out in a School Clinic of a Dental College of Minas Gerais

To evaluate the frequency of dental emergencies and specifications, along with the patient's profile attended at the Clinical School of Dentistry, Faculty of Medical Sciences and Juiz de Fora Health (Supreme). We selected 152 medical records of clinical dental school of Juiz de Fora University Hospital - MG were selected and assessed the patient's profile and the classification of emergency cases. It was found that 57.2% of the patients were female and 42.7% male. The age of these patients is on average 44 years and the most frequent causes of visits were: dental prosthesis, endodontic and dental trauma. It can be conclude that some of the diseases found in dental emergencies are likely to be prevented or identified early on. Patients with pain are part of most attending emergency care services. In order to control the emergency care and improve the solvability, preventive actions should be developed, promoting a preventive rather than curative health.

Diagnóstico precoce de acetonemia subclínica em vacas holandesas por mensuração de corpos cetônicos / Early diagnosis of subclinical acetonemia in holstein cows by measuring ketone bodies / Diagnóstico precoz de acetonemia subclínica en vacas holstein mediante la medición de cuerpos cetónicos

O trabalho foi realizado em uma fazenda de exploração leiteira em Castrolanda, no município de Castro ­ PR. O sistema de manejo é free-stall, com 220 vacas da raça Holandesa com RHA305 de 6.740 litros. Foram coletadas amostras de sangue de 18 vacas de pré-parto, 4 dias antes da data prevista para o parto; e nos dias 4, 7 e 12 pós-parto, mediante punção venosa coccígea, utilizando-se SnapTest digital Ketovet®, constituindo 72 amostras, no período de fevereiro a maio de 2020. Em 4 vacas o BHB do sangue total apresentou-se acima do limite para cetose subclínica no quarto dia após o parto e 17 apresentaram-se acima do limite no sétimo dia, declinando em seguida, principalmente devido às intervenções clínicas. As médias e desvios-padrão foram: D - 4: 0,89 ± 0,257061; D 4: 1,05 ± 0,283279; D 7: 1,81 ± 0,456131; e D 12: 1,19 ± 0,437762. O benefício do monitoramento de BHB foi a imediata intervenção clínica, evitando-se a severidade por instalação de quadro clínico e as enfermidades concomitantes.(AU)

The study was carried out on a dairy farm in Castrolanda, in the county of Castro - PR. The management system is free stall, with 220 Holstein cows with RHA305 of 6,740 liters. Blood samples were collected from 18 pre-calving cows, 4 days before the expected date of calving; and on days 4, 7 and 12 postpartum, by means of coccygeal venipuncture, using SnapTest digital Ketovet®, constituting 72 samples, from February to May 2020. In 4 cows the BHB of whole blood was shown above the limit for subclinical ketosis on the fourth day after delivery and 17 presented above the limit on the seventh day, then declining mainly due to clinical interventions. The means and standard deviations were D -4: 0.89 ± 0.257061; D 4: 1.05 ± 0.283279; D 7: 1.81 ± 0.456131; and D 12: 1.19 ± 0.437762. The benefit of monitoring BHB was immediate clinical intervention, avoiding clinical ketosis and concomitant illnesses.(AU)

El estudio se realizó en una explotación lechera de Castrolanda, en la comarca de Castro - PR. El sistema de manejo es estabulación libre, con 220 vacas Holstein con RHA305 de 6.740 litros. Se recogieron muestras de sangre de 18 vacas pre- parto, 4 días antes de la fecha prevista de parto; y en los días 4, 7 y 12 postparto, mediante venopunción coccígea, utilizando SnapTest digital Ketovet®, constituyendo 72 muestras, desde febrero a mayo de 2020. En 4 vacas la BHB de sangre total se mostró por encima del límite para cetosis subclínica en el cuarto día después del parto y 17 presentaron por encima del límite en el séptimo día, disminuyendo después debido principalmente a intervenciones clínicas. Las medias y desviaciones estándar fueron D -4: 0,89 ± 0,257061; D 4: 1,05 ± 0,283279; D 7: 1,81 ± 0,456131; y D 12: 1,19 ± 0,437762. El beneficio de monitorizar la BHB fue la intervención clínica inmediata, evitando la cetosis clínica y las enfermedades concomitantes.(AU)

Comparative study of sex estimates in adult skulls using direct measurement and tomographic image reconstruction

Abstract Sex estimation is an important procedure in forensic anthropology for human identification. The development of new technologies, such as three-dimensional computed tomography (CT), has provided excellent alternatives for this purpose. This study examined and compared a morphological method for sex estimation using two different approaches - direct measurement of physical structures and tomographic analysis using 3D images. A total of 111 skulls from the Museum of Human Anatomy at the University of São Paulo (MAH-USP) were used, (60 males and 51 females). All specimens were scanned by Philips Brilliance 64 CT scanner equipment and their corresponding images were reconstructed in three-dimensional (3D) models. The morphological characteristics of the skulls were analyzed by an observer who was blinded to the sex of the specimens. Five cranial structures were analyzed: external occipital crest, mastoid process, supraorbital margin, glabella, and mental eminence. The structures were scored 1 to 5 according to Buikstra and Ubelaker and validated by Walker. The success rates of the sex estimates obtained through direct measurement of the dry skulls ranged from 67.4% to 70.4% as compared to 60.2% to 68.1% for CT reconstruction. When analyzed separately, the maximum accuracy of the method was 68.33% in males and 88.24% in females in the physical analysis of structures. The glabella and mastoid process were the most effective structures to estimate sex through both techniques, respectively. Our results show that 3D CT images can be accurately used in the morphological analysis for sex estimation, representing a viable alternative in forensic anthropology.

Validation of the Brazilian Portuguese version of the Quick Inventory of Depressive Symptomatology and Self-Report (QIDS-SR16) for the Brazilian population

Abstract Objectives To evaluate the psychometric properties of the Quick Inventory of Depressive Symptomatology (QID-SR16), a self-report instrument based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria that assesses the severity of depression symptoms, in the Brazilian population. Methods Participants were 4,400 Brazilians over the age of 15 years recruited for an online survey assessing depressive symptoms during the early phase of the coronavirus disease 2019 (COVID-19) pandemic in Brazil. The internal consistency, construct validity, and convergent and discriminant validity of the QIDS-SR16 were evaluated. Results The model tested was considered an adequate fit to the data (comparative fit index [CFI] = 0.947, Tucker-Lewis index [TLI] = 0.927, and root-mean-square error of approximation [RMSEA] = 0.051) and its internal consistency was good, with a Cronbach's alpha of 0.71 and an average item correlation of 0.23. The correlations between the total QIDS-SR16 score and the total scores of the Patient Health Questionnaire (PHQ-9) instruments (r = 0.67, p < 0.001), the Posttraumatic Symptoms Checklist (PCL-5) (r = 0.61, p < 0.001), and the Patient-Reported Outcomes Measurement Information System (PROMIS) (r = 0.60, p < 0.001) indicate good concurrent and convergent validity. Conclusion The QIDS-SR16 has robust psychometric properties in terms of its internal consistency, construct validity, and convergent and discriminant validity. The Portuguese version of the QIDS-SR16 is an adequate instrument for assessment of depressive symptoms in the context of an online survey.

Influence of compression therapy following varicose vein surgery: a prospective randomized study / Influência da terapia compressiva no pós-operatório de flebectomia: um estudo prospectivo e randomizado

Abstract Background The use of compression dressings after phlebectomy is based solely on clinical experience due to the lack of a unified set of definitive recommendations, which makes clinical practice extremely heterogeneous. Objectives To evaluate compression therapy with elastic stockings for 7 days after phlebectomy. Methods We randomly allocated 104 lower limbs with disease classified as C1 and C2 to 1 of 2 groups: an intervention group (64 limbs) - wearing elastic compression stockings for the first 7 days after phlebectomy; or a control group (40 limbs) - given conventional bandaging for 24 hours postoperatively. We compared clinical response by analyzing the evolution of symptoms, hematoma formation, and preoperative vs. postoperative limb volume. Results Pain (median 1.0 vs. 1.5, p=0.0320) and limb volume (mean 43.7 vs. 99.8, p=0.0071) were significantly improved in patients wearing elastic compression stockings for 7 days after phlebectomy compared with controls. Conclusions Use of elastic compression therapy for 7 days after phlebectomy was effective for improving pain and lower limb volume.

Resumo Contexto O uso de curativos após flebectomia é baseado apenas na experiência clínica, visto que não existe um conjunto unificado de recomendações definitivas, o que torna a prática clínica extremamente variável. Objetivos Avaliar o uso de terapia elástica compressiva por 7 dias após flebectomia. Métodos Cento e quatro membros inferiores, classificados como CEAP C1 e C2, foram randomizados em dois grupos: grupo de intervenção (64 membros) - uso de meia elástica por 24 horas após a cirurgia - e grupo controle (40 membros) - uso de curativo convencional por 7 dias após a cirurgia. A resposta clínica foi comparada por meio de análise da evolução dos sintomas, de hematoma e do volume dos membros antes e depois da cirurgia. Resultados Os pacientes submetidos a terapia compressiva elástica apresentaram melhora significativa na dor (mediana 1,0 vs. 1,5; p=0,0320) e no volume dos membros (média 43,7 vs. 99,8; p=0,0071) em comparação ao grupo controle. Conclusões O emprego da terapia compressiva elástica por 7 dias após flebectomia mostrou-se efetivo na melhora da dor e do volume dos membros inferiores.

Agreement with COVID-19 disinformation among Portuguese-speaking older adults: an international study / Concordancia con contenido de desinformación relacionado con COVID-19 en personas mayores de habla portuguesa: estudio internacional / Concordância com conteúdos de desinformação relacionados à COVID-19 em idosos falantes do português: estudo internacional

ABSTRACT Objectives: to assess agreement with COVID-19 disinformation among Portuguese-speaking individuals aged 50 years or older. Methods: a descriptive and analytical study involving 1,214 older adults born in Portuguese-speaking countries. Data collection occurred through online information mining to recognize COVID-19 and disinformation content, and the application of a structured questionnaire. Results: agreement with disinformation content was 65.2%. Residing outside Brazil is a protective factor for agreement with disinformation content, and those who believe in the truthfulness of the information sources they receive were 31% more likely to agree with disinformation content. Conclusions: there is a high prevalence of disinformation among the older population in two Portuguese-speaking countries, which should raise the attention of healthcare professionals and guide coping strategies.

RESUMEN Objetivos: evaluar la concordancia con contenido de desinformación relacionado con COVID-19 entre personas de 50 años o más de edad, hablantes de portugués. Métodos: estudio descriptivo y analítico con 1.214 personas mayores nacidas en países de habla portuguesa. La recolección de datos se realizó mediante la minería de información en línea para el reconocimiento de contenido de desinformación y COVID-19, y la aplicación de un cuestionario estructurado. Resultados: la concordancia con contenido de desinformación fue del 65,2%. Residir fuera de Brasil es un factor de protección para la concordancia con contenido de desinformación, y aquellos que creen en la veracidad de las fuentes de información que reciben tuvieron un 31% más de probabilidades de estar de acuerdo con contenido de desinformación. Conclusiones: hay una alta prevalencia de desinformación entre la población mayor en dos países de habla portuguesa, lo que debe llamar la atención de los profesionales de la salud y la enfermería y orientar estrategias de enfrentamiento.

RESUMO Objetivos: avaliar a concordância com conteúdos de desinformação relacionados à COVID-19 entre pessoas com 50 anos ou mais de idade, falantes do português. Métodos: estudo descritivo e analítico com 1.214 idosos nascidos em países de língua portuguesa. A coleta de dados ocorreu por meio da mineração de informações online para reconhecimento de conteúdos de desinformação e COVID-19, e aplicação de questionário estruturado. Resultados: a concordância com conteúdos de desinformação foi de 65,2%. Residir fora do Brasil é um fator de proteção para a concordância com conteúdos de desinformação, e aqueles que acreditam na veracidade das fontes de informação que recebem tiveram 31% mais probabilidade de concordar com conteúdos de desinformação. Conclusões: há alta prevalência de desinformação entre a população idosa em dois países de língua portuguesa, o que deve despertar a atenção dos profissionais da saúde e enfermagem, e orientar estratégias de enfrentamento.

A cross-sectional study of the association between exposure to violence, intelligence, and executive function in Brazilian youths

Abstract We carried out an exploratory study of the association between exposure to violence, intelligence, and executive functions in Brazilian preadolescents. The study included 56 participants (31 males) aged 8 to 14 years old (mean = 11.3, SD = 1.0). We administered neuropsychological tests to evaluate executive functions and the Juvenile Victimization Questionnaire (JVQ) to evaluate exposure to violence. We used the following neuropsychological instruments: Wechsler Abbreviated Scale of Intelligence (WASI), Stroop Color-Word Interference task, digits subtest of the Wechsler Intelligence Scale for Children, and an N-back task. We generated a composite score from neuropsychological test scores and investigated the association of that score, and individual test scores, with exposure to violence and socioeconomic status (SES). Results suggest, first, that exposure to violence is associated with a 0.5-point lower intelligence quotient score for every reported victimization event in the Juvenile Victimization Questionnaire. Results also show that the digits backward subtest scores showed a significant negative correlation with exposure to violence (JVQ; rho = -0.29, p < 0.05); both analyses were adjusted for the level of schooling of parents or guardians, which was also found to be significantly associated with lower intelligence quotient scores. We discuss results in the light of the existing literature on the effects of exposure to violence on adolescent development, and the amounting evidence that suggests an association of exposure to violence, and of victimization, with tests that evaluate constructs of executive functions. The study struggled with low compliance from participants, and we underscore the challenges of carrying out empirical studies aimed at better understanding the development of underrepresented youths, such as those from Central and Latin America.

Misinformation about COVID-19 among middle-aged and older migrants residing in Brazil and Portugal / Desinformación sobre COVID-19 entre migrantes de mediana edad y mayores residentes en Brasil y Portugal / Desinformação sobre COVID-19 entre migrantes de meia-idade e mais velhos residentes no Brasil e em Portugal

ABSTRACT Objective: The aim of this study was to assess the prevalence of COVID-19 misinformation among migrants aged 50 or older residing in Brazil and Portugal. Method: This was a cross-sectional analytical study conducted among migrants from Portuguese-speaking countries living in Brazil and Portugal, who were 50 years of age or older. The prevalence ratios (PR) were estimated using the Poisson regression model. Results: Out of the 304 participants included in the study, 188 (61.8%) agreed with at least one piece of misinformation. Factors such as having a religious affiliation (aPR: 1.24), higher educational attainment (aPR: 1.17), knowing someone who died from COVID-19 (aPR: 1.78), and having no intention to get vaccinated (aPR: 1.36) were associated with a higher likelihood of agreeing with COVID-19 misinformation. Conclusion: The findings suggest that access to misinformation was influenced by social, economic, and religious factors among elderly migrants with low digital literacy, thus contributing to the dissemination of false content within this population.

RESUMEN Objetivo: Evaluar los contenidos de desinformación relacionados con COVID-19 entre migrantes de 50 años o más que residen en Brasil y Portugal. Método: Estudio transversal y analítico con migrantes de países de habla portuguesa que residen en Brasil y Portugal y tienen 50 años o más. Se utilizó el modelo de regresión de Poisson para estimar las razones de prevalencia (RP). Resultados: De los 304 participantes en este estudio, 188 (61,8%) estuvieron de acuerdo con al menos un contenido de desinformación. Tener una religión (aPR:1,24), mayor nivel educativo (aPR:1,17), conocer a alguien que murió a causa de COVID-19 (aPR:1,78) y no tener la intención de vacunarse (aPR:1,36) influyeron en la concordancia con la desinformación sobre COVID-19. Conclusión: El acceso a la desinformación estuvo relacionado con aspectos sociales, económicos y religiosos de los participantes y contribuyó a que la población migrante de edad avanzada y con bajo nivel educativo digital difundiera contenido falso entre otras personas.

RESUMO Objetivo: Avaliar os conteúdos de desinformação relacionados a COVID-19 entre migrantes com 50 ou mais anos de idade residentes no Brasil e em Portugal. Método: Estudo transversal e analítico, com migrantes de países falantes do português residentes no Brasil e em Portugal que possuíam 50 anos ou mais de idade. O modelo de regressão de Poisson foi utilizado para estimar as razões de prevalência (RP). Resultados: Dos 304 participantes deste estudo, 188 (61,8%) concordaram com ao menos um conteúdo de desinformação. Ter uma religião (aPR:1,24), maior escolaridade (aPR:1,17), conhecer alguém que morreu decorrente da COVID-19 (aPR:1,78) e não pretender se vacinar (aPR:1,36) influenciaram a concordância com a desinformação da COVID-19. Conclusão: O acesso às desinformações esteve relacionado com aspectos sociais, econômicos e religiosos dos envolvidos e contribuíram para que a população idosa migratória de baixo letramento digital, pulverizasse conteúdos falsos entre outras pessoas.

Ensino remoto emergencial na pós-graduação stricto sensu durante a pandemia da covid-19: estudo de reflexão* / Docencia remota de emergencia en posgrado stricto sensu durante la pandemia de covid-19: estudio de reflexión / Emergency remote teaching in stricto sensu graduate courses during the covid-19 pandemic: a reflection study

Objetivo: refletir sobre o ensino remoto, utilizado na pandemia da covid-19, na pós-graduação stricto sensu no contexto da universidade. Método: estudo de reflexão, apoiado em levantamento bibliográfico que permitiu o reconhecimento do predomínio do enfoque técnico, analisado à luz de autores cujo referencial teórico articula a educação e a universidade às relações sociais. Resultados: a análise do ensino remoto demanda uma investigação acerca da sua relação com mudanças que vêm se processando na universidade no cenário neoliberal, valorizando projetos de educação e sociedade com foco mercadológico, influenciando a produção do conhecimento, a formação do pesquisador e do professor da educação superior. Conclusão: ultrapassar a dimensão técnica para a apropriação da dimensão ético-política presente no ensino remoto e nos seus possíveis desdobramentos pós-pandêmico é fundamental, pois o potencial do ato educativo, em termos do encontro entre professor e aluno e da apropriação do conhecimento, não é efetivamente alcançado no ensino remoto.

Objective: to reflect on remote teaching, used during the covid-19 pandemic, in stricto sensu graduate studies in the university context. Method: this is a reflection study, supported by a bibliographical survey that allowed the recognition of the predominance of the technical focus, analyzed in the light of authors whose theoretical framework articulates education and university with social relations. Results: the analysis of remote teaching demands an investigation into its relationship with changes that have been taking place at universities in the neoliberal scenario, valuing education and society projects with a marketing focus, influencing knowledge production, researcher and professor training. Conclusion: going beyond the technical dimension to appropriating the ethical-political dimension present in remote teaching and its possible post-pandemic developments is fundamental, as the educational act's potential, in terms of the meeting between professor and student and appropriation of knowledge, is not effectively achieved in remote teaching.

Objetivo: reflexionar sobre la enseñanza a distancia, utilizada durante la pandemia de covid-19, en los estudios de posgrado stricto sensu en el contexto universitario. Método: se trata de un estudio de reflexión, sustentado en un levantamiento bibliográfico que permitió reconocer el predominio del enfoque técnico, analizado a la luz de autores cuyo marco teórico articula la educación y la universidad con las relaciones sociales. Resultados: el análisis de la enseñanza a distancia exige una investigación sobre su relación con los cambios que se vienen produciendo en la universidad en el escenario neoliberal, valorar proyectos de educación y sociedad con enfoque de marketing, incidiendo en la producción de conocimiento, la formación de investigadores y docentes de educación superior. Conclusión: ir más allá de la dimensión técnica para apropiarse de la dimensión ético-política presente en la enseñanza a distancia y sus posibles desarrollos pospandemia es fundamental, ya que las potencialidades del acto educativo, en cuanto al encuentro entre docente y alumno y la apropiación del conocimiento, no se logra efectivamente en la enseñanza remota.

Gender differences in progression to crack-cocaine use and the role of sexual and physical violence

Objective: This study aimed to evaluate whether progression from first drug use to crack-cocaine use differs according to gender, and whether the report of sexual or physical violence impacts the time of progression. Methods: We interviewed 896 crack-cocaine users (548 men; 348 women) from addiction treatment units. Cox regression models evaluated the time of progression from first drug use to crack use. We analyzed gender differences according to the absence or presence of sexual or physical violence, also considering whether violence, when present, had occurred before or after the onset of crack use. Results: Women presented a faster progression to crack use regardless of exposure to sexual or physical violence (p < 0.05). Compared to unexposed men, there was a similar progression for men exposed to sexual or physical violence before the first use of crack (p = 0.167 and p = 0.393, respectively). In both genders, we observed a faster progression among individuals exposed to these types of violence after the onset of crack use (p < 0.01). Conclusions: We found a faster progression to crack use among women and among individuals exposed to sexual and physical violence after the onset of crack use. These results encourage differentiated treatment strategies, focused on gender and individual characteristics.

Time of clerkship rotations' interruption during COVID-19 and differences on Progress Test's scores

SUMMARY OBJECTIVES: The transition from face-to-face to remote teaching is yet to be fully understood. In clinical training, traditional teaching must prevail because it is essential for the acquisition of skills and professionalism. However, the responses of each school to the pandemic and the decision on when to resume clerkship rotations were mixed. In this study, we aimed to analyze whether the time to resume clerkship rotations was associated with the performance of the students by using a multi-institutional Progress Test. METHODS: This is a cross-sectional study conducted at nine different Brazilian medical schools that administer the same annual Progress Test for all students. We included information from 1,470 clerkship medical students and analyzed the time of clinical training interruption as the independent variable and the student's scores as the dependent variable. RESULTS: The comparisons of the students' scores between the schools showed that there are differences; however, they cannot be attributed to the time the clerkship rotations were paused. The correlation between the schools' average scores and the time to resume clerkship rotations was not significant for the fifth year (r= -0.298, p=0.436) and for the sixth year (r= -0.440, p=0.240). By using a cubic regression model, the time to resume clerkship rotations could explain 3.4% of the 5-year students' scores (p<0.001) and 0.9% of the 6-year students, without statistical difference (p=0.085). CONCLUSIONS: The differences between the students' scores cannot be attributed to the time when the schools paused the clerkship rotations.

Distribution of kidney diseases in Joinville, Santa Catarina: analysis of a kidney biopsy data bank between 2008 and 2019 / Distribuição das nefropatias em Joinville, Santa Catarina: análise de um banco de dados de biópsia renal entre 2008 a 2019

Abstract Introduction: Studies based on kidney biopsies are important for the epidemiological understanding of nephropathies. Objective: To describe the main nephropathies diagnosed through renal biopsies, and compare them with regards to gender, time, healthcare insurance and age. Methods: A population-based retrospective study that reviewed all kidney disease diagnoses obtained by biopsy of a native kidney from pathology services between 2008 and 2019 in Joinville, Brazil. Results: Of 778 biopsies performed, 44.5% were primary nephropathies and 28.5% were secondary. The highest prevalence was focal segmental glomerulosclerosis (FSGS) [18.1%], followed by tubulointerstitial nephropathy (TIN) [15.9%] and IgA nephropathy (IgAN) [9.1%]. There was a growing increase in the prevalence of TIN among elderly and uninsured patients over the period. In the multivariate analysis, among the primary glomerulopathies, males had a higher risk for the occurrence of IgAN [OR=2.02; 95% CI 1.13-3.61; p=0.018], as well as being a protective factor for the occurrence of lupus glomerulonephritis (LGN) [OR=0.20, 95% CI 0.08-0.49; p<0.001]. Advancing age and dependence on a public healthcare decreased the likelihood of having a diagnosis of LGN [OR=0.91, 95% CI 0.88-0.94, p < 0.001 and OR=0.45, CI 95 % 0.21-0.96; p = 0.036, respectively]. Patients without private healthcare insurance were more likely to have TIN [OR=1.77, 95%CI 1.16-2.70; p = 0.008]. Conclusion: Sex, age and type of medical healthcare insurance may be related to the occurrence of some nephropathies. The increased risk of TIN in individuals without a private healthcare plan may be an indication of inequalities in health care.

Resumo Introdução: Estudos com base em biópsias renais são importantes para o entendimento epidemiológico das nefropatias. Objetivo: Descrever as principais nefropatias diagnosticadas por meio de biópsias renais e comparar com relação ao gênero, período, plano de saúde e à idade. Métodos: Estudo retrospectivo de base populacional que revisou todos os diagnósticos de doenças renais obtidos por biópsia de rim nativo de serviços de patologias entre 2008 a 2019, em Joinville, Brasil. Resultados: Do total de 778 biópsias realizadas, 44,5% eram nefropatias primárias e 28,5%, secundárias. A maior prevalência foi de glomeruloesclerose segmentar e focal (GESF) [18,1%], seguida por nefropatia tubulointersticial (NTI) [15,9%] e nefropatia IgA (NIgA) [9,1%]. Houve crescente aumento da prevalência de NTI nos pacientes idosos e sem plano de saúde ao longo do período. Na análise multivariada, entre as glomerulopatias primárias, o sexo masculino apresentou maior risco para ocorrência de NIgA [OR=2,02, IC 95% 1,13-3,61; p=0,018], bem como foi um fator de proteção para ocorrência de glomerulonefrite lúpica (GNL) [OR=0,20, IC 95% 0,08-0,49; p < 0,001]. O avançar da idade e a dependência de plano público de saúde diminuíram a chance para o diagnóstico de GNL [OR=0,91, IC 95% 0,88-0,94, p < 0,001 e OR=0,45, IC 95% 0,21-0,96; p = 0,036, respectivamente]. Pacientes sem plano privado de saúde apresentaram mais chance de NTI [OR=1,77, IC 95%1,16-2,70; p = 0,008]. Conclusão: Sexo, idade e tipo de assistência médica podem estar relacionados à ocorrência de algumas nefropatias. O maior risco de NTI em indivíduos sem plano de saúde privado pode ser um indicativo de desigualdades no cuidado à saúde.

Antimicrobial potential of plant extracts from the Brazilian Cerrado

Abstract Bacteria are related do different oral diseases, such as dental caries and periodontal disease. Therefore, the control or/and eradication of microorganisms and their by-products is primordial for the success of their treatment. An alternative for decrease bacterial load is the use of plant extracts used in popular medicine. The cytotoxicity and antimicrobial action of extracts of Cariniana rubra Gardiner ex Miers, Senna martiniana, Anadenanthera colubrina (Vell.) Brenan and Spiranthera odoratissima St. Hil. against strains of Streptococcus mutans, Enterococcus faecalis, Staphylococcus aureus, Escherichia coli, Aggregatibacter actinomyces- tencomitans and Candida albicans were investigated. Cytotoxicity was assessed at concentrations of 1, 10, 40, 80, 100 and 1000 μg/mL by means of the MTT test and compared to a control group with untreated cells. Those with acceptable cytotoxicity had the antimicrobial action measured by the XTT test. As a positive control, sodium hypochlorite was used. Cariniana rubra Gardiner ex Miers had the highest citototoxicity results while Spiranthera odoratissima St. Hil. had the best results, but all extracts showed acceptable cytotoxicity at different concentrations. The plant extracts showed higher activity against A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80.52%) at 40 μg/mL, Spiranthera odoratissima St. Hil (78.48%) in 1 μg/mL, Senna martiniana (73.28%) in the concentration of 40 μg/mL and Cariniana rubra Gardiner ex Miers (70.50%) in 10 μg/mL. All extracts analyzed showed acceptable cytotoxicity at different concentrations and were promising for inhibition of the pathogenic microorganisms studied.

Resumo Bactérias estão relacionadas a diferentes doenças bucais, como a cárie dentária e a doença periodontal. Assim, o controle e/ou erradicação de microrganismos e seus subprodutos é primordial para o sucesso dos tratamentos. Uma alternativa para diminuir a carga bacteriana é a utilização de extratos vegetais utilizados na medicina popular. A citotoxicidade e ação antimicrobiana de extratos de Cariniana rubra Gardinerex Miers, Senna martiniana H.S. Irwin & Barneby, Anadenanthera colubrina (Vell.) Brenan e Spiranthera odoratissima St. Hil. contra cepas de Streptococcus mutans, Enterococcusfaecalis, Staphylococcus aureus, Escherichia coli, Agartibacter actinomycetencomitans e Candida albicans foram investigados. A citotoxicidade foi avaliada nas concentrações de 1, 10, 40, 80, 100 e 1000 μg/mL por meio do teste MTT. Aqueles com citotoxicidade aceitável tiveram a ação antimicrobiana medida pelo teste XTT. Cariniana rubra Gardinerex Miers apresentou os maiores resultados de citototoxicidade, enquanto Spiranthera odoratissima St. Hil. obteve os melhores resultados, mas todos os extratos apresentaram citotoxicidade aceitável em diferentes concentrações. Os extratos vegetais apresentaram maior atividade contra A. actinomycetencomitans: Anadenanthera columbrina (Vell.) Brenan (80,52%) a 40 μg/mL, Spiranthera odoratissima St. Hil (78,48%) em 1 μg/mL, Senna martiniana H.S. Irwin & Barneby (73,28%) na concentração de 40 μg/mL e Cariniana rubra Gardinerex Miers (70,50%) em 10 μg/mL. Todos os extratos analisados apresentaram citotoxicidade aceitável em diferentes concentrações e foram promissores na inibição dos microrganismos patogênicos estudados.

Patterns of flow drainage from varicose veins originating in the incompetent great saphenous vein / Padrões de drenagem do fluxo das varizes oriundas da veia safena magna incompetente

Abstract Background Chronic venous insufficiency affects the lives of many people and therefore constitutes a public health problem. Knowledge of the drainage patterns of reflux from varicose veins secondary to incompetent saphenous veins is essential to define the best therapeutic management. Objectives To determine the reflux drainage patterns from varicose veins originating in incompetent GSV, the prevalence of perforating veins (PV), and their relationships with symptoms. Methods 55 ultrasound reports were analyzed to determine the drainage patterns of reflux from the GSV, location and diameter of PV drainage, and staging of symptoms. Results In 64% of the sample, reflux from varicose veins drained to PVs, in 4% reflux drained to the GSV itself, in another 4% drainage was to the small saphenous vein, and in 29% drainage was to varicose trunk veins in which no direct communication with the deep system could be identified. No associations were observed between symptoms and reflux drainage patterns or PV diameters. Conclusions For this sample, PVs were responsible for draining flow from varicose veins in 64% of cases. Neither PV diameters nor GSV reflux patterns were associated with severity of symptoms.

Resumo Introdução A insuficiência venosa crônica impacta a vida de muitas pessoas, constituindo-se, assim, como um problema de saúde pública. Conhecer o padrão de drenagem do refluxo das varizes associadas à veia safena incompetente é fundamental para definir a melhor programação terapêutica. Objetivos Determinar os padrões de drenagem do refluxo de varizes originadas da veia safena magna incompetente, a prevalência de veias perfurantes e a relação com os sintomas. Métodos Foram analisados 55 registros ultrassonográficos de pacientes com refluxo da veia safena magna para determinar padrões de drenagem do refluxo dessa veia, pontos de refluxo das varizes, localização e diâmetro das perfurantes de drenagem e graduação dos sintomas. Resultados O principal padrão de refluxo encontrado foi originado da junção safenofemoral com comprometimento proximal da veia safena magna. Em 64% dos pacientes, o refluxo das varizes drenou para veias perfurantes - 4% drenavam para a própria veia safena magna; em outros 4%, a drenagem era para a veia safena parva; e, em 29%, a drenavam destinava-se para varizes tronculares em que não se identificou comunicação direta com o sistema venoso profundo. Não foi observada associação dos sintomas com os padrões de drenagem do refluxo ou diâmetro das perfurantes. Conclusão Para essa amostra, as veias perfurantes foram responsáveis pelo escoamento do fluxo oriundo das varizes em 64% dos casos. O diâmetro das veias perfurantes e o padrão de refluxo da veia safena não estiveram associados à gravidade dos sintomas.