Factors associated with the health and reproductive autonomy of Quilombola women in Brazil.

Objective: To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery). Methods: Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted). Results: Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the "Decision-making" and "Freedom from coercion" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the "Total reproductive autonomy" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women. Conclusion: The association of social determinants of health such as marital status, education, and age impacts women's reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Factors associated with the health and reproductive autonomy of Quilombola women in Brazil / Factores asociados a la salud y la autonomía reproductiva de las mujeres quilombolas en Brasil / Fatores associados à saúde e autonomia reprodutiva de mulheres quilombolas no Brasil

Objective.To verify the association between reproductive autonomy and sociodemographic, sexual, and reproductive characteristics in Quilombola women (a term indicating the origin of politically organized concentrations of Afro-descendants who emancipated themselves from slavery).Methods. Cross-sectional and analytical study with 160 women from Quilombola communities in the southwest of Bahia, Brazil. Data were collected using the Reproductive Autonomy Scale and the questionnaire from the National Health Survey (adapted).Results. Out of the 160 participating women, 91.9% declared themselves as black, one out of every three were aged ≤ 23 years, 53.8% were married or had a partner, 38.8% had studied for ≤ 4 years, over half (58.1%) were unemployed, only 32.4% had a monthly income > R$ 430 (80 US dollars), 52.5% had their first menstruation at the age of 12, 70.7% had not accessed family planning services in the last 12 months, and over half used some method to avoid pregnancy (59.0%). The women had a high level of reproductive autonomy, especially in the "Decision-making" and "Freedom from coercion" subscales with a score of 2.53 and 3.40, respectively. A significant association (p<0.05) was found between the "Total reproductive autonomy" score and marital status, indicating that single or unpartnered women had higher autonomy compared to married or partnered women. Conclusion.The association of social determinants of health such as marital status, education, and age impacts women's reproductive choices, implying risks for sexual and reproductive health. The intergenerational reproductive autonomy of Quilombola women is associated with sociodemographic and reproductive factors.

Objetivo. Verificar la asociación entre autonomía reproductiva y características sociodemográficas, sexuales y reproductivas en mujeres quilombolas (término que indica procedencia de concentraciones de afrodescendientes políticamente organizadas que se emanciparon de la esclavitud). Métodos. Estudio transversal y analítico con 160 mujeres de comunidades quilombolas del sudoeste de Bahía, Brasil. Los datos fueron recolectados utilizando la Escala de Autonomía Reproductiva y el cuestionario de la Encuesta Nacional de Salud (adaptado). Resultados. De las 160 mujeres participantes 91.9% se declararon negras, una de cada tres tenía edad ≤ 23 años, 53.8% estaban casada o tenían pareja, 38.8% había estudiado por ≤ 4 años, más de la mitad (58.1%) no trabajaba, solo 32.4% tenía renta > R$ 430 mensual (87 $US dólares), el 52.5% tuvo la primera menstruación a los 12 años, 70.7% no había acudido a servicios de planificación familiar en los últimos 12 meses y más de la mitad usaba algún método para evitar embarazo (59%). Las mujeres tuvieron un alto nivel de autonomía reproductiva, especialmente en las subescalas "Toma de decisiones" y "Ausencia de coerción" con una puntuación de 2.53 y 3.40, respectivamente. Se encontró asociación significativa (p<0.05) entre la puntuación de "Autonomía reproductiva total" con el estado civil, indicando el análisis que las mujeres solteras o sin pareja tenían mayor autonomía en comparación con las casadas o con pareja. Conclusión. La asociación de determinantes sociales de la salud como el estado civil, la escolaridad y la edad interfieren en las opciones reproductivas de las mujeres, implicando riesgos para la salud sexual y reproductiva. La autonomía reproductiva intergeneracional de las mujeres quilombolas está asociada a factores sociodemográficos y reproductivos.

Objetivo. Verificar a associação entre a autonomia reprodutiva e características sociodemográficas, sexuais e reprodutivas em mulheres quilombolas (termo que indica a origem de concentrações politicamente organizadas de pessoas de ascendência africana que se emanciparam da escravatura). Métodos. Estudo transversal e analítico com 160 mulheres (80 mães e 80 filhas) de comunidades quilombolas no sudoeste baiano, no Brasil. Os dados foram construídos através da aplicação da Escala de Autonomia Reprodutiva e do questionário da Pesquisa Nacional de Saúde (adaptado). Resultados. das 160 mulheres participantes 91.9% se autodeclararam negra, a maioria com idade ≤ 23 anos (35.6%), 53.8% são casadas ou com companheiro, 38.8% com estudos ≤ 4 anos, mais da metade (58.1%) não trabalham, apenas 32.4% têm renda > R$ 430, a maioria teve a primeira menstruação até os 12 anos de idade (52.5%), não participou de grupo de planejamento familiar nos últimos 12 meses (70.7%), mais da metade utilizava método para evitar a gravidez (59%). Apresentaram elevada autonomia reprodutiva, com destaque para as subescalas "Tomada de decisão" e "Ausência de coerção" medindo 2.53 e 3.40, respectivamente. Encontrou-se associação significativa (p<0.05) entre o escore de "Autonomia reprodutiva total" e estado conjugal, com a análise indicando que mulheres solteiras ou sem companheiro apresentaram maior autonomia, comparadas às mulheres casadas ou com companheiro. Conclusão. A associação dos determinantes sociais de saúde como estado civil, menarca, escolaridade e idade interferem nas escolhas reprodutivas das mulheres, implicando em riscos à saúde sexual e reprodutiva. A autonomia reprodutiva intergeracional das mulheres quilombolas está associada a fatores sociodemográficos e reprodutivos.

Organ Transplant From SARS-CoV-2-Positive Donors: A Brazilian Experience.

Since March 2022, donors with detectable SARS-CoV-2 RNA have been accepted for extrapulmonary organ transplants in Brazil. In this report, we described 11 successful organ transplants (6 kidney, 5 liver) from 5 asymptomatic infected donors.

Donor Choriocarcinoma Transmission From Solid Organ Transplantation: A Case Report.

Transplantation of any organ has some inherent risk of disease transmission, such as infection and malignancy. The present study aims to describe 2 cases of choriocarcinoma transmission after kidney and liver transplantation originating from the same patient. The donor was a 17-year-old woman who died of cerebral hemorrhage. Both organ recipients died of metastatic choriocarcinoma few months after the transplantation, within days after starting chemotherapy. Retrospective hCG (human chorionic gonadotropin hormone) analysis in donor's blood stored at the time of donation had a result of 9324 mIU/mL. Despite its rarity, clinicians should be aware of the risk of transplant-related choriocarcinoma from female donors in childbearing age. In some cases, hCG dosage should be performed before donation.

Declínio nas doações e transplantes de órgãos no Ceará durante a pandemia da COVID-19: estudo descritivo, abril a junho de 2020 / Disminución de donaciones y trasplantes de órganos en Ceará durante la pandemia COVID-19: un estudio descriptivo, abril - junio de 2020 / Fall in organ donations and transplants in Ceará in the COVID-19 pandemic: a descriptive study, April - June 2020

Objetivo Descrever as doações e os transplantes de órgãos no Ceará, Brasil, após a declaração da pandemia da COVID-19. Métodos Estudo descritivo, com dados da Associação Brasileira de Transplantes de Órgãos. O número de doadores e transplantes do período de abril a junho de 2020 foi comparado ao mesmo período de 2019 e ao primeiro trimestre de 2020. Resultados No primeiro semestre de 2020, o estado registrou 72 doadores efetivos. Destes, 17 (23,6%) no segundo trimestre. Dos 352 transplantes do primeiro semestre de 2020, 37 (10,7%) foram realizados no segundo trimestre. Em comparação ao período de abril a junho de 2019, houve redução de 67,9% e 89,3% no número de doadores e transplantes, respectivamente, no mesmo período de 2020. Conclusão Os números de doadores e transplantes do Ceará apresentaram importante declínio nos três meses seguintes ao decreto da pandemia da COVID-19, especialmente os das modalidades de rim, coração e córneas.

Objetivo Describir las donaciones y trasplantes de órganos en Ceará, Brasil, después de la declaración de la pandemia COVID-19. Métodos estudio descriptivo con datos de la Asociación Brasileña de Trasplantes de Órganos. Se comparó el número de donantes y trasplantes de abril a junio de 2020 con el mismo período de 2019 y el primer trimestre de 2020. Resultados El primer semestre de 2020, Ceará registró 72 donantes efectivos. De estos, 17 (23,6%) en el segundo trimestre. De 352 trasplantes realizados en el primer semestre de 2020, 37 (10.7%) fueron realizados en el segundo trimestre. En comparación al período de abril a junio de 2019, hubo reducción de 67,9% y 89,3% en el número de donantes y trasplantes, respectivamente, en el mismo período de 2020. Conclusión El número de donantes y trasplantes en Ceará mostró importante disminución en los tres meses siguientes al decreto pandémico COVID-19, especialmente las modalidades renal, cardíaca y córneas.

Objective To describe organ donations and transplants in Ceará state, Brazil, following the declaration of the COVID-19 pandemic. Methods This was a descriptive study using data from the Brazilian Organ Transplantation Association. The number of donors and transplants from April to June 2020 was compared to the same period in 2019 and to the first quarter of 2020. Results In the first half of 2020, the state registered 72 effective donors, just 17 (23.6%) of whom related to the second quarter. Of the 352 transplants in the first half of 2020, 37 (10.7%) were performed in the second quarter. Compared with the period from April to June 2019, there was a reduction of 67.9% and 89.3% in the number of donors and transplants, respectively, in the same period of 2020. Conclusion The number of donors and transplants in Ceará showed an important fall in the three months following the declaration of the COVID-19 pandemic, especially for kidney, heart and cornea transplants.

Fall in organ donations and transplants in Ceará in the COVID-19 pandemic: a descriptive study, April - June 2020. / Declínio nas doações e transplantes de órgãos no Ceará durante a pandemia da COVID-19: estudo descritivo, abril a junho de 2020.

OBJECTIVE: To describe organ donations and transplants in Ceará state, Brazil, following the declaration of the COVID-19 pandemic. METHODS: This was a descriptive study using data from the Brazilian Organ Transplantation Association. The number of donors and transplants from April to June 2020 was compared to the same period in 2019 and to the first quarter of 2020. RESULTS: In the first half of 2020, the state registered 72 effective donors, just 17 (23.6%) of whom related to the second quarter. Of the 352 transplants in the first half of 2020, 37 (10.7%) were performed in the second quarter. Compared with the period from April to June 2019, there was a reduction of 67.9% and 89.3% in the number of donors and transplants, respectively, in the same period of 2020. CONCLUSION: The number of donors and transplants in Ceará showed an important fall in the three months following the declaration of the COVID-19 pandemic, especially for kidney, heart and cornea transplants.

Decline in organ donations and transplants in Ceará in the COVID-19 pandemic: a descriptive study, April ­ June 2020 / Disminución de donaciones y trasplantes de órganos en Ceará en la pandemia COVID-19: un estudio descriptivo, abril ­ junio de 2020 / Declínio nas doações e transplantes de órgãos no Ceará durante a pandemia da COVID-19: estudo descritivo, abril ­ junho de 2020

Objective: To describe organ donations and transplants in Ceará, Brazil, after the COVID-19 pandemic decree. Methods: Descriptive study using data from the Brazilian Organ Transplantation Association. The number of donors and transplants from April to June 2020 was compared to the same period in 2019 and the first quarter of 2020. Results: In the first half of 2020, the state registered 72 effective donors. Of these, 17 (23.6%) in the second quarter. Of the 352 transplants in the first half of 2020, 37 (10.7%) occurred in the second quarter. Compared the period from April to June 2019, there was a reduction of 67.9% and 89.3% in the number of donors and transplants, respectively, in the same period of 2020. Conclusion: The number of donors and transplants in Ceará showed an important decline in the three months following the COVID-19 pandemic decree, especially for kidney, heart and corneal transplants.

Objetivo: Descrever as doações e os transplantes de órgãos no Ceará, Brasil, após a declaração da pandemia da COVID-19. Métodos: Estudo descritivo, com dados da Associação Brasileira de Transplantes de Órgãos. O número de doadores e transplantes do período de abril a junho de 2020 foi comparado ao mesmo período de 2019 e ao primeiro trimestre de 2020. Resultados: No primeiro semestre de 2020, o estado registrou 72 doadores efetivos. Destes, 17 (23,6%) no segundo trimestre. Dos 352 transplantes do primeiro semestre de 2020, 37 (10,7%) foram realizados no segundo trimestre. Em comparação ao período de abril a junho de 2019, houve redução de 67,9% e 89,3% no número de doadores e transplantes, respectivamente, no mesmo período de 2020. Conclusão: Os números de doadores e transplantes do Ceará apresentaram importante declínio nos três meses seguintes ao decreto da pandemia da COVID-19, especialmente os das modalidades de rim, coração e córneas.

Outcome Domains, Outcome Measures, and Characteristics of Randomized Controlled Trials Testing Nonsurgical Interventions for Osteoarthritis.

OBJECTIVE: Core outcome set (COS) is the minimum set of outcome domains that should be measured and reported in clinical trials. We analyzed outcome domains, prevalence of use of COS published by Outcome Measures in Rheumatology (OMERACT) initiative, outcome measures for outcome domains recommended by OMERACT COS, duration and size of randomized controlled trials (RCT) testing nonsurgical interventions for osteoarthritis (OA). METHODS: We searched PubMed and analyzed RCT about nonsurgical interventions for OA published from June 2012 to June 2017. We extracted data about trial type, use of OMERACT COS, efficacy outcome domains, safety outcome domains, outcome measures used for COS assessment, duration, and sample size. RESULTS: Among 334 analyzed trials, complete OMERACT-recommended COS was used by 14% of trials. Higher median prevalence of using OMERACT COS was found in trials explicitly described as phase III, and trials of pharmacological interventions with followup ≥ 1 year, but both with wide range of COS usage. Trialists used numerous different outcome measures for analyzing core outcome domains: 50 different outcome measures for pain, 74 for physical function, 9 for patient's global assessment, and 5 for imaging. CONCLUSION: Suboptimal use of recommended COS and heterogeneity of outcome measures is reducing quality and comparability of OA trials and hinders conclusions about efficacy and comparative efficacy of nonsurgical interventions. Interventions for improving study design of trials in this field would be beneficial.

Clinical Characteristics and Outcomes of Kidney Transplantation under Urgency Priority Condition.

BACKGROUND: In several countries, patients with end-stage renal disease who are ineligible for dialysis are considered urgency priority (UP) for kidney transplantation (KT) through distinct allocation rules. There are scarce published data on clinical features and outcomes after KT of these patients. METHODS: We retrospectively reviewed and compared demographic and clinical pretransplant characteristics and outcomes after KT of all patients transplanted under UP allocation in a single Brazilian transplant center from January 10 to March 16 (n = 74) and 1: 1 patients transplanted under standard allocation in the same period (n = 74). A propensity score (PS) matching analysis was performed to evaluate risk factors for death-censored graft loss. RESULTS: UP KT group presented higher percentage of women (58.1 vs. 33.8%, p = 0.005), higher class I (22.2 ± 32.9 vs. 13.1 ± 25.3%, p = 0.027) and class II panel reactive antibodies (11.5 ± 24 vs. 5.2 ± 19.1%, p = 0.002), higher HLA mismatches (4.9 ± 0.9 vs. 3.7 ± 1.2, p < 0.001), higher percentage of retransplants (27 vs. 4.1%, p < 0.001), and spent longer time on dialysis off the waiting list (WL; 54.5 ± 52.5 vs. 31.2 ± 29.0 months, p = 0.03). After transplantation, UP KT patients presented longer hospital stay (29.3 ± 35.7 vs. 18.5 ± 19.5 days, p = 0.003) and inferior death-censored graft survival at 3 years (82 vs. 95.8%, log rank = 0.016), with 33.3% of graft losses due to vascular thrombosis. In PS-matched multivariable analysis, UP status hazard ratios (HR 4.791, 95% CI 1.052-21.722, p = 0.042) and donor age (HR 1.071, 95% CI 1.003-1.145, p = 0.041) were independent risk factors for death-censored graft loss. CONCLUSION: Patients transplanted under UP status remained a longer time on dialysis off the WL, suggesting that long-term dialysis led to exhaustion of accesses. After transplantation, outcomes are inferior and UP status was a risk factor for graft loss. These results point to the need for local policies to encourage and monitor the early referral to KT.

Exame citopatológico de câncer de colo do útero: acesso e qualidade no atendimento / Pap smear: profile of women and assisted quality assessment and access to the service / Citología vaginal de cáncer cervical: acceso y calidad en llamada

Objetivo: Conocer el acceso y la calidad al Papanicolaou a partir de la mirada de las usuarias y de la cobertura de los exámenes realizados. Métodos: Investigación exploratoria con abordaje cualitativo se utilizó para recolección de datos la entrevista semiestructurada con 30 mujeres y para los datos secundarios, el SISCOLO. Resultados: Las participantes en su mayoría tenían entre 35 a 44 años, iniciado vida sexual antes de los 19 años y 30% presentaban conocimiento inadecuado sobre el examen. El análisis de contenido temático resultó en tres categorías: acceso/ conocimiento; Sentimientos, ética y confidencialidad/información; La acogida y la evaluación de la asistencia prestada por la enfermera. Conclusión: El largo tiempo de espera y la falta de confidencialidad en los resultados (92%) son elementos dificultadores del acceso. Las principales lesiones fueron las de bajo grado y entre las mujeres de 25 a 29 años. Por lo tanto, el rastreo para el cáncer de cuello de útero se mostró poco efectivo, desigual y con baja cobertura

Objective: To know the access and the quality to the Papanicolaou from the users' perspective and the coverage of the tests performed. Methods: Exploratory research with a qualitative approach was used to collect data on the semi-structured interview with 30 women and for the secondary data, SISCOLO. Results: The participants were mostly between 35 and 44 years of age, started sexual life before age 19 and 30% had inadequate knowledge about the exam. The analysis of thematic content resulted in three categories: access/knowledge; Feelings, ethics and confidentiality/information; and assessment of care provided by the nurse. Conclusion: Long wait times and lack of confidentiality in results (92%) are difficult to access. The main lesions were those of low grade and among women aged 25 to 29 years. Therefore, the screening for cervical cancer was shown to be ineffective, unequal and with low coverage

Objetivo: Conhecer o acesso e a qualidade ao Papanicolaou a partir do olhar das usuárias e da cobertura dos exames realizados. Método: Pesquisa exploratória com abordagem qualitativa. Utilizou-se, para coleta de dados, a entrevista semi estruturada com 30 mulheres e,para os dados secundários, o SISCOLO. Resultados: As participantes, em sua maioria, tinham entre 35 a 44 anos, iniciado vida sexual antes dos 19 anos e 30% apresentavam conhecimento inadequado sobre o exame. A análise de conteúdo temática resultou em três categorias: acesso/conhecimento; sentimentos, ética e confidencialidade/informação; acolhimento e avaliação da assistência prestada pela enfermeira. Conclusão: O longo tempo de espera e a falta de confidencialidade nos resultados (92%) são elementos dificultadores do acesso. As principias lesões foram as de baixo grau e entre as mulheres com 25 a 29 anos. Portanto, o rastreamento para o câncer de colo do útero mostrou-se pouco efetivo, desigual e com baixa cobertura

Núcleos hospitalares de vigilância epidemiológica no Brasil: uma revisão integrativa de literatura científica / Hospital heads of epidemiological surveillance in Brazil: an integrative review of scientific literature / Núcleos hospitalarios de vigilancia Epidemiológica en Brasil: una revisión integradora de literatura científica

Justificativa e Objetivos: O Brasil vem apresentando uma intensa transição epidemiológica, diante desse novo cenário, o Ministério da Saúde decidiu criar os Núcleos Hospitalares de Epidemiologia (NHE) em hospitais de referência no Brasil. Levando em consideração esse cenário suscitaram-se inquietações no sentido de conhecer a funcionalidade dos NHE, avaliar a partir de uma revisão de literatura o funcionamento dos Núcleos de Vigilância Epidemiológica no Brasil. Conteúdo: Realizou-se uma revisão integrativa da bibliografia brasileira do tipo qualitativa, realizada a partir de 10 publicações científicas em língua Portuguesa entre os anos de 2007 a 2017, indexadas na BVS e BDTD no período de janeiro a março de 2018. Conclusão: Os Núcleos Hospitalares de Epidemiologia destacam-se como um setor de referência para a realização da notificação compulsória e para o manejo com as situações de doenças e agravos de notificação compulsória dentro do ambiente hospitalar. Apesar de sua importância neste contexto, verificou-se o não cumprimento das exigências e competências estabelecidas na portaria 2.529/2004.(AU)

Background and Objectives: Brazil has been presenting an intense epidemiological transition, concerning this new scenario, the Ministry of Health decided to create through Administrative Rule No. 2,529 from November 23rd, 2004, the Hospital Epidemiology Centers in reference hospitals (NHE) in Brazil. Regarding this, there were concerns about the functionality of NHE. From the review of literature, to evaluate the functioning of Epidemiological Surveillance Nucleus in Brazil. Content: An integrative review of the qualitative Brazilian bibliography was carried out, based on 10 scientific publications published in Portuguese between 2007 and 2017, indexed in VHL and BDTD database libraries in the period from January to March 2018. Conclusion: NHE's stand out as a sector of reference for the accomplishment of compulsory notification and for handling diseases situations and compulsory notification aggravations within the hospital environment. On the other hand, we still face the non-compliance of the demands and competences established in Administrative Rule number 2529/2004.(AU)

Justificación y Objetivos: Brasil viene presentando una intensa transición epidemiológica. Delante de ese nuevo escenario, el Ministerio de Salud decidió crear, a través del Decreto n° 2.529 de 23 de noviembre de 2004, los Núcleos Hospitalarios de Epidemiologia en hospitales de referencia en Brasil. Teniendo en cuenta ese escenario, se han suscitado inquietudes en el sentido de conocer la funcionalidad de los NHE, evaluar, a partir de una revisión de literatura, el funcionamiento de los Núcleos de Vigilancia Epidemiológica en Brasil. Contenido: Se ha llevado a cabo una revisión integradora de la bibliografía brasileña de tipo cualitativa, realizada a partir de 10 publicaciones científicas, publicadas en lengua portuguesa entre los años de 2007 a 2017, e indexadas en las bibliotecas de bases de datos BVS y BDTDen el período de enero a marzo de 2018. Conclusión: Los NHE se destacan como un sector de referencia para la realización de la notificación compulsoria y para el manejo de las situaciones, enfermedades y agravios de dicha notificación dentro del ambiente hospitalario. Por otro lado, nos deparamos aún con el incumplimiento de las exigencias y competencias establecidas en el Decreto 2.529/2004.(AU)

Trypanosoma cruzi seroprevalence among solid organ donors in Ceará State, Brazil.

INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

Trypanosoma cruzi seroprevalence among solid organ donors in Ceará State, Brazil

Abstract INTRODUCTION: The transmission of Chagas disease (CD) through blood transfusion, organ transplantation, and oral transmission has gained greater visibility as a result of intensified vector control activities in endemic regions and to control CD in non-endemic regions. In Brazil, Ceará is one of the states that perform the most organ transplants. Therefore, the objective of this study was to assess the prevalence of Trypanosoma cruzi infection in organ donor candidates. METHODS: A retrospective analysis was performed on data from potential organ donors at the Center of Transplantation of the State of Ceará from 2010 - 2015. RESULTS: Data from a total of 2,822 potential donors were obtained, of which 1,038 were effective donors and 1,784 were excluded, likely due to lack of family authorization or medical contraindication. The prevalence of T. cruzi infection among these potential donors was 1.3% (n = 29). The majority of infected donors were males aged 41 - 60 years, residing in the interior of the state. Interestingly, 72.4% (n = 21) had positive or inconclusive serology for additional infections, such as cytomegalovirus, hepatitis B and C, and toxoplasmosis. Probability analysis revealed that stroke was the most common cause of death among potential donors with CD. CONCLUSIONS: There was a high prevalence of CD and other coinfections among potential solid organ donors in Ceará, and statistical tests have shown that these individuals are at increased risk of stroke when compared to potential non-reactive donors. This work highlights the importance of screening DC infection in potential donors.

Representações sociais de discentes sobre o preservativo feminino / Social representations of students about the female condom

Objetivo: identificar as representações sociais de discentes de escolas públicas sobre o preservativo feminino. Método: trata-se de estudo qualitativo, exploratório e descritivo, apoiado na Teoria das Representações Sociais, com 94 estudantes do ensino médio de escolas públicas, utilizou-se a Técnica de Associação Livre de Palavras com o termo indutor "preservativo feminino", a análise dos dados deu-se por meio do software de análise textual IRAMUTEQ que originou uma figura de similitudes e a nuvem de palavras. Resultados: as discentes representaram o preservativo feminino como possibilidade de "sexo seguro" e importante tecnologia que favorece a autonomia, a prevenção, a proteção de infecções sexualmente transmissíveis e da gravidez não planejada, mas a ausência de familiaridade com o método e as relações de gênero foram identificadas como fatores que dificultam a utilização. Conclusão: constatou-se que o preservativo feminino é importante para 'prevenção de doenças e proteção contra a gravidez', isso implica no processo teórico prático acerca da importância da educação em saúde e aumento da adesão do preservativo feminino nas relações sexuais.(AU)

Analysis of Machine Learning Algorithms for Diagnosis of Diffuse Lung Diseases.

Computational Intelligence Re-meets Medical Image Processing A Comparison of Some Nature-Inspired Optimization Metaheuristics Applied in Biomedical Image Registration BACKGROUND: Diffuse lung diseases (DLDs) are a diverse group of pulmonary disorders, characterized by inflammation of lung tissue, which may lead to permanent loss of the ability to breathe and death. Distinguishing among these diseases is challenging to physicians due their wide variety and unknown causes. Computer-aided diagnosis (CAD) is a useful approach to improve diagnostic accuracy, by combining information provided by experts with Machine Learning (ML) methods. OBJECTIVES: Exploring the potential of dimensionality reduction combined with ML methods for diagnosis of DLDs; improving the classification accuracy over state-of-the-art methods. METHODS: A data set composed of 3252 regions of interest (ROIs) was used, from which 28 features were extracted per ROI. We used Principal Component Analysis, Linear Discriminant Analysis, and Stepwise Selection - Forward, Backward, and Forward-Backward to reduce feature dimensionality. The feature subsets obtained were used as input to the following ML methods: Support Vector Machine, Gaussian Mixture Model, k-Nearest Neighbor, and Deep Feedforward Neural Network. We also applied a Deep Convolutional Neural Network directly to the ROIs. RESULTS: We achieved the maximum reduction from 28 to 5 dimensions using LDA. The best classification results were obtained by DFNN, with 99.60% of overall accuracy. CONCLUSIONS: This work contributes to the analysis and selection of features that can efficiently characterize the DLDs studied.

Guidelines for the assessment and acceptance of potential brain-dead organ donors. / Diretrizes para avaliação e validação do potencial doador de órgãos em morte encefálica.

Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors.

Diretrizes para avaliação e validação do potencial doador de órgãos em morte encefálica / Guidelines for the assessment and acceptance of potential brain-dead organ donors

RESUMO O transplante de órgãos é a única alternativa para muitos pacientes portadores de algumas doenças terminais. Ao mesmo tempo, é preocupante a crescente desproporção entre a alta demanda por transplantes de órgãos e o baixo índice de transplantes efetivados. Dentre as diferentes causas que alimentam essa desproporção, estão os equívocos na identificação do potencial doador de órgãos e as contraindicações mal atribuídas pela equipe assistente. Assim, o presente documento pretende fornecer subsídios à equipe multiprofissional da terapia intensiva para o reconhecimento, a avaliação e a validação do potencial doador de órgãos.

ABSTRACT Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors.

COX-2 plays a role in angiogenic DBA(+) uNK cell subsets activation and pregnancy protection in LPS-exposed mice.

INTRODUCTION: Although uterine Natural Killer (uNK) cells have cytoplasmic granules rich in perforin and granzymes, these cells do not degranulate in normal pregnancy. DBA lectin(+) uNK cells produce angiogenic factors which stimulate remodeling of uterine arterioles to increase blood flow within the growing feto-placental unit. We sought to investigate the importance of COX-2 on mouse pregnancy inoculated with Gram-negative bacteria Lipopolysaccharide (LPS) by treating with a selective COX-2 inhibitor (nimesulide). METHODS: We have combined histochemical, immunohistochemical, stereological, morphometric, behavioral, and litter analyses to investigate mouse pregnancy inoculated with LPS with or without pre-treatment with nimesulide 30 min before LPS injections, focusing on DBA(+) uNK cell response and viability of the pregnancy. RESULTS: LPS caused sickness behavior, an immature DBA(+) uNK influx, decreased mature DBA(+) uNK cell numbers, and triggered a new DBA(low) uNK appearance. These effects of LPS, except the sickness behavior, were prevented by nimesulide. COX-2 inhibition also prevented the down-regulation of uNK perforin and spiral arteriole α-actin expression stimulated by LPS. While the litter size from Nimesulide + LPS-treated mothers was significantly smaller compared to those from LPS-treated group, nimesulide alone showed no effect on the offspring. DISCUSSION: Collectively, our data indicate that COX-2 changes angiogenic DBA(+) uNK cells in order to protect mouse pregnancy after LPS injection.