Perfil epidemiológico de internações por doenças infecciosas e bacterianas em menores de 5 anos, de 2017 a 2021 / Perfil epidemiológico de las hospitalizaciones por enfermedades infecciosas y bacterianas más prevalentes en niños menores de 5 años, de 2017 a 2021 / Epidemiological profile of hospitalizations for the most prevalent infectious and bacterial diseases in children under 5 years, from2017 to 2021

Introdução:A internação representa um impacto considerável na vida de qualquer pessoa, podendo tomar proporções ainda maiores quando se trata de uma criança. A impossibilidade de realizar sua rotina, como brincar e ir à escola, faz com que a internação infantil assuma um contexto marcante.Dito isso, nota-se que grande parte dessas internações é evitável, sendo denominadasde Internações por Condições Sensíveis à Atenção Primária. Dessa forma, o atendimento ambulatorial de qualidade poderia resolver a maioria das enfermidades infantis, evitando esse desfecho.Objetivo:Elaborar um perfil epidemiológico de internações por doenças infecciosas e bacterianas mais prevalentes em menores de 5 anos, de 2017 a 2021, no Brasil. Metodologia:A pesquisa em questão se trata de um estudo ecológico de série temporal,elaborado através de informações coletadas por vias secundárias.Os dados foram coletados na plataforma DataSUS e no Sistema de Informação Hospitalar. Posteriormente, os dados foram processados e armazenados no aplicativo Microsoft Excel®, onde foram tratados e selecionados de acordo com sua relevância para a pesquisa. Resultados:Constata-se que a faixa etária situadaabaixo do primeiro ano de vidaapresenta um grau de hospitalização superior ao dascrianças que vãodo primeiro ao quarto ano completo.Quanto àfrequência relativa, depreende-se que diarreia e gastroenterite de origem infecciosa presumível apresentaram o maior índice de prevalência em relação às demais patologias, com o maior número chegando a 23,8% no ano de 2017 e o menor situando-se na faixa de 13,22% em 2020. Conclusões: Apesar do avanço na Atenção Primária à Saúde e da cobertura pré-natal, a assistência ainda é deficitária, sendo necessários mais investimentos na área e o fomento de políticas públicas que abranjam essa população (AU).

Introduction: Hospitalization represents a considerable impact on the life of any person, and can even take on even greater proportions when it comes to a child. The impossibility of realizing their routine, such as playing and going to school, means that hospitalization during childhood takes ona remarkable context. That said, it is noted that mostofthese hospitalizations are avoidable,and are called Ambulatory Care Sensitive Conditions. Thus, quality ambulatory care could solve most childhood illnesses, avoiding this outcome.Objective:To elaborate an epidemiological profile of hospitalizations for the most prevalent infectious and bacterial diseases in children under 5 years of age,from 2017 to 2021,in Brazil. Methodology: The research in question is an ecological study of time series, elaborated through information collected through secondary data sources. Data were collected from the DataSUS platform and the Hospital Information System. Subsequently, data were processed and stored in Microsoft Excel® application, where they were managedand selected according to their relevance to the research. Results:It is observed that the age group below the first year of life presents a higher degree of hospitalization thanthat of children ranging from the first to the fourth year. As for the relative frequency, it can be seen that diarrhea and gastroenteritis of presumable infectious origin had the highest prevalence rate compared to other pathologies, with the highest number reaching 23.8% in 2017 and the lowest being in the range of 13.22% in 2020. Conclusions: Despite the advances in Primary Health Care and prenatal coverage, assistance is still deficient, requiring more investments in the area and the promotion of public policies that cover this population (AU).

Introducción: La hospitalización representa un impacto considerable en la vida de cualquier persona, quepuede adquirir proporciones aún mayores cuando se trata de un niño. La imposibilidadde realizar su rutina, como jugar e ir al colegio, hace que la hospitalización infantiltengaun contexto notable. Dicho esto, cabe señalar que una gran parte de estas hospitalizaciones son evitables, denominándose Hospitalizaciones por Condiciones Sensibles a la Atención Ambulatoria. Así pues, una atención ambulatoria de calidad podría resolver la mayoría de las enfermedades infantiles, evitando este desenlace. Objetivo: Elaborar un perfil epidemiológico de las hospitalizaciones por enfermedades infecciosas y bacterianas más prevalentes en niños menores de 5 años, de 2017 a 2021, en Brasil. Metodología: La investigación en cuestión es un estudio ecológico de series temporales, elaborado a partir de información recogida por vías secundarias. Los datos se recogieron de la plataforma DataSUS y del Sistema de Información Hospitalaria. Posteriormente, los datos se procesaron y almacenaron en la aplicación Microsoft Excel®, donde se trataron y seleccionaron en función de su relevancia para la investigación. Resultados: Se observa que el grupo de edad inferior al primer año de vida presenta un mayor grado de hospitalización que los niños del primero al cuarto año completo. En cuanto a la frecuencia relativa, se puede inferirque la diarreay lagastroenteritis presumible origen infeccioso tuvieron la tasa de prevalencia más alta en relación con las demáspatologías, siendola cifra más alto el 23,8% en 2017 y lamás bajael rango del 13,22% en el 2020. Conclusiones: A pesar de los avances en la Atención Primariade Salud y en la cobertura prenatal, la asistencia aún es deficiente, por lo que se requieren mayoresinversiones en el área y la promoción de políticas públicas que cubran a esta población (AU).

Screening and hospitalization of breast and cervical cancer in Brazil from 2010 to 2022: A time-series study.

In Brazil, during the pandemic caused by COVID-19, screening for breast and cervical cancers was postponed or interrupted due to the prevailing health conditions. These neoplasms, however, are responsible for high morbidity and mortality among women in Brazil and have a major impact on the quality of life of this population and public health. Thus, this study aims to evaluate the epidemiological behavior of hospitalization for cervical and breast cancer in Brazilian women, as well as the trend of screening tests of breast and cervical cancer in the years 2010 to 2022 according to the regions of Brazil. This is ecological research of time series, based on secondary data obtained from information systems of the country, about hospital admissions for breast and cervical cancer and screening methods used for these tumors. The data were analyzed in the Joinpoint Regression Program, to obtain the linear regression and temporal analysis of the variables. As a result, between 2010 and 2022, the rates of mammography varied from 36 to 71 exams, while in the pap smear, the variations were 126 and 226 cytopathological exams per 1000 women. Hospitalizations for these cancers peaked in 2019, with 48 hospitalizations for cervical cancer per 100,000 women and 147 hospitalizations for breast cancer for the same population. For both, in the pandemic years, between 2020 and 2022, there is a decrease in Brazil and in all its regions. As for the tracking of these diseases, it was observed that the performance of mammograms and preventive tests showed a similar behavior, in which there is a higher supply of these tests until 2019 and a drop during the pandemic period. This leads to the conclusion that even though Brazil has several policies for the screening of these diseases, there is still instability in the offering of these tests and that there was instability in this area during the pandemic.

Absenteísmo e suas causas no contexto da saúde dos trabalhadores em oncologia: revisão integrativa / Absenteeism and it's causes in the context of oncology workers health: integrative review / Ausentismo y sus causas en el contexto de la salud de los trabajadores en oncología: revisión integradora

O ritmo elevado de trabalho, somado às demandas físicas e psicológicas, levam ao estresse nos contextos pessoal e laboral, o que faz com que as pessoas se afastem de seus ambientes de trabalho como um dos motivos apontados para a incapacidade para o trabalho. Essa realidade tem sido amplamente observada no ambiente hospitalar, possivelmente associada a problemas relacionados à fadiga da compaixão, geralmente em serviços de oncologia. Dessa forma, a motivação deste estudo foi compreender os motivos do absenteísmo em oncologia, e se esse episódio ocorre devido ao processo de trabalho. Objetivo:Investigar as causas do absenteísmo entre profissionais expostos a riscos ambientais e biopsicossociais em hospitais oncológicos. Metodologia:Trata-se de uma revisaointegrativa sobre o tema do absenteísmo, o que indica novos rumos para futuras investigações. Foi realizada uma revisão da literatura com base em três pilares: 1) O processo de trabalho multidisciplinar em oncologia e o risco de adoecimento; 2) O absentismo dos profissionais de saúde em oncologia; 3) O problema da pandemia de COVID-19 para os trabalhadores da saúde. Posteriormente, foram escolhidos os descritores e a partir deles foram realizadas buscas nas bases de dados eletrônicas PUBMED, LILACS e SCOPUS. Resultados:Obteve-se um resultado de dez estudos. Constatou-se que os principais transtornos, que levam à incapacidade para o trabalho e, por sua vez, ao absenteísmo, foram de origem psíquica (depressão e Síndrome de Burnout) e de origem musculoesquelética. Conclusões:A dupla jornada de trabalho foi citada como fator facilitador para o aparecimento desses transtornos, onde tais cenários não incapacitam o trabalhador para o desenvolvimento de suas atividades, que podem ser temporárias ou permanentes (AU).

The high pace of work, added to the physical and psychological demands, lead to stress in personal and work contexts, which causes people to withdraw from their work environments as one of the reasons mentioned for incapacitation for work. This reality hasbeen widely observed in the hospital setting, possibly associated with problems related to compassion fatigue, usually in oncology services. The motivation of this study was to understand the reasons for absenteeism in oncology, and if this episode occursdue to the work process. Objective:Investigating the causes of absenteeism among professionals exposed to environmental and biopsychosocial risks in cancer hospitals. Methodology:This is a integrative review on the theme of absenteeism, which indicates new directions for future investigations. A literature review was carried out based on three pillars: 1) The multidisciplinary work process in oncology and the risk of illness; 2) The absenteeism of health professionals in oncology; 3) The problem of the COVID-19 pandemic for health workers. Subsequently, the descriptors were chosen and based on them, searches were carried out in the electronic databases PUBMED, LILACS and SCOPUS. Results:A result of ten studies was obtained. It was found that the main disorders, which lead to incapacity for work and, in turn, absenteeism, were of psychic origin (depression and Burnout Syndrome) and of musculoskeletal origin. Conclusions: Texto das conclusões em inglêsThe double work shift was cited as a facilitating factorfor the appearance of these disorders, where such scenarios do not incapacitate the worker to develop their activities, which may be temporary or permanent (AU).

El alto ritmo de trabajo, sumado a las exigencias físicas y psicológicas, genera estrés en el contexto personal y laboral, lo que provoca que las personas se alejen de sus ambientes laborales como una de las razones esgrimidas para la incapacidad detrabajar. Esta realidad ha sido ampliamente observada en el ambiente hospitalario, posiblemente asociada a problemas relacionados con la fatiga por compasión, generalmente en los servicios de oncología. Así, la motivación de este estudio fue comprender las razones del ausentismo en oncología y si este episodio ocurre debido al proceso de trabajo. Objetivo:Investigar las causas del ausentismo entre profesionales expuestos a riesgos ambientales y biopsicosociales en hospitales oncológicos. Metodología:Se trata deuna revisión integradorasobre el tema del ausentismo, que indica nuevos rumbos para futuras investigaciones. Se realizó una revisión de la literatura basada en tres pilares: 1) El proceso de trabajo multidisciplinario en oncología y el riesgo de enfermedad; 2) El ausentismo de los profesionales de la salud en oncología; 3) El problema de la pandemia de COVID-19 para los trabajadores de la salud. Posteriormente se eligieron los descriptores y a partir de ellos se realizaron búsquedas en las bases de datos electrónicas PUBMED, LILACS y SCOPUS. Resultados:Se obtuvo un resultado de diez estudios. Se encontró que los principales trastornos que conducen a la incapacidad para trabajar y, a su vez, al ausentismo, fueron de origen psíquico (depresión y síndrome deBurnout) y de origen músculoesquelético. Conclusiones:La doble jornada laboral fue citada como un factor facilitador para la aparición de estos trastornos, dondedichos escenarios no incapacitan al trabajador para el desarrollo de sus actividades, las cuales pueden ser temporales o permanentes (AU).

A study on occupational health and safety.

BACKGROUND: This study aimed to evaluate and describe the indicators of occupational health, with a focus on the medical expertise and periodic medical examination. METHODS: This is exploratory-descriptive, cross-sectional, documentary, quantitative, and retrospective research, in the historical series: 2011 to 2015. RESULTS: The number of lost days of work per worker and the frequency of licenses increased despite the decrease in the Absenteeism Duration Index and stabilization of the Frequency of Medical Workers. As for the adhesion of the workers to the Periodic Medical Examinations, it was decreasing, with a higher percentage in the year 2012 (35.3%). During the analyzed period, 5,186 workers performed the Periodic Medical Examination, and the majority (60.6%) presented non-ideal weight, 41.1% were sedentary, 33.2% had dyslipidemia, 29.0% were alcoholic, 3.2% were smokers, 5.9% had diabetics, and 16.4% reported high noise in the workplace, 27.8% inadequate lighting and 35.9% inadequate work furniture. CONCLUSIONS: The results highlight the need to maintain and strengthen the Worker Health and Safety Policy with emphasis on surveillance, aiming at the promotion and protection of the health of the workers, based on the elaboration of the epidemiological profile of health and, consequently, the implementation of positive impact strategies.

Epidemiological behavior of the COVID-19 contamination curve in Brazil: Time-series analysis.

Brazil is experiencing the greatest episode of sanitary collapse ever known in the country's history. Therefore, the relevance of this study is highlighted for the scientific advance of the epidemiological behavior of the virus in Brazil, enabling the development of analyses and discussions on the factors that influenced the high rates of contamination by SARS-CoV-2 in the country. Given the above, this study aims to analyze the epidemiological behavior of the COVID-19 contamination curve by epidemiological weeks (EW), in the years 2020-2021, in Brazil. This is an ecological study of time series, prepared using information collected through secondary means. The country of origin of the study is Brazil, and its main theme is the number of people infected during the COVID-19 pandemic, this being the dependent variable of the study. The data has been analyzed from February 23, 2020, when the first case was confirmed in Brazil, to January 1, 2022. In 2021, the country's graph shows an exponential growth, reaching a peak of approximately 250 new cases per 100,000 inhabitants in the 12th EW. This data represents the highest rate of the pandemic in Brazil, and did not vary significantly for the next twelve weeks. Thus, it was identified that Brazil was severely impacted by the new coronavirus, considering the high rates of confirmed cases of the virus in the country, the low adherence of the population to preventive measures, the late start of mass vaccination in the Brazilian population, and the lack of structure in the health system, which was not appropriately prepared for the high demand generated by COVID-19.

New Prospects in Neutering Male Animals Using Magnetic Nanoparticle Hyperthermia.

Controlling populations of free-roaming dogs and cats poses a huge challenge worldwide. Non-surgical neutering strategies for male animals have been long pursued, but the implementation of the procedures developed has remained limited to date. As submitting the testes to high temperatures impairs spermatogenesis, the present study investigated localized application of magnetic nanoparticle hyperthermia (MNH) to the testicles as a potential non-surgical sterilization method for animals. An intratesticular injection of a magnetic fluid composed of manganese-ferrite nanoparticles functionalized with citrate was administered followed by testicle exposure to an alternate magnetic field to generate localized heat. Testicular MNH was highly effective, causing progressive seminiferous tubule degeneration followed by substitution of the parenchyma with stromal tissue and gonadal atrophy, suggesting an irreversible process with few side effects to general animal health.

Predictive Model for Delivery Efficiency: Erythrocyte Membrane-Camouflaged Magnetofluorescent Nanocarriers Study.

Delivery efficiencies of theranostic nanoparticles (NPs) based on passive tumor targeting strongly depend either on their blood circulation time or on appropriate modulations of the tumor microenvironment. Therefore, predicting the NP delivery efficiency before and after a tumor microenvironment modulation is highly desirable. Here, we present a new erythrocyte membrane-camouflaged magnetofluorescent nanocarrier (MMFn) with long blood circulation time (92 h) and high delivery efficiency (10% ID for Ehrlich murine tumor model). MMFns owe their magnetic and fluorescent properties to the incorporation of manganese ferrite nanoparticles (MnFe2O4 NPs) and IR-780 (a lipophilic indocyanine fluorescent dye), respectively, to their erythrocyte membrane-derived camouflage. MMFn composition, morphology, and size, as well as optical absorption, zeta potential, and fluorescent, magnetic, and magnetothermal properties, are thoroughly examined in vitro. We then present an analytical pharmacokinetic (PK) model capable of predicting the delivery efficiency (DE) and the time of peak tumor uptake (tmax), as well as changes in DE and tmax due to modulations of the tumor microenvironment, for potentially any nanocarrier. Experimental PK data sets (blood and tumor amounts of MMFns) are simultaneously fit to the model equations using the PK modeling software Monolix. We then validate our model analytical solutions with the numerical solutions provided by Monolix. We also demonstrate how our a priori nonmechanistic model for passive targeting relates to a previously reported mechanistic model for active targeting. All in vivo PK studies, as well as in vivo and ex vivo biodistribution studies, were conducted using two noninvasive techniques, namely, fluorescence molecular tomography (FMT) and alternating current biosusceptometry (ACB). Finally, histopathology corroborates our PK and biodistribution results.

In vivo magnetic nanoparticle hyperthermia: a review on preclinical studies, low-field nano-heaters, noninvasive thermometry and computer simulations for treatment planning.

Magnetic nanoparticle hyperthermia (MNH) is a promising nanotechnology-based cancer thermal therapy that has been approved for clinical use, together with radiation therapy, for treating brain tumors. Almost ten years after approval, few new clinical applications had appeared, perhaps because it cannot benefit from the gold standard noninvasive MRI thermometry technique, since static magnetic fields inhibit heat generation. This might limit its clinical use, in particular as a single therapeutic modality. In this article, we review the in vivo MNH preclinical studies, discussing results of the last two decades with emphasis on safety as a clinical criteria, the need for low-field nano-heaters and noninvasive thermal dosimetry, and the state of the art of computational modeling for treatment planning using MNH. Limitations to more effective clinical use are discussed, together with suggestions for future directions, such as the development of ultrasound-based, computed tomography-based or magnetic nanoparticle-based thermometry to achieve greater impact on clinical translation of MNH.

Noninvasive intratumoral thermal dose determination during in vivo magnetic nanoparticle hyperthermia: combining surface temperature measurements and computer simulations.

PURPOSE: Noninvasive thermometry during magnetic nanoparticle hyperthermia (MNH) remains a challenge. Our pilot study proposes a methodology to determine the noninvasive intratumoral thermal dose during MNH in the subcutaneous tumor model. METHODS: Two groups of Ehrlich bearing-mice with solid and subcutaneous carcinoma, a control group (n = 6), and a MNH treated group (n = 4) were investigated. Histopathology was used to evaluate the percentage of non-viable lesions in the tumor. MNH was performed at 301 kHz and 17.5 kA.m-1, using a multifunctional nanocarrier. Surface temperature measurements were obtained using an infrared camera, where an ROI with 750 pixels was used for comparison with computer simulations. Realistic simulations of the bioheat equation were obtained by combining histopathology intratumoral lesion information and surface temperature agreement of at least 50% of the pixel's temperature data calculated and measured at the surface. RESULTS: One animal of the MNH group showed tumor recurrence, while two others showed complete tumor remission (monitored for 585 days). Sensitivity analysis of the simulation parameters indicated low tumor blood perfusion. Numerical simulations indicated, for the animals with complete remission, an irreversible tissue injury of 91 ± 5% and 100%, while the one with recurrence had a lower value, 56 ± 7%. The computer simulations also revealed the in vivo heat efficiency of the nanocarrier. CONCLUSION: A new methodology for determining noninvasively the three-dimensional intratumoral thermal dose during MNH was developed. The method demonstrates the potential for predicting the long-term preclinical outcome of animals treated with MNH.

IR-780-Albumin-Based Nanocarriers Promote Tumor Regression Not Only from Phototherapy but Also by a Nonirradiation Mechanism.

IR-780 iodide is a fluorescent dye with optical properties in the near-infrared region that has applications in tumor detection and photothermal/photodynamic therapy. This multifunctional effect led to the development of theranostic nanoparticles with both IR-780 and chemotherapeutic drugs such as docetaxel, doxorubicin, and lonidamine. In this work, we developed two albumin-based nanoparticles containing near-infrared IR-780 iodide multifunctional dyes, one of them possessing a magnetic core. Molecular docking with AutoDock Vina studies showed that IR-780 binds to bovine serum albumin (BSA) with greater stability at a higher temperature, allowing the protein binding pocket to better fit this dye. The theoretical analysis corroborates the experimental protocols, where an enhancement of IR-780 was found coupled to BSA at 60 °C, even 30 days after preparation, in comparison to 30 °C. In vitro assays monitoring the viability of Ehrlich ascites carcinoma cells revealed the importance of the inorganic magnetic core on the nanocarrier photothermal-cytotoxic effect. Fluorescence molecular tomography measurements of Ehrlich tumor-bearing Swiss mice revealed the biodistribution of the nanocarriers, with marked accumulation in the tumor tissue (≈3% ID). The histopathological analysis demonstrated strong increase in tumoral necrosis areas after 24 and 72 h after treatment, indicating tumor regression. Tumor regression analysis of nonirradiated animals indicate a IR-780 dose-dependent antitumoral effect with survival rates higher than 70% (animals monitored up to 600 days). Furthermore, an in vivo photothermal therapy procedure was performed and tumor regression was also verified. These results show a novel insight for the biomedical application of IR-780-albumin-based nanocarriers, namely cancer therapy, not only by photoinduced therapy but also by a nonirradiation mechanism. Safety studies (acute oral toxicity, cardiovascular evaluation, and histopathological analysis) suggest potential for clinical translation.