Rastreamento da síndrome metabólica em participantesdo programa Universidade Aberta da Terceira Idade / Metabolic syndrome screening in the participantsat the Open University of the Third Age

Hábitos alimentares inadequados, sedentarismo e a maior expectativa de vida da população contribuem significativamente para a prevalência da síndrome metabólica. Essa doença predispõe uma pessoa a desenvolver diabetes mellitus tipo 2 e doenças cardiovasculares, as quais têm um amplo impacto na saúde pública, induzindo sobrecarga no sistema de saúde e reduzindo a qualidade de vida dos indivíduos afetados. A síndrome metabólica é uma doença multifatorial e está relacionada ao processo de envelhecimento, contudo, ainda há uma lacuna significativa, em termos de estudos, sobre a prevalência da condição em populações idosas. Nesse contexto, o presente estudo objetivou rastrear a prevalência da síndrome metabólica em participantes da Universidade Aberta da Terceira Idade (UNATI), localizada em Francisco Beltrão, Paraná. Os critérios diagnósticos de síndrome metabólica abordados nesta pesquisa incluem: circunferência abdominal ≥ 90 cm para homens e ≥ 80 cm para mulheres, triglicerídeos ≥ 150 mg/dL, HDL ≤ 40 mg/dL para homens e ≤ 50 mg/dL para mulheres, pressão arterial sistólica ≥ 130 mmHg e/ou pressão arterial diastólica ≥ 85 mmHg ou estar em farmacoterapia para hipertensão, além de glicemia de jejum ≥ 100 mg/dL ou estar em tratamento farmacológico para diabetes. Um total de 44 idosos foram avaliados, apresentando uma média de idade de 66,9 ± 7,1 anos, com uma predominância de mulheres (88%). Os resultados revelaram uma prevalência alarmante de síndrome metabólica, atingindo 36,4% da amostra estudada. Além disso, observou-se uma alta prevalência de condições associadas, como hipertensão arterial (67,2%), sobrepeso (58,6%) e obesidade visceral (31%). Esses achados ressaltam a importância da implementação de medidas preventivas direcionadas à promoção da qualidade de vida saudável e ao controle dos fatores de risco metabólicos.

Inadequate dietary habits, sedentary lifestyle, and increased life expectancy significantly contribute to the prevalence of metabolic syndrome. This condition predisposes an individual to develop type 2 diabetes mellitus and cardiovascular diseases, which have a broad impact on public health, inducing a burden on the healthcare system and reducing the quality of life of affected individuals. Metabolic syndrome is a multifactorial disease and is related to the aging process; however, there is still a significant gap in terms of studies on the prevalence of the condition in elderly populations. In this context, this study aimed to screen the prevalence of metabolic syndrome in participants of the Open University for the Third Age (UNATI), located in Francisco Beltrão, Paraná. The diagnostic criteria for metabolic syndrome addressed in this research include: abdominal circumference ≥ 90 cm for men and ≥ 80 cm for women, triglycerides ≥ 150 mg/dL, HDL ≤ 40 mg/dL for men and ≤ 50 mg/dL for women, systolic blood pressure ≥ 130 mmHg and/or diastolic blood pressure ≥ 85 mmHg or being on pharmacotherapy for hypertension, in addition to fasting glucose ≥ 100 mg/dL or being on pharmacological treatment for diabetes. A total of 44 elderly individuals were evaluated, with a mean age of 66.9 ± 7.1 years, predominantly women (88%). The results revealed an alarming prevalence of metabolic syndrome, affecting 36.4% of the studied sample. Furthermore, a high prevalence of associated conditions was observed, such as arterial hypertension (67.2%), overweight (58.6%), and visceral obesity (31%). These findings underscore the importance of implementing preventive measures aimed at promoting healthy lifestyles and controlling metabolic risk factors.

Índice de massa corporal e desfechos clínicos: um estudo retrospectivo durante a pandemia de Covid-19 / Body mass index and clinical outcomes: a retrospective study in Covid-19 / Índice de masa corporal y resultado clínico: un estudio retrospectivo durante la pandemia de Covid-19

A COVID-19 é uma doença respiratória aguda provocada pela infecção do vírus SARS-CoV-2, que pode causar uma grave insuficiência respiratória hipoxêmica, complicações e mortes, principalmente na população com condições crônicas de saúde. Os mecanismos pelos quais a obesidade pode aumentar a gravidade da COVID-19 incluem mecanismos físicos, inflamação crônica e uma função imunológica prejudicada. Além disso, o índice de massa corporal elevado é um fator de risco para várias condições médicas que têm sido sugeridas para aumentar o risco de gravidade da COVID-19. Objetivo: analisar a associação entre o índice de massa corporal e desfechos clínicos dos casos confirmados de COVID-19. Metodologia: Estudo transversal, com coleta de dados de prontuários, conduzido de março de 2020 a dezembro 2021. Foram analisados os registros de prontuários, exames bioquímicos e de imagem de pacientes internados com COVID-19 em três hospitais da cidade de Francisco Beltrão (PR). As variáveis analisadas foram o diagnóstico nutricional, idade, sexo, necessidade de internação em UTI, comorbidades, dias de hospitalização, complicações, exames laboratoriais e desfecho. Os critérios para inclusão no estudo foram, pacientes hospitalizados com diagnóstico para COVID-19, com presença de diagnóstico nutricional relatado. Resultados: No ano de 2020 foram analisados 292 prontuários e no ano de 2021 foram 860 prontuários. Destes, somente 413 possuíam diagnóstico nutricional, sendo assim incluídos no presente estudo. Foram classificados como peso normal 78 (18,9%), com sobrepeso 153 (37%)e como obeso 182 (44,1%) participantes. A maior prevalência de obesidade foi encontrada no sexo feminino (52,5%), portadores de diabetes (27,6%), pacientes com estado geral comprometido (67,9%), que apresentaram complicações pulmonares (54,5%) e arritmias (23%). A média de idade encontrada em pacientes com obesidade foi mais jovem (55,54) em comparação com os classificados com sobrepeso (59,08) e normal (62,51). Observou-se que quanto maior o IMC menor foram os valores encontrados para idade (rho = -0,190), leucócitos (rho = -0,109), ureia (rho = -0,145) e D-dímero (rho = -0,155). Conclusão: Este estudo fornece evidências de que o sobrepeso e/ou obesidade então associadas a um pior quadro clínico durante a internação dos pacientes com COVID-19. Em relação a frequência de óbito, não houve diferença estatística em relação ao diagnóstico nutricional.

COVID-19 is an acute respiratory disease caused by SARS-CoV-2 virus infection, which can cause severe hypoxemic respiratory failure, complications, and deaths, especially in the population with chronic health conditions. The mechanisms by which obesity may increase the severity of COVID-19 include physical mechanisms, chronic inflammation, and impaired immune function. In addition, high body mass index is a risk factor for several medical conditions that have been suggested to increase the risk of COVID-19 severity. Objective: to analyze the association between body mass index and clinical outcomes of confirmed cases of COVID-19. Methodology: Cross-sectional study, with data collection from medical records, conducted from March 2020 to December 2021. The records of medical records, biochemical and imaging tests of patients hospitalized with COVID-19 in three hospitals in the city of Francisco Beltrão (PR) were analyzed. The variables analyzed were nutritional diagnosis, age, gender, need for ICU admission, comorbidities, days of hospitalization, complications, laboratory tests and outcome. The inclusion criteria for the study were, hospitalized patients with diagnosis for COVID-19, with presence of nutritional diagnosis reported. Results: In the year 2020, 292 medical records were analyzed and in the year 2021 there were 860 medical records. Of these, only 413 had nutritional diagnosis, thus being included in this study. Were classified as normal weight 78 (18.9%), overweight 153 (37%), and obese 182 (44.1%) participants. The highest prevalence of obesity was found in females (52.5%), patients with diabetes (27.6%), patients with impaired general condition (67.9%), who presented pulmonary complications (54.5%) and arrhythmias (23%). The mean age found in obese patients was younger (55.54) compared to those classified as overweight (59.08) and normal (62.51). It was observed that the higher the BMI the lower were the values found for age (rho = -0.190), leukocytes (rho = -0.109), urea (rho = -0.145) and D-dimer (rho = -0.155). Conclusion: This study provides evidence that overweight and/or obesity then associated with a worse clinical picture during hospitalization of patients with COVID-19. Regarding the frequency of death, there was no statistical difference in relation to nutritional diagnosis.

COVID-19 es una enfermedad respiratoria aguda causada por la infección por el virus SARS-CoV-2, que puede provocar insuficiencia respiratoria hipoxémica grave, complicaciones y muertes, especialmente en poblaciones con enfermedades crónicas. Los mecanismos por los cuales la obesidad puede aumentar la gravedad de la COVID-19 incluyen mecanismos físicos, inflamación crónica y función inmune deteriorada. Además, un índice de masa corporal alto es un factor de riesgo para varias afecciones médicas que, según se ha sugerido, aumentan el riesgo de gravedad del COVID-19. Objetivo: analizar la asociación entre el índice de masa corporal y los resultados clínicos de casos confirmados de COVID-19. Metodología: Estudio transversal, con recolección de datos de historias clínicas, realizado de marzo de 2020 a diciembre de 2021. Se analizaron historias clínicas, exámenes bioquímicos y de imagen de pacientes hospitalizados con COVID-19 en tres hospitales de la ciudad de Francisco Beltrão (PR). Las variables analizadas fueron diagnóstico nutricional, edad, sexo, necesidad de ingreso a UCI, comorbilidades, días de internación, complicaciones, exámenes de laboratorio y evolución. Los criterios de inclusión en el estudio fueron pacientes hospitalizados con diagnóstico de COVID-19, con presencia de diagnóstico nutricional informado. Resultados: En 2020 se analizaron 292 historias clínicas y en 2021 se analizaron 860 historias clínicas. De ellos, sólo 413 tenían diagnóstico nutricional, por lo que fueron incluidos en el presente estudio. 78 (18,9%) participantes fueron clasificados como normopeso, 153 (37%) como sobrepeso y 182 (44,1%) como obesidad. La mayor prevalencia de obesidad se encontró en el sexo femenino (52,5%), pacientes con diabetes (27,6%), pacientes con estado general comprometido (67,9%), quienes presentaron complicaciones pulmonares (54,5%) y arritmias (23%). La edad promedio encontrada en los pacientes con obesidad fue menor (55,54) en comparación con los clasificados como con sobrepeso (59,08) y normales (62,51). Se observó que a mayor IMC, menores son los valores encontrados para edad (rho = -0,190), leucocitos (rho = -0,109), urea (rho = -0,145) y dímero D (rho = -0,155). Conclusión: Este estudio proporciona evidencia de que el sobrepeso y/u obesidad se asocia con una peor condición clínica durante la hospitalización de pacientes con COVID-19. En cuanto a la frecuencia de muerte, no hubo diferencia estadística en relación al diagnóstico nutricional.

Sociodemographic, behavioral, obstetric, and healthcare factors associated with low weight at birth: a case-control study

ABSTRACT BACKGROUND: Understanding social determinants is crucial for implementing preventive strategies, especially for low birth weight (LBW)—a public health issue that severely increases the risk of morbimortality in children. OBJECTIVE: This study aimed to identify the factors associated with LBW among newborns, assisted by the Brazilian Unified Health System. DESIGN AND SETTING: It analyzed data from newborns and their mothers. The sample was selected by convenience from users of the public health system in Francisco Beltrão (Paraná, Brazil). METHODS: Cases (n = 26) were babies weighing ≤ 2,500 g and controls (n = 52) > 2,500 g. All babies were assessed and paired by sex and date of birth in a 1:2 proportion. Statistical power was computed a posteriori, revealing a power of 87% (α = 0.05). RESULTS: Strong and significant differences were found in the bivariate analysis, in which the number of current smokers or those who quit during pregnancy was higher among mothers of babies with LBW. Moreover, the gestational weeks were lower among these cases. Logistic regression models indicated that the gestational week (odds ratio [OR] = 0.17, 95% confidence interval [CI]:0.05-0.54) and fathers' educational level (high school or above; OR = 0.22, 95% CI:0.06-0.99) were related to lower chances of low birth weight. CONCLUSIONS: Our findings confirm previous investigations on LBW's multi-causality, showing that the gestational week could reduce up to 82% chances of a baby being born with ≤ 2,500 g. Its association with paternal education underlines the importance of comprehensive policies to protect newborns.

Evaluation of oxidative stress level: reactive oxygen species, reduced glutathione, and D-dimer in patients hospitalized due to COVID-19.

Elevated D-dimer levels at hospital admission may also indicate a higher likelihood of progressing to a severe or critical state. This study aimed to assess reactive oxygen species (ROS), non-enzymatic antioxidant reduced glutathione (GSH), and D-dimer levels in COVID-19 patients upon admission, examining their association with mortality outcomes. Data was collected from the medical records of 170 patients hospitalized in a referral hospital unit between March 2020 and December 2021. Patients were divided into two groups: the ward bed group (n = 87), comprising 51% with moderate clinical conditions, and the intensive care unit (ICU) group (n = 83), comprising 49% with severe conditions. The mean age was 59.4 years, with a male predominance of 52.4%. The overall death rate was 43%, with 30.6% in the moderate group and 69.4% in the severe group. The average time from symptom onset to hospitalization was 6.42 days. Results showed that non-survivors had high D-dimer and ROS counts, longer ICU stays, and worse saturation levels at admission. In conclusion, elevated ROS and D-dimer levels may contribute to worse outcomes in critically ill patients, potentially serving as specific and sensitive predictors of poor outcomes upon admission.

Sociodemographic, behavioral, obstetric, and healthcare factors associated with low weight at birth: a case-control study.

BACKGROUND: Understanding social determinants is crucial for implementing preventive strategies, especially for low birth weight (LBW)-a public health issue that severely increases the risk of morbimortality in children. OBJECTIVE: This study aimed to identify the factors associated with LBW among newborns, assisted by the Brazilian Unified Health System. DESIGN AND SETTING: It analyzed data from newborns and their mothers. The sample was selected by convenience from users of the public health system in Francisco Beltrão (Paraná, Brazil). METHODS: Cases (n = 26) were babies weighing ≤ 2,500 g and controls (n = 52) > 2,500 g. All babies were assessed and paired by sex and date of birth in a 1:2 proportion. Statistical power was computed a posteriori, revealing a power of 87% (α = 0.05). RESULTS: Strong and significant differences were found in the bivariate analysis, in which the number of current smokers or those who quit during pregnancy was higher among mothers of babies with LBW. Moreover, the gestational weeks were lower among these cases. Logistic regression models indicated that the gestational week (odds ratio [OR] = 0.17, 95% confidence interval [CI]:0.05-0.54) and fathers' educational level (high school or above; OR = 0.22, 95% CI:0.06-0.99) were related to lower chances of low birth weight. CONCLUSIONS: Our findings confirm previous investigations on LBW's multi-causality, showing that the gestational week could reduce up to 82% chances of a baby being born with ≤ 2,500 g. Its association with paternal education underlines the importance of comprehensive policies to protect newborns.

Latent Tuberculosis Infection Diagnosis Using QuantiFERON-TB Gold Plus Kit Among Correctional Workers: A Cross-Sectional Study in Francisco Beltrão-PR, Brazil.

Correctional workers form a high-priority group for tuberculosis control measures because of their high exposure and risk. This cross-sectional study conducted in April and May 2022 included 71 criminal police officers from the State Penitentiary of Francisco Beltrão-PR, Brazil. Their sociodemographic and laboratory data were collected. Latent tuberculosis infection (LTBI) was assessed using a QuantiFERON-TB Gold Plus in-tube test kit. Binary logistic regression was applied to calculate the odds ratios (ORs) and 95% confidence intervals (CI) of the LTBI predictors. The prevalence of LTBI was 22.6% (95% CI, 12.8-32.2%). Factors associated with LTBI were age > 43 years (OR, 0.18; 95% CI, 0.04-0.70; p < 0.014) and the use of medications (OR, 5.13; 95% CI, 1.40-18.87; p < 0.014). The prevalence was close to that estimated worldwide for LTBI in correctional workers, reinforcing the need for occupational health control measures consisting of regular screening and treatment of positive cases of latent infection among correctional workers to reduce the risk of illness and spread of infection in the penitentiary system and community.

Consentimento para processamento de dados de pesquisa em prontuários médicos / Consent for processing medical records data / Consentimiento para el procesamiento de datos de investigación en registros médicos

Resumo O manuseio de dados de pesquisa de prontuários médicos é uma preocupação que envolve questões éticas e legais. O objetivo deste artigo é fornecer uma descrição do processamento para a utilização de dados pessoais contidos em prontuários médicos, além de oferecer uma visão geral da legislação vigente sobre o manuseio desses dados, contribuindo para ampliar o entendimento da obrigatoriedade do consentimento para o manuseio prontuários médicos com finalidade de pesquisa. A agência brasileira que normatiza a análise ética em pesquisa com humanos despachou correspondência específica aos seus comitês locais tratando do assunto. No entanto, tal correspondência carece de revisão em virtude dos novos sentidos e significados estabelecidos na legislação mais recente, segundo a qual a finalidade de pesquisa científica é condição de exceção para o tratamento de dados pessoais sem o fornecimento de consentimento do titular.

Abstract Processing medical record data involves ethical and legal challenges. This study proposes a processing description for using personal data obtained from medical records, as well as offers a general view of the current legislation on handling this type of data, contributing to further our understanding regarding consent when using medical records for research purposes. The Brazilian agency responsible for the ethical standards on research with humans issued a specific guideline on the subject to its local committees; however, such guidelines require a review based on the new meanings and senses established by the more recent legislation, according to which scientific research presents an exception to data processing without express consent by its titulary.

Resumen El manejo de datos de investigación provenientes de registros médicos es una preocupación que implica cuestiones éticas y legales. El objetivo de este artículo es brindar una descripción del procesamiento para el uso de datos personales contenidos en los registros médicos, además de ofrecer una visión general de la legislación vigente sobre el manejo de estos datos y así contribuir a ampliar la comprensión del consentimiento obligatorio para el manejo de registros médicos con fines de investigación. La agencia brasileña que regula el análisis ético en investigaciones con humanos envió una correspondencia específica a sus comités locales abordando el tema. Sin embargo, dicha correspondencia requiere una revisión debido a los nuevos sentidos y significados establecidos en la más reciente legislación, según la cual la finalidad de la investigación científica es una condición de excepción para el tratamiento de datos personales sin el suministro del consentimiento del titular.

Working Conditions and Health of Prison Officers in Paraná (Brazil).

OBJECTIVES: This cross-sectional study was carried out to identify the associations between working and health conditions among prison officers at a state prison in Paraná, Brazil. MATERIAL AND METHOD: A proportional and stratified random sample of 125 individuals was used. The participants, who were not identified, completed a self-administered questionnaire. RESULTS: The results showed a prevalence of minor psychiatric disorders (MPD) of 30.4% (95%CI: 22.4-39.2). A total of 17.9% of the respondents had persistent stress (95%CI: 12.2-25.2), 66.4 had up to five health-related complaints (95%CI: 58.4-75.2) and 9.6% had scores that indicated higher risk for alcohol abuse and/or dependance (95%CI:4.8-16.0). Multivariate analyses showed that with an MPD outcome, health problems (p<0.01), physical environment (p=0.013) and organizational risks (p<0.01) were significant predictors. Persistent stress was predicted by age (p=0.031), health problems (p<0.01) and organizational risks (p=0.023), while health complaints were associated with health problems (p<0.01) and physical environment (p<0.01). There were no significant predictors for higher risk for alcohol abuse and/or dependance. DISCUSSION: In general, the results demonstrate the precarious nature of the work of prison officers, and reveal the importance of further studies to evaluate whether this is a specific reality of the unit that was investigated, or whether these results are common in other prison environments.

Prevalence of HPV and associated factors in a population of women living in southern Brazil.

OBJECTIVE: To determine the prevalence of HPV and investigate factors associated with the infection in women in the city of Francisco Beltrão, southwest Paraná, attending the public health system. METHODS: This cross-sectional study included 324 women, aged between 18 and 65 years, who were attending public health services for routine gynecological consultation. Interviews were conducted to obtain information about socioeconomic, sexual, gynecological, and life habits. After performing the Papanicolaou test, endocervical brush was employed to detect HPV by polymerase chain reaction with the primers MY09-MY11. RESULTS: The prevalence of HPV was 6.8%, out of which 58.3% presented with cytopathologic alterations. And the presence of current cervical alterations can increase the chances of having HPV by almost 33 times (ORadj: 32.688; p < 0.001), recent vaginal infection increased the chances of HPV infection by 2.7 times (ORadj: 2.773; p = 0.04). The non-white ethnicity increased HPV infection chances threefold (ORadj: 3.058; p = 0.039). CONCLUSION: The main finding was low prevalence of HPV infection. Factors that may be linked to HPV infection were cervical alterations, recent vaginal infection, and women's ethnicity.

University Students' Knowledge about the Relation between Human Papillomavirus (HPV) and Head and Neck and Oral Cancers.

INTRODUCTION: Human papillomavirus (HPV) causes the most common sexually transmitted infection (STI) in the world. It affects people regardless of gender and age, causing genital warts and cancer. OBJECTIVE: To evaluate university students' knowledge of HPV and its relationship with head and neck and oral cancers. METHODS: This is a cross-sectional study using an online questionnaire administered to undergraduate students at a public university (n=335). RESULTS: In total, 69.3% of the participants were unaware of the relationship between HPV and head and neck cancers and 34.6% claimed that HPV may not cause oral cancer.  The chances of knowing about the relationship of HPV with head and neck cancers were significant for participants who knew that HPV could be asymptomatic (OR = 9.9; p = 0.029), that might cause genital warts in men (OR = 4.0; p = 0.015), and those aged 24 years or older (OR = 1.9; p = 0.021). However, undergraduate students in the field of health and medicine (OR = 0.419; p = 0.002), who had sex at least twice a week (OR = 0.471; p = 0.017), and were unaware of the target public for the HPV vaccine (OR: 0.222, p<0.001) were less likely to know about the relationship. Students who knew of the relationship between HPV and female (OR = 3.6; p = 0.010) and male genital warts (OR = 3.0; p = 0.005) or were immunized (OR = 1.8; p = 0.020) were more likely to understand the viral interaction with oral cancer. Those who were unaware of the population eligible for HPV vaccine (OR = 0.493; p = 0.017) also showed gaps in their knowledge of this relationship. CONCLUSION: Our findings showed that there were limitations in the knowledge about HPV, its vaccine, and its relationship with head and neck and oral cancers.

Prevalence and factors associated to cervical changes in units from the Single Health System.

OBJECTIVE: To estimate the prevalence and risk factors associated with cytopathological changes in the uterine cervix of women treated by the Unified Health System. METHOD: This is a cross-sectional study carried out with 350 women, between 14 and 79 years old who underwent pap smear tests in heath units in Francisco Beltrão, Paraná. Cervical cytopathological analyses and a questionnaire were applied to obtain socioeconomic information, as well as data on sexual behavior, gynecological aspects, and life habits. Chi-square test and logistic regression with p <0.05 were applied for statistical analysis. RESULTS: The prevalence of cervical changes was 3.4% and the main categories found were low-grade cervical intraepithelial lesion, high-grade cervical intraepithelial lesion, and atypical cells of undetermined significance. From these, the first were present in 16.6% of women under 25 years old. The multivariate analysis pointed at associations between previous results of the cytopathology test (OR = 25.693), smoking (OR = 7.576), and oral contraceptives (OR = 5.265) and the outcome. CONCLUSION: Women with a history of previous cervical cytopathological abnormality, use of oral contraceptives, and smokers were more likely to have an abnormal result in the pap smear test.

Frequência e fatores associados em casos confirmados e descartados e óbitos da COVID-19 em um hospital secundário / Frequency and associated factors in confirmed and discarded cases and deaths from COVID-19 in a secondary hospital

Diante dessa emergência de caráter pandêmico e grande impacto na Saúde Pública ocasionado pela Covid ­19, a pesquisa buscou descrever a frequência e fatores associados aos casos confirmados, descartados e óbitos da doença na abrangência da 8ª Regional de Saúde do Estado do Paraná. Trata-se de um estudo quantitativo e transversal, que avaliou dados de 471 pacientes. A maior frequência do sexo masculino (56,7%). Entre os casos confirmados para COVID-19, 87,5% (n=112) faziam uso de suporte ventilatório não invasivo. A taxa de mortalidade calculada foi de 10,7% (IC95%: 7,8 ­13,4%). A letalidade geral foi de 10,6% (IC95%:8,64 ­9,20) (50/471), não apresentando diferença estatisticamente significativa entre casos confirmados 10,9% (IC95%:8,95 ­9,25) versus 10,5% (IC95%:8,91 ­9,37) os descartados. Em suma, os dados corroboram a estudos prévios ao indicar uma maior ocorrência de hospitalizações em homens idosos e de elevada alteração em exames tomográficos dentre os casos confirmados da COVID-19 na instituição analisada. (AU)

In view of this pandemic emergency and great impact on Public Health caused by Covid-19, the research sought to describe the frequency and factors associated with confirmed cases, discarded cases and deaths of the disease in the coverage of the 8th Regional Health Department of the State of Paraná. This is a quantitative and cross-sectional study, which evaluated data from 471 patients. The highest frequency was male (56.7%). Among the confirmed cases for COVID-19, 87.5% (n = 112) were using non-invasive ventilatory support. The mortality rate provided was 10.7% (95%CI: 7.8 -13.4%). Theoverall lethality was 10.6% (95%CI: 8.64 -9.20) (50/471), not statistically changing between confirmed cases 10.9% (95%CI: 8.95 -9.25 ) versus 10.5% (95%CI: 8.91 -9.37) were discarded. In short, the data corroborate previous studies by indicating a higher occurrence of hospitalizations in elderly men and high alterations in tomographic exams among the confirmed cases of COVID-19 in the analyzed institution. (AU)

Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis

ABSTRACT BACKGROUND: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2. DESIGN AND SETTING: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university. METHODS: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection. RESULTS: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33). CONCLUSIONS: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. ­Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease. PROSPERO platform: CRD42021229825.

Correction: Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study.

[This corrects the article DOI: 10.1371/journal.pone.0255173.].

Dexamethasone for treating SARS-CoV-2 infection: a systematic review and meta-analysis.

BACKGROUND: Considering the disruptions imposed by lockdowns and social distancing recommendations, coupled with overwhelmed healthcare systems, researchers worldwide have been exploring drug repositioning strategies for treating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). OBJECTIVE: To compile results from randomized clinical trials on the effect of dexamethasone, compared with standard treatment for management of SARS-CoV-2. DESIGN AND SETTING: We conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in a Brazilian public university. METHODS: We sought to compile data from 6724 hospitalized patients with confirmed or suspected SARS-CoV-2 infection. RESULTS: Treatment with dexamethasone significantly reduced mortality within 28 days (risk ratio, RR: 0.89; 95% confidence interval, CI: 0.82-0.97). Dexamethasone use was linked with being discharged alive within 28 days (odds ratio, OR: 1.20; 95% CI: 1.07-1.33). CONCLUSIONS: This study suggests that dexamethasone may significantly improve the outcome among hospitalized patients with SARS-CoV-2 infection and associated severe respiratory complications. -Further studies need to consider both dose-dependent administration and outcomes in early and later stages of the disease. PROSPERO PLATFORM: CRD42021229825.

Sleep quality and common mental disorder in the hospital Nursing team.

OBJECTIVE: to determine the prevalence of sleep quality and common mental disorder in Nursing professionals and factors associated with sleep change. METHOD: a cross-sectional, analytical and quantitative study developed with 196 Nursing professionals of a public hospital and a mixed one. Data was collected by means of an instrument of sociodemographic characterization, by the Self-Report Questionnaire 20 and Pittsburgh Sleep Quality Index and were analyzed by descriptive and inferential statistics to identify possible factors associated with sleep changes. RESULTS: sleep changes were identified among the Nursing professionals with a frequency of 76.5% (70.4-82.1). Sleep quality was classified as poor in 41.8% (41.8-55.6) and sleep disorder in 27.6%. (21.4-34.2). The prevalence of common mental disorder was identified in 36.7% (30.1-43.9). The main factor for poor sleep quality was the presence of common mental disorder (Odds Ratio: 5.15; p<0.001). CONCLUSION: sleep changes were prevalent and the characteristics of the work environment and the presence of mental disorder showed relevance in the changes.

Sociodemographic, behavioral, and geriatric characteristics in older adults with and without HIV: A case-control study.

ABSTRACT: Older adults with human immunodeficiency virus (HIV) have higher risks for early manifestations of age-related disabilities. The objective of this study was to compare HIV-positive and HIV-negative adults aged ≥50 years in relation to sociodemographic, behavioral, and geriatric characteristics. A case-control study was conducted with a >90% estimated statistical power. A total of 52 individuals living with HIV were matched by age, sex, and neighborhood of residence with 104 community controls. Age-related disabilities were assessed throughout a comprehensive geriatric assessment. Review of medical records and interviews were used to obtain behavioral and clinical covariates. No statistical differences on clinically significant age-related disabilities were found. However, multivariate regression analyses, controlling for education and income, revealed that behavioral (use of condom [odds ratio {OR}: 7.03; 95% confidence intervals {CI}: 2.80-7.65] and number of medical visits [OR: 1.25; 95%CI: 1.09-1.43]), along with faster gait speed (OR: 17.68; 95%CI: 2.55-122.85) and lower body and muscle mass indexes were independently associated with HIV (OR: .88; 95%CI: .79-.98 and OR: .72; 95%CI: .54-.97, respectively). In summary, results on age-related disabilities between groups could mean that public policies on HIV might be contributing to patients' positive outcomes regardless of the effects of aging, albeit gait speed, body and muscle mass indexes were independently associated with HIV. Screenings for age-related disabilities in specialized HIV services are recommended.

Fatores de risco associados ao acometimento pela COVID-19 em pacientes oncológicos: uma revisão sistemática / Risk factors associated with the COVID-19 infection in cancer patients: a systematic review

A pandemia da COVID-19 afetou inúmeros aspectos cotidianos mundialmente. Nesse cenário, indivíduos de imunidade fragilizada deparam--se com impasses ao comparecimento a hospitais e à manutenção de tratamentos, com risco de exposição ao vírus. Este artigo tem, portanto, o objetivo de identificar fatores de risco relacionados à COVID-19 em pacientes com câncer. Sua metodologia consiste numa revisão sistemática da literatura, cuja seleção ocorreu após pesquisa por publicações que abordassem aspectos da COVID-19 em pacientes com neoplasias, nas bases de dados BVS/Lilacs e MEDLINE/PubMed, com uso dos termos "COVID-19" and "cancer" or "câncer" and "Brazil" (DeCs e MeSH terms). As evidências indicam maior suscetibilidade a contrair COVID-19, maior chance de internamento para pacientes com câncer, assim como, maior proporção de óbitos nessa população. Desta forma, conclui-se que, consonante com estudos em outras regiões, no Brasil, a imunossupressão e a submissão a tratamentos anticâncer indicaram maiores riscos para evolução mais grave da COVID-19. (AU)

The COVID-19 pandemic affected countless everyday aspects worldwide. In this scenario, owners of weakened immunity face impasses in attending hospitals and maintaining treatments, with a risk of exposure to the virus. Therefore, this article aims to identify risk factors related to COVID-19 in cancer patients. Its methodology consists of a systematic literature review, whose selection after search for publications that address COVID-19 aspects in patients with cancer, in the databases BVS / Lilacs and MEDLINE / PubMed, using the terms "COVID-19" and " Cancer" or "cancer" and "Brazil" (DeCs and MeSH terms). Evidence indicates a greater susceptibility to contracting CO-VID-19, a greater chance of hospitalization for cancer patients, as well as a greater proportion of deaths in this population. Thus, it is concluded that, in line with studies in other regions, in Brazil, immunosuppression and submission to anticancer treatments indicated greater risks for a more serious evolution of COVID-19. (AU)

Burnout Syndrome in Brazilian Medical Doctors: A Cross-Sectional Examination of Risk and Protective Factors.

Objectives: This investigation sought to identify the prevalence of Burnout Syndrome (BS) among Brazilian medical doctors (BS) and the associations with risk factors and protective factors. Methods: Out of 206 registered MD from a medium-sized municipality, 121 were enrolled in this cross-sectional study. Convenience sampling was used. Based on Cohen's f 2, a power of 98% and a 0.05 alpha was achieved. MD responded to sociodemographic questions and to the Portuguese-version of the Maslach Burnout Inventory-Human Services Survey (MBI). Risk and protective factors linked with BS were examined with regression analyses. Results: The age of the participants ranged from 25 to 69 years (M = 40.89; SD = 10.13) and 73.6% were male. The prevalence of BS was 7.5%. Differential aspects were related to BS. For instance, while not reporting satisfaction with the institution (ß = 16.16, p < 0.001) and not practicing physical exercise (ß = 7.39, p = 0.014) were associated with higher scores in the BS composite score, those who did not intend to change their careers (ß = -17.15, p < 0.001) and participants who saw mental health specialists (ß = -8.99, p = 0.007) scored lower, accounting for nearly a half of the BS composite score (R 2 = 46%). Conclusion: The prevalence of BS in this study falls within the range previously reported among healthcare professionals (i.e., 2.6-11.8%). Moreover, data suggested that commitment with the occupation and with the participant's own mental health could boost reactions against the deleterious effects of the BS. In this sense, organizations can develop strategies for preventing BS, a process that is known to be chronic and, to some extent, preventable.

COVID-19: The question of genetic diversity and therapeutic intervention approaches.

Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2), is the largest pandemic in modern history with very high infection rates and considerable mortality. The disease, which emerged in China's Wuhan province, had its first reported case on December 29, 2019, and spread rapidly worldwide. On March 11, 2020, the World Health Organization (WHO) declared the COVID-19 outbreak a pandemic and global health emergency. Since the outbreak, efforts to develop COVID-19 vaccines, engineer new drugs, and evaluate existing ones for drug repurposing have been intensively undertaken to find ways to control this pandemic. COVID-19 therapeutic strategies aim to impair molecular pathways involved in the virus entrance and replication or interfere in the patients' overreaction and immunopathology. Moreover, nanotechnology could be an approach to boost the activity of new drugs. Several COVID-19 vaccine candidates have received emergency-use or full authorization in one or more countries, and others are being developed and tested. This review assesses the different strategies currently proposed to control COVID-19 and the issues or limitations imposed on some approaches by the human and viral genetic variability.