Involvement of IL17A and IL17RA variants in interleukin-17A levels and disease activity in ulcerative colitis.

Ulcerative colitis (UC) is characterized by chronic inflammation of the large intestine with involvement of Th17 cells and interleukin (IL)-17A. The role of IL17A and IL17A receptor (IL17RA) variants in pathophysiology of UC still remains inconclusive. The aim was to evaluate the association between IL17A and IL17RA variants with susceptibility, IL-17A plasma levels, and endoscopic activity in UC. The study included 104 patients with UC and 213 controls. Patients were divided according to endoscopic activity (remission/mild and moderate/severe). The IL17A rs3819024 A>G and rs3819025 G>A, and IL17RA rs2241043 C>T, rs2241049 A>G, and rs6518661 G>A variants were genotyped using real time polymerase chain reaction. IL-17A plasma levels were determined using immunofluorimetric assay. Neither IL17A nor IL17RA variants were associated with UC susceptibility. The IL17A rs3819024 AG genotype was associated to high levels of IL-17 only in patients. Patients with the G allele of IL17RA rs2241049 showed 2.944 more chance of developing moderate/severe disease. The haplotype analysis showed that IL17RA rs2241049 and rs6518661 was not associated with UC susceptibility and haplotypes constituted with G allele of these variants were not associated with disease severity (p = 0.09). In conclusion, the IL17A rs3819024 AG genotype was associated with elevated IL-17A plasma levels in patients with UC but not in controls and the IL17RA rs2241049 AG+GG genotypes were associated to severity of UC. These results suggest a possible hidden interaction between the IL17A rs3819024 variant and other genetic, environmental, and epigenetic factors in the IL-17A expression that is present only in patients with UC.

Correction: Maternal mortality associated with COVID-19 in Brazil in 2020 and 2021: Comparison with non-pregnant women and men.

[This corrects the article DOI: 10.1371/journal.pone.0261492.].

Serum Anti-Spike Antibodies Are Not Affected by Immunosuppressants in SARS-CoV-2 Vaccinations Given to Brazilian Patients with Inflammatory Bowel Disease.

This study aimed to evaluate humoral responses after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) of patients with inflammatory bowel disease (IBD). Patients with IBD enrolled in a tertiary outpatient unit were followed up between September 2021 and September 2022 via serial blood collection. Immunoglobulin G antibody titers against SARS-CoV-2 were measured before administration and 1 and 6 months after the administration of two doses of different vaccination regimens. The results were compared with those of a healthy control group obtained during the same period. The mean pre-vaccination antibody titers were 452.0 and 93.3 AU/mL in the IBD (n = 42) and control (n = 89) groups, respectively. After two doses of the vaccine, the titers significantly increased in both groups (IBD, 8568.0 AU/mL; control, 7471.0 AU/mL; p < 0.001). One month after the second dose, no significant differences were observed between the two groups (p = 0.955). Significant differences between vaccination schemes in the IBD group were observed, with higher titers in those who received Pfizer, younger patients (p < 0.005), and those with a previous coronavirus disease 2019 (COVID-19) infection (p < 0.012). The use of immunosuppressants and immunobiologicals did not affect the overall humoral response to COVID-19 vaccine in patients with IBD, but specific vaccine regimens, age, and previous coronavirus infection significantly did. This study reinforces the positive impact of booster doses and the safety of SARS-CoV-2 vaccination.

High and low-fidelity simulation for respiratory diseases pediatric training: a prospective and randomized study.

OBJECTIVE: To compare high and low-fidelity simulations for the recognition of respiratory distress and failure in urgency and emergency pediatric scenarios. METHODS: 70 fourth-year medical students were randomly distributed in high and low-fidelity groups and simulated different types of respiratory problems. Theory tests, performance checklists, and satisfaction and self-confidence questionnaires were used in the assessment. Face-to-face simulation and memory retention was applied. The statistics were evaluated by averages and quartiles, Kappa, and generalized estimating equations. The p-value was considered 0.05. RESULTS: In the theory test there was an increase in scores in both methodologies (p < 0.001); in memory retention (p = 0.043) and at the end of the process the high-fidelity group had better results. The performance in the practical checklists was better after the second simulation (p > 0,05). The high-fidelity group felt more challenged in both phases (p = 0.042; p = 0.018) and showed greater self-confidence to recognize changes in clinical conditions and in memory retention (p = 0.050). The same group, in relation to the hypothetical real patient to be treated in the future, felt better confident to recognize respiratory distress and failure (p = 0.008; p = 0.004), and better prepared to make a systematic clinical evaluation of the patient in memory retention (p = 0.016). CONCLUSION: The two levels of simulations enhance diagnostic skills. High fidelity improves knowledge, leads the student to feel more challenged and more self-confident in recognizing the severity of the clinical case, including memory retention, and showed benefits regarding self-confidence in recognizing respiratory distress and failure in pediatric cases.

High and low-fidelity simulation for respiratory diseases pediatric training: a prospective and randomized study

Abstract Objective: To compare high and low-fidelity simulations for the recognition of respiratory distress and failure in urgency and emergency pediatric scenarios. Methods: 70 fourth-year medical students were randomly distributed in high and low-fidelity groups and simulated different types of respiratory problems. Theory tests, performance checklists, and satisfaction and self-confidence questionnaires were used in the assessment. Face-to-face simulation and memory retention was applied. The statistics were evaluated by averages and quartiles, Kappa, and generalized estimating equations. The p-value was considered 0.05. Results: In the theory test there was an increase in scores in both methodologies (p < 0.001 ); in memory retention (p = 0.043) and at the end of the process the high-fidelity group had better results. The performance in the practical checklists was better after the second simulation (p > 0,05). The high-fidelity group felt more challenged in both phases (p = 0.042; p = 0.018) and showed greater self-confidence to recognize changes in clinical conditions and in memory retention (p = 0.050). The same group, in relation to the hypothetical real patient to be treated in the future, felt better confident to recognize respiratory distress and failure (p = 0.008; p = 0.004), and better prepared to make a systematic clinical evaluation of the patient in memory retention (p = 0.016). Conclusion: The two levels of simulations enhance diagnostic skills. High fidelity improves knowledge, leads the student to feel more challenged and more self-confident in recognizing the severity of the clinical case, including memory retention, and showed benefits regarding self-confidence in recognizing respiratory distress and failure in pediatric cases.

Teamwork in Pediatric Resuscitation: Training Medical Students on High-Fidelity Simulation.

Background: Simulation training and teamwork for medical students are essential to improve performance in pediatric cardiopulmonary resuscitation. Purpose: To evaluate if a specific approach to teamwork improves technical and nontechnical performance. Methods: We performed quasiexperimental, prospective, pre- and postinterventional, and nonrandomized research with 65 students in the fourth year of their medicine course. This was a case-control study in which teams used a customized TeamSTEPPS protocol (n=34) or not (n=31) for cardiopulmonary arrest training in children using high-fidelity simulation. All participants answered a sociodemographic and satisfaction questionnaire and underwent theory and practice pre- and posttesting. The survey data were collected in 2019 and analyzed using χ2, Mann-Whitney, κ, and Wilcoxon tests. p<0.05 was considered significant. Results: Intervention and control groups achieved better scores in theory posttesting (p<0.001 and p=0.049), but there was no difference between them in pre- (p=0.291) and posttesting (p=0.397). In the checklist of the practice test, all groups obtained their best outcomes in posttesting and the intervention group achieved higher scores (p<0.001). All groups increased the number of teamwork events and reduced the time span to perform resuscitation first steps (p<0.001) in posttesting. Conclusion: The use of teamwork training based on a customized TeamSTEPPS protocol improved performance in team behavior and group technical achievement. The evaluation of the students about the training was positive.

FOXP3 variants are independently associated with transforming growth factor Β1 plasma levels in female patients with inflammatory bowel disease.

OBJECTIVE: The aim of this study was to evaluate the association of -924 G>A (rs2232365) and -3279 C>A (rs3761548) FOXP3 variants with IBD susceptibility, clinical and endoscopic activity, and IL-10 and TGF-ß1 plasma levels. METHOD: The study included 110 IBD female patients, 60 with Ulcerative Colitis (UC) and 50 with Crohn's Disease (CD), and 154 female controls. FOXP3 variants were determined with Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). Plasma levels of IL-10 and TGF-ß1 were determined using immunofluorimetric assay. RESULTS: AA genotype of rs2232365 and rs3761548 was associated with CD (OR = 3.147, 95% CI 1.015-9.758, p = 0.047) and UC (OR = 3.221, 95% CI 1.050-9.876, p = 0.041) susceptibility, respectively. However, were not associated with TGF-ß1 and IL-10 levels, and endoscopic/clinical activity disease. GAGA haplotype was associated with IBD (OR = 4.003, 95% CI 1.100-14.56, p = 0.035) and UC susceptibility (OR = 6.107, 95% CI 1.609-23.18, p = 0.008). In addition, IBD patients with the GAGA haplotype had lower TGF-ß1 levels (p = 0.041). Moreover, G/C haplotype (dominant model) had a protective effect of 60% in CD susceptibility and lower Endoscopic Severity Index. CONCLUSIONS: These results suggest that FOXP3 variants could exert a role in the Treg, which could be one of the factors involved in the susceptibility and pathogenesis of IBD.

A Combination of Curcuma longa and Diazepam Attenuates Seizures and Subsequent Hippocampal Neurodegeneration.

Epilepsy is one of the most common neurological disorders, which occurs due to the instability in the inhibitory and excitatory synaptic transmissions in the brain. However, many patients develop resistance to the available drugs, which results in cell degeneration caused due to inadequate control of the seizures. Curcumin, Curcuma longa, is known to be effective for the treatment of organic disorders and may prevent seizures, reduce oxidative stress, and decrease brain damage. Given this, the present study evaluated the antiepileptic effects of C. longa in comparison with both the diazepam and the combined application of these two substances, in terms of their effects on the brain activity and the potential histopathological changes in the hippocampus. This study used male Wistar rats (age: 10-12 weeks; weight: 260 ± 20 g), which were pretreated for 4 days with either saline, C. longa, diazepam, or C. longa + diazepam; and on the fifth day, pentylenetetrazol (PTZ) was administered to induce the seizure. In the C. longa group, a significant increase was observed in the latency of the onset of seizure-related behavior. Surprisingly, however, the combined treatment resulted in the best control of the seizure-related behavior, with the greatest latency of the onset of spasms and isolated clonic seizures. This group also obtained the best results in the electroencephalographic trace and seizure control, with a reduction in the frequency and amplitude of the spike-waves. In the saline group, PTZ significantly reduced the number of cells present in the CA1 and CA3 regions of the hippocampus, while the combined treatment obtained the best results in terms of the preservation of the neuron-like cells. These findings indicate that C. longa may contribute to the control of both seizures and the cell damage induced by PTZ, and that its association with diazepam may be a potentially effective option for the treatment of epilepsy in the future.

Figure-based speech perception test: applicability in children with Down syndrome. / Teste de percepção de fala com figuras: aplicabilidade em crianças com síndrome de Down.

PURPOSE: To verify the applicability of the picture-based speech perception test in children with Down syndrome. METHODS: Observational, descriptive, prospective study, carried out at two speech therapy centers, approved by their Research Ethics Committees under numbers 82522217.5.0000.5440 and 79510317.8.0000.5257. A total of 41 children with Down syndrome, of both sexes, aged 2 years to 10 years and 11 months participated. They were divided into three groups: GI (2 years to 4 years and 11 months); GII (5 years to 7 years and 11 months); GIII (8 years to 10 years and 11 months). We verified their medical history and carried out meatoscopy, pure-tone threshold audiometry, speech recognition threshold test with pictures, and immittance tests. For statistical analysis, we used Fisher's Exact Test with the 5% significance level. Results: The analysis of hits and misses in relation to chronological age revealed significance in seven words: "ice", "knife", "cow", "key", "mouse", "dog", and "sun". We then analyzed this study participants' performance in the speech test with pictures and those in the study that developed and validated this test. Comparing the percentage of correct answers in the two groups, we found that the words with the most correct answers were "hand", "house", and "frog". Conclusion: The test applied in this study provides a clear and objective interpretation of the results, regardless of the child's verbal production.

OBJETIVO: Verificar a aplicabilidade do teste de percepção de fala com figuras em crianças com síndrome de Down. MÉTODO: Estudo observacional, descritivo e prospectivo, realizado em dois centros fonoaudiológicos, aprovado pelos Comitês de Ética em Pesquisa sob número 82522217.5.0000.5440 e 79510317.8.0000.5257. Participaram 41 crianças com síndrome de Down, de ambos os sexos, com idade entre dois anos e dez anos e 11 meses, as quais foram divididas em três grupos: GI (dois a quatro anos e 11 meses); GII (cinco a sete anos e 11 meses) e GIII (oito a dez anos e 11 meses). Foram realizados os procedimentos de anamnese, meatoscopia, audiometria tonal liminar, teste de limiar de recepção de fala com figuras e imitanciometria. Para a análise estatística, Teste Exato de Fisher com nível de significância de 5%. RESULTADOS: Ao ser analisado o número de acertos e erros, em relação à idade cronológica, foi encontrada significância para sete palavras: gelo, faca, vaca, chave, rato, cão e sol. Foi analisado, posteriormente, o desempenho no teste de fala com figuras, dos participantes desse estudo e o desempenho dos participantes do estudo que elaborou e validou este teste. Foi observado que, quando se equiparou a porcentagem de acertos nos dois grupos, as palavras com maior ocorrência de acertos foram: mão, casa e sapo. Conclusão: O teste aplicado nesse estudo proporciona a interpretação do resultado de forma clara e objetiva e independe da produção verbal da criança.

Chagas disease is an independent predictor of stroke and death in a cohort of heart failure patients.

BACKGROUND AND AIMS: Chagas disease is a common cause of heart failure (HF) and death in developing countries. Although stroke is known to occur in these patients, an accurate estimate of stroke incidence is lacking. We aimed to determine the incidence of stroke and death in patients with HF, comparing Chagas and non-Chagas etiologies. METHODS: Cohort of stroke-free patients with HF (Framingham criteria) followed in a university-based outpatient clinic in Brazil. Baseline characteristics included sociodemographic, risk factor assessment, echocardiographic and electrocardiographic findings. Chagas disease was defined by appropriate serologic tests. Cause-specific Cox regression was used to search for predictors of stroke or death as separate outcomes. RESULTS: We studied 565 patients with HF between January 2003 and December 2018, mean age 54.3 ± 12.9 years, 305 (54.0%) females, 271/535 (50.7%) with Chagas disease. Chagas patients were older (55.5 vs. 53.1 years), more frequently women (60.5% vs. 47.3%), less frequently harbored coronary artery disease (14.5% vs. 34.1%) when compared to non-Chagas patients. Echocardiography showed more severe disease among non-Chagas patients [median left ventricle ejection fraction (LVEF) 37.3% vs. 47.0%]. Over a mean 42.9 (±34.4) months, we followed 404 (71.5%) patients, completing 1442 patient-years of follow-up. Stroke incidence was higher in Chagas when compared to non-Chagas patients (20.2 vs. 13.9 events per 1000 patient-years), while death rate was similar (41.6 vs. 43.1 deaths per 1000 patient-years). In the multivariable analysis for stroke outcome adjusted for LVEF and arrhythmias, cause-specific hazard ratio (CSHR) for Chagas was 2.54 (95% confidence interval 1.01-6.42, p = 0.048). Chagas disease was also associated with increased risk of death (CSHR 1.83; 95% confidence interval 1.04-3.24, p = 0.037). CONCLUSION: Chagas disease is associated with increased risk of stroke and death when compared to other etiologies of HF, independently of HF severity or cardiac arrhythmias, suggesting other factors contribute to increased stroke risk and mortality in Chagas disease. Early prevention and treatment of Chagas disease is imperative to reduce a later risk of stroke in endemic areas.

Teste de percepção de fala com figuras: aplicabilidade em crianças com síndrome de Down / Figure-based speech perception test: applicability in children with Down syndrome

RESUMO Objetivo Verificar a aplicabilidade do teste de percepção de fala com figuras em crianças com síndrome de Down. Método Estudo observacional, descritivo e prospectivo, realizado em dois centros fonoaudiológicos, aprovado pelos Comitês de Ética em Pesquisa sob número 82522217.5.0000.5440 e 79510317.8.0000.5257. Participaram 41 crianças com síndrome de Down, de ambos os sexos, com idade entre dois anos e dez anos e 11 meses, as quais foram divididas em três grupos: GI (dois a quatro anos e 11 meses); GII (cinco a sete anos e 11 meses) e GIII (oito a dez anos e 11 meses). Foram realizados os procedimentos de anamnese, meatoscopia, audiometria tonal liminar, teste de limiar de recepção de fala com figuras e imitanciometria. Para a análise estatística, Teste Exato de Fisher com nível de significância de 5%. Resultados Ao ser analisado o número de acertos e erros, em relação à idade cronológica, foi encontrada significância para sete palavras: gelo, faca, vaca, chave, rato, cão e sol. Foi analisado, posteriormente, o desempenho no teste de fala com figuras, dos participantes desse estudo e o desempenho dos participantes do estudo que elaborou e validou este teste. Foi observado que, quando se equiparou a porcentagem de acertos nos dois grupos, as palavras com maior ocorrência de acertos foram: mão, casa e sapo. Conclusão: O teste aplicado nesse estudo proporciona a interpretação do resultado de forma clara e objetiva e independe da produção verbal da criança.

ABSTRACT Purpose To verify the applicability of the picture-based speech perception test in children with Down syndrome. Methods Observational, descriptive, prospective study, carried out at two speech therapy centers, approved by their Research Ethics Committees under numbers 82522217.5.0000.5440 and 79510317.8.0000.5257. A total of 41 children with Down syndrome, of both sexes, aged 2 years to 10 years and 11 months participated. They were divided into three groups: GI (2 years to 4 years and 11 months); GII (5 years to 7 years and 11 months); GIII (8 years to 10 years and 11 months). We verified their medical history and carried out meatoscopy, pure-tone threshold audiometry, speech recognition threshold test with pictures, and immittance tests. For statistical analysis, we used Fisher's Exact Test with the 5% significance level. Results: The analysis of hits and misses in relation to chronological age revealed significance in seven words: "ice", "knife", "cow", "key", "mouse", "dog", and "sun". We then analyzed this study participants' performance in the speech test with pictures and those in the study that developed and validated this test. Comparing the percentage of correct answers in the two groups, we found that the words with the most correct answers were "hand", "house", and "frog". Conclusion: The test applied in this study provides a clear and objective interpretation of the results, regardless of the child's verbal production.

FOXP3 variants are independently associated with transforming growth factor B1 plasma levels in female patients with inflammatory bowel disease

Abstract Objective: The aim of this study was to evaluate the association of -924 G>A (rs2232365) and -3279 C>A (rs3761548) FOXP3 variants with IBD susceptibility, clinical and endoscopic activity, and IL-10 and TGF-β1 plasma levels. Method: The study included 110 IBD female patients, 60 with Ulcerative Colitis (UC) and 50 with Crohn's Disease (CD), and 154 female controls. FOXP3 variants were determined with Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). Plasma levels of IL-10 and TGF-β1 were determined using immuno-fluorimetric assay. Results: AA genotype of rs2232365 and rs3761548 was associated with CD (OR = 3.147, 95% CI 1.015-9.758, p = 0.047) and UC (OR = 3.221, 95% CI 1.050-9.876, p = 0.041) susceptibility, respectively. However, were not associated with TGF-β1 and IL-10 levels, and endoscopic/clinical activity disease. GAGA haplotype was associated with IBD (OR = 4.003, 95% CI 1.100-14.56, p = 0.035) and UC susceptibility (OR = 6.107, 95% CI 1.609-23.18, p = 0.008). In addition, IBD patients with the GAGA haplotype had lower TGF-β1 levels (p = 0.041). Moreover, G/C haplotype (dominant model) had a protective effect of 60% in CD susceptibility and lower Endoscopic Severity Index. Conclusions: These results suggest that FOXP3 variants could exert a role in the Treg, which could be one of the factors involved in the susceptibility and pathogenesis of IBD.

COVID-19: quais motivos levaram os pacientes a procurarem pronto atendimento oftalmológico durante a pandemia? / COVID-19: what reasons led patients to seek emergency care during the pandemic?

RESUMO Objetivo Analisar o motivo pelo qual pacientes procuraram o pronto atendimento oftalmológico durante a pandemia da COVID-19. Métodos Estudo de corte transversal, retrospectivo, realizado a partir da análise de prontuários de pacientes atendidos em um pronto atendimento oftalmológico de um serviço privado da cidade de Santos (SP) entre 11 de março de 2020 e 16 de julho de 2020. Resultados Foram atendidos 386 pacientes no período analisado. A maior parte das consultas (60,36%) deu-se a pessoas do sexo feminino. Pessoas da faixa etária entre 19 e 59 anos foram as que mais procuraram o pronto atendimento (57,25%). Ao se considerar a profissão desses pacientes, estudantes e aposentados apresentaram a mesma proporção (10,26%) seguidos de pessoas do lar (6,99%). Do total de casos atendidos, 59 pacientes foram diagnosticados com conjuntivite, enquanto 58 tiveram diagnóstico de traumatismo de olho e órbita. Conclusão No período analisado, o pronto atendimento oftalmológico recebeu, predominantemente, mulheres na faixa etária entre 19 e 59 anos, e os diagnósticos mais frequentes foram de conjuntivite e trauma.

ABSTRACT Objective To analyze the reason why patients sought emergency eye care during the pandemic of COVID-19. Methods This was a retrospective cross-sectional study based on the analysis of medical records of patients seen at an ophthalmology emergency department of a private service in the city of Santos (SP) between March 11, 2020 and July 16, 2020. Results A total of 386 patients were seen in the analyzed period. Most appointments (60.36%) were attended by women. People between 19 and 59 years old were the ones who most sought the emergency room (57.25%). When considering the profession of these patients, students and retired people presented the same proportion (10.26%), followed by housewives (6.99%). Of the total number of cases seen, 59 patients were diagnosed with conjunctivitis, while 58 were diagnosed with eye and orbit trauma. Conclusion In the analyzed period, the ophthalmology emergency care predominantly received women in the age group between 19 and 59 years old, and the most frequent diagnoses were conjunctivitis and trauma.

Revisão de escopo das publicações sobre transtorno obsessivo-compulsivo (TOC) e a pandemia de Covid-19 entre 2020 e 2022 / Scope review of the publications on obsessive compulsive disorder (TOC) and pandemic between 2020 and 2022

A proposta desta dissertação foi realizar uma revisão de escopo de 96 artigos científicos que analisaram a relação do quadro psicopatológico do Transtorno Obsessivo-Compulsivo (TOC) no contexto da pandemia de Covid-19, disponíveis em revistas indexadas. Tais publicações utilizadas neste mapeamento foram retiradas das bases de dados PubMed, PsyInfo e da biblioteca virtual Scielo. Elas são referentes ao período entre 2020 até março de 2022. A busca e filtragem deste material foi orientada pela metodologia da revisão de escopo. A análise destes artigos indicou a presença de dois objetivos nas pesquisas indicadas: a discussão da trajetória de evolução dos quadros de TOC e a terapêutica do TOC na pandemia. No capítulo a respeito dos quadros clínicos, a análise dos dados foi organizada a partir dos grupos populacionais estudados pelos autores (adultos, profissionais de saúde, gestantes e puérperas e crianças e adolescentes). A partir da divisão em grupos populacionais, as publicações foram agrupadas tendo em vista suas metodologias para o exame de seu desenvolvimento e achados. No capítulo sobre a terapêutica do TOC na Covid-19, os achados foram organizados por metodologias para seu exame. Os dados destes estudos mostraram que a maior parte dos autores se dedicaram a analisar o público adulto ou não especificaram objetivamente a idade das pessoas que avaliaram. Os profissionais de saúde foram a população menos contemplada por esta temática dentro das populações sobre as quais os artigos versaram. Os artigos sobre grávidas e puérperas buscaram discutir a influência das condições de vida para a saúde mental e o TOC destas pessoas, o que destoa das outras pesquisas nesta revisão de escopo. O impacto da pandemia, a explicação deste impacto para indivíduos com TOC, a influência das informações midiáticas sobre a Covid-19 e do grupo familiar sobre pessoas com TOC foram questões contempladas pelos autores mencionados neste capítulo. Os artigos sobre a terapêutica do transtorno em questão na Covid-19 discutiram as limitações originárias da crise sanitária para o tratamento do TOC, e exemplificaram ferramentas tecnológicas que podem ser utilizadas no tratamento das pessoas em questão. Alguns também buscaram traçar perfil de vulnerabilidade para o TOC na pandemia com a majoritariedade dos resultados apontando para a vulnerabilidade feminina. O tratamento da população composta por crianças e adolescentes com o transtorno foi pouco foi contemplado pelos pesquisadores nesta seção. Os determinantes sociais de saúde relacionadas ao gênero feminino, indicado como mais vulnerável ao TOC nos dois capítulos acima mencionados foram discutidos em uma seção própria. Nesta seção, dados de estudos sobre as condições de vida na pandemia da população feminina no Brasil e na América Latina foram utilizados para ilustrar a vulnerabilidade desta população.

The proposition of this dissertation was to make a scope review of 96 scientific articles that analyzed the relation of the psychopathological board of obssessive compulsive disorder (OCD) in the context of covid-19 pandemics, available in indexed magazines. Such publications utilized in this mapping were taken from the databases PubMed, PsyInfo and from the Scielo virtual library. They refer to the year of 2020 up to March 2022. The research and filtering of this material were oriented by the scope review methodology. The analysis of these articles pointed to the presence of two objectives in the referred researches: the discussion about the evolutionary trajectory of OCD cases and the therapeutics of OCD in the pandemic. In the chapter about the clinical cases, the data analysis was organized by the populational groups studied by the authors (adults, health professionals, pregnant and puerperal women, children and adolescents). By dividing the populational groups, the publications were arranged considering their methodologies for examining the developments and findings. In the chapter about the therapeutics of OCD during Covid-19, the findings were organised by the methodologies for their examination. The data from these studies show that the majority of authors have either dedicated themselves to analyze the adult public or didn´t speciffy objectively the age of the population evaluated. Health professionals were the population less considered by this thematics. The articles about pregnant and puerperal women focused on discussing the influence of the living conditions to mental health and the OCD of these people, wich differs from the other researches in this scope review. The impact of the pandemic, the explanation of this impact to individuals with OCD, the influence of media informations about Covid-19 and the family group about people with OCD were points contemplated by the authors mentioned in this chapter. The articles about the therapeutics of the disorder in question, during Covid-19, argued about the limitations that came from the sanitary crisis for the treatment of OCD, and exemplified technological tools that can be used on the treatment of such people. Some also tried to trace the profile of vulnerability to OCD in the pandemic, with the majority of the results pointing to female vulnerability. The treatment of the population composed by children and adolescents with the disorder was mentioned little by the researches in this section. The social determiners of health related to the female gender, pointed as the most vulnerable to OCD in the two chapters mentioned before, were discussed in a chapter of their own. In this chapter, data from studies about the life conditions, in the pandemic, of the feminine population in Brazil and Latin America were used to illustrate the vulnerability of this population.

Maternal mortality associated with COVID-19 in Brazil in 2020 and 2021: Comparison with non-pregnant women and men.

OBJECTIVE: Mortality rates of pregnant and postpartum women grew in the second COVID-19 pandemic year. Our objective is to understand this phenomenon to avoid further deaths. METHODS: We collected data from SIVEP-Gripe, a nationwide Brazilian database containing surveillance data on all severe acute respiratory syndrome caused by COVID-19, between the first notified case (February 2020) until the 17th epidemiological week of 2021. We stratified patients into maternal women (which includes pregnant and postpartum women), non-maternal women and men and divided them by time of diagnosis in two periods: first period (February to December 2020) and second period (the first 17 epidemiological weeks of 2021 before pregnant and postpartum women were vaccinated). RESULTS: During the second period, all patients had higher risk of presenting severe COVID-19 cases, but the maternal population was at a higher risk of death (OR of 2.60 CI 95%: 2.28-2.97)-almost double the risk of the two other groups. Maternal women also had a higher risk of needing intensive care, intubation and of presenting desaturation in the second period. Importantly, maternal women presented fewer comorbidities than other patient groups, suggesting that pregnancy and postpartum can be an important risk factor associated with severe COVID-19. CONCLUSION: Our results suggest that the Gama variant, which has been related to greater virulence, transmissibility and mortality rates leads to more severe cases of COVID-19 for pregnant and postpartum women.

IL6 genetic variants haplotype is associated with susceptibility and disease activity but not with therapy response in patients with inflammatory bowel disease.

PURPOSE: The aim of the present study was to evaluate the IL6 -174 G>C (rs1800795) and -572 G>C (rs1800796) genetic variants and their association with inflammatory bowel diseases (IBDs), disease activity, and response to TNF-α inhibitors. METHODS: The study included 178 patients with IBD and 224 healthy controls. Among the IBD patients, 66 of them were in use of TNF-α inhibitors therapy and were followed during 48 weeks and categorized as responders and non-responders. RESULTS: In total, 89 (50.0%) had ulcerative colitis (UC) and 89 (50.0%) had Crohn's disease (CD). The IL6 -572 CC genotype presented a protective effect in CD patients in codominant and recessive models, while the IL6 -174 CC genotype was associated with susceptibility to UC and CD. The presence of G/C haplotype in the recessive model (GCGC) was associated with UC. The Crohn's disease endoscopic index of severity was low in those patients carrying the GCGC haplotype. It was observed that there was no association between the IL6 genetic variants and TNF-α inhibitor therapy response. CONCLUSION: The G/C haplotype (recessive model) was associated with susceptibility to UC but not to CD. However, the G/C haplotype (dominant model) was associated with the endoscopic activity of CD. Moreover, these IL6 variants did not predict the TNF-α inhibitor therapy response.

Clinical and epidemiology evaluation of Aids-infected patients hospitalized between 2011 and 2016 in the Santos region of Brazil.

INTRODUCTION: We assessed the clinical-epidemiological profile of acquired immune deficiency syndrome (AIDS) patients in the Santos region (São Paulo state) with the highest AIDS prevalence in Brazil. METHODS: Information was extracted from records of 409 AIDS-infected patients hospitalized between 2011 and 2016. RESULTS: Human immunodeficiency virus (HIV) was diagnosed in 24.7% of patients during admission, and 39.6% of already diagnosed patients received highly active antiretroviral therapy (HAART) irregularly. The mortality rate was 19.1%, and the main secondary manifestations were neurotoxoplasmosis and tuberculosis. CONCLUSIONS: AIDS patients in the Santos region had high rates of late diagnosis and low treatment adherence.