Relationship between vitamin B12 levels and motor development: A systematic review.

BACKGROUND AND OBJECTIVES: Nutrition plays a crucial role in the development and health of the human brain, from early stages to adulthood. The complex process of neurodevelopment necessitates interaction among various factors, with balance in the concentration of vital macronutrients and micronutrients being essential. Regarding micronutrients, vitamin B12 stands out, playing a vital role in the development and functioning of the motor nervous system. The objective was to investigate the influence of reduced levels of vitamin B12 on infant motor development and analyze the effects of supplementation on this aspect of development. METHODS: For this purpose, the criteria of the PRISMA method and registration in the PROSPERO database were used. The search was conducted in the following databases: PubMed (Medline), Scopus, PsycINFO, Web of Science, and ScienceDirect. A total of 684 records were initially identified. RESULTS: Of the eight included articles, there was diversity regarding geographical contexts and study designs. The final sample comprised a total of 1,559 participants of both sexes. Studies aimed at correcting low levels of vitamin B12 opted for supplementation, following various protocols that varied in dose, administration method, and duration. At the end of the studies, the serum level of this vitamin ranged from 131 pmol/L to 1141 pmol/L. CONCLUSION: There is a complex array of factors contributing to reduced levels of vitamin B12, especially in the early stages of life, which significantly impacts infant motor development. Despite methodological variations among studies, evidence suggests that low levels of vitamin B12 may affect motor development and that supplementation could be an effective means of enhancing motor aspects in healthy children. However, due to the diversity of outcomes, it is important to promote comprehensive public policies to encourage appropriate interventions in this area.

[Overview of long COVID in Brazil: a preliminary analysis of a survey to think about health policies]. / Panorama da COVID longa no Brasil: análise preliminar de um inquérito para pensar políticas de saúde.

Characterized by symptoms that remain or appear for the first time within three months of SARS-CoV-2 infection, long COVID can manifest itself in different ways, including in non-hospitalized or asymptomatic cases. Thus, this study offers an overview of long COVID in Brazil, especially of its diagnosis, symptoms, and challenges for new health management. Data from a study that investigated long COVID in people affected by COVID-19 were used. These original data stem from a survey with adult Brazilians (aged 18 years or older) who had COVID-19 that collected information from March 14 to April 14, 2022, by a questionnaire on social media. The questionnaire addressed sociodemographic characteristics, history of COVID-19 infections, vaccination against the disease, investigation of health status and quality of life before and after COVID-19, and search and access to treatment. Of the 1,728 respondents, 720 were considered eligible for analysis, of which 496 (69%) had long COVID. Individuals with long COVID reported clinical manifestations such as anxiety (80%), memory loss (78%), generalized pain (77%), lack of attention (75%), fatigue (73%), hair loss (71%), sleep changes (70%), mood swings (62%), malaise (60%), and joint pain (59%). Most sought health services during and after the acute phase of COVID-19 (94 and 80%, respectively), representing the need to structure the healthcare system for these patients.

Caracterizada por sintomas que permanecem ou aparecem pela primeira vez em até três meses após a infecção pelo SARS-CoV-2, a COVID longa pode se manifestar de diferentes formas, inclusive entre casos não hospitalizados ou assintomáticos. Nesse sentido, este artigo apresenta um panorama da COVID longa no Brasil, com ênfase no diagnóstico, nos sintomas e nos desafios para a nova gestão da saúde. Foram utilizados dados de um estudo realizado com objetivo de investigar a COVID longa em pessoas acometidas pela COVID-19, com dados originais de um inquérito com indivíduos brasileiros adultos (18 anos ou mais) que tiveram COVID-19, coletados entre 14 de março e 14 de abril de 2022, por meio de questionário divulgado em redes sociais. O questionário abordou características sociodemográficas, histórico de infecções por COVID-19, vacinação contra a doença, investigação da situação de saúde e da qualidade de vida antes e após a COVID-19, além da busca e acesso a tratamento. Dos 1.728 respondentes, 720 foram considerados elegíveis para a análise. Desses, 496 (69%) tiveram COVID longa. Os indivíduos com COVID longa reportaram manifestações clínicas como ansiedade (80%), perda de memória (78%), dor generalizada (77%), falta de atenção (75%), fadiga (73%), queda de cabelo (71%), alterações de sono (70%), alterações de humor (62%), indisposição (60%) e dor nas articulações (59%). A maioria procurou os serviços de saúde durante e após a fase aguda de COVID-19 (94% e 80%, respectivamente), o que representa a necessidade de estruturar o sistema de saúde para atender esses pacientes.

Caracterizado por síntomas que permanecen o aparecen por primera vez dentro de los tres meses posteriores a la infección por SARS-CoV-2, la COVID larga puede manifestarse de diferentes formas, incluso entre casos no hospitalizados o asintomáticos. En este sentido, este artículo presenta un panorama la COVID larga en Brasil, con énfasis en el diagnóstico, los síntomas y los desafíos para la nueva gestión de la salud. Se utilizaron datos de una encuesta realizada para investigar la COVID larga en personas afectadas por COVID-19. Se trata de datos originales de una encuesta con individuos brasileños adultos (18 años o más), que tuvieron COVID-19, con datos recolectados entre el 14 de marzo y el 14 de abril de 2022, por medio de un cuestionario divulgado en las redes sociales. El cuestionario abordó características sociodemográficas, historial de infecciones por COVID-19, vacunación contra la enfermedad, investigación de la situación de salud y de la calidad de vida antes y después de COVID-19, además de la búsqueda y acceso a tratamiento. De los 1.728 encuestados, 720 fueron considerados elegibles para el análisis. De ellos, 496 (69%) tenían COVID larga. Las personas con COVID larga informaron manifestaciones clínicas como ansiedad (80%), pérdida de memoria (78%), dolor generalizado (77%), falta de atención (75%), fatiga (73%), pérdida de cabello (71%), cambios en el sueño (70%), cambios de humor (62%), malestar (60%) y dolor en las articulaciones (59%). La mayoría recurrió a los servicios de salud durante y después de la fase aguda de COVID-19 (94% y 80%, respectivamente), lo que representa la necesidad de estructurar el sistema de salud para atender a estos pacientes.

Pre-Slaughter Stunning Methods Influence the Meat Quality of Arapaima gigas Fillets.

The aim of this study was to evaluate the influence of different stunning methods on the meat quality of Arapaima gigas fillets from fish farming. A total of 48 specimens of A. gigas in the weight class 11.1 to 14.0 kg were investigated; these fish were subjected to different stunning methods for slaughter: ice asphyxia (IA), air asphyxia (AA), electronarcosis (EE) and hypothermia followed by bleeding (HB). Then, data were obtained from the analysis of pH, rigor mortis index (RI), water activity (Aw), instrumental texture (compression strength, firmness and adhesiveness) and blood glucose and via instrumental colourimetry. During the study, for up to 15 days of refrigerated storage, the methods provided pH values below 6.0. A. gigas submitted to EE and HB remained longer in the pre-rigor status. In addition, they expressed lower percentages of Aw. The EE method resulted in better texture assignments in the fillets. The blood glucose values indicated that the fish subjected to EE were less stressed. Concerning instrumental colourimetry, the fillets submitted to EE and HB showed greater luminosity; the fillets subjected to AA showed greater red-green colour intensity, while the fillets subjected to EE showed greater yellow-blue colour intensity. Therefore, the fish did not suffer stress with electronarcosis, and the fillets showed better preservation, juiciness, and tenderness.

Beyond conventional approaches: Enhancing photodynamic therapy for refractory feline sporotrichosis caused by Sporothrix brasiliensis.

Male cat, 2 years old, with a refractory infection by Sporothrix brasiliensis, presents a single nodular lesion in the left auricular pavilion. To confirm the diagnosis, cytology, fungal culture, antifungal susceptibility test, molecular analysis, and, to aid in the differential diagnosis, bacterial culture, antibiogram, and histopathology of the lesion were performed. In the absence of therapeutic success with conventional antifungals, photodynamic therapy (PDT) was introduced, demonstrating a satisfactory response in the sixth treatment session.

A deep learning model of tumor cell architecture elucidates response and resistance to CDK4/6 inhibitors.

Cyclin-dependent kinase 4 and 6 inhibitors (CDK4/6is) have revolutionized breast cancer therapy. However, <50% of patients have an objective response, and nearly all patients develop resistance during therapy. To elucidate the underlying mechanisms, we constructed an interpretable deep learning model of the response to palbociclib, a CDK4/6i, based on a reference map of multiprotein assemblies in cancer. The model identifies eight core assemblies that integrate rare and common alterations across 90 genes to stratify palbociclib-sensitive versus palbociclib-resistant cell lines. Predictions translate to patients and patient-derived xenografts, whereas single-gene biomarkers do not. Most predictive assemblies can be shown by CRISPR-Cas9 genetic disruption to regulate the CDK4/6i response. Validated assemblies relate to cell-cycle control, growth factor signaling and a histone regulatory complex that we show promotes S-phase entry through the activation of the histone modifiers KAT6A and TBL1XR1 and the transcription factor RUNX1. This study enables an integrated assessment of how a tumor's genetic profile modulates CDK4/6i resistance.

O papel do enfermeiro educador no desenvolvimento da liderança / The role of the nurse educator in leadership development

Compreender o papel do enfermeiro educador no desenvolvimento da liderança. Método: Trata-se de um relato de experiência, realizado com cinco grupos de enfermeiros com a temática de acordo com as suas especializações: pediatria, gestão, cuidados paliativos, centro cirúrgico e geriatria no Hospital Cruz Azul de São Paulo, no período de 2021 até 2023. Resultados: Notou-se progresso nos pontos elencados a partir do plano estratégico anteriormente desenvolvido nos setores de gestão, cuidados paliativos e clínica cirúrgica. Na perspectiva de autonomia e participação, o enfermeiro docente é peça chave na promoção de mudanças no ensino, como também, deve ser responsável pela criação de medidas para fomentar o pensamento crítico e criativo de sua equipe. Conclusão: A inserção de práticas pedagógicas bem como a aproximação dos indivíduos em desenvolvimento de liderança à equipe multidisciplinar são estratégias metodológicas exitosas na formação de enfermeiros-líderes.(AU)

To understand the role of nurse educator in the development of leadership. Method: This is an experience report, conducted with five groups of nurses with the theme according to their specializations: pediatrics, management, palliative care, surgical center and geriatrics at the Cruz Azul Hospital of São Paulo, from 2021 to 2023. Results: Progress was noted in the points listed from the strategic plan previously developed in the management, palliative care and surgical sectors. From the perspective of autonomy and participation, the teaching nurse is a key player in promoting changes in teaching, as well as being responsible for creating measures to foster critical and creative thinking of his team. Conclusion: The insertion of pedagogical practices as well as the approach of individuals in leadership development to the multidisciplinar team are successful methodological strategies in training nurses-leaders.(AU)

Comprender el papel del enfermero educador en el desarrollo del liderazgo. Método: Se trata de un relato de experiencia, realizado con cinco grupos de enfermeros con la temática de acuerdo con sus especializaciones: pediatría, gestión, cuidados paliativos, centro quirúrgico y geriatría en el Hospital Cruz Azul de São Paulo, en el período de 2021 hasta 2023. Resultados: Se notó progreso en los puntos enumerados a partir del plan estratégico anteriormente desarrollado en los sectores de gestión, cuidados paliativos y clínica quirúrgica. En la perspectiva de autonomía y participación, el enfermero docente es pieza clave en la promoción de cambios en la enseñanza, como también, debe ser responsable por la creación de medidas para fomentar el pensamiento crítico y creativo de su equipo. Conclusión: La inserción de prácticas pedagógicas así como el acercamiento de los individuos en desarrollo de liderazgo al equipo multidisciplinar son estrategias metodológicas exitosas en la formación de enfermeros-líderes.(AU)

The effects of the use of customized silicone digital orthoses on pre-ulcerative lesions and plantar pressure during walking in people with diabetic neuropathy: A study protocol for a randomized controlled trial.

Background: People with diabetes and diabetic peripheral neuropathy (DPN) often develop calluses due to toe misalignment and increased plantar pressure. Untreated, these issues can progress into ulcers, making early intervention crucial. This trial protocol aims to evaluate the efficacy and safety of customized silicone digital orthoses in preventing ulcers, pre-ulcerative lesions, and peak pressure during gait in people with DPN. Methods: In this superiority randomized controlled parallel trial with single-blind assessment, 60 participants will be allocated to the control group (CG) or the intervention group (IG). The CG will receive specialized nurse-administered foot care, including callus removal, nail care guidance, and self-care education. The IG will receive the same care plus a customized silicone orthosis for toe realignment for 6 months. Assessments will occur at baseline and 3 and 6 months for the primary outcomes (pre-ulcerative lesions and ulcer incidence) and secondary outcomes (pressure distribution, foot function and health, quality of life, safety, and comfort). Two-way ANOVAs (p < .05) will assess group, time, and group by time effects following an intention-to-treat approach. Conclusion: Although recommended for foot ulcer prevention, custom silicone orthosis adoption remains limited due to the low certainty of evidence. This trial seeks to provide more consistent evidence for the use of toe orthoses in preventing callus and ulcer formation for individuals with DPN. Trial registry: ClinicalTrials.gov (NCT05683106) "Effects of Customized Silicone Digital Orthoses in People with Diabetic Neuropathy" (registered on December 20, 2022).

Use of a Modelling Tool to Optimise the Organisation of the Demand for Primary Oral Health Care in the Brazilian Unified Health System.

PURPOSE: To describe the use of work process modelling to optimise the organisation of the demand for oral health treatment in primary care units in Brazil. MATERIALS AND METHODS: The oral health care routine was at first described as the "AS IS" model, which was evaluated by the oral team professionals, rearranged, and further described as the "TO BE" model described using a business process management modelling tool. The significant increase in the demand of patients due to restrictions offered by the dental service in addition to non-urgent treatments being avoided by patients during COVID-19 pandemic was also considered. RESULTS: Structuring the work processes in a visual way using modelling tools was useful to picture the entire treatment process and adjust when needed. The use of the managerial tool was useful to understand and reorganise the workflow of organising the demand and ultimately improve the efficiency of the resources. The use of such managerial tools helped oral health professionals to efficiently rearrange their tasks and set priorities to meet their needs. CONCLUSIONS: With the use of management tools, each unit can readjust its structures and ways of working, aiming to improve the quality of public health care services provided to patients.

Molecular Characterization and Genome Mechanical Features of Two Newly Isolated Polyvalent Bacteriophages Infecting Pseudomonas syringae pv. garcae.

Coffee plants have been targeted by a devastating bacterial disease, a condition known as bacterial blight, caused by the phytopathogen Pseudomonas syringae pv. garcae (Psg). Conventional treatments of coffee plantations affected by the disease involve frequent spraying with copper- and kasugamycin-derived compounds, but they are both highly toxic to the environment and stimulate the appearance of bacterial resistance. Herein, we report the molecular characterization and mechanical features of the genome of two newly isolated (putative polyvalent) lytic phages for Psg. The isolated phages belong to class Caudoviricetes and present a myovirus-like morphotype belonging to the genuses Tequatrovirus (PsgM02F) and Phapecoctavirus (PsgM04F) of the subfamilies Straboviridae (PsgM02F) and Stephanstirmvirinae (PsgM04F), according to recent bacterial viruses' taxonomy, based on their complete genome sequences. The 165,282 bp (PsgM02F) and 151,205 bp (PsgM04F) genomes do not feature any lysogenic-related (integrase) genes and, hence, can safely be assumed to follow a lytic lifestyle. While phage PsgM02F produced a morphogenesis yield of 124 virions per host cell, phage PsgM04F produced only 12 virions per host cell, indicating that they replicate well in Psg with a 50 min latency period. Genome mechanical analyses established a relationship between genome bendability and virion morphogenesis yield within infected host cells.

Long COVID Among Kidney Transplant Recipients Appears to Be Attenuated During the Omicron Predominance.

BACKGROUND: Omicron variant has been associated with milder cases of COVID-19 among kidney transplant recipients. However, little is known about postacute sequelae, referred to as Long COVID. METHODS: Prospective, single-center cohort study investigating prevalence and risk factors for Long COVID among kidney transplant recipients during the omicron predominance in Brazil. The analysis included adult patients with confirmed SARS-CoV-2 infection between January 5, 2022, and July 18, 2022, were alive, had a functioning kidney transplant 3 mo after symptom onset, and answered a telephonic survey about physical complains of Long COVID. RESULTS: From the 1529 eligible, 602 (39%) patients responded the survey. Sixteen percent reported a previous SARS-CoV-2 infection, and 85% had been fully vaccinated. The prevalence of Long COVID was 52%, with the most common complaints being weakness (46%), myalgia (41%), dizziness (33%), and headache (31%). Among employed patients, 94% were able to resume their normal work activities. In multivariable analysis, female gender (hazard ratio [HR], 2.14; 95% confidence interval [CI], 1.51-3.02; P < 0.0001), previous SARS-CoV-2 infection (HR, 3.55; 95% CI, 1.91-6.60; P < 0.0001), fatigue (HR, 2.32; 95% CI, 1.18-4.55; P = 0.014), myalgia (HR, 1.48; 95% CI, 1.03-2.15; P = 0.036) during the acute phase, and hospitalization because of COVID-19 (HR, 1.71; 95% CI, 1.06-2.76; P = 0.028) were independently associated with Long COVID. CONCLUSIONS: In the "omicron era," Long COVID among kidney transplant recipients exhibited milder characteristics and had a less significant impact on their ability to resume normal life activities. The risk factors for persistent symptoms were similar to those observed in the general population except for the vaccination status, underscoring the importance of closer monitoring in special subgroups.

The use of Lentilactobacillus buchneri PJB1 and Lactiplantibacillus plantarum MTD1 on the ensiling of whole-plant corn silage, snaplage, and high-moisture corn.

Experiments were conducted over a 3-yr period to evaluate the effects of bacterial inoculants on the fermentation profile and aerobic stability of whole-plant corn silage (WPC), snaplage (SNA), and high-moisture corn (HMC). Whole-plant corn was inoculated with Lentilactobacillus buchneri PJB1 in combination with Lactiplantibacillus plantarum MTD1 or with Lpb. plantarum alone (experiments 1 and 2). Snaplage (experiment 3) and HMC (experiments 4 and 5) were inoculated with Len. buchneri in combination with Lpb. plantarum or with Len. buchneri alone. After inoculation, the feedstuffs were ensiled in 7.57-L silos and stored at 21 ± 2°C for 30 or 90 d. In experiment 5, silage was subjected to air stress for 2 h every 2 wk through 42 d and then for 2 h/wk until 90 d and had samples analyzed for their bacterial community composition by metagenomics. Overall, in all experiments, silages inoculated with Len. buchneri alone or in combination with Lpb. plantarum had more acetic acid and 1,2-propanediol and fewer yeasts than uninoculated silages. After 30 d of ensiling, inoculation with Len. buchneri alone or in combination with Lpb. plantarum did not affect the aerobic stability of SNA, but it slightly increased the stability of WPC and markedly improved the stability of HMC. After 90 d of ensiling, inoculation with Len. buchneri alone or in combination with Lpb. plantarum markedly improved the aerobic stability of WPC, SNA, and HMC. In experiment 5, inoculation increased the relative abundance (RA) of Lactobacillaceae and reduced the RA of Enterobacteriaceae and Leuconostocaceae in HMC at 30 and 90 d and the RA of Clostridiaceae in non-air-stressed HMC at 90 d. Air-stressed HMC inoculated with Len. buchneri had less lactic acid, more acetic acid and 1,2-propanediol, and markedly greater aerobic stability than uninoculated air-stressed HMC at 90 d. In conclusion, inoculation with Len. buchneri PJB1 alone or in combination with Lpb. plantarum MTD1 increased the production of acetic acid and 1,2-propanediol, inhibited yeasts development, and improved the aerobic stability of WPC, SNA, and HMC. In HMC, inoculation markedly improved aerobic stability as soon as after 30 d of ensiling, and after 90 d, inoculation improved stability even under air stress conditions.

High-Resolution Plasma Metabolomics Identifies Alterations in Fatty Acid, Energy, and Micronutrient Metabolism in Adults Across the Leprosy Spectrum.

BACKGROUND: High-resolution metabolomics (HRM) is an innovative tool to study challenging infectious diseases like leprosy, where the pathogen cannot be grown with standard methods. Here, we use HRM to better understand associations between disease manifestations, nutrition, and host metabolism. METHODS: From 2018 to 2019, adults with leprosy and controls were recruited in Minas Gerais, Brazil. Plasma metabolites were detected using an established HRM workflow and characterized by accurate mass, mass to charge ratio m/z and retention time. The mummichog informatics package compared metabolic pathways between cases and controls and between multibacillary (MB) and paucibacillary (PB) leprosy. Additionally, select individual metabolites were quantified and compared. RESULTS: Thirty-nine cases (62% MB and 38% PB) and 25 controls were enrolled. We found differences (P < .05) in several metabolic pathways, including fatty acid metabolism, carnitine shuttle, retinol, vitamin D3, and C-21 steroid metabolism, between cases and controls with lower retinol and associated metabolites in cases. Between MB and PB, leukotrienes, prostaglandins, tryptophan, and cortisol were all found to be lower in MB (P < .05). DISCUSSION: Metabolites associated with several nutrient-related metabolic pathways appeared differentially regulated in leprosy, especially MB versus PB. This pilot study demonstrates the metabolic interdependency of these pathways, which may play a role in the pathophysiology of disease.

Panorama da COVID longa no Brasil: análise preliminar de um inquérito para pensar políticas de saúde / Overview of long COVID in Brazil: a preliminary analysis of a survey to think about health policies / Panorama de la COVID larga en Brasil: un análisis preliminar de una encuesta para pensar en políticas de salud

Caracterizada por sintomas que permanecem ou aparecem pela primeira vez em até três meses após a infecção pelo SARS-CoV-2, a COVID longa pode se manifestar de diferentes formas, inclusive entre casos não hospitalizados ou assintomáticos. Nesse sentido, este artigo apresenta um panorama da COVID longa no Brasil, com ênfase no diagnóstico, nos sintomas e nos desafios para a nova gestão da saúde. Foram utilizados dados de um estudo realizado com objetivo de investigar a COVID longa em pessoas acometidas pela COVID-19, com dados originais de um inquérito com indivíduos brasileiros adultos (18 anos ou mais) que tiveram COVID-19, coletados entre 14 de março e 14 de abril de 2022, por meio de questionário divulgado em redes sociais. O questionário abordou características sociodemográficas, histórico de infecções por COVID-19, vacinação contra a doença, investigação da situação de saúde e da qualidade de vida antes e após a COVID-19, além da busca e acesso a tratamento. Dos 1.728 respondentes, 720 foram considerados elegíveis para a análise. Desses, 496 (69%) tiveram COVID longa. Os indivíduos com COVID longa reportaram manifestações clínicas como ansiedade (80%), perda de memória (78%), dor generalizada (77%), falta de atenção (75%), fadiga (73%), queda de cabelo (71%), alterações de sono (70%), alterações de humor (62%), indisposição (60%) e dor nas articulações (59%). A maioria procurou os serviços de saúde durante e após a fase aguda de COVID-19 (94% e 80%, respectivamente), o que representa a necessidade de estruturar o sistema de saúde para atender esses pacientes.

Characterized by symptoms that remain or appear for the first time within three months of SARS-CoV-2 infection, long COVID can manifest itself in different ways, including in non-hospitalized or asymptomatic cases. Thus, this study offers an overview of long COVID in Brazil, especially of its diagnosis, symptoms, and challenges for new health management. Data from a study that investigated long COVID in people affected by COVID-19 were used. These original data stem from a survey with adult Brazilians (aged 18 years or older) who had COVID-19 that collected information from March 14 to April 14, 2022, by a questionnaire on social media. The questionnaire addressed sociodemographic characteristics, history of COVID-19 infections, vaccination against the disease, investigation of health status and quality of life before and after COVID-19, and search and access to treatment. Of the 1,728 respondents, 720 were considered eligible for analysis, of which 496 (69%) had long COVID. Individuals with long COVID reported clinical manifestations such as anxiety (80%), memory loss (78%), generalized pain (77%), lack of attention (75%), fatigue (73%), hair loss (71%), sleep changes (70%), mood swings (62%), malaise (60%), and joint pain (59%). Most sought health services during and after the acute phase of COVID-19 (94 and 80%, respectively), representing the need to structure the healthcare system for these patients.

Caracterizado por síntomas que permanecen o aparecen por primera vez dentro de los tres meses posteriores a la infección por SARS-CoV-2, la COVID larga puede manifestarse de diferentes formas, incluso entre casos no hospitalizados o asintomáticos. En este sentido, este artículo presenta un panorama la COVID larga en Brasil, con énfasis en el diagnóstico, los síntomas y los desafíos para la nueva gestión de la salud. Se utilizaron datos de una encuesta realizada para investigar la COVID larga en personas afectadas por COVID-19. Se trata de datos originales de una encuesta con individuos brasileños adultos (18 años o más), que tuvieron COVID-19, con datos recolectados entre el 14 de marzo y el 14 de abril de 2022, por medio de un cuestionario divulgado en las redes sociales. El cuestionario abordó características sociodemográficas, historial de infecciones por COVID-19, vacunación contra la enfermedad, investigación de la situación de salud y de la calidad de vida antes y después de COVID-19, además de la búsqueda y acceso a tratamiento. De los 1.728 encuestados, 720 fueron considerados elegibles para el análisis. De ellos, 496 (69%) tenían COVID larga. Las personas con COVID larga informaron manifestaciones clínicas como ansiedad (80%), pérdida de memoria (78%), dolor generalizado (77%), falta de atención (75%), fatiga (73%), pérdida de cabello (71%), cambios en el sueño (70%), cambios de humor (62%), malestar (60%) y dolor en las articulaciones (59%). La mayoría recurrió a los servicios de salud durante y después de la fase aguda de COVID-19 (94% y 80%, respectivamente), lo que representa la necesidad de estructurar el sistema de salud para atender a estos pacientes.

Pediatricians' focus of sight at pain assessment during a neonatal heel puncture / Foco do olhar do pediatra na avaliação da dor neonatal durante uma punção de calcanhar

ABSTRACT Objective: To evaluate the focus of pediatricians' gaze during the heel prick of neonates. Methods: Prospective study in which pediatricians wearing eye tracker glasses evaluated neonatal pain before/after a heel prtick. Pediatricians scored the pain they perceived in the neonate in a verbal analogue numerical scale (0=no pain; 10=maximum pain). The outcomes measured were number and time of visual fixations in upper face, lower face, and hands, in two 10-second periods, before (pre) and after the puncture (post). These outcomes were compared between the periods, and according to pediatricians' pain perception: absent/mild (score: 0-5) and moderate/intense (score: 6-10). Results: 24 pediatricians (31 years old, 92% female) evaluated 24 neonates. The median score attributed to neonatal pain during the heel prick was 7.0 (Interquartile range: 5-8). Compared to pre-, in the post-periods, more pediatricians fixed their gaze on the lower face (63 vs. 92%; p=0.036) and the number of visual fixations was greater on the lower face (2.0 vs. 5.0; p=0.018). There was no difference in the number and time of visual fixations according to the intensity of pain. Conclusions: At bedside, pediatricians change their focus of attention on the neonatal face after a painful procedure, focusing mainly on the lower part of the face.

RESUMO Objetivo: Avaliar o foco do olhar do pediatra durante a punção do calcanhar de neonatos. Métodos: Estudo prospectivo no qual pediatras, utilizando óculos de rastreamento visual, avaliaram a dor neonatal antes/depois de uma punção de calcanhar. Os pediatras pontuaram a dor de acordo com a sua percepção por meio de uma escala analógica verbal (0=sem dor; 10=dor máxima). Os desfechos analisados foram o número e o tempo das fixações visuais na face superior, face inferior e mãos, em dois períodos de 10 segundos, antes (PRÉ) e depois da punção (PÓS). Os resultados foram comparados entre os períodos e segundo a percepção da dor do pediatra: ausente/leve (escore: 0-5) e moderada/grave (escore: 6-10). Resultados: Vinte e quatro pediatras (31 anos, 92% sexo feminino) avaliaram 24 neonatos. A mediana do escore atribuído à dor do recém-nascido durante a punção do calcanhar foi 7,0 (intervalo interquartil: 5-8). Comparado ao período PRÉ, no período PÓS, o maior número de pediatras fixou o olhar na face inferior (63 vs. 92%; p=0,036) e o número de fixações visuais foi maior na face inferior (2,0 vs. 5,0; p=0,018). Não houve diferença no número e no tempo das fixações visuais de acordo com a intensidade da dor. Conclusões: À beira do leito, os pediatras mudam seu foco de atenção visual na face do recém-nascido após um procedimento doloroso, focando o olhar principalmente na parte inferior da face.