LRRC56 is an IFT cargo required for assembly of the distal dynein docking complex in Trypanosoma brucei.

Outer dynein arms (ODAs) are responsible for ciliary beating in eukaryotes. They are assembled in the cytoplasm and shipped by intraflagellar transport (IFT) before attachment to microtubule doublets via the docking complex. The LRRC56 protein has been proposed to contribute to ODAs maturation. Mutations or deletion of the LRRC56 gene lead to reduced ciliary motility in all species investigated so far, but with variable impact on dynein arm presence. Here, we investigated the role of LRRC56 in the protist Trypanosoma brucei, where its absence results in distal loss of ODAs, mostly in growing flagella. We show that LRRC56 is a transient cargo of IFT trains during flagellum construction and surprisingly, is required for efficient attachment of a subset of docking complex proteins present in the distal portion of the organelle. This relation is interdependent since the knockdown of the distal docking complex prevents LRRC56's association with the flagellum. Intriguingly, lrrc56-/- cells display shorter flagella whose maturation is delayed. Inhibition of cell division compensates for the distal ODAs absence thanks to the redistribution of the proximal docking complex, restoring ODAs attachment but not the flagellum length phenotype. This work reveals an unexpected connection between LRRC56 and the docking complex.

Conservative treatment of sexual dysfunction among men undergoing prostate cancer treatment: a systematic review.

INTRODUCTION: One of the changes caused by pelvic cancers is the decrease in patients' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency. OBJECTIVES: This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer. METHODS: Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome. RESULTS: Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported. CONCLUSION: Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.

Microplastics and 17α Ethinylestradiol: How Do Different Aquatic Invertebrates Respond to This Combination of Contaminants?

The synthetic hormone 17α ethinyl estradiol (EE2) is a molecule widely used in female contraceptives and recognized as a contaminant of attention (Watch List) in the European Union due to its high consumption, endocrine effects and occurrence in aquatic environments. Its main source of introduction is domestic sewage where it can be associated with other contaminants such as microplastics (MPs). Due to their characteristics, they can combine with each other and exacerbate their isolated effects on biota. This study evaluated the combined effects of microplastics (MPs) and 17α ethinylestradiol (EE2) on two tropical estuarine invertebrate species: Crassostrea gasar and Ucides cordatus. Polyethylene particles were spiked with EE2 and organisms were exposed to three treatments, categorized into three groups: control group (C), virgin microplastics (MPs), and spiked microplastics with EE2 (MPEs). All treatments were evaluated after 3 and 7 days of exposure. Oysters exhibited changes in phase 2 enzymes and the antioxidant system, oxidative stress in the gills, and reduced lysosomal membrane stability after exposure to MPs and MPEs. Crabs exposed to MPs and MPEs after seven days showed changes in phase 1 enzymes in the gills and changes in phases 1 and 2 enzymes in the hepatopancreas, such as disturbed cellular health. The combined effects of microplastics and EE2 increased the toxicity experienced by organisms, which may trigger effects at higher levels of biological organization, leading to ecological disturbances in tropical coastal ecosystems.

Autonomic modulation of heart rate during physical activity in pregnant women: A systematic review of literature.

BACKGROUND: There are important physiological changes in the heart rate autonomic modulation in pregnant women and these changes may affect the way their bodies respond to exercise stimulus. The objective of this review is to verify the physical exercise influence on autonomic modulation of heart rate in pregnant women. METHODS: This study is a Systematic Review. The electronic databases used to search for the studies were Cochrane Library, MEDLINE via PUBMED, Regional Health Portal and EMBASE. Experimental studies that evaluated heart-rate variability in pregnant women practicing physical exercises were included. And articles that addressed only fetal heart-rate variability, case reports, congress abstracts, clinical trial protocols without results, preprints, and gray literature were excluded. There were no language or publication year restrictions. The descriptors used in the Search were Cardiac Chronotropism, Sympathetic Nervous System, Pregnancy, and Physical Exercise. For statistical analysis, the fixed effect model was used. RESULTS: A total of 3106 articles were found, and 12 studies were included, which 5 were nonrandomized clinical trials, 4 were randomized clinical trials, and 3 were cross-sectional studies. Three hundred and four pregnant women were included in the studies. The application of physical exercise was varied, but in general they used aerobic exercises and with increased variability of the heart rate and reflex on the autonomic modulation of heart rate. CONCLUSION: Most studies demonstrate benefits heart rate in pregnant women, but limited research makes it hard to compare specific types of exercise and larger studies are needed to identify the best exercise.

Is prehospital physical performance a predictor of functional capacity decline at discharge in hospitalized Brazilian older adults?

BACKGROUND: Hospitalization contributes to functional decline in older adults. OBJECTIVE: To assess the relationship between physical performance on admission and functional capacity and functional capacity decline at discharge, and to investigate tools capable of predicting this decline. METHODS: Prospective longitudinal study with 75 older adults admitted to a public hospital between July 2021 and February 2022. The independent variable was physical performance evaluated on admission by handgrip strength (HGS) and the Short Physical Performance Battery (SPPB). The dependent variables were functional capacity for basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs) and their decline between admission and discharge. Statistical analyses were performed using linear and logistic regression and ROC curves. RESULTS: The median time between admission and participant assessment was 1 day (IQR=1-2 days). Median hospitalization time was 18 days (IQR= 7.5-30 days). Functional capacity for BADLs and IADLs declined in 39% and 79% of the participants, respectively. Performance in HGS and the SPPB at baseline, in adjusted models, explained 29.3 to 35.3% of functional capacity at discharge. One additional point in the SPPB decreased the risk of functional capacity decline for BADLs by 20.9% (OR=0.79, 95% CI: 0.68, 0.91). The AUC values for the SPPB (AUC=0.67) and HGS (AUC=0.65) were significant in identifying functional decline for BADLs, but not IADLs. CONCLUSION: In Brazilian older adults, physical performance on admission was related to functional capacity and its decline at discharge. Physical performance on admission is predictive of functional decline at discharge.

PAH residues and toxicity levels two years after an extensive oil spill on the northeast Brazilian coast.

The most extensive oil spill ever recorded in tropical oceans occurred between August 2019 and March 2020, affecting approximately 3000 km of the Brazilian coast. This study assessed the chemical contamination and toxicity of sediments collected from affected reef areas during two sampling surveys conducted 17 and 24 months after the peak of oil slick inputs. Our results indicated that neither PAH levels nor measured toxicity showed a significant contribution from the spilled oil, with concentrations and biological effects indistinguishable from those in unaffected areas. Similarly, no differences were observed between seasons. Furthermore, there was no discernible relationship between sediment toxicity results and the measured PAH concentrations. Therefore, while biological responses indicated toxicity in most assessed areas, these responses are likely related to other local sources. This evidence suggests a natural oil attenuation process contributing to local environmental recovery. Nonetheless, further investigation is needed for other areas affected by oil spills.

Emergent properties of free-living nematode assemblages exposed to multiple stresses.

Biological communities are currently facing multi-stressor scenarios whose ecological impacts are challenging to estimate. In that respect, considering the complex nature of ecosystems and types and interaction among stressors is mandatory. Microcosm approaches using free-living nematode assemblages can effectively be used to assess complexity since they preserve the interactions inherent to complex systems when testing for multiple stress effects. In this study, we investigated the interaction effects of three stress factors, namely i-metallic mixture of Cu, Pb, Zn, and Hg (control [L0], low, [L1] and high [L2]), ii- CO2-driven acidification (pH 7.6 and 8.0), and iii- temperature rise (26 and 28 °C), on estuarine free-living nematode assemblages. Metal contamination had the greatest influence on free-living nematode assemblages, irrespective of pH and temperature scenarios. Interestingly, whilst the most abundant free-living nematode genera showed significant decreases in their densities when exposed to contamination, other, less abundant, genera were apparently favored and showed significantly higher densities in contaminated treatments. The augmented densities of tolerant genera may be attributed to indirect effects resulting from the impacts of toxicity on other components of the system, indicating the potential for emergent effects in response to stress. Temperature and pH interacted significantly with contamination. Whilst temperature rise had potentialized contamination effects, acidification showed the opposite trend, acting as a buffer to the effects of contamination. Such results show that temperature rise and CO2-driven acidification interact with contamination on coastal waters, highlighting the importance of considering the intricate interplay of these co-occurring stressors when assessing the ecological impacts on coastal ecosystems.

Polyhydroxyalkanoates and exopolysaccharides: An alternative for valuation of the co-production of microbial biopolymers.

Polyhydroxyalkanoates (PHAs) and exopolysaccharides (EPSs) belong to a class of abundant biopolymers produced by various fermenting microorganisms. These biocompounds have high value-added potential and can be produced concurrently. Co-production of PHAs and EPSs is a strategy employed by researchers to reduce costs associated with large-scale production. EPSs and PHAs are non-toxic, biocompatible, and biodegradable, making them suitable for various industrial sectors, including packaging and the medical and pharmaceutical industries. These biopolymers can be derived from agro-industrial residues, thus contributing to the bioeconomy by producing high-value-added products. This review investigates approaches for simultaneously synthesizing PHAs and EPSs using different carbon sources and microorganisms.

Urinary symptoms, falls and fear of falling in older people with cognitive impairment / Sintomas urinários, quedas e medo de cair em idosos com comprometimento cognitivo

Abstract Introduction: Among geriatric syndromes, cognitive impairment, urinary incontinence, nocturia, and falls stand out. Older adults with urinary incontinence are more prone to falls and exhibit fear of falling. Objective: To investigate the frequency of urinary incontinence and nocturia and evaluate the association of these variables with falls and fear of falling in older individuals with cognitive impairment. Methods: Cross-sectional study with older adults referred from Basic Health Units with cognitive impairment evaluated between 2019 and 2021. Information on urinary incontinence, nocturia, history of falls, and fear of falling provided by the participants and their caregivers was collected. Data were analyzed using Chi-square tests and univariate logistic regressions. Results: Data from 89 older adults were analyzed, of whom 58.4% had urinary incontinence, 28.1% had nocturia, 67.4% reported fear of falling, and 41.6% reported falls in the last six months. The group with urinary incontinence [χ2(1) = 5.147; p = 0.023] and the group with nocturia [χ2(1) = 4.353; p = 0.037] had significantly higher frequencies of fear of falling. No differences in the frequencies of history of falls were observed between individuals with and without urinary incontinence or nocturia (p > 0.05). Fear of falling was associated with urinary incontinence (OR = 2.833; 95% CI 1.137 - 7.062) and nocturia (OR = 3.365; 95% CI 1.033 - 10.966). Conclusion: Older adults with cognitive impairment have a high frequency of urinary incontinence, nocturia, falls, and fear of falling. Furthermore, there is an association between urinary incontinence, nocturia and fear of falling in this population.

Resumo Introdução: Entre as síndromes geriátricas, destacam-se o comprometimento cognitivo, a incontinência urinária, a noctúria e as quedas. Idosos com incontinência urinária são mais propensos a cair e apresentar medo de cair. Objetivo: Investigar a frequência de incontinência urinária e noctúria e avaliar a associação dessas variáveis com a ocorrência de quedas e com o medo de cair em idosos com comprometimento cognitivo. Métodos: Estudo transversal com idosos encaminhados das Unidades Básicas de Saúde com comprometimento cognitivo avaliados entre os anos de 2019 e 2021. Foram coletadas informações sobre incontinência urinária, noctúria, histórico de quedas e medo de cair, fornecidas pelos idosos e seus acompanhantes. Os dados foram analisados por meio dos testes quiquadrado e regressões logísticas univariadas. Resultados: Foram analisados dados de 89 idosos, dos quais 58,4% apresentavam incontinência urinária, 28,1% apresentavam noctúria, 67,4% tinham medo de cair e 41,6% relataram quedas nos últimos seis meses. O grupo com incontinência urinária [2(1) = 5,147; p = 0,023] e o grupo com noctúria [χ2(1) = 4,353; p = 0,037] apresentaram frequências significativamente maiores de medo de cair. Não foram observadas diferenças das frequências de histórico de quedas entre os indivíduos com e sem incontinência ou noctúria (p > 0,05). O medo de cair mostrouse associado à incontinência (OR = 2,833; IC95% 1,137 - 7,062) e à noctúria (OR = 3,365; IC 95% 1,033 - 10,966). Conclusão: Idosos com comprometimento cognitivo apresentam alta frequência de incontinência urinária, noctúria, quedas e medo de cair. Ademais, há associação da incontinência urinária e da noctúria com o medo de cair nessa população.

Procedimento operacional padrão para armazenamento de materiais estéreis em ambiente extra hospitalar / Standard operating procedure for storage of sterile materials in extra-hospital environment

Introdução: Procedimento Operacional Padrão é um recurso de gestão, baseado em evidências científicas que auxilia no raciocínio e tomada de decisões de profissionais da área da saúde. Objetivo: Elaborar um Procedimento Operacional Padrão para armazenamento de materiais cirúrgicos estéreis em ambiente extra hospitalar, guiado por evidências científicas. Material e Métodos: Estudo metodológico descritivo baseado em uma revisão integrativa da literatura, cuja busca foi realizada nas bases National Library of Medicine, Red de Revistas Científicas de América Latina y el Caribe: Redalyc, Portal Regional da Biblioteca Virtual em Saúde, em setembro de 2023, com recorte temporal entre 2018 a 2023, além de busca no site do Ministério da Saúde. Resultados: Incluiram-se oito artigos, embasados na Resolução da Diretoria Colegiada, nº 15, de 2012. Os estudos abordaram temas sobre processamento de produtos para a saúde em ambiente hospitalar e não hospitalar, etapas do processamento de produtos para a saúde, segurança do paciente e educação permanente em saúde. A partir das evidências científicas elaborou-se o Procedimento Operacional Padrão, bem como um fluxograma. Conclusão: Pautado em evidências científicas e normativas instrucionais brasileiras, o Procedimento Operacional Padrão pode contribuir para um processo de trabalho qualificado, maior segurança na realização do cuidado e aprimoramento gerencial de materiais estéreis em ambiente extra hospitalar

Introduction: Standard Operating Procedure is a management resource, based on scientific evidence that assists in reasoning and decision-making by healthcare professionals. Objective: Develop a Standard Operating Procedure for storing sterile surgical materials in an extra-hospital environment, guided by scientific evidence. Material and Methods: Descriptive methodological study based on an integrative literature review, whose search was carried out in the National Library of Medicine, Red de Revistas Científicas de América Latina y el Caribe: Redalyc, Regional Portal of the Virtual Health Library, in September 2023 with clipping period between 2018 and 2023, in addition to a search on the Ministry of Health website. Results: Eight articles were included, based on the Resolution of the Collegiate Board, nº 15, of 2012. The studies addressed topics on the processing of health products in an environment hospital and non-hospital, stages of processing health products, patient safety and continuing health education. Based on the scientific evidence, the Standard Operating Procedure was created, as well as a flowchart. Conclusion: Based on scientific evidence and Brazilian instructional regulations, the Standard Operating Procedure can contribute to a qualified work process, greater safety in providing care and management improvements of sterile materials in an extra-hospital environment

Introducción: El Procedimiento Operativo Estándar es un recurso de gestión, basado en evidencia científica, que ayuda al razonamiento y la toma de decisiones de los profesionales de la salud. Objetivo: Desarrollar un Procedimiento Operativo Estándar para el almacenamiento de material quirúrgico estéril en un ambiente extrahospitalario, guiado por evidencia científica. Material y Métodos: Estudio metodológico descriptivo basado en una revisión integradora de la literatura, cuya búsqueda se realizó en la Biblioteca Nacional de Medicina, Red de Revistas Científicas de América Latina y el Caribe: Redalyc, Portal Regional de la Biblioteca Virtual en Salud, en septiembre de 2023 con periodo de recorte entre 2018 y 2023, además de una búsqueda en el sitio web del Ministerio de Salud. Resultados: Se incluyeron ocho artículos, con base en la Resolución del Consejo Colegiado, nº 15, de 2012. Los estudios abordaron temas sobre el procesamiento de productos para la salud en un ambiente hospitalario y no hospitalario, etapas de procesamiento de productos para la salud, seguridad del paciente y educación sanitaria continua. Con base en la evidencia científica se creó el Procedimiento Operativo Estándar, así como un diagrama de flujo. Conclusión: Basado en evidencia científica y normas de instrucción brasileñas, el Procedimiento Operativo Estándar puede contribuir para un proceso de trabajo calificado, mayor seguridad en la prestación de atención y mejoras en la gestión de materiales estériles en un ambiente extrahospitalario

Comprehensive sub-mitochondrial protein map of the parasitic protist Trypanosoma brucei defines critical features of organellar biology.

We have generated a high-confidence mitochondrial proteome (MitoTag) of the Trypanosoma brucei procyclic stage containing 1,239 proteins. For 337 of these, a mitochondrial localization had not been described before. We use the TrypTag dataset as a foundation and take advantage of the properties of the fluorescent protein tag that causes aberrant but fortuitous accumulation of tagged matrix and inner membrane proteins near the kinetoplast (mitochondrial DNA). Combined with transmembrane domain predictions, this characteristic allowed categorization of 1,053 proteins into mitochondrial sub-compartments, the detection of unique matrix-localized fucose and methionine synthesis, and the identification of new kinetoplast proteins, which showed kinetoplast-linked pyrimidine synthesis. Moreover, disruption of targeting signals by tagging allowed mapping of the mode of protein targeting to these sub-compartments, identifying a set of C-tail anchored outer mitochondrial membrane proteins and mitochondrial carriers likely employing multiple target peptides. This dataset represents a comprehensive, updated mapping of the mitochondrion.

Low-Grade Myofibroblastic Sarcoma of the Oral and Maxillofacial Region: An International Clinicopathologic Study of 13 Cases and Literature Review.

Low-grade myofibroblastic sarcoma (LGMS) represents an atypical tumor composed of myofibroblasts with a variety of histological patterns and with a high tendency to local recurrence and a low probability of distant metastases. LGMS has predilection for the head and neck regions, especially the oral cavity. This study aimed to report 13 new cases of LGMS arising in the oral and maxillofacial region. This study included LGMS cases from five oral and maxillofacial pathology laboratories in four different countries (Brazil, Peru, Guatemala, and South Africa). Their clinical, radiographic, histopathological, and immunohistochemical findings were evaluated. In this current international case series, most patients were females with a mean age of 38.7 years, and commonly presenting a nodular lesion in maxilla. Microscopically, all cases showed a neoplasm formed by oval to spindle cells in a fibrous stroma with myxoid and dense areas, some atypical mitoses, and prominent nucleoli. The immunohistochemical panel showed positivity for smooth muscle actin (12 of 13 cases), HHF35 (2 of 4 cases), ß-catenin (3 of 5 cases), desmin (3 of 11 cases), and Ki-67 (range from 5 to 50%). H-caldesmon was negative for all cases. The diagnosis of LGMS was confirmed in all cases. LGMS shows predominance in young adults, with a slight predilection for the female sex, and maxillary region. LGMS should be a differential diagnosis of myofibroblastic lesions that show a proliferation of spindle cells in a fibrous stroma with myxoid and dense areas and some atypical mitoses, supporting the diagnosis with a complementary immunohistochemical study. Complete surgical excision with clear margins is the treatment of choice. However, long-term follow-up information is required before definitive conclusions can be drawn regarding the incidence of recurrence and the possibility of metastasis.

Factors Associated with Symptoms of Posttraumatic Stress in Mothers During the COVID-19 Pandemic.

OBJECTIVES: The objective of the study was to evaluate the factors associated with symptoms of posttraumatic stress in mothers during the COVID-19 pandemic. METHODS: Cross-sectional study conducted with mothers of children and adolescents living in Brazil, who answered an online questionnaire containing sociodemographic variables and the Impact of Events Scale-Revised. The Poisson regression model with robust variance was used to identify the factors associated with posttraumatic stress. RESULTS: A percentage of 83.82% of mothers reported an overload in caring for their children during the pandemic. The prevalence of posttraumatic stress symptoms was 39.05%, and this condition was associated with younger age, living in the northern region of the country, using medications, presenting neuropsychiatric comorbidities and being little/more or less satisfied with life. CONCLUSIONS FOR PRACTICE: The mental health situation of mothers during and after the pandemic must be monitored, in order to guarantee public policies capable of optimizing the coping with the situation.

The hows and whys of amastigote flagellum motility in Trypanosoma cruzi.

The protist Trypanosoma cruzi exhibits several extracellular stages characterized by the presence of a long and motile flagellum and one intracellular life cycle stage termed amastigote, which possesses a tiny flagellum barely exiting the flagellar pocket. This stage was so far described as replicative but immotile cells. Unexpectedly, the recent work of M. M. Won, T. Krüger, M. Engstler, and B. A. Burleigh (mBio 14:e03556-22, 2023, https://doi.org/10.1128/mbio.03556-22) revealed that this short flagellum actually displays beating activity. This commentary explores how such a short flagellum could be constructed and why it could affect the parasite's survival inside the mammalian host.

Spawning ecology of the Saint Paul's Gregory Stegastes sanctipauli, a damselfish endemic to the remote St Peter and St Paul's Archipelago.

We studied the spawning ecology of Stegastes sanctipauli, a damselfish endemic to the small and remote St Peter and St Paul's Archipelago (Brazil), aiming to determine the main correlates of reproductive success, as inferred from rates of egg losses along a spawning season. New clutches appeared mostly in the last quarter moon, when egg predation intensified. Predation by heterospecifics, particularly Halichoeres radiatus (Linnaeus, 1758), accounted for most egg losses, while filial cannibalism showed negligible influence. Predation pressure was highest for larger nests with higher initial density of eggs. Hatching of eggs occurred close to the new moon (i.e., ~5 days after spawning). Most nests occur in shallow reefs (<16 m depth), where main food resources for adults (turf algae) are concentrated, but abundance of egg predators, particularly H. radiatus, is also highest. This latter result suggests that the spawning activity of S. sanctipauli is influenced by the trade-offs between food accessibility by adults and egg predation risk. The patterns recorded here are similar to those known for other tropical damselfish species and may reflect strategies for attenuating predation pressure over new fry and eggs.

Ocean warming and CO2-driven acidification can alter the toxicity of metal-contaminated sediments to the meiofauna community.

Interactive effects of trace metal contamination, ocean warming, and CO2-driven acidification on the structure of a meiofaunal benthic community was assessed. Meiofauna microcosm bioassays were carried out in controlled conditions in a full factorial experimental design which included three fixed factors: metal contamination in the sediment (3 levels of a mixture of Cu, Pb, Zn, and Hg), temperature (26 and 28 °C) and pH (7.6 and 8.1). Metal contamination caused a sharp decrease in the densities of the most abundant meiobenthic groups and interacted with temperature rise, exacerbating deleterious effects for Nematoda and Copepoda, but mitigating effects for Acoelomorpha. CO2-driven acidification resulted in increased acoelomorphs density, but only in sediments with lower levels of metals. Copepod densities, in turn, were lower in the CO2-driven acidification scenario regardless of contamination or temperature. The results obtained in the present study showed that temperature rise and CO2-driven acidification of coastal ocean waters, at environmentally relevant levels, interacts with trace metals in marine sediments, differently affecting the major groups of benthic biota.

The effectiveness of interventions in the prevention of perineal trauma in parturients: A systematic review with meta-analysis.

AIM: To investigate the effectiveness of interventions to prevent the occurrence of perineal trauma in parturients. METHODS: A bibliographic search was carried out in Cochrane Library, MEDLINE via PUBMED, LILACS via Virtual Health Library (VHL), Embase, Scopus, CINAHL, Scielo, Web of Science, and PEDro databases. Randomized clinical trials evaluating the effects of any intervention to prevent perineal trauma during pregnancy and/or childbirth were included. There were no temporal or language restrictions. The risk of bias assessment was performed using the Revised Cochrane Risk-of-bias Tool for Randomized Trials. RESULTS: Fifty studies, with a total of 17,221 participants, were included in this meta-analysis. No intervention during childbirth was effective for the prevention of perineal trauma (RR = 1.07, 95% CI [0.98.1.18], p < 0.01, I2 = 83%) when compared to no intervention. However, a lower risk of perineal laceration was verified with techniques performed during pregnancy, when compared to no intervention (RR = 0.81, 95% CI [0.71, 0.93], p = 0.05, I2 = 47%). Among them, highlight the effects of perineal massage in preventing lacerations (RR = 0.69, 95% CI [0.54, 0.87], p < 0.01) when compared to no intervention. CONCLUSIONS: The techniques performed during pregnancy, especially perineal massage, are associated with a lower risk of perineal laceration.

Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain.

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain. OBJECTIVES: We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain. METHOD: This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0. RESULTS: Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.

Symptoms of depression, anxiety and stress in Brazilian mothers during the COVID-19 pandemic.

The study aimed to identify the factors associated with symptoms of depression, anxiety and stress in Brazilian mothers of children and adolescents during the COVID-19 pandemic. This is a cross-sectional study carried in 2020 with the participation of 822 mothers who answered an online questionnaire containing sociodemographic variables and the Depression, Anxiety and Stress Scale (DASS-21). The adjusted model showed a higher depression score in women who became unemployed during the pandemic, who felt a greater burden in taking care of children, who took medication on a regular basis, and who self-assessed their health as regular or poor/very poor. Having a lower family income increased their anxiety scale score. In contrast, the variables associated with a reduced anxiety scale score included greater age, not feeling overwhelmed with demands to care for children, not using medications, not having gastrointestinal diseases, and good/very good self-assessed health. These variables, together with the benefits of living in the Northeast and Midwest regions of Brazil as well as sleeping more hours per night, were also associated with reduced stress. The present study is significant as it points out elements present in the daily lives of mothers that have an impact on their mental health. The study points to the need to (re)think mental health policies taking into account the needs of the public studied.

Relationship between depressive symptoms, social isolation, visual complaints and hearing loss in middle-aged and older adults.

The prevalence of chronic diseases, especially depression, has been increasing worldwide. Health professionals have an important role in screening and early detection of the disorder, to prevent possible damage such as disability and dependence. With aging, sensory impairments can occur, such as visual and hearing losses, which can lead to isolation contributing to the development of depressive symptoms. The objective of this study was to analyze the relationship between depressive symptoms, social isolation, and self-perception of visual complaints and hearing loss in middle-aged and older adults. It was a cross-sectional quantitative study, in Três Lagoas, state of Mato Grosso do Sul, Brazil, with 300 participants of both sexes, aged 45 years and over, registered in the Primary Health Care network. Data were collected using a structured questionnaire with sociodemographic data and the questions "Do you consider yourself socially isolated?", "Do you have a vision and/or a hearing problem capable of stopping you from performing a daily life activity?" and "If yes, do you use a hearing aid and/or glasses or contact lenses?". Depressive symptoms were assessed using the Center for Epidemiological Studies - Depression (CES-D) scale with a cut-off score adapted for age. Data were analyzed with binary logistic regression, with the presence of depressive symptoms being the dependent variable. Values of p≤0.05 were considered significant. The majority of the sample were women (65.7%), with an average age of 60.9 years, 56.7% were classified with depressive symptoms, 27.0% considered themselves socially isolated, 84.7% reported visual acuity loss (70.7% used glasses) and 17.3% reported hearing loss (2.3% used hearing aids). Social isolation (OR = 6.0), visual complaints (OR = 3.85), and hearing loss (OR = 4.67) were related to the presence of depressive symptoms. Moreover, being married (OR = 0.51) was a protective factor in these participants. The results showed the importance of early diagnosis of depressive symptoms. The correction of visual and hearing deficits is highlighted, as these may be related to symptoms of depression. Health professionals in Primary Health Care should be able to monitor depressive symptoms, visual and hearing complaints, and to promote social interaction.