Substance Use and Risky Sexual Behavior in the PrEP Outpatient Clinic at the University Hospital of Brasília.

(1) Background: To evaluate the epidemiological profile of people who use drugs at the PrEP outpatient clinic of the University Hospital of Brasília; (2) Methods: Cross-sectional study with a review of data from medical records referring to the first medical consultation. The prevalence ratio was calculated using a Poisson regression model with robust variance; (3) Results: A total of 53% of subjects reported drug use in the last 3 months. The unadjusted prevalence ratio of drug use in trans women was PR: 9.0 (95%CI: 1.4-57.5). people who use drugs have a 1.9 times higher prevalence of STI diagnosis, and a 2.4 times higher prevalence of partners compared to non-users; (4) Conclusions: Substance use was associated with a higher STI prevalence ratio and number of sexual partners.

Prevalence and Associated Factors of Post-COVID-19 Syndrome in a Brazilian Cohort after 3 and 6 Months of Hospital Discharge.

(1) Objectives: To evaluate the frequency and factors associated with the Post-COVID-19 Syndrome (PCS) in COVID-19 survivors after 3 and 6 months of hospital discharge; (2) Methods: We conducted a cohort study with patients who were hospitalized with COVID-19 in a referral public hospital in Brasília, Federal District, Brazil. After 3 and 6 months of discharge, patients answered a questionnaire about PCS symptoms. Poisson regression with robust variance was used to estimate the crude and adjusted prevalence ratios (PR and aPR) of PCS. (3) Results: The prevalence of PCS was 81% and 61% after 3 and 6 months of hospital discharge, respectively. The main symptoms after 3 months of discharge were hair loss (44%), fatigue (42%), and memory loss (39%); while after 6 months, they were memory loss (29%) and fatigue (27%). In the multivariate analysis, the main factor associated with PCS was female gender (aPR): 1.28 (1.16-1.41) and 1.60 (1.34-1.90), 3 and 6 months after hospital discharge, respectively. Hypercholesterolemia was also associated with PCS after 3 months aPR of 1.15 (1.04-1.27). After 6 months of discharge, obesity [aPR: 1.22 (1.03-1.45)] and pronation [aPR: 1.15 (1.06-1.25)] were relevant associated factors. (4) Conclusions: The prevalence of PCS was high in COVID-19 survivors who had the moderate and severe forms of the disease. Memory loss was the most persistent symptom. Our data pointed to female gender, hypercholesterolemia, obesity, and pronation during hospitalization as relevant PCS-associated risk factors.

Teaching of the Black Population's Health: Anti-Racist Lenses for a Paradigm Shift to Address Racial Inequities.

Health (and its dialectical pair-illness) is determined by multiple factors: social class, educational background, income, occupation, and race/skin color. Racism can directly impact physical and psychological illnesses, with an effect on social conditions of health. This paper discusses: (1) racism as a root cause of health inequities in Brazil and elsewhere, and (2) how students at the University of Brasilia School of Medicine respond to an anti-racist curriculum. We emphasize that an environment of profound exchanges in the teaching-learning process, adopting anti-racism praxis as a competency in the medical curriculum, is a paradigm shift in medical education and future practice.

Knowledge about COVID-19 and Associated Factors Early in the Outbreak among the Brazilian Population.

(1) Background: In Brazil, the first case of the novel coronavirus occurred on the 25 February 2020, and since then, it has spread rapidly over the entire country. During a pandemic, knowledge, attitudes, and practices are expected to largely influence the adherence to non-pharmacological interventions (NPIs). We evaluated the knowledge about COVID-19 and associated factors early in the outbreak among the Brazilian population. (2) Methods: A Brazilian cross-sectional study was carried out using an online questionnaire. The questionnaire consisted of the following topics: isolation, caring for someone sick at home, cleaning habits, disinfecting habits, and true and fake news. Logistic regression was conducted using sociodemographic and associated factors as the independent variables and a knowledge score as the dependent variable to estimate factors associated with knowledge about COVID-19. Crude, sex-, and age-adjusted odds ratios (OR) were calculated. (3) Results: Participants with a better educational status had higher odds of having a higher knowledge score (OR = 2.49, 95% CI = 1.15-5.37). Similarly, healthcare providers (health students and professionals) had higher odds of having higher scores regarding knowledge about COVID-19 (OR = 1.62, 95% CI = 1.05-2.48) than other counterparts. Of the wrong answers, the most frequent was the isolation period, followed by household recommendations to prevent COVID-19 and cleaning habits. (4) Conclusions: In conclusion, our study suggests that a higher educational status and being a healthcare provider are conditions associated with superior knowledge about COVID-19. In addition, inadequate knowledge related to isolation, COVID-19 prevention, and cleaning habits were found in our study. We believe that improving awareness to address these specific COVID-19 issues through a health education campaign is a significant approach for public health policymakers to fight against COVID-19 in Brazil.

Positive Additive and Multiplicative Interactions among Clustered Components of Metabolic Syndrome with Type 2 Diabetes Mellitus among Brazilian Adolescent Students.

Background: It is still controversial whether the joint effect of Metabolic syndrome (MetS) components is greater than that expected based on their independent effects, regarding type 2 diabetes mellitus in adolescents. We evaluated additive and multiplicative interactions between pair-wise combinations of metabolic syndrome components regarding type 2 diabetes mellitus. Methods: We studied 37,815 Brazilian adolescents from a national school-based survey, The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA). A Poisson regression model was used to calculate sex-, age-, obesity-, smoking status-, sedentary behavior-, physical inactivity-, alcoholic consumption- and socioeconomic status-adjusted prevalence ratios to evaluate both additive and multiplicative interactions. Results: In the comparison of observed and expected joint effects, relative excess risk due to additive interaction (RERI) for high triglycerides and low high-density lipoprotein-cholesterol, high triglycerides and elevated waist circumference, elevated waist circumference and low high-density lipoprotein-cholesterol and elevated waist circumference and high blood pressure were 2.53 (−0.41, 5.46), 2.86 (−2.89, 8.61), 1.71 (−1.05, 4.46) and 0.97 (0.15, 1.79), respectively, thus suggesting additive interactions. Multiplicative interactions for those pairs of components were also observed, as expressed by interaction ratios > 1.0. Conclusions: The joint presence of some of the components of MetS showed a greater association with the prevalence of type 2 diabetes mellitus in adolescents than expected from the sum of their isolated effects. From a public health perspective, preventing one of the components of the pairs that interact may result in a greater reduction in the prevalence of T2DM than focusing on an individual component that does not interact with another component.

Association between Obesity, Overweight, Elevated Waist Circumference, and Insulin Resistance Markers among Brazilian Adolescent Students.

(1) Background: There is still controversy concerning the most effective and efficient strategy to identify insulin resistance in adolescents. We estimated the level of fasting insulin (fasting insulin equivalent, FIeq) that would replicate the strength of the associations of obesity, overweight, and waist circumference with two insulin resistance markers: triglyceride/high-density lipoprotein (TG/HDL) and triglyceride/glucose (TyG); (2) Methods: We studied approximately 38,000 adolescents aged 12 to 17 years, sampled from a multicenter Brazilian school-based survey, The Study of Cardiovascular Risk Factors in Adolescents (Portuguese acronym, ERICA), conducted in 2013-2014. Fasting insulin equivalents for adiposity variables were calculated by dividing the beta coefficient of each adiposity measure by the fasting insulin beta coefficient from linear regression analysis according to age (12-14, 15-17 years old) and sex, and adjusted by smoking, alcohol consumption, physical inactivity, sedentary behavior, socioeconomic status, and Tanner stage; (3) Results: The FIeqs for obesity were greater than those for overweight and elevated waist circumference for both TG/HDL and TyG in early adolescence. The FIeqs for elevated WC were greater than those for obesity and overweight in adolescents aged 15 to 17 years; (4) Conclusions: Our study suggests that WC measurements might be useful to identify adolescents with insulin resistance, particularly in late adolescence.

Problemas de saúde mental dos adolescentes e jovens ribeirinhos do paraíso ecológico da Reserva de Desenvolvimento Sustentável Mamirauá, Amazonas / Mental health problems among adolescents and youth people leaving at the riverside in an ecologic paradise at the Reserva de Desenvolvimento Sustentável Mamirauá, Amazonas

Introdução: Tendo em vista a falta de informações sobre a saúde de adolescentes e jovens das áreas ribeirinhas este estudo foi realizado como uma iniciativa do Instituto de Desenvolvimento Sustentável Mamirauá - Tefé - Amazonas e o Núcleo de Estudos da Saúde do Adolescente da Faculdade de Medicina da Universidade do Estado do Rio de Janeiro, como parte integrante do convênio realizado entre Fundação Nacional de Saúde e Ministério da Saúde, através da Área de Saúde do Adolescente e do Jovem. Objetivo: Conhecer o contexto familiar de jovens de comunidades ribeirinhas da Reserva de Mamirauá, principalmente em relação a seus aspectos de saúde mental e vulnerabilidade emocional. Métodos: A pesquisa foi realizada através de um estudo transversal, tendo como instrumento um questionário semiestruturado, previamente testado quanto à sua validade e confiabilidade. Todos os adolescentes e jovens das comunidades participantes foram convidados e solicitados que assinassem um termo de conhecimento livre e esclarecido. No questionário constavam perguntas sobre condições de vida, saúde, trabalho, exposição a riscos, sexualidade, consumo de drogas, entre outras, para avaliar suas vulnerabilidades emocionais. Resultados: Participaram das entrevistas 307 sujeitos, na faixa etária entre 10 e 24 anos, a maioria dos jovens (77,8%) morava com sua família nuclear, sendo 47,6% do sexo masculino e 52,4% do feminino. Já tinham sofrido algum tipo de violência pelos responsáveis, pai/mãe e irmãos, 48,5% e em menores percentuais referiram violência na comunidade (9,1%), na escola (5,2%) e nas relações afetivas (2,6%). A maneira de como se relacionavam com as pessoas, cerca de 70% responderam que tinham facilidade. Constatou-se que cerca de 50% dos mais novos (10 a 14 anos) referiram ter parado suas atividades rotineiras por se sentirem tristes, sendo que os participantes do sexo masculino apresentaram percentuais maiores desse ocorrido. ..