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Coronaviruses (CoV) make up a large family of viruses, known since the mid-1960s, which received this name due to the spikes on its surface, which resemble a crown (from the Latin corona). CoV infections can cause everything from a common cold to severe respiratory syndromes, such as severe acute respiratory syndrome (SARS-CoV) and Middle Eastern respiratory syndrome (MERS-CoV). COVID-19 is a new variant of the coronavirus, and its isolation occurred in China on January 7th, 2020. COVID-19 has stood out with a high impact on public health due to the high number of cases with infection in a short period of time. However, it is possible to observe that 17% of patients confirmed with COVID-19 have severe infections and about 2.5% of these patients die. Current studies have shown that the number of mild and asymptomatic cases may be even greater. Thus, the challenges for controlling unreported cases of patients with mild symptoms that are spreading the virus and interfering with the magnitude and real data of the cases stand out. The transmission of the coronavirus occurs between humans, and it can occur from person to person through the air, through coughing or sneezing, by touching or shaking hands or by contact with contaminated objects or surfaces, followed by contact with the mouth, nose or eyes. Given the fluctuation in the incidence and the lethality rate, it is essential to stand out the precepts of health promotion in search of reorienting hygiene practices, considering that there is validity in health care models, still with a curative approach and the current situation experienced by the world population requires a preventive stance.

Resumen Introducción: Ser personal sanitario en activo supone un factor de riesgo elevado para contraer la infección por SARS-CoV-2. La realización de programas de vacunación es la mejor herramienta disponible para enfrentar este problema. En España, los profesionales sanitarios han sido vacunados de manera prioritaria. Objetivo: Evaluar, a través del recuento de anticuerpos en sangre, la inmunogenicidad de las vacunas frente a SARS-CoV-2 en personal de diálisis y los factores relacionados con ella. Material y Método: Estudio observacional descriptivo de corte trasversal, multicéntrico. Se realizó una determinación serológica del recuento de anticuerpos totales anti-proteína "S" en las 12 semanas posteriores a la vacunación. La recogida de datos se realizó a través de un cuestionario ad-hoc, online, anónimo y voluntario. Resultados: 167 participantes, todos vacunados con vacunas ARN. EL 15% había pasado previamente la infección. El 96,4% han desarrollado anticuerpos (media de 15.776±13.640 AU/ml); aquellos profesionales que han pasado previamente la infección tienen un número promedio de anticuerpos significativamente mayor que los que no (23.532 vs 14.381 AU/ml) (p=0,05). La presencia de síntomas como cansancio, cefalea, fiebre y mialgias se asocia, también, a una reactividad significativamente mayor (p=0,004). No existe relación significativa entre la reactividad y sexo, edad, índice de masa corporal (IMC) o lugar de trabajo. Conclusiones: La inmunogenicidad provocada por las vacunas ARN administradas a personal de diálisis ha sido casi total. Padecer efectos adversos post vacunación, como cansancio, cefaleas, fiebre, náuseas y dolores, y haber pasado previamente la infección se asocia con mayor reactividad, manifestada con el desarrollo de mayor número de anticuerpos.

Introduction: Cardiac arrest is one of the leading public health problems worldwide and in Brazil. A victim of cardiorespiratory arrest needs prompt basic life support (BLS) to increase survival. Objective: To evaluate the performance of a synthesis lecture on BLS given to university students in Health Sciences. Methods: A total of 422 undergraduate students in Nursing, Physiotherapy, and Medicine participated in this study. Data were collected by applying a pre-test through a BLS questionnaire based on the American Heart Association guidelines. Results: Students obtained a minimum grade of 40% of the pre-test questions. The score increased to 75% in the post-test, the students with the best performance in the pre-test maintained a higher total number of correct answers in the post-test. There was also better performance in those with previous training in BLS. The students from the first year of medical school were the ones who benefited the most from the lecture. Conclusion: Regardless of the grade course, the Health Science students showed a significant improvement in their level of knowledge after attending the synthesis lecture, indicating its adequacy to promote initial learning about BLS.

Amazonas suffered greatly during the COVID-19 pandemic. The mortality and fatality rates soared and scarcity of oxygen and healthcare supplies led the health system and funerary services to collapse. Thus, we analyzed the trends of incidence, mortality, and lethality indicators of COVID-19 and the dynamics of their main determinants in the state of Amazonas from March 2020 to June 2021. This is a time-series ecological study. We calculated the lethality, mortality, and incidence rates with official and public data from the Health Department. We used the Prais–Winsten regression and trends were classified as stationary, increasing, or decreasing. The effective reproduction number (Rt) was also estimated. Differences were considered significant when p < 0.05. We extracted 396,772 cases of and 13,420 deaths from COVID-19; 66% of deaths were in people aged over 60; 57% were men. Cardiovascular diseases were the most common comorbidity (28.84%), followed by diabetes (25.35%). Rural areas reported 53% of the total cases and 31% of the total deaths. The impact of COVID-19 in the Amazon is not limited to the direct effects of the pandemic itself; it may present characteristics of a syndemic due to the interaction of COVID-19 with pre-existing illnesses, endemic diseases, and social vulnerabilities.

This study evaluated the presence of pulp stones in a Seville population, correlating their presence and size with state of the crown and pulp response to cold stimuli, encompassing variables such as age, gender, location (arch and teeth group). The study included 1090 teeth corresponding to 146 patients. Each patient underwent a visual examination, periapical radiographs and sensibility tests. The SPSS 25 software (SSPS, Chicago, USA) was used to carry out the statistical analysis, doing logistic regression to compare variables and Chi-square with a significance level p

Adiponectin and leptin play roles in the hunger response, and they can induce the inflammatory process as the initial mechanism of the innate immune response. It is possible for alterations in the levels of these adipokines to compromise the functional activity of human colostrum phagocytes. Therefore, the objective of this study is to analyze the effects of adiponectin and leptin on colostrum mononuclear (MN) cells. Colostrum was collected from 80 healthy donors, who were divided into two groups: the control group and the high body mass index (BMI) group. MN cells were used to analyze phagocytosis by flow cytometry, and reactive oxygen species (ROS), intracellular calcium, and apoptosis were assessed by fluorimetry using a microplate reader. Adipokines restored the levels of phagocytosis to the high BMI group (p < 0.05), with a mechanism that is action-dependent on the release of ROS and intracellular calcium. However, adiponectin and leptin simultaneously contributed to better microbicidal activity, thus reflecting an increase in the apoptosis level (p < 0.05) in the high BMI group. Probably, the maintenance of the balance between adiponectin and leptin levels enhances the protection and decreases the indices of neonatal infection in the breastfeeding infants of women with high BMI values. Therefore, policies that support pre-gestational weight control should be encouraged.

The resurgence of cases of Zika virus (ZIKV) infection, accompanied by epidemic of microcephaly in Brazil, has aroused worldwide interest in understanding the biological mechanisms of the virus that allow patient management and the viral dissemination control. Colostrum and human milk are possible sources of virus spread. Therefore, the objective of this study was to analyze the repercussions of ZIKV infection on rheological parameters and inflammatory cytokines of colostrum. The prospective cohort study included 40 puerperal donors of colostrum, divided into 2 groups: control (without ZIKV infection, n=20) and a group infected with ZIKV during the gestational period (n=20). Analyses were performed for the detection of ZIKV by polymerase chain reaction (PCR). In addition to obtaining the rheological parameters and quantification of IL-10 and IL-6 cytokines by flow cytometry, ZIKV and other flaviviruses were not detected in colostrum. However, maternal infection reflected increased viscosity, decreased levels of IL-10, and elevated levels of IL-6. The higher viscosity may represent a mechanical barrier that hinders the spread of the virus. The lower levels of anti-inflammatory mediators and higher inflammatory cytokines may possibly alter the viscosity, and it seems the higher viscosity represents a possible mechanism of adaptation of breastfeeding against a response to ZIKV.

The concept of assistive technology covers several areas of action; one of them is communication with the elaboration of accessible solutions to overcome daily difficulties. It contributes to the resumption of functional abilities, expanding and facilitating inclusion and independent living.To analyze the usability of a low cost prototype device to support educational activities of adolescents with cerebral palsy.A descriptive observational study. The evaluation of a prototype device was made through a validated questionnaire, Quest Version 2.0, on the level of the user's satisfaction with an assistive technology, composed of 12 evaluation items. The questionnaire was filled out by the educator based on the observation of four wheelchair-bound participants diagnosed with cerebral palsy according to the international classification of diseases and health-related problems, ICD-10, who attend a coexistence and teaching institution in the state of São Paulo, Brazil.The device developed was considered an assistive technology, which provided an experience with a positive level of satisfaction for the participants.The tested prototype contributes to communication and interaction allowing adolescents with cerebral palsy to participate in educational activities. Implications for Rehabilitation The device assists the individual in the educational activities and can positively influence their development, observe the individual number 5, who has an important limitation in coordination and fine movements, placing the role of the task in the vertical position offers a new perspective to perform the task, this stimulates him to try to perform the work, so the challenge was adjusted to the demands of each individual which can contribute to its neuromotor development, the amplitude of the distal movements and the manual ability, since it must look for alternatives to complete the task requested.

OBJECTIVE: To evaluate the effect of normal saline lavage of the distal vas deferens ampulla in patients undergoing vasectomy on the time to achieve azoospermia. METHODS: A prospective randomized study of 60 men divided into two groups, group lavage (GL, n=30) in which distal vas deferens ampulla lavage was performed with 10 ml of normal saline during the vasectomy, and group without lavage (GWL, n=30) in which control patients received only a vasectomy. The patients provided sperm for semen analysis at the 5th, 10th, 15th, 20th and 25th ejaculations. RESULTS: Fifteen participants in GL and 16 in GWL, for a total of 31 patients, were excluded due to not completing the control spermiogram. The tests carried out at the five ejaculations showed immobile spermatozoa in 40 and 85.71%, 66.67 and 78.57%, 93.33 and 85.71%, 86.67 and 71.43%, and 93.33 and 85.71% of participants in GL and GWL, respectively. CONCLUSION: Vas deferens duct lavage with 10 ml of normal saline during vasectomy did not decrease the time required to achieve postoperative azoospermia.

BACKGROUND: We aimed to evaluate the complication rate in lumbar dynamic stabilization surgery for back pain in situations where conventional rigid implants could have been employed, with a follow-up of at least five years. METHODS AND FINDINGS: All patients who underwent semi-rigid lumbar spine fixation with the dynamic system consecutively between 2002 and 2007 in our departmentwere included. Minimum follow up period was 5. Adverse events and reoperations were registered for analysis. In the study period, 144 patients were treated with the dynamic system and studied. Three screws were badly positioned. There were two (1,39%) infections, with surgical cleaning necessary in one case. The late complications included a radiolucency signal in 22 screws (2,86%) and four broken screws (0,52%) out of 770 screws.Nineteen patients (20,13%) needed reoperation due to pain or screw associated problems. Three (2,08%) of these cases received additional treatment due to segmental kyphosis, five (3,47%) due to flat back, five (3,47%) due to adjacent level stenosis, 4 (2,7%) due to lumbar pain complaints, and two (1,39%) due to a broken screw. CONCLUSIONS: The lumbar dynamic stabilization system is an option for the treatment of degenerative spinal diseases. However it is not free of adverse events and had rates of implant failure, complications, and reoperations similar to those described on literature with rigid systems.

Introduction: The association between previous injury and the risk of re-injury has been widely studied, however still there are limited studies about the prevalence and distribution of the injuries associated to rupture of Anterior Cruciate Ligament (ACL) mainly focused on people who plays sports for leisure or to improve their quality of life. Objective: To identify the prevalence of concomitant injuries with rupture of ACL and its association with sex, age and practice of sports for leisure. Methods: Cross-sectional study of clinical base. It was analyzed the data of clinical records and demographic information of 807 individuals who underwent ACL reconstruction surgery in a clinic specializing in orthopedics knees in Santo Andre, Sao Paulo, Brazil. Results: The prevalence of concomitant injuries with the ACL injury was 57.9%. The meniscus injuries were the main concomitant injuries found. It is observed a trend of concomitant injuries with ACL rupture in males (59.2%) and in individuals who do not practice recreational sports (58.9%). Individuals who had concomitant lesions had higher median age (37%, 95% CI 36-39) compared to individuals diagnosed with isolated ACL rupture. Conclusions : The prevalence of concomitant injuries with the ACL rupture found in this study points to the need of further research about injuries of adjacent structures to ACL.

Introduction: Sexual violence against children and adolescents in Brazil is an underreported public health problem. Knowing the profile of the victims and the factors related to each case is a strategy for the development of more effective public policies. Objective: To describe the profile of children and adolescent victims of sexual abuse, characteristics of aggression and aggressors, consequences for victims, and legal actions related to sexual abuse. Methods: Sociodemographic characteristics of the victims were analyzed, as well as characteristics of the aggressors and aggression, and clinical, psychological, and legal aspects of 61 sexually abused patients admitted to the specialized outpatient clinic of the Network of Health for Violence and Sexual Abuse located in Santo Andre, Sao Paulo State, Brazil. Results: Victims had a mean age of 10.4 years, female (60.7%, n= 37), white (70.5%, n= 43), and admitted to the care network after of 72 hours of having been a victim of abuse (68.3%, n = 40). Most of the aggressions were by a sexual act (65.6%, n = 40) and by an individual known by the victim (72.1%, n= 44). As a result of sexual abuse, the children had a change in family composition (42.6%, n = 26), cognitive disturbances (34.4%, n= 21), emotional disturbances (83.6%, n= 51), and behavioral disorders (54.1%, n= 33). Two-thirds of the cases resulted in a police investigation, only 20% of the offenders were convicted. Conclusion: Girls suffer sexual abuse where the perpetrator is known and close to the family; they delay seeking health services and can present mental disorders related to those abuses, but the perpetrators remain unpunished in most cases.

A series of PTA and DAPTA platinum(II) and palladium(II) thionate complexes of the type trans-[M(SN)2P2] were prepared from the reaction of cis-[MCl2P2] [M = Pt, Pd; P = PTA (1,3,5-triaza-7-phosphaadamantane), DAPTA (3,7-diacetyl-1,3,7-triaza-5- phosphabicyclo[3.3.1]nonane)] with the in situ generated sodium salts of the heterocyclic thiones S-m-methylpyrimidine-2-thione, S-4,6-dimethylpyrimidine-2- thione, S-4,6-dihydroxypyrimidine-2-thione, benzothiazole-2-thione, benzoxazole-2-thione, S-1,3,4,-thiadiazole-2-thione, S-4,5-H-thiazolan-2-thione, and S-pyrimidine-4(1H)-one-2-thione. The X-ray structures of six of the compounds confirm the trans disposition and, only in the case of [Pd 2Cl2(S-pyrimidine-4(1H)-one-2-thionate) 2(PTA)2], a dinuclear structure with a Pd-Pd distance of 3.0265(14)Å was observed. In vitro cytotoxicities against human ovarian cancer cell lines A2780 and A2780cisR were evaluated for ten complexes showing a high inhibition of cellular growth with a comparable inhibitory potency (IC50) against A2780 cells to that of cisplatin. Notably, the compounds also show significant (up to 7-fold higher) activity in cisplatin-resistant A2780cisR cell lines. © 2013 American Chemical Society., We thank the Spanish Ministry for Education, Junta de Castilla y León, as well as the University of Burgos for generous financial support (Grants CTQ2008-06716-CO3-01, BU033A06, and 112-541A-487.01).

The diagnosis of pits, grooves and fissures is one of the main challenges facing dentists in their professional activity, since the existence of an intact enamel surface may hide deep caries in dentin. Lesions of this kind were described by Weerheijm et al. (1992) as “hidden caries”. Over 70 years ago a high incidence of caries was confirmed in grooves and fissures (Hyat, 1923), in coincidence with more recent observations (Bragamian & Garcia-Godoy, 2009). In order to understand and explain this high incidence and the morphological peculiarities involved, it is essential to know the physiopathology of the tooth and of the carious lesion.