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Introduction: validated educational technologies favor access to reliable and adequate information, representing a critical risk communication tool for cancer patients during public health emergencies. Objective: to assess the validity and reliability of an electronic booklet on COVID-19 for adults with cancer. Methods: methodological validation by a panel of 22 experts linked to Brazil’s national curriculum vitae database. Sampling was performed by convenience, snowball, and selection techniques according to Jasper’s criteria. The validity of the booklet was evaluated by an electronic questionnaire using the content validity index (CVI), intraclass correlation coefficient (ICC), the suitability assessment of materials (SAM) instrument, and the metalinguistic thematic analysis for educational technologies (MeTA-Edu) of dissertation proposals. Results: the expert panel consisted of 22 doctors with homogeneous sociodemographic characteristics, high specialization in education (86.4%), and teaching experience (average = 17.8 years). In general, the educational technology was validated by experts for content (overall CVI = 0.953) with a high degree of agreement (ICC = 0.958) and suitability of the content, literacy demand, graphics, layout, and typography, learning stimulation and motivation, and cultural appropriateness (SAM = 90.6%). After thematic analysis, 94 dissertation proposals were identified, mainly of the visual language type (47.9%) and referential/informative function (68.1%). Most expert suggestions were accepted (83.0%), and only 17.0% were rejected. Conclusion: the validity and reliability of the booklet “Uncomplicating COVID-19 for people with cancer” were ratified by experts. These findings can contribute to the methodological optimization of the validation of educational technologies and innovation of health education strategies, subsidizing cancer care in times of crisis.

Interleukin-17 (IL-17) and tumor necrosis factor (TNF) regulate the remodeling of the extracellular matrix by endopeptidases. However, it is not yet clear whether these cytokines have a functional hierarchy. This study aimed to assess whether IL-17 and TNF are hierarchically structured in psoriasis. Monocytes from 60 patients with plaque psoriasis and 60 non-psoriatic controls were stimulated in vitro with IL-17 or TNF, and the production of matrix metalloproteinases (MMPs) and their inhibitor (TIMP-1) were measured. Serum levels of inflammatory mediators also were measured. Serum levels of TNF, IL-17, MMP-1, and MMP-9 were higher in psoriasis than in control subjects. Basal productions of MMP-1, MMP-2, and MMP-9 by monocytes were higher in psoriasis than in controls, while TIMP-1 production was lower. TNF stimulation increased all MMPs in psoriasis and controls; TIMP-1 production was unchanged. IL-17 stimulation increased all MMPs in psoriasis and controls and decreased TIMP-1 production only in psoriasis. MMP-9 production was higher in monocytes stimulated with IL-17 compared to TNF in psoriasis and controls. TIMP-1 production decreased more with IL-17 than with TNF, but only in cells from psoriasis patients. MMP-1/TIMP-1, MMP-2/TIMP-1, and MMP-9/TIMP-1 ratios were higher after IL-17 stimulation (compared to TNF stimulation) in psoriasis; this occurred in monocytes from controls only for the MMP-2/TIMP-1 ratio. In conclusion, IL-17 has a greater capacity than TNF to dysregulate the balance between MMPs and their tissue inhibitor. This hierarchical supremacy supports the blockade of IL-17 as the first line of treatment in plaque psoriasis over TNF inhibitors.

La cirugía de control de daños (CCD) es un recurso importante en pacientes inestables y potencialmente graves, actualmente esta estrategia quirúrgica es empleada también en determinados pacientes con patología quirúrgica urgente de origen séptico no traumático que condiciona una situación crítica de inestabilidad hemodinámica. La metodología utilizada para el presente trabajo de investigación, se enmarca dentro de una revisión bibliográfica de tipo documental. La técnica para la recolección de datos está constituida por materiales electrónicos, estos últimos como Google Académico, PubMed, Science direct, entre otros, apoyándose para ello en el uso de descriptores en ciencias de la salud o terminología MESH. La información aquí obtenida será revisada para su posterior análisis. El beneficio de este procedimiento radica en la realización de laparotomías en un solo acto quirúrgico en lo que respecta a pacientes politraumatizados, con el objetivo de restaurar y mantener las condiciones del paciente altamente traumatizado, con altas probabilidades de éxito y supervivencia, salvo que estos entren en la llamada triada de la muerte.

Tuberculosis (TB) remains one of the major global causes of death; Mycobacterium Tuberculosis causes it. Approximately 10% of patients with TB may develop extrapulmonary bone tuberculosis, with the spine being the most affected, representing 1 to 2% of all TB cases. Pott disease is a form of extrapulmonary TB, and recently it has shown a significant resurgence in developed nations possibly impacted by global migration. Pott disease is often misdiagnosed or sometimes diagnosed during its late stages, which can be associated with devastating consequences to the patient. Brazil is among the top 20 countries with a high burden of tuberculosis; however, the published evidence is still limited, particularly during the last two years of the COVID-19 pandemic. Under this context, we present a clinical case of a 43 years old female patient with Pott disease with a minimally invasive surgical approach to decompress a multi-loculated abscess in the thoracic spine.

(1) Background: The impact of SARS-CoV-2 has been variable over the time course of the pandemic and in different populations. The aim was to analyze the impact of COVID-19 infection in a known population of hemodialysis (HD) patients and professionals in Spain at different times of the pandemic. (2) Methods: We conducted an observational, descriptive study with a follow-up from 3 March 2020 to 23 April 2022 (776 days), using in average of 414 professionals and 1381 patients from 18 HD units in Spain. The data from the positive PCR or the rapid antigen detection test (RADT) subject were analyzed and segmented into six periods (waves). (3) Results: Of 703 positive COVID-19 tests, 524 were HD patients (74.5%), and 179 were HD professionals (25.5%). Overall, 38% of staff and 43% of patients were affected. Differences were observed in regard to incidence (21% vs. 13%), mortality (3.5% vs. 0%), and symptomatology between the patients and professionals and throughout the pandemic. (4) Conclusions: COVID-19 severity varied during different pandemic waves, with a greater impact seen in the first wave. HD professionals and patients had similar infection rates, but patients had higher mortality rates. Community transmission was the primary route of infection.

Introduction: in 2019, the proliferation of a virus identified as SARS-CoV-2 emerged in the city of Wuhan, a district in China, quickly spread throughout the world, gaining pandemic status and less than 1 year, its repercussions and magnitude caused scientists, governments and society to adopt severe measures to combat this disease. Objective: to analyze mortality, incidence and mortality from COVID-19 in the municipalities of Botucatu and Serrana, São Paulo, Brazil. Methods: this is an ecological study with a time series design with secondary data. All registered cases and deaths registered by COVID-19 from April 2020 to August 2021 in the municipalities of Botucatu and Serrana, São Paulo, Brazil were considered. The incidence, mortality and lethality rate were used. The monthly and/or weekly percentage variation and their respective 95% confidence intervals were estimated. Results: it identified that 12.88% of the residents of the city of Botucatu were infected with COVID-19 and 8.61% of the population of the municipality of Serrana was infected. There was a stationary trend of mortality and incidence in the period between April 2020 and May 2021 and decreasing in both sexes in the mortality rate in the municipality of Serrana, in the city of Botucatu there was a trend of increasing mortality and incidence in the same period observed. Conclusion: The mass vaccination strategy of citizens in the cities of Botucatu and Serrana present robust data to consider that immunization has a decreasing effect on the number of cases and deaths from COVID-19, which effectively contributes to fighting the pandemic and reduces the contamination and progression of the disease to more severe cases.

Introduction: the judicialization of health is an alternative to the health services in Brazil, despite criticism of judicial decisions and control of public health policy. The large number of actions that demand health services is a health problem that characterizes the political, social, ethical, legal, and health systems of the Public Health Policy. Objective: to analyze the judicialization of health care in the Acre State, Brazil, from 2010 to 2016. Methods: it is a documentary and cross-sectional study of collegiate decisions, with final judgments, in the period from 2010 to 2016, issued by the Court of Justice of the State of Acre, Results: all proposed actions were Writ of Mandamus. The use of preliminary injunction was the most common strategy (n = 34; 94.44%). One third of the respondents were not questioned by the State of Acre (n = 9; 25%) as decisions of the Court of Justice on health concern medicines, examinations, and procedures, in these cases, it only manages interests, with no litigation per se. (n = 25, 69.44%). Men and women demanded in the same proportion, all of them characterized by living in poverty (n = 28; 77.78%). Conclusion: the collective health decisions handed down by the State Court of Justice Acre, Brazil, guarantee access to health goods and services to the claimants, with emphasis on preliminary injunctions and grounds based on the principle of human dignity, physical integrity and life, and on medical prescriptions in each specific case and, in a third of the cases, serving as a mere administration of interests.

Pregnancy complicated by obesity is associated with adverse triggered gestational and neonatal outcomes, with reductions in the subtypes of CD4+ T-lymphocytes representing the modulators of inflammation. It needs to be better established how maternal nutritional statuses impact the neuroendocrine–immune system’s action and affect the immunological mechanisms of the maternal–infant relationship via breastfeeding. This study examined the effects of maternal obesity on human colostrum lymphocytes and the intracellular mechanisms of lymphocyte modulation in the presence of leptin, adiponectin, and melatonin via cell proliferation; the release of intracellular calcium; and apoptosis induction. This cross-sectional study analyzed colostrum samples from 52 puerperal splits and divided them into overweight and eutrophic groups. Colostrum lymphocytes underwent immunophenotyping and cell proliferation by flow cytometry and intracellular calcium release and apoptosis assays by immunofluorescence in the presence or absence of hormones. Significant differences were considered when p < 0.05 by the chi-square or t-test. Maternal obesity reduced the population of T-lymphocytes and TCD4+ in human colostrum and proliferative activities (p < 0.05). These hormones restore lymphocyte proliferation to a level similar to the eutrophic group (p < 0.05). Leptin, adiponectin, melatonin hormones, and biological actions consolidated in the scientific literature also represent maternal and infant protection mechanisms via colostrum and the modulation of human colostrum lymphocytes.

Dropout is one of the major problems online higher education faces. Early identification of the dropout risk level and an intervention mechanism to revert the potential risk have been proved as the key answers to solving the challenge. Predictive modeling has been extensively studied on course dropout. However, intervention practices are scarce, sometimes mixed with mechanisms focused on course failure, and commonly focused on limited interventions driven mainly by teachers' experience. This work contributes with a novel approach for identifying course dropout based on a dynamic time interval and intervening, focusing on avoiding dropout at the assessable activity level. Moreover, the system can recommend the best interval for a course and assessable activity based on artificial intelligence techniques to help teachers in this challenging task. The system has been tested on a fully online first-year course with 581 participants from 957 enrolled learners of different degrees from the Faculty of Economics and Business at the Universitat Oberta de Catalunya. Results confirm that interventions aimed at goal setting on the ongoing assessable activity significantly reduce dropout issues and increase engagement within the course. Additionally, the work explores the differences between identification mechanisms for course dropout and failure aiming to distinguish them as different problems that learners may face.

En esta guía digital se abordan los conceptos y técnicas básicos que se engloban dentro de la Patología y Terapéutica Dental, una de las ramas principales de la formación odontológica. Está concebida como una herramienta útil, tanto para los alumnos de grado y postgrado como para los recién egresados. Se ha incluido en ella numeroso material iconográfico recopilado por profesores de la Facultad de Odontología de la Universidad de Sevilla; asimismo, el lector tendrá acceso, a través de los enlaces facilitados, a vídeos didácticos elaborados por el mismo profesorado en colaboración con el Servicio de Recursos Audiovisuales y Nuevas Tecnologías (SAV) de la propia institución y a materiales que ilustran de forma visual las secuencias de trabajo descritas en la exposición teórica. Se trata de una guía digital breve y completa, de fácil uso, concebida como libro de apoyo para abordar técnicas sencillas y habituales en el tratamiento de patologías tan frecuentes en la población como son la caries, patologías pulpares y periapicales, fracturas dentales o alteraciones del color dentario, entre otras.

Introduction: by late 2019, China notified a new disease rising, and with the agent’s identification, it was called COVID-19. Despite the efforts of the World Health Organization (WHO) and worldwide countries, the disease spread out of control; on March 11, WHO declared the pandemic state. Brazil is the biggest country in South America, demarcated into 26 states with different economic, cultural, and social aspects. Paraná is one of the Brazilian federative units, it is the sixth more economically important and ranks second in Education. Its first COVID-19 case was confirmed on March 12, 2020, and the first death was on March 27, two weeks after the first death in Brazil. Objective: This study objective is to determine the mortality and case-fatality rates of COVID-19 in the State of Paraná, Brazil, from March 1, 2020, to March 31, 2021. Methods: It is an ecological time-series study, using all cases (854,326) and deaths (17,229 deaths) of COVID-19 reported in public and official database of the State of Paraná Health Department. Case fatality and mortality rates were stratified by sex and age. For trend analysis, the period was divided into a first “wave” (March to November 2020) and a second “wave” (December 2020 to March 2021). The Prais-Winsten regression model for population mortality and case-fatality rates allowed classifying whether it increased, decreased, or was flat. Results: Women were more affected by the number of cases, with 454,056 cases (53.15%) confirmed and 7,257 fatalities (42.12%). A total of 400,270 men (46.85%) were infected and 9,972(57.87%) died. For the first year of COVID-19, in the State of Paraná, the incidence was calculated as 7404.12/100,000 inhabitants, the mortality was 149.32/100,000 inhabitants, and the case-fatality rate was 2.02%. We saw a tendency for decreasing the case-fatality rate (DPC = -0,18; p