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OBJECTIVE: This study aims to assess the degree of adequacy of prenatal care (PNC) in the state of Rio Grande do Sul (RS) and in its 7 macro-regions considering the time of PNC initiation and the number of appointments attended. It also aims to verify the mode of delivery prevalence and the factors associated with PNC adequacy by mode of delivery. METHODS: Sub analysis from a cross-sectional study conducted among 13,432 childbearing women aged 15-49 years assisted in 66 maternity hospitals of the Unified Health System (SUS) and private associated facilities from September 2017 to October 2019. A standardized form was used to collect sociodemographic data, and information about PNC and delivery from the childbearing women's prenatal cards, hospital records, and medical reports. RESULTS: The PNC coverage was (98.4%), but only 57.5% of the participants had an adequate PNC defined as the one initiated until the 12th gestational week, with attendance of at least 6 appointments. The cesarean rate was 57.2%. Among women who performed vaginal delivery, multivariate analysis showed that for each 1-year increase in the age of the parturient, the chance of having an adequate PNC increased by 5%. White parturients with higher education and fewer deliveries residing in the macro-region of Valleys were more likely to have an adequate PNC when compared with non-white parturients, who were illiterate and/or had incomplete elementary school, with 3 or more deliveries and who resided in other macro-regions. During pregnancy, 96.0% of the women performed at least one anti-HIV test, 55.8% a rapid test for syphilis, and 75.0% a Venereal Disease Research Laboratory test (VDRL). CONCLUSIONS: Despite the almost universal PNC coverage in RS, the PNC offered by the SUS was adequate for just half of the population, therefore public health policies targeted at women receiving care in this setting shall be revisited.

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ABSTRACT OBJECTIVE This study aims to assess the degree of adequacy of prenatal care (PNC) in the state of Rio Grande do Sul (RS) and in its 7 macro-regions considering the time of PNC initiation and the number of appointments attended. It also aims to verify the mode of delivery prevalence and the factors associated with PNC adequacy by mode of delivery. METHODS Sub analysis from a cross-sectional study conducted among 13,432 childbearing women aged 15-49 years assisted in 66 maternity hospitals of the Unified Health System (SUS) and private associated facilities from September 2017 to October 2019. A standardized form was used to collect sociodemographic data, and information about PNC and delivery from the childbearing women's prenatal cards, hospital records, and medical reports. RESULTS The PNC coverage was (98.4%), but only 57.5% of the participants had an adequate PNC defined as the one initiated until the 12th gestational week, with attendance of at least 6 appointments. The cesarean rate was 57.2%. Among women who performed vaginal delivery, multivariate analysis showed that for each 1-year increase in the age of the parturient, the chance of having an adequate PNC increased by 5%. White parturients with higher education and fewer deliveries residing in the macro-region of Valleys were more likely to have an adequate PNC when compared with non-white parturients, who were illiterate and/or had incomplete elementary school, with 3 or more deliveries and who resided in other macro-regions. During pregnancy, 96.0% of the women performed at least one anti-HIV test, 55.8% a rapid test for syphilis, and 75.0% a Venereal Disease Research Laboratory test (VDRL). CONCLUSIONS Despite the almost universal PNC coverage in RS, the PNC offered by the SUS was adequate for just half of the population, therefore public health policies targeted at women receiving care in this setting shall be revisited.

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The aim of this study was to verify if exposure to the far-IR emitted by fabric (FIR) is able to improve the neuromuscular performance of the knee extensors of resistance-trained males regardless of changes of the temperature. It is a crossover, randomized, double-blind, and placebo-controlled trial. Fourteen resistance-trained males (age: 24.3 ± 4 years; body mass: 82.8 ± 11.3 kg; height: 176.3 ± 4.2 cm) were randomly assigned to one of initial conditions: FIR (n = 7) or placebo (n = 7). After 4 days, the participants were submitted to neuromuscular tests in an isokinetic dynamometer (maximal isometric voluntary contraction (MVC) and fatigue test). After a week of washout, participants performed the other condition. We measured peak torque (Nm), total work (J), fatigue index (%), root mean square (mV), median frequency (Hz), and temperature (°C) of thigh. The FIR was worn for 82 ± 19 h before the experimental session, totaling 317 ± 74 kJ of energy irradiation. There was a significant increase (p < 0.05) for pre-MVC (318.5 ± 68.7 Nm) and post-MVC (284.1 ± 58.2 Nm), and a trend (p = 0.055) for significant increase for total work (4,122.2 ± 699.8 J) on FIR condition regardless of none change on temperature and electromyographic (EMG) signals. FIR improved the neuromuscular performance of knee extensors in resistance-trained males regardless of changes on temperature and EMG. The present results suggest that the FIR could optimize the neuromuscular performance with 82 ± 19 h of wear.

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The objective was to characterize sociodemographic, behavioral, and clinical aspects in young Brazilian military recruits according to prevalence of syphilis. This was a descriptive study based on a nationwide population-based survey in 2016 with a probabilistic sample of military recruits 17 to 22 years of age. A confidential self-applied questionnaire was used. Blood samples were drawn from participants for treponemal and non-treponemal syphilis tests. Descriptive statistical techniques were used to estimate syphilis prevalence rates and distribution of frequencies between the target variables, considering 95% confidence intervals (95%CI), after weighting the data. Of the total of 37,282 participants, 73.7% were sexually initiated. Prevalence rates for lifetime and confirmed syphilis were 1.6% and 1.1%, respectively. The following population variables showed higher prevalence of syphilis: lack of Internet access at home; initiation of sexual activity before 14 years of age; men who have sex with men; more than five sexual partners; having received presents, drugs, or other incentives in exchange for sex; and prior history of symptoms of sexually transmissible infections. An increase was observed in syphilis in Brazilian military recruits when compared to previous surveys. This increase emphasizes the importance of this sentinel population for performing active surveillance in order to support healthcare strategies for youth, including in the school system.

O objetivo foi caracterizar aspectos sociodemográficos, comportamentais e clínicos entre conscritos brasileiros, segundo a prevalência de sífilis. Estudo descritivo desenvolvido valendo-se de pesquisa nacional de base populacional, realizada em 2016, com amostra probabilística de jovens conscritos de 17 a 22 anos de idade. Realizou-se autoaplicação de questionários confidenciais. As amostras de sangue total dos participantes foram coletadas para testagem de sífilis, com a utilização de testes treponêmicos e não treponêmicos. Empregaram-se técnicas de estatística descritiva para estimar as prevalências de sífilis e a distribuição de frequências entre as variáveis pesquisadas, considerando os intervalos de 95% de confiança (IC95%), após a ponderação dos dados. Do total de 37.282 participantes, 73,7% haviam iniciado a vida sexual. As prevalências de sífilis na vida e de sífilis confirmada foram de 1,6% e 1,1%, respectivamente. As seguintes variáveis populacionais apresentaram maior prevalência de sífilis: ausência de acesso à Internet no domicílio; início da atividade sexual antes dos 14 anos; categoria de exposição homens que fazem sexo com homens; práticas sexuais com mais de cinco parcerias; recebimento de presentes, drogas ou outros incentivos em troca de sexo; e história prévia de sintomatologia de infecções sexualmente transmissíveis. Observou-se o aumento de sífilis entre os jovens conscritos brasileiros, em comparação aos inquéritos anteriores. Tal incremento reforça a importância dessa população sentinela para realizar vigilância ativa, de forma a subsidiar estratégias de atenção à saúde dos jovens, incluindo cenários escolares.

El objetivo fue caracterizar aspectos sociodemográficos, comportamentales y clínicos entre reclutas brasileños, según la prevalencia de sífilis. Se trata de un estudio descriptivo, desarrollado a partir de una investigación nacional de base poblacional, realizada en 2016, con una muestra probabilística de jóvenes reclutas de 17 a 22 años de edad. Se realizó una autoaplicación de cuestionarios confidenciales. Las muestras de sangre total de los participantes fueron recogidas para la prueba de sífilis, con la utilización de pruebas treponémicas y no treponémicas. Se emplearon técnicas de estadística descriptiva para estimar las prevalencias de sífilis y distribución de frecuencias entre las variables investigadas, considerando intervalos del 95% de confianza (IC95%), tras la ponderación de los datos. Del total de 37.282 participantes, un 73,7% habían iniciado su vida sexual. Las prevalencias de sífilis en la vida y de sífilis confirmada fueron de 1,6% y 1,1%, respectivamente. Las siguientes variables poblacionales presentaron una mayor prevalencia de sífilis: ausencia de acceso a Internet en el domicilio; inicio de la actividad sexual antes de los 14 años; categoría de exposición hombres que practican sexo con hombres; prácticas sexuales con más de cinco personas; recibimiento de regalos, drogas u otros incentivos a cambio de sexo; e historia previa de sintomatología de infecciones sexualmente transmisibles. Se observó el aumento de sífilis entre los jóvenes reclutas brasileños, en comparación con las encuestas anteriores. Tal incremento refuerza la importancia de esa población centinela para realizar una vigilancia activa, de forma que se apoyen estrategias de atención a la salud de los jóvenes, incluyendo escenarios escolares.

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ABSTRACT: Global burden of sexually transmitted infections (STIs) remains high and has a profound impact on health and lives of children, adolescents and adults worldwide. For over a decade, the Brazilian Department of Chronic Condition Diseases and Sexually Transmitted Infections and the Ministry of Defense have been conducting the Conscripts Survey aiming to assess the STI prevalence and obtain data on knowledge regarding STIs and risk factors among youth.A cross-sectional study was conducted among conscripts across Brazil aged 17 to 22 years from August to December 2016. It included a self-reported questionnaire containing 74 questions, 25 questions related to awareness and knowledge of STIs and their associated symptoms, routes of transmission, complications and risk factors.A total of 37,282 young men across Brazil were considered for the analysis. The majority resided in the Northeast and Southeast regions (38.9% and 30.0%, respectively), followed by the South (13.9%), North (9.7%), and Central-west (7.5%) regions. Of the conscripts, 97.2% have the knowledge they may be at risk if they do not use condoms during sex. Conscripts with a higher level of education have almost 2 times greater chance of having knowledge of having sex without a condom (OR 3.23 CI95% 2.82-3.70 P = .000) and sharing needles and syringes (OR 2.84 CI95% 2.62-3.07 P = .000) represents a risk. Those with higher education also have an almost 50% greater chance of having knowledge regarding STI transmission from mother to child (OR 1.54 CI95% 1.44-1.64 P = .000), and knowledge of no transmission by mosquito bite (OR 1.61 CI95%1.51-1.72 P = .000), by kissing (OR 1.45 CI95% 1.36-1.55 P = .000) or by using public toilets (OR 1.51 CI95% 1.41-1.61 P = .000). Television (71.8%) and internet (69.4%) are the preferred forms to obtain STIs information regardless of the level of education.Conscripts with higher level of education have greater knowledge regarding transmission of STIs. However, there are gaps regarding their knowledge about HIV pre-exposure prophylaxis and the fact that other STIs can increase the chances of acquiring HIV.

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BACKGROUND: : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. AIM: : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. METHODS: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. RESULTS: : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. CONCLUSION: : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.

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BACKGROUND: COVID-19 is characterized by a rapid change in the patient's condition, with major changes occurring over a few days. We aimed to develop and evaluate an emergency system for monitoring patients with COVID-19, which may be useful in hospitals where more severe patients stay in their homes. METHODOLOGY/PRINCIPAL FINDINGS: The system consists of the home-based patient unit, which is set up around the patient and the hospital unit, which enables the medical staff to telemonitor the patient's condition and help to send medical recommendations. The home unit allows the data transmission from the patient to the hospital, which is performed using a cell phone application. The hospital unit includes a virtual instrument developed in LabVIEW® environment that can provide a real-time monitoring of the oxygen saturation (SpO2), beats per minute (BPM), body temperature (BT), and peak expiratory flow (PEF). Abnormal events may be fast and automatically identified. After the design details are described, the system is validated by a 30-day home monitoring study in 12 controls and 12 patients with COVID-19 presenting asymptomatic to mild disease. Patients presented reduced SpO2 (p<0.0001) and increased BPM values (p<0.0001). Three patients (25%) presented PEF values between 50 and 80% of the predicted. Three of the 12 monitored patients presented events of desaturation (SpO2<92%). The experimental results were in close agreement with the involved pathophysiology, providing clear evidence that the proposed system can be a useful tool for the remote monitoring of patients with COVID-19. CONCLUSIONS: An emergency system for home monitoring of patients with COVID-19 was developed in the current study. The proposed system allowed us to quickly respond to early abnormalities in these patients. This system may contribute to conserving hospital resources for those most in need while simultaneously enabling early recognition of patients under acute deterioration, requiring urgent assessment.

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O objetivo foi caracterizar aspectos sociodemográficos, comportamentais e clínicos entre conscritos brasileiros, segundo a prevalência de sífilis. Estudo descritivo desenvolvido valendo-se de pesquisa nacional de base populacional, realizada em 2016, com amostra probabilística de jovens conscritos de 17 a 22 anos de idade. Realizou-se autoaplicação de questionários confidenciais. As amostras de sangue total dos participantes foram coletadas para testagem de sífilis, com a utilização de testes treponêmicos e não treponêmicos. Empregaram-se técnicas de estatística descritiva para estimar as prevalências de sífilis e a distribuição de frequências entre as variáveis pesquisadas, considerando os intervalos de 95% de confiança (IC95%), após a ponderação dos dados. Do total de 37.282 participantes, 73,7% haviam iniciado a vida sexual. As prevalências de sífilis na vida e de sífilis confirmada foram de 1,6% e 1,1%, respectivamente. As seguintes variáveis populacionais apresentaram maior prevalência de sífilis: ausência de acesso à Internet no domicílio; início da atividade sexual antes dos 14 anos; categoria de exposição homens que fazem sexo com homens; práticas sexuais com mais de cinco parcerias; recebimento de presentes, drogas ou outros incentivos em troca de sexo; e história prévia de sintomatologia de infecções sexualmente transmissíveis. Observou-se o aumento de sífilis entre os jovens conscritos brasileiros, em comparação aos inquéritos anteriores. Tal incremento reforça a importância dessa população sentinela para realizar vigilância ativa, de forma a subsidiar estratégias de atenção à saúde dos jovens, incluindo cenários escolares.

The objective was to characterize sociodemographic, behavioral, and clinical aspects in young Brazilian military recruits according to prevalence of syphilis. This was a descriptive study based on a nationwide population-based survey in 2016 with a probabilistic sample of military recruits 17 to 22 years of age. A confidential self-applied questionnaire was used. Blood samples were drawn from participants for treponemal and non-treponemal syphilis tests. Descriptive statistical techniques were used to estimate syphilis prevalence rates and distribution of frequencies between the target variables, considering 95% confidence intervals (95%CI), after weighting the data. Of the total of 37,282 participants, 73.7% were sexually initiated. Prevalence rates for lifetime and confirmed syphilis were 1.6% and 1.1%, respectively. The following population variables showed higher prevalence of syphilis: lack of Internet access at home; initiation of sexual activity before 14 years of age; men who have sex with men; more than five sexual partners; having received presents, drugs, or other incentives in exchange for sex; and prior history of symptoms of sexually transmissible infections. An increase was observed in syphilis in Brazilian military recruits when compared to previous surveys. This increase emphasizes the importance of this sentinel population for performing active surveillance in order to support healthcare strategies for youth, including in the school system.

El objetivo fue caracterizar aspectos sociodemográficos, comportamentales y clínicos entre reclutas brasileños, según la prevalencia de sífilis. Se trata de un estudio descriptivo, desarrollado a partir de una investigación nacional de base poblacional, realizada en 2016, con una muestra probabilística de jóvenes reclutas de 17 a 22 años de edad. Se realizó una autoaplicación de cuestionarios confidenciales. Las muestras de sangre total de los participantes fueron recogidas para la prueba de sífilis, con la utilización de pruebas treponémicas y no treponémicas. Se emplearon técnicas de estadística descriptiva para estimar las prevalencias de sífilis y distribución de frecuencias entre las variables investigadas, considerando intervalos del 95% de confianza (IC95%), tras la ponderación de los datos. Del total de 37.282 participantes, un 73,7% habían iniciado su vida sexual. Las prevalencias de sífilis en la vida y de sífilis confirmada fueron de 1,6% y 1,1%, respectivamente. Las siguientes variables poblacionales presentaron una mayor prevalencia de sífilis: ausencia de acceso a Internet en el domicilio; inicio de la actividad sexual antes de los 14 años; categoría de exposición hombres que practican sexo con hombres; prácticas sexuales con más de cinco personas; recibimiento de regalos, drogas u otros incentivos a cambio de sexo; e historia previa de sintomatología de infecciones sexualmente transmisibles. Se observó el aumento de sífilis entre los jóvenes reclutas brasileños, en comparación con las encuestas anteriores. Tal incremento refuerza la importancia de esa población centinela para realizar una vigilancia activa, de forma que se apoyen estrategias de atención a la salud de los jóvenes, incluyendo escenarios escolares.

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ABSTRACT Background : The II Brazilian Consensus on Gastric Cancer of the Brazilian Gastric Cancer Association BGCA (Part 1) was recently published. On this occasion, countless specialists working in the treatment of this disease expressed their opinion in the face of the statements presented. Aim : To present the BGCA Guidelines (Part 2) regarding indications for surgical treatment, operative techniques, extension of resection and multimodal treatment. Methods: To formulate these guidelines, the authors carried out an extensive and current review regarding each declaration present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases initially with the following descriptors: gastric cancer, gastrectomy, lymphadenectomy, multimodal treatment. In addition, each statement was classified according to the level of evidence and degree of recommendation. Results : Of the 43 statements present in this study, 11 (25,6%) were classified with level of evidence A, 20 (46,5%) B and 12 (27,9%) C. Regarding the degree of recommendation, 18 (41,9%) statements obtained grade of recommendation 1, 14 (32,6%) 2a, 10 (23,3%) 2b e one (2,3%) 3. Conclusion : The guidelines complement of the guidelines presented here allows surgeons and oncologists who work to combat gastric cancer to offer the best possible treatment, according to the local conditions available.

RESUMO Racional: O II Consenso Brasileiro de Câncer Gástrico da Associação Brasileira de Câncer Gástrico ABCG (Parte 1) foi recentemente publicado. Nesta ocasião inúmeros especialistas que atuam no tratamento desta doença expressaram suas opiniões diante declarações apresentadas. Objetivo: Apresentar as Diretrizes da ABCG (Parte 2) quanto às indicações de tratamento cirúrgico, técnicas operatórias, extensão de ressecção e terapia combinada. Métodos: Para formulação destas diretrizes os autores realizaram extensa e atual revisão referente a cada declaração presente no II Consenso, utilizando as bases Medline/PubMed, Cochrane Library e SciELO, inicialmente com os seguintes descritores: câncer gástrico, gastrectomia, linfadenectomia, terapia combinada. Ainda, cada declaração foi classificada de acordo com o nível de evidência e grau de recomendação. Resultados: Das 43 declarações presentes neste estudo, 11 (25,6%) foram classificadas com nível de evidência A, 20 (46,5%) B e 12 (27,9%) C. Quanto ao grau de recomendação, 18 (41,9%) declarações obtiveram grau de recomendação 1, 14 (32,6%) 2a, 10 (23,3%) 2b e um (2,3%) 3. Conclusão: O complemento das diretrizes aqui presentes possibilita que cirurgiões e oncologistas que atuam no combate ao câncer gástrico possam oferecer o melhor tratamento possível, de acordo com as condições locais disponíveis.

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BACKGROUND: The II Brazilian Consensus on Gastric Cancer by the Brazilian Gastric Cancer Association (ABCG) was recently published. On this occasion, several experts in gastric cancer expressed their opinion before the statements presented. AIM: To present the ABCG Guidelines (part 1) regarding the diagnosis, staging, endoscopic treatment and follow-up of gastric cancer patients. METHODS: To forge these Guidelines, the authors carried out an extensive and current review regarding each statement present in the II Consensus, using the Medline/PubMed, Cochrane Library and SciELO databases with the following descriptors: gastric cancer, staging, endoscopic treatment and follow-up. In addition, each statement was classified according to the level of evidence and degree of recommendation. RESULTS: Of the 24 statements, two (8.3%) were classified with level of evidence A, 11 (45.8%) with B and 11 (45.8%) with C. As for the degree of recommendation, six (25%) statements obtained grade of recommendation 1, nine (37.5%) recommendation 2a, six (25%) 2b and three (12.5%) grade 3. CONCLUSION: The guidelines presented here are intended to assist professionals working in the fight against gastric cancer with relevant and current information, granting them to be applied in the daily medical practice.

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