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INTRODUCTION: Current evidence suggests the potential heightened vulnerability of smokers to severe coronavirus disease (COVID-19) outcomes. AIMS: This study aimed to analyze the clinical outcomes and mortality related to tobacco use in a cohort of hospitalized Brazilian COVID-19 patients. METHODS: This retrospective cohort study analyzed adults hospitalized for COVID-19 in Brazil using the SIVEP-Gripe database (official data reported by public and private healthcare facilities for monitoring severe acute respiratory syndrome cases in Brazil). The inclusion criteria were patients over 18 years of age with a positive RT-qPCR test for SARS-CoV-2. The analysis focused on in-hospital mortality, considering smoking as an exposure variable, and included covariates such as age, gender, and comorbidities. Smoking history was collected from the self-reported field in the database. Statistical analyses included descriptive statistics, crude Odds Ratios, and multivariable binary logistic regression. RESULTS: This study included 2,124,285 COVID-19 patients, among whom 44,774 (2.1 %) were smokers. The average age of the smokers was higher than that of the never-smokers (65.3 years vs. 59.7 years). The clinical outcomes revealed that smokers had higher rates of intensive care unit admission (51.6 % vs. 37.2 % for never-smokers), invasive ventilatory support (31.5 % vs. 20.2 % for never-smokers), and higher mortality (42.7 % vs. 31.8 % for never smokers). In the multivariable analysis, smokers demonstrated a heightened risk of death (aOR 1.23; 95 % CI 1.19-1.25). CONCLUSIONS: This large populational-based cohort study confirms the current evidence and underscore the critical importance of recognizing smoking as a substantial risk factor for adverse outcomes in COVID-19 patients.

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The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor's degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa's duties, and support judicial intervention in relation to the COVID-19 pandemic.

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OBJECTIVE: To describe the clinical outcomes and risk factors of death related to mental disorders in a cohort of Brazilian hospitalized patients with COVID-19. METHODS: This retrospective cohort study utilized the Brazilian database SIVEP-Gripe to analyze patients aged ≥18 years who had been hospitalized with COVID-19 between 2020 and 2022. The exposure of interest were mental disorders (anxiety, depression, schizophrenia, and bipolar disorder), identified through self-reported fields. The primary outcome was in-hospital mortality. Covariates included demographic and clinical features. Descriptive statistics, t-tests, chi-square tests, and binary logistic regression were used to analyze the data. RESULTS: A cohort of 2,124,285 patients was included in the analysis, with 23,246 individuals (1.1%) having self-reported mental disorders. Among these mental disorders, depression was the most prevalent (52.3%). The mortality rate of the patients with mental disorders was 30.8%. Analysis of risk factors for mortality revealed that age, gender, region, dyspnea, low oxygen saturation, and comorbidities were associated with an increased risk of death. Patients with schizophrenia had a higher mortality risk (aOR:1.68;95%CI:1.54-1.81). CONCLUSIONS: Patients diagnosed with schizophrenia have a greater likelihood of COVID-19- related death than those without mental health conditions. These findings underscore the significant effect of serious mental disorders on COVID-19 mortality.

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BACKGROUND: The COVID-19 pandemic had direct and indirect impacts on public health, also affecting the mental health of the population. OBJECTIVE: To analyze symptoms of generalized anxiety disorder (GAD) and associated factors, in primary health care (PHC) professionals. METHODS: Cross-sectional and analytical study conducted with professionals who work in the Primary Health Care (PHC) of the Northern health macro-region of the state of Minas Gerais, Brazil. Data collection was carried out through an online, self-administered questionnaire, made available from August 27, 2021, to October 30, 2021 using the Google Forms tool. The questionnaire included sociodemographic questions as well as questions related to the history of anxiety and work during the pandemic. To assess anxiety symptoms, the General Anxiety Disorder-7 (GAD-7) instrument was used. Data treatment consisted of descriptive analysis of the variables, bivariate analysis followed by multivariate Poisson Regression with robust variance. RESULTS: 702 health professionals participated in the study and the general prevalence of GAD was 32.2%. Current anxiety symptoms were self-reported by 37.6% of the participants. In the final model, the associated factors identified were: female sex (PR = 1.82; 95% CI = 1.17-2.84; p = 0.007), previous symptoms (PR = 1.58; 95% CI = 1.19-2.10; p = 0.002) and (PR = 2.68; 95% CI = 2.00-3.62; p < 0.001) current self-reported anxiety. CONCLUSION: The results show the need to implement actions in mental health promotion and anxiety prevention, through the dissemination of information about mental health care, health education activities, encouraging the adoption of healthy habits and professional monitoring when necessary.

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Abstract: The aim was to analyze the perception of Brazilian federal judges on the implications of COVID-19 vaccination. A study was carried out with Brazilian federal judges, who received a survey designed with multiple-choice questions on COVID-19 vaccination, covering topics such as its mandatory aspect, the application of coercive measures, hesitation to vaccinate, priority groups, the duties of Brazilian Health Regulatory Agency (Anvisa, acronym in Portuguese), the role of the Judiciary branch, and immunity passports. A total of 254 out of 1,300 federal judges from all states responded to the survey. Most respondents have a Bachelor's degree or a specialization (59.1%) and have been judges for more than 10 years (63.8%). A great majority of the judges (87.7%) agree with vaccine mandates for adults and for children and adolescents (66.1%). Over 75% of judges believe that all levels of government can impose sanctions on those who refuse to get vaccinated. The judges trust vaccination 93% of the time, 56.1% reject anti-vaccination movements, and 75.2% believe that Anvisa duties should be respected. The Judiciary branch actions concerning the COVID-19 pandemic are approved by 62.6% of judges, and 88.2% support immunity passports. There is a direct connection among mandatory vaccination, trust in the vaccine, and the adoption of immunity passports. Most federal judges agree with vaccine mandates for children and adults, support the application of sanctions for vaccination refusal, disapprove of anti-vaccination movements, agree with Anvisa's duties, and support judicial intervention in relation to the COVID-19 pandemic.

Resumo: O objetivo foi analisar a visão de juízes federais brasileiros sobre as implicações da vacinação contra a COVID-19. Foi realizado um estudo com juízes federais brasileiros, que receberam uma pesquisa elaborada com questões de múltipla escolha sobre a vacinação contra a COVID-19, abordando temas como sua obrigatoriedade, aplicação de medidas coercitivas, hesitação vacinal, grupos prioritários, ações da Agência Nacional de Vigilância Sanitária (Anvisa), o papel do Poder Judiciário e os passaportes de imunidade. Responderam à pesquisa 254 dos 1.300 juízes federais atuantes em todos os estados. A maioria dos entrevistados possui bacharelado ou especialização (59,1%) e atua como juiz há mais de 10 anos (63,8%). Grande parte dos juízes (87,7%) concorda com a obrigatoriedade da vacina para adultos e crianças e adolescentes (66,1%). Mais de 75% dos juízes acreditam que todos os níveis de governo podem impor sanções para aqueles que se recusam a ser vacinados. 93% dos juízes confiam na vacinação, 56,1% rejeitam movimentos antivacinação e 75,2% acreditam que as ações da Anvisa devem ser respeitadas. As ações do Judiciário referentes à pandemia da COVID-19 são aprovadas por 62,6% dos juízes e 88,2% apoiam passaportes de imunidade. Existe uma ligação direta entre a vacinação obrigatória, a confiança na vacina e a adoção de passaportes de imunidade. A maioria dos juízes federais concorda com a obrigatoriedade da vacina para crianças e adultos, apoia a aplicação de sanções no caso de recusa de vacinação, desaprova movimentos antivacinação, concorda com as ações da Anvisa e apoia a intervenção do Judiciário em relação à pandemia da COVID-19.

Resumen: El objetivo fue analizar la visión de los jueces federales brasileños sobre las implicaciones de la vacunación contra la COVID-19. Se realizó un estudio con jueces federales brasileños, quienes recibieron una encuesta elaborada con preguntas de opción múltiple sobre la vacunación contra la COVID-19, abordando temas como su obligatoriedad, aplicación de medidas coercitivas, reticencia a vacunarse, grupos prioritarios, acciones de Agência Nacional de Vigilancia Sanitaria (Anvisa), el papel del Poder Judicial y los pasaportes de inmunidad. Respondieron a la encuesta 254 de los 1.300 jueces federales que actúan en todos los estados. La mayoría de los encuestados tiene título de licenciatura o especialización (59,1%) y actúa como juez desde hace más de 10 años (63,8%). Gran parte de los jueces (87,7%) está de acuerdo con la obligatoriedad de la vacuna para adultos y niños y adolescentes (66,1%). Más del 75% de los jueces cree que todos los niveles de gobierno pueden imponer sanciones a quienes se nieguen a vacunarse. El 93% de los jueces confía en la vacunación, el 56,1% rechaza los movimientos antivacunas y el 75,2% cree que las acciones de Anvisa deben ser respetadas. Las acciones del Poder Judicial con relación a la pandemia de COVID-19 son aprobadas por el 62,6% de los jueces, y el 88,2% apoya los pasaportes de inmunidad. Existe un vínculo directo entre la vacunación obligatoria, la confianza en la vacuna y la adopción de pasaportes de inmunidad. La mayoría de los jueces federales está de acuerdo con la vacunación obligatoria para niños y adultos, apoya la aplicación de sanciones en caso de rechazo de la vacunación, desaprueba los movimientos antivacunas, está de acuerdo con las acciones de Anvisa y apoya la intervención del Poder Judicial con relación a la pandemia de COVID-19.

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Abstract Introduction: Brazilian scientific production has shown substantial growth and achieved international visibility. However, in general, the participation of women in scientific activities remains limited. Objective: This study aimed to evaluate the indicators of scientific productivity of women fellows of the Council for Scientific and Technological Development (CNPq) in the field of Medicine. Method: This cross-sectional study was conducted on 541 (211 women, 39%) researchers registered as recipients of CNPq research productivity (PQ) scholarships in Medicine according to a list provided in December 2022. Results: There was a predominance of male researchers (n=330; 61%). In both the male and female groups, most researchers were at level 2, with 62.5% women and 47.2% men (p=0.018). All 211 female PQ scholars were distributed among 37 different institutions and published 34,969 papers in scientific journals, averaging 165.7 articles per researcher. In the last five years of the study period (from 2018 to 2022), 9,679 papers were published. Over their careers, the 211 researchers supervised 5,440 undergraduate research students, 4,144 master's degree students, and 2,923 PhD candidates. There was a significant difference between the scholarship levels for the development of human resources in undergraduate research (p=0.040), master's degree (p=0.027), and PhD. (p<0.001). Conclusion: There are still less women participating in CNPq medical research than men. However, we observed a substantial participation of women in all the assessed items, including technical and scientific production and the human resources training.

Resumo Introdução: A produção científica brasileira apresentou crescimento substancial e visibilidade internacional. Contudo, em geral, a participação das mulheres em atividades científicas ainda é limitada. Objetivo: Este estudo objetivou avaliar os indicadores de produtividade científica de mulheres bolsistas do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) na área de medicina. Método: Foi realizado estudo transversal com 541 (211 mulheres, 39%) pesquisadores cadastrados como bolsistas de produtividade em medicina do CNPq conforme lista disponibilizada em dezembro de 2022. Resultado: Houve predomínio de pesquisadores do sexo masculino (n = 330; 61%). Em ambos os grupos, masculino e feminino, a maioria dos investigadores encontra-se no nível 2, sendo 62,5% mulheres e 47,2% homens (p = 0,018). Todos os 211 pesquisadores foram distribuídos em 37 instituições diferentes e publicaram 34.969 artigos em revistas científicas, com média de 165,7 artigos por pesquisador. De 2018 a 2022, foram publicados 9.679 artigos. Ao longo de suas carreiras, os 211 pesquisadores orientaram 5.440 alunos de iniciação científica, 4.144 alunos de mestrado e 2.923 alunos de doutorado. Houve diferença significativa entre os níveis de bolsas quanto ao desenvolvimento de recursos humanos em iniciação científica (p = 0,040), mestrado (p = 0,027) e doutorado (p < 0,001). Conclusão: Ainda há menor participação de mulheres do que de homens entre os pesquisadores médicos do CNPq. Contudo, foi possível observar participação substancial das mulheres em todos os quesitos avaliados, incluindo a produção técnica e científica e a formação de recursos humanos.

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OBJECTIVE: The aim of this case-control study was to investigate environmental factors, such as caffeine, folic acid, nutritional iron supplementation, multivitamin complexes, alcohol, and tobacco (second-hand smoking), which have been described as risk factors for the development of oral clefts. METHODS: This case-control study employed convenience sampling and included 409 mothers: 132 with children with oral clefts (cases) and 277 with children without oral clefts (controls). The age range of the children in both groups was 0 to 2 years. A questionnaire was administered to each mother to inquire about their habits and food consumption during the first trimester of pregnancy. RESULTS: Folic acid supplementation was observed in 116 (87.8%) of the case group (p < 0.001) and 271 (97.8%) of the control group. Regarding the use of ferrous sulfate, 114 (86.3%) of the case group and 271 (97.8%) of the control group reported using it. In the case group, 84 (63.6%) mothers reported being exposed to second-hand smoke, and 5 (3.7%) reported alcohol consumption (p = 0.797). In terms of caffeine consumption, 127 mothers (95.4%) in the case group consumed it (p = 0.13), while 247 (88.8%) reported consumption in the control group. CONCLUSIONS: The results suggest a direct relationship between secondhand smoke, alcohol consumption, and the lack of maternal supplementation with oral clefts.

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BACKGROUND: Nonsyndromic orofacial clefts (NSOC) are the craniofacial most common congenital malformations. There are evidences that the nonsyndromic cleft palate (NSCP) development differs from other NSOC. However, most of the publications treat NSCP without considering that information. Furthermore, few studies focus on NSCP. The aim of this study was to describe epidemiological findings of patients with isolated NSCP in Brazil. METHODS: In this cross-sectional multicenter study, four reference Centers for treatment in three different Brazilian states was investigated. Data were obtained from clinical records of patients, between November 2021 and June 2022. Researched variables were sociodemographic, clinical characteristics and pregnancy and family history. Pearson's chi-square and ANOVA One-way tests were used for associations. RESULTS: Majority were female (58.1%), white (60.7%) with incomplete NSCP (61.2%). There was an association between complete NSCP and a positive history of medical problems during pregnancy (p = 0.016; 27.9%; OR: 1.94; 1.12-3.35). Systemic alterations were perceived in 40.6% of the sample with odds ratio for development of the complete type (OR: 1.21; 0.74-1.97). Higher OR was visualized in medication use during pregnancy (OR: 1.35; 0.76-2.37) and positive family history of oral cleft (OR: 1.44; 0.80-2.55). Dental and surgical care was associated with higher age groups (p < 0.050). CONCLUSIONS: NSCP was most prevalent in white skin color female. Complete NSCP is associated with medical problems during pregnancy. Medication use during pregnancy and positive family history of oral cleft increase the chance of developing complete NSCP.

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OBJECTIVE: to analyze the prevalence of symptoms of common mental disorders (CMDs) in Primary Health Care professionals between August-October/2021. METHODS: this was a cross-sectional study conducted with health professionals in the Northern health macro-region of Minas Gerais state; snowball sampling was used; the dependent variable, CMDs, was evaluated using the Self-Reporting Questionnaire (SRQ-20); Poisson regression was used to perform the statistical analysis. RESULTS: a total of 702 health professionals took part in the study; the prevalence of CDMs was 43.2%. It was higher in those with previous [prevalence ratios (PR) = 2.42; 95%CI 1.43;4.08] and current (PR = 1.54; 95%CI 1.25;1.89) symptoms of mental disorders, overwork during the pandemic (PR = 1.42; 95%CI 1.16;1.73), previous symptoms of anxiety (PR = 1.27; 95%CI 1.01;1.61), depression (PR = 1.27; 95%CI 1.06;1.52) and other mental disorders (PR = 1.20; 95%CI 1.01;1.43). CONCLUSION: there was an association between CDMs and presenting previous and current symptoms of mental disorders and work overload during the covid-19 pandemic.

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Objective: to analyze the prevalence of symptoms of common mental disorders (CMDs) in Primary Health Care professionals between August-October/2021. Methods: this was a cross-sectional study conducted with health professionals in the Northern health macro-region of Minas Gerais state; snowball sampling was used; the dependent variable, CMDs, was evaluated using the Self-Reporting Questionnaire (SRQ-20); Poisson regression was used to perform the statistical analysis. Results: a total of 702 health professionals took part in the study; the prevalence of CDMs was 43.2%. It was higher in those with previous [prevalence ratios (PR) = 2.42; 95%CI 1.43;4.08] and current (PR = 1.54; 95%CI 1.25;1.89) symptoms of mental disorders, overwork during the pandemic (PR = 1.42; 95%CI 1.16;1.73), previous symptoms of anxiety (PR = 1.27; 95%CI 1.01;1.61), depression (PR = 1.27; 95%CI 1.06;1.52) and other mental disorders (PR = 1.20; 95%CI 1.01;1.43). Conclusion: there was an association between CDMs and presenting previous and current symptoms of mental disorders and work overload during the covid-19 pandemic.

Objetivo: analizar la prevalencia de síntomas de trastornos mentales comunes (TMC) en profesionales sanitarios de la Atención Primaria de Salud de agosto a octubre de 2021. Métodos: estudio transversal realizado con profesionales de la salud de la macrorregión norte de Minas Gerais. El muestreo fue del tipo bola de nieve. La variable dependiente, TMC, se evaluó mediante el Self-Reporting Questionnaire (SRQ-20). En el análisis estadístico se utilizó la regresión de Poisson. Resultados: participaron 702 profesionales de salud. La prevalencia de TMC fue del 43,2%, mayor en quienes presentaban síntomas de trastornos mentales previos (RP = 2,42; IC95% 1,43;4,08) y actuales (RP = 1,54; IC95% 1,25;1,89); exceso de trabajo durante la pandemia (RP = 1,42; IC95% 1,16;1,73); síntomas previos de ansiedad (RP = 1,27; IC95% 1,01;1,61), depresión (RP = 1,27; IC95% 1,06;1,52) y otros trastornos mentales (RP = 1,20; IC95% 1,01;1,43). Conclusión: hubo una asociación entre los TMC y los síntomas previos y actuales de los trastornos mentales y la sobrecarga de trabajo durante la pandemia de COVID-19.

Objetivo: analisar a prevalência de sintomas de transtornos mentais comuns (TMCs) em profissionais de saúde da Atenção Primária à Saúde, no período agosto-outubro/2021. Métodos: estudo transversal com profissionais de saúde da macrorregião Norte de saúde de Minas Gerais; amostragem de tipo "bola de neve"; a variável dependente, TMCs, foi avaliada pelo Self-Reporting Questionnaire (SRQ-20); utilizou-se regressão de Poisson na análise estatística. Resultados: participaram 702 profissionais de saúde; a prevalência de TMCs foi de 43,2%, maior naqueles que apresentaram sintomas de transtornos mentais prévios [razão de prevalências (RP) = 2,42 ;IC95% 1,43;4,08] e atuais (RP = 1,54; IC95% 1,25;1,89), trabalho a mais durante a pandemia (RP = 1,42; IC95% 1,16;1,73), sintomas prévios de ansiedade (RP = 1,27; IC95% 1,01;1,61), depressão (RP = 1,27; IC95% 1,06;1,52) e outros transtornos mentais (RP = 1,20; IC95% 1,01;1,43). Conclusão: observou-se associação de TMCs com sintomas prévios e atuais de transtornos mentais e sobrecarga de trabalho, durante a pandemia da covid-19.

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