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BACKGROUND: Laparoscopy represented one of the most innovative surgical techniques approached in the surgery field. Dexmedetomidine association with general anesthesia promotes the response control to trauma by altering the neuroinflammatory reflex, provides better clinical outcomes in the postoperative period and reduces the excessive use of drugs with risk for addiction. This trial aims to evaluate the potential drug treatment of dexmedetomidine on organic function, with the targets in neuroinflammation, perioperative pain control and blood pressure measurements in a medium-sized surgical model. METHODS: Fifty-two patients were randomized in two groups: Sevoflurane and Dexmedetomidine - A (dexmedetomidine infusion [1 µg/kg loading, .2-.5 µg/kg/h thereafter]) vs Sevoflurane and Saline .9% - B. Three blood samples were collected at three times: before surgery, 4 to 6 hours after surgery and 24 hours postoperatively. The primary outcome was inflammatory and endocrine mediators dosage analisys. Finally, we evaluated pain and opioid use as secondary outcomes, also the hemodynamic values. RESULTS: In Dexmedetomidine group A, a reduction of Interleukin 6 was found during 4-6 hours after surgery. A reduction of IL-10 was noted in the measurement of its values 24 hours after the procedure, with statistical significance. Also, systolic and diastolic blood pressure, as well heart rate were attenuated, and there was a lower incidence of pain and opioid consumption in the first postoperative hour (P < .0001) in the anesthetic recovery room. CONCLUSIONS: Dexmedetomidine provided anti-inflammatory activity, sympatholytic effect and analgesia with cardiovascular safety. It reinforces the therapeutic nature of highly selective α2-adrenergic agonists when combined within anesthetic interventions.

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OBJECTIVE: To estimate the prevalence of syphilis and its associated factors in women who were treated at public maternity hospitals and received prenatal care in a primary healthcare unit. METHODS: This cross-sectional study included 399 postpartum women. Interviews were conducted, and additional data were extracted from the pregnant woman's booklet, medical records, and printed tests. The dependent variable was a gestational syphilis diagnosis. The independent variables were grouped into socioeconomic and demographic, behavioral, reproductive, and prenatal blocks. The prevalence, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The χ 2 test was also performed (p≤0.05). Multivariate analysis was performed using Poisson regression models. RESULTS: The prevalence of gestational syphilis was 9.61% (95%CI: 7.14-12.83). We identified the following determining factors (adjusted prevalence ratios): history of sexually transmitted infections (2.3), first sexual intercourse by the age of 15 (2.42), partner having a history of syphilis (5.98), partner using crack/cocaine (6.42) and marijuana and others (3.02), not having a partner (3.07), low income (2.85), history of stillbirth (5.21), beginning prenatal care in the third trimester (3.15), and prenatal care received in a primary healthcare unit (without a Family Health Strategy team) (0.35). CONCLUSION: Individual and prenatal factors were associated with gestational syphilis. To control congenital syphilis, targeted interventions are needed to control syphilis in the adult population including expansion of access to quality prenatal care with identification of risks for syphilis and connection between prevention and treatment actions, implementation of strategies focused on early sexual education, effective establish prenatal care involving both partners, and effective implementation of the National Men's Health Policy (PNAISH - Política Nacional de Atenção Integral à Saúde dos Homens ).

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O objetivo do presente estudo foi associar status tabágico (tabagistas, ex-tabagistas e não tabagistas) e a qualidade de vida entre usuários das Unidades de Atenção Primária à Saúde(APS). Realizou-se um estudo transversal com 500 usuários de 50 Unidades de APS do município de Juiz de Fora/MG.Foi utilizado questionário estruturado para coleta de dados sociodemográficos e de saúde e o questionário WHOQOL-BREF para avaliar a qualidade de vida. Para análise de dados foi empregada Regressão Logística. Os resultados das análises multivariadas evidenciaram que há maior chance de melhor qualidade de vida total para indivíduos ex-tabagistas (OR: 1,90; IC: 1,10-3,29) e não tabagistas (OR: 1,84; IC:1,14-2,95)em relação aos tabagistas. Da mesma forma, uma maior renda e a autodeclaração de cor da pele branca foram relacionados a melhor qualidade de vida total. Indivíduos não tabagistas também apresentaram melhor qualidade de vida no domínio físico comparado aos tabagistas(OR:2,24; IC:1,40-3,59). Conclui-se que, ex-tabagistas e não tabagistas tiveram maior chance de apresentarem melhor qualidade de vida global quando comparado aos tabagistas. Não tabagistas também apresentaram maior chance de melhor qualidade de vida no domínio físico em relação aos tabagistas.

The objective of the present study was to associate smoking status (smokers, ex-smokers and non-smokers) and quality of life among users of primary healthcare units. A cross-sectional study was conducted with 500 users of 50 Primary Health Care Units in the city of Juiz de Fora. A structured questionnaire was used to collect socio-demographic and health data and the WHOQOL-BREF questionnaire to assess the quality of life. For data analysis, LogisticRegression was used. The results of the multivariate analyzes showed that there is a greater chance of a better overall quality of life for ex-smokers (OR: 1.90; CI: 1.10-3.29) and non-smokers (OR: 1.84; CI: 1.14-2.95) in relation to smokers. Likewise, higher income and self-reported White skin color were related to a better overall quality of life. Non-smokers also presented better quality of life in the physical domain compared to smokers (OR:2.24; CI:1.40-3.59). It was concluded that ex-smokers and non-smokers were more likely to have a better overall quality of life when compared to smokers. Non-smokers also had a greater chance of better quality of life in the physical domain compared to smokers.

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BACKGROUND: The Brazilian Ministry of Health (MoH) recommends double screening (DS) for syphilis and HIV during the first and third trimesters of antenatal care (ANC) to mitigate vertical transmission. We surveyed DS outcomes and their associated factors in a priority Brazilian municipality with >100 000 inhabitants who face challenges for both health problems. METHODS: A total of 399 women were followed up throughout pregnancy using medical records. Spatial and multinomial logistic analyses were performed. RESULTS: There was an incidence rate of 24.8%, 59.4% and 15.8% for 'full DS', 'partial DS' and 'without DS', respectively. Younger women and those with a history of both prematurity and multiparity were less likely to be in the 'full DS' category. There was an overlap of high-density clusters of 'full DS' and 'ANC in better quality basic health units', adherent to both the Family Health Strategy and the National Program for Access and Quality Improvement in Primary Care. CONCLUSIONS: The poor DS outcomes presented in 75% of the cases were mostly linked to delays in starting ANC appointments or their discontinuity. Thus, the MoH recommendations, accompanied by ongoing training, technical assistance and the periodic evaluation of their implementation, need to effectively reach providers and promote counseling and awareness about the importance of DS for pregnant women.

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ABSTRACT Objective To estimate the prevalence of syphilis and its associated factors in women who were treated at public maternity hospitals and received prenatal care in a primary healthcare unit. Methods This cross-sectional study included 399 postpartum women. Interviews were conducted, and additional data were extracted from the pregnant woman's booklet, medical records, and printed tests. The dependent variable was a gestational syphilis diagnosis. The independent variables were grouped into socioeconomic and demographic, behavioral, reproductive, and prenatal blocks. The prevalence, prevalence ratios, and 95% confidence intervals (95%CI) were calculated. The χ 2 test was also performed (p≤0.05). Multivariate analysis was performed using Poisson regression models. Results The prevalence of gestational syphilis was 9.61% (95%CI: 7.14-12.83). We identified the following determining factors (adjusted prevalence ratios): history of sexually transmitted infections (2.3), first sexual intercourse by the age of 15 (2.42), partner having a history of syphilis (5.98), partner using crack/cocaine (6.42) and marijuana and others (3.02), not having a partner (3.07), low income (2.85), history of stillbirth (5.21), beginning prenatal care in the third trimester (3.15), and prenatal care received in a primary healthcare unit (without a Family Health Strategy team) (0.35). Conclusion Individual and prenatal factors were associated with gestational syphilis. To control congenital syphilis, targeted interventions are needed to control syphilis in the adult population including expansion of access to quality prenatal care with identification of risks for syphilis and connection between prevention and treatment actions, implementation of strategies focused on early sexual education, effective establish prenatal care involving both partners, and effective implementation of the National Men's Health Policy (PNAISH - Política Nacional de Atenção Integral à Saúde dos Homens ).

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Objetivo: identificar a prevalência da Síndrome de Burnout, suas dimensões e analisar os fatores associados. Método: estudo transversal, realizado com 171 enfermeiros de um hospital público, em 2020. Foi utilizado o MBI-HSS para estimar a prevalência da SB, considerando sua presença quando verificada alteração em pelo menos uma de suas dimensões. Resultados: 9,9% dos participantes apresentaram alta exaustão emocional (EE), 7% alta despersonalização (DE) e 59,1% baixa realização profissional (RP). EE e DE foram associadas a modalidade contratual do tipo estatutário e recebimento de dois ou mais incentivos no exercício do trabalho. Pouca realização de atividades educativas foi associada a EE e a ausência de filhos a baixa RP. Conclusão: evidenciou-se uma alta prevalência da Síndrome de Burnout (62,6%). Reforça-se a importância de ações preventivas e de diagnóstico precoce que contribuam para a preservação da saúde física e mental desses trabalhadores e, consequentemente, para melhoria da qualidade da assistência.

Objective: to identify the prevalence and dimensions of Burnout syndrome, and to analyze associated factors. Method: this cross-sectional study with 171 nurses at a public hospital was conducted in 2020 using the MBI-HSS to estimate prevalence of Burnout syndrome, indicated by alteration in any of its dimensions. Results: 9.9% of participants displayed high emotional exhaustion (EE), 7% showed strong depersonalization (DE) and 59.1% reported poor professional achievement (PPA). EE and DE were associated with a statutory contract type and receiving two or more job incentives. Little educational activity was associated with EE and childlessness, with PPA. Conclusion: prevalence of Burnout syndrome was high (62.6%). This underlines the importance of preventive actions and early diagnosis that contribute to preserving these workers' physical and mental health and thus to improving the quality of care.

Objetivo: identificar la prevalencia de Síndrome de Burnout, sus dimensiones y analizar los factores asociados. Método: estudio transversal, realizado junto a 171 enfermeros de un hospital público, en 2020. Se utilizó el MBI-HSS para estimar la prevalencia de SB, considerando su presencia cuando hay alteración en, al menos, una de sus dimensiones. Resultados: 9,9% de los participantes tenían alto agotamiento emocional (EE), 7% alta despersonalización (DE) y 59,1% baja realización profesional (RP). EE y DE se asociaron con la modalidad contractual del tipo estatutario y tener dos o más incentivos en el ejercicio del trabajo. La realización de pocas actividades educativas se asoció con la EE y la ausencia de niños con la baja RP. Conclusión: hubo una alta prevalencia de Síndrome de Burnout (62,6%). Se destaca la importancia de acciones preventivas y de diagnóstico temprano que contribuyan a la preservación de la salud física y mental de estos trabajadores y, en consecuencia, a mejorar la calidad de la atención.

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OBJECTIVE: To analyze the socioeconomic, demographic, environmental, reproductive, behavioral, and health-care factors associated with preterm birth. METHODS: Case-control study, with case group composed of preterm infants and the control group by full term live births. Each case was paired with two controls according to sex and date of birth. Interviews were carried out with the mothers, as well as analysis of medical records. A logistic regression model was used for data analysis following the hierarchical order of entry of the blocks. RESULTS: 221 live births were allocated in the case group and 442 in the control group. After analysis adjusted for other factors under study, the highest chances of prematurity were associated with being the first child (OR 1.96; 95%CI 1.34-2.86; p=0.001); mothers with the highest income (OR 2.08; 95%CI 1.41-3.08; p<0.001), mothers with previous preterm births (OR 3.98; 95%CI 2.04-7.79; p<0.001), mothers that suffered violence during pregnancy (OR 2.50; 95%CI 1.31-4.78; p=0.005) and underwent cesarean section (OR 2.35; 95%CI 1.63-3.38; p<0.001). Live births to mothers who had more than six prenatal consultations had a lower risk of prematurity (OR 0.39; 95%CI 0.26-0.58; p<0.001). CONCLUSIONS: The factors associated with a higher chance of prematurity were: higher family income, previous preterm child, primiparity, violence against pregnant women and cesarean section. Having attended more than six prenatal visits was associated with a lower chance of premature birth. Violence against pregnant women showed a strong and consistent association, remaining in all final models, and should serve as an alert for the population and professionals.

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Objectives: The aim of the manuscript was to analyze the effects of two rest periods between volume-equated resistance exercise (RE) on inflammatory responses (cytokines and leukocyte) and muscle damage. Methods: Ten trained men (26.40 ± 4.73 years, 80.71 ± 8.95 kg, and 176.03 ± 6.11 cm) voluntarily participated in training sessions consisting of five sets of 10 reps performed at 10-RM on (1) the barbell bench press followed by (2) leg press, with either 1- or 3-min rest between sets and exercises. Circulating concentrations of different biomarkers was measured before (Pre), and after 3 h (excepted for cytokines), 6, 12, and 24 h from exercise. The rate of perceived exertion (RPE) was recorded after each set on both planned visits. Results: We found greater increases triggered by the 1-min rest period in Creatine Kinase (CK), occurring from 12 to 24 h post-exercise compared to the 3-min rest condition. A significant increase in the 1-min rest condition was also observed in the total number of leukocytes, neutrophils, and monocytes. The 1-min rest period also triggered increases compared to baseline in pro-inflammatory cytokines [Interleukin 1 beta (IL-1ß), p = 0.004; tumor necrosis factor α (TNF-α), p = 0.01; and granulocyte-macrophage colony-stimulating factor (GM-CSF), p = 0.01], which were more evident after 6 and 12 h post-exercise. Similarly, increases in anti-inflammatory cytokines [Interleukin 5 (IL-5), p = 0.01; Interleukin 6 (IL-6), p = 0.01; and Interleukin 10 (IL-10), p = 0.01] at all time-points were observed. Conclusion: Our results indicate that a 1-min rest condition in volume-equated RE promoted greater overall muscle tissue damage with a longer duration of the inflammatory processes compared to a 3-min rest.

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Abstract Introduction: Prenatal care and the procedures adopted during childbirth are essential to ensure a healthy pregnancy and delivery and prevent complications, without affecting the health of the mother and newborn. Objective: To analyze the prenatal and perinatal care provided in Governador Valadares, Minas Gerais state, Brazil, and to determine whether there is an association between adequate prenatal care and socioeconomic, demographic, behavioral and reproductive factors. Methods: Cross-sectional study with a pre-existing database. The adequacy of prenatal care was analyzed based on three criteria: 1) onset up to the 16th week and a minimum number of checkups according to gestational age; 2) professional practices during prenatal checkups; 3) counseling given to the pregnant women by healthcare professionals. Multivariate logistic regression was used for data analysis. Results: Participants were 437 postpartum women. Prenatal care was considered adequate for 72.5, 93.1 and 50.1% of the participants based on criteria 1, 2 and 3, respectively. The pregnant women who were most likely to receive inadequate prenatal care in relation to criterion 1 were those with the lowest schooling level (OR = 1.68; p = 0.046), who were single (OR = 2.18; p = 0.002), did not work during their pregnancy (OR = 2.18; p = 0.003) and whose pregnancy was unplanned (OR = 1.76; p = 0.023). With respect to perinatal care, the presence of a birth companion and skin-to-skin contact were adequate, but breastfeeding in the first hour of life was not. Conclusion: There is a need to improve the counseling provided by healthcare professionals and include breastfeeding in the first hour of life. The results could contribute to optimizing maternal and child health services in Governador Valadares.

Resumo Introdução: O acompanhamento pré-natal e as condutas adotadas durante o parto são essenciais para garantir o bom desenvolvimento da gestação, prevenir complicações e proporcionar um parto saudável, sem impacto na saúde da puérpera e do recém-nascido. Objetivo: Analisar a assistência pré-natal e perinatal oferecida em Governador Valadares, Minas Gerais, e verificar se há associação entre a adequação do pré-natal e os fatores socioeconômicos, demográficos, comportamentais e reprodutivos. Métodos: Estudo transversal com base de dados pré-existente. Para a análise da adequação do pré-natal foram utilizados três critérios: 1) início até 16ª semana e número mínimo de consultas de acordo com a idade gestacional; 2) práticas dos profissionais nas consultas de pré-natal; 3) orientações oferecidas às gestantes pelos profissionais. Para a análise dos dados foi utilizada regressão logística multivariada. Resultados: Participaram do estudo 437 puérperas. A assistência pré-natal foi considerada adequada para 72,5%, 93,1% e 50,1% das puérperas, considerando os critérios 1, 2 e 3, respectivamente. As gestantes que apresentaram maior chance de terem o pré-natal inadequado, com relação ao critério 1, foram as com menor escolaridade (RC = 1,68; p = 0,046), que não possuíam companheiro (RC = 2,18; p = 0,002), que não trabalharam durante a gestação (RC = 2,18; p = 0,003) e as que não planejaram a gravidez (RC = 1,76; p = 0,023). Com relação à assistência perinatal, a presença de acompanhante e contato pele a pele foram apropriados, mas a amamentação na primeira hora de vida foi inadequada. Conclusão: Observou-se a necessidade de aprimorar as orientações fornecidas pelos profissionais e incluir a amamentação na primeira hora de vida. Os resultados podem contribuir para otimizar os serviços de saúde materno-infantil em Governador Valadares.

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ABSTRACT Objective: To analyze the socioeconomic, demographic, environmental, reproductive, behavioral, and health-care factors associated with preterm birth. Methods: Case-control study, with case group composed of preterm infants and the control group by full term live births. Each case was paired with two controls according to sex and date of birth. Interviews were carried out with the mothers, as well as analysis of medical records. A logistic regression model was used for data analysis following the hierarchical order of entry of the blocks. Results: 221 live births were allocated in the case group and 442 in the control group. After analysis adjusted for other factors under study, the highest chances of prematurity were associated with being the first child (OR 1.96; 95%CI 1.34-2.86; p=0.001); mothers with the highest income (OR 2.08; 95%CI 1.41-3.08; p<0.001), mothers with previous preterm births (OR 3.98; 95%CI 2.04-7.79; p<0.001), mothers that suffered violence during pregnancy (OR 2.50; 95%CI 1.31-4.78; p=0.005) and underwent cesarean section (OR 2.35; 95%CI 1.63-3.38; p<0.001). Live births to mothers who had more than six prenatal consultations had a lower risk of prematurity (OR 0.39; 95%CI 0.26-0.58; p<0.001). Conclusions: The factors associated with a higher chance of prematurity were: higher family income, previous preterm child, primiparity, violence against pregnant women and cesarean section. Having attended more than six prenatal visits was associated with a lower chance of premature birth. Violence against pregnant women showed a strong and consistent association, remaining in all final models, and should serve as an alert for the population and professionals.

RESUMO Objetivo: Analisar os fatores socioeconômicos, demográficos, ambientais, reprodutivos, comportamentais e de assistência à saúde associados à prematuridade. Métodos: Estudo caso-controle, sendo o grupo caso composto de prematuros e o grupo controle, de nascidos vivos a termo. Cada caso foi pareado com dois controles, de acordo com o sexo e a data de nascimento. Foram realizadas entrevistas com as puérperas e análise de prontuários. Para análise dos dados, foi utilizada regressão logística, seguindo a ordem hierárquica de entrada dos blocos. Resultados: Participaram 221 nascidos vivos no grupo caso e 442 no grupo controle. Após análise ajustada para os demais fatores em estudo, as maiores chances de prematuridade foram associadas aos primeiros filhos (RC 1,96; IC95% 1,34-2,86; p=0,001), cujas mães possuíam maior renda (RC 2,08; IC95% 1,41-3,08; p<0,001), tiveram filho prematuro prévio (RC 3,98; IC95% 2,04-7,79; p<0,001), sofreram violência durante a gestação (RC 2,50; IC95% 1,31-4,78; p=0,005) e realizaram cesariana (RC 2,35; IC95% 1,63-3,38; p<0,001). Os nascidos vivos de mães que realizaram mais de seis consultas de pré-natal apresentaram menor chance de ser prematuros (RC 0,39; IC95% 0,26-0,58; p<0,001). Conclusões: Os fatores associados à maior chance de prematuridade foram: maior renda familiar, filho prematuro prévio, primiparidade, violência contra a gestante e cesariana. Ter realizado mais de seis consultas de pré-natal foi associado à menor chance de nascimento prematuro. A violência contra a gestante apresentou associação forte e consistente, permanecendo em todos os modelos finais, devendo servir de alerta para a população e os profissionais.