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Abstract Objectives: to elaborate and analyze the psychometric properties of a questionnaire to assess among pregnant women's knowledge about toxoplasmosis. Methods: methodological study elaborating an instrument conducted in the north of Minas Gerais in 2019. The steps followed were: 1. Elaboration of the questionnaire items based on medical literature available in indexed databases. 2. Content validation. 3. Apparent validation. 4. Construct validation with hypothesis testing after the application of the questionnaire and comparison of the mean scores using the Mann-Whitney U test. 5. Reliability analysis with internal consistency analysis and test-retest. Results: the final instrument consisted of 26 items. Content validation reached 90% agreement among experts. The hypothesis test found a significant diference among the scores of the groups evaluated (p<0.001). Cronbach's alpha found a value of 0.84 and the test-retest showed an intra-class correlation index of 0.78 (p<0.001). Conclusions: the instrument elaborated proved to be valid and reliable and could be used to assess among pregnant women's knowledge about toxoplasmosis and, therefore, guiding to the educational and preventive measures.

Resumo Objetivos: elaborar e analisar as propriedades psicométricasde um questionáriopara avaliação do conhecimento sobre toxoplasmose entre gestantes. Métodos: estudo metodológico de elaboração de instrumento, realizado no norte de Minas Gerais, em 2019. O estudo seguiu os seguintes passos: 1. Elaboração dos itens a do questionário, com base na literatura médica disponível em bases indexadas. 2. Validação de conteúdo. 3. Validação aparente. 4. Validação de constructo, com teste de hipóteses, após aplicação do questionário e comparação de médias dos escores por meio do teste U de Mann-Whitney. 5. Análise de confabilidade, com análise da consistência interna e teste-reteste. Resultados: o instrumento final foi composto por 26 itens. Na validação de conteúdo alcançou 90% de concordância entre os experts. O teste de hipótese registrou diferença significativa entre os escores dos grupos avaliados (p<0,001). O alfa de Cronbach apresentou valor de 0,84 e o teste-reteste apresentou índice de correlação intra-classe de 0,78 (p<0,001). Conclusão: o instrumento elaborado apresentou-se válido e confável e poderá ser utilizado para avaliação de conhecimento sobre toxoplasmose entre gestantes, norteando medidas educativas e preventivas.

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The aim of the present study was to analyze the effects of traffic-related air pollution (TRAP) on markers of inflammatory, neuroplasticity, and endurance performance-related parameters in recreationally trained cyclists who were adapted to TRAP during a 50-km cycling time trial (50-km cycling TT). Ten male cyclists performed a 50-km cycling TT inside an environmental chamber located in downtown Sao Paulo (Brazil), under TRAP or filtered air conditions. Blood samples were obtained before and after the 50-km cycling TT to measure markers of inflammatory [interleukin-6 (IL-6), C-reactive protein (CRP), interleukin-10 (IL-10), intercellular adhesion molecule-1 (ICAM-1)] and neuroplasticity [brain-derived neurotrophic factor (BDNF)]. Rating of perceived exertion (RPE), heart rate (HR), and power output (PO) were measured throughout the 50-km cycling TT. There were no significant differences between experimental conditions for responses of IL-6, CRP, and IL-10 (P > 0.05). When compared with exercise-induced changes in filtered air condition, TRAP provoked greater exercise-induced increase in BDNF levels (TRAP = 3.3 ± 2.4-fold change; Filtered = 1.3 ± 0.5-fold change; P = 0.04) and lower exercise-induced increase in ICAM-1 (Filtered = 1.1 ± 0.1-fold change; TRAP = 1.0 ± 0.1-fold change; P = 0.01). The endurance performance-related parameters (RPE, HR, PO, and time to complete the 50-km cycling TT) were not different between TRAP and filtered air conditions (P > 0.05). These findings suggest that the potential negative impacts of exposure to pollution on inflammatory, neuroplasticity, and performance-related parameters do not occur in recreationally trained cyclists who are adapted to TRAP.

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BACKGROUND: The aim of the present study was to determine whether PTH spikes in renal hyperparathyroidism can interfere with the interpretation of intraoperative PTH monitoring and to determine its frequency and characteristics. METHODS: This was a prospective observational study of consecutive patients who underwent surgical treatment in a single tertiary institution. Patients were divided into two groups: spike and no spike. Patients with secondary and tertiary hyperparathyroidism were analyzed separately. Intraoperative PTH monitoring by venous serial samples: two samples were taken before the excision of the parathyroid gland, and two others were taken after resection. RESULTS: PTH spikes occurred in 23.5% (53 of 226), and their occurrence was similar between secondary and tertiary hyperparathyroidism patients (p = 0.074). The relative PTH spike intensity was higher in transplanted patients than in dialysis patients (55 vs. 20%, p = 0.029). A characteristic of the secondary hyperparathyroidism patients was the highest frequency of surgical failure (23 vs. 7.5%, p = 0.016) and the higher occurrence of supernumerary glands in the spike group (23 vs. 10.3%, p = 0.035). Supernumerary parathyroid was associated with surgical failure [19.1 (6.5-55.7) odds ratio [confidence interval], p < 0.001). In the studies evaluating the diagnostic test validity for patients on dialysis and experiencing spikes, the most significant impacts were in the sensitivity, accuracy, and negative predictive value of the method. CONCLUSIONS: PTH spikes occurred in up to 23.5% of renal hyperparathyroidism surgical treatments and can negatively influence the intraoperative parathyroid hormone monitoring. Regarding the phenomenon of PTH spikes, it is prudent to think about the possibility of a hyperplastic supernumerary gland.

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Obesity is a worldwide epidemic affecting over 13% of the adult population and is defined by an excess of body fat that predisposes comorbidities. It is considered a multifactorial disease in which environmental and genetic factors interact, and it is a risk marker for cardiovascular disease. Lifestyle modifications remain the mainstay of treatment for obesity based on adequate diet and physical exercise. In addition, obesity is related to cardiovascular and skeletal muscle disorders, such as cardiac hypertrophy, microvascular rarefaction, and skeletal muscle atrophy. The discovery of obesity-involved molecular pathways is an important step to improve both the prevention and management of this disease. MicroRNAs (miRNAs) are a class of gene regulators which bind most commonly, but not exclusively, to the 3'-untranslated regions of messenger RNAs of protein-coding genes and negatively regulate their expression. Considerable effort has been made to identify miRNAs and target genes that predispose to obesity. Besides their intracellular function, recent studies have demonstrated that miRNAs can be exported or released by cells and circulate within the blood in a remarkably stable form. The discovery of circulating miRNAs opens up intriguing possibilities for the use of circulating miRNA patterns as biomarkers for obesity and cardiovascular diseases. The aim of this review is to provide an overview of the recent discoveries of the role played by miRNAs in the obese phenotype and associated comorbidities. Furthermore, we will discuss the role of exercise training on regulating miRNAs, indicating the mechanisms related to these alterations.

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We investigated the effects of AET on myomiRs expression in the skeletal muscle and serum of colon cachectic (CT26) and breast non-cachectic (MMTV-PyMT) cancer mice models. Colon cancer decreased microRNA-486 expression, increasing PTEN in tibialis anterior muscle (TA), decreasing the PI3K/mTOR protein pathway, body and muscle wasting, fibers' cross-sectional area and muscle dysfunction, that were not preserved by AET. In contrast, breast cancer decreased those muscle functions, but were preserved by AET. In circulation, the downregulation of microRNA-486 and -206 in colon cancer, and the downregulation of microRNA-486 and upregulation of microRNA-206 expression in breast cancer might be good cancer serum biomarkers. Since the microRNA-206 is skeletal muscle specific, their expression was increased in the TA, serum and tumor in MMTV, suggesting a communication among these three compartments. The AET prevents these effects on microRNA-206, but not on microRNA-486 in MMTV. In conclusion, cancer induced a downregulation of microRNA-486 expression in TA and serum of CT26 and MMTV mice and these effects were not prevented by AET; however, to MMTV, the trained muscle function was preserved, probably sustained by the downregulation of microRNA-206 expression. Serum microRNA-206 is a potential biomarker for colon (decreased) and breast (increased) cancer to monitor the disease evolution and the effects promoted by the AET.

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Although the exposure to traffic-related air pollution (TRAP) has emerged as one of main problem worldwide to inhabitants' health in urban centers, its impact on metabolic responses during exercise is poorly understood. The aim of study was to characterize the profile of non-target serum metabolomics during prolonged exercise performed under TRAP conditions. Ten healthy men completed two 90 min constant-load cycling trials under conditions of either TRAP or filtered air. Experimental trials were performed in a chamber located on an avenue with a high volume of vehicle traffic. Blood samples were taken at 30 min, 60 min, and 90 min of exercise. Based on Nuclear Magnetic Resonance metabolomics, the non-target analysis was used to assess the metabolic profile. Twelve, 16 and 18 metabolites were identified as discriminants. These were: at 30 min of exercise, the coefficient of determination (R2) 0.98, the predictive relevance, (Q2) 0.12, and the area under the curve (AUC) 0.91. After 60 min of exercise: (R2: 0.99, Q2: 0.09, AUC: 0.94); and at 90 min of exercise (R2: 0.91, Q2: <0.01, AUC: 0.89), respectively. The discriminant metabolites were then considered for the target analysis, which demonstrated that the metabolic pathways of glycine and serine metabolism (p = 0.03) had been altered under TRAP conditions at 30 min of exercise; arginine and proline metabolism (p = 0.04) at 60 min of exercise; and glycolysis (p = 0.05) at 90 min of exercise. The present results suggest that exposure to TRAP during prolonged exercise leads to a significant change in metabolomics, characterized by a transitional pattern and lastly, impairs the glucose metabolism.

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INTRODUCTION: Some authors advise in favor of delayed sampling of intraoperative parathormone testing (ioPTH) during parathyroidectomy in dialysis and kidney-transplanted patients. The aim of the present study was to evaluate the intensity and the role of delayed sampling in the interpretation of ioPTH during parathyroidectomy in dialysis patients (2HPT) and successful kidney-transplanted patients (3HPT) compared to those in single parathyroid adenoma patients (1HPT). METHODS: This was a retrospective study of ioPTH profiles in patients with 1HPT, 2HPT, and 3HPT operated on in a single institution. Samples were taken at baseline ioPTH (sampling at the beginning of the operation), ioPTH-10 min (10 minutes after excision of the parathyroid glands), and ioPTH-15 min (15 minutes after excision of the parathyroid glands). The values were compared to baseline. RESULTS: Median percentage values of ioPTH compared to baseline (100%) were as follows: 1HPT, ioPTH-10 min = 20% and ioPTH-15 min = 16%; 2HPT, ioPTH-10 min = 14% and ioPTH-15 min = 12%; 3HPT, ioPTH-10 min = 18% and ioPTH-15 min = 15%. DISCUSSION: The reduction was equally effective at 10 minutes in all groups. In successful cases, ioPTH decreases satisfactorily 10 minutes after parathyroid glands excision in dialysis and transplanted patients, despite significant differences in kidney function. The postponed sampling of ioPTH appears to be unnecessary.

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RESUMEN: Las dificultades de las personas sordas en la lengua portuguesa escrita y del docente en su enseñanza, sumadas a la escasez de investigaciones en el área, hacen relevante la revisión de estrategias en el proceso de formación docente. Se trata de una investigación cualitativa y cuantitativa con 16 profesores de los últimos años de Educación Primaria y Secundaria de la lengua portuguesa de la red de escuelas públicas que trabajaron con estudiantes Sordos en algún momento de su experiencia docente. Fueron seleccionados 8 profesores de la Educación Inclusiva y 8 de una escuela Bilingüe para Sordos. Se utilizó el software NVivo10 para el análisis de datos. En la formación inicial, los docentes no tuvieron contacto con la Lengua de Señas ni estrategias metodológicas específicas para la enseñanza de Sordos. En la educación continua, la enseñanza más eficaz fue la de otros profesores con más experiencia. Destaca una dicotomía entre los profesores de las escuelas inclusivas y los de la escuela bilingüe para Sordos, donde los primeros utilizam la Lengua Brasileña de Señales - Libras como una lengua accesoria para la enseñanza del portugués escrito, ya, los docentes de la escuela bilíngue la utilizan como lengua de instrucción con el uso del metalenguaje. En cuanto a las concepciones, los docentes sugirieron algunas prácticas en formación para trabajar con el público Sordo. Por tanto, es fundamental invertir en escuelas inclusivas y bilingües que trabajen con estudiantes Sordos, así como en la formación continua de los docentes, proponiendo grupos de estudio con todo el equipo pedagógico como parte del proceso de formación.

ABSTRACT: The difficulties of the deaf in written Portuguese and of the teacher in teaching, added to the scarcity of research in the area, make the revision of strategies in the process of teacher training relevant. This is a qualitative and quantitative research with 16 teachers from the last years of Elementary and High School of Portuguese language in the public-school network who worked with deaf students at some point in their teaching experience. Eight teachers from Inclusive Education and eight from a Bilingual School for the Deaf were selected. NVivo10 software was used for data analysis. In the initial training, the teachers did not have contact with Sign Language or specific methodological strategies for teaching the Deaf. In continuing education, the most effective teaching was that of other, more experienced teachers. There is a dichotomy between teachers from inclusive schools and those from the bilingual school for the deaf, where the former use the Brazilian Sign Language as an accessory language for the teaching of written Portuguese, whereas teachers in the bilingual school use it as the language of instruction with the use of metalanguage. Regarding the conceptions, the teachers suggested some training practices to work with the Deaf audience. Therefore, it is essential to invest in inclusive and bilingual schools that serve deaf students, as well as in the continued training of teachers, proposing study groups with the entire pedagogical team as part of the training process.

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Introdução: A sífilis durante a gravidez é um grave problema de saúde pública. Em 2016, foram notificados 37.436 casos de sífilis em gestantes e 20.474 casos de sífilis congênita, com 185 óbitos no Brasil. O fator determinante para a diminuição dos casos é o pré-natal de qualidade. Objetivo: Avaliar o perfil dos casos notificados de sífilis em gestante no estado de Minas Gerais, entre 2013 a 2017. Métodos: Trata-se de um estudo transversal descritivo sobre o perfil epidemiológico dos casos notificados de sífilis em gestante em Minas Gerais entre 2013 a 2017. Os dados foram obtidos no Sistema de Informação de Agravos de Notificação, a partir do Departamento de Informática do Sistema Único de Saúde e categorizados quanto ao número de casos, ano de diagnóstico, faixa etária, nível de escolaridade, raça, região e estágio clínico ao diagnóstico. Resultados: Em 2017 foi demonstrado um aumento de 132% dos casos de gestantes com sífilis, em comparação com 2013. Houve predomínio na região central do estado (43,30%). 92,50% se referem a gestantes moradoras da zona urbana. A faixa etária mais acometida foi 20 a 39 anos. A maior parte (46,3%) se declara como parda. E a escolaridade 5ª a 8ª série incompleto do ensino fundamental foi a mais prevalente (16,05%). A classificação clínica mais comum da sífilis materna foi a primária (34,7%). Conclusão: A assistência pré-natal adequada deve ser iniciada precocemente. É necessária a capacitação das equipes das Unidades Básicas para garantirem ações educativas, identificação de situações de risco, diagnóstico e tratamento oportuno.

Introduction: Syphilis during pregnancy is a serious public health problem. In 2016, 37,436 cases of syphilis in pregnant women and 20,474 cases of congenital syphilis were reported, with 185 deaths in Brazil. The determining factor for the decrease in cases is the prenatal quality. Objective: To evaluate the profile of notified cases of syphilis in pregnant women in Minas Gerais, between 2013 to 2017. Methods: This is a cross-sectional descriptive study on the epidemiological profile of notified cases of syphilis in pregnant women in Minas Gerais from 2013 to 2017. Data were obtained from the Notification of Disease Information System, the from the Department of Informatics of the Unified Health System and categorized according to the number of cases, year of diagnosis, age group, level of education, race, region and clinical stage at diagnosis. Results: In 2017 there was a 132% increase in cases of pregnant women with syphilis compared to 2013. There was a predominance in the central region of the state (43.30%). 92.50% refer to pregnant women living in urban areas. The most affected age group was 20 to 39 years. Most (46.3%) declare themselves as brown. And the 5th to 8th grade incomplete elementary schooling was the most prevalent (16.05%). The most common clinical classification of maternal syphilis was primary (34.7%). Conclusion: Appropriate prenatal care should be started as early as possible. The training of Basic Units teams is necessary to ensure educational actions, identification of risk situations, diagnosis and timely treatment.

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PURPOSE: Obstructive sleep apnea (OSA) is associated with multiple comorbid conditions including cardiovascular diseases and cancer. There is a growing interest in exploring biomarkers to understand the related mechanisms and improve the risk stratification of OSA. Circulating microRNAs (miRNAs) are single noncoding strands of nearly 22 nucleotides that posttranscriptionally regulate target gene expression. Our aim was to identify miRNA profiles associated with OSA. METHODS: We studied 48 male subjects, mostly Caucasian (63%) and overweight, divided by polysomnography into the no OSA control group (n = 6), mild OSA group (n = 12), moderate OSA group (n = 15), and severe OSA group (n = 15). The study groups were matched for age, body mass index (BMI), and body fat composition. miRNA profiles were measured from peripheral whole blood using two steps: (1) microarray analysis comprising more than 2500 miRNAs in a subsample of 12 subjects (three from each group); and (2) validation phase using real-time quantitative polymerase chain reaction (RTqPCR). RESULTS: The microarray assessment identified 21 differentially expressed miRNAs among the groups. The RT-qPCR assessment showed that miR-1254 and miR-320e presented a gradual increase in expression parallel to OSA severity. Linear regression analysis showed that severe OSA was independently associated with miR-1254 (ß = 68.4; EP = 29.8; p = 0.02) and miR-320e (ß = 76.1; EP = 31.3; p = 0.02). CONCLUSION: Severe OSA is independently associated with miRNAs that are involved in heart failure (miR-1254), myocardial ischemia/reperfusion (miR-320e), and cell proliferation in some cancer types (miR-1254 and miR-320e). Future investigations addressing whether these miRs may provide prognostic information in OSA are needed.

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