Brazilian Capitals Research Articles

Laboratory readiness and genomic surveillance of Covid-19 in the capital of Brazil.

This study aims to analyze the diagnostic readiness to Covid-19 and the genomic surveillance of SARS-CoV-2 in Brasília, the capital of Brazil. This is a retrospective, cross-sectional study, with data from: cases/deaths-Ministry of Health; RT-PCR analyses Brasília Central Public Health Laboratory (LACEN); genomics-Global Initiative on Sharing All Influenza Data (GISAID). It was found that in March 2021, with the Gamma variant was predominant, RT-PCR diagnostic tests administered by LACEN reached their peak, followed by a reduction, possibly due to the start of vaccination. New peaks were observed in September 2021 and January 2022. The average time for releasing RT-PCR results was reduced from eight days (July 2020), to around eight hours in 2023. The participation of private laboratories was evident in sequencing the SARS-CoV-2 variants of concern in Brasília (n = 1,897). LACEN sequenced 50% of the samples received (571). A decrease in the incidence of cases and deaths due to Covid-19 was noted in the years 2022 to 2023, following the national trend. LACEN maintained RT-PCR diagnostic tests administered satisfactorily throughout the period. Regarding the genomic surveillance of SARS-CoV-2, the vast majority of samples were sequenced by private laboratories when compared to the public laboratory.

Assessing the performance of multi-InDel panels for human identification among admixed Brazilians

Insertion/deletion polymorphisms, or InDels, are widely present in the human genome. They have been considered as potential markers for forensic analysis because they can be genotyped using the CE platform and compatible typing techniques used in forensic laboratories. Additionally, InDels have lower mutation rates and often short amplicon sizes, making them ideal for detecting degraded samples. However, most InDels are bi-allelic; therefore, their discrimination power is relatively low. A new set of genetic marker called multi-InDels was reported to improve InDel's informativeness. Multi-InDel markers are generally designated as microhaplotypes encompassing two or more InDels within a short distance, usually less than 200bp. In this study, we evaluated the applicability of three previously proposed panels of multi-InDel markers, designed for Asian populations, for human identification in Brazil. We assessed all the multi-InDel markers using high-coverage whole-genome sequencing data from a census-based cohort of 1,171 Brazilians residing in São Paulo, the largest Brazilian capital. The results showed that most markers are informative for Brazilian individuals since they present more than three frequent haplotypes with different sizes. However, most markers are prone to amplification/sequencing errors due to repetitive or low-complexity regions. Among the tested panels, the one from Huang et al. (2014) is the most promising for forensic use in Brazil, with a combined match probability and cumulative power of exclusion of 4.92 ×10-14 and 0.9991, respectively. Nevertheless, these values are low compared to the ones obtained with CODIS STRs (short tandem repeats) and larger SNP (single nucleotide polymorphisms) panels. Therefore, new attempts to scan the human genome for highly polymorphic multi-InDel markers are still necessary to obtain a suitable panel of multi-InDels for worldwide populations.

Anaemia, overweight and abdominal obesity in mothers and children are associated with the food environment in socially vulnerable areas of a northeastern Brazilian capital.

This study aimed to assess the association between community and consumer food environment (FE) measures and anaemia, overweight and abdominal obesity in mother-child dyads living insituations of social vulnerability. A cross-sectional study was carried out in 40 favelas in a capital city in the northeast of Brazil. The sample consisted of 1882 women and 665 children aged under 5 years. The community FE was assessed using a scale of perception of the availability of healthy food in the neighbourhood. Consumer FE was assessed by auditing 624 retail food stores using the AUDITNOVA instrument. This investigated various aspects of the food environment and evaluated the availability of 18 ultra-processed foods (UPF) most consumed by the Brazilian population available in these stores. The presence of overweight was assessed by measuring the weight and height of the mother and the child, and abdominal obesity was assessed by measuring the mother's waist circumference. The presence of anaemia in the mother and the child was assessed by measuring haemoglobin. Adjusted multilevel regression models were used to verify associations between the FE and malnutrition in mother-child dyads. Low perception of community FE was associated with higher risk of women being overweight (OR: 1.35; 95% CI: 1.05-1.73) and abdominally obese (OR: 1.38; 95% CI: 1.04-1.84); low health scores in food shops were associated with higher risk of abdominal obesity (OR: 1.35; 95% CI: 1.01-1.79) and anaemia (OR: 1.16; 95% CI: 1.02-1.98) in women and overweight in children (OR: 1.69; 95% CI: 1.05-2.73); and the high availability of UPF in retail shops was associated with increased odds of overweight (OR: 2.64; 95% CI: 1.61-4.33) and anaemia (OR: 2.11; 95% CI: 1.38-3.02) in children by 164% and 111%, respectively. It was observed that less healthy food environments are associated with greater chances of anaemia, overweight and abdominal obesity in mothers and children under 5 years insituations of social vulnerability in Brazil.

Domestic and external violence, parental neglect, and social sanctions among crack users: A cross-sectional study exploring the role of gender.

Substance Use Disorders are often associated with significant levels of domestic and external violence registered among abusers. This investigation aimed to evaluate the Domestic Violence Involvement (DVI) and related gender differences among Crack Cocaine Users in Brazil. For this purpose, a secondary data analysis of a multicenter cross-sectional study involving 780 Crack Cocaine Users from 6 Brazilian capitals was performed. The prevalence of DVI among abusers was not different between males and females. Crack-cocaine users with DVI versus without DVI experienced significantly more aggressions and beatings as victims throughout their life (54.7% vs. 40.5%), showed greater difficulty in controlling the impulse to assault or hurt someone throughout their life (65% vs. 36.4%), higher number of physical aggressions (25.9% vs. 11.6%), car theft (27.3% vs. 16.9%), violent crimes (12.9% vs. 6.2%). Men also reported a higher prevalence of detentions/arrests (61%) than women, while women were more frequently charged over their parental powers than men. Our findings suggested that DVI in Crack-Cocaine users may be a potential predictor of social violence in general with no significant differences between males and females. Legal punishments remain related to the cultural role assigned to each gender with men being more likely to be detained in their lives and women being reported more for parental neglect.

Influence of Sleep Time on the Consumption of Ultra-Processed Foods in Adolescents in a Capital of Brazil: A Longitudinal Study.

The study prospectively assessed the association between sleep duration and the consumption of ultra-processed foods in adolescent students from a Brazilian capital. We observed 1431 adolescents participating in the Longitudinal Study on sedentary behavior, physical activity, dietary habits, and adolescent health, aged 10 to 14 years, in the years 2014 to 2017. The percentage of consumption of ultra-processed foods was evaluated by the Friedman test. Generalized Estimation Equation (GEE) models with parameters for robust analysis were used to verify the prospective association between sleep and the consumption of ultra-processed foods. The percentage consumption of ultra-processed foods in relation to total daily calories increased in boys between 15 and 17 years old (31.8% in 2015 to 35.8% in 2017), being more stable among older girls (36.7% in 2015 to 37.7% in 2017), which may have occurred due to the influence of the social environment, reduced critical capacity, and lower concern for nutrition. This excessive consumption can lead to health and body composition impairments. Over time, adolescents who were in the fourth quartile of sleep had a 1.4% reduction (95% CI -2.49; -0.28) in the energy percentage from ultra-processed foods. When adjusting the initially used model in the GEE (Generalized Estimation Equation) with sociodemographic variables (income, maternal education, age) and lifestyle factors, sleep duration decreased by 2.1% (95% CI -4.09; -0.22) only in boys. The shorter duration of sleep in adolescents has been shown to be associated with unhealthy behavioral factors, such as a preference for fatty and sugary foods. There were no statistically significant associations for girls in this model. Sleep influences the consumption of ultra-processed foods in adolescents, showing that as sleep time increases, the consumption of foods classified as ultra-processed decreases.

Slums, social disparities and the COVID-19 pandemic: who were the people truly impacted during the pandemic in Brazil?

BackgroundBrazil was heavily impacted by COVID-19 pandemic, which intensified social and health disparities, especially in vulnerable areas such as slums. Therefore, the aim of this study was to investigate which residents of slums in Brazil were most affected by COVID-19 pandemic, with a focus on food insecurity, loss of income, ethnic and racial inequalities, and other social and geographic disparities.MethodsWe conducted a cross-sectional study among the populations of slums in Brazilian capitals and the Federal District by applying a validated instrument. Inferential descriptive statistics were used, with the application of a logistic regression model.ResultsThe study included 1,227 individuals from slums, most of whom were women, black or mixed-race, single, self-employed, and users of the Brazilian public healthcare system. Slum residents in the North region experienced the highest income loss, while those in the South region had the lowest, though the South also had the highest food insecurity. People with incomes below one minimum wage were the most affected by income loss, while those with incomes above three minimum wages were the least affected. White individuals were less impacted by food insecurity. Government aid was associated with families experiencing both income loss and food insecurity.ConclusionThis study highlights the impact of the COVID-19 pandemic among those with lower incomes living in slums, being most of them black or mixed-race women working in informal employment. It also shows that social and structural disparities have been exacerbated by the pandemic, particularly regarding race/ethnicity, income, and geographic region of residence.

Urbanization-induced simplification of isotopic space in birds from a big Neotropical city.

Among the many changes associated with the urbanization process, changes in resource availability can directly impact local wildlife populations. Urban areas suppress native vegetation and convert natural environments into impervious surfaces, modifying the composition and quantity of available food resources. Understanding the food requirements of species is crucial, mainly because it is one of the main elements that characterize their ecological niche and structure local communities. Our aim in this study was to assess the impact of urbanization intensity on the isotopic niche space of birds commonly found in urban areas of Brasília, the capital of Brazil, a big city in central Brazil with approximately 3 million inhabitants. By analyzing the δ13C and δ15N isotopic metrics of feathers from bird species found along a gradient of urbanization intensity, we evidenced a simplification but not a displacement of the bird assembly isotopic space due to urban intensification. Bird assemblage access similar food resources in the higher urban intensification areas, although less diversified than in lower urban intensification areas. In most cases, the response to urban intensification is more specific than convergent among guild members. The studied species maintain themselves in highly intensified urban areas by restricting, changing, and expanding their access to resources. The trophic dimension is one of the key components of the species' ecological niche, and understanding the urban intensification impacts on this dimension is essential for maintaining biodiversity and ecosystem services in cities.

The Peritubercle Lucency Sign as a Considerable Predictive Factor for Contralateral Hip Slippage in Unilateral Slipped Capital Femoral Epiphysis Cases.

Objective To determine whether the radiographic parameter at the epiphyseal tubercle region (peritubercle lucency sign) on the unaffected side can predict slipped capital femoral epiphysis (SCFE). Methods We retrospectively reviewed patients who received an initial diagnosis of unilateral SCFE between 1995 and 2020 at a pediatric hospital in a Brazilian state's capital. The patients were monitored for at least 18 months. Two reviewers independently and blindly assessed the radiographs for the presence or absence of the sign. Disagreements were resolved by a third senior reviewer. Results Out of the 115 cases reviewed, the peritubercle lucency sign was observed in 21 of the 30 patients who developed the disease in the contralateral hip. The sign was observed on an average of 21 days after the diagnosis on the initial side, and approximately 301 days prior to the condition affecting the contralateral hip. It was present in 95% and 85% of the cases on the lateral (frog-leg) and anteroposterior (AP) views, respectively. Interobserver reliability was measured using the Kappa test (k = 0.0801). There was a significant relationship between the presence of the sign and SCFE ( p < 0.001). Conclusions: We propose that the peritubercle lucency sign can be used as a supplementary tool in early diagnosis, for it is beneficial in the therapeutic planning. Level Of Evidence: Level III - Diagnostic Study In Nonconsecutive Patients (Without Consistently Applied 'Gold Standard' As Reference).

Sarcopenia in the Oldest-Old Adults in the Capital of Brazil: Prevalence and Its Associated Risk Factors.

In light of the demographic context in which the older adult population is prominent, sarcopenia emerges as a significant concern for the health of these individuals. To assess the frequency of sarcopenia and severe sarcopenia and the associated risk factors in the oldest adults living in the community. There were 399 participants aged 80 or older, of both sexes, using primary health care services in the metropolitan area of Brasília, Brazil. Sarcopenia was evaluated based on European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Muscle mass was measured by calf circumference, muscle function by handgrip strength, and muscle performance by gait speed. Clinical and socioeconomic variables, comorbidities, falls, and urinary incontinence were collected. The prevalence of sarcopenia was calculated with a 95% (IC) prevalence. Multivariate Poisson regression analysis was performed in Stata, with p < 5%. Among participants, 78.2% were women. Prevalence of pre-sarcopenia was 31.8%, sarcopenia 3.3%, and severe sarcopenia 25.1%. After multivariate regression, sarcopenia was associated with the female sex, low weight, and a dependency for activities of daily living (ADLs). Similarly, severe sarcopenia remained associated with female sex, low weight, and an ADLs dependency. Sarcopenia and severe sarcopenia were not associated with the level of education, marital status, income, physical activity, medications, falls, nor comorbidities. A quarter of older adults had severe sarcopenia. Sarcopenia and severe sarcopenia were associated with being a woman, being low weight, and have an ADLs dependence.

Schistosomiasis as an urban disease: summary of 7 years of studies in the city of Salvador, the first capital of Brazil

Schistosomiasis as an urban disease: summary of 7 years of studies in the city of Salvador, the first capital of Brazil

EXPLORING CLIMATIC PATTERNS AMONG BRAZILIAN CAPITALS

This study aims to examine the patterns of climatic variables and delineate climatically homogeneous regions among Brazilian capitals using Principal Component Analysis (PCA) and clustering techniques. Annual climate data from 26 state capitals and the Federal District of Brazil were analyzed, covering the period from 1958 to 2022, representing different regions of the country. The PCA results revealed that the first three principal components accounted for 91.8% of the total data variability. Four climatically homogeneous regions were identified: the East region, the Northeast region, the North region and another region that comprises the rest of the country. Cluster Analysis (CA) also confirmed the formation of four homogeneous groups among municipalities based on climatic variables. The analysis of spatial distribution showed significant variations in annual climate variables between Brazilian capitals, with maximum values observed for maximum and minimum temperatures, precipitation, wind speed, relative humidity, evapotranspiration and soil moisture. These findings contribute to a deeper understanding of climate variability in Brazilian capitals and provide a basis for future studies on climate dynamics and regional impacts. Keywords: Principal Component Analysis, Cluster Analysis, Multivariate Analysis; Biplot

Prevalence and outcomes of American Heart Association stages of heart failure in an adult brazilian population of the ELSA-Brasil study

Abstract Aims Heart failure (HF) has a major impact on public health, affecting up to 2% of adult population. HF staging is helpful in capturing pre-clinical disease and its progression to advanced stages. We aimed to determine the prevalence and mortality of HF stages in the participants of a Brazilian adult cohort. Methods The ELSA-Brasil cohort comprises 15,105 adult public servants from 6 Brazilian capitals. In the initial evaluation of the study (2008-2010), ELSA carried out interviews and clinical, laboratory, and cardiovascular ancillary tests. In this analysis, we included participants who had electrocardiogram and echocardiogram performed at baseline visit, and additional information regarding risk factors and functional capacity. The HF stages were defined based on AHA guidelines criteria as follow: Stage 0 was defined as a healthy individual with no risk factors for heart failure. Stage A (at risk for HF) included those without cardiac structural or functional abnormality but with any of the following conditions: systemic hypertension; diabetes mellitus, obesity, history of myocardial revascularization, history of rheumatic fever, and seropositivity for Chagas’ disease. Stage B (pre-HF) was defined as asymptomatic participants with history of myocardial infarction or any major abnormalities on ECG or echocardiogram. Stage C (symptomatic HF) included participants with a clinical history of HF, or HF symptoms in the presence of structural heart disease (defined as in Pre-HF stage). Considering the community-dwelling profile of the sample, we did not expect to have advanced heart failure patients in our sample. Results We included the 3,267 participants (61±9 years; 53% women) with baseline data. Prevalences of HF stages were stage 0: 938 (29%) A: 1,385 (42%), B: 651 (28%) and C: 293 (9%), with different distribution between sexes (p&amp;lt;0.001). Older participants had higher prevalences of stages B and C (p&amp;lt;0.001), with the prevalence of stage C increasing from 1.8% at 35-44 years to 12.2% at 65-74 years. After 12 years of follow-up, total mortality rates of HF stages were Stage 0: 4%; A:10%. B: 16%, and C: 26%, and respective Cox proportional hazard ratios [95% CI] adjusted for age and sex were A: 1.94 [1.3-2.8], B:2.78 [1.9-4.1], and C: 5.39 [3.6-8.1] compared to stage 0. Conclusions The prevalence of HF in Brazilians reflects what is described in international literature, with a large proportion of individuals in pre-symptomatic stages. A notable shift in the sample toward pre-symptomatic and symptomatic HF occurred gradually and persistently across the age span studied. Mortality rates increase incrementally across the HF stages. This information is important for understanding and planning health policies for this syndrome.

Biological therapy, surgery, and hospitalization rates for inflammatory bowel disease: An observational Latin American comparative study between adults and pediatric patients

ObjectiveCompare the proportions of use of biological therapy, surgeries, and hospitalizations between adults and pediatric inflammatory bowel disease (IBD)—Crohn's disease (CD) and ulcerative colitis (UC)—patients. Patients and methodsObservational, retrospective, and multicenter study. Data were collected from all consecutive IBD patients seen as outpatients or admitted to hospital, during 2015–2021, in two IBD tertiary centers in a South Brazilian capital. Patients with unclassified colitis diagnosis were excluded from this study. Patients were classified as having CD or UC and sub-categorized as adult or pediatric according to age. Data were analyzed using frequency, proportion, Fisher's exact test, and Chi-square test. ResultsA total of 829 patients were included: 509 with CD (378 adults/131 pediatric) and 320 with UC (225/95). Among patients with CD, no differences were observed for proportions of use of biological therapy (80.2% in pediatric vs. 73.3% in adults; P=0.129), surgery (46.6% vs. 50.8%; P=0.419), or hospitalization (64.9% vs. 56.9%; P=0.122). In UC, significant differences were observed for biological therapy (40.0% vs. 28.0%; P=0.048) and hospitalization (47.4% vs. 24.0%; P<0.001). No significant difference was observed in surgery rates (17.9% vs. 12.4%; P=0.219). ConclusionsBiological therapy and incidence of hospitalization were greater among pediatric patients with UC, compared with adults; no difference was observed in the need for abdominal surgery. In CD, no significant difference was observed in the three main outcomes between the age groups.

The hidden costs of free services: how donations support the corporate platformization of education

ABSTRACT The adoption of ‘free’ large-scale proprietary platforms, such as Microsoft 365 for Education and Google Workspace for Education by public education has raised significant concerns, including student privacy, technological lock-in, as well as a privatization of educational governance. Because of their ‘non-onerous’ nature, there is limited open documentation to understand the scope and substance of these agreements. This study explores the associations between public education with large software corporations associated with surveillance capitalism in Brazil. The data, requested via formal requests for information sent to all states, demonstrate that the majority of states have adopted these platforms, with a sharp rise during the COVID-19 pandemic. An in-depth legal analysis of the contracts shows that the apparently ‘non-onerous’ nature of these contracts can be used to obscure the business models of surveillance capitalism, which are based on data extraction and processing. Implications for educational governance and school actors are discussed.

DLNMs, extreme heat and the risk of mortality in the 27 State Brazilian Capitals

DLNMs, extreme heat and the risk of mortality in the 27 State Brazilian Capitals

Are Neighborhood Greenspaces Associated with Leisure-time Physical Activity? Results from ELSA-Brasil Eight-year Follow-up.

We investigated whether neighborhood greenspaces were associated with physical activity in adulthood over 3 cohort visits after considering perceived safety and neighborhood contextual factors. We also evaluated whether the association with greenspace varied by neighborhood socioeconomic status. Participants (N = 4,800) from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) residing in two Brazilian state capitals were evaluated in Visits 1 (2008-2010), 2 (2012-2014) and 3 (2017-2019). Greenspaces were categorized by quintiles of positive Normalized Difference Vegetation Index (NDVI) scores. Physical activity frequency was given by the number of visits at which participants reported moderate/vigorous physical activity (none, 1 or 2, and 3 visits). We used multinomial logistic regression. After adjustment for age, sex, education, research center, residence in slums, individuals in the 4th and 5th NDVI quintiles showed 73% higher odds of physical activity over 3 visits than those in the 1st quintile (4th quintile: 95%CI = 1.24-2.43; 5th quintile: 95%CI = 1.24-2.41). The strength of the association was attenuated after adjustment for perceived safety. After adjustment for contextual factors quantity of sidewalks and streetlights, the OR for the 4th and 5th NDVI quintiles decreased to 1.66 (95%CI = 1.18-2.33) and 1.62 (95%CI = 1.16-2.28), respectively. Finally, after including average household income per capita, the OR for physical activity in 3 visits for the 4th and 5th NDVI quintiles decreased to 1.48 (95%CI = 1.04-2.12) and 1.43 (95%CI = 1.00-2.04; p = 0.053), respectively. Greater greenspace contributed to sustained physical activity during the eight years of follow-up, indicating the potential contribution of public greenspaces to reducing health-related inequalities.

Obesity and Associated Factors in Brazilian Adults: Systematic Review and Meta-Analysis of Representative Studies.

To review the literature and select population-based studies that are representative of Brazilian capitals or Brazil as a whole to estimate the prevalence of obesity among Brazilian adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were used. The search was conducted in six databases and reference lists of included studies. We included observational studies but excluded interventional studies, reviews, in vitro studies, and editorials. The study population consisted of young adults and adults (18 to 59 years old). Adolescents, infants, children, the elderly, and pregnant women were excluded. The primary outcomes were the prevalence of obesity among Brazilian adults, both men and women. The secondary outcomes were factors associated with obesity. The meta-analysis was performed using Rstudio software, version 4.1.0, by using the 'Meta' package, version 5.0-0. The search strategy identified 5634 references, of which 19 studies and 21 national surveys were included in the meta-analysis. The pooled prevalence of obesity in Brazilian adults was 20.0% (95% CI: 14.0-25.0%) while in the capitals it was 17.0% (95% CI: 16.0-19.0%). Across the regions of Brazil, the prevalence ranged from 11.0% to 17.0%, with the highest frequency in the south. Increases in obesity prevalence were observed for both sexes in almost all periods, with consistently higher rates among women in most cases. The prevalence of obesity among Brazilian adults is high, with no statistically significant differences found in the subgroup analysis.

Time trend analysis and impacts of the COVID-19 pandemic on mammography and Papanicolaou test coverage in Brazilian state capitals

BackgroundBreast and cervical cancer are major public health issues globally. The reduction in incidence and mortality rates of these cancers is linked to effective prevention, early detection, and appropriate treatment measures. This study aims to analyze the temporal trends in the prevalence of mammography and Papanicolaou test coverage among women living in Brazilian state capitals between 2007 and 2023, and to compare the coverage of these tests before and during the Covid-19 pandemic.MethodsA time series study was conducted using data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey from 2007 to 2023. The variables analyzed included mammography and Papanicolaou test coverage according to education level, age group, race/skin color, regions, and Brazilian capitals. The Prais-Winsten regression model was used to analyze the time series, and Student’s t-test was employed to compare the prevalence rates between 2019 and 2023.ResultsBetween 2007 and 2023, mammography coverage showed a stationary trend (71.1% in 2007 and 73.1% in 2023; p-value = 0.75) with a declining trend observed among women with 12 years or more of education (APC= -0.52% 95%CI -1.01%; -0.02%). Papanicolaou test coverage for all women aged between 25 and 64 exhibited a downward trend from 82% in 2007 to 76.8% in 2023 (APC= -0.45% 95%CI -0.76%; -0.13%). This decline was also noticed among those with 9 years or more of education; in the 25 to 44 age group; among women with white and mixed race; and in the Northeast, Central-West, Southeast, and South regions. When comparing coverage before and during Covid-19 pandemic, a reduction was noted for both tests.ConclusionsOver the years, there has been stability in mammography coverage and a decline in Papanicolaou test. The COVID-19 pandemic negatively impacted the number of these tests carried out among women, highlighting the importance of actions aimed at increasing coverage, especially among the most vulnerable groups.

Análise da Metodologia de Aceleração Cicatricial MAC® com uso da própolis e azul de toluidina na cicatrização de úlceras de membros inferiores.

Introduction: Photodynamic Therapy has been an important ally in tissue repair, with positive effects in the treatment of wounds and infections. Objective: To analyze the effects of the Healing Acceleration Methodology (MAC®) using propolis and toluidine blue on lower limb ulcers. Methods: Single-center, experimental, randomized and controlled study. Carried out between April 2021 and May 2022 at the outpatient clinic of the school clinic in a Brazilian capital. Patients were randomly assigned in a 1:1 ratio to receive photodynamic therapy (experimental group) or conventional dressing alone (control group). Patients over 18 years of age diagnosed with lower limb ulcers were included. Ten patients comprised the experimental group and 10 the control group. Patients were seen three times a week and monitored for two months. The primary outcome was the assessment of healing progress and the secondary outcome was the microscopic analysis of wound smears for the presence of cells and microorganisms. Results: In the experimental group, two wounds did not heal completely while in the control group, none of the 10 wounds healed completely during the 60-day follow-up. In the experimental group, 90% of patients did not have bacteria and fungi at the end of 30 days versus 40% in the control group. Conclusion: The present study showed that photodynamic therapy is a potential effective treatment in the healing process of lower limb ulcers. This can impact cost reduction and quality of life. Larger, well-designed studies are needed to corroborate the findings of the present study.

Obesidade abdominal está associado com níveis de estresse em militares

Introduction: The modern lifestyle, marked by an intense routine and inadequate diet, contributes to the increase in Non-Communicable Diseases (NCDs), especially obesity, which can be influenced by stress. The relationship between stress, nutritional status and NCDs lacks comprehensive studies, especially when it concerns public security professionals. Objective: To evaluate the abdominal obesity and its association with stress symptoms in military personnel in the metropolitan region of a Brazilian capital. Methods: The study is part of the "SOMA-SI" program, which investigated the health of public security agents in Espírito Santo between April and December 2022. The sample included police officers, firefighters and municipal guards (n=213). Healthy adult military personnel were included and those on leave or under psychiatric treatment were excluded. Among the variables measured were blood pressure measurements, anthropometric assessment and Lipp Stress Symptom Inventory. The Statistical Package for Social Science (SPSS) v. 25 for Windows® was used for statistical analyses. Chi-square and Mann-Whitney tests were performed at 5% significance, exploring associations between categorical variables and differences in median stress scores. Results: The sample consisted of 216 participants, predominantly men (75.5%) and non-white (63.7%), revealing 61.6% with more than 15 years of work, 81.1% with income above six salaries minimum and 77.3% with completed higher education. Military police officers represented the majority (67.6%), with 72.2% being parents, 57.9% alcohol consumers and 9.3% smokers. The majority had excess body fat (70.8%) and weight (77.3%). Statistical associations were observed between waist perimeter and stress symptoms (p = 0.004). Conclusion: The study revealed an association between abdominal adiposity and stress in military personnel, highlighting the high incidence of stress symptoms and excess weight in the sample. Associations were also identified between blood glucose, blood pressure and demographic factors. However, it highlights the importance of more comprehensive studies to understand the impact of stress on the health of security agents.