Evaluation of nefrotoxicity by tacrolimus and micophenolate mofetil associated with kidney ischemia and reperfusion: experimental study in rats.

Objective: to evaluate the renal toxicity caused by tacrolimus and mycophenolate mofetil (MMF) in a single kidney ischemia and reperfusion model.

Method: experimental study using Wistar rats, submitted to right nephrectomy and left renal ischemia for 20 minutes, separated into groups in the postoperative period (PO): 1) Control (nonoperated); 2) Sham (operated, without PO drug); 3) TAC0.1, TAC1 and TAC10, tacrolimus administered PO at doses of 0.

Early keratometric and refractive results after intra-corneal rings surgery in keratoconus patients.

Objective: To evaluate early keratometric and refractive results after intra-corneal rings surgery in keratoconus patients.

Method: 50 eyes of 25 patients with keratoconus within stage 2 and 3, underwent intra-stromal corneal rings surgery by using the femtosecond surgical laser, one month after surgery, corneal keratometries and patient refraction were compared vs pre-operative ones.

Results: Mean pre-operative low keratometry was 48.

Burden and Trends of IBD in 5 Asian Countries From 1990 to 2019: A Comparison With the United States and the United Kingdom.

Background: IBD is becoming a global health challenge, with substantial variations in incidence and death rates between Eastern and Western countries.

Objective: This study aimed to investigate the burden and trends of IBD in 5 Asian countries, the United States, and the United Kingdom.

Design: This was a cross-sectional study.

[Neurocovid-19: effects of COVID-19 on the brainNeurocovid-19: efeitos da COVID-19 no cérebro].

In the COVID-19 pandemic, direct and indirect effects on mental health have been reported, including neurological, neuropsychiatric, and neuropsychological symptoms with possible long-term effects. Also, it is suspected that in the coming years there could be a worldwide increase in the incidence of neurodegenerative disorders.The objective of this article is to review the most up-to-date information on brain damage associated with COVID-19, as well as the neuropsychiatric symptoms of the disease.

[Evidence synthesis: guidelines for diagnosis and treatment of dengue, chikungunya, and zika in the Region of the AmericasSíntese de evidências: diretrizes para o diagnóstico e o tratamento da dengue, chikungunya e zika na Região das Américas].

Introduction: Dengue, chikungunya, and Zika are viral diseases that pose a constant threat to public health. These three arboviruses can produce very similar clinical pictures, which represents a challenge to achieving an accurate clinical diagnosis and can lead to inadequate management and even fatal outcomes. is part of the effort by the Pan American Health Organization and the countries of the Region of the Americas to prevent severe cases and death from these diseases, in a complex epidemiological context in which multiple factors favor transmission dynamics and lead to outbreaks and epidemics in the countries of the Region.

[Masculinities and men's health in the Region of the AmericasMasculinidades e saúde dos homens na Região das Américas].

Objective: Describe health outcomes for men based on analysis of their interrelationship with masculinities, which will make it possible to identify actions to improve health outcomes of men, women, and children.

Methods: Update and expansion of the findings stated in the report on , published by the Pan American Health Organization in 2019, which was based on a targeted, up-to-date search for secondary data on men's health and other research addressing the topic.

Results: Men's and women's health is different, not only because of biological factors, but also because of gender constructs and inequalities, and the intersection of social determinants.

[Barriers to access to health services for women and children in Latin AmericaBarreiras de acesso aos serviços de saúde para mulheres e crianças na América Latina].

Objective: Determine whether an association exists between access barriers reported by women aged 15-49 years and the use of essential health services for women and children in Latin America.

Methods: Cross-sectional study using multivariate logistic regression models based on the demographic and health surveys of Bolivia, the Dominican Republic, Guatemala, Guyana, Haiti, Honduras, Nicaragua, and Peru.

Results: Geographical and financial barriers, the need to obtain permission to visit the doctor, or not wanting to go alone to a health facility significantly reduced the likelihood of completing prenatal checkups and having an assisted delivery.

[Bringing back sounds: prevention of hearing loss and auditory rehabilitation in the elderlyRecuperando os sons: prevenção da perda auditiva e reabilitação auditiva em pessoas idosas].

Hearing loss is one of the leading causes of disability worldwide and its prevalence increases with age, though in most cases, this disability is potentially preventable and treatable. Thus, its prevention, early identification, and comprehensive rehabilitation should be points of action at the local level, since hearing loss has been linked to numerous adverse health outcomes affecting the physical, mental, social, and economic conditions of older people. The objective of this article is to highlight the importance of hearing loss prevention, promote rehabilitation throughout the life course, especially in older people, and describe strategies put forth by the World Health Organization and Pan American Health Organization.

[Processed and ultra-processed products and their relationship to quality of diet in childrenProdutos processados e ultraprocessados e sua relação com a qualidade da dieta em crianças].

Objective: Estimate the impact on quality in the early childhood diet (ages 2 to 4 years) in Uruguay, resulting from consumption of products containing excessive amounts of critical nutrients associated with noncommunicable diseases (NCDs) (free sugars, total fats, saturated fats, and sodium), according to the Pan American Health Organization (PAHO) Nutrient Profile Model.

Methods: A 24-hour dietary recall survey was used with a representative sample of 401 participants from the 2018 Nutrition, Child Development, and Health Survey. The NOVA classification system was used to categorize foods according to the nature and purposes of the industrial processes they undergo.

Near-Full-Length Genome Sequences Representing an Event of Zooanthroponotic Transmission of SARS-CoV-2 Lineage B.1.189 in Mexico during 2020.

Here, we report three near-full-length genome sequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) obtained in Mexico City, Mexico, during the pandemic of coronavirus disease 19 (COVID-19) in 2020, representing a zooanthroponotic transmission event between humans and a dog. All three genomes belong to the B.1.

Management and Outcomes of Pathologic Upstaging of Clinical Stage I Rectal Cancers: An Exploratory Analysis.

Background: Preoperative staging of clinical stage I rectal cancer can fail to diagnose T3 or nodal disease. Adjuvant treatment of these upstaged patients remains controversial.

Objective: The objective was to identify predictors of clinical stage I rectal cancer upstaging and quantify rates of local and systemic recurrence.

Cross-cultural Adaptation of Self-report S4-5 Sensory and Motor Function Questionnaire (S4-5Q) in People with Spinal Cord Injury to Portuguese.

 The "Self-report S4-5 sensory and motor function questionnaire (S4-5Q)" is a short questionnaire that aims to assess the function of the sacral segments, S4 and S5, after a spinal cord injury (SCI), with the purpose of replacing the rectal exam test. The aim of the present study was to carry out a cross-cultural adaptation of the S4-5Q to the Brazilian Portuguese language and to investigate the test-retest reliability of this version.  The translation and cross-cultural adaptation was performed using the methodology of translation and backtranslation.

[Prioritization of health resources in contexts of scarcity. SESPAS Report 2022].

The COVID-19 pandemic has been a clinical challenge, but also a legal and bioethical one. These three fundamental pillars are developed in the approach to prioritizing health resources in pandemic, clinical criteria, corresponding legal framework and applicable ethical principles. Initially, clinical criteria were applied to identify patients with the best survival prognosis, combining a clinical evaluation and the use of short-term and long-term prognostic variables.

Hemodynamic phenotype-based, capillary refill time-targeted resuscitation in early septic shock: The ANDROMEDA-SHOCK-2 Randomized Clinical Trial study protocol.

Background: Early reversion of sepsis-induced tissue hypoperfusion is essential for survival in septic shock. However, consensus regarding the best initial resuscitation strategy is lacking given that interventions designed for the entire population with septic shock might produce unnecessary fluid administration. This article reports the rationale, study design and analysis plan of the ANDROMEDA-2 study, which aims to determine whether a peripheral perfusion-guided strategy consisting of capillary refill time-targeted resuscitation based on clinical and hemodynamic phenotypes is associated with a decrease in a composite outcome of mortality, time to organ support cessation, and hospital length of stay compared to standard care in patients with early (< 4 hours of diagnosis) septic shock.

Screening Tool for Mental Health Problems During COVID-19 Pandemic: Psychometrics and Associations With Sex, Grieving, Contagion, and Seeking Psychological Care.

Background: The COVID-19 pandemic has created a public mental health crisis. Brief, valid electronic tools are required to evaluate mental health status, identify specific risk factors, and offer treatment when needed.

Objective: To determine the construct validity, reliability, and measurement invariance of a brief screening tool for mental health symptoms by sex, loss of loved ones, personal COVID-19 status, and psychological care-seeking during the COVID-19 pandemic.

Epidemiological surveillance: a brief history and the experiences of the United States and the state of São Paulo.

Objective: The objective of this narrative review was to list some historical aspects of epidemiological surveillance, a technological intervention model initially designed to help control communicable diseases in the last century.

Methods: This narrative was built based on texts selected to record the development of epidemiological surveillance in the United States and in the state of São Paulo, Brazil.

Results: The origins of some of the actions that constitute epidemiological surveillance activities are presented, as well as a brief history of the establishment of the originally named Center for Disease Control, a United States agency that is held up as an example in relation to the way surveillance has been performed, practically all over the world.

[Implementation of the plan of action for human resources for health and the COVID-19 pandemic responseImplementação do plano de ação sobre recursos humanos para a saúde e a resposta à pandemia de COVID-19].

Objectives: Systematize and analyze the response actions related to human resources for health during the pandemic, reported by 20 countries of the Region of the Americas in the mid-term evaluation of the Plan of Action on Human Resources for Universal Access to Health and Universal Health Coverage 2018-2023 (Pan American Health Organization, 2018), and assess the importance of the policies on human resources for health (HRH) and on HRH management expressed in the Plan of Action and in the Strategy on Human Resources for Universal Access to Health and Universal Health Coverage during health emergencies and in normal times.

Methods: Reports on actions taken in 20 countries of the Region against COVID-19 and for HRH were selected and systematized. These were classified as immediate contingency actions, actions related to installed capacities, and emerging actions.

[Impact of COVID-19 on mortality in Peru using triangulation of multiple data sourcesImpacto da COVID-19 na mortalidade no Peru por meio da triangulação de várias fontes de dados].

An analytic cross-sectional study was conducted to quantify the impact of COVID-19 on mortality in Peru. Total excess mortality due to natural and external causes was calculated. The direct and indirect impact of COVID-19 was estimated at two points: when COVID-19 deaths were confirmed by a laboratory test and when they were confirmed by broader criteria (reclassified deaths).

[Primary health care expenditure in the Americas: measuring what mattersGasto en atención primaria en salud en las Américas: medir lo que importa].

This special report compares the measurement of primary health care (PHC) expenditure proposed by the Organization for Economic Cooperation and Development (OECD) and by the World Health Organization (WHO), according to the global framework for reporting health expenditures (SHA 2011) in three countries in the Region of the Americas. There are conceptual differences: 1) operationalization as basic care, by OECD, versus first contact, by WHO; 2) a wider range of goods and services in the WHO definition (including medicines, administration, and collective preventive services); and 3) consideration only of services in outpatient providers by OECD. PHC expenditures as a percentage of current healthcare spending in 2017 for WHO and OECD: Mexico (43.

[Clinical practice guidelines for the diagnosis and management chronic infection of hepatitis viral C of the Peruvian Health Social Security (EsSalud)].

Introduction: This article summarizes the clinical practice guidelines (CPG) for the diagnosis and treatment of chronic infection of hepatitis viral C of the Peruvian Health Social Security (EsSalud).

Objective: To provide clinical recommendations based on evidence for the diagnosis and treatment of chronic infection of hepatitis viral C in EsSalud.

Methods: A guideline development group (GDG) was established, including medical specialists and methodologists.

DECOMP Report: Answers surgeons expect from an abdominal wall imaging exam.

Abdominal wall (AW) hernias are a common problem faced by general surgeons. With an essentially clinical diagnosis, abdominal hernias have been considered a simple problem to be repaired. However, long-term follow-up of patients has shown disappointing results, both in terms of complications and recurrence.