Arterial remodeling leading to increased arterial stiffness involves mechanisms such as oxidative stress, reactive oxygen species production, neuroendocrine alterations, and genetic predisposition. These processes are also involved in the pathophysiology of COVID-19. However, the relationship between arterial stiffness, hemodynamic parameters, and clinical-functional outcomes in post-COVID-19 patients has not yet been adequately investigated.

To investigate arterial stiffness, central and peripheral hemodynamic parameters, functional performance, quality of life, fatigue, dyspnea, and sleep quality in post-COVID-19 patients.

This cross-sectional study was conducted with individuals in the post-COVID-19 group (PCG) and matched individuals in the control group (n = 32). Arterial stiffness was assessed using pulse wave velocity (PWV) and the augmentation index corrected to a heart rate of 75 bpm (AIx@75). Functional performance was evaluated using the five-times sit-to-stand test, handgrip strength, quality of life (assessed with the 12-Item Short Form Survey), fatigue (assessed with the Brazilian version of the Fatigue Severity Scale), dyspnea (assessed with the modified Medical Research Council scale), and sleep quality.

The PCG showed higher PWV values (Δ = 0.80 m/s; 95%CI, 0.08 to 1.52; p = 0.03) and AIx@75 (Δ = 8.34; 95%CI, 2.02 to 14.66; p = 0.01) as well as higher levels of central and peripheral blood pressure. Worse functional performance was observed (Δ = 4.39 s; 95%CI, 2.70 to 6.08; p < 0.01), along with poorer quality of life in the physical component (Δ = -9.35; 95%CI, -12.45 to -6.25; p < 0.01). Fatigue, dyspnea, and sleep quality outcomes were also significantly worse in the PCG. In the adjusted analysis, PWV was independently associated with age and systolic blood pressure, but not with post-COVID-19 status.

Post-COVID-19 patients exhibit greater arterial stiffness, hemodynamic alterations, and poorer clinical-functional performance. However, arterial stiffness appears to be predominantly determined by hemodynamic factors and aging rather than by post-COVID-19 status independently, suggesting that the observed functional impairment results from multifactorial mechanisms.

To evaluate the impact of the COVID-19 pandemic and characterize the serological profile of discarded corneal donations in the coverage area of the Banco de Olhos de Londrina, through reverse transcription-polymerase chain reaction testing for COVID-19 and serological screening of cornea donors excluded because of positive test results.

This observational retrospective study included 776 cornea donors who's serological and reverse transcription-polymerase chain reaction test results were processed at the Hospital of Universidade Estadual de Londrina between May 2020 and 2022. The number of corneal donations and tissue utilization rates throughout the years of operation of the Banco de Olhos de Londrina were also analyzed.

The mean donor age was 53.14 years; 332 donors (43%) were female, and 444 (57%) were male. Positive results were identified in 15.76% of donors for hepatitis B core antibody antibodies, 0.65% for hepatitis B surface antigen, 1.03% for hepatitis C antibodies, and 0.52% for human immunodeficiency virus and human T-lymphotropic vírus. Positive reverse transcription-polymerase chain reaction results for SARS-CoV-2 were observed in 2.7% of cases. Older adults were 2.6 times more likely to test positive for SARS-CoV-2 (95% CI, 1.06-6.34) and 3.0 times more likely to test positive for hepatitis B core antibody (95% CI, 1.95-4.41) than younger individuals. A 75.2% reduction in corneal donations was observed in 2020 compared with 2019, accompanied by a 5% increase in tissue utilization, possibly associated with the effectiveness of donor screening during the pandemic.

The COVID-19 pandemic had a profound impact on the number of corneal transplants worldwide, in Brazil, and at the Banco de Olhos de Londrina because of the substantial decline in donations during this period. Hepatitis B was the leading cause of corneal tissue discard due to positive serology in both this study and previous reports, highlighting the importance of prevention programs and improved vaccination coverage. Strict legislation, comprehensive serological screening, and appropriate processing of donated tissue remain essential to eliminate potential sources of infection and ensure transplantation safety.

To analyze self-assessment of voice and swallowing in the late postoperative period of total thyroidectomy and the impact of surgery on quality of life.

This is a descriptive, observational, and cross-sectional study, approved by the Research Ethics Committee of the institution. Seventeen women aged between 32 and 58 years participated in the study, mostly married, with completed higher education, residing outside the metropolitan region, who underwent total thyroidectomy without cervical lymph node dissection, without adjuvant radiotherapy, and without postoperative speech therapy follow-up for at least 6 months. Demographic and clinical data were collected, as well as the results of the Thyroidectomy-Related Voice and Symptom Questionnaire (TVSQ) and the Thyroid-Related Patient-Reported Outcome - 39 (ThyPro-39) questionnaires. Data analysis was performed descriptively.

The median total TVSQ score was 26, with the highest scores found in the two cases that underwent cervical lymph node dissection. Domain 1 (vocal symptoms) of the TVSQ contributed most to the total score (48.52%). In domain 2 (oropharyngolaryngeal symptoms) of the TVSQ, scores were closer to the upper limit, representing a higher frequency of symptoms. The ThyPro-39 results revealed a greater impact of thyroidectomy on fatigue, anxiety, cognitive problems, emotion, and depression.

Women undergoing total thyroidectomy present vocal and swallowing symptoms, with a predominance of vocal symptoms in the long term, associated with the negative impact of surgery on physical, emotional, and mental well-being. Furthermore, there is a compromise in quality of life regarding fatigue, emotional aspects, anxiety, cognitive problems, and depression.

to assess the usability of a COVID-19 antigen self-test and identify factors associated with the perceived ease of use.

cross-sectional study conducted in São Paulo (SP), Brazil, from June to July 2023, with 90 participants who used the self-test and completed a structured questionnaire. Descriptive, bivariate, and multivariable logistic regression analyses were performed.

only 33 participants (36.7%) reported high usability. Having an income above two minimum wages was significantly associated with a higher likelihood of rating the test as easy to use (ORa = 1.92; 95% CI: 1.15-5.67; p = 0.009). The main difficulties involved understanding the instructions (70%) and handling components such as the swab and buffer (45%).

although promising for expanding access to diagnosis, the self-test faces barriers related to understanding and handling, especially among lower-income individuals. These findings reinforce the importance of clear instructions and technological adaptations tailored to users' profiles.

to assess the anxiety level of mothers of children who had COVID-19 in a city in northeastern Brazil using the State-Trait Anxiety Inventory.

this cross-sectional study included mothers of children with COVID-19 in their first year of life, reported in e-SUS Notifica from February 2020 to January 2021. Data collection was conducted via telephone contact, using a questionnaire on maternal sociodemographic and epidemiological variables, as well as the State-Trait Anxiety Inventory. The Fisher-Freeman-Halton exact test was used to assess associations between variables.

maternal anxiety was moderate (percentile between 25 and 75) for both the Trait Anxiety Inventory (50%) and the State Anxiety Inventory (50%). There was statistical significance for elevated anxiety among education level (p=0.010), income (p=0.027), and the State Anxiety Inventory.

mothers with children confirmed to have COVID-19 presented moderate anxiety levels, with elevated levels in those with low education and low income.

to analyze factors associated with healthcare professionals' decisions regarding COVID-19 vaccination schedule continuation.

an analytical cross-sectional study was conducted with 221 healthcare professionals working in public healthcare services in a regional hub municipality in Minas Gerais. A questionnaire was used with questions about sociodemographic factors, vaccination status, and the determinants of confidence, convenience, and compliance. The response variable was the number of doses of COVID-19 vaccines. Descriptive data analysis and logistic regression were performed.

it was identified that 21.5% of healthcare professionals hesitated to continue the COVID-19 vaccination schedule, with the sex (p=0.037; OR=2.163) and confidence in vaccine safety (p=0.003; OR=0.317) variables being associated with this vaccine hesitancy.

there are professionals hesitant to continue being vaccinated against COVID-19. Interventions that strengthen confidence in vaccines and adopt continuous education strategies are essential.

To evaluate the temporal evolution of mental disorder-related visits in Primary Health Care (PHC) within the Brazilian Unified Health System (SUS) and estimate the effects of social distancing, the Covid-19 pandemic, and the post-pandemic period.

This is a national ecological interrupted time-series study using data from the Primary Health Care Information System (SISAB/DATASUS). Monthly proportional and population incidence rates of mental disorder-related visits (ICD-10 F00-F99) in PHC were analyzed. Segmented regression models with negative binomial distribution and autoregressive structure were fitted.

A total of 38.7 million PHC visits were analyzed. In the pre-pandemic period, the share of mental disorder-related visits increased (exp(β)Trend=1.011; 95%CI 1.008-1.014). During social distancing, the proportion of these visits increased abruptly (exp(β)Level=1.241; 95%CI 1.149-1.339), largely associated with a reduction in the total volume of PHC visits. During the rest of the pandemic, the proportional increase plateaued. We observed regional heterogeneity (p<0.001), with greater level increase in the Northeast. In the post-pandemic period, growth resumed in both the proportion and the population incidence of mental disorder-related visits; increases were notable for anxiety, neurodevelopmental and child and adolescent disorders.

The share of mental disorder-related visits in Brazilian PHC increased over the study period. Social distancing resulted in an abrupt proportional increase in the context of reduced overall visits, followed by heterogeneous recomposition across regions and diagnostic groups. These findings indicate a recent increase in demand for mental health care in PHC.

The aim of this study was to analyze the effect of the COVID-19 pandemic on maternal mortality among immigrants in Brazil. This was a descriptive study of maternal deaths that occurred between 2014 and 2021. The frequency of deaths and underlying causes of death were analyzed. The ratio between the average number of deaths before and during the pandemic were calculated. Of the 14,205 deaths, 136 were immigrants and 14,069 were Brazilian. The excess mortality was higher for immigrants (2.10; 1.40-3.04) than for Brazilian women (1.53; 1.40-1.59), with a significant increase for Venezuelans (7.46; 2.40-17.42) and Haitians (3.67; 2.11-5.91). Before the pandemic, direct obstetric causes predominated, accounting for more than 60% of deaths. During the pandemic, indirect obstetric causes gained importance, with the main one being "other viral diseases complicating pregnancy, childbirth and the puerperium (ICD-10 O98.5)", with 33.93% of deaths for immigrants and 39.44% for natives. In this group of causes, the codes related to COVID-19 infection for immigrants (94.7%) and Brazilians (97.8%) stand out. There was an excess of maternal deaths during the pandemic, with greater intensity for Venezuelans and Haitians, when compared to Brazilian women, suggesting greater difficulty in timely access to health services for immigrants.

Preparation and response to public health emergencies involve efforts in developing systems for early detection, alert and response. In this paper, we present the strategy implemented in Rio de Janeiro municipality, where data from urgency and emergency visits were acquired and modeled, in order to detect trend shifts and generate alerts. From the ICD-10 field in electronic records, time series representing events of interest were created. A generalized additive model (GAM) was fitted for smoothing, slope determination in each point, and alert generation. When comparing trends for COVID-19 between SIVEP/e-SUS systems and emergency attendances, a gain in speed was identified. On diarrhea monitoring, the generated alert led to coordinated communication and actions in the territory. We draw attention to the potential in the use of this type of data on identifying events of interest in a timely manner, promoting a more modern approach to health surveillance.

This study aimed to assess influenza vaccination coverage among older adults and its temporal trends in Brazil, its regions, and federative units from 2000 to 2019. This ecological time series study utilized data from the National Immunization Program Information System (SI-PNI). The sample comprised vaccine doses administered and the target population each study year, stratified by territorial unit. Vaccination coverage was calculated as the proportion of the target population effectively vaccinated, and temporal trends were assessed using the Prais-Winsten generalized linear regression model. Significant fluctuation in vaccination coverage was observed in Brazil, with the lowest coverage recorded in 2000 (72.53%) and the highest in 2018 (97.16%). Amapá presented the highest average vaccination coverage over the period (95.51%), while São Paulo had the lowest (79.71%). Santa Catarina and São Paulo stood out for their highest annual variation in vaccination coverage, and increasing vaccination coverage trends were noted in 15 federative units of the country. In summary, influenza vaccination coverage among older adults showed fluctuations over 20 years, with a growing trend towards vaccination adherence in most federative units.