Background: The 5-minute APGAR score is clinically used as a screening tool to assess how the newborn has reacted to previous care, remaining relevant for predicting neonatal survival. This study aimed to analyze the determinants of the 5th minute APGAR score, and the factors associated with the death and survival of newborns with low APGAR scores hospitalized in the neonatal intensive care unit (NICU) at a referral public hospital in North Brazil. Methods: This was a hospital-based retrospective case-control study with 277 medical records. Newborns who presented with a 1-minute APGAR score < 7 followed by a 5-minute APGAR score < 7 were considered cases, while a score ≥ 7 was categorized as controls. Univariate and multivariable logistic regression analyses were used to establish the determinant factors of the low APGAR score and death outcome in this group. Survival curves were obtained using the Kaplan-Meier estimator, and then univariate and multivariate Cox regression was performed. Results: After adjusted analysis, the factor associated with low APGAR scores was vaginal delivery (OR = 3.25, 95%CI = 1.60–6.62, p = 0.001). Birth injury (OR = 0.39, 95%CI = 0.19–0.83, p = 0.014) was associated with upper APGAR scores. No significant independent associations were observed between the variables analyzed and death in the low APGAR score group. The Kaplan-Meier curve showed that individuals who presented Cesarean delivery had a shorter survival time in the ICU. Conclusion: In this setting, a 5-minute Apgar score < 7 was associated with the occurrence of vaginal delivery and birth injury with a 5-minute Apgar score ≥ 7. Survival in ICU was lower in newborns that were delivered via cesarean section.

Pelvic floor musculature assessment methods are generally invasive, subjective, and technologically expensive. Therefore, there is a need to identify other methods that can predict changes in the function of these muscles. This study aimed to verify whether the levels of strength and myoelectric activity of pelvic floor muscles (PFM) can be related to handgrip strength (HGS), to ensure faster and earlier identification of possible dysfunctions of this musculature. Furthermore, we verified whether these variables vary across different age groups. This was a cross-sectional observational study involving 44 healthy women. The women were divided into two groups: the young (18–35 years) and middle-aged (36–55 years) adult groups. Social, anthropometric, and clinical data were collected from the participants, and a functional assessment of their PFM was performed by bidigital palpation, electromyographic biofeedback (sEMG), and HGS (using a dynamometer). The levels of physical and sexual activity were measured using the International Physical Activity Questionnaire (IPAQ) and Sexual Quotient–Female version (SQ-F) questionnaire. There were no differences in HGS, power/pressure, sEMG, SQ-F score, or IPAQ score between the two groups (p > 0.05). Moderate correlation (r = 0.601; p = 0.019) was observed during multivariate analysis. HGS is related to mean amplitudes (p = 0.123), MVC (p = 0.043), sexual function (p = 0.049), and physical activity (p = 0.004). We therefore conclude that there were no differences between HGS and PFM strength in young adult and middle-aged women. Furthermore, HGS is related to the PFM functionality, sexual function, and physical activity.

Prescribing physical exercise as part of the clinical treatment of cancer patients has become an important strategy in the therapeutic arsenal available in the main health centers specialized in neoplastic diseases, but there is still uncertainty regarding the role of regular physical activity in modifying oxidative stress markers and antioxidants, as high levels of oxidative stress can lead to the development of carcinogens. Therefore, we assessed the effect of physical activity versus absence of physical activity on markers of oxidative stress and antioxidants in cancer patients. We looked for randomized controlled trials that included adult with any type of cancer performing some physical activity and compared them to a control group of cancer patients with no physical activity. The outcomes of interest collected were markers of oxidative stress and antioxidants. Six databases were used for the search (EMBASE, The Cochrane Library (CENTRAL), US National Library of Medicine (PubMed), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health (CINAHL) and SPORTDiscus via EBSCO) until January 31st, 2024. In the end, 7 randomized controlled clinical trials were included, totaling 573 participants. It was possible to conduct a meta-analysis with demonstrated that physical activity potentially increases the antioxidant marker Trolox, Taoc, Gpx, (SMD = 1.23, CI: 0.13 to 2.34). However, these findings were classified as having very low to moderate GRADE evidence. Cancer patients who participated in physical activity programs may have exhibited an increased concentration of antioxidants. Although the overall quality of the evidence in the studies was very low, these findings represent an important field of research that should be guided by studies with more participants and homogeneous methods of analysis of oxidant stress and antioxidant markers. PROSPERO CRD42021257815.

Background: Diabetic peripheral neuropathy (DPN) is one of the most common complications of type 2 diabetes mellitus. There is a gradual loss of protective sensation in the skin and the function of the foot joints, increasing the risk of injury as the disease progresses. The objective of this study was to verify whether socioeconomic factors, health risk factors, and self-care are associated with DPN. Methods: Observational cross-sectional with 228 individuals of ≥30 years in Family Health Strategies in a city in the eastern Amazon, in northern Brazil, using questionnaires containing socioeconomic information, clinical and laboratory parameters, the Summary of Diabetes Self-Care Activities Questionnaire, and the Michigan Neuropathy Screening Instrument. Results: The prevalence of DPN was 66.6%. The presence of neuropathy is associated with male gender, dyslipidemia, and increased microalbuminuria. Logistic regression analysis revealed male subjects’ increased BMI and altered HDL levels were associated with DPN. Conclusions: In men with altered BMI, and dysregulation in biochemical parameters, neuropathy is more prevalent.

Microcephaly is a neurological condition characterized by anomalies in the growth of the cranial circumference. This study aims to examine the association between sociodemographic and clinical variables and the occurrence of secondary microcephaly in newborns in Brazil. It also aims to investigate the association between this congenital anomaly and teratogenic infections. This research adopts an observational approach with an ecological, descriptive, and analytical design. The sample includes infants aged ≤28 days and registered in the country’s Live Births Information System from January 2015 to December 2021. Newborns were categorized into G1, consisting of newborns with one of the three infections (Zika, toxoplasmosis, or syphilis), and G2, consisting of newborns with two of the three infections. A total of 1513 samples were analyzed and divided into two groups: one infection (syphilis n = 423; toxoplasmosis n = 295; or Zika n = 739) and two infections (n = 56). The northeastern region of Brazil has the highest prevalence of microcephaly. Regarding the population profile, the Zika virus infection is more common among white mothers, while the syphilis infection is more common among black mothers. Among newborns with microcephaly, boys have a lower prevalence of toxoplasmosis infection, while girls have a lower prevalence of Zika virus infection. This study provides pertinent information on each infection and contributes to the epidemiologic understanding of the association between teratogenic infections and microcephaly.

Introduction: Pain is a common complication following surgical treatment for breast cancer. This symptom may result from a combination of biological, psychological, and social factors, thereby requiring a comprehensive, multidimensional approach to assessment and management. The functional impact of postoperative pain is considerable, as it can interfere with activities of daily living and compromise limb mobility. Objective: To verify the prevalence of pain, characterize it and analyze the factors associated with its intensity in patients undergoing breast cancer surgical treatment. Method: Cross-sectional study conducted between March 2021 and March 2022, in Belém, Pará, Brazil. A structured questionnaire was used to collect sociodemographic, clinical, and lifestyle data from patients in the postoperative period of breast cancer surgery. Pain was qualitatively assessed using the McGill Pain Questionnaire. Multiple linear regression was performed to identify factors associated with pain intensity, using the general pain index from the McGill instrument as the dependent variable. A 5% significance level was adopted for all statistics. Results: Forty-eight patients post-breast cancer surgery were included, the mean age was 53.64±11.64 years, 85% had undergone chemotherapy, 58.3%, mastectomy and 62.5% were feeling pain at the time of the evaluation. Pain intensity was negatively associated with alcohol consumption (p = 0.04) and positively associated with physical inactivity (p = 0.02), presence of comorbidities (p = 0.02), lymph node positivity (p = 0.03), and postoperative duration (p = 0.03). Conclusion: It was observed that most patients presented acute and moderate pain in the postoperative period and its intensity was associated with lifestyle, clinical and surgical characteristics.