DISPATCHESS evere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly worldwide during 2020-2021, but incidence has been highly variable in different countries and is diffi cult to estimate. In Portugal, which has ≈10.3 million inhabitants, the burden of disease, cases, and deaths was similar to or less than that for neighboring countries during the fi rst wave of the coronavirus disease (COVID-19) pandemic, through September 2020 (Appendix Figure, https://wwwnc.cdc.gov/ EID/article/27/11/21-0636-App1.pdf). However, it is diffi cult to estimate the true extent of SARS-CoV-2 infections in Portugal, although a previous study of clinical patients indicated a seropositivity <2.9% (1). We report a national, cross-sectional, epidemiologic survey that used quota sampling to quantify more accurately the cumulative number of infected persons in Portugal. The StudyWe used a convenience quota sampling, quasi-proportional to the population of Portugal in 9 strata: age group (<18, 18-54, and >55 years of age), each subdivided by population density of place of residence (<60, 60-500, and >500 persons/km 2 ) (Appendix). After a widespread media campaign, we recruited participants by using voluntary registration on a website specifi cally designed for this study. We obtained informed consent from all participants >16 years of age and from legal guardians for participants <18 years of age. The study was approved by the Ethics Committee of the Centro Académico de Medicina de Lisboa (#350/20, July 30, 2020).Blood collections and serologic tests were performed by Centro de Medicina Laboratorial Germano de Sousa (Lisbon, Portugal) by using standard procedures. We determined total antibodies against SARS-CoV-2 by using a chemiluminescent immunoassay test (COV2T; Advia Centaur Siemens, https:// www.siemens-healthineers.com), which targets the spike protein. This antibody test has a sensitivity of 98.1% and a specifi city of 99.9% (2), which we used to correct the seroprevalence estimates by using the Rogan-Gladen estimator (3). We used sample weights and poststratifi ed by sex to adjust the seroprevalence, extrapolating from the strata to the whole population (Appendix Tables 1-4). Participants completed a questionnaire with demographic, clinical, and epidemiologic questions regarding SARS-CoV-2 exposure (Appendix). We use standard statistical analyses to compare results at an α = 0.05 signifi cance.We enrolled 13,398 participants (55.3% women, age range 1-92 years) (Appendix Figure 2). Our sample refl ected approximately the characteristics of the

Background: SARS-CoV-2 infected individuals ≥60 years old have the highest hospitalization rates and represent >80% fatalities. Within this population, those in long-term facilities represent >50% of the total COVID-19 related deaths per country. Among those without symptoms, the rate of pre-symptomatic illness is unclear, and potential predictors of progression for symptom development are unknown. Our objective was to delineate the natural evolution of asymptomatic SARS-CoV-2 infection in elders and identify determinants of progression. Methods:We established a medical surveillance team monitoring 63 geriatric institutions. When an index COVID-19 case emerged, we tested all other eligible asymptomatic elders ≥75 or >60 years old with at least 1 comorbidity. SARS-CoV-2 infected elders were followed for 28 days. Disease was diagnosed when any COVID-19 manifestation occurred. SARS-CoV-2 load at enrollment, shedding on day 15, and antibody responses were also studied. Results:After 28 days of follow-up, 74/113(65%) SARS-CoV-2-infected elders remained asymptomatic. 21/39(54%) pre-symptomatic patients developed hypoxemia and ten pre-symptomatic patients died(median day 13.5,IQR 12). Open Peer Review Reviewer Status AWAITING PEER REVIEWAny reports and responses or comments on the article can be found at the end of the article. Gates

A oficina de saúde e sexualidade foi organizada em um encontro com escolares do 7º ano de uma escola pública e delineada a partir das demandas trazidas pela coordenação da escola e das dúvidas dos próprios escolares, ligadas à sexualidade, saúde sexual e identidade de gênero. Mudanças em curso que ocorrem na sociedade brasileira sobre direitos LGBTQ+ e igualdade de gênero foram evidenciadas, bem como a insuficiência do conhecimento acerca da saúde sexual. A oficina representou rica oportunidade de interação entre conhecimento teórico e prática de educação em saúde para os acadêmicos de medicina, o que contribui para a formação do médico generalista detentor de uma visão holística do paciente, tal como preconizado pelo CFM. Para os escolares, adolescentes inseridos em um ambiente de vulnerabilidade social, representou uma oportunidade de sanar dúvidas sobre saúde sexual e discutir paradigmas sociais, de forma a empoderá-los de saberes ligados à sexualidade e responsabilidade social.

Objective: To describe the prevalence of Helicobacter pylori (HP) in children and adolescents, and to assess its association with lesions in the esophagus, stomach, and duodenum according to the patient’s life cycle. Methodsː A cross-sectional analytical study with children and adolescents referred to a gastroenterology service and underwent esophagogastroduodenoscopy at a hospital in Vitória, Espírito Santo, Brazil, from 2001 to 2013. Variables analyzed were the following: sex, age, macro and microscopic alterations and severity of infestation. The Chi-square and Fisher's exact tests and adjusted residue analysis were used (α = 5%). Resultsː the prevalence of infection was 24.4%. Esophagitis (29.4%) and gastritis (34.1%) were associated with HP. The life cycle was associated with esophagitis and duodenitis. Infection was associated with life cycle: infants (0.8%), preschool children (10.5%), school-aged children (16.5%), and adolescents (72.2%). The residues showed a strong association between HP and gastritis, and no association between the school-aged and esophagitis. Adolescents were the major contributors to the association between life cycle and infection, and life cycle and lesion. Conclusionsː Infection with HP was associated with esophagitis and gastritis and was higher among adolescents, who had a marked tendency to develop gastritis and a milder tendency to develop esophagitis. The tendency of developing infection and gastritis was not present in the other life cycles. Public policies focusing on promotion and protecting health, especially in vulnerable population groups, are needed.

Introdução. Os efeitos da exposição pré-natal à cocaína e à metanfetamina ainda são obscuros. Tal questão apresenta grande importância, visto que essas drogas são consumidas mundialmente. Objetivo. Identificar na literatura relacionada as principais consequências da exposição fetal à cocaína e à metanfetamina no desenvolvimento cognitivo e comportamental de pré-escolares. Método. Revisão da literatura realizada nas bases de dados Pubmed, Lilacs e na Biblioteca Virtual de Saúde (BVS), durante abril e maio de 2020, atualizada em abril de 2021. Em todas as bases, usou-se os descritores do DeCS “Methamphetamine”, “Cocaine”, “Pregnancy” e “Preschool”. No Pubmed, também se utilizou “Prenatal Exposure Delayed Effects” e “Learning Disabilities”. Na BVS e no Lilacs, acrescentou-se o termo “Cognitive development”. Os artigos foram filtrados com base no seu idioma de publicação, população, substância de estudo, título e resumo. Resultados. Na amostra inicial, havia 111 artigos, destes, 10 foram selecionados. Adicionou-se a esse quantitativo 15 estudos. Alguns autores apontaram que a exposição fetal aos entorpecentes pode gerar atividade neurológica anormal, defeitos na aquisição da linguagem, hiperatividade e TDAH, desinibição comportamental, déficits cognitivos, dificuldade de leitura, além de distúrbios de socialização, comportamento agressivo e problemas de externalização. Conclusão. Não há consenso no meio científico se a exposição pré-natal à cocaína e à metanfetamina prejudica de forma direta o desenvolvimento cognitivo e comportamental dos infantos. Contudo, alguns trabalhos reiteram que o uso desses entorpecentes durante a gestação pode acarretar diversos problemas na maturação fetal. O fato dessa temática ser pouco estudada ressalta a necessidade de novas pesquisas e trabalhos de campo.