Background. Moderate to severe postoperative pain affects performance of daily activities and it contributes to persistent postoperative pain. In patients submitted to cesarean section, this pain can also interfere with women's ability to care for their babies, to effectively breastfeed, and to satisfactorily interact with their children. Factors influencing the pain perception during the immediate postoperative period have not been widely pursued. Objective. To investigate the incidence and predicting factors of postoperative pain after cesarean section. Methods. A prospective longitudinal study with 1,062 women submitted to cesarean section. We collected sociodemographic, clinical, surgical, and health behavior data. We used the 11-point Numerical Pain and the Hospital Anxiety and Depression Scales. We performed logistic analysis to identify predictors of moderate to severe postoperative pain. Results. The incidence of moderate-severe postoperative pain was 78.4% (CI: 95%: 75.9%–80.8%). The preoperative anxiety (OR = 1.60; CI 95%: 1.22–2.30) and intrathecal morphine with fentanyl (OR = 0,23; CI 95%: 0.08–0.66) were significantly associated with moderate-severe postoperative pain report. Conclusion. The preoperative anxiety increases the risk of moderate-severe postoperative pain in women submitted to cesarean section. The intrathecal morphine with fentanyl added to bupivacaine was a protective factor against this pain.

Background The coronavirus disease (COVID-19) pandemic has impacted health services and healthcare systems worldwide. Studies have shown that hospital admissions for causes related to chronic non-communicable diseases (NCDs) have decreased significantly during peak pandemic periods. An analysis of the impact of the COVID-19 pandemic on hospital admissions for NCDs is essential to implement disability and mortality mitigation strategies for these groups. Therefore, this study aimed to analyze the impact of the COVID-19 pandemic on hospital admissions for NCDs in Brazil according to the type of NCD, sex, age group, and region of Brazil. Methods This is an ecological study conducted in Brazil. Data on hospital admissions from January 1, 2017 to May 31, 2021 were extracted from the Unified Health System’s Hospital Admissions Information System. The hospital admission rates per 100,000 thousand inhabitants were calculated monthly according to the type of NCD, sex, age group, and region of Brazil. Poisson regression models were used to analyze the impact of the COVID-19 pandemic on the number of hospital admissions. In this study, the pre-pandemic period was set from January 1, 2017 to February 29, 2020 and the during-pandemic from March 1, 2020 to May 31, 2021. Results There was a 27.0% (95.0%CI: -29.0; -25.0%) decrease in hospital admissions for NCDs after the onset of the pandemic compared to that during the pre-pandemic period. Decreases were found for all types of NCDs—cancer (-23.0%; 95.0%CI: -26.0; -21.0%), diabetes mellitus (-24.0%; 95.0%CI: -25.0%; -22.0%), cardiovascular diseases (-30.0%; 95.0%CI: -31.0%; -28.0%), and chronic respiratory diseases (-29.0%; 95.0%CI: -30.0%; -27.0%). In addition, there was a decrease in the number of admissions, regardless of the age group, sex, and region of Brazil. The Northern and Southern regions demonstrated the largest decrease in the percentage of hospital admissions during the pandemic period. Conclusions There was a decrease in the hospitalization rate for NCDs in Brazil during the COVID-19 pandemic in a scenario of social distancing measures and overload of health services.

Nº 48 Octubre 2017Página 354 ORIGINALES Dolor postoperatorio en mujeres sometidas a cesáreaDor pós-operatória em mulheres submetidas à cesariana Postoperative pain in women undergoing caesarean section Resultados: La incidencia de dolor fue del 92,7% (IC 95%: 90,9 -94,2) y las puntuaciones de intensidad media en el momento de peor dolor, igual a 6,6 (dp=2,2) . Los descriptores más frecuentes escogidos fueron "dolorida" (91,6%), "dolorida a la palpación" (70,0%) y "palpitante" (56,1%). Conclusiones: El dolor postoperatorio de alta intensidad es una realidad en este grupo, señalando la importancia de la evaluación del dolor para la ejecución de las acciones curativas y preventivas para reducir las pérdidas en la recuperación de las mujeres Palabras clave: Dolor; Dolor Posoperatorio; Cesárea. RESUMO:Objetivo: Estimar a incidência, intensidade e qualidade da dor pós-operatória em mulheres submetidas à cesariana.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused several problems in healthcare systems around the world, as to date, there is no effective and specific treatment against all forms of COVID-19. Currently, drugs with therapeutic potential are being tested, including antiviral, anti-inflammatory, anti-malarial, immunotherapy, and antibiotics. Although antibiotics have no direct effect on viral infections, they are often used against secondary bacterial infections, or even as empiric treatment to reduce viral load, infection, and replication of coronaviruses. However, there are many concerns about this therapeutic approach as it may accelerate and/or increase the long-term rates of antimicrobial resistance (AMR). We focused this overview on exploring candidate drugs for COVID-19 therapy, including antibiotics, considering the lack of specific treatment and that it is unclear whether the widespread use of antibiotics in the treatment of COVID-19 has implications for the emergence and transmission of multidrug-resistant bacteria.

IntroductionMultimorbidity, defined as the coexistence of two or more chronic diseases in the same individual, represents a significant health challenge. However, there is limited evidence on its prevalence and associated factors in developing countries, such as Brazil, especially stratified by sex. Thus, this study aims to estimate the prevalence and analyze the factors associated with multimorbidity in Brazilian adults according to sex.MethodsCross-sectional population-based household survey carried out with Brazilian adults aged 18 years or older. The sampling strategy consisted of a three-stage conglomerate plan. The three stages were performed through simple random sampling. Data were collected through individual interviews. Multimorbidity was classified based on a list of 14 self-reported chronic diseases/conditions. Poisson regression analysis was performed to estimate the magnitude of the association between sociodemographic and lifestyle factors with the prevalence of multimorbidity stratified by sex.ResultsA total of 88,531 individuals were included. In absolute terms, the prevalence of multimorbidity was 29.4%. The frequency in men and women was 22.7 and 35.4%, respectively. Overall, multimorbidity was more prevalent among women, the older people, residents of the South and Southeast regions, urban area residents, former smokers, current smokers, physically inactive, overweight, and obese adults. Individuals with complete high school/incomplete higher education had a lower prevalence of multimorbidity than those with higher educational level. The associations between education and multimorbidity differed between sexes. In men, multimorbidity was inversely associated with the strata of complete middle school/incomplete high school and complete high school/incomplete higher education, while in women, the association between these variables was not observed. Physical inactivity was positively associated with a higher prevalence of multimorbidity only in men. An inverse association was verified between the recommended fruit and vegetable consumption and multimorbidity for the total sample and both sexes.ConclusionOne in four adults had multimorbidity. Prevalence increased with increasing age, among women, and was associated with some lifestyles. Multimorbidity was significantly associated with educational level and physical inactivity only in men. The results suggest the need to adopt integrated strategies to reduce the magnitude of multimorbidity, specific by gender, including actions for health promotion, disease prevention, health surveillance and comprehensive health care in Brazil.