Urban PM2.5 samples were collected in Manaus, a major city in the Amazon rainforest, to analyze dicarboxylic acids (DCA) (C2-C9), black carbon (BC), levoglucosan (LEV), and sulfate (SO4 2-) during daytime and nighttime, in periods with and without smoke over the city from biomass burning (BB). Oxalic acid (C2) was the dominant DCA, followed by malonic acid (C3) and succinic acid (C4). The 12.5% nighttime increase in oxalic acid (C2) and higher C2/TDCA ratio at night indicate ongoing secondary formation, not just accumulation from a lower boundary layer. BC showed a moderate correlation with C4, and, since no correlation was observed between BC and LEV, this suggests that fossil fuel combustion-a recognized source of BC-is one of the possible primary sources of C4 in the studied atmosphere. The phthalic acid (Ph) to azelaic acid (C9) ratio (Ph/C9), an indicator of the dominant oxidative pathway for DCA formation, was lowest at night, and C9 exhibited a strong correlation with levoglucosan (LEV) (r = 0.89), suggesting that BB serves as a major source of primary C9 and may also provide precursors that contribute to the secondary formation of PM2.5. During smoke periods, LEV increased by 479%, while C2 and C3 increased by 247% and 259%, and the ratios of C2/C4 and C2/SO4 2- increased by 40% and 259%, respectively. Biomass burning has modified the composition of DCAs, possibly influencing aerosol hygroscopicity and their potential to act as cloud condensation nuclei, with possible implications for regional climate. This study highlights the critical role of biomass burning in the formation of organic aerosols and their influence on oxidative pathways, as well as their broader environmental impacts. This study shows biomass burning increases dicarboxylic acids in Manaus air, altering aerosol formation and composition, impacting urban air quality and atmospheric processes in the Amazon region.
IMPORTANCE:Vulvovaginal atrophy (VVA) is a common manifestation of the genitourinary syndrome of menopause, associated with vaginal dryness, dyspareunia, and reduced quality of life. Despite available therapies, effective, safe, and well-tolerated alternatives remain of interest for symptomatic postmenopausal women. OBJECTIVE:To assess the therapeutic efficacy of intravaginal dehydroepiandrosterone (DHEA) for vulvovaginal atrophy in postmenopausal women. EVIDENCE REVIEW:A systematic literature search was performed in PubMed, Embase, and the Cochrane Library for studies published up to July 2025. Search terms included "DHEA," "prasterone," "Intrarosa," and "dehydroepiandrosterone." Randomized controlled trials (RCTs) evaluating intravaginal DHEA in postmenopausal women were included. Data extraction followed predefined inclusion and exclusion criteria. Risk of bias was assessed, and pooled analyses were conducted using random-effects models. FINDINGS:Six RCTs representing five unique RCTs (n=1,611) involving postmenopausal women with VVA were included. Compared with placebo, intravaginal DHEA demonstrated significant improvements in two primary outcomes: vaginal dryness with a mean difference of -0.23 (95% CI, -0.35 to -0.11) and dyspareunia of -0.40 (95% CI: -0.66 to -0.15). No major safety concerns were reported, and adverse effects were mild and infrequent. The evidence consistently supported both statistical and clinical benefits of DHEA across trials, with low to moderate heterogeneity. CONCLUSIONS AND RELEVANCE:Intravaginal DHEA significantly improves vulvovaginal symptoms, particularly vaginal dryness and dyspareunia, in postmenopausal women. These findings underscore its role as an effective and well-tolerated therapeutic option for the management of genitourinary syndrome of menopause, with potential to enhance quality of life.
INTRODUCTION:Genitourinary syndrome of menopause (GSM) is a prevalent condition among postmenopausal women, often leading to sexual dysfunction and significantly impacting quality of life. While vaginal estrogen is the standard treatment, alternatives are needed for those who cannot or prefer not to use hormonal therapies. OBJECTIVES:This study aims to evaluate the efficacy of radiofrequency (RF) compared with vaginal estrogen in treating sexual dysfunction in postmenopausal women with GSM. METHODS:A systematic search was conducted in PubMed, Embase, and Cochrane Library up to June 2025. Only randomized controlled trials (RCTs) comparing vaginal RF to vaginal estrogen in postmenopausal women with sexual dysfunction were included. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. RESULTS:Four RCTs comprising 156 participants were included in the analysis. All trials evaluated sexual function using the Female Sexual Function Index (FSFI), which ranges from 2 to 36, with higher scores indicating better sexual function. The meta-analysis showed that RF improved FSFI total score by 4.85 points compared to vaginal estrogen (95% CI 0.04 to 9.67; P = .05). However, no significant differences were observed in the FSFI domains (desire, arousal, lubrication, orgasm, satisfaction, and pain). CONCLUSION:RF appears to be a non-hormonal and potentially promising alternative to vaginal estrogen for managing sexual dysfunction in women with GSM, although its long-term durability requires further investigation.
Objetivo: Identificar estratégias de enfrentamento da Síndrome de Burnout e estresse em profissionais que atuam em um Centro de Atenção Psicossocial. Método: Estudo exploratório, transversal com abordagem qualitativa, no qual foram identificadas as estratégias de enfrentamento do estresse e da Síndrome de Burnout e os fatores que desencadeiam pelo grupo focal. Resultados: Diante das questões, do tema e das falas dos profissionais, foram agrupadas cinco categorias baseadas nas falas que se repetiam, como a experiência em saúde mental, os estressores laborais, o ambiente, a integração entre a equipe e as estratégias de enfrentamento. Conclusão: O grupo com os profissionais gerou estímulos para possíveis estratégias individuais a fim de proporcionar um ambiente de trabalho mais motivador e favorável, promovendo uma melhora na qualidade de vida.
O feminicídeo representa um importante problema de saúde pública e segurança pública. Este estudo teve como objetivo analisar o perfil epidemiológico e a tendência temporal dos feminicídios necropsiados no Instituto Médico Legal (IML) de Águas Lindas de Goiás, entre janeiro de 2023 e dezembro de 2025. Trata-se de pesquisa aplicada, quantitativa, descritiva, retrospectiva e de série temporal, baseada na análise de registros de atendimento integrado (RAI) do Instituto Médico Legal e em registros na Delegacia Especializada de Atendimento à Mulher (DEAM), com tratamento estatístico dos dados. Foram identificados 12 casos de feminicídio no período, distribuídos em cinco casos em 2023, quatro em 2024 e três em 2025. Embora os números absolutos indiquem redução anual, o pequeno tamanho da série não permite afirmar tendência estatisticamente significativa, caracterizando estabilidade temporal. O perfil das vítimas revelou predominância de mulheres pardas (75%), com idade entre 20 e 49 anos (75%), solteiras (58,3%), com ensino fundamental (41,7%) e ocupação predominante do lar (33,3%). A arma branca foi o principal instrumento utilizado (33,3%), seguida por arma de fogo (25%), e a maioria das vítimas não possuía medida protetiva registrada (75%). Os achados diferem parcialmente do cenário nacional, reforçando a importância da produção de evidências locais para subsidiar a gestão em segurança pública e saúde, visando identificar lacunas e consequente redução efetiva dessa mortalidade. Conclui-se que a utilização integrada dos registros periciais e policiais constitui ferramenta estratégica para fortalecer a vigilância epidemiológica, qualificar políticas públicas e orientar ações de prevenção, proteção e enfrentamento da violência letal contra mulheres.
