Background: COVID–19 is still a challenge, both with regard to its treatment and to the actual efficacy of the vaccines available to date, especially with the emergence of new variants. We evaluated the efficacy of the measles–mumps–rubella (MMR) vaccine in preventing SARS–CoV–2 infection and severity of COVID–19 in health workers. Methods: This analysis includes data from one ongoing blinded, randomized, placebo–controlled trial with participants aged 18–60 years were randomly assigned to receive the MMR vaccine or a placebo. The primary efficacy analysis included all participants with a positive nasopharyngeal RT–PCR test since their inclusion. Results: The MMR vaccine did not prevent the SARS–CoV–2 infection. Participants in the MMR group, compared with those in the placebo group, had a 48% risk reduction in symptomatic COVID–19 (RR = 0.52; 95% CI: 0.33-0.83; p=0.004) and a 76% risk reduction in COVID–19 treatment (RR = 0.24; 95% CI: 0.06-0.88; p = 0.020) with one dose and a 51% risk reduction in COVID–19 symptoms (RR = 0.49; 95% CI: 0.31 – 0.78; p = 0.001) and a 78% risk reduction in COVID–19 treatment (RR = 0.22; 95% CI: 0.06-0.82; p = 0.015) with two doses. Conclusions: This interim analysis of an ongoing clinical trial suggests that compared with a placebo, the vaccine reduces the risk of COVID–19 symptoms and reduces the need for COVID–19 treatment.

BACKGROUND AND OBJECTIVES: Labor pain is caused by several physiological changes and may cause psychological damage to the parturient and her relatives and, therefore, must be relieved. The objective of this study was to evaluate the knowledge, attitude, and practice of obstetricians concerning pharmacological methods of labor analgesia. METHODS: Cross-sectional study (38 obstetricians working at public maternity hospitals). A structured questionnaire was applied about knowledge, attitude and practice concerning systemic and regional pharmacological methods. The agreement magnitude was assessed by kappa coefficient. RESULTS: We observed adequate knowledge about the indications of all methods (31 to 86%), the contraindications of opioids (92%) and the adverse effects of non-opioid analgesics /antispasmodics on the fetus (76%). Concerning attitude, they agree that non-opioid analgesics/antispasmodics do not minimize labor pain (98%) but should be available at the maternity wards (89%) and that epidural analgesia is effective (100%) and should be available (94%). In practice, the indication of non-opioid analgesics/antispasmodic and epidural analgesia prevailed. In most of the requirements in each dimension (knowledge: K=-0.092 to 0.158; p=0.057 to 1.0 and attitude: K=-0.005 to 0.472; p=0.004 to 1.0), there was minimal agreement with practice, except for the non-opioid analgesics/antispasmodics (K=0.421, p=0.009), and epidural analgesia (K=0.472, p=0.004), with a moderate agreement. CONCLUSION: Knowledge was heterogeneous. The attitude was unanimous concerning the effectiveness and the need of Knowledge, attitude and practice regarding pharmacological methods of labor analgesia Conhecimento, atitude e prática em relação aos métodos farmacológicos de analgesia de parto

Extramammary Paget disease (EPD) is a rare malign neoplasm that may affect the vulva and has manifestations common to benign diseases such as itching, pain and eczema. This leads to delay in diagnosis and consequent worse prognosis. The definitive diagnosis is obtained by biopsy of the vulva, which shows Paget cells. The treatment of choice is wide excision with margins, which leads to sequelae, functional and aesthetic. Recurrence is common. This article reports the case of a 48-year-old female patient with history of vulvar itching for the past 2 years, who had been submitted to various treatments for benign pathologies. The patient was biopsied and was diagnosed with extensive EPD, being submitted to vulvectomy. This article aims to draw attention to the need for biopsy of pruritic vulvar lesions that do not respond to usual treatment.

ResumoDurante a gravidez e o puerpério, existe um estado de hipercoagulabilidade sanguínea e, portanto, de risco para eventos tromboembólicos. A trombose de veia renal é uma condição grave, pouco frequente e de difícil diagnóstico. Este estudo relatou um caso de trombose de veia renal numa puérpera, descrevendo caso clínico, fatores de risco, métodos diagnósticos e o tratamento instituído. AbstractPregnancy and puerperium are periods of blood hypercoagulability and, therefore, of risk for thromboembolic events. Renal vein thrombosis is a serious and infrequent condition of difficult diagnosis. This study reported a case of renal vein thrombosis in the puerperium, and described the clinical case, risk factors, diagnostic methods, and treatment instituted.