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RESUMO -Este trabalho objetiva avaliar a importância da disciplina de Introdução à Engenharia Química bem como os impactos que esta pode causar no empenho dos estudantes ao longo da graduação. Através de formulário aplicado a um conjunto de alunos do curso de Engenharia Química da Universidade Federal de Alagoas, pôde-se concluir o quão grande é o valor desta disciplina introdutória frente as dificuldades que o ciclo básico apresenta.

We aimed to analyze the trend of indicators of the National Immunization Program (acronym in Portuguese. PNI) in children under one-year-old and classify municipalities regarding the risk of transmission of vaccine-preventable diseases (RTVPD) in Maranhão from 2010 to 2021. This ecological time series study was based on secondary data on vaccination coverage (VC). vaccination coverage homogeneity (VCH). proportion of abandonment (PA). and RTVPD. with state coverage for vaccines in the national children’s calendar. Prais-Winsten regression estimated trends (α=5%) and the indicators’ annual percentage change (APC). We identified fluctuating and discrepant VC between vaccines. with a decreasing trend (p < 0.01). except those against Hepatitis B (p = 0.709) and oral human rotavirus (p = 0.143). The sharpest falls were for Yellow Fever (APC = 12.24%) and BCG (APC = 12.25%) vaccines. All VCH rates were lower than expected. with a drop from 2014 and APC between 5.75% (Pneumococcal 10; p = 0.033) and 14.02% (Poliomyelitis; p < 0.01). We observed an increasing trend in PA for Pentavalent (APC = 4.91%; p < 0.01) and Poliomyelitis (APC = 3.55%; p < 0.01). We identified an increase of 52.54% in the proportion of municipalities in Maranhão from 2015 to 2021. with extremely high (p = 0.025) and high (p = 0.028) RTVPD. The PNI indicators deteriorated. reaffirming the susceptibility to the emergence of vaccine-preventable diseases.

Introduction: Rheumatic heart disease (RHD) remains a significant cause of morbidity and mortality in middle- and low-income countries. However, the prevalence of RHD is often underestimated in resource limited areas due to lack of proper screening programs. Purpose: We aimed to determine the prevalence of clinical and subclinical RHD among adults in the Northwestern part of the Amazon Basin, Brazil. In addition, we evaluated the diagnostic yield of a history of self-reported rheumatic fever (RF) and cardiac auscultation Methods: We included a probability sample of adults from the general population in the Amazon Basin. Participants underwent questionnaire on medical history, cardiac auscultation and echocardiography. Participants were assessed according to the 2012 World Heart Federation (WHF) Criteria for echocardiographic diagnosis of RHD (Figure A) Results: We included a total of 591 participants (mean age 41+/-15 years, 60% women, 5% <20 years old). 3% (n=19) had definite RHD (age 50 [IQR 29-70] years, 53% women) and <1% (n=2) had borderline RHD. The distribution of definite RHD according to the WHF Criteria 2012 was: A (n=8), B (n=3), C (n=0), D (n=8). Valve pathologies are displayed in Figure B. Among definite RHD cases, 16% (n=3) were considered clinical (prevalence ~1%) and 84% (n=16) were subclinical (prevalence ~3%). A self-reported history of RF had a sensitivity of 3% and a specificity of 92% (PPV 2%/ NPV 95%) to detect RHD, whereas cardiac auscultation had a sensitivity of 38% and a specificity of 80% (PPV 5%/ NPV 97%). When combining a self-reported history of RF with cardiac auscultation, this yielded a sensitivity of 3% and a specificity of 98% (PPV 10%/ NPV 96%) Conclusions: By applying the 2012 WHF Criteria, the prevalence of clinical and subclinical RHD in adults from the Northwestern part of the Amazon Basin was 1% and 3%, respectively. A combination of a self-reported history of RF and cardiac auscultation provided low sensitivity but high specificity for RHD.