Human T-lymphotropic virus type 1 (HTLV-1) infection may cause serious disease, while pathogenicity of HTLV-2 is less certain. There are no screening or surveillance programs for HTLV-1/-2 infection in Brazil. By performing this systematic review, we aimed to estimate the prevalence of HTLV-1/-2 infections in pregnant women in Brazil. This review included cohort and cross-sectional studies that assessed the presence of either HTLV-1/-2 infection in pregnant women in Brazil. We searched BVS/LILACS, Cochrane Library/CENTRAL, EMBASE, PubMed/MEDLINE, Scopus, Web of Science and gray literature from inception to August 2020. We identified 246 records in total. Twenty-six of those were included in the qualitative synthesis, while 17 of them were included in the meta-analysis. The prevalence of HTLV-1 in Brazilian pregnant women, as diagnosed by a positive screening test and a subsequent positive confirmatory test, was 0.32% (95% CI 0.19–1.54), while of HTLV-2 was 0.04% (95% CI 0.02–0.08). Subgroup analysis by region showed the highest prevalence in the Northeast region (0.60%; 95% CI 0.37–0.97) for HTLV-1 and in the South region (0.16%; 95% CI 0.02–1.10) for HTLV-2. The prevalence of HTLV-1 is much higher than HTLV-2 infection in pregnant Brazilian women with important differences between regions. The prevalence of both HTLV-1/-2 are higher in the Northeast compared to Center-West region.

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This randomised clinical trial aimed to evaluate the effect of a pro-breast-feeding (BF) and healthy complementary feeding intervention performed during infants’ first months of life on ultraprocessed food (UPF) consumption at 4–7 years. We enrolled 323 teenage mothers and their infants from South Brazil, 163 allocated to the intervention group and 160 to the control group. Intervention consisted of sessions on BF and healthy complementary feeding promotion and was carried out in the maternity ward and at home after delivery. Food consumption was assessed using three 24-h food recalls at child’s age of 4–7 years. Foods were classified according to NOVA classification. Dietary contribution of UPF was adjusted for intra-individual variability by the SPADE method and categorised into tertiles. We used Poisson regression models with robust variance, adjusted for confounders, to estimate the effect of the intervention and duration of BF on the risk of high consumption of UPF. Our final analysis included 194 children, with mean age of 6·1 (sd 0·5) years. Mean dietary contribution of UPF was 38 % in the intervention group and 42·7 % in the control group, from total daily intakes. Results adjusted for BF duration, propensity score, income and total energy content demonstrated that the intervention reduced the risk of high consumption of UPF by 35 % (relative risk 0·65, 95 % CI 0·43, 0·98). BF duration was not associated with UPF consumption. The intervention was effective in reducing the risk of high UPF consumption at the age of 4–7 years.

We conducted a cross-sectional study to assess how the top 3 highest circulation newspapers from 25 countries are comparing and presenting COVID-19 epidemiological data to their readers. Of 75 newspapers evaluated, 51(68%) presented at their websites at least one comparison of cases and/or deaths between regions of their country and/or between countries. Quality assessment of the comparisons showed that only a minority of newspapers adjusted the data for population size in case comparisons between regions (37.2%) and between countries (25.6%), and the same was true for death comparisons between regions (27.3%) and between countries (27%). Of those making comparisons, only 13.7% explained the difference in the interpretation of cases and deaths. Of 17 that presented a logarithmic curve, only 29.4% explained its meaning. Although the press plays a key role in conveying correct medical information to the general public, we identified inconsistencies in the reporting of COVID-19 epidemiological data. Supplementary Information The online version contains supplementary material available at 10.1057/s41271-021-00298-7.

Background: To describe success and failure (S&F) after lumbar spine surgery in terms that are preciseand that are equally understandable across the entire health ecosystem. Methods: Back and leg pain (NPRS scale) and disability (Oswestry Disability Index –ODI) of patients operated were prospectively recorded before and 6 to 12 months after the procedure. Satisfaction was recorded in the postoperative period. Initially, patients were classified as Satisfied or Unsatisfied.Optimal cutoff values for disability and pain were estimated with ROC curves. Satisfied and Unsatisfied groups were subdivided into four categories based on a combination of satisfaction, disability and pain: Success, Incomplete success, Incomplete failure and Failure. These categories were translated into operational definitions with simple verbal terms, according to previously described norms of numeric-to-verbal equivalence. Results: 486 consecutive patients were recruited from May 2019 to February 2021, with a drop-out rate of 16.4%; Preoperative PROMs mean values were ODI 42.2 (+ 16.4), NPRS back 6.6 (+ 2.6) and NPRS leg 6.2 (+ 2.9) points; 19.3% were classified as Unsatisfied and cutoff values for disability (ODI=28; AUC 0.79) and pain (NPRS=6; AUC 0.79) were defined. Satisfied and Unsatisfied groups were further subdivided based on concordance or non-concordance with the discrimination cutoff values: Success (59.6%) - satisfied with pain and disability levels concordant (NPRS ≤5, AND ODI ≤27); Incomplete success (20.4%) - satisfied with pain and disability levels non-concordant (NPRS ≥6 AND/OR ODI ≥28); Incomplete failure (7.1%) – unsatisfied with pain and disability levels non-concordant (NPRS ≤5 AND/OR ODI ≤27); and Failure (12.4%) - unsatisfied with pain and disability levels concordant (NPRS ≥6 AND ODI ≥28). After that, groups were translated to: Success - patients are satisfied and present no or only mild to tolerable pain, and no or borderline disability; Incomplete Success – patients are satisfied despite levels of pain and/or disability worse than the ideal for success; Incomplete Failure – patients are not satisfied despite levels of pain and/or disability better than expected for failure; Failure – patients are unsatisfied and present moderate to severe pain and disability.Conclusion: It is possible to report S&F after surgery for degenerative disc disease of the lumbar spine with precise and meaningful operational definitions focused on the experience of the patient.