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Abstract The main objective of this paper was investigate the possible conditions and the influence of the National Program for Strengthening Family Agriculture (PRONAF) on the rural development of microregions in the state of Minas Gerais, in the years 2006 and 2017. To this end, it was built through from factor analysis, the rural development index (IDR) for the purpose of synthesizing information related to rural development in Minas Gerais. The index was used to analyze possible spatial configurations and rural development conditions according to PRONAF. The main results obtained indicated that, despite the observance of improvements in family establishments, mainly, in economic terms (modernization and income) and the advance of the IDR of some microregions, the state of Minas Gerais was unable to boost its rural development only with the PRONAF. Although the distribution of the Program's resources in poorer regions was significant in 2006, in the year 2017, there was a directing of resources to regions with greater potential and whose agricultural production is turned to the foreign market.

Resumo O objetivo principal do artigo foi investigar as possíveis condições e a influência do Programa Nacional de Fortalecimento da Agricultura Familiar (PRONAF) sobre o desenvolvimento rural de microrregiões de Minas Gerais, nos anos de 2006 e 2017. Para tanto, foi construído o índice de desenvolvimento rural (IDR), por intermédio da análise fatorial. Em seguida, o IDR foi utilizado para analisar as possíveis condições do desenvolvimento rural de acordo com o PRONAF, a partir da análise qualitativa comparativa (QCA). Os principais resultados obtidos indicam que, apesar da observância de melhorias nos estabelecimentos familiares, principalmente em termos econômicos e o avanço do IDR em algumas microrregiões, Minas Gerais não conseguiu impulsionar o seu desenvolvimento rural somente com o PRONAF. Embora a distribuição dos recursos do programa em regiões mais carentes tenha sido significativa em 2006, no ano de 2017 observou-se o direcionamento dos recursos para regiões de maior potencial e produção agrícola voltada para o mercado externo.

https://doi.org/10.1590/1806-9479.2023.264581

Avaliação da mobilidade funcional e força de preensão palmar de usuários assistidos na atenção primária após COVID-19
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Teixeira, Ana Lívia

; Souza, Luiza Morais Araújo

; Guimarães, Andrea Carmen

; Coelho, Jasiara Carla de Oliveira

; Damázio, Laila Cristina Moreira

Motricidade

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sep 2023, Volume 19 N. 3 Pages 284 - 288

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT With the COVID-19 pandemic, the existence of the post-COVID-19 Syndrome or Covid Longa became evident through the perception of resistant signs and symptoms. The assessment and rehabilitation of the present sequelae should consider functional mobility and hand grip strength for a total return to activities of daily living. The present study aimed to evaluate the functional mobility and hand grip strength in the post-COVID-19 period of Basic Health Units (UBS's) users in the city of São João del-Rei/MG. It was a cross-sectional study where 35 users of Primary Health Care (ABS) were evaluated, and the following assessments were used: a questionnaire containing 11 questions about the disease; assessment of vital signs; upper limb muscle strength with dynamometer; two-minute stationary gait test (TME´2) and time up and go (TUG). The SPSS 11.0 statistical package with the χ2 test was used for data analysis, considering the value of p< 0.05 and the description of mean values and standard deviation. It was evidenced an average handgrip strength equal to 44.52 Kgf, average knee elevation in TME’2 being equal to 80 elevations and in TUG an average of 25 seconds (p< 0.05). It was observed that individuals showed significant changes in functional mobility, while vital data, grip strength and aerobic capacity were within normal values for average age. It is concluded that the evaluated users presented functional mobility limitation as a sequel during the post-COVID-19 Syndrome, making it necessary to outline forms of functional rehabilitation aimed at improving the functional mobility of these users.

RESUMO Com a pandemia do COVID-19 evidenciou-se, mediante a percepção de sinais e sintomas resistentes, a existência da Síndrome Pós-COVID-19 ou Covid Longa. A avaliação e a reabilitação das sequelas presentes devem levar em consideração a mobilidade funcional e a força de preensão palmar para retorno íntegro das atividades de vida diária. O presente estudo teve por objetivo avaliar a mobilidade funcional e a força de preensão palmar no período pós-COVID-19 de usuários das Unidades Básicas de Saúde (UBS´s) do município de São João del-Rei/MG. Tratou-se de um estudo transversal, onde foram avaliados 35 usuários da Atenção Básica de Saúde (ABS), e utilizadas as seguintes avaliações: um questionário contendo 11 perguntas sobre a doença; avaliação dos sinais vitais; força muscular de membros superiores com dinamômetro; teste de marcha estacionária de dois minutos (TME´2) e time up and go (TUG). Para análise dos dados foi utilizado o pacote estatístico SPSS 11.0, teste χ2, considerando o valor de p< 0,05 e a descrição de valores médios e desvio padrão. Foi evidenciada uma média de força de preensão palmar igual a 44,52 Kgf, média de elevação do joelho no TME´2 sendo igual a 80 elevações e no TUG uma média de 25 segundos (p< 0,05). Observou-se que os indivíduos apresentaram alterações significativas na mobilidade funcional, enquanto os dados vitais, de força de preensão e capacidade aeróbica apresentaram dentro dos valores normais para idade média. Conclui-se que os usuários avaliados apresentaram limitação da mobilidade funcional como sequela durante a Síndrome Pós-COVID-19 sendo necessário traçar formas de reabilitação funcional voltadas para melhora da mobilidade funcional desses usuários.

https://doi.org/10.6063/motricidade.31528

Os principais desafios das políticas públicas de saúde para o enfrentamento das doenças crônicas não transmissíveis em municípios do Nordeste brasileiro
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Coelho, Ana Célia Rodrigues

; Leite, Maria Valcilene

; Carneiro, Kleyce Fernanda Prestes

; Mendonça, Joabson Romário Borges

; Mesquita, Lívia Karynne Martins

; Vasconcelos, Thiago Brasileiro de

Cadernos Saúde Coletiva

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2023, Volume 31 N. 2 elocation e31020095

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Background Chronic Noncommunicable Diseases (NCDs) are an important Public Health problem and shoud be paid more attention to the elaboration of public policies. Objective To identify the main challenges of public health policies for addressing NCDs in municipalities of northeastern Brazil. Method An integrative literature review was conducted from articles published in the last ten years. The articles considered eligible were grouped in tables and discussed on two sub-themes: “Public Health Policies” and “The main Challenges to face NCDs”. Results This study pointed out to the fragile programs and services offered in the municipal level of the northeast region of the country. It was observed the predominance of publications aimed at recognizing the profile of users with Hypertension and Diabetes, which unfeasibly contributes to integral care and health education. It was also possible to identify that even though the municipal level is closest to people’s daily lives, there are many challenges and impasses for an effective promotion of health and quality of life of these people. Conclusion Given the various challenges identified at all levels of production and knowledge, it is suggested that further studies may be conducted, thus considering the context of chronic conditions, and also further research can be developed to meet the demands of managers and users.

Resumo Introdução As doenças crônicas não transmissíveis (DCNT) são um importante problema de saúde pública e necessitam de olhar ampliado para elaboração de políticas públicas. Objetivo Identificar os principais desafios das políticas públicas de saúde para o enfrentamento das DCNT em municípios do Nordeste brasileiro. Método Revisão integrativa da literatura a partir de artigos publicados nos últimos dez anos. Os artigos considerados elegíveis foram agrupados em tabelas e discutidos frente aos subtemas: “Políticas Públicas de Saúde” e “Principais Desafios para o Enfrentamento das DCNT”. Resultados Os estudos apontaram a frágil oferta de programas e serviços no âmbito municipal da região Nordeste do país. Observou-se a predominância de estudos que visam reconhecer o perfil do usuário portador de hipertensão e diabetes, que pouco contribui para o cuidado integral e de educação em saúde. Também foi possível identificar que mesmo o âmbito municipal estando mais próximo desse público, muitos são os desafios e impasses para uma eficaz promoção da saúde. Conclusão Diante dos diversos desafios identificados em todos os níveis de produção e conhecimento, sugere-se que mais estudos sejam realizados considerando o contexto das condições crônicas e que pesquisas posteriores transcrevam as demandas a partir dos gestores e usuários.

https://doi.org/10.1590/1414-462x202331020095

Construction and validation of simulated scenarios in the emergency care of patients with chest pain
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Barbosa, Mayara dos Santos

; Ferreira, Lívia Maria Lopes

; Costa, Raphael Raniere de Oliveira

; Almeida, Rodrigo Guimarães dos Santos

; Carbogim, Fábio da Costa

; Coelho, Angélica da Conceição Oliveira

Revista Gaúcha de Enfermagem

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2023, Volume 44 elocation e20220186

Abstract: En Es Pt | Text: En Es Pt | PDF: En | PDF: Es | PDF: Pt

ABSTRACT Objective: To construct and validate clinical simulation scenarios for emergency care for patients with chest pain. Methods: A methodological study carried out in two stages: construction and validity. The construction took place through the survey of evidence from national and international literature. The validity stage took place through instrument assessment by judges, according to the Content Validity Index and application of a pilot test with the target audience. Fifteen judges with expertise in simulation, teaching and/or care participated in the research, in addition to 18 nursing students, in the pilot test. Results: Two scenarios of clinical simulation were constructed, and all the assessed items obtained a value above 0.80, showing evidence of validity, being considered instruments suitable for application. Conclusion: The research contributed to the development and validity of instruments that can be applied for teaching, assessment and training in clinical simulation in emergency care for patients with chest pain.

RESUMEN Objetivo: Construir y validar escenarios de simulación clínica para la atención de emergencia de pacientes con dolor torácico. Métodos: Estudio metodológico realizado en dos etapas: construcción y validación. La construcción se dio a través del levantamiento de evidencias de la literatura nacional e internacional. La etapa de validación se dio a través de la evaluación de los instrumentos por parte de los jueces, según el Índice de Validación de Contenido y aplicación de la prueba piloto con el público objetivo. Quince jueces con experiencia en simulación, enseñanza y/o asistencia participaron de la investigación, además de 18 estudiantes de enfermería, en la prueba piloto. Resultados: Se construyeron dos escenarios de simulación clínica y todos los ítems evaluados obtuvieron un valor superior a 0,80, mostrando evidencias de validez, siendo considerados instrumentos aptos para su aplicación. Conclusión: La investigación contribuyó al desarrollo y validación de instrumentos que pueden ser aplicados para la enseñanza, evaluación y entrenamiento en simulación clínica en la atención de emergencia a pacientes con dolor torácico.

RESUMO Objetivo: Construir e validar cenários de simulação clínica para o atendimento de emergência ao paciente com dor torácica. Métodos: Estudo metodológico realizado em duas etapas: construção e validação. A construção deu-se por meio do levantamento de evidências da literatura nacional e internacional. A etapa de validação deu-se mediante avaliação dos instrumentos pelos juízes, conforme Índice de Validação de Conteúdo e aplicação do teste-piloto com o público-alvo. Participaram da pesquisa 15 juízes com expertise em simulação, docência e/ou assistência, além de18 estudantes de Enfermagem, no teste piloto. Resultados: Foram construídos dois cenários de simulação clínica e todos os itens avaliados obtiveram valor acima de 0,80 apresentando evidência de validade, sendo considerados instrumentos aptos para aplicação. Conclusão: A pesquisa contribuiu para a elaboração e a validação de instrumentos que podem ser aplicados para o ensino, avaliação e capacitação em simulação clínica no atendimento de emergência ao paciente com dor torácica.

https://doi.org/10.1590/1983-1447.2023.20220186.en

Brazilian Portuguese version and content validity of the Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH)
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Castro, Rayane Quintão

; Barros, Lívia Vilela

; Carvalho, Pedro Henrique Berbert de

; Fonseca, Diogo Simões

; Miyamoto, Samira Tatiyama

; Coelho, Cristina Martins

; Machado, Germano Luís Rocha

; Forechi, Ludimila

Advances in Rheumatology

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2023, Volume 63 elocation 2

Abstract: En | Text: En | PDF: En

Abstract Introduction The Strengthening and Stretching for Rheumatoid Arthritis of the Hand (SARAH) program is a personalized, progressive 12-week exercise program for people with hand problems due to rheumatoid arthritis (RA). Patients are provided with two guidance documents, the ‘Patient Exercise Booklet’ and the ‘Personal Exercise Guide’, to continue the exercises independently at home. Objective This study aimed to translate and culturally adapt the SARAH protocol into Brazilian Portuguese and validate its content. Methods The guidance documents ‘Patient Exercise Booklet’ and ‘Personal Exercise Guide’ of the SARAH program were translated and culturally adapted to Brazilian Portuguese. The content validity was obtained by calculating the content validity index (CVI). Results The Brazilian version of the SARAH protocol reached semantic, idiomatic, conceptual, and cultural equivalences. The CVI was greater than 0.8, corresponding to a satisfactory index. The verbal comprehension was 4.9, showing good verbal comprehension ofthe target population. Conclusion The Brazilian Portuguese version of the SARAH protocol is available to Brazilian people with compromised hands due to RA with satisfactory content validity.

https://doi.org/10.1186/s42358-022-00284-x

Slum compassionate community: expanding access to palliative care in Brazil community
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Mesquita, Maria Gefé da Rosa

; Silva, Alexandre Ernesto

; Coelho, Lívia Pereira

; Martins, Matheus Rodrigues

; Souza, Marcela Teixeira de

; Trotte, Liana Amorim Corrêa

Revista da Escola de Enfermagem da USP

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2023, Volume 57 elocation e20220432

Abstract: Pt Es En | Text: Pt Es En | PDF: Pt | PDF: Es | PDF: En

RESUMO Objetivo: Descrever a implementação de uma comunidade compassiva nas favelas da Rocinha e Vidigal, localizadas na cidade do Rio de Janeiro. Método: Relato da experiência da implementação de uma Comunidade Compassiva a partir das bases conceituais da Organização Mundial da Saúde, amparada pelas diretrizes da extensão universitária. Resultados: Inicialmente, lideranças locais e moradores foram recrutados e receberam treinamento sobre cuidados paliativos. Posteriormente, profissionais de saúde de diferentes especialidades engajaram-se no projeto por meio da prática do voluntariado. Foram instituídas visitas domiciliares na modalidade interconsulta e “apadrinhamentos” por moradores e profissionais de saúde às pessoas em cuidados paliativos e familiares. Por fim, a Rede de Atenção à Saúde do território foi integrada de forma a reconhecer o projeto como rede de apoio. Conclusão: Destacamos a experiência como trabalho vivo em saúde, que envolve relações e processos criativos, os quais mobilizam o saber técnico estruturado e as relações entre as pessoas e as tecnologias leve-duras e leves, tornando factível o reconhecimento de potências no território. Objetivo Vidigal Janeiro Método universitária Resultados Inicialmente Posteriormente engajaramse engajaram se voluntariado apadrinhamentos “apadrinhamentos familiares fim apoio Conclusão criativos leveduras leve duras leves

RESUMEN Objetivo: Describir la implementación de una comunidad compasiva en las favelas de Rocinha y Vidigal, ubicadas en la ciudad de Río de Janeiro. Método: Relato de la experiencia de implementación de una Comunidad Compasiva a partir de las bases conceptuales de la Organización Mundial de la Salud, sustentada en lineamientos de extensión universitaria. Resultados: Inicialmente, se reclutaron y capacitaron a líderes locales y residentes en cuidados paliativos. Posteriormente, profesionales de la salud de diferentes especialidades se involucraron en el proyecto a través del voluntariado. Se instituyeron visitas domiciliarias en la modalidad de interconsulta y “patrocinios” por parte de residentes y profesionales de salud a personas en cuidados paliativos y familiares. Finalmente, se integró la Red de Atención a la Salud del territorio para reconocer el proyecto como una red de apoyo. Conclusión: Destacamos la experiencia como trabajo vivo en salud, que involucra relaciones y procesos creativos, que movilizan saberes técnicos estructurados y relaciones entre personas y tecnologías ligeras-duras y ligeras, posibilitando el reconocimiento de poderes en el territorio. Objetivo Vidigal Janeiro Método universitaria Resultados Inicialmente Posteriormente voluntariado patrocinios “patrocinios familiares Finalmente apoyo Conclusión creativos ligerasduras ligeras duras

ABSTRACT Objective: To describe the implementation of a compassionate community in Rocinha and Vidigal slums, located in the city of Rio de Janeiro. Method: Report on the experience of implementing a Compassionate Community based on the World Health Organization conceptual bases, supported by university extension guidelines. Results: Initially, local leaders and residents were recruited and trained in palliative care. Subsequently, health professionals from different specialties engaged in the project through volunteering. Home visits were instituted in the form of interconsultation and “sponsorships” by residents and health professionals to people in palliative care and family members. Finally, the health care network in the territory was integrated in order to recognize the project as a support network. Conclusion: We highlight the experience as living work in health, which involves relationships and creative processes, which mobilize structured technical knowledge and relationships between people and soft-hard and soft technologies, making it possible to recognize powers in the territory. Objective slums Janeiro Method bases guidelines Results Initially Subsequently volunteering sponsorships “sponsorships members Finally Conclusion processes softhard hard technologies

https://doi.org/10.1590/1980-220x-reeusp-2022-0432en

Dialysis-related constrictive pericarditis: old enemies may sometimes come back
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Neves, Precil Diego Miranda de Menezes

; Lario, Fábio Cerqueira

; Mohrbacher, Sara

; Ferreira, Bernadete Maria Coelho

; Sato, Victor Augusto Hamamoto

; Oliveira, Érico Souza

; Pereira, Leonardo Victor Barbosa

; Bales, Alessandra Martins

; Nardotto, Luciana Loureiro

; Ferreira, Jéssica Nogueira

; Cavalcante, Lívia Barreira

; Chocair, Pedro Renato

; Cuvello-Neto, Américo Lourenço

Brazilian Journal of Nephrology

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dec 2022, Volume 44 N. 4 Pages 602 - 606

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

ABSTRACT Cardiovascular disease is the main cause of death in patients with chronic kidney disease (CKD). Several heart conditions have been associated with CKD, including myocardial and pericardial diseases. This paper describes a case of Dialysis-related constrictive pericarditis in a patient diagnosed with sudden hypotension during a hemodialysis session. A 65-year-old man diagnosed with hypertension, diabetes, obesity, and cirrhosis on hemodialysis for two years complained of symptoms during one of his sessions described as malaise, lipothymia, and confusion. The patient had a record of poor compliance with the prescribed diet and missed dialysis sessions. He was sluggish during the physical examination, and presented hypophonetic heart sounds, a blood pressure of 50/30mmHg, and a prolonged capillary refill time. The patient was referred to the intensive care unit and was started on antibiotics and vasoactive drugs. His workup did not show signs of infection, while electrocardiography showed low QRS-wave voltage. His echocardiogram showed signs consistent with a thickened pericardium without pericardial effusion. Cardiac catheterization showed equalization of diastolic pressures in all heart chambers indicative of constrictive pericarditis. The patient underwent a pericardiectomy. Examination of surgical specimens indicated he had marked fibrosis and areas of dystrophic calcification without evidence of infection, consistent with Dialysis-related constrictive pericarditis. Hypotension for unknown causes must be considered in the differential diagnosis of dialysis patients.

RESUMO A doença cardiovascular é a principal causa de morte em pacientes com doença renal crônica (DRC). Várias formas de acometimento cardíaco têm sido associadas. à DRC, incluindo doenças miocárdicas e pericárdicas. Este artigo descreve um caso de pericardite constritiva relacionada a em um paciente diagnosticado com hipotensão súbita durante uma sessão de hemodiálise. Um homem de 65 anos com diagnósticos prévios de hipertensão, diabetes, obesidade e cirrose em hemodiálise por dois anos queixou-se de sintomas durante uma de suas sessões, descritos como mal-estar, lipotímia e confusão mental. Apresentava histórico de baixa adesão à dieta prescrita e faltas frequentes às sessões de diálise. Ele estava fraco durante o exame físico e apresentava bulhas cardíacas hipofonéticas, pressão arterial de 50/30mmHg e tempo de enchimento capilar prolongado. O paciente foi encaminhado para a unidade de terapia intensiva e iniciou o tratamento com antibióticos e drogas vasoativas. Investigação laboratorial não mostrou sinais de infecção, enquanto o eletrocardiograma mostrou baixa voltagem de complexo QRS. Seu ecocardiograma evidenciou sinais consistentes com um pericárdio espessado, sem derrame pericárdico. O cateterismo cardíaco mostrou equalização das pressões diastólicas em todas as câmaras cardíacas, indicativo de pericardite constritiva. O paciente foi submetido a uma pericardiectomia. O exame anatomopatológico mostrou sinais de acentuada fibrose acentuada fibrose e áreas de calcificação distrófica sem evidência de infecção, consistente com pericardite constritiva relacionada a por diálise. A hipotensão por causas desconhecidas deve ser considerada no diagnóstico diferencial de pacientes em diálise.

https://doi.org/10.1590/2175-8239-jbn-2020-0252

Teste de Progresso como ferramenta de intervenção curricular na implementação de um curso de Medicina
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Silva, Elisângela de Mattos

; Piechnik, Lívia Sissi Gonçalves Souza

; Silva, Mariana Xavier e

; Santos, Carlos Mauricio

; Coelho, Izabel Cristina Meister Martins

Revista Brasileira de Educação Médica

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2022, Volume 46 Suppl. 1 elocation e158

Abstract: En Pt | Text: En Pt | PDF: En | PDF: Pt

Abstract Introduction: The Progress Test (PT) is a longitudinal assessment modality composed of multiple-choice questions and allows the assessment of the student with individual feedback and the analysis of the institutional teaching-learning process. The present study aims at reporting the experience of using the progress test as a management and learning tool in the implementation of a medical course with an integrated curriculum based on active methodologies. Experience report: Since 2014, a medical school in a capital of the country uses the PT as an assessment tool to stimulate student autonomy, based on their longitudinal performance, allowing the teacher to reflect on and take the appropriate actions aimed at the teaching and learning process and providing significant elements for institutional decision-making related to curricular adequacy and course implementation. Using several strategies, such as the formation of a student and course evaluation committee (CAEC), workshops with teachers and students and inter-institutional consortia, the actors that make up the course reflect on their role in consolidating knowledge for the future medical professional and engage in this process at different times and in different ways. Discussion: The progress test is a tool with potentials and limits that must consider the safety, reliability and validity of the evaluation, using qualifying strategies, including the virtual environment. The PT enables the students, the faculty and the course self-determination and self-improvement by establishing comparisons between longitudinal performance averages of students at different stages of learning and institutions. Conclusion: The experience demonstrated the importance of the PT as an evaluation tool, brought advantages and benefits in the course implementation and guidance on interventions aimed at improving the teaching-learning process.

Resumo: Introdução: O Teste de Progresso (TP) é uma modalidade de avaliação longitudinal composta por questões de múltipla escolha que permite a avaliação do estudante com realização do feedback individual e a análise do processo de ensino-aprendizagem institucional. O presente estudo relata a experiência do uso do TP como ferramenta de gestão e aprendizado na implementação de um curso de Medicina de currículo integrado e baseado em metodologias ativas. Relato de experiência: Desde 2014, o curso de Medicina de uma capital do país utiliza o TP como ferramenta de avaliação para estimular a autonomia do estudante, baseado em seu desempenho longitudinal, possibilitar ao docente a reflexão e ação adequadas ao processo de ensino-aprendizagem e fornecer elementos significativos para a tomada de decisão institucional relacionada à adequação curricular e à implementação do curso. Com diversas estratégias, como a formação de uma Comissão de Avaliação do Estudante e do Curso (Caec), oficinas com professores e estudantes e consórcios interinstitucionais, os atores que compõem o curso refletem seu papel na consolidação do conhecimento para o futuro profissional médico e se engajam nesse processo em diferentes momentos e de diferentes formas. Discussão: O TP é uma ferramenta com potenciais e limites que devem considerar a segurança, a confiabilidade e validade da avaliação, utilizando-se de estratégias qualificadoras, incluindo o ambiente virtual. O TP possibilita a autodeterminação e o autoaperfeiçoamento do estudante, do docente e do curso ao estabelecer comparações entre médias de desempenho longitudinais dos discentes em diversos estágios de aprendizado e instituições. Conclusão: A experiência demonstrou a importância do TP como ferramenta de avaliação e trouxe vantagens e benefícios na implantação do curso e orientação de intervenções para a melhoria do processo de ensino-aprendizagem.

https://doi.org/10.1590/1981-5271v46.supl.1-20220331

HLA-DQA1*04:01 is related to a higher multiple sclerosis lesion load on T2/Flair MRI sequences
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NORO, Fabio

; ALVES-LEON, Soniza Vieira

; FONTES-DANTAS, Fabricia Lima

; VALLE BAHIA, Paulo Roberto

; ANDREIUOLO, Rodrigo Ferrone

; RUEDA LOPES, Fernanda Cristina

; PEREIRA, Valeria Coelho Santa Rita

; ABI-HAILA, Livia de Almeida Afonso

; COUTINHO, Renan Amaral

; ARAUJO, Amanda Dutra de

; MARCHIORI, Edson

Arquivos de Neuro-Psiquiatria

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dec 2021, Volume 79 N. 12 Pages 1109 - 1115

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Antecedentes: A predisposição genética para a esclerose múltipla (EM) está associada a alelos HLA, principalmente o HLA-DRB1*15:01. Objetivo: Identificar associações entre lesões na ressonância magnética e características genéticas em uma coorte brasileira de pacientes com EM. Métodos: Estudamos retrospectivamente os dados de 95 pacientes consecutivos com EM. Dois observadores independentes que desconheciam os dados clínicos identificaram “black holes” e lesões realçadas pelo contraste nas sequências de ressonância magnética T1 e contaram e mediram as lesões nas sequências T2 e FLAIR (fluid attenuated inversion recovery). Os casos foram classificados de acordo com tamanho, número e volume da lesão. Os alelos HLA-DRB1, HLA-DQB1 e HLA-DQA1 e os polimorfismos de nucleotídeo único rs4774, rs3087456, rs6897932, rs731236 e rs1033182 foram identificados por amplificação de reação em cadeia da polimerase com iniciadores específicos de sequência usando o kit One Lambda Inc., Canoga Park, CA, EUA. Resultados: Os pacientes com alelo HLA-DQA1*04:01 apresentaram carga de lesão (ajustada para idade, sexo e duração da EM) acima da mediana em comparação com outros pacientes com demais alelos HLA-DQA1 (p=0,02). Não houve diferenças entre todos os outros alelos HLA e polimorfismos de nucleotídeo único e carga lesional. Conclusões: A correlação do alelo HLA-DQA1*04:01 com maior carga de lesão nas sequências de RM em T2 sugere que a presença desse alelo pode estar associada ao risco de maior gravidade da EM.

ABSTRACT Background: The genetic predisposition to multiple sclerosis (MS) is associated with HLA alleles, especially HLA-DRB1*15:01. Objective: To identify associations between findings in magnetic resonance imaging (MRI) and genetic features in a Brazilian cohort of patients with MS. Methods: We retrospectively studied data from 95 consecutive patients with MS. Two independent observers who were blinded to the clinical data identified black holes and enhanced lesions on T1 MRI sequences, and counted and measured contrast-enhanced lesions on T2 and Flair (fluid attenuation inversion recovery) sequences. Cases were classified according to lesion size, number, and volume. The HLA-DRB1, HLA-DQB1, and HLA-DQA1 alleles, and the rs4774, rs3087456, rs6897932, rs731236, and rs1033182 single nucleotide polymorphisms were identified by polymerase chain reaction amplification with sequence-specific primers using the One Lambda Inc. Kit, Canoga Park, CA, USA. Results: Patients with the HLA-DQA1*04:01 allele had lesion load (adjusted for age, sex, and MS duration) above median compared with patients with other HLA-DQA1 alleles (p=0.02). There were no differences among all the other HLA alleles and single nucleotide polymorphisms and lesion load. Conclusions: The correlation of the HLA-DQA1*04:01 allele with a higher lesion load on T2/Flair MRI sequences suggests that the presence of this allele is associated with the risk of greater MS severity.

https://doi.org/10.1590/0004-282x-anp-2020-0487 3 downloads

10.

Atualização de Tópicos Emergentes da Diretriz Brasileira de Insuficiência Cardíaca – 2021
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Marcondes-Braga, Fabiana G.

; Moura, Lídia Ana Zytynski

; Issa, Victor Sarli

; Vieira, Jefferson Luis

; Rohde, Luis Eduardo

; Simões, Marcus Vinícius

; Fernandes-Silva, Miguel Morita

; Rassi, Salvador

; Alves, Silvia Marinho Martins

; Albuquerque, Denilson Campos de

; Almeida, Dirceu Rodrigues de

; Bocchi, Edimar Alcides

; Ramires, Felix José Alvarez

; Bacal, Fernando

; Rossi Neto, João Manoel

; Danzmann, Luiz Claudio

; Montera, Marcelo Westerlund

; Oliveira Junior, Mucio Tavares de

; Clausell, Nadine

; Silvestre, Odilson Marcos

; Bestetti, Reinaldo Bulgarelli

; Bernadez-Pereira, Sabrina

; Freitas Jr, Aguinaldo F.

; Biolo, Andréia

; Barretto, Antonio Carlos Pereira

; Jorge, Antônio José Lagoeiro

; Biselli, Bruno

; Montenegro, Carlos Eduardo Lucena

; Santos Júnior, Edval Gomes dos

; Figueiredo, Estêvão Lanna

; Fernandes, Fábio

; Silveira, Fabio Serra

; Atik, Fernando Antibas

; Brito, Flávio de Souza

; Souza, Germano Emílio Conceição

; Ribeiro, Gustavo Calado de Aguiar

; Villacorta, Humberto

; Souza Neto, João David de

; Goldraich, Livia Adams

; Beck-da-Silva, Luís

; Canesin, Manoel Fernandes

; Bittencourt, Marcelo Imbroinise

; Bonatto, Marcely Gimenes

; Moreira, Maria da Consolação Vieira

; Avila, Mônica Samuel

; Coelho Filho, Otavio Rizzi

; Schwartzmann, Pedro Vellosa

; Mourilhe-Rocha, Ricardo

; Mangini, Sandrigo

; Ferreira, Silvia Moreira Ayub

; Figueiredo Neto, José Albuquerque de

; Mesquita, Evandro Tinoco

Arquivos Brasileiros de Cardiologia

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jun 2021, Volume 116 N. 6 Pages 1174 - 1212

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

https://doi.org/10.36660/abc.20210367 3168 downloads

11.

Evaluation of Satisfaction of Adolescents Treated by Dental Students
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Coelho, Carolina Reis Fernandes

; Pedrosa, Fernanda Ribeiro

; Zina, Lívia Guimarães

; Mattos, Flávio de Freitas

; Martins, Renata de Castro

; Amaral, João Henrique Lara do

; Palmier, Andrea Clemente

; Vasconcelos, Mara

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2021, Volume 21 elocation e0045

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: To evaluate the satisfaction of adolescents undergoing dental treatment between 2016 and 2018 at the Dental School of the Federal University of Minas Gerais (FAO UFMG). Material and Methods: A descriptive cross-sectional study using the Oral Health Services Satisfaction Assessment Questionnaire (QASSaB). The structured questionnaire has eleven questions divided among the dimensions: dentist / patient relationship, relationship with other professionals, effectiveness, accessibility/availability, technical-scientific quality, cleanliness and physical environment, acceptability, effectiveness/resolution, each with five response options. Descriptive data analysis was performed using absolute and relative frequencies. Results: A total of 145 adolescents participated in this study, 60 males and 85 females; 74.85% of adolescents rated dental treatment received as excellent, 76.7% reported having no symptoms after treatment, 46.2% considered it easy/very easy to get treatment, 65.6% reported that waiting time was short/very short, 90% considered dental equipment modern/very modern, 98% regarded the cleanliness of the waiting room and bathrooms as being excellent, 83.4% reported that they always received an explanation about the treatment, and 51.57% were totally satisfied with the appearance of the treated teeth and their chewing capacity. Conclusion: It was possible to observe that the adolescents, users of FAO UFMG, were satisfied with the service in the studied dimensions: human relations, effectiveness, accessibility/availability, technical-scientific quality, physical environment/cleanliness, acceptability and resolvability/effectiveness.

https://doi.org/10.1590/pboci.2021.009 394 downloads

12.

Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents
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STONA, Priscila

; KRAMER, Paulo Floriani

; VARGAS-FERREIRA, Fabiana

; AMORIM, Lívia Mund de

; COELHO, Elisa Maria de Rosa Barros

; FELDENS, Carlos Alberto

Brazilian Oral Research

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2021, Volume 35 elocation e031

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had missing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97–3.32 and PR = 3.28; 95%CI: 1.61–6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03–1.67 and PR = 2.30; 95%CI: 1.18–4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes.

https://doi.org/10.1590/1807-3107bor-2021.vol35.0031 513 downloads

13.

Molecular epidemiology of Mycobacterium tuberculosis in Brazil before the whole genome sequencing era: a literature review
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Conceição, Emilyn Costa

; Salvato, Richard Steiner

; Gomes, Karen Machado

; Guimarães, Arthur Emil dos Santos

; da Conceição, Marília Lima

; Souza e Guimarães, Ricardo José de Paula

; Sharma, Abhinav

; Furlaneto, Ismari Perini

; Barcellos, Regina Bones

; Bollela, Valdes Roberto

; Anselmo, Lívia Maria Pala

; Sisco, Maria Carolina

; Niero, Cristina Viana

; Ferrazoli, Lucilaine

; Refrégier, Guislaine

; Lourenço, Maria Cristina da Silva

; Gomes, Harrison Magdinier

; de Brito, Artemir Coelho

; Catanho, Marcos

; Duarte, Rafael Silva

; Suffys, Philip Noel

; Lima, Karla Valéria Batista

Memórias do Instituto Oswaldo Cruz

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2021, Volume 116 elocation e200517

Abstract: En | Text: En | PDF: En

Molecular-typing can help in unraveling epidemiological scenarios and improvement for disease control strategies. A literature review of Mycobacterium tuberculosis transmission in Brazil through genotyping on 56 studies published from 1996-2019 was performed. The clustering rate for mycobacterial interspersed repetitive units - variable tandem repeats (MIRU-VNTR) of 1,613 isolates were: 73%, 33% and 28% based on 12, 15 and 24-loci, respectively; while for RFLP-IS6110 were: 84% among prison population in Rio de Janeiro, 69% among multidrug-resistant isolates in Rio Grande do Sul, and 56.2% in general population in São Paulo. These findings could improve tuberculosis (TB) surveillance and set up a solid basis to build a database of Mycobacterium genomes.

https://doi.org/10.1590/0074-02760200517 744 downloads

14.

Hepatitis B virus genotypes prevalence in patients from hepatology services in Ceará, Brazil
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Cruz, José Napoleão Monte Da

; Villar, Lívia Melo

; Mello, Francisco Campello Do Amaral

; Lampe, Elisabeth

; Hyppolito, Elodie Bomfim

; Lima, José Milton De Castro

; Hyppolito, Silvia Bomfim

; Pires Neto, Roberto Da Justa

; Nicolete, Larissa Deadame De Figueiredo

; Coelho, Ivo Castelo Branco

Revista da Sociedade Brasileira de Medicina Tropical

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2021, Volume 54 elocation e0807-2020

Abstract: En | Text: En | PDF: En

Abstract INTRODUCTION: Hepatitis B virus (HBV) infection is a public health problem; therefore, we aimed to report HBV genotypes in Ceará, Brazil. METHODS: A total of 103 HBsAg-positive samples were subjected to HBV genotyping and subgenotyping. RESULTS: The following genetic compositions of samples were found: F-54% (F2-83.33%), A-40% (A1-65%), D-6%, C2-1%, E-1%, and G-1%. CONCLUSIONS: Some genotypes are only prevalent in certain parts of the world; however, the State of Ceará is a hub for migration and has one of the most important liver transplantation centers in Brazil, which can explain the prevalence of the F genotype.

https://doi.org/10.1590/0037-8682-0807-2020 59 downloads

15.

Effect of combining photoinitiators on cure efficiency of dental resin-based composites
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Lara, Lucas

; Rocha, Mateus Garcia

; Menezes, Livia Rodrigues de

; Correr, Américo Bortolazzo

; Sinhoreti, Mario Alexandre Coelho

; Oliveira, Dayane

Journal of Applied Oral Science

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2021, Volume 29 elocation e20200467

Abstract: En | Text: En | PDF: En

Abstract Camphorquinone is the most conventionally used photoinitiator in Dentistry. Although different alternative photoinitiators have been proposed, no photoinitiator was capable of completely substituting camphorquinone. The combination of photoinitiators has been considered the best alternative. Objectives: To evaluate the effect of combining Norrish type I and II photoinitiators on the cure efficiency of dental resin-based composites. Methodology: Experimental composites were produced containing different photoinitiator systems: Norrish type I-only, mono-alkyl phosphine oxide (TPO); Norrish type II-only, camphorquinone (CQ); or its combination, CQ and TPO, in a 1: 1 molar ratio. UV-vis absorption spectrophotometry was performed to assess the consumption of each photoinitiator after curing (n=3). A multi-wave LED (Bluephase® G2, Ivoclar Vivadent) was pre-characterized and used with a radiant exposure of 24 J/cm2. The degree of conversion was evaluated by Raman spectrometry, and the elution of the monomers by nuclear magnetic resonance analysis (n=3). Data were analyzed using ANOVA and Tukey's test (α=0.05; β=0.2). Results: The combination of CQ and TPO increased the consumption of the photoinitiator system compared to CQ-only (p=0.001), but presented similar consumption compared to TPO-only (p=0.52). There was no significant difference in the degree of conversion between the composites regardless of the photoinitiator system (p=0.81). However, the elution of the monomers was reduced when both photoinitiators were combined. TPO-based material presented the highest elution of monomers. Conclusions: The combination of the photoinitiator systems seems to be beneficial for the cure efficiency of dental resin-based composites.

https://doi.org/10.1590/1678-7757-2020-0467 226 downloads

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