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Is the symptom of pain adequately addressed in hospitalization at Internal Medicine? Cross-sectional study
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Martinez, José Eduardo

; Moises, Thamires Guedes Leite

; Cabo, Júlia Santos do

BrJP

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jul 2023, Volume 6 N. 3 Pages 263 - 268

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

ABSTRACT BACKGROUND AND OBJECTIVES: Pain is one of the main reasons for seeking medical care. Thus, the objective of the present study was to evaluate the treatment of pain complaints in a medical clinic ward. METHODS: Cross-sectional and descriptive study at the Santa Lucinda Hospital (Hospital Santa Lucinda - HSL) and Sorocaba Hospital Complex (Conjunto Hospitalar de Sorocaba - CHS). Data was collected by: (1) interviewing the participants using a structured questionnaire drawn up by the researchers, and (2) accessing information such as pain records and drug prescriptions in the medical records. RESULTS: The sample consisted of 85 patients, 11.8% in the HSL and 88.2% in the CHS. More than 80% of patients had already experienced pain at some point in their lives, whether chronic or acute. Forty-one percent of patients had pain during hospitalization, regardless of the reason for admission. A minority of pain events had the complaint recorded in their medical records. Drugs were prescribed for 73.0% of the patients, mostly on demand. There was a mismatch between the type of drug prescribed and the intensity of the pain in 80% of prescriptions. CONCLUSION: The complaint of pain is prevalent in Internal Medicine hospitalizations. In this study, 41.2% of the pain was musculoskeletal, followed by abdominal pain, regardless of the reason for hospitalization. The complaint of pain was medicated in most of the patients’ pain reports, but around 23% of the patients complaining of pain did not receive drugs. Most patients (80%) with pain received drugs that were inconsistent with the intensity of the pain; however, the recording of the complaint of pain in the medical records remains insufficient.

RESUMO JUSTIFICATIVA E OBJETIVOS: Dor é um dos principais motivos por assistência ao serviço médico-hospitalar. Desta forma, o objetivo deste estudo foi avaliar o atendimento de queixas dolorosas em enfermaria de clínica médica. MÉTODOS: Estudo transversal e descritivo nos hospitais Santa Lucinda (HSL) e Conjunto Hospitalar de Sorocaba (CHS). A coleta de dados foi realizada por: (1) entrevista com os participantes direcionada por um questionário estruturado elaborado pelos pesquisadores, e (2) acesso a informações como registro de dor e prescrição de fármacos no prontuário. RESULTADOS: A amostra foi composta por 85 pacientes, sendo 11.8% no HSL e 88,2% no CHS. Mais de 80% dos participantes relataram experiência prévia de dor aguda ou crônica em algum momento da vida. Quarenta e um por cento dos participantes relatou dor durante a internação independente da causa da internação. A minoria dos eventos de dor constava nos registros da queixa em seu prontuário. Houve fármaco prescrito para 73% dos pacientes, sendo em sua maioria, por demanda. Houve uma inadequação entre o tipo de fármaco prescrito e a intensidade da dor em 80% das prescrições. CONCLUSÃO: A queixa de dor é um sintoma prevalente entre pacientes internados de Clínica Médica. Neste estudo, 41,2%; das dores foram musculoesqueléticas, seguida de dores abdominais, independente do motivo da internação. A queixa de dor foi medicada na maior parte dos relatos de dor dos pacientes, porém cerca de 23% dos pacientes com queixa de dor não receberam fármacos. A maior parte dos pacientes (80%) com dor recebeu fármacos incoerentes à intensidade da dor; porém o registro da queixa de dor nas evoluções dos prontuários permanece insuficiente.

https://doi.org/10.5935/2595-0118.20230072-en

Dimensões do assédio na escola: diálogos sobre gênero com jovens estudantes de ensino médio de São Paulo/Brasil
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Silva, Cristiane Gonçalves da

; Leite, Vanessa Jorge

; Pontes, Júlia Clara de

; Santos, Fernanda Farias dos

; Oliveira, João Vitor Saldanha de

; Hiraishi, Vitória Lopes

; Pereira, Sasha Cruz Alves

; Simões, Júlio Assis

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e210649

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

Resumen En este artículo discutimos los usos de la categoría “acoso” empleada por jóvenes estudiantes de escuelas públicas de enseñanza media para dar sentido a la experiencia de violencia y discriminación de género ocurridas dentro y fuera de la escuela. El análisis se basa en registros de trabajo en campo producidos en el ámbito de una investigación multicéntrica y de métodos mixtos, realizada en nueve escuelas de São Paulo (SP/BR). El acoso parece como una categoría polisémica que, al nombrar la violencia, ayuda en el enfrentamiento de las jerarquías y desigualdades de género y generación. Concluimos que las jóvenes han puesto en tela de juicio normativas y actitudes que alimentan las desigualdades de género de las escuelas, además de denunciar el silenciamiento o la inadecuación de la institución en el enfrentamiento del problema, lo que posibilita la identificación de convergencias con una nueva sensibilidad alrededor de la violencia contra mujeres que los discursos feministas globalizados hicieron surgir.

Abstract In this article, we discuss uses of “harassment” as a category employed by young students from public high schools to make sense of violence and gender discrimination experiences that occur in and out of school. The analysis is based on fieldwork records produced within the scope of a multicenter, mixed-methods research carried out in nine schools located in São Paulo. Harassment appears as a polysemic category that, by naming violence, helps to face gender and generation hierarchies and inequalities. We infer that the young girls have questioned norms and attitudes that feed gender inequalities in schools; in addition, they have denounced the silence or inadequacy of the institution in facing the problem. This enables to identify convergences with a new sensibility regarding violence against women that globalized feminist discourses have brought to the surface.

Neste artigo, discutimos os usos da categoria “assédio” empregada por jovens estudantes de escolas públicas de Ensino Médio para dar sentido a experiências de violência e discriminação de gênero ocorridas dentro e fora da escola. A análise baseia-se em registros de trabalho de campo produzidos no âmbito de uma pesquisa multicêntrica e de métodos mistos, realizada em nove escolas de São Paulo (SP/BR). O assédio aparece como uma categoria polissêmica que, ao nomear a violência, ajuda no enfrentamento das hierarquias e desigualdades de gênero e geração. Depreendemos que as jovens têm questionado normativas e atitudes que alimentam as desigualdades de gênero nas escolas, além de denunciarem o silenciamento ou inadequação da instituição no enfrentamento do problema, o que possibilita identificar convergências com uma nova sensibilidade em torno da violência contra mulheres que os discursos feministas globalizados fizeram emergir.

https://doi.org/10.1590/interface.210649

Transplante Cardíaco Ortotópico em Receptor com Covid-19
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Garcia, Leonardo Rufino

; Garzesi, André Monti

; Sinatora, Julia Bazzo

; Grotto, Rejane Maria Tommasini

; Passaroni, Andréia Cristina

; Campos, Nelson Leonardo Kerdahi Leite de

; Martins, Antônio Sérgio

; Felicio, Marcello Laneza

; Brito, Flávio de Souza

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 3 elocation e20220234

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

https://doi.org/10.36660/abc.20220234

Dimensões do assédio na escola: diálogos sobre gênero com jovens estudantes de ensino médio de São Paulo/Brasil
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Silva, Cristiane Gonçalves da

; Leite, Vanessa Jorge

; Pontes, Júlia Clara de

; Santos, Fernanda Farias dos

; Oliveira, João Vitor Saldanha de

; Hiraishi, Vitória Lopes

; Pereira, Sasha Cruz Alves

; Simões, Júlio Assis

Interface - Comunicação, Saúde, Educação

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2023, Volume 27 elocation e210649

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

https://doi.org/10.1590/interface.210649

Incidence of memory complaints during the COVID-19 pandemic in Southern Brazil: findings from PAMPA cohort
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Feter, Natan

; Caputo, Eduardo Lucia

; Leite, Jayne Santos

; Delpino, Felipe Mendes

; Cassuriaga, Júlia

; Silva, Carine Nascimento da

; Silva, Marcelo Cozzensa da

; Reichert, Felipe Fossati

; Rombaldi, Airton José

Dementia & Neuropsychologia

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2023, Volume 17 elocation e20220072

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

ABSTRACT. Population-level studies investigating the incidence of memory complaints during the COVID-19 pandemic are scarce. Objective: This study aimed to examine the incidence of memory complaints over 15 months during the COVID-19 pandemic in adults from Southern Brazil. Methods: Data from the PAMPA (Prospective Study about Mental and Physical Health in Adults) cohort, a longitudinal study with adults residing in Southern Brazil, were analyzed. An online-based, self-administered questionnaire was used to assess self-rated memory. Participants rated their memories as excellent, very good, good, fair, or poor. Incident memory complaints were defined as worse memory perception from baseline to follow-up. Cox proportional hazard models were used to identify factors associated with the increased risk of memory complaints. Results: During follow-up, a cumulative incidence of 57.6% for memory complaints was observed. Female sex (hazard ratio [HR] 1.49; 95% confidence intervals [CI] 1.16–1.94), lack of access to prescribed medicine (HR: 1.54; 95%CI 1.06–2.23), and worsened anxiety symptoms (HR: 1.81; 95%CI 1.49–2.21) were associated with an increased risk of memory complaints. Regular practice of physical activity was associated with a reduced risk of memory complaints (HR: 0.65; 95%CI 0.57–0.74). Conclusion: Since the COVID-19 pandemic, 6 in 10 adults in Southern Brazil have developed memory complaints. Factors including sex and lack of medications increased the risk of incident memory complaints. Physical activity reduced the risk of incident memory complaints during the COVID-19 pandemic.

RESUMO. Estudos em nível populacional que investiguem a incidência de queixa na memória durante a pandemia de COVID-19 são escassos. Objetivo: Nosso objetivo foi examinar a incidência de queixa na memória, ao longo de 15 meses durante a pandemia de COVID-19, em adultos do Sul do Brasil. Métodos: Foram analisados dados da coorte Estudo Prospectivo sobre Saúde Mental e Física em Adultos (PAMPA), um estudo longitudinal com adultos residentes no Sul do Brasil. Um questionário autoadministrado online foi usado para avaliar a memória autorreferida. Os participantes classificaram sua memória como excelente, muito boa, boa, regular ou ruim. A queixa na memória incidente foi definida como pior percepção de memória desde a linha de base até o acompanhamento. Modelos de risco proporcional de Cox foram usados para identificar fatores associados ao aumento do risco de queixa na memória incidente. Resultados: Durante o seguimento, observou-se incidência cumulativa de 57,6% para queixa na memória. Sexo feminino (hazard ratio — HR 1,49; intervalo de confiança — IC 95% 1,16–1,94), falta de acesso ao medicamento prescrito (HR: 1,54; IC95% 1,06–2,23) e sintomas de ansiedade (HR: 1,81; IC95% 1,49–2,21) foram associados a risco aumentado de queixa na memória incidente. A prática regular de atividade física foi vista como fator protetor (HR: 0,65; IC95% 0,57–0,74). Conclusões: Desde a pandemia de COVID-19, seis em cada dez adultos no Sul do Brasil desenvolveram queixa na memória. Fatores como sexo e falta de medicamentos aumentaram o risco de queixa na memória incidente. A atividade física reduziu o risco de queixa na memória incidente durante a pandemia de COVID-19.

https://doi.org/10.1590/1980-5764-dn-2022-0072

THE RELATIONSHIP BETWEEN FRACTURES IN PEDIATRIC POLYTRAUMA PATIENTS: EVALUATION OF CLINICAL OUTCOMES
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CARVALHO, DAVI BRAGA DE

; DOBASHI, EIFFEL TSUYOSHI

; GOMES, DANILO JOSÉ LEITE

; DANTAS JUNIOR, JOSÉ MANOEL

; PAJUABA, ANA JULIA MARQUEZ

; COCCO, LUIZ FERNANDO

Acta Ortopédica Brasileira

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2023, Volume 31 N. 3 elocation e268013

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

ABSTRACT Objective: To evaluate children and adolescents with polytrauma and fractures of the pelvis and proximal and diaphyseal femur and correlate the impact of these conditions and clinical outcomes. Methods: Retrospective study carried out in a public hospital in Taboão da Serra (SP), with pediatric patients with polytrauma from January 2012 to December 2021. In total, 44 patients were evaluated, 70.44% boys and 29.55% girls, aged from 12 to 17 years. Results: Diaphyseal fracture of the femur affected 70.44% of the patients, mainly caused by a fall from a height (56.81%). Linear external fixation was the most used treatment (45.45%). All patients were discharged from hospital. Conclusion: We found essential sociodemographic information: 84.11% of patients did not have associated injuries; 88.63% were hospitalized from 3 to 11 days; 90.91% did not need to be admitted to an ICU, 77.27% did not need reoperation, and 22.73% underwent another surgery; 45.45% used the external fixator to stabilize injuries; 11.36% converted the external fixator to the intramedullary nail; 9.09% needed an intramedullary nail remover; 2.27% converted to a plate (bilateral) and 2.27% to a rigid nail; 2.27% had loss of reduction and revision with rod; 2.27% underwent corrective osteotomy; 2.27% had clinical hospitalization; 2.27% had osteonecrosis of the femoral head and screws removed; 2.27% removed the plate. No deaths were recorded. Level of Evidence II, Retrospective Study.

RESUMO Objetivo: Avaliar crianças e adolescentes politraumatizados com fraturas da pelve, proximal e diafisária do fêmur e correlacionar o impacto dessas condições e desfechos clínicos. Métodos: Estudo retrospectivo realizado em hospital público de Taboão da Serra (SP), com pacientes pediátricos politraumatizados entre janeiro de 2012 e dezembro de 2021. Avaliaram-se 44 pacientes, 70,44% meninos e 29,55% meninas, de 12 a 17 anos. Resultados: A fratura diafisária fechada do fêmur acometeu 70,44%, sendo causada principalmente por queda de altura (56,81%). A fixação externa linear foi o tratamento mais utilizado (45,45%). Todos os pacientes receberam alta hospitalar. Conclusão: Identificaram-se importantes informações sociodemográficas: 84,11% dos pacientes não apresentaram lesões associadas; 88,63% ficaram internados de 3 a 11 dias; 90,91% não necessitaram de internação em unidade de terapia intensiva (UTI), 77,27% não precisaram ser reoperados; 22,73% realizaram nova cirurgia; 45,45% utilizaram fixador externo para estabilização de lesões;11,36% converteram o fixador externo para a haste intramedular; 9,09% precisaram remover as hastes intramedulares; 2,27% converteram para placa (bilateral) e 2,27% para haste rígida; 2,27% tiveram perda de redução e revisão com haste; 2,27% realizaram osteotomia corretiva; 2,27% tiveram internação clínica; 2,27% tiveram osteonecrose da cabeça femoral e parafusos removidos; e 2,27% retiraram a placa. Não foram observados óbitos. Nível de Evidência II, Estudo Retrospectivo.

https://doi.org/10.1590/1413-785220233103e268013

Percepções sobre contribuições/desafios da integração ensino-serviço-comunidade a partir da experiência de uma disciplina cirúrgica
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Mello, Ludmila Leite Sant’Anna Vaz de

; Turci, Maria Aparecida

; Said, Camila do Carmo

; Carvalho, Alessandra Aparecida de

; Gomes, Bruno Mattiello

; Holliday, Julia Braga

Revista Brasileira de Educação Médica

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2023, Volume 47 N. 3 elocation e095

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

Abstract: Introduction: The National Curriculum Guidelines (DCN, Diretrizes Curriculares Nacionais) for the undergraduate medical course emphasize the educational training in the context of primary health care and have as axes of the curricular development, the health needs of the population and the teaching, service, and community integration (TSCI), preferably in services of the Brazilian Health System (SUS). Thus, the primary health network is a unique learning scenario, as it provides students the opportunity to experience health policies, as well as the multi-professional work, in addition to the possibility of dealing with real-life problems, associating medical-academic training to the social health needs. Objectives: This work aims to analyze the characteristics of the teaching-service integration, which contribute to the university, health services and the community. It also aims to analyze the difficulties and challenges through the perception of the students, the users and the health professionals involved in the outpatient Surgery Clinic and in the extension project of UFSJ (Universidade Federal de São João del-Rei) in the health units in Tiradentes-MG. Methods: This work is a qualitative study which used, as data collection instruments, semi-structured interviews with users, students and health professionals, about the perception of Teaching Service-Community Integration (TSCI). The Content Analysis technique was used for the data analysis. Results and Discussion: The data showed that the TSCI allowed improving the quality of work in the health service, qualifying the professionals who were working there, in addition to enhancing personal achievement of the actors in this interaction. It also brought improvements to primary care, allowing an understanding of the organization of the work practice and greater effectiveness of the Basic Health Unit. Furthermore, it was possible to perceive the challenges and impasses of this integration to be overcome, such as: lack of structure and materials, a minor discomfort, but no less important, of patients to be cared by students and confrontation of the routine of local health professionals with the University. Conclusion: The university inserted in the social reality and in the primary care services trains professionals who are more qualified for more prevalent problems while benefiting the population and the local health teams.

Resumo: Introdução: As Diretrizes Curriculares Nacionais (DCN) da graduação em Medicina enfatizam a formação no contexto da atenção básica de saúde e têm como eixos do desenvolvimento curricular as necessidades de saúde da população e a integração ensino-serviço-comunidade (Iesc), preferencialmente nos serviços do Sistema Único de Saúde (SUS). Dessa forma, a rede básica de saúde é um cenário de aprendizagem singular, pois proporciona aos alunos a possibilidade de eles vivenciarem as políticas de saúde e o trabalho multiprofissional, além de permitir que lidem com problemas reais, vinculando a formação médico-acadêmica às necessidades sociais da saúde. Objetivo: Este estudo teve como objetivo analisar as características da integração ensino-serviço que contribuem para a universidade, os serviços de saúde e a comunidade, e as suas dificuldades e os seus desafios por meio da percepção dos discentes, usuários e profissionais de saúde envolvidos no ambulatório de cirurgia ambulatorial e no projeto de extensão da Universidade Federal de São João del-Rei (UFSJ) nas unidades de saúde em Tiradentes, em Minas Gerais. Método: Trata-se de estudo qualitativo que utilizou como instrumentos de coleta de dados entrevistas semiestruturadas com usuários, discentes e profissionais de saúde sobre a percepção da IESC. Para a análise dos dados, empreendeu-se a técnica de análise de conteúdo. Resultado: Os dados mostraram que a IESC permitiu melhorar a qualidade do trabalho no serviço de saúde, qualificar os profissionais ali presentes, além de ampliar a realização pessoal dos atores dessa interação. Também trouxe melhorias à atenção primária, possibilitando a compreensão da organização da prática no trabalho e maior resolubilidade da unidade básica de saúde. Ainda foi possível uma percepção dos desafios e impasses dessa integração a serem superados, como falta de estrutura e materiais, desconforto minoritário, mas, não menos importante, de pacientes a serem atendidos pelos estudantes e confronto da rotina dos profissionais de saúde locais com a universidade. Conclusão: A universidade inserida dentro da realidade social e dos serviços de atenção primária forma profissionais mais capacitados para problemas mais prevalentes ao mesmo tempo que beneficia a população e as equipes de saúde locais.

https://doi.org/10.1590/1981-5271v47.3-2021-0381

Effects of herbal choline as a replacement for choline chloride on myopathy, locomotor system, and hepatic health of broilers
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Dias, Allan Gabriel Ferreira

; Santin, Ana Paula Iglesias

; Brasileiro, Júlio César Lopes

; Leite, Carla Daniela Suguimoto

; Stringhini, José Henrique

; Gouveia, Alison Batista Vieira Silva

; Silva, Júlia Marixara Sousa da

; Café, Marcos Barcellos

Revista Brasileira de Zootecnia

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2023, Volume 52 elocation e20220177

Abstract: En | Text: En | PDF: En

ABSTRACT The objective of this study was to evaluate the effects of replacing choline chloride with a plant source of choline on the locomotor system, liver health, and development of breast myopathies in broilers aged 1-42 days of age. We allocated 1,120 one-day-old Cobb broilers to four treatment groups and fed them commercial diets based on corn and soybean meal. The treatments included choline in the form of 1,800.00 mg/kg choline chloride; 1,350.00 mg/kg choline chloride + 450.00 mg/kg herbal choline; 900.00 mg/kg choline chloride + 900.00 mg/kg herbal choline; and 1,000.00 mg/kg herbal choline. Each treatment group had eight replications. Throughout the experiment, gait score, footpad dermatitis, hock burn, and leg deformities (valgus and varus) were evaluated in the birds at 28 and 35 days of age. After slaughter, parameters such as breast myopathies, tibial dyschondroplasia score, and histological slides of the pectoral muscle, liver, and proximal tibial epiphysis were assessed. The results demonstrated good hepatic and locomotor health in the broilers, as no classical signs of choline deficiency were observed. Statistical analyses indicated no significant differences between treatments in terms of liver and locomotor health, suggesting that broilers fed diets supplemented with the plant source did not experience choline deficiency. Additionally, no statistically significant differences were found between treatments regarding breast myopathies. Overall, the tested choline plant source can effectively replace choline chloride in broiler diets.

https://doi.org/10.37496/rbz5220220177

Scientific diving in Brazil: history, present and perspectives
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Leite, Tatiana S.

; Pinheiro, Igor E.

; Berchez, Flávio

; Bertoncini, Áthila A.

; Cima, Oswaldo M. Del

; Demetrescu, Irene E.

; Francini-Filho, Ronaldo B.

; Kikuchi, Ruy K.P

; Machado, Arthur A.

; Maia-Nogueira, Rodrigo

; Martins, Flavio L.

; Mendes, Liana F.

; Rambelli, Gilson

; Sampaio, Claudio L.S.

; Segal, Barbara

; Aguiar, Aline A.

; Auler, Augusto S.

; Barroco-Neto, José

; Bonaldo, Roberta M.

; Buchmann, Francisco S.

; Calippo, Flavio

; Cesar, Augusto

; Gama, Matheus A.C.

; Ghilardi-Lopes, Natalia

; Leão, Zelinda M.A.N.

; Lessa, Guilherme C.

; Menegola, Carla

; Pinheiro, Hudson T.

; Rocha, Luiz A.

; Sabino, José

; Seoane, José C.S.

; Sestokas, Julia

; Tiago, Cláudio C.

; Wegner, Ewerton

; Lotufo, Tito

Ocean and Coastal Research

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2023, Volume 71 elocation e23045

Abstract: En | Text: En | PDF: En

Abstract Scientific diving (SD) is defined as any diving activity that applies scientific procedures to produce subsidies for studies and technical works in underwater environments. The first report of an underwater scientific study in Brazil dates to the 19th century, in the Abrolhos reefs. Currently, in Brazil, scientific diving has been performed in various areas, from shallow coastal regions to remote and sometimes hard-to-reach places, such as oceanic islands, flooded caves, and icy areas like Antarctica. However, the regulation of SD in Brazil still lacks more concrete actions towards an effective and efficient self-regulation that offers physical safety to practitioners and institutional safeguards for organizations that use it in their research projects. Thus, this article aims to contribute to a better understanding of this critical issue in Brazil and to serve as a reference and incentive for the training of professionals and the development of these activities in the country. It includes: 1) a historical review of SD; 2) a diagnosis of the training and application of SD in Brazil; 3) the evolution of marine sciences in Brazil from the perspective of SD; 4) a review of the use of environmental assessment and underwater conservation techniques in oceans and internal waters; 5) an analysis of the evolution of scientific diver training in Brazil, including a diagnosis on training; 6) the history and updates of the rules, regulations, and safety of SD. Given all the potential of diving combined with specific techniques for research, monitoring, and marine and limnic science in Brazil, we aim to understand the evolution of scientific diving teaching and to outline perspectives in the country, as it is crucial for the training of qualified scientists capable of performing these underwater tasks. Finally, we present future plans for the development of this activity in Brazil from the point of view of research and the labor market.

https://doi.org/10.1590/2675-2824071.23036tsl

10.

Determining reference ranges for immunological cells of healthy indigenous individuals from a region in Brazil
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Morais, Isa Rita Brito de

; Barbosa, Dyjaene de Oliveira

; Almeida, Gabriel Barroso de

; Costa, Regina Rossoni da

; Silva, Bruna Oliveira da

; Oliveira, Laís Albuquerque de

; Arantes, Julia Pimentel

; Leite, Layla Oliveira Campos

; Rossato, Luana

; Ribeiro, Marcos Borges

; Marchioro, Silvana Beutinger

; Freire, Songelí Menezes

; Nascimento, Roberto José Meyer

; Simionatto, Simone

; Torres, Alex José Leite

einstein (São Paulo)

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2023, Volume 21 elocation eAO0291

Abstract: En | Text: En | PDF: En

ABSTRACT Objective The establishment of reference values for a subset of leukocytes is common in clinical practice, and ethnic variations are strongly associated with disease development. In Brazil, indigenous people are vulnerable to infections, and few studies have described the health and disease conditions of this population. This study aimed to provide reference values for immunological cell subsets in indigenous Brazilians living in the state of Mato Grosso do Sul. Methods Flow cytometry and 4-color combinations of monoclonal antibodies were used to characterize cells. A total of 115 healthy adults, mostly females (72%), were included in the study. The results are presented as mean and median (2.5%-97.5% percentiles) for T and B lymphocytes, CD4+ T cells, CD8+ T cells, Natural Killer cells, monocytes, and dendritic cells, providing an average immunological profile for the population in question. Results The relative medians of CD3+, CD4+, and CD8+ T cells were significantly higher in women than in men in a healthy indigenous population. Conclusion To our knowledge, cell reference data from indigenous Brazilians are unknown in the literature. The immune cell results presented in this pioneering study will contribute to the clinical and laboratory evaluation of the Brazilian indigenous population, especially given the important differences when compared with other Brazilian ethnic groups.

https://doi.org/10.31744/einstein_journal/2023ao0291

11.

Negociação das políticas/práticas curriculares: o desenvolvimento profissional de professores(as) orientado para a decisão curricular políticaspráticas políticas práticas curriculares professoresas professores as professores(as
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Melo, Maria Julia Carvalho de

; Almeida, Lucinalva Andrade Ataide de

; Leite, Carlinda

Educar em Revista

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2023, Volume 39 elocation e87031

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

RESUMO Este artigo tem por objetivo evidenciar as possibilidades e as impossibilidades de processos de negociação das políticas/dos programas contribuírem para o desenvolvimento profissional de professores(as) orientado para a decisão curricular. Recorrendo à defesa da autonomia do exercício da atuação docente, considera-se que o desenvolvimento profissional perpassa a ideia dos(as) professores(as) se constituírem como decisores curriculares, entendida como capacidade de ação que se desenvolve a partir da articulação entre os esforços individuais do sujeito, os recursos disponíveis e os fatores contextuais. A orientação teórico-metodológica seguida tem por base a relação instável e indecidível entre particularidade e universalidade. A recolha de dados de políticas/práticas curriculares teve por lócus o município de Caruaru, Pernambuco, com o material disponível na Plataforma Instituto Qualidade no Ensino (IQE) Caruaru e o site oficial do IQE. A análise desses materiais evidencia disputas em torno da significação das políticas/práticas curriculares no município construídas a partir dos discursos das reformas educacionais globais e das políticas nacionais que vêm propondo, por meio da padronização curricular, a tentativa de fechamento da produção de respostas curriculares contextuais. No entanto, mesmo diante dessas limitações, acredita-se que existe a possibilidade de os(as) professores(as) agirem nas brechas da estrutura para disputar, com as políticas, outros sentidos de atuação docente que estimulem o desenvolvimento profissional baseado na autonomia e na consideração dos saberes docentes. políticasdos professoresas professores professores(as curricular considerase considera dosas dos(as sujeito contextuais teóricometodológica teórico metodológica universalidade políticaspráticas práticas Pernambuco IQE (IQE propondo entanto limitações acreditase acredita osas os(as disputar docentes

ABSTRACT This paper aims to highlight the possibilities and impossibilities of policies/programs negotiation processes to contribute to the teachers’ professional development oriented towards curricular decision-making. Using the defense of autonomy of the exercise of teaching enactment, it is considered that professional development permeates the idea of teachers constituting themselves as curricular decision-makers, understood as capacity for action that is developed from the articulation between individual efforts of the subject, available resources and contextual factors. The theoretical-methodological orientation is based on the unstable and undecidable relationship between particularity and universality. The locus of data collection on curricular policies/practices was the municipality of Caruaru, located in the state of Pernambuco, Brazil, with the material available on the Caruaru Platform Instituto Qualidade no Ensino (IQE) [Quality in Teaching Institute] and the IQE official website. The analysis of these materials shows disputes around the meaning of curricular policies/practices in this municipality built from the discourses of global educational reforms and national policies that have been proposing, through curricular standardization, the attempt to close the production of contextual curricular responses. However, despite these limitations, it is believed that there is a possibility for teachers to act in the structure gaps to dispute, along with policies, other meanings of teaching enactment that stimulate professional development based on autonomy and considering teaching knowledge. policiesprograms programs decisionmaking. decisionmaking decision making. making decision-making decisionmakers, decisionmakers makers, makers decision-makers subject factors theoreticalmethodological theoretical methodological universality policiespractices practices Pernambuco Brazil (IQE Quality Institute website proposing standardization responses However limitations dispute knowledge

https://doi.org/10.1590/1984-0411.87031

12.

Glycemic and nonglycemic mechanisms of congenital malformations in hyperglycemic pregnancies: a narrative review
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Negrato, Carlos Antonio

; Marques Júnior, Paulo Rubens

; Leite, Heloisa Barreto

; Torigoe, Carolina Naomi

; Silva, Beatriz Fernandes

; Costa, Kessy

; Kamei, Júlia Marchatto

; Zampa, Cárian Leoz

; Toni, Ana Clara Rocha Gomes

; Pereira, Izabella Carolina Gomes Santana

; Heinzelmann, Gabryel Luz

; Zajdenverg, Lenita

Archives of Endocrinology and Metabolism

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dec 2022, Volume 66 N. 6 Pages 908 - 918

Abstract: En | Text: En | PDF: En

ABSTRACT Congenital malformations are more frequently found among children born to mothers with diabetes than in the background population. There are several complex mechanisms involved in the development of congenital malformations in the offspring of mothers with hyperglycemia, such as the overexpression of glucose transporters (GLUTs) 1 and 2, the increased activity of the hexosamine biosynthetic pathway and the reduced expression of the PAX3 gene with a consequent increase in p53 protein expression. These alterations can lead to increased glucose and free radical concentrations in the embryo, thus promoting the process of apoptosis and causing malformation. The most frequent malformations found in the offspring of mothers with diabetes are heart and neural tube defects, urinary tract and kidney malformations, and cleft lip with or without cleft palate. Strict glycemic control should be obtained before and during pregnancy, aiming to avoid or minimize the risk of congenital malformations in the offspring. Beyond hyperglycemia, several factors may also be associated with increased risks of malformations in the offspring of these women, such as obesity, multiple pregnancies, advanced maternal age, folic acid deficiency, use of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, assisted reproduction techniques, and exposure to different types of environmental pollutants.

https://doi.org/10.20945/2359-3997000000521

13.

Changes in olfaction and taste in patients hospitalized for COVID-19 and their relationship to patient evolution during hospitalization
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Gusmão, Pedro Antônio O.A.

; Roveda, José Reinaldo C.

; Leite, Ana Sophia M.

; Leite, Arnaldo S.

; Marinho, Carolina C.

Brazilian Journal of Otorhinolaryngology

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dec 2022, Volume 88 Pages 75 - 82

Abstract: En | Text: En | PDF: En

Abstract Objectives: During the COVID-19 pandemic, several cases of changes in olfaction and taste associated with the infection have been reported. Therefore, otolaryngologists are frequently the first medical professionals sought by patients. The aim of this study was to evaluate the frequency of olfaction and taste disorders in patients hospitalized with COVID-19, and their association with other clinical manifestations and patient evolution during hospitalization. Methods: 248 patients, admitted to three public hospitals in Belo Horizonte, Minas Gerais, Brazil, were prospectively included: Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG), Hospital Júlia Kubitschek (HJK) and Hospital Eduardo de Menezes (HEM), who, upon admission to hospital, presented with Severe Acute Respiratory Syndrome due to COVID-19. Clinical and laboratory variables and outcomes during hospitalization were prospectively collected from the electronic medical records. The collection of sociodemographic and symptomatology data during the acute phase was carried out prospectively in electronic medical records and confirmed with the patients at a subsequent outpatient visit. Results: The most frequently reported symptoms were dyspnea (77.4%), cough (69.8%) and fever (55.2%). During the acute phase of the disease, 95 (38.3%) and 87 (35.1%) patients reported taste and olfaction disorders, respectively. There was a lower prevalence of dysosmia among patients with previous comorbidities (p < 0.05). Both symptoms were associated with less need for intensive care admission (p = 0.001 for dysgeusia and p = 0.021 for dysosmia) and a negative correlation with length of hospital stay (dysosmia: r= −0.175, p < 0.05; dysgeusia: r = −0.29, p < 0.001) and length of stay in the ICU (dysosmia: r = −0.136, p < 0.05; dysgeusia: r = −0.215, p < 0.05). The absence of taste disorders was also associated with a greater need for mechanical ventilation (p < 0.001). Conclusion: Changes in taste and olfaction were reported by a large number of patients in the acute phase of COVID-19. In this study, both were markers of better clinical patient evolution. Level of evidence: 1B.

https://doi.org/10.1016/j.bjorl.2021.11.002

14.

Interpositional arthroplasty with temporal muscle flap - a surgical alternative for condylar ankylosis of the temporomandibular joint
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Bastos, Carlos Eduardo de Jesus

; Gomes, Ana Viviam Souza Ferro

; Jesus, Julia Maria Benites de

; Pereira, Almira Oliveira

; Cerqueira, Caio Cezar Rebouças e

; Leite, Thiago Freitas

Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial

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sep 2022, Volume 63 N. 3 Pages 154 - 158

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

Abstract Ankylosis of the temporomandibular joint (TMJ) is characterized by a bony or fibrous fusion between the articular fossa and the condyle. It represents one of the greatest therapeutic challenges in oral and maxillofacial surgery. Several treatments have been used for its management, such as gap arthroplasty, interpositional arthroplasty, and TMJ reconstruction with autogenous bone graft and alloplastic prostheses. A 39-year-old Black male patient developed a complex mandibular symphysis fracture associated with bilateral high condylar fractures after a motorcycle accident. In the first approach, osteosynthesis was performed to reduce and fix symphysis fractures and conservatively treat the condyles. However, the patient did not proceed with physiotherapy and adequate follow-up, evolving into bilateral ankylosis. Subsequently, he underwent interpositional arthroplasty with a temporal muscle flap. The treatment of ankylosis is imperatively surgical and aims to release the joint and reanatomize the region, restoring functionality to the stomatognathic system. The choice of technique depends on many factors, including age. In children, gap arthroplasty is the most frequent choice because it helps in the centrality of condylar growth. In adult patients, gap arthroplasty with interposition of the temporal muscle is eligible, as it restores function and reduces the recurrence of bone fusion and consequent re-ankylosis. (Rev Port Estomatol Med Dent Cir Maxilofac. 2022;63(3):154-158)

Re s u m o A anquilose da articulação temporomandibular (ATM) é caracterizada pela fusão óssea ou fibrosa da fossa articular com a cabeça da mandíbula. Representa um dos maiores desafios terapêuticos na cirurgia oral e maxilofacial. Tratamentos diversos têm sido utilizados para o seu manuseamento, tais como artroplastia de gap, artroplastia interposicional e reconstrução da ATM com enxerto ósseo autógeno e próteses aloplásticas. Paciente do sexo masculino, 39 anos, melanoderma, vítima de acidente motociclístico evoluiu com fratura complexa de sínfise mandibular associada a fraturas altas dos côndilos bilateralmente. Numa primeira abordagem, foi realizada a osteossíntese para redução e fixação das fraturas da sínfise e tratamento conservador dos côndilos. Entretanto, o paciente não prosseguiu com a fisioterapia e acompanhamento orientados, evoluindo para anquilose bilateral. Foi posteriormente submetido a artroplastia interposicional com retalho do músculo temporal. O tratamento das anquiloses é imperativamente cirúrgico e tem como objetivo a liberação da articulação e reanatomização da região, devolvendo funcionalidade ao sistema estomatognático. A escolha da técnica depende de alguns fatores, incluindo a idade. Em crianças, a artroplastia em gap é a escolha mais frequente pois auxilia na centralidade do crescimento condilar. Em pacientes adultos, a artroplastia em gap com interposição do músculo temporal é elegível, pois devolve a função e diminui a recidiva da fusão óssea e consequente re-anquilose

https://doi.org/10.24873/j.rpemd.2022.09.877

15.

Depressão entre estudantes de Medicina no ano de 2022: um estudo comparativo entre o ensino tradicional e o ativo
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Montenegro-Pires, Júlia Leite

; Alves de Sousa, Milena Nunes

CES Medicina

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sep 2022, Volume 36 N. 3 Pages 9 - 25

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

Resumen Introducción: la depresión es un trastorno mental recurrente e incapacitante, que resulta de la influencia de factores sociales, psicológicos y biológicos. Entre los cursos académicos, la Medicina presenta la mayor prevalencia de esta psicopatología. Objetivo: comparar las tasas de depresión entre estudiantes de medicina matriculados en instituciones que adoptan metodologías activas y tradicionales. Metodología: investigación de campo, transversal, con abordaje cuantitativo realizada a través de formulario disponible en redes sociales y aprobado por el Comité de Ética (n° 5.210.194/2021). Para la recolección de datos se utilizó el Inventario de Beck, que se aplicó a 138 estudiantes. Los datos se analizaron mediante estadística descriptiva simple y para inferir predicciones entre variables se utilizó regresión logística binaria (método enter), U de Mann-Whitney para comparación entre grupos y cálculos de tamaño del efecto (r), además de Chi - cuadrado de Pearson (2x4) para asociaciones y cálculos de prevalencia para cada grupo (p < 0,05). Resultados: la investigación mostró una media de edad de 23,55 ±3,96 y predominio del sexo femenino (65,33%). Se observó una prevalencia de depresión entre los estudiantes de medicina de octavo año del 36,6%. Se pudo observar que la metodología de enseñanza y la depresión tuvieron un impacto estadísticamente significativo en los deseos suicidas. Así mismo, no fue posible encontrar diferencias estadísticamente significativas entre metodologías de enseñanza (metodologías activas y metodología tradicional) y depresión (U = 1633.000, z = -1.488, p < 0.13). Conclusión: los hallazgos de este estudio refuerzan la necesidad de más investigaciones, especialmente comparando la enseñanza tradicional y activa, ya que son escasas. Además, la evaluación de la salud mental de los estudiantes de medicina es fundamental, ya que es necesario cuidar a la persona que brindará la atención.

Resumo Introdução: a depressão consiste é um transtorno mental recorrente e incapacitante, resultante da influência de fatores sociais, psicológicos e biológicos, dentre os cursos acadêmicos, têm-se o de Medicina com maior prevalência desta psicopatologia. Objetivo: comparar os índices de depressão entre acadêmicos de Medicina inseridos em instituições que adotam as metodologias ativas e tradicionais. Metodologia: pesquisa de campo, transversal, com abordagem quantitativa realizada por meio de formulário disponibilizado em redes sociais e aprovada pelo Comitê de Ética (no 5.210.194/2021). Para a coleta de dados, utilizou-se o Inventário de Beck, o qual foi aplicado a 138 estudantes. Os dados foram analisados mediante estatística descritiva simples e para inferir predição entre as variáveis, usou-se a regressão logística binária (método enter), U de Mann-Whitney para comparação entre grupos e cálculos de tamanho de efeito (r), além do Qui-quadrado de Pearson (2x4) para associações e cálculos de prevalência para cada grupo (p < 0,05). Resultados: a pesquisa mostrou uma média de idade foi de 23,55 ±3,96 e predomínio do sexo feminino (65,33%). Observou-se prevalência de depressão entre estudantes do oitavo período de medicina de 36,6%. Foi possível observar a metodologia do ensino e a depressão tiveram impacto estatisticamente significativo nos desejos suicidas. Ainda, que não foi possível encontrar diferenças estatisticamente significativas entre metodologias de ensino (metodologias ativas e metodologia tradicional) e depressão (U = 1633,000, z = -1,488, p < 0,13). Conclusão: os achados deste estudo reforçam a necessidade de novas pesquisas, especialmente comparativas entre ensino tradicional e ativo, uma vez que são escassas. Ademais, avaliar a saúde mental dos acadêmicos de medicina é fundamental, pois é preciso cuidar daquele que vai prover o cuidado.

Abstract Introduction: depression is a recurrent and disabling mental disorder, resulting from the influence of social, psychological and biological factors, among the academic courses, Medicine has the highest prevalence of this psychopathology. Objective: to compare depression rates among medicine students enrolled in institutions that adopt active and traditional methodologies. Methodology: field research, cross-sectional, was a quantitative approach, carried out through a form available on social networks and approved by the Ethics Committee (n° 5.210.194/2021). For data collection, the Beck Inventory was used, which was applied to 138 students. Data were analyzed using simple descriptive statistics and to infer prediction between variables, binary logistic regression (enter method), Mann-Whitney U for comparison between groups and effect size calculations (r) were used, in addition to Pearson's chi-square (2x4) for associations and calculations of prevalence for each group (p < 0,05). Results: the research showed a mean age of 23,55 ±3,96 and a predominance of females (65,33%). A prevalence of depression was observed among eighth-year medical students of 36,6%. It was possible to observe the teaching methodology and depression had a statistically significant impact on suicidal desires. Furthermore, it was not possible to find statistically significant differences between teaching methodologies (active methodologies and traditional methodology) and depression (U = 1633,000, z = -1,488, p < 0,13). Conclusion: the results of this study reinforce the necessity for further research, especially comparing traditional and active teaching, since they are scarce. In addition, assessing the mental health of medical students is fundamental, as it is necessary to take care of the person who will provide care.

https://doi.org/10.21615/cesmedicina.6831

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