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JUDICIAL LIMITS OVER THE ADMINISTRATIVE DISCRETIONARY ACT: ANALYSIS OF THE DECISIONS OF THE INJUNCTIONS GRANTED IN ACO 3.451/DF BY THE BRAZILIAN SUPREME COURT
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Azevedo, Edgar Meira Pires de

; D’Assunção, Maria Esther Alencar Advíncula

; Presgrave, Ana Beatriz Ferreira Rebello

Revista Internacional CONSINTER de Direito - Publicação Oficial do Conselho Internacional de Estudos Contemporâneos em Pós-Graduação

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Dez 2023, Nº 17 Páginas 539 - 558

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo A grave situação sanitária decorrente da pandemia de Covid-19, além do quadro de emergência mundial de saúde também gerou crises profundas nos campos econômico, político-ideológico e de governabilidade, o que levou ao Judiciário diversas questões que, em situação de normalidade, não seriam de sua alçada. Diante disso o presente trabalho objetiva abordar a decisão proferida pelo Supremo Tribunal Federal (STF) no julgamento da ACO 3.451/DF, na qual a Corte possibilitou a autorização automática para que o Estado do Maranhão importasse e distribuísse a vacina Sputnik V para a sua população. Por decorrência, a pesquisa tem como problemática central analisar se referida postura, além de promover a releitura do controle do ato administrativo pelo Judiciário está de acordo com os dispositivos constitucionais. Realiza-se então uma pesquisa de finalidade básica estratégica, objetivo descritivo e exploratório, sob o método dedutivo, com abordagem qualitativa e realizada pelos procedimentos bibliográficos e documentais. Ao fim, verifica-se que a decisão tomada pelo STF no julgamento da ACO 3451/DF afronta o princípio da divisão funcional do poder, expresso no art. 2º da Constituição Federal, bem como culmina por violar o próprio direito à saúde, disposto no art. 196 da Carta Maior. Ademais, a maior contribuição da pesquisa está, justamente, em possibilitar a discussão da posição adotada pela Corte diante da inefetiva gestão do Executivo em razão da crise sanitária que se instaurou com a pandemia de Covid-19.

Abstract The serious health situation resulting from the Covid-19 pandemic, in addition to the global health emergency, also generated deep crises in the economic, political-ideological and governance fields, which led to the Judiciary several issues that, in a normal situation, would not be within its jurisdiction. Therefore, this paper aims to address the decision rendered by the Federal Supreme Court (STF) in ACO 3.451/DF, in which the Court allowed the automatic authorization for the State of Maranhão to import and distribute the Sputnik V vaccine for its population. Consequently, the central problem of this research is to analyze whether this position, in addition to promoting a re-reading of the control of the administrative act by the Judiciary, is in accordance with the constitutional provisions. This is a research of strategic basic purpose, descriptive and exploratory objective, under the deductive method, with a qualitative approach and performed through bibliographic and documental procedures. In the end, it is verified that the decision taken by the STF in the judgment of ACO 3451/DF affronts the principle of the functional division of power, expressed in art. 2 of the Federal Constitution, and also culminates in violating the right to health itself, set forth in art. 196 of the Constitution. Moreover, the greatest contribution of the research is, precisely, in enabling the discussion of the position adopted by the Court before the ineffective management of the Executive due to the health crisis that has been established with the Covid-19 pandemic.

https://doi.org/10.19135/revista.consinter.00017.25

The II Brazilian Guidelines for the pharmacological treatment of patients hospitalized with COVID-19 Joint Guidelines of the Associação Brasileira de Medicina de Emergência, Associação de Medicina Intensiva Brasileira, Associação Médica Brasileira, Sociedade Brasileira de Angiologia e Cirurgia Vascular, Sociedade Brasileira de Infectologia, Sociedade Brasileira de Pneumologia e Tisiologia and Sociedade Brasileira de Reumatologia
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Falavigna, Maicon

; Araujo, Cintia Laura Pereira de

; Barbosa, Alexandre Naime

; Belli, Karlyse Claudino

; Colpani, Verônica

; Dal-Pizzol, Felipe

; Silva, Rosemeri Maurici da

; Azevedo, Luciano César Pontes de

; Dias, Maria Beatriz Souza

; Amaral, José Luiz Gomes do

; Dorneles, Gilson Pires

; Ferreira, Juliana Carvalho

; Freitas, Ana Paula da Rocha

; Gräf, Débora Dalmas

; Guimarães, Hélio Penna

; Lobo, Suzana Margareth Ajeje

; Machado, Flávia Ribeiro

; Nunes, Michelle Silva

; Oliveira, Maura Salaroli de

; Parahiba, Suena Medeiros

; Rosa, Regis Goulart

; Santos, Vania Cristina Canuto

; Sobreira, Marcone Lima

; Veiga, Viviane Cordeiro

; Xavier, Ricardo Machado

; Zavascki, Alexandre Prehn

; Stein, Cinara

; Carvalho, Carlos Roberto Ribeiro de

Critical Care Science

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Set 2023, Volume 35 Nº 3 Páginas 243 - 255

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

ABSTRACT Objective: To update the recommendations to support decisions regarding the pharmacological treatment of patients hospitalized with COVID-19 in Brazil. Methods: Experts, including representatives of the Ministry of Health and methodologists, created this guideline. The method used for the rapid development of guidelines was based on the adoption and/or adaptation of existing international guidelines (GRADE ADOLOPMENT) and supported by the e-COVID-19 RecMap platform. The quality of the evidence and the preparation of the recommendations followed the GRADE method. Results: Twenty-one recommendations were generated, including strong recommendations for the use of corticosteroids in patients using supplemental oxygen and conditional recommendations for the use of tocilizumab and baricitinib for patients on supplemental oxygen or on noninvasive ventilation and anticoagulants to prevent thromboembolism. Due to suspension of use authorization, it was not possible to make recommendations regarding the use of casirivimab + imdevimab. Strong recommendations against the use of azithromycin in patients without suspected bacterial infection, hydroxychloroquine, convalescent plasma, colchicine, and lopinavir + ritonavir and conditional recommendations against the use of ivermectin and remdesivir were made. Conclusion: New recommendations for the treatment of hospitalized patients with COVID-19 were generated, such as those for tocilizumab and baricitinib. Corticosteroids and prophylaxis for thromboembolism are still recommended, the latter with conditional recommendation. Several drugs were considered ineffective and should not be used to provide the best treatment according to the principles of evidence-based medicine and to promote resource economy.

RESUMO Objetivo: Atualizar as recomendações para embasar as decisões para o tratamento farmacológico de pacientes hospitalizados com COVID-19 no Brasil. Métodos: A elaboração desta diretriz foi feita por especialistas, incluindo representantes do Ministério da Saúde e metodologistas. O método utilizado para o desenvolvimento rápido de diretrizes baseou-se na adoção e/ou adaptação de diretrizes internacionais existentes (GRADE ADOLOPMENT) e contou com o apoio da plataforma e-COVID-19 RecMap. A qualidade das evidências e a elaboração das recomendações seguiram o método GRADE. Resultados: Chegaram-se a 21 recomendações, incluindo recomendações fortes quanto ao uso de corticosteroides em pacientes em uso de oxigênio suplementar e recomendações condicionais para o uso de tocilizumabe e baricitinibe, em pacientes com oxigênio suplementar ou ventilação não invasiva, e de anticoagulantes, para prevenção de tromboembolismo. Devido à suspensão da autorização de uso, não foi possível fazer recomendações para o tratamento com casirivimabe + imdevimabe. Foram feitas recomendações fortes contra o uso de azitromicina em pacientes sem suspeita de infecção bacteriana, hidroxicloroquina, plasma convalescente, colchicina e lopinavir + ritonavir, além de recomendações condicionais contra o uso de ivermectina e rendesivir. Conclusão: Foram criadas novas recomendações para o tratamento de pacientes hospitalizados com COVID-19, como as recomendações de tocilizumabe e baricitinibe. Ainda são recomendados corticosteroides e profilaxia contra tromboembolismo, esta em caráter condicional. Vários medicamentos foram considerados ineficazes e não devem ser usados, no intuito de proporcionar o melhor tratamento segundo os princípios da medicina baseada em evidências e promover a economia de recursos.

https://doi.org/10.5935/2965-2774.20230136-en

Associação entre indicadores da capacidade funcional e do estado nutricional em idosos da comunidade: uma nova abordagem
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Wanderley, Emilia Maria

; Coimbra, Arlete Maria Valente

; Falsarella, Gláucia Maria

; Gasparotto, Lívia Pimenta Renó

; Barros-Neto, João Araújo

; Costallat, Beatriz Lavras

; Ferreira, Daniel Miranda

; Borim, Flávia Silva Arbex

; Corona, Ligiana Pires

; Coimbra, Ibsen Bellini

Cadernos Saúde Coletiva

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2023, Volume 31 Nº 1 elocation e31010443

Resumo: En Pt | Texto: En Pt | PDF: En | PDF: Pt

Abstract Background Changes in the body composition of the elderly can be quickly identified by health professionals in primary care, reducing the impact on health, nutritional status, and functional capacity. Objective To look for links between muscle mass and strength, nutritional status, and functional capacity in community-dwelling elderly. Method A cross-sectional study involving 323 elderly people was carried out. Body composition assessment was performed by absorptiometry (DEXA) and anthropometry. Functional capacity was assessed by Instrumental Activities of Daily Living and by gait speed (VM) and Time Up and Go (TUG). Results In this sample, the lean mass index (LMI) was associated with indicators of nutritional status (BMI, NC, and WC), in addition to having shown an important correlation with handgrip strength (HGS). HGS was associated with VM and TUG. Regression analysis identified an association between BMI and LMI (p < 0.001) and between GS and HGS (p = 0.003). Conclusion HGS was an important indicator of functional capacity and correlated with LMI. Consequently, the LMI is associated with indicators of nutritional status. Therefore, when it is impossible to assess the LMI, we recommend the assessment of HGS, NC and BMI as predictors of compromised nutritional status and functional disability in the elderly.

Resumo Introdução Alterações na composição corporal do idoso podem ser rapidamente identificadas por profissionais de saúde na Atenção Básica, reduzindo o impacto sobre a saúde, o estado nutricional e a capacidade funcional. Objetivo Identificar relações entre massa e força muscular com o estado nutricional e a capacidade funcional em idosos da comunidade. Método Estudo transversal, envolvendo 323 idosos. A avaliação da composição corporal foi realizada por absorciometria (DEXA) e antropometria. A capacidade funcional foi avaliada pelas Atividades Instrumentais de Vida Diária, pela velocidade da marcha (VM) e Time Up and Go (TUG). Resultados Nesta amostra, o índice de massa magra (IMM) se mostrou associado aos indicadores do estado nutricional (IMC, CP e CC), além de ter apresentado importante correlação com a força de preensão palmar (FPP). A FPP esteve relacionada à VM e ao TUG. A análise de regressão identificou associação entre o IMC e o IMM (p<0,001), bem como entre a VM e a FPP (p=0,003). Conclusão A FPP se apresentou como importante indicador da capacidade funcional e se mostrou correlacionada com o IMM. Consequentemente, o IMM está associado aos indicadores do estado nutricional. Logo, na impossibilidade de avaliação do IMM, recomendamos a avaliação da FPP, CP e IMC como preditores de comprometimento do estado nutricional e da incapacidade funcional do idoso.

https://doi.org/10.1590/1414-462x202331010443

Pain Perception Before Endodontic Treatment: from Primary Care to Specialized Care
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Lima, Rafael Franco

; Magalhães, Maria Beatriz Pires

; Oliveira, Douglas Vaz

; Freitas, Daniel Augusto Sabadini

; Ferreira, Efigênia Ferreira

; Martins, Renata Castro

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2022, Volume 22 elocation e200183

Resumo: En | Texto: En | PDF: En

Abstract Objective: To analyze patients’ pain perception requiring endodontic treatment referred to a Dental Specialties Center. Material and Methods: Data was collected through a self-administered questionnaire for patients about their experience of pain and another for endodontists about the treatment performed. The results were analyzed descriptively using Pearson’s Chi-square test and Fisher’s Exact test, with Bonferroni correction (p≤0.05). Results: The median age of the patients was 39 years, and 71.1% were female. The median waiting time for treatment was five months. Pain was reported by 75.2% of patients, occurred more than one month earlier (63.6%), with moderate/severe intensity (66.9%), and most patients sought emergency treatment more than once (79.1%). In addition, pain was associated with sex (female; p=0.008); moderate/severe intensity (p<0.001); the number of times that patient had to go to the dentist because of the tooth treatment (twice or more; p=0.002); and type of tooth treated (posterior tooth; p=0.002). Conclusion: Severe pain episodes resulted in a repeated search for emergency services, which may overload the primary care service, especially if the waiting time for endodontic treatment is long.

https://doi.org/10.1590/pboci.2022.034

Chronic use of hydroxychloroquine did not protect against COVID-19 in a large cohort of patients with rheumatic diseases in Brazil
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Pileggi, Gecilmara Salviato

; Ferreira, Gilda Aparecida

; Gomides Reis, Ana Paula Monteiro

; Reis Neto, Edgard Torres

; Abreu, Mirhelen Mendes

; Albuquerque, Cleandro Pires

; Araújo, Nafice Costa

; Bacchiega, Ana Beatriz

; Bianchi, Dante Valdetaro

; Bica, Blanca

; Bonfa, Eloisa Duarte

; Borba, Eduardo Ferreira

; Brito, Danielle Christinne Soares Egypto

; Duarte, Ângela Luzia Branco Pinto

; Santo, Rafaela Cavalheiro Espírito

; Fernandes, Paula Reale

; Guimarães, Mariana Peixoto

; Gomes, Kirla Wagner Poti

; Kakehasi, Adriana Maria

; Klumb, Evandro Mendes

; Lanna, Cristina Costa Duarte

; Marques, Claudia Diniz Lopes

; Monticielo, Odirlei André

; Mota, Licia Maria Henrique

; Munhoz, Gabriela Araújo

; Paiva, Eduardo Santos

; Pereira, Helena Lucia Alves

; Provenza, José Roberto

; Ribeiro, Sandra Lucia Euzébio

; Rocha Junior, Laurindo Ferreira

; Sampaio, Camila Santana Justo Cintra

; Sampaio, Vanderson Souza

; Sato, Emília Inoue

; Skare, Thelma

; de Souza, Viviane Angelina

; Valim, Valeria

; Lacerda, Marcus Vinícius Guimarães

; Xavier, Ricardo Machado

; Pinheiro, Marcelo Medeiros

Advances in Rheumatology

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2021, Volume 61 elocation 60

Resumo: En | Texto: En | PDF: En

Abstract Background: There is a lack of information on the role of chronic use of hydroxychloroquine during the SARS-CoV-2 outbreak. Our aim was to compare the occurrence of COVID-19 between rheumatic disease patients on hydroxychloroquine with individuals from the same household not taking the drug during the first 8 weeks of community viral transmission in Brazil. Methods: This baseline cross-sectional analysis is part of a 24-week observational multi-center study involving 22 Brazilian academic outpatient centers. All information regarding COVID-19 symptoms, epidemiological, clinical, and demographic data were recorded on a specific web-based platform using telephone calls from physicians and medical students. COVID-19 was defined according to the Brazilian Ministry of Health (BMH) criteria. Mann-Whitney, Chi-square and Exact Fisher tests were used for statistical analysis and two binary Final Logistic Regression Model by Wald test were developed using a backward-stepwise method for the presence of COVID-19. Results: From March 29th to May 17st, 2020, a total of 10,443 participants were enrolled, including 5166 (53.9%) rheumatic disease patients, of whom 82.5% had systemic erythematosus lupus, 7.8% rheumatoid arthritis, 3.7% Sjögren’s syndrome and 0.8% systemic sclerosis. In total, 1822 (19.1%) participants reported flu symptoms within the 30 days prior to enrollment, of which 3.1% fulfilled the BMH criteria, but with no significant difference between rheumatic disease patients (4.03%) and controls (3.25%). After adjustments for multiple confounders, the main risk factor significantly associated with a COVID-19 diagnosis was lung disease (OR 1.63; 95% CI 1.03-2.58); and for rheumatic disease patients were diagnosis of systemic sclerosis (OR 2.8; 95% CI 1.19-6.63) and glucocorticoids above 10 mg/ day (OR 2.05; 95% CI 1.31-3.19). In addition, a recent influenza vaccination had a protective effect (OR 0.674; 95% CI 0.46-0.98). Conclusion: Patients with rheumatic disease on hydroxychloroquine presented a similar occurrence of COVID-19 to household cohabitants, suggesting a lack of any protective role against SARS-CoV-2 infection. Trial registration Brazilian Registry of Clinical Trials (ReBEC; RBR - 9KTWX6).

https://doi.org/10.1186/s42358-021-00217-0 22 downloads

Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO)
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Magalhães, Maria Beatriz Pires de

; Oliveira, Douglas Vaz de

; Lima, Rafael Franco de

; Ferreira, Efigênia Ferreira e

; Martins, Renata de Castro

Ciência & Saúde Coletiva

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Dez 2019, Volume 24 Nº 12 Páginas 4643 - 4654

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Objetivou-se avaliar a atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO) de Belo Horizonte (MG). A coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas; (2) sobre o tratamento restaurador, com dados dos prontuários. O programa SPSS 19.0 foi utilizado para analisar os resultados por meio de frequência e percentis. Foram finalizados 452 tratamentos endodônticos em pacientes adultos. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos foi realizada em pré-molares superiores (23,7%), seguida de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o CEO em 81,2% dos casos e finalizado em 24,1% casos (n = 109). A contrarreferência após o tratamento restaurador ocorreu em 58,7% dos casos finalizados. É necessário um planejamento conjunto do tratamento odontológico entre a atenção básica e secundária e, dentro desta última, entre as especialidades, além de um adequado processo de referência e contrarreferência, visando garantir a integralidade do cuidado e a eficiência e eficácia do serviço.

Abstract This study aimed to evaluate secondary endodontic care at a Dental Specialties Center (DSC) in Belo Horizonte, MG. Data collection used two forms: (1) on endodontic treatment, completed by the endodontists (2) on the restorative treatment, with data from the medical records. The SPSS 22.0 program was used to analyze the results using frequency and percentiles. In total, 452 endodontic procedures were completed in adult patients. The patients had a median of 39 years of age, most were female (69.7%) and had a primary care referral order (96.2%). Most endodontic treatments were performed in upper premolars (23.7%) followed by lower molars (22.3%), using a mixed technique (74.1%) and in a single session (64.2%). The referral for restorative treatment was for the DSC in 81.2% of cases and finished in 24.1% (n = 109). The counter-referral following restorative treatment occurred in 58.7% of the completed cases. It is necessary to jointly plan the dental treatment between primary and secondary care and, within the latter, among the specialties, in addition to an adequate referral and counter-referral process aimed at ensuring comprehensive care and efficient and effective service.

https://doi.org/10.1590/1413-812320182412.04112018 2496 downloads

Avaliação da atenção secundária em endodontia em um Centro de Especialidades Odontológicas (CEO)
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Magalhães, Maria Beatriz Pires de

; Oliveira, Douglas Vaz de

; Lima, Rafael Franco de

; Ferreira, Efigênia Ferreira e

; Martins, Renata de Castro

Ciência & Saúde Coletiva

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Dez 2019, Volume 24 Nº 12 Páginas 4643 - 4654

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.1590/1413-812320182412.04112018

Playful educational intervention with schoolchildren on intestinal parasitosis
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Bragagnollo, Gabriela Rodrigues

; Santos, Tâmyssa Simões dos

; Fonseca, Renata Elizabete Pagotti da

; Acrani, Marcelo

; Branco, Maria Zita Pires Castelo

; Ferreira, Beatriz Rossetti

Revista Brasileira de Enfermagem

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Out 2019, Volume 72 Nº 5 Páginas 1203 - 1210

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: Analisar as intervenções educativas lúdicas no conhecimento de escolares sobre enteroparasitoses. Método: Trata-se de estudo quase-experimental, não randomizado, baseado na pré e pós-intervenção, ocorrido em escola pública de ensino fundamental de um bairro da periferia na cidade de Ribeirão Preto (SP). A população do estudo foi composta por 101 alunos que cursavam o 5º e o 6º ano. Para efetuar a comparação foi utilizada a versão generalizada do teste qui-quadrado de McNemar. Resultados: Dos 101 escolares que participaram do estudo, 48 (47,5%) eram do sexo feminino e 53 (52,5%) do sexo masculino, com idade entre 9 a 14 anos. O conhecimento dos alunos sobre enteroparasitoses após a intervenção educativa lúdica aumentou significativamente. Conclusão: As intervenções educativas lúdicas são um excelente recurso didático no contexto do processo ensino-aprendizagem de escolares.

ABSTRACT Objective: To analyze the playful educational interventions in the knowledge of schoolchildren about intestinal parasitosis. Method: This is a quasi-experimental, non-randomized study, based on pre- and post-intervention, conducted in a public elementary school in a peripheric neighborhood in the city of Ribeirão Preto (SP). The study population consisted of 101 students enrolled in the 5th and 6th grade. For comparison, we used the generalized version of the McNemar chi-squared test. Results: Of the 101 schoolchildren who participated in the study, 48 (47.5%) were female and 53 (52.5%) were male, aged from 9 to 14 years. Students’ knowledge on intestinal parasitic infections has increased significantly after the playful educational intervention. Conclusion: Playful educational interventions are an excellent didactical resource in the teaching-learning process of schoolchildren.

RESUMEN Objetivo: Analizar las intervenciones educativas lúdicas en el conocimiento de escolares sobre enteroparasitosis. Método: Se trata de estudio casi-experimental, no aleatorizado, basado en la pre y pos-intervención, que ha sido ocurrido en escuela pública de enseñanza primaria de un barrio de la periferia en la ciudad de Ribeirão Preto (SP). La población del estudio ha sido conformada por 101 alumnos que cursaban el 5º y el 6º año. Para realizar la comparación ha sido utilizada la versión generalizada de la prueba chi-cuadrada de McNemar. Resultados: De los 101 escolares que han participado del estudio, 48 (el 47,5%) eran del sexo femenino y 53 (el 52,5%) del sexo masculino, con edad entre 9 a 14 años. El conocimiento de los alumnos sobre enteroparasitosis después de la intervención educativa lúdica se ha incrementado significativamente. Conclusión: Las intervenciones educativas lúdicas son un excelente recurso didáctico en el contexto del proceso enseñanza-aprendizaje de escolares.

https://doi.org/10.1590/0034-7167-2017-0551 3750 downloads

Playful educational intervention with schoolchildren on intestinal parasitosis
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Bragagnollo, Gabriela Rodrigues

; Santos, Tâmyssa Simões dos

; Fonseca, Renata Elizabete Pagotti da

; Acrani, Marcelo

; Branco, Maria Zita Pires Castelo

; Ferreira, Beatriz Rossetti

Revista Brasileira de Enfermagem

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Out 2019, Volume 72 Nº 5 Páginas 1203 - 1210

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

https://doi.org/10.1590/0034-7167-2017-0551 77 downloads

10.

2017 Guidelines for Arterial Hypertension Management in Primary Health Care in Portuguese Language Countries
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Oliveira, Gláucia Maria Moraes de

; Mendes, Miguel

; Malachias, Marcus Vinícius Bolívar

; Morais, João

; Moreira Filho, Osni

; Coelho, Armando Serra

; Capingana, Daniel Pires

; Azevedo, Vanda

; Soares, Irenita

; Menete, Alda

; Ferreira, Beatriz

; Soares, Miryan Bandeira dos Prazeres Cassandra

; Fernandes, Mário

Arquivos Brasileiros de Cardiologia

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Nov 2017, Volume 109 Nº 5 Páginas 389 - 396

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

https://doi.org/10.5935/abc.20170165 21025 downloads

11.

Timing of thyroid ultrasonography in the etiological investigation of congenital hypothyroidism
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Borges, Maria de Fátima

; Sedassari, Nathalie de Almeida

; Sedassari, Anelise de Almeida

; Souza, Luis Ronan Marquez Ferreira de

; Ferreira, Beatriz Pires

; Lara, Beatriz Hallal Jorge

; Palhares, Heloísa Marcelina Cunha

Archives of Endocrinology and Metabolism

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Set 2017, Volume 61 Nº 5 Páginas 432 - 437

Resumo: En | Texto: En | PDF: En

ABSTRACT Objectives To describe the findings of thyroid ultrasonography (T-US), its contribution to diagnose congenital hypothyroidism (CH) and the best time to perform it. Subjects and methods Forty-four patients with CH were invited to undergo T-US and 41 accepted. Age ranged from 2 months to 45 years; 23 patients were females. All were treated with L-thyroxine; 16 had previously undergone scintigraphy and 30 had previous T-US, which were compared to current ones. Results At the current T-US, the thyroid gland was not visualized in its normal topography in 10 patients (24.5%); 31 T-US showed topic thyroid, 17 with normal or increased volume due to probable dyshormonogenesis, 13 cases of hypoplasia and one case of left-lobe hemiagenesis. One patient had decreased volume due to central hypothyroidism. Scintigraphy scans performed 3-4 years earlier showed 100% agreement with current results. Comparisons with previous T-US showed concordant results regarding thyroid location, but a decrease in current volume was observed in eight due to the use of L-thyroxine, calling the diagnosis of hypoplasia into question. Conclusions The role of T-US goes beyond complementing scintigraphy results. It allows inferring the etiology of CH, but it must be performed in the first months of life. An accurate diagnosis of CH will be attained with molecular study and the T-US can guide this early assessment, without therapy withdrawal.

https://doi.org/10.1590/2359-3997000000239 922 downloads

12.

Treatment of acromegaly patients at the Federal University of Triângulo Mineiro (UFTM): Experience Report
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de Fátima Borges, Maria

; Lara, Beatriz Hallal Jorge

; Tomé, Janaíne Machado

; de Araújo, Leopoldo Prezia

; Bugiga, Flávio Cesar Lucas

; Sousa, Júlio Cláudio

; Soares, Jacqueline Mendes Fonseca

; Dezena, Roberto Alexandre

; Ferreira, Beatriz Pires

Clinics

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Abr 2017, Volume 72 Nº 4 Páginas 218 - 223

Resumo: En | Texto: En | PDF: En

OBJECTIVE: To evaluate the effectiveness of the treatment of acromegaly patients at the Federal University of Triangulo Mineiro. METHODS: Cross-sectional and retrospective study of thirty cases treated over a period of two decades. RESULTS: 17 men (56.7%) aged 14-67 years and 13 women aged 14-86 years were analyzed. Twenty-one patients underwent transphenoidal surgery, whichwas associated with somatostatin receptor ligands in 11 patients (39.3%), somatostatin receptor ligands + radiotherapyin 5 patients (17.8%), radiotherapy in 3 patients (10.7%), and radiotherapy + somatostatin receptorligands + cabergoline in 1 patient (3.6%). Additionally, 2 patients underwent radiotherapy and surgeryalone. Six patients received somatostatin receptor ligands before surgery, and 2 were not treated due to refusal and death. Nine patients have died, and 20 are being followed; 13 (65%) have growth hormonelevels o1 ng/mL, and 11 have normal insulin-like growth factor 1 levels. CONCLUSION: The current treatment options enable patients seen in regional reference centers to achieve strict control parameters, which allows them to be treated close to their homes.

https://doi.org/10.6061/clinics/2017(04)05 829 downloads

13.

Mechanisms of carbapenem resistance in endemic Pseudomonas aeruginosa isolates after an SPM-1 metallo-β-lactamase producing strain subsided in an intensive care unit of a teaching hospital in Brazil
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Cacci, Luciana Camila

; Chuster, Stephanie Gomes

; Martins, Natacha

; Carmo, Pâmella Rodrigues do

; Girão, Valéria Brígido de Carvalho

; Nouér, Simone Aranha

; Freitas, Wania Vasconcelos de

; Matos, Juliana Arruda de

; Magalhães, Ana Cristina de Gouveia

; Ferreira, Adriana Lúcia Pires

; Picão, Renata Cristina

; Moreira, Beatriz Meurer

Memórias do Instituto Oswaldo Cruz

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Set 2016, Volume 111 Nº 9 Páginas 551 - 558

Resumo: En | Texto: En | PDF: En

Carbapenem-resistance mechanisms are a challenge in the treatment of Pseudomonas aeruginosa infections. We investigated changes in P. aeruginosa carbapenem-resistance determinants over a time period of eight years after the emergence of São Paulo metallo-β-lactamase in a university hospital in Rio de Janeiro, Brazil. Patients admitted to the intensive care unit (ICU) were screened for P. aeruginosa colonisation and followed for the occurrence of infections from April 2007 to April 2008. The ICU environment was also sampled. Isolates were typed using random amplified polymorphic DNA, pulsed-field gel electrophoresis and multilocus sequence typing. Antimicrobial susceptibility was determined by disk diffusion and E-test, production of carbapenemases by a modified-CarbaNP test and presence of carbapenemase-encoding genes by polymerase chain reaction. Non-carbapenemase resistance mechanisms studied included efflux and AmpC overexpression by PAβN and cloxacillin susceptibility enhancement, respectively, as well as oprD mutations. From 472 P. aeruginosa clinical isolates (93 patients) and 17 isolates from the ICU environment, high genotypic diversity and several international clones were observed; one environment isolate belonged to the blaSPM-1 P. aeruginosa epidemic genotype. Among isolates from infections, 10 (29%) were carbapenem resistant: none produced carbapenemases, three exhibited all non-carbapenemase mechanisms studied, six presented a combination of two mechanisms, and one exclusively displayed oprD mutations. Carbapenem-resistant P. aeruginosa displayed a polyclonal profile after the SPM-1 epidemic genotype declined. This phenomenon is connected with blaSPM-1 P. aeruginosa replaced by other carbapenem-resistant pathogens.

https://doi.org/10.1590/0074-02760160116 1542 downloads

14.

Clonidine-stimulated growth hormone concentrations (cut-off values) measured by immunochemiluminescent assay (ICMA) in children and adolescents with short stature
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Borges, Maria de Fátima

; Teixeira, Flávia Carolina Cândida

; Feltrin, Aline Karin

; Ribeiro, Karina Alvarenga

; Nascentes, Gabriel Antonio Nogueira

; Resende, Elisabete Aparecida Mantovani Rodrigues

; Ferreira, Beatriz Pires

; Silva, Adriana Paula

; Palhares, Heloísa Marcelina Cunha

Clinics

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Abr 2016, Volume 71 Nº 4 Páginas 226 - 231

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To establish cut-off values for growth hormone concentrations using clonidine as a secretagogue and an immunochemiluminescent assay as the method of measurement and to analyze the response time as well as the influence of gender, nutritional status and pubertal stage. METHODS: A total of 225 tests were performed in 3 patient groups, categorized as group 1 (normal), group 2 (idiopathic short stature) and group 3 (growth hormone deficiency). Among the 199 disease-free individuals, 138 were prepubertal, and 61 were pubertal. Clonidine (0.1 mg/m2) was orally administered, and the growth hormone level was measured by immunochemiluminescent assay. The growth hormone peak and the difference between the growth hormone peak and the baseline level were then analyzed. Statistical analyses were performed using Student’s t-test or the Mann-Whitney test and Kruskal-Wallis test followed by Dunn’s post hoc test. Cut-off values were determined using a receiver operating characteristic curve. RESULTS: Group 1 and group 2 had no difference in growth hormone peak, gender, body mass index standard deviation score, or pubertal stage. Group 3 exhibited a significantly lower growth hormone peak than the other groups did. The receiver operating characteristic curve demonstrated that growth hormone concentrations ≥ 3.0 ng/mL defined responsiveness to clonidine. In total, 3.02% of individuals in group 1 and group 2 were considered false positive, i.e., these children lacked growth hormone deficiency and had a peak below 3.0 ng/mL. CONCLUSION: Clonidine-stimulated growth hormone concentrations ≥3 ng/mL, as measured by immunochemiluminescent assay, suggest responsiveness to the stimulus regardless of gender, body mass index standard deviation score or pubertal stage.

https://doi.org/10.6061/clinics/2016(04)09 1548 downloads

15.

Evaluation of central precocious puberty treatment with GnRH analogue at the Triangulo Mineiro Federal University (UFTM)
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Borges, Maria de Fátima

; Franciscon, Priscila de Melo

; Cambraia, Thamy Contursi

; Oliveira, Débora Matias

; Ferreira, Beatriz Pires

; Resende, Elisabete Aparecida Mantovani Rodrigues de

; Palhares, Heloísa Marcelina Cunha

Archives of Endocrinology and Metabolism

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Dez 2015, Volume 59 Nº 6 Páginas 515 - 522

Resumo: En | Texto: En | PDF: En

Objective To report our experience of treating central precocious puberty (CPP) with a GnRH analogue with respect to the final heights (FH) attained in patients who completed treatment. Subjects and methods Among 105 records of children diagnosed with precocious puberty, 62 cases (54 girls and 8 boys), who were treated with leuprolide acetate/3.75 mg/monthly, were selected, and divided into 4 groups: group 1 (G1), 25 girls who attained FH; group 2 (G2), 18 girls who completed treatment but did not reach FH; group 3 (G3), 11 girls still under treatment; and group 4 (G4), 8 boys, 5 of which attained FH. Treatment was concluded at a bone age of 12 years, and follow-up continued until FH was achieved. Results In both G1 and G2 groups, height standard deviation score (SDS), weight-SDS and percentile of body mass index (PBMI) did not show intra/intergroup differences at the beginning and at interruption of treatment, but when added, G1+G2, height-SDS and weight-SDS differed significantly (p = 0.002 and 0.0001, respectively). In G1, 19 of 25 cases attained TH, and average height gain was 16.7 cm (7.7- 27.1); there was significant difference between FH and prediction of FH at the start (PFH at start) (p = 0.0001), as well as between PFH at interruption vs TH and vs FH (p = 0.007) with FH higher than TH (p = 0.004). Significant correlation was identified between FH and height gain after treatment. Conclusion As shown by some studies, GnRH analogue treatment was effective in children with CPP reaching FH near the genetic target.

https://doi.org/10.1590/2359-3997000000101 1973 downloads

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