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Abstract Background Controlling blood pressure and glycemic levels is a challenge that requires innovative solutions. Objective To assess the feasibility of implementing a text message intervention among low-income primary care patients, as well as to assess self-reported behavioral change. Methods A set of 200 text messages was developed on healthy eating, physical activity, adherence, and motivation. Participants from Vale do Mucuri, MG, Brazil diagnosed with diabetes or hypertension or undergoing screening for those diseases, received 5 to 8 messages per week for 6 months. They answered a questionnaire to report their satisfaction and behavioral changes. Results Of the 136 patients, 117 (86.0%) answered the questionnaire. Most reported that the messages were very useful (86.3%), easy to understand (90.6%), and were very helpful for behavioral change (65.0%); 84.6% reported that they had started eating healthier. The most frequent reported lifestyle changes were: improved diet quality (85.5%), reduced portions (65.8%), and weight loss (56.4%). The majority of patients shared the messages (60.7%) with family or other acquaintances, considered the number of messages to be adequate (89.7%) and would recommend the program to others (95.7%). Conclusion An intervention based on text messages to promote behavioral change in patients with hypertension or diabetes in primary care is feasible in low-resource settings. Future studies are needed to assess the program’s long-term effects on clinical outcomes.

https://doi.org/10.36660/ijcs.20220050

Thoracoscopy pulmonary biopsy by two portals with a novel pre-tied loop ligature device in rabbits: an experimental study
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Wittmaack, Monica Carolina Nery

; Sembenelli, Guilherme

; Conceição, Maria Eduarda Bastos Andrade Moutinho da

; Montanhim, Gabriel Luiz

; Crivellaro, Roberta Martins

; Rolemberg, Daniele Santos

; Dias, Luis Gustavo Gosuen Gonçalves

; Silva, Marco Augusto Machado da

; Teixeira, Pedro Paulo Maia

; Moraes, Paola Castro

Ciência Rural

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2023, Volume 53 Nº 2 elocation e20210230

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

ABSTRACT: Thoracoscopy is replacing open lung biopsies because it is less invasive, usually the technique is done using three portals and intracorporeal suture technique. This study described the feasibility and efficacy of a novel pre tied loop ligature and to propose a thoracoscopic access strategy with two portals to perform lung biopsy in patients under 5 kg. Ten rabbits were positioned in dorsal recumbency. Total thoracoscopic lung biopsy was performed using a combined transdiaphragmatic approach and a right intercostal approach. A pre tied loop ligature was placed to perform a caudal lung lobe biopsy. Insufflation of the thoracic cavity was not performed. The total surgery time was 41.4 ± 14.5 min. The procedure was carried out free of complications that prevented slippage or tightening the knot or that made it come loose after the lung biopsy; there was no serious complication during the surgical procedure. The samples obtained averaged 1x0.64x0.45 cm (Length, Width, Depth) and were considered satisfactory according to the histopathologic evaluation. Thorax radiographs taken before and after the surgeries were compared and showed no pneumothorax or hemothorax. Necropsy confirmed no knot failure occurred at the biopsy site. The use of the novel pre tied loop ligature is a safe and effective technique, avoiding problems with the limited size of the thoracic cavity in small patients.

RESUMO: A toracoscopia está substituindo as biópsias pulmonares abertas por ser menos invasiva. Usualmente a técnica é feita utilizando três portais e ligaduras feitas intra corporalmente. O objetivo deste estudo foi descrever a viabilidade e eficácia de uma nova ligadura com alça pré-amarrada e propor uma estratégia de acesso toracoscópico com dois portais para realizar biópsia pulmonar em pacientes com menos de 5kg. Dez coelhos foram posicionados em decúbito dorsal. A biópsia pulmonar por toracoscopia total foi feita pela abordagem combinada transdiafragmática e abordagem intercostal direita. Uma nova ligadura pré-amarrada foi colocada para realizar uma biópsia do lobo pulmonar caudal. Não foi realizada insuflação da cavidade torácica. O tempo total de cirurgia foi de 41,4 ± 14,5 min. Os procedimentos foram realizados sem complicações que impedissem o escorregamento ou aperto do nó ou que o soltassem após a biópsia pulmonar; não houve nenhuma intercorrência grave durante o procedimento cirúrgico. As amostras coletadas tinham tamanho médio 1x0,64x0,45 cm e foram consideradas satisfatórias de acordo com a avaliação histopatológica. As radiografias de tórax feitas antes e depois das cirurgias foram comparadas e não mostraram pneumotórax ou hemotórax. A necropsia confirmou que não ocorreu falha do nó no local da biópsia. Conclui-se que uso da nova ligadura com alça pré-amarrada é uma técnica segura e eficaz, evitando problemas com o tamanho limitado da cavidade torácica em pacientes pequenos.

https://doi.org/10.1590/0103-8478cr20210230

Could retrograde reperfusion combined with washout technique broaden the applicability of marginal grafts in liver transplantation? Intra-operative and short-term outcomes of a prospective cohort
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CIRILO NETO, OLIVAL

; MOUTINHO, LUIZ EDUARDO RAFAEL

; MELO, PAULO SÉRGIO VIEIRA DE

; COSTA, LUDMILA RODRIGUES

; RABÊLO, PRISCYLLA JENNIE MONTEIRO

; AMORIM, AMERICO GUSMÃO

; MELO, CLÁUDIO MOURA LACERDA

Revista do Colégio Brasileiro de Cirurgiões

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2023, Volume 50 elocation e20233489

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

ABSTRACT Introduction: many revascularization techniques were designed to reduce the imbalance of ischemia-reperfusion injury. This study’s objective is to evaluate retrograde reperfusion (RR) compared to sequential anterograde reperfusion (AR), with and without the washout technique (WO). Method: this prospective cohort study collected data from 94 deceased donor orthotopic liver transplants and divided it into three groups: RR with WO (RR+WO), AP with WO (AR+WO), and AP without WO (AR). This study did not assign the reperfusion technique to the participants. The primary outcome considered the early graft dysfunction, and secondary outcomes included post-reperfusion syndrome (PRS), post-reperfusion lactate, surgery fluid balance, and vasoactive drug dose during the surgery. Results: 87 patients were submitted to the final analysis-29 in the RR+WO group, 27 in the AR+WO group, and 31 in the AR group. Marginal grafts prevalence was not significantly different between the groups (34% vs. 22% vs. 23%; p=0.49) and early graft dysfunction occurred at the same rate (24% vs. 26% vs. 19%; p=0.72). RR+WO reduced serum post-reperfusion lactate (p=0.034) and the incidence of significant PRS (17% vs. 33% vs. 55%; p=0.051), but norepinephrine dosing >0.5mcg/kg/min were not different during the surgery (20,7% vs. 29,6% vs. 35,5%, p=0.45). Conclusions: primary outcome was not significantly different between the groups; however, intraoperative hemodynamic management was safer using the RR+WO technique. We theorized that the RR+WO technique could reduce the incidence of PRS and benefit marginal graft survival following diseased donor orthotopic liver transplantation.

RESUMO Introdução: várias técnicas de reperfusão foram desenvolvidas a fim de reduzir o dano da lesão induzida por isquemia-reperfusão. Este estudo objetivou avaliar a reperfusão retrograda (RR) comparado com a reperfusão anterógrada (AR), com e sem a realização da técnica de lavagem do enxerto (WO). Métodos: coorte prospectiva com 94 transplantes ortotópicos de fígado de doador falecido divididos em três grupos: RR com WO (RR+WO), reperfusão anterógrada com WO (AR+WO), e AR sem WO (AR). Este estudo não designou a técnica de reperfusão entre os participantes. O desfecho primário considerou a disfunção precoce do enxerto, e os desfechos secundários incluíram a síndrome pós-reperfusão (SPR), lactato pós-reperfusão, balanço hídrico operatório, e uso de drogas vasoativas durante o ato peratório. Resultados: 87 pacientes foram submetidos para consolidação dos dados-29 no RR+WO, 27 no AR+WO, e 31 no AR. A prevalência de enxertos maginais não diferiu entre os grupos (34% vs 22% vs 23%; p=0,49). Disfunção precoce do enxerto ocorreu em uma proporção similar (24% vs 26% vs 19%; p=0,72). RR+WO reduziu o lactato sérico pós-reperfusão (p=0,034) e a incidência de SPR severa (17% vs 33% vs 55%; p=0,051), entretanto a infusão de noradrenalina >0,5mcg/kg/min não foi diferente durante a cirurgia (20,7% vs 29,6% vs 35,5%, p=0,45). Conclusões: o desfecho primário não diferiu significativamente entre os grupos; entretanto, o manejo hemodinâmico intra-operatório foi mais seguro no grupo RR+WO. Nós teorizamos que a técnica RR+WO pode reduzir a SPR e beneficiar enxertos marginais no transplante de fígado.

https://doi.org/10.1590/0100-6991e-20233489-en

Biomechanical evaluation of four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs
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Ferreira, Danyelle Rayssa Cintra

; Dias, Luís Gustavo Gosuen Gonçalves

; Minto, Bruno Watanabe

; Rocha, Thiago André Salvitti de Sá

; Malta, Caio Afonso dos Santos

; Conceição, Maria Eduarda Bastos Andrade Moutinho da

; Lucena, Dayvid Vianêis Farias de

Acta Cirúrgica Brasileira

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2023, Volume 38 elocation e383223

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: This study compared, through biomechanical evaluation under ventral flexion load, four surgical techniques for ventral stabilization of the atlantoaxial joint in dogs. Methods: In total, 28 identical atlantoaxial joint models were created by digital printing from computed tomography images of a dog, and the specimens were divided into four groups of seven. In each group, a different technique for ventral stabilization of the atlantoaxial joint was performed: transarticular lag screws, polyaxial screws, multiple screws and bone cement (polymethylmethacrylate–PMMA), and atlantoaxial plate. After the stabilization technique, biomechanical evaluation was performed under ventral flexion load, both with a predefined constant load and with a gradually increasing load until stabilization failure. Results: All specimens, regardless of stabilization technique, were able to support the predefined load without failing. However, the PMMA method provided significant more rigidity (p ≤ 0.05) and also best resisted the gradual increase in load, supporting a significantly higher maximum force (p ≤ 0.05). There was no statistical difference in flexural strength between the transarticular lag screws and plate groups. The polyaxial screws method was significantly less resistant to loading (p ≤ 0.05) than the other groups. Conclusions: The PMMA technique had biomechanical advantages in ventral atlantoaxial stabilization over the other evaluated methods.

https://doi.org/10.1590/acb383223

Determinantes das irregularidades na gestão pública municipal: o caso dos municípios do estado de São Paulo
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SILVA, ABINAIR BERNARDES DA

; FERREIRA, AUGUSTA DA CONCEIÇÃO SANTOS

; MOUTINHO, VICTOR FERREIRA

Revista de Administração Pública

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2023, Volume 57 Nº 5 elocation e2022-0398

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

Abstract The municipal external control exercised by the Courts of Accounts reveals the irregularities found in the accounts of municipal governments through the disclosure of audit reports. They have been empirically analyzed from the point of view of their classification in terms of severity, but few studies aim to identify the factors that influence such failures. Having verified this gap, the main objective of this study is to identify factors that may influence lapses in municipal public management pointed out by the audit of the Court of Accounts. This article contributes to further research on this topic and to improving management in municipalities. This is an exploratory analysis based on econometric models for panel data. The sample includes 179 municipalities in São Paulo, with data for 2011, 2013, 2015, 2017, and 2019. The results suggest that the recommendations and determinations of the Court of Accounts and gaps in internal controls influence irregularities in small, medium, and large municipalities. The volume of legal and constitutional transfers received influences small and medium-sized municipalities, while the municipal gross domestic product (GDP) influences medium-sized municipalities.

Resumen El control municipal externo que ejercen los Tribunales de Cuentas permite, a través de la divulgación de informes de auditoría, conocer las irregularidades encontradas en las cuentas de los gobiernos municipales. Estas han sido analizadas empíricamente, desde el punto de vista de su clasificación en términos de gravedad, pero existen pocos estudios que tengan como objetivo identificar los factores que influyen en tales fallas. Verificada esta brecha, el objetivo principal de este estudio es identificar factores que puedan influir en las fallas en la gestión pública municipal señalados por la auditoría del Tribunal de Cuentas. Este artículo contribuye a profundizar en la investigación sobre este tema y a mejorar la gestión en los municipios. Se trata de un análisis exploratorio, basado en modelos econométricos para datos de panel. La muestra incluye 179 municipios de São Paulo, con datos de los años 2011, 2013, 2015, 2017 y 2019. Los resultados sugieren que las recomendaciones y determinaciones del Tribunal de Cuentas, así como las lagunas en los controles internos, influyen en las irregularidades en los municipios, pequeños, medianos y grandes. El volumen de transferencias legales y constitucionales recibidas influye en los municipios pequeños y medianos, mientras que el producto interno bruto (PIB) municipal influye en los municipios medianos.

Resumo O controle externo municipal exercido pelos Tribunais de Contas permite, por meio da divulgação dos relatórios de auditoria, conhecer as irregularidades encontradas nas contas dos governos municipais. Elas têm sido analisadas empiricamente, do ponto de vista de sua classificação em termos de gravidade, mas poucos são os estudos que visam identificar os fatores que influenciam tais falhas. Constatada essa lacuna, o principal objetivo deste estudo é identificar fatores que possam influenciar lapsos na gestão pública municipal apontados pela auditoria do Tribunal de Contas. Este artigo contribui para aprofundar a pesquisa em torno desse tema e para a melhoria da gestão nos municípios. Trata-se de uma análise exploratória, baseada em modelos econométricos para dados em painel. A amostra inclui 179 municípios paulistas, com dados relativos aos anos de 2011, 2013, 2015, 2017 e 2019. Os resultados sugerem que as recomendações e as determinações do Tribunal de Contas, bem como lacunas nos controles internos, influenciam irregularidades em municípios pequenos, médios e grandes. O volume de transferências legais e constitucionais recebidas influenciam os municípios pequenos e médios, ao passo que o produto interno bruto (PIB) municipal tem influência nos municípios médios.

https://doi.org/10.1590/0034-761220220398

Comparative evaluation of three laparoscopic cholecystectomy techniques in rabbit’s model
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Wittmaack, Monica Carolina Nery

; Conceição, Maria Eduarda Bastos Andrade Moutinho

; Vera, María Camila Maldonado

; Faccini, Rachel Inamassu

; Sembenelli, Guilherme

; Montanhim, Gabriel Luiz

; Menezes, Mareliza Possa de

; Rocha, Fabiana Del Lama

; Aires, Luiz Paulo Nogueira

; Moraes, Paola Castro

Acta Cirúrgica Brasileira

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2023, Volume 38 elocation e383523

Resumo: En | Texto: En | PDF: En

ABSTRACT Purpose: The aim of this randomized study was to compare the complications and perioperative outcome of three different techniques of laparoscopic cholecystectomy (LC). Changes in the liver function test after LC techniques were investigated. Also, we compared the degree of postoperative adhesions and histopathological changes of the liver bed. Methods: Thirty rabbits were divided into three groups: group A) Fundus-first technique by Hook dissecting instrument and Roeder Slipknot applied for cystic duct (CD) ligation; group B) conventional technique by Maryland dissecting forceps and electrothermal bipolar vessel sealing (EBVS) for CD seal; group C) conventional technique by EBVS for gallbladder (GB) dissection and CD seal. Results: Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. Gamma-glutamyl transferase and alkaline phosphatase levels increased (p ≤ 0.05) on day 3 postoperatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique. Conclusions: LC can be performed using different techniques, although the use of EBVS is highly recommended.

https://doi.org/10.1590/acb383523

Liver transplantation for the treatment of iatrogenic bile duct injury
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CIRILO NETO, OLIVAL

; MOUTINHO, LUIZ EDUARDO RAFAEL

; MELO, PAULO SÉRGIO VIEIRA DE

; RABÊLO, PRISCYLLA JENNIE MONTEIRO

; AMORIM, AMERICO GUSMÃO

; MELO, CLÁUDIO MOURA LACERDA

Revista do Colégio Brasileiro de Cirurgiões

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2023, Volume 50 elocation e20233565

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

https://doi.org/10.1590/0100-6991e-20233565-en

Vigilância civil em saúde, estudos de população e participação popular
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Guimarães, Raphael Mendonça

; Martins, Thalyta Cássia de Freitas

; Dutra, Viviane Gomes Parreira

; Oliveira, Mariana dos Passos Ribeiro Pinto Basilio de

; Santos, Laís Pimenta Ribeiro dos

; Crepaldi, Matheus Moutinho

; Cavalcante, João Roberto

Saúde em Debate

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Nov 2022, Volume 46 Nº spe4 Páginas 81 - 93

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

ABSTRACT In the mid-1990s, Victor Valla proposed to incorporate the population participation in the practice of health surveillance, through Paulo Freire’s popular education. This counterpoint to traditional surveillance practices, called civil health surveillance, added to the expanded concept of health, and has a strong connection with the critical perspective of Epidemiology as a means to understand the dialectical relationship between social classes and their lived spaces. The practice of civil surveillance aims to overcome essential gaps left by traditional methods of public health investigation. It includes a lack of attention to socio-cultural contexts, the construction of risk located only in the individual, and the representation of public health agendas that privilege and pathologize certain behaviors. This paper discusses the concept of civil health surveillance, the locus of discussion of population studies in the reification of the role of the contextual effect in explaining the social production of health and the incorporation of popular participation in health surveillance as an element of social transformation. The deepening of this discussion allows a participatory construction of new health models focused on the effective reduction of health inequities and, consequently, the effective universalization of the right to health.

RESUMO Em meados dos anos 1990, Victor Valla propôs a incorporação da participação da população à prática da vigilância em saúde, por meio da educação popular de Paulo Freire. Esse contraponto às práticas tradicionais da vigilância, nomeadas vigilância civil da saúde, somam-se à concepção ampliada de saúde, e possuem forte ligação com a perspectiva crítica da epidemiologia enquanto meio de compreender a relação dialética entre classes sociais e seus espaços vividos. A prática da vigilância civil pretende superar lacunas importantes deixadas pelos métodos tradicionais de investigação em saúde pública, como falta de atenção aos contextos socioculturais, construção do risco localizada somente no indivíduo e representação de agendas de saúde pública que privilegiam e patologizam certos comportamentos. Nesse sentido, o presente trabalho debate o conceito de vigilância civil da saúde, o locus de discussão dos estudos de população na reificação do papel do efeito contextual para a explicação da produção social da saúde e a incorporação da participação popular à vigilância em saúde como elemento de transformação social. O aprofundamento dessa discussão, no limite, permite uma construção participativa de novos modelos de saúde concentrados na redução efetiva das iniquidades em saúde e, consequentemente, universalização efetiva do direito à saúde.

https://doi.org/10.1590/0103-11042022e406

Shotgun metagenomic sequencing of the first case of monkeypox virus in Brazil, 2022
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Claro, Ingra Morales

; Romano, Camila Malta

; Candido, Darlan da Silva

; Lima, Evelyn Lepka de

; Lindoso, José Angelo Lauletta

; Ramundo, Mariana Severo

; Moreira, Filipe Romero Rebello

; Barra, Luiz Alberto Costa

; Borges, Luciana Marques Sansão

; Medeiros, Lucas Alberto

; Tomishige, Marcia Y. S.

; Moutinho, Tomas

; Silva, Anderson José Dias da

; Rodrigues, Camila Cristina Martini

; Azevedo, Luiz Cesar Fernandes de

; Villas-Boas, Lucy Santos

; Silva, Camila Alves Maia da

; Coletti, Thaís Moura

; Manuli, Erika R.

; O’Toole, Aine

; Quick, Joshua

; Loman, Nicholas

; Rambaut, Andrew

; Faria, Nuno R.

; Figueiredo-Mello, Claudia

; Sabino, Ester Cerdeira

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e48

Resumo: En | Texto: En | PDF: En

ABSTRACT Monkeypox virus (MPXV), a zoonotic virus endemic to the African continent, has been reported in 33 non-endemic countries since May 2022. We report an almost complete genome of the first confirmed case of MPXV in Brazil. Shotgun metagenomic sequencing was completed in 18 hours, from DNA extraction to consensus sequence generation.

https://doi.org/10.1590/s1678-9946202264048

10.

First case report of monkeypox in Brazil: clinical manifestations and differential diagnosis with sexually transmitted infections
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Lima, Evelyn Lepka de

; Barra, Luiz Alberto Costa

; Borges, Luciana Marques Sansão

; Medeiros, Lucas Alberto

; Tomishige, Marcia Y. S.

; Santos, Lucas de Souza Loureiro Abbud

; Silva, Anderson José Dias da

; Rodrigues, Camila Cristina Martini

; Azevedo, Luiz Cesar Fernandes de

; Villas-Boas, Lucy Santos

; Silva, Camila Alves Maia da

; Coletti, Thaís Moura

; Manuli, Erika R.

; Claro, Ingra Morales

; Romano, Camila Malta

; Ramundo, Mariana Severo

; Moutinho, Tomas

; Sabino, Ester Cerdeira

; Lindoso, José Angelo Lauletta

; Figueiredo-Mello, Claudia

Revista do Instituto de Medicina Tropical de São Paulo

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2022, Volume 64 elocation e54

Resumo: En | Texto: En | PDF: En

ABSTRACT In 2022, an outbreak of monkeypox is being reported in non-endemic areas, with unusual clinical manifestations. The detailed clinical description of the first patient that received the diagnosis of monkeypox in Brazil is reported here, whose clinical manifestations can easily lead to misdiagnosis of sexually transmitted infections. A 41 years old male presented to an emergency room with a vesicular rash with eight days of evolution. He had traveled to Portugal and Spain and reported non-penetrative sexual involvement with three different male individuals. On the third day of symptoms, he sought medical care and received empirical treatment directed to sexually transmitted infections. As the symptoms did not improve, he sought medical attention at an infectious disease referral center presenting, on admission, an ulcerated penile lesion with central necrotic crusts, a disseminated pleomorphic skin rash and an oropharyngeal ulcer. The monkeypox diagnosis was suspected due to the characteristics of the lesions and the history of intimate contact with casual partners, and it was later confirmed by sequencing the almost complete monkeypox genome. The patient was hospitalized for pain control, which required opiate administration. He developed a secondary bacterial infection on the penile lesions, which were treated with oral antibiotics. He was discharged after 14 days, with lesions in process of re-epithelialization. Given the current outbreak, we must consider the possibility of monkeypox in patients with suggestive lesions, anywhere on the body (including the genitals), added to an epidemiological link or history of intimate contact with strangers or casual partners.

https://doi.org/10.1590/s1678-9946202264054

11.

Vigilância civil em saúde, estudos de população e participação popular
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Guimarães, Raphael Mendonça

; Martins, Thalyta Cássia de Freitas

; Dutra, Viviane Gomes Parreira

; Oliveira, Mariana dos Passos Ribeiro Pinto Basilio de

; Santos, Laís Pimenta Ribeiro dos

; Crepaldi, Matheus Moutinho

; Cavalcante, João Roberto

Saúde em Debate

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2022, Volume 46 Nº spe4 Páginas 81 - 93

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

https://doi.org/10.1590/0103-11042022e406

12.

[SciELO Preprints] - Critical perspective of social participation in health surveillance
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Mendonça Guimarães, Raphael de Freitas Martins, Thalyta Cássia Gomes Parreira Dutra, Viviane Passos, Mariana Pimenta Ribeiro dos Santos, Laís Moutinho Crepaldi, Matheus Cavalcante, João Roberto

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Data de publicação: 2021-11-19

Resumo: En Pt

Many barriers impede the defense of health equity, especially those that hinder social participation in health. In the mid-1990s, Victor Valla proposed incorporating the population's participation into health surveillance through Paulo Freire's popular education. This counterpoint to traditional surveillance practices, then called civil health surveillance, is added to the expanded concept of health, and has a strong connection with the critical perspective of epidemiology to understand the dialectical relationship between social classes and their lived spaces. The practice of civil surveillance aims to overcome essential gaps left by traditional methods of public health investigation. It includes a lack of attention to socio-cultural contexts, the construction of risk located only in the individual, and the representation of public health agendas that privilege and pathologize certain behaviors. In this sense, this paper discusses concept of civil health surveillance, the locus of discussion of population studies in the reification of the role of the contextual effect in explaining the social production of health and the incorporation of popular participation in health surveillance as an element of social transformation. The deepening of this discussion allows a participatory construction of new health models focused on the effective reduction of health inequities and, consequently, the effective universalization of the right to health.

Muitas barreiras impedem a defesa da equidade na saúde, especialmente aquelas que dificultam a participação popular. Em meados dos anos 90, Victor Valla propõe a incorporação da participação da população à prática da vigilância em saúde, por meio da educação popular de Paulo Freire. Este contraponto às práticas tradicionais da vigilância, nomeadas vigilância civil da saúde, se somam à concepção ampliada de saúde, e possuem forte ligação com a perspectiva crítica da epidemiologia enquanto meio de compreender a relação dialética entre classes sociais e seus espaços vividos. A prática da vigilância civil pretende superar lacunas importantes deixadas pelos métodos tradicionais de investigação em saúde pública, como falta de atenção aos contextos socioculturais, a construção do risco localizada somente no indivíduo e a representação de agendas de saúde pública que privilegiam e patologizam certos comportamentos.  Neste sentido, o presente trabalho debate o conceito de vigilância civil da saúde, o locus de discussão dos estudos de população na reificação do papel do efeito contextual para a explicação da produção social da saúde e a incorporação da participação popular à vigilância em saúde como elemento de transformação social. O aprofundamento desta discussão, no limite, permite uma construção participativa de novos modelos de saúde focados na redução efetiva das iniquidades em saúde e, consequentemente, universalização efetiva do direito à saúde.

https://doi.org/10.1590/SciELOPreprints.3224

13.

How should health systems prepare for the evolving COVID-19 pandemic? Reflections from the perspective of a Tertiary Cancer Center
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Chen, Andre Tsin Chih

; Moniz, Camila Motta Venchiarutti

; Ribeiro-Júnior, Ulysses

; Diz, Maria Del Pilar Estevez

; Salvajoli, João Victor

; Da Conceição Vasconcelos, Karina Gondim Moutinho

; Auler-Júnior, José Otávio Costa

; Cecconello, Ivan

; Abdala, Edson

; Hoff, Paulo Marcelo Gehm

Clinics

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2020, Volume 75 elocation e1864

Resumo: En | Texto: En | PDF: En

https://doi.org/10.6061/clinics/2020/e1864 2142 downloads

14.

Correlation between hematological evaluation and the type of physical activity performed by horses in the state of São Paulo-Brazil
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Grizendi, Bianca Moutinho

; Dória, Renata Gebara Sampaio

; Passarelli, Daniele

; Reginato, Gustavo Morandini

; Hayasaka, Yumi de Barcelos

; Fantinato Neto, Paulo

Ciência Animal Brasileira

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2020, Volume 21 elocation e-56959

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

Resumo Na clínica de equinos, frequentemente, o médico veterinário se depara com resultados de exames hematológicos que são comparados com valores de referência normalmente adaptados da bibliografia internacional, baseados em exames de cavalos hígidos, com clima e atividade física padronizados. Dado isso, este estudo tem como objetivo comparar os valores obtidos de avaliações hematológicas em cavalos de esporte e de tração, levando em consideração o tipo de atividade física que realizam. Foram utilizados dados de anamnese e hematologia de 76 animais: 32 integrantes do Grupo Tração (GT), correspondendo a equinos em atividade de tração (carroceiros em atividade) e 44 pertencentes ao Grupo de Esporte (GE), correspondendo a equinos em atividade hípica de salto situados na região de Pirassununga-SP. A partir da colheita de sangue, foram realizadas contagens referentes de hemograma e dosagem de fibrinogênio plasmático. Os animais do grupo GT apresentaram menores valores na contagem de eritrocitos e hematócrito. Quanto ao leucograma, os equinos GT apresentaram maior número de leucócitos em comparação com o grupo GE. Na avaliação dos equinos estudados, foram encontradas médias de valores hematológicos menores nos equinos carroceiros, em comparação com cavalos de salto. Além disso, esses valores se mostram abaixo dos considerados fisiológicos para a espécie.

Abstract The veterinarian has to frequently assess blood tests in equine medicine. The reference values are adapted from international literature, based on examinations of healthy horses, under a standardized climate and physical activity. This study aimed to compare the blood values obtained from sports horses and traction horses, taking into account the type of activity performed. Anamnesis and hematology data from 76 animals were used: 32 members belonged to the Traction Group (TG), corresponding to equines from traction activity (cart horses) and 44 members belonged to the Sport Group (SG), corresponding to equines used in obstacle jumping, both groups were from the Pirassununga region, State of São Paulo. Complete blood counts and plasmatic fibrinogen dosage were evaluated. The animals from the TG had lower erythrocyte count and hematocrit values. The animals from the TG had greater leukocyte values in the leukogram compared to the animals from the SG. Cart horses were found to have lower means of hematological values compared to the jumping horses. Moreover, these values were below the normal physiological range for the species.

https://doi.org/10.1590/1809-6891v21e-56959 719 downloads

15.

Impact of COVID-19 pandemic on a daily-based outpatient treatment routine: experience of a radiotherapy department of a tertiary public/university hospital in Brazil
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Carvalho, Heloisa de Andrade

; Vasconcelos, Karina Gondim Moutinho C.

; Gomes, Herbeni Cardoso

; Salvajoli, João Víctor

Clinics

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2020, Volume 75 elocation e2298

Resumo: En | Texto: En | PDF: En

OBJECTIVES: To report the impact of the COVID-19 pandemic on patient attendance at a radiotherapy department two months after the implementation of specific policies regarding the pandemic. METHODS: The proposed treatment schemes, favoring hypofractionated schedules, and COVID-19 management strategies regarding irradiation are presented. Attendance after two months of implementation of these policies was measured and compared with that during the same period in 2019. RESULTS: A 10% reduction in the number of treated patients and a 26% reduction in the number of sessions was observed. The main impact was a decrease in the treatment of benign diseases and gastrointestinal tumors, with a general increase in breast cancer treatments. Eighteen (1.7%) patients were confirmed as having COVID-19 during radiotherapy in April and May 2020, three of whom were hospitalized, and one patient died because of COVID-19. Among the 18 patients, 12 had their treatments interrupted for at least 15 days from symptom appearance. CONCLUSION: There was a decrease in the number of treated patients in our radiotherapy department, with a greater decrease in the total number of sessions. This indicated, overall, a smaller number of fractions/patients treated, despite our efforts to maintain the treatment routine. We had several patients who were infected with COVID-19 and one related death during treatment in the first few months of the pandemic in São Paulo Brazil.

https://doi.org/10.6061/clinics/2020/e2298 350 downloads

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