bluuebunny/crossref_metadata_2025 huggingface dataset:
Early mortality in incident hemodialysis patients – A retrospective case-control study
Authors:   Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Nephrology Department, Lisboa, Portugal, Veríssimo Rita , Sousa Luís ,   Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Nephrology Department, Lisboa, Portugal, Carvalho Tiago ,   Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Nephrology Department, Lisboa, Portugal, Fidalgo Pedro ,   Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Nephrology Department, Lisboa, Portugal
Published: April 2022

Introduction: Chronic kidney disease has significant morbidity and mortality worldwide. Various studies have demonstrated that incident patients experience a higher mortality rate within the first 3 months of dialysis. Methods: A single-center retrospective case-control study (1:3) was performed to determine early (<90 days) mortality rate and associated risk factors in incident hemodialysis patients from January 2013 to December 2018. We compared variables between survivors and non-survivors at 90 days after initiation of hemodialysis. Multivariate logistic regression was used to calculate the adjusted odds ratio with 95% confidence intervals for the variables associated with early mortality and a predictive model was developed. Results: From a total of 626 incident hemodialysis patients, 48 (7.7%) died before 90 days of treatment. Non-survivors were older [OR 1.07 (1.03-1.11)], had higher rates of non-recovering acute kidney injury [OR 7.91 (3.63- 17.24)], emergency start of hemodialysis [OR 4.31 (2.15-8.62)], congestive heart failure [OR 5.68 (2.81-11.48)], ischemic cardiomyopathy [OR 4.50 (2.25-8.99)], chronic obstructive pulmonary disease [OR 3.60 (1.44-8.95)], Charlson comorbidity index [OR 1.47 (1.27-1.70)] and dependence of assistance in daily living activities [OR 3.46 (1.76-6.82)]. Patients were less likely to have 90-day mortality if they had nephrologist appointments at least 90 days prior to end-stage renal disease [OR 0.25, 95% CI (0.13-0.50); p<0.001] or a higher serum albumin [OR 0.34, 95% CI (0.19-0.62); p<0.001]. Multivariate analysis risk factors independently associated with early mortality were older age [aOR 1.06 (1-01-1.10), p=0.022], acute kidney injury as cause of end-stage renal disease [aOR 12.62 (4.50-35.40), p<0.001], congestive heart failure [aOR 3.79 (1.58-9.11), p=0.003], and Charlson comorbidity index [aOR 1.30 (1.09-1.56), p=0.005]. The model showed very good discriminative ability [AUROC (95% CI) 0.88 (0.83-0.94)]. Conclusion: Early mortality occurred in 7.7% of our population. Our model could be used to identify patients at higher risk of death during the first 90 days of hemodialysis and aid informed decision-making regarding end-stage renal disease treatment options.
Point-of-care ultrasound in peritoneal dialysis catheter-related infection: An observational study
Authors:   Nephrology Department, Centro Hospitalar e Universitário de São João, Oporto, Portugal, Diniz Hugo , Silva Rui ,   Nephrology Department, Centro Hospitalar e Universitário de São João, Oporto, Portugal, Oliveira Ana ,   Nephrology Department, Centro Hospitalar e Universitário de São João, Oporto, Portugal, Pereira Luciano ,   Nephrology Department, Centro Hospitalar e Universitário de São João, Oporto, Portugal,   Nephrology & Infectious Diseases R&D, i3S – Instituto de Investigação e Inovação em Saúde da Universidade do Porto, Oporto, Portugal, Beco Ana ,   Nephrology Department, Centro Hospitalar e Universitário de São João, Oporto, Portugal
Published: April 2022

Point-of-care ultrasound aims to enhance physical examination findings with real-time information from the ultrasound. Peritoneal dialysis catheter-related infections are a frequent complication of peritoneal dialysis and a major predisposing factor to peritonitis. The diagnosis of peritoneal dialysis catheter-related infections is made with physical examination, but physical findings usually lack sensitivity or specificity. This is a single-center observational study that aimed to evaluate the accuracy of point-of-care ultrasound for the diagnosis of peritoneal dialysis catheter-related infections. Sixteen peritoneal dialysis patients with peritoneal dialysis catheter-related infections clinical suspicion were enrolled in this study, as well as nine controls. Peritoneal dialysis catheter-related infection was defined as a purulent discharge with or without inflammatory signs in the peritoneal dialysis catheter exit-site or subcutaneous tunnel, and a positive microbiological culture collected from the exit-site. Point-of-care ultrasound was considered positive when an anechoic collection in relation to the external cuff or catheter tunnel was identified. Physical examination findings were coded using the Exit-site Scoring System. A total of 13 peritoneal dialysis catheter-related infections were diagnosed. The mean Exit-site Scoring System score for the suspected cases of peritoneal dialysis catheter-related infections was 2,82 ± 1,22, and the most commonly encountered sign was purulent discharge. All of the cases of peritoneal dialysis catheter-related infections had a positive point-of-care ultrasound. In contrast, none of the controls had a positive point-of-care ultrasound (p < 0,001). The area under the receiver operating characteristic curve of physical examination for the diagnosis of peritoneal dialysis catheter-related infections was 0,6 (95% CI 0,37-0,84). In contrast, point-of-care ultrasound had an AUROC of 0,91 (95% CI: 0,73-1) for the diagnosis of peritoneal dialysis catheter-related infections. Nephrologist-performed point-of-care ultrasound is feasible and superior to physical examination for the diagnosis of peritoneal dialysis catheter-related infections.
A minimal change disease (MCD) related nephrotic syndrome preceding a Hodgkin Lymphoma diagnosis – a case report
Authors:   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Castro Pedro , Oliveira Nuno ,   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Alves Rui ,   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal,   Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
Published: April 2022

We admitted a 21 -year -old female to the Nephrology ward due to proteinuria and generalized oedema, which started soon after consuming clonixin 300mg thrice a day for two weeks. Her initial blood work showed nephrotic -range proteinuria, hypoalbuminaemia, hypercholesterolaemia and normal kidney function. We conducted a full auto -immune and serological study: there were no signs of infection, complement consumption or underlying auto -immune diseases. Suspecting minimal change disease, we started prednisolone 1mg/kg/day, with good clinical response and a reduction of urinary protein losses. By the third day, a kidney biopsy was performed: the glomeruli were morphologically normal and no immune deposits were found, which suggested minimal change disease. After seven days, the patient was discharged from the hospital with a corticoid taper until her Nephrology consultation. In the following weeks she maintained clinical and laboratorial remission and prednisolone was stopped after six months. Two months after, the patient noticed a growing bilateral cervical mass and went to the emergency room. The diagnostic workup was inconclusive, so an ultrasound -guided biopsy was requested. The biopsy revealed lymphoid cell proliferation, positive for CD30, CD15, MUM -1 and BCl6. These findings confirmed a Hodgkin’s Lymphoma diagnosis and the patient started radiotherapy and chemotherapy (ABVD -doxorubicin, bleomycin, vinblastin, dacarbazine). In the following months her clinical status improved and the cervical mass had a significant size reduction. The kidney disease remained in remission, without therapeutic adjustments. A post- -treatment PET scan was requested, showing only a residual mediastinal mass.
Screening of mcr-1 among Gram-Negative Bacteria from Different Clinical Samples from ICU Patients in Alexandria, Egypt: One-Year Study
Authors: Elbaradei Amira , Sayedahmed Mahrous S. , El-Sawaf Gamal , Shawky Sherine M.
Published: April 2022

Antimicrobial resistance represents a global dilemma. Our present study aimed to investigate the presence of mcr-1 among different Gram-negative bacteria including Enterobacteriaceae (except intrinsically resistant to colistin) and Pseudomonas aeruginosa. Gram-negative bacterial isolates were collected from different ICUs in several Alexandria hospitals from June 2019 to June 2020. The identification of these Gram-negative isolates was made using the VITEK-2® system (BioMérieux, France). SYBR Green-based PCR was used to screen for the presence of mcr-1 using a positive control that we amplified and sequenced earlier in our pilot study. All isolates were screened for the presence of mcr-1 regardless of their colistin susceptibility. Isolates that harbored mcr-1 were tested for colistin susceptibility and for the presence of some beta-lactamase genes. Klebsiella pneumoniae isolates harboring mcr-1 were capsule typed using the wzi sequence analysis. Four hundred eighty isolates were included in this study. Only six isolates harbored mcr-1.1. Of these, four were resistant to colistin, while two (K. pneumoniae and P. aeruginosa) were susceptible to colistin. Five of the six isolates were resistant to carbapenems. They harbored bla
OXA-48, and three of them co-harbored bla
NDM-1. K-58 was the most often found among our K. pneumoniae harboring mcr-1.1. To our knowledge, this is the first time to report colistin susceptible P. aeruginosa and K. pneumoniae harboring the mcr-1.1 gene in Egypt. Further studies are needed to investigate the presence of the mcr genes among colistin susceptible isolates to shed more light on its significance as a potential threat.
Authentic assessment and academic performance of Marine Engineering students: A correlational study
Authors: Galicia Peter Ralph B.
Published: April 2022

Authentic assessment can validate Marine Engineering students’ competency in academe to be fully equipped with knowledge, understanding, and skills needed onboard ship. This descriptive-correlational study aimed to ascertain Marine Engineering students’ authentic assessment and academic performance on professional courses and their relationships to formulate an intervention program. Utilized for data gathering was a self-administered structured questionnaire on Authentic Assessment aligned to the course syllabus of three (3) major courses. The computer-processed statistics used were mean, frequency, and rank for descriptive analysis; and Pearson Product-Moment Correlation or Pearson r for inferential analysis. Alpha level was set at 0.05. The study found that Marine Engineering students recalled lessons and performed well during validation of skills. In addition, there was a significant relationship between the authentic assessment results and the academic performance shown on professional courses. The performance of Marine Engineering students in the classroom is likely to affect their performance during skill validation in authentic assessment. Therefore, well-performing students in the classroom are likely to pass authentic assessment. Finally, an intervention program, “bUligAnay Kita: A Peer Tutoring Program,” aims to improve Marine Engineering students’ basic knowledge, understanding, and skills in all major courses in preparation for onboard ship training.
Covid-19, catastrophic lockdown, and a couple retreat
Authors: Brown Joanne
Published: April 2022

This article will discuss the adverse impact of Covid-19 and the simultaneous move to online work on couples struggling with narcissistic difficulties and claustro– agoraphobic dilemmas. A move from the vitality of increased contact during prepandemic therapy to the safety of a psychic retreat during lockdown will be described and illustrated by a case. The question of what kind of object online therapy is (too close or too far away) will be discussed, and the disruptive effect of the rupture to the frame will be outlined. The importance of mourning during the pandemic will be reflected on as, in some cases, previous feelings of vitality, movement, and closeness were difficult to keep alive.
How close is too close? Some thoughts on couple psychotherapy in a time of constricted living imposed by Covid
Authors: Thompson Kate
Published: April 2022

Exploring case material from psychoanalytic couple psychotherapy, this article traces different reactions to living within the restrictions imposed by the global pandemic and spread of coronavirus. With particular emphasis on seeking psychological safety for couples where Henry Rey's claustro–agoraphobic dilemma is at play, the author examines the conflicting pull towards merger and push to separate, and shows the impact of uncertainty and compressed living conditions, on the dynamics of three different couples. Linking infantile deprivation and early attachment trauma to the struggle over the conflicting desires for autonomy and merged closeness within intimate adult relating, the author explores defensive couple projective systems highlighted in reaction to the abrupt changes dictated by living in lockdown.
Review of the Formulating of the Code of Conduct in South China Sea between ASEAN and the People's Republic of China
Authors: Farhan Muhammad Aditomo  , Edy Prasetyono
Published: April 2022

This paper discusses about ASEAN and the People's Republic of China (PRC)'s resolution attempts in the South China Sea (SCS) dispute. This paper discusses the process of conflict resolution between ASEAN and the People's Republic of China (PRC) in the South China Sea (SCS) dispute issue since the declaration of conduct and its following moves were not yet able to formulate the planned code of ethics. This study aims to find out the causes of slow development of the COC of the South China Sea. This research uses qualitative methods to gather both primary and the secondary sources. Regime theory by Krasner is used by this research to see what factors cause both parties to be unable to formulate a code of ethics in the South China Sea. The conclusion from this research is the COC's development as a security regime in the South China Sea.
SIVAGA CHINTHAMANI AND NORM OF PURITY [CĪVAKA CINTĀMAṆIYIL KAṞPIYAL]
Authors: RAMIAH INDRA
Published: April 2022

From the Sangam period onwards, Aimperungappiyams developed the specialty of the Tamil language. Sivaga Chintamani is one of epic of the Aimperungappiyams. The epic was composed in the 9th century by a Jain monk named Tiruttakkathevar. Sivagan was the leader of this epic. The epic is named as Sivaga Chintamani as it tells the life story of Sivagan. Sivaga Chintamani has 3145 poems and 13 chapter. Sivaka Chintamani is a book on Jainisme. Sivagan married 8 women in this book, so this book also be called Mananool. Although the book is about love story, it is full of cultural elements. The characters in Sivaga Chintamani shows the purity norm in a very modern way. Moreover, in this book, purity is mentioned from many perspectives. Through this study, it is possible to know that the life of the Sivagan and others characters is full of the Tamil cultural element of purity. Moreover, this study will be very helpful to change the view of Sivaga Chintamani which is considered only as a marriage book.
A APLICAÇÃO DA TEORIA DAS BASES DO NEGÓCIO JURÍDICO DE KARL LARENZ NO DIREITO BRASILEIRO
Authors: Ferreira Gonzaga Heitor , Enzweiler Romano José
Published: April 2022

O presente artigo investiga a possibilidade de aplicação da teoria das bases do negócio jurídico de Karl Larenz no ordenamento brasileiro, com vistas a solucionar demandas de resolução ou alteração do contrato por onerosidade excessiva e erro no negócio jurídico. Para este fim, realizou-se um apanhado histórico do desenvolvimento das teorias das bases negociais alemãs até a teoria Karl Larenz, apresentando seus postulados e confrontando-a com a doutrina, legislação e jurisprudência brasileiras. Concluiu-se que, a despeito de dissonância entre a tese de Larenz e a necessidade de “extrema vantagem” do art. 478 do Código Civil, a teoria das bases contratuais em sentido objetivo pode ser – e já é – aplicada no direito brasileiro. A teoria das bases contratuais em sentido subjetivo, contudo, não pode ser utilizada no Brasil, pois a teoria da confiança, inserida no bojo do Código Civil, valoriza os elementos objetivos do negócio jurídico em detrimento dos volitivos e psicológicos.
Palavras-chave: Karl Larenz; Teoria das bases do negócio jurídico; Direito brasileiro.
ABSTRACT: This article investigates the possibility of applying Karl Larenz's theory of the bases of legal transaction in the Brazilian legal system to solve demands for resolution or alteration of the contract due to excessive burden and error in the legal transaction, making a historical overview of the development of the german theories of the bases of transaction until Karl Larenz’s, presenting its postulates and confronting it with Brazilian doctrine, legislation and jurisprudence. It was concluded that, despite the dissonance between Larenz's thesis and the need for “extreme advantage” of article 478 of the Civil Code, the theory of busines’s bases in an objective sense can be – and already is – applied in Brazilian law. The theory of busines’s bases in a subjective sense, however, cannot be used in Brazil, as the theory of trust, which is inserted in the scope of the Civil Code, values the objective elements of the legal business to the detriment of the volitional and psychological.
Keywords: Karl Larenz; Bases of Transaction Theory; Brazilian law.
The Unmet Needs of Women Living with Cancer in Community Setting: A Professional Concern
Authors: Sari Ni Putu Wulan Purnama
Published: April 2022

Background: In the community of Surabaya, the 2nd largest city of Indonesia, women living with cancer are mostly the long-term survivors of advanced-stage cervical cancer, but the number of women living with breast cancer cannot be ignored. There were various physical and psychological problems related to the total suffering and worsening phenomena. The limited resources available in the community have led to various levels of unmet needs in their perspective. This study aimed to analyze and describe the unmet needs of female cancer survivors in the community of Surabaya.  Methods: This descriptive study involved five Public Health Centers (PHCs) among 63 PHCs in Surabaya (7.94%), Indonesia, which were selected by one-stage cluster random sampling. There were 41 and 40 women living with breast and cervical cancers, respectively, participating in this study (n = 81). The Supportive Care Needs Survey – Short Form 34 (SCNS-SF34) was used to collect the data of unmet needs (r = 0.234 – 0.821; Chronbach Alpha = 0.939). Descriptive statistic was used in data analysis (frequency, Mean, and Standard Deviation). Ethical clearance was issued. Results: Most respondents were late adult married women with low socioeconomic status. They were mostly short-term survivors and already had surgery. Most of them reported a moderate level of unmet needs (Mean ± SD = 109.30 ± 27.66). Health system and information needs became their top priorities (45.75), followed by patient care and support needs (37.89), physical and daily function needs (32.20), psychological needs (31.11), and sexuality needs (22.00). There were 9.88% of respondents who reported that there were no unmet needs. Conclusions: Female cancer survivors in the community reported a moderate level of unmet needs. Health system and information needs were the most reported unmet needs
Re-Irradiation of Recurrent Nasopharyngeal Cancer: A 4-year Follow-up Study of Treatment using 3-Dimensional Conformal Radiotherapy
Authors: Ruslim Samuel Kelvin , Selviant Selviant , Iskandar Aviciena Bin , Sie Sielvyana , Hariyanto Agustinus Darmadi , Dewi Monika Kencana
Published: April 2022

Introduction: Nasopharyngeal cancer (NPC) is a prevalent diagnosis of head and neck cancers (HNC) in Asia. In Indonesia, it is estimated that there are 12,000 new cases per year. Case Presentation: The author reports a 25-year-old male patient with recurrent NPC. This patient was first diagnosed with NPC stage IVB in 2013 and was treated by chemoradiation. In 2016, he found another mass in his neck. The biopsy result showed the recurrence of the NPC with histopathology of Undifferentiated carcinoma (WHO type III). Re-irradiation was planned, and the patient subsequently received 3D-Conformal Radiotherapy (3D-CRT) at our department. Four years after the completion of re-irradiation, the patient was alive and well with no signs of recurrence but still complained about late toxicities like trismus and fibrotic neck.  Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like intensity-modulated radiotherapy (IMRT). However, with careful planning, we can still obtain optimum tumor dose, minimize organs at-risk (OAR) dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on re-irradiation, especially in OAR dose tolerance guidelines.
Characteristics of Bladder Cancer in Dr. Sardjito General Hospital Yogyakarta: a 5-Year Report
Authors: Prisnamurti Fitra Hardian , Hendri Ahmad Zulfan , Danurdoro Aria
Published: April 2022

Background: Bladder cancer is the eleventh most common malignancy worldwide and the sixth cancer in men. Bladder cancer shows a male predominance with a sex ratio of 4:1. Most bladder cancers are transitional cell carcinoma, and the other tumors are squamous cell carcinoma, adenocarcinoma, and rare entities like small cell carcinoma. Clinical stage and grade are the most critical determinants of the prognosis of bladder cancer. Therefore, this study aims to evaluate the characteristics of bladder cancer in Dr. Sardjito General Hospital, Indonesia. Methods: We reviewed the medical records of patients with bladder cancer admitted to Dr. Sardjito General Hospital Yogyakarta from January 2015 until December 2020. The data were about demographic characteristics, clinical presentation and staging, grading and staging based on pathological examinations results, and cancer management. Results: This study found 282 patients with bladder tumors. Fifty patients did not meet the inclusion criteria so the remaining 232 patients consisted of 169 male patients (72.8%) and 62 female patients (27.2%). The stages of tumors when the patients first came in were T1 diagnosed in 46 patients (22.7%), T2 diagnosed in 81 patients (40%), T3 diagnosed in 11 patients (5.4%), and T4 diagnosed in 64 patients (31.6%). A total of 30 patients were found to have secondary bladder tumors. The pathological anatomy results showed that 177 patients (76.2%) had transitional cell carcinoma and 33 patients adenocarcinoma (14.2%). All patients had undergone Transurethral Resection of Bladder Tumor (TURBT) for diagnosis and staging, followed by definitive treatment. It consisted of TURBT and chemotherapy bladder instillation in 46 patients (19.8%), radical cystectomy in 84 patients (36.2%), partial cystectomy in 4 patients (1.7%), and multimodal therapy (en-bloc transurethral resection of bladder tumors (ERBT) and chemotherapy) in 26 patients (11.2%). There were 72 patients (31%) who underwent TURBT alone. Conclusions: From a 5-year study, we found similar results with previous studies that the most common bladder histopathological result is urothelial carcinoma. However, most patients presenting to our hospital have higher stages and grades, requiring radical treatment. These differences warrant a larger and more comprehensive, multi-center study in Indonesia.
The Profile of Soft Tissue Sarcoma Patients who Undergo Radiotherapy in Dr. Hasan Sadikin General Hospital Bandung
Authors: Adibrata Antony Abel , Utama Marhendra Satria , Kusumadjati Adji
Published: April 2022

Background: Soft Tissue Sarcoma is one of the rare cancers that increased in number in the last few years, but information about soft tissue sarcoma patients was still limited, especially in West Java, Indonesia. This study aimed to find out the patient profile and the histopathological cell distribution of soft tissue sarcoma patients who undergo radiotherapy. Methods: The study design was retrospective descriptive quantitative with the total sampling method. This study was done by observing all patients’ medical records registered from January 1, 2018, until December 31, 2019, in the Hospital-Based Cancer Registry of Radiology Department of Dr. Hasan Sadikin General Hospital Bandung, with the inclusion criterion of patients diagnosed with soft tissue sarcoma.  Results: A total of 5% (n = 75) from 1,388 cases registered were soft tissue sarcoma. The most common patient profile was female (57.3%) and age group 45–54 years (21.3%). The chief complaint was dominated by a painless mass (56.0%) at the lower limb (37.8%) with the most frequent cell of fibrosarcoma (17.3%), the most intention of the radiotherapy of curative adjuvant (78.7%). Conclusions: The number of soft tissue sarcoma is small compared to other malignancies. It is more common in women, the most age group is from 45 to 54 years with the median of 47 years old, ranging from 9 to 90 years, it tends to occur in the lower limb with a chief complaint of a painless mass, and the most frequent cell is fibrosarcoma. The common treatment combination is surgery with radiotherapy
Trichilemmal Carcinoma on the Head (Surgical Challenge to Achieve Free Margin): A Case Report
Authors: Khambri Daan
Published: April 2022

Introduction: Trichilemmal carcinoma is a rare tumor derived from the outer hair sheath. It usually appears on the face, ears, neck, scalp, and sun-exposed areas. It generally occurs in patients older than 50 years old, and there is no sex predilection to this disease.Case Presentation: A 60-year-old woman came with a complaint of a lump in the head that often bled. The size of the lump was approximately like a bean seed and broke when she combed her hair. The lump was getting bigger within a year and easier to bleed. She often felt pain. Based on the history of surgery 2 months ago, the examination implies that the patient had trichilemmal carcinoma.Conclusions: Trichilemmal carcinoma generally occurs in the elderly category. Although trichilemmal carcinoma has a benign clinical course and local recurrence cases are uncommon, sufficient free margin and immediate reconstruction are challenging if the predilection is in the head and neck. Surgical excision is the recommended treatment for this disease
Necessidade de reconfiguração do financiamento do SUS diante da austeridade: uma revisão narrativa
Authors: Pedrosa Kamyla de Arruda , Sena Daniely Bezerra de Castro , Pinto José Reginaldo , Mota Márcio de Oliveira
Published: April 2022

O financiamento do Sistema Único de Saúde (SUS) é um avanço na saúde pública no Brasil, apreciado pela seguridade social para a viabilização do direito e da cobertura universal aos serviços ofertados por esse sistema. O alto crescimento dos custos pelo incremento das tecnologias, mudanças do perfil demográfico e epidemiológico, judicialização e a austeridade ocasionada pela Emenda Constitucional n° 29 e a pandemia do coronavírus trazem reflexões sobre a capacidade de construir um novo financiamento para a sustentabilidade do SUS. O objetivo desta pesquisa foi identificar as evidências em estudos sobre o financiamento desse sistema para a cobertura universal da seguridade social relativas à saúde no Brasil, por meio de uma revisão narrativa da literatura, resultando na análise de 22 estudos. Baseado nos resultados, identificamos que a medida de austeridade econômica e os custos com a pandemia impactam no déficit público e prejudicam a cobertura universal e a atenção integral da saúde ao cidadão. É necessária a reconfiguração da alocação dos recursos financeiros para a garantia do direito aos serviços de saúde no SUS. Além disso, há a necessidade de mudança da cultura e modelo da gestão da saúde, implantar questões de qualidade e proporcionar uma maior cooperação entre os entes federativos de forma solidária com o fortalecimento da participação social.
Influência da espiritualidade na vida da pessoa com estoma intestinal: uma revisão integrativa
Authors: Faria Veridiana Bernardes , Bracarense Carolina Feliciana , Ferreira Jéssica Fernanda Marcelina Fernandes , Condeles Pedro César , Molina Nayara Paula Fernandes Martins , Nicolussi Adriana Cristina , Goulart Bethania Ferreira
Published: April 2022

As pessoas com estomas intestinais enfrentam dificuldades na adaptação. Este estudo busca analisar as evidências científicas a respeito da influência da espiritualidade na vida da pessoa com estoma intestinal, por meio de uma revisão integrativa que utilizou as seguintes bases de dados: Literatura latino-americana e do Caribe em Ciências da Saúde, Cumulative Index to Nursing and Allied Health Literature, Scopus e portal Pubmed. A amostra final de estudos selecionados foi composta de onze artigos científicos, cinco do Brasil, dois dos Estados Unidos, dois do Iran, um de Taiwan e um de Vojvodina, sendo sete quantitativos, dois mistos e dois qualitativos. Utilizou-se a seguinte questão norteadora: Quais as evidências disponíveis na literatura sobre a influência da espiritualidade na vida da pessoa com estoma intestinal? Os estudos evidenciaram que a espiritualidade influencia positivamente na aceitação do estoma pela pessoa e que os profissionais de saúde devem identificar as necessidades espirituais para auxiliar as pessoas nesta condição.
A fotobiomodulação com laser de baixa potência no tratamento do herpes labial recorrente: uma revisão integrativa
Authors: Sousa Juliane Alves de , Catão Maria Helena Chaves de Vasconcelos
Published: April 2022

A infecção pelo vírus do herpes simples tipo 1 (HSV-1) é considerada comum em todo o mundo e clinicamente manifesta sinais e sintomas na região oral. A história natural da doença compreende as fases de infecção primária, latência e infecção recorrente. O herpes labial é a manifestação clínica da infecção recorrente, caracterizada por pequenas e numerosas pápulas eritematosas e dolorosas, que constituem conglomerados de vesículas que se rompem e formam crostas. Entre as alternativas terapêuticas, estão os antivirais, terapias naturais e a laserterapia de baixa potência (TFBM). O presente estudo objtiva avaliar a eficácia da TFBM no tratamento de lesões de herpes labial, através de uma revisão integrativa da literatura. Foi realizada uma busca por artigos nas bases de dados eletrônicas MEDLINE via PubMed, LILACS via BVS, Web of Science e Cochrane Library publicados entre 2011 e 2021 que abordassem estudos de herpes labial com ensaios clínicos randomizados associando os descritores: “Low-intensity light therapy” OR “Photobiomodulation” OR “Laser” OR “Herpes Labialis”, sem restrição de idioma. Foram encontrados 60 estudos, dos quais, após a exclusão dos duplicados e dos que não atendiam aos critérios de inclusão, 5 foram selecionados para análise. Assim, a presente revisão destaca que a TFBM é um recurso terapêutico eficaz, reduzindo o tempo de cicatrização, a sintomatologia e a recorrência das lesões.
Indicadores de sustentabilidade ambientais na pecuária leiteira: revisão sistemática
Authors: Abrahão Juliana Alvarenga , Natel Andressa Santanna
Published: April 2022

A pecuária leiteira é uma atividade de grande importância socioeconômica para o Brasil e sua prática utiliza os recursos naturais como matéria prima, contudo, o manejo inadequado desses recursos pode prejudicar o solo, contaminar a água e prejudicar a manutenção da biodiversidade O presente estudo analisou de forma sistemática os parâmetros de sustentabilidade da pecuária de leite, qualidade de água e área de proteção permanente, levantados utilizando a ferramenta de índices de sustentabilidade. Foi realizada uma revisão bibliográfica sistemática nas bases de dados Web of Science, SciElo e Google Acadêmico, no período de 2011 a 2021, utilizando os parâmetros ‘índices de sustentabilidade ambiental’, ‘qualidade da água’ e ‘APPs’. Após refinamento da busca foram investigados os resultados encontrados em doze artigos, sendo que 6 utilizaram a metodologia ISA. Os parâmetros qualidade de água e APP receberam as indicações boa ou excelente em 50% (6/12) e 33% (4/12) dos artigos, respectivamente. Concluiu-se que a necessidade de conscientização dos proprietários e de criação de políticas públicas voltadas a fiscalização e preservação das APP, assim como preservação dos recursos de água na atividade da pecuária leiteira.
Diagnóstico e manejo da xerostomia em pacientes com COVID-19
Authors: Ferreira Gerson Luís Castro , Gomes Ana Viviam Souza Ferro , Sousa Ana Clarade Carvalho , Lopes Estefany Monteiro , Viegas Raissa de Oliveira , França Allana Alexia Mendes Dos Santos da , Castro Francisca Ângela Sousa , Carvalho Romayla de Andrade , Fontenele Maria Éryka Giovanna de Brito , Fortaleza Vitória Gindri
Published: April 2022

A xerostomia ou boca seca é uma alteração encontrada rotineiramente na prática clínica odontológica, esta alteração afeta diretamente a qualidade de vida do paciente, manifestando dificuldades na degustação, mastigação, fala, deglutição e causa muito desconforto na cavidade oral. Contudo, após o início da pandemia da COVID-19, foi notado pelos pesquisadores uma grande queixa de pacientes infectados relatando a sensação de boca seca. Este estudo tem como objetivo principal avaliar a forma que a xerostomia acomete os pacientes com COVID-19. O estudo foi realizado por meio de uma revisão de literatura, pesquisando os artigos do Google Acadêmico, PubMed, e SciELO utilizando os descritores: “Oral Manifestations”; “Xerostomia” e “COVID-19”. Todos os artigos foram selecionados por ano, título, resumo, texto completo e, por fim, todos os artigos selecionados foram processados para revisão final. 20 artigos selecionados foram obtidos a partir da pesquisa bibliográfica inicial de 295 artigos, relatos obtidos a partir dos estudos selecionados demonstram que a xerostomia possui alta incidência em pacientes que foram infectados pela COVID-19,  o que impacta diretamente na qualidade de vida deles e na forma que reagem aos tratamentos quando são submetidos à tratamentos hospitalares, contudo, outras manifestações orais aparecem fortemente, o que causa uma maior debilitação na saúde sistêmica do paciente. As manifestações bucais, como xerostomia, intercorrências no paladar, inflamação das glândulas salivares, devidamente citadas no estudo, são tipicamente relatadas em pacientes que apresentaram infecção viral pelo Sars-CoV-2, e cabe ressaltar que, independentemente da patogenia dessas manifestações, denota-se a importância do desenvolvimento de protocolos específicos.
Programa cuidando do mestre: a percepção dos professores da rede pública do município de Sobral-CE
Authors: Gomes Edine Dias Pimentel , Sousa Maria do Socorro de , Fernandes Maria Petrília Rocha , Veras Karlla da Conceição Bezerra Brito , Bezerra Francisca Emanuelle Sales Eugênio , Ponte Nayara Machado Melo , Sampaio Cynira Kezia Rodrigues Ponte , Aguiar Francisca Alanny Rocha
Published: April 2022

A saúde vocal é considerada um fator importante na saúde e qualidade de vida dos profissionais docentes que utilizam a voz como instrumento de trabalho, as ações educativas permitem fortalecer a promoção da saúde, apontando sempre os aspectos preventivos para uma boa qualidade vocal. Nesta perspectiva, este estudo teve como objetivo analisar a percepção dos professores acerca do Programa Cuidando do Mestre desenvolvido nas escolas municipais de Sobral-CE. Utilizou-se da pesquisa qualitativa como abordagem mais adequada, e como caminho metodológico a pesquisa-ação. O universo da pesquisa foi composto por 8 professores em exercício, efetivos, no Sistema Público Municipal de Ensino de Sobral, que participaram de todas as oficinas do Programa Cuidando do Mestre. Os dados foram obtidos, através da entrevista semi-estruturada realizada com os professores participantes da pesquisa e a análise do conteúdo ancorou-se, na análise temática. Os resultados confirmaram que, o Programa Cuidando do Mestre, possibilitou grandes mudanças na percepção dos professores acerca da saúde vocal. Portanto, é imprescindível a implantação de cursos, palestras, oficinas, consultorias com o objetivo de desenvolver o conhecimento vocal do professor como requisito para sua saúde.
Is the history of periodontal disease a risk factor for cognitive decline? Systematic Review and Meta-analysis
Authors: Raymundo Maria Letícia Barbosa , Silva Rênnis Oliveira da , Araújo Elza Cristina Farias de , Lucena Edson Hilan Gomes de , Cavalcanti Yuri Wanderley
Published: April 2022

O objetivo do estudo foi verificar através de uma revisão sistemática e meta-análise se a História da Doença Periodontal (HPD) é um fator de risco para declínio cognitivo. As buscas bibliográficas nas bases de dados PubMed, Scopus, Web of Science e Cochrane totalizaram 378 registros, após a retirada das duplicatas. Estudos observacionais que verificaram HPD e/ou perda dentária (≥22) resultante de HPD foram selecionados para investigar uma associação com o declínio do estado cognitivo. A síntese quantitativa resultou em duas meta-análises (MA). MA1 (n=5) considerou medidas de associação entre HPD e diminuição do estado cognitivo; enquanto MA2 (n=7) considerou medidas de associação entre perda dentária e diminuição do estado cognitivo. As meta-análises foram realizadas no software OpenMetaAnalyst, usando efeitos aleatórios dicotômicos (p<0,05). Ambas as meta-análises mostraram que a doença periodontal (OR=3,371; IC 95%=1,823-6,232; I²=65,42%) e a perda dentária (OR=1,875; IC 95%=1,355-2,596; I²=56,74%) o declínio do estado cognitivo, medido pelo Mini-Exame do Estado Mental. Pacientes com HPD e perda dentária resultante de periodontite são mais propensos a deteriorar o estado cognitivo, com possível associação com a Doença de Alzheimer.
Humanização aos pacientes críticos do Brasil: revisão integrativa
Authors: Pacheco Mayara Del Aguilal , Palmeira Iaci Proença , Matos Widson Davi Vaz de , Assunção Marta Cleonice Cordeiro de , Ribeiro Ana Flavia de Oliveira , Pacheco Valber Holanda , Rodrigues Wanda Carla Conde , Guedes Quézia Valéria da Costa
Published: April 2022

O presente estudo objetivou apresentar o que a literatura científica nacional produziu sobre a humanização do cuidado no contexto das Unidades de Terapia Intensiva. Elaborou-se revisão integrativa da literatura de artigos publicados no Brasil entre os anos 2011 a 2021. A análise se deu com auxílio de um instrumento construído pela autora. Resultou que entre 202 textos encontrados apenas seis direcionavam-se ao conteúdo da humanização no contexto das Unidades de Terapia Intensiva. Não houve publicações nas regiões Norte, Centro-Oeste e Sul. Profissionais, pacientes e acompanhantes/familiares foram os principais público-alvo nas pesquisas e expressaram quais as condições do cuidado nos ambientes críticos. Para os profissionais as principais dificuldades relacionam-se aos recursos humanos e estruturais, porém ainda assim esforçam-se para desenvolver a humanização no cuidado. Os pacientes e usuários reconhecem tal dedicação, mas sugerem melhorias na comunicação inclusive com o doente e família. Diante do exposto, compreendemos que deve haver conscientização dos profissionais sobre a prática de comportamentos e atitudes mais humanos, com envolvimento dos gestores e pacientes na organização do processo de trabalho, cumprindo com os preceitos da Política Nacional de Humanização e oportunizando planejamento mais direcionado às dificuldades que permeiam o cotidiano nas Unidades de Terapia Intensiva, sempre com apoio da gestão.
The application of Models Portability to predict undergraduate students’ performance by using Transfer Learning
Authors: Beltran Carlos Antonio R. , Xavier Júnior João Carlos , Barreto Cephas Alves da Silveira , Gorgônio Arthur Costa , Costa Song Jong Márcio Simioni da
Published: April 2022

One of the great challenges of education in recent years has been to accurately and reliably predict students’ performance in order to apply different strategies in order to help them with their academic deficiencies. Based on this fact, the main goal of this work is to apply a Transfer Learning approach on Learning Management Systems logs (i.e., Moodle) in order to achieve good portability of models and then predict the performance of undergraduate students. Two different scenarios have been implemented considering the activities of each course used in Moodle, the group of similar courses of the same degree as the first scenario and the group of a similar level of usage of activities as the second one. Empirical analysis has been conducted in order to evaluate the performance of the models created with three well-known classification algorithms (i.e., Decision Tree, Random Forest and Naive Bayes). AUC ROC, F-Measure, Precision and Recall have been applied as prediction measures for choosing the best models and evaluating their portability performance to the other courses. Even in the early stage, the experimental results encourage us to state that it is possible to apply transfer predictive models to the same group of courses in the majority of the cases.
Conscientização sobre a importância da inclusão do aluno com o uso de linguagem de sinais
Authors: Wulf Ivone Pereira , Oliveira Adhimar Flávio
Published: April 2022

O presente trabalho busca contribuir para a conscientização sobre a importância da inclusão de alunos portadores de deficiência auditiva através do uso de Libras no ensino. Apresenta-se neste trabalho um estudo da legislação existente sobre a inclusão, as condições atuais do ensino, e a importância do ensino inclusivo, destacando-se a inclusão do aluno surdo. Inclusão é entender as limitações do outro e proporcionar acesso, através da implantação de um artificio com a finalidade de garantir a participação social e o convívio tendo como base o respeito à diversidade e o direito individual independente de sua deficiência. Como resultado tem-se que a conscientização da importância e urgência na inclusão poderá ser muito mais produtiva e eficaz através da comunicação para os diversos campos da vida, seja a sociedade, a educação, a política, ou a saúde. Nesta pesquisa identificou-se uma carência de legislações e material didático sobre o tema e propostas de ensino, em geral, desarticuladas entre si, superficiais e incompletas. Aqui destaca-se a questão da inclusão de alunos que possuem pouca ou nenhuma audição no ensino de Física.
A Nutrição e suas implicações na endometriose
Authors: Frota Lia de Almeida , Franco Luíza Jácome , Almeida Simone Gonçalves de
Published: April 2022

A endometriose é uma doença que apresenta diversas sintomatologias em mulheres. A mudança de estilo de vida, incluindo melhora de hábitos alimentares com uma alimentação anti-inflamatória, contribui efetivamente para mitigar os sintomas. Sendo assim, o objetivo do trabalho é evidenciar a relação do perfil alimentar junto a composição corporal no desenvolvimento e prognóstico da patologia. O estudo se trata de uma revisão de literatura e para a pesquisa foram consultados 38 materiais, dentre eles artigos científicos, documentos oficiais, livros e trabalhos de conclusão de curso. A pesquisa foi realizada por meio das bases de dados Scielo, PubMed e Google Acadêmico, nos idiomas português, inglês e espanhol, publicados entre os anos de 2011 a 2021. Após a revisão de literatura, foram elencados os principais nutrientes e alimentos que podem contribuir para a redução da sintomatologia ou que podem piorar o quadro clínico referido, além de avaliar a composição corporal de mulheres com endometriose. A alimentação exerce um papel fundamental tanto no desenvolvimento, quanto no manejo da endometriose, onde um perfil alimentar pró-inflamatório aumenta a chance de desenvolvimento assim como piora os sintomas, tendo o Nutricionista uma importante contribuição na melhora de estilo de vida proporcionando qualidade de vida às mulheres com endometriose.
Adolescentes escolares e o programa saúde na escola: Uma revisão integrativa
Authors: Viana Janayna Araújo , Silva Rafaela Brito da , Araújo Anna Maria Valadares , Cresciulo Carolina Maria Soares , Euclides Ingrid Nascimento , Weiler Rosa Maria Eid , Mendes Luis Henrique Rocha , Cá Abdel Boneensa , Suzuki Denise Chrysostomo , Vitalle Maria Sylvia de Souza
Published: April 2022

Esta pesquisa teve como foco de investigação conhecer a importância das ações promovidas pelo (Programa de Saúde na Escola) PSE sob a ótica de adolescentes, à luz da literatura. Para tanto, a pesquisa caracteriza-se por uma revisão de literatura do tipo integrativa com abordagem qualitativa. Os resultados evidenciaram que temas como sexualidade, avaliação antropométrica e a participação do enfermeiro foram achados positivos segundo os adolescentes, enquanto que, os demais temas propostos nas diretrizes do PSE não estiveram evidentes como as políticas de saúde relacionadas sobre o meio ambiente e combate à violência. Conclui-se que a escola é um local propício de acesso aos adolescentes. As ações voltadas à promoção de saúde e prevenção de doença poderia vir a ser ainda mais conjunta e contínua por meio da parceria entre profissionais de saúde, professores e a família com o intuito de contribuir para a mudança de comportamento entre aos adolescentes colaborando assim para a sua saúde e qualidade de vida. Espera-se que a temática apresentada proporcione questionamentos para pesquisas futuras que venham a contribuir para a saúde de adolescentes no âmbito escolar.
Antitumor and antileishmanial activities of limonene-thiosemicarbazones bearing heterocycles nucleous
Authors: Vandresen Fabio , Almeida-Batista Sabrina Alencar de , Caldeira Maria Eduarda Bueno , Romeral Richard de Albuquerque Felizola , Nakamura Celso Vataru , Ruiz Ana Lucia Tasca Góes , Silva Cleuza Conceição da
Published: April 2022

In the present study, we provided the synthesis of a series of R-(+)- and S-(-)-limonene-based thiosemicarbazones containing different pentacyclic heterocyclic nucleus moiety focused in the search of novel antitumor and antileishmanial agents. In the antitumor assay, the derivative imidazole of S-(-)-limonene 8 was the most active compound, especially for U-251, UACC-62 and K562 human tumor cell lines with GI50 ranging from 1.0 to <0.25 µg.mL-1. On the other hand, the imidazole-thiosemicarbazone of R-(+)-limonene 4 was the most promising derivative against the promastigote form of L. amazonensis (IC50=5.9µM). Meanwhile, thiosemicarbazones without limonene moiety (9-12) showed the lowest activities in the biological assays performed. The results demonstrated the influence of the lipophilic molecular character and stereochemistry of chiral monoterpene on the evaluated activities.