bluuebunny/crossref_metadata_2025 huggingface dataset:
How do our Dialysis Patients Die?
Authors:   NephroCare Setúbal, Setúbal, Portugal, Farinha Ana , Mendes Beatriz ,   NephroCare Setúbal, Setúbal, Portugal, Mateus Ana ,   NephroCare Barreiro, Barreiro, Portugal, Branco Ana ,   Nephrocare Santa Maria da Feira, Santa Maria da Feira, Portugal, Outerelo Cristina ,   Nephrocare Santarém, Santarém, Portugal, Buinho Francisco ,   Nephrocare Amadora, Amadora, Portugal, Neves Marta ,   Nephrocare Lumiar, Lisboa, Portugal, Ponce Pedro ,   NephroCare country medical director, Lisboa, Portugal
Published: February 2023

Introduction: Elderly patients are the most frequent patients admitted to dialysis units. Relatively little is known about standards on endof-life (EOL) care among dialysis patients. From international literature, these patients are exposed to more aggressive treatments at EOL than patients with cancer or other chronic diseases and palliative referral is infrequent. This study aims to describe some end-of-life (EOL) practices in patients undergoing hemodialysis in NephroCare clinics in several cities in Portugal. Material and Methods: We designed a prospective, multicenter, observational, cross-sectional study conducted between October 1st, 2020 and September 30th, 2021 in six hemodialysis clinics including 1265 patients (pts). Results: During the year in analysis, 158 pts died (12.4%). Mean age was 76 years (25% of pts were older than 85 years) and dialysis vintage was 84 (2-963) months. Regarding comorbidities, 50% were diabetic, 40% had congestive heart failure, 25% had cancer and 17% had dementia. Mean age-adapted Charlson index was 13 ± 3. For 82 pts (51.9%), nephrologists would not be surprised if they died in the next 6 months. Seventy-three had hospital admissions in the previous three months. Four pts withdrew dialysis. Of those who died, only two had advance care directives, 18 had an opioid prescription in the last month of life and 17 were referred to palliative intervention mostly because of oncologic disorders. Seventy four percent of these pts died at the hospital and 23% died at home/nursing home. Not a single patient died under hospice care. Conclusion: Most of our patients commonly die in hospital, undergo invasive procedures, spend much of their remaining life fulfilling a demanding dialysis schedule and are admitted to the hospital wards without formal palliative intervention or discussion of goals of care, even when death is an expected outcome.
Systemic Lupus Concealed in the Shadow of a Primary Membranous Nephropathy Diagnosis
Authors:   Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Castro Pedro , Mira Filipe ,   Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal,   Faculty of Medicine, University of Coimbra, Coimbra, Portugal, Oliveira Nuno ,   Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Alves Rui ,   Nephrology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal,   Faculty of Medicine, University of Coimbra, Coimbra, Portugal
Published: February 2023

A 43-year-old male patient followed for 27 years in a Nephrology consultation with negative autoimmune diagnostic workup and a histologically proven membranous nephropathy (MN), interpreted as a primary MN. During the follow-up he had multiple relapses, requiring continuous immunosuppression. Eventually, end-stage renal disease developed and the patient started hemodialysis (HD) in January 2018. Soon after initiating HD, he was admitted to the ward due to persistent fever of unknown origin, refractory to antipyretic and antibiotic therapy, but responsive to prednisolone (40 mg/day). Again, the diagnostic workup was negative and the patient was discharged with a corticosteroid taper over 16 weeks. In a posterior admission, after prednisolone suspension, the patient presented to the emergency room with persistent fever, involuntary weight loss, pruriginous macular rash and inflammatory joint pain. As the anti-nuclear antibody and anti-dsDNA came up positive and there was complement consumption, a diagnosis of a systemic lupus flare was established. His stay was complicated by sudden respiratory distress associated with hemoptysis and hemoglobin drop, with a confirmed diffuse alveolar hemorrhage. Daily plasma exchange and intensive immunosuppression was necessary and the patient evolved into complete clinical remission with partial serological response. Usually, patients with systemic lupus erythematosus (SLE) develop clinical and serological remission upon initiating HD, reducing the number of flares and need for medication. This case depicts a lupus flare after starting HD, on a previously serologically negative patient, complicated with a rare type of lung parenchyma involvement, which is associated with a high mortality and required intensive immunosuppression for disease control. One can speculate whether or not the initial glomerulopathy was the first manifestation of SLE, previously controlled due to the continuous use of immunosuppression.
Successful Treatment of Sthaphylococcus Peritonitis Using Oral Linezolid Without Catheter Removal in a Peritoneal Dialysis Patient
Authors:   Nephrology Department, Hospital Central do Funchal, Funchal, Portugal, Carvão João , Matias Patrícia ,   Nephrology Department, CHLO – Hospital Santa Cruz, Carnaxide, Portugal, Mirco Ana ,   Pharmaceuticals Department, CHLO – Hospital Santa Cruz, Carnaxide, Portugal, Branco Patrícia ,   Nephrology Department, CHLO – Hospital Santa Cruz, Carnaxide, Portugal
Published: February 2023

Peritonitis is one of the main complications of peritoneal dialysis and accounts for considerable mortality and hospitalization. It is usually treated with intraperitoneal antibiotherapy, as it is the best way to achieve high concentrations at the site of infection. We report a case of an 86-year-old female patient with end-stage renal disease under continuous ambulatory peritoneal dialysis, who was admitted to our hospital with complaints of intense diffused abdominal pain. The effluent culture yielded Staphylococcus hominis only sensible to vancomycin and linezolid. She was diagnosed with peritonitis secondary to Staphylococcus hominis infection and treated with oral linezolid without catheter removal. Adequate linezolid peritoneal fluid concentration (between 3 and 20 µg/mL) was achieved and the antibiotic therapy was maintained for 21 days with clinical and analytical improvement. According to our knowledge, this was the first Staphylococcus peritonitis in a peritoneal dialysis patient, successfully treated with oral linezolid and has had linezolid levels monitored in the peritoneal dialysis effluent.
Life and Sleep Quality amongst Peritoneal Dialysis Patients: A Comparative Study
Authors:   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Castro Pedro , Correia Ana ,   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Mira Filipe ,   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal,   Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal, Cerqueira Sofia ,   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Oliveira Nuno ,   Serviço de Nefrologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal, Maia Pedro ,   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: February 2023

Introduction: Sleep disorders affect up to 70% of peritoneal dialysis (PD) patients and appear to have significant negative effects on their quality of life (QoL). We compared life and sleep quality between patients on automated PD (APD) and continuous ambulatory PD (CAPD). Material and Methods: Cross-sectional study in chronic PD patients followed in our Dialysis Unit in February 2022. We evaluated sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) and QoL with EUROHIS-QOL-8. Results: Fifty-two patients, mostly men (65.4%, n=32), with a mean age of 52.7±14.2 years and PD vintage of 24.3±17.1 months. Our sample had similar distribution between APD and CAPD; we found no difference between groups regarding demographic data, PD-related quality parameters or prevalence of previous sleep disturbances. Mean QoL index was 69.9%±9.3% and similar between APD and CAPD patients; EUROHIS-QOL-8 negatively correlated with the scores on ESS (p=0.004) and PSQI (p=0.011). Regarding sleep quality, the mean ESS was 8.8±4.2 and PSQI was 7.6±3.6. APD patients had similar scores on ESS, but higher prevalence of severe daytime sleepiness (ESS≥18) (p=0.04) and higher scores on PSQI (p=0.002). Within the PSQI, sleep’ latency (p=0.003), duration (p=0.002) and efficiency (p=0.013) were the most affected parameters. Higher PSQI scores also correlated with worse blood pressure control; a cut-off value for PSQI of 6 was found to increase the risk of uncontrolled hypertension. Conclusion: In our series, APD patients had worse global sleep quality (PSQI) when compared to ACPD patients. This difference was mainly due to worse sleep latency, duration and efficiency. The assessment of the quality of life showed no difference between groups, however there was a clear link between quality of life and sleep quality.
Radiocephalic Fistula Recovery Using the Forearm Basilic Vein: A Case Report
Authors:   Nephrology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Alferes Daniela , Pereira Susana ,   Nephrology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Faria Vitória ,   Nephrology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Ventura Ana ,   Nephrology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Martins Victor ,   Angiology and Vascular Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Canedo Alexandra ,   Angiology and Vascular Surgery Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal, Almeida Clara ,   Nephrology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
Published: February 2023

Dysfunction of the arteriovenous fistula for hemodialysis is a challenge for the nephrologist and the vascular surgeon. Although experience is limited, the use of the forearm basilic vein as outflow of the radiocephalic fistula has been considered. We report the case of a 60-year-old male, with cardiovascular comorbidities and a history of ischemic complications induced by the hemodialysis access. Drainage problems were present in the radiocephalic fistula and the forearm basilic vein was used in the vascular access repair. The procedure was successful, and the patient maintains a functional fistula, with secondary patency of 32 months, with no cardiac complications or hand access-induced distal ischaemia syndrome.
Adult-Onset Genetic Focal Segmental Glomerulosclerosis: A Tale of Two Mutations
Authors:   Nephrology Department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal, Sousa Luís , Pimenta Gonçalo ,   Nephrology Department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal, Veríssimo Rita ,   Nephrology Department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal, Theias Rita ,   Pathology Department, Hospital Professor Fernando da Fonseca, Amadora, Portugal, Carvalho Tiago ,   Nephrology Department, Hospital de Santa Cruz, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal
Published: February 2023

Focal segmental glomerulosclerosis (FSGS) is a kidney histologic lesion that may be caused by multiple aetiologies and pathophysiological mechanisms, with podocyte injury and depletion as the common denominator. FSGS may be subdivided into different subclasses: primary, secondary, genetic and unknown forms. Notwithstanding the overlapping clinical and histological characteristics across the different forms of FSGS, their management and response to treatment are strikingly different. Genetic FSGS may be suggested by the appearance of nephrotic syndrome during childhood, but it may also present in adulthood, where the diagnosis is rather challenging due to widely variable clinical and histological phenotypes. Herein we present the case of a 34-year-old female with a family history of chronic kidney disease of undetermined aetiology, referred for a Nephrology consultation due to haematoproteinuria and de novo arterial hypertension. Complementary evaluation revealed a urinary protein/creatinine ratio of 4.3 g/g and albumin/creatinine ratio of 3.9 g/g with hypoalbuminaemia. Kidney biopsy revealed lesions of FSGS, associated with extensive foot process effacement. The constellation of findings and family history of kidney disease raised the suspicion of a genetic cause, therefore genetic testing was performed. Two variants in the NPHS2 gene [c.686G>A, p.(Arg229Gln) and c.855_856del, p(Arg286Thrfs*17)] were found in compound heterozygosity, compatible with the diagnosis of genetic FSGS. This case highlights the importance of a detailed evaluation of patients with FSGS lesions in order to identify the FSGS form, given its therapeutic and prognostic impact, including after kidney transplantation.
Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
Authors:   Pediatric Department, Dr. Nélio Mendonça Hospital, Funchal, Portugal, Gonçalves Carolina , Fernandes Carolina ,   Pediatric Department, Dr. Nélio Mendonça Hospital, Funchal, Portugal, Pilar Carla ,   Pediatric Surgery Department, Dr. Nélio Mendonça Hospital, Funchal, Portugal, Alves Fátima ,   Pediatric Surgery Department, Dr. Nélio Mendonça Hospital, Funchal, Portugal, Borges Maria ,   Pediatric Department, Dr. Nélio Mendonça Hospital, Funchal, Portugal
Published: February 2023

Xanthogranulomatous pyelonephritis is an unusual variant of chronic pyelonephritis in which there is massive destruction of the renal parenchyma by granulomatous tissue. The pathophysiological mechanism is not yet fully understood, and the diagnosis is challenging. This is a rare and sporadic diagnosis in the pediatric population. Here, we report a case of a 2-year-old girl with a one-year history of urinary tract infections and recurrent cloudy urine with traces of sand. Several urinalyses demonstrated pyuria without bacteria growth, and she was admitted to the pediatric nephrology unit. Imaging tests were performed and a xanthogranulomatous pyelonephritis was diagnosed. After confirmation of functional exclusion of the right kidney, a successful right nephrectomy was performed, and the histology confirmed the diagnosis. This case highlights the importance of complementary tests, in a child with signs and symptoms of urinary tract dysfunction, to exclude any pathology requiring therapeutic intervention.
Potential demographic collapse in a common perennial bunchgrass on south-facing slopes in a semi-arid grassland via dramatically reduced seedling establishment
Authors: Parker Timothy , Gerber Alex , Campbell Erin , Simonson Molly , Shriver Robert , Persico Lyman
Published: February 2023

Many perennial plants in semi-arid rangelands have experienced population declines, and understanding the ecological and demographic processes behind these declines is important to slowing or reversing them. Although anthropogenic disturbances have driven declines across many landscapes, other sorts of environmental variability, such as the differences in intensity of solar radiation with aspect, may impact population success locally. We experimentally assessed the role of solar radiation in driving an apparent decline in a common perennial bunchgrass, bluebunch wheatgrass (Pseudoroegneria spicata), on south-facing slopes at a site in the Columbia Basin of North America. Across three separate experiments on south-facing slopes, we observed dramatically (5 to 36 times) higher seedling success in plots shaded to approximate the solar radiation of north-facing slopes relative to adjacent open (unshaded) plots. When we applied the rates of seedling success from these experiments to demographic models from this site, we found that seedling success in unshaded plots was often too low to allow a stable population on south-facing slopes, but that seedling success in shaded plots was often high enough to allow a stable or increasing population on north-facing slopes. We originally hypothesized that the primary mechanism driving this effect was water stress caused by greater evaporation from hotter open plots. However, despite soils in open plots being consistently hotter than soils in shaded plots, we did not observe a clear pattern of greater soil moisture in shaded plots. Therefore, it appears that higher solar radiation or higher temperatures on south-facing slopes may be sufficient to dramatically reduce seedling survival, and that the higher density of bluebunch wheatgrass on north-facing slopes relative to south-facings slopes may be driven primarily by this low survival of seedlings. Climate warming could further reduce seedling success and therefore threaten populations of this species and other perennials in similar habitats.
Conceptualizing microbe-plasmid communities as complex adaptive systems
Authors: Pilosof Shai
Published: February 2023

Plasmids shape microbial communities' diversity, structure, and function. Nevertheless, we lack a mechanistic understanding of how community structure and dynamics emerge from local microbe-plasmid interactions and co-evolution. Addressing this gap is challenging because multiple processes operate simultaneously at multiple levels of organization. For example, immunity operates between a plasmid and a cell, but incompatibility mechanisms regulate coexistence between plasmids. Conceptualizing microbe-plasmid communities as complex adaptive systems is a promising approach to overcoming these challenges. I illustrate how agent-based evolutionary modeling, extended by network analysis, can be used to quantify the relative importance of local processes governing community dynamics. These theoretical developments can advance our understanding of plasmid ecology and evolution, especially when combined with empirical data.
Nonce Formations as a Campaign Tool in the 2022 General Elections in Kenya
Authors: MBAKA NANCY
Published: February 2023

Language is primarily a system that speakers use to make meaning. When there is no available term to refer to a new phenomenon or to communicate an idea then speakers use their linguistic creativity to create new terms. This is especially witnessed in the political arena during the campaign period. Using a multi-modal approach, this study analysed nonce formations that were used as a campaign tool during the 2022 general elections in Kenya. The nonce formations were purposively selected from WhatsApp platforms that supporters of the candidates were using to campaign for their candidates of choice or against the candidate they did not want to elect. Only words/phrases and images that were coined to campaign or communicate campaign ideals were selected. The data was analysed using a multi-modal approach and transitivity analysis based on Systemic Functional Grammar. The findings of this research indicate that nonce formations were a prominent campaign tool before the elections took place. This study contributes to the theory of nonce formations and neologisms and provides linguistic material for use in the study of political discourse and political register.
Relación entre la identidad moral y los estilos de intervención de los espectadores defensores en el ciberacoso
Authors: Alcantar Nieblas Carolina , Álvarez-Montero Francisco José , Valdés-Cuervo Ángel Alberto
Published: February 2023

La conducta de los espectadores desempeña un rol esencial en la dinámica del ciberacoso. El presente estudio examinó la relación entre la identidad moral y los estilos de intervención constructiva y agresiva del espectador defensor en el ciberacoso. Participaron 684 (43.3% del sexo masculino, 56.7% del femenino) estudiantes (M edad = 14.3 años, DE = 1.7) de escuelas secundarias y preparatorias públicas del estado de Sonora. Se calculó un modelo de ecuaciones estructurales para analizar las relaciones entre las variables. Se encontró que la identidad moral se relaciona de forma positiva con la intervención constructiva y no se asocia significativamente con la intervención agresiva del espectador defensor. Se concluyó que la identidad moral es un predictor de las intervenciones constructivas de los espectadores defensores en el ciberacoso.
Bases teóricas para el estudio de representaciones sociales acerca de educación financiera
Authors: Ahumada Maldonado Blanca Irene
Published: February 2023

En este escrito se presentan los principales aspectos teóricos como una propuesta al estudiar las concepciones que poseen las personas acerca de la educación financiera. Según la Organización para la Cooperación y el Desarrollo Económicos, existe un analfabetismo económico que aqueja la vida de las personas e impide que se desenvuelvan adecuadamente en el plano económico, y esto afecta el desarrollo de los países. La Teoría de las Representaciones Sociales sustenta cómo las concepciones que se tienen de un concepto están influenciadas por las prácticas sociales de la comunidad. La educación financiera es necesaria para el crecimiento económico e incluye el conjunto de conocimientos, técnicas y habilidades que permiten planear, administrar, incrementar y proteger el patrimonio individual y colectivo. En la parte final se muestran algunos conceptos básicos de la psicología económica y cómo estos influyen en la toma de decisiones económicas de los individuos y de las sociedades. Conocer la representación social sobre los principales aspectos económicos apoyará en el diseño de un programa de educación financiera que contribuya a la toma argumentada de decisiones de tipo económico.
¿Qué habilidades requieren los universitarios para generar competitividad laboral?
Authors: Pérez-Maldonado Hugo , Peñaloza Suárez Laura , Tamayo Salcedo Ana Leticia
Published: February 2023

Actualmente en México las empresas enfrentan diversos retos, uno de ellos es el capital humano como factor indispensable para lograr competitividad empresarial, sin embargo, existe una brecha entre las competencias del capital humano y las necesidades del mercado laboral, por lo que las instituciones de educación superior (IES) adquieren un papel importante para que los profesionales desarrollen conocimientos y habilidades que les permitan incrementar su competitividad y obtener mejores puestos de trabajo en beneficio de la sociedad. Por lo anterior, el objetivo del presente trabajo es identificar las habilidades que requieren los universitarios para generar competitividad en el ámbito laboral, con la finalidad de que se tengan bases para conocer si el alumnado las adquiere durante su formación. El estudio se aborda desde una perspectiva interpretativa, con método documental en un contexto teórico conceptual, basado en la revisión de bibliográfica de diversos autores (utilizando las bases de datos Web of Science, Redalyc y SciELO, principalmente). Se concluye que la universidad (caso de estudio) aún tiene el reto de formar a profesionistas que adquieran habilidades gerenciales, digitales y emprendedoras,  necesarias para reducir la brecha entre las habilidades que adquiere el capital humano durante su proceso de formación y las necesidades del entorno empresarial del sector turístico, lo que ayudará para contribuir al avance del desarrollo social, ya que las tres habilidades en su conjunto son factor indispensable en la formación de los universitarios para generar competitividad laboral.
Autoetnografía con perspectiva de género. Una forma narrativa de producción de conocimiento desde las masculinidades no hegemónicas
Authors: Cruz Hernández Jorge Luis
Published: February 2023

El posicionamiento epistemológico de la autoetnografía como método de investigación posmoderno y constructivista implica que el sujeto visibilice la opresión corporeizada de su realidad y al mismo tiempo critique las formas hegemónicas de producción de conocimiento masculino. De ahí que este ensayo crítico emerja desde la perspectiva de género para dar a conocer las implicaciones ético-políticas de la autoetnografía como generadora de conocimiento situado, parcial e histórico. Visibilizar a los sujetos que escriben e investigan sus propias experiencias vitales es una forma de romper con la lógica patriarcal, pues esto supone la apertura del sujeto cultural implicado en el proceso de conocer la realidad. El objetivo de este trabajo es demostrar cómo la generación de conocimiento, desde la autoetnografía, implica romper con las normas legitimadas de objetividad, neutralidad y racionalidad occidentales; asimismo dar a conocer que las prácticas de hacer ciencia legítima se relacionan con las prácticas sociales de producción de hombres masculinos. Por lo tanto, la perspectiva de género es una apuesta que reconoce que la subjetividad masculina hegemónica se puede deconstruir, y que la autoetnografía posibilita las bases epistemológicas y metodológicas para la producción de masculinidades alternativas en acto. Al hacer un ejercicio retrospectivo del yo se comprende que, desde la modernidad, se instalan criterios de verdad para hacer ciencia y criterios de producción para los sujetos masculinos. Se concluye que el quehacer de la autoetnografía contribuye a que la perspectiva de género reconozca que el varón masculino no hegemónico también puede producir conocimiento subversivo.
Review of 3D Data Creation to Curation: Community Standards for 3D Data Preservation
Authors: Kramer Whitney
Published: February 2023

Review of Moore, Jennifer, Adam Rountrey, and Hannah Scates Kettler, eds., 3D Data Creation to Curation: Community Standards for 3D Data Preservation. Chicago, Illinois: Association of College and Research Libraries, 2022.
LAS REFORMAS OVANDINAS EN NUEVA GALICIA: La Audiencia de Guadalajara y la creación de un nuevo orden político, 1568-1605
Authors: González Victor
Published: February 2023

Los ensayos reunidos en este libro se originaron en la búsqueda por relacionar y contextualizar la historia de la familia y el mestizaje, tema sobre el que he trabajado en los últimos años, con las estrategias de «reproducción social» del Antiguo Régimen a partir de la conformación de un orden político basado en el Pater familias y la Economia, en donde el rey personifica la figura paterna de una gran familia formada por la aristocracia, pero también por los agentes del imperio que conformarían la monarquía universal. Porque partimos de la idea de que existe una relación clara entre el Pater familias y la Economia (la economía del hogar y del bien común) y la construcción de un orden político plural, religioso y con énfasis en la familia monogámica, a partir del cual se conformaría la sociedad novohispana. Sin embargo, poco conocemos cómo este orden se estableció particularmente en el reino de Nueva Galicia, territorio al que están enfocados los siguientes trabajos
Impacto do tratamento fisioterapêutico sobre a cefaleia em pacientes com desordem temporomandibular: uma revisão sistemática
Authors: Barbosa Alan Nogueira , Ana Paula Silva Oliveira  , Santos Fernanda Aparecida Ferreira , Colombo Gabriely Inês Colombo , Cerqueira Natale de Sena , Sales Rafaela da Silva , Cordeiro André Luiz Lisboa
Published: February 2023

Introdução: As disfunções temporomandibulares (DTM) desencadeiam dor e desconforto na articulação temporomandibular, podendo apresentar sintomas como cefaleia. Sendo assim, o tratamento fisioterapêutico vem sendo aplicado para redução desses sintomas através de técnicas manuais. Objetivo: Revisar o impacto do tratamento fisioterapêutico sobre a cefaleia em pacientes com DTM. Métodos: Trata-se de um estudo de revisão sistemática com busca de dados nas bases Scielo, Lilacs e Pubmed, no qual foram incluídos ensaios clínicos randomizados e excluídos estudos com histórias de traumas na face, em crianças, patologias reumáticas, doenças neurológicas, estudos não randomizados, relatos de caso, observações clínicas e revisões. Os artigos selecionados são tanto na língua portuguesa quanto inglesa. Foram utilizadas as seguintes palavras-chave: relação entre cefaleia e disfunção temporomandibular, dor na articulação temporomandibular e cabeça, tratamento fisioterapêutico e terapia manual. Resultados: Dos 5 estudos selecionados, 3 obtiveram resultados positivos, melhorando a intensidade da dor de cabeça e a síndrome da desarmonia corporal, além do aumento da ADM da cervical, que de certa forma influencia também na DTM. Conclusão: Conclui-se que há uma melhora significativa no quadro cefaleia após o tratamento fisioterapêutico.
Impacto da COVID-19 na saúde emocional e na rotina de trabalho de fisioterapeutas oncológicos no Brasil
Authors: Mont’Alverne Daniela Gardano Bucharles , Rodrigues Luiz Rodrigo da Silva , Bedê Julia Maria Sales , Da Silva Ana Karoline Almeida , Abreu Bianca Oliveira , Goes Fernandes Thiago , Da Conceição de Araújo Silva Roberta Luana , Moura Andréa Felinto
Published: February 2023

Introdução: A pandemia da COVID-19 vem impactando na saúde emocional e na rotina de trabalho dos profissionais de saúde. Objetivo: O objetivo deste estudo foi avaliar o efeito da pandemia da COVID-19 na saúde emocional e na rotina do trabalho dos fisioterapeutas oncológicos brasileiros. Métodos: Estudo transversal online anônimo, no qual 102 fisioterapeutas oncológicos foram recrutados de diferentes regiões do país, usando amostras de conveniência de bolas de neve nas mídias sociais. Dados sociodemográficos, referentes à formação e atuação profissional foram avaliados, além dos sintomas de Depressão, Ansiedade e Estresse. Resultados: A maioria dos fisioterapeutas era do sexo feminino (n = 89,87,3%), com média de idade de 33,8 ± 7,1 anos e especialista em fisioterapia oncológica (n = 84,82,5%). Quanto mais jovens mais estressados eram os profissionais (p = 0,022). A maioria manteve os atendimentos presenciais (n = 89, 87,3%) e o sintoma de estresse apresentou maior pontuação (6,9 ± 4,4). O aumento na jornada de trabalho e a transferência para outras unidades de trabalho resultaram em maiores sintomas de ansiedade (p = 0,016) e de estresse (p = 0,011). Conclusão: Concluímos que a pandemia afetou negativamente a rotina de trabalho e a saúde emocional de fisioterapeutas oncológicos no Brasil.
O efeito da eletroestimulação de 65 Hz sobre a incontinência urinária, força dos músculos do assoalho pélvico e impacto na vida diária de pacientes após prostatectomia radical: experimento controlado randomizado duplo cego
Authors: Zaidan Patrí­cia , Silva Elirez Bezerra da
Published: February 2023

Introdução: A prostatectomia radical é um procedimento cirúrgico eficaz para a cura do câncer de próstata. Contudo, apresenta como uma das consequências a incontinência urinária (IU). Objetivo: Verificar o efeito da eletroestimulação de 65 Hz sobre a IU de pacientes com deficiência esfincteriana, consequente de uma cirurgia de prostatectomia radical. Métodos: Trata-se de um ECR duplo cego. Os pacientes passaram por uma triagem e foram alocados aleatoriamente em três grupos: Grupo exercícios dos MAP (EMAP, n = 23), grupo eletroestimulação 50 Hz mais exercícios dos MAP (EE50+EMAP,n = 19),grupo eletroestimulação 65 Hz mais exercícios dos MAP (EE65+EMAP, n = 23). A frequência semanal foi de duas vezes e a quantidade de sessões foi aquela necessária para recuperar a continência urinária, não ultrapassando de 20. Foram utilizados o risco relativo (RR) e ANOVA 3 X 2 para a análise estatística dos dados. Resultados: O risco relativo de IU do Grupo EE65+EMAP em relação ao Grupo EMAP foi igual a 0,48 (IC95% 0,31 a 0,73), enquanto que o risco relativo de IU do Grupo EE50+EMAP em relação ao Grupo EMAP foi igual a 0,89 (IC95% 0,77 a 1,04). Conclusão: A frequência de 65Hz foi mais eficaz que a de 50 Hz na recuperação da continência urinária de homens prostatectomizados.
Impacto da fisioterapia intradialítica em doentes renais crônicos: uma revisão integrativa
Authors: Cunha Beatriz Luiza Marinho , Cabral Daniele Cosmo da Silva , Luna Ellen Ferreira de , Souza Jéssica Maria Nogueira , Silva Mírian Brandão da , Nascimento Rayane Alves do , Santos Waira Thuany de Souza Melo de Luna , Rolim Santos Gabriel Felipe , Silva Julianny Barbosa da
Published: February 2023

Introdução: A doença renal crônica (DRC) é descrita na literatura como uma perda progressiva e irreversível da função do néfron, tal disfunção resulta na deficiência do organismo em manter o equilíbrio metabólico e hidroeletrolítico. O tratamento indicado habitual para DRC é a hemodiálise (HD) que realiza a filtração sanguínea extracorpórea sem caráter curativo. Indivíduos que são submetidos à diálise sofrem complicações sistêmicas e metabólicas com prevalência em desordens pulmonares, resultado da sobrecarga hídrica e toxinas urêmicas circulantes. Tendo como decorrência a redução da capacidade ao exercício em cerca de 50% a 60% menores do que em indivíduos saudáveis, o que favorece a existência de comorbidades como o diabetes mellitus e disfunções cardiovasculares que contribuem ainda mais para o sedentarismo e restrição de atividades de vida diária. O exercício físico exerce um importante papel no tratamento não farmacológico da DRC, reduzindo o declínio funcional, risco de morte e minimizando os efeitos colaterais da HD. Objetivo: Avaliar os impactos da fisioterapia intradialítica em doentes renais crônicos. Métodos: Trata-se de uma revisão da literatura científica. A pesquisa catalogou referências dos últimos cinco anos. Os artigos selecionados estão indexados nas principais bases de dados disponíveis para leitura integral: PubMed, Lilacs e Scielo. Os descritores pré-selecionados na língua inglesa e seus respectivos termos em português, foram utilizados para refinar a busca e cruzados para melhores achados. Resultados: Um total de 58 artigos foram identificados quando cruzados os descritores, dos quais dois foram excluídos por duplicidade, ao fim da busca cinco artigos foram elegíveis para a elaboração do presente estudo. Devido ao pequeno número de artigos e suas características heterogêneas, seus resultados foram apresentados de forma descritiva. Conclusão: O presente estudo demonstrou que a realização de programas de exercícios aeróbicos e resistidos intradialítico são capazes de promover melhoras da capacidade física, tolerância ao exercício e índices de qualidade de vida.
Achados audiológicos na síndrome de Rubinstein-Taybi: revisão sistemática
Authors: Angst Otilia Valéria Melchiors , Rosa Rafael Fabiano Machado , Zen Paulo Ricardo Gazzola , Sleifer Pricila
Published: February 2023

Objetivo: Verificar os achados audiológicos em sujeitos portadores da Síndrome de Rubinstein-Taybi (SRT) através de uma busca sistemática na literatura. Métodos: Foram utilizados os descritores “Rubinstein Taybi Syndrome” AND “Hearing” nas principais bases de dados. O levantamento limitou-se a publicações realizadas até junho de 2020, sem limitação de idioma. Foram incluídos todos os estudos que envolvessem avaliações auditivas realizadas em sujeitos portadores da SRT. Foram excluídos da análise, estudos que envolvessem população não portadora de SRT, cartas ao editor e estudos nos quais não foram encontrados os artigos originais. Resultados: A pesquisa resultou na seleção de cinco artigos que evidenciaram que não há uma padronização nos testes audiológicos devido à heterogeneidade das características encontradas na SRT. A perda auditiva do tipo condutiva foi amplamente relatada, porém não foi possível verificar se há um perfil audiológico nesta população. Conclusão: Verificou-se que poucos estudos avaliaram a audição dos portadores de SRT. Além disso, foi possível observar que ainda não são padronizados os testes audiológicos. Recomenda-se que sejam realizados mais estudos com amostras maiores a fim de conhecer quais são as alterações audiológicas mais comuns de modo que se indique precocemente a intervenção terapêutica mais adequada.
Prática de exercício físico e função física em grupo de idosos durante a pandemia por COVID19 no interior do Amazonas
Authors: Silva Tatiana Araújo da , Prestes Yandra Alves , Braga Johrdy Amilton da Costa , Quialheiro Anna , Oliveira Adriano Carvalho de , Dantas Ellem Nara Tananta , Leon Elisa Brosina de , Campos Hércules Lázaro Morais
Published: February 2023

Objetivo: Descrever a presença da prática de exercício físico e de função física em um grupo de idosos durante a pandemia por COVID-19 no interior do Amazonas. Métodos: Trata-se de um estudo transversal realizado com idosos ativos que realizavam exercício físico por pelo menos 3 vezes na semana por 50 minutos no interior do Amazonas. Avaliou-se a prática de exercício físico antes e durante a pandemia e aplicaram-se duas questões investigativas referente a COVID-19. Para avaliar a capacidade funcional e física aplicou-se o Short Physical Performance Battery (SPPB). Resultados: A amostra foi composta por 63 idosos ativos da comunidade. Destes, 31,8% (21) eram analfabetos, 74,2% (49) aposentados e 75,8 % (50) de baixa renda. No SPPB 27,3% (18) apresentaram total de 10 pontos e 14,29% (9) dos idosos realizam exercício físico acima dos minutos recomendados pela Organização Mundial da Saúde (OMS). Conclusão: Neste estudo nenhum fator durante a pandemia interferiu na prática de exercício físico e nem na capacidade funcional dos idosos que residem no interior do Amazonas.
Avaliação do uso de estratégias não invasivas em pacientes com insuficiência respiratória por COVID-19
Authors: Monteiro Paulo Nixon Cardoso , Moreira Whelen de Sousa , Chaves Maylla Salete Rocha Santos , Ferreira Luana Gabrielle de França
Published: February 2023

Introdução: Durante a pandemia de COVID-19, tornou-se necessário o uso de estratégias no tratamento dos pacientes que evoluem com insuficiência respiratória aguda. Objetivo: Avaliar o uso de estratégias não invasivas no desfecho de pacientes com insuficiência respiratória aguda ou crônica agudizada por COVID-19. Métodos: Pesquisa de caráter observacional e retrospectivo por meio da coleta de dados em prontuário eletrônico com pacientes submetidos ao uso de cânula nasal de alto fluxo (CNAF) e/ou ventilação mecânica não invasiva (VNI). Resultados: 81 pacientes, sendo 70,4% (57) do sexo masculino, com 56,5 ± 14,6 anos. 49,4% (40) dos indivíduos fizeram uso de CNAF e VNI, 9,9% (8) e 40,7% (33) apenas VNI ou CNAF, respectivamente. O tempo médio de uso da CNAF foi de 4,4 ± 3,7 dias e de VNI foi de 2,7 ± 3,4 dias. Observou-se que 43 (53,1%) dos pacientes pesquisados evoluíram para intubação orotraqueal (IOT) e 40 (49,4%) para óbito. Destes, 22 encontravam-se em IOT. Houve diferença estatística quando comparados idade entre os grupos IOT e não IOT, 60,5 ± 13,9 anos vs 52,1 ± 14,2 anos (p = 0,012), respectivamente. Conclusão: O uso de VNI e/ou CNAF pode ser considerado como alternativa no tratamento de pacientes com COVID-19. Contudo, os diversos fatores intrínsecos e extrínsecos ao paciente ainda contribuem para a alta taxa de IOT e de mortalidade.
Uma análise da implementação do modelo de ensino one minute preceptor na vivência da prática profissional de estudantes de fisioterapia de uma faculdade do nordeste brasileiro
Authors: Pimentel Claudluce Marques , Vieira Juliany Silveira Braglia Cesar , Costa Juliana Monteiro , Barros Maria Clara Santos
Published: February 2023

Analisar o impacto do One Minute Preceptor na vivência da prática profissional de estudantes de fisioterapia de uma instituição de ensino superior que utiliza metodologia ativa de ensino no Nordeste brasileiro. Estudo de intervenção, qualiquantitativo, sequencial explanatório, realizado no centro de reabilitação, um dos cenários do hospital escola, com amostra de 20 estudantes e 10 preceptores. Ocorreu em quatro etapas, seguindo a resolução 510/16 do Conselho Nacional de Saúde, sob parecer 3.021.399. Análises quantitativas realizadas no Microsoft Office Excel 2016® e Software Rstudio®, a qualitativa conforme análise de conteúdo de Bardin. O One Minute Preceptor mostrou-se adequado a metodologia da instituição e perfil dos estudantes participantes. Estimulou, motivou e favoreceu o raciocínio crítico reflexivo, sendo percebido pelos grupos melhora na condução da preceptoria, feedback e postura ativa dos estudantes, possibilitando consolidar instrumentos facilitadores de ensino-aprendizagem em ambientes de prática clínica.
Should Physicians Avoid Routine Iron Supplementation in Rheumatic Musculoskeletal Diseases (RMDs)?
Authors: Islam Mohammad Aminul
Published: February 2023

Abstract not available

CBMJ 2023 January: Vol. 12 No. 01 P: 01-02
Efficacy of Cryotherapy in Comparison to Standard Oral Care to Prevent Oral Mucositis during Concurrent Chemoradiotherapy in Head and Neck Cancer Patients
Authors: Pathan Mohammad Saiful Islam , Khan Mojibur Rahman , Sultana Tanin , Mahmud Mohammad Ashraf-Us-Zaman , Saha Dipok , Rahaman ATM Shazzaeatur , Masud Md Rakibul Islam , Rahman Mohammad Arifur , Patowary Mohammed Shorfuddin , Hossain Altaf , Tanvir Sarker Md , Paul Suman , Datta Mukti Rani , Rinky Nahid Naznin
Published: February 2023

A quasi-experimental study was conducted at Radiation Oncology Department of National Institute of Cancer Research & Hospital (NICRH), Dhaka, Bangladesh, between November 2020 and October 2021, to determine the efficacy of cryotherapy in comparison to standard oral care to prevent oral mucositis in head and neck cancer patients during receiving CCRT. A total 100 Patients (50 patients in each arm) were included in this study according to inclusion and exclusion criteria by purposive sampling technique. All patients in Arm A and Arm B received total 66 Gray in 33 daily fractions, 1 fraction per day, 5 fractions per week and inj. Cisplatin 40mg/m² was given intravenously 2/3 hours before radiotherapy on 1st day and then weekly. Arm A received cryotherapy and Arm B received standard oral care. Intervention started from the 1st day of CCRT up to the end of CCRT. WHO oral mucositis grading and visual analogue scale (VAS) were employed to determine the effects. All the information was recorded in a pre-tested semi-structured questionnaire. Total 100 patients (50 patients in each arm) were enrolled. Mean age of the patients of Arm A and Arm B was 55.28±7.82 and 55.92±8.33 respectively. Male and female ratio was 6.14:1 in two Arms. Other demographic profile, baseline characteristics were statistically not significant in both arms (P>0.05). The grade-3 mucositis appeared after 5th week in Arm B and after 6th week in Arm A. The incidence of grade- 3 mucositis after 5th week during CCRT to 4 weeks after completion of therapy was 6% vs 0%, 14% vs 6%, 22% vs 10%, 14% vs 6%, 8% vs 2%, respectively for arm B and Arm A (P<0.05). Total number of patients suffering from grade 3 mucositis was 6 (12%) and 12 (24%) for Arm A and Arm B respectively (p value was <0.05). The mean duration of grade-3 or more mucositis between Arm A and Arm B was 2.04±1.78 and 10±1.72 days respectively (P<0.05). The difference of median pain intensity between two arms was not statistically significant for 1st and 2nd week (P>0.05). However, it was significant after 3rd week during CCRT to 4 weeks after completion of CCRT (P<0.05). Cryotherapy during CCRT may be beneficial to prevent oral mucositis and pain than maintaining standard oral care.

CBMJ 2023 January: vol. 12 no. 01 P: 03-11
Gender Variation of Scapula in a Bangladeshi Population – A Radiological Study
Authors: Momena Zeenatul , Rahman Md Shamsur , Perveen Rehana , Shahin Rebeka , Chowdhury Mahfuza , Mahmud Shaila
Published: February 2023

The scapula is a complex anatomical unit; it connects the humerus with the clavicle. The scapula presents several variations, based on race, sex and region. Sexual dimorphism plays a key role in forensic anthropology. The scapula is sexually dimorphic and can potentially be used in forensic investigations. A cross-sectional study was conducted under Department of Anatomy, Dhaka Medical College, Dhaka, between July 2017 and June 2018, to observe the morphometric pattern of the left scapula in adult male and female Bangladeshi people for establishment of a baseline anatomical data for future studies. Shoulder radiograph of anterior-posterior view were taken from 100 apparently healthy adult male and female patients aged between 25 and 50 years who were attending the Department of Radiology & Imaging, Dhaka Medical College Hospital, Dhaka. From these images morphological measurements like the length and breadth of left scapula, the lengths of infraspinous line and scapular spine were measured by software named RadiAnt DICOM Viewer. The length and breadth of left scapula, the length of coracoid process, as well as the lengths of infraspinous line and scapular spine were found significantly higher in males. To summarize, a significant difference was observed in morphological measurements of the left scapula between the sexes in Bangladeshi people. 

CBMJ 2023 January: Vol. 12 No. 01 P: 12-16
Incidence and Risk Factors of Congenital Heart Diseases in Syndromic Neonates
Authors: Rahman Md Mahbubur , Al Amin Abdullah , Ferdaus Jannatul , Quader Mohammad Abdul
Published: February 2023

Congenital heart defects (CHD) are the most common types of major birth defects, leading cause of infant morbidity and mortality. Syndromic babies are more affected by CHD. This observational study was conducted in a tertiary care hospital of military facility in Bangladesh. Eighty syndromic neonates were studied through history, physical examination and investigated for incidence and risk factors for CHD. Out of 80 syndromic neonates 61(76.3%) were found having CHD. Male female ratio was 1.18:1. Average age at diagnosis was 25±1.6 days of age. Down Syndrome (DS) and Congenital Rubella Syndrome (CRS) were the most common syndromes. Ventricular Septal defect (VSD) and Atrial septal defect (ASD) II were the most common CHD. Consanguinity, extracardiac malformations, maternal illness (HTN, DM, Hypothyroidism etc.), both fertility and non-fertility medication are also found to be associated with CHD in Syndromic neonates. CHDs have serious implications and it is important to understand them and how they may affect the child so that appropriate medical and surgical treatment may be provided. So, early detection of CHD in neonate will be able to decrease morbidity as well as mortality.
CBMJ 2023 January: Vol. 12 No. 01 P: 17-21