bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of diabetes mellitus according to associated factors in rural traditional populations in Goiás, Brazil: a cross-sectional study
Authors: Mota Brenda Godoi , Barp Milara , Guimarães Rafael Alves , Rosso Claci Fátima Weirech , Rocha Bárbara Souza , Nunes Cynthia Assis de Barros , Pagotto Valéria
Published: July 2022

ABSTRACT: Objective: To identify the prevalence of and factors associated with diabetes mellitus in rural traditional communities. Methods: Cross-sectional study carried out in 115 rural communities distributed in 45 municipalities in the state of Goiás, including: 13 river communities, 51 quilombolas and 63 agrarian reform settlements. Probabilistic sampling was performed, and participants were selected at random. The outcome variable was self-reported diabetes mellitus, while exposure variables were sociodemographic, lifestyle, health conditions and access to health services. Multiple regression was used to determine the association between study variables. Results: Among the 2,537 participants, the overall prevalence of diabetes was 9.8%, with 13.5% in river dwellers, 10.0% in quilombolas and 9.3% in settlers. Factors associated with diabetes were negative self-perception of health, being a former smoker, high blood pressure, hypercholesterolemia, and living in a river community. Conclusion: The results reinforce the need to strengthen strategies for the prevention and control of diabetes and its complications in rural populations, especially among river dwellers.
Prevalência de diabetes mellitus autorreferido e fatores associados em população rural e tradicional de Goiás: estudo transversal
Authors: Mota Brenda Godoi , Barp Milara , Guimarães Rafael Alves , Rosso Claci Fátima Weirech , Rocha Bárbara Souza , Nunes Cynthia Assis de Barros , Pagotto Valéria
Published: July 2022

RESUMO: Objetivo: Identificar a prevalência e os fatores associados ao diabetes mellitus em comunidades rurais. Métodos: Estudo transversal desenvolvido em 115 comunidades rurais distribuídas em 45 municípios do Estado de Goiás, sendo: 13 ribeirinhas, 51 quilombolas e 63 assentamentos de reforma agrária. Realizou-se amostragem probabilística, e os participantes foram selecionados de forma aleatória. A variável desfecho foi diabetes mellitus autorreferido, enquanto as de exposição foram sociodemográficas, estilo de vida, condições de saúde e acesso a serviços de saúde. Utilizou-se regressão múltipla para verificar a associação entre variáveis de estudo. Resultados: Entre os 2.537 participantes, a prevalência geral de diabetes foi de 9,8%, sendo 13,5% nos ribeirinhos, 10,0% nos quilombolas e 9,3% nos assentados. Os fatores associados ao diabetes foram a autopercepção negativa de saúde, ser ex-fumante, hipertensão arterial, hipercolesterolemia e residir em comunidade ribeirinha. Conclusão: Os resultados reforçam a necessidade de fortalecer estratégias para prevenção e controle da diabetes e suas complicações em populações rurais, especialmente entre os ribeirinhos.
Primary health care performance according to clusters of convergent municipalities in the state of São Paulo
Authors: Pinheiro Junior Raimundo Valdemy Borges , Carneiro Junior Nivaldo , Sala Arnaldo , Luppi Carla Gianna , Schveitzer Mariana Cabral , Andrade Marta Campagnoni , Rufino Edson , Fogaça Lissandra Zanovelo , Simões Oziris , Wagner Gabriela Arantes
Published: July 2022

ABSTRACT: Objective: To describe the performance of Primary Health Care, according to conglomerates of São Paulo cities that present homogeneous indicators. Methods: This is a descriptive study, based on secondary data extracted from official sources of the Unified Health System, for the year 2018. An analysis matrix was created, with the proposition of performance (access, effectiveness and adequacy) and context indicators (population, health determinants and financing) selected and organized in dimensions and sub-dimensions. Cluster Analysis was used to identify the groups of homogeneous municipalities. Results: 645 municipalities were divided in 6 conglomerates. Clusters 2 and 3 were formed predominantly by small municipalities with greater access to health; cluster 3 has less social vulnerability and greater investment in health. Clusters 1, 4 and 5 were formed by the largest municipalities with less access to health; cluster 4 presents greater social vulnerability, less coverage of private health plans and a greater percentage of health resources; cluster 5 was characterized by greater Gross Domestic Product per capita and greater coverage of private health plans. Cluster 6, formed by the city of São Paulo, was a particular case. Cluster 2 drew attention, as it was shown to have increased coverage, but signaled lower efficacy and adequacy levels. Cluster 3 had the best performance among all clusters. Conclusion: These findings can support regional and municipal management, given the complexity of the territory of São Paulo, pointing to scenarios that demand broader public management initiatives.
Prevalence of metabolic syndrome and its components in Brazilian adolescents: a systematic review and meta-analysis
Authors: Paiva Miguel Henrique Pereira de , Miranda Filho Valberto Alencar , Oliveira Ana Raquel Soares de , Cruz Kyria Jayanne Clímaco , Araújo Regina Maria Sousa de , Oliveira Karla Andrade de
Published: July 2022

Abstract Objective: To determine the prevalence of metabolic syndrome (MS) and its components among Brazilian adolescents. Data source: Databases, such as LILACS, MEDLINE, and SciELO, were searched for original cross-sectional studies published between 2010 and 2021. The inclusion criteria were determined based on the mnemonic CoCoPop — Condition, Context, and Population: studies determining the prevalence of MS and its components (condition) in the general population of Brazilian adolescents, female and male (population), enrolled in public or private schools in rural or urban areas (context). Reviews, editorials, and articles that did not directly relate to the prevalence of MS or that included non-adolescent age groups or groups with specific health conditions (obesity/overweight and others) were excluded. Data synthesis: A total of 15 studies, including 43,227 adolescents, were identified. MS prevalence (95% confidence interval [95%CI]) was 2.9% (2.65–3.18) and 2.4% (1.90–2.90) (p<0.001) in males and females, respectively, by using the International Diabetes Federation (IDF) criteria. There was a significant difference in MS prevalence among Brazilian regions (Q=24.7; p<0.001). The lowest MS prevalence (95%CI) was determined for North Region of Brazil, 1.8% (1.52–2.13), and the highest for Northeast Region of Brazil, 2.9% (2.62–3.23). Regarding MS components, a higher prevalence (95%CI) was found for low high-density lipoprotein (HDL), 22.1% (12.49–36.17), followed by abdominal obesity, 11.0% (8.05–14.94), and arterial hypertension, 10.3% (7.84–13.48). Conclusions: This study allowed the determination of the prevalence of MS and the MS components in Brazilian adolescents, highlighting relevant aspects to be addressed on public health management.
Violations in the marketing of milks and complementary foods that compete with breastfeeding in Rio de Janeiro City, Brazil
Authors: Bertoldo Lucilene Antônio Afonso , Oliveira Maria Inês Couto de , Boccolini Cristiano Siqueira
Published: July 2022

ABSTRACT Objective: To analyze if milk and complementary foods are being sold under the Brazilian Code of Marketing of Infant and Toddler's Food, Teats, Pacifiers and Baby Bottles (NBCAL), Law 11265/2006 of breastfeeding protection. Methods: Epidemiological survey that analyzed the marketing practices of pharmacies, supermarkets, and department stores in the Southern region of the city of Rio de Janeiro, Brazil, by direct observation. Results: Among the 349 stores in Rio de Janeiro's South Region, 339 traded milk and complementary foods and, among them, 60.8% were not complying with NBCAL. Infractions to NBCAL were more common for the selling of milk (58.6%) than complementary foods (22.8%). The most recurrent promotion strategy infringing NBCAL was discount pricing without the Ministry of Health disclaimer. Conclusions: Most retail stores infringe NBCAL in the commercialization of milk and complementary foods in the city of Rio de Janeiro, Brazil, a violation of the right to information that may impact mothers’ choice regarding their child's feeding.
Dietary calcium intake in Brazilian preschoolers and schoolchhildren: review of the literature
Authors: Galvão Rodrigo André , Pavon Bruna , Morán Maria Carolina Brandão , Barbin Maria Victória Costa , Martimbianco Ana Luiza Cabrera , Colares Neto Guido de Paula
Published: July 2022

ABSTRACT Objective: The objective of this study was to map and synthesize evidence on the adequacy of dietary calcium intake and dairy products in Brazilian preschoolers and schoolchildren. Data source: Evidence searches were performed in the MEDLINE (via PubMed) and Latin American and Caribbean Health Sciences Literature (LILACS; via BVS) databases, with no restriction on date or language of publication. Experimental or observational studies that evaluated healthy Brazilian children between 2 and 12 incomplete years old were included. Data synthesis: A total of 18 studies were included. Seven of 11 studies of 11 studies (63.6%) identified mean values of dietary calcium intake below the age recommendation, especially in schoolchildren, with the progression of the age group. Among preschoolers, studies with direct weighing of food showed higher mean values of dietary calcium ingested compared to those with dietary recall. Children attending public daycare centers on a part-time basis tended to have inadequate calcium intake. The consumption of milk and dairy products was lower among older children, especially schoolchildren. Conclusions: Inadequate dietary calcium intake seems to be prevalent in Brazil during childhood, especially among schoolchildren. Therefore, the evaluation of milk and dairy products intake must be considered in order to desgn appropriate corrective actions.
Protoformas do Processo Transexualizador no Brasil: apontamentos sobre a tortuosa institucionalização da assistência à saúde de pessoas Trans no SUS entre 1997 e 2008
Authors: Santos Marcia Cristina Brasil
Published: July 2022

Resumo Este artigo tem como objetivo analisar o Processo Transexualizador no Brasil a partir do exame da sua constituição histórica entre 1997 e 2008. Considera-se neste trabalho os anos anteriores sua institucionalização em 2008, tendo como marco inicial a autorização do Conselho Federal de Medicina, em 1997, para que os médicos realizassem cirurgias de transgenitalização em caráter experimental no interior dos quatro hospitais universitários pioneiros nessa modalidade assistencial no país. Procurou-se compreender os limites e possibilidades desse processo, buscando identificar o papel desempenhado por alguns dos principais sujeitos políticos que atuaram nesse cenário. Entende-se que o reexame dessas origens, a compreensão acerca das características dos serviços pré-institucionalização e algumas de suas limitações são fundamentais para o entendimento do Programa hoje, contribuindo, assim, para a elucidação e enfrentamento de seus inúmeros desafios.
Validation of the RAND 36-Item Health Survey questionnaire in Brazil
Authors: LINS-KUSTERER Liliane , AGUIAR Inácio , SANTOS-LINS Larissa Souza , LINS-ROCHA Matheus , AGUIAR Carolina Villa Nova , MENEZES Marta Silva , SAMPAIO Aline Santos , QUARANTINI Lucas C , COTRIM Helma P , BRITES Carlos
Published: July 2022

ABSTRACT Background: Health-related quality of life is frequently used as an outcome measure that improves the quality of care. The SF-36 and RAND-36 were derived from the Medical Outcomes Study. Objective The present study aimed to validate the RAND-36 in Brazil, in healthy individuals and patients with liver disease. Methods: Confirmatory factor analysis (CFA) was conducted by using JASP Software. The parameters of the items were estimated using the Robust Diagonally Weighted Least Squares (RDWLS) approach. Comparative fit index (CFI), Goodness-of-fit index (GFI), Tucker-Lewis Index (TLI) and the root mean square error of approximation (RMSEA) were evaluated. Internal consistency was measured using the Composite reliability index. Convergent validity between RAND-36 domains and Work Ability Index (WAI) was conducted. Results: This validation study included 763 individuals, 400 (52.4%) with chronic liver disease. The most prevalent liver diseases were hepatitis C (13.9%), alcoholic liver disease (11.8%), and steatosis (12.1%). The measurement model tested using the CFA obtained the following adjustment indicators: X2 (df): 599.65 (498); CFI: 0.998; GFI: 0.998; TLI: 0.998; RMSEA: 0.016 (90%CI: 0.011-.021). Convergent validity of RAND-36 and total WAI ranged from medium to large correlation. Conclusion: The RAND-36 is effective in measuring the perception of health-related quality of life in individuals with and without chronic liver disease. The results of our study support the developer’s claims for the reliability of the RAND-36 version 1 as a measure of health-related quality of life. The evidence for the construct validity of the RAND-36 was substantial.
HIGH VALUES OF LIVER STIFFNESS PLAY AN IMPORTANT ROLE IN STRATIFYING THE RISK OF HEPATOCELLULAR CARCINOMA IN CIRRHOTIC HEPATITIS C PATIENTS
Authors: REINOSO-PEREIRA Gleicy Luz , PARANAGUÁ-VEZOZZO Denise Cerqueira , MAZO Daniel F , FRANÇA João Italo Dias , ONO Suzane Kioko , CARRILHO Flair José
Published: July 2022

ABSTRACT Background: Evaluate the role of liver stiffness measurement (LSM) by transient elastography (TE) as a risk factor for hepatocellular carcinoma (HCC) occurrence in a prospective cohort of Brazilian hepatitis C virus (HCV) patients with cirrhosis. Methods: A cohort of 99 consecutive HCV patients was included between 2011 and 2016 with baseline LSM ≥12 kilopascals (kPa). Baseline variables were evaluated and HCC occurrence was documented. Kaplan-Meier methods with a log-rank test and the use of cox univariate and multivariate analysis assessed the association between variables and clinical results. Results: The mean age was 57.8±10.6 years. In a follow-up over a mean of 3.3 years, 20 (20.2%) patients developed HCC. In univariate logistic regression analysis, variables associated with HCC occurrence were: lower platelet count (P=0.0446), higher serum alpha-fetoprotein (P=0.0041) and bilirubin (P=0.0008) values, higher Model for End-Stage Liver Disease (MELD) score (P=0.0068) and higher LSM (P=0.0354). LSM evaluated by TE was independently associated with HCC development, and the best cut-off value for higher HCC risk was >21.1 kPa (HR: 5.548; 95%CI: 1.244-24.766; P=0.025). Conclusion: A high value of liver stiffness relates substantially to an increased risk for HCC occurrence in Brazilian patients with cirrhosis due to HCV.
FACTORS ASSOCIATED WITH CIRCULATING ZONULIN IN INFLAMMATORY BOWEL DISEASE
Authors: LACOMBE Luiz Augusto Cardoso , MATIOLLO Camila , ROSA Julia Salvan da , FELISBERTO Mariano , DALMARCO Eduardo Monguilhott , SCHIAVON Leonardo de Lucca
Published: July 2022

ABSTRACT Background: Inflammatory bowel disease (IBD) comprises the spectrum between Crohn’s disease (CD) and ulcerative colitis (UC), a condition whose prevalence in countries such as Brazil has increased significantly in recent years. Changes in the intestinal epithelial barrier function and, consequently, an increase in intestinal permeability, have been suggested as important factors in the pathogenesis of different autoimmune conditions, including IBD. Therefore, there is a need for a practical tool to assess gut barrier integrity in these patients. Objective: To study factors associated with serum zonulin levels, a marker of intestinal permeability, in patients with IBD. Methods: This was a cross-sectional observational study that included 117 patients with IBD and 32 healthy controls. Disease activity was assessed by the Simple Clinical Colitis Activity Index (SCCAI) in UC and by the Harvey-Bradshaw Index (HBI) in CD subjects. Zonulin levels were measured by ELISA and inflammatory cytokines by Cytometric Bead Array, using commercially available kits. Results: The mean age of IBD patients was 44.0±15.9 years, 66.7% were female, 57 subjects were diagnosed with CD and 60 with UC. At evaluation, clinical remission was observed in 56.7% of CD patients and in 59.2% of UC subjects. No differences were observed in zonulin levels when comparing IBD patients with the control group (95.28 ng/mL vs 96.61 ng/mL, P=0.573) and when comparing patients with CD to those with UC (79.68 ng/mL vs 106.10 ng/mL, P=0.887). Among IBD group, zonulin concentrations were higher among females, correlated positively with body mass index (BMI) and age; and negatively with hemoglobin and hematocrit. In patients with UC, zonulin correlated negatively with hemoglobin, hematocrit, and albumin; and positively with BMI and SCCAI. Among CD patients, zonulin was positively correlated with age and BMI, but not with HBI. No correlations were observed between zonulin and circulating cytokines in IBD patients. Conclusion: In this cohort mostly comprised of patients in clinical remission, serum zonulin levels were not higher in patients with IBD than healthy controls, and correlated with variables not linked to baseline disease, such as sex, age and BMI. However, zonulin correlated with clinical and laboratory parameters of disease severity and activity among subjects with UC, but not among patients with CD. These findings indicate a potential role for zonulin as a biomarker in IBD, particularly in UC.
MOLECULAR ASSESSMENT OF FECAL LACTOBACILLI POPULATIONS IN CHILDREN WITH FUNCTIONAL CONSTIPATION
Authors: JOMEHZADEH Nabi , AMIN Mansour , JAVAHERIZADEH Hazhir , RASHNO Mohammad
Published: July 2022

ABSTRACT Background: Investigation of the gut-specific bacterial strains including lactobacilli is essential for understanding the bacterial etiology of constipation. Objective: This study aimed to compare the prevalence and quantity of intestinal lactobacilli in constipated children and healthy controls. Methods: Forty children fulfilling Rome IV criteria for functional constipation and 40 healthy controls were recruited. Fecal samples were analyzed using species-specific polymerase chain reaction followed by random amplified polymorphic DNA-PCR and quantitative real-time PCR. Results: Totally, seven different species of lactobacilli were detected. Out of 80 volunteers, 65 (81.3%) were culture and species-specific PCR positive from which 25 (38.46%) constipated children and 40 (61.54%) healthy subjects. The most prevalent species were L. paracasei 21 (32.3%) followed by L. plantarum 18 (27.7%) among both healthy and patient groups. Analysis of the RAPD dendrograms displayed that strains isolated from constipated and non-constipated children have similarity coefficients of more than 90%. The qPCR assays demonstrated constipated children had a lower amount of total lactobacilli population (per gram of feces) than healthy controls. Conclusion: Our findings showed that the mere existence of various species of Lactobacillus in the gut does not enough to prevent some gastrointestinal disorders such as functional constipation, and their quantity plays a more important role.
Evaluation of different tools for body composition assessment in colorectal cancer - a systematic review
Authors: MONACO-FERREIRA Daniela Vicinansa , MAGRO Daniéla Oliveira , COY Claudio Saddy Rodrigues
Published: July 2022

ABSTRACT Background: The nutritional status of patients with colorectal cancer (CRC) impacts on treatment response and morbidity. An effective evaluation of the body composition includes the measurements of fat and visceral fat-free mass and is currently being used in the diagnosis of the nutritional status. The better understanding regarding nutritional tools for body composition evaluation in CRC patients may impact on the outcome. Methods: Systematic review conducted according to Preferred Items of Reports for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed using the BVS (LILACS), PubMed, Embase, Cochrane, Scopus, and Web of Science databases. Results: For the initial search, 97 studies were selected and 51 duplicate manuscripts were excluded. Thus, 46 were reviewed and seven studies included with a total of 4,549 patients. Among them were one clinical trial, one prospective study (cohort), two retrospective cohort and two cross-sectional studies. All studies included body composition evaluated by computed tomography, one with bioelectrical impedance, one with handgrip strength, and two employed mid-arm muscle circumference and body mass index. Conclusion: Current evidence suggests that computed tomography has better accuracy in the diagnosis of sarcopenia, visceral fat, and myopenia among individuals with CRC. Further studies are needed to identify cutoff points for these changes aggravated by CRC.
Anjos da Guarda: ferramenta para o ensino médico
Authors: Botti Sérgio Henrique de Oliveira , Galvão Mayra Gabriela Mendes , Silva Sylvia Viana Ferreira da , Sant’Anna Rodrigo Nascimento de , Corrêa Paula Ferreira
Published: July 2022

Resumo A verdadeira medicina combina conhecimento biotecnocientífico ao cuidado. No entanto, as escolas médicas têm dado maior ênfase ao conhecimento científico em detrimento da relação médico-paciente. Objetivos: Este relato tem como objetivo descrever a experiência de imersão vivida por quatro estudantes de medicina do sexto período nos meses de fevereiro e março de 2020. Método: Tal imersão deu-se em um projeto de ensino denominado Anjos da Guarda, o qual é usado como ferramenta de educação médica no Hospital Universitário Gaffrée e Guinle da Universidade Federal do Estado do Rio de Janeiro (HUGG-UNIRIO). Resultados: O Projeto Anjos da Guarda desenvolve o profissionalismo médico, a empatia e os fundamentos da medicina centrados na pessoa do paciente como parte do processo de cuidado, sem menosprezar a importância do conhecimento biotecnocientífico e do raciocínio clínico. Conclusão: A experiência possibilitou ganhos em aprendizado para os estudantes, além de contribuir com o sistema de saúde e de beneficiar os pacientes envolvidos.
Direitos humanos, vulnerabilidade e vulneração dos povos indígenas brasileiros no enfrentamento à Covid-19
Authors: Barbosa Valquiria Farias Bezerra , Caponi Sandra Noemi Cucurullo de
Published: July 2022

Resumo O objetivo deste ensaio teórico é discutir as condições de produção de vulnerabilidade e vulneração dos povos indígenas no Brasil no enfrentamento da coronavirus disease (Covid-19). Iniciamos por um panorama dos processos de negação de direitos e vulnerabilização que se intensificaram no governo Bolsonaro. Por fim, destacamos os componentes da vulnerabilidade e vulneração que afetam os povos indígenas brasileiros no enfrentamento da Covid-19. Os resultados mostraram que os povos indígenas têm múltiplas vulnerabilidades relacionadas aos seus contextos sócio-históricos e culturais que, no Brasil, são agravadas por uma política neocolonialista e autoritária. Concluímos que os povos indígenas brasileiros não estão apenas expostos à condição de vulnerabilidade, mas à vulneração frente à Covid-19. O estudo contribui para a compreensão das implicações da ausência de condições equitativas de proteção contra o coronavírus em relação à alta mortalidade dos indígenas devido à Covid-19.
Perspectivas educativas em saúde bucal: possibilidades de criação na prevenção e no enfrentamento do câncer
Authors: Biato Emília Carvalho Leitão , Luzio Juliana da Silva
Published: July 2022

Resumo Diferentes perspectivas acerca dos processos educativos podem indicar maneiras de abordá-los, inclusive no contexto dos processos de saúde e doença. Assumimos que o profissional de saúde é um educador, e essa função lhe permite contribuir efetivamente para a promoção da saúde dos indivíduos e populações. Este estudo tem como objetivo identificar e analisar, tanto em materiais educativos em saúde bucal, quanto nas vivências de usuários de um serviço odontológico em oncologia, elementos e características do trabalho educativo em saúde direcionado à prevenção e ao enfrentamento do câncer de boca. Tanto o material educativo quanto os dizeres dos pacientes foram tomados a partir das perspectivas que comparecem nos processos educativos em saúde bucal, conforme destacam-se: Tecnicismo, Pragmatismo, Construtivismo, Interacionismo e Pós-estruturalismo. Observaram-se modelos que reforçam uma relação assimétrica e autoritária entre profissionais e usuários, portanto, há necessidade de pensar a prevenção e o enfrentamento do câncer de boca de forma inovadora e poética, por meio de uma linha de fuga às generalizações que massificam o conhecimento sobre saúde bucal.
Os dentistas estão preparados para a promoção da amamentação e alimentação complementar saudável?
Authors: Brockveld Lucimeire de Sales Magalhães , Venancio Sonia Isoyama
Published: July 2022

Resumo O aleitamento materno (AM) e a introdução adequada da alimentação complementar (AC) são estratégias que comprovadamente melhoram a saúde bucal e previnem doenças. Por isso, atividades de promoção dessas práticas devem ser realizadas por todos os profissionais de saúde. Buscou-se, através da metodologia quantitativa, analisar o resultado de um inquérito realizado com dentistas cadastrados no Conselho Regional de Odontologia de São Paulo sobre sua formação acadêmica e profissional nestes temas. Os conteúdos mais recebidos na graduação foram sobre os benefícios do AM para a prevenção da saúde geral (74,6%). Entre os profissionais que receberam capacitação em serviço, foram 27,8% (AM) e 21,5% (AC), sendo que mais de 80% conseguiram aplicar o conhecimento no dia a dia. Quando solicitados a dar orientação sobre AM, apenas 15% responderam se sentir preparados. Sobre se consideram ser atribuição do dentista o apoio ao AM e AC, 92,3% responderam que sim e 85% reconhecem precisar de atualização. Conclui-se que há uma lacuna a ser preenchida com a formação acadêmica e capacitações/atualizações para que o dentista possa efetivamente atuar na promoção e apoio ao AM e AC.
“Tirando o jaleco”: notas etnográficas sobre as práticas obstétricas em um hospital de ensino
Authors: Chourabi Lizandra Flores , Cecchetto Fatima , Njaine Kathie
Published: July 2022

Resumo O estudo teve como objetivo descrever e analisar aspectos do cotidiano da assistência ao parto em um hospital universitário no Sul do Brasil. A expressão “tirando o jaleco” serve como uma metáfora para iluminar o processo de conversão da enfermeira obstetra em pesquisadora em um ambiente hospitalar. Trata-se de uma de pesquisa qualitativa que lançou mão da perspectiva socioantropológica como referencial teórico e metodológico. Os resultados mostraram uma recorrente ausência de informações sobre condutas e decisões médicas dadas as mulheres, desconsiderando-as como sujeitos de direitos, a despeito do que preconiza a política de humanização do parto, revelando nuances do parto e do nascimento pautadas no modelo tecnocrático de assistência. Esse modelo de assistência vigente nos hospitais de ensino requer importantes mudanças através da incorporação de práticas com fundamentos científicos, da inclusão de enfermeiras obstetras e do respeito à mulher como protagonista deste evento.
Transitar doente: laços e desenlaces entre os adolescentes sobreviventes de câncer infantojuvenil, seus familiares e a instituição hospitalar
Authors: Rabelo Maria Tereza Piedade , Pacheco Ana Laura Prates , Schveitzer Mariana Cabral , Len Claudio Arnaldo
Published: July 2022

Resumo Os objetivos deste artigo abrangem compreender o impacto da experiência de adoecimento em sobreviventes de câncer infantojuvenil e em seus familiares ao longo dos processos de transição inerentes à vida e, também, explorar o papel que a instituição hospitalar pode desempenhar no decorrer dessas passagens. Uma pesquisa com método psicanalítico foi realizada em um hospital público, filantrópico e considerado referência em oncologia pediátrica. Foram feitas entrevistas em profundidade com 12 adolescentes e suas respectivas mães. A análise das entrevistas embasou-se no referencial psicanalítico de Freud e Lacan, originando duas chaves de leitura: (1) a incidência do Real sobre os sobreviventes e suas mães e os efeitos de indiferenciação no registro Imaginário e de inibição ao sustentar um projeto próprio no futuro; e (2) o efeito de alienação nos sujeitos e em seus corpos produzido por meio da idealização da instituição hospitalar e seu saber biomédico. A partir da análise das entrevistas, foi possível identificar problemáticas relacionadas à modalidade de laço estabelecida entre os entrevistados e instituição hospitalar. Embasados nesta pesquisa, a instituição estudada interessou-se em construir um ambulatório de transição norteado pela ética da psicanálise, visando auxiliar o jovem no desenlace da instituição mediante, principalmente, a sua reinserção social.
Confiabilidade da autoavaliação das práticas de segurança do paciente instituídas pelo Sistema Nacional de Vigilância Sanitária: um estudo piloto
Authors: Rodrigues Ranyelle Christian Dias , Souza Alessandra Anneliese da Silva , Santana Heiko Thereza , Gama Zenewton André da Silva
Published: July 2022

Resumo Introdução: A Autoavaliação das Práticas de Segurança do Paciente é um ato regulatório para melhoria da qualidade do cuidado. Porém, há dúvidas sobre a validade das suas informações. O objetivo deste estudo foi analisar a sua confiabilidade. Método: Estudo piloto de análise da confiabilidade de 21 indicadores simples e um composto da autoavaliação como forma de embasar uma amostra nacional em estudos futuros. Participaram hospitais com leitos de terapia intensiva e comparou dados da Autoavaliação (AA) e Autoavaliação Revisada (AR) pela vigilância sanitária (Visa) com a Inspeção Presencial (IP). A análise incluiu os coeficientes Kappa e de correlação intraclasse. Resultados: Comparando com a IP, a concordância foi aceitável (Kappa≥0,4) em 12 indicadores da AA e em 18 da AR. Os indicadores menos confiáveis são relativos a protocolos de prevenção de infecções. Quanto ao indicador composto do nível de adesão, a confiabilidade melhorou com revisão da Visa (AA=0,89 e AR=0,94), embora a concordância da classificação de alta conformidade tenha sido baixa. Conclusões: A AR se mostrou essencial para melhorar a confiabilidade da Autoavaliação. Ademais, identificou-se necessidade de revisar alguns indicadores e o instrumento de verificação pela Visa.
Contributions of Maffesoli’s sensitive rationality to the foundations of territorial and community practices at the health care/social support interface
Authors: Moreira Adriana Belmonte
Published: July 2022

Abstract Michel Maffesoli is known worldwide as a thinker of postmodernity, of tribalism as a new form of sociality and sensitive reason, within an emerging epistemic or paradigmatic change. Despite not reflecting on care practices, by bringing a sociological reading that highlights the domestic, localism and tribalism, and referencing health from the perspective of personal and social potency, this essay argues that the force-ideas extracted from his thought can contribute to the epistemological, ethical-political and theoretical-methodological foundations of the actions of professionals who work at the health care/social support interface and who act in the space-time of everyday life in a given territory. By presenting a logos that validates a sensitive reason and that takes the places of daily life as space-time of connections and development of potentialities, an ecosophical ethos of respect for people, nature and the diversity of forms and ways of life, his thought can also outline places of personal and collective dwelling, which can become scenarios of interdisciplinary and interprofessional care practices (praxis) in tune with a sensitive rationality, guided by and for the potentiation of life.
Multiplicity and ontological instability in nonhuman hearts
Authors: Marini Marisol , Monteiro Marko , Slatman Jenny
Published: July 2022

Abstract This paper reflects on the relationship between biological bodies and technological artifacts, based on ethnographic research on the development of circulatory assist technologies, known as artificial hearts. To understand the embodiment that such mechanical devices help to produce, we aim to characterize two types of bodies enacted from medical practices and biotechnologies designed for patients with advanced heart failure. The immunological bodies, produced from heart transplantation, will be contrasted with the bionic bodies, composed of the assembly with artificial hearts. We propose that it is necessary to consider each of these technologies as co-produced with different natures, supported by specific materialities, practices, moralities and assumptions. The attention given to practices and materiality will allow to highlight the various material-semiotic intertwinings. Tracing the development trajectory of this field will allow exploring the imagination from which such interventions emerge and the transformations that have occurred, emphasizing the link to the body-machine woven in the biomedical scope.
Por uma história transnacional da sociologia: entrevista com Gisèle Sapiro
Authors: Valente Gabriela , Ménard Charlène , Setton Maria da Graça J.
Published: July 2022

Resumo Gisèle Sapiro é diretora de pesquisa e medalhista de prata no Centro Nacional de Pesquisa Científica (CNRS) e diretora de estudos no Centro Europeu de Sociologia e Ciência Política (EHESS) desde 2011. Defendeu sua tese em 1994 sob a orientação de Pierre Bourdieu, mobilizando o conceito de campo para compreender a história estrutural da literatura. Sua formação e contato com Bourdieu e com sua obra tornam Sapiro uma das sucessoras do legado bourdieusiano na França. Os trabalhos de Sapiro abordam temas como a autonomia dos campos, o papel político dos escritores e intelectuais e a circulação dos saberes em uma perspectiva internacional, sobretudo no que concerne às ideias de Bourdieu e notadamente nos Estados Unidos. O objetivo da entrevista com Gisèle Sapiro é colocar em perspectiva as diferentes maneiras de ler e interpretar a obra de Pierre Bourdieu, consequências das distinções de tradução e de apropriação no Brasil e no mundo, a partir do ponto de vista de uma especialista que, sem deixar de trazer suas próprias contribuições para a sociologia crítica, muito cooperou para a difusão das ideias bourdieusianas. O trabalho de Sapiro merece a atenção de todos aqueles que compartilham seu entusiasmo intelectual e estabelecem as bases para uma história transnacional da sociologia.
PRESENÇA DOS BIOMARCADORES c-MET e ABCB5 NO ADENOCARCINOMA DE PRÓSTATA E SUA ASSOCIAÇÃO COM FATORES PROGNÓSTICOS
Authors: Zahdi João Otavio Ribas , Ribas Carmen Austrália Paredes Marcondes , Zini Cassio , Gomel Bernardo May , Lemes Macleise Gomes , Lobos Giovana Landal de Almeida , Ribas Maurício Marcondes , Ribas Fernanda Marcondes
Published: July 2022

Racional: O adenocarcinoma de próstata é uma das mais prevalentes neoplasias malignas em todo o mundo. Apesar de frequentemente ter evolução lenta, ainda representa importante causa de morte em oncologia. Uma vez que seus resultados clínicos são muito heterogêneos há necessidade de se identificar marcadores de prognóstico. Biomarcadores são ferramentas e tecnologias que podem auxiliar nessa compreensão. Objetivos: Avaliar a presença do c-MET e ABCB5 no adenocarcinoma da próstata e analisar se a expressão deles apresenta correlação com fatores de prognóstico. Método: Foram selecionados 170 casos através de busca ativa em prontuário eletrônico e revisão dos prontuários físicos e de laudos 2 anatomopatológicos. Foi realizada imunoistoquímica para os biomarcadores c-MET e ABCB5 em todas as amostras. Dados clínicos retrospectivos foram coletados e plotados em tabelas. Através de TMA (tissue microarray) os tecidos foram submetidos à imunoistoquímica pela técnica de peroxidase. As informações clinicoepidemiológicas foram cruzadas com o resultado obtido pela imunomarcação e sua análise estatística. Resultados: Foram incluídos neste estudo 47 homens com média de idade de 61,6±6,9 (48-75), com PSA médio de 11±9,7 (2,4-60,5), Dos incluídos, 70,2% tiveram escore de Gleason 5 ou 6 e 29, 1%, 7 ou 8. Em relação à classificação dos tumores, 6 casos tinham estadiamento T3a e 2 T3b. Nenhum apresentou tumor superior a T3b e houve 1 caso de metástase. Com relação aos biomarcadores, houve marcação positiva de c-MET em 32 casos e de ABCB5 em 5. A marcação positiva não teve associação estatisticamente significativa com nenhum dos fatores prognósticos avaliados. Conclusão: Houve expressão do c-MET e ABCB5 nos casos de câncer de próstata, mas sem associação deles com fatores prognóticos
Discovery of the Six Members of the Platinum Group and Their Mineralogical Characterisation
Authors: Cabri Louis J.
Published: July 2022

The native platinum group elements (PGE), namely, the light PGE (ruthenium, rhodium and palladium) and the heavy PGE (osmium, iridium and platinum), are important historically, scientifically and industrially. Some of the scientists who discovered and refined these metals in the 18th and early 19th centuries, besides being chemists, were also physicians, but all were also knowledgeable of mineralogy. We cannot but be impressed by their achievements because of the complexity of the minerals they studied. The PGE alloys occurred as a fraction of the heavy minerals concentrated from alluvial deposits. Today we can understand why some details of their discovery and mineralogy have not been well understood because of a lack of modern mineralogical studies and misunderstandings of some of the early literature, especially for native palladium and platinum. Though reported widely, highlights of the historical discoveries are here assembled in a single paper and discussed with respect to the mineralogy of the samples studied.
Improving Radiotherapy Response in the Treatment of Head and Neck Cancer
Authors: Wicker Christina A. , Petery Taylor , Dubey Poornima , Wise-Draper Trisha M. , Takiar Vinita
Published: July 2022

The application of radiotherapy to the treatment of cancer has existed for over 100 years. Although its use has cured many, much work remains to be done to minimize side effects, and in-field tumor recurrences. Resistance of the tumor to a radiation-mediated death remains a complex issue that results in local recurrence and significantly decreases patient survival. Here, we review mechanisms of radioresistance and selective treatment combinations that improve the efficacy of the radiation that is delivered. Further investigation into the underlying mechanisms of radiation resistance is warranted to develop not just novel treatments, but treatments with improved safety profiles relative to current radiosensitizers. This review is written in memory and honor of Dr. Peter Stambrook, an avid scientist and thought leader in the field of DNA damage and carcinogenesis, and a mentor and advocate for countless students and faculty.
Epilepsy in patients with WWOX‐related epileptic encephalopathy (WOREE) syndrome
Authors: Al Baradie Raidah , Mir Ali , Alsaif Ali , Ali Mona , Al Ghamdi Fouad , Bashir Shahid , Howsawi Yousef
Published: July 2022

Objective. Epileptic encephalopathy (EE) is difficult to diagnose and manage. It can be caused by a variety of disorders, and its aetiology may guide management and prognosis. The human gene for WW domain‐containing oxidoreductase (WWOX) has been associated with epileptic encephalopathy, which presents in infancy with seizures, psychomotor delay, microcephaly, and optic atrophy.

Methods. We report nine patients with WWOX‐related EE from six families. We provide detailed descriptions of clinical presentations, imaging findings, neurophysiological manifestations, and related mutations. Whole‐exome sequencing (WES) was used to identify the mutations in the WWOX gene.

Results. We established correlations between genotype and phenotype in our cases and previously reported cases.

Significance. Our data support previously reported findings regarding WWOX‐related EE, indicating the importance of the human WWOX gene in brain development and the association between WWOX mutations and EE. Our study also highlights the power of WES, particularly in clinically challenging cases.
Magnetic resonance imaging features of isolated periventricular heterotopia in pediatric epilepsy: a comparative study
Authors: Tittle Benjamin James , Maheshwari Mohit , Marashly Ahmad
Published: July 2022

Objective. Periventricular nodular heterotopia is a neurodevelopmental disorder in which neurons fail to migrate to the cortical surface, forming discrete areas of grey matter adjacent to the lateral ventricles. Given that periventricular nodular heterotopia is seen as an incidental finding in patients without epilepsy, causality between periventricular nodular heterotopia and epilepsy cannot be assumed. Furthermore, the structural characteristics of periventricular nodular heterotopia in patients with epilepsy are poorly defined and can be misleading. In this article, we investigate whether structural radiological characteristics of heterotopia can predict epileptogenicity in pediatric patients.

Methods. Pediatric patients with periventricular nodular heterotopia, but no other epilepsy‐associated cortical abnormalities on magnetic resonance imaging, were identified and divided into two groups: with epilepsy and without epilepsy. Radiological characteristics of laterality, regionalization, largest dimension and number of nodules were compared between the two groups.

Results. Only periventricular nodular heterotopia spreading across several regions was associated with a statistically higher chance of epilepsy. Other features including laterality, individual region, number and largest dimension did not reliably predict epileptogenicity.

Significance. Most radiological characteristics of periventricular nodular heterotopia are similar in patients with and without epilepsy. The involvement of multiple periventricular regions with heterotopia was the only feature that inferred a higher risk of epilepsy. Periventricular nodular heterotopia requires a comprehensive work‐up and should be interpreted in the context of each individual patient and not assumed to be directly causative of epilepsy, nor unrelated to it. Therefore, further studies using additional structural and functional imaging modalities are needed to determine the radiological features of epileptogenic periventricular nodular heterotopia.
Real‐world evaluation of perampanel effectiveness in Japanese adolescents with epilepsy
Authors: Inoue Yushi , Sumitomo Kenta , Matsutani Kazuhiro , Ishii Mika
Published: July 2022

Objective. Real‐world data from adolescents treated with perampanel in a routine clinical setting are lacking in Japan. We evaluated the safety and efficacy of perampanel for adolescent patients (aged 12‐17 years) with drug‐resistant, refractory epilepsy in real‐world settings.

Methods. This was a large‐scale, prospective, observational post‐marketing study, with a 104‐week observation period. Safety was assessed by monitoring adverse effects (adverse drug reactions). For efficacy assessments, seizure frequency was compared between the four weeks immediately prior to the last observation and the four weeks before the commencement of perampanel.

Results. In total, 519 patients were enrolled;505 and 484 patients were included in the safety and efficacy analysis sets, respectively. The mean age was 14.4 years. The mean daily dose of perampanel was 4.4 mg/day. The main reasons for discontinuation at 104 weeks were adverse events (48.4%) and inadequate efficacy (46.8%). The retention rate at 104 weeks was 50.5%. Adverse effect and severe adverse effect incidences were 42.2% and 1.8%, respectively. The most common adverse effects were somnolence (13.5%), irritability (8.5%), dizziness (5.1%), and agitation (4.8%). There were significant differences in the occurrence of adverse effects between the initial titration interval of <2 weeks and 2‐4 weeks (odds ratio=0.441, p=0.029) and 4‐8 weeks (odds ratio=0.462, p=0.027). The median percent change in seizure frequency at the last observation carried forward was –50.0 for focal aware seizures with motor signs, –73.3 for focal aware seizures without motor signs, –28.6 for focal impaired awareness seizures, –62.6 for focal to bilateral tonic‐clonic seizures, and –20.0 for generalized tonic‐clonic seizures.

Significance. In adolescent patients, perampanel was well tolerated and efficacious in reducing seizure frequency. No unexpected safety issues were observed, and slow titration may reduce the incidence of adverse effects.
Удержание вербальной и невербальной серийной информации в рабочей памяти
Authors: Корнеев А.А. , Ломакин Д.И. , Курганский А.В. , Мачинская Р.И.
Published: July 2022

Представлены результаты экспериментального исследования удержания в рабочей памяти (РП) и последующего двигательного воспроизведения серийной информации двух типов — вербальной (последовательности букв) и невербальной (ломаные линии). Серии элементов предъявлялись в двух режимах: статически (единовременно) и динамически (поэлементно). Исследовали влияние режима предъявления последовательностей, их сложности (числа элементов) и времени удержания в РП на точность и латентное время (время реакции) воспроизведения запомненных серий элементов. На 33 взрослых праворуких испытуемых были получены следующие результаты. Оказалось, что точность воспроизведения обоих типов последовательностей качественно сходным образом зависит от режима предъявления и количества элементов: она меньше в динамическом режиме и падает с ростом длины последовательности. Использование динамического режима предъявления в большей степени сказывается на точности воспроизведения ломаных линий, чем буквенных последовательностей. Увели­че­ние количества элементов, напротив, больше снижает точность воспроизведения последовательностей букв по сравнению с невербальными последовательностями. Выявлено, что время удержания информации в РП существенно влияет на латентное время двигательного ответа только при воспроизведении ломаных линий, но не буквенных последовательностей. При этом латентное время ответа возрастает при увеличении длины последовательности букв, но не изменяется при увеличении числа сегментов ломаной линии. Полу­ченные результаты указывают на различия в механизмах сохранения и преобразования вербальной и невербальной серийной информации в рабочей памяти. Опираясь на них, можно утверждать, что вербальная информация сохраняется в большей степени как последовательность и при этом претерпевает меньше изменений в процессе ее удержания в рабочей памяти в задачах, связанных с воспроизведением порядка элементов.