cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.7942328
title: Cocaine/levamisole-induced systemic vasculitis with retiform purpura and pauci-immune glomerulonephritis

description: Levamisole has been increasingly used as an adulterant of cocaine in recent years, emerging as a public health challenge worldwide. Levamisole-associated toxicity manifests clinically as a systemic vasculitis, consisting of cutaneous, hematological, and renal lesions, among others. Purpura retiform, cutaneous necrosis, intravascular thrombosis, neutropenia, and less commonly crescentic nephritis have been described in association with anti-neutrophil cytoplasmic antibodies (ANCAs) and other autoantibodies. Here we report the case of a 49-year-old male who was a chronic cocaine user, and who presented spontaneous weight loss, arthralgia, and 3 weeks before admission purpuric skin lesions in the earlobes and in the anterior thighs. His laboratory tests on admission showed serum creatinine of 4.56 mg/dL, white blood count 3,800/μL, hemoglobin 7.3 g/dL, urinalysis with 51 white blood cells/μL and 960 red blood cells/μL, and urine protein-to-creatinine ratio 1.20. Serum ANCA testing was positive (&gt;1:320), as well as serum anti-myeloperoxidase and anti-proteinase 3 antibodies. Urine toxicology screen was positive for cocaine and levamisole, with 62.8% of cocaine, 32.2% of levamisole, and 5% of an unidentified substance. Skin and renal biopsies were diagnostic for leukocytoclastic vasculitis and pauci-immune crescentic glomerulonephritis, respectively. The patient showed a good clinical response to cocaine abstinence, and use of corticosteroids and intravenous cyclophosphamide. Last serum creatinine was 1.97 mg/dL, white blood cell count 7,420/μL, and hemoglobin level 10.8 g/dL. In levamisole-induced systemic vasculitis, the early institution of cocaine abstinence, concomitant with the use of immunosuppressive drugs in severe cases, may prevent permanent end organ damage and associate with better clinical outcomes.
DOI: 10.6084/m9.figshare.7942340.v1
title: Factors associated with environmental barriers of people with disabilities in Mexico

description: ABSTRACT OBJECTIVE: To examine the associations between sociodemographic, health and disability-related factors and the perception of environmental barriers outside the home environment by individuals with permanent disabilities in Mexico. METHODS: In this cross-sectional, population-based study, we used data from the 2010 National Survey of Perceptions of Disability in the Mexican Population of 2,041 participants older than 18 with permanent disability. The perceptions of barriers take into consideration the challenges of getting around and using transportation outside the home environment. The covariates consisted of sociodemographic, health-related and disability-related factors. Multivariate logistic regression was used. RESULTS: The perception of environmental barriers outside the home environment was associated with being a woman, living in an urban area, speaking an indigenous language, experiencing emotional symptoms, having walking/movement, visual or self-care disabilities, having severe/extreme disability, having disability caused by illness, using physical devices, and receiving assistance and care in the home environment. CONCLUSIONS: This information is valuable for the design of public policies and programs that promote the participation of individuals with permanent disabilities, a high-priority issue in low- and middle-income countries.
DOI: 10.6084/m9.figshare.7942328.v1
title: Cocaine/levamisole-induced systemic vasculitis with retiform purpura and pauci-immune glomerulonephritis

description: Levamisole has been increasingly used as an adulterant of cocaine in recent years, emerging as a public health challenge worldwide. Levamisole-associated toxicity manifests clinically as a systemic vasculitis, consisting of cutaneous, hematological, and renal lesions, among others. Purpura retiform, cutaneous necrosis, intravascular thrombosis, neutropenia, and less commonly crescentic nephritis have been described in association with anti-neutrophil cytoplasmic antibodies (ANCAs) and other autoantibodies. Here we report the case of a 49-year-old male who was a chronic cocaine user, and who presented spontaneous weight loss, arthralgia, and 3 weeks before admission purpuric skin lesions in the earlobes and in the anterior thighs. His laboratory tests on admission showed serum creatinine of 4.56 mg/dL, white blood count 3,800/μL, hemoglobin 7.3 g/dL, urinalysis with 51 white blood cells/μL and 960 red blood cells/μL, and urine protein-to-creatinine ratio 1.20. Serum ANCA testing was positive (&gt;1:320), as well as serum anti-myeloperoxidase and anti-proteinase 3 antibodies. Urine toxicology screen was positive for cocaine and levamisole, with 62.8% of cocaine, 32.2% of levamisole, and 5% of an unidentified substance. Skin and renal biopsies were diagnostic for leukocytoclastic vasculitis and pauci-immune crescentic glomerulonephritis, respectively. The patient showed a good clinical response to cocaine abstinence, and use of corticosteroids and intravenous cyclophosphamide. Last serum creatinine was 1.97 mg/dL, white blood cell count 7,420/μL, and hemoglobin level 10.8 g/dL. In levamisole-induced systemic vasculitis, the early institution of cocaine abstinence, concomitant with the use of immunosuppressive drugs in severe cases, may prevent permanent end organ damage and associate with better clinical outcomes.
DOI: 10.6084/m9.figshare.7942331.v1
title: A randomized, open-label clinical trial comparing the long-term effects of miltefosine and meglumine antimoniate for mucosal leishmaniasis

description: Abstract INTRODUCTION: The treatment of mucosal leishmaniasis (ML) is difficult due to the toxicity and route of administration of standard drugs. Miltefosine is an oral agent used for leishmaniasis treatment; however, no data exist regarding its use for ML in Brazil. In this study, we aimed to evaluate the efficacy of miltefosine for ML treatment compared to that of pentavalent antimonial in a pilot study. METHODS: We performed a randomized clinical trial with two parallel groups. The tested intervention consisted of miltefosine 1.3-2 mg/kg/day (two capsules) for 28 days or intravenous 20 mg SbV/kg/day of meglumine antimoniate (N-MA) for 30 days. The final endpoint was defined as complete healing of the lesion four years after treatment. We also analyzed an early endpoint at 90 days after treatment. RESULTS: Forty patients were included in this study: each experimental group comprised 20 patients. Applying a multivariate model in an intention-to-treat analysis, we observed that patients treated with miltefosine had a cure probability 2.08 times greater (95% confidence interval [CI] = 1.03-4.18) than those treated with N-MA at 90 days after treatment. At the final endpoint, we observed no differences in cure probability between miltefosine and N-MA (relative risk = 0.66; 95% CI = 0.33-1.32). With respect to adverse reactions, significant differences between groups were related to gastrointestinal effects, which were more frequent in the miltefosine group. CONCLUSIONS: Miltefosine may be an interesting alternative for treating ML because of its oral administration and cure rate after long-term follow-up.
DOI: 10.6084/m9.figshare.7942313
title: Nursing Activities Score and the cost of nursing care required and available

description: ABSTRACT Objective: To estimate the cost of nursing care required and available through the use of the Nursing Activities Score. Method: Quantitative study, direct costing of nursing care required and available in the Intensive Care Units. Data collection included variables of the patients, nursing professionals and nursing workload measured by the Nursing Activities Score. The cost of nursing care was estimated by multiplying the cost of each hour with the total number of hours of care per category. Results: The negative difference of R$ 94,791.5 between the cost of available and required nursing care indicated an increase of 3.2 nurses and 7.0 nursing technicians. Conclusion: The cost of nursing care required identified through the application of the Nursing Activities Score, which is higher than the cost of available care, indicates the need to adjust the number of professionals to meet patients' demands.
DOI: 10.6084/m9.figshare.7942322
title: Faculty Development: Social Representations Constructed by Medical School Teachers

description: ABSTRACT Faculty Development seeks to support educators in a range of functions in the areas of teaching, research, extension, management and evaluation. The aim of this study was to evaluate faculty development based on the social representations constructed by the teachers of a medical course. A qualitative survey was carried out, using the analytical method of discourse analysis and social representation as a theoretical contribution. Twelve teachers were randomly selected, and a semi-structured interview was conducted for the data collection. The responses, recorded in audio, were transcribed and discourse analysis was performed with the aim of mapping the social representations constructed by the subjects. The social representations were grouped into two categories: institutional development and personal development. Within the category institutional development, three subcategories were identified: Guiding principles of Faculty Development Programs, Teaching-learning strategies used in Faculty Development Programs, and Skills to be developed by faculty. Within the category Personal development, two subcategories were identified: Development as a person and as a social being, and Professional development. Over the years, a variety of social representations have been constructed in relation to the nature of teaching in medical education, but it is only in recent decades that managers and teachers of educational institutions have begun to focus more closely on this topic. In the present study, it was observed that for faculty development to be effective, the educator must have a desire to learn; however, institutional support and recognition are also essential. Faculty Development Programs must be flexible and adaptable, to meet the needs of the institution and its professors, and encourage reflection on their practices, though the exchange of experiences, the development of interpersonal relationships, and collaboration. However, it is vital to identify and facilitate the development of leadership skills, and to systematically evaluate the process and the results achieved. This will encourage teachers to develop in their academic careers and thereby increase the professionalization of teaching. Managers and teachers can sustain a shared mission to win resources, adapt to change, strive for excellence in the leadership of the organization in a national and international context, and consequently, provide a quality medical education.
DOI: 10.6084/m9.figshare.7942313.v1
title: Nursing Activities Score and the cost of nursing care required and available

description: ABSTRACT Objective: To estimate the cost of nursing care required and available through the use of the Nursing Activities Score. Method: Quantitative study, direct costing of nursing care required and available in the Intensive Care Units. Data collection included variables of the patients, nursing professionals and nursing workload measured by the Nursing Activities Score. The cost of nursing care was estimated by multiplying the cost of each hour with the total number of hours of care per category. Results: The negative difference of R$ 94,791.5 between the cost of available and required nursing care indicated an increase of 3.2 nurses and 7.0 nursing technicians. Conclusion: The cost of nursing care required identified through the application of the Nursing Activities Score, which is higher than the cost of available care, indicates the need to adjust the number of professionals to meet patients' demands.
DOI: 10.6084/m9.figshare.7942298
title: Evaluation of the Impact of Professional Reorientation Programs in Health Courses

description: ABSTRACT This study problematized the perception of stakeholders in the health care field at the Federal University of Goiás regarding the impact of the National Program for Professional Training and Reorientation in Health under the Program for Education for Work in Health (Propet-Saúde) on curricular restructuring. This cross-sectional study included 300 students, tutors, preceptors, teachers and graduation coordinators from seven courses. A Likert-type instrument was constructed and validated with the following dimensions: D1: curricular restructuring and the principles of Propet-Saúde and D2: the pedagogical project of the Propet-Saúde course. The instrument was validated considering semantic, cultural and conceptual equivalence, assignment of points (from 1 to 4), and randomization of the assertions tested. The score generated three interpretive intervals: from 1 to 1.99 (dissatisfaction); 2 to 2.99 (relative satisfaction) and 3 to 4 (satisfaction). The instrument was applied following a pre-test and the placement of the contributors. The instrument was then statistically validated for dispersion and reliability. Factorial analysis was performed considering function and course. Dispersion through linear correlation showed a loss of 4 assertions (11.77%), signifying excellent content validation. Reliability was 0.93 (p &lt; 0.01), showing excellent statistical density. The general averages of D1 and D2 were 3.09 and 3.11 respectively, indicating satisfaction among the respondents. In conclusion, the participants recognize important advances such as curricular restructuring from these programs, placement of students already at the beginning of the course into practice scenarios, motivation toward interdisciplinarity, diversification of evaluation practices, and use of active methodologies. After factorial analysis, it was shown that medical and biomedical courses are more resistant to the contributions of the Pró-Saúde and PET-Saúde Programs and other hurdles were identified, such as excessive workload that hinders the integration of courses and the development of still-evolving administration and management skills. The interaction of the programs in Propet-Saúde should be strengthened, as it demonstrated significant assertiveness in curricular organization as well as in the teaching and service integration, a central aspect for the strengthening of Brazilian Public Health.
DOI: 10.6084/m9.figshare.7942301
title: Is There Any Change in Inflammatory Markers in Medical Students after Participating in a Mind-Body Program?

description: ABSTRACT Introduction Medical students are exposed to high stress levels, triggered by having to deal with their illness and death of their patients, extensive workloads, sleep deprivation, competition, having to fulfil demanding duties, responsibility, and fear of making mistakes, among other factors. Some techniques and practices, such as meditation, are used in medical schools to help manage and reduce stress. Stress can activate components of the inflammatory system, triggering a series of pathologies. The disorders caused by stress can be measured by means of serological markers, with biological markers being the main ones used. Objective. To evaluate the effects of a program of mind-body practices, Reduction of Stress and Development of Empathy in Medicine (REDEMED ©), on pro- and anti-inflammatory markers of medical students. Methodology This is a quasi-experimental study, composed of 86 students: 44 in the intervention group, who participated in the REDMED© program with eight-weekly meetings that included meditation techniques and exercises of interpersonal experiences, and 42 students in the control group. Before and after the course, blood was collected from both groups for analysis of the markers: C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL06) and interleukin-10 (IL10). Results No statistically significant changes were observed in the proinflammatory cytokines CRP, TNF-α and IL06. However, IL-10, an anti-inflammatory cytokine, showed a positive and statistically significant variation (p: 0.009). It has been used in studies with integrative and complementary practices to demonstrate its benefits. Conclusion The REDEMED© program seems to benefit medical students through inflammatory modulation and as a group that provides a forum to share their stress and receive coaching in coping strategies. This study, even though it did not find a statistically significant difference in the markers studied, with the exception of IL10, raises the important theme of the high levels of stress that medical students experience, and the need for medical schools to take greater care of their students, addressing stress in order better manage it in their own lives.
DOI: 10.6084/m9.figshare.7942322.v1
title: Faculty Development: Social Representations Constructed by Medical School Teachers

description: ABSTRACT Faculty Development seeks to support educators in a range of functions in the areas of teaching, research, extension, management and evaluation. The aim of this study was to evaluate faculty development based on the social representations constructed by the teachers of a medical course. A qualitative survey was carried out, using the analytical method of discourse analysis and social representation as a theoretical contribution. Twelve teachers were randomly selected, and a semi-structured interview was conducted for the data collection. The responses, recorded in audio, were transcribed and discourse analysis was performed with the aim of mapping the social representations constructed by the subjects. The social representations were grouped into two categories: institutional development and personal development. Within the category institutional development, three subcategories were identified: Guiding principles of Faculty Development Programs, Teaching-learning strategies used in Faculty Development Programs, and Skills to be developed by faculty. Within the category Personal development, two subcategories were identified: Development as a person and as a social being, and Professional development. Over the years, a variety of social representations have been constructed in relation to the nature of teaching in medical education, but it is only in recent decades that managers and teachers of educational institutions have begun to focus more closely on this topic. In the present study, it was observed that for faculty development to be effective, the educator must have a desire to learn; however, institutional support and recognition are also essential. Faculty Development Programs must be flexible and adaptable, to meet the needs of the institution and its professors, and encourage reflection on their practices, though the exchange of experiences, the development of interpersonal relationships, and collaboration. However, it is vital to identify and facilitate the development of leadership skills, and to systematically evaluate the process and the results achieved. This will encourage teachers to develop in their academic careers and thereby increase the professionalization of teaching. Managers and teachers can sustain a shared mission to win resources, adapt to change, strive for excellence in the leadership of the organization in a national and international context, and consequently, provide a quality medical education.
DOI: 10.6084/m9.figshare.7942298.v1
title: Evaluation of the Impact of Professional Reorientation Programs in Health Courses

description: ABSTRACT This study problematized the perception of stakeholders in the health care field at the Federal University of Goiás regarding the impact of the National Program for Professional Training and Reorientation in Health under the Program for Education for Work in Health (Propet-Saúde) on curricular restructuring. This cross-sectional study included 300 students, tutors, preceptors, teachers and graduation coordinators from seven courses. A Likert-type instrument was constructed and validated with the following dimensions: D1: curricular restructuring and the principles of Propet-Saúde and D2: the pedagogical project of the Propet-Saúde course. The instrument was validated considering semantic, cultural and conceptual equivalence, assignment of points (from 1 to 4), and randomization of the assertions tested. The score generated three interpretive intervals: from 1 to 1.99 (dissatisfaction); 2 to 2.99 (relative satisfaction) and 3 to 4 (satisfaction). The instrument was applied following a pre-test and the placement of the contributors. The instrument was then statistically validated for dispersion and reliability. Factorial analysis was performed considering function and course. Dispersion through linear correlation showed a loss of 4 assertions (11.77%), signifying excellent content validation. Reliability was 0.93 (p &lt; 0.01), showing excellent statistical density. The general averages of D1 and D2 were 3.09 and 3.11 respectively, indicating satisfaction among the respondents. In conclusion, the participants recognize important advances such as curricular restructuring from these programs, placement of students already at the beginning of the course into practice scenarios, motivation toward interdisciplinarity, diversification of evaluation practices, and use of active methodologies. After factorial analysis, it was shown that medical and biomedical courses are more resistant to the contributions of the Pró-Saúde and PET-Saúde Programs and other hurdles were identified, such as excessive workload that hinders the integration of courses and the development of still-evolving administration and management skills. The interaction of the programs in Propet-Saúde should be strengthened, as it demonstrated significant assertiveness in curricular organization as well as in the teaching and service integration, a central aspect for the strengthening of Brazilian Public Health.