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Relative impact of diagnosis and clinical stage on response to electroconvulsive therapy: a retrospective cohort
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Tedeschi, Eduardo

; Hoffmann, Mauricio S.

; Magalhães, Pedro V.S.

Brazilian Journal of Psychiatry

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aug 2023, Volume 45 N. 4 Pages 334 - 337

Abstract: En | Text: En | PDF: En

Objectives: Electroconvulsive therapy (ECT) is commonly indicated for refractory psychiatric disorders. However, little research has compared response across diagnoses. Here, we aimed to evaluate the relative impact of diagnosis and clinical staging as response predictors in a cross-diagnostic sample. Methods: In a retrospective cohort of adult inpatients (n=287) who underwent at least six sessions of ECT, we investigated predictors of complete response (a clinical global impression of 1) to ECT. We use adjusted regression models to estimate the impact of clinical diagnosis and staging on complete response and dominance analysis to assess the relative importance of these predictors. Results: Those for whom a depressive episode was a primary indication for treatment were the most likely to have complete improvement, while those with psychosis were the least likely; clinical stage had a significant influence on outcome in all diagnoses. A diagnosis of psychosis was the strongest predictor of non-response. Conclusions: A diagnosis of psychosis (mainly schizophrenia) was the strongest predictor of non-response. We also found that clinical staging can aggregate information on ECT response that is independent of clinical diagnosis.

https://doi.org/10.47626/1516-4446-2023-3058

On suicidal ideation: the need for inductive methodologies to advance the field ideation
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Marchionatti, Lauro Estivalete

; Magalhães, Pedro Vieira da Silva

Trends in Psychiatry and Psychotherapy

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2023, Volume 45 elocation e20230655

Abstract: En | Text: En | PDF: En

Abstract Recent scholarly investigation of suicidal ideation has been largely based on identifying associated factors and using ideation-to-action theories to explain its occurrence. However, this approach may not be sufficient, as many aspects of suicidal ideation fall beyond the reach of such conceptualizations. The overemphasis on explaining rather than understanding this phenomenon is a significant factor in this insufficiency. As such, it is argued that qualitative methods that use data to derive theories could offer a more nuanced understanding of suicidal ideation. By adopting bottom-up approaches, researchers can explore how individuals experience and understand suicidal ideation and how it relates to their lives and experiences. Furthermore, use of qualitative research methods could aid in development of more accurate and inclusive definitions that are more firmly grounded in data. ideationtoaction action occurrence However sufficient conceptualizations insufficiency bottomup bottom up approaches experiences Furthermore

https://doi.org/10.47626/2237-6089-2023-0655

Management of acute stroke and urgent neurointerventional procedures during COVID-19 pandemic: recommendations on the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, Brazilian Society of Cerebrovascular Diseases and Brazilian Society of Neuroradiology
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MONT’ALVERNE, Francisco José Arruda

; LIMA, Fabrício Oliveira

; NOGUEIRA, Raul Gomes

; FREITAS, Carlos Clayton Macedo de

; NETO, Octávio Marques Pontes

; SILVA, Gisele Sampaio

; OLIVEIRA, Maura Salaroli de

; FRUDIT, Michel

; CALDAS, Jose Guilherme Mendes Pereira

; ABUD, Daniel Giansante

; CONFORTO, Adriana Bastos

; CARVALHO, Fernanda Martins Maia

; DIAS, Francisco Antunes

; BAZAN, Rodrigo

; AVELAR, Wagner Mauad

; MORO, Carla Heloísa Cabral

; MAGALHÃES, Pedro Silva Correa de

; MIRANDA, Maramelia

; BARBOSA, Leandro de Assis

; FIOROT JUNIOR, José Antonio

; CARDOSO, Fabrício Buchdid

; REBELLO, Leticia Costa

; PARENTE, Bruno de Sousa Mendes

; FARIA, Mário de Barros

; FREITAS, Gabriel Rodriguez de

; ZÉTOLA, Viviane de Hiroki Flumignan

; OLIVEIRA-FILHO, Jamary

; BEZERRA, Daniel da Cruz

; RODRIGUES, Jorge Luis Nobre

; KUSTER, Gustavo

; MARTINS, Sheila

; CARVALHO, João José Freitas de

Arquivos de Neuro-Psiquiatria

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jul 2020, Volume 78 N. 7 Pages 440 - 449

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Introdução: A pandemia causada pelo novo coronavírus da síndrome respiratória aguda grave 2 (SARS-CoV-2, COVID-19) apresenta novos e importantes desafios à gestão de saúde no Brasil. Além da difícil missão de prestar atendimento aos milhares de pacientes infectados pelo COVID-19, os sistemas de saúde têm que manter a assistência às emergências médicas comuns em períodos sem pandemia, tais como o acidente vascular cerebral (AVC), que continuam ocorrendo e requerem tratamento com presteza e eficiência. A alocação de recursos materiais e humanos para o enfrentamento à pandemia não pode comprometer o atendimento ao AVC agudo, uma emergência cujo tratamento é tempo-dependente e se não realizado implica em importante impacto na mortalidade e incapacitação a longo prazo. Objetivo: Este trabalho resume as recomendações do Departamento Científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia, da Sociedade Brasileira de Doenças Cerebrovasculares e da Sociedade Brasileira de Neurorradiologia para o tratamento do AVC agudo e para a realização de procedimentos de neurointervenção urgentes durante a pandemia de COVID-19, incluindo o uso adequado de ferramentas de triagem e equipamentos de proteção pessoal (para pacientes e profissionais de saúde), além da alocação apropriada de pacientes.

ABSTRACT Introduction: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. Objective: This paper summarizes the recommendations from the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Society of Cerebrovascular Diseases and the Brazilian Society of Neuroradiology for management of acute stroke and urgent neuro-interventional procedures during the COVID-19 pandemic, including proper use of screening tools, personal protective equipment (for patients and health professionals), and patient allocation.

https://doi.org/10.1590/0004-282x20200053 2310 downloads

Sociodemographic, criminal and forensic characteristics of a sample of female children and adolescents murdered in Brazil. 2010-2016
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Machado-Rios, Angelita

; Martini, Murilo

; Cardoso-Crespo, Kleber

; Fraga-Morales, Anderson

; Silva-Magalhães, Pedro Vieira-da

; Borba-Telles, Lisieux Elaine

Revista de la Facultad de Medicina

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sep 2019, Volume 67 N. 3 Pages 389 - 396

Abstract: Es En | Text: Es En | PDF: Es | PDF: En

Resumen Introducción. En Brasil, la violencia, en sus diferentes manifestaciones, es la primera causa de muerte entre adolescentes y adultos jóvenes de ambos sexos. Objetivo. Describir las características de los homicidios de niñas y adolescentes registrados en la morgue de Porto Alegre, Brasil. Materiales y métodos. Estudio transversal que analizó 70 pericias de necropsia de jóvenes víctimas de homicidio entre enero de 2010 y diciembre de 2016. Los casos fueron evaluados según los motivos de los crímenes, identificando 5 categorías: muertes causadas por tráfico de drogas, feminicidios, homicidios familiares, muertes por violencia sexual y homicidios relacionados con otras infracciones legales. Resultados. Hubo un aumento significativo en el número de niñas y mujeres adolescentes víctimas de homicidio entre 2010 (n=7) y 2016 (n=19). La mayoría de casos estuvieron relacionados con el tráfico de estupefacientes (64.2%), mientras que los casos de feminicidio representaron 15.7% da la muestra. Los homicidios cometidos por un familiar, los precedidos de violencia sexual y aquellos relacionados con otras actividades ilegales fueron menos frecuentes con un 10%, 5.7% y 4.2%, respectivamente. Conclusiones. Es necesario prestar más atención al aumento de los homicidios en esta población relacionados con el tráfico de estupefacientes a la hora de crear e implementar políticas públicas al respecto.

Abstract Introduction: In Brazil, violence, regardless of the type, is the leading cause of death in adolescents and young adults. Objective: To describe the characteristics of the homicides in which female children and adolescents were the victims based on the autopsy reports recorded in the morgue of the city of Porto Alegre, Brazil. Materials and methods: Cross-sectional study in which 70 autopsy reports of girls and female adolescents who were killed between January 2010 and December 2016 were analyzed. The cases were evaluated according to the homicide motive or the homicide perpetrator, and five categories were established: drug trafficking related death, femicide, homicide perpetrated by a family member, death preceded by sexual violence, and death related to other transgressions. Results: There was a significant increase in the number of girls and female adolescents who were murdered between 2010 (n=7) and 2016 (n=19). Most of the homicides (64.2%) were related to drug, while femicide occurred in 15.7% of the cases. Homicides perpetrated by a family member, or preceded by sexual violence or related with other transgressions were less frequent as they occurred in 10%, 5.7% and 4.2% of the cases, respectively. Conclusion: Greater attention must be paid to the increase in the number of drug trafficking related homicides among female adolescents when creating and implementing relevant public policies.

https://doi.org/10.15446/revfacmed.v67n3.73245 220 downloads

The cost of stroke in a public hospital in Brazil: a one-year prospective study
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SAFANELLI, Juliana

; VIEIRA, Luana Gabriela Dalla Rosa

; ARAUJO, Tainá de

; MANCHOPE, Lidiana Fachinete Silva

; KUHLHOFF, Maria Helena Ribeiro

; NAGEL, Vivian

; CONFORTO, Adriana Bastos

; SILVA, Gisele Sampaio

; MAZIN, Suleimy

; MAGALHÃES, Pedro Silva Corrêa de

; CABRAL, Norberto Luiz

Arquivos de Neuro-Psiquiatria

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jun 2019, Volume 77 N. 6 Pages 404 - 411

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Os países de baixa e media renda enfrentam orçamentos apertados na saúde, não somente devido aos novos recursos terapêuticos, mas relacionado ao custo oneroso do tratamento do acidente vascular cerebral. No entanto, poucos dados prospectivos sobre os custos do AVC, incluindo reperfusão cerebral de países de baixa e média renda estão disponíveis. Objetivo Mensurar os custos do atendimento ao AVC em um hospital público. Métodos Avaliamos prospectivamente todos os custos médicos e não médicos de pacientes internados com diagnóstico de acidente vascular cerebral ou AIT durante 1 ano, analisamos os custos por tipo de AVC e tratamento, tempo de permanência e comparamos os custos hospitalares com o reembolso governamental. Resultados Foram avaliados 274 pacientes. O custo total em um ano foi de US$ 1.307,114; o governo reembolsou o hospital no valor de US$ 1.095.118. Encontramos uma correlação linear significativa entre LOS e custos (r = 0,71). A mediana do custo do AVCI em 134 pacientes que não sofreram reperfusão cerebral (National Institutes of Health Stroke Scale [NIHSS] mediana = 3) foi de US$ 2.803; para pacientes submetidos a alteplase intravenosa (IV) (NIHSS 10), a mediana foi de US$ 5.099 e para os pacientes submetidos a trombectomia intra-arterial (IA) (NIHSS > 10), o custo mediano foi de US$ 10.997. A mediana do custo de uma hemorragia intracerebral primária, hemorragia subaracnóidea e AIT foram de US$ 2.436, US$ 8.031 e US$ 2.677, respectivamente. Conclusões Os tratamentos de reperfusão foram duas a quatro vezes mais caros do que o tratamento conservador. Estudo de custo-efetividade para o tratamento do AVC são necessários.

ABSTRACT Low- and middle-income countries face tight health care budgets, not only new resources, but also costly therapeutic resources for treatment of ischemic stroke (IS). However, few prospective data about stroke costs including cerebral reperfusion from low- and middle-income countries are available. Objective To measure the costs of stroke care in a public hospital in Joinville, Brazil. Methods We prospectively assessed all medical and nonmedical costs of inpatients admitted with a diagnosis of any stroke or transient ischemic attack over one year, analyzed costs per type of stroke and treatment, length of stay (LOS) and compared hospital costs with government reimbursement. Results We evaluated 274 patients. The total cost for the year was US$1,307,114; the government reimbursed the hospital US$1,095,118. We found a significant linear correlation between LOS and costs (r = 0.71). The median cost of 134 IS inpatients who did not undergo cerebral reperfusion (National Institutes of Health Stroke Scale [NIHSS] median = 3 ) was US$2,803; for IS patients who underwent intravenous (IV) alteplase (NIHSS 10), the median was US$5,099, and for IS patients who underwent IV plus an intra-arterial (IA) thrombectomy (NIHSS > 10), the median cost was US$10,997. The median costs of a primary intracerebral hemorrhage, subarachnoid hemorrhage, and transient ischemic attack were US$2,436, US$8,031 and US$2,677, respectively. Conclusions Reperfusion treatments were two-to-four times more expensive than conservative treatment. A cost-effectiveness study of the IS treatment option is necessary.

https://doi.org/10.1590/0004-282x20190059 2490 downloads

Barriers and facilitators perceived by people with bipolar disorder for the practice of exercise: a qualitative study
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Pereira, Caroline Silveira

; Padoan, Carolina Stopinski

; Garcia, Lucas França

; Patusco, Lucas

; Magalhães, Pedro V. S.

Trends in Psychiatry and Psychotherapy

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mar 2019, Volume 41 N. 1 Pages 1 - 8

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Resumo Introdução A prática regular de exercício físico tem benefícios para pessoas com transtorno bipolar. No entanto, como grupo, esses pacientes tendem a ser mais sedentários do que a população geral, e pouco se sabe do ponto de vista dos pacientes sobre as barreiras e facilitadores para tal prática. Objetivo Conhecer as barreiras e facilitadores percebidos por pessoas com transtorno bipolar para a prática de exercício. Métodos Este foi um estudo descritivo, qualitativo e exploratório. O método de investigação utilizado na coleta de dados foi entrevista semiestruturada em profundidade, segundo a grounded theory. Resultados A análise dos conteúdos que surgiram nas entrevistas gerou duas principais áreas de interesse: adesão ao exercício físico regular (barreiras e facilitadores) e a história de exercícios dos participantes e a percepção do manejo da doença. Os principais achados foram: a maioria da nossa amostra não se exercitava regularmente, nem mesmo sabia como a prática regular podia influenciar positivamente sua doença; em relação à adesão ao exercício físico, a presença dos sintomas e do estigma foram as barreiras mais importantes para praticar o exercício físico. O apoio social, especialmente da família e dos amigos, pode ser um facilitador da adesão ao exercício. Conclusões Apesar das limitações de um estudo qualitativo e exploratório, conhecer as barreiras e os facilitadores percebidos para a prática de exercício entre pessoas que sofrem de transtorno bipolar pode facilitar a promoção de atividades onde essas pessoas possam participar e se beneficiar efetivamente.

Abstract Introduction Exercising regularly has benefits for people with bipolar disorder. Nevertheless, as a group, these patients tend to be less physically active than the general population and little is known from the viewpoint of the patients about the barriers and facilitators to such a practice. Objective To know the barriers and facilitators perceived by people with bipolar disorder for the practice of exercise. Methods This study had a descriptive, qualitative, exploratory nature. The investigation method used for data collection was a semi-structured in-depth interview, using grounded theory as theoretical framework. Results The data analysis generated two main areas of interest: adherence to regular physical exercise (barriers and facilitators) and the participants’ exercise history and perception of disease management, as described below. The main findings were: most of our sample did not exercise regularly, nor knew how exercise can positively influence their disorder; with regard to adherence to physical exercise, the presence of symptoms and stigma were the most important barriers to the practice of physical exercise. Social support, especially from family and friends, could be a facilitator to the practice of exercise. Conclusions Even considering the limitations for generalization of qualitative and exploratory studies, understanding perceived barriers and facilitators for the practice of exercise among people who suffer with bipolar disorder may contribute to the promotion of activities in which people with mental illness can participate.

https://doi.org/10.1590/2237-6089-2017-0069 2684 downloads

Metabolic syndrome and psychiatric disorders: a population-based study
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Moreira, Fernanda Pedrotti

; Jansen, Karen

; Cardoso, Taiane de A.

; Mondin, Thaíse C.

; Magalhães, Pedro V.

; Kapczinski, Flavio

; Souza, Luciano D.M.

; da Silva, Ricardo A.

; Oses, Jean Pierre

; Wiener, Carolina D.

Brazilian Journal of Psychiatry

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feb 2019, Volume 41 N. 1 Pages 38 - 43

Abstract: En | Text: En | PDF: En

Objective: To identify the association of metabolic syndrome (MetS) and psychiatric disorders in young adults in southern Brazil. Methods: This population based cross-sectional study involved a total of 1,023 young adults between the ages of 21 and 32 years. Current episodes of psychiatric disorders were assessed using the Mini International Neuropsychiatric Interview – Plus version. MetS was evaluated using the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). Results: Of the 1,023 participants, 24.3% were identified with MetS, 13.5% were diagnosed with anxiety disorders, 7.5% with current depression, 3.9% with bipolar disorders and 10.1% were at risk of suicide. MetS was associated with ethnicity (p = 0.022), excess weight (p < 0.001), current anxiety disorders (p < 0.001), current mood disorders (bipolar disorder in mood episode and current depression) (p < 0.001), and suicide risk (p < 0.001). Conclusions: MetS was associated with psychiatric disorders. Awareness of factors associated with MetS can help identify high-risk individuals and stimulate disease prevention and control programs, as well as lifestyle changes.

https://doi.org/10.1590/1516-4446-2017-2328 2870 downloads

Das Constituições dos Regimes Nacionalistas do Entre-Guerras
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Magalhães, Pedro T.

Análise Social

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dec 2018, N. 229 Pages 1126 - 1129

Abstract: Pt | Text: Pt | PDF: Pt

https://doi.org/10.31447/as00032573.2018229.17 250 downloads

Lipid disorders among Black Africans non-users of lipid-lowering medication
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Borgo, Mariana Veronez

; Baldo, Marcelo Perim

; Alvim, Rafael de Oliveira

; Zaniqueli, Divanei

; Capingana, Daniel Pires

; Magalhães, Pedro

; Silva, Amilcar Bernardo da

; Oliosa, Polyana Romano

; Sartório, Carmem Luiza

; Mill, José Geraldo

Archives of Endocrinology and Metabolism

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oct 2018, Volume 62 N. 5 Pages 552 - 559

Abstract: En | Text: En | PDF: En

ABSTRACT Objective: Angola is a sub-Saharan African country where the population has scarce access to lipidlowering medication. We sought to determine the frequency of lipid disorders among Angolan nonusers of lipid-lowering medication. Material and methods: A cross-sectional descriptive study was carried out in a sample of 604 workers from the public sector. Blood pressure and anthropometric data were measured along with biochemical parameters including total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). LDL-C to HDL-C ratio (LDL-C/HDL-C) was obtained from LDL-C and HDL-C levels. Results: High frequencies of elevated blood pressure (44.8%), metabolic syndrome (20.2%), increased TC (39.2%) and increased LDL-C (19.3%) were found. Low HDL-C was more frequent in women (62.4% vs. 36.1%, p < 0.001). Isolated hypercholesterolemia was more frequent in men (9.6% vs. 2.5%, p < 0.001). Among men TC, TG, LDL-C and LDL-C/HDL-C ratio were higher and HDL-C was lower in obese than in low-weight and normal-weight participants. Among women TC, TG, LDL-C and LDL-C/HDL-C ratio were higher in obese than in normal-weight participants. Significant linear trend of increasing TC and LDL-C levels as age increased was detected for both genders (p for trend < 0.05). Conclusion: The results of our study showed a high frequency of lipid disorders in Angolan non-users of lipid-lowering medication.

https://doi.org/10.20945/2359-3997000000076 949 downloads

10.

DIAGNÓSTICO TARDIO DE SÍFILIS CONGÊNITA: UMA REALIDADE NA ATENÇÃO À SAÚDE DA MULHER E DA CRIANÇA NO BRASIL
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Andrade, Ana Laura Mendes Becker

; Magalhães, Pedro Vitor Veiga Silva

; Moraes, Marília Magalhães

; Tresoldi, Antônia Teresinha

; Pereira, Ricardo Mendes

Revista Paulista de Pediatria

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sep 2018, Volume 36 N. 3 Pages 376 - 381

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Objetivo: Descrever um caso de sífilis congênita com diagnóstico tardio e identificar as oportunidades perdidas nas diversas fases/níveis da atenção à saúde, que retardaram a realização do diagnóstico. Descrição do caso: Menino, 34 dias de vida, encaminhado da Unidade Básica de Saúde a um hospital terciário por apresentar aumento do volume abdominal e icterícia progressiva há 2 semanas, hipocolia fecal, hepatoesplenomegalia, anemia, plaquetopenia e elevação de enzimas hepáticas. Ao exame físico, apresentava lesões eritemato-descamativas nas mãos e nos pés e exantema macular em região inguinal, presença de ascite, fígado palpável a 5 cm do rebordo costal direito e baço palpável a 3 cm do rebordo costal esquerdo. Sorologia do lactente: CMIA (quimioluminescência de micropartículas) reagente, VDRL (Venereal Diseases Research Laboratory) 1:1024 e TPHA (Treponema pallidum Hemaglutination) reagente. Sorologia materna: CMIA e TPHA reagentes, VDRL 1:256. Radiografia de ossos longos mostrava periostite simétrica; levantamento periosteal; e bandas metafisárias lucentes em fêmures, úmeros, ulnas e tíbias. Após tratamento com penicilina cristalina, apresentou melhora clínica e laboratorial, recebendo alta no 18º dia de internação. Comentários: Este caso mostra que ainda ocorre diagnóstico tardio de sífilis congênita por falhas nas estratégias de prevenção dessa doença, tanto na atenção básica quanto nos níveis secundário e terciário. A aplicação das intervenções preconizadas pelo Ministério da Saúde e a identificação das situações em que ocorrem falhas na sua execução são importantes para a avaliação da assistência de rotina em todos os níveis de atenção e nas diversas unidades responsáveis pelo cuidado do recém-nascido e do lactente jovem.

ABSTRACT Objective: To describe a case of congenital syphilis with a late diagnosis and identify missed opportunities at diverse phases/levels of healthcare, which led to late diagnosis. Case description: Boy, 34 days of life, referred from a basic healthcare unit to a tertiary hospital due to enlarged abdominal volume and progressive jaundice for 2 weeks, fecal hypocholia, hepatosplenomegaly, anemia, low platelet count and elevated liver enzymes. At physical examination, the infant presented with erythematous-exfoliative lesions on the palms and soles, macular rash in the inguinal region, ascitis, palpable liver 5 cm below the right costal margin and a palpable spleen 3 cm from the left costal margin. Infant serology: reactive CMIA (chemiluminescent microparticle immunoassay), VDRL (Venereal Diseases Research Laboratory) 1:1024 and reactive TPHA (Treponema pallidum Hemagglutination). Maternal serology: reactive CMIA and TPHA, VDRL 1:256. Radiography of the long bones showed symmetric periostitis, periosteal thickening, and lucent bands in the femur, humerus, ulna and tibia. After treatment with crystalline penicillin, the infant showed clinical and laboratory improvement, receiving hospital discharge at the 18th hospitalization day. Comments: This case shows that congenital syphilis is occasionally diagnosed late as a result of failed strategies to prevent this disease, both in the basic and secondary/tertiary levels of care. The application of interventions recommended by the Ministry of Health and identification of the situation in which there is ineffective implementation of these measures are important to assess routine care in all levels of healthcare and diverse units responsible for newborn and infant health care.

https://doi.org/10.1590/1984-0462/;2018;36;3;00011 12520 downloads

11.

Tempo de Graduação em Medicina: uma Estimativa em 15 Coortes de Graduados na Universidade Agostinho Neto, Angola
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Magalhães, Pedro

; Gomes, Guilherme Bugalho

; Nicolau, Santos Morais

Revista Brasileira de Educação Médica

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dec 2017, Volume 41 N. 4 Pages 615 - 622

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO O tempo de conclusão do curso de graduação em Medicina está bem estabelecido nos programas de formação das escolas médicas em todo o mundo. Entretanto, nem todos os estudantes concluem o curso no tempo esperado, o que pode resultar numa baixa taxa de graduação. Contudo, uma análise isolada da taxa de graduação não permite prever com precisão a magnitude de custos de formação se não levar em conta o tempo médio de conclusão da formação, particularmente para a Medicina, que exige avultados recursos e cujo tempo de formação é o mais longo. O objetivo do estudo foi determinar o tempo médio de permanência no curso, assim como a proporção de estudantes que se gradua no tempo esperado de conclusão do curso. Foi feita uma análise retrospectiva dos dados de 15 coortes de estudantes graduados pela Faculdade de Medicina da Universidade Agostinho Neto (FMUAN), em Angola, no período de 2001 a 2015. Os dados foram recolhidos do arquivo acadêmico da FMUAN. Do total de 1.259 graduados, 59,7% eram mulheres, e a média de idade na conclusão do curso foi de 35 ± 7 anos. A taxa média de admissão ao curso foi de 6,8%, e foram graduados, em média, 88 médicos por ano, sendo 36 homens e 52 mulheres. A taxa de graduação foi de 82,2%, sendo que os estudantes demoraram, em média,dez anos para concluir o curso, e apenas 24,2% concluíram o curso no tempo esperado de seis anos. Os resultados sugerem que, apesar de ter havido uma elevada taxa de graduação, poucos concluem o curso no tempo regulamentar, realçando a importância de identificar as causas da estadia prolongada de estudantes no curso, o que pode ter implicação na gestão acadêmica e na planificação de recursos humanos de saúde. A taxa de graduados no tempo ideal, combinada com a taxa de graduação, pode ser um indicador de eficiência e um instrumento de apoio na gestão do sistema de educação médica.

ABSTRACT The time required to complete undergraduate medical courses is well established in medical school training programs worldwide. However, not all students complete the degree in the expected timeframe, which can lead to a low graduation rate. Nevertheless, an isolated analysis of the graduation rate does not accurately predict the magnitude of training costs if it does not take into account the average completion time, particularly for undergraduate medical course for which the training time is longer and requires substantial resources. The aim of this study was to determine the length of time to complete the degree, as well as the proportion of students who graduated within the regular timeframe. In this retrospective study, we analysed data from 15 cohorts of medical students who finished the undergraduate program at the Faculty of Medicine of the Agostinho Neto University (FMUAN) in Angola, from 2001 to 2015. Data were collected from the academic records registered at the FMUAN. From the total number of graduates (n = 1259), 59.7% were women and the average age at course completion was 35 ± 7 years. The average admission rate was 6.8%, and it was found that 88 students (36 men and 52 women) had graduated per year. On average, students took 10 years to complete the degree. The graduation rate was 82.2%, and only 24.2% of the total graduates concluded the program in the regular period of six years. The results suggest that despite a high graduation rate, less than one third of the students finished the training program within the expected timeframe, highlighting the need to identify the causes of prolonged course duration which may have implications for both academic management and for human resource planning in health. Thus, a combined analysis of graduation rate and the time to complete the undergraduate course may be a good indicator of the efficiency of the medical education system.

https://doi.org/10.1590/1981-52712015v41n3rb20160083 1037 downloads

12.

A tale of two elections: information, motivated reasoning, and the economy in the 2011 and 2015 Portuguese elections
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Magalhães, Pedro C.

Análise Social

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dec 2017, N. 225 Pages 736 - 758

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

Um conto de duas eleições: informação, raciocínio motivado e a economia nas eleições portuguesas de 2011 e 2015. Pensa-se que o desempenho da economia é um poderoso factor na explicação do desempenho eleitoral dos partidos do governo, e que o crescimento do PIB e o desemprego são os “dois grandes” factores envolvidos. No entanto, enquanto o Partido Socialista perdeu cerca de um quarto dos votos em 2011 sob uma profunda recessão económica e com o desemprego a crescer, a coligação de centro-direita sofreu perdas semelhantes em 2015 sob uma economia em recuperação e com crescimento do emprego. Por que razão sucedeu isto? Exploro três hipóteses: (1) a economia ter-se-á tornado um tema menos saliente para os eleitores em 2015; (2) a responsabilidade pelos resultados da economia ter-se-á tornado mais difusa em 2015; e (3) as avaliações da evolução da economia por parte dos eleitores foram mais contaminadas pela identificação partidária e mais afetadas pelos seus recursos cognitivos e experiências económicas pessoais em 2015.

A tale of two elections: information, motivated reasoning, and the economy in the 2011 and 2015 Portuguese elections. Economic performance is thought to be a powerful driver of incumbent electoral performance, and GDP growth and unemployment to be the “big two” factors involved. However, while in the 2011 elections, under a profound economic recession and growing unemployment, the Socialist incumbents lost about one-fourth of the electorate, the center-right coalition experienced losses of similar magnitude in 2015 under a recovering economy and growing employment. Why has this happened? I explore three hypotheses: (1) the economy became a less salient issue in 2015; (2) responsibility for economic outcomes became more blurred in 2015; and (3) national economic evaluations were more contaminated by partisanship and affected by cognitive resources and personal economic experiences in 2015.

360 downloads

13.

Frequency of brain tissue donation for research after suicide
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Longaray, Vanessa K.

; Padoan, Carolina S.

; Goi, Pedro D.

; da Fonseca, Rodrigo C.

; Vieira, Daniel C.

; Oliveira, Francine H. de

; Kapczinski, Flávio

; Magalhães, Pedro V.

Brazilian Journal of Psychiatry

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jun 2017, Volume 39 N. 2 Pages 180 - 182

Abstract: En | Text: En | PDF: En

Objectives: To describe the frequency of brain tissue donation for research purposes by families of individuals that committed suicide. Methods: All requests for brain tissue donation to a brain biorepository made to the families of individuals aged 18-60 years who had committed suicide between March 2014 and February 2016 were included. Cases presenting with brain damage due to acute trauma were excluded. Results: Fifty-six cases of suicide were reported. Of these, 24 fulfilled the exclusion criteria, and 11 others were excluded because no next of kin was found to provide informed consent. Of the 21 remaining cases, brain tissue donation was authorized in nine (tissue fragments in seven and the entire organ in two). Conclusions: Donation of brain tissue from suicide cases for research purposes is feasible. The acceptance rate of 42.8% in our sample is in accordance with international data on such donations, and similar to rates reported for neurodegenerative diseases.

https://doi.org/10.1590/1516-4446-2016-1971 985 downloads

14.

Brazilian guidelines for endovascular treatment of patients with acute ischemic stroke
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Pontes-Neto, Octávio Marques

; Cougo, Pedro

; Martins, Sheila Cristina Ouriques

; Abud, Daniel G.

; Nogueira, Raul G.

; Miranda, Maramélia

; Castro-Afonso, Luiz Henrique de

; Rebello, Leticia C.

; Caldas, José Guilherme M. Pereira

; Bazan, Rodrigo

; Bezerra, Daniel C

; Rezende, Marco Tulio

; Freitas, Gabriel R. de

; Longo, Alexandre

; Magalhães, Pedro

; Carvalho, João José Freitas de

; Montalverne, Francisco José

; Lima, Fabricio Oliveira

; Andrade, Gustavo H.V.

; Massaro, Ayrton R.

; Oliveira-Filho, Jamary

; Gagliardi, Rubens

; Silva, Gisele Sampaio

Arquivos de Neuro-Psiquiatria

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jan 2017, Volume 75 N. 1 Pages 50 - 56

Abstract: Pt En | Text: Pt En | PDF: Pt | PDF: En

RESUMO Estas diretrizes são o resultado de um esforço conjunto de membros da Sociedade Brasileira de Doenças Cerebrovasculares (SBDCV), Departamento científico de Doenças Cerebrovasculares da Academia Brasileira de Neurologia (ABN), Rede Brasil AVC (RBAVC) e da Sociedade Brasileira de Neurorradiologia Diagnóstica e Terapêutica (SBNR). Membros destas 4 entidades participaram de fórum de discussões por internet de temas pré-definidos, seguidos de encontros de videoconferência para discussão de pontos controversos e das recomendações, em busca de um consenso final. Estas diretrizes tem seu foco sobre as implicações dos recentes ensaios clínicos de tratamento endovascular do acidente vascular cerebral (AVC) isquêmico agudo relacionado a oclusão de artérias proximais. O texto final foi elaborado para servir de orientação no manejo destes pacientes AVC isquêmico pelos diferentes profissionais de saúde, gestores de saúde pública e de saúde complementar no Brasil.

ABSTRACT These guidelines are the result of a joint effort from writing groups of the Brazilian Stroke Society, the Scientific Department of Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Stroke Network and the Brazilian Society of Diagnostic and Therapeutic Neuroradiology. Members from these groups participated in web-based discussion forums with predefined themes, followed by videoconference meetings in which controversies and position statements were discussed, leading to a consensus. This guidelines focuses on the implications of the recent clinical trials on endovascular therapy for acute ischemic stroke due to proximal arterial occlusions, and the final text aims to guide health care providers, health care managers and public health authorities in managing patients with this condition in Brazil.

https://doi.org/10.1590/0004-282x20160174 10346 downloads

15.

Conservadorismo
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Magalhães, Pedro T.

Análise Social

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dec 2016, N. 221 Pages 993 - 996

Abstract: Pt | Text: Pt | PDF: Pt

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