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Atuação de consórcios de saúde no sistema público de saúde brasileiro: arranjos, papéis e desafios
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Carvalho, Brígida Gimenez

; Silva, João Felipe Marques da

; Nicoletto, Sônia Cristina Stefano

Saúde em Debate

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mar 2025, Volume 49 N. 144 elocation e9515

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

RESUMO Com objetivo de analisar arranjos, papéis desenvolvidos e desafios da atuação de consórcios de saúde no sistema de saúde brasileiro, foi realizada uma revisão integrativa, de agosto a outubro de 2022, em três bases de dados, por meio do cruzamento do descritor principal: Consórcios de Saúde, com descritores secundários: Regionalização; Gestão em Saúde; Atenção Secundária à Saúde; Política de Saúde e Integralidade em Saúde, acrescidos do operador booleano ‘and’. Foram encontrados 656 artigos. Após leitura dos títulos e resumos, foram excluídos 621. Mediante leitura do texto completo, excluíramse outros cinco, resultando em 30 artigos. As primeiras publicações datam do final da década de 1990, de consórcios horizontais entre entes municipais, recém-criados nas regiões Sul e Sudeste. A partir de 2016, são publicados artigos sobre consórcios verticais, entre o ente estadual e municipais, e consórcio horizontal, entre entes estaduais, ambos na região Nordeste. Os consórcios foram criados para ampliar a oferta de serviços especializados e promoveram impacto no acesso da população a diferentes serviços e cooperação entre entes federados. Porém, permanecem como desafios a falta de integração entre os pontos da rede de atenção, a mercantilização da saúde, a ausência de regulação e de controle social.

ABSTRACT With the objective of analyzing the arrangements, roles developed and challenges of performance of health consortia in the Brazilian health system, an integrative review was carried out, from August to October 2022, in three databases, through the crossing of the main descriptor: Consortia of Health with secondary descriptors: Regionalization; Health Management; Secondary Health Care; Health Policy and Health Comprehensiveness, plus the Boolean operator ‘and’. A total of 656 articles were found. After reading the titles and abstracts, 621 were excluded. After reading the full text, five others were excluded, resulting in 30 articles. The first publications are from the end of the 1990s, from horizontal consortia between municipal entities, recently created in the South and Southeast regions. As of 2016, articles are published on vertical consortia, between state and municipal entities, and horizontal consortia between state entities, both in the Northeast region. The consortia were created to expand the offer of specialized services and promote impact on the population’s access to different services and cooperation between federal entities. However, the lack of integration between the points of the care network, the commodification of health, the lack of regulation and social control remain as challenges.

https://doi.org/10.1590/2358-289820251449515p

Stochastic short-term mine scheduling targeting stationary grades
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Toledo, Augusto Andres Torres

; Costa, João Felipe Coimbra Leite

; Capponi, Luciano Nunes

; Marques, Diego Machado

REM - International Engineering Journal

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2025, Volume 78 N. 1 elocation e240011

Abstract: En | Text: En | PDF: En

Abstract One of the key objectives in short-term mine planning is to establish a sequence of contiguous blocks organized into diglines, each characterized by consistent low-grade variability and minimal fluctuations, ensuring a stable output. This practice guarantees a steady and reliable supply of ore to the processing plant across various operational phases, each phase outlined for clarity. The creation of this digline requires the generation of multiple random models and involves choosing a model whose grade histogram aligns closely with the predefined criteria. In stochastic mine planning, geological uncertainty and transfer functions are employed to propagate the risk into the mining schedule focusing on grade control. This is accomplished by opting for blocks that present the lowest risk associated with grade uncertainty, a process enhanced by prioritizing blocks situated in geopositions with a proven high probability of occurrence. This study unveils detailed simulation models, clearly outlined digline selection methodologies, and a thorough optimization process, each aspect exemplified within the practical context of a phosphate mine. Our findings confirm the viability of this approach in real industry practice.

https://doi.org/10.1590/0370-44672024780011

Saturated hydraulic conductivity and steady-state infiltration rate database for Brazilian soils
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Ottoni, Marta Vasconcelos

; Teixeira, Wenceslau Geraldes

; Reis, Aline Mari Huf dos

; Pimentel, Letícia Guimarães

; Souza, Luciana Rodrigues

; Albuquerque, Jackson Adriano

; Melo, Valdinar Ferreira

; Cavalieri-Polizeli, Karina Maria Vieira

; Reichert, José Miguel

; Viana, João Herbert Moreira

; Fontana, Ademir

; Medrado, Lucas de Castro

; Santos, Glenio Guimarães

; Amaral, Luís Gustavo Henriques do

; Anjos, Lúcia Helena Cunha dos

; Araújo Filho, José Coelho de

; Bhering, Silvio Barge

; Brito, Gabrielle Fernandes de

; Valle, Pedro Gomes de Campos do

; Campos, Pablo Nieto

; Costa, Adriana Monteiro da

; Marques, Jean Dalmo de Oliveira

; Martins, Alba Leonor da Silva

; Nascimento, Michele Bruna de Souza do

; Noronha, Norberto Cornejo

; Oliveira, Ricardo Duarte de

; Portela, Jeane Cruz

; Serafim, Milson Evaldo

; Silva, Marlen Barros e

; Rodrigues, Sueli

; Almeida, Wilk Sampaio de

; Moraes, Margareth Lopes de

; Curi, Nilton

Revista Brasileira de Ciência do Solo

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2025, Volume 49 elocation e0240003

Abstract: En | Text: En | PDF: En

ABSTRACT Soil saturated hydraulic conductivity (Ksat) and steady-state infiltration rate (SSIR) are essential and necessary soil properties for different geoscience applications. Values of these hydraulic properties for the Brazilian territory are difficult to access and are dispersed in research efforts carried out around the country. This study developed an easy-to-manipulate, freely accessible database of soil saturated hydraulic conductivity, comprising field and laboratory analyses, and steady-state infiltration rates for Brazilian soils. This database was named Ksat-SSIR-DB. One analysis of the Ksat-SSIR-DB aimed to evaluate its coverage in Brazilian territory and in different soil groups. Average values of these hydraulic properties were also presented for textural classes, with values compared to those reported in international literature, and for other groupings, such as soil class, land use class, and porosity class. The variability of Ksat data in these groupings and in their combinations were also analyzed. The Ksat-SSIR-DB showed broad national coverage, comprising a total of 2,579 records, corresponding to 409 sampling sites, with Ksat and/or SSIR data and other associated soil information. A significant difference was observed between Ksat values for the vast majority of Brazilian clayey and very clayey soils compared to soils from the same textural groups from temperate regions. The two groupings that presented the lowest variability in terms of Ksat standard deviation values were the combination of textural classes with soil classes at the second category level of SiBCS (Brazilian Soil Classification System), and porosity classes with soil classes at the second category level of SiBCS. The Ksat-SSIR-DB has enormous potential for developing and testing Ksat pedotransfer functions in Brazilian soils, serving as a reference source for different geoenvironmental applications and, in particular, for modeling land surface processes. It is open access and can be accessed at https://www.sgb.gov.br/ksat-ssir-dbbase-de-dados-de-condutividade-hidraulica-saturada-e-de-taxa-de-infiltracao-basica-emsolos-brasileiros, which also includes the python script for data analysis.

https://doi.org/10.36783/18069657rbcs20240003

Seroprevalence of hepatitis E virus infection in blood donors from Piauí State, Northeast Brazil
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Silva-Sampaio, João Paulo da

; Sinimbu, Raniela Borges Marques, Julia Trece Oliveira Neto, Abilio Francisco de Villar, Livia Melo

Brazilian Journal of Infectious Diseases

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2025, Volume 29 elocation 104466

Abstract: En | Text: En | PDF: En

Abstract A retrospective and cross-sectional study was carried out on blood donors from Piauí State located at Northeastern Brazil to evaluate the prevalence of Hepatitis E Virus (HEV) infection. Serum samples were tested for anti-HEV IgG and IgM using electrochemiluminescence and HEV RNA was tested using real time PCR. A total of 890 individuals were included with median age of 33.4 years and most of them were male and lived at Mid-Northern region of the State. Prevalences of anti-HEV IgG and IgM were 1.35 % and 0.11 %, respectively. None HEV-RNA was detected. This study demonstrated low prevalence of HEV infection in blood donors in this region.

https://doi.org/10.1016/j.bjid.2024.104466

Índice de vulnerabilidade social, fragilidade física e delirium em idosos hospitalizados
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Lenardt, Maria Helena

; Cechinel, Clovis

; Rodrigues, João Alberto Martins

; Marques, Daiane Maria da Silva

; Guedez, José Baudilio Belzarez

; Binotto, Maria Angélica

Acta Paulista de Enfermagem

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2025, Volume 38 elocation eAPE0001201

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

https://doi.org/10.37689/acta-ape/2025ao0001201

Characterisation of the lignocellulosic properties of pruning waste from tree species with the potential for furniture production in Acaraú, Ceará Acaraú
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Araujo, José Dionis Matos

; Sousa Filho, Men de Sá Moreira de

; Matos, Adriano Lincoln Albuquerque

; Sousa, João Alencar de

; Marques, Francisco Pereira

; Santos, Alisson Moura

; Bezerra, Antonio Marcos Esmeraldo

Revista Ciência Agronômica

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2025, Volume 56 elocation e202192212

Abstract: En | Text: En | PDF: En

ABSTRACT The aim of this study was to characterise the lignocellulosic fractions of pruning waste from tree species showing potential for furniture production in Acaraú, Ceará. The experiment was conducted in a completely randomised, split-plot design, with the plots corresponding to two water regimes (irrigated for one year and irrigated for three years) and the sub-plots to eight tree species, with three replications. The chemical attributes were determined after seven years. Except for the insoluble lignin content, there was a significant effect from the different species in terms of the chemical properties of the wood. The results for the lignocellulosic fractions show the possibility of developing technological ways of adding value to these waste products, especially considering their lignin content. The different species also showed potential for use in producing cellulose pulp, with the exception of Handroanthus impetiginosus due to its high ash content. The results of this study offer new perspectives for future research into the use of forestry waste. Acaraú Ceará randomised splitplot split plot design years subplots sub replications content wood products pulp

https://doi.org/10.5935/1806-6690.20250012

Association between the practice of fitness-related exercises and body image dissatisfaction in adolescents from Curitiba (PR), Brazil fitnessrelated fitness related PR, PR , (PR) (PR
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Dutra, Rinelly Pazinato

; Castro, Yasmin Marques

; Almeida, Maria Eduarda Santos de

; Pedrozo, Letícia Lamberty

; Sousa, João Venícios Tavares de

; Bastos, Murilo

; Campos, Wagner de

; Silva, Michael Pereira da

Revista Paulista de Pediatria

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2025, Volume 43 elocation e2023221

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

RESUMO Objetivo: Analisar a associação entre a participação em exercícios físicos relacionados ao fitness (EFRF) e a insatisfação com a imagem corporal (IIC) em adolescentes e avaliar a interação entre os exercícios físicos e o estado nutricional nesta associação. Métodos: Estudo transversal realizado em 2015 com 799 adolescentes (10 a 16 anos) de 14 escolas públicas de Curitiba (PR), Brasil. A IIC foi avaliada por meio do Body Shape Questionnaire e da Escala de Silhuetas. A participação em EFRF foi avaliada pelo Questionário de Atividade Física para Adolescentes e classificada em “não pratica”, “pratica ≤300 minutos/semana” e “pratica >300 minutos/semana”. As regressões de Poisson e logística multinomial, ajustadas por sexo, maturação sexual e estado nutricional, analisaram a associação entre EFRF e IIC. Resultados: A prevalência de IIC foi de 28,3%; 52,4% dos adolescentes queriam reduzir a silhueta e 48,7% não praticavam a EFRF. Adolescentes que praticavam EFRF >300 minutos/semana tiveram prevalência 28% maior para algum nível de IIC (razão de prevalência — RP 1,28; intervalo de confiança de 95% — IC95% 1,08–1,52) e chance 46% menor de querer reduzir silhuetas (OR 0,54; 95IC% 0,35–0,82), comparados aos não praticantes. Não houve interação entre os EFRF e o estado nutricional na associação com IIC. Conclusões: Os adolescentes que praticam EFRF >300 minutos/semana estão mais propensos a apresentar algum nível de IIC e têm menores chances de reportar o desejo de aumentar silhuetas, independentemente do estado nutricional. Objetivo (EFRF (IIC Métodos 201 79 10 (1 1 anos PR, PR , (PR) Brasil Silhuetas pratica, pratica pratica” 300 ≤30 minutossemana minutos semana >30 minutos/semana. . multinomial sexo Resultados 28,3% 283 28 3 524 52 4 52,4 487 48 7 48,7 razão 1,28 128 95 IC95 IC 1,08–1,52 108152 08 46 OR 0,54 054 0 54 95IC 0,35–0,82, 035082 0,35–0,82 35 82 0,35–0,82) praticantes Conclusões 20 ( (PR 30 ≤3 >3 28,3 2 5 52, 48, 1,2 12 9 IC9 1,08–1,5 10815 0,5 05 03508 0,35–0,8 8 ≤ > 28, 1, 1,08–1, 1081 0, 0350 0,35–0, 1,08–1 108 035 0,35–0 1,08– 03 0,35– 1,08 0,35 1,0 0,3

ABSTRACT Objective: The aim of this study was to analyze the association between participation in fitness-related exercises (FRE) and body image dissatisfaction (BID) in adolescents and evaluate the interaction between physical exercise and nutritional status in this association. Methods: A cross-sectional study was conducted in 2015 involving 799 adolescents (10–16 years old) from 14 public schools in Curitiba (PR), Brazil. BID was assessed using the Body Shape Questionnaire and the Silhouette Scale. The FRE was classified as “does not practice,” “practices ≤300 min/week,” and “practices >300 min/week” by the Physical Activity Questionnaire for Adolescents. Poisson and multinomial logistic regressions, adjusted for sex, sexual maturation, and nutritional status analyzed the association of FRE and BID. Results: The BID prevalence was 28.3%; 52.4% of the adolescents wanted to reduce their silhouettes; and 48.7% did not practice FRE. Adolescents who practiced FRE >300 min/week had a 28% higher prevalence for some level of BID (PR 1.28; 95%CI 1.08–1.52) and a 46% lower chance of wanting to reduce silhouettes (OR 0.54; 95%CI 0.35–0.82), compared to nonpractitioners. There was no interaction between FRE and nutritional status in association with BID. Conclusions: The adolescents who practice FRE >300 min/week are likely to have some level of BID and are less likely to report the desire to increase their silhouettes, regardless of their nutritional status. Objective fitnessrelated fitness related (FRE (BID Methods crosssectional cross sectional 201 79 10–16 1016 10 16 (10–1 old 1 PR, PR , (PR) Brazil Scale does practice, practices 300 ≤30 min/week, minweek min week >30 regressions sex maturation Results 28.3% 283 28 3 524 52 4 52.4 487 48 7 48.7 1.28 128 95CI CI 95 1.08–1.52 108152 08 46 OR 0.54 054 0 54 0.35–0.82, 035082 0.35–0.82 35 82 0.35–0.82) nonpractitioners Conclusions 20 10–1 101 (10– 30 ≤3 >3 28.3 2 5 52. 48. 1.2 12 9 1.08–1.5 10815 0.5 05 03508 0.35–0.8 8 10– (10 ≤ > 28. 1. 1.08–1. 1081 0. 0350 0.35–0. (1 1.08–1 108 035 0.35–0 ( 1.08– 03 0.35– 1.08 0.35 1.0 0.3

https://doi.org/10.1590/1984-0462/2025/43/2023221

Energy performance of sugarcane harvesters equipped with knives and saws for basal cutting
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Marques Filho, Aldir C.

; Testa, João V. P.

; Martins, Murilo B.

; Bortolheiro, Fernanda P. de A. P.

; Almeida, Pablo L. de

; Lanças, Kléber P.

Revista Brasileira de Engenharia Agrícola e Ambiental

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2025, Volume 29 N. 4 elocation e281575

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

RESUMO O corte mecanizado da cana-de-açúcar necessita de aprimoramentos, visto que as ferramentas de corte podem afetar a longevidade dos canaviais e aumentar os custos de produção. Além disso, essas ferramentas podem aumentar a demanda energética das máquinas no campo. Este estudo avaliou o desempenho de colhedoras de cana-de-açúcar equipadas com distintos mecanismos de corte basal: corte por impacto (lâminas) e corte contínuo (serras) em três áreas comerciais de produção de cana-de-açúcar. O consumo efetivo de combustível e a capacidade efetiva de colheita das máquinas foram avaliados em cada tratamento. O delineamento experimental adotado foi inteiramente casualizado em esquema fatorial 3 × 2 com seis repetições. As serras aumentaram o consumo de combustível por área em 3,9 e 8,9% por Mg colhido. As características produtivas da cultura determinam a demanda energética dos sistemas de colheita. Para produtividades acima de 90 Mg ha-1, a demanda energética estabilizou-se até 120 Mg ha-1. A demanda de combustível para a colheita variou entre 1,0 e 1,2 L Mg-1 de material colhido. Os resultados mostram que independente do sistema de corte, cada Mg de cana colhida necessita em média de 37,3 kJ de energia para ser retirado do campo. canadeaçúcar açúcar aprimoramentos disso campo basal lâminas (lâminas (serras canadeaçúcar. açúcar. tratamento repetições 39 9 3, 89 8 8,9 colhido ha1, ha1 ha 1, 1 ha-1 estabilizouse estabilizou se 12 ha1. 1. 10 0 Mg1 Mg- 373 37 37, 8, ha-

ABSTRACT The mechanized cutting of sugarcane requires improvements, as cutting tools can affect the longevity of sugarcane fields and increase production costs. Furthermore, these tools can increase the energy demand of machines in the field. This study evaluated the sugarcane harvester performance equipped with different basal cutting devices: impact cutting (blades) and continuous cutting (saws) in three commercial sugarcane production areas. The experimental design was completely randomized in a 3 × 2 factorial scheme with six repetitions. Effective fuel consumption and harvesting capacity were evaluated. The saws increased fuel consumption per area by 3.9 and 8.9% per Mg harvested. The crop’s yield characteristics determine harvesting systems’ energy demand. For yields above 90 Mg ha-1, energy demand has stabilized up to 120 Mg ha-1. The fuel demand for harvesting ranged between 1.0 and 1.2 L Mg-1 of harvested material. Regardless of the cutting system, each Mg requires 37.3 kJ of energy to be removed from the field. improvements costs Furthermore field devices blades (blades (saws areas repetitions 39 9 3. 89 8 8.9 crops crop s systems ha1, ha1 ha 1, 1 ha-1 12 ha1. 1. 10 0 Mg1 Mg- material system 373 37 37. 8. ha-

https://doi.org/10.1590/1807-1929/agriambi.v29n4e281575

Índice de vulnerabilidade social, fragilidade física e delirium em idosos hospitalizados social
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Lenardt, Maria Helena

; Cechinel, Clovis

; Rodrigues, João Alberto Martins

; Marques, Daiane Maria da Silva

; Guedez, José Baudilio Belzarez

; Binotto, Maria Angélica

Acta Paulista de Enfermagem

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2025, Volume 38 elocation eAPE0001201

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

Abstract Objective To analyze the relationship between the social vulnerability index and physical frailty condition and delirium in hospitalized older adults. Methods Cross-sectional analytical study of older adults developed in a hospital in southern Brazil. The collection instruments used were a sociodemographic questionnaire, the social vulnerability index, physical frailty phenotype markers and the Confusion Assessment Method. Descriptive and inferential statistics were used. Results Of the 305 older adults evaluated, 59.4% were female, 40.9% were aged over 80 years and 92.6% had morbidities. There was an association between hospitalization and female sex with low and medium vulnerability (64.8%; 95%CI 55.9-72.7 and 63%; 95%CI 53.2-71.8, respectively, with p=0.0262) . Delirium was observed in 29.5% (95%CI 22.3-38.4) of older adults over 60 years of age with low vulnerability, 17% (10.9-25.5) medium, 14.5% ( 8.6-23.9) high, with p=0.0151. There was no association between delirium and the vulnerability index in older adults aged over 80 years, with p=0.235. Delirium affected 44.3% (32.5-56.7) of older adults with low vulnerability, 35% (22.1-50.5) with medium and 25% (12-44.9) high. There was no association between frailty and social vulnerability, with p=0.927. Among older adults aged 80 years or over, frail people prevailed in the three vulnerability strata (low 59.7%; medium 57.5% and high 56%), p=0.788. Conclusion Hospitalization and delirium were associated with younger, pre-frail women from low and medium social vulnerability. The condition of frailty did not correlate with social vulnerability. The need to better understand the biopsychosocial factors that can increase delirium in hospitalized older adults with low social vulnerability is highlighted. Crosssectional Cross sectional Brazil questionnaire Method 30 evaluated 594 59 4 59.4 409 40 9 40.9 8 926 92 6 92.6 morbidities 64.8% 648 64 (64.8% 95CI CI 95 55.972.7 559727 55.9 72.7 55 72 7 55.9-72. 63% 63 53.271.8, 532718 53.2 71.8, 53 2 71 53.2-71.8 respectively p=0.0262 p00262 p 0 0262 295 29 5 29.5 22.338.4 223384 22.3 38.4 22 3 38 22.3-38.4 17 10.925.5 109255 10.9 25.5 10 25 (10.9-25.5 145 14 14.5 8.623.9 86239 8.6 23.9 23 8.6-23.9 p00151 0151 p=0.0151 p0235 235 p=0.235 443 44 44.3 32.556.7 325567 32.5 56.7 32 56 (32.5-56.7 35 22.150.5 221505 22.1 50.5 1 50 (22.1-50.5 1244.9 12449 12 44.9 (12-44.9 p0927 927 p=0.927 59.7% 597 575 57 57.5 56%, 56% , 56%) p0788 788 p=0.788 younger prefrail pre highlighted 59. 40. 92. 64.8 (64.8 972 55.972. 55972 559 55. 727 72. 55.9-72 271 53.271.8 53271 532 53. 718 71.8 53.2-71. p=0.026 p0026 026 29. 338 22.338. 22338 223 22. 384 38. 22.3-38. 925 10.925. 10925 109 10. 255 25. (10.9-25. 14. 623 8.623. 8623 86 8. 239 23. 8.6-23. p0015 015 p=0.015 p023 p=0.23 44. 556 32.556. 32556 325 32. 567 56. (32.5-56. 150 22.150. 22150 221 505 50. (22.1-50. 1244 1244. 449 (12-44. p092 p=0.92 59.7 57. p078 78 p=0.78 64. (64. 97 55.972 5597 55.9-7 27 53.271. 5327 71. 53.2-71 p=0.02 p002 02 33 22.338 2233 22.3-38 10.925 1092 (10.9-25 62 8.623 862 8.6-23 p001 01 p=0.01 p02 p=0.2 32.556 3255 (32.5-56 15 22.150 2215 (22.1-50 124 (12-44 p09 p=0.9 p07 p=0.7 (64 55.97 55.9- 53.271 53.2-7 p=0.0 p00 22.33 22.3-3 10.92 (10.9-2 8.62 8.6-2 p0 p=0. 32.55 (32.5-5 22.15 (22.1-5 (12-4 (6 53.27 53.2- 22.3- (10.9- 8.6- p=0 (32.5- (22.1- (12- (10.9 p= (32.5 (22.1 (12 (10. (32. (22. (1 (10 (32 (22 (3 (2

Resumo Objetivo Analisar a relação entre o índice de vulnerabilidade social e condição de fragilidade física e o delirium em idosos hospitalizados. Métodos Estudo transversal e analítico desenvolvido com idosos em um hospital no Sul do Brasil. Foram empregados os instrumentos de coleta questionário sociodemográfico, índice de vulnerabilidade social, marcadores do fenótipo de fragilidade física e Confusion Assessement Method. Utilizou-se estatística descritiva e inferencial. Resultados Dos 305 idosos avaliados, 59,4% eram do sexo feminino, 40,9% com idade superior a 80 anos e 92,6% com morbidades. Houve associação entre hospitalização e sexo feminino com baixa e média vulnerabilidade (64,8%; IC95% 55,9-72,7 e 63%; IC95% 53,2-71,8, respectivamente, com p=0,0262). O delirium foi observado em 29,5% (IC95% 22,3-38,4) dos idosos com idade superior a 60 anos com baixa vulnerabilidade, 17% (10,9-25,5) média, 14,5% (8,6-23,9) alta, com p=0,0151. Acima de 80 anos, não se observou associação entre delirium e o índice de vulnerabilidade, com p=0,235. A ocorrência de delirium atingiu 44,3% (32,5-56,7) idosos com baixa vulnerabilidade, 35% (22,1-50,5) média e 25% (12-44,9) alta. Não houve associação entre fragilidade e vulnerabilidade social, com p=0,927. Em idosos com 80 anos ou mais, prevaleceram os frágeis nos três estratos de vulnerabilidade (baixa 59,7%; média 57,5% e alta 56%), p=0,788. Conclusão A hospitalização e o delirium se associaram a mulheres mais jovens, pré-frágeis e provenientes de baixa e média vulnerabilidade social. A condição de fragilidade não se correlacionou à vulnerabilidade social. Destaca-se a necessidade de melhor compreensão dos fatores biopsicossociais que podem aumentar o delirium em idosos hospitalizados com baixa vulnerabilidade social. Brasil sociodemográfico Method Utilizouse Utilizou inferencial 30 avaliados 594 59 4 59,4 409 40 9 40,9 8 926 92 6 92,6 morbidades 64,8% 648 64 (64,8% IC95 IC 55,972,7 559727 55,9 72,7 55 72 7 55,9-72, 63% 63 53,271,8, 532718 53,2 71,8, 53 2 71 53,2-71,8 respectivamente p=0,0262. p00262 p p=0,0262 . 0 0262 p=0,0262) 295 29 5 29,5 (IC95 22,338,4 223384 22,3 38,4 22 3 38 22,3-38,4 17 10,925,5 109255 10,9 25,5 10 25 (10,9-25,5 145 14 14,5 8,623,9 86239 8,6 23,9 23 (8,6-23,9 p00151 0151 p=0,0151 p0235 235 p=0,235 443 44 44,3 32,556,7 325567 32,5 56,7 32 56 (32,5-56,7 35 22,150,5 221505 22,1 50,5 1 50 (22,1-50,5 1244,9 12449 12 44,9 (12-44,9 p0927 927 p=0,927 59,7% 597 575 57 57,5 56%, 56% , 56%) p0788 788 p=0,788 jovens préfrágeis pré Destacase Destaca 59, 40, 92, 64,8 (64,8 IC9 972 55,972, 55972 559 55, 727 72, 55,9-72 271 53,271,8 53271 532 53, 718 71,8 53,2-71, p0026 p=0,026 026 29, (IC9 338 22,338, 22338 223 22, 384 38, 22,3-38, 925 10,925, 10925 109 10, 255 25, (10,9-25, 14, 623 8,623, 8623 86 8, 239 23, (8,6-23, p0015 015 p=0,015 p023 p=0,23 44, 556 32,556, 32556 325 32, 567 56, (32,5-56, 150 22,150, 22150 221 505 50, (22,1-50, 1244 1244, 449 (12-44, p092 p=0,92 59,7 57, p078 78 p=0,78 64, (64, 97 55,972 5597 55,9-7 27 53,271, 5327 71, 53,2-71 p002 p=0,02 02 (IC 33 22,338 2233 22,3-38 10,925 1092 (10,9-25 62 8,623 862 (8,6-23 p001 01 p=0,01 p02 p=0,2 32,556 3255 (32,5-56 15 22,150 2215 (22,1-50 124 (12-44 p09 p=0,9 p07 p=0,7 (64 55,97 55,9- 53,271 53,2-7 p00 p=0,0 22,33 22,3-3 10,92 (10,9-2 8,62 (8,6-2 p0 p=0, 32,55 (32,5-5 22,15 (22,1-5 (12-4 (6 53,27 53,2- 22,3- (10,9- (8,6- p=0 (32,5- (22,1- (12- ( (10,9 (8,6 p= (32,5 (22,1 (12 (10, (8, (32, (22, (1 (10 (8 (32 (22 (3 (2

Resumen Objetivo Analizar la relación entre el índice de vulnerabilidad social y la condición de debilidad física y el delirium en personas mayores hospitalizadas. Métodos Estudio transversal y analítico llevado a cabo con personas mayores en un hospital del sur de Brasil. Se emplearon los siguientes instrumentos para la recopilación: cuestionario sociodemográfico, índice de vulnerabilidad social, marcadores del fenotipo de debilidad física y Confusion Assessement Method. Se utilizó la estadística descriptiva e inferencial. Resultados De las 305 personas mayores evaluadas, el 59,4 % era de sexo femenino, el 40,9 % de más de 80 años y el 92,6 % con morbilidades. Se observó asociación entre hospitalización y sexo femenino con vulnerabilidad baja y mediana (64,8 %; IC95 % 55,9-72,7 y 63 %; IC95 % 53,2-71,8, respectivamente, con p=0,0262). El delirium se observó en el 29,5 % (IC95 % 22,3-38,4) de las personas mayores de más de 60 años con vulnerabilidad baja, el 17 % (10,9-25,5) mediana y el 14,5 % (8,6-23,9) alta, con p=0,0151. No se observó relación entre delirium e índice de vulnerabilidad en personas de más de 80 años, con p=0,235. La incidencia de delirium llegó al 44,3 % (32,5-56,7) de personas mayores con vulnerabilidad baja, 35 % (22,1-50,5) mediana y 25 % (12-44,9) alta. No se observó asociación entre debilidad y vulnerabilidad social, con p=0,927. Entre las personas mayores de 80 años o más, prevalecieron los débiles en las tres categorías de vulnerabilidad (baja 59,7 %; mediana 57,5% y alta 56%), p=0,788. Conclusión La hospitalización y el delirium se asociaron a mujeres más jóvenes, predébiles y con vulnerabilidad social baja y mediana. La condición de debilidad no se correlacionó con la vulnerabilidad social. Se resalta la necesidad de una mejor comprensión de los factores biopsicosociales que pueden aumentar el delirium en personas mayores hospitalizadas con vulnerabilidad social baja. Brasil recopilación sociodemográfico Method inferencial 30 evaluadas 594 59 4 59, 409 40 9 40, 8 926 92 6 92, morbilidades 64,8 648 64 (64, IC IC9 55,972,7 559727 55,9 72,7 55 72 7 55,9-72, 53,271,8, 532718 53,2 71,8, 53 2 71 53,2-71,8 respectivamente p=0,0262. p00262 p p=0,0262 . 0 0262 p=0,0262) 295 29 5 29, (IC9 22,338,4 223384 22,3 38,4 22 3 38 22,3-38,4 1 10,925,5 109255 10,9 25,5 10 (10,9-25,5 145 14 14, 8,623,9 86239 8,6 23,9 23 (8,6-23,9 p00151 0151 p=0,0151 p0235 235 p=0,235 443 44 44, 32,556,7 325567 32,5 56,7 32 56 (32,5-56,7 22,150,5 221505 22,1 50,5 50 (22,1-50,5 1244,9 12449 12 44,9 (12-44,9 p0927 927 p=0,927 597 575 57 57,5 56%, 56% , 56%) p0788 788 p=0,788 jóvenes 64, (64 972 55,972, 55972 559 55, 727 72, 55,9-72 271 53,271,8 53271 532 53, 718 71,8 53,2-71, p0026 p=0,026 026 (IC 338 22,338, 22338 223 22, 384 38, 22,3-38, 925 10,925, 10925 109 10, 255 25, (10,9-25, 623 8,623, 8623 86 8, 239 23, (8,6-23, p0015 015 p=0,015 p023 p=0,23 556 32,556, 32556 325 32, 567 56, (32,5-56, 150 22,150, 22150 221 505 50, (22,1-50, 1244 1244, 449 (12-44, p092 p=0,92 57, p078 78 p=0,78 (6 97 55,972 5597 55,9-7 27 53,271, 5327 71, 53,2-71 p002 p=0,02 02 33 22,338 2233 22,3-38 10,925 1092 (10,9-25 62 8,623 862 (8,6-23 p001 01 p=0,01 p02 p=0,2 32,556 3255 (32,5-56 15 22,150 2215 (22,1-50 124 (12-44 p09 p=0,9 p07 p=0,7 ( 55,97 55,9- 53,271 53,2-7 p00 p=0,0 22,33 22,3-3 10,92 (10,9-2 8,62 (8,6-2 p0 p=0, 32,55 (32,5-5 22,15 (22,1-5 (12-4 53,27 53,2- 22,3- (10,9- (8,6- p=0 (32,5- (22,1- (12- (10,9 (8,6 p= (32,5 (22,1 (12 (10, (8, (32, (22, (1 (10 (8 (32 (22 (3 (2

https://doi.org/10.37689/acta-ape/2025ao0001201

10.

When a disease doesn´t come alone: A case report of polyglandular autoimmune syndrome type 2
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Silva, Mariana Vieira

; Marques, João Nuno Sousa

; Madanelo, Inês Coutinho Oliveira de Lima

; Reis, Carla Sofia Morgado Pinto

; Pimenta, Joana Filipa Marques

; Antunes, Joaquina Conceição Fernandes

; Santos, Elisabete Maria Costa e Silva

; Faria, Cristina Celeste Fernandes de

Nascer e Crescer

Journal Metrics
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sep 2024, Volume 33 N. 3 Pages 202 - 206

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

Resumo As síndromes poliglandulares autoimunes (PAS) são um grupo complexo e heterogéneo de doenças caracterizado pela combinação de duas ou mais disfunções endócrinas autoimunes. É apresentado o caso de uma adolescente de 16 anos de idade com história de astenia, prostração e perda de peso, que foi diagnosticada com hipotiroidismo e anemia ferropénica. Duas semanas após ter iniciado tratamento com levotiroxina e ferro, desenvolveu insuficiência suprarrenal com náuseas e vómitos. Os níveis de cortisol baixo e hormona adrenocorticotrópica elevada e presença de anticorpos anti-suprarrenal e antiperoxidase tiroideia positivos confirmaram o diagnóstico de síndrome poliglandular autoimune tipo 2 (PAS-2). O tratamento com hidrocortisona, fludrocortisona e levotiroxina levou à remissão dos sintomas A PAS-2 é uma condição rara, sendo necessária uma elevada suspeita clínica para a mesma, dado que a maioria dos sintomas são inespecíficos. O diagnóstico precoce pode prevenir complicações potencialmente fatais.

Abstract Autoimmune polyglandular syndromes (PAS) are a complex and heterogeneous group of diseases characterized by the combination of two or more endocrine or non-endocrine organ dysfunctions. Herein is presented the case of a 16-year-old female with a history of asthenia, prostration, and weight loss who was diagnosed with hypothyroidism and iron deficiency anemia. Two weeks after starting therapy with levothyroxine and iron, she developed an adrenal crisis with nausea and vomiting. Low cortisol, elevated adrenocorticotropic hormone, and positive antiadrenal and antithyroid peroxidase antibodies confirmed the diagnosis of autoimmune polyglandular syndrome type 2 (PAS-2). Symptoms resolved with hydrocortisone, fludrocortisone, and levothyroxine. PAS-2 is a rare but potentially serious disorder. A high clinical suspicion is required, as most symptoms are nonspecific. Early diagnosis may prevent life-threatening complications.

https://doi.org/10.25753/birthgrowthmj.v33.i3.28361

11.

Large brown macula in a newborn
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Oliveira, Ana Gisela

; Marques, João

; Antunes, Joaquina

; Sousa, Pedro Maneira

; Cabral, Rita

; Andrade, Isabel

Nascer e Crescer

Journal Metrics
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sep 2024, Volume 33 N. 3 Pages 213 - 215

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

Resumo É descrito o caso de um recém-nascido de termo, do sexo masculino, fruto de gestação vigiada sem intercorrências. Ao exame objetivo, o rapaz apresentou uma mácula hiperpigmentada, de coloração castanho claro, homogénea, com mais de 15 cm, compatível com nevo melanocítico congénito (NMC) gigante, tendo sido referenciado para a consulta de Neonatologia e Dermatologia. Desde então, tem apresentado crescimento e desenvolvimento psicomotor adequados e exame neurológico e ressonância magnética cranioencefálica sem alterações. O NMC é uma proliferação benigna de melanócitos, de coloração castanha, que forma tecas/ninhos na junção dermoepidérmica e/ou derme. Pode estar presente ao nascimento ou surgir nos primeiros dois anos de vida em qualquer localização. Os NMCs podem ser classificados em pequenos, médios, grandes, gigantes ou múltiplos. O NMC gigante é raro e representa um fator de risco para melanoma. A abordagem do NMC depende da idade e do tamanho do nevo, entre outros fatores. Dado o potencial de malignidade, o NMC gigante requer vigilância clínica com acompanhamento do neurodesenvolvimento e dermatoscopia regular e abordagem cirúrgica precoce perante lesões suspeitas.

Abstract The authors report the case of a male term newborn born after an uneventful monitored pregnancy. On physical examination, he presented with a light brown hyperpigmented homogeneous macule >15 cm in size compatible with a giant congenital melanocytic nevus (CMN). The boy was discharged with indication for Neonatology and Dermatology follow-up. Since then, he has shown adequate psychomotor growth and development and unremarkable neurologic examination and cranioencephalic magnetic resonance imaging. CMN is a benign proliferation of melanocytes forming theca/nests in the dermal-epidermal junction and/or dermis. It may be present at birth or develop during the first two years of life in any body area. CMN can be classified as small, medium, large, giant, or multiple. Giant CMN is rare and is a risk factor for melanoma. Management of CMN should be based on age, nevus size, and other factors. Because of the potential for malignancy, giant CMN requires clinical surveillance with neurodevelopmental monitoring and regular dermoscopy, as well as early surgical management of suspicious lesions.

https://doi.org/10.25753/birthgrowthmj.v33.i3.27393

12.

Deleção Parcial do Gene CUL4B: Relato de Caso
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Marques, João Mário

; Pinto, Gisela Pereira

Gazeta Médica

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sep 2024, Volume 11 N. 3 Pages 248 - 252

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

Resumo As perturbações do desenvolvimento intelectual acarretam grande morbilidade e comportam um exigente desafio nas dimensões do indivíduo, da família e da comunidade. O CUL4B é um gene envolvido em diversos processos celulares e no controlo do ciclo celular. Mutações neste gene associam-se a alterações como deficiência intelectual, macrocefalia e dismorfias, entre outras. O caso reportado é referente a uma menina de 12 anos, com identificação precoce de dismorfias (face alongada com estreitamento bitemporal e fronte longa, olhos profundos, boca grande, pavilhões auriculares com implantação baixa e endentações no lóbulo da orelha, nariz com ponta de aspeto adunco) e de atrasos no desenvolvimento intelectual e psicomotor, tendo-se identificado, após estudo genético, uma doença rara associada ao cromossoma X (deleção em Xq24 envolvendo parcialmente o gene CUL4B). Dada a sua associação ao cromossoma X, esta patologia é rara no sexo feminino e a sua abordagem requer uma equipa multidisciplinar e uma articulação eficiente entre os serviços de saúde. Analisando este caso, podemos inferir sobre a importância da Medicina Geral e Familiar, atendendo às suas características e competências, na gestão do mesmo.

Abstract Disturbances in intellectual development cause great morbidity and pose a demanding challenge in the dimensions of the individual, family, and community. CUL4B is a gene involved in several cellular processes and in the control of the cell cycle. Mutations in this are associated with changes such as intellectual disability, macrocephaly, and dysmorphia, among others. The reported case refers to a 12-year-old girl, with early identification of dysmorphia (elongated face with bitemporal narrowing and long forehead, deep-set eyes, large mouth, low-set ear pinna and indentations on the earlobe, nose with a hooked-looking tip) and delays in intellectual and psychomotor development, having identified, after genetic study, a rare disease associated with the X chromosome (deletion in Xq24 partially involving the gene CUL4B). Given its association with the X chromosome, this pathology is rare in females and its approach requires a multidisciplinary team and efficient coordination between health services. Analyzing this case, we can infer the importance of General and Family Medicine, given its characteristics and skills, in its management.

https://doi.org/10.29315/gm.v1i1.802

13.

Reshaping smiles: A successful clinical case with botulinum toxin for gummy smile reduction
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Dall'Magro, Alessandra Kuhn

; Dallepiane, Felipe Gomes

; Martin, Júlia Calliari

; Nicolini, Priscila

; Marques-Stefanello, Paulo Ricardo

; Spanenberg-Führ, Marciele Cristiane

; Trentin, Micheline Sandini Dall'Magro, Eduardo De Carli, João Paulo

Odovtos International Journal of Dental Sciences

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aug 2024, Volume 26 N. 2 Pages 20 - 27

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

Resumen El uso de toxina botulínica (BTX) representa un enfoque eficaz y seguro para el tratamiento de las sonrisas gingivales, reduciendo la exposición excesiva de las encías durante la sonrisa. Este procedimiento mínimamente invasivo puede producir resultados estéticos notables y contribuir a aumentar la confianza del paciente en sí mismo. El objetivo de este estudio es presentar el caso clínico de una paciente que se sometió a un tratamiento para corregir una sonrisa gingival. Se trata de una paciente de 21 años con una exposición gingival excesiva (5mm al sonreír) que solicitó tratamiento odontológico. El origen de su sonrisa gingival era mixto y el tratamiento consistió en la aplicación de 6 unidades de BTX tipo A en tres puntos concretos de la cara. No se observaron complicaciones durante los tres meses de seguimiento. Basándonos en el informe del caso, se puede concluir que la aplicación de BTX para el tratamiento de la sonrisa gingival demostró ser eficaz, segura y cómoda en términos de recuperación. El enfoque de BTX para la corrección de la sonrisa gingival se considera seguro y de fácil recuperación, y produce resultados satisfactorios que contribuyen a mejorar la estética y el bienestar del paciente.

Abstract The use of botulinum toxin (BTX) represents an effective and safe approach in treating the gummy smile, reducing excessive gum exposure during smiling. This minimally invasive procedure can yield remarkable aesthetic results and contribute to an increase in the patient's self-confidence. The aim of this study is to report a clinical case of a female patient undergoing treatment to correct a gummy smile. The case study involves a 21-year-old patient with excessive gum exposure (5mm when smiling) who sought dental treatment. The origin of her gummy smile was mixed, and the treatment involved the application of 6 units of BTX type A at three specific points on the face. No complications were observed during the three-month follow-up period. Based on the case report, it can be concluded that BTX application for gummy smile treatment proved to be effective, safe, and comfortable in terms of recovery. The BTX approach to correcting a gummy smile is considered safe and entails straightforward recovery, producing satisfactory results that contribute to the improvement of aesthetics and the patient's well-being.

https://doi.org/10.15517/ijds.2024.59407

14.

Stomach Herniation Through an Inguinal Hernia: A Rare Case
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Dias, Marta Vaz

; Gomes, Helena Martins

; Monteiro, João Rodrigues

; Silva, Beatriz Marques

; Gonçalves, Catarina do Vale

; Cardoso, Daniel

Acta Radiológica Portuguesa

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aug 2024, Volume 36 N. 2 Pages 34 - 35

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

Resumo Uma obstrução gástrica no contexto de hérnia inguinal é uma entidade extremamente rara, mas que acarreta uma elevada morbimortalidade e, portanto, deverá ser rapidamente reconhecida pelo radiologista, permitindo um tratamento precoce. Este artigo descreve um paciente de 70 anos, do sexo masculino com história de dor abdominal generalizada e intensa, vómitos e obstipação. Ao exame físico o doente apresentava uma volumosa hérnia inguino-escrotal direita, bem como um abdómen plano, não depressível e com defesa generalizada. Neste contexto realizou uma radiografia abdominal com raios tangenciais onde se observou um nível aéreo na porção não dependente do abdómen, tendo levantado a suspeita de pneumoperitoneu. Realizou TC onde se identificou uma volumosa hérnia inguino-escrotal direita, contendo ansas intestinais, bem como a porção inferior do estômago, que se encontrava marcadamente distendido.

Abstract Gastric obstruction in the setting of an inguinal hernia is extremely rare. However, this entity entails a high morbimortality and, therefore, should be easily recognized by the radiologist, allowing a prompt treatment. This article describes a 70-year-old man, with a history of intense and generalized abdominal pain, vomiting and constipation. On physical examination a voluminous inguinoscrotal hernia and a flat, non-compressible and tender abdomen, were identified. In this context, a tangential abdominal radiography was performed and a gas level on the non-dependent portion of the abdomen was identified, that raised the suspicion of pneumoperitoneum. A CT was obtained and a right-sided, voluminous inguinoscrotal hernia was observed. This hernia contained intestinal loops and the markedly distended stomach.

https://doi.org/10.25748/arp.33584

15.

Tratamiento de efluentes domésticos con lagunas de alta tasa, evaluación del arranque con dos porcentajes de inóculo
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SÁNCHEZ ORTIZ, IVÁN ANDRÉS

; CALIJURI, MARÍA LUCIA

; XAVIER BASTOS, RAFAEL KOPSCHITZ

; BARBOSA SALES DE MAGALHÃES, ADRIANA

; BADIM BEPLER, JANDERSON

; MARQUES BESSAS, MARIANA

; RODRIGUES COELHO, FERNANDO

; ALVES GOMES SILVA, JOÃO VICTOR

Ingeniería y Desarrollo

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jun 2024, Volume 42 N. 1 Pages 1 -

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

Resumen El objetivo de esta investigación fue evaluar el efecto de dos porcentajes de inóculo utilizados para el arranque de lagunas de alta tasa (LAT ) en el postratamiento de efluentes de tanque séptico. Las lagunas LAT1 y LAT2 se inocularon sustituyendo, respectivamente, 3,25 y 6,50 % del volumen efectivo con líquido proveniente de una LAT operada con tiempo de retención hidráulica de ocho días. Durante siete días consecutivos se midieron las variables nitrógeno orgánico (NO), nitrógeno amoniacal total (NAT), fósforo total (PT), demanda química de oxígeno (DQO) y clorofila-a; se cuantificó y caracterizó el fitoplancton. Las concentraciones de clorofila-α en la LAT1 variaron entre 451,2 y 1802,2 μg/L y en la LAT2 entre 339,1 y 2194,7 μg/L, las densidades finales de fitoplancton fueron, respectivamente, de 683 200 y 5 535.130 organismos/mL, con presencia de individuos de las clases Chlorophyceae, Cryptophyceae y Euglenophyceae en ambas lagunas. Las eficiencias de remoción calculadas para las LAT1 y LAT2 fueron, respectivamente: NO: 37,1 y 51,6 %; NAT: 89,6 y 97,3 %; PT: 30,4 y 30,3 %; DQO: -1,3 y -53,2 %; E. coli: 1,495 y 2,398 unidades Log. La inoculación favoreció el rápido desarrollo de comunidades fitoplanctónicas, con mejores resultados en la remoción de nitrógeno e inactivación de E. coli al usar mayores cantidades de inóculo.

Abstract The main objective of this research was to evaluate the effect of two percentages of inoculum used for the startup of high rate algal ponds (HRAP) in the postreatment of effluent of septic tank. The HRAP1 and HRAP2 were inoculated by the substitution of 3.25 % and 6.50 % of the effective volume with liquid from a HRAP operated with a hydraulic retention time of eight days. During seven consecutive days the variables organic nitrogen (ON), total ammonia nitrogen (TAN), total phosphorous (TP), chemical oxygen demand (COD) and chlorophyll-α were measured; the phytoplankton was quantified and characterized. The chlorophyll-a concentrations in the HRAP1 varied between 451.2 and 1,802.2 μg/L and in the HRAP2 between 339.1 and 2,194.7 μg/L, the final densities of phytoplankton were respectively of 683,200 and 5'535,130 organisms/mL, with presence of individuals of the Chlorophyceae, Cryptophyceae and Euglenophyceae classes in the two ponds. The calculated removal efficiencies for the HRAP1 and HRAP2 were respectively: 37.1 and 51.6 % for ON; 89.6 and 97.3 % for TAN; 30.4 and 30.3 % for TP; -1.3 and -53.2 % for COD; 1495 and 2398 Log units for E. coli. The inoculation promoted the rapid growth of the phytoplankton communities, with best results for nitrogen removal and E. coli inactivation due the use of higher amounts of inoculum.

https://doi.org/10.14482/inde.42.01.001.414

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