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Medicines for the management of overweight and obesity: A systematic review with network meta-analysis
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Marcon, Gabriela Masiero

; Paiva, Jhonatan Mendes

; Sakiyama, Mariana Delariva

; Tonin, Fernanda Stumpf

; Fernandez-Llimos, Fernando

; Virtuoso, Suzane

; Sanches, Andreia Cristina Conegero

Brazilian Journal of Pharmaceutical Sciences

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2025, Volume 61 elocation e24177

Abstract: En | Text: En | PDF: En

Abstract To synthesize the evidence about pharmacologic treatment of obesity and overweight and to define the options with the best risk-benefit using the stochastic analysis of multicriteria acceptability (SMAA). The analysis addresses a systematic review (PROSPERO CRD42023423308) whose research was realized in PubMed, Scopus, and Web of Science. Randomized controlled trials were included, which verified the effects of sibutramine, orlistat, liraglutide, and semaglutide in patients with IMC ≥ 26 Kg/ m². The risk of bias analysis was performed with RoB 2.0 and the outcomes evaluated were weight loss and serious adverse events. A total of 102 studies with 45.047 participants were included. The network meta-analysis revealed that all the treatments were significantly more effective than the placebo in weight reduction. The use of semaglutide (especially 0.4 mg/day) was associated with a bigger weight loss in comparison to all the other treatments (p<0.05) and the analysis of SMAA showed a risk-benefit of 95%. Besides that, we suggest re-evaluating of sibutramine 10mg/day as a therapeutic option for patients without hypertension or cardiovascular diseases, and we demonstrate the modest weight loss promoted by orlistat 120mg, sibutramine 5mg, and liraglutide 1,8mg and advise against its use, once the benefits do not outweigh the risks.

https://doi.org/10.1590/s2175-97902025e24177

L-theanine modulates tissue cortisol levels in zebrafish after single stress
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Silva, Vinícius Luís da

; Mayer, Mariana Spanamberg

; Severo, Andriele dos Reis

; Zambra, Andressa Leal

; Almeida, Joanna Moraes De

; Sestari, Laura Moura

; Parisi, Mariana Migliorini

; Giacomini, Ana Cristina Vendrametto Varrone

; Abreu, Murilo Sander De

; Bortolotto, Josiane Woutheres

; Bonfanti-Azzolin, Gabriela

Brazilian Journal of Pharmaceutical Sciences

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2025, Volume 61 elocation e23375

Abstract: En | Text: En | PDF: En

Abstract L-theanine has neuromodulatory properties, such as attenuate anxiety disorders and stress. Stress is a situation characterized by the stimulus to cortisol secretion and without specific pharmacological therapies. Thus, this study investigates the effect of L-theanine on the response to acute stress, evaluated by tissue cortisol level, oxidative status markers, and behavioral parameters, in zebrafish. The animals were divided into six groups: G1: control, G2: treated with L-theanine 45 mg/L, G3: treated with L-theanine 100 mg/L, G4: stress, G5: stress+L-theanine 45 mg/L and G6: stress+L-theanine 100 mg/L. Before the execution of the acute stress protocol that consisted of chasing the animals with a net for two minutes, exposure to L-theanine was performed in aquarium water for 1 hour. Tissue cortisol levels were analyzed, as well as cerebral oxidative status (lipoperoxidation and levels of thiolic compounds) and fish behavior (new tank test). L-theanine at a concentration of 45 mg/mL modulated the effects of acute stress on zebrafish, inhibiting increased levels of tissue cortisol. However, it was not able to alter the behavior or oxidative status of the animals. Thus, we conclude that the administration of L-theanine can promote acute stress attenuation, modulating the pathological responses of stress.

https://doi.org/10.1590/s2175-97902025e23375

Infectiousness to sand flies of a cat naturally infected with Leishmania infantum at the moment of diagnosis and after three different courses of treatment
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Dantas da Silva, Mariana

; Nakaghi, Andrea Cristina Higa Galvis-Ovallos, Fredy Leonel, João Augusto Franco Vioti, Geovanna Galati, Eunice Aparecida Bianchi Fazolato, Nayara Cristina de Oliveira Martins, Julia Pinho Oliveira, Trícia Maria Ferreira de Sousa

Revista Brasileira de Parasitologia Veterinária

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2025, Volume 34 N. 1 elocation e016524

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

Resumo Neste estudo, três tratamentos contra a leishmaniose felina (FeL) e seus impactos na transmissão de Leishmania infantum ao vetor, Lutzomyia longipalpis, foram avaliados. Um gato com sinais clínicos de FeL foi examinado e L. infantum detectada. Submetido ao xenodiagnóstico, verificou-se a transmissão de L. infantum aos vetores. O gato foi então tratado com três medicamentos diferentes e a melhora clínica e transmissibilidade do parasito ao vetor foram avaliadas. Foram observadas leishmanias em 21/52 fêmeas de flebotomíneos (40,38%) no xenodiagnóstico antes dos tratamentos. Os sinais clínicos persistiram após o primeiro tratamento com marbofloxacina, e o gato permaneceu positivo em testes sorológicos, moleculares e parasitológicos. Na sequência, o gato foi tratado com miltefosina, mas continuou doente e com testes positivos. Um segundo xenodiagnóstico foi realizado um mês após o tratamento com miltefosina. Observaram-se promastigotas em 5/9 fêmeas (55,55%). Por fim, o gato foi tratado com alopurinol, o que o levou a uma boa melhora clínica, mas sem cura parasitológica, e um xenodiagnóstico final detectou promastigotas em 2/29 (6,89%) fêmeas. Os resultados mostraram que somente o tratamento com alopurinol produziu uma boa resposta clínica, mas nenhum dos tratamentos conseguiu eliminar a infecção por L. infantum ou impedir sua transmissão ao vetor.

Abstract In this study, an evaluation was made of three treatments against feline leishmaniosis (FeL) and their impacts on the transmission of Leishmania infantum to its vector, Lutzomyia longipalpis. A cat with clinical signs of FeL was examined and L. infantum diagnosed. Subsequently, the cat was subjected to xenodiagnosis and L. infantum detected in the vectors. The cat was then treated with three different drugs and the clinical improvement and parasite transmissibility to the vector were evaluated. Promastigotes were observed in 21/52 female sandflies (40.38%) in a xenodiagnosis prior to the treatments. Clinical signs persisted after the first treatment with marbofloxacin, and the cat remained positive in serological, molecular, and parasitological tests. Therefore, the cat was treated with miltefosine but remained sick and tested positive. A second xenodiagnosis was performed a month after treatment with miltefosine, and promastigotes were observed in 5/9 females (55.55%). Lastly, the cat was treated with allopurinol, which led to good clinical improvement, but it remained positive, and a final xenodiagnosis revealed Leishmania in 2/29 (6.89%) females. The results showed that only treatment with allopurinol produced a good clinical response, but none of the treatments succeeded in eliminating L. infantum infection or preventing transmission to the vector.

https://doi.org/10.1590/s1984-29612025006

Uso do Practical Approach to Care Kit adulto por enfermeiros: revisão sistemática
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Celuppi, Ianka Cristina

; Pires, Denise Elvira Pires de

; Mendes, Mariana

; Amadigi, Felipa Rafaela

; Martins, Maria Manuela Ferreira Pereira da Silva

; Landeiro, Maria José Lumini

; Brehmer, Laura Cavalcanti de Farias

Acta Paulista de Enfermagem

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2025, Volume 38 elocation eAPE0002421

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

Resumo Objetivo Analisar a produção científica acerca da aplicação do Practical Approach to Care Kit Adulto no processo de trabalho do enfermeiro na Atenção Primária à Saúde. Métodos Revisão sistemática realizada nas bases de dados PubMed®, EMBASE, Scopus, Web of Science, Medline® e Cinahl em 17 de julho de 2023. Foram incluídos artigos que evidenciam o uso do Practical Approach to Care Kit Adulto no processo de trabalho de enfermeiros da Atenção Primária à Saúde, em países onde essa tecnologia foi implementada, no formato de estudos originais, relato de caso, artigos de opinião e revisão. Foram excluídos os artigos que tratavam das versões antigas do Practical Approach to Care Kit ou não detalham a forma de uso da tecnologia; se caracterizavam como editoriais, comentários, notícias, resumos de congressos, protocolos de pesquisa, teses e dissertações ou estavam indisponíveis na íntegra. A análise do risco de viés dos estudos foi realizada em dupla, utilizando os checklists do Joanna Briggs Institute para estudos qualitativos, de opinião e ensaios clínicos randomizados. Resultados Foram selecionados seis artigos que evidenciaram o uso do Practical Approach to Care Kit enquanto uma tecnologia de apoio à tomada de decisão clínica do enfermeiro. Também se destacou sua aplicação em ações de educação permanente da equipe nos serviços de Atenção Primária à Saúde. Conclusão Esta revisão contribui com o campo de conhecimento de enfermagem em saúde pública ao evidenciar o uso de uma tecnologia inovadora e de baixo custo no processo de cuidado dos enfermeiros.

Abstract Objective To analyze scientific production about the Practical Approach to Care Kit Adult application in nurses’ work process in Primary Health Care. Methods A systematic review carried out in the PubMed®, EMBASE, Scopus, Web of Science, MEDLINE® and CINAHL databases on July 17, 2023. Articles were included that demonstrate the Practical Approach to Care Kit Adult use in nurses’ work process in Primary Health Care, in countries where this technology has been implemented in the format of original studies, case reports, opinion articles and reviews. Articles that dealt with old versions of the Practical Approach to Care Kit or did not detail how the technology was used, were characterized as editorials, comments, news, conference abstracts, research protocols, theses and dissertations or were unavailable in full were excluded. The analysis of the risk of bias of studies was carried out in pairs, using the JBI checklists for qualitative studies, opinion and randomized clinical trials. Results Six articles were selected that highlighted the Practical Approach to Care Kit use as a technology to support nurses’ clinical decision-making. Its application in permanent education actions of the teams in Primary Health Care services also stood out. Conclusion This review contributes to public health nursing knowledge by highlighting the use of an innovative and low-cost technology in nurses’ care process.

Resumen Objetivo Analizar la producción científica sobre la aplicación del Practical Approach to Care Kit adulto en el proceso de trabajo de enfermeros de la Atención Primaria de Salud. Métodos Revisión sistemática realizada en las bases de datos PubMed®, EMBASE, Scopus, Web of Science, Medline® y Cinahl el 17 de julio de 2023. Se incluyeron artículos que demostraron el uso del Practical Approach to Care Kit adulto en el proceso de trabajo de enfermeros de la Atención Primaria de Salud, en países donde se implementó esta tecnología, en formato de estudios originales, relatos de caso, artículos de opinión y revisión. Se excluyeron los artículos que utilizaron versiones anteriores del Practical Approach to Care Kit o no detallaron la forma de uso de la tecnología, se caracterizaron como editoriales, comentarios, noticias, resúmenes de congresos, protocolos de investigación, tesis de doctorado y de maestría o los que no estaban disponibles en su totalidad. El análisis de riesgo de sesgo de los estudios se realizó en pares, utilizando las checklists del Joanna Briggs Institute para estudios cualitativos, de opinión y ensayos clínicos aleatorizados. Resultados Se seleccionaron seis artículos que demostraron el uso del Practical Approach to Care Kit como una tecnología de soporte a la toma de decisiones clínicas de los enfermeros. También se destacó su aplicación en acciones de educación permanente del equipo de los servicios de Atención Primaria de Salud. Conclusión Esta revisión contribuye con el campo de conocimiento de enfermería en salud pública porque demuestra el uso de una tecnología innovadora y de bajo costo en el proceso de cuidado de los enfermeros. Open Science Framework: 10.17605/OSF.IO/J3TZ6

https://doi.org/10.37689/acta-ape/2025ar0002421

Factors associated with the dietary total antioxidant capacity of pregnant Brazilian women
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Carvalho, Roberta Rejane Santos de

; Viola, Poliana Cristina de Almeida Fonseca

; Crispim, Sandra Patrícia

; França, Ana Karina Teixeira da Cunha

; Navarro, Anderson Marliere

; Souza, Bruno Feres de

; Faria, Franciane Rocha de

; Sperandio, Naiara

; Pizato, Nathalia

; Macedo, Mariana de Souza

; Pereira, Renata Junqueira

; Franceschini, Sylvia do Carmo Castro

; Carvalho, Carolina Abreu de

; Navarro, Anderson Marliere

; Carvalho, Carolina Abreu de

; Silva, Danielle Góes da

; Faria, Franciane Rocha de

; Sperandio, Naiara

; Meléndez, Jorge Gustavo Velásquez

; Barbosa, Míriam do Carmo Rodrigues

; Pizato, Nathalia

; Macedo, Mariana de Souza

; Pereira, Renata Junqueira

; Crispim, Sandra Patrícia

; Priore, Silvia Eloiza

; Franceschini, Sylvia do Carmo Castro

Revista Brasileira de Epidemiologia

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2025, Volume 28 elocation e250002

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

RESUMO Objetivo: Investigar os fatores sociodemográficos, maternos e gestacionais associados à capacidade antioxidante total da dieta em gestantes brasileiras. Métodos: Estudo transversal com 2.232 gestantes com 18 anos ou mais, no primeiro, segundo e terceiro trimestres de gestação de onze cidades das cinco regiões brasileiras. Foi aplicado um questionário semiestruturado para avaliação dos dados socioeconômicos, demográficos e de saúde, e o recordatório de 24h (R24h) para avaliação do consumo alimentar e análise da Capacidade Antioxidante Total da Dieta (CATd), estimada usando o método Ferric Reducing Antioxidant Power (FRAP). Resultados: A mediana de CATd foi de 5,32 mmol/dia. Aracaju (SE) apresentou a maior mediana de CATd (6,44 mmol/dia) e Palmas (TO) a menor (4,71 mmol/dia). As gestantes de 20 a 34 anos (OR 1,86; IC95% 1,26-2,76), 35 anos ou mais (OR 3,68; IC95% 2,21-6,14) e que estavam no segundo trimestre de gestação (OR 1,50; IC95%; 1,11-2,01) tiveram mais chances de estarem acima da mediana de CATd, enquanto as gestantes com maior escolaridade tinham 67% menos chance de estarem acima da mediana de CATd (OR 0,67; IC95% 0,48-0,92). Conclusão: O estudo demonstrou que há diferenças no consumo de antioxidantes em diferentes cidades do Brasil e que fatores associados, como idade, escolaridade e trimestre gestacional podem impactar na ingestão de alimentos ricos em antioxidantes. O perfil encontrado chama atenção para a importância de uma alimentação adequada e rica em antioxidantes durante o pré-natal.

ABSTRACT Objective: To investigate the sociodemographic, maternal, and gestational factors associated with the dietary total antioxidant capacity in pregnant Brazilian women. Methods: A cross-sectional study with 2,232 pregnant women aged 18 years old or older, in the first, second, and third trimesters of pregnancy, from eleven cities in the five Brazilian regions. A semi-structured questionnaire was applied to assess socioeconomic, demographic, and health data, and a 24-hour dietary recall (R24h) was used to assess food consumption and analyze the dietary total antioxidant capacity (DTAC), estimated using the ferric reducing antioxidant power (FRAP) method. Results: The median of DTAC was 5.32 mmol/day. Aracaju, Sergipe (SE) had the highest median of DTAC (6.44 mmol/day) and Palmas, Tocantins (TO) had the lowest (4.71 mmol/day). Pregnant women aged 20 to 34 years (OR 1.86; 95%CI 1.26-2.76), 35 years old or older (OR 3.68; 95%CI 2.21-6.14) and who were in the second trimester of pregnancy (OR 1.50; 95%CI 1.11-2.01) were more likely to be above the median DTAC. While pregnant women with higher education had a 67% lower chance of being above the median DTAC (OR 0.67; 95%CI 0.48-0.92). Conclusion: The study demonstrated that there are differences in antioxidant consumption in different cities in Brazil and that associated factors such as age, education, and gestational trimester can impact the intake of foods rich in antioxidants. The profile found draws attention to the importance of an adequate diet rich in antioxidants during prenatal care.

https://doi.org/10.1590/1980-549720250002

Chemical Profile, Antioxidant and Antimicrobial Activities of Combretum lanceolatum Pohl ex Eichler. (Combretaceae)
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Monção Filho, Evaldo S.

; Farias, Ruth Raquel S.

; Souza, João Sammy N.

; Campos, Carmem D. L.

; Monteiro, Cristina A. Ferreira, Éverton Leandro F. Pupo, Mônica T. Chaves, Mariana Helena Vieira Júnior, Gerardo M.

Journal of the Brazilian Chemical Society

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2025, Volume 36 N. 3 elocation e-20240163

Abstract: En | Text: En | PDF: En

Compared to other species, components of Combretum lanceolatum are still with few data reported in the literature. This work describes the compounds identification, antioxidant and antimicrobial activities of C. lanceolatum twigs. Ethanolic extract (EECLT) from C. lanceolatum twigs was submitted to partition obtaining: hexane (HF), diethyl ether (EEF), ethyl acetate (EAF) and hydromethanolic (HMF) fractions. They were analyzed by gas chromatography-mass spectrometry, high performance liquid chromatography coupled to mass spectrometry and direct insertion mass spectrometry and evaluated for antioxidant assay (2,2-diphenyl-1-picrylhydrazyl (DPPH) method) and antimicrobial assay. Fifty-seven compounds were identified in the fractions. In antioxidant assay, EECLT and EAF demonstrated good antioxidant potential (half maximal effective concentration (EC50): 57.9 and 45.4 µg mL–1, respectively), better than the positive control butylated hydroxytoluene (BHT) (EC50: 69.34 µg mL–1). For antimicrobial assay, all fractions presented promising minimal inhibitory concentration (MIC). EECLT presented the best values against Staphylococcus aureus (125 µg mL–1) and Escherichia coli (62.5 µg mL–1) and better than the positive control fluconazole (8 and 16 µg mL–1) against Candida albicans (3.9 µg mL–1) and Candida krusei (15.6 µg mL–1) strains. This study presents relevant chemical and biological information about C. lanceloatum expanding the knowledge of Brazilian flora.

https://doi.org/10.21577/0103-5053.20240163

Uso do Practical Approach to Care Kit adulto por enfermeiros: revisão sistemática
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Celuppi, Ianka Cristina

; Pires, Denise Elvira Pires de

; Mendes, Mariana

; Amadigi, Felipa Rafaela

; Martins, Maria Manuela Ferreira Pereira da Silva

; Landeiro, Maria José Lumini

; Brehmer, Laura Cavalcanti de Farias

Acta Paulista de Enfermagem

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2025, Volume 38 elocation eAPE0002421

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

https://doi.org/10.37689/acta-ape/2025ar0002421

Cáncer de mama en hombres: Reflexión sobre los aportes de enfermería
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Santos Araújo, Jeferson

; Cristina Zanovelo, Daniela

; da Silva Biasus, Guilherme

; Munhoz Gallina, Mariana

Revista Uruguaya de Enfermería (En línea)

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2025, Volume 20 N. 1 elocation e507

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

Resumo: O câncer de mama resulta de uma multiplicação anormal de células na região da mama com formação de tumor. Esta neoplasia é considerada rara quanto se desenvolve no público masculino, porém de grande gravidade, uma vez que geralmente é detectada em estágios mais avançados. O objetivo deste trabalho foi discutir reflexivamente sobre as contribuições do enfermeiro no que se refere às estratégias assistenciais e de cuidado para o paciente do sexo masculino com câncer de mama. Para tanto, foi realizada uma pesquisa bibliográfica, a qual forneceu subsídios para o desenvolvimento refletivo. Foi evidenciado que o papel do enfermeiro na assistência ao paciente é fundamental, pois auxiliá-los a atingir independência, autonomia e aceitação do tratamento e reabilitação. Através da educação, este profissional pode discutir importantes questões de saúde com sua equipe, e com os familiares, responder dúvidas, desenvolver ações de prevenção e promoção e reabilitação, funcionando como um verdadeiro canal de conscientização sobre as peculiaridades da doença. Concluiu-se que o público masculino negligencia o desenvolvimento da neoplasia mamária, o que com frequência resulta em diagnóstico tardio. Neste cenário, o enfermeiro apresenta-se como um profissional que pode implementar estratégias de educação em saúde direcionadas aos homens, contribuindo para a prevenção da doença.

Resumen: El cáncer de mama resulta de una multiplicación anormal de células en la región de la mama conformando un tumor. Esta neoplasia se considera poco habitual cuando se desarrolla en hombres, pero es muy grave, ya que generalmente se detecta en estadios más avanzados. El objetivo de este trabajo fue discutir reflexivamente las contribuciones de los enfermeros con respecto a las estrategias de asistencia y cuidado para pacientes masculinos con cáncer de mama. Para ello se realizó una investigación bibliográfica, que brindó subsidios para el desarrollo reflexivo. Se evidenció que el papel del enfermero en el cuidado del paciente es fundamental, ya que le ayuda a alcanzar independencia, autonomía y aceptación del tratamiento y rehabilitación. A través de la educación, este profesional puede discutir importantes temas de salud con su equipo y familiares, resolver dudas, desarrollar acciones de prevención, promoción y rehabilitación, funcionando como un verdadero canal de concientización sobre las peculiaridades de la enfermedad. Se concluyó que los hombres descuidan el desarrollo del cáncer de mama, lo que muchas veces resulta en un diagnóstico tardío. En ese escenario, el enfermero se presenta como un profesional que puede implementar estrategias de educación salud dirigidas a los hombres, contribuyendo a la prevención de la enfermedad.

Abstract: Breast cancer results from an abnormal multiplication of cells in the breast region that forms a tumor. This neoplasm is considered rare when it develops in men, but is very serious, as it is generally detected in more advanced stages. The objective of this work was to discuss reflectively the contributions of nurses with regard to assistance and care strategies for male patients with breast cancer. To this end, a bibliographical research was carried out, which provided subsidies for reflective development. It was evidenced that the nurse's role in patient care is fundamental, as it helps them achieve independence, autonomy and acceptance of treatment and rehabilitation. Through education, this professional can discuss important health issues with his team and family members, answer questions, develop prevention, promotion and rehabilitation actions, functioning as a true channel of awareness about the peculiarities of the disease. It was concluded that men neglect the development of breast cancer, which often results in late diagnosis. In this scenario, the nurse presents himself as a professional who can implement health education strategies aimed at men, contributing to the prevention of the disease.

https://doi.org/10.33517/rue2025v20n1a1

Is there a relation between operative birth and postpartum infection? - an observational longitudinal study
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Flores-Casteleiro, Maria

; Sarabando, Rita Forjaz, Sara Almendra, Rita Rodrigues, Raquel Barbosa, Paulina Coelho, Mariana Nogueira-Silva, Cristina

Acta Obstétrica e Ginecológica Portuguesa

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dec 2024, Volume 18 N. 4 Pages 290 - 298

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

Resumo Introdução e Objetivo: Nos países desenvolvidos, 5% das mortes puerperais devem-se a infeções pós-parto. Embora haja evidência clara de que a profilaxia antibiótica da cesariana reduz a incidência de infeção, esta evidência é menor no parto instrumentado. O objetivo deste estudo foi comparar a prevalência de infeção puerperal entre o parto instrumentado e o parto eutócico, investigando fatores de risco independentes para a mesma. Desenho do estudo: Estudo prospetivo observacional realizado no Serviço de Obstetrícia de um hospital público. População: Foram incluídas as puérperas com parto vaginal. A cada parto instrumentado, juntou-se um parto eutócico numa proporção de 1:1. Métodos: Os dados foram recolhidos 24 horas e 6 semanas após o parto, altura em que foi realizado um inquérito telefónico para avaliar a ocorrência de infeção. Resultados: Foram incluídas 385 puérperas, 35 (9,1%) desenvolveram infeção no pós-parto. A prevalência de infeção no grupo de parto instrumentado foi maior (13,4% vs. 4,7%; p=0,003). No mesmo grupo a maioria das mulheres eram nulíparas (74,7% vs. 45,5%, p<0,001), a duração mediana da rotura de membranas e da fase ativa do trabalho de parto foi superior (5,5 horas, vs. 3,0 horas, p<0. 001; 4,8 horas, vs. 3,0 horas, p<0,001), foram realizadas mais episiotomias (92,8% vs. 37,7%; p<0,001) e ocorreram menos lacerações perineais grau I ou II (6,2% vs. 25,1%; p<0,001). Na regressão logística, a anemia foi o único preditor independente de infeção (p<0,001; casos corretamente previstos=90,8%). Conclusões: Embora a prevalência de infeção pós-parto tenha sido superior no parto instrumentado, este não foi um fator de risco independente. Facto que reitera a necessidade de continuar a investigar a contribuição do parto instrumentado para a infeção pós-parto. Antes de generalizar a profilaxia antibiótica, talvez seja necessário que cada instituição analise os dados locais e pondere formas de controlar outros fatores de risco de infeção.

Abstract Overview and Aims: In high-income countries, 5% of puerperal deaths are due to postpartum infections. Although there is clear evidence that antibiotic prophylaxis before caesarean section reduces the incidence of infection, there is less evidence in operative birth. The aim of this study was to compare the prevalence of puerperal infection between operative birth and spontaneous vaginal birth, finding independent risk factors for it. Study design: A prospective observational study was carried out at the Obstetrics Department of a public hospital. Population: Patients with a vaginal birth were enrolled in this study, and for each operative birth a spontaneous vaginal birth was recruited in a ratio of 1:1. Methods: Data was collected in the first 24 hours after the birth and 6 weeks after birth, when a telephone survey was performed to assess the occurrence of infection. Results: 385 postpartum women were included, 35 (9.1%) developed postpartum infection. The prevalence of infection in the operative birth group was higher (13.4% vs. 4.7%; p=0.003). In the same group most women were nulliparous (74.7% vs. 45.5%, p<0.001), the median duration of membrane rupture and active phase of labor was higher (5.5 hours, vs. 3.0 hours, p<0.001; 4.8 hours, vs. 3.0 hours, p<0.001), more episiotomies were performed (92.8% vs. 37.7%; p<0.001) and fewer grade I or II perineal lacerations occurred (6.2% vs. 25.1%; p<0.001). In the logistic regression, anemia was the only independent predictor of infection (p<0.001; correctly predicted cases=90.8%). Conclusion: Although the prevalence of postpartum infection was higher after operative birth, it was not an independent risk factor. This reiterates the need to continue the investigation of operative birth contribution to postpartum infection. Before considering generalizing antibiotic prophylaxis, maybe each institution needs to analyze local data and think about how to control other possible risk factors for infection.

https://doi.org/10.69729/aogp.v18i4a04

10.

Schwannoma vestibular em indivíduos com surdez neurossensorial assimétrica: quando rastrear?
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Pires, Rafael

; Dentinho, Jorge Canha

; Teles, Sofia

; Neto, Mariana Castelão, Filipa Santos, Lisete Alves, Sílvia Marques, Cristina Antunes, Luís

Revista Portuguesa Otorrinolaringologia e Cirurgia de Cabeça e Pescoço

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dec 2024, Volume 62 N. 4 Pages 349 - 355

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

Resumo Objetivos: (1) Comparar parâmetros clínicos e audiométricos entre indivíduos com schwannoma vestibular (SV) e indivíduos com surdez neurossensorial assimétrica (SNSA) sem etiologia atribuída; (2) avaliar protocolos propostos para o rastreio de SV. Desenho do Estudo: Retrospetivo e transversal. Material e Métodos: Dados demográficos, clínicos e audiométricos foram analisados e comparados em 208 indivíduos com SNSA com e sem SV na RM. A sensibilidade, especificidade e exatidão de diferentes protocolos para rastreio de SV foram analisadas. Resultados: Dezoito indivíduos (8.3%) apresentaram SV. O sexo feminino, a ausência de tabagismo, acufeno unilateral, alterações da sensibilidade e motricidade hemifaciais, teste de impulso cefálico (HIT) positivo e resultado de potenciais evocados auditivos do tronco cerebral (PEA-TC) sugestivo foram significativamente mais associados ao grupo com SV. A assimetria audiométrica foi superior aos 4 kHz em indivíduos com SV. A análise de um novo protocolo proposto com critérios clínicos e audiométricos revelou uma sensibilidade (94.6%), especificidade (46.5%) e exatidão (50.9%) superiores aos protocolos exclusivamente audiométricos avaliados. Conclusões: A par da audiometria, este estudo demonstrou o benefício de contemplar também indicadores clínicos num novo protocolo de decisão de rastreio de SV.

Abstract Objectives: (1) To compare clinical and audiometric parameters between patients with vestibular schwannoma (VS) and patients with asymmetric sensorineural hearing loss (ASNHL) of unknown etiology; (2) to evaluate proposed protocols for VS screening. Study Design: Retrospective and cross-sectional. Materials and Methods: Demographic, clinical, and audiometric data were analyzed and compared in 208 patients with ASNHL with and without VS on MRI. The sensitivity, specificity, and accuracy of different protocols for VS screening were analyzed. Results: Eighteen patients (8.3%) had VS. Female gender, absence of smoking, unilateral tinnitus, facial sensory and motor symptoms, positive head impulse test (HIT), and suggestive auditory brainstem response (ABR) results were significantly more associated with the VS group. Audiometric asymmetry was greater at 4 kHz in patients with VS. Analysis of a new proposed protocol with clinical and audiometric criteria revealed higher sensitivity (94.6%), specificity (46.5%), and accuracy (50.9%) compared to exclusively audiometric protocols evaluated. Conclusions: In addition to audiometry, this study demonstrated the benefit of including clinical indicators in a new decision protocol for VS screening.

https://doi.org/10.34631/sporl.2198

11.

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

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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

12.

COVID-19 Computed tomography patterns in renal replacement therapy patients
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Carmo, Gabriel Assis Lopes do

; Oliveira, Mariana Paiva

; Campos, Anna Luiza Lino

; Couto, Bráulio Roberto Gonçalves Marinho

; Carmo, Lilian Pires de Freitas do

; Cerqueira, Tiago Lemos

; Souza, Camila Alencar Monteiro de

; Goll, Yan Lopes Souza, Vitor Santos de Vieira, Mariana Oliveira Guimarães Castro, Pedro Alves Soares Vaz de Lemos, Pedro Augusto Botelho Silva, Ana Cristina Simões e

Brazilian Journal of Nephrology

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sep 2024, Volume 46 N. 3 elocation e20230029

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

RESUMO Introdução: Doenças pulmonares são comuns em pacientes com doença renal em estágio terminal (DRET), dificultando o diagnóstico diferencial com COVID-19. Este estudo descreve achados de tomografia computadorizada de tórax (TC) em pacientes com DRET em terapia renal substitutiva (TRS) hospitalizados com suspeita de COVID-19. Métodos: Indivíduos maiores de 18 anos com DRET, encaminhados ao pronto-socorro com suspeita de COVID-19 foram incluídos. Dados clínicos e epidemiológicos foram extraídos de registros eletrônicos de saúde. A TC foi classificada como típica, indeterminada, atípica, negativa. Comparamos achados tomográficos de pacientes com COVID-19 positivos e negativos. Resultados: Recrutamos 109 pacientes (62,3% COVID-19-positivos) entre março e dezembro de 2020, idade média de 60 ± 12,5 anos, 43% mulheres. A etiologia mais comum da DRET foi diabetes. Tempo médio em diálise foi 36 meses, intervalo interquartil = 12–84. A lesão pulmonar mais comum foi opacidades em vidro fosco. O padrão típico de TC foi mais comum em pacientes com COVID-19 (40 (61%) vs. 0 (0%) em pacientes sem COVID-19, p < 0,001). Sensibilidade 60,61% (40/66), especificidade 100% (40/40). Valores preditivos positivos e negativos foram 100% e 62,3%, respectivamente. Padrão atípico de TC foi mais frequente em pacientes COVID-19-negativos (9 (14%) vs. 24 (56%) em COVID-19-positivos, p < 0,001), enquanto padrão indeterminado foi semelhante em ambos os grupos (13 (20%) vs. 6 (14%), p = 0,606), e padrão negativo foi mais comum em pacientes COVID-19-negativos (4 (6%) vs. 12 (28%), p = 0,002). Conclusões: Em pacientes com DRET em TRS hospitalizados, um padrão atípico de TC de tórax não pode excluir adequadamente o diagnóstico de COVID-19.

ABSTRACT Introduction: Lung diseases are common in patients with end stage kidney disease (ESKD), making differential diagnosis with COVID-19 a challenge. This study describes pulmonary chest tomography (CT) findings in hospitalized ESKD patients on renal replacement therapy (RRT) with clinical suspicion of COVID-19. Methods: ESKD individuals referred to emergency department older than 18 years with clinical suspicion of COVID-19 were recruited. Epidemiological baseline clinical information was extracted from electronic health records. Pulmonary CT was classified as typical, indeterminate, atypical or negative. We then compared the CT findings of positive and negative COVID-19 patients. Results: We recruited 109 patients (62.3% COVID-19-positive) between March and December 2020, mean age 60 ± 12.5 years, 43% female. The most common etiology of ESKD was diabetes. Median time on dialysis was 36 months, interquartile range = 12–84. The most common pulmonary lesion on CT was ground glass opacities. Typical CT pattern was more common in COVID-19 patients (40 (61%) vs 0 (0%) in non-COVID-19 patients, p < 0.001). Sensitivity was 60.61% (40/66) and specificity was 100% (40/40). Positive predictive value and negative predictive value were 100% and 62.3%, respectively. Atypical CT pattern was more frequent in COVID-19-negative patients (9 (14%) vs 24 (56%) in COVID-19-positive, p < 0.001), while the indeterminate pattern was similar in both groups (13 (20%) vs 6 (14%), p = 0.606), and negative pattern was more common in COVID-19-negative patients (4 (6%) vs 12 (28%), p = 0.002). Conclusions: In hospitalized ESKD patients on RRT, atypical chest CT pattern cannot adequately rule out the diagnosis of COVID-19.

https://doi.org/10.1590/2175-8239-jbn-2023-0029en

13.

Dieta no saludable y no sostenible y sindemia: el papel de los alimentos ultraprocesados
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Avelar, Bruna Aparecida

; Morito Neves, Ana Cláudia

; Cardoso Carraro, Júlia Cristina

; Carvalho de Menezes, Mariana

; da Silva Barreto, Mayckel

; de Deus Mendonça, Raquel

Revista chilena de nutrición

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aug 2024, Volume 51 N. 4 Pages 340 - 345

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

Abstract The global syndemic is an issue that is gaining notoriety in the world. The syndemic is understood as the interaction between obesity, malnutrition and climate change, that is, synergy of epidemics and complex situations, which coexist in time and place and their consequences for health. However, little is known about the relationship between the global syndemic and the consumption of ultra-processed foods (UPF). In this context, the present essay aims to reflect on the relationship established between the global syndemic and the consumption of UPA. Starting with obesity, it is known that excessive consumption of UPA is one of the main causes of this chronic non-communicable disease. However, there is also a direct relationship between malnutrition and the consumption of UPA, since people who are in a situation of food insecurity choose economically accessible foods, characterizing themselves as a double burden of malnutrition. While studies on sustainable diets advance, knowledge about the association between climate change and UPA consumption is still incipient. Although studies highlight its environmental impacts in the handling and consumption of meat, in addition to the use of pesticides, it may play a secondary role. In this sense, studies are needed that evaluate the consumption of UPA and its relationship with the global syndemic, to support the formulation of public policies aimed at improving the consumption of healthy and sustainable foods for the planet.

Resumen La sindemia global es un tema que está ganando notoriedad en el mundo. La sindemia se entiende como la interacción entre la obesidad, la desnutrición y el cambio climático, es decir, sinergia de epidemias y situaciones complejas, que coexisten en tiempo y lugar y sus consecuencias para la salud. Sin embargo, poco se sabe sobre la relación entre la sindemia global y el consumo de alimentos ultraprocesados (AUP). En este contexto, el presente ensayo tiene como objetivo reflexionar acerca de la relación que se establece entre la sindemia global y el consumo de AUP. Empezando por la obesidad, se sabe que el consumo excesivo de AUP es una de las principales causas de esta enfermedad crónica no transmisible. Sin embargo, también existe una relación directa entre desnutrición y el consumo de AUP, ya que las personas que se encuentran en situación de inseguridad alimentaria eligen alimentos económicamente accesibles, caracterizándose como una doble carga de malnutrición. Mientras avanzan los estudios sobre las dietas sostenibles, el conocimiento sobre la asociación entre el cambio climático y el consumo de AUP es aún incipiente. Aunque los estudios destacan sus impactos ambientales en el manejo y consumo de carne, además del uso de pesticidas, pudiendo jugar un papel secundario. En este sentido, se necesitan estudios que evalúen el consumo de AUP y su relación con la sindemia global, para apoyar la formulación de políticas públicas encaminadas a mejorar el consumo de alimentos saludables y sostenibles para el planeta.

https://doi.org/10.4067/s0717-75182024000400340

14.

Knowledge in Inﬂammatory Bowel Disease: Translation to Portuguese, Validation, and Clinical Application of the IBD-KNOW Questionnaire
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Sequeira, Cristiana

; Coelho, Mariana

; Santos, Inês Costa Lopes, Sara Ramos Teixeira, Cristina Mangualde, João Cremers, Isabelle Oliveira, Ana Paula

GE-Portuguese Journal of Gastroenterology

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aug 2024, Volume 31 N. 4 Pages 22 - 31

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

Resumo Introdução/objetivos: O conhecimento relacionado com a Doença Inﬂamatória Intestinal (DII) visa capacitar os doentes, proporcionando o desenvolvimento de estratégias adaptativas de coping. Recentemente, foi desenvolvido um questionário mais abrangente para avaliar os conhecimentos relacionados com a DII, o IBD-KNOW. O principal objetivo do nosso estudo foi traduzir para português e validar o questionário IBD-KNOW. Também explorámos os preditores de um elevado nível de con-hecimento relacionado com a DII e avaliámos o impacto do conhecimento na qualidade de vida associada a cuidados de saúde (QVACS) e na adesão terapêutica. Métodos: Este é um estudo observacional, unicêntrico e transversal. Traduzimos e adaptámos para português a versão original inglesa do questionário IBD-KNOW. Posteriormente, os doentes com DII de ambulatório foram convidados a preencher um questionário multimodal que incluía, a versão portuguesa do IBD-KNOW, uma escala visual analógica (EVA) de autoperceção do conhecimento, a versão portuguesa do Short IBD Questionnaire (SIBDQ) e a versão portuguesa do Morisky Adherence Scale 8-item (MMAS-8). Foram colhidos dados referentes a aspetos demográﬁcos e da doença. Avaliámos a vali-dade (através da validade discriminatória entre voluntár-ios sem DII e da correlação entre IBD-KNOW e a EVA) e a ﬁabilidade (através da consistência interna, do teste-reteste e da correlação intraclasse). A análise estatística foi realizada utilizando a versão 25.0 do SPSS. Resultados: A pontuação média do IBD-KNOW foi signiﬁcativamente diferente entre os voluntários não-DII (médicos: 23, enfermeiros: 18 e voluntários não-médicos: 12, p < 0,001). O IBD-KNOW mostrou uma elevada consistência interna (Cronbach’s α 0,78) e uma correlação intraclasse (0,90).

Abstract Background/Aims: Inﬂammatory bowel disease (IBD)-related knowledge empowers patients, providing the development of adaptative coping strategies. Recently, a more comprehensive questionnaire for evaluating IBD-related knowledge was developed, the IBD-KNOW. The main aim of our study was to translate to Portuguese and validate the IBD-KNOW questionnaire. We also explored the predictors of high scores of disease-related knowledge and the effect of knowledge on health-related quality of life (HRQoL) and therapeutic adherence. Methods: This is an observational, unicentric, and cross-sectional study. We translated and adapted the original English version of the IBD-KNOW questionnaire into Portuguese. Afterwards, IBD patients in the outpatient clinics were invited to ﬁll out a multimodal form including the Portuguese version of IBD-KNOW, a visual analogue scale (VAS) of self-perceived knowledge, the Portuguese version of Short IBD Questionnaire (SIBDQ) and the Portuguese version of Morisky Adherence Scale 8-item (MMAS-8). Demographic and disease characteristics were collected. We assessed validity (through discriminate validity among non-IBD volunteers and correlation between IBD-KNOW and VAS) and reliability (through internal consistency, test-retest, and intraclass correlation). Statistical analysis was performed using SPSS version 25.0. Results: The mean IBD-KNOW score was signiﬁcantly different among non-IBD validation group (doctors: 23, nurses: 18, and non-medical volunteers: 12, p < 0.001). IBD-KNOW showed a high internal consistency (Cronbach’s α 0.78) and intraclass correlation (0.90). As expected, the IBD-KNOW score was positively correlated with VAS for self-perceived knowledge (r =0.45, p < 0.001). One hundred and one patients with IBD (54 with ulcerative colitis and 47 with Crohn’s disease) completed the questionnaire at baseline. Multivariate analyses showed that a high IBD-KNOW score was associated with longer disease duration (OR: 2.59 [CI 1.11-5.74]; p = 0.04), previous hospitalization (OR: 3.63 [CI 1.301-9.96]; p = 0.01), current biologic treatment (OR: 3.37 [CI 1.31-8.65]; p = 0.02), and higher educational level (OR: 4.66 [CI 1.74-10.21]; p = 0.02). Moreover, there was no signiﬁcant correlation between overall IBD-KNOW and SIBDQ, nor between IBD treatment adherence (MMAS-8 = 8) and a higher mean IBD-KNOW score (p = 0.552). Conclusion: The Portuguese version of IBD-KNOW is a simple, valid, and reliable tool for assessing IBD-related knowledge. Longer disease duration, hospitalization, use of biologics, and higher educational level are associated with higher levels of knowledge. Higher patient knowledge was not associated with higher HRQoL and adherence to therapy.

https://doi.org/10.1159/000530628

15.

Post-partum osteomyelitis pubis
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d’Almeida, Mariana Gouvêa Carmo, Helena Cunha e Pereira, João Pedro Gomes, Inês Neves Leite, Cristina

Acta Obstétrica e Ginecológica Portuguesa

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jun 2024, Volume 18 N. 2 Pages 170 - 174

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

Resumo A osteomielite da sínfise púbica é uma condição rara que pode ocorrer após partos vaginais. Existem alguns casos descritos, maioritariamente associados a partos eutócicos1-11. O microrganismo mais frequentemente associado a esta patologia é o Staphylococcus Aureus, mas P. aeruginosa e infeções polimicrobianas que incluam flora fecal também são causas comuns3,12. Apesar de o trauma pélvico ser um fator de risco importante, neste trabalho apresentamos um caso de osteomielite puerperal após um parto eutócico sem complicações.

Abstract Osteomyelitis pubis is a rare condition that can occur after vaginal delivery. There are few cases reported, mostly associated with normal vaginal deliveries1-11. Most common pathogen is Staphylococcus Aureus, but P. aeruginosa and polymicrobial infections evolving faecal flora are also common3,12. Although pelvic trauma has been associated with this rare condition, we present a case of osteomyelitis pubis related to uncomplicated vaginal delivery.

https://doi.org/10.69729/aogp.v18i2a11

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Glossary and search help

You can enrich your search in a very simple way. Use the search indexes combined with the connectors (AND or OR) and specify more your search.

For example, if you want to search for articles about
cases of dengue in Brasil in 2015, use:
ti:dengue and publication_year:2015 and aff_country:Brasil

See below the complete list of search indexes that can be used:

Index code	Element
ti	article title
au	author
kw	article keywords
subject	subject (title words, abstract and keywords)
ab	abstract
ta	journal short title (e.g. Cad. Saúde Pública)
journal_title	journal full title (e.g. Cadernos de Saúde Pública)
la	publication language code (e.g. pt - Portuguese, es - Spanish)
type	document type
pid	publication identifier
publication_year	publication year of publication
sponsor	sponsor
aff_country	country code of the author's affiliation
aff_institution	author affiliation institution
volume	article volume
issue	article issue
elocation	elocation
doi	DOI number
issn	journal ISSN
in	SciELO colection code (e.g. scl - Brasil, col - Colômbia)
use_license	article usage license code

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