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Pulmonary embolism in pediatrics: A 10-year experience from a tertiary center in Brazil
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Lira, Liana Ariel de Siqueira

; Celeste, Daniele Martins

; Garanito, Marlene Pereira

; Carneiro, Jorge David Aivazoglou

Hematology, Transfusion and Cell Therapy

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jul 2023, Volume 45 Suppl. 2 Pages S85 - S90

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Although still rare, pulmonary embolism (PE) in children has been increasing over the years. Data regarding this group of patients are still sparse, which contributes to the lack of standardized prophylaxis protocols and the misdiagnosis. This study aimed to determine the incidence of pediatric PE at a Brazilian tertiary hospital, describe clinical characteristics and identify possible risk factors. We also analyzed the diagnosis and management of PE. Methods: This was a retrospective review of tertiary Brazilian single-center data of all pediatric patients (0 – 18 years) with acute PE, diagnosed radiologically, from September 2009 to May 2019. Results: The incidence of PE was 3.3 cases per 10,000 hospitalized children. All the twenty-three cases had some risk factor identified and sixteen of them (69.5%) had more than one risk factor. The most important were central venous catheter (39.1%), malignancy (34.8%) and recent surgery (34.8%). Among the children with identifiable symptoms (69.5%), the most common was dyspnea (56.2%). Only one patient did not receive antithrombotic therapy because of the high bleeding risk and most patients (70.6%) were treated for 3 to 6 months. Among the nineteen patients alive at the end of the six-month follow-up, ten (52.6%) repeated the PE image control. Seven of them (70.0%) had complete or partial resolution of the thrombosis and none had worsening images. Conclusion: Our lower incidence than that of the current literature may reflect underdiagnosis due to low suspicion of PE. At least one risk factor was identified in all patients, which emphasizes the importance of increasing awareness of high-risk children.

https://doi.org/10.1016/j.htct.2022.02.005

Estudio comparativo de la capacidad denominativa y la memoria episódica de los pacientes con demencia degenerativa
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Custodio, Nilton

; Montesinos, Rosa

; Cruzado, Lizardo

; Alva-Díaz, Carlos

; Failoc-Rojas, Virgilio E.

; Celis, Violeta

; Cuenca-Alfaro, José

; Lira, David

Revista Colombiana de Psiquiatría

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mar 2022, Volume 51 N. 1 Pages 8 - 16

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

ABSTRACT Introduction: Although the absence of memory impairment was considered among the Alzheimer's disease diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal dementia Frontotemporal Dementia (bvFTD), current and growingevidence indicates that a significant Neuropsychological assessment percentage of cases of bvFTD present with episodic memory deficits. In order to compare Memory the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. Methods: Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. Results: A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p < 0.001). Results:This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings. Conclusions: Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.

RESUMEN Introducción: Aunque la ausencia de deterioro de la memoria se consideró entre los criterios diagnósticos para diferenciar la enfermedad de Alzheimer (EA) de la demencia frontotemporal variante conductual (DFTvC), la evidencia actual, en aumento, sería la un importante porcentaje de casos de DFTvC con déficits de la memoria episódica. El presente estudio se diseñó con el fin de comparar el perfil de desempeño de la capacidad denominativa y de la memoria episódica de los pacientes con EA y DFTvC. Métodos: Estudio transversal y analítico con grupo de control (n = 32). Se incluyó a 42 sujetos con probable EA y 22 con probable DFTvC, todos mayores de 60 años. Se utilizaron instrumentos del Uniform Data Set validados en español: Multilingual Naming Test (MINT), historia de Craft-21 y Figura compleja de Benson, entre otros. Resultados: Se observó un mayor promedio de edad entre los pacientes con EA. La capacidad denominativa fue mucho menor en los pacientes con DFTvC que en aquellos con EA, medida según el MINT y el coeficiente de denominación sustantivos/verbos. Todos los pacientes con DFTvC, el 73,81% de aquellos con EAy solo el 31,25% de los controles no lograron reconocer la Figura compleja de Benson. Todas las diferencias fueron estadísticamente significativas (p< 0,001). Resultados: Este estudio confirma el perfil amnésico de los pacientes con EA y revela la disminución de la capacidad denominativa de los pacientes con DFTvC, un área del lenguaje que se afecta típica y tempranamente con las funciones ejecutivas, según recientes hallazgos. Conclusiones: Los pacientes con EA rinden peor en las tareas de memoria episódica verbal y visual, mientras que los pacientes con DFTvC rinden peor en tareas de denominación. Estos hallazgos abren la posibilidad de explorar los mecanismos de participación prefrontal en la memoria episódica, típicamente atribuida al hipocampo.

https://doi.org/10.1016/j.rcp.2020.09.003 86 downloads

Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force
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Tavares, Anna Carolina Faria Moreira Gomes

; Melo, Ana Karla Guedes de

; Cruz, Vítor Alves

; Souza, Viviane Angelina de

; Carvalho, Joana Starling de

; Machado, Ketty Lysie Libardi Lira

; Valadares, Lilian David de Azevedo

; Reis Neto, Edgard Torres dos

; Rezende, Rodrigo Poubel Vieira de

; Guimarães, Maria Fernanda Brandão de Resende

; Ferreira, Gilda Aparecida

; Braz, Alessandra de Sousa

; Vieira, Rejane Maria Rodrigues de Abreu

; Pinheiro, Marcelo de Medeiros

; Ribeiro, Sandra Lúcia Euzébio

; Bica, Blanca Elena Gomes Rios

; Baptista, Kátia Lino

; Costa, Izaias Pereira da

; Marques, Claudia Diniz Lopes

; Lopes, Maria Lúcia Lemos

; Martinez, José Eduardo

; Giorgi, Rina Dalva Neubarth

; Mota, Lícia Maria Henrique da

; Loures, Marcos Antônio Araújo da Rocha

; Paiva, Eduardo dos Santos

; Monticielo, Odirlei André

; Xavier, Ricardo Machado

; Kakehasi, Adriana Maria

; Pileggi, Gecilmara Cristina Salviato

Advances in Rheumatology

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2022, Volume 62 elocation 3

Abstract: En | Text: En | PDF: En

Abstract Objective: To provide guidelines on the coronavirus disease 2019 (COVID-19) vaccination in patients with immune-mediated rheumatic diseases (IMRD) to rheumatologists considering specific scenarios of the daily practice based on the shared-making decision (SMD) process. Methods: A task force was constituted by 24 rheumatologists (panel members), with clinical and research expertise in immunizations and infectious diseases in immunocompromised patients, endorsed by the Brazilian Society of Rheumatology (BSR), to develop guidelines for COVID-19 vaccination in patients with IMRD. A consensus was built through the Delphi method and involved four rounds of anonymous voting, where five options were used to determine the level of agreement (LOA), based on the Likert Scale: (1) strongly disagree; (2) disagree, (3) neither agree nor disagree (neutral); (4) agree; and (5) strongly agree. Nineteen questions were addressed and discussed via teleconference to formulate the answers. In order to identify the relevant data on COVID-19 vaccines, a search with standardized descriptors and synonyms was performed on September 10th, 2021, of the MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and LILACS to identify studies of interest. We used the Newcastle–Ottawa Scale to assess the quality of nonrandomized studies. Results: All the nineteen questions-answers (Q&A) were approved by the BSR Task Force with more than 80% of panelists voting options 4—agree—and 5—strongly agree—, and a consensus was reached. These Guidelines were focused in SMD on the most appropriate timing for IMRD patients to get vaccinated to reach the adequate covid-19 vaccination response. Conclusion: These guidelines were developed by a BSR Task Force with a high LOA among panelists, based on the literature review of published studies and expert opinion for COVID-19 vaccination in IMRD patients. Noteworthy, in the pandemic period, up to the time of the review and the consensus process for this document, high-quality evidence was scarce. Thus, it is not a substitute for clinical judgment.

https://doi.org/10.1186/s42358-022-00234-7

Programa de reanimación neonatal: recomendaciones actuales
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Montesinos-Ramírez, Claudia

; Pinacho-Velázquez, José Luis

; Torres-Lira, Silvia F

; Robledo-Galván, Alicia Elizabeth

; Barrera-Martínez, Pedro Iván

; Quiroz-Mendieta, Eva Karina

; García-May, Perla Karina

; Izaguirre-Alcántara, Dillan David

; Carrillo-Arteaga, Sergio

Revista mexicana de pediatría

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oct 2021, Volume 88 N. 5 Pages 209 - 213

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

Abstract: Neonatal asphyxia and its complications remain a serious problem at birth; the knowledge and skills of those who apply the Neonatal Resuscitation Program have an impact on the morbidity and mortality of the newborn. Recently, the International Liaison Committee on Resuscitation (ILCOR) has published new recommendations on neonatal resuscitation to improve outcomes in newborns, as well as methodology for provider education. It also contains a section on care during the COVID-19 pandemic. This article presents a summary of the most important changes in the book Neonatal Resuscitation, eighth edition, published in 2021 by the American Heart Association and the American Academy of Pediatrics.

Resumen: La asfixia neonatal y sus complicaciones siguen siendo un grave problema al nacimiento; el conocimiento y la destreza de quienes aplican el Programa de Reanimación Neonatal impactan en la morbilidad y mortalidad del recién nacido. Recientemente el International Liaison Committee on Resuscitation (ILCOR) ha publicado nuevas recomendaciones en la reanimación neonatal para mejorar los resultados en los recién nacidos, además se incluye la metodología para la educación de los proveedores. Asimismo, se agrega un apartado sobre la atención durante la pandemia de COVID-19. En el presente artículo se presenta una síntesis de los cambios más importantes de la octava edición del libro Reanimación Neonatal, publicado en 2021 por la Asociación Americana del Corazón y la Academia Americana de Pediatría.

https://doi.org/10.35366/103903 140 downloads

Talleres de reanimación neonatal en la Sociedad Mexicana de Pediatría durante la pandemia por SARS-CoV-2
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Montesinos-Ramírez, Claudia

; Pinacho-Velázquez, José Luis

; Torres-Lira, Silvia F

; Robledo-Galván, Alicia Elizabeth

; Martínez-Barrera, Pedro Iván

; Quiroz-Mendieta, Erika Karina

; Corral-Kassian, Erika

; Izaguirre-Alcántara, Dillan David

; Carrillo-Arteaga, Sergio

Revista mexicana de pediatría

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apr 2021, Volume 88 N. 2 Pages 51 - 52

Abstract: Es | Text: Es | PDF: Es

20 downloads

Posicionamento sobre Indicações e Reintrodução dos Métodos de Imagem Cardiovascular de Forma Segura no Cenário da COVID-19 – 2021
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Beck, Adenalva Lima de Souza

; Barberato, Silvio Henrique

; Almeida, André Luiz Cerqueira de

; Grau, Claudia R. Pinheiro de Castro

; Lopes, Marly Maria Uellendahl

; Lima, Ronaldo de Souza Leão

; Cerci, Rodrigo Júlio

; Albricker, Ana Cristina Lopes

; Barros, Fanilda Souto

; Oliveira, Alessandra Joslin

; Lira Filho, Edgar Bezerra de

; Miglioranza, Marcelo Haertel

; Vieira, Marcelo Luiz Campos

; Pena, José Luiz Barros

; Strabelli, Tânia Mara Varejão

; Bihan, David Costa de Souza Le

; Tsutsui, Jeane Mike

; Rochitte, Carlos Eduardo

Arquivos Brasileiros de Cardiologia

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mar 2021, Volume 116 N. 3 Pages 659 - 678

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

https://doi.org/10.36660/abc.20210133 299 downloads

Intense transmission of visceral leishmaniasis in a region of northeastern Brazil: a situation analysis after the discontinuance of a zoonosis control program
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Nogueira, Ranielly Araujo

; Lira, Maria Gabriela Sampaio

; Santos, Sarah Ingrid Pinto

; Mondêgo-Oliveira, Renata

; Andrade, Fábio Henrique Evangelista de

; Sousa, Eduardo Martins de

; Barbosa, David Soeiro

; Abreu-Silva, Ana Lucia

; Carvalho, Rafael Cardoso

Revista Brasileira de Parasitologia Veterinária

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2021, Volume 30 N. 1 elocation e020320

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

Resumo Em São Luís, Maranhão, região Nordeste do Brasil, a notificação de casos de Leishmaniose Visceral (LV) intensificou-se em 1982, com padrão epidêmico e endêmico. Nessa cidade, o Centro de Controle de Zoonoses (CCZ) era uma entidade que realizava ações de controle e prevenção da doença, mas, nos últimos anos, a periodicidade de suas atividades reduziram-se significativamente, devido a diversos fatores técnico-políticos. Portanto, neste estudo avaliou-se o cenário epidemiológico da leishmaniose visceral humana (LVH) e a prevalência da doença em cães, após a descontinuidade das atividades do CCZ, no período de 2007-2016. A soroprevalência canina foi determinada de acordo com o perfil clínico e a sorologia. Os casos notificados de LVH foram realizados a partir de dados da Secretaria Municipal de Saúde de São Luís. Observou-se frequência de 45,8% (p = 0,0001) de cães soropositivos, dos quais 54% (p = 0,374) eram assintomáticos. Em relação aos casos humanos, ocorreram 415 notificações, com aumento na incidência das zoonoses observada no período. Assim, pode-se inferir que, com a interrupção das atividades de controle e vigilância, houve um grande número de animais circulantes positivos, atuando como fonte de infecção tanto para cães quanto para humanos.

Abstract In São Luís, Maranhão, northeastern Brazil, the notification of visceral leishmaniasis (VL) cases intensified in 1982, showing endemic and epidemic patterns. In this city, the Center for Zoonoses Control (CZC) was an organization in charge of the control and prevention of the disease. However, technical and political reasons have led to a significant decline in the periodicity of its activities. Therefore, in this study we evaluated the epidemiological scenario of human visceral leishmaniasis (HVL) and the prevalence of the disease in dogs after the cessation of the CZC activities, covering the period of 2007 to 2016. The seroprevalence of canine leishmaniasis was determined based on clinical and serological profiles. HVL cases were notified using data provided by the Municipal Health Department of São Luís. A seropositivity rate of 45.8% (p = 0.0001) was found among dogs, 54% (p = 0.374) of which were asymptomatic. As for human cases, there were 415 notifications, with an increase in the incidence of the zoonosis observed during the aforementioned period. Thus, it can be inferred that after the control and surveillance activities were curtailed, there was an increase in the number of seropositive animals in circulation, acting as reservoirs of infection for dogs and humans.

https://doi.org/10.1590/s1984-29612021015 355 downloads

Brief cognitive tests validated in Peru for detection of cognitive impairment A systematic mapping of the scientific literature
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Custodio, Nilton

; Herrera-Pérez, Eder

; Montesinos, Rosa

; Lira, David

; Metcalf, Tatiana

Dementia & Neuropsychologia

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jun 2020, Volume 14 N. 2 Pages 134 - 144

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

Resumo. Testes cognitivos breves (TCBs) são necessários para a detecção precoce do comprometimento cognitivo, particularmente nos serviços de atenção primária. Objetivo: Este artigo descreve uma revisão sistemática dos TCBs avaliados em populações peruanas. Métodos: Utilizamos técnicas de mapeamento sistemático para identificar artigos sobre testes de triagem para comprometimento cognitivo envolvendo indivíduos peruanos. Incluímos estudos publicados em inglês e espanhol até 2018. Revisamos 6 bancos de dados de referência na rede da Biblioteca Virtual em Saúde e no Web of Science; Scopus (MEDLINE) e banco de dados EMBASE. Resultados: Dez dos 447 artigos preencheram os critérios de inclusão. Os estudos incluíram amostras ambulatoriais (9) e comunitárias (2). Os critérios de elegibilidade entre os estudos foram semelhantes. Embora os diferentes protocolos tenham sido aplicados, os critérios diagnósticos foram padronizados. Para a discriminação entre demência e controles, INECO Frontal Screening (IFS) (AUC: 0.99), Addenbrooke’s Cognitive Examination (ACE) (AUC: 0.95 to 1.00) mostraram desempnho superior, assim como o Memory Alteration Test (M@T) (AUC: 1.00) o Desenho do relógio (CDT-Mv) (AUC: 0,94 a 1,00) para discriminação entre a doença de Alzheimer (DA) e os controles. Conclusão: As evidências disponíveis são limitadas. No entanto, nossa análise com dados nacionais sugere que o ACE pode ser uma boa opção sempre que possível com pacientes peruanos. Alternativamente, o M @ T e o IFS podem ser usados para rastrear pacientes com suspeita de DA ou DFT, respectivamente.

Abstract. Brief cognitive tests (BCTs) are necessary for early detection of cognitive impairment, particularly in primary care settings. Objective: This report describes a systematic review of BCTs evaluated in Peruvian populations. Methods: We used systematic mapping techniques to identify articles on screening tests for cognitive impairment involving Peruvian subjects. We included studies published in English and Spanish up to 2018. We reviewed 6 reference databases within the Virtual Health Library network, as well as the Web of Science, Scopus (MEDLINE), and EMBASE databases. Results: Ten out of 447 articles met the inclusion criteria. Studies included both outpatient (9) and community-based (2) samples. Eligibility criteria of the studies were similar. Although different protocols were applied, the diagnostic criteria were standardized. For discrimination between dementia and controls, IFS (AUC: 0.99) and ACE (AUC: 0.95 to 1.00) showed superior performance, as did the M@T (AUC: 1.00) and CDT-Mv (AUC: 0.94 to 1.00) for discriminating between Alzheimer’s disease (AD) and controls. Conclusion: The available evidence is limited. However, our analysis of national data suggests that the ACE may be a good choice whenever it can be applied to Peruvian patients. Alternatively, the M@T and IFS can be used for screening patients with suspected AD or FTD, respectively.

https://doi.org/10.1590/1980-57642020dn14-020006 1089 downloads

White smut (Entyloma australe Speg.) resistance in tomatillo (Physalis spp.) germplasm
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Moncayo-Pérez, Cristhyan David

; Magaña-Lira, Natanael

; Peña-Lomelí, Aureliano

; Leyva-Mir, Santos Gerardo

; Sahagún-Castellanos, Jaime

; Pérez-Grajales, Mario

Revista Chapingo. Serie horticultura

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apr 2020, Volume 26 N. 1 Pages 65 - 77

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

Abstract Tomatillo (Physalis ixocarpa Brot. ex Horm.) is attacked by a great variety of pathogens, which result in high yield losses, such is the case of white smug (Entyloma australe Speg.). Therefore, the objective was to evaluate the damage caused by white smug in 24 tomatillo materials to determine their resistance and susceptibility, as well as the pathogen’s impact on yield. Two production cycles were established: spring-summer and summer-fall in 2017. In the former, yield per plant (kg) was evaluated in two harvest periods carried out 72 and 83 days after transplanting (YP1 and YP2). The size of the fruit was also evaluated in weight (g) of 10 fruits from each harvest (FW1, FW2), volume (mL), total yield per plant (TYP; kg), average weight of the fruits (AFW;g), plant height (PH; cm) and the area under the disease progress curve (AUDPC). The last two variables were also evaluated in the second cycle. Accession 12 (JAL 103) had the highest yield, but it was the most susceptible to being attacked by the pathogen, while 26 (48 BNGEN) and 64 (147 BNGEN) were more resistant to this fungus. The varieties with the highest yield and size were Tecozautla 04, Gema, Manzano T and Puebla SM3. However, Tecozutla 04, Manzano T and Gema were the most susceptible to the disease, while Zafiro MSM and Diamante were the least susceptible.

Resumen El tomate de cáscara (Physalis ixocarpa Brot. ex Horm.) es atacado por una gran diversidad de patógenos, los cuales originan grandes pérdidas en el rendimiento, como es el caso del carbón blanco (Entyloma australe Speg.). Por ello, el objetivo fue evaluar los daños causados por el carbón blanco en 24 materiales de tomate de cáscara para determinar su resistencia o susceptibilidad, así como el impacto del patógeno en el rendimiento. Se establecieron dos ciclos de producción: primavera-verano y verano-otoño de 2017. En el primero se evaluó el rendimiento por planta (kg) en dos cortes realizados a los 72 y 83 días después del trasplante (RP1 y RP2). También se evaluó el tamaño de fruto a partir del peso (g) de 10 frutos en cada corte (PF1, PF2), el volumen (mL), el rendimiento total por planta (RTP; kg), el peso promedio de frutos (PPF; g), la altura de planta (AP; cm) y el área bajo la curva del progreso de la enfermedad (ABCPE). Las dos últimas variables también se evaluaron en el segundo ciclo. La accesión 12 (JAL 103) obtuvo el mayor rendimiento, pero fue la más susceptible al ataque del fitopatógeno, mientras que 26 (48 BNGEN) y 64 (147 BNGEN) resultaron más tolerantes a este hongo. Las variedades de mayor rendimiento y tamaño de fruto fueron Tecozautla 04, Gema, Manzano T y Puebla SM3. No obstante, Tecozautla 04, Manzano T y Gema fueron las más susceptibles a la enfermedad; en tanto que Zafiro MSM y Diamante fueron las menos susceptibles.

https://doi.org/10.5154/r.rchsh.2019.09.016 904 downloads

10.

Representações sociais e educação terapêutica: questões teórico-práticas
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Apostolidis, Themistoklis

; Fonte, David

; Aléssio, Renata Lira dos Santos

; Santos, Maria de Fátima de Souza

Saúde e Sociedade

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2020, Volume 29 N. 1 elocation e190299

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

Resumo Apresentamos a contribuição da psicologia social da saúde por meio da abordagem sociorrepresentacional para refletir acerca da educação terapêutica do(a) adolescente com diabetes mellitus tipo 1. O adoecimento crônico na adolescência coloca desafios específicos para o cuidado, o olhar psicossocial permite compreender a prática de avaliação e o fortalecimento das habilidades do paciente contextualizando a educação terapêutica enquanto conjunto de relações sociossimbólicas entre os atores da situação. Essa abordagem pode servir como uma ferramenta teórico-metodológica e prática para alcançar um diagnóstico psicossocial e um planejamento de intervenção. Um programa de três pesquisas realizadas na França com adolescentes diabéticos, suas famílias e profissionais ilustra questões e desafios contemporâneos no campo da educação terapêutica, centrando sua análise nos significados que os atores mobilizam para, assim, determinar estratégias de intervenção adaptadas às tensões psicossociais que possam surgir no cuidado. Ressaltamos a importância das dinâmicas socioidentitária e ideológica advindas do contexto social e cultural de referência dos atores engajados na educação terapêutica.

Abstract We introduce the contribution of social psychology of health to the reflection on the therapeutic education of adolescents with type 1 diabetes mellitus via a socio-representational approach. Chronic illnesses during adolescence pose specific challenges for health care, and the psychosocial perspective allows one to understand the practice of evaluating and consolidating patient’s abilities, contextualizing therapeutic education as a set of socio-symbolic relations between the social actors involved in such scenario. This approach can be used both as a theoreticalmethodological and practical instrument to achieve a psychosocial diagnosis and intervention planning. A program of three studies conducted in France with diabetic adolescents, their families and professionals, illustrates contemporary issues and challenges in the field of therapeutic education. This study is focused on the meanings mobilized by the social actors to determine intervention strategies adapted to the psychosocial tensions that may arise in health care. We emphasize the importance of the socio-identity and ideological dynamics arising from the social and cultural context of the social actors engaged in therapeutic education.

https://doi.org/10.1590/s0104-12902020190299

11.

Representações sociais e educação terapêutica: questões teórico-práticas
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Apostolidis, Themistoklis

; Fonte, David

; Aléssio, Renata Lira dos Santos

; Santos, Maria de Fátima de Souza

Saúde e Sociedade

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2020, Volume 29 N. 1 elocation e190299

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

https://doi.org/10.1590/s0104-12902020190299 976 downloads

12.

Soil mapping quality for site-specific management in fruit fields in the semiarid region of Brazil
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Sales Rodrigues, Marcos

; Castro Alves, David

; Cavalcante Cunha, Jailson

; Ferreira de Melo Júnior, Júlio César

; Nascimento Lima, Augusto Miguel

; Ferreira Lira, Aíris Layanne

; Bernard, Filipe

; Araújo Silva, Kátia

Ciencia del suelo

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dec 2019, Volume 37 N. 2 Pages 328 - 337

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

O mapeamento do solo é uma técnica importante para aplicar manejo específico em frutíferas. Portanto, os objetivos deste estudo foram avaliar métodos de amostragem do solo e o uso de técnicas de interpoladores na qualidade dos mapas de textura do solo em uma área de manga e avaliar a eficiência do uso de conjuntos independentes de dados no processo de validação de mapas. O experimento foi realizado em um pomar comercial de 3,3 ha de manga, na região semiárida do Brasil. As amostras foram coletadas seguindo uma malha regular contendo 119 pontos georreferenciados espaçados de 14 x 20 m, além de cinco micro-malhas contendo cada uma seis pontos espaçados de 7 x 10 m. Para obter um conjunto de dados independente para a validação dos mapas, foram realizadas 40 amostras aleatórias. A textura do solo foi determinada. Técnicas de interpolação geoestatística e determinística foram realizadas. O método de validação cruzada com conjunto de dados interno e independente foi realizado para validar os mapas. Todas as variáveis mostraram forte dependência espacial. A Krigagem foi um pouco melhor do que as técnicas de interpolação determinística, mostrando erros de raiz quadrada média de 2,40%; 2,84%; e 2,59% para argila, areia e silte, respectivamente. O uso da micro-malha não reduziu os erros dos mapas. O conjunto de dados independente mostrou-se eficiente para validar mapas de textura do solo, uma vez que seus valores representam a precisão real.

Soil mapping is an important technique to apply site-specific management in fruit fields. Therefore, aims of this study were to evaluate soil sampling methods and the use of interpolator techniques in the quality of soil texture maps in a mango field; and to evaluate the efficiency of the use of independent data set in the validation of maps process. The experiment was in a 3.3 ha mango commercial orchard in the semiarid region of Brazil. The samples were collected following a regular grid containing 119 georeferenced spaced 14 x 20 m points, in addition to five micro-grids each containing six spaced 7 x 10 m points. To obtain an independent dataset for the maps validation, 40 random samples were performed. Soil texture was determined. Geostatistic and deterministic interpolation techniques were performed. Cross-validation method with internal and independent dataset was performed to validate the maps. All variables showed a strong spatial dependence. Kriging was slightly better than the deterministic interpolation techniques, showing root mean square errors of 2,40%; 2,84%; and 2,59% for clay, sand, and silt content, respectively. The use of micro-grid did not reduce the errors of the maps. The independent dataset showed efficient to validate soil texture maps since its values represent the real accuracy.

295 downloads

13.

Factors associated with depression in patients with Parkinson’s disease A multicenter study in Lima, Peru
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Custodio, Nilton

; Alva-Diaz, Carlos

; Morán-Mariños, Cristian

; Mejía-Rojas, Koni

; Lira, David

; Montesinos, Rosa

; Herrera-Pérez, Eder

; Castro-Suárez, Sheila

; Bardales, Yadira

Dementia & Neuropsychologia

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sep 2018, Volume 12 N. 3 Pages 292 - 298

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

Resumo O diagnóstico e tratamento da depressão em pacientes com doença de Parkinson (DP) é inadequado, frequentemente contribuindo para a redução da qualidade de vida, progressão rápida da doença, maior comprometimento cognitivo e aumento da carga de cuidado aos familiares de pacientes com DP. Objetivo: Determinar os fatores associados à depressão na DP e examinar a frequência de sintomas depressivos entre pacientes com DP. Métodos: Este estudo foi um estudo observacional, analítico, multicêntrico, de uma coorte transversal conduzida entre julho de 2016 e maio de 2017. Os pacientes com DP foram recrutados em clínicas de neurologia em Lima, Peru. Todas as análises estatísticas foram realizadas por meio de estatística descritiva. Análises de regressão logística bivariada e multivariada foram calculadas usando STATA. Resultados: Dos 124 pacientes (idade média: 68,7 anos; 58% homens) incluídos no estudo, 60,5% (75/124) apresentaram sintomas de depressão; apenas 20% (25/124) receberam antidepressivos. Os fatores associados à depressão na DP incluíram: desemprego, quedas, congelamento da marcha, movimentos involuntários micrografia, postura inclinada, hiposmia, distúrbios do movimento no sono, progressão rápida da doença e uso de inibidores da MAO. Além disso, houve diferenças estatisticamente significativas encontradas em: duração da doença, escores nas escalas UPDRS e MMSE, estágio Hoehn e Yahr (HY) e tempo de duração da L-dopa entre os pacientes com DP, entre aqueles com e sem sintomas depressivos. Conclusão: Fatores associados a sintomas depressivos em pacientes com DP foram hiposmia, rápida progressão da doença, uso de L-dopa e uso de IMAOs. A frequência de sintomas depressivos em pacientes com DP é alta; o diagnóstico precoce e o tratamento imediato são necessários para melhorar a qualidade de vida e o ambiente familiar.

Abstract The diagnosis and treatment of depression in patients with Parkinson’s disease (PD) is inadequate, often contributing to a reduced quality of life, rapid disease progression, higher cognitive impairment, and an increased burden of care for family members of patients with PD. Objective: To determine the factors associated with depression in PD and to examine the frequency of depressive symptoms among patients with PD. Methods: This study was an observational, analytical, multicenter study of a cross-sectional cohort, conducted between July 2016 and May 2017. PD patients were recruited from neurology clinics in Lima, Peru. All statistical analyses were performed using descriptive statistics. Bivariate and multivariate logistic regression analyses were calculated using STATA. Results: Out of 124 patients (average age: 68.7 years; 58% males) included in the study 60.5% (75/124) presented with symptoms of depression; only 20% (25/124) received antidepressants. Factors associated with depression in PD included: unemployment, falls, freezing of gait, involuntary movements micrographia, stooped posture, hyposmia, movement disorders in sleep, rapid disease progression, and the use of MAOIs. Furthermore, statistically significant differences were found in disease duration, UPDRS and MMSE scores, Hoehn and Yahr (HY) stage, and length of time taking L-dopa between PD patients with and without depressive symptoms. Conclusion: Factors associated with depressive symptoms in patients with PD were hyposmia, rapid progression of the disease, the use of L-dopa, and use of MAOIs. The frequency of depressive symptoms in patients with PD is high; early diagnosis and prompt treatment are needed to improve their quality of life and the family environment.

https://doi.org/10.1590/1980-57642018dn12-030010 1702 downloads

14.

Nivel de conocimientos sobre demencia frontotemporal en una muestra de médicos que evalúan regularmente a pacientes con demencia en Lima-Perú
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Custodio, Nilton

; Becerra-Becerra, Yahaira

; Cruzado, Lizardo

; Castro-Suárez, Sheila

; Montesinos, Rosa

; Bardales, Yadira

; Fonseca, José

; Mar, Marcela

; Ocampo, Héctor

; Herrera-Pérez, Eder

; Lira, David

Revista chilena de neuro-psiquiatría

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jun 2018, Volume 56 N. 2 Pages 77 - 88

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

Physicians with specialty in geriatrics, psychiatry and neurology have not received training about the differential diagnosis of dementia, particularly regarding fronto-temporal dementia (FTD). Objective: To assess the level of knowledge of physicians about FTD. Material and Method: The survey was carried out during symposiums and scientific congresses from January 2016 to July 2017. Inclusion criteria: being a general practitioner or specialist in Geriatrics, Neurology and psychiatry whose training process as a physician and specialist has been carried out in Peruvian universities. We analyzed 217 surveys of which 13 were eliminated. The survey was divided into three parts, the first about general data of doctors, the second part was about the diagnosis of dementia; and the third on specific data of FTD. STATA version 12 was used for the statistical analysis. Results: 90% of the doctors surveyed were specialists in: Psychiatry (41.3%), Geriatrics (31.3%) and Neurology (15.4%). The 98.5% of physicians surveyed claimed to diagnose dementia. The medical specialists performed better when identifying the tests used. 72.1% of the doctors surveyed could not recognize any type of FTD, while 27.9% recognized at least 1 type of FTD. 43.8% of physicians surveyed identified 5 or more of the symptoms presented in FTD. Conclusions: The level of knowledge among medical specialists surveyed about the diagnosis of dementia is acceptable, however it is deficient when it is specifically about the diagnosis of FTD.

Resumen Médicos especialistas en geriatría, psiquiatría y neurología no han recibido entrenamiento respecto al diagnóstico diferencial de demencia, en particular acerca de demencia frontotemporal (DFT). Objetivo: Evaluar el nivel de conocimiento de los médicos sobre DFT. Material y Método: La encuesta se llevó a cabo durante simposios y congresos científicos desde enero de 2016 hasta julio de 2017. Los criterios de inclusión fueron: ser médico general o especialista en Geriatría, Neurología y Psiquiatría cuyo proceso de formación como médico y especialista haya sido realizado en universidades peruanas. Se analizaron 217 encuestas de las cuales 13 fueron eliminadas. La encuesta estuvo dividida en tres partes: la primera sobre datos generales de los médicos, la segunda parte fue acerca del diagnóstico de demencia y la tercera sobre datos específicos de DFT. Para el análisis estadístico se utilizó STATA versión 12. Resultados: El 90% de los médicos encuestados fueron médicos especialistas en: Psiquiatría (41,3%), Geriatría (31,3%) y Neurología (15,4%). El 98,5% de médicos encuestados afirmó diagnosticar demencia. Los médicos especialistas tuvieron un mejor desempeño al momento de identificar las pruebas empleadas. El 72,1% de médicos encuestados no pudo reconocer ningún tipo de DFT, mientras que el 27,9% reconoció al menos 1 tipo de DFT. El 43,8% de médicos encuestados identificó correctamente 5 o más de los síntomas presentados en DFT. Conclusiones: El nivel de conocimientos entre médicos especialistas encuestados acerca del diagnóstico de demencia es aceptable, sin embargo es deficiente cuando se trata específicamente acerca del diagnóstico de DFT.

https://doi.org/10.4067/s0717-92272018000200077 2074 downloads

15.

Una complicación quirúrgica escasamente sospechada: la disfunción cognitiva postoperatoria
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Lira, David

; Mar-Meza, Marcela

; Montesinos, Rosa

; Herrera-Pérez, Eder

; Cuenca, José

; Castro-Suárez, Sheila

; Custodio, Nilton

Revista de Neuro-Psiquiatría

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apr 2018, Volume 81 N. 2 Pages 113 - 121

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

Many diseases require surgery as a treatment, either emergency or elective. Surgeries can have various complications; However, the possible postoperative cognitive alterations are not considered: delirium of anesthetic awakening, postoperative delirium and postoperative cognitive dysfunction (PCDP). DCPO is a clinical syndrome characterized by alterations in memory, concentration, attention, understanding of language and social integration after the use of anesthesia and surgery that persists after three months; although some reports consider that it would not be an individual clinical entity. Its incidence varies from 5.1 to 52.5% depending on the population studied, type of surgery, time of evaluation from surgery and neuropsychological battery used. The risk factors for DCPO are: advanced age, previous cognitive impairment, severity of coexisting diseases, severity of the surgery, duration and type of anesthesia, occurrence of complications and educational level; It is essential to carry out a neuropsychological evaluation before and after the surgery for its diagnosis. The proposed etiopathogenic mechanisms are: age, changes in cerebral perfusion, sleep disturbances, inflammation, effects of anesthetic agents, and fundamentally neuroinflammation. The DCPO is a frequent and rarely suspected entity, although its diagnosis is controversial. It is suggested that patients who will undergo major elective surgeries, especially cardiac and cerebral surgeries, undergo previous neuropsychological evaluation at 3 months, and intraoperative electroencephalographic monitoring to reduce the incidence of DCPO.

Numerosas enfermedades requieren como tratamiento una cirugía, ya sea de emergencia o electiva. Las cirugías pueden tener diversas complicaciones; sin embargo no se consideran las posibles alteraciones cognitivas postoperatorias: delirio del despertar anestésico, delirio postoperatorio y disfunción cognitiva postoperatoria (DCPO). La DCPO es un síndrome clínico caracterizado por alteraciones en la memoria, concentración, atención, comprensión del lenguaje e integración social posterior al uso de anestesia y cirugía que persiste después de tres meses; aunque algunos reportes consideran que no sería una entidad clínica individual. Su incidencia varía del 5,1 al 52,5% dependiendo de la población estudiada, tipo de cirugía, tiempo de la evaluación desde la cirugía y batería neuropsicológica empleada. Los factores de riesgo para DCPO son: edad avanzada, deterioro cognitivo previo, gravedad de enfermedades coexistentes, severidad de la cirugía, duración y tipo de la anestesia, ocurrencia de complicaciones y nivel educativo; siendo imprescindible la realización de una evaluación neuropsicológica antes y después de la cirugía para su diagnóstico. Los mecanismos etiopatogénicos propuestos son: la edad, cambios en la perfusión cerebral, disturbios del sueño, inflamación, efectos de los agentes anestésicos, y fundamentalmente la neuroinflamación. La DCPO es una entidad frecuente y escasamente sospechada, aunque su diagnóstico es controversial. Se sugiere que los pacientes que serán sometidos a cirugías electivas mayores, en especial las cardiacas y cerebrales, sean sometidos a evaluación neuropsicológica previa y a los 3 meses, así como a monitoreo electroencefalográfico intraoperatorio para disminuir la incidencia de DCPO.

https://doi.org/10.20453/rnp.v81i2.3339

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