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ABSTRACT BACKGROUND: With the increase in the older adult population, it is essential to identify the living and health conditions that can impact the quality of life of these individuals. OBJECTIVES: To identify the domains and factors associated with the quality of life of older adults under the Family Health Strategy program. DESIGN AND SETTING: This was a cross-sectional analytical study was conducted in the municipality of Palmas, Tocantins, Brazil. METHODS: We assessed 449 older adults enrolled in the Family Health Strategy program. Data were collected between April and July, 2018. World Health Organization Quality of Life Assessment (WHOQOL-OLD) was used to assess the quality of life (QoL) and multiple linear regression was used to estimate the factors associated with QoL. RESULTS: The QoL domain with the highest score was death and dying (mean = 70.4), and the lowest score was for sensory functions (mean = 61.0 points). The factors associated with QoL were single marital status (β = -4.55; P = 0.014), level of independence for daily living activities (β = 4.92; P < 0.001), self-assessment of regular health (β = 5.35; P < 0.001), and poor health (β = -8.67; P < 0.001). CONCLUSION: The death and dying domain of QoL presented the highest score. Marital status, impairment in daily activities, and health self-assessment were associated with QoL.

https://doi.org/10.1590/1516-3180.2022.0445.r1.24042023

Awareness of stroke among patients with chronic kidney disease on hemodialysis: a cross-sectional study
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Gomes, Orlando Vieira

; Guimarães, Manoel Pereira

; Barbosa, Bárbara Maria Batista

; Marinho, Christielle Lidianne Alencar

; Nicacio, Jandir Mendonça

; Barreira, Matheus Pereira

; Rodrigues, Mateus de Sousa

; Santana, Leonardo Fernandes e

; Elihimas Júnior, Ubiracé Fernando

; Schwingel, Paulo Adriano

Sao Paulo Medical Journal

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2024, Volume 142 N. 1 elocation e2022644

Abstract: En | Text: En | PDF: En

ABSTRACT BACKGROUND: Stroke is a major cause of mortality worldwide. Renal dysfunction is an important risk factor for stroke. Brazilian studies on stroke knowledge are generally population based. Studies stratifying stroke knowledge according to comorbidities are rare. Scientific data are essential to guide the awareness of stroke. OBJECTIVE: To assess stroke knowledge in patients with chronic kidney disease (CKD) on hemodialysis. DESIGN AND SETTING: Cross-sectional analytical study of patients with CKD on hemodialysis in north-eastern Brazil. METHODS: A self-administered questionnaire survey on stroke awareness was administered to patients with CKD on hemodialysis between April and November 2022. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 197 patients were included in the analysis. The Brazilian acronym for stroke was used by 53.5% of the participants. Less than 10.0% of the sample showed optimal decision-making ability regarding stroke. Of the participants, 29.9% knew at least one risk factor and one symptom; however, this was considered as having below the minimum capacity because they did not know the emergency service call number. In the analysis adjusted for income and education, females (odds ratio [OR], 0.40%; 95% confidence interval [CI], 0.20-0.82), older patients (OR, 0.24%; 95% CI, 0.09-0.63) and having at most one comorbidity (OR, 0.48%; 95% CI, 0.23-0.98) were factors for lower levels of knowledge or ideal decision-making capacity against stroke. CONCLUSIONS: Patients on hemodialysis, especially women and older people, have little knowledge about stroke.

https://doi.org/10.1590/1516-3180.2022.0644.r1.24042023

Profile of patients with essential blepharospasm and hemifacial spasm in the two largest ophthalmology reference centers in Brazil
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Fowler, Flávio A.

; Yabumoto, Cristina

; Osaki, Midori H.

; Gameiro, Gustavo R.

; Brabo, Janaina L.

; Matayoshi, Suzana

; Marinho, Regina C. R. S.

; Osaki, Tammy H.

Arquivos Brasileiros de Oftalmologia

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2024, Volume 87 N. 6 elocation e2022-0160

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

ABSTRACT Purpose: Information is scarce regarding the comprehensive profile of patients with essential blepharospasm and hemifacial spasm in Brazil. The present study aimed to assess the clinical features of patients with these conditions, followed up in two reference centers in Brazil. Methods: The study included patients with essential blepharospasm and hemifacial spasm, followed up at the Departments of Ophthalmology at Universidade Federal de São Paulo and Universidade de São Paulo. Apart from demographic and clinical features, past stressful events related to the first symptoms (triggering event), aggravating factors, sensory tricks, and other ameliorating factors for the eyelid spasms were assessed. Results: A total of 102 patients were included in this study. Most patients were female (67.7%). Essential blepharospasm was the most frequent movement disorder [51/102 patients (50%)], followed by hemifacial spasm (45%) and Meige’s syndrome (5%). In 63.5% of the patients, the onset of the disorder was associated with a past stressful event. Ameliorating factors were reported by 76.5% of patients; 47% of patients reported sensory tricks. In addition, 87% of the patients reported the presence of an aggravating factor for the spasms; stress (51%) was the most frequent. Conclusion: Our study provides information regarding the clinical features of patients treated in the two largest ophthalmology reference centers in Brazil.

RESUMO Objetivo: Há poucos dados sobre o perfil de pacientes com blefaroespasmo essencial e espasmo hemifacial no Brasil. O objetivo deste estudo é avaliar de forma mais abrangente as características clínicas dos pacientes portadores dessas doenças acompanhados em dois centros de referência em oftalmologia no Brasil. Métodos: Pacientes com blefaroespasmo essencial e espasmo hemifacial, acompanhados nos Departamentos de Oftalmologia da Universidade Federal de São Paulo e da Universidade de São Paulo foram incluídos neste estudo. Além dos dados clínicos e demográficos, foram avaliados também a presença de eventos estressantes relacionados ao início dos sintomas (evento desencadeante), fatores agravantes, truques sensoriais, e outros fatores de melhora. Resultados: Cento e dois pacientes foram incluídos no estudo. A maior parte dos pacientes era do sexo feminino (67,7%). Blefaroespasmo essencial foi a condição mais frequente, observada em 51 (50%) dos pacientes. Espasmo hemifacial correspondia a 45% dos casos, enquanto 5% dos pacientes apresentavam a Síndrome de Meige. 63,5% dos pacientes associaram o início dos sintomas com um evento estressante prévio. 76,5% dos pacientes relataram fatores de melhora para os espasmos; 47% relataram truques sensoriais. Além disso, 87% dos pacientes relataram fatores de piora; estresse (51%) foi o mais frequente. Conclusão: Este estudo fornece informações a respeito das características clínicas dos pacientes com blefaroespasmo essencial e espasmo hemifacial acompanhados nos dois maiores centros de referência em oftalmologia do Brasil.

https://doi.org/10.5935/0004-2749.2022-0160

Aplicação da Medication Fall Risk Score em doentes com notificação de incidente de queda: Análise retrospetiva
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Souza, Luciana Marques de

; Ramos, Susana Maria Sardinha Vieira

; Isoppo, Catherine Stragliotto

; Diniz, Ana Marinho

; Ferreira, Catarina Isabel Gomes Mendes

; Sousa, Paulo

Revista de Enfermagem Referência

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dec 2023, Volume serVI N. 2 elocation e22087

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

Abstract Background: Falls in hospital settings are frequent adverse events, with medications contributing significantly. Objective: To analyze inpatient fall notifications and characterize fall risk with a focus on drug therapy by applying the Medication Fall Risk Score. Methodology: An observational, descriptive, and retrospective study was conducted in a Portuguese hospital center. The Medication Fall Risk Score was applied to a sample of 183 patient fall notifications in the first quarter of 2021. Results: The Medication Fall Risk Score identified 60.6% of patients with "yes" for high fall risk. Regarding fall risk assessment recorded in the notifications using another scale, 65.8% of patients were classified as "low risk" or "no risk." Of these, 53.9% were classified as "yes" for high risk using the Medication Fall Risk Score. Conclusion: The Medication Fall Risk Score may help to improve the detection of patients at "high risk" of falling, allowing safer medication practices for fall prevention.

Resumo Enquadramento: As quedas em contexto hospitalar são eventos adversos frequentes, sendo os medicamentos um importante fator contribuinte. Objetivo: Analisar notificações de queda de doentes internados e caracterizar o risco de queda com foco na terapia farmacológica, através da aplicação da Medication Fall Risk Score. Metodologia: Estudo observacional, descritivo e retrospetivo realizado num centro hospitalar português. Aplicada a Medication Fall Risk Score, numa amostra de 183 notificações de queda ocorridas no primeiro trimestre de 2021. Resultados: A Medication Fall Risk Score identificou 60,6% dos doentes com “sim” para o alto risco de queda. Relativamente à avaliação de risco de queda registada nas notificações com recurso a outra escala, identificou-se que 65,8% dos doentes foram classificados como "baixo risco" ou "sem risco". Desses, 53,9% foram classificados com "sim” para o alto risco através da Medication Fall Risk Score. Conclusão: A Medication Fall Risk Score poderá contribuir para melhorar a deteção de doentes com “alto risco” de queda, permitindo uma gestão mais segura dos medicamentos para a prevenção das quedas.

Resumen Marco contextual: Las caídas en los hospitales son eventos adversos frecuentes y la medicación es un factor importante. Objetivo: Analizar las notificaciones de caída de pacientes hospitalizados y caracterizar el riesgo de caída centrándose en el tratamiento farmacológico, mediante la aplicación de la Medication Fall Risk Score. Metodología: Estudio observacional, descriptivo y retrospectivo realizado en un centro hospitalario portugués. Aplicada la Medication Fall Risk Score en una muestra de 183 notificaciones de caída ocurridas en el primer trimestre de 2021. Resultados: La Medication Fall Risk Score identificó al 60,6% de los pacientes con un "sí" para riesgo de caída elevado. En cuanto a la evaluación del riesgo de caída registrada en las notificaciones mediante otra escala, el 65,8% de los pacientes fueron clasificados como de “riesgo bajo" o "sin riesgo". De ellos, el 53,9% se clasificaron con un "sí" para riesgo elevado a través de la Medication Fall Risk Score. Conclusión: La Medication Fall Risk Score podría ayudar a mejorar la detección de pacientes con “riesgo elevado" de caída, lo que permitiría una gestión más segura de los medicamentos para prevenirla.

https://doi.org/10.12707/rvi22087

Route of delivery: what do Portuguese women prefer?
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Soares, Cristiana Marinho

; Sousa, Catarina Paulo de

; Soares, Catarina

; Pinto, Luísa

Acta Obstétrica e Ginecológica Portuguesa

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sep 2023, Volume 17 N. 3 Pages 205 - 212

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

Abstract Introduction: Mode of delivery is known to have a major impact on the health of women and neonates and should therefore be carefully considered. Moreover, expectations built during pregnancy influence the way pregnant women experience labor and delivery. Materials and Methods: Cross-sectional descriptive study conducted between February and August 2021 in a tertiary hospital in Portugal. Pregnant women from the the 30th week of gestation, with no contra-indication for vaginal delivery were included. A two-page multi-choice and short-answer questionnaire was handled, which included questions on sociodemographic characteristics, on delivery preferences and on reasons for those preferences. Results: 303 of the 344 (88,1%) women included wished for a vaginal delivery. The main reason for preferring a vaginal delivery was “it is more natural” (80.2%), followed by “post-partum is easier and recovery is faster”. Regarding women with a preference for cesarean section, most of them believe that it is safer for the baby. The majority (66,7%) of women with a cesarean in the past would prefer a vaginal delivery in the current pregnancy. Discussion: Although safe, a cesarean comprises higher risks for maternal and neonatal health when compared to a vaginal delivery. Globally, most women prefer a vaginal delivery. The way women experience previous labors seems to influence the subsequent pregnancies. Conclusion: Most of the women in our sample preferred a vaginal delivery. However, 11,9% of pregnant women with no indication for a surgery would choose a cesarian section. The fact that many women consider that for the baby the cesarian is the safest mode of delivery should lead the clinicians to reflect and invest in transmitting precise information.

Resumo Introdução: A via de parto tem um impacto importante na saúde materna e neonatal e, por este motivo, deve ser cuidadosamente ponderada. Por outro lado, as expetativas que as mulheres constroem durante a gravidez influenciam a forma como experienciam o parto. Materiais e Métodos: Estudo transversal descritivo conduzido entre fevereiro e agosto de 2021 num hospital terciário em Portugal. Foram incluídas mulheres com 30 ou mais semanas de gestação sem contraindicação para parto vaginal. Foi entregue um questionário de duas páginas incluindo questões sociodemográficas, questões sobre a preferência relativamente à via de parto e sobre as motivações para essa preferência. Resultados: 303 das 344 (88,1%) mulheres incluídas no estudo referiram preferir um parto por via vaginal. A principal razão para esta escolha foi “é mais natural” (80,2%), seguido de “o pós-parto é mais fácil e com recuperação mais rápida”. Relativamente às mulheres que mencionaram preferir uma cesariana, a maioria acredita que esta via de parto “é o mais seguro para o bebé”. A maioria (66,7%) das mulheres com uma cesariana no passado desejaria um parto por via vaginal na gravidez atual. Não encontrámos relação entre os fatores sociodemográficos e a preferência relativamente à via de parto. Discussão: Apesar de seguro, um parto por cesariana tem maior impacto negativo na saúde materna e neonatal quando comparado com um parto vaginal. Globalmente, a maioria das mulheres prefere um parto por via vaginal. A vivência em partos anteriores parece ter uma influência importante na forma como as mulheres experienciam as gestações subsequentes. Conclusão: A maioria das mulheres da nossa amostra referiu preferir um parto vaginal. No entanto, 11,9% das mulheres sem indicação para cirurgia mencionaram preferir uma cesariana. O facto de que muitas mulheres percecionam a cesariana como o mais seguro para o bebé deve levar os clínicos a refletir e a investir na transmissão de informação correta.

Recomendações para a Vacinação contra o Herpes Zoster: Documento de Consenso da Sociedade Portuguesa de Medicina Interna e da Associação Portuguesa de Medicina Geral e Familiar
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Duque, Sofia

; Marinho, António

; Almeida, Paulo

; Pereira, Raul Marques

; Buzaco, Rui

Medicina Interna

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sep 2023, Volume 30 N. 3 Pages 34 - 45

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

Resumo O herpes zoster (HZ), ou zona, é causado pela reativação do vírus varicela zoster latente. Trata-se de uma doença com elevada incidência, associada a grande morbilidade, que pode originar ou agravar uma situação de fragilidade do doente, o que realça a importância da vacinação. Entre os fatores de risco para HZ e nevralgia pós-herpética (NPH), a sua principal complicação, encontram-se a idade, a imunossupressão e a presença de doenças crónicas. A vacinação é uma estratégia eficaz na prevenção do HZ e da NPH. Em Portugal, estão disponíveis duas vacinas contra o HZ: a vacina viva atenuada e a vacina recombinante, a qual apresenta elevada eficácia contra o HZ e suas complicações, especialmente nas populações de maior risco, imunodeprimidas e com imunossenescência que têm contraindicação para a formulação viva atenuada. Contudo, a vacina contra o HZ não consta do Programa Nacional de Vacinação nem existem recomendações nacionais específicas para a imunização. Assim, a Sociedade Portuguesa de Medicina Interna e a As-sociação Portuguesa de Medicina Geral e Familiar elaboraram um documento de consenso que estabelece orientações para a vacinação contra o HZ. Recomenda-se a vacinação contra o HZ em todos os adultos com idade igual ou superior a 50 anos, assim como em adultos com idade entre 18 e 49 anos com risco elevado de zona, nomeadamente doentes com comorbilidades médicas ou imunossupressão. Os adultos imunocompetentes devem ser preferencialmente imunizados com a vacina recombinante, podendo receber a vacina viva atenuada em situações pontuais; os adultos imunocomprometidos só podem ser imunizados com a vacina recombinante. Recomenda-se a vacinação de indivíduos com antecedentes de zona e a imunização com a vacina recombinante de indivíduos previamente vacinados com a vacina viva atenuada. Salienta-se ainda a relevância da promoção da literacia do doente aquando do ato de prescrição da vacina contra o HZ, bem como o papel ativo do médico na sensibilização para a importância da vacinação contra esta patologia.

Abstract Herpes zoster (HZ), or shingles, is caused by the reactivation of the latent varicella zoster virus. It is a high-incidence disease, associated with great morbidity, which might create or worsen a patient’s frailty condition, thus reinforcing the importance of vaccination. Among the risk factors for HZ infection and postherpetic neuralgia (PHN), its major complication, are age, immunosuppression and the presence of chronic conditions. Vaccination is an efficacious strategy to prevent HZ and PHN. In Portugal, there are two available HZ vaccines: the live attenuated vaccine and the recombinant vaccine, which demonstrated a high efficacy against HZ and its complications, particularly in the populations with higher risk, immunosuppressed and with immunosenescence for whom live attenuated vaccine is contraindicated. No-twithstanding, the HZ vaccine is not included in the National Vaccination Program and there are not specific national recommendations for immunization. Hence, the Portuguese Society of Internal Medicine and the Portuguese Association of General and Family Medicine elaborated a consensus re-port establishing guidelines for HZ vaccination. Vaccination against HZ is recommended for all adults aged 50 years and over, as well as for adults aged between 18 and 49 years at high risk for HZ, namely patients with comorbidities or immunosuppression. Immunocompetent adults should be preferentially immunized with the recombinant vaccine, although they might receive the live attenuated vaccine in punctual situations; immunocompromised adults should only be immuni-zed with the recombinant vaccine. The vaccination of individuals with a previous HZ episode is recommended, and individuals with prior immunization with the live attenuated vaccine should receive the recombinant vaccine. Promoting patient’s literacy when prescribing HZ vaccine is highly relevant, and the physician should have an active role in raising awareness about the importance of shingles vaccination.

https://doi.org/10.24950/rspmi.1886

Rastreio da Malnutrição nos Cuidados de Saúde Primários
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Lopes, Paulo André

; Roque, Ana Carolina

; Sacramento, Ana Luísa

; Valentim, Bruno

; Gonçalves, Catarina Vieira

; Lourenço, Cristiane

; Costa, Fábio Leite

; Roque, Joana

; Grácio, João

; Agrela, Pedro

; Lopes, Pedro Tiago

; Marinho, Ricardo Cleto

; Ramos de Sousa, Ricardo

; Viana, Rita

; Ferreira, Vitor Hugo

; Veríssimo, Manuel Teixeira

; Tarantino, Silvia

; Marinho, Aníbal

Medicina Interna

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jun 2023, Volume 30 N. 2 Pages 47 - 55

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

Abstract In the community, malnutrition is manifested by the loss of muscle mass, being associated with a decrease in muscle strength, an increased risk of frailty, functional impairment and impaired healing of chronic wounds, as well as a higher incidence of infections. It is estimated that malnutrition affects one in three elderly people at home and one in three patients in elderly care institutions. Malnutrition is reversible as long as the patient has access to timely nutritional screening that identifies their nutritional risk and as long as an individualized nutritional intervention is instituted. Disease associated malnutrition continues to be perceived as a secondary problem in primary health care, so the implementation of nutritional risk screening, as a routine parameter, is the first step in improving access to nutritional care in the community. In this article, the Malnutrition Universal Screening Tool is proposed for routine nutritional screening in primary care.

Resumo Na comunidade, a malnutrição manifesta-se pela perda de massa muscular, estando associada à diminuição da força muscular, ao aumento do risco de fragilidade, ao comprometimento funcional e da cicatrização de feridas crónicas, assim como a maior incidência de infeções. Estima-se que a malnutrição afete um em cada três idosos no seu domicílio e um em cada três utentes em instituições de cuidados de idosos. A malnutrição é reversível desde que o utente tenha acesso a um atempado rastreio nutricional que identifique o seu risco nutricional e instituída uma intervenção nutricional individualizada. A malnutrição associada à doença continua a ser percecionada como um problema secundário nos cuidados de saúde primários, pelo que a implementação do rastreio do risco nutricional, como um parâmetro de rotina, é o primeiro passo na melhoria do acesso aos cuidados nutricionais na comunidade. Neste artigo, é proposta a ferramenta Malnutrition Universal Screening Tool para rastreio nutricional de rotina nos cuidados de saúde primários.

https://doi.org/10.24950/rspmi.1055

BRAZILIAN SOCIETY OF HEPATOLOGY UPDATED RECOMMENDATIONS FOR SYSTEMIC TREATMENT OF HEPATOCELLULAR CARCINOMA
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CHAGAS, Aline Lopes

; LEAL, Cassia Regina Guedes

; MELLO, Vivianne Barreto de

; BARROS, Fábio Marinho Do Rego

; BITTENCOURT, Paulo Lisboa

; MATTOS, Angelo A

; AROUCHA, Dayse

; FONSECA, Leonardo G da

; SILVA, Joyce Roma Lucas de

; DOTTORI, Mariana Fonseca

; TEIXEIRA, Rosangela

; MENDES, Liliana Sampaio Costa

; REZENDE, Rosamar Eulira Fontes

; FILGUEIRA, Norma Arteiro

; COUTINHO, Anelisa K

; ARAÚJO NETO, João Marcello de

; COELHO, Henrique Sergio Moraes

; PESSOA, Mario Guimarães

; CHEINQUER, Hugo

; PARISE, Edison Roberto

; FRANÇA, Alex

; ÁLVARES-DA-SILVA, Mário Reis

; CARRILHO, Flair José

; CORAL, Gabriela P

; PINTO, Paulo de Tarso Aparecida

; PEREIRA, Leila M M Beltrão

; PARANÁ, Raymundo

; ALVES, Rogério Camargo Pinheiro

; BRANDÃO-MELLO, Carlos Eduardo

Arquivos de Gastroenterologia

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jan 2023, Volume 60 N. 1 Pages 106 - 131

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

ABSTRACT Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related mortality worldwide. The Brazilian Society of Hepatology (SBH) published in 2020 the updated recommendations for the diagnosis and treatment of HCC. Since then, new data have emerged in the literature, including new drugs approved for the systemic treatment of HCC that were not available at the time. The SBH board conducted an online single-topic meeting to discuss and review the recommendations on the systemic treatment of HCC. The invited experts were asked to conduct a systematic review of the literature on each topic related to systemic treatment and to present the summary data and recommendations during the meeting. All panelists gathered together for discussion of the topics and elaboration of the updated recommendations. The present document is the final version of the reviewed manuscript containing the recommendations of SBH and its aim is to assist healthcare professionals, policy-makers, and planners in Brazil and Latin America with systemic treatment decision-making of patients with HCC.

RESUMO O carcinoma hepatocelular (CHC) é uma das principais causas de mortalidade relacionada a câncer no Brasil e no mundo. A Sociedade Brasileira de Hepatologia (SBH) publicou em 2020 a atualização das recomendações da SBH para o diagnóstico e tratamento do CHC. Desde então, novas evidências científicas sobre o tratamento sistêmico do CHC foram relatadas na literatura médica, incluindo novos medicamentos aprovados que não estavam disponíveis na época do último consenso, levando a diretoria da SBH a promover uma reunião monotemática on-line para discutir e rever as recomendações sobre o tratamento sistêmico do CHC. Um grupo de experts foi convidado para realizar uma revisão sistemática da literatura e apresentar uma atualização, baseada em evidências científicas, sobre cada tópico relacionado ao tratamento sistêmico e a apresentar os dados e recomendações resumidas durante a reunião. Todos os painelistas se reuniram para discutir os tópicos e elaborar as recomendações atualizadas. O presente documento é a versão final do manuscrito revisado, contendo as recomendações da SBH, e seu objetivo é auxiliar os profissionais de saúde, formuladores de políticas e planejadores no Brasil e na América Latina na tomada de decisões sobre o tratamento sistêmico de pacientes com CHC.

https://doi.org/10.1590/s0004-2803.202301000-14

Profile of patients with essential blepharospasm and hemifacial spasm in the two largest ophthalmology reference centers in Brazil
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Fowler, Flávio A.

; Yabumoto, Cristina

; Osaki, Midori H.

; Gameiro, Gustavo R.

; Brabo, Janaina L.

; Matayoshi, Suzana

; Marinho, Regina C. R. S.

; Osaki, Tammy H.

Arquivos Brasileiros de Oftalmologia

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2023, N. ahead

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

https://doi.org/10.5935/0004-2749.2022-0160

10.

Finite element analysis of a new intervertebral disc prosthesis developed for the canine cervical spine
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Marinho, Paulo Vinícius Tertuliano

; Macedo, Ana Paula

; Sampaio, Cláudio Pereira de

; Shimano, Antônio Carlos

; Marinho, Carolina Camargo Zani

; Arias, Mônica Vicky Bahr

Ciência Rural

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2023, Volume 53 N. 6 elocation e20210893

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

RESUMO: Espondilomielopatia cervical (EMC) é uma doença que geralmente afeta cães de raças grandes e gigantes. Ela é caracterizada por anormalidades da coluna cervical que podem causar danos à medula espinhal ou às raízes nervosas. Artroplastia cervical com prótese de disco tem sido proposta como opção de tratamento na medicina veterinária. O presente estudo teve como objetivo avaliar os principais estresses em uma nova prótese de disco intervertebral canina e corpos vertebrais por meio da análise de elementos finitos. Foram compostos dois grupos experimentais que representaram o material constituinte da nova prótese: grupos aço inoxidável (SSG) e o liga de titânio (TAG). Tensões equivalente de von-Mises (VMS) e tensão principal mínima (MiPS) média foram avaliadas sob forças de compressão, tração e torção para vértebras e prótese. O grupo SSG teve maior distribuição de VMS para todos parâmetros avaliados, enquanto o grupo TAG teve maior MiPS. Estresses estiveram mais concentrados nas superfícies lateral e ventral dos corpos vertebrais do que nas placas terminais. Os estresses médios da prótese foram mais concentrados na superfície de contato osso/implante do que na interface prótese/parafuso. Estresses máximos foram concentrados na superfície cranial do parafuso. A nova prótese permitiu distribuição uniforme do estresse ao longo do corpo vertebral. Comparando os materiais da prótese, a liga de titânio foi marginalmente superior quanto aos estresses médios em todas as direções, sendo menos provável que sofra afundamento da prótese.

ABSTRACT: Cervical spondylomyelopathy (CSM) is a disease that affects mostly large- and giant-breed dogs. It is characterized by abnormalities of the cervical spine that may cause damage to the spinal cord and nerve roots. Cervical disc arthroplasty has been proposed as a treatment option in veterinary medicine. The current study evaluated the main stresses in a novel canine vertebral disc prosthesis and vertebral bodies using finite element analysis. Two experimental groups were created based on the material used for the prosthesis: stainless steel group (SSG) and titanium alloy group (TAG). Vertebral and prosthetic average equivalents von-Mises stress (VMS) and minimum principal stress (MiPS) were assessed while compressive, tensile, and lateral bending shear loads were applied. The stainless steel group had greater VMS distribution on all the evaluated parameters while the titanium alloy group had greater MiPS. Stresses were more concentrated on the lateral and ventral surfaces of the vertebral bodies than on their endplates. The average prosthetic stresses were more concentrated on the bone/implant contact surface than on the prosthesis/screw interface. Maximum stresses were concentrated in the screws’ cranial surface. The novel prosthesis allows even distribution along the vertebral body. Comparing prosthesis materials, titanium alloy was marginally superior regarding average stresses in all directions and should be less likely to suffer subsidence.

https://doi.org/10.1590/0103-8478cr20210893

11.

Smartphone and application use in self-management of chronic kidney disease: a cross-sectional feasibility study
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Marinho, Christielle Lidianne Alencar

; Gomes, Orlando Vieira

; Silva Junior, Geraldo Bezerra da

; Schwingel, Paulo Adriano

Sao Paulo Medical Journal

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2023, Volume 141 N. 4 elocation e202278

Abstract: En | Text: En | PDF: En

ABSTRACT INTRODUCTION: Smartphone and application use can improve communication and monitoring of chronic diseases, including chronic kidney disease, through self-management and increased adherence to treatment. OBJECTIVE: To assess smartphone use in patients with chronic kidney disease on dialysis and their willingness to use mobile applications as a disease self-management strategy. DESIGN AND SETTING: This was a cross-sectional study of chronic kidney disease patients on hemodialysis in the São Francisco Valley in the Northeast Region, Brazil. METHODS: The questionnaire developed by the authors was administered between April and June 2021. Cronbach's alpha coefficient for the construct was 0.69. Associations between the dependent and independent variables were determined using univariate analysis. Multivariate analysis with logistic regression analysis was also performed. RESULTS: A total of 381 patients were included, of whom 64% had a smartphone, although only 3.1% knew of a kidney disease-related application. However, 59.3% believed that using an application could help them manage their disease. Having a smartphone was associated with treatment adherence, higher educational attainment, and higher per capita income. Educational attainment remained an independent factor in multivariate analysis. CONCLUSION: More than 64% of patients had a smartphone, although few knew of applications developed for kidney disease. More than half of the population believed that technology use could benefit chronic kidney disease treatment. Smartphone ownership was more common among the younger population, with higher educational attainment and income, and was associated with greater adherence to hemodialysis sessions.

https://doi.org/10.1590/1516-3180.2022.0078.r2.09082022

12.

Profile of human anti-rabies care and post-exposure prophylaxis in the state of São Paulo
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Andrade, Bruno Fonseca Martins da Costa

; Queiroz, Luzia Helena

; Marinho, Márcia

Revista da Sociedade Brasileira de Medicina Tropical

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2023, Volume 56 elocation e0473-2022

Abstract: En | Text: En | PDF: En

ABSTRACT Background: Rabies is an anthropozoonosis that greatly impacts public health and is transmitted by infected mammals. Aggression by animals is notifiable and may result in anti-rabies post-exposure prophylaxis (PEP). This study aimed to characterize anti-rabies PEP notifications in São Paulo state, Brazil. Methods: A descriptive study was conducted using data provided by the SINAN between 2013 and 2017. Results: A total of 572,889 aggressions were recorded during the study period, characterized mostly by dogs (83.5%), single wounds (56.9%), superficial wounds (58.6%), and hands/feet (34.6%). Conclusions: Animal observation was the most frequent recommendation, even in cases of attacks from non-domestic animals.

https://doi.org/10.1590/0037-8682-0473-2022

13.

Spatial analysis of the natural infection index for Triatomines and the risk of Chagas disease transmission in Northeastern Brazil
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Medeiros, Carolina de Araújo

; Silva, Maria Beatriz Araújo

; Oliveira, André Luiz Sá de

; Alves, Sílvia Marinho Martins

; Oliveira Júnior, Wilson de

; Medeiros, Zulma Maria de

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e32

Abstract: En | Text: En | PDF: En

ABSTRACT This study aimed to analyze the spatial pattern of natural infection index (NII) for triatomines and the risk of Chagas disease transmission in an endemic area of Northeastern Brazil. An ecological study was conducted, based on 184 municipalities in five mesoregions. The NII for triatomines was evaluated in the Pernambuco State, Brazil, from 2016 to 2018. Spatial autocorrelations were evaluated using Global Moran Index (I) and Local Moran Index (II) and were considered positive when I > 0 and p < 0.05, respectively. In total, 7,302 triatomines belonging to seven different species were detected. Triatoma brasiliensis had the highest frequency (53%; n = 3,844), followed by Triatoma pseudomaculata (25%; n = 1,828) and Panstrongylus lutzi (18.5%; n=1,366). The overall NII was 12%, and the higher NII values were P. lutzi (21%) and Panstrongylus megistus (18%). In the mesoregions of Zona da Mata, Agreste, Sertao, and Sertao do Sao Francisco, 93% of triatomines were detected indoors. The global spatial autocorrelation of I to NII was positive (0.2; p = 0.01), and II values calculated using BoxMap, MoranMap, Lisa Cluster Map were statistically significant for natural infections. With regard to the risk areas for the presence of triatomines, Zone 2 (the Agreste and Sertao regions) presented a relative risk of 3.65 compared to other areas in the state. Our study shows the potential areas of vector transmission of Chagas disease. In this study, the application of different methods of spatial analysis made it possible to locate these areas, which would not have been identified by only applying epidemiological indicators.

https://doi.org/10.1590/s1678-9946202365032

14.

Development of an intervertebral disc prosthesis prototype for the canine cervical spine
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Marinho, Paulo Vinícius Tertuliano

; Macedo, Ana Paula

; Rocha, Thiago André Salvitti de Sá

; Sampaio, Cláudio Pereira de

; Marinho, Carolina Camargo Zani

; Shimano, Antônio Carlos

; Arias, Mônica Vicky Bahr

Ciência Rural

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2023, Volume 53 N. 12 elocation e20220027

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

ABSTRACT: Cervical arthroplasty with disc prosthesis has been proposed as a treatment option for dogs with Cervical Spondylomyelopathy. The present study developed a novel vertebral disc prosthesis for dogs. Sixteen Functional Spinal Units (C5-C6) were collected from dog cadavers with body weights ranging between 25 and 35 kg, and their vertebral measurements were used to design a prosthetic disc. The sizing of the prosthesis was performed based on the averages of the measurements of width, height, and length of the vertebral bodies from C5-C6 of all specimens. The prosthesis was developed using the Rhinoceros 3D® and SolidWorks® programs, and 3D prototyping was carried out to define the best design. The developed prosthesis consisted of two independent parts that are fixed to the cranial and caudal vertebral bodies, in the intervertebral space, and fitted together by metal-to-metal surfaces capable of moving in the lateral, ventral, and dorsal directions. Each part of the prosthesis is angled in two portions: vertically, in the intervertebral space, and horizontally, in contact with the ventral surface of the vertebral bodies, both of which are fixed by means of monocortical locking screws. The design of the developed prototype allowed a good fit in the intervertebral space between C4-C5, C5-C6, and C6-C7.

RESUMO: A artroplastia cervical com prótese de disco tem sido proposta como uma opção de tratamento para cães com Espondilomielopatia Cervical. O presente estudo teve como objetivo desenvolver uma nova prótese de disco intervertebral para cães. Dezesseis Unidades Funcionais de Coluna Vertebral (C5-C6) foram coletadas de cadáveres de cães com peso corporal variando entre 25 e 35 kg, e suas medidas vertebrais foram usadas para projetar um disco intervertebral protético. O dimensionamento da prótese foi realizado com base nas médias das mensurações da largura, altura e comprimento dos corpos vertebrais de C5-C6 de todos os espécimes. A prótese foi desenvolvida nos programas Rhinoceros 3D® e SolidWorks® e utilizou-se prototipagem em 3D para a definição do melhor design. A prótese desenvolvida é formada por duas partes independentes que se fixam às espífises dos corpos vertebrais cranial e caudalmente ao espaço intervertebral, e se encaixam entre si por superfícies de metal-metal com capacidade de movimentação nas direções lateral, ventral e dorsal. Cada parte da prótese é angulada em duas porções: a vertical, que fica no espaço intervertebral, e a horizontal, que fica em contato com a superfície ventral dos corpos vertebrais, ambas as quais são fixadas por meio de parafusos bloqueados monocorticais. O design do protótipo desenvolvido permitiu bom encaixe no espaço intervertebral entre C4-C5, C5-C6 e C6-C7.

https://doi.org/10.1590/0103-8478cr20220027

15.

Geastrum tupiense: a new earthstar fungi species from the Brazilian Atlantic Forest and a new insertion in the Velutina subsection (Geastrales, Basidiomycota)
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Freitas Neto, Julimar Freire

; Sousa, Julieth Oliveira

; Marinho, Paulo

; Martín, Maria Paz

; Baseia, Iuri Goulart

Rodriguésia

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2023, Volume 74 elocation e00482022

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

Abstract Geastrum tupiense is a new species belonging to subsect. Velutina (Sect. Myceliostroma). The fundamental diagnostic characteristics are reddish immature basidiomata and rhizomorphs with bipyramidal crystals. It was found in two areas of the Atlantic Forest biome, considered one of the main hotspots in the world for its high level of endemism and biodiversity. Delimitation of this new species was based on morphological characters and phylogenetic analyses of ITS/LSU nrDNA. Descriptions, phylogenetic tree, photographs, and taxonomic discussion are provided.

Resumo Geastrum tupiense é uma nova espécie pertencente a subsecção Velutina (Sessão Myceliostroma). As características diagnósticas fundamentais são basidioma imaturo avermelhado e rizomorfa com cristais bipiramidais. Foi encontrado em duas áreas do bioma Mata Atlântica, considerado um dos principais hotspots do mundo pelo seu elevado nível de endemismo e biodiversidade. A delimitação desta nova espécie foi baseada em caracteres morfológicos e análises filogenéticas de ITS/LSU nrDNA. São fornecidas descrições, árvores filogenéticas, fotografias, e discussões taxonômicas.

https://doi.org/10.1590/2175-7860202374022

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