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Resumo O sarcoma de Ewing é o tumor ósseo maligno da pelve mais comum em crianças e adultos jovens. Mesmo com tratamento agressivo, sua taxa de sobrevivência está entre as piores. A apresentação clássica pode não ser a regra. Ele pode simular clinicamente, imaginologicamente e histopatologicamente outras entidades não malignas. Portanto, sua suspeita não deve ser negligenciada. Relatamos dois casos de sarcoma pélvico: o primeiro imitando granuloma eosinofílico e o segundo imitando osteomielite. Neste último, também relatamos um achado atípico de sua história natural: uma resposta inicial ao antibiótico e ao tratamento anti-inflamatório. Em ambos os casos, destacamos a possibilidade de uma biópsia óssea percutânea inconclusiva e a importância da imunoquímica e da citogenética para o diagnóstico definitivo. jovens agressivo piores regra clinicamente malignas Portanto negligenciada pélvico osteomielite último natural antiinflamatório. antiinflamatório anti inflamatório. inflamatório anti-inflamatório definitivo

Abstract Ewing sarcoma is the most common malignant bone tumor of the pelvis in children and young adults. Even with aggressive treatment, its survival rate is amongst the poorest. Classical presentation may not be the rule. It may simulate clinically, imagiologically and histopathologically other nonmalignant entities. Therefore, its suspicion should not be overlooked. We report two cases of pelvic Ewing sarcoma: the first mimicking eosinophilic granuloma, and the second mimicking osteomyelitis. In the latter, we also report an atypical finding of its natural history: an initial response to antibiotic and anti-inflammatory treatment. In both cases, we highlight the possibility of an inconclusive percutaneous bone biopsy and the importance of immunochemistry and cytogenetics for the definitive diagnosis. adults treatment poorest rule clinically entities Therefore overlooked granuloma osteomyelitis latter history antiinflammatory anti inflammatory diagnosis

https://doi.org/10.1055/s-0040-1722582

Flash glucose monitoring system in patients with type 1 diabetes in healthcare center in Brazil: real world data from a short-term prospective study
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Matheus, Alessandra S. M.

; Pascoal, Juliana Brazil Fontes

; Cabizuca, Carolina Alves

; Tannus, Lucianne Righeti Monteiro

; Guimarães, Rafael Seno

; Mattos, Diogo Menezes Ferrazani

; Cobas, Roberta Arnoldi

Archives of Endocrinology and Metabolism

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jun 2023, Volume 67 N. 3 Pages 289 - 297

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives: To evaluate the alternate use of flash glucose monitoring (FGM) with self-monitoring blood glucose (SMBG), in patients with type 1 diabetes (T1D). Materials and methods: Two weeks of open FGM (P2), both preceded (P1) and followed by 2 weeks (P3) of SMBG with a blinded FGM system. Mean absolute relative difference (MARD) was calculated by (|FGMi − SMBGi|) / SMBGi, where it was a paired data sample. Results: In total, 34 patients were evaluated. Time in range (TIR) did not change between P1 and P2. In 12 patients (35.3%), TIR increased from 40% at P1 to 52% at P2 (p = 0.002) and in 22 (64.7%), TIR decreased or did not change. FGM use resulted in decreased % time spent in hypoglycemia (<70 mg/dL) (6.5% vs. 5.0%; p = 0.005), increased % time spent in hyperglycemia (>180 mg/dL) (44.5% to 51%; p = 0.046) with no significant change in % TIR. The proportion of patients who reached sensor-estimated glycated hemoglobin (eA1c) < 7% decreased from 23.5% at P1 to 12.9% at P2, p = 0.028. For the whole sample, the MARD between the two methods was 15.5% (95% CI 14.5-16.6%). For normal glucose range, hyperglycemic levels and hypoglycemic levels MARD were 16.0% (95% CI 15.0-17.0%), 13.3% (95% CI 11.5-15.2%) and 23.4% [95% CI 20.5-26.3%)], respectively. Conclusion: FGM after usual SMBG decreased the % time spent in hypoglycemia concomitant with an undesired increase in % time spent in hyperglycemia. Lower accuracy of FGM regarding hypoglycemia levels could result in overcorrection of hypoglycemia.

https://doi.org/10.20945/2359-3997000000540

Validation of Blood Transfusion Risk Scores (TRACK and TRUST) in a Cardiac Surgery Service in Brazil
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Cunha, Cristiano Berardo Carneiro da

; Monteiro, Verônica Soares

; Ferraz, Diogo Luiz de Magalhães

; Tchaick, Rodrigo Mezzalira

; Carvalho Júnior, Jeú Delmondes de

; Silva, Igor Tiago Correia

; Figueira, Fernando Augusto Marinho dos Santos

; Andrade, Lívia Barbosa

Brazilian Journal of Cardiovascular Surgery

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2023, Volume 38 N. 2 Pages 227 - 234

Abstract: En | Text: En | PDF: En

ABSTRACT Introduction: Transfusion of red blood cells is recurrent in cardiac surgery despite the well-established deleterious effects. Identifying patients with higher chances of requiring blood transfusion is essential to apply strategic preventive measures to reduce such chances, considering the restricted availability of this product. The most used risk scores to predict blood transfusion are the Transfusion Risk and Clinical Knowledge (TRACK) and Transfusion Risk Understanding Scoring Tool (TRUST). However, these scores were not validated for the Brazilian population. The objective of this study was to assess the accuracy of TRACK and TRUST scores in estimating the need for postoperative transfusion of red blood cell concentrates (TRBCC) after cardiac surgery. Methods: A clinical retrospective study was conducted using the database of a Brazilian reference service composed of patients operated between November 2019 and September 2021. Scores were compared using Mann-Whitney U test. Hosmer-Lemeshow goodness of fit test assessed calibration of the scores. Accuracy was assessed using the area under the receiver operating characteristic curve (AUC). All analyses considered a level of significance of 5%. The study was approved by the research ethics committee (CAAE 55577421.4.0000.5201). Results: This study assessed 498 patients. Only the TRACK score presented good calibration (P=0.238; TRUST P=0.034). AUC of TRACK was 0.678 (95% confidence interval 0.63 to 0.73; P<0.001), showing a significant accuracy. Conclusion: Between the scores analyzed, only the TRACK score showed a good calibration, but low accuracy, to predict postoperative TRBCC after cardiac surgery.

https://doi.org/10.21470/1678-9741-2022-0156

Extra-articular manifestations of rheumatoid arthritis remain a major challenge: data from a large, multi-centric cohort
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Bonfiglioli, Karina Rossi

; Ribeiro, Ana Cristina de Medeiros

; Carnieletto, Ana Paula

; Pereira, Ivânio

; Domiciano, Diogo Souza

; Silva, Henrique Carriço da

; Pugliesi, Alisson

; Pereira, Leticia Rocha

; Guimarães, Maria Fernanda Resende

; Giorgi, Rina Dalva Neubarth

; Reis, Ana Paula Monteiro Gomides

; Brenol, Claiton Viegas

; Louzada-Júnior, Paulo

; Sauma, Maria de Fátima Lobato da Cunha

; Radominski, Sebastião Cezar

; Mota, Licia Maria Henrique da

; Castelar-Pinheiro, Geraldo da Rocha

Advances in Rheumatology

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2023, Volume 63 elocation 34

Abstract: En | Text: En | PDF: En

Abstract Introduction Although Rheumatoid Arthritis (RA) extra-articular manifestations (ExtRA) occurrence has been decreasing over time, they are still a major mortality risk factor for patients. Objective To determine the prevalence of ExtRA in a large cohort, and its association with demographic and clinical variables. Method Cross-sectional and observational study, based on a multi-centric database from a prospective cohort, in which 11 public rheumatology centres enrolled RA patients (1987 ARA or 2010 ACR-EULAR). Data collection began in 08-2015, using a single online electronic medical record. Continuous variables were compared using Mann–Whit-ney U-test, and Fisher's exact test or chi-square test, as appropriate, were used for categorical variables. The level of significance was set at 5% (p < 0.05). Results 1115 patients were included: 89% women, age [mean ± SD] 58.2 ± 11.5 years, disease duration 14.5 ± 12.2 years, positive Rheumatoid Factor (RF, n = 1108) in 77%, positive anti-cyclic citrullinated peptide (ACPA, n = 477) in 78%. Regarding ExtRA, 334 occurrences were registered in 261 patients, resulting in an overall prevalence of 23.4% in the cohort. The comparison among ExtRA and Non-ExtRA groups shows significant higher age (p < 0.001), disease duration (p < 0.001), RF high titers (p = 0.018), Clinical Disease Activity index (CDAI) (p < 0.001), Disease Activity Index 28 (DAS 28) (p < 0.001), and Health Assessment Questionnaire (HAQ) (p < 0.001) in ExtRA group. Treatment with Azathioprine (p = 0.002), Etanercept (p = 0.049) Glucocorticoids (GC) (‘p = 0.002), and non-steroidal anti-inflammatory drugs (NSAIDs) (p < 0.001) were more frequent in ExtRA group. Conclusions ExtRA manifestations still show an expressive occurrence that should not be underestimated. Our findings reinforce that long-term seropositive disease, associated with significant disability and persistent inflammatory activity are the key factors related to ExtRA development.

https://doi.org/10.1186/s42358-023-00318-y

Assistência farmacêutica prisional paraense: fatores determinantes ao acesso aos medicamentos e ao direito à saúde
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Costa, Anna Paula Alves Monteiro

; Soler, Orenzio

; Queiroz, Luana Melo Diogo de

Ciência & Saúde Coletiva

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dec 2022, Volume 27 N. 12 Pages 4579 - 4588

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

Resumo O acesso integral à saúde é um problema global. Estima-se, que um terço da população não tenha acesso regular aos medicamentos essenciais. A Pessoa Privada de Liberdade (PPL) é uma das que apresenta situações de iniquidades de acesso. Diante da singularidade do sistema penitenciário, esta pesquisa objetivou identificar os fatores determinantes no acesso aos medicamentos disponibilizados pelo Sistema Único de Saúde (SUS) para a PPL paraense. Trata-se de uma pesquisa aplicada, exploratória, qualitativa, realizada no período de agosto de 2019 a fevereiro de 2020, utilizando-se, também do framework APOTECA. Evidenciou-se na análise do framework APOTECA que fatores técnicos, políticos e administrativos são identificados como principais barreiras na garantia ao acesso equânime aos medicamentos disponibilizados pelo SUS para a PPL paraense. A privação de liberdade, vulnerabilidade social e outros fatores inerentes a realidade carcerária dificultam a efetivação do direito à saúde das PPL, sendo que diversos desafios devem ser superados quanto a garantia ao acesso equânime aos medicamentos.

Abstract Comprehensive access to health is a global issue. One-third of the population does not have regular access to essential medicines. People Deprived of Liberty (PDL) are one of those people in a situation of unequal access. Given the uniqueness of the penitentiary system, this research aimed to identify the determining factors in the access to medicines made available by the Brazilian Unified Health System (SUS) for the PDLs in Pará, Brazil. The applied, exploratory, qualitative research was conducted from August 2019 to February 2020 using the APOTECA framework. The APOTECA framework analysis revealed that technical, political, and administrative factors are the main hurdles to guaranteeing equal access to medicines made available by the SUS for the PDLs in Pará. The deprivation of liberty, social vulnerability, and other factors inherent to the prison reality hinder the implementation of PDLs’ right to health, and several challenges must be overcome to secure equal access to medicines.

https://doi.org/10.1590/1413-812320222712.10742022

Outcomes of varicose vein surgery in patients with HIV/AIDS - a nested case-control study
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Pereira-Neves, António

; Domingues-Monteiro, Diogo

; Nóbrega, Leandro

; Duarte-Gamas, Luís

; Cerqueira, Alfredo

; Rocha-Neves, João

; Oliveira-Pinto, José

; Mansilha, Armando

Angiologia e Cirurgia Vascular

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dec 2022, Volume 18 N. 4 Pages 215 - 218

Abstract: En | Text: En | PDF: En

Abstract Introduction: Currently, people living with HIV/ AIDS (PLWHA) attain a life expectancy similar to a non-HIV population. However, these patients experience a status of chronic inflammation, which is a known cause of arteriopathy. Yet, literature is scarce regarding the potential venous inflammatory effect, especially after varicose vein surgery. The aim of this study was to perform a descriptive analysis alongside evaluating short and long-term outcomes after varicose vein surgery in PLWHA while comparing with a control group. Methods: A retrospective nested case-control study was performed resorting to codification. All PLWHA patients which had any hospital interaction with the Vascular Surgery Department (either outpatient clinic, emergency or surgery) due to venous disease between April 2006 and December 2019 were identified. PLWHA found to have undergone varicose vein surgery within the study inclusion period were included. The immediately consecutive varicose vein surgery in a patient with no-HIV infection was included in the control group in a 1:1 ratio. Comorbidities were collected at the time of index event. Results: The cohort included 118 patients (59 PLWHA and 59 control) and had a mean follow-up of 86 [Interquartile range (IQR) 25-75%, 43-111] months. At baseline, PLWHA were younger (45.2 ± 10.71 vs 49.9 ± 10.69 years, p=0.017) and had a male predominance (54% vs 27%, p=0.003). Furthermore, there were a higher prevalence of smokers (54% vs 17%, p<0.001) and history of drug abuse (34% vs 2%, p<0.001) in the study group. Although not statistically significant, PLWHA presented higher pre-operative CEAP classifications. Regarding post-operative outcomes, no differences were found for complications, reinterventions or overall-mortality. Conclusion: To the authors knowledge, this is the first study addressing varicose vein treatment in PLWHA. In summary, PLWHA undergoing varicose vein surgery seem to be younger and have higher CEAP classifications. Nonetheless, short and long-term outcomes seem to be good and similar to a control population. Further studies with larger populations and disease specific outcomes are necessary to confirm such findings.

https://doi.org/10.48750/acv.492

O que mudou entre os períodos de pico e de platô durante a primeira onda do SARS-CoV-2? Estudo multicêntrico português em unidades de cuidados intensivos
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Pereira, Rui Antunes

; Sousa, Marta

; Cidade, José Pedro

; Melo, Luís

; Lopes, Diogo

; Ventura, Sara

; Aragão, Irene

; Lima Neto, Raul Miguel de Freitas

; Molinos, Elena

; Marques, Ana

; Cardoso, Nelson

; Marino, Flávio

; Monteiro, Filipa Brás

; Oliveira, Ana Pinho

; Silva, Rogério C

; Real, André Miguel Neto

; Banheiro, Bruno Sarmento

; Reis, Renato

; Adão-Serrano, Maria

; Cracium, Ana

; Valadas, Ana

; Ribeiro, João Miguel

; Póvoa, Pedro

; Tapadinhas, Camila

; Mendes, Vítor

; Coelho, Luís

; Maia, Raquel

; Freitas, Paulo Telles

; Ferreira, Isabel Amorim

; Ramires, Tiago

; Val-Flores, Luís Silva

; Cascão, Mariana

; Alves, Rita

; Rodeia, Simão C

; Barrigoto, Cleide

; Cardiga, Rosa

; Silva, Maria João Ferreira da

; Vale, Bruno

; Fonseca, Tatiana

; Rios, Ana Lúcia

; Camões, João

; Pérez, Danay

; Cabral, Susana

; Ribeiro, Maria Inês

; Mendes, João João

; Gouveia, João

; Fernandes, Susana Mendes

Revista Brasileira de Terapia Intensiva

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dec 2022, Volume 34 N. 4 Pages 433 - 442

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

ABSTRACT Objective: To analyze and compare COVID-19 patient characteristics, clinical management and outcomes between the peak and plateau periods of the first pandemic wave in Portugal. Methods: This was a multicentric ambispective cohort study including consecutive severe COVID-19 patients between March and August 2020 from 16 Portuguese intensive care units. The peak and plateau periods, respectively, weeks 10 - 16 and 17 - 34, were defined. Results: Five hundred forty-one adult patients with a median age of 65 [57 - 74] years, mostly male (71.2%), were included. There were no significant differences in median age (p = 0.3), Simplified Acute Physiology Score II (40 versus 39; p = 0.8), partial arterial oxygen pressure/fraction of inspired oxygen ratio (139 versus 136; p = 0.6), antibiotic therapy (57% versus 64%; p = 0.2) at admission, or 28-day mortality (24.4% versus 22.8%; p = 0.7) between the peak and plateau periods. During the peak period, patients had fewer comorbidities (1 [0 - 3] versus 2 [0 - 5]; p = 0.002) and presented a higher use of vasopressors (47% versus 36%; p < 0.001) and invasive mechanical ventilation (58.1 versus 49.2%; p < 0.001) at admission, prone positioning (45% versus 36%; p = 0.04), and hydroxychloroquine (59% versus 10%; p < 0.001) and lopinavir/ritonavir (41% versus 10%; p < 0.001) prescriptions. However, a greater use of high-flow nasal cannulas (5% versus 16%, p < 0.001) on admission, remdesivir (0.3% versus 15%; p < 0.001) and corticosteroid (29% versus 52%, p < 0.001) therapy, and a shorter ICU length of stay (12 days versus 8, p < 0.001) were observed during the plateau. Conclusion: There were significant changes in patient comorbidities, intensive care unit therapies and length of stay between the peak and plateau periods of the first COVID-19 wave.

RESUMO Objetivo: Analisar e comparar as características de pacientes críticos com a COVID-19, a abordagem clínica e os resultados entre os períodos de pico e de platô na primeira onda pandêmica em Portugal. Métodos: Este foi um estudo de coorte multicêntrico ambispectivo, que incluiu pacientes consecutivos com a forma grave da COVID-19 entre março e agosto de 2020 de 16 unidades de terapia intensiva portuguesas. Definiram-se as semanas 10 - 16 e 17 - 34 como os períodos de pico e platô. Resultados: Incluíram-se 541 pacientes adultos com mediana de idade de 65 [57 - 74] anos, a maioria do sexo masculino (71,2%). Não houve diferenças significativas na mediana de idade (p = 0,3), no Simplified Acute Physiology Score II (40 versus 39; p = 0,8), na pressão parcial de oxigênio/fração inspirada de oxigênio (139 versus 136; p = 0,6), na terapia com antibióticos na admissão (57% versus 64%; p = 0,2) ou na mortalidade aos 28 dias (24,4% versus 22,8%; p = 0,7) entre o período de pico e platô. Durante o período de pico, os pacientes tiveram menos comorbidades (1 [0 - 3] versus 2 [0 - 5]; p = 0,002); fizeram mais uso de vasopressores (47% versus 36%; p < 0,001) e ventilação mecânica invasiva na admissão (58,1% versus 49,2%; p < 0,001), e tiveram mais prescrição de hidroxicloroquina (59% versus 10%; p < 0,001), lopinavir/ritonavir (41% versus 10%; p < 0,001) e posição prona (45% versus 36%; p = 0,04). Entretanto, durante o platô, observou-se maior uso de cânulas nasais de alto fluxo (5% versus 16%; p < 0,001) na admissão, remdesivir (0,3% versus 15%; p < 0,001) e corticosteroides (29% versus 52%; p < 0,001), além de menor tempo de internação na unidade de terapia intensiva (12 versus 8 dias; p < 0,001). Conclusão: Houve mudanças significativas nas comorbidades dos pacientes, nos tratamentos da unidade de terapia intensiva e no tempo de internação entre os períodos de pico e platô na primeira onda da COVID-19.

https://doi.org/10.5935/0103-507x.20210037-pt

Recomendações para a avaliação e prescrição de treino da força em indivíduos com dificuldade intelectual e desenvolvimental: revisão narrativa
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Jacinto, Miguel Ângelo

; Monteiro, Diogo

; Oliveira, Rafael

; Brito, João

; Vitorino, Anabela

Motricidade

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jun 2022, Volume 18 N. 1 Pages 73 - 84

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

ABSTRACT There are several benefits through the realization of physical exercise programs (EP) in individuals with Intellectual and Developmental Difficulties (DID), however, the literature presents a shortage in the implementation and a small number of studies with very different methodologies and types of training. Short-term interventions, a reduced number of longitudinal studies, methodological gaps and inappropriate training methods, hinder more explicit and consensual conclusions regarding the prescription and its results. However, EP programs, in particular strength training (ST), which has been associated with a reduced risk of cardiovascular and metabolic diseases, can be an asset for the individual with DID, given the prevalence of several comorbidities, namely hypertension, cholesterol and type II diabetes. The present study aims to identify the fundamental and structuring aspects for the prescription of ST, namely the assessment methods, intensity, duration, frequency, appropriate exercises and their relationship with the results, through the methodology using the narrative review, starting from the characterization of various ST programs implemented in individuals with DID. The results are presented in the form of recommendations for the evaluation and prescription of ST programs, in the population with DID.

RESUMO Existem diversos benefícios através da realização de programas de exercício físico (EF) em indivíduos com Dificuldade Intelectual e Desenvolvimental (DID), no entanto a literatura apresenta uma escassez na implementação e um reduzido número de estudos com metodologias e tipos de treino muito diversos. Intervenções de curto prazo, número reduzido de estudos longitudinais, lacunas metodológicas e métodos de treino inapropriados, dificultam conclusões mais explícitas e consensuais ao nível da prescrição e dos seus resultados. Contudo, os programas de EF, em particular, o treino da força (TF) que tem sido associado à diminuição do risco de aparecimento de doenças cardiovasculares e metabólicas, pode ser uma mais-valia para o indivíduo com DID, atendendo à prevalência de diversas comorbilidades, nomeadamente hipertensão, colesterol e diabetes tipo II. O presente estudo tem por objetivo identificar os aspetos fundamentais e estruturantes para a prescrição de TF, nomeadamente os métodos de avaliação, intensidade, duração, frequência, exercícios adequados e a sua relação com os resultados, através da metodologia com recurso à revisão narrativa, partindo da caracterização de vários programas de TF implementados em indivíduos com DID. Os resultados são apresentados sob a forma de recomendações para a avaliação e prescrição de programas de TF, na população com DID.

https://doi.org/10.6063/motricidade.22470

Parsonage-Turner Syndrome Revisited: Four Case Reports and Literature Review
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Monteiro, Sara

; Gomes, Diogo Silva

; Moura, Nuno

; Sarmento, Marco

; Cartucho, António

Gazeta Médica

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mar 2022, Volume 9 N. 1 Pages 60 - 66

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

Resumo Introdução: A síndrome de Parsonage-Turner é uma patologia pouco frequente, caracterizada por omalgia intensa de início súbito e parésia da cintura escapular, que é frequentemente subdiagnosticada. O objetivo deste trabalho é revisitar o tema expondo quatro casos clínicos ilustrativos e uma revisão teórica sumária. Casos Clínicos: Foram avaliados os resultados funcionais e satisfação de quatro doentes (idades compreendidas entre 56 e 84 anos) com o diagnóstico de síndrome de Parsonage-Turner, tratados conservadoramente com analgesia e fisioterapia. Apesar da apresentação típica, o diagnóstico foi tardio em todos os casos. Apenas um doente apontou um fator desencadeante: uma infeção viral precedente. A dor resolveu ao fim de 3-8 dias, persistindo apenas o défice motor no membro superior. Todos os doentes recuperaram, total ou parcialmente, no momento da avaliação final. A reabilitação prolongou-se entre 6-15 meses e foi monitorizada pela clínica e eletromiografia. Todos os doentes estavam satisfeitos à data do último follow-up. Conclusão: A síndrome de Parsonage-Turner tem uma incidência superior à previamente conhecida e é frequentemente subdiagnosticada. Deve ser considerada no diagnóstico diferencial de omalgia, especialmente quando acompanhada de défice motor. Apesar de ser uma doença autolimitada, a recuperação é demorada, pelo que um diagnóstico atempado é essencial para tranquilizar o doente e iniciar o tratamento de suporte adequado.

Abstract Introduction: Parsonage-Turner syndrome is a rare disease characterized by acute and severe shoulder pain followed by upper extremity paralysis, that is severely underdiagnosed in clinical practice. The objective is to describe four illustrative clinical cases and provide a summary review of the topic. Case Reports: Four patients (aged 56 to 84 years-old) diagnosed with Parsonage-Turner syndrome were followed up for functional recovery and patient satisfaction after conservative treatment. Despite presenting with typical sudden-onset pain in the shoulder region, followed by weakness in the shoulder/arm, all patients had delayed diagnosis. Only one patient reported a preceding viral infection, which is the most common trigger. Pain subsided after 3-8 days, but shoulder/arm weakness persisted. All patients recovered, totally or partially, with pain management and physical therapy. Recovery took 6-15 months and was monitored through clinical evaluation and electromyography. At last follow-up, all patients were satisfied. Conclusion: Parsonage-Turner syndrome has a higher incidence than previously assumed and is frequently underdiagnosed. It must be considered in the differential diagnosis of the painful shoulder, especially if muscle weakness is present. Despite being a self-limited condition, recovery is usually slow, and a prompt diagnosis is key for patient’s reassurance and starting adequate supportive treatment.

https://doi.org/10.29315/gm.v1i1.503 6 downloads

10.

The effect of contralateral carotid occlusion in patients undergoing carotid artery endarterectomy
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Duarte-Gamas, Luís

; Pereira-Neves, António

; Jácome, Filipa

; Domingues-Monteiro, Diogo

; Rocha-Neves, João P.

Angiologia e Cirurgia Vascular

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mar 2022, Volume 18 N. 1 Pages 30 - 35

Abstract: En | Text: En | PDF: En

Abstract Introduction: Contralateral carotid occlusion (CCO) is considered a high-risk condition for patients undergoing carotid artery endarterectomy (CEA). Patients with a CCO may be intolerant to carotid cross-clamping during CEA, thus prone to postoperative adverse neurological outcomes. Patients with CCO may also have a higher burden of atherosclerotic disease, leading to a higher rate of cardiovascular events. Methods: A Medline search was performed in order to identify publications focused on the impact of CCO on outcomes after CEA. Results: Patients with CCO present a higher incidence of intolerance to carotid cross-clamping. The rates of shunt use are higher in patients with CCO. In the postoperative period, patients with CCO show a higher rate of stroke. Evidence regarding the effect of CCO on long-term outcomes remains controversial, with most studies reporting a lack of association between CCO and adverse long-term outcomes after CEA. Conclusion: Patients with CCO have an increased risk of postoperative adverse outcomes. The best strategy for this group of patients should be based on a case-by-case approach.

https://doi.org/10.48750/acv.419 20 downloads

11.

In vitro and in silico evaluation of the schistosomicidal activity of eugenol derivatives using biochemical, molecular, and morphological tools
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Souza, Isabella Maria Monteiro de

; Novaes, Romulo Dias

; Gonçalves, Reggiani Vilela

; Fialho, Felipe Leonardo Bley

; Carvalho, Diogo Teixeira

; Souza, Thiago Belarmino de

; Dias, Danielle Ferreira

; Lavorato, Stefânia Neiva

; Souza, Raquel Lopes Martins

; Marques, Marcos José

; Castro, Aline Pereira

Journal of Venomous Animals and Toxins including Tropical Diseases

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2022, Volume 28 elocation e20210108

Abstract: En | Text: En | PDF: En

Abstract Background Eugenol shows both antibacterial and antiparasitic activities, suggesting that it might be evaluated as an option for the treatment of praziquantel-resistant schistosome. Methods The in vitro activities of three eugenol derivatives (FB1, FB4 and FB9) on adult worms from Schistosoma mansoni were examined by fluorescence and scanning electron microscopy to analyze effects on the excretory system and integument damage, respectively. Biochemical tests with verapamil (a calcium channel antagonist) and ouabain (a Na+/K+-ATPase pump inhibitor) were used to characterize eugenol derivative interactions with calcium channels and the Na+/K+-ATPase, while in silico analysis identified potential Na+/K+-ATPase binding sites. Results The compounds showed effective doses (ED50) of 0.324 mM (FB1), 0.167 mM (FB4), and 0.340 mM (FB9). In addition, FB4 (0.322 mM), which showed the lowest ED50, ED90 and ED100 (p < 0.05), caused the most damage to the excretory system and integument, according to both fluorescence and scanning electron microscopy analysis. The death of adult worms was delayed by ouabain treatment plus FB1 (192 versus 72 hours) and FB9 (192 versus 168 hours), but the response to FB4 was the same in the presence or absence of ouabain. Besides, no changes were noted when all of the eugenol derivatives were combined with verapamil. Moreover, FB1 and FB9 inhibited Na+/K+-ATPase activity according to in silico analysis but FB4 did not show a time-dependent relationship and may act on targets other than the parasite Na+/K+-ATPase. Conclusion Eugenol derivatives, mainly FB4 when compared to FB1 and FB9, seem to act more effectively on the integument of adult S. mansoni worms.

https://doi.org/10.1590/1678-9199-jvatitd-2021-0108

12.

A Reprodução Social como perspectiva metodológica para análise contextualizada das condições de vida e de saúde
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Medeiros, Marcílio Sandro de

; Augusto, Lia Giraldo da Silva

; Costa, André Monteiro

; Barca, Stefania

; Santos, Solange Laurentino dos

; Gonçalves, Isabela Cristina de Miranda

; Martinez-Espinosa, Flor Ernestina

; Rocha, Diogo Ferreira da

Cadernos de Saúde Pública

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2022, Volume 38 N. 10 elocation e00150320

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

Este artigo objetiva discutir o uso da categoria Reprodução Social, proposta por Juan Samaja, na análise sobre condições de vida e de saúde em um contexto de uma unidade de conservação ambiental da Amazônia brasileira. Trata-se de um estudo de abordagem compreensiva sobre os processos da reprodução social que integram a rede de determinação hierarquicamente organizada por meio da análise de interações sociais dos acontecimentos narrados e observáveis, aplicados a matriz de dados. A Reprodução Ecológica da vida na floresta dos ribeirinhos é expressa negativamente na vida biocomunal, pois as estratégias de ação propiciadas pelas Reproduções Política, Econômica e Cultural, ou seja, as ações da política ambiental, não valorizam o modo de vida local. O deficitário acesso aos bens e serviços sociais, incluindo a atenção à saúde, provenientes das Reproduções Política e Tecnoeconômica, repercutem na base material da Reprodução Biocomunal, cujo desfecho são elevadas frequências de queixas de doença e de acidentes de trabalho, como gastroenterites infecciosas, malária, tuberculose, hanseníase e intoxicação por animais peçonhentos. Garantir o acesso aos bens e serviços sociais, em especial à saúde, são imprescindíveis para uma maior resiliência às adversidades da floresta. Conclui-se, então, que a matriz de dados da Reprodução Social possibilitou compreender os processos da reprodução social que integram a rede de determinação hierarquicamente organizada, cujas interações modelaram as condições de vida e de saúde dos ribeirinhos.

This article aims to discuss the use of Social Reproduction, proposed by Juan Samaja, in the analysis of living and health conditions in a context of an sustanaible development reserve in the Brazilian Amazon. This study uses a comprehensive approach to Social Reproduction processes that comprise the network of hierarchically organized structures using the analysis of social interactions of narrated and observable events, applied to the data matrix. The Ecological Reproduction of life in the riverside forest is negatively expressed in bio-communal life, as the strategic actions provided by the Political, Economic and Cultural Reproductions, that is, the environmental policy actions, do not value the local way of life. The deficient access to social goods and services, including health care, from the Political and Techno-Economic Reproductions, has an impact on the material basis of the Bio-Communal Reproduction, whose outcome is high frequency of disease complaints and workplace accidents, such as infectious gastroenteritis, malaria, tuberculosis, leprosy, and poisoning by venomous animals. Ensuring access to social goods and services, in particular health care, is essential for improving resilience to the forest adversities. In conclusion, the social reproduction data matrix helped understand the processes of Social Reproduction that are part of the hierarchically organized structures, whose interactions shaped the living and health conditions of the riverside population analyzed in this study.

Este artículo tiene como objetivo discutir el uso de la categoría Reproducción Social, propuesta por Juan Samaja, en el análisis sobre condiciones de vida y de salud en un contexto de una unidad de conservación ambiental de la Amazonía brasileña. Se trata de un estudio de enfoque integral sobre los procesos de la reproducción social que integran la red de determinación jerárquicamente organizada por medio del análisis de interacciones sociales de los acontecimientos narrados y observables, aplicados a la matriz de datos. La Reproducción Ecológica de la vida en los bosques ribereños es expresada negativamente en la vida biocomunal, pues las estrategias de acción propiciadas por las Reproducciones Política, Económica y Cultural, es decir, las acciones de la política ambiental, no valoran el modo de vida local. El deficiente acceso a los bienes y servicios sociales, incluida la atención a la salud, procedentes de las Reproducciones Política y Tecnoeconómica, repercuten en la base material de la Reproducción Biocomunal, cuyo desenlace son elevadas frecuencias de quejas de enfermedad y de accidentes de trabajo, como gastroenteritis infecciosas, malaria, tuberculosis, lepra e intoxicación por animales venenosos. Garantizar el acceso a los bienes y servicios sociales, especialmente la atención a la salud, es esencial para una mayor resistencia a las adversidades del bosque. Se concluye, entonces, que la matriz de datos de la Reproducción Social permitió comprender los procesos de la reproducción social que integran la red de determinación jerárquicamente organizada, cuyas interacciones modelaron las condiciones de vida y salud de los ribereños.

https://doi.org/10.1590/0102-311xpt150320

13.

A Reprodução Social como perspectiva metodológica para análise contextualizada das condições de vida e de saúde
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Medeiros, Marcílio Sandro de

; Augusto, Lia Giraldo da Silva

; Costa, André Monteiro

; Barca, Stefania

; Santos, Solange Laurentino dos

; Gonçalves, Isabela Cristina de Miranda

; Martinez-Espinosa, Flor Ernestina

; Rocha, Diogo Ferreira da

Cadernos de Saúde Pública

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2022, Volume 38 N. 10 elocation e00150320

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

https://doi.org/10.1590/0102-311xpt150320

14.

Validation of Blood Transfusion Risk Scores (TRACK and TRUST) in a Cardiac Surgery Service in Brazil
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Cunha, Cristiano Berardo Carneiro da

; Monteiro, Verônica Soares

; Ferraz, Diogo Luiz de Magalhães

; Tchaick, Rodrigo Mezzalira

; Carvalho Júnior, Jeú Delmondes de

; Silva, Igor Tiago Correia

; Figueira, Fernando Augusto Marinho dos Santos

; Andrade, Lívia Barbosa

Brazilian Journal of Cardiovascular Surgery

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2022, N. ahead

Abstract: En | Text: En | PDF: En

https://doi.org/10.21470/1678-9741-2022-0156

15.

Assistência farmacêutica prisional paraense: fatores determinantes ao acesso aos medicamentos e ao direito à saúde
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Costa, Anna Paula Alves Monteiro

; Soler, Orenzio

; Queiroz, Luana Melo Diogo de

Ciência & Saúde Coletiva

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2022, Volume 27 N. 12 Pages 4579 - 4588

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

https://doi.org/10.1590/1413-812320222712.10742022

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