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Avaliação de indicadores sociais e de saúde em municípios de Minas Gerais conforme tipologia rural-urbano
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Pereira, João Alves

; Damasceno, Renata Fiúza

; Vieira, Marta Raquel Mendes

; Paula, Alfredo Maurício Batista de

; Pinto, Rafaela da Silveira

; Leal, Daniele Lopes

; Haikal, Desirée Sant’Ana

Saúde em Debate

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2024, Volume 48 N. 140 elocation e8449

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

ABSTRACT This article aims to evaluate social and health indicators of municipalities according to the rural-urban typology. This is an ecological study that used official publicly accessible data from the 853 municipalities in the state of Minas Gerais, Brazil. Descriptive and bivariate analysis were carried out using Poisson Regression and Kruskal-Wallis Test. 547 (64.12%) are rural municipalities. The highest average of the Municipal Human Development Index (MHDI) was observed among urban municipalities. The highest average coverage of the Family Health Strategy (FHS) was found among rural municipalities. In these municipalities, the best results were shown for the indicators of infant mortality, premature mortality and mortality from preventable causes, vaccine homogeneity and prevalence of malnutrition. The findings of this study show that greater FHS coverage is associated with the occurrence of better general living and health conditions in the populations served in rural municipalities. It is recommended that health managers encourage the consolidation of the FHS in communities with unfavorable socioeconomic and cultural contexts, such as remote rural locations and urban agglomerations, and the establishment of intersectoral actions with a positive impact on health.

RESUMO O presente artigo tem o objetivo de avaliar indicadores sociais e de saúde de municípios conforme a tipologia rural-urbano. Trata-se de estudo ecológico que utilizou dados oficiais de acesso público dos 853 municípios do estado de Minas Gerais, Brasil. Foram conduzidas análises descritivas e bivariadas através da Regressão de Poisson e Teste de Kruskal-Wallis. Do total de municípios, 547 (64,12%) são rurais. A maior média do Índice de Desenvolvimento Humano Municipal (IDH-M) foi observada entre os municípios urbanos. A maior média de cobertura da Estratégia Saúde da Família (ESF) foi verificada entre os municípios rurais, nos quais também foram demonstrados os melhores resultados para os indicadores de mortalidades infantil, prematura e por causas evitáveis, homogeneidade vacinal e prevalência de desnutrição. Os achados deste estudo evidenciam que uma maior cobertura da ESF está associada à ocorrência de melhores condições gerais de vida e de saúde das populações atendidas em municípios de tipologia rural. Recomenda-se aos gestores de saúde o fomento à consolidação da ESF em comunidades com contextos socioeconômicos e culturais desfavoráveis, como localidades rurais remotas e aglomerados urbanos, e o estabelecimento de ações intersetoriais com impacto positivo na saúde.

https://doi.org/10.1590/2358-289820241408449p

[SciELO Preprints] - Study of Health in Pomerode (SHIP-Brazil): aims, methodological issues and descriptive results
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Santa Helena, Ernani Tiaraju de Sousa, Clóvis Arlindo de Silveira, João Luiz Gurgel Calvet da Nunes, Carlos Roberto de Oliveira Azevedo, Luciane Coutinho de Nilson, Luana Gabriele Valente, Caroline Prado, Rosana Leal do Cordova, Caio Mauricio Mendes de Batista, Keila Zaniboni Siqueira Botelho, Tatiani Karini Rensi Cunha, Angela Duebbers Starke, Siegmar Zimmermann, Sergio Luiz Damasceno, Nágila Raquel Teixeira Santos, Raul Dias Ittermann, Till Völzke, Henry Markus, Marcello Ricardo Paulista

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Publication date: 2023-11-22

Abstract: En Pt

Background Few studies compared populations with similar genetic and culture background on different continents with standardized methods. Objective To describe methodological issues of the Study of Health in Pomerode - SHIP-Brazil and some characteristics of the participants of the baseline examination. Design and Setting Prospective, population-based cohort study of a representative sample of residents (aged 20 to 79 years) of Pomerode, Santa Catarina, Brazil. Methods Data for the baseline survey (from 2014 to 2018) were collected through interviews and medical examinations, including socio-demographic and lifestyle information, clinical and subclinical conditions, oral and mental health, among others. Biosamples (blood, urine, stool, and saliva) were collected and stored. Methods of data collection and quality control are described. Preliminary descriptive statistics were performed. Results The response rate was 67.6% (n=2,488 individuals). The Kappa test-retest of some variables varied from 0.54 to 1.0. German culture participants are older (46.5 vs 38.7 years), self-declared white (97.3% vs 82.1%), more frequently never smokers (71.4% vs 66.9%) but had higher risk of consuming alcohol (16.9% vs 13.4%) compared to participants with non-German background. Germans were taller (169 cm vs 166 cm), had greater abdominal circumference among men (101.9 cm vs 97.3 cm). Furthermore, they reported more multimorbidity (56.7% vs 43.6%) , had more arterial hypertension (30.7% vs 18.5%), but less depression (15.4% vs 19,1%) than non-Germans. Conclusions The interaction of genetic and social/environmental issues should be examined to understand the role of risk factors on clinical conditions observed.

Introdução Poucos estudos compararam populações com histórico genético e cultural semelhante em diferentes continentes com métodos padronizados. Objetivos Descrever questões metodológicas do estudo de “Vida e Saúde em Pomerode - SHIP-Brazil” e algumas características dos participantes do exame inicial do estudo. Desenho de estudo e local Estudo de coorte prospectivo de base populacional em amostra representativa de moradores (20 a 79 anos) de Pomerode, Santa Catarina. Métodos As informações para a linha de base (de 2014 a 2018) foram coletadas por meio de entrevistas e exames médicos, incluindo dados sociodemográficos, de estilo de vida, condições clínicas e subclínicas, saúde bucal e mental, entre outros. Amostras biológicas (sangue, urina, fezes e saliva) foram coletadas e armazenadas. A coleta de dados e o controle de qualidade foram descritos. Foram realizadas análises descritivas preliminares. Resultados A taxa de resposta foi de 67,6% (n=2.488 indivíduos). O Kappa teste-reteste de algumas variáveis variou  de 0,54 a 1,0. Os participantes de cultura alemã são mais velhos (46,5 vs 38,7 anos ), autodeclarados brancos (97,3% vs 82,1%), com menor número de fumantes (71,4% vs 66,9%), mas tiveram maior risco de consumir álcool (16,9% vs 13,4%), eram mais altos (169 cm vs 166 cm), tinham maior circunferência abdominal entre os homens (101,9 cm vs 97,3 cm) em comparação com participantes “não-alemães”. Pessoas de cultura alemã relataram mais multimorbidade (56,7% vs 43,6%), apresentavam mais hipertensão arterial (30,7% vs 18,5%), mas menos depressão (15,4% vs 19,1%). Conclusões A interação genética e social/ambiental devem ser examinadas para melhor entender o papel desses fatores de risco nas condições clínicas observadas.

https://doi.org/10.1590/SciELOPreprints.7276

Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais
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Vieira, Marta Raquel Mendes

; Magalhães, Tatiana Almeida de

; Vieira, Magda Mendes

; Prates, Thalita Emily Cezário

; Silva, Rosângela Ramos Veloso

; Paula, Alfredo Maurício Batista de

; Silveira, Marise Fagundes

; Haikal, Desirée Sant’Ana

Ciência & Saúde Coletiva

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jul 2023, Volume 28 N. 7 Pages 2075 - 2086

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

Resumo O objetivo deste artigo é avaliar inter-relações de fatores associados a sintomas depressivos (SD) em professores, considerando a insatisfação com o trabalho docente como possível mediador. Estudo transversal utilizando dados de 700 professores da rede pública de ensino de um município brasileiro. O desfecho de interesse foi SD aferido pelo Inventário de Depressão de Beck (BDI). Foram testadas inter-relações diretas e indiretas entre o desfecho e insatisfação com o trabalho, idade, renda, estilo de vida e adiposidade. Essas variáveis compuseram modelo operacional testado por meio de modelagem de equações estruturais. A maior idade (β=0,12) e a maior insatisfação com o trabalho (β=0,12) associaram-se diretamente aos SD. Já o estilo de vida mais favorável (β=-0,60) e a adiposidade (β=-0,10), associaram-se a menor ocorrência de SD. As variáveis estilo de vida (β=-0,06) e adiposidade (β=-0,02) também apresentaram efeitos indiretos negativos nos SD, mediados pela insatisfação com o trabalho. O modelo de equação estrutural testado identificou inter-relações que influenciaram os SD. A insatisfação com o trabalho docente associou-se aos SD e mediou a relação de outros fatores sobre tais sintomas.

Abstract The objective of this article is to evaluate the interrelationships of factors associated with depressive symptoms (DS) in teachers, considering dissatisfaction with the teaching job as a possible mediator. This was a cross-sectional study using data from 700 teachers from the public school system of a Brazilian municipality. The outcome of interest was DS, as assessed using the Beck Depression Inventory (BDI). Direct and indirect interrelationships between the outcome and dissatisfaction with work, age, income, lifestyle and adiposity were tested. These variables composed the operational model tested by structural equation modelling. Older age (β=0.12) and greater dissatisfaction with work (β=0.12) were directly associated with DS. A more favourable lifestyle (β=-0.60) and adiposity (β=-0.10) were associated with a lower occurrence of DS. The variables lifestyle (β=-0.06) and adiposity (β=-0.02) also had negative indirect effects on DS, mediated by job dissatisfaction. The structural equation model tested identified interrelationships that influenced DS. Dissatisfaction with teaching work was associated with DS and mediated the relationship of other factors with such symptoms.

https://doi.org/10.1590/1413-81232023287.16362022

Inter-relações entre insatisfação com o trabalho docente e sintomas depressivos: modelagem com equações estruturais
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Vieira, Marta Raquel Mendes

; Magalhães, Tatiana Almeida de

; Vieira, Magda Mendes

; Prates, Thalita Emily Cezário

; Silva, Rosângela Ramos Veloso

; Paula, Alfredo Maurício Batista de

; Silveira, Marise Fagundes

; Haikal, Desirée Sant’Ana

Ciência & Saúde Coletiva

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jul 2023, Volume 28 N. 7 Pages 2075 - 2086

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

https://doi.org/10.1590/1413-81232023287.16362022

Inflammatory Fibrous Hyperplasia Associated with Chondroid Metaplasia - Report and Morphological Analysis of Five Cases
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da-Silva-Barros, Caio César

; Medeiros, Maurília Raquel de Souto

; Rêgo, Delane Maria

; Miguel, Márcia Cristina da Costa

; da-Silveira, Éricka Janine Dantas

International journal of odontostomatology

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mar 2023, Volume 17 N. 1 Pages 101 - 106

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

RESUMEN: La hiperplasia fibrosa inflamatoria (HFI) es una lesión reactiva común en los usuarios de prótesis dentales que puede estar asociada con la metaplasia cartilaginosa (MC). La metaplasia es un proceso celular adaptativo que puede ser causado por un trauma. El presente informe analizó cinco casos de HFI asociados a MC y se analizaron morfológicamente la deposición de colágeno en estas lesiones. Los pacientes tenían una edad media de 58,8 años y eran usuarios de prótesis dentales mal adaptadas. Se observaron lesiones nodulares localizadas en el la parte anterior del maxilar Microscópicamente se observó tejido conectivo fibroso hiperplásico con infiltrado inflamatorio crónico y cartílago hialino. No se observaron diferencias morfológicas en la deposición de colágeno bajo microscopía óptica, pero el análisis cuantitativo reveló una deposición de colágeno significativamente mayor en el tejido conectivo cerca de MC (p = 0,015). La HFI asociada con la MC afecta a los usuarios de prótesis dentales mal adaptadas. La presencia de MC no es significativa para el pronóstico de la lesión. Sin embargo, su formación y la mayor deposición de colágeno cerca de MC refuerza el origen reactivo de HFI.

ABSTRACT: Inflammatory fibrous hyperplasia (IFH) is a common reactive lesion in dental prostheses users that may be associated with chondroid metaplasia (CM). Metaplasia is an adaptive cellular process that may be caused by trauma. We reported here five cases of IFH associated with CM and analyzed morphologically the deposition of collagen in these lesions. Patients had a mean age of 58.8 years-old and were ill-fitting dental prostheses users. They presented nodular lesions located in the anterior maxilla. Microscopically, it was observed hyperplastic fibrous connective tissue with chronic inflammatory infiltrate and hyaline cartilage. No morphological differences were observed in collagen deposition under light microscopy, but quantitative analysis revealed a significantly higher collagen deposition at the connective tissue near CM (p = 0.015). IFH associated with CM affects ill-fitting dental prostheses users. The presence of CM is not significant to the lesion prognosis. However, its formation and the higher collagen deposition near it reinforces the IFH reactive origin.

Prevalence of thyroid dysfunction in neonates receiving parenteral nutrition in the intensive care unit
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Pérsico, Raquel Stocker

; Silveira, Rita de Cassia dos Santos

; Gazal, Claudia Hallal Alves

; Viana, Luciana Verçoza

Jornal de Pediatria

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jan 2023, Volume 99 N. 1 Pages 79 - 85

Abstract: En | Text: En | PDF: En

Abstract Objective: The use of parenteral nutrition (PN) formulations that do not contain iodine can contribute to the deficiency of this mineral, potentially leading to hypothyroidism and, ultimately, neurocognitive impairments. This study aimed to evaluate TSH alterations in newborns receiving PN. Methods: Retrospective study of neonatal intensive care unit patients receiving PN for > 15 days. Nutritional, anthropometric, and biochemical variables (TSH, T4, CRP) were analyzed. Hypothyroidism was defined by TSH > 10 mU/L. Results: Two hundred newborns were evaluated [156 (78%) preterm, 31±5 weeks of gestational age, 112 (56%) with very or extremely low birth weight]. The median (IQR) hospital stay was 68 (42-110) days, PN duration was 31 (21-47) days, and 188 (94%) patients also received enteral nutrition. Overall, 143 (71.5%) newborns underwent at least one TSH measurement. The prevalence of hypothyroidism was 10.5%. The Median PN duration in this group was 51 (34-109) days. Among those with hypothyroidism, 10 received Lugol’s solution and six levothyroxine. Thirteen patients received prophylactic Lugol’s solution with a median PN duration of 63 (48-197) days. TSH levels correlated positively with PN duration (r = 0.19, p = .02). Conclusions: The present data suggest that changes in TSH and T4 levels are present in neonates receiving PN for > 15 days, suggesting this population may be at risk for developing hypothyroid-ism. Therefore, the authors suggest that TSH and T4 measurements should be included as routine in neonatal patients receiving PN for > 15 days if PN formulations are not supplemented with iodine, and that iodine supplementation be provided as necessary.

https://doi.org/10.1016/j.jped.2022.06.004

Autoimmune hepatitis and primary biliary cholangitis overlap syndrome after COVID-19
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Cunha-Silva, Marlone

; França, Eloy Vianey Carvalho de

; Greca, Raquel Dias

; Mazo, Daniel Ferraz de Campos

; Costa, Larissa Bastos Eloy da

; Moraes, Priscilla Brito Sena de

; Veiga, Clauber Teles

; Assis-Mendonça, Guilherme Rossi

; Boin, Ilka de Fátima Santana Ferreira

; Stucchi, Raquel Silveira Bello

; Sevá-Pereira, Tiago

Autopsy and Case Reports

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2023, Volume 13 elocation e2023422

Abstract: En | Text: En | PDF: En

ABSTRACT COVID-19 is commonly associated with high serum levels of pro-inflammatory cytokines, and the post-infection status can disturb self-tolerance and trigger autoimmune responses. We are reporting a 45-year-old male who was admitted with fatigue, jaundice, elevated liver enzymes (with cholestatic pattern), and acute kidney injury two weeks after recovering from a mild SARS-CoV-2 infection. Serologies for viral hepatitis and anti-mitochondrial antibody were negative, while anti-nuclear and anti-smooth muscle antibodies were positive. There were no signs of chronic liver disease, and a magnetic resonance cholangiography showed no dilatation of biliary ducts. Histologic evaluation of the liver evidenced numerous foci of lobular necrosis without ductopenia or portal biliary reaction. Considering the autoantibody profile and histologic changes, the medical team started oral prednisone, but there was a suboptimal biochemical response in the outpatient follow-up. Two months later, a second liver biopsy was performed and revealed non-suppurative destructive chronic cholangitis, extensive areas of confluent necrosis with hepatocytes regenerating into pseudorosettes, and numerous plasma cells. According to the Paris Criteria, the patient was then diagnosed with an autoimmune hepatitis-primary biliary cholangitis overlap syndrome (AIH-PBC-OS). After adding azathioprine and ursodeoxycholic acid to the treatment, there was a satisfactory response. This is the second worldwide report of an AIH-PBC-OS triggered by COVID-19, but the first case with a negative anti-mitochondrial antibody. In this setting, histologic evaluation of the liver by an experienced pathologist is a hallmark of achieving the diagnosis and correctly treat the patient.

https://doi.org/10.4322/acr.2023.422

Can domestic dogs be considered a good reservoir of Leishmania (L.) infantum chagasi in an endemic area of nonulcerated cutaneous leishmaniasis in Southern Honduras?
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Segura, Gabriela Beatriz Rodriguez

; Ochoa, Wilfredo Humberto Sosa

; Matta, Vânia Lúcia Ribeiro da

; Martínez, Mercedes

; Tercero, Carol Rodriguez

; Gonzalez, Raquel Romero

; Pacheco, Carmen M. Sandoval

; Flores, Gabriela V. Araujo

; Silveira, Fernando Tobias

; Henriquez, Maria Mercedes Rueda

; Laurenti, Márcia Dalastra

Revista do Instituto de Medicina Tropical de São Paulo

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2023, Volume 65 elocation e24

Abstract: En | Text: En | PDF: En

ABSTRACT Dogs are considered to be the main domestic reservoir associated with the transmission of Leishmania (L.) infantum chagasi to humans in endemic areas of visceral leishmaniasis in America. However, little is known about the role of canines as a source of infection in endemic areas of nonulcerated cutaneous leishmaniasis (NUCL). Therefore, the objective of the present study was to investigate the role of dogs as a possible reservoir of the parasite in Southern Honduras. Dogs (n = 107) living with individuals affected by NUCL were clinically examined and biological material was collected for parasitological and immunological diagnosis. Most animals showed a healthy appearance and a few presented slight weight loss (64%), alopecia (7%), onychogryphosis (5%) and skin lesions (1%). The overall seroprevalence of Leishmania infection based on the DDP ® quick test and/or in-house ELISA serological test was 41%. The presence of the parasite’s DNA was confirmed in 94% of the dogs; however, the average parasite load in the buffy coat was low at 6.09 parasites/µL, ranging between 0.221 and 50.2. The skin of seropositive dogs examined by histopathology using paraffin sections stained by hematoxylin and immunohistochemistry did not show cutaneous lesions or parasite amastigotes. Based on the absence of parasites in the skin and the low parasite load detected in the buffy coat, it seems that the dog does not represent a good source of infection for the vector in the endemic area of NUCL transmission in Southern Honduras. Other domestic and/or wild animals should be investigated.

https://doi.org/10.1590/s1678-9946202365024

Psychometric properties of an oral health literacy scale for people living with diabetes
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MARTINS, Andréa Maria Eleutério de Barros Lima

; SANTOS, Ana Maria Rodrigues

; ALENCAR, Gizelton Pereira

; SOUZA, João Gabriel Silva

; SOARES, Maria Alice Aguiar

; MARTINS, Maria Barros Lima

; SILVEIRA, Marise Fagundes

; MAIA, Melissa Barral

; FARIAS, Paula Karoline Soares

; FERREIRA, Raquel Conceição

; PINTO, Rodrigo Alves

; CRESPO, Thaisa Soares

; FERREIRA, Efigênia Ferreira e

Brazilian Oral Research

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2023, Volume 37 elocation e022

Abstract: En | Text: En | PDF: En

Abstract This study evaluated the construct validity of the instrument Oral Health Literacy among diabetics. A probabilistic random sample of 239 diabetics from an infinite population answered the 10 items of the questionnaire. The structural validity was assessed by confirmatory factor analysis and goodness of fit, chi-square per degrees of freedom ratio (X2/df), comparative fit index (CFI), goodness-of-fit index (GFI), and root-mean-square error of approximation (RMSEA). Internal consistency was estimated by the average variance extracted (AVE) and composite reliability (CR). The scores were dichotomized with the upper limit of the 95% confidence interval as the cutoff point. The three-dimensional model presented good quality parameters (X2 /df = 2.459; CFI = 0.988; TLI = 0.981) and poor RMSEA (0.078). Internal consistency was adequate; AVE for the Access, Understand/appraise, and Apply subscales were 0.831, 0.981, and 0.954 and the CR for these subscales were 0.893, 0.962, and 0.822, respectively. Inadequate literacy ranged from 41.8 to 48.1%. The three-dimensional model identified (access, understand/appraise, and apply) showed structural validity, good internal consistency, and understandability.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0022

10.

Lesão Miocárdica e Prognóstico em Pacientes Hospitalizados com COVID-19 no Brasil: Resultados do Registro Nacional de COVID-19
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Barbosa, Hannah Cardoso

; Martins, Maria Auxiliadora Parreiras

; Jesus, Jordana Cristina de

; Meira, Karina Cardoso

; Passaglia, Luiz Guilherme

; Sacioto, Manuela Furtado

; Bezerra, Adriana Falangola Benjamin

; Schwarzbold, Alexandre Vargas

; Maurílio, Amanda de Oliveira

; Farace, Barbara Lopes

; Silva, Carla Thais Cândida Alves da

; Cimini, Christiane Corrêa Rodrigues

; Silveira, Daniel Vitorio

; Carazai, Daniela do Reis

; Ponce, Daniela

; Costa, Emanuel Victor Alves

; Manenti, Euler Roberto Fernandes

; Cenci, Evelin Paola de Almeida

; Bartolazzi, Frederico

; Madeira, Glícia Cristina de Castro

; Nascimento, Guilherme Fagundes

; Velloso, Isabela Vasconcellos Pires

; Batista, Joanna d’Arc Lyra

; Morais, Júlia Drumond Parreiras de

; Carvalho, Juliana da Silva Nogueira

; Ruschel, Karen Brasil

; Martins, Karina Paula Medeiros Prado

; Zandoná, Liege Barella

; Menezes, Luanna Silva Monteiro

; Kopittke, Luciane

; Castro, Luís César de

; Nasi, Luiz Antônio

; Floriani, Maiara Anschau

; Souza, Maíra Dias

; Carneiro, Marcelo

; Bicalho, Maria Aparecida Camargos

; Lima, Maria Clara Pontello Barbosa

; Godoy, Mariana Frizzo de

; Guimarães-Júnior, Milton Henriques

; Mendes, Paulo Mascarenhas

; Delfino-Pereira, Polianna

; Ribeiro, Raquel Jaqueline Eder

; Finger, Renan Goulart

; Menezes, Rochele Mosmann

; Francisco, Saionara Cristina

; Araújo, Silvia Ferreira

; Oliveira, Talita Fischer

; Oliveira, Thainara Conceição de

; Polanczyk, Carisi Anne

; Marcolino, Milena Soriano

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 N. 2 elocation e20220151

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

Abstract Background Cardiovascular complications of COVID-19 are important aspects of the disease’s pathogenesis and prognosis. Evidence on the prognostic role of troponin and myocardial injury in Latin American hospitalized COVID-19 patients is still scarce. Objectives To evaluate myocardial injury as independent predictor of in-hospital mortality and invasive mechanical ventilation support in hospitalized patients, from the Brazilian COVID-19 Registry. Methods This cohort study is a substudy of the Brazilian COVID-19 Registry, conducted in 31 Brazilian hospitals of 17 cities, March-September 2020. Primary outcomes included in-hospital mortality and invasive mechanical ventilation support. Models for the primary outcomes were estimated by Poisson regression with robust variance, with statistical significance of p<0.05. Results Of 2,925 patients (median age of 60 years [48-71], 57.1% men), 27.3% presented myocardial injury. The proportion of patients with comorbidities was higher among patients with cardiac injury (median 2 [1-2] vs. 1 [0-2]). Patients with myocardial injury had higher median levels of brain natriuretic peptide, lactate dehydrogenase, creatine phosphokinase, N-terminal pro-brain natriuretic peptide, and C-reactive protein than patients without myocardial injury. As independent predictors, C-reactive protein and platelet counts were related to the risk of death, and neutrophils and platelet counts were related to the risk of invasive mechanical ventilation support. Patients with high troponin levels presented a higher risk of death (RR 2.03, 95% CI 1.60-2.58) and invasive mechanical ventilation support (RR 1.87, 95% CI 1.57-2.23), when compared to those with normal troponin levels. Conclusion Cardiac injury was an independent predictor of in-hospital mortality and the need for invasive mechanical ventilation support in hospitalized COVID-19 patients.

Resumo Fundamento As complicações cardiovasculares da COVID-19 são aspectos importantes da patogênese e do prognóstico da doença. Evidências do papel prognóstico da troponina e da lesão miocárdica em pacientes hospitalizados com COVID-19 na América Latina são ainda escassos. Objetivos Avaliar a lesão miocárdica como preditor independente de mortalidade hospitalar e suporte ventilatório mecânico em pacientes hospitalizados, do registro brasileiro de COVID-19. Métodos Este estudo coorte é um subestudo do registro brasileiro de COVID-19, conduzido em 31 hospitais brasileiros de 17 cidades, de março a setembro de 2020. Os desfechos primários incluíram mortalidade hospitalar e suporte ventilatório mecânico invasivo. Os modelos para os desfechos primários foram estimados por regressão de Poisson com variância robusta, com significância estatística de p<0,05. Resultados Dos 2925 pacientes [idade mediana de 60 anos (48-71), 57,1%], 27,3% apresentaram lesão miocárdica. A proporção de pacientes com comorbidades foi maior nos pacientes com lesão miocárdica [mediana 2 (1-2) vs. 1 (0-20)]. Os pacientes com lesão miocárdica apresentaram maiores valores medianos de peptídeo natriurético cerebral, lactato desidrogenase, creatina fosfoquinase, N-terminal do pró-peptídeo natriurético tipo B e proteína C reativa em comparação a pacientes sem lesão miocárdica. Como fatores independentes, proteína C reativa e contagem de plaquetas foram relacionados com o risco de morte, e neutrófilos e contagem de plaquetas foram relacionados ao risco de suporte ventilatório mecânico invasivo. Os pacientes com níveis elevados de troponina apresentaram um maior risco de morte (RR 2,03, IC95% 1,60-2,58) e suporte ventilatório mecânico (RR 1,87;IC95% 1,57-2,23), em comparação àqueles com níveis de troponina normais. Conclusão Lesão cardíaca foi um preditor independente de mortalidade hospitalar e necessidade de suporte ventilatório mecânico em pacientes hospitalizados com COVID-19.

https://doi.org/10.36660/abc.20220151

11.

Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study
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KIRSCHNICK, Laura Borges

; SILVEIRA, Felipe Martins

; SCHUCH, Lauren Frenzel

; VASCONCELOS, Ana Carolina Uchoa

; GOMES, Ana Paula

; SANTOS, Jean Nunes dos

; SANTANA, Dandara Andrade

; FONSECA, Felipe Paiva

; MESQUITA, Ricardo Alves

; MENDONÇA, Elismauro Francisco de

; SOUSA-NETO, Sebastião Silvério

; PONTES, Hélder Antônio Rebelo

; ROBINSON, Liam

; HEERDEN, Willie van

; CARLOS-BREGNI, Román

; TAGER, Elena María José Román

; SILVA, Luan César da

; ZANELLA, Virgílio Gonzales

; RIVERO, Luis Fernando

; BITTENCOURT, Raquel

; MARTINS, Marco Antonio Trevizani

; LOPES, Márcio Ajudarte

; WAGNER, Vivian Petersen

; VARGAS, Pablo Agustin

; MARTINS, Manoela Domingues

Brazilian Oral Research

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2023, Volume 37 elocation e050

Abstract: En | Text: En | PDF: En

Abstract The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.

https://doi.org/10.1590/1807-3107bor-2023.vol37.0050

12.

Factors that cause women with osteoporosis to fall
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Correa, Renata Gonçalves Pinheiro

; Pivovarsky, Madeline Luiza Ferreira

; Santos, Guilherme da Silva

; Gomes, Anna Raquel Silveira

; Borba, Victoria Zeghbi Cochenski

Archives of Endocrinology and Metabolism

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2023, Volume 67 N. 4 elocation e000578

Abstract: En | Text: En | PDF: En

ABSTRACT Objectives: To analyze and compare intrinsic and extrinsic factors that cause falls among women receiving treatment for osteoporosis. Subjects and methods: A cross-sectional study of women ≥50 years receiving treatment for osteoporosis. Participants filled out questionnaires (demographic characteristics), and researchers took anthropometric measurements of bone mineral density, handgrip strength (HGS), ankle range of motion (ROM), and gait speed (GS). We also evaluated the Timed Up and Go Test (TUGT), Five Times Sit-to-Stand Test (SST), and Falls Efficacy Scale–International (FES-I) and investigated the extrinsic factors for falls. Results: We included 144 participants (71.6 [8.3 years]), who reported 133 falls. We classified participants into a non-faller group (NFG; 0 falls, n = 71, 49.5%), a faller group (FG; 1 fall, n = 42, 28.9%), and a recurrent-faller group (RFG; more than 1 fall, n = 31, 21.5%). Most patients had an increased risk of falling according to the TUGT, SST, reduced ankle ROM, and GS (P < .005 for all). FES-I was associated with sporadic and recurrent falls. For the multivariate analysis, the number of falls was influenced by the presence of ramps (RR 0.48, 95% CI, 0.26-0.87, P = .015), uneven surfaces (RR 1.6, 95% CI. 1.05-2.43, P = .028), and antislippery adhesive on stairs (RR 2.75, 95% CI, 1.77-4.28, P < .001). Conclusion: Patients receiving treatment for osteoporosis are influenced by intrinsic and extrinsic factors that cause falls. Lower-limb strength and power-discriminated participants at a higher risk of falls, but extrinsic factors varied. Only uneven floors and antislippery adhesives on stairs were associated with increased frequency of falls.

https://doi.org/10.20945/2359-3997000000578

13.

POLÍTICAS PÚBLICAS ESTADUAIS/DISTRITAL DE ESPORTE E LAZER: PROBLEMATIZAÇÕES E INTERESSES NA AGENDA COLETIVA DE PESQUISA
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Rampazzo, Marcelo

; Dotto, Augusto Dias

; Silveira, Raquel da

; Myskiw, Mauro

Movimento

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2023, Volume 29 elocation e29048

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

Abstract This work is part of an investigation on Public Policies for Sport and Leisure (PPELs) in the State/District sphere of the Brazilian federative pact. It aimed to understand the constitution of a collective investigative work agenda on sectoral initiative PPELs. An integrative review was carried out, based on the selection of 80 works, regarding which crossing points of problematizations and sources of coordination of interests of the studies were identified and described. We conclude that there is a group of work composing a scientific agenda on the PPELs of the States/Federal District. In terms of problematizations, social rights and sectoral inequalities stand out. Regarding the coordination of interests, studies on funding and policy settings stand out.

Resumen Este trabajo forma parte de una investigación sobre Políticas Públicas para el Deporte y el Ocio (PPELs) en el ámbito Estatal/Distrital del pacto federativo brasileño. Se buscó comprender la constitución de una agenda colectiva de trabajo investigativo sobre los PPEL de iniciativa sectorial. Se realizó una investigación cualitativa denominada revisión integradora, a partir de la selección de 80 trabajos, respecto de los cuales se identificaron y describieron puntos de cruce de problematizaciones y fuentes de coordinación de intereses de los estudios. Concluimos que existe un cuerpo de trabajo que compone una agenda científica sobre los PPEL de los Estados/Distrito Federal. En cuanto a las problematizaciones, se destacan los derechos sociales y las desigualdades sectoriales. Y, en cuanto a la coordinación de intereses, destacan los estudios sobre financiación y configuración de políticas.

Resumo Este trabalho faz parte de uma investigação sobre Políticas Públicas de Esporte e Lazer (PPELs) na esfera Estadual/Distrital do pacto federativo brasileiro. Procurou compreender a constituição de uma agenda de trabalho investigativo coletivo sobre as PPELs de iniciativa setorial. Foi realizada uma revisão integrativa, com base na seleção de 80 trabalhos, a respeito dos quais foram identificados e descritos pontos de passagem das problematizações e fontes de coordenação de interesses dos estudos. Concluímos que existe um conjunto de trabalhos compondo uma agenda científica sobre as PPELs dos Estados/Distrito Federal. Em termos de problematizações se destacam o direito social e as desigualdades setoriais. A respeito da coordenação de interesses, sobressaem os estudos sobre financiamento e configurações das políticas.

https://doi.org/10.22456/1982-8918.133077

14.

Transition and continuity of care after hospital discharge for COVID-19 survivors
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Acosta, Aline Marques

; Nora, Carlise Rigon Dalla

; Fontenele, Raquel Malta

; Aued, Gisele Knop

; Silveira, Cristhiane de Souza

; Sanseverino, Amanda Xavier

Revista da Escola de Enfermagem da USP

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2023, Volume 57 elocation e20230083

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

ABSTRACT Objective: To assess care transition quality and compare it with the clinical characteristics and continuity of care after hospital discharge of COVID-19 survivors. Method: This is a descriptive, observational and cross-sectional study, carried out with 300 patients with COVID-19 who were discharged from a hospital in southern Brazil. The Care Transitions Measure (CTM-15) and question guide about symptoms, difficulties and use of health services after discharge were used. Student’s t-test, Pearson and Spearman correlation were used. Results: The mean score for care transition quality was 74.2 (±18.2). Factors associated with higher quality were receiving care in intensive care (p = 0.001), using non-invasive mechanical ventilation (p = 0.05), using vasopressors (p = 0.027) and having an appointment at the hospital after discharge (p = 0.014). Positive correlated factors were length of stay (p = 0.017), and negative factors were post-discharge symptoms of fatigue (p = 0.001), weakness (p = 0.008), difficulty doing moderate activities (p = 0.003) and how difficult recovery is (p = 0.003). Conclusion: Most participants had a satisfactory perception of care transition. However, aspects such as care plans, referrals and follow-up after hospital discharge require improvements.

RESUMEN Objetivo: Evaluar la calidad de la transición asistencial y compararla con las características clínicas y de continuidad de la atención post alta hospitalaria para sobrevivientes de COVID-19. Método: Estudio descriptivo, observacional y transversal, realizado con 300 pacientes con COVID-19 que fueron dados de alta de un hospital del sur de Brasil. Se utilizó el Care Transitions Measure (CTM-15) y un guión de preguntas sobre síntomas, dificultades y uso de los servicios de salud post alta. Se utilizaron pruebas t de Student, correlación de Pearson y Spearman. Resultados: El puntaje promedio para la transición de la calidad de la atención fue 74,2 (±18,2). Los factores asociados con mayor calidad fueron recibir atención en cuidados intensivos (p = 0,001), utilizar ventilación mecánica no invasiva (p = 0,05), utilizar vasopresores (p = 0,027) y visitar el hospital después del alta (p = 0,014). Los factores correlacionados positivamente fueron el tiempo de estancia hospitalaria (p = 0,017), y los negativos, síntomas de fatiga después del alta (p = 0,001), debilidad (p = 0,008), dificultad para realizar actividades moderadas (p = 0,003) y la dificultad de la recuperación (p = 0,003). Conclusión: La mayoría de los participantes tuvo una percepción satisfactoria sobre la transición del cuidado. Sin embargo, aspectos como el plan de cuidados, las derivaciones y el seguimiento post alta hospitalaria requieren mejoras.

RESUMO Objetivo: Avaliar a qualidade da transição do cuidado e compará-la com as características clínicas e de continuidade do cuidado pós-alta hospitalar de sobreviventes de COVID-19. Método: Estudo descritivo, observacional e transversal, realizado com 300 pacientes com COVID-19 que tiveram alta de hospital do sul do Brasil. Utilizaram-se o Care Transitions Measure (CTM-15) e um roteiro de perguntas sobre sintomas, dificuldades e uso de serviços de saúde pós-alta. Utilizaram-se os testes t de Student, correlação de Pearson e Spearman. Resultados: O escore médio para a qualidade da transição do cuidado foi de 74,2 (±18,2). Fatores associados à maior qualidade foram ter atendimento em terapia intensiva (p = 0,001), usar ventilação mecânica não invasiva (p = 0,05), usar vasopressores (p = 0,027) e consultar no hospital após alta (p = 0,014). Fatores correlacionados positivos foram tempo de permanência (p = 0,017), e negativos, sintomas pós-alta de fadiga (p = 0,001), fraqueza (p = 0,008), dificuldade para fazer atividades moderadas (p = 0,003) e quão difícil é a recuperação (p = 0,003). Conclusão: A maioria dos participantes teve percepção satisfatória da transição do cuidado. Entretanto, aspectos como plano de cuidado, encaminhamentos e acompanhamento pós-alta hospitalar necessitam de melhorias.

https://doi.org/10.1590/1980-220x-reeusp-2023-0083en

15.

SOLUÇÕES PARA PROBLEMAS PÚBLICOS EM JUÍZO: UMA PRÁTICA INTERDISCIPLINAR ENTRE CAMPO DE PÚBLICAS E DIREITO
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Silveira, Raquel Maria da Costa

; Leite, Gisele Maria da Silva Araújo

; Cavalcanti, Flávio Luiz Carneiro

; Meira, Maísa de Oliveira

; Inácio, Márcio Vinícius do Nascimento

Cadernos Gestão Pública e Cidadania

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2023, Volume 28 elocation e86370

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

ABSTRACT This article reflects on the experience of the university extension project Building Collaborative Solutions for Judicialized Public Issues, highlighting the potential of the Public Field in the debate about judicialized public issues. The study was based on bibliographic and documentary research and interviews with students who participated in the extension project. The results showed the lessons learned from participating in the project and from the Undergraduate Program in Public Policy Management of the Universidade Federal do Rio Grande do Norte, which is related to the extension project. Also, the findings show the benefits of extension projects to motivate participants to engage in innovative learning opportunities. The study demonstrates the potential of the project to contribute to mediating judicialized public conflicts and, equally, to strengthening the link between knowledge and teaching, research, and extension. The project has achieved concrete results, expanding the dialogue between the many institutions involved.

RESUMEN Este artículo pretende reflexionar sobre la experiencia del Proyecto de Extensión “Construyendo Soluciones Colaborativas para Conflictos Públicos Judicializados”, tomándolo como base para resaltar el potencial del Campo de las Políticas Públicas en el debate sobre los conflictos públicos que se judicializan. Para ello, se ha basado en la investigación bibliográfica y documental. Además, se recogió información sobre la percepción de los estudiantes participantes a través de entrevistas, generando resultados relacionados con los aprendizajes construidos y proporcionados por la participación en esta extensión, así como los de la Licenciatura en Gestión de Políticas Públicas de la Universidade Federal do Rio Grande do Norte y la contribución del proyecto, como actividad extensionista, en la motivación de la búsqueda de nuevos aprendizajes. Al final, se destacó el potencial de la iniciativa en la participación de las mediaciones para los conflictos públicos judicializados e, igualmente, en el fortalecimiento del vínculo entre los conocimientos y entre la enseñanza, la investigación y la extensión. Se demostró que el proyecto ha ido generando resultados concretos, ampliando la apertura al diálogo entre diversas instituciones.

RESUMO O presente artigo objetiva refletir sobre a experiência do Projeto de Extensão Construindo Soluções Colaborativas para Questões Públicas Judicializadas, tomando-a como base para destacar a potencialidade do Campo de Públicas no debate sobre conflitos públicos judicializados. Para tanto, fundamentou-se em pesquisas bibliográfica e documental. Além disso, foram coletadas informações sobre a percepção dos discentes participantes por meio de entrevistas, gerando resultados relativos aos aprendizados construídos e proporcionados pela participação nessa extensão, como também por aqueles próprios do Bacharelado em Gestão de Políticas Públicas da Universidade Federal do Rio Grande do Norte e do Projeto, como atividade extensionista, na motivação para a busca de novas aprendizagens. Ao final, foram destacadas as potencialidades da iniciativa na participação de mediações para conflitos públicos judicializados e, igualmente, no fortalecimento do elo entre saberes e o ensino, a pesquisa e a extensão. Demonstrou-se que o Projeto vem gerando frutos concretos, ampliando a abertura ao diálogo entre diversas instituições.

https://doi.org/10.12660/cgpc.v28.86370

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