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Legislation in Hospital Dentistry: Gaps, Perspectives and Desires Dentistry Gaps
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Simões, Ana Clara Correa Duarte

; Campos, Felipe Rodrigues de Oliveira

; Câmara, João Victor Frazão

; Probst, Livia Fernandes

; Groisman, Sonia

; Cedro, Vinicius Queiroz Miranda

; Pereira, Antonio Carlos

Pesquisa Brasileira em Odontopediatria e Clínica Integrada

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2024, Volume 24 elocation e220153

Resumo: En | Texto: En | PDF: En

Abstract Objective: To analyze the existing state legislation, including not only the ordinary laws, but also their infralegal regulation and the state legislation on Hospital Dentistry. Material and Methods: A survey was carried out in the databases of the Legislative Assemblies of the Brazilian States and the Federal District, as well as the Regional and Federal Councils of Dentistry in Brazil. Subsequently, a survey was carried out in the databases of the Ministry of Health, State Dental Councils and Federal Dental Council in Brazil. Results: Only 8 Brazilian states have legislation in force regarding hospital dentistry, which represents 29.63% of the federative units. Among the Brazilian regions, the Midwest presented the highest prevalence of the laws found (37.50%), followed by the North (25%) and the other regions with the same coverage (12.50%). Also, an orientation and an ordinance from the Ministry of Health, six resolutions from the Federal Council of Dentistry, and a technical note from the National Health Surveillance Agency were found. Conclusion: Several States do not have rules on the subject, making it imperative to create a federal rule that not only imposes the presence of the dentist, but also regulates the proportion of the team, workload, and availability. Objective Methods District Brazil Subsequently Results dentistry 2963 29 63 29.63 units 37.50%, 3750 37.50% , 37 50 (37.50%) 25% 25 (25% 12.50%. 1250 12.50% . 12 (12.50%) Also Conclusion subject dentist team workload availability 296 2 6 29.6 375 37.50 3 5 (37.50% (25 125 12.50 1 (12.50% 29. 37.5 (37.50 (2 12.5 (12.50 37. (37.5 ( 12. (12.5 (37. (12. (37 (12 (3 (1

https://doi.org/10.1590/pboci.2024.003

Exploring Myrciaria dubia liquid extract as a potential semen extender for breeding roosters
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Silva, Marcia Lorena Monteiro da

; Rufino, João Paulo Ferreira

; Lima, Brenda de Meireles

; Mendonça, Marco Antonio de Freitas

; Chaves, Francisco Alberto de Lima

; Oliveira, Roseane Pinto Martins de

; Costa Neto, Pedro de Queiroz

; Andrade, Paulo Cesar Machado

Animal Reproduction

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2024, Volume 21 Nº 4 elocation e20240020

Resumo: En | Texto: En | PDF: En

Abstract The current investigation aimed to explore the effects of Myrciaria dubia liquid extract (MDLE) as the primary component of an extender for breeder rooster semen over different periods at room temperature. Fifteen breeder roosters (40 weeks of age, average body weight of 2.05±0.12) with confirmed fertility were used. Employing a factorial design (3x4), the treatments consisted of semen in natura and two semen extenders (an experimental based on MDLE and a commercial) subjected to four periods at room temperature post-collection (5, 10, 15 and 20 minutes) with four replicates (tubes) each. All variables evaluated in this study yielding significant results (p<0.05). Analyzed individually, the experimental extender based on MDLE exhibited a linear reduction (p<0.05) in motility and vigor results, while it caused an increase in pH values and percentages of sperm defects evaluated. When compared with semen in natura and commercial extender, the efficiency of MDLE as a semen extender was inferior to that observed with the commercial extender and similar to the results observed with semen in natura. Nonetheless, the experimental extender based on MDLE yielded satisfactory results for up to 15 minutes of storage time. In conclusion, MDLE can be considered as an alternative for composing a roosters’ semen extender, maintaining sperm characteristics within acceptable limits for up to 15 minutes at room temperature. However, this experimental extender demonstrated lower efficiency than the commercial extender in maintaining the sperm quality at room temperature across all periods tested. (MDLE 40 (4 age 2.05±0.12 205012 2 05 0 12 used 3x4, 3x4 x , (3x4) postcollection post collection 5, 5 (5 10 1 tubes (tubes each p<0.05. p005 p p<0.05 . individually (p<0.05 Nonetheless time conclusion However tested 4 ( 2.05±0.1 20501 3x (3x4 p00 p<0.0 (p<0.0 2.05±0. 2050 (3x p0 p<0. (p<0. 2.05±0 205 p<0 (p<0 2.05± p< (p< 2.05 (p 2.0 2.

https://doi.org/10.1590/1984-3143-ar2024-0020

Development and Implementation of a Computerized Decision Support System for Screening Hypertension and Diabetes in a Resource-Constrained Region ResourceConstrained Resource Constrained
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Melo, Laura Defensor Ribeiro de

; Ribeiro, Antonio Luiz Pinho

; Oliveira, João Antonio de Queiroz

; Maia, Junia Xavier

; Sá, Thábata Queiroz Vivas de

; Pinto, Vânia Soares de Oliveira e Almeida

; Lima, Marcia Maria Oliveira

; Enlich, Patrick Wander

; Ribeiro, Leonardo Bonisson

; Cimini, Christiane Correa Rodrigues

; Marcolino, Milena Soriano

International Journal of Cardiovascular Sciences

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2024, Volume 37 elocation e20230085

Resumo: En | Texto: En | PDF: En

Abstract Background Strategies aimed at improving the diagnosis and treatment of cardiovascular diseases (CVD) are of utmost importance. Clinical decision support systems (CDSS) are guided by updated guidelines and may be capable of benefiting screening and early diagnosis initiatives in remote regions. Objective To develop a CDSS for screening hypertension and diabetes mellitus (DM), as well as to assess its feasibility and usability in the context of a primary care setting in a resource-constrained region. Methods This research focused on the strategy of screening hypertension and DM based on CDSS. A software was developed and implemented in 10 municipalities in the Northeast of the state of Minas Gerais, Brazil, from April 2017 to October 2018. Patients of 30 to 69 years of age were attended by primary care practitioners using the software. A Likert-scale questionnaire with 15 questions to assess usability (System Usability Scale) and satisfaction was applied to the professionals at the end of study. Groups were compared by applying the chi-squared test for categorical variables. Statistical significance was considered as p < 0.05. Results In the field study, 13,775 individuals were assessed; 185 patients were diagnosed with hypertension; 35 were diagnosed with DM, and 5 were diagnosed with both diseases. For the usability and satisfaction assessment, 258 healthcare professionals participated. Fifty-one percent considered their prior knowledge for the use of technologies to be good; 53.7% reported a desire to use the application frequently, and 78.4% would recommend the platform. Conclusion The implementation of a CDSS developed to assist in the screening of hypertension and DM was feasible in the context of a primary care setting in a resource-constrained region, with good user satisfaction. CVD (CVD importance (CDSS regions , (DM) resourceconstrained resource constrained region 1 Gerais Brazil 201 2018 3 6 Likertscale Likert scale System Scale study chisquared chi squared variables 005 0 05 0.05 13775 13 775 13,77 assessed 18 assessment 25 participated Fiftyone Fifty one 537 53 7 53.7 frequently 784 78 4 78.4 platform (DM 20 00 0.0 1377 77 13,7 2 53. 78. 0. 137 13,

https://doi.org/10.36660/ijcs.20230085

A new lectin from Crotalaria incana seeds and studies of toxicity in Artemia salina nauplii
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Pereira, Antônio Mateus Gomes

; Martins, Maria Gleiciane de Queiroz

; Oliveira, Messias Vital de

; Lóssio, Claudia Figueiredo

; Souza, Elnatan Bezerra de

; Araújo, Francisco Fernandes de

; Cavada, Benildo Sousa

; Nascimento, Kyria Santiago do

; Cajazeiras, João Batista

Acta Botanica Brasilica

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2024, Volume 38 elocation e20230155

Resumo: En | Texto: En | PDF: En

ABSTRACT Lectins are proteins that recognize and bind to carbohydrates in a reversible and specific manner. In this work, a lectin from Crotalaria incana L. seeds was purified by Sephadex G-50 affinity chromatography. The purified lectin was named CiL and presented affinity towards D-mannose, D-glucose, D-galactose, α-methyl-D-mannoside and derivatives. CiL was stable over a wide range of temperatures and pH values, and it was divalent cation-dependent. SDS-PAGE analysis indicated that CiL is composed of two subunits with apparent masses of 29 and 30 kDa. The amino acid sequence of five tryptic peptides was obtained through mass spectrometry. Partial primary structure data indicated the similarity between CiL and lectins from Phaseolus vulgaris, Cladrastis kentukea, Lens culinaris, Pisum sativum, Crotalaria pallida and C. juncea. CiL showed no toxicity to Artemia salina nauplii at the concentration of 2 mg/mL, thus reinforcing the potential of this protein for further studies in other biological models and elucidation of possible effects. manner work L G50 G 50 G-5 chromatography Dmannose, Dmannose D mannose, mannose D-mannose Dglucose, Dglucose glucose, glucose D-glucose Dgalactose, Dgalactose galactose, galactose D-galactose αmethylDmannoside α methyl mannoside derivatives values cationdependent. cationdependent cation dependent. dependent cation-dependent SDSPAGE SDS PAGE 3 kDa spectrometry vulgaris kentukea culinaris sativum C juncea mgmL mg mL mg/mL effects G5 5 G-

https://doi.org/10.1590/1677-941x-abb-2023-0155

Construção e Validação do Protocolo EmpoderACO Direcionado a Pacientes em Anticoagulação Oral com Varfarina
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Barbosa, Hannah Cardoso

; Torres, Heloisa de Carvalho

; Oliveira, João Antônio de Queiroz

; Santos, Rebeca Priscila de Melo

; Costa, Josiane Moreira da

; Miranda, Leonardo Gonçalves

; Pagano, Adriana Silvina

; Praxedes, Marcus Fernando da Silva

; Martins, Maria Auxiliadora Parreiras

Arquivos Brasileiros de Cardiologia

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2023, Volume 120 Nº 6 elocation e20220576

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamento A varfarina é um anticoagulante oral útil para prevenção de tromboembolismo, embora seja considerado fármaco de alto risco de causar eventos adversos. Considerando os desafios práticos no controle da anticoagulação oral, os pacientes poderiam se beneficiar de estratégias educacionais que visem mudança de comportamento, participação ativa no autocuidado e adesão à farmacoterapia. Objetivo Construir e validar o protocolo EmpoderACO para mudança de comportamento em pacientes em uso de varfarina. Métodos As etapas metodológicas foram: definição de conceitos e domínios do autocuidado, identificação dos objetivos, construção e seleção dos itens, avaliação da validade de conteúdo e pré-teste na população alvo. Resultados Relevância, adequação, clareza e confiabilidade interna dos itens do instrumento foram avaliadas por comitê de juízes multiprofissional pela plataforma web E-surv, obtendo-se média de concordância ≥0,91. A compreensão do instrumento pela população-alvo teve clareza adequada com média de 0,96. Conclusão O EmpoderACO poderá contribuir para qualificar o processo de comunicação entre profissionais e pacientes, melhorar a adesão ao tratamento e os resultados clínicos, podendo ser replicado nos serviços de saúde. tromboembolismo adversos farmacoterapia objetivos préteste pré teste alvo Relevância adequação Esurv, Esurv E surv, surv E-surv obtendose obtendo 091 0 91 ≥0,91 populaçãoalvo 096 96 0,96 clínicos saúde 09 9 ≥0,9 0,9 ≥0, 0, ≥0 ≥

Abstract Background Warfarin is an oral anticoagulant that is very useful in preventing thromboembolism, though it is considered a drug with a high risk of causing adverse events. Considering the practical challenges in controlling oral anticoagulation, the patients on warfarin could benefit from educational strategies aimed at behavioral changes, active participation in self-care, and adherence to drug therapy. Objective The aim was to construct and validate the EmpoderACO protocol for behavioral changes in warfarin patients. Methods The methodological steps were: definition of concepts and domains of self-care, identification of objectives, construction and selection of items, assessment of content validity, and pre-test in the target population. Results Relevance, adequacy, clarity, and internal reliability of the instrument’s items were assessed by a multidisciplinary judges committee (JC) through the E-surv web platform, obtaining an average agreement of ≥0.91. The understanding of the instrument measured by the target population revealed adequate clarity with a coefficient average of 0.96. Conclusion EmpoderACO can aid in qualifying the communication process between medical professionals and patients, as well as in improving adherence to both treatment and clinical outcomes, and can be replicated in healthcare settings. thromboembolism events anticoagulation selfcare, selfcare self care, care self-care therapy objectives validity pretest pre test Relevance adequacy instruments s JC (JC Esurv E surv platform 091 0 91 ≥0.91 096 96 0.96 outcomes settings 09 9 ≥0.9 0.9 ≥0. 0. ≥0 ≥

https://doi.org/10.36660/abc.20220576

The Challenges of Implementing a Text Message Intervention to Promote Behavioral Change in Primary Care Patients With Hypertension and Diabetes
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Oliveira, João Antonio de Queiroz

; Cimini, Christiane

; Almeida, Vania

; Maia, Junia Xavier

; Resende, Raissa Eda

; Gualberto, Leticia Alves

; Santos, Pedro Henrique Lauar

; Gomes, Paulo R.

; Bonisson, Leonardo

; Paixão, Maria Cristina

; Costa, Janaina Moutinho

; Cardoso, Clareci Silva

; Santo, Karla

; Ribeiro, Antonio

; Martins, Maria Auxiliadora

; Marcolino, Milena S.

International Journal of Cardiovascular Sciences

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2023, Volume 36 elocation e20220050

Resumo: En | Texto: En | PDF: En

Abstract Background Controlling blood pressure and glycemic levels is a challenge that requires innovative solutions. Objective To assess the feasibility of implementing a text message intervention among low-income primary care patients, as well as to assess self-reported behavioral change. Methods A set of 200 text messages was developed on healthy eating, physical activity, adherence, and motivation. Participants from Vale do Mucuri, MG, Brazil diagnosed with diabetes or hypertension or undergoing screening for those diseases, received 5 to 8 messages per week for 6 months. They answered a questionnaire to report their satisfaction and behavioral changes. Results Of the 136 patients, 117 (86.0%) answered the questionnaire. Most reported that the messages were very useful (86.3%), easy to understand (90.6%), and were very helpful for behavioral change (65.0%); 84.6% reported that they had started eating healthier. The most frequent reported lifestyle changes were: improved diet quality (85.5%), reduced portions (65.8%), and weight loss (56.4%). The majority of patients shared the messages (60.7%) with family or other acquaintances, considered the number of messages to be adequate (89.7%) and would recommend the program to others (95.7%). Conclusion An intervention based on text messages to promote behavioral change in patients with hypertension or diabetes in primary care is feasible in low-resource settings. Future studies are needed to assess the program’s long-term effects on clinical outcomes. solutions lowincome low income selfreported self 20 activity adherence motivation Mucuri MG diseases months 13 11 86.0% 860 86 0 (86.0% 86.3%, 863 86.3% , 3 (86.3%) 90.6%, 906 90.6% 90 (90.6%) 65.0% 650 65 (65.0%) 846 84 84.6 healthier 85.5%, 855 85.5% 85 (85.5%) 65.8%, 658 65.8% (65.8%) 56.4%. 564 56.4% . 56 4 (56.4%) 60.7% 607 60 7 (60.7% acquaintances 89.7% 897 89 (89.7% 95.7%. 957 95.7% 95 (95.7%) lowresource resource settings programs s longterm long term outcomes 2 1 86.0 (86.0 86.3 (86.3% 90.6 9 (90.6% 65.0 (65.0% 84. 85.5 (85.5% 65.8 (65.8% 56.4 (56.4% 60.7 (60.7 89.7 (89.7 95.7 (95.7% 86. (86. (86.3 90. (90.6 65. (65.0 85. (85.5 (65.8 56. (56.4 60. (60. 89. (89. 95. (95.7 (86 (90. (65. (85. (56. (60 (89 (95. (8 (90 (65 (85 (56 (6 (95 ( (9 (5

https://doi.org/10.36660/ijcs.20220050

Pre-hospital Care for Suspected Stroke Patients, Cared for by Mobile Emergency Care Units in Northern Minas Gerais
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Gusmão, Lorenn Lages

; Nascimento, Israel Junior Borges do

; Rocha, Gabriel Almeida Silqueira

; Oliveira, João Antonio de Queiroz

; Machado, Geisiane Sousa Braga

; Antunes, Izabella de Oliveira

; Sant’anna, Romeu Vale

; Fernandes, Breno Franco Silveira

; Correia, Ubiratam Lopes

; Ribeiro, Antonio Luiz Pinho

; Marcolino, Milena S.

International Journal of Cardiovascular Sciences

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Jun 2021, Volume 34 Nº 3 Páginas 245 - 252

Resumo: En | Texto: En | PDF: En

Abstract Background Stroke management require rapid identification, assessment, and transport of patients to qualified health care centers. However, there is little description in the literature on the multiple challenges associated with the pre-hospital transport of suspected stroke patients. Objective To characterize the pre-hospital care provided to suspected stroke patients by the Brazilian Emergency Medical Service (SAMU in Portuguese), by means of a descriptive case study. Methods This is a descriptive study of a series of cases. Data from the SAMU regarding the responses to emergency calls from suspected stroke patients were collected. Independent reviewers confirmed the diagnostic hypothesis and all discordances were assessed using kappa statistics. Clinical data and transport times were described as frequency and proportion or central tendency and dispersion measures. Normality of continuous variable distribution was assessed using the Kolmogorov-Smirnov test. The Mann-Whitney U test was used for comparison of medians, with a 5% significance level. Results During the studied period, 556 suspected stroke patients were treated. The kappa index was 0.82 (95% CI 0.737 to 0.919) CI. In 74.7% of the cases, the symptom onset time was not recorded. The median time elapsed between the call for emergency services and the ambulance arrival was 18 minutes, and the median transport time was 38 minutes. A total of 34% of the patients were taken to referral hospitals for stroke. Conclusion This study revealed a low level of knowledge regarding the need to determine the exact time of symptom onset of suspected stroke patients. Also, the study showed the low rate of patients taken to referral hospitals. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

https://doi.org/10.36660/ijcs.20190199 128 downloads

Selenium concentrations in elderly people with Alzheimer’s disease: a cross-sectional study with control group
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Nascimento, Carlos Queiroz do

; Barros-Neto, João Araújo

; Vieira, Nathalia Fidelis Lins

; Menezes-Filho, José Antonio

; Neves, Sabrina Joanny Felizardo

; Lima, Sonia Oliveira

Revista Brasileira de Enfermagem

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2021, Volume 74 Supl. 2 elocation e20200984

Resumo: Pt En Es | Texto: Pt En Es | PDF: Pt | PDF: En | PDF: Es

RESUMO Objetivo: Investigar possíveis diferenças nas concentrações de selênio no plasma e nos eritrocitos de idosos com e sem a doença de Alzheimer (DA). Métodos: Estudo transversal, realizado com idosos com DA, diagnosticados por médico geriatra, e comparado a um grupo de idosos sem a doença, pareado por sexo, escolaridade e idade. As concentrações de selênio total (Set) intraeritocitárias e plasmáticas foram determinadas por espectrofotometria de absorção atômica. Resultados A média da idade foi 74,41±7,1 anos no grupo DA e 71,46±5,1 anos no grupo-controle. O grupo doença de Alzheimer apresentou menores concentrações plasmáticas (média de 45,29±14,51 µg/dL vs. 55,14±4,01 µg/dL; p = 0,004) e eritrocitárias de Set (mediana de 56,36 µg/L vs. 76,96 µg/L; p < 0,001). O modelo de regressão logística indicou associação entre concentrações eritrocitárias de Set e o diagnóstico de doença de Alzheimer (p = 0,028). Conclusão Idosos com DA apresentam concentrações menores de selênio plasmático e eritrocitário..

ABSTRACT Objective: To investigate possible differences in plasma and erythrocyte concentrations of selenium among elderly with and without a diagnosis of Alzheimer’s disease (AD). Methods: Cross-sectional study, performed with an elderly group with Alzheimer’s disease, diagnosed by a geriatric doctor, and compared to an elderly group without the disease, equaling gender, education, and age. Atomic absorption spectrophotometry determined plasma and erythrocyte concentrations of total selenium (Set). Results: The mean age was 74.41±7.1 years in the Alzheimer’s disease group and 71.46±5.1 years among the control group. The Alzheimer’s disease group presented lower plasma concentrations (mean of 45.29±14.51 µg/dL vs. 55.14±14.01 µg/dL; p=0.004), and erythrocyte Set (median of 56.36 µg/L vs. 76.96 µg/L; p<0.001). The logistic regression model indicated an association between erythrocyte Set concentrations and diagnosis of Alzheimer’s disease (p=0.028). Conclusion: Elderly with Alzheimer’s disease present lower selenium concentrations in the evaluated organic compartments.

RESUMEN Objetivo: Investigar posibles diferencias en las concentraciones plasmáticas y eritrocitarias de selenio entre ancianos con y sin diagnóstico de Alzheimer (DA). Métodos: Estudio transversal, realizado con un equipo de ancianos con diagnóstico de Alzheimer, diagnosticados por geriatra, y comparado a un equipo de ancianos sin la enfermedad, pareado por sexo, escolaridad y edad. Las concentraciones plasmáticas y eritrocitarias de selenio total (Set) determinadas por espectrofotometría de absorción atómica. Resultados: La mediana de edad han sido 74,41±7,1 años en el equipo diagnóstico de Alzheimer y 71,46±5,1 años en el equipo-control. El equipo diagnóstico de Alzheimer presentó menores concentraciones plasmáticas (mediana de 45,29±14,51 µg/dL vs. 55,14±4,01 µg/dL; p = 0,004) y eritrocitarias de Set (mediana de 56,36 µg/L vs. 76,96 µg/L; p < 0,001). El modelo de regresión logística indicó relación entre concentraciones eritrocitarias de Set y el diagnóstico de diagnóstico de Alzheimer (p = 0,028). Conclusión Ancianos con diagnóstico de Alzheimer presentan menores concentraciones de selenio en los compartimentos orgánicos evaluados.

https://doi.org/10.1590/0034-7167-2020-0984 237 downloads

Implications for Clinical Practice from a Multicenter Survey of Heart Failure Management Centers
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Bocchi, Edimar Alcides

; Moreira, Henrique Turin

; Nakamuta, Juliana Sanajotti

; Simões, Marcus Vinicius

; Casas, Alberto de Almeida Las

; Costa, Altamiro Reis da

; Assis, Amberson Vieira de

; Durães, André Rodrigues

; Pereira-Barretto, Antonio Carlos

; Ravessa, Antonio Delduque de Araujo

; Macedo, Ariane Vieira Scarlatelli

; Biselli, Bruno

; Pinto, Carolina Maria Nogueira

; Filho, Conrado Roberto Hoffmann

; Costantini, Costantino Roberto

; Almeida, Dirceu Rodrigues

; Santos Jr, Edval Gomes dos

; Soliva Junior, Erwin

; Figueiredo, Estevão Lanna

; Albuquerque, Felipe Neves de

; Paulitsch, Felipe

; Neuenschwander, Fernando Carvalho

; Figueiredo Neto, José Albuquerque de

; Brito, Flavio de Souza

; Lopes, Heno Ferreira

; Villacorta, Humberto

; Souza Neto, João David de

; Sepulveda, João Mariano

; Ayoub, José Carlos Aidar

; Vilela-Martin, José F.

; Cardoso, Juliano Novaes

; Uemura, Laercio

; Moura, Lidia Zytynski

; Maia, Lilia Nigro

; Oliveira, Lucia Brandão de

; Maia, Lucimir

; Silva, Luís Beck da

; Gowdak, Luís Henrique Wolff

; Danzmann, Luiz Claudio

; Andrade, Marcus

; Braile-Sternieri, Maria Christiane Valeria Braga

; Moreira, Maria da Consolação Vieira

; França Neto, Olimpio R

; Filho, Otavio Rizzi Coelho

; Esteves, Paulo Frederico

; Raupp-da-Rosa, Priscila

; Silva, Ricardo Jorge de Queiroz e

; Mourilhe-Rocha, Ricardo

; Viégas, Ruy Felipe Melo

; Rassi, Salvador

; Mangili, Sandrigo

; Kaiser, Sergio Emanuel

; Martins, Silvia Marinho

; Kawabata, Vitor Sergio

Clinics

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2021, Volume 76 elocation e1991

Resumo: En | Texto: En | PDF: En

OBJECTIVES: This observational, cross-sectional study based aimed to test whether heart failure (HF)-disease management program (DMP) components are influencing care and clinical decision-making in Brazil. METHODS: The survey respondents were cardiologists recommended by experts in the field and invited to participate in the survey via printed form or email. The survey consisted of 29 questions addressing site demographics, public versus private infrastructure, HF baseline data of patients, clinical management of HF, performance indicators, and perceptions about HF treatment. RESULTS: Data were obtained from 98 centers (58% public and 42% private practice) distributed across Brazil. Public HF-DMPs compared to private HF-DMP were associated with a higher percentage of HF-DMP-dedicated services (79% vs 24%; OR: 12, 95% CI: 94-34), multidisciplinary HF (MHF)-DMP [84% vs 65%; OR: 3; 95% CI: 1-8), HF educational programs (49% vs 18%; OR: 4; 95% CI: 1-2), written instructions before hospital discharge (83% vs 76%; OR: 1; 95% CI: 0-5), rehabilitation (69% vs 39%; OR: 3; 95% CI: 1-9), monitoring (44% vs 29%; OR: 2; 95% CI: 1-5), guideline-directed medical therapy-HF use (94% vs 85%; OR: 3; 95% CI: 0-15), and less B-type natriuretic peptide (BNP) dosage (73% vs 88%; OR: 3; 95% CI: 1-9), and key performance indicators (37% vs 60%; OR: 3; 95% CI: 1-7). In comparison to non- MHF-DMP, MHF-DMP was associated with more educational initiatives (42% vs 6%; OR: 12; 95% CI: 1-97), written instructions (83% vs 68%; OR: 2: 95% CI: 1-7), rehabilitation (69% vs 17%; OR: 11; 95% CI: 3-44), monitoring (47% vs 6%; OR: 14; 95% CI: 2-115), GDMT-HF (92% vs 83%; OR: 3; 95% CI: 0-15). In addition, there were less use of BNP as a biomarker (70% vs 84%; OR: 2; 95% CI: 1-8) and key performance indicators (35% vs 51%; OR: 2; 95% CI: 91,6) in the non-MHF group. Physicians considered changing or introducing new medications mostly when patients were hospitalized or when observing worsening disease and/or symptoms. Adherence to drug treatment and non-drug treatment factors were the greatest medical problems associated with HF treatment. CONCLUSION: HF-DMPs are highly heterogeneous. New strategies for HF care should consider the present study highlights and clinical decision-making processes to improve HF patient care.

https://doi.org/10.6061/clinics/2021/e1991 870 downloads

10.

Clinical characteristics and outcomes among Brazilian patients with severe acute respiratory syndrome coronavirus 2 infection: an observational retrospective study
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Nascimento, Israel Júnior Borges do

; Pinto, Luiz Ricardo

; Fernandes, Valéria Alves

; Romero, Israel Molina

; Oliveira, João Antonio de Queiroz

; Marcolino, Milena Soriano

; Leite, Maria Fátima

Sao Paulo Medical Journal

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Dez 2020, Volume 138 Nº 6 Páginas 490 - 497

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Since February 2020, data on the clinical features of patients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and their clinical evolution have been gathered and intensively discussed, especially in countries with dramatic dissemination of this disease. OBJECTIVE: To assess the clinical features of Brazilian patients with SARS-CoV-2 and analyze its local epidemiological features. DESIGN AND SETTING: Observational retrospective study conducted using data from an official electronic platform for recording confirmed SARS-CoV-2 cases. METHODS: We extracted data from patients based in the state of Pernambuco who were registered on the platform of the Center for Strategic Health Surveillance Information, between February 26 and May 25, 2020. Clinical signs/symptoms, case evolution over time, distribution of confirmed, recovered and fatal cases and relationship between age group and gender were assessed. RESULTS: We included 28,854 patients who were positive for SARS-CoV-2 (56.13% females), of median age 44.18 years. SARS-CoV-2 infection was most frequent among adults aged 30-39 years. Among cases that progressed to death, the most frequent age range was 70-79 years. Overall, the mortality rate in the cohort was 8.06%; recovery rate, 30.7%; and hospital admission rate (up to the end of follow-up), 17.3%. The average length of time between symptom onset and death was 10.3 days. The most commonly reported symptoms were coughing (42.39%), fever (38.03%) and dyspnea/respiratory distress with oxygen saturation < 95% (30.98%). CONCLUSION: Coughing, fever and dyspnea/respiratory distress with oxygen saturation < 95% were the commonest symptoms. The case-fatality rate was 8.06% and the hospitalization rate, 17.3%.

https://doi.org/10.1590/1516-3180.2020.00365.r1.08092020 1016 downloads

11.

Use of smartphone-based instant messaging services in medical practice: a cross-sectional study
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Nascimento, Israel Junior Borges do

; Oliveira, João Antonio de Queiroz

; Wolff, Iago Souza

; Ribeiro, Laura Defensor

; Silva, Maíra Viana Rego Souza e

; Cardoso, Clareci Silva

; Mars, Maurice

; Ribeiro, Antonio Luiz

; Marcolino, Milena Soriano

Sao Paulo Medical Journal

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Fev 2020, Volume 138 Nº 1 Páginas 86 - 92

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Instant messaging services (IMS) are widely used in medical practice. OBJECTIVE: To evaluate perceptions regarding use and usability of IMS within clinical practice and assess users’ knowledge of the ethical and legal context involved in using IMS within medical practice. DESIGN AND SETTING: Cross-sectional study conducted in different hospitals and medical institutions in Minas Gerais, Brazil. METHODS: Medical students, medical residents, primary care physicians and specialist doctors answered an online questionnaire regarding epidemiological data, graduation level and use of IMS for medical communication. Responses were collected over a five-month period and data were assessed using the IBM-SPSS software. RESULTS: 484 people answered the questionnaire: 97.0% declared that they were using IMS for medical-related purposes; 42.0%, to elucidate medical concerns every week; 75.0%, to share imaging or laboratory tests and patients’ medical records; and 90.5%, to participate in clinical case-study private groups. Moreover, only 37.0% declared that they had knowledge of the legislative aspects of use of smartphones within clinical practice. Differences in the frequency of discussion of medical concerns within the daily routine between student/residents and general practitioners/specialists, and in the frequency of image-sharing and patient-guiding/assistance between students and medical doctors, were observed. CONCLUSIONS: Our results provide reliable proof that medical doctors and students use IMS, as a tool for clinical case discussions, interactions between healthcare providers and patients, or dissemination of knowledge and information. Nonetheless, because of limitations to the ethical and legal regulations, evidence-based discussions between authorities, academics and medical institutions are needed in order to fully achieve positive outcomes from such platforms.

https://doi.org/10.1590/1516-3180.2020.0010.r1.28032020 1040 downloads

12.

Resin-modified glass ionomer containing calcium glycerophosphate: physico-mechanical properties and enamel demineralization
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SANTOS, Sâmia Sass

; DELBEM, Alberto Carlos Botazzo

; MORAES, João Carlos Silos

; SOUZA, José Antônio Santos

; OLIVEIRA, Lenara Queiroz Chaves

; PEDRINI, Denise

Journal of Applied Oral Science

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2019, Volume 27 elocation e20180188

Resumo: En | Texto: En | PDF: En

Abstract Sources of calcium and phosphate have been added to dental restorative materials to improve their anticaries effect. Objective This study evaluated the effect of adding calcium glycerophosphate (CaGP) to resin-modified glass ionomer cement (RMGIC) on the physico-mechanical properties, ion release, and enamel demineralization. Material and Methods: Specimens were fabricated for each experimental group: RMGIC without CaGP (Control), RMGIC with 1, 3 and 9% CaGP. To determine the release of fluoride (F), calcium (Ca) and phosphorus (P), six specimens were immersed in demineralization and remineralization solutions for 15 days. In another experimental trial, the following physico-mechanical properties were evaluated at time intervals of 1 and 7 days after fabrication: compressive strength (n=12), diametral tensile strength (n=12), surface hardness of material (n=6) and the degree of conversion of monomers (n=8). To study enamel demineralization, specimens (n=12) were attached to enamel blocks and submitted to pH-cycling. Subsequently, surface and cross-sectional hardness and the concentration of F, Ca and P in enamel were determined. Results The addition of CaGP to RMGIC led to higher mean release of F, Ca and P when compared with control (p<0.001). Mechanical properties were within the range of those of the ionomer cements after addition of 1% and 3% CaGP. The degree of conversion did not differ between groups at the 1st and the 7th day (p>0.439). The addition of 3% and 9% CaGP reduced mineral loss and increased F, Ca and P in the enamel when compared with control (p<0.05). Conclusion The addition of 3% CaGP in RMGIC increased the release of F, P and Ca, reduced enamel demineralization, and maintained the physico-mechanical properties within the parameters for this material.

https://doi.org/10.1590/1678-7757-2018-0188 1831 downloads

13.

Satisfaction of Emergency Physicians with the Care Provided to Patients with Cardiovascular Diseases in the Northern Region of Minas Gerais
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Marcolino, Milena Soriano

; Oliveira, João Antonio de Queiroz

; Silva, Grace Kelly Matos e

; Dias, Thatiane Dantas

; Marino, Barbara Campos Abreu

; Antunes, André Pires

; Ribeiro, Antonio Luiz

; Cardoso, Clareci Silva

Arquivos Brasileiros de Cardiologia

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Ago 2018, Volume 111 Nº 2 Páginas 151 - 159

Resumo: Pt En | Texto: Pt En | PDF: Pt | PDF: En

Resumo Fundamentos: A insatisfação dos profissionais de saúde dos serviços de urgência tem influência negativa na qualidade do cuidado ao infarto agudo do miocárdio (IAM) e na fixação desses profissionais. Objetivo: Avaliar a satisfação de médicos com a estrutura de atendimento e diagnóstico de serviços públicos de urgência na Região Ampliada Norte de Minas Gerais, previamente à implantação da linha de cuidado ao IAM. Métodos: Estudo transversal, que incluiu médicos das unidades de emergência do SAMU e de hospitais regionais nível II, III e IV. Foi avaliada a satisfação usando a escala CARDIOSATIS-Team. O escore mediano para cada item, a escala global e os domínios foram calculados e então comparados por grupos, utilizando o teste não paramétrico de Mann-Whitney. Foi avaliada a correlação entre tempo de formação e nível de satisfação com o método de Spearman. Um valor-p < 0,05 foi considerado significativo. Resultados: De 137 médicos incluídos, 46% trabalhavam no SAMU. A maior parte dos entrevistados demonstrou insatisfação geral com a estrutura de atendimento, cuja mediana da escala global foi 2,0 (intervalo interquartil [IQ] 2,0-4,0). A maioria dos médicos do SAMU demonstrou-se insatisfeita quanto a atendimento prestado (54%), estrutura para condução das doenças cardiovasculares (52%) e tecnologia disponível para diagnóstico (54%). Na avaliação da satisfação global, evidenciou-se que a insatisfação dos médicos do SAMU foi menor quando comparada à dos médicos de urgência hospitalar. Os médicos de hospitais nível III/IV demonstraram maior satisfação global quando comparados aos de hospitais nível II. Conclusão: Este estudo demonstrou insatisfação geral dos médicos dos serviços de urgência na região em relação à estrutura de atendimento às emergências cardiovasculares.

Abstract Background: The dissatisfaction of health professionals in emergency services has a negative influence on both the quality of care provided for acute myocardial infarction (AMI) patients and the retention of those professionals. Objective: To assess physicians’ satisfaction with the structure of care and diagnosis at the emergency services in the Northern Region of Minas Gerais before the implementation of the AMI system of care. Methods: This cross-sectional study included physicians from the emergency units of the ambulance service (SAMU) and level II, III and IV regional hospitals. Satisfaction was assessed by using the CARDIOSATIS-Team scale. The median score for each item, the overall scale and the domains were calculated and then compared by groups using the non-parametric Mann-Whitney test. Correlation between time since graduation and satisfaction level was assessed using Spearman correlation. A p value < 0.05 was considered significant. Results: Of the 137 physicians included in the study, 46% worked at SAMU. Most of the interviewees showed overall dissatisfaction with the structure of care, and the median score for the overall scale was 2.0 [interquartile range (IQR) 2.0-4.0]. Most SAMU physicians expressed their dissatisfaction with the care provided (54%), the structure for managing cardiovascular diseases (52%), and the technology available for diagnosis (54%). The evaluation of the overall satisfaction evidenced that the dissatisfaction of SAMU physicians was lower when compared to that of hospital emergency physicians. Level III/IV hospital physicians expressed greater overall satisfaction when compared to level II hospital physicians. Conclusion: This study showed the overall dissatisfaction of the emergency physicians in the region assessed with the structure of care for cardiovascular emergencies.

https://doi.org/10.5935/abc.20180143 1407 downloads

14.

Cardiovascular emergencies in primary care: an observational retrospective study of a large-scale telecardiology service
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Marcolino, Milena Soriano

; Santos, Thales Matheus Mendonça

; Stefanelli, Fernanda Cotrim

; Oliveira, João Antonio de Queiroz

; e Silva, Maíra Viana Rego Souza

; Andrade Júnior, Diomildo Ferreira

; Silva, Grace Kelly Matos e

; Ribeiro, Antonio Luiz

Sao Paulo Medical Journal

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Out 2017, Volume 135 Nº 5 Páginas 481 - 487

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: Electrocardiograms (ECGs) are an essential examination for identification and management of cardiovascular emergencies.The aim of this study was to report on the frequency and recognition of cardiovascular emergencies in primary care units. DESIGN AND SETTING: Observational retrospective study assessing consecutive patients whose digital ECGs were sent for analysis to the team of the Telehealth Network of Minas Gerais. METHODS: Data from patients diagnosed with cardiological emergencies in the primary care setting of 750 municipalities in Minas Gerais, Brazil, between March and September 2015, were collected via telephone contact with the healthcare practitioner who performed the ECG. After collection, the data were subjected to statistical analysis. RESULTS: Over the study period, 304 patients with cardiovascular emergencies were diagnosed within primary care. Only 73.4% of these were recognized by the local physicians. Overall, the most frequent ECG abnormalities were acute ischemic patterns (44.7%) and the frequency of such patterns was higher among the ECGs assigned as emergency priority (P = 0.03). It was possible to obtain complete information on 231 patients (75.9%). Among these, the mean age was 65 ± 14.4 years, 57.1% were men and the most prevalent comorbidity was hypertension (68.4%). In total, 77.9% were referred to a unit caring for cases of higher complexity and 11.7% of the patients died. CONCLUSION: In this study, cardiovascular emergencies were misdiagnosed in primary care settings, acute myocardial ischemia was the most frequent emergency and the mortality rate was high.

https://doi.org/10.1590/1516-3180.2017.0090110617 1405 downloads

15.

2 nd Brazilian Consensus on Chagas Disease, 2015
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Dias, João Carlos Pinto

; Ramos Jr., Alberto Novaes

; Gontijo, Eliane Dias

; Luquetti, Alejandro

; Shikanai-Yasuda, Maria Aparecida

; Coura, José Rodrigues

; Torres, Rosália Morais

; Melo, José Renan da Cunha

; Almeida, Eros Antonio de

; Oliveira Jr., Wilson de

; Silveira, Antônio Carlos

; Rezende, Joffre Marcondes de

; Pinto, Fabiane Scalabrini

; Ferreira, Antonio Walter

; Rassi, Anis

; Fragata Filho, Abílio Augusto

; Sousa, Andréa Silvestre de

; Correia, Dalmo

; Jansen, Ana Maria

; Andrade, Glaucia Manzan Queiroz

; Britto, Constança Felícia De Paoli de Carvalho

; Pinto, Ana Yecê das Neves

; Rassi Jr., Anis

; Campos, Dayse Elisabeth

; Abad-Franch, Fernando

; Santos, Silvana Eloi

; Chiari, Egler

; Hasslocher-Moreno, Alejandro Marcel

; Moreira, Eliane Furtado

; Marques, Divina Seila de Oliveira

; Silva, Eliane Lages

; Marin-Neto, José Antonio

; Galvão, Lúcia Maria da Cunha

; Xavier, Sergio Salles

; Valente, Sebastião Aldo da Silva

; Carvalho, Noêmia Barbosa

; Cardoso, Alessandra Viana

; Silva, Rafaella Albuquerque e

; Costa, Veruska Maia da

; Vivaldini, Simone Monzani

; Oliveira, Suelene Mamede

; Valente, Vera da Costa

; Lima, Mayara Maia

; Alves, Renato Vieira

Revista da Sociedade Brasileira de Medicina Tropical

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Dez 2016, Volume 49 Supl. 1 Páginas 3 - 60

Resumo: En | Texto: En | PDF: En

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research .

https://doi.org/10.1590/0037-8682-0505-2016 9267 downloads

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