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Gender differences among dentistry conference speakers in Brazil
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Martorell, Leandro Brambilla

; Silva, Ana Luiza Mustafe

; Leles, Cláudio Rodrigues

; Silva, Brunno Santos de Freitas

; Santos, Cristina Vianna Moreira dos

; Finkler, Mirelle

Saúde em Debate

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Out 2021, Volume 45 Nº spe1 Páginas 73 - 82

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

RESUMO Este estudo objetivou avaliar possíveis disparidades de gênero entre palestrantes de congressos de odontologia. Os congressos selecionados (n=15) aconteceram em diferentes estados, distribuídos entre as cinco regiões do País. A programação dos congressos foi avaliada, e um banco de dados foi construído. Os dados foram analisados por estatística descritiva (testes qui-quadrado e Mann-Whitney). Foram identificados 1.195 palestrantes, dos quais 19,7% (n=235) eram mulheres. Os resultados deste estudo fornecem uma visão geral das tendências de disparidade de gênero em conferências odontológicas no Brasil. Sugerem disseminação de prática discriminatória na participação de mulheres como palestrantes nesses eventos. São necessárias abordagens mais eficazes para promover o equilíbrio de gênero entre os comitês organizadores dos congressos, encorajando e promovendo políticas de equidade e diversidade, ampliando a participação e o protagonismo das mulheres nesses eventos.

ABSTRACT This study aimed to evaluate possible gender differences among the invited speakers of Brazilian dentistry meetings. The selected meetings (n=15) were held in different states distributed among the five Brazilian regions. The conference programs were manually reviewed, and a database was constructed. Data analysis was performed using descriptive statistics, chi-square and Mann-Whitney tests. A total of 1,195 speakers was identified, 19.7% (n= 235) of which were women. The results of this study provide an overview of the trends of gender disparity in dentistry conferences in Brazil. These findings suggest disseminated gender-discriminatory practices in the promotion of women participation as speakers in such events. This requires more effective approaches to promote gender balance among conference organizing committees and encourage greater visibility and promotion of equity and diversity policies in dental professional societies to ensure more equitable conference programs.

https://doi.org/10.1590/0103-11042021e106

Gender differences among dentistry conference speakers in Brazil
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Martorell, Leandro Brambilla

; Silva, Ana Luiza Mustafe

; Leles, Cláudio Rodrigues

; Silva, Brunno Santos de Freitas

; Santos, Cristina Vianna Moreira dos

; Finkler, Mirelle

Saúde em Debate

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Out 2021, Volume 45 Nº spe1 Páginas 73 - 82

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

https://doi.org/10.1590/0103-11042021e106

Estudos de Saúde Mental publicados nos últimos 25 anos na Revista Ciência & Saúde Coletiva
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Campos, Rosana Onocko

; Santos, Deivisson Vianna Dantas dos

; Diaz, Alberto Velzi

; Emerich, Bruno

; Trape, Thiago

; Gama, Carlos Alberto Pegolo da

; Amaral, Carlos Eduardo Menezes

; Poderoso, Rosana Evangelista

; Ferrer, Ana Luiza

; Miranda, Lilian

; Pereira, Mariana Barbosa

; Surjus, Luciana Togni

Ciência & Saúde Coletiva

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Dez 2020, Volume 25 Nº 12 Páginas 4771 - 4790

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

Resumo Realizou-se revisão sistemática de 25 anos de produção da Revista Ciência & Saúde Coletiva sobre a temática de Saúde Mental buscando responder se essa produção tinha se modificado ao longo do tempo. Perguntou-se se essas mudanças guardariam alguma relação com a implementação de um novo marco regulatório e legal para essa área assim como com a expansão de serviços públicos e com os estímulos à investigação do tema por Agencias Públicas de financiamento. Analisaram-se 278 artigos originais, apresentados a partir das categorias: transformações socioculturais relacionadas à loucura e sua abordagem; mudanças legislativas; implantação, capilaridade e funcionamento da rede de serviços substitutivos; clínica/cuidado desenvolvido nos serviços substitutivos; o papel e as possibilidades da atenção básica; problemas relacionados ao uso de drogas; saúde mental de crianças e adolescentes; estudos epidemiológicos/categorias psiquiátricas; e outros - nas quais foram incluídas as questões étnico-raciais, de violência, acerca da população idosa, suicídio, bullying e migração. Pode ser observada relação cronológica entre o aumento de publicações e os editais de pesquisa e a expansão de serviços, não parecendo ser da mesma forma em relação ao tema dos cuidados a pessoas com problemas com álcool e outras drogas.

Abstract A systematic review of the 25-year Mental Health production of Journal Ciência & Saúde Coletiva was performed to identify whether this production had changed over time. We investigated whether these changes would have any relationship with the implementation of a new regulatory and legal framework for this field and the expansion of public services and the promotion of public funding agencies’ investigation on the subject. A total of 278 original papers were analyzed from the following categories: sociocultural transformations related to madness and its approach; legislative changes; implantation, coverage range and operation of the network of substitute services; clinic/care developed in substitute services; the role and possibilities of primary care; drug use-related problems; mental health of children and adolescents; epidemiological studies/psychiatric categories; and others - which included ethnic-racial issues, violence, about the elderly population, suicide, bullying, and migration. A chronological relationship can be observed between the increase in publications and research notices and the expansion of services, not seemingly in the same way concerning care for people with alcohol and other drug problems.

https://doi.org/10.1590/1413-812320202512.27932020 1838 downloads

Estudos de Saúde Mental publicados nos últimos 25 anos na Revista Ciência & Saúde Coletiva
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Campos, Rosana Onocko

; Santos, Deivisson Vianna Dantas dos

; Diaz, Alberto Velzi

; Emerich, Bruno

; Trape, Thiago

; Gama, Carlos Alberto Pegolo da

; Amaral, Carlos Eduardo Menezes

; Poderoso, Rosana Evangelista

; Ferrer, Ana Luiza

; Miranda, Lilian

; Pereira, Mariana Barbosa

; Surjus, Luciana Togni

Ciência & Saúde Coletiva

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Dez 2020, Volume 25 Nº 12 Páginas 4771 - 4790

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

https://doi.org/10.1590/1413-812320202512.27932020

Role of Myocardial Fibrosis in Hypertrophic Cardiomyopathy: A Systematic Review and Updated Meta-Analysis of Risk Markers for Sudden Death
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Bittencourt, Marcelo Imbroinise

; Cader, Samária Ali

; Araújo, Denizar Vianna

; Salles, Ana Luiza Ferreira

; Albuquerque, Felipe Neves de

; Spineti, Pedro Pimenta de Mello

; Albuquerque, Denilson Campos de

; Mourilhe-Rocha, Ricardo

Arquivos Brasileiros de Cardiologia

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Mar 2019, Volume 112 Nº 3 Páginas 281 - 289

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

Resumo Fundamento: A cardiomiopatia hipertrófica (CMH) está associada à morte súbita (MS). A fibrose miocárdica está supostamente correlacionada à MS. Objetivo: Realizamos uma revisão sistemática com metanálise, atualizando os marcadores de risco (MR) em CMH enfatizando a fibrose miocárdica. Métodos: Revisamos estudos de CMH que abordaram desfechos arrítmicos graves e certos MR: história familiar de MS, hipertrofia ventricular grave, síncope inexplicada, taquicardia ventricular não sustentada (TVNS) na monitorização com Holter de 24 horas, resposta anormal da pressão arterial ao exercício (ABPRE), fibrose miocárdica e obstrução da via de saída do ventrículo esquerdo (VSVE) nas bases de dados MEDLINE, LILACS e SciELO. Utilizamos os riscos relativos (RRs) como uma medida de efeito e modelos aleatórios para a análise. O nível de significância foi estabelecido em p < 0,05. Resultados: Vinte e um estudos foram selecionados (14.901 pacientes com idade de 45 ± 16 anos; homens, 62,8%). A fibrose miocárdica foi o principal MARCADOR DE RISCO (RR, 3,43; IC95%, 1,95-6,03). Os outros MR, exceto obstrução da VSVE, também foram preditores: história familiar de MS (RR, 1,75; IC95%, 1,39-2,20), hipertrofia ventricular grave (RR, 1,86; IC95%, 1,26-2,74), síncope inexplicada (RR, 2,27; IC95%, 1,69-3,07), TVNS (RR, 2,79; IC95%, 2,29-3,41) e ABPRE (RR, 1,53; IC95%, 1,12-2,08). Conclusões: Confirmamos a associação de fibrose miocárdica e outros MR com desfechos arrítmicos graves na CMH e enfatizamos a necessidade de novos modelos de previsão no manejo desses pacientes.

Abstract Background: Hypertrophic cardiomyopathy (HCM) is associated with sudden death (SD). Myocardial fibrosis is reportedly correlated with SD. Objective: We performed a systematic review with meta-analysis, updating the risk markers (RMs) in HCM emphasizing myocardial fibrosis. Methods: We reviewed HCM studies that addressed severe arrhythmic outcomes and the certain RMs: SD family history, severe ventricular hypertrophy, unexplained syncope, non-sustained ventricular tachycardia (NSVT) on 24-hour Holter monitoring, abnormal blood pressure response to exercise (ABPRE), myocardial fibrosis and left ventricular outflow tract obstruction (LVOTO) in the MEDLINE, LILACS, and SciELO databases. We used relative risks (RRs) as an effect measure and random models for the analysis. The level of significance was set at p < 0.05. Results: Twenty-one studies were selected (14,901 patients aged 45 ± 16 years; men, 62.8%). Myocardial fibrosis was the major RISK MARKER (RR, 3.43; 95% CI, 1.95-6.03). The other RMs, except for LVOTO, were also predictors: SD family history (RR, 1.75; 95% CI, 1.39-2.20), severe ventricular hypertrophy (RR, 1.86; 95% CI, 1.26-2.74), unexplained syncope (RR, 2.27; 95% CI, 1.69-3.07), NSVT (RR, 2.79; 95% CI, 2.29-3.41), and ABPRE (RR, 1.53; 95% CI, 1.12-2.08). Conclusions: We confirmed the association of myocardial fibrosis and other RMs with severe arrhythmic outcomes in HCM and emphasize the need for new prediction models in managing these patients.

https://doi.org/10.5935/abc.20190045 1522 downloads

What do Cochrane systematic reviews say about interventions for insomnia?
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Melo, Florence de Lucca

; Mendoza, Juan Fulgencio Welko

; Latorraca, Carolina de Oliveira Cruz

; Pacheco, Rafael Leite

; Martimbianco, Ana Luiza Cabrera

; Pachito, Daniela Vianna

; Riera, Rachel

Sao Paulo Medical Journal

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Dez 2018, Volume 136 Nº 6 Páginas 579 - 585

Resumo: En | Texto: En | PDF: En

ABSTRACT CONTEXT AND OBJECTIVE: Insomnia is a frequent complaint that generates more than five million visits to doctors per year in the United States. This study summarizes all Cochrane systematic reviews (SRs) that evaluated interventions to treat insomnia. DESIGN AND SETTING: Review of SRs, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). METHODS: A sensitive search was carried out in the Cochrane Database of Systematic Reviews to identify Cochrane SRs that assessed the effects of any type of intervention for people with insomnia. The results, main characteristics of the SRs and the certainty of the evidence obtained from them were synthesized and discussed. RESULTS: Seven SRs were included. They addressed the benefits and harm of acupuncture (n = 1), behavioral interventions (n = 1), music (n = 1), pharmacotherapy (n = 2), phototherapy (n = 1) and physical exercise (n = 1). The certainty of the evidence ranged from moderate to very low. CONCLUSION: Acupuncture, music, physical exercise, paroxetine, doxepin, trimipramine and trazodone seem to present some benefit for patients with insomnia. However, the uncertainty around these results means that no robust and definitive recommendations for clinical practice can be made until the benefits and harms from each intervention for patients with insomnia have been confirmed through further studies.

https://doi.org/10.1590/1516-3180.2018.0380311018 1860 downloads

What do Cochrane systematic reviews say about the use of cannabinoids in clinical practice?
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Latorraca, Carolina de Oliveira Cruz

; Pacheco, Rafael Leite

; Martimbianco, Ana Luiza Cabrera

; Pachito, Daniela Vianna

; Riera, Rachel

Sao Paulo Medical Journal

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Out 2018, Volume 136 Nº 5 Páginas 472 - 478

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: The therapeutic effects of cannabinoid compounds have been the center of many investigations. This study provides a synthesis on all Cochrane systematic reviews (SRs) that assessed the use of cannabinoids as a therapeutic approach. DESIGN AND SETTING: Review of SRs, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP). METHODS: A broad search was conducted in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed the efficacy and safety of cannabinoids as a therapeutic approach. The results and key characteristics of all reviews included were summarized and discussed. RESULTS: Eight SRs were included. They assessed the use of cannabinoids for the following types of conditions: neurological (two SRs), psychiatric (two SRs), rheumatological (one SR), infectious (one SR) and oncological (two SRs). There was moderate-quality evidence showing that the use of cannabinoids reduced nausea and vomiting among adults, compared with placebo. Additionally, there was moderate-quality evidence showing that there was no difference between cannabinoids and prochlorperazine regarding the number of participants who reported vomiting, in this same population. CONCLUSIONS: This review identified eight Cochrane systematic reviews that provided evidence of unknown to moderate quality regarding the use of cannabinoids as a therapeutic intervention. Further studies are still imperative for solid conclusions to be reached regarding practical recommendations.

https://doi.org/10.1590/1516-3180.2018.0313210818 1678 downloads

Central venous catheter-related infections caused by Corynebacterium amycolatum and other multiresistant non-diphtherial corynebacteria in paediatric oncology patients
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Carvalho, Ricardo Vianna de

; Lima, Fernanda Ferreira da Silva

; Santos, Cíntia Silva dos

; Souza, Mônica Cristina de

; Silva, Rondinele Santos da

; Mattos-Guaraldi, Ana Luiza de

Brazilian Journal of Infectious Diseases

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Ago 2018, Volume 22 Nº 4 Páginas 347 - 351

Resumo: En | Texto: En | PDF: En

ABSTRACT Bloodstream and venous catheter-related corynebacterial infections in paediatric patients with haematological cancer were investigated from January 2003 to December 2014 at the Brazilian National Cancer Institute in Rio de Janeiro, Brazil. We observed that during cancer treatment, invasive corynebacterial infections occurred independent of certain factors, such as age and gender, underlying diseases and neutropenia. These infections were ssscaused by Corynebacterium amycolatum and other non-diphtherial corynebacteria. All cases presented a variable profile of susceptibility to antimicrobial agents, except to vancomycin. Targeted antibiotic therapy may contribute to catheters maintenance and support quality of treatment. Non-diphtherial corynebacteria must be recognized as agents associated with venous access infections. Our data highlight the need for the accurate identification of corynebacteria species, as well as antimicrobial susceptibility testing.

https://doi.org/10.1016/j.bjid.2018.07.004 802 downloads

What do Cochrane systematic reviews say about interventions for treating psoriasis?
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Pacheco, Rafael Leite

; Hosni, Nicole Dittrich

; Latorraca, Carolina de Oliveira Cruz

; Martimbianco, Ana Luiza Cabrera

; Pachito, Daniela Vianna

; Yarak, Samira

; Riera, Rachel

Sao Paulo Medical Journal

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Ago 2018, Volume 136 Nº 4 Páginas 354 - 360

Resumo: En | Texto: En | PDF: En

ABSTRACT CONTEXT AND OBJECTIVE: Psoriasis is a common chronic inflammatory skin disease characterized by abnormal and increased growth of the cells that produce keratin and abnormal functioning of the immune system. We aimed to summarize the evidence available regarding interventions for patients with psoriasis. DESIGN AND SETTING: Review of systematic reviews, developed in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: A systematic search was conducted to identify Cochrane systematic reviews that fulfilled the eligibility criteria. Two authors screened titles and abstracts that had been retrieved through the search strategy. The results from all the Cochrane systematic reviews that were included were summarized and presented in a narrative synthesis. RESULTS: We included six Cochrane systematic reviews assessing interventions for treating psoriasis. The findings from high-quality evidence were that (a) etanercept reduced the psoriasis severity index, compared with placebo and (b) steroids plus vitamin D, compared with vitamin D alone, improved the skin clearance rate, as assessed by investigators, but was associated with a higher proportion of participants who dropped out due to adverse events. For all other comparisons, the quality of the evidence ranged from moderate to very low. CONCLUSION: This review included six Cochrane systematic reviews that provided evidence ranging in quality from unknown to high, regarding management of psoriasis. Further randomized controlled trials are imperative to reduce the uncertainties relating to several treatments that are already used in clinical practice.

https://doi.org/10.1590/1516-3180.0271250618 936 downloads

10.

What do Cochrane systematic reviews say about new practices on integrative medicine?
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Riera, Rachel

; Braga, Vinícius Lopes

; Rocha, Luana Pompeu dos Santos

; Bernardo, Daniel Damasceno

; Andrade, Luísa Avelar Fernandes de

; Hsu, Jessica Chiu

; Silva, Luciana Di Giovanni Marques da

; Suetsugu, Rodrigo Cesar de Sá

; Dittrich, Nicole Hosni

; Lima, Lucas Riguete Pereira de

; Silveira, Vicente Penido da

; Kruglensky, Barbara Caon

; Leonel, Letícia de Freitas

; Barros, Edivando de Moura

; Costa, Anderson Adriano Leal Freitas da

; Quintella, Miguel Lins

; Pacheco, Rafael Leite

; Cruz, Carolina de Oliveira

; Martimbianco, Ana Luiza Cabrera

; Pachito, Daniela Vianna

; Mozetic, Vania

; Teixeira, Tatiana de Bruyn Ferraz

; Torloni, Maria Regina

; Atallah, Alvaro Nagib

Sao Paulo Medical Journal

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Mai 2018, Volume 136 Nº 3 Páginas 251 - 261

Resumo: En | Texto: En | PDF: En

ABSTRACT BACKGROUND: This study identified and summarized all Cochrane systematic reviews (SRs) on the effects of ten integrative practices that were recently added to the Brazilian public healthcare system (SUS). DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (Unifesp). METHODS: Review of Cochrane SRs on the following interventions were identified, summarized and critically assessed: apitherapy, aromatherapy, bioenergetics, family constellation, flower therapy, chromotherapy, geotherapy, hypnotherapy, hand imposition or ozone therapy. RESULTS: We included a total of 16 SRs: 4 on apitherapy, 4 on aromatherapy, 6 on hypnotherapy and 2 on ozone therapy. No Cochrane SR was found regarding bioenergetics, family constellation, chromotherapy, clay therapy, flower therapy or hand imposition. The only high-quality evidence was in relation to the potential benefit of apitherapy, specifically regarding some benefits from honey dressings for partial healing of burn wounds, for reduction of coughing among children with acute coughs and for preventing allergic reactions to insect stings. CONCLUSION: Except for some specific uses of apitherapy (honey for burn wounds and for acute coughs and bee venom for allergic reactions to insect stings), the use of ten integrative practices that have recently been incorporated into SUS does not seem to be supported by evidence from Cochrane SRs.

https://doi.org/10.1590/1516-3180.2018.0172170418 2326 downloads

11.

Effect of cavity preparation design and ceramic type on the stress distribution, strain and fracture resistance of CAD/CAM onlays in molars
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VIANNA, Ana Luíza Serralha de Velloso

; PRADO, Célio Jesus do

; BICALHO, Aline Aredes

; PEREIRA, Renata Afonso da Silva

; NEVES, Flávio Domingues das

; SOARES, Carlos José

Journal of Applied Oral Science

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2018, Volume 26 elocation e20180004

Resumo: En | Texto: En | PDF: En

Abstract Objective This study aimed to evaluate the effect of the cavity preparation and ceramic type on the stress distribution, tooth strain, fracture resistance and fracture mode of human molar teeth restored with onlays. Material and Methods Forty-eight molars were divided into four groups (n=12) with assorted combinations of two study factors: BL- conventional onlay preparation with boxes made from leucite ceramic (IPS-Empress CAD, Ivoclar Vivadent); NBL- conservative onlay preparation without boxes made from leucite ceramic; BD- conventional onlay preparation with boxes made from lithium disilicate glass ceramic (IPS e.max CAD, Ivoclar Vivadent); NBL- conservative onlay preparation with boxes made from lithium disilicate glass ceramic cuspal deformation (µS) was measured at 100 N and at maximum fracture load using strain gauge. Fracture resistance (N) was measured using a compression test, and the fracture mode was recorded. Finite element analysis was used to evaluate the stress distribution by modified von Mises stress criteria. The tooth strain and fracture resistance data were analyzed using the Tukey test and two-way ANOVA, and the fracture mode was analyzed by the chi-square test (α=0.05). Results The leucite ceramic resulted in higher tooth deformation at 100 N and lower tooth deformation at the maximum fracture load than the lithium disilicate ceramic (P<0.001). The lithium disilicate ceramic exhibited higher fracture resistance than the leucite ceramic (P<0.001). The conservative onlay resulted in higher fracture strength for lithium disilicate ceramic. Finite element analysis results showed the conventional cavity preparation resulted in higher stress concentration in the ceramic restoration and remaining tooth than the conservative onlay preparation. The conservative onlays exhibited increased fracture resistance, reduced stress concentration and more favorable fracture modes. Conclusion Molars restored with lithium disilicate CAD-CAM ceramic onlays exhibited higher fracture resistance than molars restored with leucite CAD-CAM ceramic onlays.

https://doi.org/10.1590/1678-7757-2018-0004 5450 downloads

12.

What do Cochrane systematic reviews say about interventions for vitamin D supplementation?
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Mateussi, Mariana Vendramin

; Latorraca, Carolina de Oliveira Cruz

; Daou, Júlia Pozetti

; Martimbianco, Ana Luiza Cabrera

; Riera, Rachel

; Pacheco, Rafael Leite

; Pachito, Daniela Vianna

Sao Paulo Medical Journal

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Out 2017, Volume 135 Nº 5 Páginas 497 - 507

Resumo: En | Texto: En | PDF: En

ABSTRACT CONTEXT AND OBJECTIVE: Despite the high prevalence of vitamin D supplementation, its use remains controversial. The objective of this review was to identify and summarize the evidence from Cochrane systematic reviews regarding vitamin D supplementation for preventing ortreating any clinical condition. DESIGN AND SETTING: Review of systematic reviews, conducted in the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: A search was conducted to identify all Cochrane systematic reviews that fulfilled the inclusion criteria. Titles and abstracts were screened by two authors. RESULTS: We included 27 Cochrane systematic reviews: 10 assessing use of vitamin D for prevention and 17 for treatment. The reviews found moderate to high quality of evidence regarding the benefit of vitamin D for pregnant women (prevention of adverse events: preterm birth risk [rate ratio, RR 0.36; 95% confidence interval, CI 0.14 to 0.93] and low birthweight risk [RR 0.40; 95% CI 0.24 to 0.67]) and for asthma patients (reduction of severe exacerbations [RR 0.63; 95% CI 0.45 to 0.88]). No benefit was found regarding vitamin D supplementation alone (without calcium) for preventing hip or any new fracture. For all other outcomes assessed under various conditions, the current quality of evidence is low or unknown, and therefore insufficient for any recommendation. CONCLUSION: Based on moderate to high quality of evidence, the Cochrane systematic reviews included here showed that there were some benefits from vitamin D supplementation for pregnant women and asthma patients and no benefits for preventing fractures.

https://doi.org/10.1590/1516-3180.2017.0230150817 2569 downloads

13.

Práctica profesional de los egresados del programa de Fisioterapia de la Universidad Nacional de Colombia en el marco del sistema de salud colombiano
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Molina-Achury, Nancy Jeaneth

; Vianna-DAvila, Ana Luiza

; Benavides-Piracón, John

; Quintana-Cortés, Mónica Alejandra

Revista de la Facultad de Medicina

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Jun 2017, Volume 65 Nº 2 Páginas 311 - 319

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

Resumen Introducción. Los cambios en el saber y en la práctica han logrado consolidar a la fisioterapia como una profesión emergente de rápido crecimiento; sin embargo, las dinámicas del mercado y los sistemas de salud han transformado las características del recurso humano, las condiciones de trabajo y los avances y tendencias de la práctica profesional. Objetivo. Caracterizar el estado actual de la práctica profesional de la fisioterapia en el marco de organización del sistema de salud colombiano, cuyas transformaciones han impactado el conjunto de prácticas profesionales del sector salud. Materiales y métodos. Se realizó una encuesta electrónica a estudiantes de Fisioterapia de la Universidad Nacional de Colombia graduados durante el período 1980-2012 que evalúa campos y áreas de desempeño, condiciones de trabajo, autonomía profesional, valoración social y perfil de morbilidad. Resultados. La fisioterapia aparece como una profesión socialmente requerida, con campos y áreas de desempeño que se proyectan más allá del sector salud. Sin embargo, son preocupantes las condiciones de deterioro del trabajo, destacando las formas de contratación, los bajos salarios y las restricciones para la práctica profesional autónoma, en particular en el campo asistencial. Conclusiones. Es necesario garantizar condiciones de trabajo que promuevan una práctica profesional idónea y que garanticen la permanencia de los profesionales, en especial en la práctica asistencial.

Abstract Introduction: Changes in knowledge and practice have consolidated physiotherapy as an emerging fast-growing profession. However, the market dynamics and the configuration of health systems have transformed the characteristics of human resources, as well as the working conditions, advances and trends of professional practice. Objective: To characterize the current state of the professional practice of physiotherapy in the organizational framework of the Colombian health system, since its transformations have impacted the professional practices of the health sector. Materials and methods: An online survey was applied to physiotherapists graduated from Universidad Nacional de Colombia between 1980 and 2012. The survey evaluates the fields and areas of performance, working conditions, professional autonomy, social assessment and morbidity profile. Results: Physiotherapy is conceived as a profession required by society, with fields and areas of performance projected beyond the health sector. However, the deteriorating work conditions are worrying, particularly recruitment, low wages and restrictions for autonomous professional practice, especially those related to healthcare services. Conclusions: It is necessary to ensure working conditions that promote a suitable professional practice and the permanence of professionals, particularly in clinical practice.

https://doi.org/10.15446/revfacmed.v65n2.55671 645 downloads

14.

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?
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Lyra, Larissa

; Rizzo, Luiz Eduardo

; Sunahara, Camila Sá

; Pachito, Daniela Vianna

; Latorraca, Carolina de Oliveira Cruz

; Martimbianco, Ana Luiza Cabrera

; Riera, Rachel

Sao Paulo Medical Journal

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Abr 2017, Volume 135 Nº 2 Páginas 192 - 201

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

RESUMO CONTEXTO E OBJETIVO: Os transtornos do espectro autista (TEA) incluem autismo, doença de Asperger e transtorno global do desenvolvimento. As manifestações dos TEA podem ter importante impacto na aprendizagem e funcionamento social, que pode persistir durante a fase adulta. O objetivo foi resumir as evidências de revisões sistemáticas Cochrane sobre intervenções para TEA. TIPO DE ESTUDO E LOCAL: Revisão de revisões sistemáticas conduzida na Disciplina de Medicina Baseada em Evidências da Escola Paulista de Medicina, Universidade Federal de São Paulo. MÉTODOS: Nós incluímos e resumimos os resultados de revisões sistemáticas Cochrane sobre intervenções para TEA. RESULTADOS: Foram incluídas 17 revisões que encontraram evidências fracas de benefícios da acupuntura, dietas isentas de glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais, modelo cognitivo de Teoria da Mente, aripiprazol, risperidona, antidepressivos tricíclicos, inibidores seletivos da recaptação da serotonina (ISRS); o último apenas para adultos. Nenhum benefício foi encontrado com terapias sonoras, agentes quelantes, oxigenoterapia hiperbárica, ômega-3, secretina, vitamina B6/magnésio e ISRS para crianças. CONCLUSÃO: Acupuntura, dietas sem glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais e modelo cognitivo de Teoria da Mente parecem ter benefícios para pacientes com TEA (evidência de qualidade muito baixa a baixa). Aripiprazol, risperidona, antidepressivos tricíclicos e ISRS (o último apenas para adultos) também apresentam algum benefício, embora estejam associados a maior risco de eventos adversos. Estudos experimentais confirmando a relação entre prováveis terapias e a doença, e então ensaios clínicos de alta qualidade e de longo seguimento, são necessários.

ABSTRACT CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger’s disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS: We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed.

https://doi.org/10.1590/1516-3180.2017.0058200317 10667 downloads

15.

ERICA: prevalence of metabolic syndrome in Brazilian adolescents
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Kuschnir, Maria Cristina C

; Bloch, Katia Vergetti

; Szklo, Moyses

; Klein, Carlos Henrique

; Barufaldi, Laura Augusta

; Abreu, Gabriela de Azevedo

; Schaan, Beatriz

; Veiga, Gloria Valeria da

; Silva, Thiago Luiz Nogueira da

; Vasconcellos, Maurício T L de

; Moraes, Ana Júlia Pantoja de

; Oliveira, Ana Mayra Andrade de

; Tavares, Bruno Mendes

; Oliveira, Cecília Lacroix de

; Cunha, Cristiane de Freitas

; Giannini, Denise Tavares

; Belfort, Dilson Rodrigues

; Santos, Eduardo Lima

; Leon, Elisa Brosina de

; Oliveira, Elizabete Regina Araújo

; Fujimori, Elizabeth

; Borges, Ana Luíza

; Magliano, Erika da Silva

; Vasconcelos, Francisco de Assis Guedes

; Azevedo, George Dantas

; Brunken, Gisela Soares

; Guimarães, Isabel Cristina Britto

; Faria Neto, José Rocha

; Oliveira, Juliana Souza

; Carvalho, Kenia Mara B de

; Gonçalves, Luis Gonzaga de Oliveira

; Monteiro, Maria Inês

; Santos, Marize M

; Muniz, Pascoal Torres

; Jardim, Paulo César B Veiga

; Ferreira, Pedro Antônio Muniz

; Montenegro Jr, Renan Magalhães

; Gurgel, Ricardo Queiroz

; Vianna, Rodrigo Pinheiro

; Vasconcelos, Sandra Mary

; Martins, Stella Maris Seixas

; Goldberg, Tamara Beres Lederer

Revista de Saúde Pública

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2016, Volume 50 Supl. 1 elocation 11s

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

RESUMO OBJETIVO Determinar a prevalência de síndrome metabólica e de seus componentes em adolescentes brasileiros. MÉTODOS Foram avaliados 37.504 adolescentes, participantes do Estudo de Riscos Cardiovasculares em Adolescentes (ERICA), estudo transversal de âmbito nacional e de base escolar. Os adolescentes, de 12 a 17 anos de idade, residiam em municípios com mais de 100 mil habitantes. A amostra foi estratificada e conglomerada em escolas e turmas. Os critérios da International Diabetes Federation foram utilizados para definir síndrome metabólica. Prevalências de síndrome metabólica foram estimadas segundo sexo, faixa etária, tipo de escola e estado nutricional. RESULTADOS Dos 37.504 adolescentes, 50,2% eram do sexo feminino; 54,3% tinham de 15 a 17 anos e 73,3% estudavam em escolas públicas. A prevalência nacional de síndrome metabólica foi 2,6% (IC95% 2,3-2,9), discretamente maior no sexo masculino e naqueles de 15 a 17 anos na maioria das macrorregiões. A prevalência foi a maior nos residentes na macrorregião Sul, nas adolescentes mais jovens e nos adolescentes mais velhos. A prevalência foi maior nas escolas públicas (2,8% [IC95% 2,4-3,2]) que nas escolas privadas (1,9% [IC95% 1,4-2,4]) e nos adolescentes obesos em comparação aos não obesos. As combinações de componentes mais frequentes, respondendo por 3/4 das combinações, foram: circunferência de cintura elevada, HDL-colesterol baixo e pressão arterial elevada, seguida de circunferência da cintura elevada, lipoproteína de alta densidade (HDL-c) baixo e triglicerídeos elevados, e wpor circunferência da cintura elevada, HDL baixa e triacilgliceróis e pressão arterial elevados. A HDL baixa foi o segundo componente mais frequente, mas a maior prevalência de síndrome metabólica (26,8%) foi observada na presença de triglicerídeos elevado. CONCLUSÕES O ERICA é o primeiro estudo nacional a apresentar prevalências de síndrome metabólica e descrever a participação dos seus componentes. Apesar de a prevalência da síndrome metabólica ter sido baixa, as altas prevalências de alguns componentes e de participação de outros na composição da síndrome torna importante o diagnóstico precoce de tais alterações, mesmo que não agrupadas na síndrome metabólica.

ABSTRACT OBJECTIVE To determine the prevalence of metabolic syndrome and its components in Brazilian adolescents. METHODS We evaluated 37,504 adolescents who were participants in the Study of Cardiovascular Risks in Adolescents (ERICA), a cross-sectional, school-based, national study. The adolescents, aged from 12 to 17 years, lived in cities with populations greater than 100,000 inhabitants. The sample was stratified and clustered into schools and classes. The criteria set out by the International Diabetes Federation were used to define metabolic syndrome. Prevalences of metabolic syndrome were estimated according to sex, age group, school type and nutritional status. RESULTS Of the 37,504 adolescents who were evaluated: 50.2% were female; 54.3% were aged from 15 to 17 years, and 73.3% were from public schools. The prevalence of metabolic syndrome was 2.6% (95%CI 2.3-2.9), slightly higher in males and in those aged from 15 to 17 years in most macro-regions. The prevalence was the highest in residents from the South macro-region, in the younger female adolescents and in the older male adolescents. The prevalence was higher in public schools (2.8% [95%CI 2.4-3.2]), when compared with private schools (1.9% [95%CI 1.4-2.4]) and higher in obese adolescents when compared with nonobese ones. The most common combinations of components, referring to 3/4 of combinations, were: enlarged waist circumference (WC), low HDL-cholesterol (HDL-c) and high blood pressure; followed by enlarged WC, low HDL-c and high triglycerides; and enlarged WC, low HDL-c, high triglycerides and blood pressure. Low HDL was the second most frequent component, but the highest prevalence of metabolic syndrome (26.8%) was observed in the presence of high triglycerides. CONCLUSIONS ERICA is the first Brazilian nation-wide study to present the prevalence of metabolic syndrome and describe the role of its components. Despite the prevalence of Metabolic Syndrome being low, the high prevalences of some components and participation of others in the syndrome composition shows the importance of early diagnosis of this changes, even if not grouped within the metabolic syndrome.

https://doi.org/10.1590/s01518-8787.2016050006701 1789 downloads

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