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Introduction: The National Scientific Congress (NSC) is an annual event held in Peru in which medical students from all over the country present their research work. Objectives: To determine the publication rate in indexed scientific journals of research papers submitted to the NSCs held between 2010 and 2014, as well as the factors associated with their publication, and to describe the characteristics of the published papers. Materials and methods: Retrospective study in which 407 abstracts of research papers were reviewed. A publication time window of 6 years (from submission) was considered. A bivariate analysis was performed to assess differences between categorical and numerical variables using the chi-square and Mann-Whitney U tests, respectively. In addition, a multivariate analysis was performed using Poisson regression models (a crude and an adjusted model), calculating relative risk (RR) values with their respective 95% confidence intervals (95%CI) to determine the factors associated with the publication of papers. A significance level of p

Objective: The purpose of this study is to present a methodology for assessing patients’ demands and calculating pre-test probabilities using paper forms in Primary Care. Method: Most developing countries do not use Electronic Health Records (EHR) in primary care settings. This makes it difficult to access information regarding what occurs within the health center working process. Basically, there are two methodologies to assess patients’ demands and problems or diagnosis stated by doctors. The first is based on single attendance at each appointment, while the second is based on episodes of care; the latter deals with each problem in a longitudinal manner. The methodology developed in this article followed the approach of confronting the ‘reason for the appointment’ and ‘the problem registered’ by doctors. Paper forms were developed taking this concept as central. All appointments were classified by the International Classification of Primary Care (ICPC). Discussion: Even in paper form, confrontation between ‘reason for the appointment’ and ‘problem registered’ is useful for measuring the pre-test probabilities of each problem-based appointment. This approach can be easily reproduced in any health center and enables a better understanding of population profile. Prevalence of many illnesses and diseases are not known in each reality, and studies conducted in other settings, such as secondary and tertiary care, are not adequate for primary health care. Conclusion: This study offers adequate technology for primary health care workers that have potential to transform each health center into a research-led practice, contributing directly to patient care.

This article presents suggestions and notions to write research papers articles. General ideas are presented with the aim of guiding motivanting students in their writing tasks, without limiting their creativity and choice of topics. On the opposite, it is intended as a stimulus for the written production because everybody has creative and innovative power, all that is necessary to put ideas in practice.

This paper raises the discussion of the importance to create relevant knowledge and experience by developing the Culture Intelligence - CI of Brazilian students and has the follow objectives: i) to propose a model that can capture the relationship between culture, knowledge and intelligence and ii) to provide qualitative evidence of its effectiveness to reduce brain drain. In order to explain the impact of CI on Knowledge Management- KM and Organizational Intelligence - OI this work explores the development of a CI model based on KM and OI (CKI model) and change the “culture of student’s dependence” and therefore reduce the talent deficit in Brazil. The CKI model is constructed based on the results of 35 interviews in two Peruvian Universities, two Brazilian Universities and one German University and empirically tests 3 hypotheses through Structural Equation Modelling. The main conclusion is that Cultural Intelligence impacts maturity and democracy and therefore it would be very important to build a more robust Exchange program than the current Latin American Alianza del Pacifico Program, in partnership with the European Erasmus program.

Background: Mental health is an important issue in general practice/family medicine. The Patient Health Questionnaire for Depression and Anxiety (PHQ-4) allows depression and anxiety screening and psychologic distress evaluation. PHQ-4 cross-cultural adaptation and concurrent validation was the objective of this paper in a population of general practice/family medicine (GP/FM) doctors. Methods: Translation, linguistic verification and back-translation, internal consistency, and reliability of the final translated tool were performed for the cultural adaptation of the PHQ-4 scale. The European Quality of Life 5 Dimensions 3L (EQ-5D-3L) scale and the “Sentimentos Negativos – Negative Feelings”, subscale of the “Questionário da Avaliação da Sobrecarga da Gestão da Multimorbilidade em Medicina Geral e Familiar – Questionnaire of Evaluation of Burden of Management of Multimorbidity in General Practice and Family Medicine” [SoGeMM-MGF]) were used for concurrent validation. Descriptive, inferential, and correlational statistics were used, according to the distribution of data, with a p-value of

Introduction: Physicians’ main responsibility is to practice medicine for the benefit of patients. However, there are situations where secondary interests affect this commitment and give rise to conflicts of interest. Objective: To analyze currently available systematic reviews and meta-analyses on conflicts of interest in medicine to summarize relevant evidence in this regard. Material and methods: A literature search was performed in the MEDLINE and LILACS databases using the following search strategy: systematic reviews and meta-analysis on conflicts of interests in medicine published in serialized scientific journals; no publication time or language limits were applied. Studies that met the inclusion criteria were grouped according to the medical activity they assessed, and information on the type and number of studies and conclusions of all publications included in the review was collected. Results: 29 publications were included, and they were classified as follows: studies based on research articles, on clinical practice guidelines, on clinical practice, and on patient-oriented papers. Conclusions: It was found that the authors of the original research papers included in the meta-analyses and systematic reviews analyzed here do not always state if they have conflicts of interest or not. Nevertheless, when said conflicts are reported, they tend to present results favoring the drugs or medical technologies of their sponsor.

Introduction: A literature review in databases was carried out on suicidal behavior in indigenous peoples to identify its characterization as a public health problem. Objective: To systematize the knowledge on suicide in indigenous peoples based on papers and research reports published until 2014. Materials and Methods: Literature review of 149 papers published regarding suicide in indigenous communities, which were analyzed according to topographic, chronological, approach and content aspects. Results: Scientific research on suicide in indigenous peoples is limited. However, the literature reviewed indicates that suicide rates are higher in indigenous peoples than in the general population, especially among young people, worldwide. Research on suicide in indigenous communities is predominantly based on risk factors, and should be understood more as a social rather than an individual event resulting from an imbalance between destructive processes and health and quality of life programs. Conclusions: Suicide in indigenous peoples is a public health problem whose comprehensive study should be encouraged from an intercultural approach, thus facilitating the implementation of culturally appropriate interventions.

The current situation shows the importance of the insertion of society in the relationship between the State and the private sector, with the objective of collaboration to improve government programs. Shared Governance is one of the great challenges that the Italian government is currently facing to avoid the crises of governance (society) and governability (negotiation with opposition and work with the public administration), in particular after the decision of the new government (September 2022) to extinguish the Reform of the Public Administration - National Recovery and Resilience Plan - PNRR, and also the largest social participation initiative in Italy, the Tuscany Regional Policy for Social Participation - TRPP. This article recuperates the good points of PNRR and TRPP and another case study in Emilia-Romagna region. Offering a new perspective to the existing literature, this paper share the “famous” model for the Public Administration, the New Public Service (NPS), created to spread the idea that public service is seen as an extension of citizenship, and therefore both government and citizens need to abandon short-term interests and imitation of the competition of private sector of the New Public Management (NPM), assuming collaborative roles in building an educated and mature civil society. Based in a literature review on the NPS model, Knowledge Management - KM, Governmental Intelligence -OI and Cultural Intelligence -CI, the article presents a theoretical model of CI, OI and Social Participation – SP (CIGISP) to improve the effectiveness of public policies. This work concludes that CIGISP model is useful to identify how the learning by comparison with other values, believes and assumptions (CI) and use of GI Practices leads to a better quality of social participation.

This paper presents a case report of a perimenopausal woman who repeatedly attended health care institutions due to chronic insomnia, and underwent pharmacological treatments and psychiatric hospitalizations without achieving any positive result for nearly three years. After compiling all the information of the case, as well as analyzing previous and recent paraclinical studies, the patient was diagnosed with hypothyroidism. The purpose of this paper is to draw attention on the adequate use of clinical diagnostic tools and processes to optimize the medical practice and to offer a better service to patients.

Resumen La discapacidad, como una construcción social, implica las representaciones sociales y las prácticas que, en consecuencia, se derivan y tienen implicaciones sobre la vida de individuos, grupos o poblaciones. Algunas de las respuestas a las necesidades de las personas con discapacidad se han gestado en instituciones que nacieron con fines filantrópicos y se han ido transformado. Este escrito forma parte de una investigación sobre las construcciones sociales de discapacidad en Colombia en las últimas cuatro décadas, la cual fue desarrollada a través de una etnografía multisituada con perspectiva crítica, cuyas fuentes de indagación fueron experiencias institucionales, grupales, personales y documentos; aquí, se ilustran las transformaciones de instituciones dedicadas a la atención de esta población en lo relacionado con su inserción en la lógica del mercado de la salud a partir de la Ley 100 de 1993. Igualmente, este estudio muestra cómo las instituciones han instaurado una carrera desmedida para poder entrar y mantenerse en los juegos del mercado de la venta de servicios, situación que confirma el posicionamiento de la salud como un negocio, y en este campo, a la rehabilitación funcional como el estandarte a seguir. Artificios como la acreditación de servicios, el mercadeo social, la oferta de las últimas tecnologías y las diversas especialidades y subespecialidades, además de los eufemismos de cambios de nombre, se esgrimen a manera de capitales simbólicos, culturales y económicos que mantienen estos actores en el campo de la discapacidad como un asunto de prestación de servicios que aleja la relación entre la salud pública y la discapacidad. Palabras clave: Antropología médica; Salud pública; Servicios de Salud (DeCS). Summary Disability as a social construct involves social representations and practices that are a consequence of it, and which have implications on the lives of individuals, groups or populations. Some of the answers to the needs of people with disabilities had their birth in institutions that were create with philanthropic purposes and have been experiencing a transformation processs. This paper is part of an investigation about social constructions of disability in Colombia over the past four decades, developed through a critical perspective multipurpose ethnography whose sources of inquiry were expediencies from institutions, groups, and people, as well as documentation related to this topic. In this paper the transformation of institutions devoted to the care of this population with regard to their entry into the health market, since the enactment of Law 100 of 1993, is illustrated. Furthermore, this study shows how the institutions take part in an inordinate career to enter and stay in services provision market , a scenario that confirms the positioning of Health as a business, and in this field, functional rehabilitation as the standard to follow. Artifices like service accreditation, social marketing, modern technologies offer and the different specialties and subspecialties, in addition to the euphemisms related to name changes, are put forward as symbolic, cultural and economic capitals that keep the players on the field disability as a matter of service delivery, which takes away the relationship between public health and disability. Keywords: Medical anthropology; Public health; Health services (MeSH).

Dengue is an infection caused by dengue virus and is the most important arthropod transmitted viral disease in the world, causing near 100 million cases and 50 000 fatalities each year. Health authorities believe that these numbers will grow in coming years. In Colombia, almost 600 municipalities are in regions with Aedes aegypti circulation, and the presence of four dengue serotypes has been demonstrated. Despite the increasing knowledge about disease pathogenesis and the dengue virus, some technical or scientific difficulties with diagnosing dengue remain, negatively affecting both public health surveillance and the appropriate attention to patients in health settings and hospitals. This paper reviews the principles and developments of the current diagnostic techniques for dengue, pointing out the difficulties with making accurate dengue diagnoses and case confirmations in public health and specialized laboratories. The principles and limitations of MAC-ELISA, IgG serology, viral NS1 detection and viral isolation by cell culture are presented. In addition, the review of immunochromatography techniques (rapid diagnostic tests) that have been put forward to help the point-of-care diagnosis is proposed. This paper is intended to bring forward some points of view about the issues related to dengue diagnosis and contribute to improve the discussion surrounding the strategies and techniques needed for reducing the impact of the disease and favoring its control.

This paper presents the case of an 11 year-old male who attended the Internal Medicine Service at a high complexity pediatric hospital. Initially, the patient attended due to a clinical profile consisting of autoimmune hemolytic anemia that was partially responsive to steroid treatment and, after exhaustive complimentary analysis, was associated to a Hodgkin lymphoma. Similar cases found in the scientific literature were reviewed in order to analyze this case. Through this paper, the authors intend to remind the medical community about the importance of a prompt and deep study of all autoimmune hemolytic anemia cases found in pediatric patients, without overlooking possible malignant causes related to this condition such as a lymphoproliferative disorder. Thus, before diagnosing a hemolytic anemia as idiopathic, the practitioner must be certain that the condition is not a clinical manifestation of an underlying disease.

The Journal of the Faculty of Medicine (Revista de la Facultad de Medicina) started its operation back in 1932, and has undergone interesting changes in the last decade, achieving greater visibility and impact on the national and international sphere. Similarly, it has managed to maintain the periodicity of its publication and to be included in important bibliographic indexes. Currently, biomedical journals published in English often make a greater impact and rank better in scientific databases in Spanish, thus giving prestige to the institutions that support them (1). Given this scenario, the medium-term objective of this journal is to publish papers in English only, which leads to a series of structural changes in editorial management and administrative academic support in order to maintain the current number of published scientific articles with excellent quality and a greater international visibility and, therefore, with a higher citation possibility. Publishing the results from the scientific activity of authors through papers in scientific journals is very important, since this has been the traditional way of doing so. Thus, a Latin American journal published in English is the perfect medium to present patents and other research products of the authors from this region and the best way to make visible the results of their work in the world.

Instrução aos autores da Revista Brasileira de Medicina de Família e Comunidade A Revista Brasileira de Medicina de Família e Comunidade (RBMFC) é uma publicação trimestral da Sociedade Brasileira de Medicina de Família e Comunidade, que tem por finalidades: sensibilizar profissionais e autoridades da área de saúde sobre a área de interesse da Medicina de Família e Comunidade; estimular e divulgar temas e pesquisas em Atenção Primária à Saúde (APS); possibilitar o intercâmbio entre academia, serviço e movimentos sociais organizados; promover a divulgação da abordagem interdisciplinar e servir como veículo de educação continuada e permanente no campo da Medicina de Família e Comunidade, tendo como eixo temático a APS.Os trabalhos serão avaliados por editores do Conselho Científico e Editorial, como também por pareceristas convidados ad-hoc. O processo de avaliação por pares preserva a identidade dos autores e suas afiliações, sendo estas informadas ao Conselho Editorial somente na fase final de avaliação.Todos os trabalhos deverão ser escritos em português, com exceção dos redigidos por autores estrangeiros não-residentes no Brasil, que poderão fazê-lo em inglês ou espanhol.Tipos de TrabalhoA revista está estruturada com as seguintes seções:EditorialArtigos OriginaisArtigos de RevisãoDiretrizes em Medicina de Família e ComunidadeEnsaiosRelatos de ExperiênciaTesesCartas ao EditorO Editorial é de responsabilidade do editor da revista, podendo ser redigido por terceiros por solicitação dele.A seção Artigos Originais é composta por artigos resultantes de pesquisa científica, apresentando dados originais de descobertas com relação a aspectos experimentais ou de observação, voltados para investigações qualitativas ou quantitativas em áreas de interesse da APS. Artigos originais são trabalhos que desenvolvem crítica e criação sobre a ciência, tecnologia e arte das ciências da saúde que contribuem para a evolução do conhecimento sobre o homem, a natureza e a inserção social e cultural. O texto – contendo introdução, material ou casuística, métodos, resultados, discussão e conclusão – deve ter até 25 laudas.A seção Artigos de Revisão é composta por artigos nas áreas de Gerência, Clínica, Educação em Saúde. Os artigos de revisão são trabalhos que apresentam síntese atualizada do conhecimento disponível sobre matérias das ciências da saúde, buscando esclarecer, organizar, normalizar e simplificar abordagens dos vários problemas que afetam o conhecimento humano sobre o homem e a natureza e sua inserção social e cultural. Têm por objetivo resumir, analisar, avaliar ou sintetizar trabalhos de investigação já publicados em revistas científicas e devem ter até 20 laudas, contendo introdução, desenvolvimento e conclusão.A seção Diretrizes em MFC é composta por artigos estruturados dentro das normas da Associação Médica Brasileira para diretrizes clínicas, validados pela SBMFC. Sua confecção, sob orientação da Diretoria Científica da SBMFC, é uma proposta de organizar e referendar o trabalho dos MFC no Brasil.A seção Ensaios visa à divulgação de artigos com as análise crítica sobre um tema específico relacionado à Medicina de Família e Comunidade e deve ser apresentada em uma média de 5 a 10 laudas.A seção Relatos de Experiência é composta de artigos que relatam casos ou experiências os quais explorem um método ou problema por meio do exemplo. Os relatos de caso apresentam as características do indivíduo estudado – com indicação de sexo e idade, podendo este ser humano ou animal –, ressaltam sua importância na atuação prática e mostram caminhos, condutas e comportamentos para a solução do problema. Essa parte deve ocupar até 8 laudas, com a seguinte estrutura: introdução, desenvolvimento e conclusão.A seção Resumos de Tese, que deve ter apenas 1 lauda, tem como proposta a divulgação da produção científica na temática do periódico. Nela, devem ser expostos resumos de dissertações de mestrado ou teses de doutoramento/livredocência defendidas e aprovadas em universidades brasileiras ou não. Os resumos deverão ser encaminhados com o título oficial da Tese, informando o título conquistado, o dia e o local da defesa. Devem ser informados, igualmente, o nome do Orientador e o local onde a tese está disponível para consulta.Em Cartas ao Editor, opiniões de leitores e sugestões sobre a revista são bem recebidas. As cartas, contendo comentários sobre material publicado, devem ter no máximo 2 laudas.Os trabalhos a serem submetidos à apreciação do Conselho Científico deverão ser encaminhados por e-mail para a Secretaria da Sociedade Brasileira de Medicina de Família e Comunidade ou ao Editor da revista. O padrão de formatação exigido é Word for Windows – versão 6.0 ou superior -, página padrão A4, letra Arial (tamanho 11), espaçamento entre linhas 1,5 e numeração seqüencial em todas as páginas. As notas de rodapé devem ser limitadas ao máximo possível, assim como as tabelas e os quadros – que devem ser de compreensão independente do texto.Os autores deverão informar seus nomes e endereços completos e quais organizações de fomento à pesquisa apoiaram os seus trabalhos, fornecendo inclusive o número de cadastro do projeto.Os trabalhos que envolverem pesquisas com seres humanos deverão vir acompanhados da devida autorização do Comitê de Ética da Instituição.Os trabalhos devem obedecer à seguinte seqüência de apresentação:1. Título em português e também em inglês(*).2. Nome completo – nome(s) seguido(s) do(s) sobrenome(s) do(s) autor(es) – e, no rodapé, a indicação da Instituição a qual está vinculado, cargo e titulação.3. Resumo do trabalho em português, no qual fiquem claros a síntese dos propósitos, os métodos empregados e as principais conclusões do trabalho.4. Palavras-chave – mínimo de 3 e máximo de 5 palavras-chave ou descritores do conteúdo do trabalho, apresentados em português de acordo com o DeCS – Descritores em Ciências da Saúde da BIREME - Centro Latino Americano e do Caribe de Informação em Ciências da Saúde –URL: .5. Abstract – versão do resumo em inglês(*).6. Key words – palavras-chave em inglês, de acordo com DeCS(*).7. Artigo propriamente dito, de acordo com a estrutura recomendada para cada tipo de artigo, citada no item 2.8. Figuras (gráficos, desenhos e tabelas) devem ser enviadas à parte, com indicação na margem do local de inserção no texto; as fotografias em preto e branco devem ser apresentadas em papel brilhante.9. Referências: são de responsabilidade dos autores e deverão ser limitadas às citações do texto, além de numeradas segundo a ordem de referência, de acordo com as regras propostas pelo Comitê Internacional de Revistas Médicas (International Committee of Medical Journal Editors). Requisitos uniformes para manuscritos apresentados a periódicos biomédicos. Disponível em: http://www.icmje.org.(*) A versão do título do trabalho, do resumo e das palavras-chave para o idioma inglês ficará a cargo da própria revista, salvo eventual decisão ao contrário em época futura que, se vier ao caso, será comunicada no Editorial da revista.Exemplos:PeriódicoValla VV. Educação popular e saúde diante das formas de se lidar com a saúde. Revista APS. 2000; (5): 46-53.LivroBirman J. Pensamento freudiano. Rio de Janeiro: Jorge Zahar; 1994. 204p.Capítulo de livroVasconcelos EM. Atividades coletivas dentro do Centro de Saúde. In: ________. Educação popular nos serviços de saúde. 3. ed. São Paulo: HUCITEC; 1997. p. 65-69.DissertaçãoCaldas CP. Memória dos velhos trabalhadores. [Dissertação]. Rio de Janeiro, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro; 1993.EventoMauad NM, Campos EM. Avaliação da implantação das ações de assistência integral à saúde da mulher no PIES/UFJF; 6º Congresso Brasileiro de Saúde Coletiva; 2000, Salvador. Salvador: Associação Brasileira de Pós-graduação em Saúde Coletiva; 2000. p.328.Documento eletrônicoCivitas. Coordenação de Simão Pedro P. Marinho. Desenvolvido pela Pontifícia Universidade Católica de Minas Gerais, 1995-1998. Apresenta textos sobre urbanismo e desenvolvimento de cidades. Disponível em: www.gcsnet.com.br/oamis/civitas. Acesso em: 27 nov. 1998.Fluxo dos trabalhos submetidos à publicação.Os artigos são de total e exclusiva responsabilidade dos autores.Avaliação por pares: os artigos recebidos são protocolados na secretaria da revista e encaminhados tanto ao editor geral quanto aos editores associados, para a triagem, a avaliação preliminar e a posterior distribuição ao Conselho Editorial e Científico, em conformidade com as áreas de atuação e especialização dos membros, bem como o assunto tratado no artigo. Todos os textos são submetidos à avaliação de dois consultores –provenientes de instituição diferente daquela do(s) autor(es) –, em um processo duplo cego, que os analisam em relação aos seguintes aspectos: adequação do título ao conteúdo; estrutura da publicação; clareza e pertinência dos objetivos; metodologia; informações inteligíveis; citações e referências adequadas às normas técnicas adotadas pela revista e pertinência à linha editorial da publicação. Os consultores preenchem o formulário de parecer, aceitando, recusando ou recomendando correções e/ou adequações necessárias. Nestes casos, os artigos serão devolvidos ao(s) autor(es), para os ajustes e reenvio, e aos consultores para nova avaliação. O resultado é comunicado ao(s) autor(es), e os artigos aprovados ficam disponíveis para publicação em ordem de protocolo. Não serão admitidos acréscimos ou modificações após a aprovação.Declaração de responsabilidade dos autoresTodas as pessoas responsáveis como autores devem responder pela autoria dos trabalhos, tendo como justificada a sua participação de forma significativa no trabalho para assumir responsabilidade pública pelo seu conteúdo. Deverão, portanto, assinar a seguinte declaração de autoria e de responsabilidade:“Declaro que participei de forma significativa na construção e formação deste estudo ou da análise e interpretação dos dados, como também na redação deste texto, tendo, enquanto autor, responsabilidade pública pelo conteúdo deste. Revi a versão final deste trabalho e aprovo para ser submetido à publicação. Declaro que nem o presente trabalho nem outro com conteúdo semelhante de minha autoria foi publicado ou submetido à apreciação do Conselho Editorial de outra publicação.”Artigos com mais de um autor deverão conter uma exposição sobre a contribuição específica de cada um no trabalho. Os autores de cada artigo receberão, após a publicação de seu trabalho, três exemplares da revista em que o seu estudo foi publicado.Ética em pesquisaCom relação às pesquisas iniciadas após janeiro de 1997, nas quais exista a participação de seres humanos nos termos do inciso II.2 da Resolução 196/ 96 do Conselho Nacional de Saúde (“pesquisa que, individual ou coletivamente, envolva o ser humano de forma direta ou indireta, em sua totalidade ou partes dele, incluindo o manejo de informações ou materiais”), sempre que pertinente, deve ser declarado no texto que o trabalho foi aprovado pelo Comitê de Ética em Pesquisa em Seres Humanos.Os trabalhos devem ser enviados para:Sociedade Brasileira de Medicina de Família e Comunidade - SBMFCCorrespondênciaRua 28 de Setembro, 44 sala 804Rio de Janeiro - RJCep: 20551-031Tel/fax: 21 2264-5117Endereço eletrônico:rbmfc@sbmfc.org.brThe Brazilian Journal of Family and Community Medicine (BJFCM) is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC) issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC.Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process.All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish.Categories and formats of papersThe journal is divided into the following sections:EditorialOriginal articlesReview articlesDirectives in Family and Community MedicineEssaysCase reportsThesesLetters to the EditorThe Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request.The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including introduction, material or rationale, methods, results, discussion and conclusion – should not exceed 25 pages.The section Reviews is composed by articles about Health Management, Clinics and Health Education. Review articles are papers presenting an up-to-date synthesis of available knowledge on health science subjects, with the intent to elucidate, organize, normalize and simplify approaches to the different problems affecting human knowledge about Man and nature and social and cultural inclusion. These papers are aimed at summarizing, analyzing, evaluating and synthesizing investigations already published in scientific journals and should not exceed 20 pages, including introduction, rationale and conclusion.The section Directives in FCM receives articles prepared according to the norms for Clinical Directives of the Brazilian Association of Physicians, validated by the BSFCM. The purpose of these articles - prepared under the guidance of the Scientific Board of the BSFCM – is to organize and reference the work of physicians involved in FMC in Brazil.The section Essays publishes critical analyses regarding specific topics related to Family and Community Medicine. Articles should have 5 to 10 pages.Case Reports are articles addressing cases or experiences by exploring a method or problem based on an example. These articles indicate details such as sex and age of the studied individual – human or animal – emphasize their importance in practice and indicate ways, procedures and conducts for solving the problem. Articles for this section should not exceed 8 pages and include introduction, rationale and conclusion.The section Abstracts of Theses is aimed at publishing scientific production in the field covered by the journal in form of abstracts of master’s and doctor’s dissertations defended in Brazilian universities or abroad. Abstracts should not exceed one page, state the official title of the dissertation, the academic degree achieved, date and place where the thesis was defended and indicate the name of the supervisor and where the dissertation is available for consultation.In the section Letters to the Editor, readers are invited to express their opinion and make suggestions to the journal.Articles should be submitted by electronic mail, directed to the Secretariat of the Brazilian Society of Family and Community Health or to the Editor. Papers should be typed in word processor Word for Windows – version 0.6 or superior – paper size ISO A4, font Arial, size 11, space between lines 1,5, and all pages should be numbered sequentially. References should be kept to the necessary minimum. The same refers to tables and figures, which should be understandable independently from the text. Corresponding authors should inform their full names and addresses. The funding sources by which the work was supported should be stated.Articles describing investigations on human subjects must include a statement referring institutional ethics committee clearance.Manuscripts should be structured as below:1. Title2. Complete names – first name(s) followed by family name(s) of the author(s)3. Abstract giving a clear synthesis of the purpose, describing the methods used and mainconclusions of the study.4. Key words – a minimum of 3 and a maximum of 5 key words or describers of the contents of the work, following the norms of DeCS, available at http://decs.bvs.br/5. Text of the article, according to the recommendations for each category given above.6. Figures (graphs, diagrams and tables) according to the recommendations given above.7. References: are responsibility of the authors and should be arranged numerically according to the order in which they appear in the text, according to the rules of the International Committee of Medical Journal Editors, Uniform.Requirements for Manuscripts Submitted to Biomedical Journals, available at http://www.icmje.orgExamples:PeriodicalValla VV. Educação popular e saúde diante das formas de se lidar com a saúde. APS Journal. 2000; (5): 46-53.BookBirman J. Pensamento freudiano. Rio de Janeiro: Jorge Zahar; 1994. 204p.Book chapterVasconcelos EM. Atividades coletivas dentro do Centro de Saúde. In: ________. Educação popular nos serviços de saúde. 3rd. ed. São Paulo: HUCITEC; 1997. p. 65-69.DissertationCaldas CP. Memória dos velhos trabalhadores. [Dissertation]. Rio de Janeiro, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro; 1993.EventMauad NM, Campos EM. Avaliação da implantação das ações de assistência integral à saúde da mulher no PIES/UFJF; 6th Brazilian Congress on Collectyive Health; 2000, Salvador. Salvador: Associação Brasileira de Pós-graduação em Saúde Coletiva; 2000. p.328.References from the internetCivitas. Coordinated by: Simão Pedro P. Marinho. Developed by: Pontifícia Universidade Católica de Minas Gerais, 1995-1998. Presents texts on urbanism and city development. Available at: . Accessed: Nov 27. 1998.Review procedures and publication of submitted manuscripts.The articles are of the full and exclusive responsibility of the authors.Peer-review procedure: received articles are registered by the Secretariat of the journal and submitted to the Scientific and Editorial Board for screening, preliminary evaluation and posterior distribution to ad hoc referees with specific expertise in the subject addressed by the article. All manuscripts are submitted to two referees, coming from institutions different from those of the author(s) who, in a double-blind review process, assess them with respect to the following aspects: pertinence of the title in relation to the content, structure of the manuscript, pertinence and clearness of objectives, methodology, intelligible information, conformity of citations and references with the technical norms and alignment with the editorial line of the journal. The referees fill in the review form accepting or rejecting the manuscript or suggesting improvements and/or necessary corrections. In this case, the manuscript is returned to the author(s) for revision and resubmission, followed by a new evaluation. The result is communicated to the author(s) and accepted articles will be published following the order of registry. No additions or modifications in manuscripts already accepted for publication will be admitted.Responsibility StatementAll individuals named as authors for having participated substantially in the submitted study have to take public responsibility for the integrity of their work and consequently sign the following Responsibility Statement:“I hereby declare to have participated substantially in the conception and design of the present work and in the writing of the manuscript, taking public responsibility for its integrity. I have read the final version of this work and agreed to its submission for publication. The work in its present or a similar form has not been published elsewhere, nor is it currently under consideration for publication in another periodical.”Articles prepared by more than one author should state the specific contribution of each of them. The authors of each article will receive three exemplars of the edition in which their study was published.Ethics in experimentationArticles based on investigations involving human subjects should declare in the text that the investigation has beencleared by the responsible Ethics Committee on Human Experimentation.Manuscripts should be submitted electronically to:Sociedade Brasileira de Medicina de Família e Comunidade - SBMFCContact Address:Rua 28 de Setembro, 44 sala 804Rio de Janeiro - RJCep: 20551-031Tel/fax: 21 2264-5117 e-mail: rbmfc@sbmfc.org.br

The Brazilian Journal of Family and Community Medicine (BJFCM) is a three-monthly publication of the Brazilian Society of Family and Community Medicine, aimed at sensitizing professionals and health authorities to this field of interest, stimulating and disseminating Primary Health Care (PHC) issues and investigations, and facilitating interchange between academic institutions, health care services and organized social movements. The periodical also aims to promote an interdisciplinary approach to this area and to serve as a vehicle for continued and permanent education in the field of Family and Community Health, with emphasis to the central subject PHC. Manuscripts will be reviewed by members of the Scientific and Editorial Board as well as by outside referees. This peer-review process safeguards the identity of authors and their institutions of origin, which only will be revealed to the Editorial Board in the end of the evaluation process. All manuscripts should be prepared in Portuguese language. Foreign authors, not living in Brazil, can submit their papers in English or Spanish. Categories and formats of papers The journal is divided into the following sections: Editorial Original articles Review articles Directives in Family and Community Medicine Essays Case reports Theses Letters to the Editor The Editorial is responsibility of the editor of the journal, but can be prepared by third persons on his request. The section Original Articles is dedicated to reports on scientific investigations, presenting original data on findings from experiments or observation with emphasis to qualitative or quantitative studies in fields of interest for PHC. Original articles are criticisms or creations on science, technology and the art of health sciences, contributing to the evolution of knowledge about Man, nature and social and cultural inclusion. The papers - including introduction, material or rationale, methods, results, discussion and conclusion should not exceed 25 pages. The section Reviews is composed by articles about Health Management, Clinics and Health Education. Review articles are papers presenting an up-to-date synthesis of available knowledge on health science subjects, with the intent to elucidate, organize, normalize and simplify approaches to the different problems affecting human knowledge about Man and nature and social and cultural inclusion. These papers are aimed at summarizing, analyzing, evaluating and synthesizing investigations already published in scientific journals and should not exceed 20 pages, including introduction, rationale and conclusion. The section Directives in FCM receives articles prepared according to the norms for Clinical Directives of the Brazilian Association of Physicians, validated by the BSFCM. The purpose of these articles - prepared under the guidance of the Scientific Board of the BSFCM – is to organize and reference the work of physicians involved in FMC in Brazil. The section Essays publishes critical analyses regarding specific topics related to Family and Community Medicine. Articles should have 5 to 10 pages. Case Reports are articles addressing cases or experiences by exploring a method or problem based on an example. These articles indicate details such as sex and age of the studied individual – human or animal – emphasize their importance in practice and indicate ways, procedures and conducts for solving the problem. Articles for this section should not exceed 8 pages and include introduction, rationale and conclusion. The section Abstracts of Theses is aimed at publishing scientific production in the field covered by the journal in form of abstracts of master’s and doctor’s dissertations defended in Brazilian universities or abroad. Abstracts should not exceed one page, state the official title of the dissertation, the academic degree achieved, date and place where the thesis was defended and indicate the name of the supervisor and where the dissertation is available for consultation. In the section Letters to the Editor, readers are invited to express their opinion and make suggestions to the journal. Articles should be submitted by electronic mail, directed to the Secretariat of the Brazilian Society of Family and Community Health or to the Editor. Papers should be typed in word processor Word for Windows version 0.6 or superior paper size ISO A4, font Arial, size 11, space between lines 1,5, and all pages should be numbered sequentially. References should be kept to the necessary minimum. The same refers to tables and figures, which should be understandable independently from the text. Corresponding authors should inform their full names and addresses. The funding sources by which the work was supported should be stated. Articles describing investigations on human subjects must include a statement referring institutional ethics committee clearance. Manuscripts should be structured as below: 1. Title 2. Complete names – first name(s) followed by family name(s) of the author(s) 3. Abstract giving a clear synthesis of the purpose, describing the methods used and main conclusions of the study. 4. Key words – a minimum of 3 and a maximum of 5 key words or describers of the contents of the work, following the norms of DeCS, available at http://decs.bvs.br/ 5. Text of the article, according to the recommendations for each category given above. 6. Figures (graphs, diagrams and tables) according to the recommendations given above. 7. References: are responsibility of the authors and should be arranged numerically according to the order in which they appear in the text, according to the rules of the International Committee of Medical Journal Editors, Uniform Requirements for Manuscripts Submitted to Biomedical Journals, available at http://www.icmje.org Examples: Periodical Valla VV. Educação popular e saúde diante das formas de se lidar com a saúde. APS Journal. 2000; (5): 46-53. Book Birman J. Pensamento freudiano. Rio de Janeiro: Jorge Zahar; 1994. 204p. Book chapter Vasconcelos EM. Atividades coletivas dentro do Centro de Saúde. In: ________. Educação popular nos serviços de saúde. 3rd. ed. São Paulo: HUCITEC; 1997. p. 65-69. Dissertation Caldas CP. Memória dos velhos trabalhadores. [Dissertation]. Rio de Janeiro, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro; 1993. Event Mauad NM, Campos EM. Avaliação da implantação das ações de assistência integral à saúde da mulher no PIES/UFJF; 6th Brazilian Congress on Collectyive Health; 2000, Salvador. Salvador: Associação Brasileira de Pós-graduação em Saúde Coletiva; 2000. p.328. References from the internet Civitas. Coordinated by: Simão Pedro P. Marinho. Developed by: Pontifícia Universidade Católica de Minas Gerais, 1995-1998. Presents texts on urbanism and city development. Available at: . Accessed: Nov 27. 1998. Review procedures and publication of submitted manuscripts The articles are of the full and exclusive responsibility of the authors. Peer-review procedure: received articles are registered by the Secretariat of the journal and submitted to the Scientific and Editorial Board for screening, preliminary evaluation and posterior distribution to ad hoc referees with specific expertise in the subject addressed by the article. All manuscripts are submitted to two referees, coming from institutions different from those of the author(s) who, in a double-blind review process, assess them with respect to the following aspects: pertinence of the title in relation to the content, structure of the manuscript, pertinence and clearness of objectives, methodology, intelligible information, conformity of citations and references with the technical norms and alignment with the editorial line of the journal. The referees fill in the review form accepting or rejecting the manuscript or suggesting improvements and/or necessary corrections. In this case, the manuscript is returned to the author(s) for revision and resubmission, followed by a new evaluation. The result is communicated to the author(s) and accepted articles will be published following the order of registry. No additions or modifications in manuscripts already accepted for publication will be admitted. Responsibility Statement All individuals named as authors for having participated substantially in the submitted study have to take public responsibility for the integrity of their work and consequently sign the following Responsibility Statement: “I hereby declare to have participated substantially in the conception and design of the present work and in the writing of the manuscript, taking public responsibility for its integrity. I have read the final version of this work and agreed to its submission for publication. The work in its present or a similar form has not been published elsewhere, nor is it currently under consideration for publication in another periodical.”” Articles prepared by more than one author should state the specific contribution of each of them. The authors of each article will receive three exemplars of the edition in which their study was published. Ethics in experimentation Articles based on investigations involving human subjects should declare in the text that the investigation has been cleared by the responsible Ethics Committee on Human Experimentation. Manuscripts should be submitted electronically to: Sociedade Brasileira de Medicina de Família e Comunidade - SBMFC Contact Address: Rua 28 de Setembro, 44 sala 804 Rio de Janeiro - RJ Cep: 20551-031 Tel/fax: 21 2264-5117 e-mail: rbmfc@sbmfc.org.brA Revista Brasileira de Medicina de Família e Comunidade (RBMFC) é uma publicação trimestral da Sociedade Brasileira de Medicina de Família e Comunidade, que tem por finalidades: sensibilizar profissionais e autoridades da área de saúde sobre a área de interesse da Medicina de Família e Comunidade; estimular e divulgar temas e pesquisas em Atenção Primária à Saúde (APS); possibilitar o intercâmbio entre academia, serviço e movimentos sociais organizados; promover a divulgação da abordagem interdisciplinar e servir como veículo de educação continuada e permanente no campo da Medicina de Família e Comunidade, tendo como eixo temático a APS. Os trabalhos serão avaliados por editores do Conselho Científico e Editorial, como também por pareceristas convidados ad hoc. O processo de avaliação por pares preserva a identidade dos autores e suas afiliações, sendo estas informadas ao Conselho Editorial somente na fase final de avaliação. Todos os trabalhos deverão ser escritos em português, com exceção dos redigidos por autores estrangeiros não-residentes no Brasil, que poderão fazê-lo em inglês ou espanhol. Tipos de Trabalho A revista está estruturada com as seguintes seções: Editorial Artigos Originais Artigos de Revisão Diretrizes em Medicina de Família e Comunidade Ensaios Relatos de Experiência Teses Cartas ao Editor O Editorial é de responsabilidade do editor da revista, podendo ser redigido por terceiros por solicitação dele. A seção Artigos Originais é composta por artigos resultantes de pesquisa científica, apresentando dados originais de descobertas com relação a aspectos experimentais ou de observação, voltados para investigações qualitativas ou quantitativas em áreas de interesse da APS. Artigos originais são trabalhos que desenvolvem crítica e criação sobre a ciência, tecnologia e arte das ciências da saúde que contribuem para a evolução do conhecimento sobre o homem, a natureza e a inserção social e cultural. O texto – contendo introdução, material ou casuística, métodos, resultados, discussão e conclusão – deve ter até 25 laudas. A seção Artigos de Revisão é composta por artigos nas áreas de Gerência, Clínica, Educação em Saúde. Os artigos de revisão são trabalhos que apresentam síntese atualizada do conhecimento disponível sobre matérias das ciências da saúde, buscando esclarecer, organizar, normalizar e simplificar abordagens dos vários problemas que afetam o conhecimento humano sobre o homem e a natureza e sua inserção social e cultural. Têm por objetivo resumir, analisar, avaliar ou sintetizar trabalhos de investigação já publicados em revistas científicas e devem ter até 20 laudas, contendo introdução, desenvolvimento e conclusão. A seção Diretrizes em MFC é composta por artigos estruturados dentro das normas da Associação Médica Brasileira para diretrizes clínicas, validados pela SBMFC. Sua confecção, sob orientação da Diretoria Científica da SBMFC, é uma proposta de organizar e referendar o trabalho dos MFC no Brasil. A seção Ensaios visa à divulgação de artigos com as análise crítica sobre um tema específico relacionado à Medicina de Família e Comunidade e deve ser apresentada em uma média de 5 a 10 laudas. A seção Relatos de Experiência é composta de artigos que relatam casos ou experiências os quais explorem um método ou problema por meio do exemplo. Os relatos de caso apresentam as características do indivíduo estudado com indicação de sexo e idade, podendo este ser humano ou animal –, ressaltam sua importância na atuação prática e mostram caminhos, condutas e comportamentos para a solução do problema. Essa parte deve ocupar até 8 laudas, com a seguinte estrutura: introdução, desenvolvimento e conclusão. A seção Resumos de Tese, que deve ter apenas 1 lauda, tem como proposta a divulgação da produção científica na temática do periódico. Nela, devem ser expostos resumos de dissertações de mestrado ou teses de doutoramento/livre-docência defendidas e aprovadas em universidades brasileiras ou não. Os resumos deverão ser encaminhados com o título oficial da Tese, informando o título conquistado, o dia e o local da defesa. Devem ser informados, igualmente, o nome do Orientador e o local onde a tese está disponível para consulta. Em Cartas ao Editor, opiniões de leitores e sugestões sobre a revista são bem recebidas. As cartas, contendo comentários sobre material publicado, devem ter no máximo 2 laudas. Os trabalhos a serem submetidos à apreciação do Conselho Científico deverão ser encaminhados por e-mail para a Secretaria da Sociedade Brasileira de Medicina de Família e Comunidade ou ao Editor da revista. O padrão de formatação exigido é Word for Windows versão 6.0 ou superior -, página padrão A4, letra Arial (tamanho 11), espaçamento entre linhas 1,5 e numeração seqüencial em todas as páginas. As notas de rodapé devem ser limitadas ao máximo possível, assim como as tabelas e os quadros que devem ser de compreensão independente do texto. Os autores deverão informar seus nomes e endereços completos e quais organizações de fomento à pesquisa apoiaram os seus trabalhos, fornecendo inclusive o número de cadastro do projeto. Os trabalhos que envolverem pesquisas com seres humanos deverão vir acompanhados da devida autorização do Comitê de Ética da Instituição. Os trabalhos devem obedecer à seguinte seqüência de apresentação: 1. Título em português e também em inglês(*). 2. Nome completo – nome(s) seguido(s) do(s) sobrenome(s) do(s) autor(es) – e, no rodapé, a indicação da Instituição a qual está vinculado, cargo e titulação. 3. Resumo do trabalho em português, no qual fiquem claros a síntese dos propósitos, os métodos empregados e as principais conclusões do trabalho. 4. Palavras-chave – mínimo de 3 e máximo de 5 palavras-chave ou descritores do conteúdo do trabalho, apresentados em português de acordo com o DeCS - Descritores em Ciências da Saúde da BIREME – Centro Latino Americano e do Caribe de Informação em Ciências da Saúde – URL: . 5. Abstract – versão do resumo em inglês(*). 6. Key words – palavras-chave em inglês, de acordo com DeCS(*). 7. Artigo propriamente dito, de acordo com a estrutura recomendada para cada tipo de artigo, citada no item 2. 8. Figuras (gráficos, desenhos e tabelas) devem ser enviadas à parte, com indicação na margem do local de inserção no texto; as fotografias em preto e branco devem ser apresentadas em papel brilhante. 9. Referências: são de responsabilidade dos autores e deverão ser limitadas às citações do texto, além de numeradas segundo a ordem de referência, de acordo com as regras propostas pelo Comitê Internacional de Revistas Médicas (International Committee of Medical Journal Editors). Requisitos uniformes para manuscritos apresentados a periódicos biomédicos. Disponível em: . (*) A versão do título do trabalho, do resumo e das palavras-chave para o idioma inglês ficará a cargo da própria revista, salvo eventual decisão ao contrário em época futura que, se vier ao caso, será comunicada no Editorial da revista. Exemplos: Periódico Valla VV. Educação popular e saúde diante das formas de se lidar com a saúde. Revista APS. 2000; (5): 46-53. Livro Birman J. Pensamento freudiano. Rio de Janeiro: Jorge Zahar; 1994. 204p. Capítulo de livro Vasconcelos EM. Atividades coletivas dentro do Centro de Saúde. In: ________. Educação popular nos serviços de saúde. 3. ed. São Paulo: HUCITEC; 1997. p. 65-69. Dissertação Caldas CP. Memória dos velhos trabalhadores. [Dissertação]. Rio de Janeiro, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro; 1993. Evento Mauad NM, Campos EM. Avaliação da implantação das ações de assistência integral à saúde da mulher no PIES/UFJF; 6º Congresso Brasileiro de Saúde Coletiva; 2000, Salvador. Salvador: Associação Brasileira de Pós-graduação em Saúde Coletiva; 2000. p.328. Documento eletrônico Civitas. Coordenação de Simão Pedro P. Marinho. Desenvolvido pela Pontifícia Universidade Católica de Minas Gerais, 1995-1998. Apresenta textos sobre urbanismo e desenvolvimento de cidades. Disponível em: www.gcsnet.com.br/oamis/civitas. Acesso em: 27 nov. 1998. Fluxo dos trabalhos submetidos à publicação Os artigos são de total e exclusiva responsabilidade dos autores. Avaliação por pares: os artigos recebidos são protocolados na secretaria da revista e encaminhados tanto ao editor geral quanto aos editores associados, para a triagem, a avaliação preliminar e a posterior distribuição ao Conselho Editorial e Científico, em conformidade com as áreas de atuação e especialização dos membros, bem como o assunto tratado no artigo. Todos os textos são submetidos à avaliação de dois consultores provenientes de instituição diferente daquela do(s) autor(es), em um processo duplo cego, que os analisam em relação aos seguintes aspectos: adequação do título ao conteúdo; estrutura da publicação; clareza e pertinência dos objetivos; metodologia; informações inteligíveis; citações e referências adequadas às normas técnicas adotadas pela revista e pertinência à linha editorial da publicação. Os consultores preenchem o formulário de parecer, aceitando, recusando ou recomendando correções e/ou adequações necessárias. Nestes casos, os artigos serão devolvidos ao(s) autor(es), para os ajustes e reenvio, e aos consultores para nova avaliação. O resultado é comunicado ao(s) autor(es), e os artigos aprovados ficam disponíveis para publicação em ordem de protocolo. Não serão admitidos acréscimos ou modificações após a aprovação. Declaração de responsabilidade dos autores Todas as pessoas responsáveis como autores devem responder pela autoria dos trabalhos, tendo como justificada a sua participação de forma significativa no trabalho para assumir responsabilidade pública pelo seu conteúdo. Deverão, portanto, assinar a seguinte declaração de autoria e de responsabilidade: “Declaro que participei de forma significativa na construção e formação deste estudo ou da análise e interpretação dos dados, como também na redação deste texto, tendo, enquanto autor, responsabilidade pública pelo conteúdo deste. Revi a versão final deste trabalho e aprovo para ser submetido à publicação. Declaro que nem o presente trabalho nem outro com conteúdo semelhante de minha autoria foi publicado ou submetido à apreciação do Conselho Editorial de outra publicação. Artigos com mais de um autor deverão conter uma exposição sobre a contribuição específica de cada um no trabalho. Os autores de cada artigo receberão, após a publicação de seu trabalho, três exemplares da revista em que o seu estudo foi publicado. Ética em pesquisa Com relação às pesquisas iniciadas após janeiro de 1997, nas quais exista a participação de seres humanos nos termos do inciso II.2 da Resolução 196/ 96 do Conselho Nacional de Saúde (pesquisa que, individual ou coletivamente, envolva o ser humano de forma direta ou indireta, em sua totalidade ou partes dele, incluindo o manejo de informações ou materiais), sempre que pertinente, deve ser declarado no texto que o trabalho foi aprovado pelo Comitê de Ética em Pesquisa em Seres Humanos. Os trabalhos devem ser enviados para: Sociedade Brasileira de Medicina de Família e Comunidade - SBMFC Correspondência Rua 28 de Setembro, 44 sala 804 Rio de Janeiro - RJ Cep: 20551-031 Tel/fax: 21 2264-5117 Endereço eletrônico: rbmfc@sbmfc.org.br

This paper seeks to outline a conceptual framework for child care during the hospitalization, by the light ofBetty Neuman’s Theory, which views are based on the effects caused by coping situations in the body together with thevariables: duration, occurrences, present or past individual’s conditions, nature and intensity of the stressor, and theamount of energy required by the body to adapt to situations. The stressors mentioned by Neuman occur by intrapersonal,interpersonal and extra personal factors. This paper describes the interventions that permeate this conceptual frameworkand its application in the care of hospitalized children to enable nurses to develop a therapeutic approach with the childclient in order to minimize disruption and breakdown of family dynamics.

Objective: to identify the Brazilian scientific production about Nursing consultation teaching in nurses' training. Method: a descriptive study of a bibliometric nature conducted in the portal of Biblioteca Virtual em Saúde and in PubMed from April to May 2021, with the following inclusion criteria: full articles, in Portuguese or English, published from 2009 to 2020. Results: a total of 13 studies were identified, of which four were published in a B2 journal from the Northeast region, although with predominance of papers from the South region (38.46%), with the experience report type standing out. The most frequently observed themes were related to the teaching methodologies, especially the active ones with use of technological tools. “Nursing consultation” was not found to be one of the most frequent keywords. Conclusion: by verifying the incipience of the production on the theme, this study provides subsidies for expanding this knowledge area, reverberating in improvements in Nursing consultation teaching and in nurses' training.

"Dr. Licia Mota, president of the Scientific Committee, explains the evaluation of the submitted papers and the main topics that will be addressed from August 10 to 13 in Miami."

Introduction: Remote contact between general practitioners and patients is a key component of accessibility to primary care. Objective: This study aims to determine the frequency of (and attitudes towards) the use of telephone and e-mail between general practitioners working in Matosinhos and their patients. Methods: A census of general practitioners working in Matosinhos was invited to participate in a cross-sectional survey-based study. An anonymous, paper, self-administered questionnaire was applied, and descriptive data analysis was used. Results: Eighty-one completed questionnaires were obtained (90.0% response rate). All general practitioners reported communicating with patients by telephone but one-third never/rarely exchanged e-mails with them. Most considered that the use of the telephone and e-mail is an overload for which they do not have enough time but acknowledged that both tools facilitate the management of patient lists and appointments. Participants stated that they would use both tools more often if interactions could be recorded in real-time and that they would use the telephone more often if it was accounted for in their performance evaluation. General practitioners with larger lists more often reported telephone calls with their patients. General practitioners working in ‘Model B’ practices more often used e-mail with their patients. General practitioners that use e-mail less often considered that it represents an overload and has a negative risk/benefit ratio, they less often agree that it facilitates the management of patient lists and appointments and wouldn't increase the frequency of use even if it was accounted for in their performance evaluation. Conclusion: All general practitioners have telephone calls with patients but express several negative attitudes towards this type of remote contact. General practitioners who are frequent e-mail users more often express positive attitudes, compared to the ones who are not regular e-mail adopters. Organizational policies should consider general practitioners’ attitudes.

Quando se fala em Estratégia Saúde da Família, muito se questiona sobre a necessidade de uma maior qualificação dos seus profissionais e os resultados que, de fato, são alcançados pela Atenção Primária à Saúde (APS) em nosso país. Para que as dúvidas levantadas sobre esses temas não fiquem a pairar ao sabor do vento, é urgente envidarmos todos os esforços possíveis para investigarmos os múltiplos aspectos envolvidos nessas questões. A produção científica deve ser, portanto, capaz de demonstrar a influência positiva da APS sobre a saúde da população e o papel decisivo do médico de família e comunidade (MFC) nos resultados e no impacto desta atenção. A Revista Brasileira de Medicina de Família e Comunidade (RBMFC) vem, neste editorial, ressaltar a importância e convidar os profissionais envolvidos na APS a desenvolverem pesquisas, avaliando séries históricas e estudos transversais, em que a prática de uma atenção ativa, comprometida com a comunidade e contextualizada com a realidade do território onde atua – típica da APS – possa ser evidenciada. É interessante, também, que possam ser desenvolvidos estudos comparativos desta APS com o modelo tradicional de atenção, mais passivo e focado nas doenças. Além disso, seria relevante analisar o impacto da atenção prestada por MFC em comparação com os demais médicos, para aquilatar o quanto é necessário investir na qualificação e para demonstrar que o profissional que atua no campo da APS deve estar devidamente capacitado para desenvolver essas atividades. A população brasileira, ao longo de várias gerações, teve como referência de assistência à saúde o modelo “flexneriano”, centrado na doença e na oferta de produtos e serviços, segundo uma lógica de mercado, fundamentados em hospitais e especialidades focais. Sendo este o modelo hegemônico, é comum que as comunidades ainda o reivindiquem aos gestores – solicitando prontos-socorros, hospitais e especialistas focais. Mudar isso é tarefa de todos os que assumem a APS e a MFC. Não basta somente a boa prática e o bom trabalho nos locais onde se atua. É necessário a sua demonstração consistente e a divulgação das diferenças. Isso só pode ser bem aquilatado por meio de pesquisas científicas bem conduzidas. Mais que uma disciplina ou um nível de atenção, a MFC constitui hoje um campo do conhecimento científico a ser explorado. Nesta perspectiva, Willian Phillips e Deborah Haynes1 nos alertam que somente nós, os médicos de família, podemos delimitar o território da nossa especialidade. Se não estivermos dispostos a dizer ‘não’, qualquer outra coisa que dizemos poderá não importar. A assistência está em crise nesta loucura que é a medicina moderna. A especialidade da medicina de família não somente dispõe dos meios como tem a responsabilidade de agregar o serviço, a ciência e o bom senso que sabemos necessários. Ela tem de ser enxergada a partir da visão ampla do relacionamento, da integralidade e do profissionalismo, e percorrida pelos caminhos da assistência ao paciente e do serviço comunitário. A melhor forma de explorar este terreno é tomando posição, avançando contra as fronteiras da ciência e dos sistemas. Não há mapa que possa nos guiar através deste campo rico e diversificado. E, citando o professor Ian McWhinney, concluem: “Quando se trata de curar, chega um momento em que temos de deixar os nossos mapas de lado e explorar o terreno de mãos dadas com o paciente”. Neste sentido, a Diretoria da Sociedade Brasileira de Medicina de Família e Comunidade, notadamente a de Pesquisa Científica e a de Publicações, coloca-se como parceira no desenvolvimento dessas investigações, apoiando os seus membros para que possamos mostrar à população e aos governos das diversas esferas o papel central que a APS tem na promoção e manutenção da saúde da população. A idéia é que no 9º Congresso Brasileiro de Medicina de Família e Comunidade, em maio de 2008, na bela cidade de Fortaleza, os autores possam apresentar esses dados, dando mais um passo no sentido do reconhecimento e da valorização de nossa especialidade e da Atenção Primária à Saúde. Referência: 1. The Domain of Family Practice: Scope, Role, and Function. William R. Phillips, MD, MPH; Deborah G. Haynes, MD (Dr Phillips); and Preferred Medical Associates Northeast, Wichita, Ks (Dr Haynes). From the Department of Family Medicine, University of Washington. The Keystone Papers: Formal Discussion Papers From Keystone III.[s.d.]; 33(4): 273-277.

A ética é nas palavras de Megale o que de mais justo existe. Estas palavras, que são sem dúvida muito fortes, pretendem afirmar dentro do possível, tudo aquilo que move a dinâmica deste trabalho. Com efeito, tendo o artigo por tema “Reflexões sobre a ética no quotidiano da profissão”, a primeira questão que importa saber é naturalmente o que é a ética, o que é a profissão, para num passo seguinte se demonstrar por que formas poderá a ética influenciar a conduta do profissional, quais as causas e consequências das responsabilidades éticas na profissão. Não se pretende de forma alguma fazer aqui algum tipo de juízos de valor, não é da nossa competência, mas caracterizar uma realidade que pode ser controversa e até por vezes dramática para a consciência das pessoas. Cada vez mais as realidades complexas da sociedade, em geral, e da profissão em particular, interagem nos comportamentos dos profissionais. Quer isto dizer que do nosso ponto de vista vale a pena revisitar algumas ideias que possam contribuir não só para identificar alguns indicadores para a reflexão, mas também para que permitam lançar pistas susceptíveis de serem continuadas a aprofundar no futuro. According to Megale ethics is the fairest thing on earth. This is a strong idea that is aimed at describing, as much as possible, this paper’s dynamics. Bearing in mind its title, it is important to know what ethics and profession are in order to show in what ways ethics may influence the professional’s behaviour, what causes and consequences derive from ethical responsibilities in professions. The aim of this paper is not to make judgements, but to characterize a reality that can be controversial and even dramatic to people’s consciousness. Complex realities from society, in general, and from profession, in particular, interact more and more with the behaviours of professionals. This means that, from our point of view, it is important to revisit some ideas that can identify some indicators for the reflection as well as allow us to launch some hints that may be studied deeply in the future.

The development of venous thromboembolism (VTE) in surgical patients is a serious public health problem since it increases morbidity and mortality rates, as well as the costs associated with in-hospital care for this population. Notwithstanding the above, and although their effectiveness has been demonstrated, prophylactic measures are not properly used in these patients in Colombia. A possible cause of this situation is the poor adherence of health professionals to clinical practice guidelines (CPG) addressing the prevention of VTE. In this regard, several methodological approaches to achieve an adequate implementation of thromboprophylaxis by transforming physicians' behaviors have been described. However, to accomplish this, it is necessary to comprehensively consider the multifactorial barriers and sociological conditions that underlie this problem. Better adherence to VTE prophylaxis CPGs is known to lead to better clinical practice. Therefore, the aim of this paper is to carry out a reflective analysis of the causes and possible solutions to the low adherence of Colombian health professionals to these guidelines.

Objectives: To summarize published information on coagulation disorders in patients with SARS-CoV-2 infection, namely its characteristics, pathophysiology, diagnosis, and response to anticoagulant or antiplatelet therapy, either prophylactic or therapeutic. Methods: A scoping review was conducted according to both Joanna Briggs Institute Guidelines on Scoping Reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review guidelines (PRISMA-ScR). A search on the MEDLINE®, SciELO®, and Web of Science® databases was performed between the 1st and 2nd May 2020. The articles selection was divided into three sequential stages: based on title, on abstract, and full article reading. At each stage, articles were assessed against the inclusion and exclusion criteria and accepted or rejected accordingly. The data were then charted, and the relevant evidence was summarized. Results: After selection, 106 records were obtained. Of those, 36 corresponded to letters, 28 to original studies, 25 to reviews, and 14 to case reports; one metanalysis, one commentary, and one consensus paper were also included. Results have shown an association between COVID-19 and thrombotic complications, although different kinds of events and frequency rates were found. The triad inflammation, endothelial dysfunction, and coagulopathy seem to underly pathophysiological changes. Laboratory and imaging techniques may be useful for an adequate intervention. Prophylaxis with parenteral anticoagulants, preferably Low Molecular Weight Heparin (LMWH), in an intermediate dose between the commonly used ones for prophylaxis or treatment is indicated to hospitalized patients, especially those having a severe illness. It should be kept during a variable period after discharge, in an individualized patient-based approach. Therapeutical anticoagulation seems not to differ significantly from other disease settings. Conclusions: Various uncertainties persist at coagulation disorders’ approach in patients with SARS-CoV-2 infection. The existing information has its origin mainly in the hospital setting and less robust sources. Thus, well-designed, randomized controlled clinical trials are needed to sustain clinical decisions at all stages.

The SARS-CoV-2 Delta variant has become one of the greatest public health challenges worldwide since, after being first identified in India in December 2020, it has spread rapidly, affecting mainly countries with low vaccination rates and those that have relaxed the public health and social measures implemented to control the COVID-19 pandemic. The Delta variant has a higher replication capacity and is associated with viral loads up to 1 260 times higher than those of infections caused by the original strain, which may be associated with an increased likelihood of hospitalization, ICU admission, need for oxygen therapy, pneumonia, or even death. Fully vaccinated individuals have almost similar protection against both Delta and Alpha variants. Given the impact of Delta in countries where it is the dominant variant, it is necessary for all countries to develop systematic action plans focused on implementing strict public health and social measures in the context of the COVID-19 pandemic and on increasing vaccination coverage. Bearing this in mind, the objective of this reflection paper is to describe the main characteristics of the Delta variant, its impact on the dynamics of the pandemic in some of the countries where it has been detected, the effectiveness of vaccines against this variant, and its implications for public health in Colombia.

The COVID-19 pandemic has had a strong impact on education, forcing the implementation of distance learning methodologies using information and communication technologies (ICT). The digital textbook is a didactic resource used to guide the training process of students; besides, its interactivity allows systematic work, favoring metacognition and the construction of self-learning. The aim of this paper is to describe, through a descriptive cross-sectional design, the design, review, digitalization and implementation phases of a digital textbook about physical agents as a learning resource to support distance education in the training process of physical therapy students enrolled in the physical agents course offered by Universidad Andres Bello in Santiago, Chile, in the context of the human mobility restriction measures implemented due to the COVID-19 pandemic. The textbook consists of thirteen thematic sections and once it was reviewed and validated by peers and by the editorial committee of the university it was digitalized and indexed into the digital resource database of the university, where it was made available to the entire cohort of students enrolled in the physical agents course during the first semester of 2020 (n=115).The digital textbook was successfully implemented as a didactic resource to guide the autonomous and distance learning of students during the time human mobility restriction measures were established in Chile due to the pandemic. Future studies should focus on reporting the students’ satisfaction and perception of this tool and its effect on learning outcomes in order to obtain effective feedback.

Objectives: Gastroesophageal reflux disease is one of the most common gastrointestinal diagnoses. This disorder causes many symptoms and may induce the development of Barret’s esophagus and esophageal adenocarcinoma. Proton pump inhibitors are the most used treatment and, usually, are prescribed for once-daily dosing before breakfast. However, many patients describe night-time symptoms, a period when an increase of basal gastric acid secretion occurs. Therefore, this evidence-based review was performed in order to understand which is the best regimen for proton pump inhibitor intake. Methods: The MeSH words ‘proton pump inhibitors’, ‘gastro-oesophageal reflux’, GERD, and pH were chosen to search for synopses, guidelines, meta-analysis, systematic reviews, and original papers, published after 2008 in the databases MEDLINE, National Guideline Clearinghouse, NHS Evidence, Canadian Medical Association, TRIP Database, The Cochrane Library, DARE and Bandolier in English, French, Spanish and Portuguese. A search in the Índex de Revistas Médicas Portuguesas with the words “inibidores das bombas de protões”, “refluxo gastroesofágico”, DRGE, and pH was also performed. The search retrieves 2,546 articles, from those, three were used in this review. Results: Three prospective studies that evaluate the effects of dosage and/or timing of proton pump inhibitors intake in gastric pH were obtained. These studies indicate that, in patients with predominant night-time symptoms, intake before dinner achieves better results than before breakfast. Additionally, doubling the dose reduces symptoms and the time of pH lower than four. Conclusion: Symptom timing and patient compliance are crucial when choosing the therapeutic regimen. The timing of proton pumps inhibitors intake should be associated with the symptom’s timing; C-level of recommendation.

Introduction: Latin America and the Caribbean (LAC) is one of the regions most affected by the COVID-19 pandemic. Yet, there is scarce literature addressing the research strategies developed in LAC to face COVID-19. Objective: To quantify and assess the production of scientific publications about COVID-19 in 32 countries of LAC between January 1 and July 31, 2020. Materials and methods: Bibliometric study. Scientific papers on COVID-19 conducted in LAC or reporting data pertaining to LAC and published between January 1 to July 31, 2020, were searched in the Scopus, PubMed, and LILACS databases. A subgroup analysis including only original research articles was performed to determine the contribution of LAC countries to research on COVID-19, and standardization measures (# of articles per million people) were applied to compare the country-specific production of this type of articles. Results: A total of 1 291 publications were retrieved. Overall, most of them were non-original research articles (81.72%), and the countries with the highest scientific production were Brazil (43.91%) and Mexico (9.14%). However, after applying the standardization measures, Chile was the country with the highest production of original articles (0.58 per million inhabitants). Regarding original studies (n=236), cross-sectional design was the most common (25.84%). Diagnosis and treatment of the disease was the main research focus (n=354; 27.42%). However, in the subgroup analysis (n=236), epidemiology and surveillance were the most prevalent research focus (n=57; 24.15%). Conclusions: During the study period, non-original research articles were predominant in the scientific production of the LAC region, and interventional studies were scarce among original articles, while the cross-sectional design predominated. Further research with a better quality of evidence should be performed in these countries to contribute to the making of health policies aimed at easing the burden of COVID-19 in the region and preparing for future pandemics.

Of the many discourses on nutrition and food, two opposing perspectives stand out. On the one hand, "nutritionism" emerged strongly in the last decades, reducing the concept of food to the presence or absence of nutrients and the concept of health to the absence of diseases, a discourse that has influenced modern nutritional and food sciences, as well as the conceptualization of the current corporate food regime. On the other hand, "healthy, supportive, and sustainable food" is a re-emerging perspective associated with the traditional ancestral food system and is founded on the principle of common good since millennia ago. This paper presents a reflection on these two perspectives, taking into account the historical scenario and the socio-political context that characterize them, in order to contribute to the recognition of a food paradigm consistent with the Millennium Development Goals and the human right to food. In addition, this reflection aims to assess the progress that has been made in Colombia to achieve healthy, supportive, and sustainable eating practices in the general population.

We greatly appreciate the comments made by Rojas-Botero et al.1 on our paper entitled “Critical reflections on the Municipal Epidemiological Resilience Index used for public policy decision-making regarding the control of the COVID-19 pandemic in Colombia”.2 We acknowledge that public health, understood as the well-being of the community, should be the focus of all our efforts as health professionals. In this sense, decision-making amid a major emergency, such as the one we are currently experiencing due to the COVID-19 pandemic, requires a balanced and calm judgment that considers both the general context and local specificities, as well as the best available scientific evidence, that is, evidence that not only supports decisions, but also prioritizes benefits over risks.

Introduction: Since the first COVID-19 cases were reported, the disease’s clinical and epidemiological characteristics have continuously been studied, although they have not been yet defined. Objective: To estimate the epidemiological profile of pediatric patients with COVID-19, as well as their clinical, laboratory and radiological characteristics. Materials and methods: A living systemic review was conducted in the PubMed, Scopus and SciELO databases. Observational studies describing clinical, radiological, and laboratory characteristics of pediatric patients with COVID-19 and published between January 1, 2020, and July 20, 2020, were considered for the search; there were no language restrictions. Government, epidemiological, and pre-print papers were also considered. Meta-analyses of single proportion (frequentist approach) and two proportions (Bayesian method) were carried out. The study registration and protocol are available at https://osf.io/y43wm and https://osf.io/r8ktv, respectively. Results: 13 studies, with a total of 9 152 patients, were retrieved. The Bayesian meta-analysis reported that males are more affected by the disease: OR 1.24 (HDI95%: 1.09-1.4). The proportion results calculated by means of the frequentist meta-analysis are: 52% cough (95%CI: 50-55), 0% death (95%CI: 0-0.1), 16% high aspartate transaminase levels (95%CI: 13-19), and 60% lung changes observed in chest X-ray (95%CI: 57-64). Conclusions: Based on the current data, it is not possible to describe accurately the clinical and epidemiological characteristics of COVID-19 in the pediatric population. However, evidence suggests that males are more affected by the disease and that lung alterations in imaging studies are more frequent than clinical signs such as cough and fever. Laboratory test results are not conclusive and show that different organs and systems of the human body may be affected by SARS-CoV-2. The results reported here must be compared to prospective controlled studies conducted in larger samples and a more rigorous design.

The aim of this article is to reflect on the contextual factors that influence medical education, in order to provide some recommendations about the challenges that physicians face. A literature review was conducted to write this reflection paper, and it was found that the education of health professionals has undergone significant changes that are based on the development of biomedical sciences, technology, and pedagogy, and are influenced by the needs of the general population, the requirements of the health systems of each country, and scientific progress. These changes have given rise to challenges inherent to the special characteristics of each country and related to the quantity, quality, and relevance of the training of physicians. In this regard, it has been suggested that, in the face of such changes, it is necessary to design curricula that integrate all aspects of health care, consider the supply and demand of medical services, emphasize professionalism, take into account the pedagogical training of health sciences teachers, comply with quality standards, assist students in selecting undergraduate programs adequately (in this case Medicine), and ensure relevant clinical practice scenarios. It should also be noted that medical education has not adapted adequately to the aforementioned changes in many countries and, therefore, the development of teaching and learning strategies has lagged behind and physicians in such countries do not have the capacity to provide the health care required by the general population in a proper manner.

Poor adherence to treatment is a common problem in patients with chronic diseases since, given their nature, they involve long-term therapeutic regimens, hence the importance of permanent follow-up. In general, it is known that adherence to treatment is necessary to achieve better health outcomes, improve quality of life, and reduce health care-related costs. The growth of eHealth, particularly telemedicine and mobile health (mHealth), has resulted in a real benefit of technological platforms in the therapeutic adherence of these patients. With this in mind, the aim of this reflection paper is to briefly describe the current state of eHealth strategies and the impact they may have on adherence to treatment in patients with chronic diseases.

Competency-based medical education (CBME) is currently the most common type of curriculum used worldwide. However, its limitations include fragmented learning and difficulties to use properly the knowledge, skills, and attitudes acquired using this educational model. Having this in mind, Entrustable Professional Activities (EPA) emerge as a tool to mediate the transfer of the competency-based curriculum into physicians’ professional practice in graduate medical education. Therefore, based on a narrative review of the existing literature on EPA and the authors’ experience in teaching community-based health care integration services, the aim of this paper is to reflect on the possible use of these activities in undergraduate medical education for the development of a CBME model integrated with primary health care and community medicine. The reflections presented here allow suggesting that, although it is a challenging process, incorporating EPA into undergraduate medical education is appropriate to improve the provision of primary health care to individuals, families, and communities in general.

Introduction: The quantity and quality of papers published in journals are often considered as research trends indicators in several fields of study. In the case of occupational therapy (OT) there are few studies addressing this issue. Objective: To describe the characteristics of occupational therapy electronic journals, including year of creation, publication frequency, peer review process, language of publication, and content access policies. Materials and methods: A descriptive, quantitative study was carried out based on a search conducted in the following databases by using the term “occupational therapy”: Web of Science, Scopus, SciELO, CINAHL, OTDBASE, Ulrich’s International Periodical Directory, NCBI Databases, CINAHL-EBSCOhost, ProQuest, Medline, and Directory of Open Access Journals. Simple descriptive statistics was used to analyze data. Results: After the search was conducted, 39 journals were included for analysis, of these 85% had been created after 1990. All journals were indexed in different databases, but most of them were in Journal Citation Reports, CINAHL, Medline, Science Citation Index Expanded, OTDBase, and PsycINFO. Likewise, approximately 36% publish an issue every three months, and mainly in English. Conclusion: A more comprehensive understanding of the characteristics of these journals may help OT researchers choosing the best option to submit their works for publication, and contribute to achieving higher rates of production and dissemination of knowledge on OT by said journals.

Introduction: Sockets and interfaces are important elements for lower limb orthoses and prostheses, as they allow for proper contact and fit between the devices and the affected limb or stump. Objective: To review the different polymers used in the development of lower limb sockets and external prosthetic and orthotic interfaces, their functional requirements and the possible skin problems caused by their use. Materials and methods: A literature review was conducted using the databases EBSCO, Embase, LILACS, SciELO, ScienceDirect and Scopus. Results: 47 articles and papers that met the inclusion criteria were retrieved. Thermoplastics, thermosets, foams, gels and elastomers are among the polymers used for manufacturing prosthetic and orthotic interfaces and sockets. However, studies estimate that between 32% and 90.9% of the population that use these devices have experienced skin problems on the affected stump or limb, such as excessive sweating, wounds and irritation. Conclusion: There is a clear need for further research to develop prosthetic and orthotic interfaces and sockets for lower limbs that can prevent or control damage to the skin of users.

Introduction: Pseudohypoparathyroidism (PHP) is a rare hereditary disease, characterized by hypocalcemia/hyperphosphatemia secondary to peripheral resistance to parathyroid hormone (PTH). PHP diagnosis is usually precluded since hypocalcemia is considered as the primary diagnosis, thus delaying further diagnostic studies and preventing an adequate management of this clinical condition. Materials and methods: Retrospective review of the databases of the Endocrinology departments of two tertiary care centers of Medellin, Colombia from January 2012 to December 2016. Patients diagnosed with PHP based on clinical presentation and confirmatory laboratory values were included. Results: Four patients met the inclusion criteria. All PHP cases were diagnosed in adulthood despite strong early clinical and laboratory evidence of the disease. Three patients were diagnosed with Fahr’s syndrome and two with Albright’s hereditary osteodystrophy. The mean values obtained were PTH of 376.8 pg/mL, calcium of 6.17 mg/dL and phosphorus of 6.55 mg/dL. Conclusions: PHP is a rare disorder. This paper describes four PHP cases diagnosed during adulthood. Emphasis should be placed on the judicious approach to the patient with hypocalcemia and hyperphosphatemia with increased PTH and normal renal function, since these symptoms strongly suggest a diagnosis of PHP.

Introduction: This paper presents the first case of empyema necessitatis secondary to infection with Citrobacter freundii (according to the databases consulted), and one of the few reports of this pathology in Colombia. Case presentation: This is the case of a 26-year-old patient from a rural area, with a history of severe cognitive deficit, who was taken to the emergency department due to a clinical picture of 15 days of evolution consisting of neurological deterioration associated with asthenia, adynamia, fever and cough with purulent expectoration. On admission, a chest x-ray was taken, finding pneumonia of the middle lobe with associated pleural effusion, for which empirical antibiotic management was initiated. The patient presented clinical deterioration and appearance of right pectoral mass, so a computed tomography of the thorax was performed, revealing empyema necessitatis. Close drainage and culture of the collection were made, with negative mycobacteria culture and positive report for C. freundii. The patient received specific antibiotic treatment for 8 weeks, with complete improvement of his clinical condition. Conclusion: Besides being the first case of empyema necessitatis by C. freundii that has been reported, this case is important because of the low amount of reports on this pathology in Colombia, considering that its main cause is tuberculosis, which is endemic in the country.

Introduction: One way to evaluate research function is analyzing the scientific production indexed in databases. Objective: To evaluate the level of scientific production in medicine in South America using the SCOPUS database. Materials and methods: Bibliometric, observational, descriptive and cross-sectional study based on Scopus database records of medical publications between 1996 and 2016. Results: Brazil is the country with the highest volume of scientific production in South America and the Mercosur bloc with 210 969 publications over the period under study, followed by Argentina with 44 826. Bolivia and Paraguay are the countries with the lowest contribution, with 1 173 and 784 scientific papers, respectively. Conclusion: The countries with the highest volume of scientific production in South America are Brazil, Argentina, Chile and Colombia, since their combined scientific production in Medicine accounts for more than 90% of the region’s total production. Similarly, there are countries with low levels of scientific production, but with significant average annual growth rates.

Introduction: Metabolic syndrome (MS) is defined as a set of conditions including high blood pressure, dyslipidemia, glucose intolerance and visceral obesity. In recent years, an increase of obesity in university students has been observed, although the accurate prevalence of MS is unknown. Objective: To determine the prevalence of MS in university students between January 2000 and January 2016. Materials and methods: A systematic review of studies published in the PubMed, LILACS, ScienceDirect, UpToDate, Imbiomed, SciELO and Google Scholar databases was performed. To ensure the highest number of papers, different combinations of words related to MS were used in Spanish, English, and Portuguese. Results: A total of 16 studies met the inclusion criteria. Students from different health, social and human sciences careers from America, Asia and Europe participated in said studies. The prevalence of MS ranged from 0 to 19.2% according to NCEP-ATP III. Conclusions: The prevalence of MS varies widely across studies. It is important to expand MS research, as this would allow designing specific interventions for high-risk groups in the university context.

Introduction: Basic body measurements (height, weight, and body mass index) of children and adolescents are essential indicators in the field of health and sports talent identification and selection. Objectives: To identify and synthesize original research studies on basic body measurements in children and adolescents aged 2 to 18 years published between 2003 and 2018. Materials and methods: The search was carried out in PubMed, Epistemonikos, and Google Scholar between May 2017 and June 2018. The inclusion criteria established that the works to be analyzed should be original research articles published in English, Spanish or Portuguese and that they should discuss morphological profile, use basic body measurements or physical fitness measurements as reference criteria, include children and adolescents aged 2 to 18 years in their study population, and be published between 2003 and 2018 in open-access journals with an impact factor. Results: The search yielded 18 articles that described the morphological profile of children and adolescents aged 2 to 18 years; all had a cross-sectional design. Five papers were conducted in Colombia and the remaining 13 in countries or regions of America, Europe, and Asia. Conclusion: This systematic review allowed establishing reference values for height, weight, and BMI, and highlighted the variability of the basic body measurements associated with sex, age, and country of evaluation.

Objective: to investigate the sociodemographic and surgical profile of neuro-oncology patients subjected to neurological surgeries. Method: a descriptive and retrospective study with a quantitative approach, conducted during a five-year period (2014-2018) in a hospital with 236 beds, which is a reference in cancer treatment in the state of Pará. The data were collected from September to December 2019 and analyzed by means of descriptive statistics. Results: the profile was characterized by the age group of 41 to 50 years old (30.8%; n=20) and by individuals with complete elementary school (44.6%; n=29). They were subjected to elective surgeries (87.7%; n=57), considered clean (95.4%; n=62), and large (96.9%; n=63). The main complications were surgical site infection (10.7%; n=8) and tumors located in the encephalus (60%; n=39). Conclusion: the paper contributed to delineate the profile of the population served by the hospital, enabling the expansion of debates aimed at improving hospital planning and at refining the quality of the health services and of the Nursing assistance.

Introduction: The prevalence of occupational diseases in the agricultural sector is higher than in other industries, since agricultural workers are at higher risk of exposure to different chemicals and pesticides, and are more prone to occupational accidents. Objective: To conduct a review of recent literature on occupational health and risk in agriculture. Materials and methods: A literature search was conducted in PubMed, SciencieDirect and Scopus using the following search strategy: type of articles: original research papers; publication language: English; publication period: 2006-2016; search terms: “agricultural health”, “agrarian health”, “risk factors”, “epidemiology”, “causality” and “occupational”, used in different combinations (“AND” and “OR”). Results: The search yielded 350 articles, of which 102 met the inclusion criteria. Moreover, 5 articles were found in grey literature sources and included in the final analysis. Most research on this topic has been conducted in the United States, which produced 91% (97/107) of the articles included in the review. Conclusions: Most studies on agricultural health focused primarily on the harmful effects of occupational exposure to agrochemicals and pesticides, and the consequences of occupational accidents. However, since more than 90% of these studies come from USA, a more comprehensive approach to agricultural health is required, since what is reported here may be far from the reality of other regions, especially Latin America.

Introduction: An important cause of hip prosthesis failure is loosening related to cytokine-mediated release of enzymes that produces lysis of the bone that supports the implant. Objective: This paper aims to describe the biological interaction mechanisms of the molecules that promote total hip prosthesis loosening, the most frequent problem observed during the process. Materials and methods: The authors conducted a literature search in the PubMed and Scopus databases for original articles and clinical cases with no filters by publication date. MeSH terms hip prosthesis loosening, aseptic loosening, cytokines, and hip arthroplasty failure were used. Data were extracted from 250 studies, of which 66 were representative for this review and were selected for writing purposes. Results: The most representative molecules involved in hip prosthesis loosening are described, and the interactions between them are presented. Conclusions: Enzymes and cytokines have been widely studied for four decades, although their interaction mechanisms are still misunderstood. In consequence, an interaction mechanism, which may be called “enzymes and cytokines disease” or “immune loosening”, is proposed.

Introduction: Low birth weight (LBW) is one of the main risk factors that affects infant morbidity and mortality worldwide. Approximately one third of neonatal deaths are attributable to this cause. Objective: To review the most relevant papers related to low birth weight in the Americas between 2010 and 2016. Materials and methods: Narrative literature review. The information was obtained from the PubMed, SciELO, LILACS and Portal Regional da BVS databases, using DeCS and MeSH descriptors. Results: Most of the studies were published between 2012 and 2015. Of 29 articles published, 11 (40.7%) dealt with sociodemographic factors, 9 (33.3%) with environmental risks, 3 (11.1%) with behavioral factors, 2 (7.4%) with prenatal or coverage controls and 2 (7.4%) were interrelated with other risk factors. Conclusion: Most of the studies agree on the association of sociodemographic, biological and behavioral factors. Those studies that refer to the association of LBW with environmental risk factors are growing in strength.

Introduction: Pneumatosis intestinalis (PI) is a rare entity characterized by the presence of gas in the intestine wall, which is usually diagnosed as an incidental radiological finding. Clinical case: This paper reports the case of a 63-year-old patient with a history of chronic epigastralgia, who consulted due to a clinical picture of 1 week of evolution consisting of diffuse abdominal pain associated with abdominal distension, anorexia, emesis and diarrhea. Physical examination revealed a distended, tympanic abdomen, painful on palpation, with decreased bowel sounds and no signs of peritoneal irritation. A simple abdominal radiograph was performed, showing overdistension of intestinal loops, air-fluid levels, absence of distal gas and pneumoperitoneum. The patient was taken to exploratory laparotomy, where severe PI was observed in the final 100cm of the ileum. Discussion: PI, especially the cystic variant, is a rare pathology, with only 565 cases described worldwide and 6 in Latin America. This condition may go unnoticed due to its difficult diagnosis. Although diagnosis is considered to be radiological, 40% of the cases are found during surgery, as was the case of this patient. Surgical indication for this case was pneumoperitoneum, the most common complication (51%).

Lipodystrophy (lipohypertrophy, lipoatrophy) is one of the most common complications of subcutaneous insulin injections. This paper presents the case of a 46-year-old patient with uncontrolled type 2 diabetes mellitus, treated with insulin glargine 45UI/day, no glycemic control and multiple adjustments and hospitalizations. On admission, self-monitoring showed off-target basal and postprandial values, baseline glucose of 299 mg/dL and HbA1c of 11%. Medical history revealed flaws in the technique used for insulin administration, particularly, lack of application site rotation. Physical examination allowed to observe lipohypertrophy caused by excess bilateral infraumbilical adipose panniculus and induration of the subcutaneous cellular tissue. Ultrasound exposed fat infiltration in anterior recti. The patient was instructed on the correct technique for applying insulin with daily rotation of the application site, and allowing the areas affected by lipohypertrophy to rest. A self-monitoring guide was also provided. Self-monitoring within the first 10 days showed improvement in baseline glucose levels up to 116 mg/dL and borderline value of 75 mg/dL, compared to the previous baseline blood glucose level of 242 mg/dL with the same type of insulin and dose. Close follow-up was done to define the required insulin dose and to monitor possible hypoglycemia, obtaining an improvement in HbA1c of 9.2% and 8.8% at 4 and 11 months, respectively.

Deliberation is a basic rational human activity recognized since ancient times due to its role in decision making during daily life activities and in specialized areas of knowledge such as medicine, politics and ethics. The objective of this reflection paper is to study the contribution of Aristotle to the deliberative process through his work the Nicomachean Ethics, where the following aspects of deliberation were identified for analysis: origin, definition, characteristics, and types and conditions for its development. Bioethics defend these aspects, since it finds in Aristotelian phronesis the fundamental axis to guide its actions in search of human self-realization and the analysis and decision making of the clinical bioethical problems. Twenty-four centuries have passed until the importance of this process and the need to educate about it was finally rediscovered.

ABSTRACT BACKGROUND AND OBJECTIVES: Different types of exercises are being used for the treatment of fibromyalgia, such as aerobic, resistance, flexibility exercises and body awareness therapy, but there is strong evidence that the gold standard for the non-pharmacological treatment of this disease is the aerobic exercise. The objective of this study was to collect reports of patients with fibromyalgia who practiced three months of dance (Zumba) and had to stop dancing for three months due to the recess of the academic activity at the end of 2016 and beginning of 2017. CASE REPORTS: This is a qualitative study about the experience of 16 women with fibromyalgia, who participated in Zumba class for three months in 2016. The reports were collected when they resumed their dance activities in March 2017. Therefore, the patients remained with no intervention for three months, during the academic recess. The patients wrote their reports on a sheet of paper, answering three questions. According to the reports, we noticed that Zumba brought several benefits for these patients, such as pain relief, improved sleep quality, self-esteem and physical performance. CONCLUSION: Based on patients’ reports we can conclude that Zumba, as a three-month intervention, produced positive effects in improving pain, functional capacity, and quality of life of women with fibromyalgia.

The history of obstructive sleep apnea is long and complicated, and some descriptions can be traced back to the early nineteenth century in The Posthumous Papers of the Pickwick Club, the first novel written by Charles Dickens. The definition of this term by different researchers highlights the importance of understanding the entities associated with the syndrome, such as alveolar hypoventilation and excessive daytime sleepiness. Thus, the neurophysiological studies carried out since then, as well as the European Society of Neurology conference held in 1964, the description of the syndrome in pediatric patients, the confirmation of cardiovascular co-morbidity associated with the disease, tracheostomy as treatment and the creation of hypoglossal nerve stimulus implants —including Sullivan’s discovery of positive pressure as a home treatment— have been essential for the understanding of this syndrome