Search

Introduction: Currently, chronic kidney disease (CKD) is a major health problem and in the most severe conditions, kidney transplantation is an alternative treatment. However immunosuppression induced these patients to respiratory complications and endotracheal intubation. In order to assist the decision of the best time for weaning and extubation of these patients, there are predictive indexes that should be considered in preliminary assesment. Objective: To check the capacity of predictive indexes for weaning of mechanical ventilation, rapid shallow breathing index (RSBI), oxygenation rate (PaO2 /FiO2 ) and maximum inspiratory pressure (MIP) in predicting the success or extubation failure in kidney transplant patients. Methods: This study is a prospective cohort carried out with patients aged over 18, under mechanical ventilation for more than 24 hours. The patients were submitted to the Spontaneous Breathing Test, also the assessment of the Rapid Shallow Breathing Index, oxygenation index (PaO2 /FiO2 ), and maximum inspiratory pressure (MIP) and they were observed during 48 hours after to evaluate the success and extubation failure. Results: A total of 106 patients were eligible, and 20 of these were included with mean age of 46.9 ± 3.06 years and 14 of the subjects were male. Three patients showed extubation failure, and needed to have reintubation within the period of 48 hours as considered. Conclusion: The indices to predict weaning of mechanical ventilation, when within the expected normal values, seem to be able to predict extubation, with the exception of MIP that, even in cases of success, showed itself to be at levels lower than the predicted percentage.

Esse artigo buscou identificar os fatores associados na depressao do profissional da enfermagem no Brasil. Para isto, foi realizada uma busca eletronica de 15 artigos nas bases de dados online da Scielo e Lilacs, utilizando como criterio de inclusao textos completos, escritos nas linguas portuguesa, inglesa e publicados entre os anos de 2007 a 2020, e os criterios de exclusao foram artigos em formato de resumo ou incompletos e incompativeis com a tematica aqui proposta. Dentre os fatores que desencadeiam a depressao nos profissionais de enfermagem foram: Exigencia de habilidades como autonomia, lideranca, relacionamento interpessoal e comunicacao, estresse e dupla jornada de trabalho e exaustao emocional. Com isto, O estudo constatou que a depressao esta presente nos profissionais e e desencadeada por diversos fatores sociais e pessoais, que agem em efeito domino, onde um fator esta ligado ao outro, levando o individuo a apresentar comportamento diferenciado e distante.

In 2016, during the American Zika virus (ZIKV) outbreak, the interest in a rapid diagnosis intensified due to a sudden increase in cases of Guillain-Barre syndrome in adults and microcephaly in newborns of infected pregnant women related to ZIKV. According to CDC the diagnosis of symptomatic patients should be done through nucleic acid detection by qPCR in paired samples of blood and urine. The chapter goes on to discuss research using saliva analyzed through loop-mediated Isothermal amplification (LAMP) as feasible alternative to diagnose ZIKV compared with urine. Saliva requires less processing than blood, which greatly simplifies the assay process, and LAMP is a molecular test with high sensibility and specificity for rapid detection of DNA or RNA of pathogens, including ZIKV. The recent findings are contributing to the knowledge of the ZIKV behavior in the human organism improving the diagnostic methods.

Resumo Fundamento: A embolia pulmonar aguda (EPA) tem desfecho clínico variável. A angiotomografia computadorizada (angio-CT) é considerada o padrão-ouro para o diagnóstico. Objetivo: Avaliar se o volume vascular pulmonar (VVP) quantificado por software automatizado é um preditor de mortalidade após EPA. Métodos: Estudo de coorte retrospectivo no qual a imagem da angio-CT de 61 pacientes com EPA foi reanalisada. O VVP e o volume pulmonar (VP) foram estimados automaticamente pelo software Yacta. Calculamos o VVP ajustado pela razão: VVP(cm3)/VP(litros). Parâmetros prognósticos clássicos da angio-CT (carga embólica; razão do diâmetro do ventrículo direito/ventrículo esquerdo; razão do diâmetro da artéria pulmonar/aorta; desvio do septo interventricular; infarto pulmonar e refluxo de contraste na veia hepática) foram avaliados. A mortalidade em 1 mês foi o desfecho analisado. Consideramos um valor de p

The fact of having a usual source of care can improve access to health services and preventive activities. The article aimed to estimate the proportion of factors associated with usual source of care among female sex workers. This was a socio-behavioral survey with 4,328 female sex workers, ≥ 18 years, in 12 Brazilian cities. Female sex workers were recruited by the respondent-driven sampling method (RDS). A descriptive profile was performed of the female sex workers who had usual source of care and the association was analyzed between usual source of care and indicators of access to HIV prevention and reproductive health. As effect measure, the study used adjusted odds ratio (OR) in a logistic regression model. The data were weighted by the RDS-II estimator. 71.5% of the female sex workers reported having a usual source of care, and of these, 54.3% cited primary healthcare (PHC) as their main usual source of care. Among female sex workers 18-24 years of age, there was an association between usual source of care and having a Pap smear test (OR = 2.27; 95%CI: 1.66-3.12), seven or more prenatal visits (OR = 2.56; 95%CI: 1.30-5.03), and the use of a contraceptive method (OR = 1.64; 95%CI: 1.09-2.46). Among female sex workers ≥ 25 years, there was an association between usual source of care and attending talks on sexually transmitted infections (STIs) (OR = 1.45; 95%CI: 1.12-1.89), prior knowledge of post-exposure prophylaxis (OR = 1.32; 95%CI: 1.02-1.71), and history of Pap smear test (OR = 1.92; 95%CI: 1.54-2.40). The study's results showed that female sex workers have PHC as their main usual source of care. usual source of care can also positively impact care and activities in reproductive health and prevention of HIV and STIs in this population group.Ter uma fonte habitual de cuidado pode melhorar o acesso a serviços de saúde e ações de prevenção. Assim, o objetivo foi estimar a proporção e fatores associados à fonte habitual de cuidado entre mulheres trabalhadoras do sexo. É um inquérito sociocomportamental com 4.328 mulheres trabalhadoras do sexo, ≥ 18 anos, realizado em 12 cidades brasileiras. Essas mulheres foram recrutadas pelo método respondent-driven sampling (RDS). Foi realizada uma análise descritiva do perfil das mulheres trabalhadoras do sexo que possuíam fonte habitual de cuidado e investigada sua associação aos indicadores de acesso à prevenção do HIV e à saúde reprodutiva. Utilizou-se como medidas de efeito o odds ratio (OR) ajustado em um modelo de regressão logística. Os dados foram ponderados pelo estimador RDS-II. Referiram ter fonte habitual de cuidado, 71,5% das mulheres trabalhadoras do sexo e, destas, 54,3% indicaram a atenção primária à saúde (APS) como a principal fonte habitual de cuidado. Entre as mulheres trabalhadoras do sexo com idades de 18-24 anos, observou-se associação entre a fonte habitual de cuidado e a realização de exame de preventivo ginecológico (OR = 2,27; IC95%: 1,66-3,12), realização de sete ou mais consultas de pré-natal (OR = 2,56; IC95%: 1,30-5,03) e utilização de método contraceptivo (OR = 1.64; IC95%: 1.09-2.46). Entre as mulheres trabalhadoras do sexo com idade ≥ 25 anos, verificou-se associação entre a fonte habitual de cuidado e a participação em palestras sobre infecções sexualmente transmissíveis (IST) (OR = 1,45; 1,12-1,89), conhecimento prévio de profilaxia pós-exposição (OR = 1,32; IC95%: 1,02-1,71) e realização de exame de preventivo ginecológico (OR = 1,92; IC95%: 1,54-2,40). Os resultados deste estudo mostraram que as mulheres trabalhadoras do sexo têm a APS como principal fonte habitual de cuidado. Além disso, a fonte habitual de cuidado pode impactar nos cuidados e ações em relação à saúde reprodutiva e à prevenção de HIV e IST nessa população.Contar con una fuente habitual de cuidado puede mejorar el acceso a servicios de salud, así como las acciones de prevención. El objetivo fue estimar la proporción de fuente habitual de cuidado, y analizar factores asociados entre mujeres trabajadoras del sexo de 12 ciudades brasileñas. Se trata de una encuesta sociocomportamental con 4.328 mujeres trabajadoras del sexo, edad ≥ 18 años en 12 ciudades brasileñas. Las mujeres trabajadoras del sexo se reclutaron mediante el método respondent-driven sampling (RDS). Se realizó un análisis descriptivo del perfil de las mujeres trabajadoras del sexo que poseían fuente habitual de cuidado. Y se analiza la asociación entre fuente habitual de cuidado e indicadores de acceso a la prevención del VIH, así como a la salud reproductiva, a través del odds ratio (OR) ajustado en modelos de regresión logística. Los dados fueron ponderados mediante el estimador RDS-II. Un 71,5% de las mujeres trabajadoras del sexo informaron tener fuente habitual de cuidado, de estas un 54,31% indicaron la atención primaria en salud. Entre las mujeres trabajadoras del sexo con ≥ 25 años se observó una asociación entre fuente habitual de cuidado y participación en ponencias sobre infecciones sexualmente trasmisibles (IST) (OR = 1,45; IC95%: 1,12-1,89), uso de método anticonceptivo (OR = 1.64; IC95%: 1.09-2.46), conocimiento previo de la profilaxia pos-exposición (OR = 1,32; IC95%: 1,02-1,71), haber realizado un examen preventivo ginecológico (OR = 1,92; IC95%: 1,54-2,40) y haber tenido 7 o más consultas prenatales (OR = 2,56; IC95%: 1,30-5,03). Los resultados de este estudio muestran que las trabajadoras sexuales tienen la APS como su principal fuente habitual de atención. Además, la fuente habitual de atención puede impactar la atención y las acciones en relación con la salud reproductiva y la prevención del VIH y las ITS en esta población.

Aim The aim of this study was to evaluate oral characteristics and comorbidities that may affect dental treatment of individuals with Williams syndrome (WS). Methods and results Fifty-two subjects diagnosed with WS were included in this observational study. Demographic data and medical history were compiled. Facial aspects, tooth abnormalities and oral characteristics were obtained through clinical and radiographic evaluation by a researcher/dentist. Among 52 subjects, 25 were also evaluated for temporomandibular and occlusal disorders, caries and periodontal disease. From the 52 subjects, 23 (44.2%) were female and the average age was of 20 years old (range from 4 to 35 years old). Cognitive impairment and congenital heart disease were the most common medical disorders found in all 52 (100%) and in 41 (78.8%) subjects, respectively. Among the 52 subjects, 51 (98%) presented at least one dental developmental abnormality, with generalized diastemas (72.5%) and hypodontia (50.9%) being the most frequent ones. Angle class III malocclusion was observed in 52% (13/25) of the subjects. Conclusions The dentist should be aware of the medical conditions of individuals with WS and thus offer an adequate dental treatment. The high prevalence of tooth abnormalities and occlusal disorders requires an early dental treatment planning.

Leukemic infiltration of the gingival tissue associated or not with gingival enlargement may be the first manifestation of acute leukemia, despite being rarely reported in the literature. A 10-year-old female patient presented with a 1-month history of an asymptomatic, firm, and pinkish-red generalized gingival overgrowth. There was no bone resorption. Incisional biopsy of the gingival tissue was performed, with histopathological examination revealing a diffuse and hypercellular infiltration of monocytoid cells. The patient was referred to a hematologist and underwent a bone marrow biopsy, which led to a conclusive diagnosis of acute myeloid leukemia. The patient was treated with chemotherapy and we observed regression of gingival enlargement after 4 weeks from the initial therapy.

Purpose To evaluate salivary characteristics, such as flow rate, buffering capacity and amylase activity, and associate these parameters with oral health in individuals with Moebius syndrome (MS) and controls. Methods The researchers assessed caries (ICDAS), periodontal disease (PSR), and plaque (Silness Loe) indexes in both groups. Unstimulated, stimulated, and bilateral parotid saliva were also collected. The salivary flow (milliliters/minute) and α-amylase activity were measured in all samples. The α-amylase activity was determined by maltose production. The buffering capacity was measured in stimulated saliva by titration of 0.01N HCl. Results The occurrence of carious lesions, related to cut-off 2, as well as the occurrence of periodontal disease, was significantly higher (p > 0.05) in participants with MS when compared to the control group. Also, MS individuals presented decreased salivary flow, decreased buffering capacity, and amylase activity. Conclusions MS individuals present salivary alterations, which can be related to higher risk for caries.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2019-04-01T18:59:27Z No. of bitstreams: 1 Diss.Talita Matteoni. 2018.pdf: 2476038 bytes, checksum: 6edd2b251a3961418125502695d29e9f (MD5) Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2019-04-02T18:11:02Z (GMT) No. of bitstreams: 1 Diss.Talita Matteoni. 2018.pdf: 2476038 bytes, checksum: 6edd2b251a3961418125502695d29e9f (MD5) Made available in DSpace on 2019-04-02T18:11:02Z (GMT). No. of bitstreams: 1 Diss.Talita Matteoni. 2018.pdf: 2476038 bytes, checksum: 6edd2b251a3961418125502695d29e9f (MD5) Este é um estudo do tipo transversal, desenvolvido a partir de dados da pesquisa nacional “Corrente da Saúde II” realizada com Mulheres Trabalhadoras do Sexo (MTS) de 12 capitais brasileiras. O objetivo foi investigar fatores associados a ter uma fonte usual de cuidado de saúde, e aos tipos de fonte usual de cuidado, entre mulheres trabalhadoras do sexo de 12 cidades brasileiras. Espera-se que os resultados deste estudo tragam subsídios para identificação e enfrentamento de questões referentes à população de MTS no Brasil, uma vez que pouco se sabe a respeito das fontes de cuidado de saúde utilizadas por estas mulheres que vivem, em sua grande maioria, em situação de risco para contaminação por doenças relacionados ao sexo, por exemplo. Pretende-se que estes resultados repercutam para a qualificação de políticas públicas de saúde voltadas para as Mulheres Trabalhadoras do Sexo.

Leukemic infiltration of the gingival tissue associated or not with gingival enlargement may be the first manifestation of acute leukemia, despite being rarely reported in the literature. A 10-year-old female patient presented with a 1-month history of an asymptomatic, firm, and pinkish-red generalized gingival overgrowth. There was no bone resorption. Incisional biopsy of the gingival tissue was performed, with histopathological examination revealing a diffuse and hypercellular infiltration of monocytoid cells. The patient was referred to a hematologist and underwent a bone marrow biopsy, which led to a conclusive diagnosis of acute myeloid leukemia. The patient was treated with chemotherapy and we observed regression of gingival enlargement after 4 weeks from the initial therapy.

Objective This study aimed to identify and quantify polyomaviruses (BKPyV and JCPyV) in the saliva, mouthwash, blood and urine of liver pre-transplant patients. Materials & Methods A case-control study was performed using a convenience sample of 21 end-stage liver disease patients (EG = experimental group) and 20 normoreactive controls (CG = control group). In total, 162 samples were collected. Detection and quantification of polyomaviruses were performed by using real-time PCR method. Results In the EG, 21 samples (25%) were positive for BKPyV and 10 (11.90%) for JCPyV, while in the CG 27 samples (34.61%) were positive for BKPyV and 6 (7.69%) for JCPyV. With regard to the number of samples positive for BKPyV and JCPyV, there was no statistically significant difference between EG and CG (P = 0.52 and P = 0.25). In the EG, we observed a panorama similar to that of the CG regarding the presence of polyomaviruses in mouthwash, blood and urine. The greatest difference between the samples was that regarding the identification of BKPyV in saliva. Conclusion Cirrhotic patients on the liver transplant waiting list did not show higher prevalence of BKPyV and JCPyV compared to normoreactive controls. This article is protected by copyright. All rights reserved.

Background New clinical approaches to diagnose and monitor individuals with systemic diseases have been employed through the use of oral fluids. Polyomavirus BK (BKPyV) and JC (JCPyV) infect asymptomatically around 80% of general population worldwide remaining latent in the body. In case of immunosuppression, a replication can occur, leading to diseases. Objective The aim of this study was to detect and quantify BKPyV and JCPyV in oral fluids of individuals with chronic kidney failure (CKF), kidney transplantation (KT) and controls compared with their detection in blood and urine, traditionally used for this test. Study design Forty six subjects were included and distributed into 3 groups: 14 with CKF (Group 1), 12 with KT (Group 2) and 20 healthy individuals (Group 3). In a total, 315 samples were collected and analyzed through RT-PCR, being 151 of gingival crevicular fluid, 46 of saliva, 46 of mouthwash, 43 of blood and 29 of urine. Results All subjects from group 1 were positive for BKPyV in at least one collected samples and 14% were positive for JCPyV. In Group 2, 91.7% were positive for BKPyV and 51.7% for JCPyV. Among subjects of Group 3, 80% were positive for BKPyV and 45% for JCPyV. Conclusions Oral fluids exhibited high prevalence of BKPyV and JCPyV and were equally efficient compared to urine and blood. The use of oral fluids to detect these polyomaviruses enhances positivity in screening, even in cases of absence of viremia and especially in individuals who are not able to urinate.

Moebius syndrome (MS) is a rare congenital facial diplegia characterized by partial or complete sixth and seventh cranial nerve palsy. Orofacial manifestations include micrognathia, increased overbite, high arched palate, morphological changes in the tongue, and dental crowding. Case reports and small case series have shown a high prevalence of caries in MS patients. The purpose of this study was to compare the prevalence of caries between individuals with Moebius syndrome and controls using the International Caries Detection and Assessment System (ICDAS).A total of 90 participants were divided into two groups: (1) the study group, comprising 34 individuals with MS; and (2) the control group, comprising 56 age- and gender-matched healthy subjects without MS. All individuals were evaluated for the presence of caries using the ICDAS. For statistical analysis, different ICDAS scores were used as cutoff points.The number of carious lesions in the MS group was higher only for early-stage caries (i.e., ICDAS scores of 1 and 2; 27.0±23.0 versus 16.0±14.1 and 26.3±23.2 versus 15.2±13.6, respectively).Moebius syndrome patients have more early carious lesions than controls without the syndrome.

As chamadas sociedades ocidentais, desde o final dos anos 1960, têm testemunhado a ascensão de movimentos feministas com um cunho mais radical em relação às manifestações pró-sufrágio universal surgidas no começo do século XX. Esses movimentos mais recentes, conhecidos como a “segunda onda do feminismo” ou o “novo feminismo”, propunham uma política social revolucionária e afirmavam que a opressão das mulheres estava enraizada em processos psíquicos e culturais profundos.

Estudo qualitativo, com objetivo de apontar elementos que favoreçam o reconhecimento da violência conjugal como agravo à saúde das mulheres. Realizaram-se entrevista e Análise Temática. O estudo revelou que, além das manifestações visíveis decorrentes da agressão física, a violência conjugal guarda relação com o aborto provocado e com aspectos da saúde mental, tal como a depressão. Os profissionais de saúde suspeitam de violência doméstica diante das sequelas físicas, o que permeia a formação tecnicista de valorização dos aspectos clínicos. Faz-se necessário espaço de discussão sobre a temática da violência doméstica contra a mulher e sobre as questões de gênero durante a formação. Qualitative study aiming to point out elements that favor the recognition of marital violence as injury to women's health. We conducted interviews and thematic analysis to organize the raw material. The study revealed that besides the visible manifestations resulting from physical assault, domestic violence is related to the abortion and mental health aspects, such as depression. Health workers suspected of domestic violence injuries on physical sequelae, which permeates the technical education to clinical recovery. It is necessary space for discussion on the topic of domestic violence against women and on gender issues during training.

Background Moebius syndrome (MS) is a rare congenital condition that is characterised by facial hypomimia and congenital strabismus caused by complete or partial impairment of the 6th and 7th cranial nerves. MS may be further associated with other nerves or malformations, mainly involving the extremities. The objective of this study was to quantify the decrease in oral motor performance in people with MS compared with normoreactive individuals using the Oral Motor Assessment Scale (OMAS). Methods The study group comprised 33 subjects between the ages of 2 and 20 years (average age: 10 ± 5 years) with MS along with 46 age- and gender-matched control subjects. Results The study group displayed a lower average functional score than the control group (P