Início Preocupação deste século: longevidade com alimentação saudável
Número atual: 9 (2022)
A importância das políticas públicas para o tratamento da hemoglobinúria paroxística noturna
Resumo:
Introduction: Rare disease is classified as one that affects up to 65 people per 100,000 individuals. They are usually chronic and degenerative conditions, many of them without a cure or effective and accessible treatment, which cause a high degree of morbidity and mortality, in addition to facing a great challenge, because due to their low incidence, health professionals do not have the knowledge about their existence, which reflects in a late diagnosis and lack of public health preparation. Review: This article focuses on the rare disease called Paroxysmal Nocturnal Hemoglobinuria (PNH) and its scenario in public health. Discussion: The PNH is characterized as a rare acquired chronic hemolytic anemia, caused by the non-malignant clonal expansion of one or several hematopoietic stem cells, developing various symptoms in their carriers. Its estimated annual incidence is 1.3 new cases per one million individuals, but as it is a difficult disease to diagnose, the number may be underestimated and does not reflect reality. Final considerations: PNH patients face a long and difficult trajectory, from diagnosis to effective treatment. Even with established guidelines, many patients with rare diseases and their respective families receive unequal treatment in the health service. Public policies are necessary and need to be effective to improve access to information and treatment, provide the necessary structure and follow-up, to reduce the impact caused by these diseases and contribute to improving the quality of life of patients.
Keywords: rare disease, paroxysmal nocturnal hemoglobinuria, PNH, public health, unified health system, SUS.
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Integrative literature review on COVID-19 racial ethnic disparities among black pregnant and postpartum women
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Introdução: As mulheres pretas grávidas e puérperas têm um risco de morte da COVID-19 quase duas vezes maior do que o das mulheres brancas. Estudos brasileiros detalham o impacto das falhas dos serviços de saúde nesta tragédia em que 15% das mulheres grávidas ou pós-parto que morreram da COVID-19 até Julho de 2020 não receberam assistência ventilatória, 28% não tiveram acesso à UTI, 36% não foram entubadas nem receberam ventilação mecânica. Revisão: Revisão Integrativa da Literatura (RIL), adotando os seguintes critérios de inclusão: artigos publicados a partir de Março de 2020, artigos disponíveis electronicamente e gratuitamente em bases de dados/portais. Os critérios de exclusão foram: artigos que não correspondiam recorte temporal de 2020/2021, que não estavam em inglês e português, textos não disponíveis na íntegra, artigos duplicados na base de dados e artigos de revisão. A coleta de dados foi realizada de Maio a Julho de 2021, na base de dados/portal Web Of Science, Science Direct (SciVerse) de Elsevier Scientific Publications, National Library of Medicine (PUBMED) e Medical Literature Analysis and Retrieval System Online (MEDLINE). Foram utilizados os seguintes Descritores de Ciências da Saúde (DeCS): "COVID-19" OR "SARS-COV" AND "Mulheres Negras" OR "Mulheres Negras" AND "Grávidas" OR "Gravidez" AND "Racismo" OR "Racismo". Discussão: Para selecção de artigos, iniciou-se a pesquisa na base de dados Web Of Science, resultando em 02 artigos, dos quais 02 foram seleccionados para leitura completa e, após uma leitura crítica e completa, 01 artigo foi incluído na revisão. Em Science Direct foram seleccionados 02 artigos, dos quais 02 foram seleccionados para uma leitura completa e, após uma leitura crítica e exaustiva, 01 artigo foi incluído na revisão. No PUBMED, 26 artigos resultaram, 10 foram seleccionados para uma leitura completa e, após uma leitura crítica e exaustiva, 6 artigos foram incluídos na revisão. Finalmente, MEDLINE resultou em 18 artigos, dos quais 5 foram seleccionados para uma leitura completa e, após uma leitura crítica e exaustiva, 3 artigos foram incluídos na revisão. Considerações finais: O estudo incluiu estudos observacionais, com pequenas amostras e grupos étnicos diversos, não permitindo conclusões eficazes. Destacam os estudos brasileiros que utilizaram bases de dados secundárias e baseadas na população, encontraram a raça/cor preta como fator de risco independentemente associado à severidade da COVID-19.
Palavras-chave: COVID-19, gravidez, mulher grávida, racismo, grupos étnicos, morte materna.
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O papel da monitoria em fisiologia do exercício na formação profissional: relato de experiência
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Introduction: Monitoring is a form of teaching that greatly contributes to the understanding and learning of students in their academic training. Objective to provide good development and improvement at a maximum level for performance in the specific modality. Material and methods: descriptive, of the experience report type, based on the experiences of a student monitor of the Exercise Physiology discipline taught in the higher education bachelor's course in Physical Education at a private higher education institution in the north of the state of Ceará. Results and discussion: experience and validity, the use of these materials made by students of the Exercise Physiology discipline can be considered, as an aid for learning the contents. Final considerations: it was possible to notice the improvement of students in the exercise physiology subject, through the grades given to them, especially those who were pending in the subject, who were able to recover their grades with the use of this material and with the help monitors and carrying out additional work that served for a better understanding.
Keywords: monitoring, exercise physiology, professional training.
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Avaliação do processo de monitoria da disciplina de cinesiologia nos dias atuais: relato de experiência
Resumo:
Introduction: Monitoring is a form of teaching that greatly contributes to the understanding and learning of students in their academic training. Academic monitoring seeks to assist in the teaching-learning process by providing a diversified environment, reinforcing contents seen in classes, so that students in training can better assimilate the knowledge that will be charged in partial assessments. Results and discussion: As a result, the knowledge and skills acquired with the guiding teacher and monitored students are integrated with the intellectual and social load of the student monitor, revealing new horizons and academic perspectives. Monitoring in higher education, in addition to enriching the monitor's academic training, promotes experiences that provide the monitor student with personal and professional growth. Experience is necessary for the construction of a quality teaching-learning process.
Keywords: evaluation, monitoring, kinesiology.
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Relato de Caso Clínico: Atendimento Pré Hospitalar (APH) a Hemorragia Exsanguinante relacionada a Trauma Crânio Encefálico (TCE)
Resumo:
Introduction: Unusual traumas are considered accidents that health care services prefer to name random and unavoidable traumatic injuries. Case Report: Basic Support Unit (BSSU) was called at 5:00 pm to attend to a male patient, approximately 30 years old, with head injury, with signs of intoxication, victim of falling from his own height. The basic ambulance was manned by the nursing technician and the first-aid nurse, accompanied by the Pre-Hospital Care (PHC) Resident (R1) and the first-aid driver. Discussion: Traumatic brain injury is an aggression of external cause that causes injuries involving the skull scalp, brain, central nervous system and a process that can last for days or weeks, but begins right at the moment of impact, with a combination of neurological damage, vascular insufficiency inflammatory effects.
Keywords: Pre-hospital care (PHC), Exsanguinating haemorrhage, Traumatic Brain Injury (TBI).
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Benefícios da fisioterapia pélvica nas disfunções sexuais femininas e na qualidade de vida: revisão integrativa
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Background: Sexual dysfunctions are characterized as any disorder that will have effects and / or will cause damage to the female sexual function that directly impact the quality of life and affective food relationships. Objective: The aim of this research was to carry out an integrative review with a view to proving the benefits of pelvic physiotherapy in the treatment of female sexual dysfunction and quality of life. Revision: This is an integrative literature review study, with bibliographic search of published articles published, Latin American and Caribbean platforms in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System Online - (MEDLINE / PUBMED ), Scientific Electronic Library Online (SCIELO), Sciencedirect and Mendeley, combined in English and Portuguese. The search took place between January and June 2021 and the year of publication was not used as a selection criterion. Discussion: The initial search found 28,100 titles, which, after cc, were reduced to just 560 articles. Of these, only 7 were consistent with the survey. Final considerations: Based on this research, it identifies that pelvic physiotherapy plays a key role in the treatment of female sexual dysfunctions (FSD), and in improving the quality of life, since as FSD they change not only the woman's physical structures, but also psychological and social.
Keywords: sexual dysfunction, physiotherapy, quality of life.
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Abstinência dos rituais fúnebres e seus impactos
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Introduction: Dying has been part of the society since the origin and the rituals have accompanied this moment. The death has its meaning in every culture, however, along these last years, the pandemic has occupied a meaningful social place, at the thought that the world lives a collective mourning. Facing the problematics, it is observed that pandemic, besides causing physical impacts and abrupt changes, it also alters the funeral rituals. With that in mind, it occurs the question about the mental health of the bereaved in front of farewell privation like has always occurred. Besides the mass deaths, the abstinence from ritualized and accompanied goodbye is a question to be analyzed. Review: It is about a bibliographic review in which has been realized a research in books and indexed articles in digital platforms. Discussion: The death is universally known at the same way its nature is completely untouchable. Depending on in what culture the man is inserted, thinking and talking about death can generate chaos to those are close to. However, besides being an old subject, it’s totally unavoidable and of utmost importance for life. After all, it is understood a lot about the life observing how that culture faces death. Final considerations: The abstinence from funeral rituals disorganizes the process of mourning, and may develop in the bereaved a complicated bereavement, becoming relevant to think in other ways to ritualize the loss during pandemic scenario.
Keywords: death, mourning, rituals, impacts on mental health.
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Utilização de ácido valproico para redução da resistência do sorafenibe no tratamento de pacientes com hepatocarcinoma refratário
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Introduction: Hepatocarcinoma is the most common type of liver tumor, with sorafenib, the first approved option approved by the United Stated Food and Drug Administration (FDA) for advanced disease. However, resistance to sorafenib has recently been reported, compromising its beneficial clinical results. Recent studies have shown that valproic acid could increase sorafenib antitumor activity in resistant hepatocarcinoma cells by modulating signaling pathways. The work aims to present the signaling pathways by which the association between sorafenib and valproic acid demonstrated positive results, thus reversing the resistance to sorafenib presented in patients with hepatocarcinoma. Review: The research was carried out based on searches in the Virtual Health Library (VHL) and Pubmed databases, with the keywords in English sorafenib, valproic acid, mechanisms of resistance and hepatocellular carcinoma, and their respective terms in Portuguese. The search period was from December 7, 2020 to February 7, 2021, and articles published between 2011 and 2021 were considered valid, using the inclusion and exclusion criteria, the abstract and introduction, resulting in 19 articles included in the research. Discussion and Final considerations: The evidence shows that the combined treatment between sorafenib and valproic acid can act in different signaling pathways in order to overcome drug resistance, but also inhibit the expression of genes related to hepatocarcinoma. However, even though valproic acid has been suggested as a possible adjuvant drug for the treatment of various types of cancers, the mechanism used in reversing the resistance of hepatocarcinoma cells is not clear, thus requiring further studies.
Keywords: valproic acid, hepatocellular carcinoma, mechanisms of resistance, sorafenib.
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Tratamento fisioterapêutico tardio em indivíduo submetido a cirurgia de fixação de fêmur, pós-fratura: um estudo de caso
Resumo:
Introduction: Proximal femur fractures are common after a fall, and are considered a public health problem. The aim of the study was to verify the effects of late physical therapy treatment applied to an individual who underwent fixation surgery after fracture of the femur. Case report: This is a case study of a 55-year-old female patient with femur fixation after trans trochanteric fracture of the right femur, under physical therapy treatment performed in 12 weeks, which involved manual therapies, strength training, balance and proprioception, as well as hydrotherapeutic resources. Discussion: After treatment application, it was possible to observe improvement and maintenance of muscle strength and range of motion, improvement of balance, proprioception and reduction of pain. Thus, it can be concluded that such an approach applied to the patient in question, was able to have positive effects related to pain, muscle strength, range of motion, balance and proprioception.
Keywords: physical therapy specialty, femoral fractures, hydrotherapy, rehabilitation.
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Encefalite autolimitada na COVID-19: relato de um caso
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Introduction: COVID-19 is a systemic infection with the new coronavirus (SARS-COV2), which appeared in China in 2019 and has been plaguing the world. Its contagion rate is high and has already caused millions of deaths on all continents. Although it is asymptomatic in most patients, many cases usually lead to severe acute respiratory syndrome. Neurological symptoms, especially headache, anosmia and mental confusion, are prominent, possibly due to direct involvement of brain structures or the peripheral nervous system. Cases of critical encephalitis have been reported in several countries. Memory loss seems to be a commom sequel. Case report: We describe the case of a young woman who presented epileptic seizures due to coronavirus infection, with changes in the cerebrospinal fluid and transient abnormalities in neuroimaging, evolving with spontaneous improvement. Discussion: Our findings suggest the existence of cases of post-covid encephalitis from autoimmune nature and benign evolution, a potentially underdiagnosed entity in the face of the most serious manifestations of the pandemic, and perhaps responsible for sequelae such as memory loss and anosmia.
Keywords: COVID-19, epileptic seizures, autoimmune encephalitis, pandemic.
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