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1.
Braz. j. oral sci ; 21: e226351, jan.-dez. 2022. ilus
Article in English | LILACS, BBO | ID: biblio-1355010

ABSTRACT

Aim: This study aimed to assess the reporting characteristics of systematic review abstracts published in the proceedings of the Sociedade Brasileira de Pesquisa Odontológica (SBPqO) meeting. Methods: We selected abstracts published in the SBPqO meeting proceedings of 2019 and 2020, mentioning that a systematic review was conducted in the title, objective or methods sections. One researcher performed the screening and the data extraction after a pilot test training. The following data were extracted: affiliation of the primary author, dental specialization, the term "systematic review" mentioned in the title, reporting of the objective, reporting of eligibility criteria, reporting of information sources, reporting of the number of included studies and if a meta-analysis was performed. A descriptive analysis of the data was performed with data summarized as frequencies. Results: We included 235 abstracts. A total of 20 studies were from the Universidade de Uberlândia (8.5%), and the main specialization was Restorative and Esthetic Dentistry, with 47 studies (20%). Most of the studies mentioned the term "systematic review" in the title (n=219; 93.2%) and reported the objective (n=231; 98.3%). A great majority of studies did not report the eligibility criteria (n=97; 41.3%) or it was classified as unclear (n=96; 40.8%). The great majority of studies only reported the databases searched (n=103; 43.8%) or databases and date of search (n=74; 31.5%). Most of the studies reported the number of included studies (n=204; 86.8%). Conclusion: Based on this study, the reporting characteristics of systematic review abstracts published in the proceedings of the SBPqO meeting are satisfactory. However, there is room for improvement


Subject(s)
Congresses as Topic , Dental Research/statistics & numerical data , Abstracting and Indexing , Research Report , Systematic Reviews as Topic
2.
Porto Alegre; Editora Rede Unida; 20220420. 486 p.
Monography in Portuguese | LILACS | ID: biblio-1377861

ABSTRACT

A 16ª Conferência Nacional de Saúde (8ª+8), conhecida pela marca da 8ª+8, em referência à relevância da 8ª Conferência Nacional de Saúde, realizada em 1986 e que deu origem às bases políticas e operacionais que permitiram a criação do Sistema Único de Saúde (SUS), percorreu um longo processo até a etapa nacional, realizada no período de 4 a 7 de agosto de 2019, em Brasília. A Comissão de Organização, instituiu amplo debate com conselheiros profissionais de saúde, gestores e prestadores, usuários, movimentos sociais e sindicais, que elaborou um documento orientador, o qual foi disponibilizado aos municípios e estados, para subsidiar os debates locais. Além dessa atribuição, acreditamos que seria necessário organizar um documento que permitisse o registro da 16ª Conferência para a memória da história da saúde no Brasil. A estruturação do presente relatório procurou dar conta dessa condição e foi feita de forma que se materialize a singularidade de cada momento e ações ofertadas e experienciadas por cada um(a) e, no seu todo, que representasse a relevância para a história do nosso sistema de saúde e para o contexto em que vivemos.


Subject(s)
Health Conferences , Health Councils , Health Policy , Professional Staff Committees , Unified Health System , Health Personnel , Research Report , Counselors
3.
REME rev. min. enferm ; 26: e:1442, abr.2022.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1378086

ABSTRACT

Objetivo: relatar a experiência da utilização das tecnologias body painting e body projectioncomo ferramentas facilitadoras do processo ensino-aprendizagem na perspectiva de docentes de Enfermagem durante o ensino do exame físico cardiovascular. Método: relato de experiência de estratégia facilitadora aplicada ao processo de ensino-aprendizagem do exame físico cardiovascular durante o curso de graduação em Enfermagem de uma universidade privada de São Paulo­Brasil. Resultados: participaram da experiência 40 estudantes, dois professores, um artista plástico e dois modelos que receberam a pintura corporal. O uso das referidas tecnologias suscitou reflexões sobre a possibilidade de utilizá-las como ferramentas para o ensino de forma lúdica e eficaz, otimizando o contexto acadêmico formal. Conclusão: as ferramentas body painting e body projection, de acordo com a percepção dos docentes, facilitam o processo de ensino-aprendizagem do exame físico cardiovascular, uma vez que aproximam a teoria da prática e permitem, aos estudantes, associações visuais que superam as tradicionais barreiras de ensino-aprendizagem.(AU)


Objective: to report the experience of using the body painting and body projection technologies as facilitating tools in the teaching-learning process from the perspective of Nursing professors during teaching of the cardiovascular physical examination. Method: an experience report of a facilitating strategy applied to the teaching-learning process corresponding to the cardiovascular physical examination in the Nursing undergraduate course at a private university from São Paulo, Brazil. Results: a total of 40 students, two professors, one plastic artist and two models on whom body painting was applied took part in the experience. Use of the aforementioned technologies raised reflections about the possibility of employing them as tools for playful and effective teaching, optimizing the formal academic context. Conclusion: according to the professors' perception, the body painting and body projection tools facilitate the teaching-learning process corresponding to the cardiovascular physical examination, as they bring the theory closer to the practice and allow students to make visual associations that overcome the traditional teaching-learning barriers.(AU)


Objetivo: informar sobre la experiencia del uso de las tecnologías de body painting y body projection como herramientas facilitadoras del proceso de enseñanza-aprendizaje desde la perspectiva de los profesores de enfermería durante la enseñanza del examen físico cardiovascular. Método: informe de experiencia de estrategia facilitadora aplicada en el proceso de enseñanza-aprendizaje del examen físico cardiovascular durante el curso de graduación en enfermería de una universidad privada de São Paulo- Brasil. Resultados: participaron en la experiencia 40 alumnos, dos profesores, un artista plástico y dos modelos que recibieron la pintura corporal. El uso de estas tecnologías suscitó reflexiones sobre la posibilidad de utilizar ambas como herramientas para la enseñanza de forma lúdica y eficaz, optimizando el contexto académico formal. Conclusión: las herramientas de body painting y body projection, según la percepción de los profesores, facilitan el proceso de enseñanza-aprendizaje del examen físico cardiovascular, ya que aproximan la teoría a la práctica y permiten a los alumnos realizar asociaciones visuales que superan las barreras tradicionales de enseñanza-aprendizaje.(AU)


Subject(s)
Humans , Education, Nursing , Anatomy, Artistic/methods , Learning , Qualitative Research , Faculty, Nursing , Research Report
4.
San Salvador; MINSAL; feb. 02, 2022. 32 p. ilus, graf.
Non-conventional in Spanish | LILACS, BISSAL | ID: biblio-1361737

ABSTRACT

En los presentes lineamientos técnicos se describen los conceptos y procedimientos a realizar en la implementación del registro, además se presentan entre otros aspectos, los componentes relacionados con la obligatoriedad en el reporte, definición de caso registrable, las variables a registrar, las fuentes de información, metodología de la recolección, los centros de diálisis y trasplante, así como el reporte de resultados y la hoja de recolección de la información


These technical guidelines describe the concepts and procedures to be carried out in the implementation of the registry, in addition to presenting, among other aspects, the components related to the obligatory nature of the report, the definition of the registrable case, the variables to be registered, the sources of information, collection methodology, dialysis and transplant centers, as well as the results report and the information collection sheet


Subject(s)
Records , Kidney Transplantation , Dialysis , Registries , Research Report
5.
Esc. Anna Nery Rev. Enferm ; 26: e20210328, 2022.
Article in Portuguese | LILACS, BDENF | ID: biblio-1360444

ABSTRACT

Resumo Objetivos relatar a experiência de produção de cuidado no pré-natal de alto risco, por meio de visitas domiciliares estruturadas na solicitude. Método estudo descritivo, na modalidade relato de experiência, pautado na vivência de enfermeiras em desenvolver visitas domiciliares, sob o referencial da solicitude para 17 mulheres com gravidez de alto risco. Resultados as visitas domiciliares possibilitaram às enfermeiras a valoração dos aspectos subjetivos do cuidado, com apreensão de necessidades das mulheres e compreensão da gravidez na vida de cada uma delas, aspectos determinantes à atenção pré-natal integral. Promoveu cuidado singular e contraposição às insuficiências e negativas experienciadas na atenção pré-natal recebida, ancorada no modelo biomédico. Conclusão e implicações para a prática a visita domiciliar por enfermeiras, sob os auspícios da solicitude, revelou-se como tecnologia de atenção pré-natal de alto risco que produz acolhimento de necessidades singulares, assim como conduz a reconstrução do cuidado no contexto da gravidez de alto risco.


Resumen Objetivo relatar la experiencia de producción del cuidado en la atención prenatal de alto riesgo a través de visitas domiciliares estructuradas por la solicitud. Método estudio descriptivo, en la modalidad de relato de experiencia, basado en la experiencia de enfermeras en el desarrollo de visitas domiciliaras a partir de la solicitud con 17 mujeres con embarazos de alto riesgo. Resultados las visitas domiciliaras permitieron a las enfermeras apreciar los aspectos subjetivos del cuidado, comprender las necesidades de la mujer y comprender el embarazo en la vida de las mujeres, aspectos determinantes de las demandas de la atención prenatal. Conclusión e implicaciones para la práctica la visita domiciliara de enfermeras bajo el auspicio de la solicitud se reveló como una tecnología de atención prenatal de alto riesgo que produce la acogida de necesidades únicas y capaz de conducir la reconstrucción de la atención prenatal en el contexto de embarazo de alto riesgo.


Abstract Objectives to report the experience of producing high-risk prenatal care through home visits structured on request. Method this is a descriptive study in the experience report modality, based on the experience of nurses in developing home visits under the solicitude framework for 17 women with high-risk pregnancies. Results home visits allowed nurses to value the subjective aspects of care, with apprehension of women's needs and understanding of pregnancy in the lives of each one of them, determining aspects of comprehensive prenatal care. It promoted unique care and opposed to the insufficiencies and negatives experienced in the prenatal care received, anchored in the biomedical model. Conclusion and implications for practice home visit by nurses under the auspices of solicitude has revealed itself as a high-risk prenatal care technology that produces reception of unique needs, as well as leads to care reconstruction in the context of high-risk pregnancy.


Subject(s)
Humans , Female , Pregnancy , Prenatal Care , Pregnancy, High-Risk , House Calls , Nurse-Patient Relations , Research Report , Integrality in Health
6.
Rev. Ciênc. Plur ; 8(1): e24820, 2022. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-1348511

ABSTRACT

Introdução:O carcinoma de células escamosas de cavidade oral e orofaringe é uma neoplasia epitelial maligna comum, respondendo pela maioria dos casos de tumores de cabeça e pescoço. Ele está relacionado a hábitos comportamentais, como tabagismo e etilismo de longa duração, e à infecção pelo Papilomavírus humano. Objetivos:Esse estudo objetivou descrever o perfil epidemiológico dos pacientes diagnosticados com essa neoplasia na Liga Mossoroense de Estudos e Combate ao Câncer. Metodologia: Foi realizado um estudo observacional com delineamento transversal a partir de dados presentes nos prontuários clínicos e laudos anatomopatológicos e no Sistema de Informações sobre Mortalidade no período entre 2006 a 2018. Os dados foram analisados a partir do Software R, utilizandoo teste de Wilcoxon-Mann-Whitney para as análises inferenciais e o método de Kaplan-Meier para análise da sobrevida. Resultados:225 prontuários foram analisados, sendo 70,22% de homens, 65,33% na faixa etária entre 46-70 anos e cor branca (51,57%). Destes, 25,78% eram tabagistas e 39,11% tabagistas e etilistas. O principal tratamento identificado foi a associação de cirurgia, quimioterapia e radioterapia. Observou-se que 49,10% dos óbitos foram em decorrência dessa neoplasia. O principal estádio patológico encontrado foi o quatro A (34,22%). Foi identificada maior sobrevida nos pacientes acima de 70 anos, cujo tratamento foi exclusivamente cirúrgico. Menor sobrevida foi identificada em indivíduos que tinham associação de hábitos (etilismo e tabagismo). Conclusões:Nossos resultados sugerem que a evolução à óbito foi o principal desfecho clínico e, isso pode estar relacionado aos hábitos comportamentais que influenciam diretamente o curso e prognóstico da doença. Ademais, destaca-se a importância do diagnóstico precoce a fim de reduzir óbitos e melhorar a qualidade de vida dos indivíduos, assim como a necessidade de implementar políticas educativas sobre os principais fatores de risco associados ao desenvolvimento dessa neoplasia (AU).


Introduction: Squamous cell carcinoma of the oral cavity and oropharynx is a common malignant epithelial neoplasm, accounting for most cases of head and neck tumors. It is related to behavioral habits, such as long-standing smoking and alcoholism, as well as to the human Papillomavirus infection. Objectives: This study aimed at describing the epidemiological profile of the patients diagnosed with this neoplasm in the Mossoró League for Studying and Combating Cancer. Methodology:An observational study with a cross-sectional design was carried out based on data present in the medical records and anatomopathological reports and in the Mortality Information System during the 2006-2018 period. The data were analyzed using the R Software, resorting to the Wilcoxon-Mann-Whitneytest for the inferential analyses and to the Kaplan-Meier method for survival analysis. Results: 225 medical records were analyzed: 70.22% belonging to men, 65.33% aged between 46 and 70 years old and white-skinned (51.57%). Of these, 25.78% were smokers and 39.11% were smokers and alcoholics. The main treatment identified was the association of surgery, chemotherapy and radiotherapy. It was observed that 49.10% of the deaths were due to this neoplasm. The main pathological stage found wasfour A(34.22%).Longer survival was identified in patients over 70 years of age, whose treatment was exclusively surgical. Shorter survival was identified in individuals who had associated habits (alcoholism and smoking). Conclusions:Our results suggest that evolution to death was the main clinical outcome; this can be related to the behavioral habits that exert a direct influence on the course and prognosis of the disease. Furthermore, the importance of early diagnosis is highlighted in order to reduce the number of deaths and improve the individuals' quality of life, as well as the need to implement educational policies on the main risk factors associated with the development of this neoplasm (AU).


Introducción: El carcinoma de células escamosas de la cavidad oral y la orofaringe es una neoplasia epitelial maligna común, que representa la mayoría de los casos de tumores de cabeza y cuello. Se relaciona con hábitos de comportamiento, como el tabaquismo y el alcoholismo, y la infección por el virus papiloma humano. Objetivos:Este estudio tuvo como objetivo describir el perfil epidemiológico de los pacientes diagnosticados con esta neoplasiaen la Liga Mossoroense de Estudios y Combate al Cáncer. Metodología: Se realizó un estudio observacional, transversal a partir de los datos presentes en las historias clínicas e informes patológicos y en el Sistema de Información de Mortalidad en el período 2006-2018. Los datos se analizaron mediante el Software R, con utilización de la Prueba de Wilcoxon-Mann-Whitney para análisis inferencial y el método de Kaplan-Meier para análisis de supervivencia. Resultados:Se analizaron 225 historias clínicas, 70,22% en hombres, 65,33% con edades entre 46-70 años y blancos (51,57%). De estos, 25,78% eran fumadores y 39,11% eran fumadores y alcohólicos. El principal tratamiento identificado fue la asociación de cirugía, quimioterapia y radioterapia. 49,10% de las muertes se debieron a esta neoplasia. El principal estadio patológico encontrado fue cuatro A (34,22%). Se identificó mayor sobrevida en pacientes mayores de 70 años, cuyo tratamiento fue exclusivamente quirúrgico. Se identificó una menor sobrevida en personas que tenían hábitos asociados. Conclusiones:Nuestros resultados sugieren que la evolución hacia la muerte fue el principal resultado clínico y esto puede estar relacionado con hábitos de comportamiento que influyen directamente en el curso y pronóstico de la enfermedad. Además, se destaca la importancia del diagnóstico precoz para reducir las muertes y mejorar la calidad de vida, así como la necesidad de implementar políticas educativas sobre los principales factores de riesgo asociados al desarrollo de esta neoplasia (AU).


Subject(s)
Humans , Health Profile , Brazil/epidemiology , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Oropharyngeal Neoplasms/pathology , Head and Neck Neoplasms/pathology , Tobacco Use Disorder , Survival Analysis , Epidemiology , Cross-Sectional Studies , Statistics, Nonparametric , Papillomavirus Infections , Research Report , Smokers
7.
Journal of Integrative Medicine ; (12): 213-220, 2022.
Article in English | WPRIM | ID: wpr-929225

ABSTRACT

BACKGROUND@#Acupuncture has been widely used to relieve migraine-related symptoms. However, the findings of previous systematic reviews (SRs) and meta-analyses (MAs) are still not completely consistent. Their quality is also unknown, so a comprehensive study is needed.@*OBJECTIVE@#To evaluate the reporting and methodological quality of these MAs concerning acupuncture for migraine, and summarize evidence about the efficacy and safety of acupuncture for migraine.@*SEARCH STRATEGY@#PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Databases, Wanfang Data, and VIP databases were searched from inception to September 2020, with a comprehensive search strategy.@*INCLUSION CRITERIA@#The pairwise MAs of randomized controlled trials (RCTs) concerning migraine treated by acupuncture or acupuncture-based therapies, with a control group that received sham acupuncture, medication, no treatment, or acupuncture at different acupoints were included.@*DATA EXTRACTION AND ANALYSIS@#Two independent investigators screened studies, extracted relevant data, and assessed reporting and methodological quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), then all results were cross-checked. Spearman correlation test was used to evaluate the correlation between reporting and methodological quality scores.@*RESULTS@#A total of 20 MAs were included in this study. The included MAs indicated that acupuncture was efficacious and safe in preventing and treating migraine when compared with control intervention. There was a high correlation between reporting and methodological quality scores (rs = 0.87, P < 0.001). The quality of the included SRs needs to be improved mainly with regard to protocol and prospective registration, using a comprehensive search strategy, summarizing the strength of evidence body for key outcomes, a full list of excluded studies with reasons for exclusion, reporting of RCTs' funding sources, and assessing the potential impact of risk of bias in RCTs on MA results.@*CONCLUSION@#Acupuncture is an effective and safe intervention for preventing and treating migraine, and could be considered as a good option for patients with migraine. However, the reporting and methodological quality of MAs included in this overview is suboptimal. In the future, AMSTAR 2 and PRISMA tools should be followed when making and reporting an SR with MA.


Subject(s)
Acupuncture Points , Acupuncture Therapy/methods , China , Humans , Meta-Analysis as Topic , Migraine Disorders/therapy , Research Report
8.
Article in Chinese | WPRIM | ID: wpr-927343

ABSTRACT

OBJECTIVE@#To overview the methodological quality, report quality and evidence quality of the systematic review (SR) of acupuncture for vascular cognitive impairment ( VCI ).@*METHODS@#The SRs regarding acupuncture for VCI were searched in PubMed, Cochrane Library, EMbase, CNKI, SinoMed, Wanfang and VIP databases. The retrieval period was from the establishment of the database to September 24, 2020. The report quality, methodological quality and evidence quality of the included SRs were evaluated by PRISMA statement, the AMSTAR 2 tool and the GRADE system.@*RESULTS@#A total of 22 SRs were included, including 102 outcome indexes. The methodological quality was generally low, with low scores on items 2, 5, 7, 10, 14, 15 and 16. The report quality was good, with scores ranging from 19 points to 24.5 points. The problems of report quality were mainly reflected in the aspects of structural abstract, program and registration, other analysis and funding sources. The level of outcome indexes of SRs was mostly low or very low, and the main leading factor was limitation, followed by inconsistency and inaccuracy.@*CONCLUSION@#Acupuncture for VCI is supported by low quality evidence of evidence-based medicine, but the methodological quality and evidence body quality of relevant SRs are poor, and the standardization is needed to be improved.


Subject(s)
Acupuncture Therapy , Cognitive Dysfunction/therapy , Databases, Factual , Humans , Research Report , Systematic Reviews as Topic
9.
Braz. J. Pharm. Sci. (Online) ; 58: e18681, 2022. graf
Article in English | LILACS | ID: biblio-1360162

ABSTRACT

Abstract Vascular ulcers (VU) constitute a major cause of pain and disability, and significantly compromise quality of life. VU have a natural tendency to become chronic and in many cases exhibit anunsatisfactoryresponse to many of the standard therapeutic options.The case of a 73 year-old Caucasian female with severe pain and poorly-controlled pain (Visual Analogic Scale-VAS- of 8-9) due to three lower leg long-standing VUs is reported and discussed herein. The patient was treated with topical instillations of undiluted sevoflurane as per institutional off-label protocol (starting doses of 1mL/cm2 twice a day, and up-titrated according to response to a maximum of 7 mL twice daily). The VAS score dropped to 0-1 shortly after initiation of therapy and remained stable throughout treatment up until the closure of the observations. Subsequently, opioid therapy was gradually tapered down and ultimately abandoned.Sevoflurane application resulted on adequate and sustained pain management of refractory VU, with no significant side effects. On account of its beneficial effectivity and safety profiles, topical sevoflurane emerges as an add-on alternative for the long-term management of VU, and potentially other painful conditions.


Subject(s)
Humans , Female , Aged , Pain/drug therapy , Varicose Ulcer , Research Report , Sevoflurane/analysis , Drug Tapering/methods , Analgesics, Opioid/agonists , Patients/classification , Pain Management/classification
10.
Esc. Anna Nery Rev. Enferm ; 26: e20210056, 2022. graf
Article in Portuguese | LILACS, BDENF | ID: biblio-1356217

ABSTRACT

Resumo Objetivo relatar a experiência de indução da lactação em nuligestas realizada por enfermeira consultora em aleitamento. Método relato de experiência. O processo de indução láctea foi realizado com três mulheres por motivo de gestação em útero de substituição e relacionamento homoafetivo. Resultados todas perceberam o aumento de tamanho e a sensibilidade nas mamas, bem como apresentaram secreção láctea. No entanto, a continuidade da amamentação foi diferenciada entre elas. A primeira não recebeu apoio de profissionais de saúde no contexto de pós-parto hospitalar, nem em casa, e não deu continuidade à amamentação. A segunda recebeu apoio da equipe do hospital e da parceira, amamentando por três meses. A terceira, com o apoio da parceira, amamentou por dois meses, mas interrompeu por sentir-se inibida por familiares. Conclusão e implicações para a prática a técnica de indução é capaz de desencadear a produção láctea. Já o processo de amamentação só se estabeleceu mediante a associação com a rede de apoio, o acolhimento, o incentivo da equipe de saúde e o olhar integral à mulher e sua família. Dessa forma, o cuidado de Enfermagem na indução láctea não deve focar apenas no manejo da indução, mas transcender o aspecto técnico, o que se mostra como fundamental para a proteção, o estabelecimento e a continuidade da amamentação.


Resumen Objetivo reportar la experiencia de inducir la lactancia en nuligestas realizada por una consultora de enfermería en lactancia materna. Método relato de experiencia. El proceso de inducción de la leche se realizó con tres mujeres por embarazo en útero de reemplazo y relación homoafectiva. Resultados todas notaron el aumento de tamaño y la sensibilidad en las mamas, además de presentar secreción de leche. Sin embargo, la continuidad de la lactancia materna se diferencia entre ellos. La primera no recibió apoyo de los profesionales de la salud en el contexto posparto hospitalario, ni en el domicilio, y no continuó con la lactancia. La segunda recibió apoyo del personal del hospital y su pareja, amamantando durante tres meses. La tercera, con el apoyo de su pareja, amamantó durante dos meses, pero la interrumpió porque se sentía inhibida por familiares. Conclusión e implicaciones para la práctica la técnica de inducción es capaz de desencadenar la producción de leche. El proceso de lactancia materna, en cambio, solo se estableció a través de la asociación con la red de apoyo, la acogida, el estímulo del equipo de salud y la mirada integral a la mujer y su familia. Así, el cuidado de Enfermería en la inducción de la leche no debe enfocarse solo en el manejo de la inducción, sino trascender el aspecto técnico, que se muestra fundamental para la protección, el establecimiento y la continuidad de la lactancia materna.


Abstract Objective to report the experience of lactation induction in women who never got pregnant by a lactation consultant nurse. Method experience report. The process of lactation induction was performed with three women due to surrogate pregnancy and homosexual relationships. Results all noticed an increase in the size and sensitivity of the breasts, as well as milk secretion. However, the continuity of breastfeeding was different between them. The first did not receive support from health professionals in the postpartum hospital setting, nor at home, and did not continue breastfeeding. The second received support from the hospital staff and her partner, breastfeeding for three months. The third, with the support of her partner, breastfed for two months, but stopped because she felt inhibited by family members. Conclusion and implications for practice the induction technique is capable of triggering milk production. However, the breastfeeding process was only established through the association with the support network, the reception, the encouragement of the health team, and the comprehensive view of the woman and her family. Thus, nursing care in lactation induction should not focus only on the management of induction, but transcend the technical aspect, which is essential for the protection, establishment, and continuity of breastfeeding.


Subject(s)
Humans , Female , Breast Feeding/methods , Lactation , Social Support , Weaning , Women's Rights , Breast/injuries , Lactation/drug effects , Surrogate Mothers , Consultants , Domperidone/therapeutic use , User Embracement , Galactogogues/therapeutic use , Research Report , Breast Milk Expression , Sexual and Gender Minorities , Nurse Midwives
11.
Esc. Anna Nery Rev. Enferm ; 26: e20210354, 2022.
Article in Portuguese | LILACS, BDENF | ID: biblio-1356212

ABSTRACT

Resumo Objetivo Relatar a experiência da equipe de saúde da atenção especializada na reorganização do processo de trabalho para a continuidade do cuidado às pessoas com condições crônicas complexas durante a pandemia da covid-19. Métodos Relato de experiência vivenciada em ambulatório do Estado do Paraná entre março e julho de 2020. O serviço ambulatorial em questão adota o Modelo de Atenção às Condições Crônicas para o atendimento de gestantes, crianças, idosos, pessoas com hipertensão arterial, diabetes mellitus e transtornos mentais, estratificadas como condições complexas. Resultados O avanço da pandemia no Brasil implicou a necessidade de planejar a reorganização da atenção ambulatorial especializada, definindo atividades assistenciais presenciais no serviço, atividades itinerantes nos municípios e uso de tecnologias remotas para assistência e matriciamento. Conclusão e Implicações para a prática O rigor no cumprimento das recomendações sanitárias possibilitou a reorganização dos processos de trabalho no serviço, com modificações que permitiram a continuidade do cuidado de pessoas com condições crônicas complexas. O planejamento e o desenvolvimento das modificações no serviço foram fundamentais para manter o acompanhamento e o monitoramento da saúde das pessoas com condições crônicas complexas em meio a pandemia, minimizando as descompensações e, consequentemente, diminuindo a necessidade de essas pessoas utilizarem os serviços de saúde.


Resumen Objetivo Exponer la experiencia del equipo de atención a la salud especializada, en la reorganización del proceso de trabajo para la continuidad de la atención a personas con enfermedades crónicas complejas durante la pandemia de COVID-19. Métodos Informe de experiencia en un centro ambulatorio del estado brasileño de Paraná entre marzo y julio de 2020. El servicio adopta el Modelo de Atención a Condiciones Crónicas para el atendimiento de: gestantes, niños, ancianos, personas con hipertensión arterial, diabetes mellitus y trastornos mentales, estratificado como condiciones complejas. Resultados El avance de la pandemia en Brasil implicó en la necesidad de planificar la reorganización de la atención ambulatoria especializada, al definir acciones de actividades asistenciales presenciales en el servicio, actividades itinerantes en los municipios y el uso de tecnologías remotas para la asistencia y apoyo matricial. Conclusión e implicaciones para la práctica El rigor en el cumplimiento de las recomendaciones sanitarias permitió la reorganización de los procesos de trabajo en el servicio, con cambios que permitieron la continuidad del cuidado de las personas con condiciones crónicas complejas. La planificación y el desarrollo de los cambios en el servicio fueron fundamentales para mantener el acompañamiento y la vigilancia de la salud de personas con condiciones crónicas complejas en medio a la pandemia, minimizando las descompensaciones y, consecuentemente, disminuyendo la necesidad de que estas personas utilicen los servicios de salud.


Abstract Objective To report the experience of the specialized care health team in reorganizing the work process for the continuity of care for people with complex chronic conditions during the COVID-19 pandemic. Methods Experience report lived in an outpatient clinic in Paraná State between March and July 2020. The outpatient service in question adopts the Chronic Conditions Care Model for pregnant women, children, elderly people, people with hypertension, diabetes mellitus, and mental disorders, stratified as complex conditions. Results The advance of the pandemic in Brazil implied the need to plan the reorganization of specialized ambulatory care, defining face-to-face care activities in the service, itinerant activities in municipalities, and the use of remote care technologies and matrix support. Conclusion and Implications for practice Rigorous compliance with health recommendations allowed the reorganization of work processes in the service with modifications that allowed continuity of care for people with complex chronic conditions. The planning and development of the modifications in the service were fundamental to maintain the follow-up and monitoring of the health of people with complex chronic conditions amid the pandemic, minimizing decompensations and, consequently, reducing the need for these people to use health services.


Subject(s)
Humans , Patient Care Team/organization & administration , Chronic Disease , Continuity of Patient Care/organization & administration , Ambulatory Care/organization & administration , COVID-19/prevention & control , Referral and Consultation/organization & administration , Risk Groups , Remote Consultation , Research Report , Healthcare Models/organization & administration , Health Services/supply & distribution
12.
Braz. J. Pharm. Sci. (Online) ; 58: e18893, 2022. tab, graf
Article in English | LILACS | ID: biblio-1364414

ABSTRACT

Abstract On the increasing prevalence of using mAbs (monoclonal antibodies) in cancer therapy and the severe risk of hyperglycemia, we aimed to analyze the main clinical ADRs of mAbs, with a focus on adverse hyperglycemic events associated with currently clinically used mAbs. mAbs as well as target information were selected from Martinadale book and published articles. Drug approving information was collected from each government website, and ADR statistic data were collected from VigibaseR, comparing with Adverse Event Reporting System of US FDA. Top 10 mAbs were classified within listing in total ADR records, ADRs per year, hyperglycemic ADR records. Vigibase data were updated onto 15 Feb 2019. 20 mAbs were analyzed with 263217 ADR reports, wherein 16751 records on Metabolism and nutrition disorders and 1444 records on Glucose metabolism disorders. The geographic, age, gender distributions and annual ADR report numbers were listed respectively. Of the top 10, Rituximab, Bevacizumab and Nivolumab were on the top 3 in total ADR record and hyperglycemic record. Top 3 record results were similar in Vigibase and FDA database. It is of increasing importance for clinicians to be aware of early detection, patient management, or drug selection strategies when using mAbs, particularly within the high glycemic risk-reported mAbs, to improve the efficacy and tolerability of mAbs regiment and optimize patient outcomes.


Subject(s)
Blood Glucose/analysis , Glucose Metabolism Disorders/pathology , Drug-Related Side Effects and Adverse Reactions , Research Report , Rituximab , Glucose/adverse effects , Hyperglycemia , Antibodies, Monoclonal/classification , Patients/statistics & numerical data , Computer Communication Networks/instrumentation , Efficacy/statistics & numerical data , Health Strategies , Antibodies, Monoclonal , Neoplasms
13.
Edumecentro ; 14: e1987, 2022.
Article in Spanish | LILACS | ID: biblio-1356191

ABSTRACT

RESUMEN Fundamento: la labor conjunta del sector educacional y de la salud en Cuba encamina sus esfuerzos hacia la prevención, y establece vínculos para mejorar la calidad de vida de las personas que padecen del trastorno por déficit de atención con hiperactividad. Objetivo: describir resultados parciales de una investigación realizada en el municipio Santa Clara, provincia Villa Clara, basada en la atención integral a escolares con trastorno por déficit de atención con hiperactividad, mediante la articulación de la educación primaria con instituciones de salud mental. Métodos: el estudio fue realizado con un enfoque cualitativo a partir del diseño de una investigación-acción y se utilizó el estudio de caso como estrategia de investigación en el periodo 2014-2019 en cuatro instituciones de la educación primaria y las respectivas áreas de salud mental. Se emplearon métodos del nivel teórico y empírico, y entre las técnicas, el diario del investigador y el análisis de evidencias. Resultados: los obstáculos y progresos del propio proceso investigativo permitieron la concepción de la atención integral a escolares con trastorno por déficit de atención con hiperactividad, y la materialización de su efectividad en la evolución de los escolares, la preparación de familias y docentes, y el intercambio entre las instituciones educativas y de salud. Conclusiones: la concepción de la atención integral a escolares con trastorno por déficit de atención con hiperactividad con una perspectiva multisectorial desde los sectores educativos y sanitarios involucra a docentes y especialistas de salud en una atención individualizada para reducir las consecuencias del trastorno.


ABSTRACT Background: the joint work of the educational and health sector in Cuba directs its efforts towards prevention, and establishes links to improve the quality of life of people suffering from attention deficit hyperactivity disorder. Objective: to describe partial results of a research carried out in the Santa Clara municipality, Villa Clara province, based on comprehensive care for schoolchildren with attention deficit hyperactivity disorder, through the articulation of primary education with mental health institutions. Methods: the study was carried out with a qualitative approach based on the design of an action research and the case study was used as a research strategy in the period from 2014 to 2019 in four primary education institutions and the respective areas of mental health. Methods of the theoretical and empirical level were used, and among the techniques, the researcher's diary and the analysis of evidence. Results: the obstacles and progress of the research process itself allowed the conception of comprehensive care for schoolchildren with attention deficit hyperactivity disorder, and the materialization of its effectiveness in the evolution of schoolchildren, the preparation of families and teachers, and the exchange between educational and health institutions. Conclusions: the conception of comprehensive care for schoolchildren with attention deficit hyperactivity disorder with a multisectoral perspective from the educational and health sectors involves teachers and health specialists in individualized care to reduce the consequences of the disorder.


Subject(s)
Attention Deficit Disorder with Hyperactivity , Research Report
14.
An. Fac. Cienc. Méd. (Asunción) ; 54(3): 85-102, Dec. 2021.
Article in Spanish | LILACS | ID: biblio-1352914

ABSTRACT

Introducción: Considerando la Ley de la Nación Paraguaya 4995/2013 "De Educación Superior", en su artículo 82°, establece que "la Agencia Nacional de Evaluación y Acreditación de la Educación Superior (ANEAES) es el organismo técnico encargado de evaluar y acreditar la calidad académica de los Institutos de Educación Superior". Por Resolución N°08/07 del Consejo Directivo de la ANEAES de fecha 17 de diciembre de 2007 aprueba los criterios de calidad para la carrera de medicina, donde en la dimensión 5, componente "egresados" establece: La carrera debe velar por el cumplimiento de las metas establecidas en cuanto a duración real de la carrera, logro del perfil de egreso e inserción de sus egresados en el mercado laboral. A los efectos se deberá establecer y aplicar mecanismos de consulta a los egresados para determinar su grado de satisfacción y retroalimentar el proceso formativo y los planes de mejora. Objetivos: contribuir a obtener información de la situación laboral y formación académica que permitan evaluar la calidad de la educación superior brindada y proponer mecanismos que contribuyan a la mejora del desempeño profesional de los egresados. Materiales y métodos: Los datos fueron procesados utilizando estadística descriptiva para todas las variables. El Instrumento utilizado es un Cuestionario conformado por 63 preguntas divididas en 5 secciones. Se contactó con los egresados por llamadas telefónicas y mensajería instantánea. Resultados: Durante los años 2010-2017, egresaron 984 profesionales. Total, de Encuestados: 133 egresados, siendo 73 mujeres (55%) y 60 hombres (45%). El 25 % de los egresados que han respondido la encuesta consideran que la formación académica recibida es excelente, el 44% considera que es muy buena, el 23% que es buena, el 6% regular y el 2% considera que es mala. Conclusión: El nivel de inserción laboral es alto al momento del egreso. La Satisfacción con la formación académica recibida es muy buena, con recomendaciones viables para el plan de mejoras en el programa de estudio


Introduction: Considering the Law of the Paraguayan Nation 4995/2013 "On Higher Education", in its article 82°, establishes that "the National Agency for the Evaluation and Accreditation of Higher Education (ANEAES) is the technical body in charge of evaluating and accrediting the academic quality of the Institutes of Higher Education". By Resolution N ° 08/07 of the Board of Directors of the ANEAES dated December 17, 2007, it approves the quality criteria for the medical career, where in dimension 5, the "graduates" component, it establishes: The career must ensure compliance of the goals established in terms of real duration of the career, achievement of the graduation profile and insertion of its graduates in the labor market. For this purpose, consultation mechanisms must be established and applied to graduates to determine their degree of satisfaction and provide feedback on the training process and improvement plans. Objectives: The objective of this follow-up report was to obtain useful information on the employment situation and academic training that allow evaluating the quality and relevance of the higher education provided and proposing mechanisms that contribute to the improvement of the professional performance of graduates. Materials and methods: The data were processed using descriptive statistics for all variables. The Instrument used is a Questionnaire made up of 63 questions divided into 5 sections. Graduates were contacted by phone calls and instant messaging. Results: During the years 2010-2017, 984 professionals graduated. Total of Respondents: 133 graduates, being 73 women (55%) and 60 men (45%). 25% of the graduates who responded to the survey consider that the academic training received is excellent, 44% consider it very good, 23% that it is good, 6% fair and 2% consider that it is bad. Conclusion: The level of labor insertion is high at the time of graduation. Satisfaction with the academic training received is very good, with viable recommendations for the improvement plan in the study program


Subject(s)
Teaching , Running , Surveys and Questionnaires , Universities , Research Report , Accreditation , Job Satisfaction , Medicine
15.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 58-65, 28 dec. 2021.
Article in Portuguese | LILACS | ID: biblio-1352328

ABSTRACT

Este artigo consiste em um estudo de caso de paciente do sexo masculino, 40 anos, com diarreia e perda ponderal significativa iniciada sete meses depois da sua admissão no Hospital Geral Roberto Santos. O paciente não apresentava alterações significativas no exame físico e as investigações clínicas e laboratoriais foram inexpressivas. Foram realizados estudos endoscópicos e anatomopatológicos, confirmando o diagnóstico de neoplasia neuroendócrina gástrica. Os achados histopatológicos evidenciaram um tumor bem diferenciado do tipo dois, sendo uma neoplasia rara de bom prognóstico. O paciente foi submetido a gastrectomia segmentar de corpo gástrico e evoluiu com melhora clínica da diarreia. Ele recebeu alta hospitalar e segue em acompanhamento com os serviços de gastroenterologia e endocrinologia.


This study reports the case of a 40-year-old male patient presenting with diarrhea and significant weight loss initiated seven months before admission at the Hospital Geral Roberto Santos. The patient showed no significant changes in the physical examination, and clinical and laboratory investigations were inexpressive. Gastric neuroendocrine neoplasia was diagnosed by endoscopic and anatomopathological studies. Histopathological findings showed a well-differentiated type 2 tumor ­ a rare neoplasm with a good prognosis. The patient underwent segmental gastrectomy of the gastric body, evolving with clinical improvement of diarrhea. He was discharged from the hospital and is being followed by gastroenterology and endocrinology services.


Paciente del sexo masculino, 40 años, con diarrea y pérdida significativa de peso, que inició siete meses después de su ingreso en el Hospital Geral Roberto Santos. El paciente no presentó cambios significativos en la exploración física y las investigaciones clínicas y de laboratorio fueron inexpresivas. Se realizaron estudios endoscópicos y anatomopatológicos que confirmaron el diagnóstico de neoplasia neuroendocrina gástrica. Los hallazgos histopatológicos mostraron un tumor tipo 2 bien diferenciado, que es una neoplasia poco frecuente y de buen pronóstico. El paciente fue sometido a gastrectomía segmentaria del cuerpo gástrico y evolucionó con mejoría clínica de la diarrea. Fue dado de alta del hospital y aún está en seguimiento con los servicios de gastroenterología y endocrinología.


Subject(s)
Weight Loss , Neuroendocrine Tumors , Diarrhea , Research Report , Gastrectomy
16.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 66-78, 28 dec. 2021.
Article in English | LILACS | ID: biblio-1352330

ABSTRACT

Hyperbaric oxygenation (HBO2) is a successful treatment of diabetic foot ulcerations. Research on the characterization of tissue by ultrasonography (CATUS) or by imaging (CATIM) has grown. We investigated the photographic pCATIM feasibility to quantitate HBO2 effects. Besides, we analyzed pre and post HBO2 treatment photographs quantitatively based on pixel brightnesses of gray-scale imaging versions. Grayscale Medians (GSM) for (1) entire ulceration, (2) inner core, (3) ulceration border, and (4) adjacent skin decreased from 92 to 77, 60 to 56, 105 to 101, and 105 to 90. Entire ulceration post-HBO2 pixel percentages were lower in the 112-153 intervals, 11% vs 29% (p = .0013 by Chi-square), and higher in the 41-111 brightness range, 87% vs 68% (p = .0008). A case report showed quantifiable relative changes detected by pCATIM post HBO2 treatment of diabetic foot ulceration. Further investigation may quantify brightness variabilities and/or specific GSM for ulceration and skin regions.


A oxigenioterapia hiperbárica (HBO2) tem sido um tratamento de sucesso para úlceras do pé diabético, enquanto cresce o número de pesquisas caracterizando o tecido por meio de ultrassonografia (Catus) ou imagem (Catim) ­ sendo que a pCatim torna viável quantificar os efeitos da oxigenioterapia hiperbárica. Fotografias do pré e pós tratamento foram analisadas quantitativamente com base em brilhos de pixel de versões de imagens em escala de cinza. Houve redução das medianas da escala de cinza (gray scale medians ­ GSM) para (1) ulceração inteira, de 92 para 77; (2) núcleo interno, de 60 para 56; (3) borda da ulceração, de 105 para 101; e (4) pele adjacente, de 105 para 90. Na úlcera completa, após a HBO2, as porcentagens de pixels foram menores nos intervalos 112-153 (11% contra 29%, p = 0,0013 por qui-quadrado) e maiores na faixa de brilho 41-111 (87% contra 68%, p = 0,0008). Um relato de caso demonstrou mudanças relativas quantificáveis detectadas por pCatim após o tratamento com HBO2 de uma úlcera do pé diabético, e investigações mais aprofundadas podem quantificar as variabilidades de brilho e/ou GSM específicas para cada ulceração e regiões da pele.


La oxigenación hiperbárica (HBO2) ha sido un tratamiento exitoso de las ulceraciones del pie diabético. Ha crecido la investigación sobre la caracterización de tejidos por ecografía (CATUS) o por imágenes (CATIM). Se investigó la viabilidad fotográfica de pCATIM para cuantificar los efectos de HBO2. Las fotografías anteriores y posteriores al tratamiento con HBO2 se analizaron cuantitativamente en función del brillo de los píxeles de las versiones de imágenes en escala de grises. Medianas de escala de grises (GSM) para (1) ulceración completa, (2) núcleo interno, (3) borde de ulceración y (4) piel adyacente disminuyeron de 92 a 77, 60 a 56, 105 a 101 y 105 a 90, respectivamente. En la ulceración completa, después de HBO2, los porcentajes de píxeles fueron más bajos en los intervalos 112-153, 11% vs 29% (p = .0013 por Chi-cuadrado) y más altos en el rango de brillo 41-111, 87% vs 68% (p = .0008). Un informe de caso demostró cambios relativos cuantificables detectados por pCATIM después del tratamiento con HBO2 de una ulceración del pie diabético. Una investigación adicional puede cuantificar las variaciones de brillo y o GSM específico para ulceraciones y regiones de la piel.


Subject(s)
Foot Ulcer , Diabetic Foot , Research Report , Hyperbaric Oxygenation
17.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 98-107, 28 dec. 2021.
Article in English | LILACS | ID: biblio-1352336

ABSTRACT

Cutaneous manifestations of dermatomyositis are unusual and difficult to treat. This study aimed to report a case of cutaneous manifestations of dermatomyositis treated with hyperbaric oxygen. We present a case of dermatomyositis in a 44-year-old female with pain ulcers in her left leg for 17 months, refractory to an exclusive clinical treatment, who underwent a hyperbaric oxygen therapy (HBOT) breathing O2 100%, 90 minute sessions, six days a week, at 2.4 ATA. HBOT therapy proved to be highly efficacious in wound healing in this case and HBOT should be considered as a treatment in the assistance given to such patients.


Manifestações cutâneas da dermatomiosite são raras e difíceis de ser tratadas. O objetivo deste estudo é relatar um caso de manifestações cutâneas da dermatomiosite tratadas com oxigenioterapia hiperbárica, ocorrido em uma paciente de 44 anos, sexo feminino, com úlceras dolorosas em seu membro inferior esquerdo por 17 meses. O caso foi refratário ao tratamento clínico exclusivo e a paciente submetida a tratamento de oxigenioterapia hiperbárica (HBOT), respirando oxigênio a 100%, em sessões de noventa minutos, seis dias por semana, a 2,4 ATA. O HBOT mostrou ser altamente eficaz na cicatrização da lesão neste caso e deve ser um tratamento considerado no cuidado desses pacientes.


Las manifestaciones cutáneas de la dermatomiositis son inusuales y difíciles de tratar. El objetivo de este estudio fue reportar un caso de manifestaciones cutáneas de dermatomiositis tratadas con oxigenoterapia hiperbárica. Presentamos un caso de dermatomiositis en una mujer de 44 años con úlceras dolorosas en su pierna izquierda durante 17 meses, refractaria a un tratamiento clínico exclusivo, que se sometió a oxigenoterapia hiperbárica (HBOT) respirando O2 100%, sesiones de 90 minutos, seis días a la semana, a 2,4 ATA. La terapia con HBOT demostró ser muy eficaz en la cicatrización de heridas en este caso y la HBOT debe considerarse como un tratamiento en la asistencia brindada a estos pacientes.


Subject(s)
Humans , Female , Skin Manifestations , Ulcer , Dermatomyositis , Research Report , Hyperbaric Oxygenation
18.
Rev. baiana saúde pública ; 45(3,supl.n.esp): 130-140, 28 dec. 2021.
Article in Portuguese | LILACS | ID: biblio-1352343

ABSTRACT

O angiossarcoma primário hepático é o tumor mesenquimal mais comum do fígado, representando cerca de 2% das neoplasias malignas primárias do órgão. Esse raro tumor tem sintomas inespecíficos, evolução agressiva e diagnóstico usualmente tardio, com prognóstico reservado mesmo quando tratado. Este trabalho consiste em um relato de caso de um paciente do sexo masculino, de 44 anos, que foi encaminhado à emergência do Hospital Geral Roberto Santos para investigação de quadro de anemia grave sintomática, síndrome consumptiva e hepatoesplenomegalia. Durante investigação laboratorial, evidenciou-se anemia com provável componente microangiopático associado à anemia da doença crônica. As sorologias para doenças virais e baciloscopia do escarro foram negativas. Foram detectados em exames de imagem dois nódulos hepáticos de grandes dimensões, adenomegalias retroperitonais, esplenomegalia de grande monta, volumoso derrame pleural à direita, além de alterações do esqueleto axial e apendicular. Evoluiu com síndrome da lise tumoral após tratamento clínico com corticoterapia por suspeita de linfoma, com óbito. A biópsia guiada por uma tomografia realizada previamente teve como conclusão perfil imuno-histoquímico compatível com angiossarcoma hepático. O angiossarcoma é um raro tumor, de difícil diagnóstico e tratamento, com evolução agressiva e achados clínico-laboratoriais pouco elucidativos, devendo a hipótese desta doença ser considerada no diagnóstico diferencial das neoplasias hepáticas. As opções terapêuticas são limitadas. Relatos de casos como este são de suma importância para o aumento do grau de suspeição clínica e um diagnóstico mais precoce dessa entidade de costumeira evolução catastrófica.


Primary hepatic angiosarcoma is the most common mesenchymal tumor of the liver, representing about 2% of primary hepatic malignancies. This rare tumor has nonspecific symptoms, delayed diagnosis, and aggressive evolution, with a poor prognosis even when treated. This study reports the case of a 44-year-old male patient referred to the emergency department of the Hospital Geral Roberto Santos with symptomatic severe anemia, consumptive syndrome, and hepatosplenomegaly. Laboratory investigation indicated anemia with a probable microangiopathic component and chronic disease anemia. Serology tests for viral diseases returned negative results, as well as sputum smear microscopy for tuberculosis. Imaging exams revealed two large hepatic nodules, retroperitoneal adenomegaly, large splenomegaly, large pleural effusion in the right lung, and bone involvement. After clinical treatment with corticosteroids for suspected lymphoma, the patient evolved with tumor lysis syndrome and died. Tomography-guided liver biopsy was previously performed, indicating an immunohistochemical profile compatible with hepatic angiosarcoma ­ a rare tumor of difficult diagnosis and treatments due to its aggressive evolution and poor clinical and laboratory findings. Considering the nonspecificity of imaging exams, this disease should be considered in the differential diagnosis of liver neoplasms investigation. Case reports such as the one described in this study are important for increasing the degree of clinical suspicion and earlier diagnosis of this malignancy.


El angiosarcoma hepático primario es el tumor mesenquimatoso del hígado más común y representa el 2% de las neoplasias malignas primarias del hígado. Este raro tumor presenta una sintomatología inespecífica, diagnóstico tardío y evolución agresiva, con mal pronóstico incluso en tratamiento. Este es un reporte de caso de un hombre de 44 años de edad, que fue remitido al servicio de urgencias del Hospital Geral Roberto Santos para investigar anemia severa sintomática, síndrome de consunción y hepatoesplenomegalia. Durante la investigación de laboratorio, se evidenció anemia con un probable componente microangiopático asociado a anemia por enfermedad crónica. La serología para enfermedades virales resultó negativa, así como la microscopía de frotis de esputo para tuberculosis. Las imágenes revelaron dos grandes nódulos hepáticos, adenomegalia retroperitoneal, gran esplenomegalia, gran derrame pleural en el pulmón derecho, así como afectación del esqueleto axial y apendicular. El paciente evolucionó con síndrome de lisis tumoral tras el tratamiento clínico con corticoides por sospecha de linfoma, y no se resistió. Previamente se realizó biopsia hepática guiada por tomografía con perfil inmunohistoquímico compatible con angiosarcoma hepático. El angiosarcoma es un tumor raro, de difícil diagnóstico y tratamiento por su evolución agresiva y deficientes hallazgos clínicos y de laboratorio. Los exámenes por imágenes son inespecíficos y la posibilidad de esta enfermedad debe considerarse en el diagnóstico diferencial de la investigación de neoplasias hepáticas. Las opciones terapéuticas son limitadas. Reportes de casos como este son importantes para incrementar el grado de sospecha clínica y el diagnóstico precoz de este tipo de evolución catastrófica habitual.


Subject(s)
Humans , Male , Tumor Lysis Syndrome , Research Report , Anemia , Hemangiosarcoma , Liver , Liver Neoplasms
19.
Dent. press endod ; 11(3): 58-65, Sept-Dec.2021. Ilus
Article in English | LILACS | ID: biblio-1379391

ABSTRACT

Introdução: A periodontite apical assintomática (PAA) é caracterizada pela inflamação e destruição dos tecidos periapicais, e sua progressão promove reabsorção óssea, podendo ser agravada pelo uso contínuo de isotretinoína. Objetivo: O objetivo do presente estudo foi relatar a resolução de uma PAA com rompimento de cortical óssea mandibular em um paciente sob tratamento contínuo com isotretinoína (Roacutan®), por meio de procedimentos químicos-mecânicos convencionais e controle com tomografia computadorizada de feixe cônico (TCFC). Descrição: Um paciente com 21 anos de idade, ASA I, em tratamento contínuo com isotretinoína, procurou atendimento odontológico com moderada dor na região do elemento dental #38. Após exames clínicos, radiográficos e tomográficos, verificou-se a necessidade de tratamento endodôntico do dente #36. A TCFC mostrou uma imagem apical extensa e hipodensa entre os dentes #36 e #37, compatível com lesão cística óssea, com dimensões de 25,59 mm (largura) x 14,37 mm (altura) x 8,40 mm (profundidade). Também foram observados reabsorção apical da raiz distal, halo hipodenso sob a restauração coronal do #36 e ruptura da cortical externa vestibular e lingual. O tratamento endodôntico foi realizado em três sessões, com auxílio de um microscópio operatório e protocolos químicos-mecânicos, como Easy Clean e terapia fotodinâmica. Resultado: A resolução da PAA foi observada após acompanhamento por três anos. Conclusão: O tratamento endodôntico permitiu o reparo de uma lesão periapical extensa, evitando a cirurgia parendodôntica imediata, e o uso contínuo de isotretinoína não afetou a resolução da PAA(AU).


Introduction: Asymptomatic apical periodontitis (AAP) is characterized by inflammation and destruction of the periapical tissues and its progression leads to bone resorption, which may be aggravated by continuous use of Isotretinoin. The objective of this study was to report the resolution of AAP with mandibular cortical disruption in a patient under continuous treatment with isotretinoin (Roacutan®) and kickboxing practitioner, by conventional chemical-mechanical procedures and cone-bean computed tomography (CBCT) follow-up. Description: A 21-year-old Caucasoid individual, ASA I, under continuous use of isotretinoin and kickboxing practitioner sought dental care with moderate pain at the region of tooth #38. After clinical, radiographic and tomographic examination, the need for endodontic treatment of tooth #36 was verified. The CBCT showed an extensive and hypodense apical image between teeth #36 and #37, compatible with cystic bone lesion, with dimensions of 25.59 mm wide x 14.37 mm high x 8.40 mm deep. Apical resorption of the distal root, hypodense halo under a coronal restoration at #36, and rupture of the external buccal and lingual cortical bone were also observed. The endodontic treatment was performed in three sessions with the aid of a microscope and chemical-mechanical protocols, such as Easy Clean and photodynamic therapy. Result: Resolution of AAP was observed after follow-up for three years. Conclusion: Endodontic treatment allowed healing of an extensive periapical lesion, avoiding immediate parendodontic surgery and the continuous use of isotretinoin did not affect the AAP resolution. (AU).


Subject(s)
Humans , Periapical Periodontitis , Isotretinoin , Cone-Beam Computed Tomography , Cortical Bone , Research Report
20.
Braz. j. oral sci ; 20: e211701, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1254532

ABSTRACT

Aim: This study aimed to evaluate how meta-analyses are conducted and reported in dentistry. Methods: We conducted a search to identify dentistry-related Systematic Reviews (SRs) indexed in PubMed in 2017 (from January 01 until December 31) and published in the English language. We included only SRs reporting at least one meta-analysis. The study selection followed the 4-phase flow set forth in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement (PRISMA), and it was independently conducted by two researchers. Data extraction was performed by one of three reviewers, and data related to conducting and reporting of the meta-analysis were collected. Descriptive data analysis was performed summarizing frequencies for categorical items or median and interquartile range for continuous data. Results: We included 214 SRs with meta-analyses. Most of the studies reported in the title that a meta-analysis was conducted. We identified three critical flaws in the included studies: Ninety (90) meta-analyses (43.1%) did not specify the primary outcome; most of the meta-analyses reported that a measure of statistical heterogeneity was used to justify the use of a fixed-effect or random-effects meta-analysis model (n=114, 58.5%); and a great part did not assess publication bias (n=106, 49.5%). Conclusion: We identified deficiencies in the reporting and conduct of meta-analysis in dentistry, suggesting that there is room for improvement. Educational approaches are necessary to improve the quality of such analyses and to avoid biased and imprecise results


Subject(s)
Oral Health , Research Report , Systematic Reviews as Topic
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