The "Phase Down" of Dental Amalgam Restorations - What are the Criteria for Replacement and Indication?

ABSTRACT Objective: To guide professionals about the criteria for replacing amalgam restorations and inform them about the new guidelines regarding the use/indication of this (amalgam) material after the Minamata Convention - COP-4. Material and Methods: The articles were selected from the databases (PubMed, Scielo, Bireme), and relevant articles on the subject between the years 2003-2021 were selected. Recently, social media have been flooded with dental treatments that aim to perform restorations only with composite resins or other types of esthetic material and completely replace all dental amalgam restorations, irrespective of their time in place, size, and functionality. Results: Although improperly, it has been noted that this information reaches patients, and they are led to believe in the inaccurate data that is passed on, such as, for example, (that amalgam leads to) permanent contamination by mercury, causing systemic problems and the loss of the tooth. Conclusion: The "phase down" of amalgam in research and teaching has previously been observed in several countries worldwide; however, its use is still necessary given particular circumstances, which, theoretically, make it a material with exact indication.

Risk factors associated with occlusal caries in first permanent molars in a school program: longitudinal study

Aim: Evaluate the longitudinal status of dental caries in the occlusal surface of first permanent molars (FPM) and to identify risk factors for the progression to cavitated caries lesions in a school oral health program. Methods: Children who were enrolled in the program between September 2017 and October 2019, 5 to 10 years-old, presenting the four FPM were included. Four calibrated examiners assessed dental caries according to Nyvad criteria. Descriptive analysis included frequency, mean, and standard deviation calculations. Chi-square test was used in the bivariate analysis and, logistic regression adjusted for cluster effect was used to identify significant risk factors for cavity among the following independent variables: gender, age in the baseline, deft, upper/lower molar, initial caries score, Molar Incisor Hypomineralization (MIH), fluorosis, occlusal sealing. Odds ratio (OR) and respective confidence intervals (CI) are presented. Results: From 174 children enrolled in the program between 2017/2019, 120 were reevaluated in 2022. Eleven (2.6%) FPM in 11 children (9.2%) presented cavitated caries in the follow up examination. Significant risk factors for cavity were caries experience in the primary teeth (OR = 5.59; CI: 1.4 ­ 22.3) and the presence of MIH (OR = 5.33; CI: 1.6 ­ 18.1). Most of the active lesions in the follow up were considered active in the baseline examination. Conclusions: The progression to cavity was relatively low, significantly influenced by past caries experience and MIH

Tratamiento de reemplazo enzimático en pacientes cubanos con enfermedad de Gaucher: experiencia de 15 años / Enzyme replacement treatment in Cuban patients with Gaucher disease: 15 years of experience

Introducción: La enfermedad de Gaucher es una entidad de acúmulo lisosomal, con un patrón de herencia autosómico recesivo, debido a la deficiencia de le enzima betaglucocerebrosidasa ácida. El gen está mapeado en el cromosoma 1q21 y se han descrito más de 500 mutaciones. Se caracteriza por presentar anemia, trombocitopenia, hepatoesplenomegalia, manifestaciones esqueléticas y, en ocasiones, compromiso neurológico. Entre los tratamientos se utiliza el reemplazo enzimático con imiglucerasa. Objetivo: Evaluar los resultados de la aplicación de imiglucerasa (Cerezyme®) en pacientes con enfermedad de Gaucher. Métodos: Se realiza un estudio longitudinal, descriptivo para evaluar el comportamiento de las variables clínicas, hematológicas y ultrasonográficas de ocho pacientes cubanos con enfermedad de Gaucher tras recibir el tratamiento sustitutivo enzimático. Se evaluaron al año, cinco y de diez a quince años de tratamiento. Resultados: Al inicio, todos los pacientes presentaron anemia y la mayoría tuvieron trombocitopenia y hepatoesplenomegalia al diagnóstico de la enfermedad. Los pacientes con manifestaciones neurológicas y la mutación L444P en estado homocigótico se clasificaron en EG tipo 3, el resto en tipo1. En todos los pacientes se constató aumento de las cifras de hemoglobina, la elevación del número de plaquetas y reducción de la hepatoesplenomegalia posterior al año de tratamiento. Los pacientes con tipo 3 mantuvieron la afectación neurológica. No se reportaron reacciones adversas al medicamento. Conclusiones: La terapia de reemplazo enzimática con imiglucerasa (Cerezyme®) es un pilar fundamental en el tratamiento de los pacientes con esta enfermedad, lo cual influye de forma positiva en la calidad de vida, obteniéndose mejores resultados con su comienzo en edad pediátrica.

Introduction: Gaucher disease is an entity of lysosomal accumulation, with an autosomal recessive inheritance pattern, due to the deficiency of the acid betaglucocerebrosidase enzyme. The gene is mapped on chromosome 1q21 and more than 500 mutations have been described. It is characterized by anemia, thrombocytopenia, hepatosplenomegaly, skeletal manifestations and sometimes neurological involvement. Among the treatments, enzyme replacement with imiglucerase is used. Objective: To evaluate the results of the application of imiglucerase in patients with Gaucher disease. Methods: A longitudinal, descriptive study to evaluate the behavior of the clinical, hematological and ultrasonographic variables of eight Cuban patients with Gaucher disease after receiving enzyme replacement treatment was carried out. They were evaluated after one, five and ten to fifteen years of treatment. Results: At debut, all patients presented anemia, and the majority showed thrombocytopenia and hepatosplenomegaly at diagnosis of the disease. Patients with neurological manifestations and the L444P mutation in a homozygous state were classified as type 3 GD, the rest as type 1. In all patients, an increase in hemoglobin levels, an increase in the number of platelets and a reduction in hepatosplenomegaly was observed after one year of treatment. Patients with type 3 maintain neurological involvement. No adverse reactions to the medication were reported. Conclusions: Enzyme replacement therapy with imiglucerase (Cerezyme®) is a fundamental pillar in the treatment of patients with this disease, which positively influences quality of life, obtaining better results with its onset in pediatric age.

Incidence of Dental Caries and Associated Factors in the School Period in a Municipality in Southern Brazil

Abstract Objective: To estimate the incidence of dental caries and associated factors in the school period from six/seven to ten years of age. Material and Methods: A longitudinal study involving 168 children was followed up between 2015 and 2019 in the municipality of Palhoça, Brazil. The dependent variable was the caries incidence rate in the mixed dentition. The independent variables included information regarding demographic and socioeconomic status. Multivariate analyzes were carried out using Poisson Regression with a robust estimator. Variables with p <0.20 in the bivariate analysis were included in the adjusted model. Relative risks were estimated, as well as 95% confidence intervals. Results: Of 168 followed schoolchildren, 32 developed the disease, providing an incidence rate of 19.0%. Female children had a 10% higher risk [RR = 1.10 (95% CI 1.03; 1.18)] of developing caries than males. Also, children born from fathers with ≤ 8 years of schooling at baseline had a 9% higher risk [RR = 1.09 (95% CI 1.01; 1.16)] of developing dental caries compared to fathers with higher education. Conclusion: The incidence of dental caries in a four-year period was 19.0%. Females and children born from fathers with a lower level of education showed higher incidence rates.

Longitudinal study on catch-up growth in preterm infants with small for gestational age at corrected ages 0-24 months / 中国当代儿科杂志

OBJECTIVES@#To understand the growth and development status and differences between small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants during corrected ages 0-24 months, and to provide a basis for early health interventions for preterm infants.@*METHODS@#A retrospective study was conducted, selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022, including 144 SGA and 680 AGA infants. The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared.@*RESULTS@#The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months (P<0.05), while there were no significant differences between the two groups at corrected age 24 months (P>0.05). At corrected age 24 months, 85% (34/40) of SGA and 79% (74/94) of AGA preterm infants achieved catch-up growth. Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age <34 weeks and the AGA subgroups with gestational age <34 weeks and 34 weeks (P<0.05). In addition, the weight and length of the SGA subgroup with gestational age 34 weeks showed significant differences compared to the AGA subgroups with gestational age <34 weeks and 34 weeks at corrected ages 0-18 months and corrected ages 0-12 months, respectively (P<0.05). Catch-up growth for SGA infants with gestational age <34 weeks and 34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months, respectively.@*CONCLUSIONS@#SGA infants exhibit delayed early-life physical growth compared to AGA infants, but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants. Catch-up growth can be achieved earlier in SGA infants with a gestational age of <34 weeks compared to those with 34 weeks.

Análisis de los factores pronósticos de mortalidad en los pacientes con enfermedad renal crónica en hemodiálisis / Analysis of Mortality Prognostic Factors in Patients with chronic Kidney Disease on Hemodialysis

Introducción: La enfermedad renal crónica es una de las principales causas de mortalidad en todo el mundo. La estratificación del riesgo a través del análisis de factores pronósticos podría generar un cambio de paradigma. Objetivo: Analizar los factores pronósticos de mortalidad en los pacientes con enfermedad renal crónica en hemodiálisis. Métodos: Se realizó un estudio no experimental, longitudinal de cohorte retrospectivo en los pacientes con enfermedad renal crónica en hemodiálisis en el Hospital General Docente: Dr. Ernesto Guevara de la Serna durante el período del 1 de enero de 2017 al 31 de diciembre de 2021. En general, se analizaron los factores pronósticos de mortalidad mediante el análisis multivariado de regresión logística binaria y se determinó el porcentaje correcto de clasificación del modelo de regresión. Resultados: Se analizaron como variables pronosticas de mortalidad la enfermedad cardiovascular [B = 3,831; p = 0,000; Exp (B) = 46,118], Albúmina 17 mmol/L [B = 1,326; p = 0,027; Exp (B) = 3,767], glucemia < 4 mmol/L [B = 1,600; p = 0,015; Exp (B) = 4,955] y ganancia de peso interdialítica excesiva [B = 2,243; p = 0,001; Exp (B) = 9,420]. El porcentaje global de clasificación del modelo de regresión logística binaria fue de 89,5 por ciento. Conclusiones: Se analizó el modelo predictivo de regresión logística que presentó una buena precisión con los factores de pronósticos asociados a la mortalidad en los pacientes en hemodiálisis(AU)

Introduction: Chronic kidney disease is one of the main causes of mortality worldwide. Risk stratification through the analysis of prognostic factors could generate a paradigm shift. Objective: To analyze the prognostic factors of mortality in patients with chronic kidney disease on hemodialysis. Methods: A non-experimental, longitudinal retrospective cohort study was carried out on patients with chronic kidney disease on hemodialysis at Dr. Ernesto Guevara de la Serna General Teaching Hospital from January 2017 to December 31, 2021. The prognostic factors of mortality were analyzed using multivariate binary logistic regression analysis and the correct percentage of classification of the regression model was determined. Results: Prognostic variables of mortality were analyzed, such as cardiovascular disease [B = 3.831; p = 0.000; Exp (B) = 46.118], albumin 17 mmol/L [B = 1.326; p = 0.027; Exp (B) = 3.767], blood glucose < 4 mmol/L [B = 1.600; p = 0.015; Exp (B) = 4.955] and excessive interdialytic weight gain [B = 2.243; p = 0.001; Exp(B) = 9.420]. The overall classification percentage of the binary logistic regression model was 89.5percent. Conclusions: The logistic regression predictive model was analyzed, which showed good precision with the prognostic factors associated with mortality in hemodialysis patients(AU)

Actividad física durante el embarazo y su relación con la ganancia de peso gestacional / Physical activity during pregnancy and its relationship with gestational weight gain / Atividade física durante a gestação e sua relação com o ganho de peso gestacional

Objetivo: describir los patrones de actividad física de una cohorte de gestantes de nuestro medio y explorar su asociación con la ganancia de peso en cada uno de los trimestres del embarazo. Método: estudio descriptivo longitudinal sobre una muestra de 151 mujeres. Se utilizó el Cuestionario Internacional de Actividad Física para evaluar la actividad física durante el embarazo en función del volumen, intensidad y ámbito de realización. Se llevaron a cabo diferentes modelos de regresión lineal múltiple para analizar la asociación entre actividad física y ganancia de peso gestacional. Resultados: la actividad física disminuyó durante el embarazo, tanto en tiempo como en intensidad. El índice de masa corporal pre-gestacional fue el principal factor asociado con una menor ganancia de peso a lo largo de todo el embarazo. La influencia de la actividad física sobre la ganancia de peso gestacional se limitó al tercer trimestre del embarazo en el que se observó una asociación inversa entre ambas variables. Conclusión: los resultados de este estudio muestran un importante descenso de la actividad física en la época del embarazo y sugieren una influencia limitada de ésta sobre la ganancia de peso gestacional.

Objective: to describe the physical activity patterns of a cohort comprised by pregnant women from our environment and to explore its association with weight gain in each of the trimesters of pregnancy. Methods: a descriptive and longitudinal study conducted with a sample of 151 women. The International Physical Activity Questionnaire was used to assess physical activity during pregnancy based on volume, intensity and setting where it is performed. Different multiple linear regression models were performed to analyze the association between physical activity and gestational weight gain Results: physical activity decreased during pregnancy, both in terms of time and intensity. Pre-gestational Body Mass Index was the main factor associated with lower weight gain throughout pregnancy. The influence of physical activity on gestational weight gain was limited to the third trimester of pregnancy, where an inverse association was observed between both variables. Conclusion: the results of this study show an important reduction in physical activity during pregnancy and suggest that it exerts a limited influence on gestational weight gain

Objetivo: descrever os padrões de atividade física de uma coorte de gestantes em nosso meio e explorar sua associação com o ganho de peso em cada um dos trimestres de gestação. Método: estudo descritivo longitudinal com uma amostra de 151 mulheres. O Questionário Internacional de Atividade Física foi utilizado para avaliar a atividade física durante a gestação de acordo com o volume, intensidade e escopo do desempenho. Diferentes modelos de regressão linear múltipla foram utilizados para analisar a associação entre atividade física e ganho de peso gestacional. Resultados: a atividade física diminuiu durante a gestação, tanto em tempo quanto em intensidade. O índice de massa corporal pré-gestacional foi o principal fator associado ao menor ganho de peso ao longo da gestação. A influência da atividade física no ganho de peso gestacional limitou-se ao terceiro trimestre de gestação, no qual foi observada associação inversa entre ambas as variáveis. Conclusão: os resultados deste estudo mostram uma diminuição significativa da atividade física no momento da gravidez e sugerem uma influência limitada desta no ganho de peso gestacional.

Capacidad de los Centros de Atención Psicosocial de Alcohol y Drogas para manejar situaciones de crisis / The ability of Psychosocial Care Centers specialized in Alcohol and Drugs to handle crises / Capacidade de manejo de situações de crise por Centros de Atenção Psicossocial Álcool e Drogas

Objetivo: evaluar la capacidad de los Centros de Atención Psicosocial de Alcohol y Otras Drogas 24 horas para manejar situaciones de crisis de las personas que consumen AOD en la atención integral. Método: estudio cuantitativo, evaluativo y longitudinal, realizado de febrero a noviembre de 2019. La muestra inicial estuvo compuesta por 121 personas que consumen AOD, que recibieron atención integral en situaciones de crisis en dos Centros de Atención Psicosocial para Alcohol y Otras Drogas 24 horas en el centro de São Paulo. Los mismos fueron reevaluados después de 14 días de atención. La capacidad para manejar la crisis se evaluó mediante un indicador validado. Los datos se analizaron utilizando estadísticas descriptivas y modelos de regresión de efectos mixtos. Resultados: sesenta y siete personas que consumen AOD completaron el follow-up (54,9%). Durante la atención de las situaciones de crisis, nueve personas que consumen AOD (13,4%; p=0,470) fueron derivadas a otros servicios de la red de salud: siete por complicaciones clínicas, una por intento de suicidio y una por hospitalización psiquiátrica. La capacidad de los servicios para manejar situaciones de crisis fue del 86,6%, fue considerada positiva. Conclusión: los dos servicios evaluados fueron capaces de manejar situaciones de crisis en su área de influencia, evitando internaciones y contando con el apoyo de la red cuando fue necesario, logrando así los objetivos de desinstitucionalización.

Objective: to assess the ability of 24-hour Psychosocial Care Centers specialized in Alcohol and Other Drugs to handle the users' crises in comprehensive care. Method: a quantitative, evaluative, and longitudinal study was conducted from February to November 2019. The initial sample consisted of 121 users, who were part of the comprehensibly care in crises by two 24-hour Psychosocial Care Centers specialized in Alcohol and other Drugs in downtown São Paulo. These users were re-evaluated 14 days after admission. The ability to handle the crisis was assessed using a validated indicator. The data were analyzed using descriptive statistics and regression of mixed-effects models. Results: 67 users (54.9%) finished the follow-up period. During crises, nine users (13.4%; p=0.470) were referred to other services from the health network: seven due to clinical complications, one due to a suicide attempt, and another for psychiatric hospitalization. The ability to handle the crisis in the services was 86.6%, which was evaluated as positive. Conclusion: both of the services analyzed were able to handle crises in their territory, avoiding hospitalizations and enjoying network support when necessary, thus achieving the de-institutionalization objectives.

Objetivo: avaliar a capacidade dos Centros de Atenção Psicossocial Álcool e outras Drogas 24 horas em manejar situações de crise dos usuários no acolhimento integral. Método: estudo quantitativo, avaliativo e longitudinal, realizado de fevereiro a novembro de 2019. A amostra inicial foi composta por 121 usuários, acolhidos integralmente em situações de crise por dois Centros de Atenção Psicossocial Álcool e outras Drogas 24 horas do centro de São Paulo. Estes foram reavaliados após 14 dias de acolhimento. A capacidade de manejar a crise foi avaliada por um indicador validado. Os dados foram analisados por estatística descritiva e por regressão de modelos de efeitos mistos. Resultados: sessenta e sete usuários concluíram o follow-up (54,9%). Durante o acolhimento às situações de crise, nove usuários (13,4%; p=0,470) foram encaminhados para outros serviços da rede de saúde: sete por complicações clínicas, um por tentativa de suicídio e um para internação psiquiátrica. A capacidade de manejo das situações de crise pelos serviços foi de 86,6%, avaliada como positiva. Conclusão: os dois serviços avaliados foram capazes de manejar situações de crise no próprio território, evitando internações e tendo apoio da rede quando necessário, atingindo assim, os objetivos da desinstitucionalização.

Estudio multicéntrico sobre multimorbilidad en internados en áreas clínicas / Multicenter Study on Multimorbidity in Patients in Clinical Areas

Introducción: El estudio de la comorbilidad requiere de un enfoque multilateral con vistas a mejorar la calidad de la atención de los enfermos por el sistema de atención. Objetivos: Explorar la magnitud de la comorbilidad de enfermedades crónicas en adultos internados en los hospitales. Métodos: Se realizó un estudio prospectivo-observacional-longitudinal-analítico. Se incluyeron pacientes internados en las Salas de Clínica Médica o pacientes clínicos en Salas de Internación Indiscriminada. Se realizó un estudio multicéntrico en 42 centros en un período de 2 años, con un muestreo consecutivo. Para el estudio se tuvo en cuenta la estadística descriptiva, inferencial y de regresión. Resultados: El total de pacientes en el estudio fue de 5925, masculinos con el 50,3 por ciento de edad 60,66 ± 0,25 años. Principal procedencia desde la guardia el 73 por ciento. La estadía hospitalaria de 12,61 ± 0,24 días, mayormente en pacientes quirúrgicos (15,45 ± 0,67 vs 11,76 ± 0,23; p < 0,00001). El 23 por ciento recibió tratamiento quirúrgico. El principal nivel educativo: secundario completo 21,6 por ciento. Dificultades económicas: 20 por ciento, mortalidad 9,26 por ciento; prevalencia de dislipemia, diabetes e hipertensión: 22,53 por ciento; 28,82 por ciento y 51,86 por ciento con 473 nuevos diagnósticos, IMC: 27,88 ± 0,65, Charlson global 2,09 ± 0,02 y en óbitos 3,84 ± 0,11. La media de patologías por paciente fue de 2,14 ± 0,01 y aumentó con la edad (p valor regresión lineal < 0,00001). Conclusiones: La hipertensión, la diabetes y la dislipemia representaron las entidades más prevalentes en Salas de Internación Clínica, Las enfermedades cardiovasculares, respiratorias, infectológicas, oncológicas, neurológicas, metabólicas y nefrológicas fueron predictores independientes de mortalidad(AU)

Introduction: The study of comorbidity requires a multilateral approach with a view to improving the quality of care for these patients by the care system. Objectives: To explore the magnitude of the comorbidity of chronic diseases in adults admitted to hospitals. Methods: Prospective-observational-longitudinal-analytical study. Patients hospitalized in a medical clinic room or clinical patients in indiscriminate hospitalization rooms are included, Multicenter study in 42 centers, with 2 years of recruitment. Consecutive sampling. Descriptive, inferential and regression statistics. Results: 5925 recruited, male gender 50,3percent, age 60,66 ± 0,25 years, main origin from the guard 73percent, stay 12,61 ± 0,24 days, longer in surgical (15,45 ± 0,67 vs 11,76 ± 0,23, p < 0,00001), 23percent received surgical treatment. Main educational level: complete secondary school 21,6%. Economic difficulties: 20percent, mortality 9,26percent, prevalence of dyslipidemia, diabetes and hypertension: 22,53percent, 28,82percent and 51,86percent with 473 new diagnoses in said pathologies, BMI: 27,88 ± 0,65, Global Charlson 2,09 ± 0,02 and in deaths 3,84 ± 0,11. The average number of pathologies per patient was 2,14 ± 0,01 and increased with age (p value for linear regression < 0,00001). Conclusions: Hypertension, diabetes and dyslipidemia represented the most prevalent entities in the clinical hospitalization room, cardiovascular, respiratory, infectious, oncological, neurological, metabolic and nephrological diseases were independent predictors of mortality(AU)

Possibilidades de integração entre a fonoaudiologia e a nutrição com base em produções nacionais / Possibilities of integration between speech therapy and nutrition based on national productions / Posibilidades de integración entre la terapia del lenguaje y la nutrición a partir de las producciones nacionales

Introdução: A atuação interdisciplinar entre a fonoaudiologia e a nutrição colabora para um atendimento mais integral entre os usuários da saúde, fato que demonstra a importância de pesquisar suas correlações. Objetivo: O objetivo deste estudo foi verificar se existe integração entre a atuação do fonoaudiólogo e do nutricionista, identificando as publicações existentes, as especialidades contempladas, bem como a atuação dos profissionais nos diferentes ciclos de vida e níveis de atenção à saúde. Metodologia: Foram analisados 3.551 artigos eletrônicos disponíveis eletronicamente dos periódicos CODAS, CEFAC, Distúrbios da Comunicação e Audiology Communication Research, entre os anos de 2013 e 2022, por meio de um Protocolo de Classificação de Artigos. Resultados: Dentre as publicações analisadas, 274 (7,7%) integram a Fonoaudiologia e a Nutrição, especialmente na Especialidade da Motricidade Orofacial (n=124; 26,9%), no Ciclo Vital Infantil (n=132; 43%) e no Nível de Atenção Secundário (n=97; 35,4%). Conclusão: Concluiu-se que existe interface entre as duas profissões, porém, ainda é necessário fortalecer a atuação nos diferentes ciclos de vida. Além disso, incentivar a prática profissional em outros níveis de atenção, especialmente na primária, para prevenção dos distúrbios alimentares e promoção da alimentação saudável entre usuários do sistema de saúde.

Introduction: Interdisciplinary performance between speech therapy and nutrition contributes to a more integral care among health users, a fact that demonstrates the importance of researching their correlations. Objective: The purpose of this study was to verify if there is integration between the performance of the speech therapist and nutritionist, identifying the existing publications, the specialities contemplated, as well the performance of professionals in different life cycles and levels of health care. Methods: 3.551 electronic articles were analyzed, in the electronic journals CODAS, CEFAC, Distúrbios da Comunicação and Audiology Communication Research, between the years 2013 and 2022, through an Article Classification Protocol. Results: Among the analyzed publications, 274 (7,7%) integrate Speech Language and Hearing Sciences and Nutrition, especially in orofacial motricity (n=124; 26,9%), Children's Life Cycle (n=132; 43%), and secondary care level (n=97; 35,4%). Conclusion: it was concluded that there is an interface between the two professions, although it is still necessary to strengthen the performance in the different life cycles. Furthermore, to encourage professional practice at other levels of care, especially in the primary, to prevent nourishment disorders and promote healthy eating among users of the health system

Introducción: El rendimiento interdisciplinario entre la terapia del habla y la nutrición contribuye a una atención más integral entre los usuarios de la salud, un hecho que demuestra la importancia de investigar sus correlaciones. Objetivo: El objetivo de este estudio fue verificar si existe integración entre la terapia del habla y la nutricionista, identificando las publicaciones existentes, las especialidades contempladas, así como la actuación de los profesionales en diferentes ciclos de vida y niveles de atención a la salud. Métodos: Fueron analizados 3.551 artículos electrónicos, en las revistas electrónicas CODAS, CEFAC, Distúrbios da Comunicação y Audiology Communication Research, entre los años 2013 a 2022, a través de un Protocolo de Clasificación de Artículos. Resultados: Entre las publicaciones analizadas, 274 (7,7%) integran terapia del habla y Nutrición, especialmente en motricidad orofacial (n=124; 26,9%), Ciclo de Vida Infantil (n=132; 43%), y secundaria nivel asistencial (n=97; 35,4%). Conclusións: Se concluyó que existe una interfaz entre las dos profesiones, aunque aún es necesario fortalecer el desempeño en los diferentes ciclos de vida. Además, incentivar la práctica profesional en otros niveles de atención, especialmente en el primario, para prevenir trastornos de la alimentación y promover la alimentación saludable entre los usuarios del sistema de salud.

Tempo de Transição da alimentação por sonda gástrica para alimentação por via oral em recém-nascidos pré-termo de uma unidade neonatal do Sistema Único de Saúde / Transition time from gastric tube feeding to oral feeding in preterm infants at a neonatal unit of the Unified Health System / Tiempo de transición de la alimentación por sonda gástrica a la alimentación oral en recién nacidos prematuros en una unidad neonatal del Sistema Único de Salud

Introdução: A retirada da sonda no recém-nascido pré-termo (RNPT) e o adequado estabelecimento da via oral são importantes para a saúde do bebê, já que favorecem aleitamento materno e alta hospitalar, entretanto, é um desafio nas unidades neonatais. Objetivos: Analisar os fatores associados ao tempo de transição da sonda para via oral em RNPT internados em Unidade Neonatal do Sistema Único de Saúde (SUS). Método: Foi realizado um estudo observacional analítico de coorte, com 45 RNPT que usaram sonda para alimentação no período de dezembro de 2021 a janeiro de 2022 e foram acompanhados pela equipe de Fonoaudiologia do serviço. Foram avaliados: a prontidão do prematuro para alimentação oral; a via oral com a técnica do finger feeding; a mamada e os níveis de habilidade oral. Resultados: Estiveram relacionadas ao maior tempo para transição da sonda para a via oral a idade gestacional ao nascimento inferior a 32 semanas, o peso ao nascimento inferior a 1500 gramas, a ausência de prontidão para via oral e a alta hospitalar em aleitamento artificial. Conclusão: Características do RNPT e da alimentação na avaliação e na alta hospitalar foram associados ao menor tempo de transição da sonda para a via oral. Assim, intervenções que estimulem o alcance da via oral no período de internação podem contribuir para a redução do tempo de transição e para o estímulo do aleitamento materno, favorecendo a saúde do RN, o vínculo mãe-bebê, a alta precoce, propiciando a rotatividade de leitos e, consequentemente, maior oferta aos usuários do SUS. (AU)

Introduction: The removal of the feeding tube in premature infants and the successful establishment of oral feeding are important for the baby's health, as they promote breastfeeding and hospital discharge. However, it is a challenge in neonatal units. Objectives: This article analyzes the factors associated with the time of transition from tube feeding to oral feeding in premature infants admitted to the Neonatal Unit of the Brazilian Unified Health System (SUS). Method: An analytical observational cohort study was conducted with 45 premature infants who used a feeding tube from December 2021 to January 2022 and were accompanied by the Speech Therapy team of the service. The following factors were evaluated: premature infant's readiness for oral feeding, oral feeding with finger feeding technique, breastfeeding, and levels of oral skill. Results: Factors associated with a longer transition time from tube feeding to oral feeding included gestational age at birth of fewer than 32 weeks, birth weight under 1500 grams, lack of readiness for oral feeding, and hospital discharge with artificial feeding. Conclusion: Characteristics of the premature infant and feeding at assessment and hospital discharge were associated with a shorter transition time from the tube to oral feeding. Therefore, interventions that stimulate oral feeding during hospitalization can help reduce the transition time and promote breastfeeding, benefiting the health of premature infants and the mother-baby bond. They can also contribute to early discharge, allowing for bed turnover and, consequently, increased availability for SUS users. (AU)

Introducción: La retirada de la sonda en los prematuros y el establecimiento adecuado de la vía bucal son importantes para la salud del bebé, ya que favorecen la lactancia y el alta hospitalaria, sin embargo, es un desafío en las unidades neonatales. Objetivos: Este artículo analiza los factores asociados al tiempo de transición de la sonda a la vía oral en prematuros internados en la Unidad Neonatal del Sistema Único de Salud (SUS). Método: Se realizó un estudio observacional analítico de cohortes, con 45 prematuros que utilizaron sonda de alimentación desde diciembre de 2021 hasta enero de 2022 y fueron seguidos por el equipo de logopedia del servicio. Se evaluaron: la disposición del prematuro para la alimentación oral; la vía oral con la técnica de alimentación con los dedos; lactancia materna y niveles de habilidad oral. Resultados: La edad gestacional ao nacer de menos de 32 semanas, el peso de nacimiento de menos de 1500 gramos, la falta de preparación para la administración oral y el alta hospitalaria con alimentación artificial se relacionaron con el mayor tiempo de transición de la vía por sonda a la vía oral. Conclusión: Las características del recién nacido prematuro y la alimentación en el momento de la evaluación y el alta hospitalaria se asociaron con un menor tiempo de transición de la sonda a la vía oral. Así, las intervenciones que fomenten la vía oral durante el período de hospitalización pueden contribuir a reducir el tiempo de transición y fomentar la lactancia materna, favoreciendo la salud del prematuro y el vínculo madre-bebé, además de contribuir al alta precoz, promoviendo la rotación de enfermeras, camas y, en consecuencia, mayor oferta a los usuarios del SUS. (AU)

Supervivencia de injerto graso en la lipotransferencia glútea / Survival of fat graft in gluteal lipotransfer

Introducción: El aumento de glúteos tiene como objetivo lograr una apariencia y contorno más joven; así como crear la proporción ideal entre cintura y cadera. Esto se puede lograr mediante la lipoinyección, aunque en este caso existen controversias en cuanto a la viabilidad del tejido injertado y la supervivencia de la grasa. Objetivo: Determinar el porcentaje de supervivencia del injerto de grasa autóloga y su relación con el volumen inyectado en pacientes sometidas a lipotransferencia glútea. Métodos: Se realizó un estudio observacional, descriptivo, de corte longitudinal y prospectivo con una muestra de 44 pacientes sometidas a lipotransferencia glútea en el Servicio de Cirugía Plástica del Hospital Docente Clínico Quirúrgico Dr. Miguel Enríquez en el período comprendido entre marzo de 2018 y junio de 2021. Resultados: El estudio evidencia que, mediante ultrasonido y fórmulas, el volumen promedio y la altura de la de grasa en los glúteos se duplica en el posoperatorio mediato y disminuye en el posoperatorio tardío sin llegar a los valores del preoperatorio. Además, se estableció que cerca de la media del volumen de grasa autóloga injertada en los glúteos sobrevive de manera definitiva en el posoperatorio tardío. Además, quedó establecido que la relación entre el volumen infiltrado y la supervivencia del injerto de grasa autóloga es inversamente proporcional: mientras mayor es el volumen, menor es su supervivencia. Conclusiones: Solo la mitad del volumen de grasa autóloga injertada en los glúteos sobrevive de manera definitiva, y la supervivencia de la grasa es inversamente proporcional al volumen infiltrado(AU)

Introduction: Buttock augmentation aims to achieve a more youthful appearance and contour; as well as creating the ideal proportion between waist and hips. This can be achieved by lipoinjection, although in this case there are controversies regarding the viability of the injected tissue and the survival of the fat. Objective: To determine the percentage of autologous fat graft survival and its relationship with the injected volume in patients undergoing gluteal fat transfer. Methods: An observational, descriptive, longitudinal and prospective study was carried out, with a sample of 44 patients undergoing gluteal lipotransfer, in the plastic surgery service of the Dr. Miguel Enriquez Clinical Surgical Teaching Hospital, in the intermediate period between March 2018 to June 2021. Results: The study shows that through ultrasound and formulas, the average volume and height of fat in the buttocks doubles in the immediate postoperative period, decreasing in the late postoperative period, without reaching preoperative values. Furthermore, it's established that about the mean volume of autologous fat grafted to the buttocks survives definitively in the late postoperative period. In addition, it was established that the relationship between the infiltrated volume and the survival of the autologous fat graft is inversely proportional, the greater the volume, the less its survival. Conclusions: Only half of the volume of autologous fat injected into the buttocks survives definitively, and the survival of the fat is inversely proportional to the volume injected(AU)

Solidão e sobrecarga materna em tempos de pandemia de COVID-19 à luz da escuta psicanalítica dos vínculos / Loneliness and maternal burden of care in times of COVID-19 pandemic in the light of psychoanalytic listening to bonds / Soledad y sobrecarga materna en tiempos de pandemia COVID-19 a la luz de la escucha psicoanalítica de los vínculos

Este estudo teve por objetivo analisar o impacto do confinamento doméstico provocado pela pandemia de COVID-19 sobre o exercício da maternidade em mulheres trabalhadoras em situação de home office. Trata-se de um estudo exploratório, com delineamento longitudinal e referencial teórico da psicanálise dos vínculos. Entre abril e julho de 2020 foram realizadas entrevistas on-line com 20 mães de camadas sociais médias, de 29 a 45 anos. Um ano depois foram realizadas novas entrevistas com 10 participantes, todas transcritas e analisadas por meio da análise temática. Os resultados apontaram que, em comparação com o período inicial da pandemia, as mães mostraram-se próximas do esgotamento físico e psíquico devido ao excesso de trabalho contínuo e falta de apoio social e familiar, com impactos deletérios na saúde mental das participantes, relatos de sofrimento e desamparo psicológico. A busca pela medicalização revela uma percepção individualizada do problema e uma tentativa de demonstrar estoicismo para atenuar o sofrimento decorrente dessa experiência. (AU)

This study aimed to analyze how domestic confinement resulting from the COVID-19 pandemic impacted motherhood among working women in a home office situation. This was an exploratory study, employing a longitudinal design and the theoretical framework of the psychoanalysis of bonds. Between April and July 2020, online interviews were conducted with 20 mothers from middle social strata, aged 29 to 45. One year later, new interviews were conducted with 10 participants, all transcribed and subjected to thematic analysis. The results showed that, compared to the initial period of the pandemic, mothers were close to physical and psychological exhaustion due to continuous overwork and lack of social and family support. These factors had deleterious impacts on the participants' mental health, leading to reports of suffering and psychological helplessness. The search for medicalization reveals an individualized perception of the problem and an attempt to demonstrate stoicism to mitigate the suffering resulting from this experience. (AU)

Este estudio tuvo como objetivo analizar el impacto del confinamiento doméstico debido a la pandemia de COVID-19 en la maternidad de mujeres trabajadora en situación de teletrabajo. Se trata de un estudio exploratorio, con diseño longitudinal y marco teórico del psicoanálisis de los vínculos. Entre abril y julio de 2020 se realizaron entrevistas online a 20 madres de clases sociales medias, de 29 a 45 años; un año después, se realizaron nuevas entrevistas con 10 participantes. Las entrevistas fueron transcritas y analizadas mediante análisis temático. Los resultados mostraron que, en comparación con el período inicial de la pandemia, las madres experimentaron un acercamiento al agotamiento físico y psicológico por el exceso de trabajo y la falta de apoyo social y familiar, con impactos deletéreos en la salud mental de las participantes, relatos de sufrimiento e impotencia psicológica. La búsqueda de la medicalización revela una percepción individualizada del problema y un intento de demostrar estoicismo para aliviar el sufrimiento resultante de esta experiencia. (AU)

Educación alimentaria en pacientes en dialisis / Nutritional education in dialysis patients

La enfermedad renal crónica terminal aumenta el riesgo cardiovascular y puede ocasionar defectos en la mineralización ósea. Para prevenir esto, se debe mantener el fósforo plasmático normal, que depende de la diálisis, los quelantes y la ingesta de fósforo, principalmente de origen inorgánico, incorporado mediante aditivos alimentarios. Las intervenciones nutricionales son pilares en el tratamiento de estos pacientes. El objetivo es facilitar estrategias alimentarias a un grupo de pacientes pediátricos en diálisis, mediante educación alimentaria nutricional, para aumentar el consumo de alimentos naturales, disminuyendo la ingesta de fósforo inorgánico especialmente de los productos cárnicos procesados. Materiales y métodos: se estudió una población pediátrica en diálisis. Se preparó un programa educativo con atención personalizada, instrucción alimentaria y seguimiento mensual, seguido de un taller. Resultados: n: 17 pacientes, edad decimal media de 12,3, 53% sexo masculino, 88% en hemodiálisis. Previo a la intervención el 64,7% consumía productos cárnicos procesados. Luego del taller el 58,8% disminuyó su consumo, el 41,2% aumentó la ingesta de preparaciones caseras, el 53% incorporó nuevos condimentos, de los cuales el 89% presentó al incorporarlos, mejor aceptación a las preparaciones. Conclusiones: la hiperfosfatemia está presente en alrededor del 50% de los pacientes en diálisis asociándose a un incremento entre 20% al 40% del riesgo de mortalidad. La presencia de fósforo oculto en los alimentos y la falta de adherencia hacen prioritario trabajar en programas educativos que favorezcan el aprendizaje colaborativo, centralizados en prácticas culinarias, para brindar herramientas que faciliten una alimentación natural, disminuyendo el consumo de ultraprocesados (AU)

Chronic end-stage renal disease increases the risk of cardiovascular disease and may lead to defects in bone mineralization. In order to prevent these risks, normal plasma phosphorus levels should be maintained. Achieving this goal depends on dialysis, chelators, and phosphorus intake, mainly of inorganic origin, incorporated through food supplements. Nutritional interventions are crucial in the treatment of these patients. The objective is to facilitate nutritional strategies to a group of pediatric dialysis patients, through food education, to increase the consumption of natural foods, decreasing the intake of inorganic phosphorus, especially from processed meat products. Materials and methods: a pediatric population undergoing dialysis was studied. An educational program was prepared with personalized care, nutritional instruction, and monthly follow-up visits, followed by a workshop. Results: n: 17 patients, mean age 12.3 years, 53% male, 88% on hemodialysis. Prior to the intervention, 64.7% consumed processed meat products. After the workshop, 58.8% decreased their consumption, 41.2% increased the intake of homemade food, 53% incorporated new seasonings, of whom 89% reported better acceptance of the preparations when they were incorporated. Conclusions: hyperphosphatemia is observed in around 50% of patients undergoing dialysis and is associated with a 20% to 40% increased risk of mortality. The presence of hidden phosphorus in food and the lack of adherence point to the need for the development of educational programs that promote collaborative learning, focusing on food-preparation practices. These programs should provide tools that facilitate a natural diet, reducing the consumption of ultra-processed food (AU)

Resistencia genotípica del HIV a los antirretrovirales en niños de Argentina entre 2006 y 2021 / HIV genotypic drug resistance to antiretrovirals in children in Argentina between 2006 and 2021

Introducción: La resistencia del HIV a los antirretrovirales (ARVs) es una de las principales causas de fallo terapéutico en niños, niñas y adolescentes que conviven con el virus. Desde el año 2006, el Laboratorio de Biología Celular y Retrovirus del Hospital Garrahan realiza el estudio genotípico de resistencia (ER) del HIV-1 a los ARVs a fin de identificar mutaciones que disminuyen la susceptibilidad del virus a los fármacos que componen el tratamiento ARV. Objetivos: El objetivo del trabajo fue estudiar el tipo y frecuencia de resistencia del HIV a los ARVs, a través de un análisis de 371 ER realizados entre los años 2006 y 2021 en niños, niñas y adolescentes con HIV-1 adquirido por transmisión vertical y con solicitud médica de ER por presentar fallo terapéutico. Resultados: Entre los años 2006 y 2013 la proporción de casos con resistencia a al menos una clase de fármaco ARV fue mayor al 90%, sugiriendo una asociación directa entre el fallo virológico y la disminución en la susceptibilidad del HIV-1 a uno o más componentes del TARV. A partir del año 2012, se observa una disminución progresiva del nivel de resistencia de HIV-1, llegando al 50% en 2021 (p<0.0001). La frecuencia de mutaciones de resistencia fue diferente para cada una de las clases de ARVs. Mientras que la resistencia a INNTR no sufrió cambios significativos a lo largo del período de estudio, oscilando entre 27% y 75%. La proporción de mutaciones a IPs en pacientes con fallo virológico disminuyó de 87% en 2006 a 17% en 2021 y para los INTR, disminuyó de 79% en 2006 a 45% en 2021. Conclusión: El nivel de resistencia a los ARVs ha disminuido de manera sustancial a lo largo de los últimos 16 años, probablemente por el uso de nuevos fármacos ARV con alta potencia que posibilitaron la intensificación de los tratamientos ARV y la implementación de criterios de fallo terapéutico más estrictos tanto a nivel clínico como virológico (AU)

Introduction: HIV resistance to antiretroviral (ARV) drugs is one of the main causes of therapeutic failure in children and adolescents living with the virus. Since 2006, the Cell Biology and Retrovirus Laboratory of the Garrahan Hospital has been performing the genotypic study of HIV-1 resistance to ARV drugs in order to identify mutations that reduce the susceptibility of the virus to the drugs that constitute ARV treatment. Objectives: The aim of this study was to assess the type and frequency of HIV resistance to ARV drugs through an analysis of 371 genotype studies performed between 2006 and 2021 in children and adolescents with HIV-1 acquired through motherto-child transmission and with medical request for genotype study due to therapeutic failure. Results: Between 2006 and 2013, the proportion of cases with resistance to at least one ARV drug class was greater than 90%, suggesting a direct association between virologic failure and decreased susceptibility of HIV-1 to one or more components of ART. From 2012 onwards, a progressive decrease in the level of HIV-1 resistance was observed, reaching 50% in 2021 (p<0.0001). The frequency of resistant mutations was different for each of the ARV classes, while resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) did not change significantly over the study period, ranging from 27% to 75%. The proportion of drug-resistant mutations to protease inhibitors (PI) in patients with virologic failure decreased from 87% in 2006 to 17% in 2021 and for NNRTIs from 79% in 2006 to 45% in 2021. Conclusion: The level of resistance to ARV drugs has decreased substantially over the last 16 years, probably due to the use of new ARV drugs with high potency that allowed the intensification of ARV treatments and the implementation of stricter criteria for therapeutic failure both clinically and virologically (AU)

A internação da gestante pode afetar a condição bucal do filho no terceiro ano de vida? / Can a pregnant woman's hospitalization affect the child's oral condition in the third year of life?

Objetivo: Avaliar se a hospitalização na gestação pode influenciar na condição bucal do filho no terceiro ano de vida. Métodos: Estudo longitudinal com bebês de gestantes internadas e acompanhadas no setor da Obstetrícia de um Hospital Escola em Pelotas, RS, Brasil. Os dados referentes a hospitalização e ao parto foram coletados do prontuário hospitalar e no terceiro de vida do filho (a) de um questionário aplicado a mãe e do exame bucal da criança. Cada agravo bucal foi avaliado com critérios específicos, por uma examinadora calibrada e analisado no programa IBM SPSS Statistics com 5% de nível de significância. Resultados: Participaram 20 díades mãe-filho (a). Alterações da oclusão acometeram 95% das crianças, sendo a mordida aberta anterior (MAA) a principal. Ainda, 25% das crianças apresentaram opacidades demarcas e/ou hipoplasia do esmalte, sendo significativamente maior em filhos de mães mais jovens e 20% tinham cárie da primeira infância (CPI), estando relacionada à ausência de creme dental fluoretado e à qualidade da higiene bucal. Conclusão: O reflexo mais evidente da hospitalização na gestação na saúde bucal no terceiro ano de vida do filho (a) foi a oclusão alterada, especialmente a MAA.(AU)

Objective: To assess whether hospitalization during pregnancy can influence the child's oral condition in the third year of life. Methods: Longitudinal study with babies of pregnant women hospitalized and followed up in the Obstetrics sector of a Teaching Hospital in Pelotas, RS, Brazil. Data referring to hospitalization and childbirth were collected from the hospital records and in the child's third of life through a questionnaire applied to the mother and the child's oral examination. Each oral condition was evaluated with specific criteria, by a calibrated examiner and analyzed in the IBM SPSS Statistics program with a 5% minimum significance level. Results: 20 mother-child participated. Occlusion alterations affected 95% of the children, with anterior open bite (AOB) being the main. Still, 25% of the children had opacities and/or enamel hypoplasia, which was significantly higher in children of younger mothers, and 20% had early childhood caries, which is related to the absence of fluoride toothpaste and the quality of oral hygiene. Conclusion: The clearest reflection of hospitalization during pregnancy on oral health in the third year of the child's life was altered occlusion, especially the AOB.(AU)

O uso de métodos contraceptivos hormonais em pacientes com asma: repercussões clínicas / The use of hormonal contraceptives methods in patients with asthma: clinical repercussions

Objetivo: Analisar o uso dos contraceptivos hormonais em mulheres com asma e a escolha desses métodos contraceptivos para essa população, com avaliação de eventuais repercussões sobre novos episódios de asma e sibilos. Métodos: Foram selecionados estudos longitudinais, ensaios clínicos, revisões sistemáticas e metanálises. As plataformas consultadas foram PubMed, Embase, Cochrane e SciELO, com a utilização dos descritores: "contracepção", "contracepção hormonal", "sistema intrauterino liberador de levonorgestrel" e "asma". Resultados: Dois grandes estudos demonstraram que o uso de contraceptivos hormonais esteve associado à redução do risco de novos episódios de asma. Uma revisão sistemática concluiu que os resultados para o uso de contraceptivos hormonais para mulheres com asma foram mistos, com aumento ou redução dos seguintes riscos: novo episódio de asma e aumento da frequência das crises e dos sibilos. O uso da contracepção hormonal em pacientes obesas portadoras de asma é controverso. Conclusão: Os resultados para o uso de contraceptivos hormonais em mulheres com asma são inconsistentes, com relatos de aumento ou de redução do risco de novos episódios. O uso do método contraceptivo deve ser discutido individualmente, levando-se em consideração outros fatores de risco associados e o desejo da mulher. A paciente deverá ser orientada se houver piora dos sintomas clínicos de asma na vigência do uso de qualquer método contraceptivo hormonal.

Objective: To analyze the use of hormonal contraceptives in women with asthma and the choice of this contraceptive method for this population, evaluating possible repercussions on new episodes of asthma and wheezing. Methods: Longitudinal studies, clinical trials, systematic reviews and meta-analyses were selected. Platforms consulted: PubMed, Embase, Cochrane, SciELO, using the descriptors: "contraception", "hormonal contraception", "levonorgestrel-releasing intrauterine system" and "asthma". Results: Two large studies demonstrated that the use of hormonal contraceptives was associated with a reduced risk of new episodes of asthma. A systematic review concluded that the results for the use of hormonal contraceptives for women with asthma were mixed, with increased or decrease in the following risks: new asthma episodes, increased frequency and wheezing. The use of hormonal contraception in obese patients with asthma is controversial. Conclusion: The results for the use of hormonal contraceptives in women with asthma are inconsistent, with reports of increased or reduced risk of new episodes. The use of the contraceptive method should be discussed individually, taking into account other associated risk factors and the woman's desire. The patient will be advised if there is a worsening of the clinical symptoms of asthma while using any hormonal contraceptive method.

Experiencia en cirugía de tiroides en el Hospital Oncológico Conrado Benítez de Santiago de Cuba / Thyroid Surgery Experience at Hospital Oncológico Conrado Benítez of Santiago de Cuba

Introducción: Los nódulos de tiroides son un problema clínico común. La tiroidectomía es una de las técnicas más realizadas en los servicios de cabeza y cuello y constituye un tratamiento con intención curativa en el cáncer de tiroides y afecciones benignas como el bocio nodular y el adenoma. Objetivo: Describir la experiencia en cirugía de tiroides del servicio de cabeza y cuello en el Hospital Oncológico Conrado Benítez. Métodos: Se realizó un estudio descriptivo, longitudinal y prospectivo de los pacientes que recibieron algún tratamiento quirúrgico por enfermedad tiroidea en el período comprendido entre el 1 de septiembre de 2017 y el 31 de agosto de 2022. Resultados: El 87 por ciento de los pacientes eran mujeres, con una edad media de 47,1 años. A todos se les realizó ecografía y biopsia por aspiración con aguja fina con una estrecha concordancia con el diagnóstico definitivo. Predominó el carcinoma papilar (39,5 por ciento), la tiroidectomía total como técnica más empleada (86,5 por ciento) y el 94,6 por ciento de los pacientes no tuvo complicaciones. La lesión recurrencial solo estuvo presente en el 1,1 por ciento de los casos. Conclusiones: La experiencia en tiroidectomía en el Hospital Oncológico Conrado Benítez es buena, con una concordancia entre medios diagnósticos y biopsia definitiva, tiempo quirúrgico adecuado y pocas complicaciones(AU)

Introduction: Thyroid nodules are a common clinical problem. Thyroidectomy is one of the most performed techniques in head and neck surgery services, as well a treatment with curative intent for thyroid cancer and benign conditions such as nodular goiter and adenoma. Objective: To describe the experience in thyroid surgery at the head and neck surgery service from Hospital Oncológico Conrado Benítez. Methods: A descriptive, longitudinal and prospective study was carried out with patients who received any surgical treatment for thyroid disease in the period from September 1, 2017 to August 31, 2022. Results: 87 percent of patients were female, with a mean age of 47.1 years. All of them underwent ultrasonography and fine-needle aspiration biopsy, presenting a close concordance with their definitive diagnosis. Papillary carcinoma predominated (39.5 percent), total thyroidectomy was the most commonly used technique (86.5 percent) and 94.6 percent of patients had no complications. Any recurrent lesion was present in only 1.1 percent of cases. Conclusions: The thyroidectomy experience at Hospital Oncológico Conrado Benítez is good, based on the concordance between diagnostic means and definitive biopsy, as well as adequate surgical time and few complications(AU)

Tracking de 10 anos da aptidão física e capacidade funcional de mulheres adultas praticantes de atividade física / 10-Year tracking of fitness and functional capacity of adult women practicing physical activity of physical activity

Contexto e objetivo: Diversos benefícios são advindos da prática da atividade física durante o envelhecimento, porém poucos são os achados que apresentem os dados ao longo do tempo. Assim, o objetivo deste estudo foi verificar a estabilidade das variáveis da aptidão física e capacidade funcional de mulheres adultas praticantes de atividade física em um período de 10 anos. Desenho e local: Estudo longitudinal com mulheres de São Caetano do Sul. Métodos: A amostra foi composta por 157 mulheres com idade entre 45 e 86 anos (65,7 ± 6,7), analisadas em quatro intervalos de tempo: baseline, 6, 8 e 10 anos, todas praticantes de atividade física. A avaliação incluiu variáveis antropométricas, neuromotoras e de capacidade funcional. A análise estatística utilizada foi o teste t de Student, correlação de Spearman Rho e delta percentual. O nível de significância adotado foi de P < 0,01. Resultados: Os resultados apresentaram correlações de estabilidade alta e significante (rho = 0,64 a 0,87) nos três grupos nas variáveis índice de massa corporal, adiposidade, força de membros superiores, flexibilidade e agilidade. O acompanhamento de 6 a 10 anos evidenciou diferenças significantes de força de membros superiores, inferiores, agilidade e equilíbrio, sendo expressa pela redução da força de membros superiores de 8% a 13%, força de membros inferiores de 18% a 21%, agilidade de 18% a 19% e equilíbrio de 28% a 34%. Conclusão: Houve estabilidade das variáveis antropométricas, neuromotoras, capacidade funcional e equilíbrio de mulheres adultas praticantes de atividade física, mesmo apresentando redução significativa nas variáveis citadas anteriormente.

Efectividad del mousse de sangrecita y nivel de hemoglobina en los niños de 3 años en las instituciones educativas iniciales, Ica-Perú / Effectiveness of sangrecita mousse little blood and hemoglobin level in children from 3 years of age in the initial educational institutions Ica-Peru

El estudio tuvo como Objetivo: Evaluar la efectividad del mousse de sangrecita en los niveles de hemoglobina en los niños de dos instituciones Educativas iniciales. Materiales y métodos: Estudio Experimental con diseño cuasi experimental de corte longitudinal, la población de estudio estuvo conformada por 80 niños los cuales todos participaron (consentimiento de los padres), 52 niños fueron de la IEI de Ica y 28 de la IEI de Comatrana, para la muestra se realizó un muestreo no probabilístico mediante el descarte de anemia utilizando el analizador de hemoglobina (hemoQ), microcubetas, lancetas y demás implementos, de ellos 9 niños tuvieron una hemoglobina <=11gr/dl quienes ingresaron al programa de mousse de sangrecita. Se elaboró una ficha de control. Resultados: Después de 7 semanas de consumir el mousse de sangrecita los 9 niños que ingresaron al programa de las dos IEI, se evidencio un incremento en sus niveles de hemoglobina superior al primer control. Conclusiones: El consumo de mousse de sangrecita es efectiva en el tratamiento de la anemia en niños de la IEI incrementando el nivel de hemoglobina. (AU)

The Objective of the study was to evaluate the effectiveness of blood mousse on hemoglobin levels in children from two initial educational institutions. Materials and Methods: Study experimental Quasi-experimental desing of longitudinal cut, the study population was made up of 80 children who all participated (parental consent), 52 children were from the IEI of Ica and 28 from the IEI of Comatrana, for the sample a non-probability sampling was carried out by discarding anemia using the hemoglobin analyzer (hemoQ), microcuvettes, lancets andother implements, of them 9 children had a hemoglobin < = 11gr / dl who would enter the blood mousse program. A control sheet was drawn up. Results: After 7 weeks of consuming the blood mousse of the 9 children who entered the program of the two IEI, there was evidence of an increase in their hemoglobin levels higher than the first control. Conclusions: The consumption of blood mousse is effective in the treatment of anemia in children with IEI by increasing the level of hemoglobin. (AU)