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In Vivo ; 36(6): 2531-2541, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36309355


Human papillomavirus (HPV) infections are associated with cervical cancer and other anogenital cancers. Despite progresses in HPV vaccination and screening, these cancers still show high incidence and mortality, requiring improved prognostic markers and tailored therapies. This review addresses the role of Matrix metalloproteinases (MMPs) in HPV-induced cancers and the modulation of MMP expression by HPV oncoproteins. Scientific literature indexed in PubMed and ScienceDirect about Human papillomavirus modulates matrix metalloproteinases was retrieved and critically analyzed, to obtain an overview of expression patterns and their implications for carcinogenesis and patient prognosis. Matrix metalloproteinases such as MMP1, MMP9 and MMP13 have been associated with patient prognosis in HPV-induced cancers and play a major role in the degradation of the extracellular matrix, tumor invasion and metastasis. The HPV E2 and E7 oncoproteins regulate MMP expression via AKT, MEK/ERK and AP-1 signaling among other mechanisms. Increased expression of MMPs is associated with cancer progression and poor prognosis in multiple HPV-induced cancers, suggesting their potential use as prognostic markers. The identification of specific signaling pathways that mediate MMP regulation by HPV is essential for developing efficient new cancer therapies.

Alphapapillomavirus , Proteínas Oncogênicas Virais , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Feminino , Humanos , Papillomaviridae , Infecções por Papillomavirus/complicações , Infecções por Papillomavirus/genética , Infecções por Papillomavirus/patologia , Alphapapillomavirus/metabolismo , Metaloproteinase 2 da Matriz , Proteínas Oncogênicas Virais/genética , Proteínas E7 de Papillomavirus , Neoplasias do Colo do Útero/patologia , Metaloproteinases da Matriz/metabolismo , Carcinogênese/genética
Cad Saude Publica ; 38(9): e00130022, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36169516


Health care for patients with serious illnesses usually implies the need to make a large number of decisions, ranging from how information is shared to which diagnostic or therapeutic procedures will be adopted. The method of such decision-making has important implications from an individual and collective point of view and may contribute to either relieving or aggravating suffering. In this consensus document, the Bioethics Committee of the Brazilian National Academy of Palliative Care (ANCP) and the Permanent Committee on Palliative Care of the Brazilian Geriatrics and Gerontology Society (SBGG) adopt the principles of compassionate listening proposed by Saunders, of the nature of suffering proposed by Cassel, of dignity-preserving care proposed by Chochinov, and of cultural humility as a starting point for the construction of an official position of ANCP and SBGG on shared decision-making in palliative care. The position statement posits that, unlike paternalistic and consumerist models, the decision-making process in the sphere of palliative care must follow the mutualistic model of shared decision, where decisions are built based on dialogue between healthcare professionals and patients/family. The document sets forth the assumptions of this process, the limits of autonomy of patients/family and healthcare professionals and the distinction between futile and potentially inappropriate treatments, besides ratifying its incompatibility with any forms of coercion and conflict of interest foreign to the best interests of patients.

Os cuidados de saúde com pacientes portadores de doenças graves usualmente implicam a necessidade de tomada de um grande número de decisões, envolvendo desde a forma como a informação é compartilhada até quais procedimentos diagnósticos ou terapêuticos serão adotados. A maneira como tais decisões são tomadas têm importantes implicações do ponto de vista individual e coletivo, podendo contribuir tanto para o alívio como para o agravamento do sofrimento. No presente documento de consenso, o Comitê de Bioética da Academia Nacional de Cuidados Paliativos (ANCP) e a Comissão Permanente de Cuidados Paliativos da Sociedade Brasileira de Geriatria e Gerontologia (SBGG) adotam os princípios da escuta compassiva proposto por Saunders, da natureza do sofrimento proposto por Cassel, dos cuidados preservadores da dignidade propostos por Chochinov e da humildade cultural como ponto de partida para a construção de um posicionamento oficial da ANCP e SBGG acerca do processo de tomada de decisão compartilhada em cuidados paliativos. O posicionamento estabelece que, em contraposição aos modelos paternalistas e consumistas, o processo de tomada de decisão no âmbito dos cuidados paliativos deve seguir o modelo mutualista de decisão compartilhada, no qual as decisões são construídas a partir do diálogo entre profissionais de saúde e pacientes/familiares. O documento estabelece os pressupostos deste processo, os limites da autonomia de pacientes/familiares e profissionais de saúde, a distinção entre tratamentos fúteis e potencialmente inapropriados, bem como ratifica sua incompatibilidade com quaisquer formas de coerção e conflitos de interesse alheios ao melhor interesse dos pacientes.

Los cuidados de salud de pacientes portadores de enfermedades graves usualmente implican la necesidad de tomar un gran número de decisiones, que abarcan desde cómo se comparte la información hasta qué procedimientos diagnósticos o terapéuticos se adoptarán. La forma en que se toman tales decisiones tiene importantes implicaciones desde el punto de vista individual y colectivo, y puede contribuir tanto a aliviar como a agravar el sufrimiento. En el presente documento de consenso, el Comité de Bioética de la Academia Nacional de Cuidados Paliativos (ANCP) y la Comisión Permanente de Cuidados Paliativos de la Sociedad Brasileña de Geriatría y Gerontología (SBGG) adoptan los principios de la escucha compasiva propuesta por Saunders; de la naturaleza del sufrimiento propuesta por Cassel, de los cuidados preservadores de la dignidad propuestos por Chochinov y de la humildad cultural como punto de partida para la construcción de un posicionamiento oficial de la ANCP y SBGG sobre el proceso de toma de decisiones compartidas en cuidados paliativos. El posicionamiento establece que, en contraposición a los modelos paternalistas y consumistas, el proceso de toma de decisiones en el ámbito de los cuidados paliativos debe seguir el modelo mutualista de decisión compartida, donde las decisiones son construidas a partir del diálogo entre los profesionales de salud y los pacientes/familiares. El documento establece los supuestos de este proceso, los límites de la autonomía de los pacientes/familiares y de los profesionales de la salud, la distinción entre los tratamientos inútiles y los potencialmente inapropiados, así como ratifica su incompatibilidad con cualquier forma de coerción y los conflictos de intereses distintos del interés superior de los pacientes.

Geriatria , Cuidados Paliativos , Brasil , Tomada de Decisões , Pessoal de Saúde , Humanos , Cuidados Paliativos/métodos
Front Physiol ; 13: 817263, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910573


Lung physiology research advanced significantly over the last 100 years. Respiratory mechanics applied to animal models of lung disease extended the knowledge of the workings of respiratory system. In human research, a better understanding of respiratory mechanics has contributed to development of mechanical ventilators. In this review, we explore the use of respiratory mechanics in basic science to investigate asthma and chronic obstructive pulmonary disease (COPD). We also discuss the use of lung mechanics in clinical care and its role on the development of modern mechanical ventilators. Additionally, we analyse some bench-developed technologies that are not in widespread use in the present but can become part of the clinical arsenal in the future. Finally, we explore some of the difficult questions that intensive care doctors still face when managing respiratory failure. Bringing back these questions to bench can help to solve them. Interaction between basic and translational science and human subject investigation can be very rewarding, as in the conceptualization of "Lung Protective Ventilation" principles. We expect this interaction to expand further generating new treatments and managing strategies for patients with respiratory disease.

Acta Radiol ; : 2841851221113518, 2022 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-35876308


BACKGROUND: Magnetic resonance diffusion tensor imaging (MR-DTI) has been increasingly applied for carpal tunnel syndrome (CTS) diagnosis, but relatively little is known about the effect of CTS treatment on median nerve (MN) integrity and functional outcome prediction. PURPOSE: To assess how structural changes in MR-DTI of the MN correlates with symptom severity, functional status, and electrophysiological parameters in patients suffering from CTS before and after decompression surgery. MATERIAL AND METHODS: Nine wrists were prospectively enrolled to perform MR-DTI pre- and postoperatively. The apparent diffusion coefficients (ADC) and fractional anisotropy (FA) of the MN were examined in three different regions-distal radioulnar joint, pisiform bone, and hamate bone-and correlated with clinical and electrophysiological parameters. RESULTS: Postoperatively, mean Boston Carpal Tunnel Questionnaire scores decreased 1.55 points (range = 0.08-3; P = 0.0172) and 1.01 points (-0.13 to 1.88; P = 0.0381) in the symptomatic and functional domains, respectively. Postoperative clinical improvement was reflected in proximal FA elevation (P = 0.0078), but not in diffusivity in comparison to baseline examination. Preoperative electrophysiological parameters were correlated with a reduction in the pre- (sensory latencies [rho = -0.6826; P = 0.0312]) and postoperative (motor latencies [rho = -0.7488; P = 0.0325]) distal FA values. Higher sensory amplitudes indicated higher postoperative proximal FA values (rho = 0.7618; P = 0.0280) ​​and lower postoperative proximal ADC values (rho = -0.9047; P = 0.0020). CONCLUSION: Our study demonstrated that pre- and postoperative proximal FA values are useful biomarkers for the structural evaluation of the MN in patients with CTS. Symptomatic improvement can be better predicted by analyzing FA changes.

J. health sci. (Londrina) ; 24(2): 157-160, 20220704.
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1412649


Opportunistic viral infections are common in kidney transplant recipients. They are mainly caused by cytomegalovirus, which in addition to causing infection, can increase immunosuppression and facilitate colonization by other pathogens. This study presents the clinical case report of a kidney transplant recipient affected by cytomegalovirus who presented oral lesions caused by Pseudomonas aeruginosa. A 55-year-old male patient with gingival burning and chewing pain presented whitish areas in his gums in the region from element 22 to 24, surrounded by erythematous areas. Culture examination and biopsy revealed the presence of the bacteria P. aeruginosa, confirmed by blood culture. After seven days of antibiotic therapy, a significant improvement was observed in his oral condition. Thus, it was concluded that the oral cavity was the infection site in this kidney transplant patient, demonstrating the importance of a dentist in a multidisciplinary team to perform early diagnosis of oral lesions, and thus prevent possible systemic complications that may culminate in graft rejection. (AU)

Infecções virais oportunistas são comuns em transplantados renais, principalmente causadas pelo citomegalovírus, que além de causar infecção, pode aumentar a imunossupressão e facilitar a colonização por outros patógenos. Nós apresentamos aqui o relato de caso clínico de um transplantado renal acometido por citomegalovírus que apresentou lesões bucais causadas por P. aeruginosa. Paciente do sexo masculino, 55 anos, com ardência gengival e dor à mastigação, apresentava áreas esbranquiçadas em gengiva na região do 22 ao 24 circundadas por áreas eritematosas. Exame de cultura e biópsia revelaram a presença da bactéria P. aeruginosa, confirmada na hemocultura. Após sete dias de antibioticoterapia, observamos melhora significativa da condição bucal. Assim, concluímos que a cavidade bucal foi o sítio da infecção no paciente transplantado renal demonstrando a importância do dentista em equipe multidisciplinar para realizar diagnóstico precoce de lesões bucais e assim prevenir possíveis complicações sistêmicas que possam culminar com a rejeição do enxerto. (AU)

Int J Ment Health Addict ; : 1-22, 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35677712


The objective of this study is to conduct a systematic review and meta-analysis to assess the effect of psychosocial interventions in reducing problematic Internet use (PIU), anxiety, and depression symptoms in a sample of people. This review was registered on the PROSPERO database (CRD42020181912) and a total of 15 studies were included. Analyses of the effect of the interventions were conducted based on the standardized mean difference of the studied outcomes (PIU, anxiety, and depression). Most studies reported a positive effect of psychosocial interventions on reducing symptoms of PIU, depression, and anxiety among people with PIU. However, only one detected a robust effect in reducing symptoms of anxiety. For depression, this effect was more modest, and there was no difference between the different modalities of psychosocial interventions. The results suggest that psychosocial interventions are effective in reducing both symptoms of PIU and co-occurring symptoms of depression and anxiety in individuals with PIU. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-022-00846-6.

Life Sci ; 301: 120599, 2022 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-35513085


Lung inflammation is modulated by cholinergic signaling and exercise training protects mice against pulmonary emphysema development; however, whether exercise training engages cholinergic signaling is unknown. AIMS: As cholinergic signaling is directly linked to the vesicular acetylcholine transporter (VAChT) levels, we evaluated whether the effects of aerobic exercise training depend on the VAChT levels in mice with pulmonary emphysema. MAIN METHODS: Wild-type (WT) and mutant (KDHOM) mice (65-70% of reduction in VAChT levels) were exposed to cigarette smoke (30 min, 2×/day, 5×/week, 12 weeks) and submitted or not to aerobic exercise training on a treadmill (60 min/day, 5×/week, 12 weeks). Lung function and inflammation were evaluated. KEY FINDINGS: Cigarette smoke reduced body mass in mice (p < 0.001) and increased alveolar diameter (p < 0.001), inflammation (p < 0.001) and collagen deposition (p < 0.01) in lung tissue. Both trained groups improved their performance in the final physical test compared to the initial test (p < 0.001). In WT mice, exercise training protected against emphysema development (p < 0.05), reduced mononuclear cells infiltrate (p < 0.001) and increased MAC-2 positive cells in lung parenchyma (p < 0.05); however, these effects were not observed in KDHOM mice. The exercise training reduced iNOS-positive cells (p < 0.001) and collagen fibers deposition (p < 0.05) in lung parenchyma of WT and KDHOM mice, although KDHOM mice showed higher levels of iNOS-positive cells. SIGNIFICANCE: Our data suggest that the protective effects of aerobic exercise training on pulmonary emphysema are, at least in part, dependent on the integrity of the lung cholinergic signaling.

Fumar Cigarros , Enfisema , Enfisema Pulmonar , Animais , Colinérgicos , Inflamação , Pulmão , Camundongos , Camundongos Endogâmicos C57BL , Enfisema Pulmonar/etiologia , Enfisema Pulmonar/prevenção & controle , Proteínas Vesiculares de Transporte de Acetilcolina
Rev Esc Enferm USP ; 56: e20210569, 2022.
Artigo em Inglês, Português | MEDLINE | ID: mdl-35635790


OBJECTIVE: to assess the effects of an educational intervention on smoking cessation aimed at the nursing team. METHOD: this is a quasi-experimental study with 37 nursing professionals from a Brazilian hospital from May/2019 to December/2020. The intervention consisted of training nursing professionals on approaches to hospitalized smokers divided into two steps, the first, online, a prerequisite for the face-to-face/videoconference. The effect of the intervention was assessed through pre- and post-tests completed by participants. Smokers' medical records were also analyzed. For analysis, McNemar's chi-square test was used. RESULTS: there was an increase in the frequency of actions aimed at smoking cessation after the intervention. Significant differences were found in guidelines related to disclosure to family members of their decision to quit smoking and the need for support, encouragement of abstinence after hospital discharge, and information on tobacco cessation and relapse strategies. CONCLUSION: the educational intervention proved to be innovative and with a great capacity for disseminating knowledge. The post-test showed a positive effect on the frequency of actions aimed at smoking cessation implemented by the nursing team.

Fumantes , Abandono do Hábito de Fumar , Hospitalização , Humanos , Alta do Paciente , Fumar
J Neurovirol ; 28(2): 312-318, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35366736


Olfactory dysfunction is reported frequently in patients with coronavirus disease 2019. However, an effective treatment for this dysfunction is unknown. The present study evaluated carbamazepine as a treatment option for olfactory dysfunction based on its use in cases of neuralgia, especially of the V cranial nerve. The study included 10 patients with coronavirus disease with olfactory complaints who were part of a cohort of 172 coronavirus disease patients monitored for late neurological manifestations. Carbamazepine was administered for 11 weeks. The adverse effects reported were drowsiness (9/10) and dizziness (2/10); 9 of the 10 patients reported improved olfactory function after carbamazepine treatment. While the role of carbamazepine in the control of post-coronavirus disease olfactory dysfunction could not be confirmed in this study, the satisfactory response observed in most patients in this series suggests that further studies are warranted.

COVID-19 , Transtornos do Olfato , COVID-19/complicações , Carbamazepina/uso terapêutico , Humanos , SARS-CoV-2 , Olfato
Psicol. pesq ; 16(1): 1-23, jan.-abr. 2022. ilus, tab
Artigo em Português | LILACS-Express | LILACS, Index Psicologia - Periódicos | ID: biblio-1356621


Transtornos Mentais Comuns (TMC) caracterizam-se por sintomas que causam sofrimento. Esta revisão sistemática teve por objetivo descrever e analisar artigos sobre prevalência de TMC entre universitários brasileiros. A busca foi realizada no Portal da Biblioteca Virtual em Saúde com os descritores "Acadêmicos" OR "Universitários" AND "Transtornos Mentais Comuns". Dentre os 229 artigos elegíveis, foram incluídos 18. A prevalência de TMC detectada variou de 19% a 55,3%, e em 11 estudos foi maior que 40%; frequência superior às identificadas em estudos internacionais com universitários, nacionais com população geral e outras amostras. Sugere-se medidas de atenção em saúde mental para este público.

Common Mental Disorders (CMD) are characterized by symptoms that cause suffering. This systematic review aimed to describe and analyze articles on the prevalence of CMD among Brazilian university students. The search was carried out on the Biblioteca Virtual em Saúde Portal using the keywords "Academic" OR "University Students" AND "Common Mental Disorders". Among the 229 eligible articles, 18 were included. The prevalence of CMD detected ranged from 19% to 55.3%, and in 11 studies it was greater than 40%; higher than when compared to international studies with university students, nationals with general population and other samples. Mental health care interventions are suggested for this public.

Los Trastornos Mentales Comunes (TMC) se caracterizan por síntomas que causan sufrimiento. Esta revisión sistemática tuvo como objetivo describir y analizar artículos sobre la prevalencia de Trastornos Mentales Comunes (TMC) entre estudiantes universitarios brasileños. La búsqueda se realizó en el Portal de la Biblioteca Virtual en Salud con los descriptores "Académicos" OR " Universitarios" AND "Trastornos Mentales Comunes". Entre los 229 artículos elegibles, se incluyeron 18. La prevalencia de TMC detectada osciló entre el 19% y el 55,3%, y en 11 estudios fue superior al 40%. Dicha frecuencia es más alta que las identificadas en estudios internacionales con universitarios, nacionales con población general y otras muestras. Se sugieren medidas de atención en salud mental para este público.

Cell Biol Int ; 46(6): 976-985, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35257436


The physiological variations during the crustacean molting cycle have intrigued researchers for many years. Maintaining osmotic homeostasis in the face of hemolymph dilution and dealing with dynamic intracellular and extracellular calcium fluctuations are challenges these animals continuously confront. It has recently been shown that water channels present in the cell membrane (aquaporins) are essential for water uptake during premolt and postmolt. This study aims to investigate whether hypoosmotic shock and intracellular and extracellular calcium variations can lead to translocation of Aquaporin 1 (AQP-1) from the intracellular region to the plasma membrane during premolt and postmolt, thus allowing increased water flow in these stages. For this, we investigate in vitro the rapid change of AQP-1 positions in the abdominal muscle cells in the freshwater shrimp, Palaemon argentinus. Using cell volume analysis and immunohistochemistry, we show that hypoosmotic conditions and an elevation of the intracellular and extracellular calcium concentrations are concurrent with the translocation of AQP-1 to the plasma membrane. These results indicate that calcium flux and hypoosmotic shock may be regulators of AQP 1 in the translocation process.

Aquaporina 1 , Cálcio , Animais , Aquaporina 1/metabolismo , Cálcio/metabolismo , Tamanho Celular , Células Musculares/metabolismo , Água/metabolismo
Life Sci ; 295: 120405, 2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35181311


AIMS: The rostral ventrolateral medulla (RVLM) is the main sympathetic output of the central nervous system to control blood pressure. Reportedly, reactive oxygen species (ROS) can increase arterial pressure, leading to hypertension. As ROS increase the sympathetic tone in RVLM and obese animals present grater oxidative stress, it would be important to note this relationship. MAIN METHODS: Therefore, we evaluated the systemic and central effects (in the RVLM) of vitamin C (vit C, an antioxidant) on the redox balance and cardiovascular and autonomic profiles in hyperadipose male rats. We also evaluated the neurotransmission by L-glutamate (L-glu) and vit C in the RVLM of awake hyperadipose rats. KEY FINDINGS: Our study confirmed that hyperadipose rats were hypertensive and tachycardic, presented increased sympathetic and decreased parasympathetic modulation of the heart, and had increased plasma lipoperoxidation compared with the control rats (CTR). Oral vitamin C treatment reverted cardiovascular, autonomic, and plasma redox dysfunction. Hyperadipose rats presented a higher blood pressure increase after L-glu microinjection and a lower response to vit C in the RVLM compared with the CTR group. Biochemical analysis of redox balance in RVLM punches showed that hyperadipose rats have increased NBT and T-BARS, and after treatment with vit C, the oxidative profile decreased. The antioxidative activity of vit C reduced the amount of ROS in the RVLM area that might have resulted in lowered blood pressure and sympathetic modulation. SIGNIFICANCE: Our data suggest central and peripheral benefits of vit C treatment on cardiovascular, autonomic, and oxidative dysfunctions in hyperadipose animals.

Ácido Ascórbico/farmacologia , Hipertensão/tratamento farmacológico , Bulbo/metabolismo , Animais , Antioxidantes/farmacologia , Sistema Nervoso Autônomo/fisiopatologia , Pressão Sanguínea/efeitos dos fármacos , Sistema Cardiovascular/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Hipertensão/fisiopatologia , Masculino , Bulbo/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Ratos , Ratos Wistar , Espécies Reativas de Oxigênio/farmacologia , Superóxido Dismutase/metabolismo , Sistema Nervoso Simpático/efeitos dos fármacos , Sistema Nervoso Simpático/metabolismo
J Health Psychol ; 27(13): 2964-2981, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35148652


This article describes the reporting characteristics of systematic reviews (SRs) in Psychology. The inclusion criteria were self-declared SRs in all branches of Psychology, published between 2019 and 2020. The search was performed in the PsycINFO and MEDLINE databases, from which 2487 records were identified, and 305 papers selected. There were many discrepancies in the reporting of Psychology SRs. Some PRISMA items, such as self-identification as an SR, description of the aim and the inclusion criteria, specification of the databases, and the description of the search and selection process using a flow diagram were reported in more than 90% of the SRs. Other items had lower coverage, such as the specification of the PICO framework, presentation of the complete search strategies, mention of the reporting guidelines, description of the exclusion criteria, performance of a risk of bias assessment, and analysis of the quality of the evidence, among others. The study highlights the need to improve the planning, performance and reporting of SR in Psychology.

Viés , Humanos
Am J Med Genet A ; 188(5): 1635-1638, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35080105


We report an individual from Brazil with SHORT syndrome. The term SHORT stands for its common characteristics: short stature (S), hyperextensibility of joints, and/or inguinal hernia (H), ocular depression (O), Rieger anomaly (R), and teething delay (T). In addition to most of the clinical signs previously described in SHORT syndrome, the patient presented here also shows microcephaly and intellectual disability. Diagnosis was confirmed by exome sequencing revealing a novel heterozygous variant c.1456G>A (p.Ala486Thr) at PIK3R1. Human recombinant growth hormone (r-hGH) therapy was administered prior to diagnosis; however, the use of r-hGH may have had a role in anticipating and worsening the glucose metabolic profile in the patient, as previously described. This article contributes to providing a better understanding of the SHORT syndrome genotype and its correlation with the phenotype, by comparing with it other reported cases.

Doenças Metabólicas , Nefrocalcinose , Adulto , Brasil , Classe Ia de Fosfatidilinositol 3-Quinase/genética , Transtornos do Crescimento , Humanos , Hipercalcemia , Nefrocalcinose/diagnóstico , Nefrocalcinose/genética , Fenótipo
Artigo em Português | LILACS | ID: biblio-1368306


RESUMO: Objetivo: analisar os fatores associados ao perfil psicossocial de mulheres durante o pré-natal no Hospital Universitário ­ Unidade Materno Infantil da Universidade Federal do Maranhão ­ HUUFMA. Métodos: estudo transversal realizado com 160 gestantes sem limite de faixa etária, atendidas no Ambulatório de Obstetrícia do HUUFMA no período de março a outubro de 2017. A avaliação do perfil psicossocial foi mensurada por meio do Prenatal Psychosocial Profile (PPP-VP). Resultados: a maioria das gestantes, cerca de 41,25% (66), possui somente o Ensino Médio completo, faixa etária de 15 a 35 anos , cerca de 65,66% (105), no último trimestre gestacional 46,25% (74), a maior parte primigesta, 60% (96), com menos de seis consultas pré-natais realizadas, 67,52% (108). Quanto ao trimestre gestacional, não houve significância estatística com os constructos do PPP-VP, relativo à paridade, as multíparas foram as que mais evidenciaram estresse e o teste de Tukey demonstrou que as multíparas tiveram mais estresse quando comparada com as nulíparas. Conclusão: é pertinente inferir que, em relação ao trimestre gestacional, não houve influência relativa aos constructos do perfil psicossocial, porém ao se relacionar paridade, a situação contrária foi observada, principalmente em multíparas, onde o maior número de partos refletia diretamente no nível desajustado do estresse, sendo assim é necessária uma maior atenção a essas questões para uma assistência pré-natal adequada. (AU)

ABSTRACT: Objective: analyze the factors associated with the psychosocial profile of women during prenatal care at the University Hospital ­ Maternal-Child Unit of the Federal University of Maranhão ­ HUUFMA. Methods: a cross-sectional study conducted with 160 pregnant women without age limit assisted at the HUUFMA Obstetrics Outpatient Clinic from March to October 2017. The assessment of the psychosocial profile was measured using the Prenatal Psychosocial Profile (PPP-VP). Results: most pregnant women, about 41.25% (66) had only completed high school; aged from 15 to 35 years old, about 65.66% (105); in the last gestational trimester 46.25% (74); most of them primigravid, 60% (96); with less than six prenatal appointments performed 67.52% (108). As for the gestational trimester, there was no statistical significance with the PPP-VP constructs; concerning parity, multiparas were the ones who showed more stress, and the Tukey test showed that this group had more stress when compared to nulliparas. Conclusion: it is pertinent to infer that about the gestational trimester, there was no influence on the constructs of the psychosocial profile, but when relating parity, the opposite situation was observed, especially in multiparous women, in which the greater number of births directly reflected in the maladjusted level of stress. Greater attention is necessary to these issues for adequate prenatal care.

Humanos , Feminino , Gravidez , Adolescente , Adulto , Cuidado Pré-Natal , Apoio Social
Rev. Enferm. Atual In Derme ; 96(37): 1-11, Jan-Mar. 2022.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1378458


Objetivo: O presente estudo objetivou sintetizar o conhecimento produzido na literatura sobre os instrumentos utilizados para medir o raciocínio diagnóstico em enfermagem. Método:Realizou-se uma revisão integrativa da literatura, em setembro de 2020, as fontes de dados consultadas foram Literatura Latino-Americana e do Caribe em Ciências da Saúde, Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed e Web of Science. Foram selecionados nove artigos para compor a amostra. Em relação aos estudos incluídos, todos eram internacionais (100%) e 44,4% foram do ano de 2019.Os principais delineamentos foram descritivo, prospectivo, transversal e ensaio clínico randomizado. Resultados:Os instrumentos identificados foram: Teste de Concordância de Script (SCTs); Health Sciences Reasoning Test (HSRT); Lasater Clinical Judgment Rubric (LCJR); Creighton Simulation Evaluation Instrument (C-SEI); Nursing Process Skills Checklist; Critical Thinking Disposition Inventory -versão chinesa (CTDI-CV); Teste verdadeiro ou falso e de múltipla escolha; e Jogo de Simulação Virtual. As principais facilidades identificadas foram: baixo nível de complexidade e identificação de fontes potenciais de erros. As limitações foram: conhecimento tecnológico e subjetividade no julgamento dos discentes. Conclusão:A síntese do conhecimento produzido na literatura, realizada no presente estudo, identificou oito instrumentos para medir o raciocínio diagnóstico em enfermagem, bem como suas facilidades e limitações de uso. Acredita-se que esse conhecimento é de suma importância para avaliar e direcionar o ensino dessa importante etapa do processo de enfermagem.

Objective: This study aimed to synthesize the knowledge produced in the literature about the instruments used to measure diagnostic reasoning in nursing. Method: An integrative literature review was conducted in September 2020. The data sources consulted were Latin American and Caribbean Literature on Health Sciences, Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed, and Web of Science. Nine articles were selected to compose the sample. Regarding the included studies, all were international (100%) and 44.4% were from the year 2019. The main designs were descriptive, prospective, cross-sectional, and randomized clinical trial. Results: The instruments identified were Script Concordance Test (SCTs); Health Sciences Reasoning Test (HSRT); Lasater Clinical Judgment Rubric (LCJR); Creighton Simulation Evaluation Instrument (C-SEI); Nursing Process Skills Checklist; Critical Thinking Disposition Inventory -Chinese version (CTDI-CV); True or False and Multiple Choice Test; and Virtual Simulation Game. We conclude that there are several instruments to measure diagnostic reasoning in nursing. Conclusion: Knowledge of these instruments is of utmost importance to evaluate and direct the teaching of this important stage of the nursing process.

Objetivo: El presente estudio tuvo como objetivo sintetizar el conocimiento producido en la literatura sobre los instrumentos utilizados para medir el razonamiento diagnóstico en enfermería. Método: Se realizó una revisión integrativa de la literatura en septiembre de 2020, las fuentes de datos consultadas fueron Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Scopus Content Overview, Cumulative Index to Nursing and Allied Health Literature, PubMed y Web of Science. Nueve artículos fueron seleccionados para componer la muestra. En cuanto a los estudios incluidos, todos eran internacionales (100%) y el 44,4% eran del 2019. Los diseños principales fueron ensayo clínico descriptivo, prospectivo, transversal y aleatorizado. Resultados: Los instrumentos identificados fueron: Test de Concordancia de Guión (SCTs); Prueba de Razonamiento de Ciencias de la Salud (HSRT); Rúbrica de juicio clínico de Lasater (LCJR); Instrumento de evaluación de simulación de Creighton (C-SEI); Lista de Verificación de Habilidades del Proceso de Enfermería; Inventario de disposición de pensamiento crítico -versión en chino (CTDI-CV); Verdadero o falso y prueba de opción múltiple; y Juego de Simulación Virtual. Las principales facilidades identificadas fueron: bajo nivel de complejidad e identificación de potenciales fuentes de errores. Las limitaciones fueron: conocimiento tecnológico y subjetividad en el juicio de los estudiantes. Conclusión: La síntesis del conocimiento producido en la literatura, realizada en el presente estudio, identificó ocho instrumentos para medir el razonamiento diagnóstico en enfermería, así como su facilidad y limitaciones de uso. Secree que este conocimiento es de suma importancia para evaluar y orientar la enseñanza de esta importante etapa del proceso de enfermería.

Humanos , Masculino , Feminino , Ensino , Diagnóstico de Enfermagem , Tecnologia Educacional , Educação em Enfermagem
Artigo em Inglês | IBECS | ID: ibc-204336


Background: To evaluate the efficacy of intra-alveolar administration of dexamethasone 4 mg in the control of edema, trismus, and pain resulting from the extraction of impacted lower third molars and the drug permeability through the oral mucosa by in silico prediction. Material and Methods: The randomized, double-blind, split-mouth clinical trial included patients who had both impacted lower third molars in equivalent positions. Hemiarches were divided into control side when dexamethasone was administered orally and experimental side when dexamethasone was administered using the intra-alveolar route. Patients were evaluated considering edema, trismus, and pain. The permeability of dexamethasone through the oral mucosa was assessed by in silico prediction. Student’s t-test was selected for comparative analysis of edema and trismus, and the chi-square test analyzed the distribution of postoperative pain between the sides. Results: There were no significant differences between the routes of administration in measuring symptoms between the pre and postoperative times (p>0.05). In silico prediction suggested that dexamethasone molecular characteristics facilitate intra-alveolar administration. Conclusions: Intra-alveolar administration had similar efficacy to oral administration in controlling symptoms of post-surgical inflammation of impacted lower third molars.(AU)

Humanos , Edema/etiologia , Edema/prevenção & controle , Dente Serotino/cirurgia , Dor Pós-Operatória/prevenção & controle , Dor Pós-Operatória/terapia , Dente Impactado , Trismo/etiologia , Trismo/prevenção & controle , Humanos , Dexametasona
J Health Psychol ; 27(2): 341-351, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-32878479


We evaluated the association between risk behaviors and quality of life in 1,081 adolescents classified into the risk behavior (RB) or the non-risk behavior (nRB) group. The data were analyzed with logistic regression models, analysis of variance, and network analysis. The nRB group had higher quality-of-life scores, and having a religion (OR = .42) and better quality of life (OR = .95) significantly reduced the odds of risk behaviors. The network analysis identified that religion, gender, and type of school showed the best centrality and connectivity indices. These data showed a negative association between risk behaviors and lower quality-of-life levels.

Comportamento do Adolescente , Qualidade de Vida , Adolescente , Brasil , Humanos , Religião , Assunção de Riscos
Clin Rheumatol ; 41(2): 421-428, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34537904


OBJECTIVE: The association between brain-derived neurotrophic factor (BDNF) and neuropsychiatric systemic lupus erythematosus (NPSLE) is controversial in the literature. Cognitive dysfunction (CD) is a common, underdiagnosed NPSLE manifestation, but its pathophysiology is unknown. Thus, we investigate serum BDNF as a potential biomarker of CD in a cohort of SLE patients. METHODS: We included 63 SLE patients, 48 NPSLE, and 57 age- and gender-matched controls (CON). All participants underwent neuropsychological assessment. Data on cardiovascular comorbidities, SLE disease activity index (SLEDAI), and Systemic Lupus International Collaborating Clinics damage index (SLICC-DI) were compiled. Multiple regression analyses evaluated predictors of serum BDNF levels. RESULTS: Serum BDNF levels were lower in SLE and NPSLE patients than in CON (SLE 800.4 ± 502.7 vs. NPSLE 779.7 ± 426.3 vs. CON 1,345.5 ng/mL ± 438.4; p < 0.001). In addition, hypertension (B: - 192.5, SE: 84.3, 95% CI: - 359.7 to - 25.3, p = 0.024) and SLICC-DI score (B: - 75.9, SE: 27.2, 95% CI: - 129.8 to - 22, p = 0.006) were predictors of serum BDNF levels in SLE. There was no relation between BDNF levels and CD. CONCLUSION: BDNF levels are lower in SLE patients than CON and inversely associated with hypertension and SLICC-DI scores. No association between BDNF levels and CD or NPSLE was observed in this cohort. These findings indicate that BDNF may be associated with overall burden in SLE rather than specific manifestations such as cognition impairment. Key Points • BDNF is associated with an overall burden in SLE rather than specific manifestations such as cognition dysfunction. • BDNF levels are reduced in patients with SLE, and higher SLICC-DI scores and hypertension are independent predictors of lower serum BDNF levels. • The cognitive dysfunction rate is elevated (46%) among Brazilian SLE patients.

Fator Neurotrófico Derivado do Encéfalo/sangue , Disfunção Cognitiva , Lúpus Eritematoso Sistêmico , Vasculite Associada ao Lúpus do Sistema Nervoso Central , Estudos de Coortes , Humanos , Lúpus Eritematoso Sistêmico/complicações , Vasculite Associada ao Lúpus do Sistema Nervoso Central/complicações