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1.
BMC Public Health ; 21(1): 518, 2021 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-33726728

RESUMO

BACKGROUND: The National Policy for Integral Attention to Women's Health Care (PNAISM) was implemented in 2004, with monitoring of potential benefits. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion are actions carried out by the Brazil National Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women's main causes of death as well as the mortality trends of such causes, especially after implementation of PNAISM. METHODS: An ecological study was conducted from 2018 to 2020. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996-2004 and 2005-2016 the latter to correspond with the implementation of the National Policy. The death records of Brazilian women aged 40 to 64 years who had a designated cause of death were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. RESULTS: The main causes of death in women from 1996 to 2016 were circulatory system diseases (22.47%, 697,636 deaths), neoplasms (19.69%, 611,495 deaths), respiratory system diseases (5.5%, 170,716 deaths), endocrine, nutritional, and metabolic disorders (5.27%, 163,602 deaths), and digestive system diseases (3.74%, 116.280 deaths). Analyzing the changes in the major causes of death of climacteric women after implementation of the PNAISM we observed that mortality from circulatory system diseases and endocrine and nutritional diseases were significantly declined in post-PNAISM period: (ß = - 3.63; 95% CI - 4.54 to - 2.73 r2 = 0.87; p < 0.001; ß = - 0.51; 95% CI, - 0.71 to - 0.31; R2 = 0.73; p < 0.001, respectively). No changes were observed in mortality from neoplasms and respiratory system diseases in post-PNAISM period (p = 0,765; p = 0,233, respectively). CONCLUSIONS: After implementation of the PNAISM, we observed a downward trend in rates of mortality from diseases of the circulatory and digestive systems and from endocrine, nutritional, and metabolic diseases but stability in the rates of death from neoplasm and respiratory system diseases.

2.
Acta ortop. bras ; 28(6): 296-302, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1142037

RESUMO

ABSTRACT Objective: To compare the postoperative outcomes of transforaminal intersomatic lumbar arthrodesis with structured iliac bone autograft and PEEK device. Methods: The total of 93 medical records of patients undergoing transforaminal intersomatic fusion between January 2012 and July 2017 with at least 1 year of postoperative follow-up, with complete medical record, containing clinical file and radiological exams, were reviewed. Results: From the medical records evaluated, 48 patients underwent the procedure with structured iliac autograft (group 1) and 45 with PEEK device (group 2). There was an improvement in functional capacity in both groups (p < 0.001), however there was no difference when comparing them (p = 0.591). Conclusion: The postoperative clinical and radiological results of lumbar arthrodesis with TLIF technique, using a structured iliac bone autograft compared to a PEEK device, were similar. Level of Evidence II, Retrospective study.


RESUMO Objetivo: Comparar os desfechos pós-operatórios da artrodese lombar intersomática transforaminal com autoenxerto ósseo ilíaco estruturado e dispositivo em poliéter-éter-cetonico-polímero (PEEK). Métodos: Foram revistos 93 prontuários de pacientes submetidos à fusão intersomática transforaminal entre janeiro de 2012 e julho de 2017 com pelo menos um ano de acompanhamento pós-operatório, com prontuário completo, contendo ficha clínica e exames radiológicos. Resultados: Dos prontuários avaliados, 48 pacientes foram submetidos ao procedimento com autoenxerto ilíaco estruturado (Grupo 1) e 45 com dispositivo em PEEK (Grupo 2). Houve melhora da capacidade funcional em ambos os grupos (p < 0,001), no entanto não houve diferença ao compará-los (p = 0,591). Conclusão: Os resultados clínicos e radiológicos pós-operatórios da artrodese lombar na técnica Fusão Intersomática Lombar Transforaminal (TLIF) utilizando autoenxerto ósseo ilíaco estruturado, em comparação com o uso de dispositivo em PEEK, foram semelhantes. Nível de Evidência II, Estudo retrospectivo.

3.
PLoS One ; 15(11): e0241674, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33180790

RESUMO

BACKGROUND: Low national immunization coverage (44.64%) requires strengthening the vaccination campaign to improve knowledge about HPV and its vaccine among adolescents and parents/guardians. Our aim is to evaluate factors related to knowledge about HPV, its vaccine, acceptability and divergences among Brazilian adolescents and parents/guardians. METHODS: A cross-sectional study was performed at a health unit of Sao Paulo University, Brazil, from 2015 to 2016. The convenience sample comprised 1047 individuals, including 74% (n = 776) adolescents and 26% (n = 271) parents/guardians, who answered a survey (knowledge about HPV, its vaccine, barriers and acceptability). RESULTS: The main source of information for adolescents was school (39%, n = 298); for parents/guardians, it was health professionals (55%, n = 153). Parents/guardians were 2.48 times more likely than adolescents to know that HPV caused changes in the Pap smear test [RR 2.48, 95% CI 2.03-3.01 (p < 0.001)], 1.43 times likely to be aware that HPV was a sexually transmitted infection [RR 1.43, 95% CI 1.22-1.68 (p < 0.001)], and 2.77 times likely to be informed that the HPV vaccine decreased the chance of having genital warts [RR 2.77, 95% CI 2.22-2.47 (p < 0.001)]. Girls knew more about the topic than boys (RR 1.67; 95% CI 1.10-2.60); education increased parents' knowledge [(RR 3.38; 95% CI 1.71-6.69)]. CONCLUSION: Female adolescents and parents/guardians with a higher level of education are factors related to suitable knowledge about HPV and its vaccine among Brazilian respondents. There were differences between parents/guardians and adolescents in HPV awareness, clinical implications, vaccine knowledge and vaccine acceptance.

4.
Reprod Health ; 17(1): 139, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894142

RESUMO

BACKGROUND: Condom non-use among sexually active adolescents is a major cause of unintended pregnancy and sexually transmitted infections. In order to promote condom use, it is essential to understand factors associated with condom non-use. AIM: Our aim was to evaluate sex differences and associated factors of condom non-use based on the nationally representative Brazilian National School Health Survey. METHODS: The study participants were 100,962 adolescents 13-18 years old, 9th graders from both public and private schools throughout Brazil. The following factors were considered as explanatory group variables for the outcome of condom non-use among adolescents: school and health service, sexual behavior, substance use, and self-reported body and health perception. Poisson regression model was performed. RESULTS: Of the total students, 28% (n = 28,157) had had sexual intercourse at least once. (boys, 37.1%; girls, 19.5%). Of these, 69.2% had used condoms the last time they had intercourse (girls: 68%; boys: 69.9%). The variables associated with condom non-use for both sexes were not having accessed a health service or approached a health professional for health-related care; not having received pregnancy prevention counseling or guidance on AIDS or STI prevention at school; early sexual initiation; no additional contraception method; substance use; feeling alone; not being satisfied with their own body; feeling fat or thin; and poor self-reported health. The number of sexual partners was also associated with condom non-use; however, contrasting behavior was indicated between sexes. A higher number of sexual partners indicated less use of condoms among girls, while for boys, a higher number of sexual partners indicated higher condom use. CONCLUSION: High condom non-use appears to be associated with lack of health care access and sexual health education, poor sexual practices, substance use, and poor self-perception, indicating areas for health promotion programs.

5.
Rev Assoc Med Bras (1992) ; 66(8): 1036-1042, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32935795

RESUMO

OBJECTIVE: The association between gynecological diagnoses and their distribution across healthcare sectors benefits health promotion and the identification of topics for continued education of gynecological care. This study aimed to identify healthcare diagnoses and referral flow in climacteric women. METHODS: This is a cross-sectional study conducted at the Women's Health Clinic of the University Hospital, University of São Paulo, with a reference to gynecology and training for Residents of Family and Community Medicine, between 2017 and 2018. The medical records of 242 women whose sociodemographic and clinical information, gynecological diagnoses, and distribution of healthcare services (primary, secondary, and tertiary) had been processed were collected. Statistical analysis included the chi-square test and odds ratio. RESULTS: Smoking (OR = 2.27, 95% CI 1.05-4.89; p = 0.035) was associated with the referral of climacteric women to higher complexity services. Considering the distribution of non-oncological diagnoses in climacteric patients, the chance of women being referred to medium- and high-complexity health services presented a 2-fold increase in cases of breast diseases, a 2.35-fold increase in cases of noninflammatory disorders of the female genital tract, and a 3-fold increase in cases of inflammatory diseases of the pelvic organs. CONCLUSION: Climacteric women aged over 55 years, postmenopausal women, and smoking women were most frequently referred to medium- and high-complexity outpatient surgery.


Assuntos
Climatério , Estudos Transversais , Feminino , Humanos , Encaminhamento e Consulta , Saúde da Mulher
6.
Rev Assoc Med Bras (1992) ; 66(8): 1062-1069, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32935799

RESUMO

PURPOSE: To analyze the level of knowledge about and the acceptability of the HPV vaccine among vaccinated and unvaccinated adolescents in the Western Amazon. METHODS: A cross-sectional study on adolescents aged 10 to 19 years. The instrument used to collect data contains demographic and socioeconomic information and 27 questions that assess the knowledge and acceptability of the HPV vaccine. To compare the prevalence of vaccinated adolescents with the correct answers to questions about HPV and acceptability and vaccination, the robust variance Poisson regression model was used in the Stata 13.0 software. FINDINGS: A total of 190 adolescents participated in the study, 60.5% in the age group of vaccination recommended by the Brazilian government, among them, 53.9% reported not having been vaccinated (p <0.001). A total of 150 (78.9%) adolescents correctly recognized HPV as a virus; 121 (63.7%) recognized HPV as a cause of cervical cancer. Participants who know HPV is a causative factor for cervical cancer are 1.94 times more likely to have been vaccinated than those who do not. Among the interviewees, the main sources of knowledge about the vaccine were schools (51.6%) and health professionals (22.6%). CONCLUSION: Unvaccinated adolescents have knowledge gaps about HPV and its vaccine when compared to those vaccinated. Our results emphasize the need for effective campaigns to deliver adequate information about HPV and its vaccine to adolescents, their parents, and health professionals.


Assuntos
Infecções por Papillomavirus , Vacinas contra Papillomavirus , Adolescente , Brasil , Criança , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Inquéritos e Questionários , Neoplasias do Colo do Útero , Vacinação , Adulto Jovem
7.
Artigo em Inglês | MEDLINE | ID: mdl-32796632

RESUMO

Women's health assistance at the low-complexity level is focused on the most common diseases and can be affected by primary health care coverage, particularly in areas far away from large urban centers. Thus, in this work, we aim to analyze the relationship between socioeconomic status, health care indicators, and primary care coverage in mortality from neoplasms of the lower genital tract and breast in Brazilian women during reproductive and non-reproductive periods. We conducted an ecological study at the Gynecology Discipline, Medicine School, University of São Paulo. Secondary data were collected from women according to reproductive periods and mortality data from the Mortality Information System based on International Classification of Disease-10th edition regarding breast and lower genital tract neoplasms in 2017. The health service and socioeconomic indicators were obtained from the Informatics Department of the Unified Health System and Brazilian Institute of Geography and Statistics. Our results showed that primary care coverage and health service indicators were not associated with mortality from breast cancer and the female lower genital tract, both in reproductive and non-reproductive periods. Sociodemographic indicators were found to be associated with mortality from breast cancer and the female lower genital tract, with income being associated with reproductive period (ß = -0.4; 95% CI, -0.8 to -0.03) and educational level in the non-reproductive period (ß = 9.7; 95% CI, 1.5 to 18.0).


Assuntos
Neoplasias da Mama/mortalidade , Neoplasias dos Genitais Femininos/mortalidade , Atenção Primária à Saúde/organização & administração , Brasil/epidemiologia , Feminino , Genitália , Serviços de Saúde , Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Fatores Socioeconômicos
8.
Rev. Assoc. Med. Bras. (1992) ; 66(8): 1062-1069, Aug. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1136331

RESUMO

SUMMARY PURPOSE To analyze the level of knowledge about and the acceptability of the HPV vaccine among vaccinated and unvaccinated adolescents in the Western Amazon. METHODS A cross-sectional study on adolescents aged 10 to 19 years. The instrument used to collect data contains demographic and socioeconomic information and 27 questions that assess the knowledge and acceptability of the HPV vaccine. To compare the prevalence of vaccinated adolescents with the correct answers to questions about HPV and acceptability and vaccination, the robust variance Poisson regression model was used in the Stata 13.0 software. FINDINGS A total of 190 adolescents participated in the study, 60.5% in the age group of vaccination recommended by the Brazilian government, among them, 53.9% reported not having been vaccinated (p <0.001). A total of 150 (78.9%) adolescents correctly recognized HPV as a virus; 121 (63.7%) recognized HPV as a cause of cervical cancer. Participants who know HPV is a causative factor for cervical cancer are 1.94 times more likely to have been vaccinated than those who do not. Among the interviewees, the main sources of knowledge about the vaccine were schools (51.6%) and health professionals (22.6%). CONCLUSION Unvaccinated adolescents have knowledge gaps about HPV and its vaccine when compared to those vaccinated. Our results emphasize the need for effective campaigns to deliver adequate information about HPV and its vaccine to adolescents, their parents, and health professionals.


RESUMO OBJETIVO Analisar o nível de conhecimento e aceitabilidade da vacina contra o HPV entre adolescentes vacinados e não vacinados na Amazônia Ocidental. MÉTODOS Estudo transversal com adolescentes de 10 a 19 anos. O instrumento usado para coletar dados contém informações demográficas e socioeconômicas e 27 perguntas que avaliam o conhecimento e a aceitabilidade da vacina contra o HPV. Para comparar a prevalência de adolescentes vacinados com as respostas corretas para perguntas sobre conhecimento, aceitabilidade e vacinação contra o HPV, o modelo de regressão de Poisson de variância robusta foi utilizado no software Stata 13.0. Resultados: Participaram do estudo 190 adolescentes, 60,5% (n=115) na faixa etária de vacinação recomendada pelo governo brasileiro; dentre eles, 53,9% (n=62) relataram não ter sido vacinados (p<0,001). A proporção de resultados corretos entre os adolescentes foi de 78,9% (n=150), que reconheceram o HPV como vírus; 63,7% (n=121) relataram o HPV como causa de câncer do colo do útero. Os participantes que sabem que o HPV é um fator causal no câncer do colo do útero têm 1,94 (IC 1,18-3,18; p=0,009) vez mais chances de terem sido vacinados do que aqueles que não sabem. Entre os entrevistados, as principais fontes de conhecimento sobre a vacina foram escolas (51,6%) e profissionais de saúde (22,6%). CONCLUSÃO Adolescentes não vacinados apresentam lacunas de conhecimento sobre o HPV e sua vacina quando comparados aos vacinados. Nossos resultados enfatizam a necessidade de campanhas eficazes para fornecer informações adequadas sobre o HPV e sua vacina a adolescentes, pais e profissionais de saúde.

9.
Rev. Assoc. Med. Bras. (1992) ; 66(8): 1036-1042, Aug. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1136348

RESUMO

SUMMARY OBJECTIVE The association between gynecological diagnoses and their distribution across healthcare sectors benefits health promotion and the identification of topics for continued education of gynecological care. This study aimed to identify healthcare diagnoses and referral flow in climacteric women. METHODS This is a cross-sectional study conducted at the Women's Health Clinic of the University Hospital, University of São Paulo, with a reference to gynecology and training for Residents of Family and Community Medicine, between 2017 and 2018. The medical records of 242 women whose sociodemographic and clinical information, gynecological diagnoses, and distribution of healthcare services (primary, secondary, and tertiary) had been processed were collected. Statistical analysis included the chi-square test and odds ratio. RESULTS Smoking (OR = 2.27, 95% CI 1.05-4.89; p = 0.035) was associated with the referral of climacteric women to higher complexity services. Considering the distribution of non-oncological diagnoses in climacteric patients, the chance of women being referred to medium- and high-complexity health services presented a 2-fold increase in cases of breast diseases, a 2.35-fold increase in cases of noninflammatory disorders of the female genital tract, and a 3-fold increase in cases of inflammatory diseases of the pelvic organs. CONCLUSION Climacteric women aged over 55 years, postmenopausal women, and smoking women were most frequently referred to medium- and high-complexity outpatient surgery.


RESUMO INTRODUÇÃO A associação entre diagnósticos ginecológicos e sua distribuição nos setores de saúde proporciona benefícios no campo da promoção de saúde e na identificação de temas para educação continuada na assistência. OBJETIVO Identificar os diagnósticos em saúde e o fluxo de encaminhamento de mulheres no climatério. MÉTODO Trata-se de estudo transversal realizado no Ambulatório de Saúde da Mulher do Hospital Universitário da Universidade de São Paulo, de referência em ginecologia e de treinamento para residentes de Medicina de Família e Comunidade, entre 2017-2018. A casuística foi realizada a partir de 274 prontuários de mulheres atendidas e foram processados informações sociodemográficas e clínicas, diagnósticos ginecológicos e distribuição dos serviços de saúde (primário, secundário e terciário). O teste qui-quadrado e razão de chance foram utilizados para estatística. RESULTADOS O tabagismo (OR=2,27, IC95% 1,05;4,89, p=0,035) foi associado ao encaminhamento de mulheres no climatério para a maior complexidade. Em relação aos tipos de diagnóstico, a chance de serem encaminhadas para a média e alta complexidade foi de 135% (OR=1,69, IC95% 0,93;3,08) nos transtornos não inflamatórios do trato genital feminino, 200% (OR=0,98, IC95% 0,23;4,02) nas doenças da mama, 300% (OR=1,51, IC95% 0,47;4,83) nos transtornos inflamatórios do trato genital feminino, sem predomínio entre os diagnósticos. CONCLUSÃO As mulheres climatéricas e na pós-menopausa acima de 50 anos e tabagistas com diagnósticos de transtornos não inflamatórios do trato genital feminino e inflamatórios, bem como doenças da mama, foram as mais direcionadas para ambulatório cirúrgico na média e alta complexidade.

10.
Expert Rev Clin Pharmacol ; 13(6): 615-622, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32538185

RESUMO

INTRODUCTION: The coronavirus disease (COVID-19) is a global health emergency. Major disruption to healthcare services during the current COVID-19 pandemic will last even after its peak. Sexual and reproductive health (SRH), specially contraception, needs to be understood as an essential service. AREAS COVERED: This paper is a narrative review. Data from PubMed/MEDLINE, Scopus, and websites of scientific societies were screened during the months of April and May 2020. It addresses the main aspects related to contraception during the COVID-19 pandemic, with special emphasis on family planning services, extended use of long-acting reversible contraceptive (LARC) methods, drug interactions, and thromboembolism risk. We also specified some issues focused on the Brazilian reality. EXPERT OPINION: Ensuring proper contraception use in the COVID-19 time is very important. We encourage women, healthcare providers, policymakers, and the society to consider SRH services as priority.


Assuntos
Betacoronavirus , Anticoncepção , Infecções por Coronavirus/epidemiologia , Serviços de Planejamento Familiar , Pneumonia Viral/epidemiologia , Adulto , Infecções por Coronavirus/tratamento farmacológico , Interações Medicamentosas , Feminino , Humanos , Pandemias , Pneumonia Viral/tratamento farmacológico , Saúde Reprodutiva , Saúde Sexual , Tromboembolia Venosa/etiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-32517042

RESUMO

Brazilian law requires that treatment for breast cancer begin within 60 days of diagnosis. This waiting time is an indicator of accessibility to health services. The aim of this study was to analyze which factors are associated with waiting times between diagnosis and treatment of breast cancer in women in Brazil between 1998 and 2012. Information from Brazilian women diagnosed with breast cancer between 1998 and 2012 was collected through the Hospital Registry of Cancer (HRC), developed by the National Cancer Institute (INCA). We performed a secondary data analysis, and found that the majority of women (81.3%) waited for ≤60 days to start treatment after being diagnosed. Those referred by the public health system, aged ≥50 years, of nonwhite race, diagnosed at stage I or II, and with low levels of education waited longer for treatment to start. We observed that only 18.7% experienced a delay in starting treatment, which is a positive reflection of the quality of the care network for the diagnosis and treatment of breast cancer. We also observed inequalities in access to health services related to age, region of residence, stage of the disease, race, and origin of referral to the health service.


Assuntos
Neoplasias da Mama/diagnóstico , Listas de Espera , Brasil/epidemiologia , Neoplasias da Mama/epidemiologia , Feminino , Acesso aos Serviços de Saúde , Humanos , Encaminhamento e Consulta , Sistema de Registros , Fatores Socioeconômicos
12.
Rev Assoc Med Bras (1992) ; 66(3): 353-358, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32520157

RESUMO

OBJECTIVE: Melatonin has anti-inflammatory and antioxidant properties that can influence tissue growth and apoptosis. This aspect may influence the success of organ transplantation. To evaluate the relationship between melatonin and organ transplantation. METHODS: A systematic review was performed in PubMed databases using the search terms: "melatonin physiology" or "melatonin therapy" and "transplant pharmacology" or "transplant physiology" or "transplant therapy" or "Transplant therapy". Experiments on the organs of the reproductive system were not included. After analysis, five articles were selected after reading the title and abstract of 50 manuscripts. The works were divided into two aspects: a) analysis of the influence of the organ transplantation procedure on melatonin production; b) action of melatonin on organ transplantation. RESULTS: The cardiac transplantation surgical procedure, immunosuppression, and graft did not influence melatonin secretion in rodents, but there was a significant reduction of melatonin in the renal transplantation procedure in patients with renal insufficiency. Melatonin administration in experimental models decreased rejection and improved transplant success. CONCLUSION: Studies show that melatonin can reduce organ and species dependence, and the use of melatonin decreases graft rejection.


Assuntos
Antioxidantes/administração & dosagem , Rejeição de Enxerto/prevenção & controle , Melatonina/administração & dosagem , Transplante de Órgãos , Animais , Sobrevivência de Enxerto/efeitos dos fármacos , Transplante de Coração , Humanos , Imunossupressão , Transplante de Rim , Melatonina/fisiologia , Ratos
13.
PLoS One ; 15(3): e0230058, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32191725

RESUMO

OBJECTIVE: To analyze factors associated with knowledge gaps and acquisition about HPV and its vaccine among medical students. METHOD: Cross-sectional and analytical study conducted at the University of São Paulo Medicine School, in 2016. A convenience sample of students completed a data collection instrument containing questions on knowledge about HPV and its vaccine, and vaccine acceptability. The level of knowledge and acceptability established as a "good level" was 80% of correct answers on the questionnaire. Internal validity was calculated with Cronbach's alpha value (α) = 0.74. Bivariate and multiple analyzes were performed using the Stata® program (Stata Corp, College Station, USA) 14.0. RESULTS: To evaluate the internal consistency of the instrument applied, the Cronbach's alpha equation was used, obtaining the alpha value (α) = 0.74 for this population. This value attests that the consistency of the answers obtained with this questionnaire is considered substantial and acceptable. Among the 518 medical students who completed the survey, the majority were men 312 (60.4%) with a mean age of 23 (± 2.8) years old; 199 (38.3%) of the students were in the final years of graduation (5th and 6th years). Students in the first, second and third year of study had a 51% higher risk of a knowledge gap when compared to students in the final years of graduation [PR 1.51 (1.3:1.8); p <0.001]. Men were at 22% higher risk of unsatisfactory knowledge than women are [PR 1.22 (1.07: 1.39). There was no knowledge acquisition during medical school in the following questions (p <0.05), indication of vaccine for individuals with HIV and contraindication in pregnant patients. CONCLUSION: Male medical students, in the first year of medical school, and those who were not vaccinated had significant knowledge gaps about HPV. The novelty of the study includes the finding of non- acquisition of knowledge during the medical school graduation on safety and vaccination schedule and vaccine administration in specific populations.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Aceitação pelo Paciente de Cuidados de Saúde , Estudantes de Medicina/psicologia , Neoplasias do Colo do Útero/prevenção & controle , Vacinação/psicologia , Adulto , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Papillomaviridae/isolamento & purificação , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários , Universidades , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Vacinação/estatística & dados numéricos , Adulto Jovem
14.
Rev. Assoc. Med. Bras. (1992) ; 66(3): 353-358, Mar. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS, Sec. Est. Saúde SP | ID: biblio-1136204

RESUMO

SUMMARY Melatonin has anti-inflammatory and antioxidant properties that can influence tissue growth and apoptosis. This aspect may influence the success of organ transplantation. OBJECTIVE To evaluate the relationship between melatonin and organ transplantation. METHODS A systematic review was performed in PubMed databases using the search terms: "melatonin physiology" or "melatonin therapy" and "transplant pharmacology" or "transplant physiology" or "transplant therapy" or "Transplant therapy". Experiments on the organs of the reproductive system were not included. After analysis, five articles were selected after reading the title and abstract of 50 manuscripts. The works were divided into two aspects: a) analysis of the influence of the organ transplantation procedure on melatonin production; b) action of melatonin on organ transplantation. RESULTS The cardiac transplantation surgical procedure, immunosuppression, and graft did not influence melatonin secretion in rodents, but there was a significant reduction of melatonin in the renal transplantation procedure in patients with renal insufficiency. Melatonin administration in experimental models decreased rejection and improved transplant success. CONCLUSION Studies show that melatonin can reduce organ and species dependence, and the use of melatonin decreases graft rejection.


RESUMO A melatonina tem propriedades anti-inflamatórias e antioxidantes que podem influenciar o crescimento e a apoptose dos tecidos. Esse aspecto pode influenciar o sucesso do transplante de órgãos. OBJETIVO Avaliar a relação entre a melatonina e o transplante de órgãos. MÉTODO A revisão sistemática foi realizada nas bases de dados do PubMed, usando os termos de pesquisa: "fisiologia da melatonina" ou "terapêutica da melatonina" e "farmacologia do transplante" ou "fisiologia do transplante" ou "terapêutica do transplante" ou "terapia do transplante". Não foram incluídos os experimentos sobre os órgãos do sistema reprodutivo. Após análise, cinco artigos foram selecionados após a leitura do título e do resumo de 50 manuscritos. Os trabalhos foram divididos em duas vertentes: a) análise da influência do procedimento de transplante de órgão na produção de melatonina; b) ação da melatonina sobre o transplante de órgãos. RESULTADOS O procedimento cirúrgico do transplante cardíaco, a imunossupressão e o enxerto não influenciaram a secreção de melatonina em roedores, mas houve redução significante da melatonina nos casos do procedimento de transplante renal em pacientes com insuficiência renal. A ministração de melatonina em modelos experimentais diminuiu a rejeição e melhorou o sucesso de transplante. CONCLUSÃO Os estudos mostram que a melatonina pode reduzir a dependência da espécie e do órgão e que o emprego da melatonina diminui a rejeição do órgão.

16.
PLoS One ; 15(1): e0225866, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31940354

RESUMO

Heart Rate Variability (HRV) represents cardiac autonomic behavior and have been related to menopausal symptoms, mainly vasomotor symptoms and their imbalance to cardiovascular risk. It is not clear in the literature which index represents this imbalance and what is their involvement with the menopausal state. The aim of this study was to evaluate HRV in menopausal transition and post-menopausal symptoms with different intensities. This cross-sectional study was conducted in Rio Branco, State of Acre, Brazil from October 2016 to July 2017. We used Kupperman-Blatt Menopausal Index (KMI) to measure menopausal symptoms intensity. HRV analysis was performed based on the guidelines of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. HRV is lower in the group with moderate/intense menopausal symptoms compared to mild symptoms. (RMSSD: p = 0.005, Cohen's d = 0.53, pNN50: p = 0.0004, Cohen's d = 0.68; HF: p = 0.024, Cohen's d = 0.44). There was association between HRV and KMI (RMSSD: r = -1.248, p = 0.004; and pNN50: r = -0.615, p: 0.029) in inverse relation to the intensity of vasomotor symptoms in women in TM. In conclusion, HRV was able to distinguish menopausal symptoms, indicating reduced vagal control in women with more intense symptoms.


Assuntos
Frequência Cardíaca , Menopausa/fisiologia , Idoso , Feminino , Humanos , Pós-Menopausa/fisiologia , Estudos Prospectivos
17.
Clinics (Sao Paulo) ; 74: e1166, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596339

RESUMO

OBJECTIVE: To evaluate the knowledge and acceptability of the human papillomavirus (HPV) vaccine among health professionals from western Amazonia. METHODS: A cross-sectional study was conducted in the Sistema Assistencial è Saúde da Mulher e da Criança (Health Care System for Women and Children; SASMC) in Acre, Brazil, in 2017. The participants comprised 196 health professionals. The data collection instrument contained 31 questions about HPV, its clinical repercussions for women, and the HPV vaccine. Quantitative variables were presented as medians and 95% confidence intervals (CIs), and p<0.05 was considered statistically significant. For the analyses, chi-square tests and Mann-Whitney tests were used. The collected data were analyzed using Stata®11.0. RESULTS: Of the 196 health professionals, 39.8% (n=76) were physicians and 61.2% (n=120) were other health professionals. The interviewees were mostly female (n=143, 73%, 95% CI 66.1 to 78.9%) who worked in the medical field (n=81, 41.3%, 95% CI 34.4 to 48.6%), and the median age was 38 years (95% CI 36.0 to 39.7). Physicians had increased knowledge regarding only the statement "cervical cancer is one of the main causes of cancer in women", with a proportion ratio of 0.88 (0.80; 0.97) and p<0.001. Regarding clinical knowledge of the HPV vaccine, a low proportion of correct answers was obtained for all the questions, and no significant differences were found between the groups. CONCLUSION: Acceptability and knowledge of HPV and its vaccine were similar among health professionals, with knowledge gaps in questions about the relation between smoking and cervical cancer and specific clinical knowledge.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/estatística & dados numéricos , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus , Adulto , Brasil , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino
18.
Int. j. cardiovasc. sci. (Impr.) ; 32(5): 546-550, Sept-Oct. 2019. ilus
Artigo em Inglês | LILACS | ID: biblio-1040097

RESUMO

We present a case of a female adolescent with severe acute Chagas myocarditis, acquired by oral transmission in an endemic area in the Brazilian western Amazon, who had electrocardiographic changes normalized after empirical treatment with the antiparasitic drug benznidazole combined with conventional treatment for severe heart failure


Assuntos
Humanos , Feminino , Criança , Cardiomiopatia Chagásica , Doença de Chagas/epidemiologia , Eletrocardiografia/métodos , Volume Sistólico , Trypanosoma cruzi , Ecocardiografia/métodos , Insuficiência Cardíaca , Antiparasitários/uso terapêutico
19.
Rev Assoc Med Bras (1992) ; 65(5): 699-705, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31166448

RESUMO

Breast Cancer is common in women, but its etiology is not yet fully understood. Several factors may contribute to its genesis, such as genetics, lifestyle, and the environment. Melatonin may be involved in the process of breast cancer. Therefore, the aim of this study is to evaluate the influence of the levels of melatonin on breast cancer through a systematic review and meta-analysis. We performed a systematic review according to PRISMA recommendations. The primary databases MEDLINE, Embase, and Cochrane were consulted. There was no restriction on the year of publication and language. Data of systematic reviews from April 2017 to September to 2017 were analyzed. The meta-analysis was conducted using RevMan 5.3 software provided by the Cochrane Collaboration. From a total of 570 articles, 9 manuscripts were included in this review. They analy onzed women with breast cancer and control patients, of which 10% and 90% were in the reproductive period and after menopause, respectively. The lowest level of melatonin was found in approximately 55% of studies with breast cancer in post-menopause. The metanalyses of the studies demonstrated low levels of melatonin in breast cancer patients (n=963) compared with control patients (n= 1332), with a mean difference between the studies of -3.54 (CI -6.01, -1.06). Another difference found was in the comparison between smoking patients, with an average difference between 1.80 [0.97-2.63]. Our data suggest that low levels of melatonin might be a risk factor for breast cancer.


Assuntos
Neoplasias da Mama/sangue , Neoplasias da Mama/urina , Melatonina/sangue , Melatonina/urina , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/urina , Neoplasias da Mama/etiologia , Feminino , Humanos , Valores de Referência , Fatores de Risco
20.
Sci Rep ; 9(1): 7162, 2019 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-31073127

RESUMO

This cross-sectional study utilized the National School Health Survey 2015 database to assess the association between school cafeterias; the meals offered by the Brazilian School Food Program (PNAE); and the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks among Brazilian adolescents. A sample of 102,072 adolescents, aged 11-19 years, who were enrolled in the 9th grade completed the survey. The evaluated outcome was the consumption of industrialized/ultra-processed salty foods, sweets, and soft drinks. A Poisson regression model-based multivariate analysis was performed. The effect measure was the prevalence ratio (PR) with its respective 95% confidence intervals (CIs). The results indicated that Brazilian adolescents who attended schools without meals offered through the PNAE had a higher probability of regularly (≥5 times/week) consuming ultra-processed salty foods [PR = 1.06, CI = 1.01-1.11] and soft drinks [PR = 1.08, CI = 1.03-1.14] compared to those who attended schools that offered PNAE meals. Moreover, the presence of a school cafeteria was associated with a higher probability to consume industrialized/ultra-processed salty foods [PR = 1.05, CI = 1.02-1.08], sweets [PR = 1.09, CI = 1.07-1.11], and soft drinks [PR = 1.10, CI = 1.07-1.13]. School meals appear to be associated with the consumption of ultra-processed foods by Brazilian adolescents, indicating areas for health promotion programs.


Assuntos
Comportamento Alimentar , Refeições , Adolescente , Brasil , Bebidas Gaseificadas/estatística & dados numéricos , Estudos Transversais , Bases de Dados Factuais , Fast Foods/estatística & dados numéricos , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Instituições Acadêmicas , Adulto Jovem
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