Attributable patient risk in nuclear medicine procedures and establishment of diagnostic reference levels.

The assessment of risk related to medical exposures as a justification tool to assist decision-making of the medical team is not available in clinical routine. The determination of diagnostic reference levels (DRLs) for nuclear medicine (NM) procedures has been proposed as an optimization tool, but this tool has still been aimed at a standard adult individual. It is known that the activity administered, and the consequent absorbed doses in critical organs, represents the risk of a procedure being cancer induction the greatest concern, especially for young patients. Thus, the adjustment of administered activity and procedure risk to promote risk-benefit assessment is a promising tool for routine clinical use. This work aims to present a tool for determining DRLs in the administered activity related to the patient's characteristics-age group, sex, and body mass index (BMI), in order to assist the medical decision regarding the risk-benefit ratio. Thus, it is possible to assess the risk of carcinogenesis in groups of patients, considering absorbed doses in organs, cancer incidence, and mortality rates in our country. NIREA is an IT tool developed in PHP language for web environment as a friendly software. It allows the establishment of DRL and risk of cancer induced by radiation assessment through the estimation of absorbed doses in specific organs and based on the risk methodology of BEIR VII. The absorbed and effective doses were estimated based on the dose conversion factors of the radiopharmaceuticals published by the International Commission on Radiological Protection adjusted for the patient groups. Based on data from 2256 patients who underwent diagnostic procedures at National Cancer Institute between 2017 and 2019, the program was used, resulting in important information for conducting the clinical routine extracted as DRL, absorbed doses, and risk assessments, considering patient-specific data such as age, sex, and BMI. The methodology developed in this work allows NM services to keep their data available and updated regarding local DRLs, in addition to allowing the nuclear physician to know the risk of each procedure performed, extracted by individual characteristics of the patient. The affirmative is significant because the data could be used by the regulatory body of practices with ionizing radiation in Brazil to establish a reference level in Activity that has not yet existed in the country.

A systematic review and meta-analysis on cognitive frailty in community-dwelling older adults: risk and associated factors.

OBJECTIVES: To identify which factors are associated with cognitive frailty (CF), as well as the impact of CF on the incidence of dementia and mortality. METHODS: A systematic review with meta-analysis was carried out using papers that enrolled a total of 75,379 participants and were published up to January 2020. RESULTS: Of the 558 identified records, 28 studies met the inclusion criteria and were included in the review. The meta-analysis of cross-sectional studies showed that CF has a significant association of having an older age and a history of falls. In longitudinal studies, the analysis showed a significant increase in risk of mortality and dementia for those with CF. DISCUSSION: This is the first systematic review and meta-analysis on CF, which addressed a wide variety of factors associated with the theme and which pointed out some as a potential target for prevention or management with different interventions or treatments, showing the clinical importance of its identification in the most vulnerable and susceptible groups.

Effect of perioperative hypothermia on surgical site infection in abdominal surgery: A prospective cohort study.

AIM: To estimate the incidence rates of surgical site infection and identify the independent effect of perioperative hypothermia on the incidence of this type of infection in patients undergoing abdominal surgery. BACKGROUND: Around the world, surgical site infection is a frequent complication in surgical patients, mainly causing increased morbidity and mortality rates and health service costs. DESIGN: A prospective cohort study. METHODS: The 484 patients were recruited from a large private philanthropic hospital in the state of São Paulo, Brazil, from July 2016 to May 2017. Crude and adjusted models were constructed for the hypothermia indicators to assess the effect of this exposure on surgical site infection. RESULTS: The incidence rate of surgical site infection was 20.25% (n = 98). The attributable fraction to exposed to hypothermia was >40%. A greater probability of developing surgical site infection (relative risk = 1.89) was found for patients who experienced body temperatures <36.0°C (from entry time into the operating room until the end of the surgery) for more than five hypothermic episodes or longer than 75 min. CONCLUSION: Perioperative hypothermia was an independent risk factor for surgical site infection. SUMMARY STATEMENT: What is already known about this topic? Around the world, surgical site infection is a complication that leads to damage to the patient and increased costs for the health services. Despite recent advances in surgical techniques, surgical site infection remains one of the most frequent complications in abdominal surgery. Perioperative hypothermia can increase the incidence rates of surgical site infection. There is evidence that perioperative hypothermia is associated with surgical site infection in abdominal surgery, but most studies were conducted in developed countries using retrospective designs. What this paper adds? Perioperative hypothermia was identified as an independent risk factor for surgical site infection in patients undergoing abdominal surgery. The attributable fraction to the exposed indicated that, if the main exposure of interest (perioperative hypothermia) could be prevented during surgical anaesthetic procedures, more than 40% of surgical site infection cases would be avoided. The classification of the American Society of Anaesthesiologists was independently associated with the surgical site infection and presented a dose-response effect among its categories. Spinal anaesthesia served as an independent protective factor for surgical site infection. The implications of this paper: The health service managers need to be aware of potential cost-savings associated with perioperative hypothermia prevention as a measure to reduce the incidence of surgical site infection. During the perioperative period, health professionals need to implement effective measures to maintain patients' normothermia, promoting improved care and surgical patient safety. In this context, the nurse's role is fundamental. Future research projects using a prospective design and developed to address the reality of developing countries can contribute to the strengthening and consistency of the findings with a view to a global understanding of the surgical site infection problem.

Oil well drill cuttings and sunflower cake: effects on sunflower crop and soil chemical attributes.

Onshore oil well drill cuttings and sunflower cake from biodiesel production require an appropriate destination to reduce the risks of environmental contamination. The aim of this study was to evaluate the potential use of the combination of different doses of these wastes on the growth of sunflower plants (Helianthus annus L.) and on soil chemical attributes after cultivation, making it possible to recommend safe application doses. Sunflower plants, cultivar Neon, were cultivated in a greenhouse for 80 days in Planossolo Háplico (Ultisol) as the main substrate. The design used was completely randomized, in a 6 × 6 factorial arrangement, composed of five doses of sunflower cake (2, 4, 8, 16 and 32 Mg ha-1) and five doses of drill cuttings (5, 15, 30, 45 and 60 Mg ha-1) and an experimental control using only Ultisol After cultivation, soil chemical attributes and the parameters height (H), stem diameter (D), and dry mass (DMAP) and nutrient contents in the aerial part of the plants were analyzed. Sunflower cake dose of 32 Mg ha-1 limited the germination of sunflower plants. In sunflower plants, the highest contents of calcium (Ca), magnesium (Mg), phosphorus (P) and potassium (K) were verified when the sunflower cake doses were associated with drill cuttings doses >45 Mg ha-1. The mixture between sunflower cake and drill cuttings in the proportion of 16:45 Mg ha-1, respectively, promoted higher H, D and DMAP of sunflower plants, as well as a considerable improvement in soil fertility, without causing significant increments in sodium content in the soil after cultivation.HighlightsInadequate disposal of agro-industrial wastes represents loss of raw material and energy.Drill cuttings and sunflower cake wastes enable improvements in soil fertility attributes.The combination of sunflower cake and drill cuttings contributed to sunflower growth and nutrient contents.The mixture of drill cuttings and sunflower cake has potential for use as agricultural input.

Effect of perioperative hyperglycemia on surgical site infection in abdominal surgery: A prospective cohort study.

BACKGROUND: Surgical site infection (SSI) remains one of the most frequent complications in abdominal surgery, and hyperglycemia prevention is recommended as a measure to reduce this type of infection. The aims of this study were to estimate the incidence of SSI and to identify the effect of perioperative hyperglycemia on the incidence of this type of infection in patients undergoing abdominal surgery. METHODS: We enrolled 484 abdominal surgery patients ≥ 18 years of age, recruited between July 2016 and May 2017. Data were collected through structured interviews and patient assessments in the perioperative period and at the surgical outpatient clinic (30th day after surgery). Crude and adjusted models were built to identify the effect of hyperglycemia on SSI. RESULTS: The incidence rate of SSI was 20.25%. The attributable fraction for patients exposed to hyperglycemia was >60%. In the multivariable analysis, patients with hyperglycemia, at the end of the surgery and 12 hours later, were more likely to develop this type of infection (relative risk = 1.89 and 2.17, respectively). CONCLUSIONS: Perioperative hyperglycemia was identified as an independent risk factor for SSI. The evidence generated reinforces the importance of proper glycemic control management in the perioperative period for the prevention of SSI.

Evaluation of the quality of life after vertebroplasty to treat compressive osteoporotic fractures.

OBJECTIVE: with increasing life expectancy around the world, fractures due to osteoporosis have become more common and the expenditure for treating them has also increased. The aim here was to evaluate the improvement in pain and quality of life among patients with compressive osteoporotic vertebral fractures undergoing vertebroplasty. METHODS: eighteen patients with 27 fractured vertebrae underwent vertebroplasty and were evaluated using the Oswestry 2.0 limitations questionnaire before the operation and 24 h and six months after the operation. RESULTS: there was a 75% improvement in pain and quality of life, going from a mean preoperative Oswestry of 40% to 10% 24 h after the operation and 9% six months after the operation (p ≤ 0.05). CONCLUSION: vertebroplasty is effective in managing compressive osteoporotic vertebral fractures, with improvement in pain and quality of life in the immediate postoperative period and over the medium term.

OBJETIVO: com o aumento da expectativa de vida no mundo, as fraturas por osteoporose se tornaram mais frequentes e aumentaram também os gastos no tratamento. Avaliar a melhoria na dor e na qualidade de vida de pacientes com fraturas vertebrais osteoporóticas compressivas submetidos a vertebroplastia. MÉTODOS: foram submetidos à vertebroplastia 18 pacientes com 27 vértebras fraturadas e avaliados pelo questionário de limitações de Oswestry 2.0 de forma pré-operatória, 24 horas e seis meses no pós-operatório. RESULTADOS: melhoria de 75% da dor e na qualidade de vida, com Oswestry médio pré-operatório de 40%, em 24 horas de 10% e após seis meses da cirurgia, de 9%. (p ≤ 0,05). CONCLUSÃO: s vertebroplastia é efetiva no manejo das fraturas vertebrais osteoporóticas por compressão e melhora a dor e a qualidade de vida dos pacientes no pós-operatório imediato e médio prazo.

Fatores de risco de infecção da ferida operatória em neurocirurgia / Risk factors for surgical site infection in neurosurgery

Objetivo Analisar os fatores de risco de infecção da ferida operatória em neurocirurgia. Métodos Estudo transversal, prospectivo, conduzido em hospital de nível terciário com 85 neurocirurgias eletivas e limpas, tendo como desfecho a infecção até 30 dias após o procedimento cirúrgico. Resultados A ocorrência de infecção de sítio cirúrgico foi de 9,4% (n=8). Na análise bivariada observou-se que os fatores de risco: tempo total de internação, Índice de Massa Corporal, porte cirúrgico e transfusão sanguínea foram associados com a presença de infecção. Após ajuste no modelo de regressão logística binária, apenas o tempo total de internação mostrou relação estatisticamente significativa com a presença de infecção. Conclusão A ocorrência de infecção de sítio cirúrgico em neurocirurgia na instituição estudada foi maior do que o preconizado na literatura científica. Os resultados apontaram que o acompanhamento ambulatorial do paciente cirúrgico após a alta hospitalar pode reduzir a subnotificação dos casos de infecção...

Objective To analyze risk factors for surgery site infection in neurosurgery. Methods A prospective cross-sectional study conducted in a tertiary hospital analyzing 85 elective and clean neurosurgeries with an outcome of infection within 30 days after surgery. Results Surgical site infection occurred in 9.4% (n=8) of cases. Bivariate analysis revealed that the following risk factors were associated with the presence of infection: total length of hospital stay, Body Mass Index, surgical size and blood transfusion. After running binary logistic regression adjustments, only the total length of hospital stay was significantly related to the presence of infection. Conclusion The occurrence of surgical site infection in neurosurgery in the studied institution was higher than recommended by the scientific literature. The results show that outpatient follow up of patients who undergo surgery after hospital discharge may reduce the underreporting of infection cases...

Evaluation of the quality of life after vertebroplasty to treat compressive osteoporotic fractures

Objective: with increasing life expectancy around the world, fractures due to osteoporosis have become more common and the expenditure for treating them has also increased. The aim here was to evaluate the improvement in pain and quality of life among patients with compressive osteoporotic vertebral fractures undergoing vertebroplasty. Methods: eighteen patients with 27 fractured vertebrae underwent vertebroplasty and were evaluated using the Oswestry 2.0 limitations questionnaire before the operation and 24 h and six months after the operation. Results: there was a 75% improvement in pain and quality of life, going from a mean preoperative Oswestry of 40% to 10% 24 h after the operation and 9% six months after the operation (p ≤ 0.05). Conclusion: vertebroplasty is effective in managing compressive osteoporotic vertebral fractures, with improvement in pain and quality of life in the immediate postoperative period and over the medium term...

Objetivo: Com o aumento da expectativa de vida no mundo, as fraturas por osteoporose se tornaram mais frequentes e aumentaram também os gastos no tratamento. Avaliar a melhora da dor e da qualidade de vida de pacientes com fraturas vertebrais osteoporóticas compressivas submetidos a vertebroplastia. Métodos: Foram submetidos à vertebroplastia 18 pacientes com 27 vértebras fraturadas e avaliados pelo questionário de limitações de Oswestry 2.0 de forma pré-operatória, 24 horas e seis meses no pós-operatório. Resultados: Melhora de 75% da dor e da qualidade de vida, com Oswestry médio pré-operatório de 40%, em 24 horas de 10% e após seis meses da cirurgia, de 9%. (p ≤ 0,05). Conclusão: A vertebroplastia é efetiva no manejo das fraturas vertebrais osteoporóticas por compressão e melhora da dor e da qualidade de vida dos pacientes no pós-operatório imediato e médio prazo...

Ocorrência e fatores de risco para infecção de sítio cirúrgico em cirurgias ortopédicas / Occurrence and risk factors for surgical site infection in orthopedic surgery

OBJETIVO: Analisar a ocorrência e os fatores de risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias ortopédicas. MÉTODOS: Estudo transversal prospectivo com 93 pacientes submetidos a cirurgias ortopédicas eletivas e limpas. RESULTADOS: A infecção de sítio cirúrgico foi diagnosticada em 16 pacientes (17,2%). Na análise dos dados, após ajuste do modelo de regressão logística binária, apenas a variável tempo total de internação mostrou-se com relação estatisticamente significativa com a presença ou não de infecção. CONCLUSÃO: A ocorrência de infecção de sítio cirúrgico em cirurgia ortopédica foi mais elevada, sendo 75% dos casos diagnosticados após a alta hospitalar, resultado que reforça a necessidade da vigilância pós-alta.

OBJECTIVE: To analyze the occurrence and risk factors for surgical site infection in patients undergoing orthopedic surgery. METHODS: A prospective cross-sectional study with 93 patients undergoing elective and clean orthopedic surgery. RESULTS: The surgical site infection was diagnosed in 16 patients (17.2%). In data analysis, after adjusting the binary logistic regression model, only the variable total time of hospitalization was statistically significant with respect to the presence or absence of infection. CONCLUSION: The occurrence of surgical site infection in orthopedic surgery was higher, with 75% of cases diagnosed after hospital discharge, this result reinforces the need for post-discharge surveillance.

Controle glicêmico no perioperatório: evidências para a prevenção de infecção de sítio cirúrgico / Blood glucose control in the perioperative period: evidence for preventing surgical site infections / Control glucémico en el perioperatorio: evidencias para la prevención de infección del sitio quirúrgico

O presente estudo teve como objetivo analisar as evidências disponíveis na literatura sobre o controle glicêmico para a prevenção de infecção de sítio cirúrgico no perioperatório. A revisão integrativa da literatura foi o método de revisão adotado. Para a busca dos estudos primários, as seguintes bases de dados foram selecionadas: Medline, CINAHL, EMBASE e LILACS. Dos 26 estudos primários incluídos na revisão, 12 foram conduzidos com amostra de pacientes com diabetes e 14 pesquisas realizadas com pacientes com e sem diabetes. Os resultados evidenciaram redução na taxa de infecção de sítio cirúrgico, mortalidade e tempo de internação hospitalar quando realizado o controle glicêmico. Entretanto, devido aos diferentes delineamentos de pesquisa dos estudos incluídos, amostra investigada, tipo de cirurgia, parâmetros e métodos para o controle glicêmico, conclui-se que ainda não há evidências suficientes para delimitar o melhor nível de glicose alvo e o regime ideal para o controle glicêmico no perioperatório.

The objective of the present study was to analyze the evidence available in literature regarding blood glucose control to prevent surgical site infection in the perioperative period. The integrative literature review was the chosen review method. The primary studies were searched on the following databases: Medline, CINAHL, EMBASE and LILACS. Of the 26 primary studies included in the review, 12 were conduced with diabetes patients and 14 were performed with patients with and without diabetes; results showed a reduction in surgical site infection rates, mortality, and length of stay, when blood glucose is practiced. Nevertheless, due to the different outlines of the studied included, the investigated sample, type of surgery, blood glucose control parameters and methods, it is concluded that evidence is still insufficient to delimit the best level of target blood glucose and the ideal diet for blood glucose in the perioperative period.

Se objetivó analizar las evidencias disponibles en la literatura sobre control glucémico para prevención de infección del sitio quirúrgico en el perioperatorio. Se adoptó el método de revisión integrativa de literatura. Para localización de los estudios primarios, se seleccionaron las siguientes bases de datos: Medline, CINAHL, EMBASE y LILACS, De los 26 estudios primarios incluidos en la revisión, 12 fueron realizados con muestra de pacientes diabéticos y 14 con pacientes con y sin diabetes; los resultados expresaron reducción en la tasa de infección del sitio quirúrgico, mortalidad y tiempo de internación hospitalaria, cuando se realizó control glucémico. Mientras tanto, en razón de diferencias en el diseño de los estudios incluidos, muestra investigada, tipo de cirugía, parámetros y métodos de control glucémico, se concluye que aún no existen evidencias suficientes como para delimitar el mejor nivel de glucosa-blanco y el régimen ideal para el control glucémico en el perioperatorio.

Efeito da hipotermia sobre a incidência de infeção de sítio cirúrgico em cirurgias abdominais: estudo de coorte / Effect of hypothermia on the incidence of surgical site infection in abdominal surgeries: a cohort study

A infecção de sítio cirúrgico (ISC) é uma complicação frequente que pode acometer o paciente submetido ao procedimento anestésico cirúrgico, acarretando o aumento da morbidade, mortalidade e dos custos hospitalares, bem como do sofrimento emocional e físico do paciente. Este estudo teve como objetivos estimar a incidência de ISC em pacientes submetidos à cirurgia abdominal, identificar as taxas de ISC segundo fatores relacionados ao paciente, ao procedimento anestésico cirúrgico e ao ambiente da sala cirúrgica, identificar os fatores de risco e de proteção, e identificar o efeito independente da hipotermia sobre a incidência de ISC. Para o alcance dos objetivos propostos, conduziu-se estudo de coorte com 484 pacientes submetidos à cirurgia abdominal. Para a coleta de dados elaborou-se instrumento, submetido à validação aparente e de conteúdo por cinco juízes. A coleta de dados foi realizada na unidade de internação ou na sala de recepção do centro cirúrgico, no período intraoperatório, no período de internação e reinternação, e no retorno no 30° dia após a cirurgia. A hipotermia foi avaliada a partir de três mensurações distintas, a saber: 1 - temperatura Delta; 2 - número de vezes em que a temperatura do paciente foi <36,0°C; 3 - tempo de exposição, em minutos, em que o paciente esteve submetido a temperaturas <36,0°C. A incidência bruta de ISC foi de 20,25% (98 casos). A incidência de ISC apresentou maior magnitude nos participantes do sexo feminino (22,43%), nos pacientes na faixa etária de 60 anos e mais (27,22%), e com obesidade classe II (25,71%). As médias de duração da anestesia e da cirurgia foram maiores no grupo com ISC, a incidência de ISC apresentou maior magnitude naqueles pacientes submetidos a cirurgias de porte III (85,71%) e anestesia combinada (41,10%). A incidência de ISC apresentou maior magnitude naquele participante que no final da cirurgia estava exposto à temperatura da sala de operação < 20°C (33,33%), e naqueles expostos à umidade do ar entre 45-55 kg/m3 (22,18%). Na mensuração 1 (modelo final), a hipotermia não apresentou relação causal com a ISC, e as variáveis classificação ASA, porte cirúrgico e tipo de anestesia permaneceram independentemente associadas à ISC. Na mensuração 2 (modelo final), identificou-se o efeito causal independente da hipotermia sobre a ISC, os pacientes que estiveram submetidos mais de cinco vezes a temperaturas <36,0°C apresentaram maior probabilidade (89%; RR=1,89) de desenvolverem ISC, as variáveis classificação ASA e tipo de anestesia mantiveram-se independentemente associadas à ISC. Na mensuração 3 (modelo final), também identificou-se o efeito causal independente da hipotermia sobre a ISC, os pacientes que estiveram submetidos a mais de 75 minutos a temperaturas <36,0°C apresentaram maior probabilidade (89%; RR=1,89) de desenvolverem ISC, as variáveis classificação ASA e tipo de anestesia permaneceram independentemente associadas à ISC. A raquianestesia foi fator de proteção independente para ISC, nos três modelos finais. Os resultados evidenciados poderão subsidiar a tomada de decisão dos profissionais de saúde na implementação de ações direcionadas para a prevenção e controle de ISC, com ênfase em medidas para a prevenção da hipotermia perioperatória

Surgical site infection (SSI) is a frequent complication that can affect the patient undergoing surgical anesthetic procedure, leading to increased morbidity, mortality and hospital costs, as well as emotional and physical suffering of the patient. This study aimed to estimate the incidence of SSI in patients undergoing abdominal surgery; to identify SSI rates according to factors related to the patient, to the surgical anesthetic procedure and to the operating room environment; to identify risk and protective factors; and to identify the independent effect of hypothermia on the incidence of SSI. To reach the proposed objectives, a cohort study was conducted with 484 patients undergoing abdominal surgery. An instrument was developed for data collection, and submitted to face and content validation by five judges. Data collection was performed in the inpatient care unit or in the surgical center reception room, during the intraoperative period, the hospitalization and readmission period, and on the 30th postoperative day. Hypothermia was evaluated from three different measurements: 1) delta temperature; 2) number of times the patient temperature was <36.0°C; 3) exposure time, in minutes, in which the patient was submitted to temperatures <36.0°C. The crude incidence of SSI was 20.25% (98 cases). The incidence of SSI presented higher magnitude in female participants (22.43%), in patients aged 60 years and over (27.22%), and with class II obesity (25.71%). The mean duration of anesthesia and surgery were higher in the SSI group, the SSI incidence was higher in patients undergoing surgery III (85.71%) and combined anesthesia (41.10%). The incidence of SSI presented higher magnitude in participants who were exposed, in the end of surgery, to temperature <20°C (33.33%) at the operating room; and in those exposed to air humidity between 45-55 kg/m3 (22, 18%). In the measurement 1 (final model), hypothermia did not present a causal relationship with SSI, and the variables ASA classification, surgical size and type of anesthesia remained independently associated with SSI. In the measurement 2 (final model), the independent causal effect of hypothermia on SSI was identified; patients who were submitted more than five times to temperatures <36.0°C were more likely (89%; RR=1.89) to develop SSI, the variables ASA classification and type of anesthesia remained independently associated with SSI. In the measurement 3 (final model), the independent causal effect of hypothermia on SSI was also identified; patients who were submitted to more than 75 minutes to temperatures <36.0°C were more likely (89%; RR = 1.89) to develop SSI, the variables ASA classification and type of anesthesia remained independently associated with SSI. Spinal anesthesia was an independent protective factor for SSI in the three final models. The found results may support the decision-making of health professionals in the implementation of actions directed to the prevention and control of SSI, with emphasis on measures for the prevention of perioperative hypothermia

Acne vulgar e bem-estar em acadêmicos de medicina / Acne vulgaris and well-being in medical students

FUNDAMENTOS - Observa-se comorbidade psiquiátrica em 40% dos pacientes dermatológicos adultos, sendo a acne vulgar de interesse da psicodermatologia por ter entre suas complicações seqüelas psicossociais. OBJETIVOS - Estabelecer a relação entre acne e o status de bem-estar. MÉTODOS - Estudo de caso-controle com dados coletados a partir do Índice de Bem-Estar da Organização Mundial da Saúde, por meio de entrevistas com dois grupos de 50 acadêmicos de medicina, sendo um com acne e outro sem acne. RESULTADOS - Foi verificado que 26% dos acadêmicos do grupo de casos e 24% do grupo controle apresentaram de 0 a 4 pontos em pelo menos um dos itens questionados. CONCLUSÕES - Apesar de a maioria dos pacientes apresentar atitudes e sentimentos desencadeados pela acne, não se demonstrou associação estatisticamente significativa entre essa dermatose e baixo nível de bem-estar.

BACKGROUND - Psychiatric comorbidity is observed in 40% of adult dermatological patients. Acne vulgaris, in particular, is in the interest of psychodermatology because of its psychological and social stigmas. OBJECTIVE - To establish the relation between acne and the state of well-being. METHODS - This consisted of a case-control study with data collected from the World Health Organization Well-being Index, through interviews with two groups of 50 medical students, one with and other without acne. RESULTS - It was verified that 26% of the students from the case group and 24% from the control group presented from 0 to 4 points in at least one item. CONCLUSIONS - Although the majority of the patients presented attitudes and feelings related to acne, a statistically significant association between this dermatosis and low level of well-being was not demonstrated.

IdeiaSUS: saberes e práticas nos territórios do sistema único de saúde

Nesta obra é apresentada a Plataforma Colaborativa do SUS, para além de um banco de práticas. Nesse contexto, são apresentadas seis práticas premiadas na Mostra Nacional 'Aqui Tem SUS', promovida durante o Congresso do Conasems de 2018, e na Mostra Estadual IdeiaSUS e o Conselho de Secretarias Municipais de Saúde do Estado do Rio de Janeiro (Cosems RJ) de 2019, que foram acompanhadas nos últimos meses pela equipe do IdeiaSUS e parceiros. Destaca-se, também, outras ações das quais lança-se mão nesses sete anos, a exemplo da realização das Rodas de Práticas e da Curadoria em Saúde. A primeira trata de encontros para o compartilhamento e a problematização das diversas práticas que fazem parte da Plataforma IdeiaSUS. A segunda estratégia implica a sistematização de experiências por meio de uma metodologia participativa que permite a reflexão e a ressignificação das práticas de saúde. Traz para o leitor, à luz ainda da reflexão dos vários atores envolvidos nessa construção, a ideia de que o compartilhamento é essencial ao SUS, significa apoiar e fortalecer o trabalho de gestores, profissionais, líderes comunitários, estudantes, pesquisadores e usuários da saúde pública brasileira. Afinal, o papel estratégico da Plataforma Colaborativa IdeiaSUS é dar visibilidade às práticas de saúde que surgem nos vários territórios do nosso país, por meio do convite à gestão do conhecimento que emana dessas produções, oportunizando, por sua vez, desdobramentos em ações de sistematização, curadorias, educação a distância, pesquisa-ação de base territorial, projetos de pesquisa e inovação tecnológica. Busca-se aqui fortalecer o Sistema Único de Saúde, patrimônio do povo brasileiro.