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Paroxysmal nocturnal haemoglobinuria (PNH) is a rare, complement-associated, haematological disorder. The level of knowledge about the disease and its management varies around the world. This narrative review provides an overview of available clinical data on PNH in Latin America (LATAM). A search of the PubMed, EMBASE and LILACS/IBECS databases to February 2023, and addition of author-known articles, yielded 24 relevant published articles, the majority (n = 15) from Brazil. Fourteen articles were full papers; 10 were conference abstracts. The prevalence of PNH in Brazil is estimated at 1:237,000 inhabitants. Among blood samples sent for flow cytometry screening for suspected PNH in Brazil and Colombia, 14 - 30% were positive. There is suggestion that disease subtypes may differ among LATAM populations, with classical PNH more common in Brazilian patients and PNH with aplastic anaemia more common in Mexican patients. Median age at diagnosis of PNH ranged from 24 to 41 years. Common symptoms included fatigue, haemoglobinuria, and abdominal pain, although the symptom profile varied by subtype. Three available studies indicated that eculizumab was effective at reducing haemolysis, improving anaemia, and reducing the risk of thrombosis in patients with PNH with intravascular haemolysis. A consensus document from the Brazilian Association of Hematology, Hemotherapy and Cell Therapy RBC and Iron Committee provides guidance on identifying and managing PNH patients, including appropriate selection of patients for eculizumab. Additional data on the epidemiology, natural history and outcomes of patients with PNH in LATAM countries are needed to better understand the disease and its management throughout the region.
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Las fisuras labio-máxilo-palatinas (FLMP) son malformaciones congénitas que requieren de un manejo quirúrgico complejo para devolver un correcto funcionamiento del sistema estomatognático. Sin embargo, aún no existe un consenso sobre qué modalidad quirúrgica representa los mejores resultados y sus efectos a largo plazo en el desarrollo esqueletal y funcional de los individuos. El objetivo de este trabajo fue describir mediante la información científica disponible; el efecto de los diferentes protocolos quirúrgicos para el cierre de la FLMP sobre el crecimiento y desarrollo esqueletal de los pacientes. Se realizó una búsqueda de la literatura en bases de datos Pubmed, Cochrane y Epistemonikos, contemplando estudios desde el año 2013 hasta la actualidad. Se obtuvieron un total de 999 estudios encontrados. Una vez aplicados los criterios de inclusión y exclusión, se seleccionaron 13 estudios. El tratamiento quirúrgico de las FLMP consiste en procedimientos complejos que implican alteraciones en el desarrollo esqueletal de los individuos intervenidos a largo plazo. Las discrepancias en el desarrollo esqueletal de los pacientes empiezan a detectarse durante la dentición mixta. Es recomendable extender el seguimiento hasta la etapa de la pubertad y adultez, ya que podría demostrar diferencias significativas entre las diferentes cronologías quirúrgicas empleadas.
Cleft Lip and Palate (CLP) belong to a group of congenital anomalies that require complex surgical management, in order to restore the normal function of the stomatognathic system. However, there is no consensus that determines which surgical technique is better according to its outcomes and long- term effects on the skeletal and functional development of treated individuals. The objectives of this study are To describe, using the available scientific information, the effect of the different surgical protocols regarding CLP closure, on the skeletal and functional development patients undergoing surgery. A research of the available information was made in three different databases: PubMed, Cochrane and Epistemonikos. This research included articles released since the year 2013 onwards. A total of 999 studies were found. Once exclusion and inclusion criteria were applied, 13 studies were selected. Surgical treatment of CLP consists of complex procedures which imply long-term skeletal alterations in undergoing patients. These skeletal discrepancies are first detected during the mixed dentition phase. It is recommended to extend patient follow-up up until puberty and adulthood, as it might demonstrate significant differences among the different surgical approaches.
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Introduction: The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. Methods: A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. Results: The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. Conclusion: External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.
Introducción: La siguiente revisión bibliográfica se realizó con el propósito de reconocer las características clínicas y radiográficas que deben ser evaluadas para el diagnóstico de las reabsorciones radiculares externas incluyendo también sus tratamientos. Metodología: Se llevó a cabo una búsqueda en las bases de datos MEDLINE/PubMed, Cochrane Library y Google Scholar bajo el término , incluyendo estudios experimentales y revisiones bibliográficas desde 2010 a 2022 en español e inglés, incluyendo finalmente 17 artículos. Resultados: Los resultados obtenidos señalaron que cada tipo de reabsorción radicular externa presenta características clínicas específicas que las diferencian. Estas diferencias son: para la reabsorción externa inflamatoria la vitalidad pulpar negativa; para la reabsorción externa de reemplazo la ausencia de movilidad y percusión metálica; para la reabsorción externa cervical una coloración rosada de la corona; la reabsorción externa superficial no presenta ningún tipo de sintomatología clínica y la reabsorción de colapso apical transitorio presenta un cambio de coloración transitorio. Conclusión: Las reabsorciones radiculares externas requieren un diagnóstico preciso y temprano. Se debe realizar un examen clínico con énfasis en sondaje, coloración, movilidad y pruebas de vitalidad.
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Resorción Radicular , Humanos , Resorción Radicular/diagnóstico por imagen , Resorción Radicular/terapiaRESUMEN
INTRODUCCIÓN: La siguiente revisión bibliográfica se realizó con el propósito de reconocer las características clínicas y radiográficas que deben ser evaluadas para el diagnóstico de las reabsorciones radiculares externas incluyendo también sus tratamientos. METODOLOGÍA: Se llevó a cabo una búsqueda en las bases de datos MEDLINE/PubMed, Cochrane Library y Google Scholar bajo el término , incluyendo estudios experimentales y revisiones bibliográficas desde 2010 a 2022 en español e inglés, incluyendo finalmente 17 artículos. RESULTADOS: Los resultados obtenidos señalaron que cada tipo de reabsorción radicular externa presenta características clínicas específicas que las diferencian. Estas diferencias son: para la reabsorción externa inflamatoria la vitalidad pulpar negativa; para la reabsorción externa de reemplazo la ausencia de movilidad y percusión metálica; para la reabsorción externa cervical una coloración rosada de la corona; la reabsorción externa superficial no presenta ningún tipo de sintomatología clínica y la reabsorción de colapso apical transitorio presenta un cambio de coloración transitorio. CONCLUSIÓN: Las reabsorciones radiculares externas requieren un diagnóstico preciso y temprano. Se debe realizar un examen clínico con énfasis en sondaje, coloración, movilidad y pruebas de vitalidad.
INTRODUCTION: The following bibliographic review was carried out with the purpose of recognizing the clinical and radiographic characteristics that must be considered in the diagnosis of external root resorption, including treatments. METHODS: A bibliographic search was carried out in PubMed/Medline, Cochrane Library and Google Scholar databases under the term "external root resorption", from 2010 to 2022 in Spanish and English. Experimental studies and bibliographic reviews were selected, and finally 17 articles were included. RESULTS: The results obtained indicated that each type of resorption presents specific clinical characteristics that differentiate them, these are: for external inflammatory resorption a negative pulp vitality; for replacement external resorption the absence of mobility and metallic percussion; for cervical external resorption a pink coloration of the crown; superficial external resorption does not present any type of clinical symptoms and transient apical collapse presents a transient change in color. CONCLUSION: External root resorptions require accurate and early diagnosis. A clinical examination should be performed with emphasis on the following: probing, coloration, mobility, and vitality tests.
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Humanos , Resorción Radicular/terapia , Resorción Radicular/diagnóstico por imagenRESUMEN
Given the psychosocial and economic costs of behaviors of patients who seem not to benefit from the medications, technologies, and medical therapies available for chronic diseases such as Type 1 Diabetes Mellitus, therapeutic adherence has been identified as one of the main focuses in the intervention. This paper presents contributions from semiotic cultural clinical psychology for understanding problems associated with the implementation of medical treatment in patients with Type 1 Diabetes Mellitus to explore psychological dimensions not yet reported in depth. A narrative review of 24 scientific articles published between 2012 and 2023 is carried out. The information is produced through thematic analysis, and the results are presented in three themes: 1. illness characteristics, 2. adherence and associated concepts, and 3. modes of intervention. It concludes with the development of a two-axis proposal for understanding the experience of patients that privileges psychological aspects involved in the disease and its treatment, considering the approach to the goals of treatment as dynamic and fluctuating rather than as final states.
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Diabetes Mellitus Tipo 1 , Humanos , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Diabetes Mellitus Tipo 1/psicología , Cumplimiento y Adherencia al TratamientoRESUMEN
The target trial framework has emerged as a powerful tool for addressing causal questions in clinical practice and in public health. In the healthcare sector, where decision-making is increasingly data-driven, transactional databases, such as electronic health records (EHR) and insurance claims, present an untapped potential for answering complex causal questions. This narrative review explores the potential of the integration of the target trial framework with real-world data to enhance healthcare decision-making processes. We outline essential elements of the target trial framework, and identify pertinent challenges in data quality, privacy concerns, and methodological limitations, proposing solutions to overcome these obstacles and optimize the framework's application.
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Registros Electrónicos de Salud , Humanos , Bases de Datos FactualesRESUMEN
Esse trabalho trata-se de uma pesquisa qualitativa de revisão narrativa que busca apresentar e discutir as práticas da Psicologia na política de Assistência Social em situações de violência infantojuvenil, tendo como fonte de informações as publicações científicas da área. A pesquisa foi realizada em três bases de dados e contou com um montante final de 23 artigos que foram lidos e analisados. O tema mostra-se relevante pois, ainda nos dias de hoje, crianças e adolescentes aparecem como as maiores vítimas de violência no Brasil e a política de Assistência Social se apresenta como um importante espaço de intervenção visando o enfrentamento de tais situações. Por meio da análise dos artigos científicos, conclui-se que as práticas descritas nas produções ora se articulam com matrizes de pensamento individualizantes e hegemônicas da Psicologia, ora produzem discursos que buscam a construção de saberes pautados na perspectiva social, territorial e no pensamento crítico. (AU)
This paper presents qualitative research of narrative review, which seeks to present and discuss the interventions of Psychology in the Social Assistance policy in situations of child and youth violence, havingassourceofinformationthescientificpublications. The research was conducted in three databases and had a final amount of 23 articles that were read and analyzed.The theme is relevant, because even today children and adolescents appear as the biggest victims of violence in Brazil and the Social Assistance presents itself as an important space for confrontation in this situations. Through the analysis of scientific articles, it is concluded that these productions point practices that sometimes are articulate with individualizing and hegemonic thought matrices of Psychology and in another moment produce discourses that seek to build knowledge based on the social, territorial perspective and on critical thinking. (AU)
Este trabajo presenta una investigación cualitativa de revisión narrativa, que busca presentar y discutir las intervenciones de la Psicología en la política de Asistencia Social en situaciones de violencia infantil y juvenil, teniendo como fuente de información las publicaciones científicasdel area.La investigación se realizó en tres bases de datos y contó con un total de 23 artículos que fueron leídos y analizados. El tema se muestra relevante, ya que aún en la actualidad los niños y adolescentes aparecen como las principales víctimas de violencia en Brasil, y la política de Asistencia Social se presenta como un importante espacio de confrontacionfrente a estas situaciones. A través del análisis de artículos científicos, se concluye que estas producciones apuntan prácticas descritas a veces se articulan con matrices de pensamiento individualizantes y hegemónicas de la Psicología, mientras que otras veces producen discursos que buscan la construcción de saberes basados en la perspectiva social, territorial y en el pensamiento crítico. (AU)
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Psicología/métodos , Política Pública , Servicio Social , Maltrato a los Niños , Investigación CualitativaRESUMEN
Peru is a historically unique and culturally diverse Latin American country. As a low-to-middle-income country (LMIC), Peru faces health implications from the spread of communicable diseases as well as a growing rate of noncommunicable diseases, both of which have been worsened by the recent COVID-19 pandemic's impact on the national health system. Over the past two decades, the country has aimed to improve health access for its population through various efforts described in this review. Despite this, there are notable neurological health disparities that exist today. This narrative review investigates such disparities through the leading neurological contributors to the national burden of disease in the country, including migraine headaches, cerebrovascular disease, and dementia. Public health disparities that contribute to other major neurological diseases in the country, including epilepsy, neurocysticercosis, Chagas disease, multiple sclerosis, traumatic brain injury, traumatic and non-traumatic spinal cord injuries are also investigated. We also explore potential solutions for overcoming the various neurological health disparities covered in this review that may be applied through public policies, as well as in similar LMICs in Latin America. By overcoming such disparities, the country may be able to successfully address the major contributors of neurological disease burden and create a healthcare environment that can sustainably and equitably improve health outcomes for Peruvian people.
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COVID-19 , Enfermedad de Chagas , Humanos , Perú/epidemiología , COVID-19/epidemiología , Pandemias , Costo de EnfermedadRESUMEN
El cuerpo adiposo de la boca (CAB) es un componente adiposo multilobulado bien delimitado, localizado de manera bilateral en la región facial íntimamente relacionado a estructuras nerviosas y vasculares. La remoción de CAB es un procedimiento ampliamente estudiado en el campo de la cirugía maxilofacial, utilizado principalmente para cubrir defectos. Su influencia en la estética facial ha iniciado una popularización de la remoción de la extensión bucal de CAB para obtener un rostro más estilizado, intervención difundida como poco invasiva y sin complicaciones. El objetivo de este estudio fue recopilar y evaluar estudios que reporten y evalúen complicaciones asociadas a la remoción por razones estéticas de CAB. Se revisó la evidencia en las bases de datos Medline vía PubMed, Epistemonikos, Scopus y Google Scholar, utilizando términos predefinidos, seleccionando estudios primarios de reportes de casos. Se incluyeron 7 artículos con un total de 10 pacientes; de estos, ocho pacientes se realizaron este procedimiento en Brasil, uno en Estados Unidos y uno en Chile. La distribución de la población fue de 3:7 entre hombres y mujeres con edad promedio de 35 años y un rango entre los 23 a los 49 años. En relación a las complicaciones reportadas, 100 % de los pacientes presentaron asimetría facial, un 80 % presentó edema facial, 30 % manifestaron sialocele, Trismus 20 %, 40 % presentó hematoma, 20 % compromiso del estado general, 20 % presentaron disfagia, en los casos de hipoestesia, parestesia, absceso, seroma, parálisis facial, odinofagia, fiebre se expresaron en 10 % de la población estudiada. En todos los estudios se describió una reintervención quirúrgica posterior a la remoción estética del cuerpo adiposo de bichat. La escasa literatura y la baja calidad de esta, no permite estimar el porcentaje real de posibles complicaciones, tampoco es posible determinar sus resultados a largo plazo ya que no existe en la evidencia un seguimiento apropiado para estos pacientes.
The buccal adipose body (BAB) is a well- defined multilobulated adipose component, located bilaterally in the facial region, closely related to nervous and vascular structures. BAB removal is a widely studied procedure in the field of maxillofacial surgery, used mainly to cover defects. Its influence on facial aesthetics has started to popularize the removal of the BAB buccal extension to obtain a more stylized face, an intervention widely known as minimally invasive and without complications. The objective of this study was to collect and evaluate studies that report and evaluate complications associated with the removal of BAB for cosmetic reasons. The evidence was reviewed in the Medline databases via PubMed, Epistemonikos, Scopus, and Google Scholar, using predefined terms, selecting primary studies from case reports. 7 articles with a total of 10 patients were included; Of these, eight patients underwent this procedure in Brazil, one in the United States, and one in Chile. The distribution of the population was 3:7 between men and women with an average age of 35 years and a range between 23 to 49 years. In relation to the reported complications, 100 % of the patients presented facial asymmetry, 80 % presented facial edema, 30 % manifested sialocele, trismus 20 %, 40 % presented hematoma, 20 % compromised general state, 20 % presented dysphagia, in the cases of hypoesthesia, paresthesia, abscess, seroma, facial paralysis, odynophagia, fever were expressed in 10 % of the studied population. All the studies described a surgical reintervention after cosmetic removal of the bichat adipose body. The scarce literature and its low quality do not allow estimating the real percentage of possible complications, nor is it possible to determine their long-term results since there is no evidence of appropriate follow-up for these patients.
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Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Tejido Adiposo/cirugía , Procedimientos Quirúrgicos Orales/efectos adversos , Mejilla/cirugía , Procedimientos de Cirugía Plástica/efectos adversosRESUMEN
La infección por SARS-CoV-2 podría gatillar la ocurrencia de numerosas patologías, algunas de ellas de tipo endocrinológico. Se presenta una revisión narrativa sobre la asociación entre COVID-19 y tiroiditis subaguda, en la que se describen aspectos epidemiológicos, fisiopatológicos, manifestaciones clínicas y de laboratorio, tratamiento y pronóstico. La prevalencia de alguna disfunción tiroidea en pacientes COVID-19 fluctúa entre 13 y 64%, específicamente en relación con tiroiditis subaguda se describe un cambio en la prevalencia de 0,5% a 10% entre los años 2019 y 2020. La tiroiditis subaguda se produce por la unión del virus SARS-CoV-2 con la enzima convertidora de angiotensina 2 (ACE-2) ampliamente expresada en la glándula tiroides, generando manifestaciones clínicas tipo tirotoxicosis, aunque la presentación de la tiroiditis subaguda asociada a COVID-19 puede ser atípica. Los elementos centrales del tratamiento son similares a los empleados ante cualquier tiroiditis subaguda. Se concluye la necesidad de considerar esta entidad en el diagnóstico diferencial de pacientes actual o previamente infectados por SARS-CoV-2 que presenten síndrome febril, elevación de parámetros inflamatorios o taquicardia persistente, sin etiología precisada.
SARS-CoV-2 infection can trigger the occurrence of numerous pathologies, some of them endocrinological. The present narrative review works on the association between COVID-19 and subacute thyroiditis, which describes epidemiological and pathophysiological aspects, clinical and laboratory manifestations, treatment, and prognosis. The prevalence of thyroid dysfunction in COVID-19 patients fluctuates between 13 and 64%, explicitly concerning subacute thyroiditis; it has been described as a change in prevalence from 0.5% to 10% between 2019 and 2020. The binding of the SARS-CoV-2 virus with the angiotensin-converting enzyme 2 receptor (ACE-2) widely expressed in the thyroid gland causes subacute thyroiditis, generating thyrotoxicosis-like clinical manifestations. However, the presentation of subacute thyroiditis associated with COVID-19 may be atypical. The central elements of the treatment are similar to those used in any subacute thyroiditis. We conclude that this entity must be considered in differential diagnoses of patients currently or previously infected with SARS-CoV-2 that present a febrile syndrome, elevated inflammatory parameters, or persistent tachycardia without a specified aetiology.
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BACKGROUND: The arrival of COVID-19 in Brazil and the accelerated process of dissemination/contamination added to the evolution of the clinical picture of the disease, and the saturation of the capacity of health services, creating new challenges for researchers, governments, and professionals involved in the occupational health area. OBJECTIVE: This article aims to systematize and synthesize the proposals adopted by the legislation and by the Brazilian State, with a focus on worker protection and guaranteeing a safe work environment for the performance of their professional activities. METHODS: This is qualitative bibliographical research of the narrative literature review type, developed from October 2020 to June 2021 in legislation databases using the strategy: "COVID-19" AND "coronavirus/coronavirus" AND "worker health" on official Brazilian government websites. RESULTS: The lack of an emergency plan for efficient actions to respond to the epidemic caused and is still causing the daily deaths of workers. CONCLUSION: There is a need to guarantee the effectiveness of national and international policies and norms that have been neglected by the Brazilian government.
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COVID-19 , Salud Laboral , Humanos , COVID-19/epidemiología , COVID-19/prevención & control , Personal de Salud , Lugar de Trabajo , Brasil/epidemiologíaRESUMEN
Background: The lack of precise definitions and terminological consensus about the impact studies of COVID-19 vaccination leads to confusing statements from the scientific community about what a vaccination impact study is. Objective: The present work presents a narrative review, describing and discussing COVID-19 vaccination impact studies, mapping their relevant characteristics, such as study design, approaches and outcome variables, while analyzing their similarities, distinctions, and main insights. Methods: The articles screening, regarding title, abstract, and full-text reading, included papers addressing perspectives about the impact of vaccines on population outcomes. The screening process included articles published before June 10, 2022, based on the initial papers' relevance to this study's research topics. The main inclusion criteria were data analyses and study designs based on statistical modelling or comparison of pre- and post-vaccination population. Results: The review included 18 studies evaluating the vaccine impact in a total of 48 countries, including 32 high-income countries (United States, Israel, and 30 Western European countries) and 16 low- and middle-income countries (Brazil, Colombia, and 14 Eastern European countries). We summarize the main characteristics of the vaccination impact studies analyzed in this narrative review. Conclusion: Although all studies claim to address the impact of a vaccination program, they differ significantly in their objectives since they adopt different definitions of impact, methodologies, and outcome variables. These and other differences are related to distinct data sources, designs, analysis methods, models, and approaches.
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Vacunas contra la COVID-19 , COVID-19 , Humanos , Estados Unidos , COVID-19/prevención & control , Vacunación , Renta , Modelos EstadísticosRESUMEN
Introduction: the first COVID-19 case in Brazil was confirmed on February 26, 2020. As of March 17, 2023, the Ministry of Health reported 699,634 deaths from COVID-19, with a case fatality rate of 1.9%. The impact of the COVID-19 pandemic in Brazil extends to socioeconomic and healthcare systems, reflecting significant regional disparities. Objective: To analyze mortality, incidence, and case fatality rates for COVID-19 in the states of Paraná and Santa Catarina, in the southern region of Brazil. Methods: This is an ecological time-series study using official Brazilian secondary data for COVID-19 cases and deaths. Data were extracted from the dashboard of the State Health Department of Santa Catarina and Paraná. Temporal series were developed for trend analysis using the Prais-Winsten regression model. Statistical analyses were performed using STATA 14.0 software (College Station, TX, USA, 2013). Results: In the analysis of rates over the entire period, trends for mortality, case fatality, and incidence in the state of Santa Catarina are decreasing, decreasing, and stationary, respectively. In Paraná, rates over the entire period showed a stationary trend for mortality, decreasing for case fatality, and increasing for incidence. Conclusion: COVID-19 had a devastating effect on the states of Santa Catarina and Paraná. Both states experienced the progression of the COVID-19 pandemic, with higher case fatality and mortality rates observed in Paraná, while Santa Catarina had a higher incidence rate over the three years of the COVID-19 pandemic.
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Resumo A presença de mecanismos de participação popular na saúde mental é fundamental para a democratização. Embora prevista por lei há algumas décadas enquanto diretriz do Sistema Único de Saúde (SUS), a implementação de tais mecanismos é um processo inacabado e complexo, cujos avanços têm sofrido um desmantelamento sistemático em virtude de políticas neoliberais. Este artigo faz uma breve análise histórica desse processo, tendo em vista a construção da reforma psiquiátrica brasileira e, em seguida, apresenta os resultados de uma revisão narrativa, baseada em artigos publicados nos últimos 10 anos acerca do tema da participação popular na saúde mental. São tratados, primeiramente, os sentidos comumente atribuídos ao termo "participação" e os tipos de espaços participativos existentes. Mais adiante, abordam-se algumas potencialidades da participação nesses espaços, como a produção de autonomia e o seu caráter formativo na vida política dos usuários, além de algumas dificuldades que se impõem ao seu funcionamento, como a burocratização dos serviços e os vestígios crescentes de um modelo asilar. Por fim, há a indicação de saídas possíveis para resolver esses problemas, como a promoção de mudanças culturais e a articulação entre movimentos e atores sociais, visando ao fortalecimento dos espaços de participação popular.
Abstract The presence of mechanisms for popular participation in mental health is fundamental for the democratization. Although it has been provided for by law as a guideline of the Brazilian National Health System (SUS) for some decades, the implementation of such mechanisms is an unfinished and complex process, whose advances have been systematically dismantled due to neoliberal policies. This article provides a brief historical analysis of this process, considering the construction of the Brazilian psychiatric reform, and then presents the results of a narrative review, based on articles published in the last 10 years about popular participation in mental health. First, the common meanings of "participation" and the existing types of participatory spaces are discussed. Further on, some potentialities of participation in those spaces, such as producing autonomy and its formative character in the political life of users, in addition to some difficulties that are imposed on its functioning, such as the bureaucratization of services and the growing traces of an asylum model, are analyzed. Finally, possible ways out of these problems, such as promoting cultural changes and articulating movements and social actors, aiming at strengthening spaces for popular participation, are indicated.
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Humanos , Masculino , Femenino , Control Social Formal , Sistema Único de Salud , Salud Mental , Participación de la ComunidadRESUMEN
RESUMO Este artigo analisou como as publicações sobre dupla carreira (DC) no Brasil abordaram esse tema conceitualmente e metodologicamente. Realizamos uma revisão narrativa dos estudos publicados entre 2018 e 2023, e os analisamos a partir dos tipos de abordagens metodológicas, os conceitos e o direcionamento dessas pesquisas brasileiras. Notamos que a DC é vista como objeto de conciliação de rotinas a partir das idiossincrasias de cada grupo de investigação, carecendo de aprofundamento sobre possíveis causas para má gestão das agendas do estudante-atleta. Sugerimos uma maior interação entre os grupos de pesquisa, buscando mínimos consensos entre os investigadores sobre a noção de DC tal como a adoção de métodos holísticos que auxiliem a captar a complexidade desse fenômeno social.
ABSTRACT We analyse the conceptual and methodological approaches taken by Brazilian research on the Dual Career (DC). We conducted a narrative review of published studies between 2018 and 2023; we analysed them based on the methodological approach, the concept used, and their basic premises that support research. We observe that DC is viewed as the form of combining routines by Brazilian researchers, conducting debate from their theoretical perspectives. Still, we note little engagement among these researchers to provide a combination approach to deep knowledge about DC and their issues with managing student-athletes schedules. So, we suggest more interaction among Brazilian research groups, seeking consensus to adopt holistic research methods that aid in understanding the DC complexity.
RESUMEN Ese artículo analizó cómo las recientes publicaciones se acercaron conceptual y metodológicamente a la Carrera Dual (CD) en Brasil. Revisamos los artículos desde 2018 a 2023, y los analizamos a través de sus metodologías, conceptos y premisas teóricas que los basaron los investigadores. Observamos que la CD fue acercada como la manera de compaginar rutinas y los investigadores conducían al debate desde sus perspectivas teóricas. También notamos poco involucro entre los investigadores, lo que puede limitar la interpretación a cerca de la CD y la manera de compaginar a las agendas de los estudiantes-deportistas. Por lo tanto, sugerimos una interacción entre los investigadores brasileños, buscando acuerdos para adoptar metodologías holísticas para comprender el fenómeno de la CD.
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INTRODUCTION: Multiple myeloma in Latin America (LATAM) face multiple challenges related to the lack of resources according to low- and middle-income in the region. AREAS COVERED: in this narrative review, several aspects of myeloma multiple epidemiology, diagnostic methods and risk stratification, medication commonly employed, and treatment results in LATAM are discussed. CONCLUSION: Patients usually are diagnosed in an advanced stage of the disease, and routine and risk evaluations are usually not ideal due to lack of access to different studies. Treatment is limited in many cases to the use of thalidomide and dexamethasone with and without cyclophosphamide. Access to autologous stem cell transplantation is far from ideal. Efforts must be made at the national health system level in our countries to offer our vast majority of MM patients a real chance to improve results in the diagnostic, risk stratification, and treatment. Currently, several groups in our region are working to make an impact in the field of MM.
Asunto(s)
Trasplante de Células Madre Hematopoyéticas , Mieloma Múltiple , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Dexametasona/uso terapéutico , Humanos , América Latina/epidemiología , Mieloma Múltiple/diagnóstico , Mieloma Múltiple/epidemiología , Mieloma Múltiple/terapia , Talidomida/uso terapéutico , Trasplante AutólogoRESUMEN
Abstract Background The chronic aspect that begins to characterize long COVID appeals to the need for interventions proposed by institutions such as the World Health Organization (WHO) and the National Institute for Health and Care Excellence (NICE) to manage the disease, emphasizing behavioral change and self-care. Objective To perform a narrative review of the psychological literature that offers intervention strategies in alignment with the recommendations of the long COVID management guidelines proposed by WHO and NICE. Method MEDLINE, EBSCO, Google Scholar, SciELO, PsycINFO, PubMed, Cochrane, and CONRICYT databases were consulted, using Boolean operators and keywords for an exhaustive search. Results The contributions of the studies were categorized into five intervention strategies based on WHO and NICE recommendation guidelines: Psychoeducation, Self-care, Support networks, Relaxation, and Goal setting. These are given a brief introduction and their relevance to the management of long COVID symptomatology is described. Discussion and conclusion The persistent condition of COVID-19 symptoms makes it necessary to recognize that lifestyle changes must be made, primarily focused on health care and prevention of worsening disease sequelae. These lifestyle changes can be achieved through behavior modification, focusing on protective factors such as education, self-care, support networks, relaxation techniques and, setting appropriate goals.
Resumen Antecedentes El aspecto crónico que empieza a caracterizar al COVID persistente hace un llamado a la propuesta de intervenciones desde instituciones como la Organización Mundial de la Salud (OMS) y el National Institute for Health and Care Excellence (NICE) para lograr un manejo de la enfermedad, el cambio conductual y el autocuidado. Objetivo Elaborar una revisión narrativa sobre la literatura psicológica que ofrece estrategias de intervención acordes a las recomendaciones de las guías de manejo del COVID persistente propuestas por la OMS y el NICE. Método Se consultaron las bases de datos MEDLINE, EBSCO, Google Scholar, SciELO, PsycINFO, PubMed, Cochrane y CONRICYT. Se utilizaron operadores booleanos y palabras claves para una búsqueda exhaustiva. Resultados Las aportaciones de los estudios fueron categorizadas en cinco estrategias de intervención basadas en las guías de recomendación de la OMS y el NICE: Psicoeducación, Autocuidado, Redes de apoyo, Relajación y Establecimiento de metas. En ellas se realiza una breve introducción y se expone su relevancia para el manejo de la sintomatología del COVID persistente. Discusión y conclusión El padecimiento persistente de los síntomas del COVID-19 hace necesario reconocer que deben realizarse cambios en el estilo de vida, principalmente enfocados en el cuidado de la salud y la prevención del empeoramiento de las secuelas de la enfermedad. Estos cambios en el estilo de vida podrán lograrse mediante la modificación de la conducta, orientándola a factores protectores como la educación, el autocuidado, las redes de apoyo, las técnicas de relajación y el establecimiento de metas adecuadas.
RESUMEN
Hernia repair is one of the most frequent interventions in surgery worldwide. The approach to abdominal wall and inguinal hernias remains a challenge due to emerging evidence on aspects such as timely diagnosis, use of innovative techniques or post-surgical care. However, pre-operative preparation is also a factor that substantially affects the absolute success rate of this type of condition. Time management between diagnosis and intervention, control of diseases that increase intra-abdominal pressure, weight and nutritional status, are some of the many elements to be considered in this type of patients before surgery. Considering that this condition carries high health care costs, especially in case of recurrence, has a risk of complications and affects the individual's functional capacity, the objective of this review is to synthesize evidence on the role of these factors on the short- and long-term outcome of inguinal hernia management, and to make suggestions on the general approach to this type of patients.
RESUMEN
ABSTRACT BACKGROUND: This article systematically updates the literature on changes in visual functions during the phases of the normal menstrual cycle in women. OBJECTIVES: To update Guttridge's 1994 review of visual structures and functions associated with the menstrual cycle and broaden the search through psychophysical, neuroimaging and neurobehavioral measurements covering 1994-2020. DESIGN AND SETTING: Narrative review conducted in a neurosciences and behavior laboratory in Brazil. METHODS: The PubMed, Cochrane Clinical Answers and Google Scholar databases were searched. After screening and applying the eligibility criteria, 32 articles were examined. Through this analysis, the following information was extracted: (1) geographical distribution of the study; (2) sample size (according to age and phase of the menstrual cycle); (3) type of measurements according to psychophysical, neuroimaging and neurobehavioral instruments; (4) vision testing model; (5) visual subcategory evaluated; (6) categories of processed visual stimuli; and (7) main findings. RESULTS: The menstrual phases give rise to significant changes in visual functions, including in relation to orientation and spatial attention, visual campimetry and visual sensitivity. These relate specifically to the follicular and luteal phases. CONCLUSIONS: These findings theoretically expand the effects of menstrual cycles on visual functions found by Guttridge (1994). Despite some inconsistencies in the studies analyzed, it was found that visual processing during the follicular and luteal phases of the normal menstrual cycle of healthy women can explain physiological, cognitive, behavioral and social modulations.