RESUMO
Resumo Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.
Abstract This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.
RESUMO
Resumo Esta revisão narrativa tem por objetivo analisar a literatura no âmbito da Saúde Coletiva no intento de reconhecer o que se tem discutido em Educação Popular em Saúde (EPS) entre 2019 e 2022. Após busca, 59 artigos foram selecionados, analisados criticamente e separados em seis categorias-síntese: as práticas de educação popular como promotoras de uma visão participativa da saúde; educação popular e a valorização dos saberes e práticas da cultura popular local; a educação popular em saúde como estratégia de apoio à reconstrução social ante aos retrocessos nas políticas públicas; a importância da articulação nacional em educação popular como resposta à sua desvalorização; a educação popular como projeto libertador pensando a formação democrática e luta contra violências institucionais e estruturais; educação popular no processo de formação universitária em saúde. Pôde-se obter importantes resultados que elucidam a importância da EPS no contexto do Sistema Único de Saúde e na formação acadêmica de profissionais da saúde, favorecendo o respeito aos saberes ancestrais e a horizontalidade do cuidado. Ainda, reafirma-se a necessidade de articulação nacional e dialogada com os movimentos populares para o avanço de uma agenda emancipadora e dignificante da saúde no Brasil.
Abstract This narrative review aims to analyze the literature on Collective Health to recognize what has been discussed in Popular Health Education (PHE) from 2019 to 2022. Fifty-nine articles were selected, critically analyzed, and separated into six summary categories: popular education practices as promoters of a participatory vision of health; popular education and the valorization of local popular culture knowledge and practices; popular health education as a strategy to support social reconstruction in the face of setbacks in public policies; the importance of national articulation in popular education as a response to its devaluation; popular education as a liberating project thinking about the democratic formation and the fight against institutional and structural violence; popular education in the university health training process. We achieved significant results that elucidate the importance of PHE within the Unified Health System and the academic education of health professionals, fostering respect for ancestral knowledge and care horizontality. We also reaffirm the need for national articulation and dialogue with grassroots movements to advance Brazil's emancipatory and dignifying health agenda.
RESUMO
This narrative review aims to analyze the literature on Collective Health to recognize what has been discussed in Popular Health Education (PHE) from 2019 to 2022. Fifty-nine articles were selected, critically analyzed, and separated into six summary categories: popular education practices as promoters of a participatory vision of health; popular education and the valorization of local popular culture knowledge and practices; popular health education as a strategy to support social reconstruction in the face of setbacks in public policies; the importance of national articulation in popular education as a response to its devaluation; popular education as a liberating project thinking about the democratic formation and the fight against institutional and structural violence; popular education in the university health training process. We achieved significant results that elucidate the importance of PHE within the Unified Health System and the academic education of health professionals, fostering respect for ancestral knowledge and care horizontality. We also reaffirm the need for national articulation and dialogue with grassroots movements to advance Brazil's emancipatory and dignifying health agenda.
Esta revisão narrativa tem por objetivo analisar a literatura no âmbito da Saúde Coletiva no intento de reconhecer o que se tem discutido em Educação Popular em Saúde (EPS) entre 2019 e 2022. Após busca, 59 artigos foram selecionados, analisados criticamente e separados em seis categorias-síntese: as práticas de educação popular como promotoras de uma visão participativa da saúde; educação popular e a valorização dos saberes e práticas da cultura popular local; a educação popular em saúde como estratégia de apoio à reconstrução social ante aos retrocessos nas políticas públicas; a importância da articulação nacional em educação popular como resposta à sua desvalorização; a educação popular como projeto libertador pensando a formação democrática e luta contra violências institucionais e estruturais; educação popular no processo de formação universitária em saúde. Pôde-se obter importantes resultados que elucidam a importância da EPS no contexto do Sistema Único de Saúde e na formação acadêmica de profissionais da saúde, favorecendo o respeito aos saberes ancestrais e a horizontalidade do cuidado. Ainda, reafirma-se a necessidade de articulação nacional e dialogada com os movimentos populares para o avanço de uma agenda emancipadora e dignificante da saúde no Brasil.
Assuntos
Educação em Saúde , Humanos , Brasil , Educação em Saúde/métodos , Política Pública , Pessoal de Saúde/educação , Programas Nacionais de Saúde/organização & administração , Atenção à Saúde/organização & administração , Saúde Pública/educação , Política de SaúdeRESUMO
This paper aims to bring reflections and notes for strengthening Brazilian structuring public policies, focusing on Popular Health Education in the Unified Health System (SUS) from the perspectives built in the Observatory of Popular Health Education and the Brazilian Reality. The Observatory is a valuable space for sharing health professionals' and popular educators' interpretations and experiences about local and Brazilian realities from the perspective of Popular Health Education. During its two years of activity, the Observatory has gathered summary interpretations of Popular Health Education for the crises that traverse the country's recent history in a dialogical and participatory way. In a panoramic view, the shared statements point to challenges for valuing the human approach to health promotion, including respecting local and community knowledge and social practices. Moreover, we underscore the importance of social participation in constructing participatory social processes in public health toward citizen autonomy and expanded democratic dynamics in the Brazilian State and its social equipment.
Este trabalho se propõe a trazer reflexões e apontamentos para o fortalecimento de políticas públicas estruturantes no Brasil, com foco na Educação Popular em Saúde no Sistema Único de Saúde (SUS), a partir das perspectivas construídas no Observatório de Educação Popular em Saúde e Realidade Brasileira. O Observatório é um espaço profícuo para o compartilhamento de interpretações e experiências de profissionais de saúde e educadores populares sobre a realidade local e realidade brasileira, a partir da ótica da Educação Popular em Saúde. De forma dialógica e participativa, ao longo de seus 2 anos de atividade, o Observatório foi capaz de reunir interpretações sintéticas da Educação Popular em Saúde para as crises que atravessam a história recente do país. De maneira panorâmica, as falas compartilhadas apontam desafios para valorização da abordagem humana na promoção da saúde, com a inclusão e o respeito aos saberes e práticas sociais locais e comunitárias. Além disso, destaca-se a importância da participação social na construção de processos sociais participativos na saúde pública, visando à autonomia do cidadão e à ampliação da dinâmica democrática no Estado brasileiro e em seus equipamentos sociais.
Assuntos
Educação em Saúde , Política de Saúde , Promoção da Saúde , Saúde Pública , Brasil , Humanos , Educação em Saúde/métodos , Promoção da Saúde/métodos , Saúde Pública/educação , Programas Nacionais de Saúde/organização & administração , Política Pública , Atenção à Saúde/organização & administração , Participação Social , Participação da Comunidade/métodosRESUMO
O texto trata da abordagem teórico-prática da Educação Popular em Saúde (EPS), apresentando reflexões sobre construções possíveis com base nos princípios dessa filosofia. Esse processo de discussão teórica transita pelos processos educativos em saúde; pela capacidade mobilizadora da participação social e promoção de encontros humanos transformadores nos serviços de saúde; e pelas possibilidades para o presente e o futuro do Sistema Único de Saúde (SUS). Tem-se, pois, a importância da participação social nos serviços de saúde, destacando a abordagem comunitária como estratégia para potencializar o trabalho na Atenção Primária à Saúde e dinamizar a promoção e a vigilância em saúde. Desse modo, com os caminhos viabilizados e orientados pela EPS, pode-se contribuir para a construção de práticas mais democráticas e emancipadoras no SUS.(AU)
El texto trata del abordaje teórico-práctico de la Educación Popular en Salud (EPS), presentando reflexiones sobre construcciones posibles con base en los principios de esa filosofía. Este proceso de discusión teórica transita por los procesos educativos en salud, por la capacidad movilizadora de la participación social y promoción de encuentros humanos transformadores en los servicios de salud y por las posibilidades para el presente y el futuro del Sistema Brasileño de Salud (SUS). Se ve, por lo tanto, la importancia de la participación social en los servicios de salud, destacando el abordaje comunitario como estrategia para potenciar el trabajo en la Atención Primaria de la Salud y dinamizar la promoción y vigilancia en salud. De ese modo, con los caminos viabilizados y orientados por la EPS es posible contribuir para la construcción de prácticas más democráticas y emancipadoras en el SUS.(AU)
The text deals with the theoretical-practical approach of Popular Education in Health (PEH), presenting reflections on possible constructions based on the principles of this philosophy. This process of theoretical discussion covers educational processes in health, the mobilizing capacity of social participation and the promotion of transformative human encounters in health services and the possibilities for the present and future of the Brazilian National Health System (SUS). This highlights the importance of social participation in health services, highlighting the community approach as a strategy to enhance work in Primary Health Care and boost health promotion and surveillance. In this way, the paths made possible and guided by the EPS can contribute to the construction of more democratic and emancipatory practices in the SUS.(AU)
RESUMO
The incessant search for new natural molecules with biological activities has forced researchers in the field of chemistry of natural products to seek different approaches for their prospection studies. In particular, researchers around the world are turning to approaches in metabolomics to avoid high rates of re-isolation of certain compounds, something recurrent in this branch of science. Thanks to the development of new technologies in the analytical instrumentation of spectroscopic and spectrometric techniques, as well as the advance in the computational processing modes of the results, metabolomics has been gaining more and more space in studies that involve the prospection of natural products. Thus, this chapter summarizes the precepts and good practices in the metabolomics of microbial natural products using mass spectrometry and nuclear magnetic resonance spectroscopy, and also summarizes several examples where this approach has been applied in the discovery of bioactive molecules.
Assuntos
Produtos Biológicos , Metabolômica/métodos , Espectrometria de Massas/métodos , Espectroscopia de Ressonância Magnética/métodosRESUMO
BACKGROUND: Although the cornerstone treatment for deep vein thrombosis (DVT) remains anticoagulation, clinicians perform stenting or angioplasty (SA) in particular patients. To assess the effects of SA in this setting, we performed a systematic review of randomized controlled trials. METHODS: Based on the Cochrane standards, we searched the Cochrane CENTRAL, MEDLINE, Embase, CINAHL, LILACS and IBECS databases, and trial registries. Our primary outcomes were post-thrombotic syndrome (PTS), venous thromboembolism (VTE) and all-cause mortality. RESULTS: We included 7 randomized controlled trial (1485 participants). There was no clinically significant difference between SA and best medical practice (BMP) for the additional treatment of acute DVT regarding PTS (standardized mean difference -7.87, 95% confidence interval [CI] -12.13 to -3.61; very low-certainty) and VTE (risk ratio [RR] 1.19, 95% CI 0.28-5.07, very low-certainty), and no deaths. Compared to BMP, the SA plus BMP and thrombolysis results in little to no difference in PTS (mean difference [MD] -1.07, 95% CI -1.12 to -1.02, moderate-certainty), VTE (RR 1.48, 95% CI 0.95-2.31, low-certainty), and mortality (RR 0.92, 95% CI 0.34-2.52, low-certainty). There was no clinical difference between stenting and BMP for chronic DVT regarding PTS (MD 2.73, 95% CI -2.10 to 7.56, very low certainty) and no VTE and death events. CONCLUSIONS: SA results in little to no difference in PTS, VTE and mortality in acute DVT compared to BMP. The evidence regarding SA in chronic DVT and whether SA, compared to BMP and thrombolysis, decreases PTS and VTE in acute DVT is uncertain. Open Science Framework (osf.io/f2dm6).
Assuntos
Tromboembolia Venosa , Trombose Venosa , Humanos , Anticoagulantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Trombose Venosa/tratamento farmacológico , Tromboembolia Venosa/tratamento farmacológicoRESUMO
Under natural and well-managed conditions, the buffalo has good reproductive and productive indices. However, in vitro embryo production (IVEP) has been used commercially to maximise the number of elite animals. In this species, several factors (donor management, in vitro culture medium, semen, in vitro conditions, embryo transfer) still affect the IVEP results. In addition, the cost of this technique is very high for this purpose. Therefore, more studies, as well as adequate plans, are needed to achieve this objective efficiently. In this review, we discussed the current commercial status, influencing factors (in vivo and in vitro), and the progress and future challenges of IVEP in buffalo. A total of 81 references were used from 1979 to 2022. The relevant data or literature were searched using the following databases: Google, ResearchGate, Science Alert, Science Direct and PubMed, using the following keywords: buffalo oocytes/COCs, buffalo embryos, pregnancy and calving or live birth rate after embryo transfer. The best maturation, cleavage and blastocyst rates in the in vitro production of buffalo embryos were 95.8, 75.2 and 33.4%, respectively. The pregnancy and live birth rates ranged from 22.2% to 43.5% and from 15.3% to 36.5%, respectively, after the transfer of fresh embryos produced in vitro to the recipients. This review will help to contextualise IVEP in buffaloes, as well as create an adequate plan for implementing IVEP in buffaloes.
RESUMO
The role of waning immunity in basic epidemic models on networks has been undervalued while being noticeably fundamental for real epidemic outbreaks. One central question is which mean-field approach is more accurate in describing the epidemic dynamics. We tackled this problem considering the susceptible-infected-recovered-susceptible (SIRS) epidemic model on networks. Two pairwise mean-field theories, one based on recurrent dynamical message-passing (rDMP) theory and the other on the pair quenched mean-field (PQMF) theory, are compared with extensive stochastic simulations on large networks of different levels of heterogeneity. For waning immunity times longer than or comparable with the recovering time, rDMP outperforms PQMF theory on power-law networks with degree distribution P(k)â¼k^{-γ}. In particular, for γ>3, the epidemic threshold observed in simulations is finite, in qualitative agreement with rDMP, while PQMF leads to an asymptotically null threshold. The critical epidemic prevalence for γ>3 is localized in a finite set of vertices in the case of the PQMF theory. In contrast, the localization happens in a subextensive fraction of the network in rDMP theory. Simulations, however, indicate that localization patterns of the actual epidemic lay between the two mean-field theories, and improved theoretical approaches are necessary to understanding the SIRS dynamics.
RESUMO
The study aimed to verify the influence of the FecGE mutation in superovulated ewes and to evaluate the probability of logistic models to determine the response capacity of these ewes to superovulatory treatment. Santa Inês ewes (n = 29) were genotyped for the FecGE mutation and separated for their genotype group in carriers of the mutant E allele (FecGE/E, FecG+/E) and non-carrier (FecG+/+) alleles. The ewes underwent hormonal treatment for superovulation. Aside from the genotypes, variables included in the statistical model were reproductive status (empty, early lactation, or late lactation), age (> or < 6 years), and number of births (nulliparous, primiparous, multiparous). The carriers of the mutation could be discriminated from the non-carriers based on the number of corpora lutea, rate of frozen embryos, and fecundity. Recovery rate was significantly higher (P < 0.05) in FecGE/E (94.31%) compared to FecG+/E (63.15%) and FecG+/+ (61.90%) (P < 0.05), whereas fecundity rate of FecG+/+ ewes (50.76%) was significantly higher than FecG+/E (18.96%) and FecGE/E (32.53%) (P < 0.05). We determined in this study that the response to superovulation and embryo production can be discriminated between FecGE/E and FecG+/E ewes in relation to the FecG+/+ genotype. Logistic models that included reproductive status and mutation, or reproductive status and age, or reproductive status and number of births were effective in predicting the response to superovulatory treatment.
Assuntos
Embrião de Mamíferos , Superovulação , Animais , Corpo Lúteo , Feminino , Lactação , Modelos Logísticos , OvinosRESUMO
Titanosaurs were successful herbivorous dinosaurs widely distributed in all continents during the Cretaceous, with the major diversity in South America. The success of titanosaurs was probably due to several physiological and ecological factors, in addition to a series of morphological traits they achieved during their evolutionary history. However, the generalist nesting behaviour using different palaeoenvironments and strategies was key to accomplish that success. Titanosaur nesting sites have been found extensively around the world, with notable records in Spain, France, Romania, India, and, especially, Argentina. Here, we describe the first titanosaur nesting site from the Late Cretaceous of Brazil that represents the most boreal nesting site for South America. Several egg-clutches, partially preserved, isolated eggs and many eggshell fragments were discovered in an Inceptisol palaeosol profile of the mining Lafarge Quarry, at the Ponte Alta District (Uberaba Municipality, Minas Gerais State), corresponding to the Serra da Galga Formation (Bauru Group, Bauru Basin). Although classical mechanical preparation and CT scans have not revealed embryonic remains in ovo, the eggs and eggshell features match those eggs containing titanosaurian embryos found worldwide. The morphology of the egg-clutches and observations of the sedimentary characteristics bolster the hypothesis that these sauropods were burrow-nester dinosaurs, as was already suggested for the group based on other nesting sites. The egg-clutches distributed in two levels along the Lafarge outcrops, together with the geopalaeontological data collected, provide clear evidence for the first colonial nesting and breeding area of titanosaur dinosaurs in Brazil.
Assuntos
Dinossauros , Animais , Evolução Biológica , Brasil , Dinossauros/anatomia & histologia , Casca de Ovo/anatomia & histologia , Fósseis , Comportamento de NidaçãoRESUMO
BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients' lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.
Assuntos
Malformações Arteriovenosas , Hemangioma , Mancha Vinho do Porto , Malformações Arteriovenosas/terapia , Brasil , Criança , Hemangioma/terapia , Humanos , Mancha Vinho do Porto/cirurgia , Revisões Sistemáticas como AssuntoRESUMO
ABSTRACT BACKGROUND: Congenital vascular anomalies and hemangiomas (CVAH) such as infantile hemangiomas, port-wine stains and brain arteriovenous malformations (AVMs) impair patients' lives and may require treatment if complications occur. However, a great variety of treatments for those conditions exist and the best interventions remain under discussion. OBJECTIVE: To summarize Cochrane systematic review (SR) evidence on treatments for CVAH. DESIGN AND SETTING: Review of SRs conducted in the Division of Vascular and Endovascular Surgery of Universidade Federal de São Paulo, Brazil. METHODS: A broad search was conducted on March 9, 2021, in the Cochrane Database of Systematic Reviews to retrieve any Cochrane SRs that assessed treatments for CVAH. The key characteristics and results of all SRs included were summarized and discussed. RESULTS: A total of three SRs fulfilled the inclusion criteria and were presented as a qualitative synthesis. One SR reported a significant clinical reduction of skin redness by at least 20%, with more pain, among 103 participants with port-wine stains. One SR reported that propranolol improved the likelihood of clearance 13 to 16-fold among 312 children with hemangiomas. One SR reported that the relative risk of death or dependence was 2.53 times greater in the intervention arm than with conservative management, among 218 participants with brain AVMs. CONCLUSION: Cochrane reviews suggest that treatment of port-wine stains with pulsed-dye laser improves redness; propranolol remains the best option for infantile hemangiomas; and conservative management seems to be superior to surgical intervention for treating brain AVMs.
Assuntos
Malformações Arteriovenosas/terapia , Mancha Vinho do Porto/cirurgia , Hemangioma/terapia , Brasil , Revisões Sistemáticas como AssuntoRESUMO
Coronary obstruction is an uncommon and severe complication after a transcatheter aortic valve replacement (TAVR), that occurs during the procedure in the vast majority of patients. In the present case even in the absence of classic risk factors, an acute coronary syndrome occurred one day after TAVR. Selective angiography revealed a severe left main ostium obstruction by the bulky native leaflet calcification. This is the first case of delayed presentation of coronary obstruction with a transfemoral balloon-expandable valve using the Inovare bioprosthesis (Braile Biomedica, Brazil). In addition, after drug-eluting stent placement in the left main coronary, intravascular ultrasound revealed severe stent underexpansion, so that a second layer of a bare-metal stent and high-pressure balloon post-dilatation was necessary to improve the final result. The patient was discharged after 7 days, and at the 6-month follow-up remained asymptomatic.
RESUMO
Objetivo: relatar o acompanhamento de reabilitação psicossocial de um usuário da Rede de Atenção Psicossocial (RAPS) de um município da região Amazônica, em função de seu Projeto Terapêutico Singular (PTS). Método: utilizamos o relato de experiência como método de trabalho para narrar o acompanhamento e a intervenção em relação ao caso estudado. Resultados: os resultados demonstraram que pela articulação e implementação de projeto de reabilitação, por meio da integração entre profissionais da RAPS e família, foi possível diminuir o número de internações psiquiátricas, promover a autonomia, favorecer o exercício da cidadania, garantir a defesa dos direitos sociais e humanos ao paciente em estudo. Dessa forma, as etapas necessárias para realizar um projeto de reabilitação, à luz do caso estudado, foram registradas, apresentadas e discutidas no presente trabalho. Conclusão: a intervenção relatada mostrou ser viável, por meio de um projeto de reabilitação psicossocial - construído e articulado através do trabalho em equipe e integração da rede de saúde mental - promover o bem-estar, a funcionalidade e certo grau de autonomia ao paciente do estudo, proporcionando-lhe o exercício da cidadania e dignidade humana.
RESUMO
The objective of this article is to analyze the impact of stigma and discrimination against the LGBT adolescents' psychic suffering. Qualitative study conducted in a specialized outpatient service of Child and Adolescent Mental Health Secondary Care of the Federal District's Health Secretariat. Nine adolescents participated. In-depth interviews facilitated data collection, and data were analyzed with Iramuteq software and Bardin's Content Analysis. Gender identity and sexual orientation intolerance based on heteronormativity violate human rights and are relevant social determinants in health, and overcoming the psychological distress problems identified, combined with respect for human rights of the LGBT community, is an essential vector for facing adolescent health inequalities. Discrimination against LGBT adolescents is a social determinant that health services must address since its leads to harmful consequences, such as school dropouts, lack of opportunities, family bond losses, and suicidal behavior.
O objetivo deste artigo é analisar o impacto do estigma e da discriminação diante do sofrimento psíquico de adolescentes LGBT. Estudo qualitativo em serviço ambulatorial especializado de Saúde Mental Infantojuvenil, da Atenção Secundária da Secretaria de Saúde do Distrito Federal. Participaram do estudo nove adolescentes. Entrevista em profundidade viabilizou a coleta de dados, cuja análise ocorreu com utilização do software Iramuteq e da Análise de Conteúdo de Bardin. Intolerância à identidade de gênero e orientação sexual, fundamentada na heteronormatividade, viola direitos humanos e constitui relevante determinante social em saúde, e a superação dos sofrimentos psíquicos apresentados, articulada com o respeito aos direitos humanos da comunidade LGBT, constitui importante vetor para enfrentamento das iniquidades em saúde na adolescência. A discriminação de adolescentes LGBT é um determinante social que também deve ser enfrentado pelos serviços em saúde, pois ocasiona prejuízos, como a evasão escolar, falta de oportunidades, perda do vínculo familiar e comportamento suicida.
Assuntos
Identidade de Gênero , Estigma Social , Adolescente , Criança , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pesquisa Qualitativa , Comportamento SexualRESUMO
BACKGROUND: Low schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood. OBJECTIVE: To investigate whether schooling stands as an independent risk factor for mortality in STEMI patients. METHODS: STEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and >10 years). Groups were compared by student's t test for continuous variables and qui-square for categorical. Incidence of all-cause mortality was compared with Kaplan-Meyer with Cox regression adjusted by age, gender, and GRACE score. Values of p < 0.05 were considered significant. SPSS21.0 was used for all analysis. RESULTS: The mean schooling duration was 6.63±4.94 years. During the follow-up period (mean: 21 months; up to 6.8 years), 83 patients died (cumulative mortality of 15%). Mortality rate was higher among the lowest quartile compared to those in the highest quartile [18.5 vs 6.8%; HR 2.725 (95% CI: 1.27-5.83; p=0.01)]. In multivariate analysis, low schooling has lost statistical significance for all-cause mortality after adjustment for age and gender, with HR of 1.305 (95% CI: 0.538-3.16; p=0.556), and after adjustment by GRACE score with an HR of 1.767 (95% CI: .797-3.91; p=0.161). CONCLUSION: Low schooling was not an independent risk factor for mortality in STEMI patients.
FUNDAMENTO: A baixa escolaridade tem sido considerada um fator de risco modificável significativo para o desenvolvimento de doenças cardiovasculares há bastante tempo. Apesar disso, ainda não se sabe muito sobre esse fator impactar ou não os desfechos após infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). OBJETIVO: Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST. MÉTODOS: Os pacientes com diagnóstico de IAMCSST foram consecutivamente incluídos em uma coorte prospectiva (Brasília Heart Study) e categorizados de acordo com os anos dos quartis de estudo (0-3, 4-5, 6-10 e >10 anos). Os grupos foram comparados pelo teste t de Student para variáveis contínuas e qui-quadrado para categóricas. A incidência de mortalidade por todas as causas foi comparada com Kaplan-Meyer com regressão de Cox ajustada por idade, sexo e escore GRACE. Valores de p < 0,05 foram considerados significativos. SPSS21.0 foi utilizado para todas as análises. RESULTADOS: A média de escolaridade foi de 6,63±4,94 anos. Durante o período de acompanhamento (média: 21 meses; até 6,8 anos), 83 pacientes vieram à óbito (mortalidade cumulativa de 15%). A taxa de mortalidade foi maior entre o quartil inferior em comparação com aqueles do quartil superior [18,5 vs. 6,8%; RR 2,725 (IC 95%: 1,27-5,83; p=0,01)]. Na análise multivariada, a baixa escolaridade perdeu significância estatística para mortalidade por todas as causas após ajuste para idade e sexo, com RR 1,305 (IC 95%: 0,538-3,16; p=0,556), e após ajuste pelo escore GRACE com RR 1,767 (IC 95%: 0,797-3,91; p=0,161). CONCLUSÃO: Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST.
Assuntos
Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Brasil/epidemiologia , Humanos , Estudos Prospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
Resumo Fundamento A baixa escolaridade tem sido considerada um fator de risco modificável significativo para o desenvolvimento de doenças cardiovasculares há bastante tempo. Apesar disso, ainda não se sabe muito sobre esse fator impactar ou não os desfechos após infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). Objetivo Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST. Métodos Os pacientes com diagnóstico de IAMCSST foram consecutivamente incluídos em uma coorte prospectiva (Brasília Heart Study) e categorizados de acordo com os anos dos quartis de estudo (0-3, 4-5, 6-10 e >10 anos). Os grupos foram comparados pelo teste t de Student para variáveis contínuas e qui-quadrado para categóricas. A incidência de mortalidade por todas as causas foi comparada com Kaplan-Meyer com regressão de Cox ajustada por idade, sexo e escore GRACE. Valores de p < 0,05 foram considerados significativos. SPSS21.0 foi utilizado para todas as análises. Resultados A média de escolaridade foi de 6,63±4,94 anos. Durante o período de acompanhamento (média: 21 meses; até 6,8 anos), 83 pacientes vieram à óbito (mortalidade cumulativa de 15%). A taxa de mortalidade foi maior entre o quartil inferior em comparação com aqueles do quartil superior [18,5 vs. 6,8%; RR 2,725 (IC 95%: 1,27-5,83; p=0,01)]. Na análise multivariada, a baixa escolaridade perdeu significância estatística para mortalidade por todas as causas após ajuste para idade e sexo, com RR 1,305 (IC 95%: 0,538-3,16; p=0,556), e após ajuste pelo escore GRACE com RR 1,767 (IC 95%: 0,797-3,91; p=0,161). Conclusão Investigar se a escolaridade é um fator de risco independente para mortalidade em pacientes com IAMCSST.
Abstract Background Low schooling has been considered an important modifiable risk factor for the development of cardiovascular disease for a long time. Despite that, whether this factor impacts the outcomes following ST-segment elevation myocardial infarction (STEMI) is poorly understood. Objective To investigate whether schooling stands as an independent risk factor for mortality in STEMI patients. Methods STEMI-diagnosed patients were consecutively enrolled from a prospective cohort (Brasilia Heart Study) and categorized according to years of study quartiles (0-3, 4-5, 6-10 and >10 years). Groups were compared by student's t test for continuous variables and qui-square for categorical. Incidence of all-cause mortality was compared with Kaplan-Meyer with Cox regression adjusted by age, gender, and GRACE score. Values of p < 0.05 were considered significant. SPSS21.0 was used for all analysis. Results The mean schooling duration was 6.63±4.94 years. During the follow-up period (mean: 21 months; up to 6.8 years), 83 patients died (cumulative mortality of 15%). Mortality rate was higher among the lowest quartile compared to those in the highest quartile [18.5 vs 6.8%; HR 2.725 (95% CI: 1.27-5.83; p=0.01)]. In multivariate analysis, low schooling has lost statistical significance for all-cause mortality after adjustment for age and gender, with HR of 1.305 (95% CI: 0.538-3.16; p=0.556), and after adjustment by GRACE score with an HR of 1.767 (95% CI: .797-3.91; p=0.161). Conclusion Low schooling was not an independent risk factor for mortality in STEMI patients.
Assuntos
Humanos , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST , Brasil/epidemiologia , Estudos Prospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
Resumo O objetivo deste artigo é analisar o impacto do estigma e da discriminação diante do sofrimento psíquico de adolescentes LGBT. Estudo qualitativo em serviço ambulatorial especializado de Saúde Mental Infantojuvenil, da Atenção Secundária da Secretaria de Saúde do Distrito Federal. Participaram do estudo nove adolescentes. Entrevista em profundidade viabilizou a coleta de dados, cuja análise ocorreu com utilização do software Iramuteq e da Análise de Conteúdo de Bardin. Intolerância à identidade de gênero e orientação sexual, fundamentada na heteronormatividade, viola direitos humanos e constitui relevante determinante social em saúde, e a superação dos sofrimentos psíquicos apresentados, articulada com o respeito aos direitos humanos da comunidade LGBT, constitui importante vetor para enfrentamento das iniquidades em saúde na adolescência. A discriminação de adolescentes LGBT é um determinante social que também deve ser enfrentado pelos serviços em saúde, pois ocasiona prejuízos, como a evasão escolar, falta de oportunidades, perda do vínculo familiar e comportamento suicida.
Abstract The objective of this article is to analyze the impact of stigma and discrimination against the LGBT adolescents' psychic suffering. Qualitative study conducted in a specialized outpatient service of Child and Adolescent Mental Health Secondary Care of the Federal District's Health Secretariat. Nine adolescents participated. In-depth interviews facilitated data collection, and data were analyzed with Iramuteq software and Bardin's Content Analysis. Gender identity and sexual orientation intolerance based on heteronormativity violate human rights and are relevant social determinants in health, and overcoming the psychological distress problems identified, combined with respect for human rights of the LGBT community, is an essential vector for facing adolescent health inequalities. Discrimination against LGBT adolescents is a social determinant that health services must address since its leads to harmful consequences, such as school dropouts, lack of opportunities, family bond losses, and suicidal behavior.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Estigma Social , Identidade de Gênero , Comportamento Sexual , Pesquisa Qualitativa , Acessibilidade aos Serviços de SaúdeRESUMO
The aim of this study was to evaluate the correlation between the corpus luteum vascularization with the concentration of progesterone and the fertility of embryo recipient mares. Mangalarga Marchador mares (n = 33) were distributed into groups according to the days (D) after ovulation, as follows: D3 (n = 8), D4 (n = 8), D5 (n = 9), and D6 (n = 8). The evaluations of the corpus luteum, endometrium, and blood collection to quantify the progesterone concentration were carried out on D3, D4, D5, and D6. Among the parameters evaluated, only progesterone concentration on D6 differed from the other groups (P <0.05). A positive correlation (P <0.05) between the diameter and the area of the corpus luteum, and the objective and subjective methods of the corpus luteum vascular perfusion, was identified. Likewise, a positive correlation (P <0.05) was observed between the objective and subjective methods of the vascular perfusion in the corpus luteum and the progesterone concentration. The pregnancy rate obtained in this study (54.54%) was not affected (P> 0.05) by the day of embryo transfer, whose percentages were 37.50% (3/8) on D3, 50% (4/8) on D4, 66.70% (6/9) on D5, and 62.50% (5/8) on D6. It was estimated that with each increase on the day of embryo transfer, the pregnancy rate increases. The results allow to conclude that the corpus luteum vascularization in mares, evaluated by Doppler ultrasound, correlates with progesterone concentration and the embryo transfer day.