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INTRODUCTION: One of the changes caused by pelvic cancers is the decrease in patients' sexual function, which influences their quality of life (QoL) during and after treatment. Sexual dysfunction (SD) is associated with severe ejaculatory dysfunction, sexual dissatisfaction, reduced libido and sexual desire, decreased intensity of orgasm, difficulty in erection, and lower sexual frequency. OBJECTIVES: This systematic review investigated the effectiveness of conservative treatments (nonsurgical and nonpharmacologic) for SD in males with pelvic cancer. METHODS: Systematic searches were performed in the Cochrane Library, PubMed, CINAHL, PEDro, Embase, and VHL databases in September 2023 by using MeSH terms related to population, study design, intervention, and outcome. RESULTS: Only prostate cancer studies were included due to a lack of studies in other treatments. Studies used pelvic floor muscle training (8 studies); biofeedback (1 study); a penile vibrator (1 study); electrostimulation (2 studies); shock wave therapy (2 studies); aerobic, resistance, and flexibility exercises (2 studies); and a vacuum erection device (1 study). All articles assessed sexual function and reported improvements in the intervention group, including 5 with no differences between the groups. Articles involving shock wave therapy described improvements in SD but were not clinically relevant. Studies evaluating QoL reported benefits in the experimental groups. Adverse effects of a vacuum erection device and penile vibrator were reported. CONCLUSION: Conservative treatments are more effective than others in treating SD in men with prostate cancer. Further studies are needed to assess the unwanted effects of these treatments. In this study, we found evidence that this type of therapy improves sexual function and QoL in this population.
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Tratamento Conservador , Neoplasias da Próstata , Disfunções Sexuais Fisiológicas , Humanos , Masculino , Neoplasias da Próstata/terapia , Neoplasias da Próstata/complicações , Disfunções Sexuais Fisiológicas/terapia , Disfunções Sexuais Fisiológicas/etiologia , Qualidade de VidaRESUMO
Amyotrophic lateral sclerosis (ALS) involves the degeneration of motor neurons and debilitating and possibly fatal symptoms. The COVID-19 pandemic directly affected the quality of life of this group, and the SARS-CoV-2 infection accelerated the present neuroinflammatory process. Furthermore, studies indicate that the infection may have led to the development of the pathology. Thus, the scenario after this pandemic presents "long-lasting COVID" as a disease that affects people who have been infected. From this perspective, studying the pathophysiology behind ALS associated with SARS-CoV-2 infection and possible supporting therapies becomes necessary when we understand the impact on the quality of life of these patients. Thus, the purinergic system was trained to demonstrate how its modulation can add to the treatment, reduce disease progression, and result in better prognoses. From our studies, we highlight the P2X7, P2X4, and A2AR receptors and how their activity can directly influence the ALS pathway.
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Thyroid cancer usually responds to surgical and ablative therapy, but when it's refractory the alternative lies in tyrosine kinase inhibitors that, in addition to harmful side effects, acts only in a palliative way. The concern for other therapeutic possibilities brought evidence on flavonoids, hypothesizing a possible strategy. This review aimed to organize a compilation of in vitro studies using polyphenol substances in TPC-1 (human papillary thyroid carcinoma cell line) summarizing it's results and describing the metabolic pathways involved. Articles were selected on PubMed, Google Scholar, LILACS, BVS and SciELO, using keywords "thyroid cancer", "flavonoids" and "TPC-1", until June 2022. 185 studies were selected. After identification and exclusion of duplicates and exclusion criteria applied, 11 original articles were evaluated. Of these, the findings of flavonoids added to TPC-1 were: inhibition of cell growth and viability, promotion of cell cycle arrest and induction of apoptosis. Polyphenolic compounds have antineoplastic properties by different mechanisms as shown in vitro, but the concentrations needed are above usual dietary consumption and the findings are limited to experimental cellular studies. Despite that, these results should be useful to guide further analysis aiming to reveal the real safety and efficacy of polyphenols in this scenario.
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Antineoplásicos , Neoplasias da Glândula Tireoide , Humanos , Câncer Papilífero da Tireoide/tratamento farmacológico , Câncer Papilífero da Tireoide/patologia , Polifenóis/farmacologia , Linhagem Celular Tumoral , Neoplasias da Glândula Tireoide/patologia , Antineoplásicos/farmacologia , Flavonoides/farmacologiaRESUMO
The aim of the work was to evaluate antagonistic activity of Lactobacillus spp. and Bifidobacterium spp. in vitro against cariogenic Streptococcus mutans UA 159 and viability in chewing gum, during storage. Antagonistic activity was evaluated in vitro by the "spot on the lawn" test. Two bacteria were chosen and subjected to lyophilization and microencapsulation using the atomization method, containing polyvinylpyrrolidone polymer and lactose as encapsulating agents. For application in food matrices, four treatments were elaborated: chewing gum containing lyophilized B. lactis B94 (BLL), microencapsulated B. lactis B94 (BLE), lyophilized L. brevis (LBL), and microencapsulated L. brevis (LBE). Both microorganisms demonstrated a high capacity for inhibition against S. mutans, when compared to oral antiseptic chlorhexidine 0.2% in vitro, and according to the test of sensitivity profile to proteolytic enzymes, all the bacteria tested are producers of antimicrobial peptides, resulting in the inhibitory activity of the cariogenic bacterium. Furthermore, the viability of B. lactis B94 and L. brevis was maintained after microencapsulation, indicating that the process was efficient, with no significant difference (p < 0.05) between the results. And, in the chewing gum containing the bacteria during the storage period (33 days), it was found that cell immobilization did not significantly influence (p < 0.05) the counts of L. brevis but benefited the viability of B. lactis B94. Therefore, both probiotic bacteria are producers of antimicrobial substances with the ability to inhibit S. mutans, in vitro. The microencapsulation was considered efficient since it influenced the viability of B. lactis B94 (> 8 log CFU/g); however, the microencapsulation did not influence the viability of L. brevis since in both lyophilized and encapsulated form; the concentration of the bacteria remained above 8 log CFU/g during the storage period of the chewing gum.
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Probióticos , Streptococcus mutans , Lactobacillus/fisiologia , Goma de Mascar , Bifidobacterium/fisiologia , Probióticos/farmacologiaRESUMO
ABSTRACT Thyroid cancer usually responds to surgical and ablative therapy, but when it's refractory the alternative lies in tyrosine kinase inhibitors that, in addition to harmful side effects, acts only in a palliative way. The concern for other therapeutic possibilities brought evidence on flavonoids, hypothesizing a possible strategy. This review aimed to organize a compilation of in vitro studies using polyphenol substances in TPC-1 (human papillary thyroid carcinoma cell line) summarizing it's results and describing the metabolic pathways involved. Articles were selected on PubMed, Google Scholar, LILACS, BVS and SciELO, using keywords "thyroid cancer", "flavonoids" and "TPC-1", until June 2022. 185 studies were selected. After identification and exclusion of duplicates and exclusion criteria applied, 11 original articles were evaluated. Of these, the findings of flavonoids added to TPC-1 were: inhibition of cell growth and viability, promotion of cell cycle arrest and induction of apoptosis. Polyphenolic compounds have antineoplastic properties by different mechanisms as shown in vitro, but the concentrations needed are above usual dietary consumption and the findings are limited to experimental cellular studies. Despite that, these results should be useful to guide further analysis aiming to reveal the real safety and efficacy of polyphenols in this scenario.
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The present study aimed to evaluate the association between premature primary tooth loss and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted in 769 5-year-old preschool children. The children and their parents or guardians answered the Brazilian version of the Scale of Oral Health Outcomes for 5-Year-Old Children for the assessment of OHRQoL. Meanwhile, clinical examinations were performed for the assessment of premature primary tooth loss. Unadjusted and adjusted multilevel Poisson regression models were utilized to investigate the associations between the variables. In the parental version of the scale, premature posterior primary tooth loss (rate ratio [RR] = 2.65; 95% confidence interval [CI] = 1.51-4.68), weak sense of coherence (RR = 2.25; 95% CI = 1.62-3.11), and visit to a dentist (RR = 1.61; 95% CI = 1.04-2.52) were associated with OHRQoL. Based on the children's perceptions, only the preschool type was associated with OHRQoL (RR = 1.92; 95% CI = 1.21-3.05). Premature posterior primary tooth loss had a greater impact on OHRQoL based on the parents' perception, whereas only the preschool type was associated with OHRQoL based on the children's perception.
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Cárie Dentária , Qualidade de Vida , Brasil/epidemiologia , Pré-Escolar , Estudos Transversais , Humanos , Saúde Bucal , Inquéritos e Questionários , Dente DecíduoRESUMO
Resumo: Introdução: Atualmente, a maioria das pessoas está inserida num contexto sócio-histórico de negação da morte, incluindo médicos que lidam com o morrer diariamente que se consideram despreparados perante a morte de um paciente. O desconforto desses profissionais nesse processo de morte deve-se em parte à deficiência da formação ocorrida durante a graduação. Objetivo: Este estudo teve como objetivos analisar a opinião dos alunos de Medicina da Faculdade Pernambucana de Saúde (FPS) acerca da abordagem referente à morte e ao morrer durante a graduação, verificar a importância disso na formação médica e descrever esse tema por meio da perspectiva dos estudantes. Também se objetifica identificar aspectos que influenciam a percepção dos graduandos acerca do tema. Método: É um estudo exploratório, de corte transversal, com metodologia quantitativa, realizado entre agosto de 2020 e julho de 2021. A coleta de dados foi realizada por meio de questionários on-line, com amostra de 365 sujeitos, após aceite e marcação no Termo de Consentimento Livre e Esclarecido, enviados aos alunos por e-mail. Para análise, adotou-se o software Epi-Info, em que se utilizaram frequências relativas e absolutas para descrever as variáveis qualitativas e medidas de posição e dispersão para descrever variáveis quantitativas. Para verificação de relações, foi utilizado o teste de qui-quadrado, considerando um nível de significância de 5%. O estudo seguiu todos os preceitos da Resolução nº 510/2016 do Conselho Nacional de Ética em Pesquisa e teve aprovação do Comitê de Ética da FPS - Parecer nº 4.228.016. Resultado: A maioria dos alunos associa angústia, medo e tristeza ao processo de morte e concorda que a discussão desse processo na graduação impacta o exercício da medicina e o bem-estar psicossocial do médico. Os estudantes concordam que a abordagem do processo de morte aconteceu em raros momentos durante a graduação e julgam necessária a inclusão de mais disciplinas que tratem do tema. Conclusão: A discussão acerca do processo de morte e morrer durante a graduação em Medicina é necessária, e recomenda-se a inserção de módulos que abordem o tema no curso da FPS, a fim de contribuir para a compreensão dos estudantes acerca desse processo e o preparo psicológico deles para lidar com a morte no exercício da profissão.
Abstract: Introduction: Currently, most people are inserted in a sociohistorical context of denial of death, including physicians who deal with dying daily who consider themselves unprepared in the face of the death of a patient. The discomfort of these professionals in the face of the death process is due in part to the lack of the training that occurred during graduation. Objective: This study aimed to analyze the opinion of medical students at the Faculdade Pernambucana de Saúde (FPS) about teaching and perceptions on death and dying during graduation, verify the importance in medical education and describe this approach through the students' perspective. It is also objective to find aspects that influence the belief of undergraduates about the theme. Method: This is an exploratory cross-sectional study with quantitative method, conducted between August 2020 and July 2021. Data collection was carried out through online questionnaires, with a sample of 365 subjects, after acceptance and marking on the free and informed consent form, sent to students by e-mail. For analysis, epi-info software was used using relative and absolute frequencies to describe qualitative variables and position and dispersion measures to describe quantitative variables. The chi-square test was used to verify the chi-square test, considering a significance level of 5%. The study followed all the precepts of Resolution nº 510/2016 of the National Council of Ethics in Research and received approval from the ethics committee of the college under opinion number 4,228,016. Result: Most students associate anguish, fear, and sadness with the process of death and agree that the discussion of this process in graduation impacts on the practice of medicine and on the psychosocial well-being of the physician. The students agree that the approach to the death process happened in rare moments during graduation and consider it necessary to include more disciplines that address it. Conclusion: The discussion about the process of death and dying process during medical graduation is necessary, and the insertion of modules that approach it is recommended in the medical course of FPS to contribute to the students' understanding of this process and in the psychological preparation of these students to deal with death in the exercise of the profession.
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As neoplasias cardíacas primárias são raras, e o diagnóstico correto é essencial para planejar o tratamento mais adequado. O objetivo deste estudo foi demonstrar o papel da ressonância magnética cardíaca na avaliação, no diagnóstico e no acompanhamento de fibroma cardíaco. Paciente do sexo feminino, 21 anos, com massa miocárdica ao ecocardiograma. Realizou ressonância magnética com diagnóstico de fibroma cardíaco. Foi acompanhada durante 6 anos com estabilidade do quadro. Fibromas cardíacos correspondem à segunda neoplasia mais comum em crianças e jovens. À ressonância magnética, caracterizam-se por realce tardio intenso e homogêneo.(AU)
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Humanos , Feminino , Adulto , Adulto Jovem , Fibroma/ultraestrutura , Fibroma/diagnóstico por imagem , Ventrículos do Coração/anormalidades , Neoplasias/diagnóstico , Fatores de Tempo , Imageamento por Ressonância Magnética , Ecocardiografia/métodos , Espectroscopia de Ressonância Magnética/métodos , Tomografia/métodos , SeguimentosRESUMO
BACKGROUND: The prevalence of dental caries is high in adolescents worldwide, and a large percentage have never been to a dentist or have not had regular dental appointments. AIM: To evaluate the influence of oral health literacy and sociodemographic, clinical, and family factors on dental visits among early adolescents. DESIGN: A cross-sectional study was conducted with 740 12-year-old students in Campina Grande, Brazil. Students answered about their level of oral health literacy (BREALD-30), levels of family adaptability and cohesion (FACES III), and visits to the dentist sometime in life. Dental caries experience was evaluated using Nyvad criteria. Robust Poisson regression for complex samples was performed. RESULTS: A higher level of oral health literacy (PR = 1.01; 95% CI: 1.01-1.03), high social class (PR = 1.28; 95% CI: 1.09-1.50), higher mother's schooling (PR = 1.58; 95% CI: 1.37-1.83), family cohesion classified as enmeshed (PR = 1.55; 95% CI: 1.19-2.02) and connected (PR = 1.22; 95% CI: 1.02-1.44), and the absence of toothache (PR = 1.18; 95% CI: 1.01-1.38) remained associated with having visited a dentist. CONCLUSIONS: Oral health literacy and sociodemographic, family, and clinical factors were predictors of having visited a dentist among early adolescents.
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Cárie Dentária , Letramento em Saúde , Adolescente , Brasil/epidemiologia , Estudos Transversais , Cárie Dentária/epidemiologia , Humanos , Saúde BucalRESUMO
Many types of nanocomposites employed in food packaging are based on silver nanoparticles (AgNP) because of their antibacterial properties, which can increase food shelf-life. As the commercialization of AgNP products has been expanding, the released of such nanoparticles in the environment has caused enormous concern, once they can pose potential risks to the environment and human beings. For instance, exposure of the maternal environment to nanomaterials during pregnancy may impact the health of the dam, fetus and offspring. In this context, here we investigated the effects of prenatal exposure of AgNP on the pregnancy outcomes of dams and postnatal development of their offspring. Pregnant Wistar rats were exposed to distinct AgNP concentrations (0, 1, 3 and 5 µg/kg/day) from beginning to the end of pregnancy. At parturition, newborns were observed regarding clinical signs of toxicity and survival rate. The offspring was examined by evaluating developmental endpoints. A delay in time for vaginal opening and testes descent were detected in the offspring exposed to AgNP during embryonic development. Our results indicate that prenatal exposure to AgNP can compromise neonatal rats' postnatal development, especially the reproductive features.
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Nanopartículas Metálicas/toxicidade , Efeitos Tardios da Exposição Pré-Natal , Prata/toxicidade , Animais , Desenvolvimento Embrionário/efeitos dos fármacos , Feminino , Masculino , Troca Materno-Fetal , Gravidez , Ratos Wistar , Testículo/efeitos dos fármacos , Testículo/crescimento & desenvolvimento , Vagina/efeitos dos fármacos , Vagina/crescimento & desenvolvimentoAssuntos
Humanos , Masculino , Pessoa de Meia-Idade , Dor no Peito/complicações , Doença das Coronárias/congênito , Anomalias dos Vasos Coronários/patologia , Artéria Coronária Esquerda Anormal/diagnóstico por imagem , Angiocardiografia/métodos , Espectroscopia de Ressonância Magnética/métodos , Morte Súbita/etiologia , Achados Incidentais , Revascularização Miocárdica/métodosAssuntos
Humanos , Masculino , Idoso , Doença da Artéria Coronariana/fisiopatologia , Ruptura Cardíaca Pós-Infarto/complicações , Falso Aneurisma/etiologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Cateterismo Periférico/métodos , Ecocardiografia , Espectroscopia de Ressonância Magnética/métodos , Tomografia Computadorizada por Raios X/métodos , Comorbidade , StentsRESUMO
Fundamento: O infarto do miocárdio é uma das principais causas de morbimortalidade no mundo, e 13,2% dos pacientes com síndrome coronariana aguda apresentam coronárias sem obstrução significativa, denominada MINOCA (do inglês Myocardial Infarction with Non-Obstructive Coronary Artery, Infarto do Miocárdio sem Doença Coronariana Obstrutiva). Apesar do MINOCA ter evolução mais favorável que o infarto do miocárdio por obstrução coronariana, seu prognóstico não é benigno. A ressonância magnética cardíaca é o exame que apresenta importância no diagnóstico das diversas causas de MINOCA, e seu valor prognóstico não está completamente elucidado. Objetivo: Avaliar o valor prognóstico da ressonância magnética cardíaca na detecção de eventos adversos maiores em pacientes com MINOCA. Métodos: Coorte prospectiva por meio de coleta de dados de pacientes admitidos na urgência de pacientes com hospital terciário, diagnosticados com MINOCA, no período de 2012 a 2019. Resultados: Foram avaliados 179 pacientes com seguimento médio de 45 ± 21 meses, sendo 52% do sexo masculino, com idade média de 57,3 ± 15,5 anos. Observou-se incidência de eventos adversos maiores de 17,9%. A taxa de mortalidade ao final do acompanhamento foi de 3,8%. Na análise multivariada, apenas a ressonância magnética cardíaca com resultado normal se mostrou como preditor independente de bom prognóstico (hazard ratio: 0,09; intervalo de confiança de 95% 0,01- 0,88; p = 0,04), com curva de Kaplan-Meier apresentando diferença significativa (log-rank x2 = 9,83; p = 0,02) na predição de eventos adversos maiores. Conclusão: A ressonância magnética cardíaca normal mostrou-se como variável independente de bom prognóstico nessa população, podendo ser útil na estratificação de risco de pacientes com MINOCA.
Background: Myocardial infarction is one of the major causes of morbidity and mortality worldwide and 13.2% of patients with acute coronary syndrome have normal or unobstructed coronary arteries, called MINOCA (Myocardial Infarction with Non-Obstructive Coronary Artery). Cardiac magnetic resonance (CMR) is the gold standard for investigating the etiology of acute coronary syndrome. Although MINOCA has a more benign evolution than myocardial infarction due to coronary obstruction, its prognostic factors are not completely elucidated. Objective: To evaluate prognosis, predictive factors and describe the incidence of major adverse cardiovascular events in patients with MINOCA. Methods: Prospective cohort through data collection of patients admitted to the emergency department of a tertiary hospital, diagnosed with MINOCA from 2012 to 2019. The mean follow-up was 45 months, the outcomes considered were: death, rehospitalization due to cardiac causes, recurrence of chest pain, myocardial revascularization (MACE).
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Síndrome Coronariana Aguda/diagnóstico por imagem , Hipertensão/complicações , Infarto do Miocárdio/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Análise Multivariada , Estudos de Coortes , Avaliação de Resultados em Cuidados de SaúdeAssuntos
Humanos , Feminino , Idoso , Linfoma Difuso de Grandes Células B/terapia , Linfoma Difuso de Grandes Células B/diagnóstico por imagem , Disfunção Ventricular Esquerda/patologia , Insuficiência Cardíaca/complicações , Alta do Paciente , Fatores de Tempo , Dexametasona/administração & dosagem , Prednisona/administração & dosagem , Ecocardiografia/métodos , Espectroscopia de Ressonância Magnética/métodos , Radiografia Torácica/métodos , Tomografia Computadorizada por Raios X/métodos , Metotrexato/administração & dosagem , Pulsoterapia/enfermagem , Rituximab/administração & dosagem , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodosRESUMO
OBJECTIVE: To compare automated and manual magnetic resonance imaging protocols for estimating liver iron concentrations at 1.5 T. MATERIALS AND METHODS: Magnetic resonance imaging examination of the liver was performed in 53 patients with clinically suspected hepatic iron overload and in 21 control subjects. Liver iron concentrations were then estimated by two examiners who were blinded to the groups. The examiners employed automated T2* and T1 mapping, as well as manual T2* and signal-intensity-ratio method. We analyzed accuracy by using ROC curves. Interobserver and intraobserver agreement were analyzed by calculating two-way intraclass correlation coefficients. RESULTS: The area under the ROC curve (to discriminate between patients and controls) was 0.912 for automated T2* mapping, 0.934 for the signal-intensity-ratio method, 0.908 for manual T2*, and 0.80 for T1 mapping, the last method differing significantly from the other three. The level of interobserver and intraobserver agreement was good (intraclass correlation coefficient, 0.938-0.998; p < 0.05). Correlations involving T1 mapping, although still significant, were lower. CONCLUSION: At 1.5 T, T2* mapping is a rapid tool that shows promise for the diagnosis of liver iron overload, whereas T1 mapping shows less accuracy. The performance of T1 mapping is poorer than is that of T2* methods.
OBJETIVO: Comparar protocolos automatizados e manuais de ressonância magnética para estimar a concentração hepática de ferro em 1,5 T. MATERIAIS E MÉTODOS: Foi realizada ressonância magnética hepática em 53 pacientes com suspeita de sobrecarga de ferro hepática e 21 controles, seguida da estimativa cega da concentração hepática de ferro por dois examinadores usando mapas automáticos T2* e T1, assim como o manual T2* e o método signal-intensity-ratio. O desempenho foi medido usando curvas ROC e a correlação interobservador e intraobservador usando o coeficiente de correlação intraclasse bidirecional. RESULTADOS: O desempenho da curva ROC separando pacientes e controles mostrou áreas sob a curva de 0,912 para o mapa automático T2*, 0,934 para o método signal-intensity-ratio, 0,908 para manual T2* e 0,80 para mapa T1 (este difere significativamente dos outros três métodos). Houve boa correlação interobservador e intraobservador (coeficiente de correlação intraclasse entre 0,938 e 0,998; p < 0,05). Correlações envolvendo o mapa T1, embora ainda significativas, foram menores. CONCLUSÃO: Em 1,5 T, o mapa T2* representa uma nova ferramenta rápida e promissora para avaliar o diagnóstico de sobrecarga de ferro hepática, enquanto o mapa T1 mostrou menor precisão. O desempenho do mapa T1 foi menor que o dos métodos T2*.
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Abstract Objective: To compare automated and manual magnetic resonance imaging protocols for estimating liver iron concentrations at 1.5 T. Materials and Methods: Magnetic resonance imaging examination of the liver was performed in 53 patients with clinically suspected hepatic iron overload and in 21 control subjects. Liver iron concentrations were then estimated by two examiners who were blinded to the groups. The examiners employed automated T2* and T1 mapping, as well as manual T2* and signal-intensity-ratio method. We analyzed accuracy by using ROC curves. Interobserver and intraobserver agreement were analyzed by calculating two-way intraclass correlation coefficients. Results: The area under the ROC curve (to discriminate between patients and controls) was 0.912 for automated T2* mapping, 0.934 for the signal-intensity-ratio method, 0.908 for manual T2*, and 0.80 for T1 mapping, the last method differing significantly from the other three. The level of interobserver and intraobserver agreement was good (intraclass correlation coefficient, 0.938-0.998; p < 0.05). Correlations involving T1 mapping, although still significant, were lower. Conclusion: At 1.5 T, T2* mapping is a rapid tool that shows promise for the diagnosis of liver iron overload, whereas T1 mapping shows less accuracy. The performance of T1 mapping is poorer than is that of T2* methods.
Resumo Objetivo: Comparar protocolos automatizados e manuais de ressonância magnética para estimar a concentração hepática de ferro em 1,5 T. Materiais e Métodos: Foi realizada ressonância magnética hepática em 53 pacientes com suspeita de sobrecarga de ferro hepática e 21 controles, seguida da estimativa cega da concentração hepática de ferro por dois examinadores usando mapas automáticos T2* e T1, assim como o manual T2* e o método signal-intensity-ratio. O desempenho foi medido usando curvas ROC e a correlação interobservador e intraobservador usando o coeficiente de correlação intraclasse bidirecional. Resultados: O desempenho da curva ROC separando pacientes e controles mostrou áreas sob a curva de 0,912 para o mapa automático T2*, 0,934 para o método signal-intensity-ratio, 0,908 para manual T2* e 0,80 para mapa T1 (este difere significativamente dos outros três métodos). Houve boa correlação interobservador e intraobservador (coeficiente de correlação intraclasse entre 0,938 e 0,998; p < 0,05). Correlações envolvendo o mapa T1, embora ainda significativas, foram menores. Conclusão: Em 1,5 T, o mapa T2* representa uma nova ferramenta rápida e promissora para avaliar o diagnóstico de sobrecarga de ferro hepática, enquanto o mapa T1 mostrou menor precisão. O desempenho do mapa T1 foi menor que o dos métodos T2*.
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Objetivo: verificar se a estratégia de simulação empregada para capacitação em suporte básico de vida e situações de obstrução de vias aéreas interfere na autoconfiança interprofissional no âmbito da atenção primária à saúde. Método: estudo quaseexperimental desenvolvido com 68 profissionais da atenção primária do Distrito Federal, entre junho e dezembro de 2018. Utilizaram-se questionários para caracterização do conhecimento e avaliação da autoconfiança. Realizou-se aula expositiva e simulação realística sobre parada cardiopulmonar e obstrução de vias aéreas como intervenção, sendo significativos os resultados com diferença estatisticamente significativa antes e após (p<0,05). Resultados: amostra majoritariamente feminina (69,1%), com idade entre 21 e 70 anos, com predomínio de agentes comunitários de saúde (32,4%). Houve melhora na autoconfiança para o manejo correto da parada cardiopulmonar e da desobstrução de vias aéreas (p<0,001) após a intervenção. Conclusão: a simulação favorece aprendizagem experiencial, desenvolvendo autoconfiança interprofissional para lidar com emergências na atenção primária à saúde.
Objective: to verify if the simulation strategy employed for basic life support training and situations of airway obstruction interferes with interprofessional self-confidence in primary health care. Method: quasi-experimental study conducted with 68 primary care professionals in the Federal District, Brazil, between June and December 2018. Questionnaire to characterize knowledge and self-confidence were used. A lecture and realistic simulation on cardiopulmonary arrest and airway obstruction were performed as intervention, being statistically significant different results before and after intervention (p<0,05). Results: mostly female sample (69.1%), aged between 21 and 70 years. Community health agents predominated (32.4%). Self-confidence improved for the correct management of cardiopulmonary arrest and airway clearance (p <0.001) after intervention. Conclusion: Simulation supports experiential learning, developing interprofessional self-confidence in dealing with emergencies in primary health care.
Objetivo: verificar si la estrategia de simulación empleada para el entrenamiento de soporte vital básico y las situaciones de obstrucción de las vías respiratorias interfieren con la autoconfianza interprofesional en la atención primaria de salud. Método: estudio cuasi experimental realizado con 68 profesionales de atención primaria en el Distrito Federal, Brasil, entre junio y diciembre de 2018. Se utilizó un cuestionario para caracterizar el conocimiento y la autoconfianza. Una intervención y una simulación realista sobre el paro cardiopulmonar y la obstrucción de las vías aéreas se realizaron como intervención, siendo resultados estadísticamente significativos diferentes antes y después de la intervención (p <0,05). Resultados: muestra mayoritariamente femenina (69,1%), con edades comprendidas entre 21 y 70 años. Predominaron los agentes comunitarios de salud (32,4%). La autoconfianza mejoró para el manejo correcto del paro cardiopulmonar y el despeje de la vía aérea (p <0.001) después de la intervención. Conclusión: La simulación apoya el aprendizaje experimental, desarrollando la autoconfianza interprofesional para enfrentar emergencias en la atención primaria de salud.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Atenção Primária à Saúde , Autoimagem , Pessoal de Saúde , Treinamento por Simulação , Centros de Saúde , Capacitação ProfissionalRESUMO
Objetivo Mostrar a correlação existente entre a massa corporal de aves e a distância de fuga das mesmas. Métodos Foram observadas aves em período reprodutivo e não reprodutivo em diferentes locais do município de Jacareí-SP. Foi realizada uma abordagem em diferentes espécies de aves andando em direção a elas, considerando o ser humano como um potencial predador. A distância de início de voo (FID) foi anotada para cada abordagem e comparada à massa corporal de cada espécie observada. Resultados Um total de 13 espécies aves foram observadas e os resultados demonstraram uma ausência de correlação linear significativa entre distância de início de voo e massa corpórea de aves (r = 0,4142 e p = 0,1594). À medida que uma das variáveis aumenta a outra nem sempre acompanha. Conclusões Os resultados obtidos não podem ser restritos. Se faz necessário um estudo mais amplo a respeito dos fatores de interferência, tanto na distância de fuga, como na massa corpórea, para que seja possível conservar a integridade dos processos biológicos e as espécies de aves, como de outros animais. Observar para compreender e intervir
Objective To show the correlation between the body mass of birds and their flight distance. Methods Reproductive and non-reproductive birds were observed in different locations of Jacarei-SP. An approach was taken on different bird species walking towards them, considering the human being as a potential predator. The flight start distance (FID) was noted for each approach and compared to the body mass of each observed species. Results A total of 13 bird species were observed and the results showed a lack of significant linear correlation between flight start distance and bird body mass (r = 0.4142 and p = 0.1594). As one of the variables, increases the other does not always follow. Conclusions The results obtained cannot be restricted. A broader study is needed on interference factors, both in the flight distance and body mass, in order to preserve the integrity of biological processes and species of birds and other animals. Observe to understand and intervene.