Revista da Faculdade de Ciências Médicas de Sorocaba

Factors associated with violence against homeless people

Reinaldo José Gianini, Abel, Kathleen Vilarim Villena — Mon, 08 Sep 2025 00:00:00 -0300

The problem of homelessness (HLN) has been the subject of discussion in various spheres of public policy, given its complexity and the need for intervention from different sectors. Analyzing the factors associated with the types and perpetrators of violence against HLN, with special attention to drug use, social and demographic variables, and variables related to homelessness and health, is very important. This research refers to the HLN population present in the Municipality of Sorocaba. The interviews were carried out from August 2022 to July 2023, in places known to be frequented by HLN. This is a cross-sectional study involving 84 individuals. Data collection was conducted through interviews using a standardized questionnaire. This project was submitted to and approved by the Research Ethics Committee of the Faculty of Medical Sciences of Sorocaba. The results of the present study show high rates of drug use among the HLN population, with crack users presenting a more critical profile: irregular eating habits, history of arrest, history of psychiatric hospitalization, reports of various mental health problems, and non-adherence to prevention measures. The prevalence of reported morbidity and psychiatric hospitalizations is relevant in the sample. Victimization due to physical violence, predominantly by the police and mainly involving cocaine and crack users, is another aspect that deserves attention. The results showed that drug use is the main factor complicating access to healthcare among the HLN population, being the primary reason for the loss of housing, with family conflicts predominating as the main cause of homelessness among ...

Impact of COVID-19 on postoperative mortality in patients with proximal femoral fractures

Wed, 18 Jun 2025 00:00:00 -0300

Objective: This systematic review and meta-analysis aims to characterize the impact of the COVID-19 pandemic on postoperative mortality rates in patients with proximal femoral fractures. Methodology: A systematic review and meta-analysis were performed using Cochrane tools, employing a PICO strategy (Patient or Problem: Femur fracture with COVID-19; Intervention: Surgery; Control or Comparison: Femur fracture without COVID-19; Outcomes: Overall mortality and length of hospital stay; Time: Minimum follow-up of six months. Results: After applying the inclusion and exclusion criteria, eight studies were deemed eligible for meta-analysis from an initial pool of 264 articles. These studies collectively involved 10,902 participants. The overall mortality rate was found to be 28.2% among patients with COVID-19, in contrast to 8.25% among those without the infection. A significantly higher proportion of deaths was observed among COVID-19 positive patients compared to their negative counterparts, yielding an overall odds ratio (OR) of 4.93 (95% CI: 2.79 - 8.71; p <0.001). Conclusion: The findings underscore the profound impact of COVID-19 on the mortality of patients undergoing surgery for hip fractures, indicating an almost five-fold increased risk of death. This data underscores the severity of the infection within an already vulnerable population.

Faucets and keyboards as major reservoirs for Gram-negative bacilli in a regional hospital in Northeast Brazil

Mon, 18 Nov 2024 00:00:00 -0300

Erratum: correction of the title of the article in English and Portuguese

Social determinants of health in ischemic stroke in a municipality in Northeast Brazil

Mon, 04 Aug 2025 00:00:00 -0300

Objective: To analyze the relationship between the social determinants of health and the incidence of ischemic stroke in a municipality in the Brazilian Northeast. Method: This is an exploratory, descriptive, and cross-sectional study with a quantitative approach, conducted in the Emergency Department, Intermediate Care Unit I, Stroke Unit, and Special Care Unit (SCU) of a public hospital in the state of Ceará. The study population consisted of 60 patients, with a mean age of 69.6 years. Results: A predominance of male participants was observed, totaling 36 individuals (60%), as well as a predominance of self-declared non-white individuals, with 46 participants (76.7%). Among the modifiable risk factors, low educational attainment (less than eight years of schooling) was the most prevalent, affecting 49 participants (81.7%). Regarding the work environment, although 97% reported favorable satisfaction, it is noteworthy that one-third of the participants (68.3%) did not adopt health protection measures. There was a predominance of deficiencies in components related to housing infrastructure, especially concerning street paving, sewage systems, and housing conditions in urban areas. Conclusion: In summary, it can be inferred that social factors require careful and intersectoral attention beyond the health environment, and that risk factors should be prioritized in public policies.

Effects of lidocaine patch on orofacial pain and sleep quality in patients with bruxism

Ana Luiza Hehnes Silbiger Martins, Gabriela Gerenutti, Marli Gerenutti — Mon, 08 Sep 2025 00:00:00 -0300

Introduction: Sleep bruxism is a movement disorder characterized by teeth grinding or clenching, which results in rhythmic contractions of the masseter muscles. These contractions can increase tooth compression during sleep compared to wakefulness. This mechanical stress may contribute to chronic orofacial pain, tooth fractures, dental wear, and temporomandibular joint damage. Objective: To evaluate the effects of applying a 5% lidocaine patch on orofacial pain and sleep quality in patients with sleep bruxism. Methodology: This was a pilot outpatient treatment study, open-label, self-controlled, with both quantitative and qualitative assessments. It included 10 volunteers diagnosed with sleep bruxism for over five years. Participants self-applied a 5% lidocaine patch at a daily dose of 350 mg, worn nightly for 8 hours over a 30-day
period. Sleep quality and pain levels were assessed using a self-reported questionnaire. Results: Nine patients adhered satisfactorily to the treatment protocol. Significant improvements in orofacial pain associated with sleep bruxism were observed on days 10, 20, and 30 of treatment (p < 0.001). Improved sleep quality was also reported at the end of the
intervention (p < 0.005). As expected, teeth grinding behavior remained unchanged (p > 0.05). Conclusion: The use of a 5% lidocaine patch as an adjunct treatment for moderate to severe sleep bruxism promoted muscle relaxation, reduced orofacial pain, improved sleep quality, and was well tolerated, with no adverse reactions reported.

Prevalence and risk factors associated with obesity in children and adolescents in an isolated rural district

Thu, 19 Dec 2024 00:00:00 -0300

The prevalence of childhood overweight and obesity is growing in Brazil and around the world, influenced by genetic, behavioral, environmental, and social determinants. Objective: To evaluate the prevalence of overweight and obesity in children and adolescents in an isolated rural district and identify its determinants. Methods: Cross-sectional, quantitative, descriptive, and analytical study evaluating the anthropometric and sociodemographic data of students and their parents from the only (municipal) elementary school in an isolated rural district in a municipality in the State of São Paulo. Results: The prevalence of excess weight observed was 33.3% (overweight 9.5%, and obesity 23.8%), higher than the national average (14.1% for obesity). No difference was observed in the prevalence of obesity between male and female genders. The risk of obesity increases with age. The prevalence of obesity was positively associated with greater consumption of
fried foods and carbohydrates and negatively with the consumption of fruits and vegetables. No correlation was observed with hours of physical activity or time spent in front of screens (TV and cell phones). Families with overweight mothers or fathers are more likely to have overweight or obese children. Overweight fathers and mothers have a higher prevalence of high blood pressure and type 2 diabetes mellitus. Conclusions: Obesity in children and adolescents in this isolated rural district is higher than the national average. It is associated with families whose parents are also overweight and excessive consumption of fried foods and carbohydrates.

Helicobacter pylori infection in patients with dyspeptic complaints

Thu, 25 Jul 2024 00:00:00 -0300

Erratum: In PDF file

Where the author's name reads: Cintia Maria de Melos Mendes1
Read: Cintia Maria de Melo Mendes1

FODMAP content in meals at a university restaurant and the presence of gastrointestinal symptoms among students

Mon, 07 Oct 2024 00:00:00 -0300

Objectives: to verify the presence of gastrointestinal symptoms in student using a university restaurant, in addition to identifying the FODMAP content of the menus offered and its relationship with the presence of symptoms. Material and Methods: observational and cross-sectional study that included 28 students from a public university in the city of Santos, SP,
Brazil. Data collection took place between March and April 2022. Students responded to an (on-line) form with sociodemographic questions, intestinal habit (stool typology) and gastrointestinal manifestations, occurring within 24 hours of eating the meal. The FODMAP content of the menus was evaluated, considering: low content; moderate content and high content. Results: of the participants (n=28), 28.6% were male; the age ranged between 18 and 26 years. The majority of students (n=12) reported a bowel movement pattern between constipation and diarrhea. Among the other manifestations, 78.5% (n=22) reported abdominal pain/stomachache; 57.1% reported flatulence and 42.8% diarrhea and/or urgent bowel movements. As for the menus (14), more than half (n = 8) contained a high FODMAP content. Symptoms appeared between four and six hours after the meal among more than 50% of students who reported symptoms (n = 6). Conclusions: meals with moderate and high FODMAP content were related with the presence of gastrointestinal manifestations such as abdominal pain, flatulence, diarrhea and bowel movement urgency, within 24 hours after consumption among university students.

Land use and land cover factors associated with snakebites

Edenilson Osinski Francisco, Millena Fernandes, Josiane Somariva Prophiro — Wed, 02 Apr 2025 00:00:00 -0300

Objective: This study aimed to identify factors related to land use and land cover that affect the incidence and occurrence of snakebite accidents. Methods: A systematic review was conducted using published studies from ScienceDirect, Scopus, PubMed, and Web of Science between 2012 and 2022. Results: 883 studies were obtained, and five publications were
selected after the full-text reading, all conducted in Brazil. Thirteen different variables were found, most of which were related to natural land cover. Vegetation cover was the most studied variable, with its effects depending on the ecological characteristics of the snake involved in the bite. Variables related to urbanization and population density were identified
as negatively related to snakebites, while Agriculture and all identified agriculture-related variables showed a positive association. Conclusion: Land use and land cover changes impact snakebite accidents, although retrospective studies on the subject are scarce.

Effect of prone position on oxygenation of patients with COVID-19 under invasive mechanical ventilation

Carolaine Ramos Martins, Iuri Dheloi Oliveira de Lima, Lucas Lima Ferreira — Wed, 02 Apr 2025 00:00:00 -0300

Objective: To evaluate the behavior of the ventilation/perfusion ratio of patients with positive COVID-19 under mechanical ventilation (MV) after the prone position. Methodology: Quantitative, descriptive, retrospective research in an intensive care unit (ICU) COVID-19 from May to December 2020. Data were collected: age, sex, comorbidities, PaO2 collected from arterial blood gases, FiO2 collected of the mechanical ventilator at the time of blood gas collection to calculate the PaO2/FiO2 ratio. This relationship was calculated at the pre-prone, one-hour post-prone, six-hour post-prone, and four-hour post-supine moments. The time spent on MV (in days), the SAPS III score, the length of stay in the ICU (in days), and the outcomes of discharge or death in the unit were also collected. All data were collected from patients' electronic medical records. Results: 71 patients with a mean age of 58.7 ± 15.5 years, 60.5% male, were selected. The most prevalent comorbidity was arterial hypertension with 60.6%. The mean PaO2/FiO2 ratio before prone positioning was 113.11 mmHg, with a significant increase (p < 0.0001) of 91.97 mmHg after six hours in the prone position, with a mean duration of 19h46min ± 0h14min in the prone position. There was 55.5% of death among patients. Conclusion: The prone position caused a significant increase in oxygenation in patients
with COVID-19 under MV.

Sociodemographic, clinical, and treatment profile of women with breast cancer at a referral hospital in Amazonas

Mon, 04 Aug 2025 00:00:00 -0300

Introduction: Breast cancer is the most frequent malignant neoplasm among women worldwide. In Brazil, it accounts for 20.3% of all cancer cases and in the state of Amazonas, the estimated incidence for 2023 was 500 new cases. Objective: To outline the sociodemographic, clinical, and treatment profile of women with breast cancer treated at the referral hospital in Amazonas. Methods: This is a retrospective, descriptive, and cross-sectional study based on secondary data from all women undergoing breast cancer treatment at a referral hospital in the state of Amazonas. Data were obtained from the public database of the “Instituto Nacional de Câncer” (INCA) and the “Registro Hospitalar de Câncer” (RHC) from 2013 to 2022. Results: A total of 2,311 cases of women with breast cancer were analyzed. Most patients self-identified as “parda” (mixed race) (80.23%), lived in the state of Amazonas (96.19%), had completed secondary education (37.47%), and were married (51.02%). The predominant age group was 40 - 49 years (28.65%). Approximately 80% were referred by the Brazilian Unified Health System (Sistema Único de Saúde - SUS), 32.93% had a family history of cancer, and 44% had no recorded cancer staging. Among the staged cases, only 4.93% were diagnosed at an early stage (0/I). Conclusion: These findings support the discussion on public policies aimed at strengthening awareness strategies for timely diagnosis and
improving hospital care management. They also contribute to the management of prevention, diagnosis, and care strategies in oncology within the perspective of the state of Amazonas and the teams ...

Perception of the interprofessional team on the use of telemedicine in intensive care units during the COVID-19 pandemic

Vivian Menezes Irineu, Maria Eduarda Bueno, Flavio Morgado — Mon, 10 Nov 2025 00:00:00 -0300

The COVID-19 pandemic has boosted the use of telemedicine as a means of communication and knowledge sharing. Objective: To understand real-world experiences through multiple facets of interprofessional interaction regarding the effectiveness of telemedicine in the Intensive Care Unit (ICU). Methods: A cross-sectional, mixed-methods, exploratory study was conducted using questionnaires and focus group interviews with the ICU team from Itapetininga (SP, Brazil), who had contact with telemedicine during the pandemic period. Quantitative data were analyzed using SPSS Statistics version 21. Thematic content analysis was performed, and categories were constructed non–a priori, following Bardin’s approach. After the analysis, the data were grouped and, for the final interpretation, structured based on insights from Moscovici’s theory of social representations. Results: The team reported satisfaction with the use of telemedicine, with consistency being the main obstacle to be overcome and integration serving as the key facilitator for its implementation. Conclusion: This study makes a significant contribution to the healthcare field, providing an overview of telemedicine from the perspective of its main stakeholders and revealing potentially modifiable factors that may support better use of this technology. the biggest obstacle to be overcome and integration being the facilitator for its implementation. Conclusion: the work presents a significant contribution to the health sector, and shows an overview of the use of telemedicine from the perspective of its main actors, revealing potentially modifiable factors that will support better use of the technology.

Epidemiological data of pregnant women with COVID-19 in Sorocaba, São Paulo, and Brazil

Wed, 02 Apr 2025 00:00:00 -0300

Objective: This article aims to investigate the epidemiological data on COVID-19 in pregnant women at national, state, and municipal levels. Methodology: Data from the Brazilian Obstetric Observatory (OOBr) between 2020 and June 2022 were analyzed. A descriptive analysis was performed to integrate the data, complemented by Tukey's Test for Multiple Proportion Comparisons, as described by Zar, considering p-values below 0.05 as significant. Results: Between March 2020 and June 2022, Brazil reported 22,245 cases and 2,031 deaths from severe COVID-19 in pregnant women, with the mortality peak occurring in 2021. Young women aged 20 to 34 years, with a high school education and predominantly of mixed race, were the most affected. Black women showed higher rates of complications and mortality, reflecting the impact of structural racism, unfavorable socioeconomic conditions, and limited access to healthcare services. The third trimester of pregnancy emerged as the period of highest vulnerability. Conclusion: The analysis revealed that young, mixed-race, and Black pregnant women were the most affected by COVID-19, highlighting social and racial inequalities. The third trimester was identified as the highest-risk period, with worsening conditions in 2021 due to low vaccination rates but improvements in 2022 following mass immunization. The study underscores the need for public policies to ensure equitable access to healthcare and combat misinformation.

Efficacy of comfrey in foot ulcerations related to diabetes

Thu, 19 Dec 2024 00:00:00 -0300

Objective: To evaluate the effects of external use of comfrey on diabetes-related foot ulceration in the outpatient stomatherapy nursing clinic of a quaternary public teaching hospital. Methods: This is a randomized-controlled, parallel, double-blind, two-arm, quantitative clinical trial conducted with 19 participants. The control group used hydrogel, while the intervention group used a 5% ointment made from the aqueous extract of comfrey leaves. The groups used the formula for 60 days, applying it every 24 hours, and were reassessed every 15 days. To collect data, an instrument was used consisting of a section with clinical information related to the injury and another dedicated to the measurements and dimensions of the injury. Results: There was an increase in the percentage of lesion contraction in the group using 5% comfrey on the 15th (p < 0.05), 30th (p < 0.01), 45th (p < 0.05) and 60th (p < 0.05) days of treatment, rapid improvement in the Texas classification and in the predominance of granulation tissue after the 15th day, in relation to the control group. Conclusion: The analysis of this study's results, it was possible to observe that comfrey promoted faster healing, decreased exudate and pain levels, improved Texas classification, tissue repair in a shorter time, increased percentage of lesion contraction, and improved tissue perfusion.

Social determinants of health and hospitalization of children from zero to four years old by COVID-19 in Northeast Brazil

Mon, 09 Sep 2024 00:00:00 -0300

Objective: to analyze the association between social determinants and morbidities for COVID-19 outcomes related to hospitalization, ICU stay and death in children aged 0 to 4 years in Northeast Brazil. Methodology: this is a quantitative, documentary study of reported cases regarding hospitalization due to COVID-19 in children aged 0 to 4 years between
March 13, 2020 and June 19, 2021. Data collection was carried out by consulting the secondary publicly accessible database. A total of 2,039 cases of COVID-19 were confirmed in the states of the Northeast region of Brazil. Results: male children predominated (58.1%), aged 1 year (56.8%), brown skin color (83.3%); with preexisting morbidity (70.0%) and multimorbidities (24.5%). There was an association between the social determinants of health and the morbidities, of which the following were significant: age and ICU stay; age and death outcome; morbidity and evolution to ICU admission. Conclusion: the results of the study contribute to the planning of health strategies and public policies to reduce hospitalizations and deaths from COVID-19.

Peroneus brevis tendon subluxation

Mon, 04 Aug 2025 00:00:00 -0300

Subluxation of the peroneal tendons is a rare pathology, usually related to sports trauma, which occurs due to rupture of the superior peroneal retinaculum. The diagnosis is mostly clinical, but imaging techniques such as dynamic ultrasonography and magnetic resonance imaging may help confirm it. If there is no improvement with conservative treatment, surgical intervention may be indicated, although there is no consensus on the most appropriate technique. In this case report, the authors present a case of subluxation of the peroneus brevis tendon with no apparent traumatic cause, in which surgical intervention was required after failure of conservative management. The chosen technique was superior peroneal retinaculum reconstruction by overlapping, which proved to be successful.

Low success rate of recovery of Sporothrix spp. from a fungal collection using storage through mineral oil technique

Mon, 09 Sep 2024 00:00:00 -0300

Subject: We aimed to evaluate the recovery rate of Sporothrix spp. isolates maintained for years through the mineral oil technique. Methods: Two hundred and seventeen isolates of Sporothrix spp. from the fungal collection of the Mycology Laboratory of Faculdade de Medicina - Universidade Federal do Rio Grande (FAMED-FURG), Southern Brazil, with a mean period of storage of five years, were included in the study. Isolates were subcultured in duplicate on Sabouraud dextrose agar and on brain heart infusion agar. Results: Of the 217 isolates, only 16.6% (n = 36) were recovered. The median period of storage was similar between the viable (n = 36) and non-viable (n = 181) isolates, being 5.8 years and 4.7 years, respectively (p ˃ 0.05). Conclusion: Considering the low rate of Sporothrix spp. recovery using mineral oil, we reject to use this methodology and strongly recommend another storage methods to guarantee the maintenance of viable Sporothrix spp. isolates in fungal cultures.

Prevalence of priority congenital anomalies in the Northern Region of Brazil

Wed, 13 Nov 2024 00:00:00 -0300

Objectives: The study aimed to assess the reasons for alcohol consumption in adolescence and the influence of school units on alcohol use among adolescents through data collection at a private school. Based on the data collected, the objective was to implement interventions in the school to identify the best ways to address alcohol use. Methods: The AUDIT-C questionnaire, adapted for research purposes, was administered to high school students and ninth graders at a private school in a large municipality in the state of São Paulo, enabling the collection of data on students' alcohol use. Specific intervention methods were then devised based on the gathered data. In this context, informative lectures and active methodologies were employed, along with the creation of educational materials for the school. Results: Among the main findings, out of 170 student responses, only 41 (24.1%) reported never having used alcohol, while 129 students (75.9%) had experimented with alcoholic beverages. Regarding the age of first consumption, 61 (35.9%) students reported first use between the ages of 14 and 16, 15 (8.8%) between 10 and 12 years old, and no one reported trying alcohol after the age of 18. Conclusion: Alcohol consumption among adolescents is an issue of utmost importance for public health, as it relates to preventing the early development of alcoholism, thereby avoiding public expenditures and health complications. Interventions within schools are necessary for prevention and improved outcomes.

Residual anatomic, hemodynamic and functional abnormalities after Tetralogy of Fallot repair

Wed, 02 Apr 2025 00:00:00 -0300

Objective: Most patients are left with residual abnormalities after post-surgical repair of Tetralogy of Fallot. The aim of this study is to assess anatomic, hemodynamic and functional outcomes after surgical repair of this congenital heart disease, long-term follow-up and factors that influence these results. Methods: It was performed a systematic literature review through “Preferred Reporting Items for Systematic review and Meta-Analysis Protocols” (PRISMA-P) checklist. The following databases were included: PubMed, Virtual Health Library, Cochrane Library, and Scientific Electronic Library Online of studies published from 2018 to 2022. Results: The transannular patch and homograft/conduit implant techniques expose patients to chronic pulmonary regurgitation, while valve-sparing procedures may cause residual pulmonary stenosis. After surgical repair, most patients remain with residual lesions, such as right ventricular dilatation from chronic pulmonary regurgitation, pulmonary artery stenosis, right ventricular outflow tract aneurysm, tricuspid regurgitation, ventricular septal defects and dilation of aorta. Dysfunction of the right ventricle may appear and, subsequently, the left, arrhythmias, right ventricular strain, pulmonary edema, heart failure, and sudden death. Anatomical and functional cardiac alterations may arise, like obstruction of the right ventricular outflow tract, pulmonary artery branch stenosis, and pulmonary valve regurgitation. Conclusion: Residual lesions after repair lead to significant morbidity in adult patient's lives. The knowledge of outcomes provides opportunities to assess treatment decisions and guide surgical strategies. It is essential to evaluate the adverse clinical events to improve the quality of life of these patients and reduce morbidity and mortality.

Insecticidal effect of Cannabis

Mon, 07 Oct 2024 00:00:00 -0300

Currently, there is a need for the development of vector insect control products that are ecologically viable, utilizing active principles available in nature. Natural compounds with insecticidal potential already identified in Cannabis are promising prospects for the control and management of vector arthropods of diseases. In this context, the work aims to investigate
possible disparities in the toxicity effects of Cannabis in different formulations and at different stages of the vectors' life. This is a systematic review. Experimental studies describing the toxic effects of Cannabis on eggs, larvae, pupae, and adult vector insects were included. Articles in which the insect was characterized as a mechanical vector, literature review research, and ethnobotanical studies were excluded. The study revealed the potential insecticidal effect of Cannabis when applied in different formulations on Ctenocephalides felis felis, Aedes albopictus, Anopheles stephensi, Anopheles gambiae, and Culex quinquefasciatus at different stages of development. Cannabis proved to be a promising plant in terms of mortality and evidenced effects on insect fertility, birth rates, and adult emergence. The study revealed a potential insecticidal effect of Cannabis. However, further investigations are crucial to elucidate the role of this plant in vector insect control strategies.

Prevalence and factors associated with dyslipidemia in a municipality of Espírito Santo, Brazil

Wed, 02 Apr 2025 00:00:00 -0300

Objective: To identify the prevalence and factors associated with dyslipidemia in adults living in the city of Alegre, Espírito Santo. Methods: A cross-sectional study was conducted in the city of Alegre, Brazil. Descriptive analyses were performed based on the frequency distributions of sociodemographic characteristics, health profile, pre-existing diseases, medication use, and quality of life. Factors associated with dyslipidemia were analyzed using Poisson regression with robust variance. Results: A total of 694 individuals were interviewed, of whom 174 (25.1%) reported having been diagnosed with dyslipidemia. The majority of participants were women (72.9%), self-declared white (47.5%), lived in the city center (69.6%), and were married (43.3%). Factors associated with dyslipidemia included older age, physical activity, polypharmacy, and having more than two comorbidities. Conclusion: Guidance from health professionals regarding physical activity, healthy eating, and medical monitoring is essential,
as high levels of total cholesterol, triglycerides, and LDL are evidenced as risk factors for cardiovascular diseases.

Factors associated with extubation success in premature infants submitted to the spontaneous breathing trial

Thu, 19 Dec 2024 00:00:00 -0300

Many factors can influence the extubation of premature infants and it is not safe to use only the spontaneous breathing trial. Objective: To connect cardiac, neurological and pulmonary factors that influence the extubation success in premature infants
submitted to the 5-minute Spontaneous Breathing Trial (SBT). Methods: The sample consisted of 27 premature infants that passed through the weaning protocol until eligibility for extubation. The premature infants were followed daily from birth to post-extubation. The extubation protocol/checklist was composed for clinical and neurological conditions, pulmonary and cardiac factors, medication, post-extubation ventilatory support, physiological variables, ventilatory parameters and SBT test with the Silverman Andersen Respiratory Severity Score (SA-RSS). Descriptive analyzes of quantitative variables and Mann-Whitney statistical tests were performed. Results: The ventilatory parameters that showed statistical differences between the groups were plateau pressure and tidal volume. The gestational age (GA) using Capurro method, GA corrected and birth weight were higher in the success group (0.02, 0.003 and 0.0). The use of caffeine may have contributed to successful extubation (p = 0.03). The post-extubation support that presents statistical significance was non-invasive intermittent positive pressure ventilation (NIPPV) (0.01). Conclusion: The study pointed out important variables that contributed to the extubation success, such as the ventilatory parameters, clinical stability and use of caffeine for the weaning process.

Quality of life after hospitalization for COVID-19

Mon, 07 Oct 2024 00:00:00 -0300

Objective: To analyze quality of life (QoL) and associated factors in individuals after hospitalization due to COVID-19. Method: Cross-sectional study of patients hospitalized for COVID-19. The WHOQOL-BREF instrument was used for QOL analysis. A multiple linear regression model was used to evaluate the QOL of the stakeholders. Results: The highest mean QOL was observed in the social relationships domain (14.97 ± 3.43), followed by the psychological (14.53 ± 2.07), environmental (14.20 ± 2.49) and physical domains (12.75 ± 2.10). For each additional year of age, there was an increase of 0.44 points in the physical domain, 0.06 in the social relationship domain and 0.49 in the environmental domain. Individuals earning up to 2 times the minimum wage had a reduction of 1.60 points in the environmental domain; retired or a pensioner had a reduction of 1.84 points in the physical domain score, 1.40 in the psychological domain score and 2.62 in the social
domain score in the ICU had a negative impact of 1.52 points on the scores in the social relationship domain. Conclusions: After hospitalization for COVID-19, individuals presented a good perception of their QOL. Demographic, social and clinical aspects influenced the perception of QOL, which indicates the need for the adoption and implementation of public policies
aimed at minimizing these differences.

Association between environment and functionality in manual wheelchair users

Fabiola Hermes Chesani, Camila Cristine Tavares, Marigleice Pauline Stolben — Wed, 18 Jun 2025 00:00:00 -0300

Objective: People with physical disabilities who use manual wheelchairs face significant functional restrictions in their environment. The study explores the association between environment and functionality using the International Classification of Functioning, Disability, and Health (ICF). Methods: Exploratory and qualitative research with ten adults with acquired physical disabilities who use manual wheelchairs. Semi-structured interviews were conducted addressing the environmental components of the ICF. Results: Identified categories include urban accessibility, emotional support and family care, social stigmatization, disability rights, and the perception of the beginning of the rehabilitation process. Conclusion: The study analyzed the interactions between environment and functionality of manual wheelchair users, identifying challenges such as lack of urban accessibility and the importance of family and professional support. It highlighted the need for a more inclusive society to improve the quality of life for these individuals.

Profile of people with obstructive sleep apnea syndrome undergoing positive airway pressure treatment

Fabiola Hermes Chesani, Tatiane Kremer Rhoden, Carina Nunes Bossardi — Thu, 19 Dec 2024 00:00:00 -0300

Objective: To identify the profile of people with Obstructive Sleep Apnea Syndrome (OSAS) who are undergoing continuous positive airway pressure treatment. Methods: This study had a quantitative, descriptive-correlational character. Fifty individuals over 18 years of age, of both genders, with a positive diagnosis, participated. The data collection instrument used was a structured questionnaire. Results: It was observed that the older the individual, the greater the probability of an individual presenting the syndrome. The average body mass index (BMI) of 31 which is classified as a degree of obesity. Regarding gender, 30 (60%) were male; 27 (54%) did not smoke; 19 (38%) exercised three times a week, while 20 (40%) never exercised; 22 (44%) consumed alcohol once a week; 30 had 5 to 10 symptoms of OSAS and everyone reported snoring. Hypertension was the most reported comorbidity, with 39 (58%) cases, followed by obesity with 27 (57%) and heart disease with 19 (38%). Difficulty in reaching an OSA diagnosis was reported by 25 (50%) participants, while the other 25 (50%) said they had no difficulties with the diagnosis. Most CPAP treatment was indicated in 41 (82%) by a doctor, 6 (12%) by a physiotherapist, 1 (2%) by a family member and 2 (4%) by friends. Conclusion: The results indicate difficulties in diagnosis in 50% of cases and list comorbidities in patients with diagnosis and treatment, making it easier for the clinician to identify a profile of patients who may have the disease and carry out investigation.

Early alcoholism and alcohol use among adolescents

Wed, 13 Nov 2024 00:00:00 -0300

Characterization of the factors associated with HIV infection during the COVID- 19 pandemic in western Maranhão, Brazil

Marcelo Leite Viana, Maria Aparecida Alves de Oliveira Serra — Wed, 02 Apr 2025 00:00:00 -0300

Objective: To analyze the sociodemographic and behavioral factors related to HIV infection during the COVID-19 pandemic in 2020. Method: Observational and retrospective study that analyzed 869 service records from a Testing Center in Northeast Brazil. Results: The HIV infection rate was 8.2% throughout 2020. Patients who were married (CI = 0.22 - 0.76) and from rural areas (CI = 0.07 - 0.99) had a lower probability of infection, while those tested in the second semester (CI = 0.35 - 0.94) and with access to condoms (CI = 0.06 - 0.36) had a lower risk. People of White or Asian race (CI = 0.06 - 1.20) and patients who had an occupation (CI = 0.16 - 0.73) showed a lower probability of infection in the second half of the year. Conclusion: Prevention and social isolation measures during the pandemic may have impacted the demand for testing services, increasing vulnerability to HIV infection. The study characterized the associated factors and the most vulnerable groups during this period.

Development of a teacher training program for autism spectrum disorders

Wed, 24 Jul 2024 00:00:00 -0300

Objective: Continuing education focused on the inclusion of children with autism spectrum disorder (ASD) can contribute to better implementation of educational practices, and the use of online technologies is an alternative to increasing the number of specialized professionals. Methods: This study develops a distance teacher training program (DTTP) based on the previous research’s identification of the essential requirements for training education professionals caring for children with ASD within a collaborative digital learning environment are used to facilitate learning techniques, strategies, and resources with the goal of fostering innovation; and tests and discusses the program’s feasibility. Results: A total of 187 education professionals from a municipality in Brazil participated in this study and answered a structured questionnaire to collect information on practices, attitudes, and knowledge. Data were analyzed quantitatively to characterize the sample, and the answers were analyzed qualitatively using Nvivo coding assistance software and manual coding; key concepts were isolated, themes developed, and quotes were identified within the interview transcripts to illustrate data analysis. Data saturation was achieved through interviews to identify themes for the syllabus of the course. Conclusion: From the results and based on active learning methodologies to address real-world problems and promote practical and collaborative solutions to daily challenges with theoretical support, the DTTP was designed, and its application was conducted and evaluated.

Peripartum hysterectomy in a high-risk maternity hospital in the Brazilian Amazon

Wed, 13 Nov 2024 00:00:00 -0300

Objective: To describe the clinical and epidemiological profile of patients undergoing puerperal hysterectomy (PH) at the Fundação Santa Casa de Misericórdia do Pará (FSCMP), a reference hospital of the Northern Region for high-complexity maternal and child care. Materials and Methods: A retrospective, observational and descriptive study
was conducted on the electronic medical records of patients who underwent PH between January 2020 and December 2022 at the FSCMP. Results: 94 PH were performed over three years, with a rate of 3.97 PH per 1,000 births. The mean age of the patients was 30 years-old. The most common educational level was complete high school (49%), and the majority were single (51%). Nearly 40% of the patients had four or more pregnancies, and 36% had three or more previous deliveries. The most frequent route of delivery was cesarean section (91%). The main reasons for PH were refractory uterine atony and pelvic sepsis. Regarding the surgical technique, total abdominal hysterectomy was the majority (56%). In 60% blood transfusion was required, and 73% of cases required ICU care. The mean mortality rate
was 3.1 deaths per 100 PH. Conclusion: The incidence of PH at the FSCMP was high. Most patients were multiparous with one or more previous cesarean deliveries and the route of delivery of the current pregnancy was cesarean section. A large portion required ICU care and blood component transfusions. The mortality rate for PH at the research institution was lower than found in the literature.

Enteral nutrition and quality of life

Andre Henrique Haddad Serejo, Renata Costa Fortes — Mon, 04 Aug 2025 00:00:00 -0300

Objective: To evaluate the association between enteral nutrition and quality of life using a quanti-qualitative approach in individuals undergoing tumor resection. Methods: A cross-sectional study was conducted with postoperative head and neck cancer patients receiving exclusive enteral nutrition during hospitalization. Data were collected from April to
July 2022. Participants over 18 years old completed the Hospital Anxiety and Depression Scale (HADS) and the Functional Assessment of Cancer Therapy – Head and Neck (FACT-H&N). Variables included duration of enteral nutrition, oncological treatments, anthropometric factors, and length of hospital stay. A significance level of p < 0.05 was adopted. Kruskal-Wallis, Student’s t-test, and Chi-square tests were applied. Qualitative data were analyzed using the Collective Subject Discourse (CSD) methodology until data saturation was achieved. Results: The “additional concerns” subscale (p = 0.01; mean = 16.40; SD = 4.64) and the “physical well-being” domain (p = 0.001; mean = 18.90; SD = 6.03) showed significant associations with depression levels (mean = 10.5; SD = 6.11). Anxiety levels (mean = 16.47; SD = 3.76) were significantly correlated with “physical well-being” (p = 0.00) and “emotional well-being” (p = 0.02; mean = 14.17; SD = 4.64). Conclusion: Limited knowledge about therapeutic approaches was associated with reduced quality of life and contributed to symptoms of depression and anxiety in patients receiving postoperative enteral nutrition..

Faucets and keyboards as major reservoirs for Gram-negative bacilli in a regional hospital in Northeast Brazil

Wed, 13 Nov 2024 00:00:00 -0300

Infections related to healthcare assistance represent a major public health problem worldwide, and the main etiological agents associated with these infections are microorganisms also found on inanimate hospital surfaces. Therefore, understanding the dynamics of bacterial contamination of hospital surfaces is essential for professionals working in these services. Objective: To evaluate the contamination of inanimate surfaces by Gram-negative bacilli (GNB) in a Regional Hospital in Northeast Brazil. Methods: This is an observational and cross-sectional study. Samples were collected from different hospital wards using a sterile swab soaked in saline solution. They were then plated on MacConkey agar and incubated at 36°C for 48 hours. The bacterial isolates were counted and identified using the Gram staining method, TSI agar, and oxidase test. Results: Out of the 150 samples collected, 71 showed no microbiological growth, 11 showed growth of filamentous fungi, and 66 showed growth of Colony Forming Units (CFU). A total of 132 morphologically distinct colonies were identified, with 55 identified as yeasts and 77 as GNB. In the evaluation of hospital wards, the Adult Emergency Room and the Orthopedic Surgical Clinic showed the highest growth of GNB. Regarding the surfaces studied, the most contaminated were faucets, computer keyboards, mattresses, and beds. Conclusions: Hospital areas with higher human traffic are the most contaminated, particularly on frequently handled objects. Therefore, it is necessary to focus on disinfecting these surfaces to break the transmission chain of these etiological agents.

Aggregation of risk factors for COVID-19 mortality in Vila Velha, Espírito Santo, Brazil

Mon, 08 Sep 2025 00:00:00 -0300

Introduction: COVID-19 presents higher lethality in individuals with comorbidities. However, the aggregation of some of these conditions and their association with increased risk of death has not yet been evaluated, with a view to guiding prevention strategies and clinical management. Objective: To analyze the aggregation of four comorbidities
(cardiopathies, pneumopathies, diabetes, and obesity) in COVID-19 lethality. Method: A cross-sectional study including 390,454 COVID-19 patients residing in Vila Velha (ES), who died from COVID-19 between April 2020 and May 2022. Aggregation was analyzed by comparing the observed prevalence with the expected prevalence across various groupings. Poisson regression was used to identify the risk of death, and analyses were conducted using Stata 16.0. Results: The lethality rate was 0.7%, and prevalence was higher among men, individuals of Yellow/Indigenous race, the elderly, and illiterate individuals. The risk of death was 313% higher in obese patients (HR 4.13; 95%CI 3.39–5.03), 126% higher in diabetics (HR 2.26; 95%CI 1.98–2.58), 90% higher in those with cardiopathies (HR 1.90; 95%CI 1.68–2.15), and 85% higher in those with pneumopathies (HR 1.85; 95%CI 1.49–2.31). The aggregation of two, three, or four comorbidities increased disease lethality. Conclusion: Obesity, diabetes, cardiopathies, and pneumopathies—whether isolated or combined—increase COVID-19 lethality.

Knowledge of primary healthcare nursing professionals about the accuracy and validation of the automatic sphygmomanometer

Kayco Damasceno Pereira, Priscila Rangel Dordetto — Wed, 13 Nov 2024 00:00:00 -0300

Objective: This research aimed to evaluate the knowledge of nursing professionals working in Primary Healthcare regarding the need to validate automatic sphygmomanometers. Materials and Methods: Field research, descriptive, methodological, with a quantitative approach. A convenience sampling was used, and it was composed of nursing professionals who worked in Basic Health Units and the Family Health Strategy Unit in Sorocaba (SP). Semi-structured interviews were carried out using the “Google Forms®” tool. Results: 31 nursing professionals participated, aged between 23 and 59 years, with a mean age of 41.9 and a standard deviation of 9.9 years, 93.5% female, and 80.6% with higher education and/or postgraduate education. It was found that 77.4% used an automatic sphygmomanometer regularly, 45.8% received some type of guidance regarding its use, and 75.0% of them chose it because of its practicality/ease. Regarding the concept of validating these devices, 71.0% were unaware, and only one participant (3.2%) was able to indicate a scientific validation entity. Conclusions: Even though the use of automatic sphygmomanometers has increased considerably, it is noticed that the people who use them do not have adequate knowledge about validation, which directly interferes with the accurate and reliable measurement of blood pressure. The research revealed a gap in the knowledge of nursing professionals. Therefore, it emphasizes the need to invest in educational actions for all health professionals who use these devices to promote a more efficient and qualified practice for patients.

Effective tutoring in problem-based learning

Tatiane Muniz Barbosa, Ana Júlia Franceschi, Sabrine Santos Delunardo — Wed, 18 Jun 2025 00:00:00 -0300

Objective: To analyze the characteristics that influence the effectiveness of the tutor in problem-based learning (PBL), from the perspective of students of a medical course that uses active methodologies. Methodology: This study employed a mixed-methods approach, characterized as both quantitative and qualitative. Data were collected through questionnaires based on domains related to the aptitude of an effective tutor, specifically content expertise, social congruence, and cognitive congruence. The research sample consisted of 157 students from the second phase onwards of the course. The study was conducted after receiving approval from the Research Ethics Committee (opinion number 4.793.638). Results: Among the students who completed the questionnaire, 98.7% considered that demonstrating preparation and knowledge is fundamental for achieving content mastery. Additionally, within the domain of social congruence, the interaction among members of the tutorial group and the tutor’s ability to foster a welcoming and humanized environment stood out. Furthermore, over 80% of the students indicated that cognitive congruence should involve stimulating discussion and fostering the development of clinical reasoning. Conclusions: The characteristics that stand out, for medical students, in relation to tutor effectiveness are associated with the domain of content competence and cognitive congruence.

Evaluation of the impact of social isolation during the COVID-19 pandemic on the development of children in the school system of Piracicaba, SP, Brazil

Mon, 09 Sep 2024 00:00:00 -0300

Objective: COVID-19 pandemic affected children's lives, specifically child development and learning. Understanding the impact of this isolation allows us to establish measures to manage the deficits caused during this period. This research aimed to evaluate the impact of social isolation during the COVID-19 pandemic on family income, teaching activities and learning. Methods: In this context, this article is a descriptive, analytical, and prospective study, carried out by completing a socioeconomic and lifestyle questionnaire, during the period of isolation, by those responsible for children aged between 24 and
72 months enrolled in daycare centers/public schools in Piracicaba, SP, Brazil. Results: From a total of 1,763 electronic forms distributed to the target population, a response rate of 72% was obtained, with 1,283 individuals completing the questionnaire completely. Data collection showed that during the pandemic, the families of 77% of the children participating in the research were in social isolation. Based on the data reported, according to those responsible, only 15% of children did not show any change in behavior during the pandemic, although 63% described that the child had no change in sleep. However, only 8% of children stopped playing, while most children interviewed maintained some form of physical activity during the pandemic. Around 7% of those responsible reported having observed educational difficulties, such as learning, and 11% described observing social difficulties, such as interaction difficulties in these children. Conclusion: These findings suggest that social isolation directly and indirectly affected the child development of preschoolers in the Public Education Network of ...

Contributing factors to death due to tuberculosis and COVID-19 co-infection in a cohort in northeastern Brazil

Wed, 02 Apr 2025 00:00:00 -0300

Objective: To identify the factors that increase the risk of death in people with tuberculosis and COVID-19 co-infection. Methods: This was a retrospective cohort study conducted in the state of Pernambuco, Brazil. A total of 10,572 patients diagnosed with tuberculosis, regardless of whether they contracted COVID-19, were evaluated. Risk factors for death from COVID-19 were identified using bivariate analysis and multivariate logistic regression with a stepwise forward approach. Results: Among the 10,572 patients with tuberculosis, pulmonary tuberculosis was the most prevalent in 8,833 patients (83.5%), followed by 488 patients with peripheral lymph node tuberculosis (28%). Of these, 2,643 patients (25%) contracted COVID-19. Of the 814 tuberculosis patients who died, COVID-19 was responsible for 98 deaths (12%). Bivariate analysis demonstrated that being male increased the likelihood of dying from COVID-19 by 60%. Logistic regression analysis identified the following factors associated with an increased risk of death from COVID-19: male sex (RR = 1.71, 95% CI 1.0 to 2.92), age (RR = 1.04, 95% CI % 1.02 to 1.05), diabetes (RR = 1.95, 95% CI 1.17 to 3.23), abandonment of tuberculosis treatment (RR = 3.41, 95% CI 1.19 to 9.76) and admission to a ward or intensive care unit due to COVID-19 (RR = 4.79, 95% CI 2.17 to 10.57). Conclusions: People with tuberculosis who did not adhere to tuberculosis treatment or who required hospitalization or intensive care due to COVID-19 had a higher risk of dying from COVID-19.

Evolution of empathy scores of medical students in an institution with a humanist curriculum

Wed, 29 May 2024 00:00:00 -0300

Introduction: The medical literature has recorded that among many medical students, as the course progresses, there is a decrease in empathy scores as well as an increase in stress, depressive symptoms, and exhaustion. However, few studies have evaluated how empathy levels behave during graduation, in all years of the course. Objective: To assess how the empathy scores of medical students at the Faculty of Medical and Health Sciences of the Pontifical Catholic University of São Paulo (FCMS of PUC-SP) behave in all academic years. Participants and Methods: This is a quantitative, cross[1]sectional, descriptive, experimental (survey) study. The levels of empathy were evaluated using the student version of the Jefferson Scale (JSPE-S, Jefferson Scale of Physician Empathy - Student version) in 336 of the 633 medical students of the FCMS of PUC-SP, from the first to sixth year. The medical course of FCMS of PUC-SP is humanist, based on active methodologies implanted in 2006. Results: The study observed that the levels of empathy among students from the first to the sixth year of FCMS of PUC-SP remain stable, with values of 121.1 ± 8.0 (mean ± SD). Female participants had higher empathy scores than male students (122.6 ± 6.8 vs 118.2 ± 9.1; p < 0.001). Conclusion: The study observed that the empathy scores of medical students at FCMS of PUC-SP remained stable in all academic years and that female students had higher empathy scores than male students.

Helicobacter pylori infection in patients with dyspeptic complaints

Wed, 24 Jul 2024 00:00:00 -0300

Objective: To determine the frequency of Helicobacter pylori infection in patients with dyspeptic complaints and to assess the agreement between urease test results and histopathological examination in the diagnosis of infection. Methods: Ob[1]servational, cross-sectional and descriptive study, based on the results of the urease test, histopathological examination and endoscopic report of patients undergoing upper digestive endoscopy (EDA) at a University Hospital in the city of Teresina, Piauí. Results: The sample consisted of 300 patients, mostly women, with a mean age of 53.93 years. The urease test was positive in 34% of the exams and the histopathological test in 55%. The main justification for EDA was epigastric pain. The predominant alteration of the gastric mucosa in the histopathological examination was chronic gastritis, while in the endoscopic report the most common finding was erosive gastritis. The accuracy of the urease test in relation to the histo[1]pathological test was 76.33%, with a moderate level of agreement. On the other hand, the accuracy between UDE and histopathology was 67.7%, not showing agreement (kappa 0.05), according to the classification of the Kappa test by Landis and Koch (1977). Conclusion: The frequency of Helicobacter pylori infection was high. There was moderate agreement between diagnosis by urease and histopathological tests, but not between endoscopic and histopathological findings, with a greater presence of gastritis identified in the histopathological results.

Reflex sympathetic dystrophy

Thu, 19 Dec 2024 00:00:00 -0300

Reflex Sympathetic Dystrophy is a rare condition, characterized by continuous painful and disabling conditions. The present study described clinical data of a 37-year-old male patient who, in childhood, after trauma to the lower limb, presented with continuous, high-intensity and progressive pain. It took 20 years without diagnosis and treatment, causing symptoms to radiate to all limbs, difficulty walking and weekly exacerbations. During monitoring by a multidisciplinary team, a patient was found to be bedridden, obese, with neuropathic pain, depressed, with decreased muscle mass and strength and dependent on assistance to meet his physiological needs. After follow-up, there was a significant improvement in his clinical condition and, consequently, in his quality of life. Considering that the disease is poorly understood and difficult to diagnose, it is important to report the case for better understanding by health professionals.

Musculoskeletal pain secondary to the use of smartphones in medical academics

Wed, 24 Jul 2024 00:00:00 -0300

Objective: To estimate the prevalence of musculoskeletal pain due to smartphone use among medical students and its associated factors. Methods: In 2023, a cross-sectional study was conducted with 129 medical students regarding musculoskeletal pain secondary to smartphone use. A questionnaire was used to address sociodemographic and behavioral issues as well as the Nordic Musculoskeletal Questionnaire (NMQ). Crude and adjusted prevalence ratios, with their respective 95% confidence intervals, were obtained using Poisson Regression. Results: A prevalence of musculoskeletal pain of 54.2% and 87.6% was found among the students in the past week and in the past 12 months, respectively. In addition, the results showed females (RP = 1.68; CI 95% 1.02-2.77); the previous diagnosis of RSI/WRMD (RP = 0.87; CI 95% 0.79 - 0.95) and minimum shipping of 25 messages/day (RP = 1.22; CI 95% 1.00 - 1.49) as factors associated with musculoskeletal pain secondary to the use of smartphone. Conclusion: The results emphasize the importance of preventive measures regarding smartphone use aimed at reducing pain and promoting the health of medical students.

Intervention for the psychological well-being of adolescents

Wed, 29 May 2024 00:00:00 -0300

Objective: To evaluate an intervention's effect on adolescents' psychological well-being. Methodology: Quasi-experimental, self-controlled study, of the before and after type, carried out with 20 adolescents between December 2020 and June 2021, in Primary Health Care Units of a city in Maranhão. Data collection consisted of 3 stages: pre-test; psychoeducational intervention and post-test. Descriptive analysis was applied using frequencies for socioeconomic variables, Student's T and Shapiro-Wilk tests for paired data, and Pearson's correlation. Results: Most participants were male (60%), with ages averaged on 12.7 years. After the psychoeducational intervention, there was an increase in the average response related to the domains of physical activity and health, general mood, family and home life, and feelings of embarrassment. Conclusions: The intervention was positive and showed improvement in knowledge and skills of the participants in areas such as physical activity, mood, family life and feelings of embarrassment, aiming for prevention of general damage to mental health, directed at quality of life related to health.

Emergency cart

Wed, 02 Apr 2025 00:00:00 -0300

The high quality of Cardiopulmonary Resuscitation (CPR) requires agility from the multidisciplinary team, and the presence of an Emergency Cart (EC) is essential in healthcare units. Objective: This study aimed to assess the nursing team's knowledge regarding the composition, organization, and use of the EC. Methodology: A qualitative-quantitative, cross-sectional, descriptive, and exploratory study was conducted with the nursing team of a teaching hospital in São Paulo State, Brazil. Results: The findings revealed that 78.5% of professionals had previously used the EC, with 45.6% reporting confidence in handling emergency situations. However, only 22.8% accurately identified the sequence of EC drawers. Analysis of the facilitators and barriers to using the cart highlighted various perceptions and experiences. Efficient organization, clear labeling of materials, and adequate knowledge were emphasized as essential factors for effective cart usage. Conversely, challenges included issues related to the organization and accessibility of supplies and medications. Conclusion: This study underscores the need for continuous training for nursing teams, as inadequate preparation directly affects response time and, consequently, patient outcomes.

Clinical characteristics and tobacco dependence in individuals treated in smoking cessation program on a public hospital

Mon, 08 Sep 2025 00:00:00 -0300

Objective: The study aims to characterize the tobacco dependence profile, as well as the clinical, social, and cultural characteristics of smokers treated at the Smoking Cessation Outpatient Clinic of a public hospital affiliated with a medical school. Methods: Data were collected from consultations conducted between 2016 and 2020, with a sample of 217 individuals. This is a retrospective study, carried out through the evaluation of medical records, using a standardized questionnaire to identify behavioral, psychological, and physical nicotine dependence; the prevalence of tobacco-related diseases; and pre-existing comorbidities. Results: The analysis of the data showed that 55% of the smokers treated were women; 36% had not completed elementary school (up to the 5th grade); 38.7% started smoking before the age of 13; 53% were between 40 and 60 years old at the time of the interview; 8% did not have a prior diagnosis of Chronic Obstructive Pulmonary Disease (COPD); 60% had a high level of nicotine dependence; and 57% of the patients showed a moderate level of
motivation to quit smoking. Conclusions: Most of the smokers evaluated in this study were female; had a low level of education; were between 40 and 60 years old; had an early onset of smoking; had a prior diagnosis of at least two comorbidities; had a high degree of nicotine dependence; and had a moderate level of motivation for smoking cessation.

Cutaneous melanoma in the capital of the Amazon

Thu, 19 Dec 2024 00:00:00 -0300

Introduction: Melanoma is a type of cancer derived from melanocytic cells, the most aggressive and lethal among skin cancers. The research’s purpose was to characterize the epidemiological profile of patients diagnosed with melanoma at the Dermatology Service of the Federal University of Pará. Methods: An observational, cross-sectional and retrospective analytical study was carried out, based on information from medical records and histopathological reports of patients with confirmed diagnoses by biopsy between January 2010 and December 2019. Results: 33 lesions of 32 patients were studied. North’s region peculiarity was observed on the greater impairment of phototypes III, IV and V. Extensive superficial was the most frequent clinical type, as well as the region of the lower limbs, lesion diameter greater than 1 cm, Breslow stage V and vertical growth phase were the most prevalent. Discussion: A higher Breslow score was positively correlated with older age, nodular melanoma subtype, and vertical growth phase. A greater skin phototype was related to a greater diameter and location of the lesion on the lower limb. The clinical type of lesion had positive correlations with age group, site of lesion and phase of growth. Conclusion: Notably, the number of studies published on the disease in the region is not very expressive, probably due to the lower frequency of melanoma cases in the North region, which demonstrates the need for more studies on the subject in this region.

Analysis of care provided to the mother and the newborn at the time of delivery in public and private maternities in the state of Espírito Santo – Brazil

Wed, 29 May 2024 00:00:00 -0300

Objective: To analyze the care offered to mothers and newborns at the time of birth in maternity hospitals in Espírito Santo, according to the type of service provided, evaluated through indicators based on recommendations for good care practices recommended by the WHO and the Rede Cegonha program. Methods: This was a cross-sectional study nested within a multicenter hospital birth cohort. Interviews were carried out in the maternity ward, at 7 and 27 days. The evaluation of care was based on the recommendations of the labor and birth component, with the outcome being the type of service provided: public or private. For analysis, a hierarchical model and Poisson regression with robust variance adjustment were used. Results: Public maternity hospitals showed a higher prevalence regarding gestational risk classification (PR: 3.33; 95% CI: 2.99; 3.70); pre-delivery examination (PR: 2.38; 95% CI: 1.60; 3.53); use of oxytocin (PR: 1.23; 95% CI: 1.11; 1.29) and vaginal delivery (PR: 1.15; 95% CI: 1.09; 1.21); and lower prevalence regarding the presence of a companion (PR: 0.83; 95% CI: 0.77; 0.89); skin-to-skin contact in the delivery room (PR: 0.92; 95% CI: 0.86; 0.98); pediatrician in the delivery room (PR: 0.81; 95% CI: 0.70; 0.93); rooming-in (PR: 0.92; 95% CI: 0.86; 0.98) and guidance on breastfeeding (PR: 0.90; 95% CI: 0.84; 0.96). Conclusion: Both public and private maternity hospitals still need to adjust to ensure the implementation of good practices as defined by the WHO and SUS that ensure qualified assistance for the mother-child binomial.

Women´s knowledge about HPV and its relationship with cervical cancer

Carla Jardim Maia, Licinio Esmeraldo da Silva, André Ricardo Araújo Silva — Wed, 29 May 2024 00:00:00 -0300

Introduction: Main preventive measures for early detection of cervical cancer; Papanicolau test (detects early tumor lesions), and vaccine against Human Papillomavirus (HPV). Objective: Considering this, the objective of the study was to analyze the association between women's knowledge about HPV and cervical cancer. Material and method: Cross-sectional study carried out on women over 18 years of age in the community of Viradouro, Niterói, (RJ), Brazil, (10/2021 to 5/2022). Two questionnaires were used with objective questions about demographic data, knowledge about the existence of the Pap test, HPV, DNA for HPV and HPV vaccine. Prevalences, means and medians were calculated. Results: 191 participants with a median age of 40 (range 18 to 84 years). Everyone knows or has heard about the Pap smear test. Among the reasons reported for not taking the test were: shame in 186 (97.4%), fear 152 (79.6%), lack of time 102 (53.4%), being in good health 98 (51.3%). 151 (79.1%) heard about HPV, 14 (7.3%) heard about DNA testing for HPV and 8 (3.3%) about quadrivalent recombinant HPV vaccine. Conclusion: The association between HPV and cervical cancer was known to more than 80% of the sample studied, but there was little knowledge about DNA testing for HPV and the quadrivalent recombinant vaccine against HPV 6, 11, 16, 18.

Relationship between animal and plant protein consumption and body composition in gym members

Wed, 29 May 2024 00:00:00 -0300

body composition of gym members. Methods: A cross-sectional study was conducted, assessing gym users. Protein intake was determined using the average of three dietary recalls and body composition using a bioimpedance scale. Pearson's correlation test was utilized to evaluate the association between variables. Results: Most of the participants were classified as overweight (43.2%), presented a high body fat percentage (66.4%), and had an adequate percentage of muscle mass (56.8%). The average protein intake was 1.51 ± 0.72 g/kg, with a prevalence of inadequacy (53.6%). The dietary protein content was predominantly of animal origin (80.26 ± 13.51%). The percentage of animal protein in the diet exhibited a positive correlation with body weight (r = 0.212; p = 0.020), body mass index (BMI) (r = 0.192; p = 0.034), and visceral fat (r = 0.202; p = 0.025). In contrast, the percentage of vegetable protein in the diet presented a negative correlation with weight (r = -0.202; p = 0.025), BMI (r = -0.197; p = 0.029), and visceral fat (r = -0.235; p = 0.009). Conclusion: The dietary protein consumption predominantly relied on animal protein sources, which positively correlated with body weight, BMI, and visceral fat. Conversely, vegetable protein exhibited an inverse correlation with these parameters. These findings suggest the importance of considering the protein source in the diet of gym practitioners, as the origin of protein consumed may influence body composition and related health and fitness outcomes.

Assessment of quality of life and nasal peak flow in the post-operative surgery of rhinoseptoplasty and lower turbinectomy

Wed, 02 Apr 2025 00:00:00 -0300

Objectives: To compare three subjective methods with an objective method for evaluating nasal obstruction in patients undergoing functional nasal surgeries and to analyze the effectiveness of these surgeries in the early (35 to 45 days) and late (six months) postoperative periods. Methods: Thirty-five patients undergoing functional nasal surgery were evaluated at three different time points: preoperatively, early postoperatively (30 to 45 days), and late postoperatively (after six months), using the objective method Inspiratory Nasal Peak Flow and subjective scales - Visual Analog Scale (VAS), Nasal Index Score (NIS), and Nasal Obstruction Symptom Evaluation (NOSE) scale. Results: All methods proved efficient in evaluating patients undergoing rhinoseptoplasty and inferior turbinectomy with nasal obstruction in the early and late postoperative periods. Inspiratory Nasal Peak Flow showed an average improvement of 100% in inspiratory flow. The subjective scales NOSE, NIS, and VAS also showed significant improvement in nasal obstruction and quality of life. When comparing the NOSE, NIS, and VAS scales with Inspiratory Nasal Peak Flow, no disparity was found between the preoperative results and the early and late postoperative results. Conclusion: There is a strong correlation between the methods used (NOSE, NIS, VAS, and Inspiratory Nasal Peak Flow) and the clinical status of the patients, making any of them suitable for evaluating nasal obstruction and quality of life.

Clustering of risk factors with the macrossomia fetal in participants of the Viver Project

Wed, 13 Nov 2024 00:00:00 -0300

Objective: This study aimed to analyze the aggregation of risk factors (multiparity, advanced maternal age, overweight and gestational diabetes) for fetal macrosomia in women participating in “Projeto Viver”. Methods: This is a cross-sectional study with a convenience sample conducted using the study's database “Projeto Viver”, carried out between August 2019 and March 2020. The aggregation of risk factors was evaluated based on the ratio of the prevalence of observed factors in relation to the expected prevalence. There is aggregation when the observed combination (O) of factors exceeds the expected prevalence (E) of the combination, and the prevalence odds ratio was calculated to identify the aggregation of two behaviors. Results: The sample consisted of 2,488 postpartum women. There is aggregation of the four analyzed factors (O/E = 3.9). In the aggregation of the three risk factors, the most frequent was advanced age, gestational diabetes and overweight (O/E = 1.7). Regarding the aggregation of two factors, the aggregation between advanced age and gestational diabetes stands out (O/E = 2.9). As for the prevalence odds ratio, it was higher among gestational diabetes and advanced age (ORP = 2.76). Conclusions: It is important to verify how the risk factors related to fetal macrosomia are found, how they act and interact with each other, since their presence can lead to consequences for the newborn not only during childhood, but also in adult life. Knowing the real situation of this population can serve as a warning for the formulation of health policies and educational actions.

Fetal hemoglobin in adulthood

Vitorino Modesto dos Santos, Laura Campos Modesto, Julia Campos Modesto — Wed, 13 Nov 2024 00:00:00 -0300