ABCS Health Sciences

Prevalence of neurological symptoms in patients with SARS-CoV-2: Systematic Review and Meta-Analysis

Júlio Araújo Rendeiro — 2024-12-12

Introduction: The novel coronavirus, dubbed SARS-CoV-2, which causes the COVID-19 disease, was detected on December 31, 2019, in Wuhan, China. Objective: To perform a systematic review with a meta-analysis about the prevalence of headache and myalgia in patients with SARS-CoV-2. Methods: High-sensitivity research was conducted on the main platforms (Medline by PubMed, Embase (Elsevier), and Cochrane Library). The entire versions of the manuscripts were analyzed by three independent researchers, and only observational studies describing the symptoms of the selected sample were included. Results: 1,782 studies were identified, which were submitted to exclusion criteria, remaining only 62 manuscripts to do qualitative synthesis and metanalysis. Of the 28,412 patients diagnosed with SARS-CoV-2, 12% (95% CI 9% - 16%) presented headache and 19% (95% CI 14% - 24%) presented myalgia, both with statistical significance and high heterogeneity (I2=97.0%, p<0.01 and I2=98.0%, p<0.01, respectively). Conclusion: It was noticed that headache and myalgia were the most ordinary neurological symptoms, but it is important to emphasize the prevalence of symptoms in different degrees of severity of the patients.

Municipal localization of the Sustainable Development Goals (SDGs) as a device to the continuous activation of the 2030 Agenda: a narrative review

Marco Akerman — 2024-12-12

Will the 2030 Agenda that advocates the 17 Sustainable Development Goals (SDGs) be immune from the consequences of the effects of the pandemic? This article analyzes the international debate that states that it is more necessary than ever to follow the 2030 agenda with the same ambition, regardless of the effects of the pandemic, and points to possibilities for continuing to act on the agenda’s activation. From the perspective of a narrative review, contextualized and qualitative, the implementation plans of the 2030 Agenda of only five Brazilian municipalities that voluntarily reported on the UN website, between 2017-2023. These plans are presented and analyzed 1) for their vision of the future, 2) for their ambition in defining goals, and 3) for the Local Agenda activities Activation. The municipalities respond to the international call for the necessary localization of the agenda, as all five identify actions connected with the 17 SDGs but make their respective choices and priorities. These three cases demonstrate the possibilities of activating Agenda 2030 locally, despite the social, health, and economic impact of COVID-19.

Serious Games as tools for food and nutrition education: a systematic review

Iago Almeida da Ponte — 2024-10-15

Serious games emerge as teaching tools with a purpose beyond entertainment, aiming to improve some aspect of the teaching-learning process. Given the high prevalence of chronic noncommunicable diseases in the Brazilian population, this study aimed to evaluate, through a systematic literature review, the potential of serious games as a tool for Food and Nutrition Education. To this end, we searched the PubMed, Biblioteca Virtual de Saúde, and SciELO databases for articles published in the last five years in english and portuguese. A total of 63 studies were identified, of which only 10 met the inclusion and exclusion criteria established for this review. Most studies reported positive outcomes with the use of serious games as an educational tool, finding positive effects on the retention of knowledge learned about food and nutrition, and their use showed promise as an alternative to traditional teaching methodologies. Despite this, the studies had limitations regarding the duration of the interventions and the representativeness of their sample sizes, indicating the need for future studies with methodological designs that fill such gaps. This review shows that gamified approaches to nutrition education seem promising in the context of the teaching-learning process but still lack methodological standardization for interventions based on serious games to be validated as a tool for Food and Nutrition Education.

What are the benefits of antenatal education as a maternal health promotion tool? A systematic review with meta-analysis

Miriam Raquel Diniz Zanetti — 2024-10-15

Introduction: Antenatal education is a low-cost intervention designed to increase the knowledge of pregnant women on pregnancy and childbirth and reduce fear related to labor pain. However, the impact of antenatal education programs on maternal outcomes is unclear. Objective: To investigate whether structured antenatal education programs affect maternal health outcomes. Methods: Electronic databases were searched from inception to November 2019, and randomized controlled trials investigating antenatal educational programs for low-risk pregnant women were included. Results: A total of 348 studies were identified; nine were included in this review. One study assessed the number of antenatal visits, while three showed that antenatal education programs significantly improved childbirth self-efficacy (outcome expectancy16.00 [95% CI 9.86-22.15] and efficacy expectancy 20.44 [95% CI=13.62-27.25]). Self-diagnosis on labor was investigated in two studies, and five demonstrated that antenatal education increased the frequency of vaginal delivery (odds ratio 1.28 [95% CI 1.01-1.63]) but not episiotomy (as observed in three studies). Conclusion: Structured antenatal education programs may increase childbirth self-efficacy and the frequency of vaginal delivery.

Deep brain stimulation of dorsal and ventral borders of the subthalamic nucleus in patients with Parkinson’s disease: a systematic review

Mariane de Oliveira Gomes — 2024-07-31

Parkinson's disease patients experience motor signs and non-motor symptoms caused by the disease. Deep brain stimulation of the Subthalamic Nucleus (STN) itself or its ventral or dorsal borders is one of the treatment options indicated to treat the refractory symptoms of this disease. However, it is still unknown which edge, when stimulated, generates more beneficial effects for these patients, which is the objective of this systematic review. To answer this question, electronic and manual searches were conducted in five databases and gray literature to identify studies that answered the question in this review. The selection of studies, data extraction, and analysis of the risk of bias of the included studies were performed. In total, seven studies were included in this systematic review. Most studies presented a minimal risk of bias, and their main methodological limitation was related to the sample inclusion criteria. Stimulation of the dorsal or ventral borders of the STN resulted in improved motor signs of Parkinson's disease, with some of the studies tending towards the choice of dorsal border stimulation for better motor effects, while the improvement in non-motor symptoms and inhibitory control was due to stimulation of the ventral border. The findings of this systematic review suggest that the improvement in the motor signs of Parkinson's disease can be brought about by stimulating the dorsal or ventral borders of the subthalamic nucleus, whereas non-motor symptoms such as anxiety improve with stimulation of the ventral border.

Red blood cell transfusions in preterm infants in 2021: a narrative review

Cristina Ortiz Sobrinho Valete — 2024-07-31

Anemia is frequent in preterm infants. Red blood cell transfusion practices vary between different centers. The objective of this study was to review red blood cell transfusion practices in preterm infants between 2020 and 2021. This was a narrative review that included studies published on PubMed (Medline) and Web of Science between October 2020 and October 2021. Ten studies were included finally. Red blood cell transfusion frequency was variable. Some neonatal units did not report transfusion protocols. Most studies reported volumes of 10-15 ml/kg per transfusion. The implementation of an anemia care bundle and adoption of restrictive transfusion resulted in a reduction in the number of transfusions, the volume transfused, and a reduction in the rate of multiple transfusions. We suggest that neonatal units that care for preterm infants should have a transfusion protocol based on the best evidence available and this issue may improve.

The Long-Term Loss of Smell and Taste in COVID-19 Patients – A Systematic Review and Meta-Analysis

Jaqueline Dal Curtivo Passos — 2024-06-10

Introduction: Olfactory symptoms have been reported as particular in COVID-19 patients. Objective: To synthesize and analyze the existing evidence on the monitoring loss of sense of smell and taste in COVID-19 patients, and for how long symptoms persist after the virus is no longer active in the organism. Methods: A search was implemented in PubMed, Embase, Scopus, Science Direct, and Web of Science databases. This systematic review and meta-analysis were conducted according to PRISMA, and the risk of bias was assessed through the Newcastle-Ottawa Scale. The review protocol is registered in PROSPERO. Results: Our systematic review included data from 14 articles with a total of 2143 participants. The most reported sensory symptom of COVID-19 was anosmia, which was detected in 1499 patients, being the only symptom to appear in all studies. Ageusia was detected in 595 patients, dysgeusia in 514 patients, and hyposmia in 209 patients. The studies provided the number of 729 patients with sensory symptoms during the acute COVID-19 infection of 15 days, and 1020 patients with lasting sensory symptoms, presenting sensory dysfunctions after the average latent period of 15 days of the acute COVID-19 infection. Conclusion: Evidence points to the loss or dysfunction of taste and smell as one of the symptoms of COVID-19 persisting for an average time of 15 days, with 44% of COVID-19 patients with persistent symptoms for more than 15 days. Nevertheless, most studies do not perform a follow-up with those patients. Therefore, further research on sensory symptoms and their follow-up is required.

Nursing care regarding the psycho-emotional aspects of women submitted to mastectomy

Amanda de Oliveira Bernardino — 2024-06-10

Breast cancer, or breast neoplasm, is one of the most frequent types of cancer, and one of the most prevalent among women. The diagnosis and specific treatments, such as mastectomy surgery, lead women to experience different feelings, with the most predominant negative thoughts. In this way, the objective of this study is to describe the importance of nursing care in the face of the psycho-emotional aspects of women after mastectomy. This is an integrative literature review study, developed in electronic Medline and Lilacs databases. The following terms were used: Breast neoplasm; Nursing; Emotions; Mastectomy. A total of 2,314 articles were found, of which eight were selected. The results and discussions were divided into two thematic axes: The first deals with the emotions of women after mastectomy, whose feelings arising from the diagnosis of the disease start to affect different areas, such as personality, sexuality, family, and social relationships. Furthermore, the second deals with nursing care after mastectomy, which must be conducted integrally, aiming at restoring physical and emotional health. Nursing is the vehicle capable of planning and collaborating with these women, promoting humanized treatment and assistance, oriented and aimed at a better quality of life, and stimulating self-help, self-esteem, and acceptance of their body.

Acknowledgements to reviewers

ABCS Health Sciences — 2024-06-11

Home office and health outcomes of adults in southern Brazil

Fernanda Oliveira Meller — 2024-12-12

Introduction: During the COVID-19 pandemic, the home office was of paramount importance for the continuity of work functions and home economic maintenance. However, this practice can influence the population’s lives. Objective: To assess the relationship between working from home during the COVID-19 pandemic and health outcomes in two cities in Southern Brazil. Methods: This is a cross-sectional, population-based study, conducted between 2020 and 2021, in two cities from Southern Brazil: Criciúma (Santa Catarina) and Rio Grande (Rio Grande do Sul). Individuals aged 18 years or older, residing in the urban area of the cities, were eligible for the study, and the sampling process was conducted in two stages, with the random selection of census tracts and households. The exposure variable was the home office during the pandemic. The outcomes studied were sleep, physical activity, body weight, food consumption, smoking, and alcohol intake. Results: 2,170 individuals were studied, and the prevalence of home office was 7.7%. Higher prevalence of home office was found in individuals aged up to 49 years (p<0.001), white skin color (p=0.036), university education (p<0.001) and richer (p<0.001). In the adjusted analysis, the home office was associated with more likely to increase the practice of physical activity (PR=1.95; 95%CI 1.06-3.58) and increasing the consumption of healthy foods (PR=2.37; 95%CI 1.58-3.54), during the COVID-19 pandemic. Conclusion: These results demonstrate that home office during the COVID-19 pandemic had positive repercussions on some health outcomes in adults from Southern Brazil.

Cyberchondria and quality of life: a cross-sectional study in Brazilian individuals

Jaqueline Alves Zwierzikowski — 2024-12-12

Introduction: Cyberchondria is a newly described entity in which patients recurrently search health information on the internet developing distress and suffering with the obtained information. Objective: To study cyberchondria in a sample of the Brazilian population: its association with epidemiological variables and interference with quality of life. Methods: This is a cross-sectional observational study, with 948 participants. Three questionnaires were applied through the internet: one epidemiological; the Cyberchondria Severity Scale (CSS) questionnaire and the SF-12 (12-Item Short-Form Health Survey) quality of life (QoL) questionnaire. Results: CSS was weakly and negatively correlated with the age of participants in the subscale “compulsion” (r=-0.08, p=0.01) and “distress” (r=-0.12, p<0.0001). Men had higher scores on “compulsion” (p=0.02). A weak and negative correlation was found between the subscales of “compulsion,” “distress,” “excessiveness” and “reassurance seeking” of CSS and SF-12-physical domains and the subscales of “compulsion” and “distress” with SF-12 mental domain. An independent relationship was found between the male sex (p=0.009), living in rural areas (p=0.002), having less than 10 years of formal education (p<0.0001), and earning less than 5 minimal wages/month (p=0.0002) with the subscale “mistrust of medical professional”. Conclusion: Males and younger individuals have higher levels of compulsion in the CSS than females and the elderly. Mistrust of medical professionals was less common in females, in those living in urban areas, and in those with better education and higher income. Cyberchondria interferes with mental and physical QoL.

Level of physical activity, hope of life, and intensity of depressive and anxious symptoms in hemodialysis patients

Tiago da Rosa Rambo — 2024-12-12

Introduction: Individuals with advanced-stage chronic kidney disease require hemodialysis, in which the resource has harmful physical and mental effects, and it is still unclear how the level of physical activity is related to cognitive status in this population. Objective: To compare the level of physical activity with hope of life and the intensity of depressive and anxious symptoms in hemodialysis patients. Methods: A cross-sectional study carried out with 59 hemodialysis patients dichotomized into two groups (sufficiently active and insufficiently active) according to the level of physical activity (International Physical Activity Questionnaire), evaluated in terms of hope of life (Herth Hope Index) and the intensity of depressive symptoms (Beck Depression Inventory) and anxious (Beck Anxiety Inventory). The association between categorical variables was evaluated using Pearson's chi-square test and numerical variables using the Student's T-test and Mann-Whitney U test (p<0.05). Results: There was a prevalence of subjects categorized as sufficiently active (64%) and with a minimal depression (57%) and anxiety (59%). Insufficiently active individuals had higher scores on the depression (p=0.001) and anxiety (p=0.019) instrument, and similar scores on the hope of life instrument (p=0.067). There was a greater intensity of depressive and anxious symptoms in those who were insufficiently active (p<0.001; p=0.003). Conclusion: When compared to insufficiently active, sufficiently active hemodialysis patients have similar hope of life and lower intensity of depressive and anxious symptoms.

John Cunningham Virus seroconversion during natalizumab treatment

Erica Freire de Vasconcelos-Pereira — 2024-12-12

Introduction: Multiple sclerosis is a progressive disease that is difficult to predict, originating in cases of disability. Natalizumab is a highly effective disease-modifying therapy but is associated with greater John Cunningham virus (JCV) reactivation and consequent increased risk of developing Progressive Multifocal Leukoencephalopathy (PML). Objective: To analyze JCV seroconversion in patients treated with natalizumab. Methods: A retrospective study was conducted involving patients diagnosed with multiple sclerosis, between January 2012 and December 2021. To assess seroconversion during treatment with natalizumab, patients were considered seronegative at the beginning of treatment and who had at least one result in the period of medication use. The study was approved by the Human Research Ethics Committee under protocol 3,177,442. Results: Sixty-two patients treated with Natalizumab were included, with a seroprevalence of 67.7%. At the start of treatment, 41.9% (26/62) of the patients were negative for anti-JCV, of which 23.1% (6/26) were seroconverted. The mean time to seroconversion was 2.5 years. The baseline index of anti-JCV antibodies was statistically significant with the age of the patients. Among patients with a negative anti-JCV antibody result at baseline, 82.6% (19/23) remained negative throughout monitoring. Treatment was discontinued in 53.2% (33/62) of patients, and 72.7% (24/33) due to anti-JCV positivity with a consumption index >1.5 in 41.9% of cases. Conclusion: Knowing how to monitor the anti-JCV antibody index and treatment approaches in our patient cohort may be useful in future clinical decisions in treating MS.

Is total muscle strength related to pelvic floor muscle strength in young women?

Thaís Passos de Oliveira — 2024-12-12

Introduction: The intravaginal examination is an important part of the pelvic floor muscle (PFM) functional assessment. However, women sometimes refuse to submit to this procedure due to being embarrassed. This justifies the investigation of other alternatives of evaluation that could contribute to the treatment of pelvic floor disorders. Handgrip strength (HGS) provides an approximation of overall muscle strength, strongly associated with functionality, and this could be indirectly linked to the pelvic floor musculature. Objective: To verify whether there is a correlation between PFM strength and HGS. Methods: This is an observational study that evaluated 51 young women who filled out a clinical evaluation form and were submitted to pelvic floor evaluation, using the Modified Oxford Scale, Peritron® perineometer, and HGS (Saehan® dynamometer). For the perineometer and handgrip strength test, three repetitions of the maximum contraction were performed, considering the average of the attempts for analysis. Student’s t-test and Pearson’s coefficient were used to determine the correlation between variables, considering significance <0.05. Results: The participants were normotrophic, with a mean age of 23.14 ± 3.14 years, most were undergraduate students and physically active. The correlation coefficient between handgrip and pelvic floor musculature strength was 0.21 with a confidence interval of -0.07 to 0.46 and a significant value of 0.137. Conclusion: Pelvic floor muscle strength had a weak positive association with HGS. Therefore, it is not possible to state that women who have satisfactory HGS have a strong pelvic floor.

Erectile dysfunction after COVID-19 infection: A cross-sectional study in a male sample from Brazil

Gabriel Marton Bressa — 2024-12-12

Introduction: COVID-19 infection may cause erectile dysfunction due to local viral infection and impairing mental health. Objective: To analyze the erectile function in Brazilian sample patients during pandemics with and without COVID-19 infection and compare with results from a sample obtained before the pandemic. Methods: Internet survey with epidemiologic questions, data on COVID-19 infection, and the International Index for Erectile Function (IIEF). Patients were divided into those with and without infections. A control group with results obtained before the pandemic was also included. Results: Four hundred twenty-two males were studied 210 with data obtained before the pandemic; 208 with data obtained during the pandemic (84 with COVID-19 infection and 124 without). Patients with COVID-19 infection had worse results of IIEF than those without (in the pandemics and before pandemics) with p=0.01 and used more sexual stimulants (p=0.02). The results were worse in the first month after the infection. Conclusion: Patients with COVID-19 infection had impairment in erectile function that is more severe in the first month after infection.

Impact of the COVID-19 pandemic on the physical fitness of older adults: a longitudinal study

Laís Schmidt — 2024-10-15

Introduction: Older adults, who are considered to be at higher risk of contracting the COVID-19 virus, have been adversely affected by the pandemic. Objective: This prospective longitudinal study aimed to verify changes in the physical fitness of older adults during the period of the COVID-19 pandemic, considering gender and age group. Methods: Seventy-six older individuals (aged 72.6 ± 6.47 years) who were part of a university extension program participated in the study. Their physical fitness was assessed using the Senior Fitness Test (SFT), which was administered by trained researchers before the pandemic (November 2019) and during the pandemic (April 2022). Results: The results showed a significant decline in physical fitness in all tests, except for the elbow flexion test. The greatest decline was observed in the 6-minute walk test. Both men and women exhibited greater declines in aerobic endurance and lower limb strength. Older adults aged 80 years or older were the most affected, exhibiting the greatest declines, particularly in aerobic endurance and lower limb strength. Conclusion: The study concludes that the COVID-19 pandemic had a significant negative impact on the physical fitness of older adults, especially women and those aged 80 years or older. Therefore, physical activity programs should be implemented for these populations to minimize or even reverse the negative impacts caused by COVID-19 on their physical fitness.

Factors associated with alcohol health literacy among patients with diabetes assisted by primary health care

Ana Monique Gomes Brito — 2024-10-15

Introduction: The drinking habit is an important factor of metabolic imbalance among people with diabetes. However, individuals with higher levels of health literacy can perform behaviors that create barriers to the emergence of complications of this disease. Checking the health reading related to the drinking habit can be useful to reduce the consequences of diabetes. Objective: To identify the factors associated with health literacy related to the addiction among people with diabetes assisted by primary health care. Methods: Cross-sectional study conducted in health units in the city of Montes Claros, MG, Brazil. Demographic and economic conditions were analyzed, in addition to the levels of health literacy assessed from the instrument Alcohol Health Literacy. Results: The study included 215 people with diabetes with a mean age of 60.73 years, mostly women (63.7%; n=137). Lower levels of alcohol health literacy were present in 31.2% (n=67) of the participants. The following variables were associated with lower levels of health literacy: sex (men, OR 0.46; 95%CI 0.23-0.94; p=0.032), low schooling (early childhood education, OR 7.00; 95%CI 2.55-19.20; p<0.001; illiterate, OR 28.06; 95%CI 4.40-178.83); and spending on diabetes-related drugs (OR 2.27; 95%CI 1.14-4.50; p=0.019). Conclusion: There were better levels of health literacy related to the habit of alcohol use among men, with higher education and who did not have spending on diabetes-related drugs.

Prevalence of atrial fibrillation without diagnosis or treatment in Primary Health Care in Joinville, Brazil

Marcelo Pitombeira de Lacerda — 2024-10-15

Introduction: Estimation of the prevalence of undiagnosed or untreated atrial fibrillation (AF) is crucial for the prevention of AF-related ischemic stroke. Objective: To assess the prevalence of undiagnosed or untreated AF in primary care. Methods: We conducted a prospective cross-sectional non-randomized study in Joinville, Brazil, among elderly individuals in primary care units (PCUs). Results: One thousand individuals were included, with a mean age of 69±7 years, and 57% women. Prevalence of AF was 3%, with 50% of AF patients being previously undiagnosed and 33% of previously diagnosed AF patients not receiving oral anticoagulation despite clinical indication. Using age-standardized prevalences, we estimated 68 and 27,342 strokes per year due to untreated or undiagnosed AF in Joinville and Brazil, respectively. Conclusion: The observation that two out of three AF patients were either undiagnosed or untreated is very alarming. Screening strategies to uncover this population are urgently needed.

Relationship between exposure to sexual abuse in childhood and adolescence and parenting style

Carlos Alberto Landi — 2024-10-15

Introduction: Sexual violence can be treated as a public health problem because of its high prevalence worldwide and the negative physical and mental impacts. Objective: Investigate the relationship between parenting styles and the occurrence of sexual violence experienced by adolescents and young adults at some point in life. Methods: Validated instruments were applied to a population of university students to assess the presence or absence of sexual violence (Questionnaire on Exposure to Traumatizing Events) and parenting style Parenting Styles Inventory (PSI). The initial statistical analysis was descriptive and inferential, applying multivariate logistic regression and assessing the risk factors for sexual violence associated with parenting styles. Results: Of the 858 students who responded to the survey, 71 (8.3%) were the victims of sexual violence and 52 (73.0%) were female. The PSI showed that in victims of sexual violence, less protective styles predominate (p=0.002), with higher scores in the following practices: inconsistent punishment (p=0.003), negligence (p=0.001), negative monitoring (p=0.017), and physical abuse (p<0.001). The logistic regression shows that the chance of an individual being a victim increases by 11.0% with each increase in the score of negligence and 23.4% with each increase in the physical abuse score. As for positive monitoring, the chance of an individual being a victim decreases by 10.0% with each increase in the score (p=0.009). Conclusion: Parenting styles directly influence the possibility of sexual abuse occurring monitoring is a protective factor, while neglect and physical abuse (punishment) increase the individual’s risk of being a victim.

Associated factors for the decrease of force of inspiratory muscle in pregnant women of high risk

Alianny Raphaely Rodrigues Pereira — 2024-10-15

Introduction: The gestational period brings anatomical and physiological changes to women in several systems, especially the respiratory system. Objective: To determine whether there is an association between gestational age (GA), Diabetes, uterine fundal height (UFH), Body Mass Index (BMI), level of dyspnea, and physical activity with maximum respiratory and nasal pressures. Methods: Cross-sectional study that included 55 high-risk pregnant women in the 2nd and 3rd trimester of pregnancy at the Obstetrics Outpatient Clinic of the Hospital das Clínicas in Recife – PE, Brazil, personal, sociodemographic, anthropometric, clinical and Maximal Inspiratory Pressure (MIP) data were described and nasal inspiratory pressure (NIP), that, using regression and multivariate analysis, analyzed the influence of risk factors for high-risk pregnancy with NIP considering a p<0.005. Results: Among the pregnant women, according to the clinical variables, it was observed that 56.4% (n=31) had a gestational age above 28 weeks, 27.3% (n=15) diabetes, 25.5% (n=14) asthma, 43.6% (n=24) Gestational Hypertension, 56.4% (n=31) obesity, 85.5% (n=47) complaints of dyspnea 38.1% (n=21) mild to severe dyspnea and 65.5% (n=36) vigorous physical activity. Low MIP (76.76 cmH₂O) and NIP (68.62 cmH₂O) values were found for age. An association was observed between an increase in UFH and a decrease of 0.8 cmH₂O in NIP, regardless of gestational age. Conclusion: High-risk pregnant women in the second and third trimester of pregnancy have decreased NIP and MIP with a negative association of UFH with NIP regardless of gestational age.

Effect of kinesio tape application on the lymphatic system during knee arthroscopy surgery

Luana Fernanda Voinaroski — 2024-10-15

Introduction: To control edema, physical therapy employs several techniques, such as elastic bandages application - Kinesio tape (KT) - to block or drain subcutaneous body fluids, due to the secondary effects of its elastic properties. Objective: To evaluate the effect kinesio tape application on the lymphatic system during knee arthroscopy surgery. Methods: Controlled clinical trial, with 28 patients, alternately divided into two groups (intervention and control) referred to arthroscopic surgical treatment of anterior cruciate ligament and meniscus injuries. Patients were evaluated in the preoperative and, on the 1^st postoperative day, while the intervention group received KT application for the lymphatic system in the intraoperative period. Results: The intervention group showed statistically significant results in the non-formation of edema, according to perimetric (Point 2: p=0.010, Point 3: p≤0.001 and Point 4: p≤0.001) and ultrasound (p=0.007) analyses when compared to the control group. On the other hand, pain (p=0.056) did not present a significant difference, but in the intragroup comparison pre and postoperative, a considerable reduction (p=0.002) was observed. Conclusion: KT application for the lymphatic system in the intraoperative period of knee arthroscopy effectively minimized edema formation and reduced pain.

Catheter-related thrombosis in a neonatal intensive care unit: a case-control study

Cristina Ortiz Sobrinho Valente — 2024-07-31

Introduction: Catheter-related thrombosis (CRT) accounts for most thrombotic events in the neonate. Objective: Investigate CRT frequency, association with days of catheter use until diagnosis, and number of catheters used, in a single-center Neonatal Intensive Care Unit. Methods: A case-control study that included 14 cases and 42 controls. Data collection occurred between January 2017 and December 2020 in a public NICU. Crude odds ratios (COR) were calculated. The study complied with ethical standards from national guidelines. Results: Two hundred and ninety-four neonates used central venous catheters, of which 14 (4.7%) were diagnosed with CRT. Catheter in use when diagnosis was made was centrally inserted central catheters in 8 (57.1%). Before diagnosis, the cumulative duration of catheter use was 34.5 days and the median number of catheters used was three. A higher SNAPPE-II (COR 1.03; 95% CI 1.01-1.06; p=0.03), cumulative days of catheter use >30 (COR 19.11; 95% CI 2.28-160.10; p=0.007) and number of catheters used >3 (COR 7.66; 95% CI 1.51-38.70; p=0.01) were associated with CRT. Conclusion: CRT cases were associated with clinical severity; number of catheters and cumulative days of catheter use. We suggest that screening for thrombosis should be performed in neonates who need a long time of catheter use and more than three catheters. Reducing the duration and number of venous catheters used will help to reduce CRT.

Epidemiological study of Hepatitis C in people deprived of liberty

Geisa Perez Medina Gomide — 2024-07-31

Introduction: The prevalence of hepatitis C (HCV) is high among prisoners. If untreated, a substantial number of patients progress to cirrhosis, hepatocarcinoma, or liver failure. World Health Organization aims to reduce the incidence of infection by 90% by 2030. Objective: To describe the prevalence of anti-HCV and sociodemographic and clinical aspects, related to the presence of the antibody, in the population deprived of liberty. Methods: Cross-sectional and epidemiological survey, with exploratory, observational, quantitative-analytical components. A simple random sample of 233 participants, with 95% Confidence Interval (CI) and, a 4% margin of error, was calculated for a population of 1,564 prisoners. The relationship between sociodemographic and clinical variables was evaluated, considering as outcome of the rapid test for anti-HCV results, using the associative measure Prevalence Ratio (PR) with a 95% CI. Results: 240 people participated. The prevalence of anti-HCV was 2%, and the use of injectable drugs (PR 14.75; PRIC_95% 2.09-104.28), being born in the decades of 1951 to 1980 (PR 9.28; PRIC_95% 1.06-81.57) and be co-infected with hepatitis B virus (PR 10.75; PRIC_95% 1.66-69.65) were the aspects that presented a relevant prevalence ratio for the presence of the virus, which could be generalized to the population. Conclusion: This is a population that is difficult to access, the study is relevant because it contributes to preventive measures of public health in the prison system. Moreover, it shows the need to implement measures to prevent and contain the spread of HCV, aiming at the elimination of hepatitis C in this population.

Effects of moderate sedation induced by propofol or midazolam on intracranial pressure

Bianca Drewnowski — 2024-07-31

Introduction: Propofol and midazolam are the main options for moderate sedation in clinical practice. In addition, these drugs are used to reduce intracranial pressure in cases of intracranial hypertension, and their use in these situations is guided by limited evidence. Objective: To compare the effects of propofol and midazolam on intracranial pressure wave morphology in moderate sedation in patients undergoing upper digestive endoscopy. Methods: Sixty patients were included in this study, being divided into two groups, propofol and midazolam group. Intracranial pressure was monitored during and after upper digestive endoscopy, using non-invasive monitoring equipment developed by the company Brain4care. Arterial pressure was measured before and after the exam. Results: The propofol group had lower intracranial pressure (p=0.037) during moderate sedation compared to intracranial pressure after endoscopy and a significant decrease in systolic (p=0.0001) and diastolic pressure (p=0.001) after sedation. Midazolam, on the other hand, reduced systolic pressure (p=0.001), but didn’t change the other parameters after the procedure. There wasn’t a significant difference between the propofol and midazolam groups. Conclusion: There was no significant difference between the groups studied, however, analyses within the propofol and midazolam groups indicate that propofol, but not midazolam, causes changes in intracranial pressure in moderate sedation.

Time trends of avoidable deaths in Brazil, 1996 to 2019

Stefanie Lievore Cruz — 2024-07-31

Introduction: The known achievements of the Brazilian Unified Health System (SUS) stand against an adverse context. This makes it necessary to examine the effect of the SUS on the population’s health, using indicators such as deaths by avoidable causes. Objective: To describe the time trends of mortality from avoidable causes in Brazil and compare them to those of non-avidable causes. Methods: Ecological time-series study with official mortality data, during years 1996-2019, in the age group 5-74 years. Time trends in mortality were estimated as the annual percent reduction in mortality rates, and impact of SUS was calculated as the difference in trend between avoidable (immunization-sensitive, infectious and noncommunicable diseases, maternal deaths, external causes) and non-avoidable causes. The analyses consisted of multivariable binomial regression models, by quadrennium. Results: Death rates for each avoidability group remained stable or declined throughout the study period. The probability of a positive impact was greater than 90% for immunization-sensitive diseases throughout the study period; infectious diseases in 1996-2003 and 2016-2019; noncommunicable diseases in 1996-2003 and 2008-2019; maternal deaths in 1996-1999; and external causes in 1996-2007. This probability was less than 10% for maternal deaths in 2016-2019; and external causes in 2008-2015. Conclusion: SUS has had a positive impact in reducing deaths from immunization-sensitive, infectious and noncommunicable diseases in Brazil, although not so much for maternal deaths and external causes.

Use of antimicrobials in patients in Palliative Care admitted to the Intensive Care Unit: A retrospective study

Carlos Daniel Handar — 2024-07-31

Introduction: Palliative care (PC) improves the quality of life of patients and their families. The use of antimicrobials is controversial in PC patients, especially in those admitted to the intensive care unit (ICU). Objective: To evaluate the use of antimicrobials in PC patients admitted to the ICU. Methods: This is a retrospective study, performed from August 2019 to September 2020. Data on demographic profile, hospitalization, PC, and use of antimicrobials were collected from the Erasto Gaertner Hospital database, in Curitiba, Brazil. Results: 182 patients were studied, median age of 65 years and 52% men. The median length of stay in the ICU was 3 days; the median total length of stay in the hospital was 6 days and 89.5% of the patients died. The time in ICU of patients treated with antibiotics (14.8%) was significantly longer (p=0.033) than for patients who were not (85.2%). Using or not using antibiotics did not change the outcome. Among those who took antibiotics, death occurred in 81.5% of cases and among those who did not use, 74.8% died (p=0.627). Between the cases that used broad-spectrum antibiotics 17/19 (89.5%) died and the mean hospital stay was 16.2 days. Among cases that used narrow-spectrum 5/9 (62.5%) died and the mean hospital stay was 6.4 days (p=0.033). Conclusion: The administration and/or the spectrum of antibiotics in PC patients admitted to the ICU did not change the mortality rate. The administration of antibiotics increased the length of stay in the ICU.

Association between pulp stones and systemic diseases: A case-control study

Bruna de Souza Romano — 2024-07-31

Introduction: Pulp stones (PS) are calcifications commonly found in the pulp tissue that may be associated with systemic diseases. Objective: To evaluate the association between PS and systemic diseases. Methods: A case-control study with the inclusion of individuals from 18 to 65 years of age, of both sexes. Analysis was made of 1047 digital panoramic radiographs. The controls could not have any teeth with PS; the cases were the contrary. A questionnaire comprising demographic, habit, and general health (diabetes, problems with blood vessels, altered cholesterol level, heart attack, kidney or gallbladder stone, arthritis, or autoimmune disease, and for women, endometriosis, and ovarian cyst). Data were submitted to the Student's t-test to identify differences between groups about sex and age. The Chi-square test was applied to the cross-tabulation. The analyses were performed using SPSS^®, version 25.0, with a 5% significance level. Results: 490 patients participated (242 cases and 248 controls). There was no difference between groups for the sex (p=0.966) and age (p=0.186). Only “kidney stone” was associated with the case group (p=0.001), being almost three times higher when compared to the control group. No significant differences were found in females about the presence or absence of PS (p>0.05). Conclusion: In this research, it is suggested the existence of an association between kidney stones and the presence of pulp stones.

Prevalence of depression and anxiety and associated factors among students in southern Brazil: results from Respire study

César Augusto Häfele — 2024-06-10

Introduction: The prevalence of anxiety and depression symptoms has significantly increased in Brazil since the beginning of the COVID-19 pandemic. However, the studies investigating the prevalence of these symptoms in school-aged in Brazil are scanty. Objective: To identify the prevalence of moderate or severe symptoms of depression and anxiety and the associated factors among students in southern Brazil. Methods: This was a census study with all 14 sites of the Federal Institute Sul-rio-grandense. We used a self-administered, online instrument to assess biological, sociodemographic, health, nutrition, and behavior-related variables. The Hospital Anxiety and Depression Scale assessed depression and anxiety. Results: The sample consisted of 5,112 students. The prevalence of students who presented moderate or severe symptoms of anxiety and depression was 34.3% and 24.3%, respectively. In the fully adjusted analysis, factors associated with anxiety and depression symptoms were female sex, low income, screen time at work, worse health perception, unhealthy diet, poor sleep quality, smoking, alcohol consumption, and medication use. Early age and students whose family members or friends died from COVID-19 were associated with anxiety. Married and having less screen time during leisure was a protective factor for depression. Physical activity reduced by 18% and 33% the likelihood of moderate or severe symptoms of anxiety and depression, respectively. Conclusion: Public policies to improve the health care of Brazilian students during the return to face-to-face activities are required.

Occupational stress and coping strategies of nursing staff in times of Covid-19

Katiusci Colman Magalhães Schirmann — 2024-06-10

Introduction: The increase in the workload of health professionals and the degree of complexity of patients, attribute greater risk to psychosocial stress. Objective: To evaluate the associations between occupational stress, quality of life at work, and coping strategies by the hospital nursing team during the COVID-19 pandemic. Methods: Cross-sectional, quantitative study with convenience sampling, data collection from August to December 2020; in two units of the private hospital network, with sociodemographic, occupational and health questionnaires; visual analogue scale for assessing quality of life at work; Demand-Control-Support (DCS); Occupational Coping Scale. Results: The total sample consisted of 196 nursing professionals. There was significant certainty (negative, however, the dimension “Demand” of the DCS and QWL (<0.001, r=-0.367). Control over work-related work has a significant quality (but the “Control” dimension of the DCS and QWL (=0.025, r=0.160); and significantly negative, however, between the “Social Support” dimension of DCS and “Negative Equivalence” of Coping (p=0.003, r=-0.2013). Conclusion: The findings of this study allowed the correlation between occupational stress, coping and quality of life at work, showing that the lower the social support, the greater the use of avoidance strategies and consequently decline in quality of life at work. They also allowed us to identify the coping strategies used by the nursing staff and quality of life at work in the face of occupational stress during the COVID-19 pandemic.

Nurses’ perceptions about management practices of nurse managers during pandemics: a descriptive and cross-sectional study

Ayla Tisinli — 2024-06-10

Introduction: Hospitals may not be able to manage the chaotic environment during pandemics through classical management principles. Management can only be achieved with the help of effective leadership, appropriate flow of crisis management systems, teamwork, and collaboration. Nurse managers should have effective management skills. Objective: To evaluate the perception of the nurse managers' practices by nurses such as resource management, organization, communication, psychosocial, care-training, and decision-making practices in the management of the pandemic based on the COVID-19 pandemic. Methods: A quantitative, cross-sectional method was used, and a web-based online questionnaire was applied to collect data. This study included 182 nurses working in a public and private hospital in İstanbul. Result: The nurses perceived the management practices of their managers at a moderate level. The leaders' resource management practices as low (16.5%), and medium (78.6%) perceive. There was a statistically significant difference (p<0.01) between the communication and team relations (p<0.05), resource management (p<0.01), care-training (p<0.05), and decision-making scores (p<0.01) of the nurses working in the private hospitals compared to those working in the public hospital. Conclusion: To effectively manage a complex and chaotic environment, nurse managers should trust their team, have speed and adaptation skills, be based on human factor principles, and provide a safe working environment. Education should be emphasized so that nurses can work in specialized areas and nurse managers can improve their management skills.

Effectiveness of Pilates-based exercises on the diastasis recti abdominis in climacteric women: a randomized controlled trial

Elaine Priscila Garcia Silva — 2024-06-10

Introduction: Recent studies have related the climacteric period with changes in connective tissue elasticity that may be related to diastasis recti abdominis. Mat Pilates is a method of exercise without impact that currently has more practitioners, due to its satisfactory results. However, there are no studies that evaluate the effectiveness of mat Pilates for women with diastasis recti abdominis. Objective: To evaluate the effectiveness of the mat Pilates program in climacteric women with diastasis recti abdominis. Methods: This randomized single-blinded clinical trial evaluated climacteric women with diastasis recti abdominis. The participants were randomized into the experimental group, which participated in 3 weekly sessions of mat Pilates for 12 weeks for a total of 36 sessions, and the control group (without exercises). The inter-rectus distance was measured with a digital caliper. The G*Power Version 3.1.9.2. software was used for the sample calculation, and the SPSS 20.0 program was used for statistical analysis. Results: The study comprised 21 women, including 10 in the control group and 11 in the experimental group, with mean ages of 54.3 ± 7.1 and 55.3 ± 6.0 years and body mass index values of 28.8 ± 5.5 kg/m² and 29.9 ± 4.48 kg/m², respectively. In the experimental group, reductions were observed in all the measures related to diastasis recti abdominis (p<0.05) in the supraumbilical, umbilical, and infra-umbilical regions. Conclusion: The mat Pilates method is effective for reducing diastasis recti abdominis in the climacteric period.

Sexual risk behavior and knowledge about sexually transmitted infections in a university population in Sorocaba, Brazil

Paula Munhoz de Barros — 2024-06-10

Introduction: Sexually transmitted infections (STIs) are a major public health problem to which young people are highly exposed and knowledge about vulnerabilities that affect them is needed. Objective: To evaluate the knowledge about STIs and sexual behavior of a university population in the city of Sorocaba/SP. Methods: A descriptive, cross-sectional study was conducted with data collection realized by an online application with qualitative and quantitative characteristics. Results: Four hundred and seventy-seven (477) university students from different areas of knowledge were analyzed. The majority pointed to the beginning of sexual life between 15 and 18 years old. Information about sex education was obtained mainly through parents and/or guardians, while little additional knowledge was obtained after entering higher education. Biological and Health Sciences students achieved a higher score on the knowledge questionnaire and were less likely (0.391) to contract STIs when compared to Applied Social Sciences or Engineering students (2.8 and 2.9 more likely, respectively). Conclusion: Students who demonstrated greater knowledge about STIs and acquired more information on the subject during graduation were less likely to become infected, suggesting that campaigns aimed at the university public are essential for the prevention and control of these pathogens.

Hospitalizations in older adults from the Zona da Mata of Minas Gerais, Brazil: data from the Unified Health System, 2016–2018

Juliano Bergamaschine Mata Diz — 2024-06-10

Introduction: The growing older population increases proportionately the demand for hospital care due to the increase in health problems. Objective: To estimate the prevalence and incidence of hospitalizations, and to investigate associated factors in older adults from the Zona da Mata of Minas Gerais, Brazil, between 2016-2018. Secondly, to provide a more comprehensive epidemiological overview of hospitalizations, the following were estimated: monthly hospitalization rate; hospital mortality rate; frequency of hospitalizations according to diagnosis, hospitalizations for conditions sensitive to primary care and in-hospital death; and hospital costs. Methods: This is an ecological and descriptive-analytic study. Data were obtained from the Brazilian Hospital Information System (SIH/SUS). Results: The prevalence of hospitalizations was 35.1% (31.2% in women and 39.7% in men). The monthly rate of hospitalizations was higher in older men when compared with older women (Rate-Ratio=1.35 [95% CI=1.27-1.43]) and adult men between 40–59 years (Rate-Ratio=2.42 [95% CI=2.26-2.58]). The cumulative incidence of hospitalization was 144/1,000 older persons (125/1,000 women and 169/1,000 men). Factors significantly associated with hospitalizations were: male sex (PR=1.52 [95% CI=1.11-2.08]); hospitalization in surgical bed (PR=1.93 [95% CI=1.05-3.56]); absence of death (PR=1.94 [95% CI=1.03-3.65]); and hospital stay ≥15 days (PR=0.71 [95% CI=0.54-0.95]). The cost of hospitalizations was R$ 220,8 million (mean of R$ 201,700/day). Conclusion: The findings strengthen the need for preventive healthcare for the older population living in the Zona da Mata of Minas Gerais and alert managers to the substantial socioeconomic impact of hospitalizations.

Short-term treatment with Uncaria tomentosa aggravates the injury phenotype in mdx mice

David Feder — 2024-06-10

Introduction: Uncaria tomentosa (Willd. ex Roem. & Schult.) DC. (Rubiaceae) or UT is a medicinal plant with antiviral, antimutagenic, anti-inflammatory and antioxidant properties. Duchenne muscular dystrophy (DMD) is a severe muscle wasting disease caused by mutations in the dystrophin gene; this deficiency leads to sarcolemma instability, inflammation, muscle degeneration and fibrosis. Objective: Considering the importance of inflammation to dystrophy progression and the anti-inflammatory activity of UT, in the present study we evaluated whether oral administration of UT extract would ameliorate dystrophy in the mdx mice, a DMD model. Methods: Eight-week-old male mdx mice were submitted to 200 mg/kg body weight daily UT oral administration for 6 weeks. General histopathology was analysed, and muscle tumor necrosis factor α, transforming growth factor-β, myostatin and osteopontin transcript levels were assessed. The ability of mice to sustain limb tension to oppose their gravitational force was measured. Data were analysed with the unpaired Student’s t-test. Results: Morphologically, both untreated and UT-treated animals exhibited internalised nuclei, increased endomysial connective tissue and variations in muscle fibre diameters. Body weight and muscle strength were significantly reduced in the UT-treated animals. Blood creatine kinase was higher in UT-treated compared to untreated animals. In tibialis anterior, myostatin, transcript was more highly expressed in the UT-treated while in the diaphragm muscle, transforming growth factor-β transcripts were less expressed in the UT-treated. Conclusion: While previous studies identified anti-inflammatory, antiproliferative and anticarcinogenic UT effects, the extract indicates worsening of dystrophic muscles phenotype after short-term treatment in mdx mice.

Correlation between postoperative cardiac risks factors, functionality and hospital length of stay

Micaele Farias Nascimento — 2024-06-10

Introduction: Cardiac surgery (CS) may be associated with several organic repercussions responsible for the appearance of cardiac risk factors during the postoperative period. These, associated with prolonged hospital length of stay (LoS), may trigger critical manifestations in individuals undergoing this surgical procedure. Objective: To investigate the relationships between postoperative cardiac risk factors, LoS, and changes in functioning state. Methods: Patients undergoing reconstructive, substitutive, or corrective cardiac surgeries were evaluated. The presence of postoperative cardiovascular risks was assessed using the InsCor score, while LoS and functionality were collected from medical records. Results: One-hundred patients with a mean age of 59.2±12.3 years were included. Significant correlations between functionality and both the hospital and Intensive Care Unit (ICU) LoS (p<0.0001, ρ=0.56; p=0.002, ρ=0.29, respectively), as well as between hospital LoS and the number of comorbidities (p=0.003, ρ=0.28) were found. No significant relationships were observed between the number of postoperative risk factors and LoS. Conclusion: Functionality and comorbidities are associated with increased hospital and ICU LoS in patients undergoing cardiac surgery.

In silico evaluation of the gene expression profile of syndecan-4 in different breast tumor subtypes

Carina Mucciolo Melo — 2024-06-10

Introduction: Breast cancer is one of the main causes of death in women. Luminal tumors A and B show good response with hormonal treatments, tumors that overexpress HER-2 can be treated with monoclonal antibodies, whereas triple-negative tumors have few treatments available because they present low or absent expression of hormone receptors and HER-2, in addition, they present worse tumor progression. Syndecans are heparan sulfate proteoglycans that have the function of interacting with growth factors, cytokines, and extracellular matrix, thus modulating important processes in tumor progression. Objective: Analyze the expression of syndecan-4 in different subtypes of breast tumors. Methods: Bioinformatics is a useful tool for the study of new biomarkers. In the present study, the TCGA database (514 patients) and Metabric (1,898 patients) were analyzed using the cBioportal software. Gene expression data were analyzed by RNA-Seq and Microarray from biopsies of breast tumors. Results: An alteration in syndecan-4 gene expression was observed among the different subtypes of breast tumors. Patients with a triple-negative tumor had decreased expression for syndecan-4 in both databases. Conclusion: Syndecan-4 is a potential biomarker for breast tumor prognosis since decreased expression of syndecan-4 is related to triple-negative breast cancer.

Factors associated with early initiation of breastfeeding

Jéssica Helena Lourenço Szymanski — 2024-06-10

Introduction: Early initiation of breastfeeding (EIBF) is still little stimulated in several hospitals in Brazil. Objective: To estimate the prevalence and factors associated with Early initiation of breastfeeding (EIBF). Methods: Cross-sectional, quantitative study with retrospective secondary data collection in hospital records of 250 full-term newborns, regardless of the type of delivery, with no history of maternal gestational risk, seen in the last six months. Data collection period in a public maternity hospital in Greater São Paulo. Data collection was performed between November 2018 and January 2019, with approval from the hospital and the FMABC Research Ethics Committee under register n. 2,924,393. Results: The prevalence of EIBF was 66%. BFH is associated with anesthesia at childbirth (p<0,001), APGAR less than or equal to 8 in the 1st and 5th minutes (p<0,001), and with c-section (p<0,001), which represented 29.2% of deliveries in the sample. Respiratory distress (38.82%), hypotonia (24.70%), followed by unfavorable maternal conditions (18.82%), were shown to be impeding factors for EIBF, although 90% of newborns received Apgar 9 /10 in the 5th minute. Conclusion: The prevalence of early breastfeeding is lower than recommended, but compatible with the most recent national frequency proportions.