Sports Rehabilitation and Interprofessional Collaboration

Background: The demand for interprofessional collaboration continues to grow due to changing priorities of the health care system.  The benefits of interprofessional collaboration are well documented; however, the methods of collaboration are often unclear and often difficult to put into practice.  While there is a growing number of studies on the impact of interprofessional collaboration in settings such as inpatient, intensive care units, and acute care, there are limited documented cases regarding the interprofessional management of a physical therapy patient in the outpatient orthopedic private practice setting.   Purpose: The purpose of this paper is to describe the reflections of a physical therapist and an athletic trainer in their experience with interprofessional collaboration, describe the barriers they have experienced that make interprofessional collaboration challenging, and to offer solutions to these barriers.  The barriers discussed in the paper include limited knowledge of and respect for other professionals’ skill set, high-productivity work environments, medical hierarchy, overlapping bodies of knowledge, discrepancy between professional reasoning, territorial behavior, and ineffective communication.  Discussion: It appears that contextual factors, such as community in which the professionals practice, the healthcare setting, and the practice environment, have a far less important impact to successful collaboration than the professionals’ attitudes and investment in the collaborative efforts.  Conclusion: Collaboration between a PT and an AT can lead to power struggles and suboptimal patient care if these barriers are not overcome and collaboration may be necessary to provide the highest quality of patient care

Unusual dyspnea in a hemodialysis patient: A case report

The typical clinical symptoms of hemothorax include a rapid development of chest pain or dyspnea, which may be life-threatening without immediate management. As we know, spontaneous hemothorax, a collection of blood within the pleural cavity without previous history of trauma or other cause, which usually onsets suddenly. The early and accurate diagnosis of spontaneous hemothorax is imperative in clinical practice. We reported a middle-age male undergoing regular hemodialysis was referred to our emergency department due to unknown cause of dyspnea and acute respiratory failure. Chest radiography revealed bilateral patchy infiltration of lung. Pleural tap analysis showed exudative pleural effusion with numerous red blood cells. Video-assisted thoracic surgery (VATS) were performed and confirmed the final diagnosis of spontaneous hemothorax. He was then successfully treated with the surgery of VATS combined chest tube thoracostomy

Aiming for Intrasectorality: Public Safety and Health

         Question: Are Public policies that contemplate intrasectorality capable of producing better results for society, public health and safety?           Design: Descriptive study with data analysis from September 2014 to December 2015.           Participants: Civil and Military Police of São Paulo State (western region of São Paulo City).           Intervention: Analysis of criminal indicators of public health interest in the western region of São Paulo City during the period of applicability of intrasectorality as public health and safety policy.           Outcome measures: analysis of the management model and record of reports interesting to public health. The first analysis was carried out in 3 police districts, later spreading to the entire western region of São Paulo City.           Qualitative variables were based on the International Code of Diseases (ICD). The quantitative results obtained were extracted from the Criminal Intelligence System.           Data were analyzed using descriptive statistics with a significance level of 95%. The software used was the bioestat 5.0 for windows.           Results: There was a reduction of 4% to 44% in criminal indicators of public health interest.           Conclusion: Intrasectorality was able to improve public health outcomes when used as public policy in police institutions, reducing the impact of violence on public health

Prosthetic Rehabilitation in Older Adult with Free Gingival Graft: Case Report

Aim: The aim of the present study was to perform the clinical evaluation of the thickness of the soft tissue around dental implants using a free gingival graft obtained from the palate. Background: Rehabilitation in elderly patients improves physiological functions and quality of life, and when this rehabilitation involves a surgical stage, it becomes a challenge, even for more experienced surgeons. Methods: a 64-year-old, white, female patient with a complaint of difficulty chewing and discomfort stemming from her dental status. Rehabilitation was proposed involving a multidisciplinary approach to reestablish esthetics, function and wellbeing. For such, 4.1 Bone Level Tapered® implants were installed. During the presurgical preparation, a free gingival graft was planned to increase the gingival area using the Miller technique. After establishing the suitability of the oral environment, impressions were made in alginate for the fabrication of an acrylic surgical stent to protect the donor site on the hard palate and minimize the morbidity of the surgical intervention. Conclusion: In the case reported, the increase in the gingival tissue using a free gingival graft provided satisfactory peri-implant health in an older patient  throughout annual follow-up for 15 years

Suicidal Ideation among Medical Students: An Integrative Review

Background: Suicide is more common among people who follow a medical career. This occurs because undergraduation course subjects students to psychologically strained situations, which can reduce their mental health and predispose them to suicidal ideation. Objectives: To analyze the factors related to suicidal ideation among medical graduates, highlighting depression and personality traits. To check stigmas surrounding suicidal ideation. Methodology: An integrative review study was carried out using the Scopus database (Elsevier). We selected studies published between 2014 and 2019, using two descriptors: "medical students" and "suicidal ideation". Results and Findings: 139 scientific articles were selected, of which 10 met the eligibility criteria. Specific personality traits and depression predispose to suicide. Although the stigma of suicide and substance use is greater among men, female gender, poor financial status, and psychiatric disorders increase depression scores. Students close to graduation are more likely to cope with stress than others. Limitations: The articles included in this work were produced using different methodologies and different measurement instruments. The prevalence of depression and suicidal ideation among students may be greater, given that stigma may favor the occurrence of response bias. Conclusion: Rates of suicidal ideation are very prevalent in medical students. To solve this problem, medical schools should take steps to prevent adverse situations. &nbsp

Negative impacts of the adaptation process linked to local cultural stress levels in immigrants and development of psychiatric disorders: a systematic review and meta-analysis

Background Current studies underline and enable the international scientific community to reflect on migrant needs to restart, mostly without fluency in the language from the country of destination, without a way of proving his/her knowledges and abilities, with an incomplete family core, without cultural references that until that moment defined him/her as belonging to a specific group, with defined and meaningful habits, full of symbolic representations. Iams Conduct an analysis on the implications of migration in refugees’ mental health, and the link between these implications and Post-traumatic Stress Disorder (PTSD). Method Indexed journals in MEDLINE and LILACS databases hosted in Biblioteca Virtual em Saúde (BVS), as well as papers hosted in Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Periodicals Portal. Searches were carried using the following DeCS descriptors: “Stress Disorders, Post-Traumatic”, "Refugees” e “Mental Health”. Results The 10 studies included in the present review were carried in Australia, Denmark, Ethiopia, Turkey, Uganda, Israel, South Korea and Papua New Guinea, and were published in 2014 (2), 2015 (6), and 2017 (2). Regarding the subject, 50% of the articles concentrate information regarding PTSD and mental health problems, while the remaining half deals with psychosocial effects of mass conflict on refugees. Meta-analysis concludes that a considerable percentage of refugees suffer from psychiatric disorder, I-squared (variation in ES attributable to heterogeneity) = 96,46%; Estimate of between-study variance Tau^2= 0.02. Test of ES=0 : z= 17.75 p= 0.00. Conclusion Exposure to traumatic events such as public executions and other extreme acts of violence, murder of family members, family and friends’ death due to starvation, homelessness, are closely related to PTSD prevalence in refugees. Acculturation and family’s prolonged estrangement are predictors of depressive symptoms in refugees and both exposure to a new culture and adaptation to new laws and norms of welcoming countries act as stressors and aggravators of depressive symptoms. &nbsp

Working conditions of nurses in the Family Health Strategy

Background: To describe the working conditions of the nurses of the Family Health Strategy, characterizing the forms and modalities of work contract, types of bond, working hours, benefits, career plan and salaries. Method and Findings: Exploratory qualitative approach study. Participants were 18 nurses from the teams of the Family Health Strategy of a municipality in the countryside of Mina Gerais, Brazil. The data collection took place in July 2018 through interviews, using a script with closed questions. The Ethics Committee of the proposing Institution according to Official Letter 090/2018, CAAE 83419418.2.0000.5393, approved the study. Two forms of work contracts have been identified represented by the city hall and outsourced companies, the latter being the mode that offers the most benefits to workers. In addition, there was a lack of commensurate links, in addition to units with physical infrastructure that were compromised, lack of basic materials and supllies essential for the provision of care, absence of essential benefits for this category, insalubrity, commission for productivity, long journeys and overload of work, neglect and devaluation of the worker. Conclusions: This study should promote the managers' reflection on the working conditions offered to nurses in basic care, rethinking management models that help them cope with problems related to their work context, stimulating a healthy environment, mitigating possible occupational risks that could compromise physical or mental health of the worker.   &nbsp

How does the ZIKA infection is higher among black women?

Introduction: ZIKA is a single-stranded RNA, from the Flaviviridae family. The infection of this virus became extremely visible during its epidemic in 2015 at South America, after the outbreak many speculations that includes newborns with central nervous system malformations and neurological disorders. Objective: determine the epidemiological profile of the Brazilian female population afflicted with Zika virus, by means of database research of 2017. Results: the higher incidence shows the social inequality of those affected by arboviruses: young, poor, black and brown women, the majority of population in the Northeast and North of Brazil. Conclusion: Brazilian epidemiology of Zika virus and Congenital Zika Virus is concentrated in the black and poor female population due to the historical and cultural Brazilian history of colonization, as it is concentrated in the same region where the Aedes mosquito has an easy procreation due to a wet and hot summer leading to propagation of arboviruses

An unusual case of diffuse ST elevation mimicking acute myocardial infarction: A challenge of emergent percutaneous coronary intervention?

Coronary artery disease combined sepsis associated myocardial ischemia resulting in diffuse ST elevation on electrocardiogram has rarely been reported. We reported a rare case of diffuse ST elevation precipitated by septic shock and preexisting severe atherosclerosis heart disease. In clinical scenario, it is imperative for physicians to be aware of non-ischemic ST elevation etiologies and avoid inappropriate activation of the percutaneous coronary intervention (PCI) protocol, while not missing ST elevation myocardial infarction

Leprosy: demographic and clinical characteristics of patients of endemic area in Amazon Region

Introduction: The hyperendemicity of leprosy in the northern region permeates regional aspects, including its large territorial extension and waterways, which make it difficult to access health and, consequently, control the disease. So that, the objective of this project is to describe the demographic and clinical profile of patients with leprosy and to evaluate their intradomiciliary contacts. Methods and findings: Observational, descriptive study, type of case series, through interview and complementary analysis of the medical records of patients undergoing specific treatment and / or treatment of leprosy reactions followed at the Dermatology outpatient clinic of the University of the State of Pará, in the city of Belém-PA, from January 2015 to December 2017. With convenience sampling, we interviewed 83 patients that met the inclusion criteria and collected socioeconomic and demographic variables, as well as clinical aspects based on the Madrid classification. Descriptive and inferential statistical methods were applied as: tables, graphs and statistical measures of position and Test G, with alpha significance = 0,05 and reliability of 95%. The predominance of males was observed (60.24%), the most affected age group was between 30 and 44 years old and the majority with incomplete secondary education. The predominant family income was up to 1 minimum wage. The most frequent clinical type was Virchowian (38 patients). Most of the patients did not present leprosy reaction and those who presented, the type 1 reaction was the most frequent and the nerve most affected was ulnar. Conclusion: Prevalence of multibacillary cases is a reflex of late diagnosis. It is important that there be intensification of actions and monitoring and active search for new cases