Patologia Psiquiátrica nos Cuidados Primários de Saúde

É consensual a alta prevalência de patologia psiquiátrica ao nível dos Cuidados Primários Saúde. Consensual será também o papel fulcral que estes mesmos Cuidados desempenham enquanto primeiro filtro na abordagem dos problemas psiquiátricos, reconhecendo-se que, frequentemente, o Clínico Geral é o agente melhor posicionado para uma correcta abordagem diagnóstica e terapêutica deste tipo de problemas. Assume-se assim como necessidade objectiva que o Clínico Geral tome a seu cargo a maioria destes doentes e proceda à referenciação criteriosa duma minoria verdadeiramente necessitada de cuidados mais especializados. Em termos práticos, configura-se como prioritária uma progressiva melhoria da capacidade de actuação dos Clínicos Gerais, na área da Saúde Mental. É portanto neste contexto que surge a importância da articulação dos Serviços de Psiquiatria com os Centros de Saúde e a relevância do trabalho Consiliar e de Ligação do Psiquiatra junto dos Clínicos Gerais. No presente artigo os autores tecem algumas considerações e lançam diversas questões sobre o tema em apreço, procurando abordar determinados aspectos centrais, nomeadamente, as particularidades de apresentação da patologia psiquiátrica nos Cuidados de Saúde Primários, em particular da “depressão”, e decorrendo deste facto, as dificuldades na avaliação e abordagem das perturbações mentais neste setting particular

Desenvolvimento de um sistema para compara??o de pre?os em supermercados na cidade de Te?filo Otoni

Diante do per?odo de crise econ?mica em que o pa?s se encontra o que se busca s?o pre?os baixos e ofertas promocionais. Ao se analisar os supermercados existentes na cidade de Te?filo Otoni - MG, p?de-se perceber que, apesar de divulgarem seus pre?os atrav?s de redes sociais como o Facebook, os principais meios pelos quais se faz essa divulga??o de pre?os de produtos e ofertas promocionais s?o an?ncios em r?dio e televis?o al?m de se utilizar banners e panfletos, os quais trazem consigo impedimentos no quesito facilidade de acesso ? informa??o. O objetivo desse estudo ? desenvolver um sistema para compara??o de pre?os em supermercados na cidade de Te?filo Otoni que, com base em uma lista de compras incrementada pelo pr?prio usu?rio, indique onde comprar cada item com o menor pre?o, bem como realizar uma compra ?nica com o melhor custo benef?cio, al?m de indicar promo??es em tempo real, tudo em prol da economia e facilidade ao realizar as compras. Levando em considera??o a dissemina??o da internet e a populariza??o dos smartphones, optou-se pelo desenvolvimento de um sistema web para compara??o de pre?os em supermercados. O banco de dados desse sistema possui informa??es de c?digos de barras de produtos comercializados no Brasil, com funcionalidades criadas para trazer economia e mitigar o tempo gasto em pesquisa de pre?os. Durante a fase inicial do projeto atentou-se para a parte visual do produto, investindo-se em interfaces intuitivas que por serem amig?veis e f?ceis de utilizar diminuem significativamente a curva de aprendizado, capazes de se adaptar a qualquer tipo de tela de dispositivos m?veis ou n?o. Foram aplicados algoritmos inteligentes capazes de otimizar o processo de busca e compara??o de pre?os, tornando a experi?ncia de uso bastante agrad?vel. ? v?lido lembrar que esse projeto contou com a experi?ncia de empres?rios donos de supermercados, os quais contribu?ram com informa??es relevantes agregando muito mais valor ? pesquisa. Ap?s a implementa??o do sistema e de v?rios testes realizados, observou-se que tal ferramenta ser? sim importante se inserida no contexto do objeto de estudo diante do per?odo de crise e recess?o que o pa?s enfrenta, trazendo vantagens financeiras tanto para o empres?rio que poder? dar mais visibilidade ao seu neg?cio quanto ao consumidor em agilidade, praticidade e economia no processo de compra. Durante os testes observou-se que o sistema de compara??o de pre?os em supermercados mostrou ser tamb?m uma ferramenta capaz de coletar informa??es de h?bitos alimentares dos usu?rios e varia??es de pre?os de alimentos, podendo essas informa??es serem ?teis para profissionais da ?rea da sa?de nutricional e ?rg?os estat?sticos como IBGE e DIEESE.Disserta??o (Mestrado Profissional) ? Programa de P?s-Gradua??o em Tecnologia, Sa?de e Sociedade, Universidade Federal dos Vales do Jequitinhonha e Mucuri, 2017.Faced with the period of economic crisis in which the country is located, centralization and variety of products is not enough, now we are looking for low prices and promotional offers. When analyzing the existing supermarkets in the city of Te?filo Otoni - MG, despite spreading their prices through social networks such as Facebook, it can be seen that the main means by which product prices and promotional offers are advertised are radio and television advertisements, besides the use of banners and pamphlets, which carry with them impediments in the modus operandi, especially in the question of ease of access to information. The goal of this study is to develop a price comparison system in supermarkets in the city of Te?filo Otoni, which, based on a user-supplied shopping list, indicates where to buy each item with the lowest price, where to make a single purchase with the better costeffectiveness besides indicating promotions in real time, all for the sake of economy and ease when making purchases. Taking into account the spread of the internet and the popularization of smartphones, we opted for the development of a web system to compare prices in supermarkets. The database of this system has information of barcodes of products commercialized in Brazil, with features designed to bring savings and mitigate time spent on price research. During the initial phase of the project we looked at the visual part of the product, investing in intuitive interfaces, able to adapt to any type of screen of mobile devices or not. Intelligent algorithms capable of optimizing the search process and price comparison were applied, making the use experience quite pleasant. It is worth remembering that this project relied on the experience of entrepreneurs who owned supermarkets, who contributed with relevant information adding much more value to the research. After the implementation of the system and several tests carried out, it was concluded that such a tool will be important if inserted in the context of the object of study in the period of crisis and recession that the country faces, bringing financial advantages to both the entrepreneur who can to give more visibility to your business regarding the consumer in agility, practicality and economy in the process of purchase. During the tests, it was observed that the system of comparison of prices in supermarkets was also a tool capable of collecting information on users eating habits and variations in food prices, and this information could be useful for professionals in the area of nutritional health and organs such as IBGE and DIEESE

Injury to the Superior Gluteal Artery during Intramedullary Fixation of a Proximal Femoral Fracture - A Case Report

Proximal femoral fractures represent a health problem of global proportions. Iatrogenic vascular lesion in the treatment of these fractures is an unusual potentially lethal complication, reported in only 0.2% of trochanteric fractures treated with intramedullary implants. Superior gluteal artery injury is extremely rare, with only two cases reported in literature.info:eu-repo/semantics/publishedVersio

Fluorometric Liposome Screen for Inhibitors of a Physiologically Important Bacterial Ion Channel

The bacterial K+ homeostasis machinery is widely conserved across bacterial species, and different from that in animals. Dysfunction in components of the machinery has an impact on intracellular turgor, membrane potential, adaptation to changes in both extracellular pH and osmolarity, and in virulence. Using a fluorescence-based liposome flux assay, we have performed a high-throughput screen to identify novel inhibitors of the KtrAB ion channel complex from Bacillus subtilis, a component of the K+ homeostasis machinery that is also present in many bacterial pathogens. The screen identified 41 compounds that inhibited K+ flux and that clustered into eight chemical groups. Many of the identified inhibitors were found to target KtrAB with an in vitro potency in the low µM range. We investigated the mechanisms of inhibition and found that most molecules affected either the membrane component of the channel, KtrB alone or the full KtrAB complex without a preference for the functional conformation of the channel, thus broadening their inhibitory action. A urea derivative molecule that inhibited the membrane component of KtrAB affected cell viability in conditions in which KtrAB activity is essential. With this proof-of-concept study, we demonstrate that targeting components of the K+ homeostasis machinery has the potential as a new antibacterial strategy and that the fluorescence-based flux assay is a robust tool for screening chemical libraries.This work was supported by FEDER funds through COMPETE 2020-POCI, Portugal 2020, and FCT – Fundação para a Ciência e a Tecnologia/Ministério da Ciência, Tecnologia e Ensino Superior: POCI-01-0145-FEDER-029863 (PTDC/BIA-BQM/29863/2017), and by “Fundação Luso-Americana para o Desenvolvimento” FLAD Life Science 2020 awarded to JM-C. We acknowledge FCT fellowship SFRH/BPD/105672/2015 and contract DL 57/2016/CP1355/CT0026 awarded to AF, fellowship SFRH/BPD/107785/2015 to AP, and fellowship SFRH/BD/123761/2016 to CT-D

Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

Objective. SLE has a relapsing-remitting course with disease activity flares over time. This study aims to identify clinical predictors of SLE flares.Methods. This prospective cohort study over 24 months included all SLE patients on follow-up at one academic lupus clinic. Flare was defined as an increase in SLEDAI-2K score ≥4 points. Baseline clinical and demographic parameters were compared using survival analysis for time-to-flare outcome with univariate log-rank tests. Variables with significant differences were further evaluated as predictors with multivariate Cox regression models adjusting for potential confounding or contributing factors and hazard ratio (HR) calculation.Results. A total of 202 SLE patients were included. Over the follow-up period, 1083 visits were documented and 16.8% of patients presented with flares. In multivariate analysis, the following parameters emerged as flare predictors: SLE diagnosis up to 25 years of age (HR = 2.14, P = 0.03), lupus nephritis previous to baseline visit (HR = 4.78, P < 0.0001) and immunosuppressor treatment for severe SLE (HR = 3.22, P < 0.001). Baseline disease activity, disease duration and treatment with prednisone or HCQ were not predictive factors.Conclusion. Patients with an SLE diagnosis before age 25 years, lupus nephritis or immunosuppressor treatment for severe SLE present greater HRs for flares, suggesting the need for tighter clinical monitoring. Current immunosuppressive strategies seem to be inefficient in providing flare prevention

Survival of Lactobacillus sakei during heating, drying and storage in the dried state when growth has occurred in the presence of sucrose or monosodium glutamate

Spray-dried cells of Lactobacillus sakei CTC 494 survived ca. 60% longer in the spray dried state when cells were grown in the presence of 20 g sucrose l)1 or 12.5 g monosodium glutamate l)1. No significant differences were observed in viability during storage in the freeze dried state with the addition of these compounds to the growth medium, nor in survival during a heat treatment (55ºC). Both sucrose and glutamate in the growth medium suppressed intracellular accumulation of total amino acids and changed the overall pattern of the individual amino acids. Glutamate in the growth medium enhanced intracellular glutamate by ca. 38

Left Atrial Appendage Volume As a New Predictor of Atrial Fibrillation Recurrence After Catheter Ablation

PURPOSE: Recurrence of atrial fibrillation (AF) after catheter ablation is common, being clinically relevant to identify predictors of recurrence. The left atrial appendage (LAA) role as an AF trigger is scarcely explored. Our aim was to identify if LAA volume is an independent predictor of AF recurrence after catheter ablation. METHODS: We analysed 52 patients (aged 54 ± 10 years, 58% male) with paroxysmal and persistent AF who underwent a first AF catheter ablation and had performed contrast-enhanced cardiac computed tomography (CT) prior to the procedure. RESULTS: The mean left atrial and LAA volumes measured by cardiac CT were 98.9 ± 31.8 and 9.3 ± 3.5 mL, respectively. All patients received successful pulmonary vein isolation and were followed up for 24 months. AF recurrence occurred in 17 patients (33%). LAA volume was significantly greater in patients with AF recurrence than in those without recurrence (11.3 ± 2.9 vs. 8.2 ± 3.4 mL; p = 0.002). Multivariable analysis using Cox regression revealed that LAA volume (hazard ratio 1.32; 95% confidence interval 1.12-1.55; p = 0.001) and persistent AF (hazard ratio 4.22; 95% confidence interval 1.48-12.07; p = 0.007) were independent predictors for AF recurrence. An LAA volume greater than 8.825 mL predicted AF recurrence with 94% sensitivity and 66% specificity. The Kaplan-Meier analysis showed a lower rate free from AF recurrence in the group with an LAA volume >8.825 mL (p < 0.001). CONCLUSIONS: Larger LAA volume was associated with AF recurrence after catheter ablation in patients with paroxysmal and persistent AF.info:eu-repo/semantics/publishedVersio