Pé diabético: análise microbiológica e atenção farmacêutica ao paciente morador de Juiz de Fora

-Diabetes Mellitus é uma enfermidade crônica que predispõe a uma série de complicações, sendo o pé diabético a mais relevante diante do impacto socioeconômico nos sistemas de saúde, em todo mundo. O estudo objetivou avaliar a ocorrência de bactérias e fungos em lesões de pé, o perfil de susceptibilidade a drogas antimicrobianas, a terapia medicamentosa bem como a inter-relação de variáveis que levam à ocorrência do pé diabético. Trata-se de um estudo descritivo e observacional de 10 pacientes diabéticos portadores de lesão dos pés do Programa de Atendimento Interdisciplinar ao Diabético do Núcleo Interdisciplinar de Estudo e Pesquisa em Nefrologia da UFJF em Juiz de Fora - MG, entre junho a outubro de 2007. Para a análise de fatores de risco do pé diabético foi inserido um grupo controle com 20 pacientes diabéticos sem lesão de pé. Dentre os pacientes avaliados 70% eram do sexo masculino, com idade média de 65 anos, 60% aposentados, 80% concluíram o ensino fundamental, renda entre 1 e 3 salários mínimos. Como fatores desencadeantes das lesões destacam-se arteriopatia (100%) e neuropatia (60%). A HAS foi a patologia mais associada ao DM. Na avaliação microbiológica foram isolados 45% BGN, 38% CGP, 17% leveduras do gênero Candida, sendo detectada alguma resistência antimicrobiana. Na avaliação terapêutica foi observada extensa utilização de medicamentos pelos pacientes. A prescrição estava adequada à maioria das indicações, no entanto foram identificadas muitas interações medicamentosas, sugerindo um acompanhamento de equipe multiprofissional, incluindo o Farmacêutico, para adoção estratégias racionais na terapia medicamentosa

Uso de jogos e redes sociais como estratégias de promoção de saúde para crianças e adolescentes: um relato de experiência de extensão universitária

The pandemic caused by the new coronavirus has had consequences in many areas. With the suspension of face-to-face classes, students and educators have been encouraged to develop better technological aptitude to optimize the use of distance communication media. Thus, academic institutions have prioritized the use of digital media to enable and supervise studies and projects. Therefore, the extension project entitled "Healthy Eating and Physical Activity Practice as a Health Prevention Strategy for Children and Adolescents", which aims to encourage the adoption of good eating habits and physical exercise in health promotion for public school students, has adapted the materials applied in previous face-to-face versions to the digital format. This paper aims to share the experience report of the conversion and innovation of the original proposal. Survey questionnaires were made on Google Forms; video recordings posted on YouTube; and posts on the social network Instagram. However, the big innovation was the creation of games on the Wordwall platform. As a result, there was a closer relationship between extensionists and the children, despite the distance in person, with a high degree of improvement in digital communication abilities. The extensionists went further into the technological universe, always reflecting on the children's performance. In this way, this process proved to be a true exercise for professional practice from a virtual perspective, generating more qualified, updated, and empathetic citizens.A pandemia provocada pelo novo coronavírus trouxe consequências para diversas áreas. Com a suspensão das aulas presenciais, alunos e educadores foram instados a desenvolver melhor aptidão tecnológica para otimizar o uso de meios de comunicação a distância. Assim, instituições de Ensino Superior aperfeiçoaram o uso de mídias digitais para fomentar e supervisionar estudos e projetos. Dessa forma, o projeto de extensão intitulado “Alimentação Saudável e Prática de Atividade Física como estratégia de Prevenção em Saúde de crianças e adolescentes”, que visa a incentivar a adoção de bons hábitos alimentares e do exercício físico na promoção da saúde de estudantes da rede pública, adaptou para o formato digital os materiais aplicados em versões presenciais anteriores. Este trabalho objetiva compartilhar o relato de experiência da conversão e inovação da proposta original. Foram feitos questionários de sondagem no Google Forms; gravação de vídeos postados no YouTube; e postagens na rede social Instagram. Entretanto, a grande inovação foi a criação de games na plataforma Wordwall. Como resultados, destaca-se o estreitamento dos vínculos entre extensionistas e o público-alvo, a despeito do distanciamento presencial, com elevado grau de aperfeiçoamento de habilidades de comunicação digital. Os extensionistas se aprofundaram mais no universo tecnológico, refletindo sempre no aproveitamento das crianças. Desse modo, esse processo mostrou-se um verdadeiro exercício para a prática profissional numa perspectiva virtual, formando cidadãos mais qualificados, atualizados e empáticos. Destaca-se o uso dos jogos e redes sociais como grandes aliados no processo de ensino-aprendizagem que poderão ser incorporados à ação presencial da extensão universitária

Health-related quality of life in patients with type 1 diabetes mellitus in the different geographical regions of Brazil : data from the Brazilian Type 1 Diabetes Study Group

Background: In type 1 diabetes mellitus (T1DM) management, enhancing health-related quality of life (HRQoL) is as important as good metabolic control and prevention of secondary complications. This study aims to evaluate possible regional differences in HRQoL, demographic features and clinical characteristics of patients with T1DM in Brazil, a country of continental proportions, as well as investigate which variables could influence the HRQoL of these individuals and contribute to these regional disparities. Methods: This was a retrospective, cross-sectional, multicenter study performed by the Brazilian Type 1 Diabetes Study Group (BrazDiab1SG), by analyzing EuroQol scores from 3005 participants with T1DM, in 28 public clinics, among all geographical regions of Brazil. Data on demography, economic status, chronic complications, glycemic control and lipid profile were also collected. Results: We have found that the North-Northeast region presents a higher index in the assessment of the overall health status (EQ-VAS) compared to the Southeast (74.6 ± 30 and 70.4 ± 19, respectively; p < 0.05). In addition, North- Northeast presented a lower frequency of self-reported anxiety-depression compared to all regions of the country (North-Northeast: 1.53 ± 0.6; Southeast: 1.65 ± 0.7; South: 1.72 ± 0.7; Midwest: 1.67 ± 0.7; p < 0.05). These findings could not be entirely explained by the HbA1c levels or the other variables examined. Conclusions: Our study points to the existence of additional factors not yet evaluated that could be determinant in the HRQoL of people with T1DM and contribute to these regional disparities

Genomics and epidemiology for gastric adenocarcinomas (GE4GAC): a Brazilian initiative to study gastric cancer

Abstract Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings

Neurostimulation Combined With Cognitive Intervention in Alzheimer’s Disease (NeuroAD): Study Protocol of Double-Blind, Randomized, Factorial Clinical Trial

Despite advances in the treatment of Alzheimer’s disease (AD), there is currently no prospect of a cure, and evidence shows that multifactorial interventions can benefit patients. A promising therapeutic alternative is the use of transcranial direct current stimulation (tDCS) simultaneously with cognitive intervention. The combination of these non-pharmacological techniques is apparently a safe and accessible approach. This study protocol aims to compare the efficacy of tDCS and cognitive intervention in a double-blind, randomized and factorial clinical trial. One hundred participants diagnosed with mild-stage AD will be randomized to receive both tDCS and cognitive intervention, tDCS, cognitive intervention, or placebo. The treatment will last 8 weeks, with a 12-month follow-up. The primary outcome will be the improvement of global cognitive functions, evaluated by the AD Assessment Scale, cognitive subscale (ADAS-Cog). The secondary outcomes will include measures of functional, affective, and behavioral components, as well as a neurophysiological marker (Brain-derived neurotrophic factor, BDNF). This study will enable us to assess, both in the short and long term, whether tDCS is more effective than the placebo and to examine the effects of combined therapy (tDCS and cognitive intervention) and isolated treatments (tDCS vs. cognitive intervention) on patients with AD.Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02772185—May 5, 2016

Effectiveness and safety of multidrug therapy containing clofazimine for paucibacillary leprosy and clarithromycin for rifampicin-resistant leprosy: a systematic review and meta-analysis

Introduction: The present study aimed to evaluate leprosy cure and relapse rates as primary outcomes related to two additional strategies for leprosy treatment: clofazimine for paucibacillary (PB) leprosy patients and clarithromycin for patients with rifampicin-resistant leprosy. Methods: We conducted two systematic reviews (protocols CRD42022308272 and CRD42022308260). We searched the PubMed, EMBASE, Web of Science, Scopus, LILACS, Virtual Health Library and Cochrane Library databases, registers of clinical trial databases and gray literature. We included clinical trials evaluating the addition of clofazimine to PB leprosy treatment and the use of clarithromycin for treating patients with rifampicin-resistant leprosy. Risk of bias (RoB) in randomized clinical trials was assessed by the RoB 2 tool and that in non-randomized clinical trials was assessed by the ROBINS-I tool; and the certainty of the evidence was assessed by the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. A meta-analysis of dichotomous outcomes was performed. Results: For clofazimine, four studies were included. Cure and relapse rates were not dierent with the addition of clofazimine to PB leprosy treatment and demonstrated very low certainty of evidence. For clarithromycin, six studies were included. Considerable heterogeneity resulted from the dierence between comparators, and studies showed no dierence in the assessed outcomes with the addition of clarithromycin to rifampicin-resistant leprosy treatment. Mild adverse events were reported for both drugs but did not significantly impact treatment. Discussion: The eectiveness of both drugs still needs to be determined. Adding clofazimine to PB leprosy treatment may reduce the repercussions of an incorrect operational classification with no apparent relevant side.Faculdade de Medicina (FM

Relato de experiência: exercício de memória aplicados em idosos com comprometimento cognitivo leve Experience report: Exercise applied memory in elderly people with mild cognitive impairment

Este relato de experiência procura descrever uma sessão do exercício de memória de pacientes com Comprometimento Cognitivo Leve (CCL) no Hospital Dia do Idoso em Anápolis. O comprometimento cognitivo leve caracteriza-se por ser uma diminuição cognitiva incapaz de afetar as atividades de vida diárias (AVDs) mas que constituem um foco de constrangimento e desconforto para o individuo. O objetivo do relato é avaliar os membros do grupo portador de Comprometimento Cognitivo Leve quanto a memória declarativa (imediata, curto e longo prazo). Procurou-se evocar a memória autobiográfica através de imagens retiradas de revistas populares e os critérios avaliados inserem nas respectivas esferas: compreensão da atividade, coordenação motora ao manusear a figura, reflexão sobre a foto, expressão verbal e não-verbal e receptividade à proposta. Os resultados obtidos evidenciam que os participantes aderiram positivamente ao exercício e mais da metade  foi capaz de exercer as duas etapas. Os membros que demonstraram dificuldade apresentaram déficit auditivo ou  foram incapazes de expor um relato autobiográfico. É possível concluir que as atividades realizadas foram bem sucedidas em estimular  áreas cerebrais relativas a memória, expressão verbal e permitiram aos avaliadores estimar a preservação da integridade mental. Os estudos de Hertzog são contemporâneos em reafirmar a eficácia do exercício de memória em idosos com baixo decréscimo cognitivo. Sob a perspectiva do estudante a ação introduziu novos parâmetros de avaliação mental e busca incentivar a criação de grupos específicos  pacientes com Comprometimento Cognitivo Leve de forma humanizada

Subconjunctival 0.1% epinephrine versus placebo in maintenance of mydriasis during vitrectomy: a randomized controlled trial

Abstract Background Pupil dilation and mydriasis maintenance throughout vitreoretinal surgeries are important to allow satisfactory fundus visualization and reduce risk of complications. The purpose of this study is to evaluate the role of subconjunctival epinephrine 0.1% injection in mydriasis maintenance during vitrectomy. Methods Ninety-nine consecutive patients undergoing vitrectomy were enrolled. All subjects were preoperatively dilated with tropicamide 1%. Each patient was randomly allocated either in the epinephrine or placebo group. In epinephrine group, patients were submitted to a 0.2 cc subconjunctival injection of a 0.1% epinephrine solution just before first incisions. In placebo group, the same procedure was performed with 0.2 cc of saline 0.9%. Horizontal pupil diameter was measured with calipers before and in the end of the procedure. Results Patients in the epinephrine group showed a significantly larger mean pupil diameter in the end of the surgery compared to placebo. There was a significant increase of mean pupil diameter from the beginning to the end of the surgery in such patients. Blood pressure was significantly higher in the epinephrine group than in placebo group. No other adverse effects were noted. Conclusion Subconjunctival epinephrine is effective for maintaining and increasing pupil size during vitrectomy, compared to placebo. Caution should be taken regarding intraoperative blood pressure levels. Trial registration RBR; RBR-3qzhvg; Registered 8 May 2018—Retrospectively registered, http://www.ensaiosclinicos.gov.br/rg/RBR-3qzhvg/

Sensoriamento Remoto na detecção e análise de focos de calor na bacia hidrográfica do Rio Munim

Os incêndios são a causa da devastação de milhares de hectares de ecossistemas do planeta, gerando impactos à saúde pública, prejuízos econômicos e ambientais. O presente estudo tem como objetivo realizar uma análise temporal dos focos de calor detectados em diferentes usos e cobertura da terra mapeados entre 2008 e 2018 na Bacia Hidrográfica do Rio Munim (BHRM), leste Maranhense. Os dados utilizados no trabalho foram obtidos junto à plataforma digital do Instituto Nacional de Pesquisas Espaciais (INPE), sendo provenientes dos satélites TERRA, AQUA, GOES, NOAA, MSG-02 e ERS-2. Constatou-se um total de 74.752 ocorrências de focos de incêndios na área da bacia entre os anos de 2008 a 2018, tendo como destaque o mês de novembro o mais crítico registrando 30,33% do total de focos, seguido pelo mês de outubro com 23,03%, período em que praticamente não existe precipitação na região. Verificou-se que o ano de 2015 foi o que apresentou o maior índice de focos com 14.025 ocorrências e que o ano de 2011 foi o menos expressivo, com 2.116 ocorrências