ESTUDO DA POTENCIALIDADE TURÍTICA DO PARQUE NACIONAL DE SETE CIDADES – PIAUÍ

O Ecoturismo é uma alternativa para apreciar a natureza, sendo um refúgio das atividades rotineiras dos grandes centros. Unidades de Conservação, como os Parques Nacionais, são áreas de proteção ambiental salvaguardadas de atividades impactantes à fauna e flora por atividades antrópicas, contribuindo para a preservação e conservação da biodiversidade dos biomas para as gerações futuras. Desta forma, como esses espaços são receptores de turistas, faz-se necessário uma estrutura para recebê-los, assim o principal objetivo do artigo é analisar a estrutura do Parque Nacional de Sete Cidades localizado no Piauí, a partir da análise SWOT. A metodologia empregada foi de cunho qualitativo, bibliográfico e pesquisa de campo. Assim sendo, pode-se concluir que o PARNA apresenta relevantes pontos fortes e oportunidades para se trabalhar o turismo, entretanto observam-se necessárias melhorias a serem aplicadas para que se tenha um melhor atendimento ao turista, além de investimentos em marketing atraindo, assim, mais visitantes ao PARNA

A randomized, open-label clinical trial comparing the long-term effects of miltefosine and meglumine antimoniate for mucosal leishmaniasis

INTRODUCTION: The treatment of mucosal leishmaniasis (ML) is difficult due to the toxicity and route of administration of standard drugs. Miltefosine is an oral agent used for leishmaniasis treatment; however, no data exist regarding its use for ML in Brazil. In this study, we aimed to evaluate the efficacy of miltefosine for ML treatment compared to that of pentavalent antimonial in a pilot study. METHODS: We performed a randomized clinical trial with two parallel groups. The tested intervention consisted of miltefosine 1.3-2 mg/kg/day (two capsules) for 28 days or intravenous 20 mg SbV/kg/day of meglumine antimoniate (N-MA) for 30 days. The final endpoint was defined as complete healing of the lesion four years after treatment. We also analyzed an early endpoint at 90 days after treatment. RESULTS: Forty patients were included in this study: each experimental group comprised 20 patients. Applying a multivariate model in an intention-to-treat analysis, we observed that patients treated with miltefosine had a cure probability 2.08 times greater (95% confidence interval [CI] = 1.03-4.18) than those treated with N-MA at 90 days after treatment. At the final endpoint, we observed no differences in cure probability between miltefosine and N-MA (relative risk = 0.66; 95% CI = 0.33-1.32). With respect to adverse reactions, significant differences between groups were related to gastrointestinal effects, which were more frequent in the miltefosine group. CONCLUSIONS: Miltefosine may be an interesting alternative for treating ML because of its oral administration and cure rate after long-term follow-up

Family and Community Health Medical Residency Program for Hypertense Care

The objective of the present study was to evaluate the care provided to patients with systemic arterial hypertension by comparing the basic health units (BHU) of the municipality of Gurupi-TO with and without the family and community health residency program. This is a descriptive, cross-sectional and retrospective research conducted in twelve BHUs. Project approved by the research ethics committee of the University of Gurupi, in which health servants answered the QualiAB assessment and monitoring instrument and the data were tested by the chi-square test to verify if there is a difference in care considering p≤5%. or 0,05. Of the 21 items analyzed, 14 obtained better levels in UBS with MRPFCH. Therefore, it is concluded that BHU with MRPFCH, as single health system policies, have better quality in the care of hypertension

ABORDAGEM MULTIDISCIPLINAR NO TRATAMENTO DE DOENÇAS CRÔNICA

Introdução: Sendo uma das principais causas de morte pelo mundo, as doenças crônicas se caracterizam por patologias com desenvolvimento gradual e de longa duração, podendo se estender por cerca de 6 meses ou se perdurar por toda a vida. Classificando-se em transmissíveis, causadas por um agente infeccioso e não transmissíveis frequentemente relacionadas à predisposição genética e estilo de vida. Objetivos: Revisar a abordagem multidisciplinar no tratamento de doenças crônicas. Metodologia: Pesquisa realizada entre abril e maio do ano de 2024, com base em uma revisão integrativa da literatura científica nas bases de dados SciELo e Biblioteca Virtual em Saúde (BVS), utilizando os descritores: "Doenças crônicas" e "Abordagem no tratamento para doenças crônicas". Resultados e discussão:  Resultados e discussão: A abordagem multidisciplinar no tratamento de doenças crônicas é fundamental para melhorar os resultados clínicos e a qualidade de vida dos pacientes. A participação de diferentes profissionais de saúde facilita a adesão ao tratamento e reduz maiores complicações. Conclusão: É essencial promover e implementar estratégias que incentivem a colaboração entre diferentes profissionais de saúde no manejo dessas condições, a fim de facilitar o processo do tratamento.&nbsp

ENCONTRO SABERES E PRÁTICAS NO SUS

Este texto tem por objetivo apresentar a experiência vivenciada durante o planejamento, sistematização e realização do I Encontro Saberes e Práticas no SUS, evento de extensão universitária desenvolvido no formato online em novembro de 2021. Durante o encontro discentes de graduação e pós graduação e profissionais de saúde integrantes do Programa de Extensão Saberes e Práticas no SUS apresentaram 08 (oito) atividades desenvolvidas ao longo do ano de 2021.A realização do encontro oportunizou a vivência do processo de sistematização e apresentação de trabalhos na perspectiva de formação de recursos humanos para o SUS

EFEITOS DA PREMATURIDADE NO DESENVOLVIMENTO INFANTIL

Introduction: Prematurity, defined as birth before 37 completed weeks of gestation, is a condition that affects millions of babies around the world. Prematurity can result in a variety of medical complications and developmental delays that can have lasting, lifelong impacts and can occur for a variety of reasons, from complications during pregnancy to the mother's underlying medical conditions, genetic and environmental factors, becoming one of the main causes of neonatal morbidity and mortality in many countries, representing a significant challenge for health systems and affected families. Objectives: Objectively describe the impacts caused by prematurity on child development and the biggest challenges faced as a result of this factor. Methodology: Research carried out between April and May 2024, based on an integrative review of scientific literature in the SciELo and Virtual Health Library (VHL) databases, using the descriptors: “Prematurity” and “Child development”. Results and discussion: Prematurity has several impacts on child development, from delays in neurological evolution, physical growth to respiratory, immunological and nutritional health. Children born prematurely are at greater risk of developing cognitive and motor delays, attention deficits, hyperactivity and learning difficulties throughout their lives, facing challenges related to physical health and well-being. Conclusion: Premature babies face a series of challenges from the moment of birth, where they often require intensive care to ensure their survival and promote adequate growth and development. Furthermore, throughout childhood, these children often require specialized medical and therapeutic support to monitor and intervene in possible health complications, such as chronic respiratory, visual and hearing problems. Therefore, it is crucial to ensure a sensitive and welcoming care environment, in addition to offering emotional support to parents, to promote the best possible development for these children. Introdução: A prematuridade, definida como o nascimento antes das 37 semanas completas de gestação, é uma condição que afeta milhões de bebês em todo o mundo. A prematuridade pode resultar em uma variedade de complicações médicas e atrasos no desenvolvimento, que podem ter impactos duradouros ao longo da vida, podendo ocorrer por uma variedade de razões, desde complicações durante a gravidez até condições médicas subjacentes da mãe, fatores genéticos e ambientais, se tornando uma das principais causas de morbidade e mortalidade neonatais em muitos países, representando um desafio significativo para os sistemas de saúde e para as famílias afetadas. Objetivos: Descrever de forma objetiva quais os impactos causados pela prematuridade no desenvolvimento infantil e os maiores desafios enfrentados por consequência desse fator. Metodologia: Pesquisa realizada entre abril e maio do ano de 2024, com base em uma revisão integrativa da literatura científica nas bases de dados SciELo e Biblioteca Virtual em Saúde (BVS), utilizando os descritores: "Prematuridade", "Manejo da prematuridade" e "Desafios da prematuridade". Resultados e discussão: A prematuridade acarreta diversos impactos no desenvolvimento infantil, desde atrasos na evolução neurológica, no crescimento físico até a saúde respiratória, imunológica e nutricional. Crianças nascidas prematuramente apresentam maior risco de desenvolver atraso cognitivo e motor, déficits de atenção, hiperatividade e dificuldades de aprendizagem ao longo da vida, enfrentando desafios relacionados à saúde física e ao bem-estar. Conclusão: Os prematuros enfrentam uma série de desafios desde o momento do nascimento, onde muitas vezes necessitam de cuidados intensivos para garantir sua sobrevivência e promover um crescimento e desenvolvimento adequado. Além disso, ao longo da infância, essas crianças frequentemente necessitam de acompanhamento médico e terapêutico especializado para monitoração e intervenção em possíveis complicações de saúde, como problemas respiratórios crônicos, visuais e auditivos. Assim, é crucial garantir um ambiente de cuidados sensível e acolhedor, além de oferecer apoio emocional aos pais, para promover o melhor desenvolvimento possível para essas crianças.&nbsp

A relação dos fármacos agonistas de receptores GLP-1 e a proteção de doença renal para pacientes com Diabetes Mellitus

A diabetes mellitus compreende a incapacidade do organismo de desempenhar a função fisiológica da insulina, ocasionando uma grande carga de doenças, incluindo doença renal ou renal crônica e cardiovasculares. Os agonistas do receptor de GLP-1 são empregados em pacientes com diabetes tipo 2 como terapias de redução da glicose diversos à saúde destes pacientes. O objetivo deste estudo foi analisar a forma de ação dos agonistas de receptores GLP-1 como um fator de proteção à patologia renal crônica, em indivíduos portadores de diabetes mellitus do tipo 2, por meio de uma revisão bibliográfica sistemática. Os dados publicados demonstram que que agonistas do receptor GLP-1 reduzem a morte e incidência de doença renal terminal ou de insuficiência renal. Adicionalmente estes fármacos podem bloquear os mecanismos envolvidos em doenças renais, além de amenizar o estresse oxidativo e apoptose celular no rim. As terapias utilizadas com o uso de agonistas GLP-1 têm se mostrado agentes redutores da glicose e eficazes para pacientes com diabetes mellitus tipo 2, sendo recomendadas por instituições americanas e européias

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks