Uma análise sobre o aumento da prevalência do Transtorno do Espectro Autista em crianças

O Transtorno do Espectro do Autismo (TEA) é um distúrbio do desenvolvimento neurológico caracterizado por anormalidades nas relações sociais e padrões comportamentais repetitivos ou restritos. A descrição das principais características do transtorno está relacionada a déficits de comunicação social e comportamentos repetitivos e incomuns não mudou substancialmente desde o seu delineamento original. O aumento da prevalência ao longo do tempo gerou preocupações sobre uma epidemia de autismo impulsionada por mudanças nos fatores ambientais

Depressão pós-parto: importância de falar sobre

A revisão integrativa destaca a elevada prevalência da depressão pós-parto, afetando entre 15% e 29% das mulheres durante a gestação e puerpério, com uma incidência de uma em cada oito mulheres após o parto. No Brasil, essa taxa é ainda mais significativa, atingindo uma em cada cinco parturientes. Fatores como baixo nível socioeconômico, história de doença psiquiátrica, tristeza pós-parto e ansiedade pré-natal estão associados à depressão. O apoio social, otimismo e boa relação conjugal são considerados protetores. A relação mãe-bebê, incluindo a amamentação, é afetada, podendo influenciar o desenvolvimento cognitivo da criança. O tratamento, principalmente com antidepressivos, é desafiador devido aos riscos para o recém-nascido. A genotipagem pode ser uma abordagem promissora. Em conclusão, a detecção precoce, associada a fatores sociodemográficos, é crucial para um tratamento eficaz e aprimoramento das políticas de saúde pública

Saúde mental de discentes dos cursos de pós-graduação stricto sensu

Reconhece-se a saúde mental em estudantes de pós-graduação uma questão urgente, embora menos pesquisada. Em vista disso, objetivou-se mapear evidências científicas sobre saúde mental de estudantes de pós-graduação, no contexto dos cursos stricto sensu. Para tanto, considerou-se pertinente a realização de uma revisão de escopo, nas bases de dados LILACS, SCIELO e MEDLINE. As evidências mapeadas demonstraram que na última década, o número de programas de pós-graduação, em nível de mestrado e doutorado, vem crescendo de forma constante no cenário mundial e nacional e, concomitantemente, o número de discentes inseridos em tais programas. Por conseguinte, pesquisas publicadas no período de 2018 a 2023 passaram a investigar o adoecimento psíquico na vida acadêmica, evidenciando taxas variando de 15,9 a 78% de ansiedade, 13 a 89% de depressão, 0,99 a 31% de insônia, 5,5% de pânico e 27,4% ideação suicida passiva e 16,5% ideação suicida ativa. Nas amostras dos estudos analisados, cuja quantidade variou de 90 a 5.985 pós-graduandos, houve predomínio do sexo feminino e adultos jovens, com idade média de 30 anos. Foram apontados como fatores que afetam a saúde mental em discentes de pós-graduação de cursos stricto sensu os seguintes: relações deficientes e/ou conflituosas entre orientador e orientando, estresse financeiro, excesso de atividades, competitividade acadêmica e falta de equilíbrio entre vida acadêmica, pessoal e profissional

Extrarenal Pelvis in a Cat - Diagnosis by Scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report. Keywords: renal scintigraphy, chronic kidney disease, ultrasonography, nuclear medicine. Título: Pelve extrarrenal em uma gata - diagnóstico por cintilografia. Descritores: cintilografia renal, doença renal crônica, ultrassonografia, medicina nuclear

Extrarenal pelvis in a cat : diagnosis by scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report

Preval?ncia de pielonefrite aguda e incid?ncia de cicatriz renal em crian?as menores de dois anos de idade com infec??o do trato urin?rio avaliadas atrav?s da cintilografia renal com 99mTcDMSA : a experi?ncia de hospital universit?rio

Made available in DSpace on 2015-04-14T13:33:05Z (GMT). No. of bitstreams: 1 448602.pdf: 5444949 bytes, checksum: 5f077f7aa23c0ec642d7726b401ada78 (MD5) Previous issue date: 2013-03-04OBJECTIVE: To calculate the frequencies of acute pyelonephritis and renal scarring in youngers than two years old through scintigraphy with 99mTcDMSA with first episode of UTI in a Brazilian university hospital and comparing with international literature. MATERIALS AND METHODS: We reviewed reports scintigraphy of youngers than two years old who underwent scintigraphy with 99mTcDMSA in a university hospital in Rio Grande do Sul, between 2006 and 2009 to search for APN and renal scarring. It was also revised the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities that were recorded in e lectronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. We excluded patients with no electronic record. RESULTS: 157 children met the inclusion criteria, where 48 had APN and 8 of these had renal scars. There was no statistical difference in the association of VUR and APN (p=1.0) as well as among all comorbidities (p=0.470). There was no significance relation to early use of antibiotics and APN (p=0.130) and renal scarring (p=0.720). CONCLUSION: The frequency of renal scarring and APN obtained agree with the results of most studies.OBJETIVO: Calcular as frequ?ncias de pielonefrite aguda (PNA) e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99mTcDMSA com primeiro quadro de ITU em hospital universit?rio brasileiro comparando com dados da literatura internacional. MATERIAIS E M?TODOS: Foram revisados laudos cintilogr?ficos de crian?as menores de dois anos de idade que realizaram cintilografia renal com 99mTcDMSA em um hospital universit?rio de no Rio Grande do Sul, entre 2006 e 2009 para pesquisa de PNA/cicatriz renal. Revisouse a presen?a de refluxo v?sicoureteral (RVU), uso precoce de antibi?tico, e presen?a de comorbidades que constassem nos prontu?rios eletr?nicos. Calculouse a amostra baseado num estudo de revis?o sistem?tica e obtevese um m?nimo de 147 pacientes. Excluiu-se pacientes sem registro eletr?nico. RESULTADOS: 157 crian?as preencheram crit?rios de inclus?o do estudo, 48 tiveram PNA e 8 destes apresentaram cicatriz renal. Nem a idade e g?nero dos pacientes apresentaram associa??o significativa com PNA (p=0,405; p=0,124 respectivamente). N?o houve diferen?a estat?stica nas associa??es de RVU e PNA (p=1,0) e outras comorbidades (p=0,470); e em rela??o ao uso precoce de antibi?tico com PNA (p=0,130) e cicatriz renal (p=0,720). CONCLUS?O: As frequ?ncias de PNA e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicado

Prevalência de pielonefrite aguda e incidência de cicatriz renal em crianças menores de dois anos de idade com infecção do trato urinário avaliadas através da cintilografia renal com 99mTcDMSA: a experiência de hospital universitário

OBJETIVO: Calcular as frequências de pielonefrite aguda (PNA) e cicatriz renal em pacientes menores de dois anos com cintilografia renal com 99mTcDMSA com primeiro quadro de ITU em hospital universitário brasileiro comparando com dados da literatura internacional.MATERIAIS E MÉTODOS: Foram revisados laudos cintilográficos de crianças menores de dois anos de idade que realizaram cintilografia renal com 99mTcDMSA em um hospital universitário de no Rio Grande do Sul, entre 2006 e 2009 para pesquisa de PNA/cicatriz renal. Revisouse a presença de refluxo vésicoureteral (RVU), uso precoce de antibiótico, e presença de comorbidades que constassem nos prontuários eletrônicos. Calculouse a amostra baseado num estudo de revisão sistemática e obtevese um mínimo de 147 pacientes. Excluiu-se pacientes sem registro eletrônico.RESULTADOS: 157 crianças preencheram critérios de inclusão do estudo, 48 tiveram PNA e 8 destes apresentaram cicatriz renal. Nem a idade e gênero dos pacientes apresentaram associação significativa com PNA (p=0,405; p=0,124 respectivamente). Não houve diferença estatística nas associações de RVU e PNA (p=1,0) e outras comorbidades (p=0,470); e em relação ao uso precoce de antibiótico com PNA (p=0,130) e cicatriz renal (p=0,720).CONCLUSÃO: As frequências de PNA e cicatriz renal obtidas concordam com os resultados da maioria dos estudos publicadosOBJECTIVE: To calculate the frequencies of acute pyelonephritis and renal scarring in youngers than two years old through scintigraphy with 99mTcDMSA with first episode of UTI in a Brazilian university hospital and comparing with international literature.MATERIALS AND METHODS: We reviewed reports scintigraphy of youngers than two years old who underwent scintigraphy with 99mTcDMSA in a university hospital in Rio Grande do Sul, between 2006 and 2009 to search for APN and renal scarring. It was also revised the presence of vesicoureteral reflux, early use of antibiotics, and comorbidities that were recorded in e lectronic records. The sample size calculation was based on a systematic review study and obtained a minimum of 147 patients. We excluded patients with no electronic record.RESULTS: 157 children met the inclusion criteria, where 48 had APN and 8 of these had renal scars. There was no statistical difference in the association of VUR and APN (p=1. 0) as well as among all comorbidities (p=0. 470). There was no significance relation to early use of antibiotics and APN (p=0. 130) and renal scarring (p=0. 720).CONCLUSION: The frequency of renal scarring and APN obtained agree with the results of most studies

Depressão em idosos submetidos à Hemodiálise: uma revisão sistemática

A depressão atinge 3,8% da população mundial e 5,7% dos adultos com mais de 60 anos. Os transtornos depressivos aumentam a morbidade, a mortalidade, e comprometem a qualidade de vida. Da mesma maneira, a doença renal crônica é um problema de saúde pública mundial. Com uma prevalência global de cerca de 9%, é também muito prevalente na população idosa, com alto impacto na qualidade de vida, incluindo na saúde mental. Assim, o objetivo desta revisão sistemática é analisar os dados publicados acerca da prevalência de sintomas depressivos em pacientes idosos submetidos à hemodiálise, de maneira a contribuir para o entendimento e otimização do manejo dessa comorbidade em pacientes renais crônicos geriátricos. Foram analisados estudos publicados entre 2010 e 2021 originalmente em língua inglesa, tendo como referência a bases de dados PubMed (National Library of Medicine), utilizando-se as seguintes combinações de palavras-chave (Mesh Terms): older people or elderly and dialysis or dialytic and depression symptoms or depression. Foram excluídos os artigos que não avaliaram depressão nos pacientes, que não incluíram pacientes em diálise, ou que não incluíram pacientes idosos. Foram incluídos, após a análise,13 estudos. Nestes, verificou-se que a presença de sintomas depressivos é prevalente na população geriátrica em tratamento dialítico, independente do tempo de tratamento dialítico e modalidade proposta. No entanto, os estudos apresentam fragilidade metodológica, requerendo estudos com validação de uma escala para avaliação de sintomas depressivos nesta população

Extrarenal Pelvis in a Cat - Diagnosis by Scintigraphy

Background: In people, extrarenal pelvis is a normal anatomical variant, characterized by the protusion of the pelvis out of the renal hilum, which can be associated with other anomalies, or predispose to stasis or infection. While other diagnostic imaging methods provide anatomical and morphological information about the kidney, scintigraphy allows to determine the renal function and has greater sensitivity in the detection of functional alterations. The aim of this work is to report the case of an asymptomatic cat diagnosed with extrarenal pelvis detected by scintigraphy, which presented alterations in laboratory and renal imaging tests, and absence of associated obstructive process. Case: A 7-year-old mixed-breed female cat was evaluated for a routine health assessment at the Veterinary Teaching Hospital of the Federal University of Rio Grande do Sul (HCV-UFRGS). When performing the imaging and laboratory tests, renal alterations compatible with chronic kidney disease were found in the abdominal ultrasonography examination and in serum creatinine levels. Therefore, it was decided to perform scintigraphy evaluation to better assess renal function. Dynamic renal scintigraphy with 99mTcDTPA revealed an evident concentration of the radiotracer in the left kidney with effective elimination only after the diuretic stimulus. The right kidney exhibited less concentration of the radiotracer but showed effective elimination before the diuretic stimulus. Image analysis suggested the presence of an extrarenal pelvis on the left side. The relative renal uptake was 68% for the left kidney and 32% for the right kidney. The glomerular filtration rate was 1.65 mL/min/kg. Static renal scintigraphy with 99mTcDMSA revealed irregularity in the distribution of the radiotracer in both kidneys, showing less activity in the caudal pole of the left kidney. The right kidney was apparently reduced and with less activity, especially in the medial portion. The relative renal uptake was 65% for the left kidney and 35% for right kidney, while the absolute renal uptake of the left kidney was 33% and that of the right kidney was 17%. The alteration described in the left kidney, in correlation with dynamic renal scintigraphy, suggested an aspect of lower activity in the caudal pole due to the presence of activity in the extrarenal pelvis. The left kidney was classified as presenting normal renal function and there was moderate to severe deficit of renal function on the right side. Discussion: Chronic kidney disease may be present before clinical signs and biochemical abnormalities are identified. In this report, the animal was referred for a routine evaluation and showed no clinical signs nor alterations on physical examination. However, as renal morphological alterations were seen on ultrasonography and the cat presented mild azotemia, it was decided to perform two renal scintigraphy exams. Despite the radiotracer elimination from the left kidney was seen only after the diuretic stimulus, dynamic renal scintigraphy did not show any obstructive process. This delay on elimination was probably a result of the anatomical variant called extrarenal pelvis. In the static renal scintigraphy, it was possible to evaluate morphological changes in the kidneys and suggest less activity in the caudal pole of the left kidney, due to the presence of activity in the extrarenal pelvis, apparently causing the mentioned defect. The correct diagnosis of morphological changes is essential and for this purpose the best combination of imaging tests is necessary. Renal scintigraphy was fundamental, in this case, for the diagnosis of extrarenal pelvis in one of the kidneys, an abnormality not reported in the feline species within the literature researched by the authors. In addition, renal scintigraphy helped to guide the clinical management of the patient described in this report. Keywords: renal scintigraphy, chronic kidney disease, ultrasonography, nuclear medicine. Título: Pelve extrarrenal em uma gata - diagnóstico por cintilografia. Descritores: cintilografia renal, doença renal crônica, ultrassonografia, medicina nuclear

PET-CT has low specificity for mediastinal staging of non-small-cell lung cancer in an endemic area for tuberculosis: a diagnostic test study (LACOG 0114)

Abstract Background The present study aims to assess the performance of 18F-FDG PET-CT on mediastinal staging of non-small cell lung cancer (NSCLC) in a location with endemic granulomatous infectious disease. Methods Diagnostic test study including patients aged 18 years or older with operable stage I-III NSCLC and indication for a mediastinal lymph node biopsy. All patients underwent a 18F-FDG PET-scan before invasive mediastinal staging, either through mediastinoscopy or thoracotomy, which was considered the gold-standard. Surgeons and pathologists were blinded for scan results. Primary endpoint was to evaluate sensitivity, specificity and positive and negative predictive values of PET-CT with images acquired in the 1st hour of the exam protocol, using predefined cutoffs of maximal SUV, on per-patient basis. Results Overall, 85 patients with operable NSCLC underwent PET-CT scan followed by invasive mediastinal staging. Mean age was 65 years, 49 patients were male and 68 were white. One patient presented with active tuberculosis and none had HIV infection. Using any SUV_max > 0 as qualitative criteria for positivity, sensitivity and specificity were 0.87 and 0.45, respectively. Nevertheless, even when the highest SUV cut-off was used (SUV_max ≥5), specificity remained low (0.79), with an estimated positive predictive value of 54%. Conclusions Our findings are in line with the most recent publications and guidelines, which recommend that PET-CT must not be solely used as a tool to mediastinal staging, even in a region with high burden of tuberculosis. Trial registration The LACOG 0114 study was registered at ClinicalTrials.gov, before study initiation, under identifier NCT02664792