Direito e loucura: um roteiro noir: uma breve análise do entrelace entre o racismo, a dependência química e a instituições jurídicas

O presente trabalho pretende analisar as intersecções entre o direito e a medicina, com foco na psiquiatria, no que tange à construção de políticas públicas e oferta de tratamento psíquico para a população brasileira. O processo de estabelecimento das novas modalidades médicas no Brasil, em especial a medicina psiquiátrica, vem acompanhado de fortes discursos higienistas, eugênicos, capacitistas e racistas, fato que perdura ao longo das décadas. Para este estudo, foram analisadas as obras de Lima Barreto Diário do Hospício e O Cemitério dos Vivosescritos durante a internação do escritor no Hospital Nacional de Alienados, em razão de seu vício em álcool e o processo nº 1001521-57.2017.8.26.0360, que teve como resultado a esterilização de Janaína Quirino, também em razão de seu vício em álcool, bem como de demais substâncias entorpecente

Drug interactions and adverse events in elderly heart disease patients

Chronic and multiple diseases are more prevalent in elderly individuals and, epidemiological highlight can be given to cardiovascular conditions requiring multi-drug therapies, which favor the occurrence of drug interactions. This study aims to analyze potential drug interactions and correlate them with adverse events in elderly heart-disease patients in a hospital setting. This is a prospective description of the analysis of medical prescriptions and records of 80 patients, with data collection performed by using validated instruments during a seven-month period. The drug interactions found were indicated by scientifically recognized databases and subsequently treated statistically with adequate software. 1841 potential interactions between drugs were detected, of which 74.1% did not show any therapeutic benefits, with antithrombotic and analgesic drugs accounting for the worst results. Thenumber of potential interactions was proportional to the occurrence of adverse events, classified at 87.3% as moderate to severe. It is concluded from such results that there is a proportionality between the occurrence of potential drug interactions and the detection of adverse events, with therapeutic management being of great importance for safety, quality and affordability of the treatment

Análise de custos durante o pós-parto numa exploração leiteira em Montemor-o-Velho

Dissertação de Mestrado Integrado em Medicina VeterináriaA presente dissertação refere-se ao estudo desenvolvido durante o Estágio Curricular de Mestrado Integrado em Medicina Veterinária, na área da Clínica de Espécies Pecuárias. Os dados utilizados são provenientes de uma das maiores explorações de bovinos leiteiros do concelho de Montemor-o-Velho, a “Quinta do Muroz”, localizada em Arazede. A amostra escolhida abrange 126 vacas, cujos partos ocorreram entre 1 de Outubro de 2008 a 1 de Abril de 2009. Para a concretização deste trabalho foi realizada uma análise da fertilidade, após avaliação do intervalo parto-concepção, do número de inseminações por concepção e do número de animais refugados precocemente, dando especial importância a avaliação dos custos associados ao aumento destes parâmetros. Foi ainda calculado até quantos dias é rentável alongar o intervalo parto-concepção antes de se refugar o animal por causas reprodutivas, tendo sido diferenciada a alta e a média produção. Foram também avaliadas as principais complicações do parto e do pós-parto, incluindo a distócia, a retenção placentária, as infecções do tracto reprodutivo, os ovários quísticos, a hipocalcémia, a cetose, o deslocamento do abomaso, a mamite e a laminite. Foi calculado o custo de tratamento por caso clínico de cada doença e posteriormente o custo de tratamento de todas as ocorrências, tendo em consideração a sua incidência no grupo de estudo. A mamite revelou ser a doença com maior impacto económico. Os custos associados à alimentação foram também estudados, permitindo assim calcular os custos de produção de uma novilha. No final são feitas várias sugestões que podem ajudar o produtor a reduzir os custos de produção.ABSTRACT - The current dissertation refers to a study developed during the curricular training period of the Integrated Master degree in Veterinary Medicine. All data used were obtained from one of the larger dairy herds of Montemor-o-Velho, “Quinta do Muroz”, located in Arazede. Data from a group of 126 dairy cows that calved between 1st October 2008 and 1st April 2009 were collected and analyzed. The fertility was evaluated with the analyses of the following fertility parameters: calving to conception interval, number of inseminations by conception and the involuntary culling rate. Special attention was given to the costs associated to the increase of these indexes. It was also calculated how many days it is profitable to increase the calving to conception interval before involuntary culling. A distinction is made between high and medium producing cows. The most common calving and postpartum disorders, such as, dystocia, twining, retained placenta, uterine infections, ovarian cysts, hypocalcaemia, ketosis, displaced abomasum, mastitis and lameness were also studied. The treatment costs for each disease for one single case were calculated, as well as the total treatment costs of each disease taking into account the incidence in the studied herd. Mastitis reveals to be the disease with higher economical impact. The costs associated with nutritional management were also studied, and it was possible to find the production costs per heifer. In order to help the farmer reducing the production costs, several suggestions are made

Olive oil consumption confers protective effects on maternal-fetal outcomes: A systematic review of the evidence

Because of the maternal diet's importance, numerous studies have examined the effects of olive oil on pregnancy outcomes. This study provides a systematic review that evaluates the evidence between olive oil consumption and maternal-fetal outcomes. We hypothesized that olive oil reduced the risk of adverse pregnancy complications. We searched Web of Science, Scopus, PubMed, and Biblioteca Virtual em Saúde electronic databases (October and November 2021). The keywords used were pregnancy, olive oil, and pregnancy outcomes. This review included all the available studies in English and Portuguese. The exclusion criteria were (1) unrelated to olive oil consumption, (2) other outcomes, and (3) animal studies. The review included 9 articles (6 experimental and 3 observational). In the maternal outcome studies (n = 6), a higher olive oil consumption was associated with a lower prevalence of gestational diabetes mellitus, preeclampsia, and cardiovascular risk. In the fetal outcome studies (n = 8), olive oil consumption was associated with a lower risk for small- or large-for-gestational-age infants. Olive oil consumption confers protective effects on pregnancy outcomes; however, further studies are needed that are specifically designed for the impact of olive oil consumption on maternal-fetal outcomes.This work was supported by the Foundation for Science and Technology (FCT, Portugal) for financial support through the National Funds FCT/MCTES (PIDDAC) to CIMO ( UIBD/00690/2020 and UIPD/00690/2020 ) and SusTEC ( LA/P/0007/2021 ); and the North Regional Operation Program funded by the European Social Found –NORTE 2020 (M.M. scientific-contract NORTE-06-3559-FSE-000188 ).info:eu-repo/semantics/publishedVersio

Effectiveness of electrical stimulation in expiratory muscle on cough of patients after stroke

Individuals with sequelae of stroke present as a common complication hypotonia and weakness of trunk muscles, in special the rectus abdominal muscle which is the main muscle activated for cough. The electrical stimulation (ES) is being widely used to fiber recruitment in many muscle groups and pathologies. The present study aimed to evaluate the efficiency of electrical stimulation with median frequencies (ETMF) in expiratory muscles strength and cough in patients with sequels of stroke. It is a quasi-experimental study (before and after) where 11 individuals were selected after stroke between 40 and 65 years, both sexes and hemodynamically stable. Patients were evaluated about clinic and respiratory scores (ventilometer, peak of expiratory flow (PEF) and manometer (MIP and MEP) and submitted to the protocol, which consisted of ETMF in expiratory muscle (abdominals rectus) with the unit of Russian current with 2,500 Hz carrier frequency modulated at 40 Hz for 15 minutes by 15 sessions. In the initial assessment evidenced decreasing in inspiratory and expiratory muscular strength (MIP, MEP) and PEF when compared to predicted values in literature. In the end of ETMF it happened an increase in MIP, MEP without statistical significance (p=0.18 and p=0.29) but the PEF has had an increase of 283.73 L/minute to 347.27 L/minute (p=0.03). It can be seen that the ETMF was effective in the improvement of the parameters evaluated, with PEF being the greatest impact and statistical significance, however further studies with larger populations are necessary to analyze this new therapeutic approach.Indivíduos com sequelas de acidente vascular encefálico (AVE) apresentam como complicação comum a hipotonia de tronco com consequente fraqueza da sua musculatura, em especial, o reto abdominal que é o principal músculo acionado para a tosse. As correntes elétricas têm sido amplamente utilizadas para recrutamento de fibras musculares nas mais diversas patologias. O presente estudo teve como objetivo avaliar a eficácia da eletroestimulação transcutânea de média frequência (ETMF) na força muscular expiratória e tosse de pacientes com sequela de AVE. Trata-se de um estudo quase-experimental (antes e depois) onde foram selecionados 11 indivíduos pós-AVE entre 40 a 65 anos, ambos os sexos e estáveis hemodinamicamente. Os pacientes foram avaliados quanto a parâmetros clínicos e pneumofuncionais (ventilometria, pico de fluxo expiratório (PFE) e manovacuometria) e submetidos ao protocolo, que constava de ETMF no músculo reto abdominal com o aparelho de corrente Russa, frequência portadora de 2.500 Hz modulada a 40 Hz, durante 15 minutos, por 15 sessões. Na avaliação inicial observou-se diminuição da força muscular inspiratória e expiratória (Pimáx; Pemáx) e do PFE quando comparados aos valores de normalidade preditos na literatura. Após a ETMF houve incremento da Pimáx e Pemáx sem significância estatística (p=0,18 e p=0,29) já o PFE teve um acréscimo de 283,73 L/minuto para 347,27 L/minuto (p=0,03). Pode-se observar que a ETMF foi eficaz no incremento dos parâmetros avaliados, com o PFE sendo o de maior impacto e significância estatística, no entanto, mais estudos com populações maiores se fazem necessários para análise dessa nova abordagem terapêutica.Faculdade ASCESUniversidade Federal do Rio Grande do Sul (UFRGS)Universidade Federal de Pernambuco (UFPE)UFPEUniversidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Epigenetic marks are modulated by gender and time of the day in the hippocampi of adolescent rats : a preliminary study

Although the involvement of gender in epigenetic machinery in peripheral tissues during the neonatal period has been suggested, the gender-related epigenetic profile of brain areas during the adolescent period is rarely exploited. Furthermore, the influence of time of day on hippocampal acetylation marks has been demonstrated in young adult and aged rats; however, there are no studies reporting epigenetic changes in the adolescent period. Therefore, this study aimed to investigate the effects of gender on hippocampal DNA methyltransferase 1 content and histone deacetylase (HDAC) activity of adolescent rats at different time points, specifically early morning and afternoon. Both epigenetic markers increased significantly in the hippocampi of female rats compared to the male group, an indicator of reduced transcriptional activity. In addition, HDAC activity during the early morning was higher compared to afternoon groups in both male and female rats, while DNA methyltransferase 1 content was not altered by the time of day. Our findings demonstrate that hippocampal DNA methylation and histone acetylation status can be influenced by gender during the adolescent period, while the time of the day impacts HDAC activity

Representações da andropausa: um estudo de métodos mistos com mulheres portuguesas

Since psychosocial factors have some impact on andropause, and this phenomenon can affect conjugal relationships (and women tend to be health information seekers) it becomes important to study the representations of andropause using the Common-Sense Model – a model used to understand the representations of menopause. This research aimed to assess Portuguese women’s representations of andropause, the suitability of the Common-Sense Model in explaining those representations, and to explore differences among participants with different characteristics (e.g., level of education), regarding andropause representations. Interviews to 30 women were analysed (directed qualitative content analysis). A multiple correspondence analysis explored the association between the emergent categories. Mann-Whitney U tests were performed to test differences regarding the frequency of emergent categories. Undefined identity was the most frequently mentioned feature regarding andropause Identity, whereas Sexual Function was the most mentioned Negative Consequence; few Positive Consequences were mentioned, being the Absence of positives consequences and the Lack of information the most frequent ones. Two bidimensional models were found - one for Identity of andropause: (1) Aging related changes, and (2) Sexual changes/lack of information; the other for Negative Consequences: (1) Symptoms/health problems, and (2) Depression/lack of information. No differences were found in the frequency of andropause representations between women with different characteristics (e.g., with a romantic relationship vs. without a romantic relationship). The suitability of the Common-Sense Model to explain these women’s andropause representations did not differ among participants with distinctive characteristics. This research may help healthcare professionals to develop comprehensive interventions (based on this theoretical model) in order to help couples to better understand and cope with andropause.info:eu-repo/semantics/publishedVersio

Enzymatic vitreolysis for the treatment of tractional diabetic macular edema

© The Author(s), 2019. Article reuse guidelines: sagepub.com/journalspermissionsBackground: A new approach to address focal vitreomacular adhesion in patients with diabetic macular edema may control and stabilize diabetic macular edema with fewer antivascular endothelial growth factor injections. Objectives: The aim of this study was to demonstrate that diabetic macular edema can be improved by inducing the release of a vitreomacular adhesion, with less than 2500μm, with enzymatic vitreolysis. Methods: From a retrospective analysis of clinical records from patients with diabetic retinopathy, patients with diabetic macular edema and vitreomacular adhesion <2500μm were selected for a single-arm prospective study. The primary endpoint was to control diabetic macular edema with fewer anti-vascular endothelial growth factor injections after an observed vitreomacular adhesion release. A statistical subanalysis was performed for the following two groups: the group with vitreomacular adhesion release (group 1) and the group without vitreomacular adhesion release (group 2). Results: A total of 23 eyes from 19 patients were included. A reduction of the median number of injections was achieved in group 1 (p=0.006). Adverse events were mild and transitory. Conclusion: Release of vitreomacular adhesion <2500μm through enzymatic vitreolysis contributed to the control and stabilization of diabetic macular edema with fewer anti-vascular endothelial growth factor injections, reducing the burden and the risks related to these invasive and frequently chronic treatments.info:eu-repo/semantics/publishedVersio