REPERCUSSÕES RELACIONADAS À FRATURA DE FÊMUR NO BRASIL: UM ESTUDO DE REVISÃO INTEGRATIVA

The present study aims to describe the repercussions related to femur fractures in Brazil, according to the literature. This is an integrative literature review, carried out between March 15 and April 30, 2024, in the indexed databases LILACS and SCIELO, using the descriptors: “Femur Fractures”, which are registered in the Descriptors in Health Sciences, which were defined according to the thematic proposal for this study. The inclusion criteria for the study were the full original articles available in the databases, written in Portuguese, and which were published in the last ten years, between the period from 2014 to 2024. After searching the databases using the aforementioned descriptors were found in 95 studies in LILACS and 106 in SCIELO. After analysis, reading of the studies and application of the inclusion and exclusion criteria, a quantity of 7 articles were selected, as they covered the thematic proposal, answered the research question and achieved the objective proposed by this integrative review. After selecting the studies in the indexed databases, they were distributed in a data table containing the following information: title, author, year, objective, study approach, and place where it was developed. In the present review, it was possible to verify that femur fractures caused great physical and functional weakness in our elderly, corroborating psychological implications. It can also be observed that implications are linked to the high costs to the country's health system, as well as impacts on family dynamics.O presente estudo tem como objetivo descrever as repercussões relacionadas à fratura de fêmur no Brasil, conforme a literatura. Trata-se de uma revisão de literatura do tipo integrativa, realizada entre o período de 15 de março a 30 de abril de 2024, nas bases de dados indexadas LILACS e SCIELO, utilizando os descritores: “Fraturas de Fêmur”, que estão registrados nos Descritores em Ciências da Saúde, e que foram definidos conforme a temática proposta por esse estudo. Os critérios de inclusão do estudo foram os artigos originais na íntegra disponíveis nas bases de dados, escritos em língua portuguesa, e que foram publicados nos últimos dez anos, entre o período de 2014 a 2024. Após a busca nas bases de dados utilizando os referidos descritores foram encontrados 95 estudos no LILACS e 106 no SCIELO. Após a análise, leitura dos estudos e aplicação dos critérios de inclusão e exclusão, foram selecionados um quantitativo de 7 artigos, pois esses abrangeram a temática proposta, responderam a questão de pesquisa e atingiu o objetivo proposto por essa revisão integrativa. Após a seleção dos estudos nas bases indexadas, esses foram distribuídos em um quadro de dados contendo as seguintes informações: título, autor, ano, objetivo, abordagem do estudo, e local onde foi desenvolvido. Diante da revisão realizada pode-se constatar que as fraturas de fêmur ocasionaram uma grande debilidade fisíco-funcional nos idosos, corroborando em implicações psicológicas. Também, pode-se observar que acarretaram implicações atreladas aos altos custos ao sistema de saúde do país, assim como trouxeram impactos na dinâmica familiar

Avaliação de manejo da insuficiência valvar mitral a partir de estudos clínicos randomizados: uma revisão integrativa

A insuficiência valvar mitral ou regurgitação mitral é uma condição caracterizada pela reversão do fluxo sanguíneo do ventrículo esquerdo para o átrio esquerdo, que apresenta uma prevalência em torno de de 11% em pacientes com idade maior que 75 anos, sendo uma condição de grande impacto para a saúde pública global. O presente estudo de revisão buscou avaliar novas abordagens terapêuticas para a insuficiência valvar mitral, documentadas por meio de ensaios clínicos randomizados. Trata-se de uma pesquisa de revisão integrativa realizada por meio da base de dados PubMed, que levou em consideração os seguintes critérios de inclusão: testes controlados e randomizados; artigos publicados no último ano (2023-2024); que possuíam texto completo disponível e que abordassem acerca do manejo da insuficiência valvar mitral. Ficou constatado que uma titulação precoce de hidralazina, em conjunto com o tratamento convencional, apresenta boa tolerabilidade e segurança em pacientes com regurgitação mitral grave, desde que administrada sem pré-carga inadequada. Além disso, verificou-se que a minitoracotomia apresenta resultados de eficácia e segurança semelhantes com a esternotomia em relação ao reparo da valva mitral, o que demonstra novas opções para o manejo de pacientes com regurgitação mitral degenerativa

Deaths by tuberculosis in a priority city for disease control in the Brazilian Northeast: sociodemographic-operational characteristics and vulnerable territories.

Introduction: Incorporating spatial approaches into epidemiological research is a challenge in public health research. The goal in this study was to analyze the spatial distribution of cases of deaths by tuberculosis in Imperatriz – MA (Brazil) and to characterize these events according to sociodemographic and operational characteristics. Methods: In this ecological study, all deaths from tuberculosis as the primary cause registered in the Mortality Information System from 2005 to 2014 were considered. The research variables were subject to descriptive analysis, point density analysis (Kernel Intensity Estimation) and area analysis. Results: Fifty cases of deaths by TB were identified, particularly the pulmonary clinical form. Male patients were predominant, with a median age of 59 years, mulatto race/color, single, who had finished secondary education. Most deaths happened at the hospital, with medical care before death and without autopsy. Most events happened at the hospital, with medical care delivery by an assistant physician and without autopsy. The point density revealed heterogeneity in the spatial distribution of the deaths, with rates of up to 2.33 deaths/km2. The area analysis by census sector presented age standardized mortality rates of 0.00 to 4.00 deaths/100,000 inhabitants-year. Conclusion: The results contributed to the knowledge on the spatial distribution of cases of deaths by Tuberculosis and their characteristics in the research scenario. The importance of space is highlighted as a methodological alternative to support the planning, monitoring and assessment of health actions, targeting interventions to the control of the disease in vulnerable territories. Keywords: Tuberculosis; Health Information Systems; Mortality; Spatial analysis

Factors associated with mortality in a neonatal intensive care unit

Aims: To describe the factors associated with mortality of newborns hospitalized in a Neonatal Intensive Care Unit in the period from 2012 to 2015. Methods: This was a descriptive, quantitative study of secondary data, correlated with the causes of death and hospitalization according to classification by ICD-10.  The categorical variables were presented in absolute and relative frequencies, with measurements of central tendency and dispersion. Evaluation of the factors associated with neonatal death was made by the logit model of analysis with correction of robust errors by the statistical program Stata 12.0, considering values of p<0.05 and interval of confidence of 95%.  Results: Of the 563 newborns, 58.6% were of the male sex; 89.0% were early newborns, 73.0% were premature. 181 newborns died (32.3%). The main causes of hospitalization were: difficulties during birth, conditions of birth and immaturity (45.0%), pathologies associated with the respiratory system (21.1%), congenital malformations (9.7%). The main causes of death were: septicemia of the NB (40.4%), respiratory discomfort of the NB (22.4%). The significant associations for mortality were the use of ventilatory supports: Mechanical Ventilation (p=0.001), Hallo (p=0.000), CPAP (p=0.000), VNI (p=0.005). Conclusions: The major risk factors for neonatal mortality were associated with septicemia and use of mechanical ventilation

Tratamentos para a Epilepsia: Uma Análise da Literatura Recente

The text provides a comprehensive analysis of the various therapeutic approaches to epilepsy, highlighting both significant advancements made and persistent challenges that remain in this area. While the identification of potential therapeutic targets through an understanding of epilepsy genetics has been a crucial breakthrough, current antiepileptic medications face significant limitations, such as limited long-term efficacy and adverse side effects. This underscores the urgent need for therapeutic innovation, addressing not only genetic aspects but also the pathophysiology of the disease. Diversified therapeutic alternatives, such as surgery, special diets, and neuromodulation therapies, offer hope for medication-resistant patients. Additionally, emerging approaches like chronopharmacology and the use of cannabidiol show promise, albeit requiring further research to validate their efficacy and safety. The growing understanding of the role of the intestinal microbiota in epilepsy also suggests new therapeutic possibilities, despite gaps in our understanding of underlying mechanisms. In summary, a personalized, multidisciplinary approach, coupled with collaborations between researchers, physicians, and the industry, is essential to translate scientific advancements into more effective and accessible therapies, offering hope for a better future for all epilepsy patients.O texto analisa de maneira abrangente as diferentes estratégias terapêuticas para o tratamento da epilepsia, destacando tanto os avanços significativos quanto os desafios persistentes nessa área. Apesar da identificação de potenciais alvos terapêuticos por meio da compreensão da genética da epilepsia, os medicamentos antiepilépticos atuais enfrentam limitações, como eficácia a longo prazo limitada e efeitos colaterais adversos. Isso ressalta a necessidade urgente de inovação terapêutica, considerando não apenas os aspectos genéticos, mas também a fisiopatologia da doença. Alternativas terapêuticas diversificadas, como cirurgia, dietas especiais e terapias de neuromodulação, oferecem esperança para pacientes resistentes a medicamentos. Além disso, abordagens emergentes, como a cronofarmacologia e o uso de canabidiol, mostram promessas, embora exijam mais pesquisas para validar sua eficácia e segurança. A crescente compreensão do papel da microbiota intestinal na epilepsia também sugere novas possibilidades terapêuticas, apesar de lacunas em nosso entendimento dos mecanismos subjacentes. Em suma, uma abordagem personalizada e multidisciplinar, aliada a colaborações entre pesquisadores, médicos e a indústria, é essencial para transformar avanços científicos em terapias mais eficazes e acessíveis, oferecendo esperança para um futuro melhor para todos os pacientes com epilepsia

Congenital malformations in neonates: analysis of morbidity and associated factors

Objective: To evaluate the neonatal morbidity due to congenital malformations in the city of Petrolina-PE, from 2008 to 2013. Methods: A descriptive study with data from the Information System on Live Births (Sinasc). The analyzes were carried out through frequency distribution and measures of central tendency and dispersion. The associations were tested by the Pearson and Kruskal Wallis chi-square tests. Significance was set at 5% and 95% confidence. Results: 436 cases of congenital malformations were recorded in the study period, with 2011 being the highest occurrence year. The mothers of the newborns were young (25.2 years old), single, upper level of education and household. In general multiparous, with single gestation, vaginal delivery and performed up to six prenatal visits. The newborns were males, at 39 weeks or more of gestation and with normal weight (> = 2500g). The malformations of the musculoskeletal system were the most frequent followed by the genitourinary system. Congenital malformations were especially associated with neonatal characteristics such as gender and weight. In all causes the mean weight was greater than 2500g (p <0.05). The causes of malformation of greater occurrence in both sexes were osteomuscular (p <0.05). The aspects of the mother did not present significant differences in the present study (p> 0.05). Conclusion: The present study evidenced relevant aspects in the occurrence of morbidities due to congenital malformations, directing to a greater attention the occurrence of these diseases especially in relation to the newborn

Genomic epidemiology unveils the dynamics and spatial corridor behind the Yellow Fever virus outbreak in Southern Brazil

Despite the considerable morbidity and mortality of yellow fever virus (YFV) infections in Brazil, our understanding of disease outbreaks is hampered by limited viral genomic data. Here, through a combination of phylogenetic and epidemiological models, we reconstructed the recent transmission history of YFV within different epidemic seasons in Brazil. A suitability index based on the highly domesticated Aedes aegypti was able to capture the seasonality of reported human infections. Spatial modeling revealed spatial hotspots with both past reporting and low vaccination coverage, which coincided with many of the largest urban centers in the Southeast. Phylodynamic analysis unraveled the circulation of three distinct lineages and provided proof of the directionality of a known spatial corridor that connects the endemic North with the extra-Amazonian basin. This study illustrates that genomics linked with eco-epidemiology can provide new insights into the landscape of YFV transmission, augmenting traditional approaches to infectious disease surveillance and control