Dinâmica de fluxo dos casos de dengue no acesso aos estabelecimentos de saúde em São Sebastião – Distrito Federal

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Geografia, 2020.A dengue é uma doença febril aguda do tipo arboviroses, apresentando quatro sorotipos diferentes da doença, se manifesta de forma benigna até um quadro mais grave de saúde. É transmitida principalmente pelo mosquito Aedes aegypti e sua infecção ocorre pela picada do mosquito ao homem. Questões ambientais e urbanas favorecem a proliferação do mosquito e consequentemente o desenvolvimento da doença, o Brasil apresenta graves problemas da doença por apresentar essas condições favoráveis. As organizações territoriais dos estabelecimentos de saúde podem impactar diretamente no tratamento e combate da doença, o acesso da população ao diagnóstico gera a notificação do agravo para que as análises possam ser feitas. Primeiramente este trabalho realizou uma revisão literária sobre a relação da geografia e saúde, buscando os encontros das duas ciências e importantes delimitações para a pesquisa. A dengue no contexto geográfico e quais fatores podem estar ligados ao seu desenvolvimento, e no contexto da saúde quais entendimentos sobre o combate a doença. Em seguida foram apresentadas a análise de construção e estruturação da política e indicadores de saúde, o processo realizado no banco de dados de dengue e as informações utilizadas e a área de estudo deste trabalho. Foram analisados os estabelecimentos de saúde e sua organização no território do Distrito Federal (DF), e como os tipos de estabelecimentos podem impactar o acesso aos serviços de saúde. Por último, foram apresentados os resultados deste trabalho com a dinâmica espacial de fluxo aos estabelecimentos de saúde entre os anos 2009 a 2019 e os mapas dessas análises com o objetivo de identificar a dinâmica de fluxo no acesso ao diagnóstico (prováveis e confirmados) de dengue da população de São Sebastião (DF).Dengue is an acute febrile disease of the arbovirus type, presenting four different serotypes of the disease, it manifests itself in a benign way until a more serious health condition. It is transmitted by the Aedes aegypti mosquito and its infection occurs by the mosquito bite to man. Environmental and urban issues favor the proliferation of mosquitoes and, consequently, the development of the disease, Brazil presents serious problems of the disease for presenting these favorable conditions. The territorial organizations of health establishments can directly impact the treatment and fight of the disease, the population's access to the diagnosis generates the notification of the disease so that the analyzes can be made. Firstly, this work carried out a literary review on the relationship between geography and health, seeking the meeting of the two sciences and important delimitations for research. Dengue in the geographical context and which factors may be linked to its development, and in the context of health, which understandings about fighting the disease. Next, the analysis of construction and structuring of health policy and indicators, the process carried out in the dengue database and the information used and the study area of this work were presented. Health establishments and their organization in the territory of the Federal District (DF) were analyzed, and how the types of establishments can impact access to health services. Finally, the results of this work with the spatial dynamics of flow to health establishments between the years 2009 to 2019 were presented, presenting the maps of these analyzes in order to identify the dynamics of flow in the access to the diagnosis (probable and confirmed) of dengue fever in the population of São Sebastião (DF)

Visceral leishmaniasis in a Brazilian endemic area: an overview of occurrence, HIV coinfection and lethality

The Brazilian municipality of Rondonópolis, Mato Grosso State, represents an important visceral leishmaniasis (VL) endemic area. This study described epidemiological and clinical aspects of the occurrence, VL/HIV coinfection and lethality related to VL in Rondonópolis. Data from autochthonous cases reported between 2011 and 2016 were obtained from official information systems. During this period, 81 autochthonous cases were reported, with decreasing incidence through 2016. Contrastingly, the lethality rate was 8.6% overall, but varied widely, reaching a peak (20%) in 2016. Almost 10% of patients had VL/HIVcoinfection. The occurrence of VL prevailed among men (56.8%), brown-skinned (49.4%), urban residents (92.6%), aged 0-4 years (33.3%). Housewives or retired (29.6%) were the most affected occupational groups. Lower age was the main difference among the total VL cases and those who were coinfected or died. Clinically, fever, weakness and splenomegaly were more frequent among all VL cases and VL/HIV coinfected individuals. Bacterial infections (p=0.001) and bleeding (

Is there a direct and temporary relationship between fire persistence and hospitalization due to respiratory diseases? : analysis of the scenario of Palmas and the Lajeado’s APA, Tocantins, between the years of 2012 and 2018

A poluição do ar é uma das consequências das queimadas, em razão da quantidade do material particulado e compostos químicos que são liberados para a atmosfera, durante o processo de combustão. Em atenção a isto, morbidades respiratórias são rotineiras, associadas à intensidade e à persistência do incêndio. De 2008 a 2018, o DATASUS registrou, em média, 9450 internações por doenças respiratórias no Tocantins, pouco sabido, entretanto, se existe uma relação entre o total de internações e a persistência de queimadas. Desta forma, o objetivo do trabalho foi correlacionar mensalmente os registros de internação por doenças respiratórias com a persistência de queimadas no município de Palmas e na APA do Lajeado, Tocantins, durante o período de estiagem entre os anos de 2012 e 2018. A análise compreendeu as médias e anomalias de cada variável, resultando em valores de internação díspar ao esperado. Concluiu-se que é preferível considerar estudos do particulado emitido, da circulação atmosférica e de procedimentos em unidades básicas de saúde para explicar a relação de doenças respiratórias por consequência das queimadas.Air pollution is one of the consequences of fires, because of the amount of particulate matter and chemical compounds that are released into the atmosphere during the combustion process. In this regard, respiratory morbidities are routine, associated with the intensity and persistence of the fire. From 2008 to 2018, DATASUS registered, on average, 9450 hospitalizations for respiratory diseases in Tocantins, although it isn't known, however, whether there is a relation between the total admissions and the persistence of fires. Thus, the objective of this study was to correlate the monthly hospitalization records for respiratory diseases with the persistence of burnings in the municipality of Palmas and in the environmental protection area of Lajeado, Tocantins, during the drought period between 2012 and 2018. The analysis comprised the averages and anomalies of each variable, resulting in hospitalization values different from those expected. It was concluded that it's preferable to consider studies of emitted particles, atmospheric circulation and procedures in basic health units to explain the relation of respiratory diseases due to fires

A NATUREZA COMPORTAMENTAL DA PANDEMIA DE COVID-19

The purpose of this article is to analyze the behavioral aspects of the COVID-19 pandemic. The variables that control prevention behavior are addressed. Some general contingencies are highlighted, which affect the behavior of virtually everyone, as well as some that reach groups differentially, according to social class, gender, and race. The role played by the media and government, as controlling agencies, are also subject to analysis, seeking to indicate how they favor or hinder the installation and maintenance of classes of behaviors related to the prevention of COVID-19. In sum, this article is expected to demonstrate that Behavior Analysis has a lot to offer for understanding and addressing this pandemic.Keywords: COVID-19; pandemic; prevention; Behavior Analysis.O objetivo deste artigo é analisar os aspectos comportamentais da pandemia de COVID-19. São abordadas as variáveis que controlam o comportamento de prevenir-se. Destacam-se algumas contingências gerais, que afetam o comportamento de virtualmente todas as pessoas, bem como algumas que atingem grupos diferenciados em função de classe social, gênero e raça. O papel exercido pelas agências controladoras mídia e governo também são objeto de análise, buscando-se indicar como elas favorecem ou dificultam a instalação e manutenção de classes de comportamentos relacionadas à prevenção da COVID-19. Espera-se que, no seu conjunto, este artigo demonstre que a Análise do Comportamento tem muito a oferecer para a compreensão e enfrentamento dessa pandemia.Palavras-chave: COVID-19; pandemia; prevenção; Análise do Comportamento

PERDA DE PESO ASSOCIADA AO USO DE SEMAGLUTIDA: EFICÁCIA E MECANISMO DE AÇÃO

Este estudo possui o objetivo de analisar e fazer a exposição da relação entre o uso de semaglutida e a perda de peso, fazendo a análise dos mecanismos de ação e da sua eficácia. Para tanto, este trabalho é uma revisão integrativa que foi feita com base na busca dos seguintes Descritores em Ciências da Saúde (DeCS) feita na base de dados PubMed: weight; loss; and; semaglutide. Sendo escolhidos apenas artigos publicados de 2022 a 2023, até a data de 03/11/2023, em que foi encontrado 23 artigos, sendo estes analisados em sua integralidade, onde 13 foram excluídos e apenas 10 foram utilizados para a realização deste trabalho. A obesidade, por ser uma doença de extrema crescente e por trazer diversas complicações cardiovasculares e metabólicas necessita de uma terapia farmacológica, para além de uma terapia de mudança de hábitos de vida, dessa forma, para atender esta demanda surgiu o medicamento semaglutida que se mostrou eficaz na redução do peso e índice de massa corporal. Com base nessas informações é necessária a união de diversos artigos com relação a esta temática para que haja a ampliação dos conhecimentos de profissionais de saúde e pacientes, além de proporcionar uma maior evidenciação dos efeitos da semaglutida

Desafios e Avanços no Manejo da Hemorragia Pós-Parto: Estratégias Emergentes e Melhores Práticas

This article presents a literature review on the management of postpartum hemorrhage (PPH), focusing on emerging strategies and best practices. PPH is a significant obstetric complication that continues to pose a challenge for healthcare professionals. The review encompasses guidelines and recommendations from organizations such as the American College of Obstetricians and Gynecologists (ACOG) and the World Health Organization (WHO), as well as highlighting studies on arterial embolization and other innovative interventions. The results emphasize the importance of a multidisciplinary approach and early identification of PPH to prevent serious complications. It is concluded that arterial embolization emerges as a valuable option in the management of refractory PPH, but its use should be carefully considered in conjunction with other therapeutic and preventive approaches.Este artigo apresenta uma revisão da literatura sobre o manejo da hemorragia pós-parto (HPP), com foco em estratégias emergentes e melhores práticas. A HPP é uma complicação obstétrica significativa que continua a representar um desafio para os profissionais de saúde. A revisão abrange diretrizes e recomendações de organizações como o Colégio Americano de Obstetras e Ginecologistas (ACOG) e a Organização Mundial da Saúde (OMS), além de destacar estudos sobre embolização arterial e outras intervenções inovadoras. Os resultados destacam a importância da abordagem multidisciplinar e da identificação precoce da HPP para prevenir complicações graves. Conclui-se que a embolização arterial surge como uma opção valiosa no manejo da HPP refratária, mas que seu uso deve ser cuidadosamente considerado em conjunto com outras abordagens terapêuticas e preventivas

Uso de telas pela população pediátrica e seus impactos oftalmológicos a curto e a longo prazo: uma revisão sistemática : Use of screens by the pediatric population and its short and long-term ophthalmological impacts: a systematic review

Ao se discorrer sobre a formação e formatação da nossa sociedade, pode-se notar que cada vez mais esta está permeada pela tecnologia e pelos sistemas integrativos, processo esse benéfico para comunicação, gestão e tomada de decisões para além de ser uma ferramenta de trabalho e entretenimento, porém, com a progressiva quantidade de horas que ficamos expostos a este tipo de tecnologia também podem acarretar prejuízos a acuidade visual dos usuários. Juntamente a isso, nota-se que as crianças estão tendo cada vez mais precocemente acesso os equipamentos eletrônicos e deixando de lado as brincadeiras, desta forma a partir de uma pesquisa qualitativa, feita a partir de um levantamento bibliográfico, pode-se dispor que esta busca compreender quais são os sintomas e efeitos do uso excessivo deste tipo de ferramenta e algumas formas de tratamento e profilaxia que podem ser dispostas sobre o tema, com enfoque na população pediátrica

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Os primórdios da organização do espaço territorial e da vila cearense: algumas notas

This paper presents, in outline, the action taken by economic agents, representatives of the Church and the Portuguese State in organizing the space of the Captaincy of Ceará in the eighteenth century. The Portuguese State founded towns in strategic locations for better capitalization of the cattle breeder economy, where first settled sesmeiros and the Church. There was no reason or justification of geopolitical nature that demanded technical and financial investments by the Portuguese in the full adequacy of the local conditions to Portuguese urban guidelines. In the face of the late occupation, the article also discusses the late cartographic representation as expressing the lack of interests of the Portuguese administration in relation to a fuller understanding of the region

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030