Single scrotal incision orchiopexy - a systematic review

Objective: To conduct a systematic review on single scrotal incision orchiopexy. Materials and Methods: A search was performed using Pubmed, through which 16 articles were selected out of a total of 133. the following conditions were considered exclusion criteria: other surgical methods such as an inguinal procedure or a laparoscopic approach, retractile testes, or patients with previous testicular or inguinal surgery.Results: A total of 1558 orchiopexy surgeries initiated with a transcrotal incision were analyzed. Patients' ages ranged between 5 months and 21 years. Thirteen studies used high scrotal incisions, and low scrotal incisions were performed in the remainder of the studies. in 55 cases (3.53%), there was a need for inguinal incision. Recurrence was observed in 9 cases, testicular atrophy in 3, testicular hypotrophy in 2, and surgical site infections in 13 cases. High efficacy rates were observed, varying between 88% and 100%.Conclusions: Single scrotal incision orchiopexy proved to be an effective technique and is associated with low rates of complications.Univ Fed Bahia, BR-41170290 Salvador, BA, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc

Comparison of the nutritional status in children aged 5 to 10 years old on the Conditional Cash Transfer Programme in the States of Acre and Rio Grande do Sul, Brazil

Introduction: In recent years, there has been a reduction in cases of malnutrition in Brazil but this has been accompanied with an increase in the overweight and obesity rates. These changes, together with others, such as changes in eating patterns and lifestyle, characterise the process of nutritional transition. Objective: We aimed to compare the prevalence of nutritional status of beneficiary children of the Bolsa Família Program (PBF) in the states of Acre and Rio Grande do Sul, Brazil, and to analyse the changes in the anthropometric profile of these children during 5 years. Methods: This is an ecological study using secondary data from the Food and Nutrition Surveillance System (SISVAN) and Bolsa Família Department of SUS (DATASUS), which assessed the nutritional status of children over 5 years and under 10 years benefiting from the PBF in the years 2011 to 2015 in the states of Acre and Rio Grande do Sul. The sample consisted of 94,865 children from Acre and 342,462 children from Rio Grande do Sul. The Body Mass Index was used to classify the nutritional status. Results: The mean prevalence of eutrophic children aged 5 to 10 years in Acre was 70.42% and was 61.28% in Rio Grande do Sul. Overweight was 13.06% in Acre and 19.48% in Rio Grande do Sul. Obesity was 5.08% in Acre and 9.36% in Rio Grande do Sul. Severe obesity was 4.02% in Acre and 6.92% in Rio Grande do Sul. Conclusion: Overweight and obesity in children benefiting from the PBF has been growing in the last 5 years, notably in the state of Rio Grande do Sul. This is possibly due to the fact that the nutritional transition is at a more advanced stage here than in Acre State. 

Pregnancy resulting from sexual abuse: Reasons alleged by Brazilian women for carrying out the abortion - Pregnancy and violence

http://www.healthmedjournal.com/vol06-no3.pd

Um olhar para a vulnerabilidade: análise da ausência de acesso à saúde pelos quilombolas no Brasil

Introduction: In Brazil, access to health care is a constitutional right guaranteed by the Unified Health System that provides, in its guiding principles, universality, and equity of access to health services. Objective: To analyze the factors associated with the quilombola population's access to health services. Methods: Cross-sectional study with 91,085 quilombolas. To measure the absence of access to health, the variables sex, ethnicity, work, disability, age group, illiteracy, place of residence, and average family income were used. The lack of access to health services was due to the identification of health care establishments by quilombola families in the Cadastro Único database. The association between socioeconomic characteristics and the lack of access to health services were assessed using the chi-square test and the measures of magnitude of the association and respective confidence intervals were estimated by Poisson Regression with robust variance. Results: Among the factors associated with access to health services for the quilombola population, it is observed that the group with the highest risk is the elderly quilombolas, who declare themselves indigenous and who reside in the central west region It is noted that in 2004 there was a reduction in the lack of access to health by quilombolas to health services, however, between 2005 and 2015, there is an increase in the lack of access to health by quilombolas, after that period there is an ascendancy of access to health by this population. Conclusion: Several factors are associated with access to health by quilombola populations, which, related to the inequalities experienced by this population, directly impact government actions.Introdução: No Brasil, o acesso à saúde é um direito constitucional garantido a partir do Sistema Único de Saúde que prevê, em seus princípios norteadores, a universalidade e a equidade de acesso aos serviços de saúde. Objetivo: Analisar os fatores associados ao acesso da população quilombolas aos serviços de saúde. Método: Estudo transversal com 91.085 quilombolas. Para mensurar a ausência do acesso à saúde utilizou-se as variáveis sexo, etnia, trabalho, deficiência, faixa etária, analfabetismo, local de domicílio e a renda média familiar. A ausência do acesso aos serviços de saúde se deu a partir da identificação dos estabelecimentos de assistência à saúde pelas famílias quilombolas na base de dados do Cadastro Único. A associação entre as características socioeconômicas e a ausência do acesso aos serviços de saúde foram avaliadas pelo teste qui-quadrado e as medidas de magnitude da associação e respectivos intervalos de confiança foram estimados por Regressão de Poisson com variância robusta. Resultados: Dentre os fatores associados ao acesso aos serviços de saúde da população quilombolas, observa-se que o grupo com maior risco são os quilombolas idosos, que se autodeclaram indígenas e que residem na região centro oeste. Nota-se que no ano de 2004 houve uma redução na ausência do no acesso à saúde dos quilombolas aos serviços de saúde, entretanto entre 2005 a 2015 iniciou-se um aumento na ausência do acesso à saúde, a partir desse período uma ascendência do acesso à saúde por parte dessa população. Conclusão: Diversos fatores estão associados ao acesso à saúde pelas populações quilombolas, os quais, relacionado às desigualdades vivenciadas por essa população, impactam diretamente nas ações governamentais

Florística, diversidade e fitossociologia em um fragmento de cerrado sentido restrito, em Chapadão do Sul – MS/ Floristic, diversity and phytoosociology in a fragment of cerrado stricto sensu, in Chapadão do Sul – MS

Este estudo teve como objetivo obter informações qualitativas e quantitativas de um cerrado sentido restrito na microbacia do pasto ruim, no município de Chapadão do Sul, com base em um inventário florestal. Para a coleta de dados foram amostradas cinco parcelas de 1.000m² (10x100m) e mesurados todos os indivíduos com diâmetro a altura do solo (DAS)  ? 5 cm. Foram coletados dados de DAS e DAP (diâmetro a altura do peito), altura total, espécie, parcela e subparcela. Foram calculados parâmetros fitossociológicos horizontais e verticais como frequência, densidade, e dominância, absolutas e relativas, índice de valor de importância (IVI), e posição sociológica. O total de 1327 indivíduos mensurados está distribuído em 35 famílias botânicas, 56 gêneros e 69 espécies. A área basal e densidade por hectare foi 29,1m² e 2354 indivíduos. A diversidade da floresta foram 3,33 e 0,94, calculados pelo método de Shannon-Weaver e Simpson, respectivamente, equabilidade de Pielou foi 0,78, indicando heterogeneidade alta e dominância de espécies. As espécies com maior importância na floresta foram: Myrcia bella Cambess., Miconia leucocarpa Dc., Qualea grandiflora Mart., Q. parviflora Mart., Emmotum nitens (Benth.) Miers, Diptychandra aurantiaca Tul., Styrax ferrugineus Nees & Mart., Byrsonima pachyphylla A. Juss., e Qualea multiflora Mart., juntas somaram 43,7% do IVI. As famílias mais importantes foram: Vochysiaceae, Myrtaceae, Melastomataceae, Fabaceae (Papilionoideae e Mimosideae), Styracaceae e Icacinaceae, representando 62,8% do total

Evolução da COVID-19 da semana epidemiológica 16 a 53 em um Estado da Amazônia Ocidental-Acre/Brasil em 2020

Introduction: coronavirus is part of a group of RNA viruses belonging to the Coronaviridae family, widely distributed in humans and other mammals. Currently, it has been seriously affecting the whole world, without a definitive cure yet. Objective: to analyse the association between the HDI and confirmed cumulative cases of COVID-19 that occurred during epidemiological week 16 to 53 of 2020, in the State of Acre. Methods: this is an ecological study of descriptive time series, evaluating the State of Acre and its 22 municipalities affected by COVID-19, in the period corresponding to the epidemiological weeks 16 to 53 of 2020. The State of Acre and its municipalities are aggregated by five regions with a total of approximately 881 thousand inhabitants, with an HDI of 0.663. Rio Branco is the state capital with 407,000 inhabitants. The 22 municipalities were analyzed, relating the HDI variables, confirmed cases per day and number of inhabitants to each other. Results: it was observed that the population evaluated, affected by COVID-19 during SE 16 to 53 of 2020, in the State of Acre, had as predominant general characteristics brown skin color, male sex, and the evolution to death from the disease was related with older age and comorbidity. Acre had a mortality rate (deaths per 100,000 inhabitants) of 90.9 and a lethality rate of 1.9%, with the highest mortality rate observed in the municipality of Rio Branco (121.3/100,000 inhabitants) and lethality in Rodrigues Alves (2.9%). The incidence of COVID-19 in Acre was 4,759.9 cases per 100,000 inhabitants, the municipalities of Assis Brasil and Xapuri had the highest incidences in the state with 10273.7 and 9330.8 new cases per 100,000 inhabitants, respectively. Conclusion: although the accumulated numbers of cases are different for the same day, the behavior is very similar, that is, the curves vary in the same way over time, regardless of the municipality observed.Introdução: o coronavírus faz parte de um grupo de vírus de RNA pertencente à família Coronaviridae, amplamente distribuídos em humanos e outros mamíferos. Atualmente, vem atingindo de forma grave o mundo todo, sem ainda existir uma cura definitiva. Objetivo: analisar a associação entre o IDH e os casos acumulados confirmados de COVID-19 que ocorreram durante a semana epidemiológica (SE) 16 até a (SE) 53 de 2020, no Estado do Acre. Método: trata-se de um estudo ecológico de séries temporais de caráter descritivo, sendo avaliado o Estado do Acre e seus 22 municípios atingidos pela COVID-19, no período correspondente à SE 16 a 53 de 2020. O Estado do Acre e seus municípios são agregados por cinco regionais com um total de, aproximadamente, 881 mil habitantes, tendo um IDH de 0,663. Rio Branco é a capital do Estado com 407 mil habitantes. Foram analisados os 22 municípios, relacionando entre si as variáveis IDH, casos confirmados por dia e números de habitantes. Resultados: observou-se que a população avaliada acometidas pela COVID-19 durante a SE 16 a 53 de 2020, no Estado do Acre, teve como características gerais predominantes a cor da pele parda, sexo masculino, e a evolução ao óbito pela doença apresentou relação com a idade mais avançada e comorbidade. O Acre apresentou um coeficiente de mortalidade (óbitos por 100 mil habitantes) de 90,9 e de letalidade de 1,9%, sendo que o maior coeficiente de mortalidade foi verificado no município de Rio Branco (121,3/100 mil habitantes) e de letalidade em Rodrigues Alves (2,9%). A incidência da COVID-19 no Acre foi de 4.759,9 casos por 100 mil habitantes, os municípios de Assis Brasil e Xapuri apresentaram as maiores incidências do Estado com 10273,7 e 9330,8 novos casos por 100.000 habitantes, respectivamente. Conclusão: apesar dos números acumulados de casos serem diferentes para um mesmo dia, o comportamento é bem similar, isto é, as curvas variam da mesma forma com o passar do tempo, independente do município observado

Prevalência e fatores associados à síndrome metabólica em população vulnerável do norte do Brasil: um estudo transversal

Introduction: metabolic syndrome (SM) is a set of metabolic imbalances that are associated with the development of cardiovascular diseases, type 2 diabetes mellitus, in addition to other chronic non-communicable diseases. SM has been gaining prominence in the scientific community mainly due to link with the increase of the obesity epidemic in the world. Objective: To analyze the factors associated with metabolic syndrome and its prevalence in a vulnerable population in the Northern Region of Brazil. Methods: This is a cross-sectional study with artisanal fishers from the state of Tocantins, and data collected between 2016 and 2017 were used. The outcome variable for MS was defined according to the criteria of the International Diabetes Federation. The following variables were assessed: socioeconomic and demographic information, fish consumption, and smoking. For statistical and data analysis, the Shapiro–Wilk test, Poisson regression, Student's t-test, and interquartile regression were evaluated. Results: The general prevalence rate (PR) of MS was 31.9% higher in women than in men. The factors associated with MS were economic class and smoking, and there was an association between socioeconomic class and smoking (p=0.015). The most prevalent component was abdominal obesity with a rate of 62.5% (95% confidence interval [CI]: 54.5, 70.5). The prevalence of MS in terms of sex (PR=2.27, 95% 1.04 CI, 4.92, p=0.037), smoking (PR=2.40, 95% CI, 30, p=0.003) and years of professional experience (>10 PR=2.07, 95% CI 1.06, 4.05, p=0.033) was also assessed. Conclusion: In the present study, the prevalence of SM was associated with smoking and socioeconomic status, which is considered high when compared to the worldwide prevalence. These findings highlight the importance of looking at public policies so that health services can develop actions that generate greater adherence to good health practices by the population.Introdução: A síndrome metabólica (SM) é um conjunto de desequilíbrios metabólicos que estão associados ao desenvolvimento de doenças cardiovasculares, diabetes mellitus tipo 2 além de outras doenças crônicas não transmissíveis. A SM vem ganhando destaque na comunidade científica principalmente por sua ligação com o aumento da epidemia de obesidade no mundo. Objetivo: Analisar os fatores associados à síndrome metabólica e sua prevalência em população vulnerável da Região Norte do Brasil. Método: Trata-se de um estudo transversal com pescadores artesanais do estado do Tocantins, e foram utilizados dados coletados entre 2016 e 2017. A variável desfecho para SM foi definida de acordo com os critérios da International Diabetes Federation. As seguintes variáveis foram avaliadas: informações socioeconômicas e demográficas, consumo de peixe e tabagismo. Para análise estatística e de dados, foram avaliados o teste de Shapiro – Wilk, regressão de Poisson, teste t de Student e regressão interquartil. Resultados: A taxa geral de prevalência (RP) da SM foi 31,9% maior em mulheres do que em homens. Os fatores associados à SM foram classe econômica e tabagismo e houve associação entre classe socioeconômica e tabagismo (p = 0,015). O componente mais prevalente foi obesidade abdominal com uma taxa de 62,5% (intervalo de confiança de 95% [IC]: 54,5, 70,5). A prevalência de SM em termos de sexo (RP = 2,27, IC 95% 1,04, 4,92, p = 0,037), tabagismo (RP = 2,40, IC 95%, 30, p = 0,003) e anos de experiência profissional (> 10 RP = 2,07, IC 95% 1,06, 4,05, p = 0,033) também foi avaliado. Conclusão: No presente estudo, a prevalência de SM esteve associada ao tabagismo e ao nível socioeconômico, sendo considerada elevada quando comparada a prevalência mundial. Esses achados assinalam a importância de um olhar das políticas públicas para que os serviços de saúde possam desenvolver ações que geram maior adesão as boas práticas de saúde pela população

Saphenofemoral arteriovenous fistula as hemodialysis access

<p>Abstract</p> <p>Background</p> <p>An upper limb arteriovenous (AV) fistula is the access of choice for haemodialysis (HD). There have been few reports of saphenofemoral AV fistulas (SFAVF) over the last 10-20 years because of previous suggestions of poor patencies and needling difficulties. Here, we describe our clinical experience with SFAVF.</p> <p>Methods</p> <p>SFAVFs were evaluated using the following variables: immediate results, early and late complications, intraoperative and postoperative complications (up to day 30), efficiency of the fistula after the onset of needling and complications associated to its use.</p> <p>Results</p> <p>Fifty-six SFAVF fistulas were created in 48 patients. Eight patients had two fistulas: 8 patent (16%), 10 transplanted (20%), 12 deaths (24%), 1 low flow (2%) and 20 thrombosis (39%) (first two months of preparation). One patient had severe hypotension during surgery, which caused thrombosis of the fistula, which was successfully thrombectomised, four thrombosed fistulae were successfully thrombectomised and revised on the first postoperative day. After 59 months of follow-up, primary patency was 44%.</p> <p>Conclusion</p> <p>SFAVF is an adequate alternative for patients without the possibility for other access in the upper limbs, allowing efficient dialysis with good long-term patency with a low complication rate.</p

Baroreflex sensitivity differs among same strain Wistar rats from the same laboratory

Previous studies showed that a proportion of normotensive Sprague-Dawley rats spontaneously exhibit lower baroreflex sensitivity. However, investigations have not yet been carried out on Wistar rats. We aimed to compare baroreflex sensitivity among rats from the same strain and the same laboratory. Male Wistar normotensive rats (300–400g) were studied. Cannulas were inserted into the abdominal aortic artery through the right femoral artery to measure mean arterial pressure and heart rate. Baroreflex was calculated as the derivative of the variation of heart rate in function of the mean arterial pressure variation (ΔHR/ΔMAP) tested with a depressor dose of sodium nitroprusside (50 µg/kg) and with a pressor dose of phenylephrine (8µg/kg) in the right femoral venous approach through an inserted cannula. We divided the rats into four groups: i) high bradycardic baroreflex, baroreflex gain less than −2 tested with phenylephrine; ii) low bradycardic baroreflex, baroreflex gain between −1 and −2 tested with phenylephrine; iii) high tachycardic baroreflex, baroreflex gain less than −3 tested with sodium nitroprusside; and iv) low tachycardic baroreflex, baroreflex gain between −1 and −3 tested with sodium nitroprusside. Approximately 71% of the rats presented a decrease in bradycardic reflex while around half showed an increase in tachycardic reflex. No significant changes in basal mean arterial pressure and heart rate, tachycardic and bradycardic peak and heart rate range were observed. There was a significant change in baroreflex sensitivity among rats from the same strain and the same laboratory