Treatment Of Bone Pain Secondary To Metastases Using Samarium-153-edtmp.

More than 50% of patients with prostate, breast or lung cancer will develop painful bone metastases. The purpose of treating bone metastases is to relieve pain, reduce the use of steroids and to maintain motion. To evaluate the use of samarium-153-EDTMP (153Sm-EDTMP) for the treatment of bone pain secondary to metastases that is refractory to clinical management. Retrospective. Division of Nuclear Medicine, Universidade Estadual de Campinas (Unicamp). Fifty-eight patients were studied (34 males) with mean age 62 years; 31 patients had prostate cancer, 20 had breast cancer, three had lung cancer, one had lung hemangioendothelioma, one had parathyroid adenocarcinoma, one had osteosarcoma and one had an unknown primary tumor. All patients had multiple bone metastases demonstrated by bone scintigraphy using 99mTc-MDP,and were treated with 153Sm-EDTMP. Response to treatment was graded as good (pain reduction of 50-100%), intermediate (25-49%) and poor (0-24%). All patients showed good uptake of 153Sm-EDTMP by bone metastases. Among the patients with prostate cancer, intermediate or good response to therapy occurred in 80.6% (25 patients) and poor response in 19.4% (6). Among the patients with breast cancer, 85% (17) showed intermediate or good response to therapy while 15% (3) showed poor response. All three patients with lung cancer showed poor response to treatment. The lung hemangioendothelioma and unknown primary lesion patients showed intermediate response to treatment; the osteosarcoma and parathyroid adenocarcinoma patients showed good response to treatment. No significant myelotoxicity occurred. Pain control is important for improving the quality of life of patients with advanced cancers. The mechanism by which pain is relieved with the use of radionuclides is still not yet completely understood, however, the treatment is simple and provides a low risk of mielotoxicity. Treatment with 153Sm-EDTMP can control the pain secondary to bone metastases effectively in most patients with breast and prostate cancer without significant side effects.122208-1

Pesquisa de corpo inteiro com gálio-67 em uma paciente com paracoccidioidomicose: relato de caso

A 26 year-old female was admitted with abdominal pain, fever and weight loss. The clinical and laboratory investigations led to the diagnosis of paracoccidioidomycosis. Gallium-67 whole body images correlated well with the clinical course of the disease and with the patient's prognosis.Paciente do sexo feminino de 26 anos foi internada com dor abdominal, febre e emagrecimento. A investigação clínico-laboratorial estabeleceu o diagnóstico de paracoccidioidomicose. Os achados cintilográficos com citrato de gálio-67 correlacionaram-se com o curso clínico da paciente

Effects of modified Restricted Environmental Stimulation Therapy on relaxation, heart rate, blood pressure and flexibility

Background: Restricted Environmental Stimulation Therapy (REST) promotes physiological and behavioral changes that reduce the deleterious effects of stress. However, it requires expensive equipment and is accessible to a limited number of professionals and patients. We aimed to evaluate the physiological and behavioral effects of modified REST (mREST) in healthy young women. Method: Twenty-one healthy young women (20-25 yrs) participated. mREST consists of positioning the patient floating in the pool with 32oC for about 15 minutes, for twelve sessions, with blindfolded and wearing earplugs. The evaluation was performed before and after the intervention. The analysis of the state of relaxation was investigated by a questionnaire and the self-reports were categorized. Measures of heart rate and blood pressure were used as indicators of the cardiovascular response. Flexibility, measured by the finger-to-floor test, was used as an indicator of muscle relaxation. Results: Heart rate and blood pressure significantly decreased while flexibility and relaxation increased after the sessions (p<0.001 for all comparisons). Self-reports of relaxation were consistent with the blood pressure measures and indicated that the participants showed states of relaxation associated with the decrease of blood pressure and the increase of flexibility (p<0.001 for all comparisons). Conclusion: Healthy women undergoing mREST reported relaxation, with effects on muscular and cardiovascular systems. mREST is a simple, practical and affordable option for therapy in the aquatic environment

Functional Electrical Stimulation Improves Brain Perfusion In Cranial Trauma Patients.

Demonstrate brain perfusion changes due to neuronal activation after functional electrical stimulation (FES). It was studied 14 patients with hemiplegia who were submitted to a program with FES during fourteen weeks. Brain perfusion SPECT was performed before and after FES therapy. These patients were further separated into 2 groups according to the hemiplegia cause: cranial trauma and major vascular insults. All SPECT images were analyzed using SPM. There was a significant statistical difference between the two groups related to patient's ages and extent of hypoperfusion in the SPECT. Patients with cranial trauma had a reduction in the hypoperfused area and patients with major vascular insult had an increase in the hypoperfused area after FES therapy. FES therapy can result in brain perfusion improvement in patients with brain lesions due to cranial trauma but probably not in patients with major vascular insults with large infarct area.69682-

Factors associated with grazing behavior in candidates for bariatric surgery at a hospital in the Amazon

BlackgroundTo assess grazing behavior and associated factors in candidates for bariatric surgery monitored at a public hospital that is a reference in the care of people with severe obesity.MethodsCross-sectional analytical study, with candidates for bariatric surgery of both genders, treated in a public hospital in the Amazon. To assess grazing behavior, the Repetitive Eating Questionnaire was used, and to investigate patterns of eating behavior, the Three Factor Eating Questionnaire was used, which assesses: Emotional Eating, Cognitive Restriction and Uncontrolled Eating. Sociodemographic information was obtained through self-report and the description of medication use through the medical record. Body mass index (BMI) was also calculated by measuring weight and height. The SPSS program, v. 21.0 was used. The study was approved by the Research Ethics Committee.ResultsA total of 205 participants were evaluated, with a mean age of 37.5 ± 8.6 years, the majority (93.7%) being women and the majority (59.5%) was not also using medication to lose weight. About 66.3% of the participants had compulsive grazing. The factor with the highest score was cognitive restriction (p < 0.001). Individuals who used weight loss drugs had higher scores in the cognitive restriction factor (p = 0.015) and lower scores for uncontrolled eating (p = 0.008), compulsive grazing (p = 0.021) and non-compulsive grazing (p = 0.034).ConclusionLinear regression showed that emotional eating and uncontrolled eating were predictors of both compulsive grazing and non-compulsive grazing behavior. It was observed that grazing behavior, cognitive restriction, emotional eating and uncontrolled eating are present and correlated in the studied patients. In addition, the use of weight loss drugs seems to help reduce dysfunctional eating behaviors in patients with severe obesity

Estudo Retrospectivo do perfil epidemiológico das lesões autoprovocadas no estado do Piauí entre 2018 a 2020 / Retrospective study of the epidemiological profile of self-harm in the state of Piauí between 2018 and 2020

Objetivou-se: conhecer o perfil epidemiológico das vítimas de lesão autoprovocada no estado do Piauí entre 2018 e 2020 e verificar se houve aumento ou diminuição dos casos notificados no período inicial da pandemia do COVID-19. Para tal, realizou-se um estudo descritivo, com coleta de dados retrospectiva, por meio do BO epidemiológico 001/2020, disponibilizado pela secretaria de saúde do estado do Piauí (SESAPI). Durante o período de 2018, 2019 e 2020, houve um montante de 3.757 registros de violência autoprovocada, no tracejo do perfil, houve destaque para o biotipo feminino, com idade variando de 15 a 29 anos, principalmente, a raça/cor mais afetada na pratica foi a cor parda, situação conjugal: solteiro, escolaridade: ensino fundamental incompleto, como principal meio usado: envenenamento/intoxicação e como local: residência. Apesar de os dados do ano de 2020 serem somente ate a metade do ano, verifica-se um aumento acentuado dos registros, principalmente se observados os mesmos períodos nos anos de 2018 e 2019. 

ESTRATÉGIAS DE PREVENÇÃO E MANEJO DA ENDOMETRIOSE: UMA REVISÃO BIBLIOGRÁFICA DE LITERATURA

Introduction: Endometriosis is a chronic and debilitating condition that affects the quality of life of women of reproductive age. Its complexity demands a multidisciplinary approach to ensure proper management. Objective: This study reviewed recent literature on endometriosis, highlighting its epidemiology, impact on quality of life, diagnostic challenges, conventional and innovative therapies, as well as the importance of complementary approaches and the need for a multidisciplinary approach. Methods: A systematic search was carried out of scientific literature published in the last 15 years, using databases such as PubMed, Web of Science, Scopus and Google Scholar. Original studies and reviews addressing different aspects of endometriosis were selected. Results and Discussion: Endometriosis is associated with a high prevalence and significant impact on patients' quality of life. Diagnostic and therapeutic challenges and the need for a multidisciplinary approach were discussed, along with conventional and innovative therapies, including new therapeutic perspectives and complementary approaches. Conclusion: A multidisciplinary approach is essential for the effective management of endometriosis. Recent advances in understanding the disease offer new therapeutic hope, while complementary therapies highlight the importance of considering different aspects of patients' health. Collaboration between health professionals is key to improving the care and quality of life of women affected by this condition.Introducción: La endometriosis es una enfermedad crónica y debilitante que afecta a la calidad de vida de las mujeres en edad reproductiva. Su complejidad exige un enfoque multidisciplinar para garantizar un tratamiento adecuado. Objetivo: Este estudio revisó la literatura reciente sobre endometriosis, destacando su epidemiología, impacto en la calidad de vida, desafíos diagnósticos, terapias convencionales e innovadoras, así como la importancia de los abordajes complementarios y la necesidad de un abordaje multidisciplinario. Métodos: Se realizó una búsqueda sistemática de la literatura científica publicada en los últimos 15 años, utilizando bases de datos como PubMed, Web of Science, Scopus y Google Scholar. Se seleccionaron estudios originales y revisiones que abordaban diferentes aspectos de la endometriosis. Resultados y Discusión: La endometriosis se asocia a una alta prevalencia y a un impacto significativo en la calidad de vida de las pacientes. Se discutieron los retos diagnósticos y terapéuticos y la necesidad de un enfoque multidisciplinar, junto con las terapias convencionales e innovadoras, incluyendo nuevas perspectivas terapéuticas y enfoques complementarios. Conclusión: Un enfoque multidisciplinar es esencial para el tratamiento eficaz de la endometriosis. Los recientes avances en la comprensión de la enfermedad ofrecen nuevas esperanzas terapéuticas, mientras que las terapias complementarias subrayan la importancia de tener en cuenta distintos aspectos de la salud de las pacientes. La colaboración entre profesionales sanitarios es clave para mejorar la atención y la calidad de vida de las mujeres afectadas por esta dolencia.A endometriose é uma condição crônica e debilitante que afeta a qualidade de vida das mulheres em idade reprodutiva. Sua complexidade demanda uma abordagem multidisciplinar para garantir um manejo adequado. Objetivo: Este estudo revisou a literatura recente sobre endometriose, destacando sua epidemiologia, impacto na qualidade de vida, desafios diagnósticos, terapias convencionais e inovadoras, além da importância de abordagens complementares e da necessidade de uma abordagem multidisciplinar. Métodos: Foi realizada uma busca sistemática na literatura científica publicada nos últimos 15 anos, utilizando bases de dados como PubMed, Web of Science, Scopus e Google Scholar. Foram selecionados estudos originais e revisões que abordaram diferentes aspectos da endometriose. Resultados e Discussão: A endometriose é associada a uma alta prevalência e impacto significativo na qualidade de vida das pacientes. Os desafios diagnósticos, terapêuticos e a necessidade de uma abordagem multidisciplinar foram discutidos, juntamente com terapias convencionais e inovadoras, incluindo novas perspectivas terapêuticas e abordagens complementares. Conclusão: Uma abordagem multidisciplinar é essencial para o manejo eficaz da endometriose. Avanços recentes na compreensão da doença oferecem novas esperanças terapêuticas, enquanto terapias complementares destacam a importância de considerar diferentes aspectos da saúde das pacientes. A colaboração entre profissionais de saúde é fundamental para melhorar o cuidado e a qualidade de vida das mulheres afetadas por essa condição.Introdução: A endometriose é uma condição crônica e debilitante que afeta a qualidade de vida das mulheres em idade reprodutiva. Sua complexidade demanda uma abordagem multidisciplinar para garantir um manejo adequado. Objetivo: Este estudo revisou a literatura recente sobre endometriose, destacando sua epidemiologia, impacto na qualidade de vida, desafios diagnósticos, terapias convencionais e inovadoras, além da importância de abordagens complementares e da necessidade de uma abordagem multidisciplinar. Métodos: Foi realizada uma busca sistemática na literatura científica publicada nos últimos 15 anos, utilizando bases de dados como PubMed, Web of Science, Scopus e Google Scholar. Foram selecionados estudos originais e revisões que abordaram diferentes aspectos da endometriose. Resultados e Discussão: A endometriose é associada a uma alta prevalência e impacto significativo na qualidade de vida das pacientes. Os desafios diagnósticos, terapêuticos e a necessidade de uma abordagem multidisciplinar foram discutidos, juntamente com terapias convencionais e inovadoras, incluindo novas perspectivas terapêuticas e abordagens complementares. Conclusão: Uma abordagem multidisciplinar é essencial para o manejo eficaz da endometriose. Avanços recentes na compreensão da doença oferecem novas esperanças terapêuticas, enquanto terapias complementares destacam a importância de considerar diferentes aspectos da saúde das pacientes. A colaboração entre profissionais de saúde é fundamental para melhorar o cuidado e a qualidade de vida das mulheres afetadas por essa condição

Hemofilia adquirida A e B principais apresentações clínicas da doença de Pott em crianças: Hemofilia adquirida A e B main clinical presentations of Pott disease in children

A hemofilia é uma doença sanguínea caracterizada por distúrbios nos mecanismos de coagulação do sangue, podendo ser de origem hereditária ou adquirida. A hemofilia adquirida ocorre devido à produção de autoanticorpos contra a atividade pró-coagulante dos fatores VIII (Hemofilia A) e IX (Hemofilia B). O objetivo desse trabalho é a realização de um estudo observacional e exploratório sobre os artigos publicados nos últimos 5 anos sobre a hemofilia adquirida A e B, uma vez que é uma enfermidade considerada rara. Dos 68 resultados obtidos na pesquisa, apenas 7 abordaram de forma objetiva sobre o tema, sendo utilizados na confecção do estudo. Segundo a literatura, as manifestações clínicas envolvem sangramento mucocutâneo, urogenital e gastrointestinal, e são mais prevalentes em idosos. Em crianças, o sangramento pode ser menos expressivo, provocando dúvidas quanto ao diagnóstico. O tratamento da hemofilia envolve a reposição dos fatores de coagulação deficientes e o uso de imunossupressores, ainda que nas obras analisadas apenas o tratamento hemostático tenha sido descrito, revelando uma carência de estudos sobre o uso de imunossupressores nos casos de hemofilia adquirida

O PACIENTE COM TRANSTORNO MENTAL: A PERCEPÇÃO DE FAMILIARES CUIDADORES ACERCA DESSA CONDIÇÃO

This is a qualitative and descriptive study, whose objective was to verify the perception of caregivers about patients with mental disorders treated in the public health network in the city of Montes Claros-MG. The work was developed at the Psychosocial Care Center (CAPS). The data were obtained through a focal group and analyzed through the discourse analysis technique. After data collection, categories related to the difficulties and challenges encountered by caregivers, patient behavior and caregiver overload emerged. It was concluded that the family caregiver of the mentally ill person presents suffering and lack of information. This demonstrates the need to bring the health team closer to the caregiver, since this interaction may contribute to the process of mitigating the responsibility of caring.Trata-se de um estudo qualitativo e descritivo, cujo o objetivo foi verificar a percepção de cuidadores acerca de pacientes com transtornos mentais atendidos na rede pública de saúde na cidade de Montes Claros-MG. O trabalho foi desenvolvido no centro de atenção psicossocial (CAPS). Os dados foram obtidos através da realização de um grupo focal e analisados através da técnica de análise do discurso. Após a coleta de dados surgiram categorias relacionadas as dificuldades e desafios encontrados pelos cuidadores, comportamento do paciente e sobrecarga dos cuidadores. Concluiu-se que o familiar cuidador do portador de transtorno mental apresenta sofrimento e carência de informação. Isso demonstra a necessidade da aproximar a equipe de saúde ao cuidador, pois essa interação poderá contribuir no processo de amenização da responsabilidade do ato de cuida