AMP-Student: Challenges for Scientific Publishing

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Narrando o rolê: encantamentos das festas de rua fazendo ferver a urbe

Imaginem um mundo dito apenas por meio de verbos e advérbios, semconcessões a adjetivos e muito menos aos ensimesmados substantivos: realidade feita deacontecimentos em relações de composição. Uma cidade constantemente (re)narradapelos corpos, gestos, cotidianos, edificações, ruas, relevos, clima, matérias e máquinasem geral, que lhe arranjam enquanto potência acontecimental com suas possibilidadesde afetações e de ser afetada. Cada modulação narrativa que se agencia com esta tramaurbana compõe um encanto no qual coletivos emergem e imergem afirmando sentidos,divisando certos acontecimentos do mundo, atribuindo-lhes valores, significados,afetos, modulando possibilidades de agenciamento. Compor acontecimentos e (re)narrara urbe por meio da realização de festas nas ruas é uma estratégia contra-narrativa paraquebrar certos encantos e reencantar outros na qual apostamos. jean é o personagem quecorpografa as controvérsias das festas na composição do urbano afirmando a festa comodispositivo clínico-político

APLICAÇÃO DA AVALIAÇÃO AMBIENTAL ESTRATÉGICA EM PLANEJAMENTO TERRITORIAL: O EXEMPLO DA ALEMANHA

A Avaliação de Impacto Ambiental - AIA, em função de suas escalas de abordagem, se divide em dois instrumentos de apoio à tomada de decisão: o Estudo de Impacto Ambiental - EIA, que considera a viabilidade ambiental de projetos, e a Avaliação Ambiental Estratégica - AAE, instrumento de apoio à tomada de decisão que avalia as conseqüências ambientais de políticas, planos e programas inserindo a variável ambiental no processo de planejamento. Observando etapas, procedimentos e objetivos detalhados, a AAE apresenta estudos baseados em cenários, agrega valores ambientais no processo de decisão, é instrumento para tomada de decisão, mas não executa a decisão, e não se aplica a empreendimentos, uma exclusividade do EIA, como acontece ainda hoje no Brasil

Arteriolar C4d in IgA Nephropathy:A Cohort Study

Rationale & Objective: Glomerular C4d (C4dG) as an indicator of the lectin pathway of complement activation in immunoglobulin A nephropathy (IgAN) has been associated with more severe kidney damage. Recent studies have suggested that vascular lesions in IgAN biopsy specimens with complement deposition are also associated with disease progression. We aimed to study the clinical significance of arteriolar C4d (C4dA) in IgAN kidney biopsy tissue. Study Design: Retrospective cohort study. Setting & Participants: Kidney biopsy specimens from 126 adults with IgAN diagnosed by Oxford classification criteria were stained using immunohistochemistry and classified according to C4dG and C4dA deposition. Additionally, vascular lesions including acute and chronic microangiopathy, arteriolar hyalinosis, and arterial intima fibrosis were characterized. Predictor: C4dA. Outcome: Progressive kidney disease, defined as a decline in estimated glomerular filtration rate by >= 50% or occurrence of kidney failure. Analytical Approach: The association of C4dA and C4dG with baseline clinical and histologic characteristics, as well as progressive kidney disease, were assessed with survival analysis using multivariable Cox regression analysis. Results: C4dA was identified in 21 (17%) patients and was associated with mean arterial pressure, arterial intima fibrosis, and chronic microangiopathy. C4dA was also significantly associated with C4dG and both were associated with progressive kidney disease. In regression analysis, C4dA remained significantly associated with progressive kidney disease after adjusting for other significant predictors, including baseline estimated glomerular filtration rate, mean arterial pressure, and the presence of crescents. Limitations: Findings based on the retrospective evaluation of a single center's experience, limited number of events, a small number of patients with a broad range of kidney disease stages, and use of immunohistochemistry rather than immunofluorescence to detect C4d. Conclusions: C4dA is a potential biomarker for disease progression in IgAN. It should be further investigated in larger cohorts to determine the value of C4dA in improving prediction of IgAN disease progression

One-year mortality after hemodialysis initiation: the prognostic role of the CHA2DS2-VASc Score

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Background: CKD is a significant cause of morbidity, cardiovascular and all-cause mortality. CHA2DS2-VASc is a score used in patients with atrial fibrillation to predict thromboembolic risk; it also appears to be useful to predict mortality risk. The aim of the study was to evaluate CHA2DS2-VASc scores as a tool for predicting one-year mortality after hemodialysis is started and for identifying factors associated with higher mortality. Methods: Retrospective analysis of patients who started hemodialysis between January 2014 and December 2019 in Centro Hospitalar Universitário Lisboa Norte. We evaluated mortality within one year of hemodialysis initiation. The CHA2DS2-VASc score was calculated at the start of hemodialysis. Results: Of 856 patients analyzed, their mean age was 68.3 ± 15.5 years and the majority were male (61.1%) and Caucasian (84.5%). Mortality within one-year after starting hemodialysis was 17.8% (n = 152). The CHA2DS2-VASc score was significantly higher (4.4 ± 1.7 vs. 3.5 ± 1.8, p < 0.001) in patients who died and satisfactorily predicted the one-year risk of mortality (AUC 0.646, 95% CI 0.6-0.7, p < 0.001), with a sensitivity of 71.7%, a specificity of 49.1%, a positive predictive value of 23.9% and a negative predictive value of 89.2%. In the multivariate analysis, CHA2DS2-VASc ≥3.5 (adjusted HR 2.24 95% CI (1.48-3.37), p < 0.001) and central venous catheter at dialysis initiation (adjusted HR 3.06 95% CI (1.93-4.85)) were significant predictors of one-year mortality. Conclusion: A CHA2DS2-VASc score ≥3.5 and central venous catheter at hemodialysis initiation were predictors of one-year mortality, allowing for risk stratification in hemodialysis patients.info:eu-repo/semantics/publishedVersio

C-reactive protein-to-albumin ratio and six-month mortality in incident hemodialysis patients

© 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.Background: The first few months of hemodialysis (HD) are associated with a higher risk of mortality. Protein-energy malnutrition is a demonstrated major risk factor for mortality in this population. The C-Reactive Protein to Albumin ratio (CAR) has also been associated with increased mortality risk. The aim of this study was to determine the predictive value of CAR for six-month mortality in incident HD patients. Methods: Retrospective analysis of incident HD patients between January 2014 and December 2019. CAR was calculated at the start of HD. We analyzed six-month mortality. A Cox regression was performed to predict six-month mortality and the discriminatory ability of CAR was determined using the receiver operating characteristic (ROC) curve. Results: A total of 787 patients were analyzed (mean age 68.34 ± 15.5 years and 60.6% male). The 6-month mortality was 13.8% (n = 109). Patients who died were significantly older (p < 0.001), had more cardiovascular disease (p = 0.010), had central venous catheter at the start of HD (p < 0.001), lower parathyroid hormone (PTH) level (p = 0.014) and higher CAR (p = 0.015). The AUC for mortality prediction was 0.706 (95% CI (0.65-0.76), p < 0.001). The optimal CAR cutoff was ≥0.5, HR 5.36 (95% CI 3.21-8.96, p < 0.001). Conclusion: We demonstrated that higher CAR was significantly associated with a higher mortality risk in the first six months of HD, highlighting the prognostic importance of malnutrition and inflammation in patients starting chronic HD.info:eu-repo/semantics/publishedVersio

O ENFERMEIRO E O EXERCÍCIO DA ADVOCACIA DO PACIENTE: REFLEXÃO TEÓRICA

RESUMO OBJETIVO: o presente estudo buscou tecer reflexão acerca da atuação do enfermeiro no exercício da advocacia ao paciente frente à atual conjuntura de serviços de saúde no Brasil. Para o profissional de Enfermagem a advocacia em saúde ainda está sendo acrescida como função, a fim de promover e defender os interesses e o bem-estar do paciente, assegurando que ele detenha o conhecimento dos seus direitos e acesso às informações, melhorando a sua saúde. Discutir sobre as dificuldades e desafios éticos da profissão do enfermeiro, sobretudo a atividade de advogar pelo usuário, deveria ser intrínseco às práticas diárias de saúde realizadas, principalmente durante a formação acadêmica. É possível concluir que a Enfermagem tem um caminho a percorrer no que concerne à advocacia do paciente, para que futuramente possa alicerçar essa atividade à sua prática diária

Cryosurgery as an Option for the Treatment of Vascular Lesions of the Oral Cavity

Cryosurgery is a treatment modality consisting in the destruction of tissue by the application of extremely low temperatures. This causes irreversible damage to cellular metabolism, leading to tissue destruction within minutes, a mechanism that may be beneficial when used in diseased tissues. Because cryosurgery is effective, simple, and easy to perform, it has been used in the treatment of lesions in both medical and dental fields. This technique provides many advantages, such as easy operation, absence of intraoperative bleeding, and low infection rate. We report the case of a patient with a hemangiomatous lesion of the oral cavity who was treated with liquid nitrogen spray cryosurgery, with successful results at 18-month follow-up

Síndrome POEMS: desafios no diagnóstico de um caso atípico

Introduction: POEMS syndrome is a rare paraneoplastic event, with no current report in the literature about its real prevalence. Most cases occur in middle-aged men. Case Report: Male patient, 65 years old, complaining of edema and paresthesia in the legs that evolved to plegia, associated with hyporexia and fatigue. Initial outpatient investigation revealed Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) of undefined etiology. Excluding secondaries, the patient was diagnosed with primary hypothyroidism, severe hypogonadism, hyperchromic skin lesions, ascites, pleural effusion and thrombocytosis, in addition to monoclonal IgA Lambda gammopathy by serum immunofixation. Viral serologies was negative. Excluding the possibility of Multiple Myeloma and other gammopathies, the hypothesis of POEMS Syndrome was raised, and plasma VEGF measurement was performed (425 pg/mL; RV = &lt;96.2). This is an atypical case in that bone lesions, present in up to 97% of cases, were not evidenced in the patient in question, making the diagnosis challenging. Conclusions: The diagnosis of rare syndromes, although challenging, brings the clinician a broader view of the patient as it increases clinical reasoning.Introdução: Síndrome POEMS trata de um raro evento paraneoplásico, sem relato atual na literatura sobre sua real prevalência. A maior parte dos casos ocorre em homens de meia idade. Relato do Caso: Paciente masculino, 65 anos, com queixa edema e parestesia em pernas que evoluiu para plegia, associada a hiporexia e fadiga. Investigação ambulatorial inicial evidenciou Polirradiculoneuropatia Inflamatória Desmielinizante Crônica (PIDC) de etiologia indefinida. Excluídos secundarismos, o paciente foi diagnosticado com hipotireoidismo primário, hipogonadismo severo, lesões hipercrômicas em pele, ascite, derrame pleural e trombocitose, além de gamopatia monoclonal IgA Lambda por imunofixação sérica. Sorologias virais negativas. Excluída a possibilidade de Mieloma Múltiplo e outras gamopatias, foi aventada a hipótese de Síndrome POEMS, sendo realizada dosagem de VEGF plasmática (425 pg/mL; VR = &lt;96.2). Trata-se de um caso atípico na medida em que, lesões ósseas, presentes em até 97% dos casos, não foram evidenciadas no paciente em questão, tornando desafiador o diagnóstico. Conclusões: O diagnóstico de síndromes raras, embora desafiante, traz ao clínico um olhar mais amplo do paciente na medida em que incrementa o raciocínio clínico

SAÚDE MENTAL DO POLICIAL MILITAR: PERCEPÇÕES, CONDIÇÕES DE TRABALHO E POSSIBILIDADES DE MELHORIA

Objetivo: identificar os fatores relacionados ao processo saúde-doença e a qualidade de vida de policiais militares de dois municípios do interior da Paraíba. Método: estudo qualitativo do tipo exploratório-descritivo com 38 homens policiais militares de um Batalhão da Polícia Militar da Paraíba. Foram utilizados para coleta de dados um roteiro de entrevista semiestruturado criado pelas pesquisadoras para atender o recorte qualitativo da pesquisa. Resultados: evidenciou-se o risco de adoecimento físico e psíquico que pode ser indicativo de um trabalho exaustivo e de alta carga de estresse. Além disso, o estudo demonstrou uma situação de carência de assistência à saúde em que esses profissionais estão submetidos. Conclusão: O estudo constata a importância da prevenção e promoção à saúde nesse público, enfatizando a ideia de uma assistência à saúde mais acessível voltada as especificidades da profissão militar