Determinantes do escore de apgar e mortalidade neonatal em Foz do Iguaçu -PR - resultados preliminares

Anais do VI Encontro de Iniciação Científica e II Encontro Anual de Iniciação ao Desenvolvimento Tecnológico e Inovação – EICTI 2017 - 04 a 06 de outubro de 2017 - temática Ciências da SaúdeO óbito neonatal, ocorrido nas primeiras quatro semanas de vida, além de refletir condições socioeconômicas, destaca as condições relacionadas à assistência ao pré-natal, parto e ao recém-nascido (DE CARVALHO; GOMES, 2005), sendo que a asfixia é causa importante de morbimortalidade neonatal. O escore de Apgar é um método utilizado sistematicamente em hospitais, que avalia o risco de asfixia e morte no recém-nascido. Em Foz do Iguaçu, no ano de 2016, 70% dos óbitos infantis ocorreram no período neonatal. Atualmente não existem estudos que apontem as causas da morbimortalidade neonatal no municípioUniversidade Federal da Integração Latino-Americana (Unila); Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq); Fundação Araucária; Parque Tecnológico Itaipu (PTI) e Companhia de Saneamento do Paraná (SANEPAR

The effect of natural products in animal models of temporomandibular disorders

Treatment of temporomandibular disorders (TMD) is a challenge for health care professionals. Therefore, new approaches have been investigated, such as the use of natural products. Objective: This systematic review aims to summarize the natural products used in treatment of experimental models of TMD. Methodology: A systematic search was performed in the databases Medline, Web of Science, Scopus, Embase, SciELO, LILACS, and Scholar Google databases in January 2020, dating from their inception. Pre-clinical studies with natural products for intervention in experimental TMD were included. Two reviewers independently selected the studies, extracted the data, and evaluated the risk of bias. Results: 17 records were selected, and 17 different natural products were found, including three lectins, three plants or algae extracts, three sulfated polysaccharides, three cocoa preparations, and five isolated compounds. Concerning the risk of bias, most studies lacked on randomization and blinding. Nociception induced by phlogistic agents was evaluated in most articles, and in five studies it was associated with analysis of inflammatory parameters. In order to investigate the mechanism of action of the natural products used, eight studies evaluated expression of neural or glial molecular markers. Conclusions: 16 of 17 natural products found in this review presented positive results, showing their potential for treatment of TMD. However, the lack of methodological clarity can influence these results

Valores e Preferências no Consumo de Carne Frente ao Risco de Câncer

Trabalho de conclusão de curso apresentado ao Instituto Latino Americano de Ciências da Vida e Natureza da Universidade Federal da Integração Latino-Americana, como requisito parcial à obtenção do título de Bacharel em MedicinaOs valores e preferências das pessoas relacionadas ao consumo de alimentos determinam fortemente as escolhas alimentares diárias. Existem estudos recentes mostrando uma associação entre consumo de carne vermelha (CV) e carne vermelha processada (CVP) e doenças crônicas não transmissíveis. O presente estudo avaliou os valores e preferências dos adultos brasileiros em relação ao consumo de carne vermelha e carne vermelha processada e sua disposição de mudar seu consumo diante possíveis consequências indesejáveis à saúde. Métodos. Neste estudo transversal de métodos mistos realizou-se uma avaliação quantitativa por meio de uma pesquisa on-line seguida de uma investigação qualitativa por meio de entrevistas semiestruturadas e uma avaliação de acompanhamento após três meses. Além da estatística descritiva, conduzimos regressão logística e análises temáticas quando aplicável. Resultados. Mais de 60% dos 358 respondentes iniciais não estavam dispostos a interromper o consumo de CV ou CVP. Dentre aqueles que não estavam dispostos a parar, mais de 80% também não estavam dispostos a reduzir. As faixas de consumo mais prevalentes foram menores a 1 porção de CVP por semana (34%), 3 a 4 porções de CV por semana (33%) e 1 a 2 porções de CVP por semana (30%). A idade, grau de instrução e a religião dos participantes são preditores significativo para a disposição de parar ou reduzir o consumo de CV e CVP. Pessoas com maior grau de instrução são mais dispostas a parar o consume de CV no cenário de incidência de câncer (OR: 0,72; IC 95%: 0,59–0,91). A partir das entrevistas semiestruturadas, identificamos três temas principais em relação ao consumo de carne: 1) consumo de carne no contexto social e / ou familiar, 2) preocupações com a saúde e não relacionadas à saúde sobre a carne, e 3) incerteza das evidências cientificas. Três meses após a entrevista, a maioria (64%) dos participantes relatou diminuição da ingestão de carne. Conclusões. Adultos brasileiros participantes, ainda que informados acerca da incidência e mortalidade por câncer em virtude do consumo de carne vermelha ou carne vermelha processada, preferem manter o consumo atual. A pesquisa tem caráter informativo no desenvolvimento de diretrizes, recomendações nutricionais e de saúde pública relacionadas ao consumo de carne. As diretrizes nutricionais devem garantir que suas recomendações sejam consistentes com os valores e preferências da população.A Fundação Araucária de Apoio ao Desenvolvimento Científico e Tecnológico do Estado do Paran

Health related values and preferences regarding meat intake : a cross-sectional mixed-methods study

Background. In addition to social and environmental determinants, people's values and preferences determine daily food choices. This study evaluated adults' values and preferences regarding unprocessed red meat (URM) and processed meat (PM) and their willingness to change their consumption in the face of possible undesirable health consequences. Methods. A crosssectional mixed-methods study including a quantitative assessment through an online survey, a qualitative inquiry through semi-structured interviews, and a follow-up assessment through a telephone survey. We performed descriptive statistics, logistic regressions, and thematic analysis. Results. Of 304 participants, over 75% were unwilling to stop their consumption of either URM or PM, and of those unwilling to stop, over 80% were also unwilling to reduce. Men were less likely to stop meat intake than women (odds ratios < 0.4). From the semi-structured interviews, we identified three main themes: the social and/or family context of meat consumption, healthand non-health-related concerns about meat, and uncertainty of the evidence. At three months, 63% of participants reported no changes in meat intake. Conclusions. When informed about the cancer incidence and mortality risks of meat consumption, most respondents would not reduce their intake. Public health and clinical nutrition guidelines should ensure that their recommendations are consistent with population values and preferences

How do cancer screening guidelines trade off benefits versus harms and burdens of screening? A systematic survey

Objectives Cancer screening guidelines differ in their recommendations for or against screening. To be able to provide explicit recommendations, guidelines need to specify thresholds for the magnitude of benefits of screening, given its harms and burdens. We evaluated how current cancer screening guidelines address the relative importance of benefits versus harms and burdens of screening.Data source We searched the Guidelines International Network, International Guideline Library, ECRI Institute and Medline. Two pairs of reviewers independently performed guideline selection and data abstraction.Eligibility criteria We included all cancer screening guidelines published in English between January 2014 and April 2019.Results Of 68 eligible guidelines, 25 included a statement regarding the trade-off between screening benefits versus harms and burdens (14 guidelines), or a statement of direction of the net effect (defined as benefits minus harms or burdens) (13 guidelines). None of these 25 guidelines defined how large a screening benefit should be to recommend screening, given its harms and burdens. 11 guidelines performed an economic evaluation of screening. Of these, six identified a key benefit outcome; two specified a cost-effectiveness threshold for recommending a screening option. Eight guidelines commented on people’s values and preferences regarding the trade-off between benefits versus harms and burdens.Conclusions Current cancer screening guidelines fail to specify the values and preferences underlying their recommendations. No guidelines provide a threshold at which they believe the benefits of screening outweigh its harms and burdens.PROSPERO registration number CRD42019138590

Instruments for the detection of frailty syndrome in older adults: A systematic review.

Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context

Less intensive antileukemic therapies (monotherapy and/or combination) for older adults with acute myeloid leukemia who are not candidates for intensive antileukemic therapy: A systematic review and meta-analysis

Elderly patients with acute myeloid leukemia not eligible for intensive antileukemic therapy are treated with less intensive therapies, uncertainty remains regarding their relative merits. To compare the effectiveness and safety of less intensive antileukemic therapies for older adults with newly diagnosed AML not candidates for intensive therapies. We included randomized controlled trials (RCTs) and non-randomized studies (NRS) comparing less intensive therapies in adults over 55 years with newly diagnosed AML. We searched MEDLINE and EMBASE from inception to August 2021. We assessed risk of bias of RCTs with a modified Cochrane Risk of Bias tool, and NRS with the Non-Randomized Studies of Interventions tool (ROBINS-I). We calculated pooled hazard ratios (HRs), risk ratios (RRs), mean differences (MD) and their 95% confidence intervals (CIs) using a random-effects pairwise meta-analyses and assessed the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. We included 27 studies (17 RCTs, 10 NRS; n = 5,698), which reported 9 comparisons. Patients were treated with azacitidine, decitabine, and low-dose cytarabine (LDAC), as monotherapies or in combination with other agents. Moderate certainty of evidence suggests no convincing difference in overall survival of patients who receive azacitidine monotherapy compared to LDAC monotherapy (HR 0.69; 95% CI, 0.31-1.53), fewer febrile neutropenia events occurred between azacitidine monotherapy to azacitidine combination (RR 0.45; 95% CI, 0.31-0.65), and, fewer neutropenia events occurred between LDAC monotherapy to decitabine monotherapy (RR 0.62; 95% CI 0.44-0.86). All other comparisons and outcomes had low or very low certainty of evidence. There is no convincing superiority in OS when comparing less intensive therapies. Azacitidine monotherapy is likely to have fewer adverse events than azacitidine combination (febrile neutropenia), and LDAC monotherapy is likely to have fewer adverse events than decitabine monotherapy (neutropenia)