A importância da abordagem de doenças sexualmente trnasmissíveis em ações sociais – Relato de experiência

Introdução: Segundo estimativas da OMS (2013), mais de um milhão de pessoas adquirem uma Infecção Sexualmente Transmissível (IST) diariamente. A manutenção da epidemia de IST no Brasil é decorrente da interação de inúmeros fatores socioeconômicos, culturais e comportamentais. Há uma concentração de casos em homens homossexuais, pessoas trans e profissionais do sexo. Além disso, ultimamente, destaca-se o acometimento em adolescentes e jovens, sendo os principais fatores de risco início da vida sexual precoce, falta de conhecimento e acesso sobre os métodos de prevenção das ISTs. A testagem rápida para IST é uma ferramenta preventiva, pois possibilita diagnóstico precoce, permite o início do tratamento, tornando este mais efetivo, e estabelece estratégias de prevenção de parceiros, reduzindo a cadeia de transmissão das doenças¹. Os testes rápidos para HIV, sífilis, hepatites B e C possuem elevada sensibilidade e especificidade, o que garante de um diagnóstico seguro. Objetivos: Este trabalho visa relatar a experiência dos acadêmicos de medicina da Faculdade Alfredo Nasser (FAN) e do Centro Universitário de Anápolis (UniEVANGÉLICA) na realização de testes rápidos para HIV, sífilis, hepatites B e C durante evento municipal realizado em Senador Canedo–GO. Relato de experiência: Esta experiência foi realizada no evento Ação Social em Garantia à Cidadania pelos alunos de medicina da FAN e da UniEVANGELICA, no dia 15 de junho de 2019, na Praça Criativa Central, em Senador Canedo. O projeto abordou a prevenção e o diagnóstico de ISTs. Foram realizados testes rápidos gratuitos para HIV, sífilis, hepatites B e C. O paciente, após seu cadastro, realizava coleta da amostra de sangue na polpa digital para realização dos exames. O diagnóstico era informado após 15 minutos com orientações acerca das doenças e suas principais medidas preventivas e abordando as dúvidas da população sobre do assunto. Nos pacientes com diagnóstico positivo, eram realizadas a notificação compulsória e orientações a respeito do seguimento com tratamento no Sistema Único de Saúde. Durante o evento foram realizados testes rápidos em 122 indivíduos. Os resultados incluíram 3 reagentes para HIV (testes de triagem e teste confirmatório), 4 para sífilis, 1 para Hepatite B e 1 para hepatite C. Ao diagnóstico, também abordamos os anseios destes indivíduosem que foi perceptível sentimentos de revolta, rejeição do resultado e medo de discriminação. Ademais, a ação também disponibilizou preservativos masculinos gratuitos para os cidadãos, com objetivo de conscientizar e orientar sobre a importância da prevenção do próprio indivíduo e de seus parceiros sexuais. Atualmente existem várias estratégias de prevenção e é essencial a abordagem dos vários métodos para conferir condições de autoproteção diante das diferentes situações6. A prevenção combinada, recomendada pelo Ministério da Saúde, inclui uso correto da camisinha masculina/feminina em todas as relações sexuais, ações de prevenção, testagem para HIV, sífilis e hepatites B e C, profilaxia pré-exposição, imunização e tratamento das ISTs. Essa estratégia deve ser aplicada dentro do contexto sexual apresentada por cada indivíduo, de modo detalhado e de fácil compreensão, sendo primordial para garantir o conhecimento do paciente quanto a aquisição da doença, permitindo notificação, segmento terapêutico, prevenção da transmissão para parceiros³ e suporte psicológico adequado para os pacientes com diagnóstico positivo para HIV e outras ISTs. Conclusão: Com esta experiência, foi possível constatar a importância dos testes rápidos somados às orientações educativas para ISTs como forma de prevenir a transmissão das doenças, além da necessidade de um suporte psicológico adequado nas redes básicas de saúde

USE OF ATHEROGENIC INDICES AS ASSESSMENT METHODS FOR CLINICAL ATHEROSCLEROTIC DISEASES

Accurate assessment of clinical atherosclerotic diseases is essential to guide effective therapeutic interventions, and atherogenic indices have emerged as valuable methods in this setting. The complexity of these pathologies demands approaches that go beyond the simple measurement of total cholesterol, requiring tools that consider the interaction between different lipoproteins and other risk factors. In this context, the use of atherogenic indices appears as a promising approach, providing a more comprehensive and refined assessment of atherosclerotic conditions. Objective: To comprehensively analyze scientific studies published in the last 10 years that investigated the use of atherogenic indices as methods of evaluating clinical atherosclerotic diseases. The review seeks to consolidate the available evidence by examining the effectiveness of these indices in early identification, risk stratification and monitoring the progress of atherosclerotic diseases. Methodology: The systematic review was conducted following the PRISMA guidelines. The PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were "atherogenic indices", "atherosclerotic diseases", "clinical assessment", "lipoproteins" and "cardiovascular risk factors". Inclusion criteria considered original studies that investigated the use of atherogenic indices in clinical populations, while exclusion criteria involved studies with unrepresentative samples and inadequate atherosclerotic assessment methods. Results: The results of the review highlight the diversity of available atherogenic indices and their usefulness in evaluating different aspects of atherosclerotic diseases, including prediction of cardiovascular events, risk stratification and treatment monitoring. The analysis identified indices that proved to be particularly sensitive and specific in different clinical contexts. Conclusion: In summary, the systematic review highlights the relevance of atherogenic indices as valuable tools in the assessment of clinical atherosclerotic diseases. The diversity of these indices and their ability to provide comprehensive information highlights their importance in clinical practice, contributing to a more refined and personalized approach to the management of these conditions.Accurate assessment of clinical atherosclerotic diseases is essential to guide effective therapeutic interventions, and atherogenic indices have emerged as valuable methods in this setting. The complexity of these pathologies demands approaches that go beyond the simple measurement of total cholesterol, requiring tools that consider the interaction between different lipoproteins and other risk factors. In this context, the use of atherogenic indices appears as a promising approach, providing a more comprehensive and refined assessment of atherosclerotic conditions. Objective: To comprehensively analyze scientific studies published in the last 10 years that investigated the use of atherogenic indices as methods of evaluating clinical atherosclerotic diseases. The review seeks to consolidate the available evidence by examining the effectiveness of these indices in early identification, risk stratification and monitoring the progress of atherosclerotic diseases. Methodology: The systematic review was conducted following the PRISMA guidelines. The PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were "atherogenic indices", "atherosclerotic diseases", "clinical assessment", "lipoproteins" and "cardiovascular risk factors". Inclusion criteria considered original studies that investigated the use of atherogenic indices in clinical populations, while exclusion criteria involved studies with unrepresentative samples and inadequate atherosclerotic assessment methods. Results: The results of the review highlight the diversity of available atherogenic indices and their usefulness in evaluating different aspects of atherosclerotic diseases, including prediction of cardiovascular events, risk stratification and treatment monitoring. The analysis identified indices that proved to be particularly sensitive and specific in different clinical contexts. Conclusion: In summary, the systematic review highlights the relevance of atherogenic indices as valuable tools in the assessment of clinical atherosclerotic diseases. The diversity of these indices and their ability to provide comprehensive information highlights their importance in clinical practice, contributing to a more refined and personalized approach to the management of these conditions

RISK FACTORS FOR OPERATIVE WOUND INFECTION IN PATIENTS UNDERGOING PEDIATRIC CARDIAC SURGERY

  Surgical wound infection is a significant complication in patients undergoing pediatric cardiac surgery, which can compromise the postoperative recovery process and increase morbidity. Several risk factors are associated with this condition, including patient characteristics, type of surgical procedure, hospital environment, and postoperative care practices. Understanding these factors is crucial to developing effective prevention strategies and optimizing clinical outcomes in this vulnerable population. Objective: To analyze and synthesize the available evidence on the risk factors for surgical wound infection in patients undergoing pediatric cardiac surgery. The aim is to identify patterns and gaps in the literature, contributing to a more comprehensive understanding of the elements that influence the occurrence of this specific complication. Methodology: The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scielo and Web of Science databases were consulted to identify studies published in the last 10 years, using the descriptors "pediatric heart surgery", "operative wound infection", "risk factors", "children" and "prevention ". Three inclusion criteria were established, considering original studies that addressed risk factors in pediatric cardiac surgery, while three exclusion criteria were applied to filter articles that did not meet the specific objectives of the review. Results: Results revealed a variety of risk factors, including patient age, length of surgery, presence of comorbidities, and infection control practices. The review highlighted the importance of specific preventive strategies for the pediatric population undergoing cardiac procedures. Conclusion: This systematic review provides a comprehensive overview of risk factors for surgical wound infection in pediatric cardiac surgery, emphasizing the need for personalized prevention approaches. The conclusions highlight the importance of targeting preventive interventions, adapting them to the unique characteristics of this population, aiming to improve clinical results and reduce the incidence of postoperative infections.  Surgical wound infection is a significant complication in patients undergoing pediatric cardiac surgery, which can compromise the postoperative recovery process and increase morbidity. Several risk factors are associated with this condition, including patient characteristics, type of surgical procedure, hospital environment, and postoperative care practices. Understanding these factors is crucial to developing effective prevention strategies and optimizing clinical outcomes in this vulnerable population. Objective: To analyze and synthesize the available evidence on the risk factors for surgical wound infection in patients undergoing pediatric cardiac surgery. The aim is to identify patterns and gaps in the literature, contributing to a more comprehensive understanding of the elements that influence the occurrence of this specific complication. Methodology: The review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The PubMed, Scielo and Web of Science databases were consulted to identify studies published in the last 10 years, using the descriptors "pediatric heart surgery", "operative wound infection", "risk factors", "children" and "prevention ". Three inclusion criteria were established, considering original studies that addressed risk factors in pediatric cardiac surgery, while three exclusion criteria were applied to filter articles that did not meet the specific objectives of the review. Results: Results revealed a variety of risk factors, including patient age, length of surgery, presence of comorbidities, and infection control practices. The review highlighted the importance of specific preventive strategies for the pediatric population undergoing cardiac procedures. Conclusion: This systematic review provides a comprehensive overview of risk factors for surgical wound infection in pediatric cardiac surgery, emphasizing the need for personalized prevention approaches. The conclusions highlight the importance of targeting preventive interventions, adapting them to the unique characteristics of this population, aiming to improve clinical results and reduce the incidence of postoperative infections

Síndrome do pé torto congênito: uma revisão sistemática / Congenital clubfoot syndrome: a systematic review

O pé torto congênito é uma deformidade causada nos membros inferiores, embora seja mais comum nesta região, outras áreas do corpo podem ser afetadas e as características desta deformidade serem observadas. Em relação à doença, discussões ainda surgem já que a etiologia e o seu tratamento ainda não são completamente contemplados por uma única definição ou método característico de tratamento. Métodos como o de Ponseti e a Osteotomia são mais usados frequentemente. Tendo em vista esses métodos, acreditam ainda que a cirurgia deva ser a última forma de intervenção. Ao utilizarem do método cirúrgico, priorizam corrigir a deformidade de forma localizada, ou seja, à lá carte. Futuramente novos métodos ganharam forma e consequentemente ganharam o lugar de outros. Esta evolução ocorre principalmente pela abrangência acerca do conhecimento etiológico e morfológico, assim as novas formas de tratamento serão um reflexo provenientes destas mudanças acerca da doença