A Rare Cause of Abdominal Pain: Intestinal Angioedema

Angioedema with evidence of mucosal swelling is a rare condition that can be caused by angiotensin-converting enzyme inhibitors. The authors describe a case of a 28-year-old woman medicated with lisinopril 2 months before, with abdominal pain associated with nausea, vomiting and a onetime watery stool. A small volume of ascites was found in the abdominal ultrasound and the parietal thickening of the middle ileum in the abdominal computed tomography (CT). The complementary study was negative. The symptoms stopped after drug withdrawal. The authors intend to warn to this diagnosis, which has non-specific symptoms and if not suspected, can lead to a great morbidity for patients. The authors also intend to identify various signs that can be clues for its correct diagnosis.info:eu-repo/semantics/publishedVersio

A importância da psicologia social comunitária para o desenvolvimento sustentável

O presente artigo aborda a importância da Psicologia Social Comunitária para o Desenvolvimento Sustentável. Neste sentido, pretende-se investir principalmente nas discussões acerca das contribuições da Psicologia Social Comunitária para a busca por alternativas originais e sustentáveis de desenvolvimento. Um dos grandes desafios que encontramos atualmente no trabalho conjunto com os atores sociais é propor alternativas originais de desenvolvimento que visem à sustentabilidade humana e social. A Psicologia Social Comunitária brasileira tem muito a contribuir neste debate, tanto com pesquisas sobre lazer, sustentabilidade e desenvolvimento como elaborando soluções para os principais problemas urbanos. Contudo, a importância da Psicologia Social Comunitária, no âmbito do Desenvolvimento Sustentável consiste em apontar discussões e ferramentas operativas, na busca de uma alternativa de desenvolvimento mais adequada à realidade local, agregando à dinâmica social do destino a importância do sujeito como transformador da sua própria realidade. Realidade esta mais humana, ética e sustentável

Módulo V: Fundamentos históricos e conceituais da saúde mental e atenção psicossocial

Ministério da Saúd

Chemical composition, antinociceptive and free radical-scavenging activities of geopropolis from Melipona subnitida Ducke (Hymenoptera: Apidae: Meliponini)

Like many stingless bee species, Melipona subnitida Ducke uses geopropolis (a mixture of wax, plant resins, pollen grains and mud) for sealing small crevices in their nest cavities, in order to avoid the entry of air, and for defense against pathogenic microorganisms. The aim of this study was to evaluate the antinociceptive and free radical-scavenging activities of ethanolic extracts of six geopropolis samples from M. subnitida and the phenolic fractions obtained by C18-SPE extraction. The in vivo antinociceptive activity was analyzed on abdominal constriction induced by acetic acid in mice and in vitro free radical-scavenging activities by DPPH and ABTS assays. Additionally we analyzed the chemical composition of the phenolic fractions by HPLC-DAD. The six samples of geopropolis showed variations in the total phenolic content over the period, but not in the chemical profile observed by HPLC-DAD. Geopropolis is a rich source of bioactive compounds as phenolics 6-O-p-coumaroyl-D-alactopyranose, 6-O-cinnamoyl-1-Op-coumaroyl-β-D-glucopyranose, 7-O-methyl naringenin, 7-O-methyl aromadendrin, 7,4’-di-O-methyl aromadendrin, 4’-O-methyl kaempferol, 3-O-methyl quercetin, 5-O-methyl aromadendrin and 5-O-methyl kaempferol with potential antioxidant and antinociceptive activities. The antioxidant activity is related to the total phenolic content

Differences in the diagnosis of primary cutaneous melanoma in the public and private healthcare systems in Joinville, Santa Catarina State, Brazil

Background: Cutaneous melanoma accounts for up to 80% of deaths caused by skin cancer. Diagnostic suspicion and access to medical care and early intervention in suspected cases is vital to the patient’s prognosis. Objectives: To compare demographic and histopathological characteristics of primary cutaneous melanoma diagnosed in the public healthcare system (Sistema Único de Saúde SUS) and the private system in Joinville, Santa Catarina State, Brazil. Methods: This cross-sectional retrospective study analyzed primary cutaneous melanoma cases recorded from 2003 to 2014 in the resident population of Joinville. Ethical approval was obtained from the local Research Ethics Committee. Results: 893 cases of primary cutaneous melanoma were identified. Patients in the private system were mostly younger, while there were more elderly patients in the public healthcare system (p <0.001). There was no statistically significant association between type of care (public/private) and gender or presence of multiple primary cutaneous melanomas. Histological diagnosis of superficial spreading melanoma was more common in patients treated in private healthcare, while nodular melanoma was more frequent in patients in the public healthcare system (p <0.001). Mean Breslow depth in patients treated in private healthcare was 1.35mm, compared to 2.72mm in the public system (p <0.001). Study limitations: This was a retrospective study using secondary databases. Conclusions: Thin cutaneous melanoma (in situ cutaneous melanoma and Breslow T1) showed the strongest association with the private healthcare system, while thick cutaneous melanoma was more frequent in the public system (Breslow category T3 and T4) (p <0.001)

Decision-making executive function profile and performance in older adults with major depression:a case-control study

OBJECTIVES: Decision making (DM) is a component of executive functioning, essential for choosing appropriate decisions. Executive dysfunctioning is particularly common in late-life depression, however the literature is scarce on DM. This case-control study aimed to evaluate the DM profile and performance in participants with and without unipolar major depression. METHOD: The DM profile and performance were assessed by the Melbourne Decision Making Questionnaire and the Iowa Gambling Task (IGT), respectively, in three groups of older adults from a university-based geriatric psychiatry clinic, i.e. current depression (n = 30), remitted depression (n = 43) and healthy controls (n = 59). The Hamilton Depression scale (HAM-D) 21 items, the Hamilton Anxiety scale, and the Mini-Mental State Examination were used to access depressive symptoms, anxiety symptoms, and cognitive impairment, respectively. Multinomial, nominal and binary logistic regression was used to evaluate the associations between depression, depressive symptomatology and DM. RESULTS: In comparison to the control group, patients with current depression presented higher scores in buck-passing and proscratination DM profiles. In the hypervigilance profile, there was a significant difference between current and remitted depression groups. A higher value ​in the HAM-D scale increased the probability of disadvantageous DM profiles. Depressive patients showed a tendency of a higher mean score in both disadvantageous decks (A and B) of IGT. Patients with current depression showed a worse performance compared to the remitted depression group in the IGT netscore. CONCLUSION: Older adults with current depression showed DM profiles considered maladaptive or disadvantageous compared to both remitted depression and healthy controls groups

Pharmaceutical supply centers of Rio Grande do Sul

Objetivos: O objetivo deste estudo foi descrever as Centrais de Abastecimento Farmacêutico (CAFs) de municípios do Rio Grande do Sul, quanto à estrutura, aos processos realizados e os resultados obtidos. Métodos: Trata-se de um estudo de caráter transversal e descritivo cuja coleta de dados deu-se por visitas às CAFs de 29 municípios. Além de entrevistas in loco, utilizando um questionário elaborado a partir da revisão da literatura, realizou-se análise de documentos e observação direta da estrutura e das condições de armazenamento. Resultados: Os resultados mostram que o registro do controle diário de temperatura e umidade era realizado em 84,6% e 76,9% das CAFs respectivamente e todas aquelas que possuíam refrigerador para os termolábeis, realizavam o controle destes parâmetros. A maioria das centrais que armazenavam medicamentos sujeitos a controle especial utilizavam uma sala separada e com chave (75,0%). No recebimento dos medicamentos, era realizada a inspeção referente à validade e documentações necessárias (nota fiscal, por exemplo) em 92,3% dos locais. Todas as CAFs utilizavam sistema informatizado para controle de estoque, em seis (23,1%) havia um acúmulo de estoque resultante de demanda superestimada, de recursos aproveitados do ano anterior, excesso de compra ou sazonalidade e 88,5% realizavam inventário. Para que funcionem dentro da legalidade são necessárias algumas documentações como alvará sanitário, que apenas 26,9% das CAFs afirmaram possuir. Conclusão: Na avaliação da etapa de armazenamento da AF, por meio dos componentes: estrutura, processos e resultados, observou-se resultados parcialmente positivos em relação às recomendações técnicas e administrativas para as CAFs, necessitando de melhorias em alguns quesitos.Objectives: The objective of this study is to depict the Pharmaceutical Supply Centers (PSCs) of municipalities in Rio Grande do Sul, regarding the structure, the processes carried out and the results obtained. Methods: The sample consists of a total of 29 municipalities. Data collection took place through visits to the PSC of these municipalities and on-site interviews, document analysis, direct observation, and the use of a questionnaire developed with questions drawn from the literature review. Results: The results showed that the daily control of temperature and humidity is recorded in 84.6% and 76.9% of the PSCs, respectively, and all those that have a refrigerator for thermolabile, control these parameters. Most centers that store controlled drugs (Portaria 344/98) use a separate room with a key (75.0%). Upon receipt of the medicines, an inspection is carried out regarding the validity and necessary documentation (invoice, for example) in 92.3% of the places. All PSCs used a computerized system for stock control, in six (23.1%) there was an accumulation of stock resulting from overestimated demand, resources used from the previous year, excess purchases or seasonality and 88.5% carry inventory. For them to function legally, some documentation is needed, such as a health permit, which only 26.9% of the PSCs claimed to have. Conclusion: In the evaluation of the quality of the storage stage of the AF, through the components: structure, processes, and results, partially positive results were observed about the technical and administrative recommendations for the PSCs, requiring improvements in some aspects

Sedação com benzodiazepínicos orais na prática odontológica em pacientes cardíacos: uma revisão de literatura

Existem diferentes tipos de sedação utilizados para a realização de procedimentos médicos e odontológicos. As medicações mais comumente usadas para este fim são os benzodiazepínicos, considerados seguros e efetivos na prática odontológica hospitalar ou ambulatorial. No entanto, na prática clínica odontológica, eles são subutilizados, especialmente em pacientes com doenças cardiovasculares. O objetivo deste estudo foi abordar o uso de benzodiazepínicos como sedativos orais, suas indicações, contraindicações e peculiaridades, bem como sua correlação com pacientes cardíacos, através de uma revisão da literatura. Sedação, ou ansiólise mínima, é um estado induzido por medicamentos, durante o qual os pacientes respondem normalmente a comandos verbais e reflexos das vias aéreas, enquanto a função respiratória e cardiovascular não é afetada. Os efeitos benéficos de benzodiazepínicos incluem redução da ansiedade, indução e manutenção do sono, relaxamento muscular e tratamento e prevenção de convulsões epiléticas. Benzodiazepínicos são indicados para pacientes com ansiedade, mas devem ser usados com cautela em pacientes com doenças graves, gravidez ou que utilizem outros depressores do sistema nervoso central. É importante que o dentista conheça e use esta classe de medicamentos, melhorando a qualidade de atendimento para o paciente cardíaco.There are different types of sedation used for performing medical and dental procedures. The medications most commonly used for this purpose are benzodiazepines, which are considered safe and effective in the hospital or outpatient dental practice. However, in dental clinical practice, they are underutilized, especially in patients with cardiovascular disease. The aim of this study was to address the use of benzodiazepines as oral sedatives, their indications, contraindications, and peculiarities, as well as their correlation with cardiac patients, through a literature review. Sedation or minimum anxiolysis is a drug-induced state during which patients respond normally to verbal commands and airway reflexes, while respiratory and cardiovascular functions are unaffected. The beneficial effects of benzodiazepines include reduced anxiety, sleep induction and maintenance, muscle relaxation, and treatment and prevention of epileptic seizures. Benzodiazepines are indicated for patients with anxiety but should be used with caution in patients with serious illnesses, pregnancy or using other central nervous system depressants. Its use in cardiac patients is safe and effective because it reduces the hemodynamic function. It is important for the dentist to know and use this class of medications, improving the quality of care for the cardiac patient