Análise dos hábitos alimentares e da prática de atividade física em discentes de medicina / Analysis of alimentary habits and physical exercise on medicine students

A obesidade é definida como o ganho de peso resultado de balanços energéticos positivos, é uma doença crônica contemporânea em crescimento, na qual o excesso de gordura acumulada pode trazer complicações para a saúde. Diante disso, o principal objetivo do estudo é investigar como os hábitos alimentares e a prática de atividade física, atuam como fator de risco para ganho de peso em discentes de uma instituição de ensino superior. Este é um estudo do tipo transversal, observacional, com abordagem quantitativa realizado em discentes de 1° ao 8° período do curso de medicina do Centro Universitário de Anápolis – UniEVANGÉLICA. Foram aplicados o Questionário Internacional de Atividade Física versão curta (IPAQ) para avaliação da atividade física, e o questionário 10 passos para uma alimentação saudável para avaliação dos hábitos alimentares. Foi realizada análise de 435 questionários, constatou-se que 73,1% possui alimentação parcialmente adequada e 34,0% se enquadra na classificação Ativo no Questionário Internacional de Atividade Física versão curta (IPAQ) sendo que não houve diferença significativa entre os períodos. Evidenciou-se que a classificação Ativo e a Parcialmente Adequada do questionário alimentar tiveram maior frequência em relação as demais, tanto em relação aos períodos quanto aos sexos. Notou-se que houve aumento do sedentarismo do 1º ao 8º período, porém este não ocorre de maneira linear. Dessa forma, diante dos determinantes atividade física e alimentação serem fatores importantes para uma vida saudável e seus bons hábitos atuam na prevenção de sobrepeso e obesidade, observa-se importância desse estudo na área médica

Uso da vacina contra HPV, suas indicações, resultados e complicações

RESUMO: O papilomavírus humano (HPV) é um vírus epiteliotrófico sexualmente transmissível. Em sua genética é observada interação entre partículas E6/E7 e as proteínas supressoras de tumor gerando patologias, tais como de câncer de colo uterino, de cabeça e pescoço e câncer de ânus. Este trabalho tem como objetivo a etiologia da doença e suas complicações, sendo importante analisar a profilaxia do HPV através de vacinas bivalentes, tetravalentes e nonavalentes, visando idade, composição e resposta imunológica desencadeada. Para redigir esta revisão integrativa da literatura foram pesquisados artigos dos últimos 7 anos, sendo selecionados 20 artigos distribuídos entre as plataformas Scielo (9), Lilacs (2), ResearchGate (2) , PubMed (6) e ScienceDirect (1). Ao analisar as vacinas foi possível determinar que a bivalente garante proteção contra os sorotipos HPV 16/18, a tetravalente garante contra os sorotipos hpv 6/11/16/18 e a nonavalente contra os sorotipos 6/11/16/18/31/33/45/52/58, esta atua também como um fator de tratamento, atacando proteínas causadoras de lesão e ativando uma resposta imunológica mais efetiva. Diante do que os diferentes artigos apresentaram acerca da ação das vacinas, foi possível verificar a eficácia contra o HPV, mas não de todos os tipos de vacina, devido ao não acompanhamento além do período de latência do vírus impedindo a análise da eficácia contra o aparecemento dos cânceres. Já diante das lesões, foi possível concluir que há importância clínica na prevenção das lesões de alto grau. Entretanto, deve-se expandir o campo de pesquisa na vacinação do HPV, para vislumbrar a real eficácia da mesma.Palavras-chave:Papilomavírus humano. Vacina. Câncer

High anti-SARS-CoV-2 antibody seroconversion rates before the second wave in Manaus, Brazil, and the protective effect of social behaviour measures: results from the prospective DETECTCoV-19 cohort

Background: The city of Manaus, Brazil, has seen two collapses of the health system due to the COVID-19 pandemic. We report anti-SARS-CoV-2 nucleocapsid IgG antibody seroconversion rates and associated risk factors in Manaus residents before the second wave of the epidemic in Brazil. Methods: A convenience sample of adult (aged ≥18 years) residents of Manaus was recruited through online and university website advertising into the DETECTCoV-19 study cohort. The current analysis of seroconversion included a subgroup of DETECTCoV-19 participants who had at least two serum sample collections separated by at least 4 weeks between Aug 19 and Oct 2, 2020 (visit 1), and Oct 19 and Nov 27, 2020 (visit 2). Those who reported (or had no data on) having a COVID-19 diagnosis before visit 1, and who were positive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at visit 1 were excluded. Using an in-house ELISA, the reactivity index (RI; calculated as the optical density ratio of the sample to the negative control) for serum anti-SARS-CoV-2 nucleocapsid IgG antibodies was measured at both visits. We calculated the incidence of seroconversion (defined as RI values ≤1·5 at visit 1 and ≥1·5 at visit 2, and a ratio >2 between the visit 2 and visit 1 RI values) during the study period, as well as incidence rate ratios (IRRs) through cluster-corrected and adjusted Poisson regression models to analyse associations between seroconversion and variables related to sociodemographic characteristics, health access, comorbidities, COVID-19 exposure, protective behaviours, and symptoms. Findings: 2496 DETECTCoV-19 cohort participants returned for a follow-up visit between Oct 19 and Nov 27, 2020, of whom 204 reported having COVID-19 before the first visit and 24 had no data regarding previous disease status. 559 participants were seropositive for anti-SARS-CoV-2 nucleocapsid IgG antibodies at baseline. Of the remaining 1709 participants who were seronegative at baseline, 71 did not meet the criteria for seroconversion and were excluded from the analyses. Among the remaining 1638 participants who were seronegative at baseline, 214 showed seroconversion at visit 2. The seroconversion incidence was 13·06% (95% CI 11·52–14·79) overall and 6·78% (5·61–8·10) for symptomatic seroconversion, over a median follow-up period of 57 days (IQR 54–61). 48·1% of seroconversion events were estimated to be asymptomatic. The sample had higher proportions of affluent and higher-educated people than those reported for the Manaus city population. In the fully adjusted and corrected model, risk factors for seroconversion before visit 2 were having a COVID-19 case in the household (IRR 1·49 [95% CI 1·21–1·83]), not wearing a mask during contact with a person with COVID-19 (1·25 [1·09–1·45]), relaxation of physical distancing (1·31 [1·05–1·64]), and having flu-like symptoms (1·79 [1·23–2·59]) or a COVID-19 diagnosis (3·57 [2·27–5·63]) between the first and second visits, whereas working remotely was associated with lower incidence (0·74 [0·56–0·97]). Interpretation: An intense infection transmission period preceded the second wave of COVID-19 in Manaus. Several modifiable behaviours increased the risk of seroconversion, including non-compliance with non-pharmaceutical interventions measures such as not wearing a mask during contact, relaxation of protective measures, and non-remote working. Increased testing in high-transmission areas is needed to provide timely information about ongoing transmission and aid appropriate implementation of transmission mitigation measures. Funding: Ministry of Education, Brazil; Fundação de Amparo à Pesquisa do Estado do Amazonas; Pan American Health Organization (PAHO)/WHO.World Health OrganizationRevisión por pare

Núcleos de Ensino da Unesp: artigos 2012: volume 7: educação inclusiva

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)