CAPACITAÇÃO DAS AGENTES DE SAÚDE DA UBSF RECANTO DO SOL PARA IDENTIFICAÇÃO DE POSSÍVEIS CASOS DE DEMÊNCIA NA POPULAÇÃO - UM RELATO DE EXPERIÊNCIA.

O presente trabalho objetiva relatar a experiência vivida por estudantes de medicina em uma Unidade Básica de Saúde (UBS) cuja tarefa fora a realização de uma capacitação com os agentes comunitárias de saúde (ACS) para o reconhecimento dos principais tipos de demências que acometem os idosos. A tarefa foi realizada com a equipe da UBS do Setor Recanto do Sol, Anápolis – GO, com a finalidade de complementar o trabalho por ele realizados perante a sociedade. Foi realizado um encontro em que todas as ACS estavam presentes e então os acadêmicos abordaram os vários tipos de demências, como se desenvolvem no paciente, quais as principais características e qual deveria ser o procedimento do profissional diante de cada situação encontrada na senilidade. O tema foi considerado relevante a ser tratado com as ACS devido sua óbvia importância em qualquer região majoritariamente de terceira idade (grupo mais susceptível a desenvolver demências), além de ser facilmente simplificado a um público leigo, aumentando, portanto a resolutividade da capacitação

Prevalência e fatores associados ao uso de narguilé e cigarro eletrônico por estudantes universitários

O tabagismo é considerado um problema de saúde publica e apesar da queda da prevalência deste, uma grande quantidade de jovens ainda experimenta diversas formas de uso, o que os tornam vulneráveis à iniciação e, consequentemente, à dependência tabágica. Todas as formas de utilização do tabaco têm em comum a liberação de nicotina para o sistema nervoso central, dentre elas o narguilé e cigarro eletrônico. O presente trabalho tem por objetivo identificar a prevalência e fatores associados ao uso de narguilé e cigarro eletrônico entre universitários. Será realizada uma pesquisa epidemiológica, analítica transversal, de análise quantitativa norteada pelo método positivista com universitários da UniEVANGELICA, Onde será utilizada uma entrevista estruturada sugerida por Martins et al (2014), a partir de perguntas provenientes de Global Health Professions Student Survey (2005) aos alunos que estejam regularmente matriculados nos cursos de Direito, Engenharia Civil e Medicina. Espera-se com essa pesquisa avaliar prioritariamente a prevalência e fatores associados ao inicio do uso do tabaco através dos dois dispositivos citados

Assessing the extent of flood-prone areas in a south-american megacity using different high resolution dtms

Current forecasts estimate that almost 68% of the global population will be living in urban centers by 2050. As a result, the increase in impermeable surface area can result in severe hydrological impacts, such as the increase in surface runoff and the frequency of floods and their magnitude. Thus, this work analyzes the performance of the hydrodynamic model HEC-RAS for assessing the extent of flood-prone areas, using two digital terrain models (DTM) with different spatial resolutions (5 and 0.50 m). Four different computing intervals (1, 15, 30, and 60 s) were adopted aiming to evaluate the simulations outputs performance. Additionally, reported data by the civil defense are used for calibration and validation. In general, the model showed to be a powerful tool in the identification of susceptible areas to urban flooding. The simulated results in this work provide crucial geographic information when identifying spots with the highest risk of flooding, which should receive priority attention during such events. The simulations with a spatial resolution of 5 m showed the flood maps with the largest coverage of the flooded points (278 points out of 286—97.20%), within the shortest computation times. We highlight that the more refined DTM derived from spatial images did not produce the best flood simulation compared to the DTM with a spatial resolution of 5 m derived from orthoimages

Coma e outros estados de consciência

As alterações do nível de consciência podem variar entre dois extremos, desde uma desorientação têmporo-espacial até um estado de coma profundo. Na prática clínica é extremamente comum o médico se deparar frente a um paciente com alteração do nível de consciência. Em hospitais gerais, estudos indicam o alcoolismo, o traumatismo cranioencefálico e as doenças cardiovasculares como as principais causas de coma (82%). O médico deve saber reconhecer as principais causas de alteração da consciência, seus diagnósticos diferenciais, identificar o paciente grave e tratar as possíveis alterações emergenciais que possam levar aum dano neurológico secundário. Nesta revisão destacamos os principais pontos no exame neurológico para determinar as diferentes alterações do nível de consciência.The alterations of the level of conscience can vary among two ends, from a mental confusion to a state of deep coma. In clinical practice it is extremely common apatient with alteration of the level of conscience without diagnosis. In general hospitals, studies indicate that the alcoholism, the brain trauma and the cardiovascular diseases are the main causes of coma (82%). Its necessary know how to recognize the main causes of unconsciousness of and their differential diagnosis, aimed to identify the severe ill patient and to treat the possible emergency states that take to a secondary neurological damage. In this revision, we emphasized the key points in the neurological exam to determine the different alterations ofthe level of consciousness

Benznidazole Treatment : Time- and Dose-Dependence Varies with the Trypanosoma cruzi Strain

As the development of new drugs for Chagas disease is not a priority due to its neglected disease status, an option for increasing treatment adherence is to explore alternative treatment regimens, which may decrease the incidence of side effects. Therefore, we evaluated the efficacy of different therapeutic schemes with benznidazole (BNZ) on the acute and chronic phases of the disease, using mice infected with strains that have different BNZ susceptibilities. Our results show that the groups of animals infected by VL-10 strain, when treated in the chronic phase with a lower dose of BNZ for a longer period of time (40 mg/kg/day for 40 days) presented better treatment efficacy than with the standard protocol (100 mg/kg/day for 20 days) although the best result in the treatment of the animals infected by the VL-10 strain was with100 mg/kg/day for 40 days. In the acute infection by the Y and VL-10 strains of T. cruzi, the treatment with a standard dose, but with a longer time of treatment (100 mg/kg/day for 40 days) presented the best results. Given these data, our results indicate that for BNZ, the theory of dose and time proportionality does not apply to the phases of infectio

EXPOSIÇÃO PÓS-NATAL A POLUENTES DO AR (MP≤2,5) COMO FATOR DE RISCO PARA O DESENVOLVIMENTO DE COMPORTAMENTOS DE DEPRESSÃO E ANSIEDADE: UM ESTUDO EXPERIMENTAL

The purpose of study was to evaluate the behavioral changes of male and female adult rats exposed to fine and ultrafine particulate matter (PM≤2,5) suspended in air pollution during development. Wistar rats aged 7 days postnatal were exposed to the chamber of an atmospheric particle concentrator. Open field tests and sucrose preference tests were performed to assess the presence of anxiety and depression behaviors. Male rats from the pollution group showed reduced locomotor activity and length of stay in the open field center when compared to the control group males. The sucrose preference test showed statistical significance between the pollution and control groups, and among the males of the pollution and control group. The study concluded that exposure to PM≤2.5 causes behavioral changes characteristic of depression and anxiety in adult male rats exposed during the developmental period.O objetivo do estudo foi avaliar as alterações comportamentais de ratos machos e fêmeas adultos, expostos ao material particulado fino e ultrafino (MP≤2,5) suspenso na poluição do ar, durante o desenvolvimento.  Ratos Wistar com idade de 7 dias pós-natal, foram expostos à câmara de um concentrador de partículas atmosféricas. Foram realizados os testes de campo aberto e teste de preferência por sacarose para avaliação da presença de comportamentos de ansiedade e depressão. Ratos machos do grupo poluição apresentaram redução da atividade locomotora e do tempo de permanência no centro do campo aberto quando comparados aos machos do grupo controle. O teste de preferência por sacarose evidenciou significância estatística entre os grupos poluição e controle, e entre os machos do grupo poluição e controle. O estudo concluiu que a exposição ao MP≤2,5 causa alterações comportamentais características de depressão e ansiedade, em ratos machos adultos expostos durante o período de desenvolvimento.&nbsp

Estimation of intracranial pressure by ultrasound of the optic nerve sheath in an animal model of intracranial hypertension

Antecedentes: La ecografía del diámetro de la vaina del nervio óptico (ONSD) se ha utilizado como alternativa no invasiva y rentable a la monitorización invasiva de la presión intracraneal (PIC). Sin embargo, aún se desconoce el comportamiento temporal del ONSD en la hipertensión intracraneal (HIC) y su alivio mediante infusión salina o cirugía. El objetivo de este estudio fue correlacionar la presión intracraneal (PIC) y la ultrasonografía de la vaina del nervio óptico (ONS) en un modelo animal experimental de HIC y determinar el intervalo necesario para que la ONSD vuelva a los niveles basales. Métodos: Se realizó un estudio experimental en 30 cerdos. La ONSD se evaluó mediante ecografía a diferentes PIC generadas por inflado intracraneal con balón, infusión salina y desinflado con balón, y se midió utilizando un catéter intraventricular. Resultados: Todas las variables obtenidas por ultrasonografía ONS como ONSD izquierdo, derecho y promedio (AON) fueron estadísticamente significativas para estimar el valor de la PIC. La ONSD cambió inmediatamente después del inflado del balón y volvió a los valores basales tras un retraso medio de 30 min después del desinflado del balón (p = 0,016). No se observó significación estadística en los valores de PIC y ONSD con la infusión de solución salina hipertónica. En este modelo porcino, la PIC y la ONSD mostraron una correlación lineal y la PIC pudo estimarse mediante la fórmula: -80,5 + 238,2 × AON. Conclusiones: En el presente estudio, la ecografía para medir la ONSD mostró una correlación lineal con la PIC, aunque se observó un breve retraso en volver a los niveles basales en el caso de alivio súbito de la HIC.Background: Ultrasound of the optic nerve sheath diameter (ONSD) has been used as a non-invasive and cost-effective bedside alternative to invasive intracranial pressure (ICP) monitoring. However, ONSD time-lapse behavior in intracranial hypertension (ICH) and its relief by means of either saline infusion or surgery are still unknown. The objective of this study was to correlate intracranial pressure (ICP) and ultrasonography of the optic nerve sheath (ONS) in an experimental animal model of ICH and determine the interval needed for ONSD to return to baseline levels. Methods: An experimental study was conducted on 30 pigs. ONSD was evaluated by ultrasound at different ICPs generated by intracranial balloon inflation, saline infusion, and balloon deflation, and measured using an intraventricular catheter. Results: All variables obtained by ONS ultrasonography such as left, right, and average ONSD (AON) were statistically significant to estimate the ICP value. ONSD changed immediately after balloon inflation and returned to baseline after an average delay of 30 min after balloon deflation (p = 0.016). No statistical significance was observed in the ICP and ONSD values with hypertonic saline infusion. In this swine model, ICP and ONSD showed linear correlation and ICP could be estimated using the formula: −80.5 + 238.2 × AON. Conclusion: In the present study, ultrasound to measure ONSD showed a linear correlation with ICP, although a short delay in returning to baseline levels was observed in the case of sudden ICH relief

Early administration of fibrinogen concentrate in patients with polytrauma with thromboelastometry suggestive of hypofibrinogenemia: A randomized feasibility trial

OBJECTIVE: To evaluate the clinical effects of early administration of fibrinogen concentrate in patients with severe trauma and hypofibrinogenemia. METHODS: We conducted an open randomized feasibility trial between December 2015 and January 2017 in patients with severe trauma admitted to the emergency department of a large trauma center. Patients presented with hypotension, tachycardia, and FIBTEM findings suggestive of hypofibrinogenemia. The intervention group received fibrinogen concentrate (50 mg/kg), and the control group did not receive early fibrinogen replacement. The primary outcome was feasibility assessed as the proportion of patients receiving the allocated treatment within 60 min after randomization. The secondary outcomes were transfusion requirements and other exploratory outcomes. Randomization was performed using sequentially numbered and sealed opaque envelopes. ClinicalTrials.gov: NCT02864875. RESULTS: Thirty-two patients were randomized (16 in each group). All patients received the allocated treatment within 60 min after randomization (100%, 95% confidence interval, 86.7%-100%). The median length of intensive care unit stay was shorter in the intervention group (8 days, interquartile range [IQR] 5.75-10.0 vs. 11 days, IQR 8.5-16.0; p=0.02). There was no difference between the groups in other clinical outcomes. No adverse effects related to treatment were recorded in either group. CONCLUSION: Early fibrinogen replacement with fibrinogen concentrate was feasible. Larger trials are required to properly evaluate clinical outcomes