Revista Eletrônica Acervo Médico

Dengue fever in the state of Pará: a temporal analysis and spatial distribution, from 2014 to 2024

2025-01-29T17:20:37+00:00

Objective: To outline the epidemiological profile of dengue cases in the state of Pará, from 2014 to July 2024. Methods: This is an epidemiological, retrospective, longitudinal study, of an exploratory and analytical nature, in addition to being quantitative, with collection of data from the Information Technology Department of the Unified Health System (DATASUS) between the years 2014-2024. Results: In the state of Pará, from 2014 to July/2024, 80,139 cases of dengue were confirmed. The highest absolute number of cases per year was in the year 2024 until July, with 18905 (23.6%). Regarding the distribution of cases in the state of Pará by health regions, the Carajás region was the one with the highest incidence of cases with 14,487, corresponding to 18.3% of the total. Specifically in relation to the municipalities in the southeast region of Pará, Conceição do Araguaia presented 2399 cases (21.4%). Conclusion: We concluded that there was a significant increase in dengue cases in Pará, especially between 2022 and 2024, with a greater impact on women and those aged 20 to 39 years. The Carajás region stood out for its high incidence of cases, indicating the need for specific interventions and reinforcement of disease control strategies in the state.

Perception of Chronic Kidney Disease patients returning to hemodialysis after kidney graft loss

2025-01-29T17:34:09+00:00

Objective: To understand the perception of patients who have resumed hemodialysis after losing their kidney graft. Métodos: This was a qualitative descriptive field study, using an instrument with guiding questions whose answers were analyzed according to Bardin's content analysis. Results: The sample consisted of eight subjects aged between 29 and 74, five men and three women. Two participants had undergone two transplants each. The time taken for patients to return to hemodialysis treatment after graft loss ranged from 2 months to 14 years. The categories of discourse analyzed were: “Experiencing Renal Transplantation”, “Experiencing Hemodialysis”, “Perspectives on Renal Transplantation” and “Communication and the work of professionals as an instrument of care and choice of treatment”. Final considerations: The return to dialysis therapy after kidney transplantation can generate suffering and expectations for patients, so recognizing and understanding the difficulties faced by patients, as well as having a multi-professional team involved in the process of change and return to dialysis therapy is important to promote the search for well-being and satisfaction in the return to hemodialysis after the loss of the kidney graft.

La influencia del uso de cigarrillos electrónicos en el desarrollo de enfermeda des pulmonares

2025-02-16T19:40:13+00:00

Objective: Evaluate the influence of electronic cigarette use on the development of lung diseases. Methods: Integrative review, in Biblioteca Virtual em Saúde (BVS) and National Institutes of Health (PubMed) databases. The search was carried out on August 14th, 2024. The descriptors in health sciences (DeCS) were: “lung diseases”, “e-cigarette”, “vaping”, “vape” and “respiratory diseases, with the boolean operator AND. The inclusion criteria were: original studies of a primary nature, freely accessible, made available in full and published between 2019 and 2024. Results: This study was carried out through the analysis of 15 articles on the relation between the use of electronic cigarettes and the development of lung diseases. The results obtained were presented in Table 1, which highlights authors, types of studies and the main findings. Final considerations: In view of the analysis, it was evident that the use of electronic cigarettes provides a greater chance of developing lung diseases.

Clinical and psychosocial aspects of bariatric surgery as a treatment for obesity

2025-03-18T18:32:12+00:00

Objective: To examine the clinical and psychosocial consequences of bariatric surgery as a treatment for obesity. Bibliographic review: Obesity has become increasingly common. It is a chronic disease characterized by excess adipose tissue and is related to type 2 diabetes mellitus (DM 2), cardiovascular diseases and obstructive sleep apnea (OSA). Body mass index (BMI) values above 30 kg/m2 are considered class 1 obesity. Bariatric surgery is highly effective, promotes sustained weight loss and has evidence of reducing associated comorbidities. The most used surgical techniques are Roux-en-Y gastric bypass (RYGB) and laparoscopic lateral gastrectomy (LSG). Despite the benefits, some patients may face issues such as eating disorders, low self-esteem, transfer of addictions, difficulty socializing and development of unrealistic expectations. Final Considerations: It is concluded that the treatment of obesity with bariatric surgery must have a multidisciplinary approach to help patients deal with the psychosocial adversities involved in the process and adapt to the changes resulting from the new lifestyle.

Opsimodysplasia: report of a rare case of skeletal dysplasia with clinical and diagnostic approach

2025-02-05T20:29:35+00:00

Objective: To report a rare case of opsismodysplasia (OPS), aiming to improve the understanding of this condition's manifestations and discuss the available clinical management options, given the generally poor prognosis that often accompanies the disease. Case Details: A case of a 5-year-old patient presenting with short stature, delayed bone growth, and skeletal abnormalities since birth. The main symptoms include limb shortening, macrocephaly, and deformities in the limbs and thorax. The diagnosis of OPS was confirmed through clinical evaluation and molecular testing, which identified variants in the INPPL1 gene. Since birth, the patient has been monitored by a multidisciplinary team. Corrective surgery for genu varum was performed at 4 years and 10 months of age. The definitive diagnosis was obtained in 2019 through exome sequencing, which revealed pathogenic variants. Despite supportive interventions, no curative treatment is currently available.Final Considerations: Opsismodysplasia poses both diagnostic and therapeutic challenges, requiring continuous follow-up to manage symptoms and improve quality of life. A multidisciplinary team is essential for the management of this complex and lifelong condition.

Osteopenia após uso prolongado de acetato de medroxiprogesterona em paciente na menacme

2025-02-16T19:22:33+00:00

Objective: To report and compare contraceptive methods (progestogens), their types and routes of administration, relating them to the incidence of osteopenia. Case details: This is a case report of a 34-year-old patient, under follow-up due to NIC 2/3, with no risk factors for fractures, no comorbidities, and in prolonged use (14 years) of medroxyprogesterone acetate. Due to this fact, osteoporosis was investigated by means of bone densitometry. The densitometry revealed osteopenia, which is mainly due to hypoestrogenism caused by prolonged use of progesterone alone, thus causing a blockage in the axis, taking into account that estrogen has a protective effect on bone mass by inhibiting its reabsorption. Other risk factors also highlighted are lifestyle, such as a sedentary lifestyle and a copious diet. Final considerations: It is considered that the use of isolated progestogens, specifically injectable use, is a major risk factor for the development of osteoporosis. However, the same does not happen with oral progestogens or implants.

Takayasu Arteritis with infrarenal abdominal aorta involvement

2025-03-11T20:01:37+00:00

Objective: To report a case of Takayasu arteritis with infrarenal abdominal aortic stenosis in a smoking patient. Case report: A 52-year-old female patient presented with symptoms of intermittent claudication associated with pallor, absence of pulses in the lower limbs, and a 10 kg weight loss over two months. In 2018, angiography revealed infrarenal abdominal aortic stenosis, and the patient underwent abdominal aortic angioplasty with stent placement. In 2023, stenosis was observed in both the right and left common iliac arteries, and bilateral stent angioplasty was performed. The patient consulted a rheumatologist because intermittent claudication persisted, and after recurrence of the stenosis, she was diagnosed with TA in 2024. Final considerations: The reported case, along with the reviewed articles, discusses the course, therapeutic approach, and impact of TA. Early diagnosis and the use of advanced imaging modalities are essential for detecting vascular involvement and monitoring disease progression. When an appropriate and individualized therapeutic strategy is implemented, combined with lifestyle modifications, the prognosis is generally favorable for most patients.

Therapeutic effects of using medicinal Cannabis use in people with Autism Espectrum Disorder (ASD)

2025-01-04T11:20:21+00:00

Objective: Analyze the improvement of patients with Autism Spectrum Disorder (ASD) with Cannabis-based treatment. Methods: An integrative review was carried out in which the following databases were used: Biblioteca Virtual em Saúde (BVS), National Library of Medicine and National Institutes of Health (Pubmed), Web of Science, Cochrane, Scientific Electronic Library Online (Scielo), National Library of Medicine's (NLM) and EBSCO, selecting 22 articles in the end. Furthermore, the boolean operators “AND”, “OR” were used in research related to ASD and Cannabis. The inclusion criteria used were: articles published in the last 5 years, written in Portuguese, English and Spanish, published in scientific journals. Results: Cannabis-based treatment showed satisfactory results in the treatment of patients with ASD in the studies analyzed. Showing improvement in the main symptoms of the disorder, such as: sleep disturbances, difficulty in social interaction, dietary restrictions, behavioral crises and seizures. Final considerations: Analyzing the articles, it was possible to see that the use of Cannabis as a form of treatment in patients with ASD brought positive results. However, more studies with a longer follow-up period are needed to prove that the use of Cannabis is beneficial.

The effect of regular practice of physical activity in reducing postpartum depression

2025-01-04T12:07:04+00:00

Objective: Objective: To analyze the effect of regular physical activity on the reduction of postpartum depression (PPD). Methods: This is an integrative review conducted in the databases Virtual Health Library (VHL) and National Library of Medicine (PubMed). The descriptors "Depression, Postpartum" and "exercise" were used, using the Boolean operator "AND". Articles whose studies were of the type clinical trial, controlled clinical trial or observational study, in English, with full text and published in the last 5 years (2018-2023) were included. Results: Of the 19 articles selected, 12 found an inverse relationship between regular practice of physical activity and PPD. It has been shown that the practice of regular exercises throughout pregnancy and after delivery by pregnant and postpartum women decreased the incidence of PPD and reduced its symptomatology. 7 selected studies did not observe this relationship, however there were limitations such as decreased adherence to the proposed interventions and the possibility that pregnant women considered active were not sufficiently active in observational studies. Final considerations: It is considered that the practice of regular physical activity has an effective preventive and therapeutic effect in reducing PPD, constituting an effective and safe intervention in its management.

Analysis of the characteristics of acute viral bronchiolitis and bronchiolitis obliterans

2025-01-06T01:32:33+00:00

Objective: To analyze the characteristics of Acute Viral Bronchiolitis (AVB) and Bronchiolitis Obliterans (BO). Literature review: AVB is mainly caused by the respiratory syncytial virus, has a seasonal pattern of incidence, which was influenced by the Covid-19 pandemic. It can be caused by viral co-infections, which seems to require a longer period of hospitalization and the identification of serious cases has been facilitated with the use of bedside ultrasound. Treatment is supportive. BO is a chronic lung disease that affects the patient's quality of life; its pathogenesis is not fully known, which makes it difficult to develop an effective therapy. It can hinder the success of lung transplants and requires the patient and their caregivers to adapt their routine in order to guarantee the necessary support in the face of this irreversible condition. Final considerations: It is necessary to encourage more studies focused on these diseases. Furthermore, it is essential that health professionals have a good understanding of them, so that they can assist in managing the child and their guardians, taking into account their particularities.

The influence of physical exercise on the behavior of children with Autism Spectrum Disorder

2025-01-06T11:54:30+00:00

Objective: Explain the influence of physical exercise in functioning of children who suffer from autistic spectrum disorders (ASD). Methods: An integrative literature review has been carried out in renowned databases such as Pubmed, BVS and Web of Science and the key-words “Physical exercise”; “Autism”; “Children”; “Mental disorders” and the Boolean operator AND were used. Results: The performance of children with ASD without physical activities and the ones submitted to various different activities such as swimming and wrestling were throughly observed and compared. The references reinforced the benefits of exercise in various aspects such as cognitive, behavioral, in sleep and in movements in the children with ASD in the studies. Conclusion: The practice of physical activities is essential for a better functioning in children with ASD, which makes it a fundamental alternative resource to be used in the treatment of ASD.

An analysis of the clinical aspects of Celiac Disease

2025-01-06T01:20:58+00:00

Objective: Examine the characteristics of Celiac Disease (CD). Bibliographic review: CD is an autoimmune disease triggered by the ingestion of gluten protein by genetically susceptible individuals. The main manifestations are gastrointestinal symptoms such as diarrhea, abdominal pain, nausea, vomiting and chronic constipation. Chronic fatigue, deficiency anemia and neuropsychiatric symptoms are also common. Diagnosis should be made as early as possible to improve the quality of life of celiac patients and prevent complications. The effective treatment is the total elimination of gluten from the diet. There are other therapies, but they are used in cases of accidental ingestion of gluten. Final considerations: It is concluded that untreated CD causes great harm to the quality of life of patients and can lead to serious complications. It is extremely important that the diagnosis is made early and that the total elimination of gluten is implemented as soon as possible. In addition, psychological support and specialized nutritional monitoring are essential to promote adherence to the diet and improve the emotional well-being of individuals living with celiac disease.

Neuropalliative care: a review on palliative care for neurological patients

2025-01-10T15:59:00+00:00

Objective: To explore the practice of palliative care in neurological patients, focusing on the effectiveness of these interventions in improving quality of life and reducing suffering in the context of neurodegenerative diseases. Methods: A bibliographic search was conducted using the PubMed and Regional Portal of the Ministry of Health Virtual Library databases, employing the descriptors "Palliative Care", "Patient", "Nervous System Diseases", and "Terminal Care". We selected 26 articles that addressed various aspects of palliative care in neurological patients. Results: The analysis of the articles revealed a variety of outcomes, emphasizing the efficacy of palliative care in enhancing comfort and symptom management, particularly in patients with brain tumors and dementia. However, significant challenges were identified, including variations in the quality and accessibility of palliative care services, as well as cultural and educational barriers that affect their effective implementation. Final considerations: This review underscores the critical importance of palliative care in neurological patients, highlighting the need for targeted strategies to enhance healthcare professionals' education, promote early discussions on care planning, and strengthen support for family caregivers. Research investments are essential to adapt and validate approaches that maximize the benefits of palliative care.

Indications and benefits of hormone replacement therapy in menopause

2025-01-10T15:40:07+00:00

Objective: To analyze the indications and benefits of Hormone Replacement Therapy (HRT) during the climacteric period. Literature Review: Menopause marks the decline in female reproductive function, defined by the absence of menstruation for at least 12 months, retrospectively, which occurs due to primary ovarian insufficiency, generally between the ages of 45 and 55. In addition to increasing the risk of chronic conditions, such as cardiovascular disease, a lack of estrogen during this period is also associated with osteoporosis. This review's main objective is to analyze the indications and benefits of hormone replacement therapy in menopause. In this scenario, HRT constitutes an efficient approach for the management of vasomotor and genitourinary symptoms that occur at this stage, in addition to presenting benefits on the cardiovascular and bone health of women who are in the window of opportunity. Despite this, hormonal therapy may have contraindications, such as use in patients with a family history of breast and endometrial cancer, for example. Final Considerations: This therapy must be individualized, considering personal preferences and appropriate clinical indications, in order to maximize its benefits.

An analysis of the clinical aspects of Obstructive Sleep Apnea

2025-01-10T15:41:32+00:00

Objective: Explore the clinical features of Obstructive Sleep Apnea (OSA). Bibliographic review: OSA is a condition defined by the blockage of the airways during sleep, leading to episodes of apnea or hypopnea, which must last at least 10 seconds. These respiratory pauses cause intermittent hypoxia (IH) that generates several consequences in the body and corroborates the appearance of cardiovascular diseases and type 2 diabetes mellitus (T2DM). The main symptoms are persistent snoring and excessive daytime sleepiness (EDS), which directly affect the quality of life of the affected patient. The main risk factors are obesity and craniofacial anatomical abnormalities. Diagnosis is made by clinical data and polysomnography (PSG). The gold standard treatment is the use of a continuous positive airway pressure (CPAP) device, but its effectiveness depends on adherence. Final considerations: It can be considered that diagnosis and multidisciplinary treatment are essential for the adequate management of OSA with the aim of improving the well-being and quality of life of patients affected by this pathology.

The use of Barcelona anastomosis to avoid or reverse ostomies

2025-01-11T12:12:52+00:00

Objective: To evaluate the use of the Barcelona anastomosis technique, its risks and benefits, in order to avoid ostomies. Literature Review: Ostomies are surgical openings created in the abdomen to allow intestinal transit to continue to the external environment. It is necessary for the surgeon to correctly assess whether or not the use of ostomies is indicated and, when necessary, choose the most appropriate technique for the patient. Currently, ostomies still have a great psychological impact on the patient and prejudices on the part of society; these factors must be addressed prior to surgery and monitored by the healthcare team. From this perspective, the Barcelona anastomosis offers a lower risk of stenosis, fistula, and anastomotic dehiscence compared to ostomies. However, these patients must be selected carefully by professionals due to contraindications to the procedure. Final considerations: The Barcelona anastomosis, despite having a high risk of complications, appears to be an effective alternative, due to more effective healing and a lower risk of anastomotic strictures.

Clinical management and prognosis of diabetic gastroparesis

2025-01-11T12:15:27+00:00

Objective: To review the available literature on the clinical management and prognosis of diabetic gastroparesis. Methods: A literature review was conducted using the PubMed and Virtual Health Library (BVS) databases, covering studies published between 1995 and 2023, in English and Portuguese. Search terms included "diabetic gastroparesis," "management," "prognosis," and their variations. The review included observational studies, clinical trials, systematic reviews, and meta-analyses focusing on the clinical management and prognosis of patients with diabetic gastroparesis. Studies that did not specify diabetic etiology or that addressed other causes of gastroparesis were excluded. Results: The review identified that the management of diabetic gastroparesis involves a combination of dietary interventions, pharmacological therapies, and, in some cases, non-pharmacological treatments such as gastric electrical stimulation. Prognosis varies depending on disease severity, response to treatment, and the presence of associated complications. Final considerations: The management of diabetic gastroparesis is complex and requires a multidisciplinary approach. Early identification and appropriate treatment are essential to improve clinical outcomes and the quality of life of patients.

Analysis of music therapy as a pain tool in cancer patients care

2025-01-11T12:16:56+00:00

Objective: To analyze and consolidate the relevance of music therapy (MT) as a non-invasive adjuvant treatment for pain management in cancer patients. Methods: Its methodology was created with the help of the National Library of Medicine (PubMed) and the Virtual Health Library (VHL) platforms as databases used to constitute the bibliographic compilation of this literature review. The descriptors used were “Music therapy”, “Pain” and “Cancer”. The inclusion criteria were articles published in the last 10 years (2013-2023), free access and whose studies were controlled clinical trials, observational studies or case reports. Duplicate articles or those that were unrelated to the objective of the study were excluded. Results: Among the 22 articles selected in this study, 21 concluded great relevance in the use of music therapy for pain management through the promotion of physical and psychosocial benefits to cancer patients, while 1 of them did not demonstrate effective relevance in reducing pain. Final considerations: An important relevance of music therapy was observed in maintaining the quality of life of cancer patients when used as a non-invasive adjuvant treatment aimed at managing pain, since this is a common symptom that is difficult to control at different moments of treatment.

The practice of physical exercises and interference in the clinical manifestations of Parkinson's disease

2025-01-11T12:18:39+00:00

Objective: To identify evidence that the intervention of physical exercise in patients with diagnosed Parkinson's disease alleviates the clinical manifestations of the disease. Method: This is an integrative literature review that evaluates data from twenty-two studies from the National Library of Medicine, National Institutes of Health and Scientific Electronic Library Online and Literatura Latino-Americana e do Caribe em Ciências da Saúde databases. For this search, the selected descriptors were “intervention studies” and “Parkinson disease” and “physical exercise”, including full articles, in English and published from 2019 to 2024. Results: It was found, through the studies, that the The practice of physical exercise in patients with Parkinson's disease had a positive impact on the clinical manifestations of the disease, such as motor and cognitive aspects, and, in some cases, on the patient's quality of life. Conclusion: There is interference from physical exercise in Parkinson's disease, alleviating the symptoms. Finally, the main limitation was the heterogeneity of the types of exercises, which disperses the focus and in-depth studies.

Risks of using zolpidem to treat insomnia in the elderly and its therapeutic alternatives

2025-01-11T13:04:12+00:00

Objective: to analyze the risks of using zolpidem in the elderly and evaluate the existence of possible effective therapeutic alternatives. Methods: this is a qualitative, retrospective and cross-sectional approach, carried out through an integrative review of literature extracted from the databases: National Library of Medicine (PubMed) and the Virtual Health Library (VHL). The search was carried out using the descriptors “elderly”, “zolpidem” and “effects”, using the Boolean operator “AND”. Articles published in the last 5 years (2018-2023), full texts, of the controlled clinical trial type, were included. Duplicates and off-topic articles were excluded, resulting in 26 articles. Results: despite therapeutic efficacy, studies have demonstrated serious adverse effects in the use of zolpidem in the elderly, being related to higher rates of falls, fractures and daytime fatigue, which can cause dependence and an increased risk of suicide, when combined with opioids and benzodiazepines. Final considerations: it is considered that the use of zolpidem in the treatment of insomnia in the elderly should be discouraged, due to the serious adverse effects it can cause in this population, and another therapeutic alternative should be prioritized and, as a last resort, special caution should be exercised when using it in elderly.

Female sexuality and its associated factors based on the climacteric

2025-01-11T13:16:53+00:00

Objective: to evaluate how climacteric symptoms affect female sexuality and mental health. Methods: This is an integrative literature review, in which six stages of elaboration were followed. The guiding question was established by the PICo method and, to choose the articles, three different databases and the PRISMA method were used as a way to include and exclude literature. The research carried out identified 603 articles, of which 20 were included and analyzed in full. These are articles published between 2019 and 2024, with a predominance of cross-sectional studies. Results: female sexual dysfunction and sexual dissatisfaction, depression and negative feelings, relationship problems, negative sociocultural and individual beliefs about menopause and other effects were the main results found in the literature, and they are closely related to each other. Final considerations: it is concluded that there are complex effects of the climacteric on women, covering physical and psychological symptoms, highlighting the importance of multidisciplinary interventions, including hormonal therapy, psychological support, education on sexual health and physical activity. Although there are limitations and the need for more research, a comprehensive and sensitive approach to promoting women's health and well-being during this phase is crucial.

The impact of hormone replacement therapy on the cognitive health of postmenopausal women

2025-01-29T17:23:29+00:00

Objective: The goal of the present study was to analyze the impact of Hormone Replacement Therapy (HRT) on the cognitive health of postmenopausal women. Methods: For this purpose, a compilation of bibliographical research with a qualitative approach and descriptive character was used, through an integrative review of the literature in journals indexed in the Pubmed and LILACS databases. Results: The results demonstrated that HRT, when started during perimenopause or in initial period, is related to improvement in performance in several fields of the cognitive domain, especially regarding cognitive deficit, verbal fluency, memory and psychomotor speed, however, if used in the short and medium term. On the other hand, they highlighted possible negative impacts on already menopausal and elderly women. Final considerations: In this way, studies indicated a relationship between the cognitive health of postmenopausal women and HRT, which is beneficial when started early and possibly harmful when instituted late, with more studies needed to prove this relationship.

Management of opioid poisoning in the emergency department and methods of prevention

2025-01-29T17:28:26+00:00

Objective: To analyze the management and prevention of opioid intoxication syndrome in the emergency room. Literature review: Opioids are essential drugs in the treatment of moderate to severe pain and have a potent analgesic effect. Despite this, these drugs can cause some serious side effects that compromise the patient's general well-being. In addition, inappropriate prescription can generate chemical dependence and withdrawal syndrome. Naloxone was the most widely used drug to reverse opioid intoxication, which was developed in the 1960s and was the first opioid receptor antagonist to reduce the clinical symptom of induced respiratory depression, without producing receptor agonist effects. Final considerations: Naloxone is an effective drug for the management of opioid intoxication in the current drug treatment. Furthermore, the preoperative preventive approach is an efficient approach to avoid possible opioid intoxication resulting from the incorrect use, dependence or abuse of opioids formally prescribed by doctors.

Vaccine hesitation and refusal among healthcare professionals

2025-01-29T17:32:01+00:00

Objective: To analyze vaccine hesitancy and refusal among healthcare professionals. Methods: This is an integrative literature review with articles published between 2017 and 2023. The electronic databases PubMed and Scielo were used, using the following descriptors in English and Portuguese for the primary selection of articles: “ refusal to vaccination”, “health professionals”, “vaccination refusal”, hesitation, vaccination. Results: 8 articles were evaluated that met the proposed criteria. Studies carried out in Italy and Canada predominated. As for the year of publication, the years 2022 and 2019 together presented half of the studies analyzed in this review. cross-sectional analysis methodology, using a semi-structured questionnaire and interviews to obtain data. Final considerations: Health workers play an important role in carrying out actions in the promotion and acceptance of vaccines. However, they are also subject to vaccine hesitancy and refusal, especially after the advent of the Covid-19 pandemic, as they are the main public influencing decisions about immunization.

Efficacy of the use of anticoagulant therapy in the prevention of venous thrombosis in hospitalized patients

2025-02-04T10:40:49+00:00

Objective: To analyze the efficacy of anticoagulant therapy in preventing venous thrombosis in hospitalized patients, with an emphasis on reducing thromboembolic events and complications associated with treatment. Methods: This is an integrative literature review conducted through searches in the PubMED and BVS databases, using the descriptors “Anticoagulant”, “Thrombosis” and “Patient”, together with the Boolean operator “AND”. Articles published in the last 5 years, available in full and that met the research objective were included. Results: The study highlights the importance of individualizing the use of anticoagulants to prevent venous thrombosis in hospitalized patients, especially in risk groups such as the elderly and cancer patients. Therapies such as rivaroxaban, enoxaparin, mesoglycan and milvexian have varied efficacy and safety profiles, requiring adjustments according to the clinical condition. In patients with atrial fibrillation or undergoing invasive procedures, the choice between monotherapy and combination therapy should consider the risk of bleeding and the patient's profile. Final considerations: Prophylaxis and treatment of venous thrombosis are essential in clinical practice, requiring a careful and individualized choice of anticoagulants according to the profile and clinical context of each patient, aiming at the efficacy and safety of each drug.

Effects of aspirin use on the prevention of preeclampsia in high-risk pregnant women

2025-02-04T10:36:57+00:00

Objective: To evaluate the efficacy of prophylactic aspirin use in reducing the incidence of preeclampsia in high-risk pregnant women. Methods: This is an integrative literature review carried out through the PubMED, Virtual Health Library (VHL) and CAPES Periodical databases, using the descriptors: "Aspirin", "Effects", "Pre-Eclampsia", "Prevention" and obtaining the search truncation: (Effects) AND (Aspirin) AND (Prevention) AND (Pre-Eclampsia). A total of 1,122 articles were found, filtered according to inclusion criteria (Portuguese, English and Spanish; period from 2019 to 2024; full articles) and exclusion criteria (duplicate articles, abstracts, out of scope). Results: Aspirin is recommended to improve perinatal outcomes, especially when started between 11 and 16 weeks of gestation. However, adherence to treatment is low, affecting its effectiveness, with up to 50% of pregnant women not following the recommendations. Factors such as lack of information and concerns about adverse effects contribute to this resistance, and although aspirin has shown benefits, there are still challenges, such as resistance to treatment and variations in response. Final considerations: Prophylactic use of aspirin is effective in reducing preeclampsia in high-risk pregnant women. However, further studies are needed to optimize the use of aspirin and maximize its benefits.

The Efficiency of New Technologies in Valve Calcification Therapeutics

2025-02-05T20:26:09+00:00

Objective: To investigate how advances in the understanding of molecular mechanisms of valvular calcification can impact the development and efficacy of emerging therapies for the treatment of this condition, compared to traditional methods. Methods: An integrative literature review conducted in PubMed and the Virtual Health Library (VHL), focusing on articles published between 2019 and 2024. Relevant DeCS/MeSH descriptors such as calcification, RNA, valve calcification, and aortic valve calcification were used. Initially, 422 studies were identified and screened to include those addressing the molecular mechanisms of Aortic Valve Calcification (CAVD) and potential therapeutic interventions. Results: The analysis revealed significant advances with biomarkers such as cfDNA, IL-38, and microRNAs, as well as experimental therapies like vitamin K2, curcumin, and H₂S, which showed potential in inhibiting valvular calcification progression. Conclusions: New molecular therapies show promising results for treating valvular calcification. However, future studies should include larger and more diverse samples to validate their efficacy in different populations, thereby expanding the clinical applicability of these technologies.

Active learning methodologies in medical education

2025-02-05T20:26:56+00:00

Objective: To identify the tools used in active methodologies that help in Brazilian medical education. Methods: This is an integrative review, the search for articles was carried out in the CAPES, SciELO and LILACS databases. The search was carried out in April 2024. The Health Science Descriptors (DeCS) were: Students, Teaching-Learning, Teaching Material and Medical Education and their correspondents in English, with the combinations of Boolean operators AND and OR. The inclusion criteria were: publications in Portuguese and English, original studies of a primary nature, of open access, made available in full and published between 2019 and 2024. Results: After applying the criteria, 15 studies were selected. 4 main tools that help in learning were listed: problem-based learning, team-based learning, case study and simulation-based teaching. Final considerations: It was verified the effective application of the analyzed tools, and their aspects of influence, such as protagonism, motivation and the acquisition of knowledge by the students. Educational actions based on active methodologies consolidate the collective construction of knowledge by meaning, in which different situations of reality experienced are shared, democratizing opportunities, to ensure permanent education in health.

Exploring chronic traumatic encephalopathy in american football athletes

2025-02-05T20:30:37+00:00

Objective: To evaluate the main neurological disorders associated with chronic traumatic encephalopathy (CTE) and their relationship with the practice of American soccer. Methods: This is an integrative literature review, carried out in the Latin American and Caribbean Health Sciences Literature (LILACS), US National Library of Medicine (PubMed) and Web of Science databases, based on complete scientific articles published from 2019 to 2024, with free access in Portuguese and English. Ninety-six articles were found, of which 79 were excluded for not meeting the criteria, giving a total of 17 articles to be read and analyzed in full. Results: Based on the articles read, a similarity was observed between the neurological disorders generated by CTS observed in athletes, these being increased perivascular volume, Parkinsonism and recurrent headache. Final considerations: This review pointed out the main causes of the main complications cited as a result of CTE, exploring the position played by each player, the length of time they have been involved in American soccer and the occurrence of repetitive impacts on the head.

The relationship between the Covid-19 pandemic and health problems in patients with Obsessive-Compulsive Disorder and the emergence of new cases

2025-02-14T18:26:08+00:00

Objective: To understand the impact of the COVID-19 pandemic on the mental health of individuals with a focus on the development and worsening of Obsessive Compulsive Disorder (OCD). Methods: This is a integrative bibliographic review in which a five-year time frame was used, from August 2024 to 2019. Results: It was noted the worsening of compulsive behaviors and the increase in intrusive and irrational thoughts as a result of isolation, intensification of cleaning rituals and stress related to the fear of contracting the SARS-CoV-2 virus. Furthermore, the emergence of new dimensions of obsessions and compulsions associated with the anxiety levels of these patients in relation to the intensity of their fear of contracting the disease was observed. Final considerations: It can be concluded that individuals were seriously impacted by the stress, uncertainty and fear triggered by the interruption of normality, so that the development of anxiety disorders, such as obsessive compulsive disorder (OCD), were enhanced, it is essential to maintain psychological support, proactively offering support to vulnerable groups through alternative strategies, such as telemedicine and online therapy.

How self-medication with antibiotics impacts the gastrointestinal tract’s microbiome

2025-02-16T19:28:48+00:00

Objective: To clearly and objectively highlight the impacts of self-medication with antibiotics on the microbiota of the gastrointestinal tract. Methods: This article used randomized, open and multicenter studies with exposure of individuals to antibiotics and a placebo group with fecal analysis, cross-sectional and screening studies with analysis of the intestinal microbiome, by shotgun metagenomics, of individuals who underwent antimicrobial therapy and a sectional, epidemiological study and quantitative with interviews and application of questionnaires about self-medication and the use and knowledge of antibiotics in a given population. Results: Changes in the intestinal microbiota and treatments against infections, dysbiosis, impacts on the body's immune and inflammatory response, increased resistance of bacteria and changes in the structure of the microbiome were observed. Final considerations: It is concluded that self-medication with antibiotics is predominant in the population observed and studied. Furthermore, the consequences of this phenomenon reflect a lack of understanding about the self-administration of antimicrobials and their metabolic effects.

Drug and non-drug therapies in the management of severe COVID

2025-03-18T17:29:21+00:00

Objective: To bring together and analyze the main pharmacological and non-pharmacological methods used in the management of severe COVID-19 during the pandemic and discuss how it is recommended in the literature. Methods: This is an integrative review, with a search for articles carried out in the PUBMED and BVS databases. After applying two criteria of inclusion and exclusion, 13 articles were selected to carry out the study. Results: The results demonstrate benefits in the following therapies: dexamethasone, metoprolol, tocilizumabe, combined therapy with baracitinib, remdesevir and dexamethasone, Anankira, early and prolonged prone tracheostomy. The use of isolated remdesevir, low current volume ventilatory therapy facilitated by ECMO, use of the APRV ventilatory mode, use of aspirin and ruxolitinib are not favored by the treatment of the severe form of COVID-19. Final considerations: Despite two results obtained from this review, controversial findings could be observed, requiring further studies, considering the patient individually and new guidelines for COVID-19.

The physical and psychosocial effects of endometriosis on women's health

2025-03-18T17:44:27+00:00

Objective: To describe the main characteristics of endometriosis, discussing the impact on women's health and quality of life. Methods: This is an integrative bibliographic review which searched for articles in three different databases, PubMed, BVS, and Web of Science. Wherein, amongst 175 articles researched, 20 were selected to carry out the review, articles were excluded which fit the following criteria: articles outside the established temporality (time cut of 7 years [2018 to 2024]) of reviews, doctorate theses, master's dissertations and course completion works, which were not original, which did not address the research topic, duplicates, which were not freely accessible and which were not written in Portuguese or English. The Rayyan tool was used to select and separate the articles. Results: The consequences that affect quality of life were observed: intense pelvic pain, psychological symptoms, such as depression and anxiety, in addition to negatively interfering with interpersonal relationships, including identity and relationship problems. Final considerations: The way in which the disease interferes in women's health and the possible consequences of the symptoms presented by patients highlights the need for rapid and promiscuous diagnosis, a holistic approach and multidisciplinary treatment.

Analysis of the main current trends in the use of long-acting reversible contraception (LARC) methods by women of reproductive age

2025-03-18T17:51:33+00:00

Objective: To analyze current trends in the use of long-acting reversible contraception (LARC) by women of reproductive age, highlighting the benefits, challenges and factors that influence adherence. Methods: This study was developed through an integrative literature review. The search took place in the PubMed database, using the indexed descriptors “Long-Acting Reversible Contraceptives”, “Contraception”, “Intrauterine Device”, combined with the Boolean operator AND. Articles published in the last six years, in English or Portuguese, with free access were selected, excluding reviews and those without available translations. After screening, 22 articles were included for analysis and discussion. Results: LARCs have stood out for their high effectiveness, practicality and promotion of female autonomy. Their applicability is notable in adolescents, postpartum women and women with comorbidities. However, challenges remain, including the lack of public policies for professional training and the dissemination of information based on scientific evidence. Educational reports strengthen use, while unfounded fears generate resistance. Final Considerations: LARCs offer effective and sustainable contraception, reinforcing female autonomy. However, expanding access depends on structured initiatives that combat misinformation and promote professional training and information accessible to women.

El síndrome de DiGeorge y sus manifestaciones ecográficas prenatales

2025-03-18T18:26:44+00:00

Objetivo: Analizar el síndrome de DiGeorge y sus manifestaciones ecográficas prenatales. Revisión de la literatura: El síndrome de DiGeorge es una enfermedad genética autosómica dominante que resulta de la depleción del brazo largo del cromosoma 22 (22q11.2). Este síndrome afecta aproximadamente a 1 de cada 3.000 nacidos vivos y presenta signos y síntomas distintivos. Las manifestaciones más frecuentes incluyen malformaciones cardiacas, inmunodeficiencia debida a malformaciones tímicas, alteraciones craneofaciales, agenesia paratiroidea y anomalías laringotraqueales. La ecografía obstétrica es un método de bajo coste que ya está incluido en la rutina prenatal y puede ser útil para el diagnóstico precoz. El síndrome se sospecha principalmente cuando se detectan malformaciones cardiacas en el segundo trimestre, y la investigación genética está indicada con la prueba de análisis in situ de fluorescencia (FISH) para detectar la microdeleción del cromosoma 22. El tratamiento se basa en un apoyo multiprofesional, adaptado individualmente a los fenotipos presentados en cada individuo. Consideraciones finales: el síndrome de DiGeorge presenta múltiples fenotipos, por lo que el uso de tecnologías como la ecografía prenatal es viable como cribado inicial para pruebas más específicas como la FISH, con el objetivo de mejorar los resultados obstétricos y fetales. La realización de nuevos estudios para estandarizar los hallazgos del síndrome puede resultar útil para facilitar el cribado.

Mindfulness and stress reduction: an analysis of its influence on healthcare professionals

2025-03-18T18:30:37+00:00

Objective: To analyze the influence of Mindfulness on stress reduction among healthcare professionals. Methods: Integrative review, in the databases Virtual Health Library (BVS) and National Library of Medicine and National Institutes of Health (PubMed). The search was realized in august 2024. The descriptors in health sciences (DeCS) were: “Mindfulness,” “Healthcare workers,” and the keyword “Stress,” combined with the Boolean operator “AND”. The inclusion criteria were: articles published between 2019 and 2024, articles written in Portuguese, articles written in English, articles published in journals, and original articles. Results: This study was conducted through the analysis of 16 articles on the influence of mindfulness in reducing stress among healthcare professionals. The results obtained are presented in Table 1 and demonstrate that mindfulness programs helped healthcare professionals cope with workplace stress, facilitating clinical practices, fostering calm, focus, and acceptance of limitations, while increasing compassion and attention to patients. Conclusion: Based on the studies, it was evident that mindfulness has a positive and significant influence on stress reduction among healthcare professionals.

The impact of diuretic resistance on the Treatment of congestive heart failure

2025-03-18T19:35:58+00:00

Objective: To evaluate the impact of the development of diuretics resistance in their use for the treatment of congestive heart failure, its etiology, how to foresee it and evade it. Methods: integrative review, which selected 20 publications from international databases such as Scopus and PubMed. The included articles were analyzed based on relevance and methodological quality criteria. The research covered studies published until 2024, providing a comprehensive overview of the investigated topic. Results: The chosen articles contemplate studies from diverse countries, all of which point to the possible pharmacological measures in the management of diuretic resistance, especially and gravely ill patients. The integration of these studies collaborates for the creation of new procedures considering the possible benefits of alterations: in the administration routes and of possible drug interactions of certain classes of diuretics. Final considerations: These studies are an excellent assistance for the differential treatment, while still existing the need of further studies to amplify the knowledge about possible mechanisms that could lead to this condition, such as self-medicating.