Revista Eletrônica Acervo Médico

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

Wed, 29 Jan 2025 00:00:00 +0000

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

Wed, 29 Jan 2025 00:00:00 +0000

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

Sun, 16 Feb 2025 19:32:00 +0000

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

Ana Santos Rocha, Natalia Barreto e Sousa — Tue, 18 Mar 2025 18:28:05 +0000

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.

Impact of nicotinic electronic devices for smoking on lung capacity

Fri, 11 Apr 2025 11:22:56 +0000

Objective: To analyze the systemic effects on users of electronic smoking devices. Methods: This is a integrative literature review, with a qualitative approach, using a five-year time frame, from 2020 to 2024. The study design was integrated by applying the PICO strategy (acronym for P: population/patients; I: intervention; C: comparison/control; O: outcome) to guide data collection. The PICO strategy is a mnemonic that helps identify key topics where P: users of electronic smoking devices; I: Use of electronic smoking devices; C: Comparison with healthy individuals; O: Analyze the pulmonary effects of electronic smoking device users. Results: The increase in the use of electronic nicotine delivery systems (ENDS), such as e-cigarettes and heated tobacco, raises concerns about respiratory effects. Despite being promoted as safer alternatives, evidence shows that ENDS are associated with acute and chronic lung injuries, such as EVALI; in addition to decreasing lung capacity, causing cytotoxicity of e-liquids and inducing inflammatory responses. These adverse impacts affect respiratory function in the short and long term. Final considerations: We hope to fosternew studies on the topic, expanding investigations into the impacts of electronic smoking devices and encouraging research that clarifies the pathophysiological mechanisms, in addition to assisting in the formulation of public policies and awareness strategies.

Cervical cancer associated with human papilomavírus

Fri, 11 Apr 2025 21:39:07 +0000

Objective: to analyze the incidence of cervical cancer in women vaccinated against HPV, in order to evaluate the effectiveness of the vaccine in preventing this disease Methods: quantitative study, of an exploratory and longitudinal nature, 100 women participated. Data collection was carried out through virtual questionnaires, in which participants provided information about their vaccination history and health status, allowing a detailed analysis of the impact of the vaccine on preventing cervical cancer. Results: it is concluded that awareness about the effectiveness of the HPV vaccine is crucial for women's health, as it plays an important role in preventing cervical cancer. However, current studies have not conclusively proven the relationship between vaccination and the reduction in cancer incidence, highlighting the need for more research to establish this correlation with greater precision. Conclusion: The HPV vaccine is essential to prevent cervical cancer, but more research is needed to establish a clear relationship between vaccination and reducing the risk of developing cancer, in order to ensure proof of its effectiveness

Interference of palliative care and physical activities on the quality of life of people with Multiple Sclerosis

Fri, 02 May 2025 16:33:25 +0000

Objetivo: Evaluar diferentes vías de tratamiento y seguimiento, que permitan mejorar la calidad de vida en pacientes diagnosticados con Esclerosis Múltiple. Métodos: Se trata de una investigación de revisión bibliográfica integrativa con enfoque cualitativo, con un horizonte temporal de cinco años, desde 2019 hasta agosto de 2024. El diseño del estudio, una investigación no clínica, se integró aplicando la estrategia PICO. Para la elaboración de los resultados se evaluó: Ubicación, Base de Datos/Revista, Autor(es) del artículo/Año, objetivo, Nivel de Evidencia. Resultados: Mejora significativa en el rendimiento y confort de los pacientes con Esclerosis Múltiple, tanto mediante el aumento de la frecuencia de los ejercicios físicos como mediante la adopción de cuidados paliativos, con el fin de aliviar los síntomas y permitir una mejor calidad. de vida para el paciente y su familia. Consideraciones finales: Estudios recientes destacan avances en el tratamiento de la esclerosis múltiple (EM), con enfoque en el entrenamiento físico y los cuidados paliativos. Sin embargo, la adherencia a los programas de rehabilitación es un desafío y falta información sobre sus beneficios.

A general approach to gestational diabetes mellitus

Carla Coelli Cardoso, Mayra Beatriz Sousa dos Santos, Natália Barreto e Sousa — Fri, 02 May 2025 17:22:16 +0000

Objective: Describe the characteristics of Gestational Diabetes Mellitus (GDM). Bibliographic review: GDM is defined as glucose intolerance diagnosed during pregnancy. The main risk factors include advanced maternal age, obesity, poor eating habits and a sedentary lifestyle. In Brazil, approximately 18% of pregnancies have GDM. This condition can cause complications in the mother, such as adverse birth conditions and an increased risk of metabolic and cardiovascular diseases. For the baby, it can cause macrosomia, neonatal hypoglycemia and a risk of developing obesity and diabetes mellitus later in life. The main treatment is lifestyle changes, with the implementation of an appropriate diet, regular exercise and avoiding excessive weight gain during pregnancy. If glycemic goals are not achieved, pharmacological therapy with insulin or metformin can be instituted. Final considerations: It is concluded that recognizing GDM is essential because it is a condition that can cause both maternal and fetal complications. Strategies such as nutritional education and psychological support are essential for adherence to treatment and its success.

Trends and psychosocial factors of work-related absences due to mental and behavioral disorders in Brazil (2015-2024)

Magno Muniz dos Santos — Tue, 27 May 2025 12:49:43 +0000

Objective: To analyze the mental health scenario in the Brazilian workplace, focusing on absences due to mental and behavioral disorders and their psychosocial and organizational factors. Methods: A quali-quantitative approach was adopted, employing documentary and bibliographic analysis. Data were collected from the INSS (2015–2024) through the Observatory of Occupational Safety and Health (administered by SmartLab), reports from the World Health Organization, International Labour Organization, and ADP Research Institute. Articles from SciELO and BVS databases were also used for the analysis and discussion of the collected data. Results: Between 2015 and 2024, 2.44 million work-related absences were recorded, with anxiety disorders (27.4%) and depressive disorders (25.6%) as the primary causes. The most affected sectors were public administration and banking in general. The main psychosocial factors related to these absences were moral harassment (reported by 42% of workers), labor precarization, and chronic stress, which intensified mental health disorders. The lack of organizational support and the "uberization" of work further aggravated this scenario. Conclusion: The study highlights precarization and harassment as key drivers of mental health disorders. Brazil has made progress in addressing this issue, notably with the update of NR-1 by the Ministry of Labor and Employment, but significant limitations remain in its practical implementation.

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

Wed, 05 Feb 2025 20:19:51 +0000

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

Sun, 16 Feb 2025 19:20:02 +0000

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

Tue, 11 Mar 2025 20:00:17 +0000

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.

Clinical management of grade IV renal injury with contralateral renal agenesis

Wed, 09 Apr 2025 15:46:35 +0000

Objective: To report a case of successful clinical management of a patient with grade IV renal injury and contralateral renal agenesis, highlighting the effectiveness of the conservative approach in preserving renal function. Case details: Male patient, 22 years old, victim of a car accident, arrived at the emergency room with signs of abdominal trauma, pain in the left flank, tachycardia and hypotension. He was stabilized with serum therapy and underwent indwelling bladder catheterization, which revealed macroscopic hematuria. Imaging tests confirmed grade IV renal injury in the left kidney and congenital absence of the right kidney. Given hemodynamic stability, conservative treatment was chosen, with admission to an intensive care unit for strict monitoring. The patient presented a favorable evolution, being discharged from hospital after 15 days. Within 30 days, a new urotomography demonstrated complete renal healing. Final considerations: Severe kidney trauma can result in severe complications, such as kidney failure and hypovolemic shock. Management depends on hemodynamic stability and tomographic evaluation. In hemodynamically stable patients, conservative treatment has been shown to be effective in preserving renal function. This case reinforces the importance of an individualized, non-surgical approach to reduce risks and ensure a better quality of life for the patient.

Childhood leprosy

Fri, 11 Apr 2025 12:26:26 +0000

Objective: To present a case of multibacillary (MB) childhood leprosy, emphasizing the importance of its treatment and longitudinal care. Case Details: A 10-year-old male patient with MB leprosy of the Virchowian type, presenting with skin patches and nodules. The diagnosis was confirmed after a positive bacilloscopy result. Multidrug therapy (MDT) was initiated, which successfully interrupted disease transmission. However, the patient developed a type 2 leprosy reaction and was prescribed Thalidomide and Prednisolone. Adverse reactions, including edema and fever, occurred, requiring medication adjustments and close medical follow-up. The patient now engages in normal daily activities and is awaiting dermatological care to address skin discoloration. Final Considerations: Leprosy is a chronic infectious disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. It is classified as Paucibacillary (PB) or Multibacillary (MB). Common symptoms include skin lesions and patches, reduced sensitivity, numbness, tingling, lumps and plaques, and decreased muscle strength. The most frequent mode of transmission is through saliva droplets expelled during speaking, coughing, or sneezing, in close and frequent contact with untreated patients. A less common form of transmission occurs via armadillos, which can act as reservoirs and transmit the bacteria.

Fetal acardia in monochorionic-diamniotic twin pregnancy

Fri, 11 Apr 2025 12:31:25 +0000

Objective: Report the case of a patient with monochorionic and diamniotic pregnancy, diagnosed with an acardiac fetus, treated in a city in the interior of São Paulo, scientifically reviewing the subject, including clinical presentation, diagnosis and therapy. Case detail: Female patient, 19 years old, healthy, low maternal weight, no relevant family history, second-pregnant with a previous spontaneous abortion, resident in the interior of São Paulo. She was diagnosed with monochorionic diamniotic twins and, later, with reverse twin arterial perfusion sequence and, consequently, fetal malformation because an acardiac fetus. The pregnancy was monitored in high-risk prenatal care and the resolution occurred at 33 weeks of gestation due to preterm labor. It gave rise to an acardiac fetus, dead, and another fetus without malformations, referred to the care of pediatrics. Final considerations: Acardiac pregnancy is a rare phenomenon that occurs in 1% of monochorionic twin pregnancies. Due to the vascular alterations of TRAPS, the donor fetus may present a reduction in circulating blood volume and increased cardiac effort. Early ultrasound plays a crucial function in the diagnosis and monitoring of these conditions, allowing timely interventions when necessary.

Gravidez gemelar e a relação entre cordão umbilical de dois vasos com hipoplasia do coração esquerdo e atresia esofágica

Fri, 11 Apr 2025 20:07:50 +0000

Objective: To report a dichorionic diamniotic twin pregnancy with intrauterine growth restriction (IUGR) in both fetuses, emphasizing the relationship between a two-vessel umbilical cord in one of the twins and its congenital anomalies, such as hypoplastic left heart syndrome (HLHS) and esophageal atresia. Case details: This is a dichorionic diamniotic pregnancy case in which one twin’s umbilical cord had only one artery (single umbilical artery, SUA) and its impacts, as this fetus presented with HLHS, among other conditions. Case report drawn from Texas Children’s Hospital and Materno Infantil Hospital from Goiânia/GO. Fetus 1 was born healthy, while Fetus 2 presented multiple anomalies, including HLHS, esophageal atresia and a single umbilical artery. If left untreated, HLHS leads to high mortality within the first months of life, whereas esophageal atresia may cause serious complications, such as asphyxia and pneumonia. Final considerations: Early diagnosis, by fetal echocardiography and Doppler, proved to be crucial for appropriate management and better neonatal outcomes, as well as the multidisciplinary approach in handling the case.

The use of manual intrauterine aspiration in ectopic pregnancy located in a cesarean section scar

Fri, 11 Apr 2025 21:42:48 +0000

Objective: To report the case of a patient submitted to the use of manual intrauterine aspiration (MVA) in an ectopic pregnancy with a cesarean section scar as an alternative conservative treatment. Case details: Female patient, 31 years old, pregnant, G5P3A1C1, presented with an ectopic pregnancy implanted in a cesarean section scar, without criteria that would allow the use of methotrexate. To avoid hysterectomy for a patient who still wanted to preserve fertility, conservative treatment was chosen, with the use of MVA guided by transvaginal and pelvic ultrasound, with in hysterectomy, which compromises the reproductive desire of many patients of fertile age, in addition to causing complications inherent to the surgical procedure. Treatment involving the use of resolution of the condition. Final considerations: Ectopic pregnancy in a cesarean section is a serious diagnosis, which can lead to uterine rupture and hemorrhages and, therefore, often results a less invasive procedure, such as intrauterine manual aspiration, allowed the preservation of reproductive desire, faster and better recovery for the patient, and may prove to be an interesting alternative for such cases.

Thrombolysis of thrombus inside the right atrium in transit to the right ventricle associated with pulmonary thromboembolism in an unstable patient

Fri, 02 May 2025 16:25:54 +0000

Objective: To report the case of a patient with deep vein thrombosis and pulmonary thromboembolism who, after presenting syncope and clinical instability, was successfully treated by thrombolysis with alteplase, resulting in significant improvement within 72 hours. Case details: Male patient, 32 years old, obese, suffered trauma to the right lower limb in a car accident, developing DVT and was treated with rivaroxaban for 6 months. After a month, with the anticoagulant being discontinued, the patient had an episode of syncope and was taken to the health service in clear instability. The echocardiogram showed a thrombus in transit in the right atrium, right ventricular dysfunction and PTE. After thrombolysis with alteplase, there was satisfactory clinical and hemodynamic improvement. The post-thrombolysis echocardiogram highlighted the absence of thrombi and improvement in cardiac function. The patient was then discharged after a week and remained under outpatient follow-up. Final considerations: The early discovery of PTE with thrombus in transit is essential for adequate treatment, and chemical thrombolysis resulted in significant effectiveness, with adequate recovery and improvement in clinical parameters.

Renal Tuberculosis

Gabriela de Lima Alves, Halita Vieira Gallindo Vasconcelos — Tue, 27 May 2025 13:09:39 +0000

Objective: Report a case of Renal Tuberculosis, an infectious disease caused by the bacterium Mycobacterium tuberculosis. Case details: Information was collected based on the carrier's physical and electronic records, following appropriate guidelines. The patient, who already suffered from chronic kidney disease and had been undergoing renal replacement therapy for two years, was admitted in December 2022 and was diagnosed with renal tuberculosis. Final considerations: Extrapulmonary tuberculosis, including genitourinary tract involvement, is reported in about 15% of tuberculosis cases. Clinical manifestations can be varied and not necessarily preceded by typical pulmonary symptoms. Diagnosis is often challenging and delayed, leading to permanent damage. In this case, the patient had chronic kidney disease and developed renal tuberculosis, emphasizing the importance of recognizing this atypical form of the disease and early diagnosis for the appropriate treatment and management of patients with extrapulmonary tuberculosis

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

Sat, 04 Jan 2025 03:21:24 +0000

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

Sat, 04 Jan 2025 12:00:31 +0000

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

Isadora Rosa Telles, Claudio Eduardo Aguiar Moreira, Ramon Fraga de Souza Lima — Mon, 06 Jan 2025 00:32:15 +0000

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

Mon, 06 Jan 2025 00:45:17 +0000

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

João Pedro Carvalho Neves, Helcio Serpa de Figueiredo Júnior — Mon, 06 Jan 2025 00:58:51 +0000

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

Natália Barreto e Sousa, Jaqueline Benedito dos Santos — Fri, 10 Jan 2025 13:43:07 +0000

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

Fri, 10 Jan 2025 13:45:04 +0000

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

Raniellen Carvalho de Medeiros, Natália Barreto e Sousa — Fri, 10 Jan 2025 15:29:50 +0000

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

Sat, 11 Jan 2025 12:01:10 +0000

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

Sat, 11 Jan 2025 12:01:33 +0000

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

Sat, 11 Jan 2025 12:01:56 +0000

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

Sat, 11 Jan 2025 12:02:22 +0000

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

Sat, 11 Jan 2025 12:02:42 +0000

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

Sat, 11 Jan 2025 12:03:12 +0000

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

Wed, 29 Jan 2025 00:00:00 +0000

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

Wed, 29 Jan 2025 00:00:00 +0000

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

Wed, 29 Jan 2025 00:00:00 +0000

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

Tue, 04 Feb 2025 10:32:52 +0000

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

Tue, 04 Feb 2025 10:36:56 +0000

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

Wed, 05 Feb 2025 19:51:19 +0000

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

Wed, 05 Feb 2025 20:10:50 +0000

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

Wed, 05 Feb 2025 20:20:07 +0000

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

Fri, 14 Feb 2025 13:35:40 +0000

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

Sun, 16 Feb 2025 19:22:56 +0000

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

Thiago de Amorim Ferreira, Emílio Conceição de Siqueira — Tue, 18 Mar 2025 16:57:47 +0000

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

Tue, 18 Mar 2025 17:40:41 +0000

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

Tue, 18 Mar 2025 17:45:03 +0000

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

Tue, 18 Mar 2025 18:00:18 +0000

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

Tue, 18 Mar 2025 18:28:36 +0000

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

Tue, 18 Mar 2025 19:34:06 +0000

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.

The neurotoxic effects resulting from treatment with CAR-T cells in hematologic cancers

Wed, 09 Apr 2025 17:36:17 +0000

Objective: To define the clinical picture of neurological events associated with CAR-T cell therapy and which approaches are effective for control, in order to ensure greater safety and to disseminate its use as a prototype for future treatments of solid and brain tumors. Methods: This article was an integrative review of controlled clinical trials, whose data were collected in the virtual databases: Medline and PubMed, in the period from April to May 2024. Results: Of the 35 articles selected, only 3 did not report the presence of neurological effects with the use of CAR-T cell therapy. Furthermore, most patients who underwent the therapy had complete remission, emphasizing the therapeutic efficacy against severe and refractory hematological cancers. Final considerations: The literature provides a divergent conclusion, without stating whether administration of smaller doses or the overall activity of the CAR-T product can vary the level of toxicity. However, there is no doubt that impairment of consciousness and focal deficit were evident in many cases after infusion of modified T cells, with most being treatable only with symptomatic treatment.

Evaluation of the use of complementary therapies in the treatment of depression in primary health care

Fri, 11 Apr 2025 10:47:47 +0000

Objective: Evaluate the use of complementary therapies in the treatment of depression in Primary Health Care. Methods: This is an integrative literature review, based on scientific studies, in English and Portuguese, published in virtual databases Library Virtual Health (VHL) and Scientific Electronic Library Online (Scielo), which addressed the effectiveness of complementary therapies in the treatment of depression. Results: The results found suggest that complementary therapies can be effective in reducing depressive symptoms and promoting general well-being. However, there is consensus on the need for more high-quality studies and adequate training of professionals to integrate these practices more effectively into Primary Health Care. Furthermore, such therapies are seen as a viable and low-cost alternative, but face significant barriers related to infrastructure and their formal recognition in healthcare. Final considerations: The use of complementary therapies has proven its effectiveness as adjuvants in the treatment of depression, recommending them to reduce depressive symptoms and as aids in reducing the side effects of antidepressants.

The psychosocial impacts of epidermolysis bullosa on quality of life

Fri, 11 Apr 2025 10:56:08 +0000

Objective: To assess the psychosocial impact of epidermolysis bullosa on the quality of life of individuals with the disease and their parents and caregivers. Methods: It is an integrative literature review, in which the guiding question was: “What are the psychosocial impacts of epidermolysis bullosa on quality of life?”. The bibliographic search was carried out in theNational Library of Medicine (PubMed/MEDLINE), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Science Literature (LILACS) and Web of Science databases, using the descriptors “Epidermolysis Bullosa”, “Psychosocial Impact” and “Quality of Life”. Thirteen articles were selected between 2017 and 2024. Results: The psychosocial impacts of epidermolysis bullosa on quality of life were observed in three aspects.In terms of social interactions, the isolation of those with the disease was noted, due to the difficulty in carrying out daily activities.As a psychological burden, there were feelings of guilt, helplessness and physical and emotional exhaustion among parents and discomfort and embarrassment among sufferers. In terms of socio-professional dynamics, most of the parents gave up their jobs, while the patients faced challenges in gaining employment. Final considerations: Epidermolysis bullosa is responsible for various negative psychosocial impacts on quality of life, both at an individual level and within the family unit.

The use of nanotechnology in the diagnosis and treatment of cancer and the impact on the patient's life

Fri, 11 Apr 2025 10:59:19 +0000

Objective: To analyze how nanotechnology has contributed to the diagnosis and treatment of cancer. Methods: A methodological approach to this work carried out an elaboration of clinical trials, planned and unplanned through an integrative review of the literature in the PubMed and Virtual Health Library databases. The descriptors used were “nanotechnology”, “neoplasms”, “nanoparticles” and “nanomedicine”. The inclusion criteria were observational studies and controlled clinical trials, published in English, between 2019 and September 2024. Results: The results surprisingly demonstrate that the Ayurvedic medicine NSB (Nano Swarna Bhasma) has significant therapeutic efficacy as reflected in its ability to control/ reduce tumor volumes by more than 80% (during 60 days of treatment; compared to control groups). Final considerations: The improvement in quality of life and increased free survival in patients who used the treatment route added with nanoparticles became evident and, regarding diagnoses, we brought together methods that, with the use of nanotechnology, became notorious. efficiency and specificity when compared with conventional oncological exams.

Challenges for adherence to cervical cancer screening programs for vulnerable brazilian women

Fri, 11 Apr 2025 00:00:00 +0000

Objective: To describe the challenges to adherence to cervical cancer screening programs for Brazilian women in situations of social vulnerability. Methods: This is an integrative literature review, focusing on articles published between 2019 and 2024. The guiding question was: “What are the main challenges to adherence to cervical cancer screening programs among women in situations of social vulnerability?” The bibliographic search was conducted using the Latin American and Caribbean Health Sciences Literature (LILACS) and Scientific Electronic Library Online (SciELO) databases, with the Health Sciences Descriptors (DeCS): cancer, cervix, screening, vulnerability, and Boolean operators “AND” and “OR”. Results: The main factors related to adherence to cervical cancer screening programs include emotional, social, geographical, and health-related challenges, as well as structural challenges within the Basic Health Unit. Additionally, opportunistic screening creates inequalities, with some women being over-screened and others never undergoing the exam, wasting resources that could be better allocated. Final considerations: The challenges encountered in carrying out the Pap smear emphasize the importance of disseminating information about the exam and ensuring comprehensive, longitudinal care for the population.

The efficacy of bacteriophage use in multidrug-resistant bacterial infections

Fri, 11 Apr 2025 11:15:01 +0000

Objective: To investigate the efficacy of bacteriophages against ultra-resistant bacteria. Methods: The Scopus, U.S. National Library of Medicine National Institutes of Health (PubMed), and Latin American and Caribbean Health Sciences Literature (LILACS) databases were searched. Descriptors “bacterial infections OR bacteria Infections” AND “phage therapy OR phage therapy” AND “antibacterials OR antibacterial agents” AND “treatment result OR treatment result” NOT “review OR review”. Original articles published in Portuguese or English in the last 3 years were selected. A total of 1,072 articles were found, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) methodology. Results: Study of 17 articles on the effectiveness of bacteriophage therapy in antioxidant microorganisms. The following were highlighted: article code, author, year of publication, type of study, intervention, and main development. Categorization into groups: ineffectiveness of treatment, effectiveness with bacteriophages alone, and effectiveness with bacteriophages in synergy with antibiotics, indicating that the latter group is more effective than the other two. Final considerations: The use of phage therapy may be a promising alternative for bacterial infections, so there is a need for research to better understand the mechanisms of action of bacteriophages and improve their clinical use.

Correlation between the development of insulin resistance and Polycystic Ovary Syndrome and its therapeutic conduct

Fri, 11 Apr 2025 12:27:05 +0000

Objective: To analyze the association between Polycystic Ovary Syndrome (PCOS) with the development of insulin resistance (IR), including the types of treatments involved. Methods: This consists of an integrative literature review conducted in September 2024, using the National Library of Medicine and National Institutes of Health (PubMed) and Biblioteca Virtual de Saúde (BVS) databases. The descriptors used, based on the Descritores em Ciências da Saúde (DeCS), were “polycystic ovary syndrome” and “insulin resistance,” combined with the Boolean operator AND. Systematic reviews, meta-analyses, and literature reviews were excluded, and studies freely available, published between 2019 and 2024, were included. Results: This article was developed based on the analysis of 15 studies addressing the correlation between PCOS and insulin resistance, including the necessary interventions for these conditions. The findings are presented in Tables 1 and 2, which includes the authors and the main findings. Conclusions: Based on the analysis of the studies, it can be concluded that women with PCOS have a higher tendency of developing IR, and there are treatments that can attenuate these outcomes.

Problematic Internet use for the mental health of children and adolescentes

Fri, 11 Apr 2025 12:27:28 +0000

Objective: To analyze the effects of problematic internet use (PIU) on the mental health of children and adolescents. Methods: An integrative literature review was carried out using the following databases: PUBMED and BVS and the following descriptors: “Problematic Internet use” AND “Mental health” “Children” AND “Adolescents” NOT “COVID-19”. In the end, 19 articles were selected for the study with the help of the Rayyan platform. The inclusion criteria used were: articles published in the last 5 years, written in Portuguese, English and Spanish, published in scientific journals. Results: PIU is related to symptoms of low self-esteem, daily stress, low quality of life and sleep in children and adolescents. Final considerations: By analyzing the articles, it was possible to see the negative impacts of PIU on the lives of children and adolescents. Therefore, preventive measures should be taken both at home and in schools, so that PIU does not cause greater harm.

Efficacy of viscosupplementation in hip osteoarthritis

Fri, 11 Apr 2025 12:31:02 +0000

Objective: To analyze whether viscosupplementation is truly effective in treating symptoms of hip osteoarthritis. Methods: This is an integrative literature review, conducted through the analysis of original articles found in the PubMed Central (PMC), Virtual Health Library (VHL) and Scientific Electronic Library Online (SciELO) databases using the combination of the descriptors: “Viscosupplementation,” “Osteoarthritis,” “Hyaluronic Acid,” and “Hip” with the boolean operator “AND.” Inclusion criteria included studies published in English, Portuguese, and Spanish in the past five years, with open access. Incomplete and duplicate studies were excluded. Results: The results of this review indicated that, overall, viscosupplementation with hyaluronic acid is indeed effective in treating symptoms caused by osteoarthritis, such as pain and joint function. Additionally, no adverse events or infections were reported. However, it is important to note that this type of treatment does not address the underlying cause of joint destruction, serving instead as symptomatic relief. Final considerations: Viscosupplementation has proven to be an effective and promising procedure for the treatment of osteoarthritis. Therefore, it is crucial for healthcare professionals to have mastery and continuous updates on this topic.

Use of methylphenidate by children and adolescents with ADHD: therapeutic and adverse effects

Júlia Beatriz Carvalho Manarin, Renata David — Fri, 11 Apr 2025 12:33:12 +0000

Objective: To determine the use of methylphenidate by children and adolescents diagnosed with ADHD, establishing its therapeutic effects and potential adverse effects, as well as the criteria used in the medical decision to prescribe the drug to young people. Methods: Integrative literature review in the Lilacs, Scielo and PubMed databases of studies published between 2013 and 2022. The descriptors “Attention Deficit Hyperactivity Disorder”, “Methylphenidate” and “ADHD” were used. Results: The final sample consisted of 14 articles, which addressed the benefit of the drug mainly in cognitive functions and several adverse effects, such as insomnia, anxiety, headache, growth suppression, gastrointestinal and cardiovascular events and psychotic symptoms. There was no evidence of a guideline that would assist in the decision to prescribe the drug. Final considerations: The undesirable effects of methylphenidate were well established and studied in depth in the sample studies, while the benefits and repercussions on social interactions were not studied in such depth, which could be an obstacle to an ethical medical prescription.

Impact of cognitive-behavioral therapy on the management of chronic insomnia

Fri, 11 Apr 2025 12:33:52 +0000

Objective: To investigate the effects of cognitive-behavioral therapy in the management of chronic insomnia, focusing on improving sleep quality and reducing associated symptoms. Methods: This is an integrative literature review conducted through searches in the PubMED, CAPES and BVS databases, using the descriptors “Cognitive Behavioral Therapy”, “Health Impact” and “Chronic Insomnia”, together with the Boolean operator “AND”. Nineteen articles that met the research objective were selected. Results: Chronic insomnia affects a large part of the population, compromising quality of life and mental health. Cognitive-behavioral therapy for insomnia (CBT-I) has stood out as an effective non-pharmacological alternative, reducing symptoms and improving sleep, and its digital versions have been studied as viable alternatives, offering promising results. Studies have shown a reduction of up to 50% in the severity of insomnia, improvements in sleep quality and decreased use of medications. CBT-I is effective but faces challenges of access and shortage of therapists. Final considerations: The review demonstrated the effectiveness of CBT-I in the treatment of chronic insomnia, outperforming pharmacological approaches, and highlighted strategies such as cultural adaptation and digital platforms to amplify its impact.

How has the lockdown affected people with ASD and their families during the COVID-19 pandemic

Íris Salles Gonçalves Pereira Nunes, Hélcio Serpa de Figueiredo Junior — Fri, 11 Apr 2025 21:39:28 +0000

Objective: To assess the response of individuals with Autism Spectrum Disorder (ASD) and their families to social isolation during the pandemic. Methods: This study adopted an integrative literature review approach, thoroughly examining scientific articles published from 2020 to 2022. Following a meticulous selection process based on stringent inclusion and exclusion criteria, and culminating in an analytical procedure, 20 articles were identified and preserved out of the initially considered 244. Results: After a detailed analysis of the selected corpus, it was concluded that the period of home confinement resulting from the COVID-19 pandemic had a challenging impact on all evaluated individuals, with a more pronounced incidence of distress observed among those with Autism Spectrum Disorder (ASD) and their respective families and caregivers. Final considerations: The assessment highlighted that home isolation during the COVID-19 pandemic posed a challenging impact for individuals with Autism Spectrum Disorder (ASD) and their families.

The impact of social conditions on preventing overweight and obesity in children and adolescentes

Fri, 11 Apr 2025 00:00:00 +0000

Objective: To describe the impact of obesity prevention on the quality of life of children and adolescents, with a focus on those in social vulnerability. Methods: This is an integrative review, with studies from the last five years (2019-2024) from the PubMed and Web of Science databases, using the PICO strategy: P (children in social vulnerability), I (obesity prevention), C (healthy and obese children) and O (health consequences). The guiding question was: “What is the impact of social conditions on preventing obesity in children and adolescents?”. Descriptors and Boolean operators were applied, resulting in 378 articles, reduced to 24 after careful exclusion. Results: Tables based on the 24 articles selected show the authors, types of study, objectives and main findings. The first table showed the relationship between socio-economic aspects and the diagnosis studied, while the second addressed its prevention, focusing on patients' contexts. Final considerations: It was concluded that socio-economic factors are influential in the health and quality of life of this age group, and that equitable and adapted interventions are recommended.

Physiological changes in patients with diabetes mellitus: impact of vitamin D supplementation

Fri, 11 Apr 2025 21:41:18 +0000

Objective: To evaluate the physiological effects of vitamin D use in patients with diabetes mellitus. Methods: This is an integrative literature review, with articles published between 2015 and 2024. The guiding question used was: “What is the relationship between the use of vitamin D and diabetes mellitus?”. The bibliographic research was carried out in the Web of Science (CLARIVATE), PubMed (MEDLINE) and Scopus (Elsevier) databases, using the Health Sciences Descriptors (DECS): “Vitamin D” and “Diabetes mellitus” and the Boolean operator “AND. Results: The relationship between vitamin D and diabetes mellitus through the analysis of blood glucose, bone density and beta cell function indicates that supplementation of this vitamin improves insulin sensitivity. Thus, vitamin D deficiency is related to the risk of developing Diabetes Mellitus. Final considerations: Vitamin D supplementation prevents the control of Diabetes Mellitus. Although more studies are still needed to define dosages and evaluate long-term effects, vitamin D is promising in the treatment of the disease.

Family consent for organ donation: Factors that influence the decision

Fri, 11 Apr 2025 21:41:39 +0000

Objective: To identify the factors that interfere with family consent for organ donation in cases of brain death. Methods: This is an integrative literature review, with articles published between 2008 and 2023. The guiding question used was: “What are the factors that hinder family consent for organ donation in cases of brain death?”. The bibliographic research was carried out in the Publisher Medline (PubMed), Scientific Electronic Library Online (SciELO), Latin American and Caribbean Health Sciences Literature (LILACS), Web of Science, and SCOPUS databases, using the Health Sciences Descriptors (DeCS): Interview, Decision making, Organ donation, and Boolean operator “AND”. Results: The main factors that influence family decision-making are emotional and psychological in nature, cultural and religious values, impact of the donor's desire on the family and general information about organ donation. The obstacles highlighted were intense grief, lack of understanding about brain death, and ineffective approaches by health professionals. Final considerations: The factors that hinder family consent for organ donation act in a multifactorial way, reinforcing the importance of a humanized and informative approach that takes into account the cultural and emotional aspects of family members.

General approach to acute pancreatitis

Fri, 11 Apr 2025 21:42:13 +0000

Objective: To analyze the characteristics of Acute Pancreatitis (AP). Bibliographic review: PA is one of the main causes of hospital admissions related to the gastrointestinal tract. In general, gallstones and alcohol abuse are the two most common causes of AP, while hypertriglyceridemia ranks third with an increasing trend. Although often self-limiting, 20% of patients with AP progress to a more severe form with organ failure and mortality between 15% and 35%. Organ failure usually manifests as respiratory, renal, or cardiovascular failure. Final considerations: Acute pancreatitis is a sudden inflammatory disease of the pancreas whose incidence has increased by more than 20% in the last 20 years. Approximately 20% of affected people develop severe disease, resulting in high morbidity and mortality. As there is no specific therapy, current management revolves around early fluid resuscitation, pain control, and nutrition. Supportive care using intravenous fluid hydration is the mainstay of BP management in the first 12 to 24 hours, along with enteral nutrition and pain management with opioids.

Reintegration into the labor market of individuals with Post-Traumatic Stress Disorder (PTSD)

Magno Muniz dos Santos — Fri, 02 May 2025 16:14:54 +0000

Objective: Analyze the strategies and interventions described in the scientific literature aimed at reintegrating workers with Post-Traumatic Stress Disorder (PTSD) and other work-related mental health issues into the labor market. Methods: An integrative literature review was conducted, with searches performed in SciELO, PubMed, Scopus, and BVS, covering studies from 2010 to 2025. Articles, dissertations, and theses in Portuguese, English, or Spanish, available in full text, addressing the labor reintegration of workers with PTSD were included. Descriptors such as "PTSD," "labor reintegration," and "interventions" were used, combined with Boolean operators. The selection process involved five stages: identification, removal of duplicates, screening, eligibility, and inclusion, with data analysis structured in tables. Results: Out of 55 initial records, 9 articles were included after screening and analysis. Identified barriers included a lack of psychological support and workplace stigma. Highlighted interventions encompassed psychosocial support and workplace adaptations. Public policies and companies play a crucial role in facilitating labor reintegration. Final considerations: The study highlights the complexity of reintegration and the effectiveness of structured interventions, though limited by the lack of local guidelines. Further research is recommended for personalized approaches.

Chronic Granulomatous Disease

Fri, 02 May 2025 17:27:57 +0000

Objective: To describe the pathophysiology of Chronic Granulomatous Disease (CGD) and its main clinical manifestations. Literature review: CGD is a primary immunodeficiency caused by mutations in genes encoding components of the NADPH oxidase complex, essential to produce reactive oxygen species (ROS) by phagocytic cells. The inability to generate ROS compromises pathogen elimination, resulting in recurrent infections and a dysregulated inflammatory response. Clinically, CGD manifests with frequent lung infections, often associated with nodular infiltrates and abscess formation. Additionally, the disease affects the gastrointestinal tract, contributing to chronic inflammation and obstructions. A hallmark of CGD is the formation of granulomas, which can impair the function of organs such as the liver and kidneys, leading to significant morbidity. Final considerations: Early diagnosis is essential to improving patients’ quality of life, as timely identification and management help prevent severe complications that can hinder child development. Therapeutic strategies include antibiotics, antifungals, and corticosteroid therapy, requiring continuous medical monitoring. Given the chronic nature of CGD, adequate medical follow-up and individualized treatment approaches are crucial to improving prognosis, reducing morbidity, and preventing life-threatening complications.

The role of breastfeeding in the prevention of childhood obesity

Fri, 02 May 2025 17:54:34 +0000

Objective: To investigate the relationship between breastfeeding and the prevention of childhood obesity, assessing its protective role. Methods: This is an integrative review. The research was conducted in the PubMed and BVS databases using the descriptors “Breast Feeding,” “Disease Prevention,” and “Obesity.” The review included free-access studies in English, published between 2018 and 2023. A total of 21 articles were selected for analysis. Results: The evidence indicates that exclusive breastfeeding for up to six months is associated with a reduced risk of childhood obesity by age four. The composition of breast milk, particularly the presence of hormones that regulate appetite, plays a key role in this association. Additionally, prolonged breastfeeding and the appropriate introduction of complementary foods were critical factors in preventing excessive weight gain. Final considerations: Breastfeeding serves as a protective factor against childhood obesity. However, promoting environments that support healthy eating habits and physical activity is essential to reinforce this protection.

Pathophysiology and treatment of Chronic Obstructive Pulmonary Disease

Fri, 02 May 2025 17:57:57 +0000

Objective: To provide a didactic review of the pathophysiology and treatment of Chronic Obstructive Pulmonary Disease (COPD). Bibliographic review: COPD is a lung condition characterized by chronic and progressive airway obstruction, often associated with prolonged exposure to irritants. Its pathophysiology involves continuous inflammation of the airways, which results in damage to the lung parenchyma and, consequently, causes respiratory difficulties. Its prevalence is around 10% to 15% of the global population, making it the third leading cause of death worldwide. The diagnosis of the disease is made through patient history, physical examination, chest X-ray, and pulmonary function tests. Treatment includes medications such as bronchodilators, which are used to open the airways, along with oxygen therapy in cases of significant O2 drop. Final considerations: In summary, COPD is a condition that requires immediate diagnosis and prompt treatment to prevent complications that may worsen the patient’s condition.

The sedentary lifestyle and Covid-19

Fri, 02 May 2025 18:02:11 +0000

Objective: To verify the impact of the Covid-19 pandemic on people's lifestyles. Methods: This article was written through qualitative bibliographic research, constituting an integrative review. The databases used were the National Library of Medicine (PubMed) and Latin American and Caribbean Literature in Health Sciences (LILACS). The search for articles was performed using the descriptors “Covid-19”, “sedentary lifestyle” and “pandemic” using the Boolean operator “and”. Results: The search resulted in 844 articles. 796 articles were found in PubMed and 48 in LILACS, of which 18 were excluded for straying from the topic. In three selected studies that included family (parents, mothers and children) or a form of encouragement, such as video classes, there was a lower prevalence of sedentary lifestyle. However, most studies have shown that people have become or become more sedentary, either by decreasing physical activity or by increasing the time spent sitting, as well as by increasing screen time. Final considerations: It can be considered that there was an increase in the prevalence of sedentary lifestyle during the pandemic. However, physical activity was greater when it involved family groups or when guided by video classes.

Increased incidence of atypical femur fracture due to prolonged use of bisphosphonates

Fri, 02 May 2025 18:14:13 +0000

Objective: To correlate prolonged bisphosphonate use, for more than 3 years, as a risk factor for atypical femur fractures. Methods: This is an integrative literature review conducted using the descriptors “atypical femur fracture” and “bisphosphonate,” employing the Boolean operator “AND.” The databases used were the National Library of Medicine (PubMed), the Virtual Health Library (BVS), and the Cochrane Library. Articles were included based on the following criteria: published between 2013 and 2023, available in full text in Portuguese, English, or Spanish, and belonging to one of the following study types: clinical trials, controlled clinical trials, and observational studies. Results: The search and selection criteria yielded a total of 23 articles that associated bisphosphonate use with atypical femur fractures after a certain duration of treatment. Final Considerations: Bisphosphonate users should be evaluated after 3 years of use, considering the risk of atypical femur fractures and the need to individualize treatment continuation decisions to balance benefits and risks.

Advances and challenges en knee osteoarthritis management: innovative therapies and digital technologies

Mon, 05 May 2025 21:01:51 +0000

Objective: To analyze recent advances in the treatment of knee osteoarthritis (OA), with an emphasis on innovative pharmacological and non-pharmacological therapies, including the use of stem cells and digital technologies. Methods: This is a narrative literature review, built from a search for scientific articles contained in the National Library of Medicine (Medline) database. The descriptors “pain,” “osteoarthritis,” and “treatment” were used, considering the Boolean operator “AND.” Clinical trials and randomized clinical studies published in 2024, available in Portuguese or English, were included. Results: Of the selected articles, 3 highlight the beneficial effects of digital technologies, while 4 emphasize the importance of biological therapies. Two of the studies address other types of pharmacological therapies, and 6 articles assessed the impacts of non-pharmacological measures. Final Considerations: The future of knee OA treatment involves a focus on innovative and personalized therapies for each patient, considering disease progression and individual profiles. However, significant challenges remain that must be addressed to improve the patient’s quality of life.

The use of clopidogrel in the treatment of acute myocardial infarction with ST elevation

Tue, 06 May 2025 18:18:14 +0000

Objective: To evaluate the effectiveness of clopidogrel compared to other antiplatelet agents, demonstrating its use in different populations and its association with mortality. Methods: Searches were carried out in the PubMed and Virtual Health Library (VHL) databases and included studies published between 2018-2023, controlled clinical trials, observational studies, full and free texts and excluded off-topic and duplicate articles. Results: 25 articles were included for the narrative synthesis, where through analysis of the studies, it was observed that clopidogrel, despite not being the most recommended antiplatelet currently, is the most used due to the financial costs and its reliability in use, and that factors such as age over 75 years, drug interactions and chronic drug use present favorable outcomes. Final considerations: It can be considered that the use of clopidogrel in acute myocardial infarction with ST elevation presents a certain disadvantage when compared to other antiplatelet agents, however, its use is described reliably and considered a good inhibitor of the P2Y12 receptor. The present studies were not able to reliably prove its superiority or inferiority compared to other medicines, since the population, culture and countries were different.

Differentiated Vulvar Intraepithelial Neoplasia

Marina Souza Rocha, Walquiria Quida Salles Pereira Primo — Tue, 27 May 2025 12:56:32 +0000

Objective: To analyze the main clinical, diagnostic, and therapeutic characteristics of Differentiated Vulvar Intraepithelial Neoplasia (dVIN). Methods: A narrative literature review was conducted using the PUBMED/MEDLINE, COCHRANE, ACOG, and RCOG databases, with the descriptors “differentiated vulvar intraepithelial neoplasia” and “neoplasia intraepitelial vulvar diferenciada.” Articles published between January 2018 and January 2024, written in English or Portuguese, with full-text access and a specific focus on dVIN, were included. After screening based on eligibility criteria, nine studies were selected and analyzed regarding methodological design, objectives, and main findings. Results: dVIN is a precursor lesion of keratinizing squamous cell carcinoma of the vulva, characterized by an HPV-independent etiology and a predominance in postmenopausal women. It is frequently associated with lichen sclerosus and TP53 gene mutations, exhibiting a keratinizing histologic architecture and a higher neoplastic progression rate. Diagnosis is histopathological, supported by immunohistochemical markers such as p53, Ki-67, and GATA3. The treatment of choice is surgical excision with clear margins; ablative and topical approaches are contraindicated. Systematic clinical follow-up is essential due to the risk of recurrence. Final considerations: dVIN represents a clinically relevant premalignant entity. Early detection, histopathological confirmation, and appropriate surgical management are crucial to preventing progression to invasive carcinoma and improving prognosis.