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Avaliação da qualidade de vida relacionada à saúde de pacientes pós-implante de marca-passo em hospital universitário brasileiro
(Universidade Federal de Goiás, 2024-07-08) Augusto, Laura Porto; Guará, Pedro Teixeira; Simão, Victor Cordeiro; Sá, Luiz Antônio Batista de; Araújo, Fabrício Alves; Araújo, Fabrício Alves; Sá, Luiz Antônio Batista de; Cavalcante, Kalley Santos
INTRODUCTION: Health-related quality of life (HRQoL) is an important subjective parameter that considers an individual's perception of their place in life and cultural context. For patients with pacemakers (PM), assessing HRQoL is crucial because the device aims to improve the well-being and living conditions of patients. Thus, understanding the factors that can influence HRQoL is essential. OBJECTIVES: To evaluate the HRQoL of PM patients at a tertiary university hospital in Goiânia. METHODOLOGY: This cross-sectional study included a sample of 57 patients monitored at the PM outpatient clinic of a tertiary university hospital in Goiânia. Data collection was conducted between October 2023 and March 2024 using the AQUAREL and SF-36 questionnaires, as well as a clinical questionnaire that addressed activities that may be considered safe or unsafe for PM patients. Statistical tests were used to investigate the association of HRQoL with sociodemographic variables (gender, age, marital status, income, ethnicity, education) and clinical variables (time since PM implantation and presence of Chagas disease). Additionally, ordinal logistic regression was performed to identify and estimate odds ratios between sociodemographic, clinical variables, and the worsening of HRQoL assessment. The significance level was set at 5%. RESULTS: The sample consisted predominantly of elderly patients (71.9%), female (57.9%), without a partner (52.6%), mixed race (47.4%), retired (61.4%), with a family income of ≤ 2 minimum wages (66.7%), and with completed primary education (45.6%). In 41 patients (71.9%), the time since PM implantation was less than 10 years, and Chagas disease was the main reason for PM implantation, with 29 patients (50.9%). Most patients (87.7%) considered the care in the outpatient clinic as "excellent" or "very good". It was identified that many did not find it safe or were unaware of the safety of various daily activities, such as using cell phones (38.6%), microwave ovens (63.2%), and physical activities (40.3%). The best HRQoL results were observed in the domains "Chest Discomfort" and "Arrhythmia" of the AQUAREL, and "Social Aspects" and "Mental Health" of the SF-36. Chagas disease was associated with poorer evaluations in the domains "Arrhythmia" and "Dyspnea on Effort" of the AQUAREL. The presence of Chagas disease was considered a factor associated with poorer scores in the AQUAREL. The odds of a patient without Chagas disease having a higher category in HRQoL scores on the AQUAREL were 2.7 times for the Chest Discomfort domain, 7.9 times for the Arrhythmia domain, and 4.4 times for the Dyspnea on Effort domain. Age was negatively correlated with the "Mental Component" of the SF-36 and also represented higher chances of poor HRQoL scores on the SF-36, but there was no significant association between HRQoL and gender, marital status, income, ethnicity, or education. CONCLUSION: The HRQoL of patients evaluated in the PM outpatient clinic of the tertiary university hospital is reasonable, according to the analysis of the AQUAREL and SF-36 questionnaire scores. Most patients consider the care satisfactory, but many still have uncertainties and insecurities about risk activities. The main factors for poorer scores were Chagas disease in the AQUAREL and being older and having lower education in the SF-36.
Prevalência de morte súbita cardíaca no período de 2019 a 2022 no Município de Goiânia
(Universidade Federal de Goiás, 2024-06-28) Rodrigues, Isabela de Jesus; Dias, Laura Stival; França, Letícia Carvalho de; Sousa, Ana Luiza Lima; Menezes Junior, Antônio da Silva; Menezes Junior, Antônio da Silva; Ramos, Gilson Cassem; Batista, Sandro Rogério Rodrigues
Background:Sudden Cardiac Death (SCD) is a medical term used for cases in which patients with heart disease, often unknown, die unexpectedly about an hour after the initial symptoms appear, without a pre-existing diagnosis of potentially fatal diseases. However, even though it is a relatively frequent event in Brazil, there are few epidemiological studies on the subject. Objective: To highlight the epidemiological profile of SCD in the metropolitan region of Goiânia between 2019 and 2022 and probable associations with risk factors. Method: A descriptive study was carried out using the medical records of the Goiânia Death Verification Service (SVO) and necropsy reports as the data source. Results: 2878 records of sudden death were identified in the three-year period and 1920 (67.3%) of them were defined as cardiac, in which 322 (16.8%) necropsies were carried out. The incidence of SCD confirmed by autopsy was 303 (94.1%), with a higher frequency among men (70.0%) and in the 35-60 age group (49.5%). The highest frequency of deaths was at home (50.5%), followed by health establishments other than hospitals (17.5%). The main associated factors were: hypertension 45.9% (n=139), smoking 43.2% (n= 131), alcoholism 41.9% (n=127) and diabetes mellitus 14.9% (n=45). Conclusion: Sudden cardiac death was recorded in 16.8% of the cases, and the necropsy confirmed almost all of them.
Tempo de espera entre referenciamento e atendimento inicial em pacientes oncológicos no Hospital das Clínicas da Universidade Federal de Goiás
(Universidade Federal de Goiás, 2024-07-03) Tafuri, Gabriela Batista; Rigueiral, Júlia Rodrigues Picazo; Rangel, Lorrane de Oliveira Braga; Le Campion, Edmond Raymond; Le Campion, Edmond Raymond; Tredicci, Thiago Miranda; Penhavel, Félix André Sanches
Introduction: The Brazilian Unified Health System (SUS) is a major advance in terms of national public health, and it is of great importance to evaluate its effectiveness in relation to serving the population. In this sense, it is important to evaluate the waiting time between referral and consultation with a specialist in patients with malignant diseases, as delays in treating these individuals can negatively impact their prognosis and quality of life. Objective: To quantify the average waiting time between the referral of patients with malignant diseases to Primary Health Care and the first specialized care in a tertiary hospital, in the SUS of the state of Goiás (HC-UFG). Methodology: This is a prospective descriptive study, based on primary data from medical records and consultations between the years 2023 and 2024 in the Digestive System Surgery outpatient clinics of HC-UFG. Were included 50 patients with malignant diseases who had referral data, after excluding 44 who did not meet the inclusion criteria. The analyzes were carried out using SPSS software, using descriptive measures such as mean, median and standard deviation of waiting times. Results: The average waiting time was 17.16 days, ranging from 4 to 60 days, with a standard deviation of 12.418, indicating considerable variation. Most waiting times were around 20 days, with 25% of patients waiting up to 8 days, 50% up to 12.5 days, and 75% up to 23.75 days. Therefore, 15% of patients waited more than 23 days. Conclusion: The average waiting time found was shorter than other services according to a bibliographic review, highlighting the efficiency of the regulatory complex. However, the study faces limitations, such as the lack of knowledge of the time from suspicion to referral. Similar studies are recommended in other SUS hospitals to assess whether this phenomenon can be generalized to other regions of the state.
Prevalência da síndrome de Burnout em estudantes de medicina no Brasil: uma revisão bibliográfica
(Universidade Federal de Goiás, 2024-07-08) Nunes, Laila Souza; Elias, Berta Baltazar; Elias, Berta Baltazar; Oliveira, Paulo Maurício de; Amaral, José Reinaldo do
Introduction: Burnout Syndrome is a state of psychological suffering associated with work, composed of multidimensional components: emotional exhaustion, disbelief and professional depersonalization. In medical students, in addition to the common stressors of teaching, there is the fact that they deal directly with patients, which can trigger the dimensions of the syndrome even before their training. Aims: Compile information to provide an overview regarding Burnout Syndrome in medical students at universities in Brazil, analyzing the possible factors that contribute to the emergence of this disorder. Methodology: This is a literature review, through an investigation of articles selected from the CAPES and SciELO scientific journal publishing platforms and Google Scholar. Exclusion and inclusion measures were established and 8 articles were selected to make up the final sample. Results: From the analysis it is clear that there is no defined main cause, but the sum of intrinsic and extrinsic factors in the students' routine contribute to the triggering of Burnout Syndrome. Conclusion: Since chronic stress has gained prominence in the daily lives of medical students who face physically and mentally demanding situations on a daily basis, this study highlights the importance of attention to the prevention, diagnosis and treatment of Burnout Syndrome
Correlação de presença de linhas B em ultrassonografia pulmonar e elevação de BNP em pacientes com insuficiência cardíaca
(Universidade Federal de Goiás, 2024-06-28) Medeiros, João Lucas Brasil; Oliveira , João Paulo Borges de; Oliveira, Simone Dias Souza de; Ramos, Gilson Cassem; Brasil , Guilherme Visconde; Oliveira, Simone Dias Souza de
Cardiovascular diseases (CVD) are one of the leading causes of death globally, with heart failure (HF) affecting approximately 64 million people, posing a significant public health challenge. Dyspnea is a common symptom of HF. Biomarkers and imaging play a crucial role in disease diagnosis and management. Bedside pulmonary ultrasound (US) assessing B lines is a useful tool for evaluating pulmonary congestion, correlating positively with elevated brain natriuretic peptide (BNP), an important biomarker for HF diagnosis and prognosis. In Brazil, HF is the leading cause of hospital admissions under the Unified Health System (SUS). Early intervention during decompensation episodes is essential to control symptoms, reduce hospital stay, improve quality of life, and decrease work disability and costs. OBJECTIVE: To evaluate the positive correlation between B-lines in pulmonary US and elevated BNP levels in patients with cardiac-related dyspnea. METHODOLOGY: This study is an integrative literature review aiming to organize and analyze publications on the correlation between B-lines in pulmonary ultrasound and elevated BNP in HF patients. Using the PICO strategy, a search on PUBMED yielded 59 studies, of which 28 were selected by two evaluators using the RAYYAN tool. RESULTS AND DISCUSSION: The International Consensus on Pulmonary US showed high sensitivity in detecting pulmonary congestion, surpassing the diagnostic accuracy of chest radiographs and NT-proBNP. Randomized studies indicated that combining pulmonary US with clinical evaluation significantly improves sensitivity and specificity in HF diagnosis. Integrated US approaches demonstrated superiority in sensitivity and specificity compared to BNP. In emergencies, pulmonary US proved more accurate and easier to implement. In primary care, US was also effective, especially when used alongside BNP. CONCLUSION: US protocols demonstrate high sensitivity and specificity in detecting pulmonary congestion, thereby enhancing HF management.
Como estamos classificando dengue na região das Américas ?
(Universidade Federal de Goiás, 2024-07-08) Filgueira, Arthur Calisto; Simionato, Bruna Biava; Soares, Fabrício Marques; Siqueira Junior, João Bosco; Siqueira, Cláudio Morais; Franca, Divânia Dias Da Silva; Siqueira Junior, João Bosco
American countries began to adhere to a new definition of dengue cases throughout the 2010s, however, after the new definition, no studies were carried out comparing how surveillance in these countries is classifying cases. From this perspective, the present study aims to review how dengue is classified in the Americas. By surveying epidemiological data relating to the annual incidence rate, dengue without an alarm signal, dengue with an alarm signal, severe dengue and lethality, the aim is to draw comparisons between the countries covered and their respective proportions of dengue cases. Thus, it is expected to raise the need for deeper academic discussions on the topic, given the great importance and repercussion of dengue on the American continent.
Análise de protocolos para o tratamento de sífilis congênita: uma revisão de escopo
(Universidade Federal de Goiás, 2024-06-14) Novais, Jordana Alves; Albuquerque, Juliana Silva; Garrido, Larissa Bernardes Araújo; Abe, Adriana Helena de Matos; Carvalho, Simone Resende de; Franco, Glaucimeire Marquez; Abe, Adriana Helena de Matos
Introduction: Congenital syphilis is an infectious disease caused by the bacterium Treponema pallidum with gestational transmission, which has a significant impact on the health of the fetus. Although prevention of this disease during pregnancy is safe and the treatment effective, its incidence has remained high in several countries, especially Brazil, which makes congenital syphilis a serious global public health problem that needs to be studied. Objective: To analyze the protocols for the treatment of congenital syphilis in Brazil and the United States in order to identify possible reasons for the increase in the incidence rate of this disease in different countries with different territorial areas, development rates and economies. Method: This is a scoping review based on a search of the PubMed database for the period 2013 to 2023. Results: One of the main factors responsible for the difference in congenital syphilis rates in each country is economic and territorial differences. In addition, the offer of screening for syphilis during pregnancy is not homogeneous throughout the territory of the countries analyzed and there are differences in the form of access for each social group within the same country. Conclusion: The protocols of the two countries analyzed are adequate and the biggest problem is adequate access to information and screening during prenatal care, treatment during pregnancy, for both the pregnant woman and her partner, and after childbirth.
Associação entre diabetes mellitus e capsulite adesiva: uma revisão sistemática e meta-análise
(Universidade Federal de Goiás, 2024-07-04) Piai, Ricardo Figueiredo Paro; Silva, Rômulo Freire Gomes; Oliveira, Thalles Pires de; Fernandes , Marcos Rassi; Costa, Paulo Sérgio Sucasas da; Naghettini, Alessandra Vitorino; Fernandes, Marcos Rassi
Adhesive Capsulitis (AC) is a progressive painful condition associated with a gradual reduction in the range of motion of the shoulder joint, being associated with factors such as Diabetes Mellitus (DM). DM is a metabolic disorder that can damage connective tissues, including the shoulder joint capsule, increasing the risk of developing CA. Brazil, with a high prevalence of DM, faces a significant number of CA cases. The results can provide important insights into the clinical management of these patients. This review aims to analyze the relationship between adhesive capsulitis and diabetes mellitus, considering sex, dyslipidemia and glycemic control as possible influencers. The present systematic review was carried out in the Scopus, Embase and PubMed databases until April 2024. Observational studies were included, without time limitations, that evaluated risk factors for CA. This study used the PECOT criteria and converted them into Medical Subject Headings (MeSH) terms to investigate the relationship between adhesive capsulitis and diabetes. The terms "frozen shoulder" OR "adhesive capsulitis", "shoulder", "diabetes" OR "diabetes mellitus" OR "diabetic", and "risk factors" OR "risk" were used, combined by the Boolean operator "AND" in their variations in the English language. Articles outside the scope of the topic, incomplete articles and articles in languages other than English were excluded from the study. This study presents three retrospective cohort studies, totaling 3,812,635 participants. Our study demonstrated that patients with DM2 are associated with a higher chance of developing CA compared to patients without DM2 (OR 2.17; 95% [CI] = 1.32 to 3.56; p = 0.002). Multivariate analysis indicated that individuals with DM2 were more likely to develop CA than those without DM2 (HR 1.46; 95% [CI] = 1.33 to 1.61; p < 0.00001). Dyslipidemia was also associated with an increased risk of AC in patients with T2DM (HR 1.37; 95% [CI] = 1.24 to 1.51; p < 0.00001). Furthermore, women had a higher risk of developing AC compared to men (HR 1.44; 95% [CI] = 1.23 to 1.69; p < 0.00001). A correlation was also observed between lack of glycemic control and the development of CA. In conclusion, this study highlights the strong association between T2DM, dyslipidemia, female sex and CA, emphasizing the importance of strict metabolic control and adequate management of dyslipidemia in patients with T2DM to prevent or minimize the risk of developing CA. Future prospective, randomized controlled studies are needed to confirm these findings and elucidate the mechanisms underlying this association.
Câncer de endométrio: o papel da terapia adjuvante
(Universidade Federal de Goiás, 2024-06-27) Anjos, Daniela dos Santos; Silva, Haila Cristina do Rêgo; Pereira, Isabella Victória Silva; Ramos, Marina Matos; Silva, Pedro Henrique Costa Matos da; Sousa, Juarez Antônio de; Ferreira, Sarah Hasimyan; Silva, Pedro Henrique Costa Matos da
Introduction: Endometrial cancer (EC) is one of the most common forms of gynecological cancer, significantly impacting women's health and an estimate of around 8.000 new cases in 2022 according to INCA (National Cancer Institute). This study investigates the current treatment approaches for women with endometrial cancer, with a particular attention to adjuvant therapy. Objective: The main objective is to understand the current landscape of adjuvant therapy in the management of endometrial neoplasia. Methodology: For the construction of the integrative literature review, a search was conducted in the SCIELO, PUBMED, and LILACS databases in January 2024, using the following descriptors: Endometrial Cancer, Treatment, Diagnosis, Management, Therapeutics, Endometrial Neoplasms, Câncer de Endométrio, Manejo, and Tratamento. Results: The search resulted in a total of 1.828 articles, of which 40 were selected based on the reading of titles and abstracts. From these, 18 texts were chosen for full reading, and finally, 9 were included. According to the evidence found, adjuvant therapy is recommended for patients at intermediate and high risk. In high-risk cases, combined chemotherapy can improve progression-free survival; however, the necessity must be evaluated individually. In advanced endometrial cancer, chemotherapy with Carboplatin and Paclitaxel is standard, but caution is needed due to toxicity, especially when associated with Doxorubicin. Regarding hormonal therapy, its effectiveness as an adjuvant is still unclear. Conclusion: Although the primary treatment for EC is surgical, adjuvant therapy plays a crucial role in patient prognosis, involving modalities such as chemotherapy, brachytherapy, radiotherapy, and hormone therapy. Additionally, given the increasing incidence of endometrial cancer, there is an urgent need for more research to improve the management and adjuvant therapy, given the variations in observed prognoses.
Alimentação e hipertensão arterial sistêmica no Brasil: uma revisão integrativa
(Universidade Federal de Goiás, 2024-05-02) Pasqualetto, Alan Gabriel Natã; Brandão, Elymar Santana; Nascimento, Gabriel Melo Toledo; Barros, Fernando Passos Cupertino de; Azevedo, Monarko Nunes de; Pereira, Edsaura Maria
Systemic arterial hypertension is a disease with a prevalence of up to 1/3 of the Brazilian population and the 2020 guideline recommends changing diet as a form of control in all advances of the disease, with recommendation grade I and level of evidence A. The objective was to analyze in the literature which foods or diets were related to the control of this disease in the Brazilian population and discuss the principles of their effectiveness and the difficulties in their effective implementation. Search for articles published between January 2013 and March 2023 on Web of Science by MeSH descriptors, using the PICO strategy and classification by the GRADE system as selection criteria. 156 studies were obtained, 5 of which met the inclusion criteria, 3 of which were planned clinical trials, addressing the DASH diet and consumption of Brazil nuts, and 2 cohort studies on the risk of a diet rich in ultra-processed foods. Clinical trials obtained positive results on blood pressure levels and laboratory parameters, while groups with high consumption of ultra-processed foods had a relative risk and higher achievement. It was noted that dietary strategies sought to include common foods in Brazil, as a way of facilitating adherence for cultural reasons, however social disparities still remain limited.
Câncer de mama em homens: prevalência e suas principais características
(Universidade Federal de Goiás, 2024-06-29) Dias, Aylton Albernaz; Silva, Diego de Oliveira; Abreu Filho, Fernando Costa; Sousa, Juarez Antônio de; Amaral, Waldemar Naves do; Saidah, Tárik Kassem
Breast cancer is widely recognized as a major public health concern worldwide, predominantly affecting women. However, although it is relatively rare, breast cancer can also occur in men, accounting for a significant portion of cases diagnosed annually. Although less common, male breast cancer presents unique challenges in diagnosis, treatment, and clinical management, requiring a specific and personalized approach to ensure optimal patient outcomes. Understanding the prevalence and characteristics of breast cancer in men is critical to guide effective public health policies, prevention strategies, and clinical interventions. The general objective of this study is to discuss the prevalence and clinical, histopathological and therapeutic characteristics of breast cancer in men, in order to consolidate existing knowledge and identify gaps that can guide future research. The methodology of this work is the Literature Review. It is concluded that studies on breast cancer in men have provided a comprehensive view of this condition, from its prevalence to its main clinical characteristics and challenges associated with diagnosis and treatment.

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