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Item Perfil dos atendimentos em urgência e emergência em um centro de atenção integrada à saúde(Universidade Federal de Goiás, 2020-04-04) Costa, Webse da Mota; Amaral, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579; Amaral, Waldemar Naves do; Saidah, Tárik Kassem; Ferreira, Ruy Gilberto; Sousa, Juarez Antônio deIntroduction: Urgent and emergency care has undergone important restructuring since 2003, with the creation of the National Policy for Attention to Urgencies, by the Ministry of Health. Based on this, the urgency and emergency service started to be composed of a network of units specialized in providing this service at levels of secondary or tertiary care, depending on its structuring and resolution capacity, with primary care responsible for the care of low complexity emergencies. Objective: To analyze the profile of the demand of patients admitted to the emergency room at an Integrated Health Care Center. Methods: This is a cross-sectional, descriptive study with a quantitative approach. To analyze the demand profile of patients admitted to the urgency and emergency, linked to the request for AIH through the Regulation System. All AIHs requested from January 1, 2018 to June 30, 2018 were evaluated. Patients of both genders, any age, and any city of origin were included, and cases with incomplete AIH were excluded for the survey data. The data referring to the sociodemographic profile (gender, age group and city of origin), data from the requested AIH (month of application, period of application and regulation, waiting interval, medical specialty, and application opinion), initial diagnoses were analyzed related to AIH, and the characterization of the approved AIH (executing establishment and purpose of the AIH). The data were analyzed using descriptive statistics, obtaining the absolute and relative frequency of the variables, in addition to Pearson's Chi-square test to compare the study variables, with significance of p <0.05. The study was submitted to and approved by the Research Ethics Committee. Results: A total of 2013 AIHs were selected for the sample. Male gender was more prevalent with 1021 cases (50.72%). Age ranged from 1 to 101 years, with a mean of 44.24 years (SD ± 23.13). The age group ≥50 years was more frequent, with 43.52% of the cases, in relation to the other categories (p <0.001). In relation to the municipality of origin, the highest number of cases was observed for Aparecida de Goiânia with 66.57% of the records, followed by Goiânia with 18.03%. In general, there was no variation per month. As for the request and regulation period, the day shift was noted as the most frequent with 68.95% and 69.50% of cases, respectively. The most prevalent waiting intervals were 60 min (45.11%), 1 to 6 hours (23.00%), 6 to 12 hours (5.81%), and 12 to 24 hours (11.03%). Regarding the request's opinion, a total of 71.49% was approved, while 17.14% was denied. About 5.32% of patients were discharged, and 5.12% escaped from the site. The specialties most frequently requested were general practice (54.25%), general surgery (18.63%) and pediatrics (12.62%). The most observed health problems were acute abdomen (8.00%), stroke (7.65%) and other intracranial injuries (6.46). The services required for the most frequent approved AIHs were highly complex procedures (36.00%), evaluation by a specialist (35.86%), and hospitalization (25.85%). Public establishments were the most frequent with 76.86, followed by private (19.88%). Conclusions: Problems with structure, equipment for exams and qualified labor were observed, in addition to the excessive request for highly complex exams, due to the absence of internal protocols to guide your request. In addition, like profile there was a higher frequency for males, aged> 50 years and from Aparecida de Goiânia. Most of the cases were approved in the 60 min waiting interval, mainly related to acute abdomen. The purpose of AIHs was frequent to the evaluation of urgency and tests of high complexity in public establishments.Item Avaliação da incidência pélvica por tomografia computadorizada(Universidade Federal de Goiás, 2020-03-18) Daher, Murilo Tavares; Rabahi, Marcelo Fouad; http://lattes.cnpq.br/1489771770609266; Rabahi, Marcelo Fouad; Gama, Hugo Pereira Pinto; Teixeira, Kim Ir-Sen Santos; Herrero, Carlos Fernando Pereira da Silva; Porto, Maximiliano AguiarThe Pelvic incidence (PI) is the most important pelvic parameter. It is considered a fixed, anatomical, parameter that is not influenced by the pelvis's position. However, the projection of the pelvis, a three-dimensional structure, in the radiographic, two-dimensional examination, may be influenced by its positioning in relation to the x-ray bulb during image acquisition. Our aim was to describe a new way of measuring PI using computed tomography (CT) and to evaluate the reliability and reproducibility of this measurement by comparing it with the total and lumbosacral spine radiogragphys. A retrospective study was carried out in which patients who underwent radiography of the total spine, lumbosacral spine and computed tomography (CT) of the total abdomen, pelvis or lumbar spine were included, with a maximum interval of 3 months between examinations. Two independent examiners performed PI measurement, with each measurement being permorded twice, with an interval of two months betwenn assesmentes. To measure the pelvic incidence on CT, the image overlay technique was applied. SURGIMAP, Excel and IBM-SPSS 20.0 software were used to calculate IP, data tabulation and statistical analysis, respectively. The intra and inter-examiner validity and reproducibility were verified using the intraclass correlation coefficients (ICC), considering CI = 95%. During the study the examinations of 55 patients of both genders with an average age of 58.7 years (± 19) were analyzed. The mean PI in the analysis of both examiners at the two different times was 54.85° (± 13.73) on the total spine radiography, 54.06° (± 11.67) on the lumbosacral spine radiography, and 49, 96° (± 9.85) in the measurement using CT. There was good reliability and reproducibility both intra (ICC examiner 1 0,913 and ICC examiner 2 0,871) and inter-examiner (ICC avaliation 1 0,906 and ICC avaliation 2 0,824). High agreement was also found with the radiographs of the whole spine and lumbosacral spine. These findings suggest that it is possible to calculate PI using CT usind the image overlay technique, eith good reproducibility both intra and inter-observer.Item Avaliação da fragilidade em pacientes com doença pulmonar obstrutiva crônica(Universidade Federal de Goiás, 2020-04-24) Dias, Lara de Souza; Rabahi, Marcelo Fouad; http://lattes.cnpq.br/1489771770609266; Rabahi, Marcelo Fouad; Silva, Daniela Graner Schuwartz Tannus; Lira, Claudio Andre Barbosa deIntroduction: Frailty has been recognized as a prognostic factor for chronic diseases, despite being mostly age-related, in patients with Chronic Obstructive Pulmonary Disease (COPD), frailty has been implicated in worse survival. Objectives: To assess the prevalence of frailty and associated factors in patients with COPD. Methods: Cross-sectional study in COPD patients registered for public access to pharmacological treatment. Data were collected in Goiânia, at the High Cost Medication Center, from January to December 2018, after approval by the CEP. Demographic data, lung function, medication in use for COPD were collected; number of exacerbations, emergency consultations in the last 12 months; MRC, CAT, Charleston Index (ICCI) and frailty was assessed by applying FRAIL-BR and classified as Frail (3 to 5 points), Pre- Frail (1 or 2 points) and robust (0 points). A significance level of 5% was assigned. The descriptions used proportion, median and interquartile range (IQR). The categorical variables: sex, origin, race and drugs in use and the linear variables: medians of age and time in the program; were analyzed using the Chi-square test and Mann-Whitney, respectively. For the correlations between FRAIL and CAT, MRC and FEV1 variables, Spearman's correlation coefficient was used. Results: 153 patients were evaluated, predominantly elderly (83.0%), with a median age of 68 years (IIQ: 63-72) and male (54.9%). The prevalence of frailty in the sample was 50.3%, the pre-frail corresponded to 35.3%, only 14.3% of the patients were normal. The fragile, pre-frail and normal groups were similar with respect to age, sex, income, race / skin color, the presence of comorbidities, BMI, the medications used, exacerbations in the last 12 months, current smoking, hospitalizations, FEV (l) and vef1 / cvf (p-value> 0.05). The median of years of schooling was statistically higher in the normal than in the frail group (6.5 versus 5.0; p-value = 0.011), frail patients had worse lung function than normal patients with respect to FEV% (p- value = 0.011), highest median mMRC and CAT score (p-value <0.001), (p-value <0.001) respectively, finally, the groups were different regarding GOLD staging (p-value <0.001). GOLD A was more frequent in normals, while GOLD D was more prevalent in pre-frail and frail. After ordinal regression, the chances of frailty increased with increasing MRC (Model 1: ORaj = 1.94; p-value <0.001; Model 2: ORaj = 1.63; p-value <0.001), with the increase in CAT (ORaj = 1.12; p-value <0.001) and in individuals GOLD B (ORaj = 3.42; p-value = 0.011) and D (ORaj = 4.74; p-value = 0.003) when compared to A. Conclusion: Frailty is very prevalent in COPD patients, correlates with worse symptoms of the disease and worse lung function.Item Comparação entre os efeitos do sal do Himalaia e sal comum nos valores de sódio urinário e pressão arterial de indivíduos hipertensos(Universidade Federal de Goiás, 2020-07-08) Loyola, Isabela Pires; Sousa, Mauri Felix; http://lattes.cnpq.br/7545015260291638; Jardim, Paulo César Brandão Veiga; http://lattes.cnpq.br/2775666330217597; Jardim, Paulo César Brandão Veiga; Moreira, Humberto Graner; Mendes, Marcela Moraes; Jardim, Thiago Souza Veiga; Abreu, Vanessa Roriz Ferreira deBackground: Himalayan salt (HS) emerged and have spread as an alternative for traditional salt, especially for hypertensive individuals. Despite the increase in consumption and the health claims for hypertension, HS continuous without scientific evidence that justifies the clinical use or guidance by a health professional. This study aims to compare the impact of Himalayan and table salt (TS) consumption on systolic (SBD) and diastolic (DBP) blood pressure values, and calcium, sodium, and potassium urine concentration in hypertensive individuals. Methods: Randomized crossover study. Methods: A total of 14 hypertensive women participated in the survey. All received Himalayan salt and white salt at different times for 4 weeks each, with a washout period of two weeks. Participants collected a 24-hour urine and performed home blood pressure monitoring (HBPM) for 4 days. Statistical analyzes were performed using the SPSS program. Wilcoxon and Mann-Whitney tests were used for data without normal distribution. The 5% significance level was adopted for all tests. Results: No significant differences were found between the consumed SH and SC in both systolic blood pressure (p = 0.908) and diastolic blood pressure values (p = 0.645). Likewise, no difference was found in urinary sodium (p = 0.734), urinary potassium (p = 0.593) and urinary calcium (p = 0.613) values. When comparing these same parameters before and after the intervention with SH, we did not observe statistical difference either. Conclusion: There seems to be no significant difference between the consumption of SH and SC in blood pressure and electrolyte excretion of hypertensive patients. Thus, its use for the benefit of BP continues without scientific basis. Further studies with larger samples are needed to confirm our findings.Item Percepção dos estudantes de medicina sobre o uso da metodologia da problematização durante a graduação(Universidade Federal de Goiás, 2020-06-02) Santiago, Rejane de Carvalho; Almeida, Rogério José de; http://lattes.cnpq.br/5504604536035282; Moraes, Vardeli Alves de; http://lattes.cnpq.br/2078225868415338; Almeida, Rogério José de; Naghettine, Alessandra Vittorino; Carvalho, Iracema Gonzaga Moura de; Pereira, Edna Regina; Queiroz, Maria Goretti deThe National curriculum guidelines (NCG) for medical graduation state that the course should be centered on the student as the subject of learning, with the professor as a facilitator and mediator of the process, with a view to full professional training. Medicine courses must use methodologies that favor student participation in the construction of knowledge. The aim of this study was to understand the medical student's perception about the problematization methodology in the Competence Integrating Problem (CIP) unit of the Pontifical Catholic University of Goiás (PUC Goiás). This is a cross-sectional descriptive study with a qualitative approach, which seeks to understand the context where the phenomenon occurs, centered on the qualitative deepening of the discourses produced by students. Data were collected through a semi-structured interview that used a previously prepared script of themes. Interviews were made with thirty academics from the first to the twelfth modules about the unit called Integrating Competence Problem (CIP), which is developed through the problematization methodology together with the insertion of the Charles Maguerez Arch. For data analysis it was used the Grounded Theory or Grounded Theory. With the results obtained after carrying out the transcription and analysis of the interviews, it was possible to create explanatory categories of the investigated phenomenon, they were: Previous knowledge of active methods; Impact and adaptation to the CIP; Positives, negatives and improvements; Characteristics of the student in the CIP; Characteristics of the professor in the CIP; CIP contributions to medical training. The present study showed the efficiency and the contributions of the functionality and applicability of the problematization methodology in the CIP unit, such as: communication skills, research, problem solving, proactivity, how to work in a team, how to listen and respect the opinion of colleagues, they became more critical and learned to see the patient holistically, for medical formation. As a new methodology inserted in the field of medical education, there are weaknesses both in the training of the student and in the performance of the mediator professor, such as such as dispersions that were not carried out or carried out without reaching the objectives, the neglect of both students and professors, the lack of preparation of some professors, the workload of the curricular matrix, and the recurrent absences of professors. Through the correct applicability of the problematization methodology, it becomes feasible to train medical professionals who have a holistic view, who do not treat only the disease but the human being in an integral way.Item Fatores de risco cardiovascular em cardiologistas especialistas pela Sociedade Brasileira de Cardiologia(Universidade Federal de Goiás, 2020-03-12) Teixeira, Maria Emília Figueiredo; Vitorino, Priscila Valverde de Oliveira; http://lattes.cnpq.br/1815619227221108; Souza, Weimar Kunz Sebba Barroso de; http://lattes.cnpq.br/6847019017274804; Teixeira, Maria Emília Figueiredo; Vitorino, Priscila Valverde de Oliveira; Veiga Jardim, Paulo César BrandãoBackground: Most important cause of death worldwide, the cardiovascular diseases and its prevalence amongst cardiologists are still not well known. Objectives: To describe the cardiovascular risk profile of Brazilian cardiologists, their knowledge about their diseases, and to compare with population data. Methods: A transversal national multicentric study that evaluated cardiologists in all Brazilian regions through a structured questionnaire about life habits, previous personal diseases, use of medications, besides anthropometric measurements, blood pressure and serum glucose and lipids dosage. Weight was obtained with digital scales OMRON HN-290T. For the purpose of comparing the prevalences with the population, VIGITEL and PNS data were used. Results: Most of the 555 cardiologists evaluated were male (67,93%), with a mean age of 47,211,7 years, non smokers (88,6%), physically active (77,1%), alcohol berevage consumers (78,2%), with normal abdominal circumference (51,7%) and were above normal weighr (56%). The prevalences of hypertension was 31,41%, diabetes 4,86% and dyslipidemia 51,71% and, of those, only 57,22%, 55,55% e 47,38% stated to have those diseases, respectively, at the questionnaire. Conclusion: Cardiologists consume more alcohol beverages, and present similarly weight excess in comparison with the general population. The prevalence of hypertension and dyslipidemia amongst Brazilian cardiologistas was higher than the Brazilian population and diabetes was lower among the first group. Moreover, the number of physicians who ignored their pathological situation was much higher than expected, as within the population studies presented. Hard endpoints, such as myocardial infarction and stroke, were less prevalent among cardiologists.