Mestrado em Ciências da Saúde (FM)

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    Efeito da orientação para perda de peso em pacientes inférteis com sobrepeso e obesidade
    (Universidade Federal de Goiás, 2022-01-27) Benetti, Beatriz Bacheschi do Carmo; Approbato, Mário Silva;; Approbato, Mário Silva; Moraes, Alexandre Vieira Santos; Barbosa, Maria Alves
    Introduction: Obesity is considered a worldwide epidemic, being a serious public health problem. Overweight and obesity are characterized by the accumulation of body fat that poses a health risk. Several pathophysiological disorders are caused by obesity, especially in people with Body Mass Index (BMI) above 30 kg/m². It is increasingly common among women of childbearing age. Obese women are three times more likely to suffer from infertility than women with a normal body mass index. Objective: Evaluate the response to weight loss guidance in anthropometric parameters of obese and overweight infertile patients undergoing assisted fertilization treatment (high and low complexity). Methods: Retrospective cohort. A survey was carried out of a population of overweight and obese infertile patients one to two years after the first visit. In the first consultation at the assisted reproduction clinic (Human Reproduction Laboratory HC / UFG) as obese and overweight patients were instructed to lose weight and information that excess weight could decrease as chances of being successful in the treatment. As endocrine variables, estradiol, FSH, and LH were evaluated between obese and overweight patients in relation to normal weight patients. Proportions were compared using the chi-square test. Medians with the Mann-Whitney test. The H0 Rejection Level was 5%. Results: The age of the patients and the values of FSH, LH and estradiol were evaluated and paired, it was then verified that all presented p>0.05 after the adjustments. The age range of patients ranged from 21 to 40 years, with a mean of 35.59 ± 3.23 for the group with normal BMI and 35.78 ± 3.70dp for the group classified as overweight and obese. The mean weight in kg before and after orientation was 77.11±11.77 and 78.98±12.86 (p<0.0046). The mean BMI (kg/m²) before guidance was 29.69 ± 3.75dp and after guidance was 30.42 ± 4.32 (p<0.0038). Regarding ovulation, 31.6% of patients who lost weight did not ovulate compared to 20.0% of patients who gained weight. Patients who maintained their weight (16.7%) did not ovulate compared to 20.0% of patients who gained weight. Statistically non-significant difference. As for the endocrine variables, FSH, LH and estradiol, when comparing the population with normal weight with the population with overweight and obesity, no significant differences were found. Conclusions: There was a low percentage of weight loss in the patients, as only 37.5% achieved this goal. A greater number of patients gained or maintained their initial weight. Regarding ovulation, no significant associations were found when comparing patients who lost weight and those who gained weight, and also patients who maintained their weight compared to those who gained weight. As for the endocrine variables, in this study, the influence of obesity or overweight on these variables was not detected. The main diagnosis of infertility was bilateral tubal obstruction due to tubal ligation and other causes. Regarding the type of infertility, it was observed that cases of the primary type were the most frequent.
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    Qualidade de vida relacionada à saúde em pacientes com glomerulopatias primárias
    (Universidade Federal de Goiás, 2023-08-31) Borges, Marcela Oliveira Faria Braga; Barbosa, Maria Alves;; Fernandes, Marcos Rassi;; Fernandes, Marcos Rassi; Naghettini, Alessandra Vitorino; Veloso, Valéria Soares Pigozzi
    Introduction Primary Glomerulopathies (PG) represent around 20% of prevalent cases of Chronic Kidney Disease (CKD) in the world and can be a cause of irreversible kidney damage, a source of personal suffering, and also a socioeconomic problem. This study aims to evaluate Health-Related Quality of Life (HRQoL) using Patient Reported Outcome Measures (PROM), and identify predictive factors associated with worse HRQoL in patients with GP. Methods A PROMIS (Patient-Reported Outcome Measurement Information System) instrument was completed by 46 patients with GP to assess HRQoL. Five domains were assessed: global health, fatigue, anxiety, depression and sleep impairment. Exploratory univariate statistical analyzes were performed followed by multiple linear regression analysis. Results Forty-six patients participated in the study. The mean age was 38.5 ± 16.4 years (ranging from 18 to 76 years). Female patients had worse scores for anxiety (p=0.044), depression (p=0.040) and sleep disorders (p=0.007). Patients younger than 60 years had worse anxiety scores (p=0.041). Better educational level was related to lower depression score (p=0.010). Obesity determined a worse physical health score (43.95 versus 40.14, p=0.022). The presence of pain, swelling, diagnosis time ≥9 months and Diabetes Mellitus (DM) were predictors of worse HRQoL in more than one evaluated domain. Conclusion The predictive variables of worse HRQoL in patients with PG were female gender, age younger than 60 years, lower educational level, overweight and obesity, need for emergency care, DM, diagnosis time ≥9 months and the presence of pain and edema at the time of the study. The study concludes that the assessment of HRQoL domains using MRRP makes it possible to identify factors that worsen HRQoL, allowing early intervention and improving patient care.
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    MicroRNAs associados aos mecanismos fisiopatológicos da diabetes mellitus gestacional
    (Universidade Federal de Goiás, 2023-09-19) Silva, Pedro Henrique Costa Matos da; Santos, Rodrigo da Silva;; Reis, Angela Adamski da Silva;; Reis, Angela Adamski da Silva; Soares, Leonardo Ribeiro; Franchi, Leonardo Pereira
    Gestational diabetes mellitus (GDM) is a common condition during pregnancy and can be diagnosed from the beginning of prenatal care. Studies have highlighted the role of microRNAs (miRNAs) in the pathophysiological mechanism and as possible biomarkers for the diagnosis and treatment of GDM. miRNAs, a class of small non-coding RNAs, play a role in post-transcriptional gene expression. Therefore, this study aimed to perform a systematic review of miRNAs associated with GDM, to build a panel of miRNAs. A bibliographic search was carried out in PubMed/Medline, Virtual Health Library (VHL), Web of Science and EMBASE databases, selecting observational studies in English, without time restriction. The protocol is registered on the PROSPERO platform (number CRD42021291791). Fifty-five studies were included in this systematic review, and 82 altered miRNAs in DMG were identified. Furthermore, four miRNAs were more frequently upregulated in GDM (mir-16-5p, mir-20a-5p, mir-222- 3p and mir-330-3p). The dysregulation of these miRNAs is associated with mechanisms of cell cycle homeostasis, growth and proliferation of pancreatic β cells, glucose uptake and metabolism, insulin secretion and resistance. Therefore, identifying miRNAs associated with GDM and elucidating its main mechanisms can help in the characterization and definition of possible biomarkers for the diagnosis and treatment of GDM.
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    Impacto da implementação da resolução 2173 / 2017 do CFM no processo diagnóstico de morte encefálica doação de órgãos em um hospital público de Goiás em 2017 e 2018
    (Universidade Federal de Goiás, 2022-12-16) Carneiro, Lórimer Sandoval; Diniz, Denise Sisterolli;; Diniz, Denise Sisterolli; Guimarães, Valeriana de Castro; Mendonça, Helena Rezende Silva
    Brain death (BD) diagnosis is essential to establish potential donor status for organ transplantation. In Brazil, the Federal Council of Medicine (CFM) establishes the diagnostic parameters for BD. CFM Resolution 1480 / 1997 showed the need to perform two clinical examinations (including two apnea tests) with a minimum interval of six hours for patients aged two years or more. In 2017, Resolution 2173 / 2017 revoked the previous one and reduced the minimum interval to one hour between the two examinations (requiring only one apnea test). In Brazil, organ donation after the diagnosis of BD only occurs after an interview with family members of the potential donor. This research aimed to evaluate the change resolution impact in the process of diagnosis of BD-organ donation in the years 2017 and 2018 in a public hospital in Goiás. Methodology: A descriptive-comparative study was conducted by collecting data (retrospective) from the State Transplant Center of Goiás. The sample consisted of patients diagnosed with brain death at HUGOL from 2017 to 2018 (n=230), 93 patients in 2017 and 137 in 2018. The following were evaluated: age, sex, cause of coma, date and time of the first clinical examination, date and time of the second clinical examination, the time between the two clinical examinations, date and time of the complementary examination, time of diagnostic conclusion, date and time of death, eligibility (submission to family interview), acceptance or refusal of organ donation, and reason for family refusal. Results: Data distribution was not normal (application of Kolmogorov- Smirnov test), and Mann-Whitney and Chi-square tests were applied (95% CI and p≤0.05). The total time spent for the diagnosis of brain death was reduced (p=0.014); when the complementary exam was performed between the two clinical exams, the total time spent was reduced (p<0.001). The causes of coma were: TBI, TBI/polytrauma, CVA, HCVA, arterial malformation, hydrocephalus, CNS infection, sepsis, and tumor. Family from 108 patients refused organ donation for the following reasons: unawareness of the DP's wish, no living donor, family members wishing the body intact, undecided family members, family members against the donation, fear of the delay in releasing the body, religious convictions, and others. Conclusion: CFM Resolution 2173 / 2017 promoted a reduction in the time to diagnosis of brain death without impacting the decision of acceptance/refusal of organ donation. The time to diagnosis was not a reported cause for donation refusal. Organ donation depends on the community's knowledge about the transplant program, the DP's living wishes, and conditions related to their own beliefs. For this, we suggest public policies to encourage family dialogue on the subject - of organ donation and transplants.
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    Apraxia da marcha em paciente com demência: prevalência, características motoras e fatores associados
    (Universidade Federal de Goiás, 2013-10-01) Resende, Lorena Dias; Menezes, Ruth Losada de;; Caixeta, Leonardo Ferreira;; Caixeta, Leonardo Ferreira; Malloy-Diniz, Leandro Fernandes; Vieira, Renata Teles
    Introduction: Gait apraxia is an alteration of the gait characterized by a deficiency in the integration of the sensorial, motor and cerebellar functions necessary for rambling. The patients with this compromise have difficulty initiating and there is a congelation of the gait, mainly when turning ove their own axle. It is frequently associated with a cognitive dysfunction, an emotional instability, a urinary bladder dysfunction and behavioral abnormalities. Objectives: To evaluate the gait apraxia in patients with dementia, its prevalence and association with other types of apraxia as well as observing what phase of the disease in which it appears. Methods: Gait apraxia has been researched in a universe of patients with dementia consecutively assisted in the HC-UFG Dementia Ambulatory. The tests applied were the Mini-Mental State Examination and Clinical Dementia Rating Scale (CDR) to evaluate the cognitive functions, Pfeffer's Questionnaire for the functional evaluation of the activities of the daily life, the Scale of Berg's Functional Balance (BERG) and the Timed Up and Go Test (TUG) for the balance mensuration, besides the evaluation of the gait and the posture of the trunk. Results: A total of fifteen patients with gait apraxia were included in the study and all had some other associated apraxia. Regarding the CDR showed that 33.3% of patients were mild stage of the disease, 46.7% in the moderate and 20% in the severe. In Pfeffer Questionnaire patients had an average of 28.6 ± 1.40. There balance and coordination deficit in all patients, since the scores of the tests BERG and TUG showed inferior results. On the scale of BERG total score obtained average 11.07 ± 8.06 and varying between 2 and 24 points. The TUG test was performed above 20 seconds for all the patients. In the assessment of gait and postural trunk (AWS) the average score was 14.00 ± 6.88 ranging between 7 and 27 points. The correlation between AWS and scale BERG was significant (p = 0.001). Apraxia dynamics (90.9 %), ideatory (72.2 %) and kinetic members (63.6 %) were more frequent among patients. Forms of dementia who had gait apraxia were corticbasal degeneration (53.3 %), frontotemporal dementia (13.3%), Alzheimer's disease (6.6%), dementia with chronic subdural hematoma (6.6%), normal pressure hydrocephalus (6.6%), dementia in Parkinson's disease (6.6%) and multiple system atrophy (6.6%). The prevalence of patients with dementia and apraxia of gait was 9.37%. Conclusion: Gait apraxia is little prevalent in the universe of dementia and it is always associated with cortic-cortical dementia. Other forms of apraxia frequently follow gait apraxia. The corticbasal degeneration is the type of dementia most associated with the gait apraxia.
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    Prevalência das alterações radiológicas osteoarticulares e suas associações com controle hormonal a funcionalidade e a qualidade de vida em pacientes com acromegalia
    (Universidade Federal de Goiás, 2021-03-19) Jatene, Natalia; Rodrigues, Monike Lourenço Dias;; Silva, Nilzio Antonio da;; Silva, Nilzio Antonio da; Rassi, Nelson; Diniz, Denise Sisteroli
    Arthropathy is the most prevalent comorbidity of acromegaly, and studies are inconclusive about its associations with GH/IGF-1 control and/or other clinical features, so we elected to evaluate the prevalence of radiological arthropathy of lumbar vertebral column and lower limbs and its associations with quality of life, functionality, joint pain scores, clinical and psychiatric variables in acromegalic patients Methods: Cross-sectional study with 40 acromegalic patients of a tertiary Hospital. Clinical data was retrieved from medical records. WOMAC questionnaire was obtained to assess pain, stiffness and functionality in lower limbs, AcroQoL for quality-of -life and BDI-II for depressive symptoms assessment. X-rays of the hands, hips, knees, and lumbar spine were analyzed by a single radiologist. Osteoarthritis (OA) was graded according to Kellgren and Lawrence classification. Results: OA prevalence was 87% in lumbar spine, 77.4% in hips, 68.7% in knees. OA severity was associated with diabetes mellitus in lumbar spine (p <0.01) and higher IGF-1 levels at diagnosis in knees (p <0.05). No association was found among OA severity and questionnaires scores, but hypogonadism was significantly associated with worse WOMAC scores (p <0.05). Female gender was associated with higher BDI-II score (p <0.05), but not AcroQol or WOMAC. Conclusion: OA prevalence was high; however, its severity was not associated with acromegaly hormonal control, WOMAC, AcroQol or BDI-II scores. Modifiable factors as hypogonadism can be as important as hormonal control in acromegaly for chronic pain management.
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    Avaliação do efeito do bevacizumab, 5-fluoruracila e triancinolona na modulação cicatricial de feridas cirúrgicas em ratos
    (Universidade Federal de Goiás, 2017-03-13) Rios, José Eduardo Simarro; Carvalho, Roberto Murillo Limongi de Souza;; Silva, Leopoldo Magacho dos Santos;; Silva, Leopoldo Magacho dos Santos; Carvalho, Roberto Murillo Limongi de Souza; Almeida, Fábio Marques de
    The aim of the present study was to analyze the influence of 5-Fluorouracil (5Fu), Triamcinolone (T) and Bevacizumab (BVZ) on scar modulation in an experimental model of surgical lesions performed on rats. Rattus novergicus albinus rats were selected, divided into four groups: Group 1: BVZ; Group 2: 5Fu + T; Group 3: BVZ + 5Fu + T and Control Group (CG): received no medication. The incision surgery performed was linear, wedged and sutured in the first intention, similar to the surgical incision of upper blepharoplasty, followed by suturing the edges with simple stitches using 6.0 nylon thread. Stitches were removed on the 7th postoperative day. Immediately after, the medications from each group were applied by subcutaneous retro injection below the surgical scar. Euthanasia and tissue removal, which contained the surgical scar and 2 mm margin, were performed on the 14th day of the experiment. In the macroscopic evaluation, performed daily, no delay, suture dehiscence or signs of infection were observed. For histological evaluation, the tissue was stained with hematoxylin eosin and picrosirius. In the morphometric analysis between groups, there was difference in the number of monocytes only in group 2 (p = 0.03). There was a 56%, 86% and 85% decrease in the number of neovasculars in groups 1, 2 and 3 respectively (p = 0.002). There was no statistical difference in the number of fibroblasts, hemorrhage and hemosiderin. Analysis of picrosirius staining by electron microscopy showed an increase in collagen density (Group 1: 16%, Group 2: 87% and Group 3: 59%) and a more organized disposition in the groups receiving the medications compared to CG (p <0.001). Scar modulation was observed in all groups, and group 2 achieved better results. This was the first experimental study to evaluate the influence of the three medications together on healing. Drugs when used together can act in the prevention and treatment of unsightly scars, and these associations act in different ways of healing and have promising alternatives of molecular action as new options to the current treatment that is based on the use of corticosteroids that in addition to not responding in some patients, lead to unwanted and frequent side effects in their use alone.
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    Avaliação do genótipo de pacientes com síndrome de Usher do Centro de Referência em Oftalmologia da Universidade Federal de Goiás
    (Universidade Federal de Goiás, 2014-12-16) Cruvinel Filho, Ricardo Campos; Ávila, Marcos Pereira de;; Ávila, Marcos Pereira de; Rassi, Alan Ricardo; Lima, Francisco Eduardo Lopes de; Silva, Leopoldo Magacho dos Santos
    Cross-sectional study conducted at the Center of Reference in Ophthalmology UFG in conjunction with Oregon Health and Science University and the Brazilian Center for Eye Surgery (CBCO). To evaluate the genotype of patients with Usher syndrome of Reference Center for Ophthalmology, Federal University of Goias (UFG-CEROF). Patients clinically diagnosed with SU underwent complete ophthalmic examination, Goldmann manual kinetic perimetry, audiometry and subsequent collection of peripheral blood chromosomal microarray for sequencing. We examined 19 patients with clinical suspicion of SU with a mean age at first visit was 42.5 years (± 12.2) and a slight predominance of males (52.63%). The most prevalent subtype in clinical diagnosis of type I disease (68.4%). The visual acuity measured on the day of the exam for eye examination was 20/92 on the Snellen chart. Examinations audiometry showed hearing loss in all patients ranging from moderate in 12.5% of patients, deep (56.25%) and severe (31.25%). In 36.8% of patients analyzed, we found at least two mutations in the same gene, and of these, 21% were heterozygous mutations, and 15.8% homozygous. The homozygous mutations, which were of the type no sense, occurred in the gene CLRN1 whose patients had a previous diagnosis of USH 2. Met 26.31% of the sample analyzed in heterozygous. Of these, two patients showed mutations in the MYO7A gene (40%), both with clinical suspicion of USH 1. For the proposed methodology, we found no disease-causing mutations in 79% of the sample analyzed. Following the proposed methodology, the authors were able to determine the mutation in seven patients of nineteen patients inclued in this study. Of these, three patients were diagnosed with homozygous mutations in gene CLRN1, and had previous clinical diagnosis of type 2. Two patients had heterozygous mutations in gene MYO7A, both with previous clinical diagnosis of type 1.
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    Qualidade de vida de mulheres com e sem risco cardiovascular atendidas em uma Unidade Básica de Saúde
    (Universidade Federal de Goiás, 2021-05-07) Carvalho, Sebastião Paulo dos Santos; Silva, Maria Sebastiana;; Silva, Maria Sebastiana; Soares, Viviane; Guimarães, Valeriana de Castro
    Population's quality of life has been an area of study from health academics and professionals because of increased longevity and disorder as hypertension, diabetes and dyslipidemia that induce cardiovascular diseases and add to physic and mental debilities going to death. Hence the aim of the study was measure life of quality of women with cardiovascular risk (WCVR) and without cardiovascular risk (WHCVR). A transversal observation study was made with 116 women attended on Health Basic Unit in the city of Santo Antonio de Goiás – GO in 2019. The cardiovascular risk (CVR) was measure by score of Framingham that used age, presence of dyslipidemia, diabetes, systolic blood pressure (SBP), tabagism, high density lipoprotein cholesterol (HDL-c), low density lipoprotein cholesterol (LDL-c) and cholesterol total (TC). Two groups were established by CVR: without risk (50 women) and with risk (66 women). To measure life of quality was used the Outcomes Short-Form 36-item Health Survey (SF-36) that have questions to assess physics and mental aspects. The statistical analysis was made in software package SPSS v.20. The average of age, height, BMI, TG, TC, LDL, HDL, SBP and glycemic leve were different between groups. In WCVR 90.9% had climacteric period, 59.09% had dyslipidemia, 63.63% had hypertension, 46.96% had diabetic and 7.57% are smokers. The groups were differents in two domains of quality of life (DQoL) body pain (BP) p<0.02 and role-physical (RP) p<0.01. The factors of cardiovascular risk (FCVR) age and BMI impacted in DQoL social functioning (SF), TG in physical functioning (PF), BMI in general health (GH) from women WCVR. LDL-c and CT impacted in role emotional (RE) from women WHCVR. All scores of DQoL from women WCVR is lower than women WHCVR (excepted SF). all analyzed factors negatively impacted the domains of quality of life, indicating impairment of cardiovascular risk on the quality of life of these women.
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    Percepção do psicólogo sobre a assistência psicológica ao paciente com Covid-19 em unidade de terapia intensiva
    (Universidade Federal de Goiás, 2021-05-20) Moraes, Andrea Silva; Suzuki, Karina;; Souza, Ana Luiza Lima;; Sousa, Ana Luiza Lima; Suzuki, Karina; Pegoraro, Renata Fabiana
    Critically ill patients with Covid-19 admitted to the Intensive Care Unit regularly need to use mechanical ventilation as life support. Orotracheal intubation limits patient communication through speech, which can lead to anxiety, low mood and/or depression. The role of the psychologist should not be restricted to patients who are able to express themselves in terms of their psychological and emotional needs through speech, but rather provide the intubated patient with emotional and psychic expression, in addition to welcoming their perceptions, regarding the treatment and experience of hospitalization. Objective to analyze the perception of psychology professionals about their practice in the Intensive Care Unit, with critically ill patients diagnosed with Covid-19. Method: descriptive cross-sectional observational study, with psychologists working with patients with Covid-19 in intensive care units, in hospitals located in a Brazilian capital. Sociodemographic variables were used: age, sex and marital status; also education and professional performance: place of higher education/graduation, time of basic education, specialization and time of practice in a hospital unit and specifically in ICUs, and self-perception about the experience of professional practice was evaluated. Data collection was performed remotely, with the application of a sociodemographic questionnaire and the Free Word Association Technique (TALP) instrument to assess self-perception. Four phrase-type stimuli were chosen for TALP: Stimulus1- Patient admitted to an isolation infirmary. Stimulo2- Conscious and oriented patient admitted to the intensive care unit. Stimulus3- Patient under mechanical ventilation (MV) in the intensive care unit. Stimulus4- Considering the pandemic and my work with the patient diagnosed with Covid-19, I feel. Data analysis was performed using the Excel program (2016) and the Tri-Deux-Mots application (version 5.1) which performs factor analysis by correspondence and presents the results in spatial quadrants. Results: 59 psychologists participated, 66.1% of them aged between 24 and 35 years old, 86.5% female and 59.3% with a partner; 86.5% were trained in private institutions in the years 2014 to 2020, proportion of 52.5% and 47.5% are specialists in Health and Hospital Psychology. Practice in the ICU with experience of less than one year was 35.6% and 37.3% with hospital practice for between one and four years. The most common words when considering the experience of psychological care with the patient with Covid-19 in the infirmary (stimulus 1) were: anguish, anxiety, isolation, fear and loneliness. With conscious patients in the ICU (stimulus2) were: anxiety, anguish, fear and with patients on MV (stimulus 3) were: anxiety, severity, death, fear and family. In addition to the psychologists expressing (stimulus 4) feeling anxiety, anguish and fear as the most present psychic symptoms at this time when working with patients with Covid-19. Conclusion: the psychologist expressed concern with the patient and possible outcomes, such as death, and with their families, given the delicacy and uncertainty in this type of hospitalization. In addition to being concerned about the physical condition and worsening of the clinical condition of the ventilating patient. The word “tiredness” reflected new habits and work routines, a high demand coming not only from patients and family members, but also from the team and peers, in the face of the unknown.
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    Avaliação da associação das medidas de isolamento social na pandemia por Covid19 nas exacerbações em pneumopatas crônicos
    (Universidade Federal de Goiás, 2022-07-08) Velasco, Flávia Castro; Silva, Daniela Graner Schuwartz Tannus;; Rabahi, Marcelo Fouad;; Rabahi, Marcelo Fouad; Silva, Clystenes Odyr Soares; Carneiro, Lilian Carla
    Objective: To assess the association between social isolation and the frequency of exacerbations in patients with chronic lung disease at the pulmonology outpatient clinics of the HC/UFG Methods: Observational, descriptive, cross-sectional study, in which patients from the hospital of the UFG clinics who were scheduled in the pulmonology outpatient clinics (COPD, asthma, pulmonary circulation, cystic fibrosis and bronchiectasis) from March to July 2020 were evaluated. Elective outpatient consultations were suspended in compliance with the social isolation measures defined by the Ministry of Health during the COVID-19 pandemic. The data collection questionnaires were filled out over the phone by the researcher with the call recorded. The data contained epidemiological assessment, characteristics of isolation, access to medication, exacerbations in the period evaluated and perception of symptoms. Results: In the evaluated period, 516 patients were scheduled, and 344 patients were excluded due to inability to access the telephone or inability to answer the research questionnaires, or refusal to participate, leaving 172 patients included in the study. The most prevalent diseases were asthma and COPD, 40.1% and 25.6% respectively, followed by pulmonary hypertension (16.9%), non-cystic fibrosis bronchiectasis (5.2%) and cystic fibrosis (4.7%). It was observed that the majority did not work outside the home (77%), and after social isolation there was a reduction in patients who worked outside the home (15%) compared to before isolation (23%). It is noticed that most people left the house less after the beginning of isolation (93%). Regarding the treatment, 80.2% had no difficulties in getting medications for continuous use. In physical activities, about half of the participants stopped exercising. It was observed that 117 patients (68%) had no exacerbation in the period. There was an association of exacerbation in patients who clarified doubts with a doctor (27.3%, p 0.01), who considered they were not well (69.1%, p < 0.01) and who rated more severe levels of dyspnea 2 -3 and 4-5; 61.8% and 18.2% (p<0.01) respectively. The absence of exacerbations was associated with the lowest rating of shortness of breath 0-1 (52.1%, p<0.01). Regarding the socio-demographic profile, life habits and risk factors, exacerbation was associated with black patients (21.8%, p=0.04) with no associations with other variables. Conclusions: Most of the participants avoided leaving the house during isolation, and 2/3 of the patients did not experience an exacerbation during the analyzed period. There was an association with exacerbation in patients who sought medical care and participants who reported worse symptoms and did not consider themselves to be well.
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    Diagnóstico precoce do pé diabético em pacientes atendidos em um serviço do sistema único de saúde
    (Universidade Federal de Goiás, 2019-02-21) Cardoso, Hígor Chagas; Mrué, Fátima;; Mrué, Fátima; Rosa, Suélia de Siqueira Rodrigues Fleury; Parisi, Maria Cândida Ribeiro
    Introduction: Ulceration and (or) destruction of soft tissues that occur in the feet of the diabetic patient associated with neurological changes and peripheral arterial disease characterize the clinical condition known as diabetic foot. The person with diabetes mellitus has a lifetime risk of developing this complication estimated at 25%, diabetic foot injuries accounting for 20% of all hospitalizations of diabetic patients. Objective: To evaluate the factors related to the development of diabetic foot in individuals attended in a public health service. Method: An observational, descriptive, quantitative study of diabetic patients older than 18 years of age, of both gender, who were attended by endocrinologists, between July 2018 and July October 2018 at the Dr. Ilion Fleury Jr. public Health Unit municipality of Anápolis, Goiás, Brazil. Participants were evaluated for their socioeconomic and clinical characteristics, with vascular and neurological evaluations, as well as the classification of the risk of developing diabetic foot, according to the International Working Group on the Diabetic Foot (IWGDF). For statistical analysis, the IBM SPSS Statistics® program was used, with the Chi-Square Test, Chi-Square Test for Trend and Fisher's Exact Test. Significance was defined as a p value <0.05. Results: A total of 85 patients were evaluated. The prevalence of diabetic foot in the sample was 10.6%. The parameters evaluated diagnosis time of diabetes, nail appearance, humidity and foot deformities presented a statistically significant association with the development of diabetic foot (p <0.05). Considering the IWGDF classification, grade 0, 1, 2 and 3 risks, respectively, were observed in 28.2%, 29.4%, 23.5% and 8.2% of the patients. Conclusion: This study demonstrated the importance of the identification of symptoms and signs of loss of protective sensitivity and peripheral occlusive arterial disease, which are the most important triggering factors for diabetic foot development. The results obtained in this study is hoped to contribute to the development of a more attractive protocol for the basic health units system with greater effectiveness and success.
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    Sífilis materna no estado de Goiás: análise de série histórica de 2007 a 2017
    (Universidade Federal de Goiás, 2020-08-13) Oliveira, Iana Mundim de; Oliveira, Rivert Paulo Braga;; Alves, Rosane Ribeiro Figueiredo;; Alves, Rosane Ribeiro Figueiredo; Deus, José Miguel de; Silveira, Érika Aparecida da
    BACKGROUND: Maternal syphilis is an important public health problem in Brazil and worldwide, responsible for high rates of intrauterine and postnatal morbidity and mortality. In the last decades there has been an increase in the number of cases in Goiás, which requires epidemiological studies on the behavior of the disease in pregnant women OBJECTIVES: Analyze trends in incidence, clinical and laboratory aspects of maternal syphilis, in the state of Goiás, between 2007 and 2017. METHODS: Time series study, using data from compulsory notification of syphilis during pregnancy, in the state of Goiás, between the years 2007 to 2017. The incidence of maternal syphilis was calculated by dividing the number of reported cases by the population of live births each year, times a thousand live births. The analysis of the average annual percentage variation and the incidence by municipality size were calculated using a linear model with first order autoregressive errors (AR), via Prais Winsten's transformation, in the R software, and for this, the number of inhabitants 2010 CENSUS was considered. The spatial correlation was measured using the Moran Index (I). The clinical and sociodemographic variables were analyzed descriptively. The Cochran-Armitage test was used to verify trends in proportions. RESULTS: Between 2007 and 2017, 7,774 cases of maternal syphilis were recorded in Goiás. The age of pregnant women with syphilis varied between 12 and 49 years, with an average of 24.8 years (SD 6.5). The incidence was higher in the second trimester of pregnancy, in those with a lower level of education and brown skin, and the most frequent clinical form was the primary. The annual incidence rate of syphilis during pregnancy ranged between 2.9 and 15.6 cases per thousand live births, with an average annual growth of 1.21 cases per year from 2007 to 2017 (95% CI: 0.78-1, 65). The annual percentage change (APC) increased by 17.8% (95% CI: 16.9-18.8) in the period studied, with a statistically significant spatial correlation (p = 0.0035). The size of the municipality was not significant to explain the variation in incidence. Between 2007 and 2017, there was an increasing trend in the percentage of reports of latent syphilis (14.1% to 30.7%), secondary (5.2% to 19.0%) and tertiary (4.4% to 11, 4%) and treatment with benzathine penicillin at a dose of 7.2 million (19.3% to 59.6%). A decreasing trend was observed in the percentages of data without information (from 10.0% in 2007 to 8.8% in 2017) or ignored (from 22.9% in 2007 to 8.0% in 2017). CONCLUSION: There was a linear increase in the incidence of syphilis during pregnancy in Goiás in recent years, with a statistically significant spatial correlation, however, the size of the municipality was not significant to explain the variation in incidence. The increase in reports of latent syphilis and the use of penicillin in the appropriate dose for this classification, associated with the reduction of ignored or unfilled data, suggest an improvement in the notification process.
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    Percepção de distúrbios musculoesqueléticos e a sua repercussão nas atividades de vida diária em profissionais intérpretes de língua brasileira de sinais
    (Universidade Federal de Goiás, 2021-09-01) Lisboa, Leandro Vieira; Rodríguez Martín, Dolores;; Chaveiro, Neuma;; Chaveiro, Neuma; Barbosa, Maria Alves; Duarte, Soraya Bianca Reis; Barbosa, Diego Maurício
    OBJECTIVE: to investigate the perception of musculoskeletal disorders and their impact on activities of daily living in professional sign language interpreters. METHODOLOGY: this is a qualitative research of analytical descriptive nature, consisting of a sample of 12 sign language interpreters working in the city of Goiânia, Goiás. For data collection, the following instruments were used: a sociodemographic questionnaire and a semi-structured interview. The collected data were treated according to Laurence Bardin's content analysis technique, identifying “sense cores” and their frequency to find meanings for the analytical object of this study. RESULTS: the dissertation was structured in the form of articles, featuring five scientific productions. The first and third articles are systematic review protocols according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols, the second and fourth are the referred systematic reviews according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis and the fifth article it is about the qualitative research of analytical descriptive nature. These productions presented content about the health of the sign language interpreter professional. The first scientific production was submitted to the journal Systematic Reviews and has the title: Quality of life of sign language interpreters: a systematic review protocol in which it addresses criteria and the step-by-step for conducting a systematic review on quality of life in language interpreters of signs, with the objectives: analyzing the perception of quality of life of sign language interpreters; to correlate the functionality of sign language interpreters and the perception of quality of life. The second was submitted to the Scientific Interfaces - Human and Social journal entitled “Quality of life of sign language interpreters: a systematic review” whose objective was to analyze the quality of life of sign language interpreters based on a systematic review. The third, submitted to the journal Systematic Reviews, has the title: Musculoskeletal disorders in sign language interpreters: a systematic review protocol and addresses criteria and step-by-step for conducting a systematic review of musculoskeletal disorders in professional sign language interpreters, with objectives: to analyze the prevalence of musculoskeletal disorders in professional sign language interpreters; identify the most affected body region with musculoskeletal disorders. The fourth production, “Musculoskeletal disorders in sign language interpreters: a systematic review” aims to identify the musculoskeletal disorders that most affect sign language interpreters. The fifth article addresses the "Perception of musculoskeletal symptoms and their impact on activities of daily living in sign language interpreters" and this study is presented in the methodology of this summary, resulting in an unsatisfactory perception of pain, fatigue, and difficulties in the activities of daily life. CONCLUSION: professional sign language interpreters had an unsatisfactory perception of quality of life and a high prevalence of musculoskeletal disorders, as evidenced by systematic review articles, and these data were also confirmed by qualitative research in which professional sign language interpreters showed the perception of several musculoskeletal symptoms, in addition to physical and mental fatigue resulting from their role as sign language interpreters.
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    Posição do forame apical em imagens de tomografia computadorizada de feixe cônico na dentição permanente humana
    (Universidade Federal de Goiás, 2017-12-05) Couto, Gabriela Soares; Estrela, Carlos;; Estrela, Carlos; Pécora, Jesus Djalma; Decúrcio, Daniel Almeida
    Aim: This study determined the apical foramen position in relation of root surfaces in human permanent teeth using cone beam computed tomography (CBCT) images. Methods: It was selected a sample of 1,400 teeth from CBCT scans of 422 patients (394 women; 44.46 mean age-years). AF position in relation of root surfaces was determined longitudinally on 0.1-mm/0.1-mm axial slices of CBCT images, from the pulp orifice to the root apex. The findings were recorded into categories: 1. buccal; 2. mesiobuccal; 3. mesial; 4. mesiolingual/palatal; 5. lingual/palatal; 6. distolingual/palatal; 7. distobuccal; 8.central. Analysis of the data used in the statistical classification. Categorical variables were described by frequency and percentage. A statistical analysis of the data was performed without the Microsoft Excel program for Windows 2013 (Redmond, Washington, USA).Results: The position of the apical foramen most frequently found in the lower central incisors was vestibular (35.48%), followed by the central position (30.64%). The distal position (31%) of the apical foramen was the second highest frequency seen in the maxillary lateral incisors. In the upper second premolars, the buccal and mesiobuccal root canal presented a higher frequency (27.51%) of the apical foramen in the central position, followed by the mesial position. In the second maxillary molar the greater foramen frequency in the central position was found in the mesiobuccal root (20.25%), and in the lower first molar, the mesiobuccal root was the one with the highest frequency (18.80%).Conclusions: AF position in human permanent teeth was central in 51.15% and 48.85% in maxillary and mandibular teeth, respectively. The CBCT and the strategies of longitudinal map-reading represent a dynamic and nondestructive method and improve to identify the AF position.
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    Tradução, adaptação transcultural e validação do questionário STOP- Bang para a língua portuguesa falada no Brasil para triagem de apneia obstrutiva do sono
    (Universidade Federal de Goiás, 2016-03-23) Fonseca, Lorena Barbosa de Moraes; Silveira, Erika Aparecida;; Rabahi, Marcelo Fouad;; Rabahi, Marcelo Fouad; Jardim, Thiago de Souza Veiga; Corrêa, Krislainy de Sousa
    Introduction: Obstructive sleep apnea (OSA) is a disorder characterized by repeated interruption of ventilation during sleep due to the closure of the upper airway. The polysomnography in laboratory is the "gold standard" for diagnosis of OSA. It is a procedure that takes a lot of time in achieving and it is expensive, so a number of screening questionnaires have been developed to help identify patients with OSA. One of these tools is the STOP-Bang questionnaire. Objective: The objective of this study was to translate, make cross-cultural adaptation and validate the STOP-Bang questionnaire for Portuguese language spoken in Brazil to screen for obstructive sleep apnea. Methods: This study was approved by the ethics committee and all patients signed an informed consent. In the first stage of the work was carried out the translation and crosscultural adaptation of the STOP-Bang questionnaire for the Portuguese language spoken in Brazil.There were followed all the necessary steps, always based on the principles of good practice to carry out this process. The second stage was carried out to validate the Portuguese version spoken in Brazil, the STOP-Bang questionnaire to screen for obstructive sleep apnea. Participated in this stage 228 patients older than 18 years. Initially completed version of the STOP-Bang questionnaire translated and adapted culturally for Portuguese language spoken in Brazil and later underwent overnight polysomnography. Results: The final version of the STOP-Bang questionnaire translated and adapted culturally for Portuguese language spoken in Brazil showed good internal consistency, and the clarity averages were between 9.1 and 9.8. The age of patients ranged 30-71 years. The averaged of body mass index was 43.7 ± 8.5 kg / m² and of the neck circumference 41.3 ± 3.6 cm. In the validation phase, the 228 patients, 157 were male, accounting for 68.9%, and were most people in the group with apnea. In this study noted that by increasing the cut-off point of the STOP-Bang questionnaire, had corresponding increase in specificity in the group with moderate / severe and severe, accompanied by gradual reduction of sensitivity. In the ROC curve analysis, the cut-off point found the STOP-Bang questionnaire translated and culturally adapted for Brazil was greater than 3, and was found the predictive value of the questionnaire Abstract 73% for apnea-hypopnea index (AHI) > 5, 72% for AHI> 15 and 78% for AHI> 30. Conclusion: The STOP-Bang questionnaire translated and culturally adapted to Brazil proved to be understandable, clear and enforceable. It shows good consistency in the equivalence of translation and cultural adaptation to Portuguese language spoken in Brazil. It was shown that has a good performance for predicting OSA, being an important screening tool for the diagnosis of this disease.
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    Incisões relaxadoras e resistência à tração na parede abdominal de suínos
    (Universidade Federal de Goiás, 2019-04-16) Pedroso, Aline Ribeiro; Melo, Renato Miranda de;; Oliveira, Enio Chaves de;; Oliveira, Enio Chaves de; Melo, Renato Miranda de; Penhavel, Félix André Sanches
    Introduction: Some complications, such as wound dehiscence and incisional hernia (IH), may arise after surgical closure of the abdominal cavity, with excessive tension in the suture line being a major cause. In order to correct IH, Alcino Lázaro da Silva developed the bilateral longitudinal peritoneo-aponeurotic transposition technique (TRANSPALB), which uses the hernial sac to close the defect after performing relaxing incisions in the rectus abdominis muscle sheath. Purpose: To analyze the resistance to medial traction of abdominal wall muscles, before and after performing relaxing incisions. Methods: Seventeen live pigs were used. After a median laparotomy, the abdominal rectus muscles (MR) were made to fit the dynamometer. Step 1 (control phase): tensile strength measured without performing relaxant incisions. Step 2: A curvilinear relaxant incision was made on the anterior slide of the right MR sheath and then the resistance edge was measured by the edge of the wound. The same procedure was adopted after incision of the left posterior lamina. Step 3: Relaxing incisions were made on the right and left anterior slides, so that both sides were left with a relaxing incision on both slides. Measurements of resistance were performed. Results: There was no significant difference between the sides. On the right and left side, all treatments reduced the tensile strength when compared to each other and to the control. There was a reduction of 12% and 9.8% after incision of the anterior and posterior lamina, respectively. Conclusion: Relaxing incisions reduced tensile strength on the ventral abdominal wall.
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    Prevalência de antigenemia criptocócica em pessoas com Aids em um hospital de referência em Goiânia, Goiás
    (Universidade Federal de Goiás, 2019-03-08) Borges, Moara Alves Santa Bárbara; Araújo Filho, João Alves de;; Turchi, Marília Dalva;; Turchi, Marília Dalva; Pereira, Ledice Inácia de Araújo; Bermudez, José Ernesto Vidal
    Introduction: Cryptococcosis is caused by Cryptococcus species complex (Cryptococcus neoformans and Cryptococcus gattii) and targets immunocompromised individuals, including those with AIDS. Cryptococcal antigen (CrAg) detection in the HIV population with CD4 counts <100-200 cells/μL has been recommended by the World Health Organization since 2011 in areas with CrAg prevalence >3%. Objectives: To estimate the prevalence and to evaluate associated factors to CrAg positivity in AIDS population in Goiás, Midwest of Brazil. Methodology: A cross-sectional study, which evaluated HIV-infected adults, with a CD4 T-cell count <200 cells / μL, without previous history of cryptococcosis, regardless of the use of antiretroviral therapy (ART), time of diagnosis or symptoms, attended at a infectious diseases reference hospital in Goiânia, Goiás, from June 2015 to July 2018. Demographic, clinical and laboratory characteristics were investigated through interviews with the participants and review of medical records. The serum CrAg test was performed by the Lateral Flow Assay technique (Immuno-Mycologics Inc®, Norman, Oklahoma). The prevalence of cryptococcal antigenemia with Confidence Interval of 95% (95% CI) was estimated. Chi-square test or Fisher's exact test was used to compare categorical variables and T-test for continuous variables. The level of significance was set at p <0.05. Results: Of the 214 individuals recruited, 72% were men ranging in age from 18 to 78 years (median, 40 years). HIV diagnosis was recent in 47% (≤12 months) and 88.8% (n=190) were antiretroviral experienced, of which 51.4% (n=110) were taking this regularly in the previous 3 months. Viral load was undetectable in 25/214. CD4 values ranged from 1 to 199 cells/μL (median, 47 cells/μL). The overall prevalence of CrAg was 7.9% (95% CI, 4.7-12.4); 7.5% (12/159) in those with CD4 ≤100 cells/μL and 9.1% (5/55) in those with CD4 101 to 199 cells/μL. There were no statistically significant differences between sociodemographic, clinical or laboratory characteristics to predict CrAg positivity (p> 0.05). Conclusion: The prevalence of cryptococcal antigenemia in an HIV population with CD4 <200 cells/μL from midwest Brazil is high, above the cut-off point for the cost-effectiveness of CrAg screening. No clinical or laboratory factors could predict positivity, corroborating the need for universal screening for CrAg in severely immunosuppressed individuals infected with HIV in similar regions.
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    Intoxicações exógenas por medicamentos em crianças: perfil clínico-epidemiológico e qualidade dos dados do Sistema de Informação de Agravos de Notificação (Sinan) e do Sistema Nacional de Vigilância Sanitária (Sinavisa), em Goiânia, Goiás, 2012-2016
    (Universidade Federal de Goiás, 2018-11-24) Cardoso, Huilma Alves; Avelino, Mariza Martins;; Avelino, Mariza Martins; Siriano, Liliane da Rocha; Nakano, Simone Moraes Stefani
    Introduction: Exogenous drug intoxications are considered a serious public health problem in Brazil and in the world, especially in children. Objective: To describe the clinical and epidemiological profile of the reported cases of exogenous poisoning by drugs in children and the quality of the information systems in Goiânia, Goiás. Methods: This is a descriptive study, using secondary data from children from zero to 12 years of age, obtained from the Notification of Injury Information System (Sinan) and National Sanitary Surveillance Information System (Sinavisa) between 2012 and 2016. We analyzed general, individual data, epidemiological history, exposure, care, conclusion of the case and risk factors for hospitalization. Regarding data quality, the incompleteness and inconsistencies of the variables were evaluated. The agreement between the data was made by calculating the Kappa index and the Intraclass Correlation Coefficient (p <0.05). After extracting the data using Tabwin®, the analysis was performed in the IBM® SPSS Statistics®, version 22 program. Results: A total of 389 cases of drug intoxication were reported in children in Sinan and 680 cases in Sinavisa, with 243 cases common to both systems. The prevalence of cases in the two systems was divergent between 2012 and 2013, and from 2014, there was a progressive increase in the number of cases after convergence. The drug poisoning at Sinan and Sinavisa was predominant, consecutively, in the age range of one to four years (53.1%; 72.0%), at home (88.4%, 95.4%), through the digestive route (88.3%, 96.1%), due to accidental causes (60.7%, 77.2%) and the single acute type (92.0%, 99.6%). In both systems, the highest frequency was hospital (82.0%, 53.8%), in the public sector (96.9%, 80.4%) and without hospitalization (55.0%, 71% 9%). A wide variety of medications led to intoxications, most frequently central nervous system depressants in both systems (25.7%, 22.9%). In Sinan, hospitalizations were more likely to occur in children aged one to eight years. In Sinavisa, hospitalizations were more likely to occur in cases treated in the public sector and involving drugs controlled by Portaria n. 344/98. There were inconsistencies in both systems. In both systems, the completeness of the variables was greater than 91.0%, but four variables were not fulfilled. Between the two systems, only the variables gender, date of birth and age had excellent agreement. Conclusions: Medication poisonings occur more frequently in infancy, by accidental circumstance, orally, in the residences, in a unique acute form and present cure without sequelae. The drugs most involved are the central nervous system depressants. The greatest chance of hospitalization occurs among children aged one to eight years, in public units and involving controlled medications. The quality of the data and the agreement between the Sinan and Sinavisa systems are unsatisfactory.
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    Perfil de diagnósticos de enfermagem para população adulta de duas comunidades quilombolas em Goiás
    (Universidade Federal de Goiás, 2019-10-29) Marinho, Núbia Aguiar; Santos, Mônica de Oliveira;; Moraes Filho, Aroldo Vieira de;; Carneiro, Lilian Carla;; Carneiro, Lilian Carla; Brasileiro, Marislei de Sousa Espíndula; Oliveira, Michele Dias da Silva
    The nurse needs to have a cephalocaudal and psychosocial view of all his clients and for this, the Data Collection and Physical Examination of this individual should be performed as soon as the first contact. After the registration and interpretation of all the collected data, the nurse will be able to raise the possible Nursing Diagnoses. The objective of this study was to apply the data collection and physical examination in the quilombola communities of Jardim Cascata/ Vila Del Fiore in Aparecida de Goiânia-GO (urban area) and in the community of Almeidas in Silvânia-GO (rural area), establishing the the most prevalent nursing diagnoses in this population. Data collection and physical examination of 26 adults in the rural community and 21 adults in the urban community were carried out by the adult members who accepted to participate in the survey. Developing data collection and physical examination, establishing the most prevalent nursing diagnoses in this population was extremely important and relevant because this conduct will allow the development of future nursing interventions that will contribute to the development and implementation of adequate public policies to these realities. In general, the diagnoses raised for the quilombolas of the urban zone presented higher values in comparison to the values of the diagnoses of quilombolas of the rural zone. We observed that the health care offered by the Unified Health System (SUS) does not address all the health needs of these two quilombola populations studied.