Doutorado em Ciências da Saúde (FM)

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    Percepção da qualidade de vida de acadêmicos e de professores de educação física em inicio de carreira
    (Universidade Federal de Goiás, 2023-06-01) Souza, Lídia Acyole de; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Brasil, Virgínia Visconde; Ferreira, Pedro Augusto de Melo Lopes; Rechenchosky, Leandro; Póvoa, Thaís Inácio Rolim
    Introduction: Quality of life (QOL) is an important indicator of population health, and covers the inspection of different areas of a person's life. The process of formation and insertion in the labor market is characterized by change and uncertainty, and therefore the importance of studying QoL in this period. The aim of this study is to evaluate QoL in the academic training and beginning pysical education teachers (PET) career Methodology: The field research was transversal, quantitative, with academics and graduates of Physical Education at a University in Goiás. The sample was probabilistic by clusters and occurred in 2019. A sociodemographic form and the WHOQOL BREF questionnaire were used to assess QOL. The SPSS package was used and the significance value was set at 5%. Results: There were 330 participants, where 246 (74.5%) were academics and 84 (25.4%) were teachers. In general, lows were more frequent in women in Domino Social (OR: 1.93; p = 0.005) and general QOL (OR: 1.63; p = 0.030); Academics had higher chances of scores up to 33.3 in the Psychological Domain in relation to professors (OR: 11.1; p = 0.002), and each year unit, increased the chance of lower scores in the psychological domain (OR: 0.94 ; p = 0.0039). Conclusion: Women had low perceptions in the social domain and QOL, and increasing age showed higher scores in the psychological domain. In female undergraduates, it was associated with low scores in QOL domains, however, at the beginning of the Physical Education Teacher's career, time since training in the area of expertise contributed to worse results in the social, psychological and QVG domains. In the association between academics and early-career professors, academics were worse in the field of psychology.
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    Detecção do papilomavírus humano e análise de P16ink4a em carcinomas colorretais
    (Universidade Federal de Goiás, 2021-03-26) Libera, Larisse Silva Dalla; Saddi, Vera Aparecida; http://lattes.cnpq.br/7496804650895441; Saddi, Vera Aparecida; Silva, Antônio Márcio Teodoro Cordeiro; Carneiro, Megmar Aparecida dos Santos; Guillo, Lidia Andreu; Mrué, Fátima
    Introduction: Colorectal cancer (CRC) is one of the most prevalent cancers, being the second leading cause of cancer death worldwide. Despite the well established role of human papillomavirus (HPV) in anal cancer, its involvement in colon and rectum tumors is still a controversial issue. Objective: To investigate the presence of HPV and the expression of p16INK4a in colorectal carcinomas and in non-tumor controls, and to describe the prevalence of HPV in colon, rectum and anal cancers through a literature review. Methodology: This is a retrospective observational study that used clinical and pathological data and paraffin embedded specimens from patients with and without colorectal carcinoma. HPV detection was accomplished by PCR, genotyping by reverse hybridization, and the expression of the cellular protein p16INK4a was investigated by immunohistochemistry. A systematic review was also carried out on the databases, PUBMED, LILACS and SCIELO, according to PRISMA recommendations. Results: HPV was detected in 13% of the cases and the most prevalent genotype was HPV 16. The virus was not detected in both control groups. A high expression of p16INK4A was observed in 30% of the cases, but it was not associated with the presence of HPV. The overall survival was 53.3% and it was influenced by the prognostic factors such as advanced staging, lymph node and distant metastasis. Regarding the literature review, data were collected from 42 studies (5,834 samples). HPV was detected in 88.9% of anal cancer cases, and in 10.9% of colorectal cancer cases. Genotypes 16 and 18 were the most prevalent in both tumors. HPV was associated with anal squamous cell carcinoma (p <0.0001) and more prevalent in women with anal cancer (p <0.0001). Conclusion: Our results demonstrate that HPV is unlikely to be involved in colorectal carcinogenesis, and that p16INK4a expression is not a relevant biomarker of transcriptionally active HPV infection in CCR. The literature review data reassures the HPV causal relationship in anal cancer, but not in colorectal cancer.
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    Teleducação enquanto estratégia para qualificação profissional: uma imersão no contexto do Telessaúde Goiás
    (Universidade Federal de Goiás, 2024-08-27) Santana, Cristina Célia de Almeida Pereira; Taleb, Alexandre Chater; http://lattes.cnpq.br/3191620401627150; Taleb, Alexandre Chater; Naghettini , Alessandra Vitorino; Dornelas, Rodrigo Faria; Alves, Sergiane Bisinoto; Ferreira, Eric Benchimol
    A assistência à saúde tem sido impulsionada por constante inovação e pela incorporação da tecnologia em seus processos de trabalho. Neste contexto, a telessaúde se traduz como um método de mediação entre os profissionais e o ato de cuidar com o intuito de instrumentalizar as atividades teórico-práticas para garantir maior acessibilidade, resolutividade e qualidade à assistência. Durante a Pandemia pela COVID-19, a telessaúde tornou-se um pilar essencial para o atendimento de demandas assistenciais e educativas na saúde. Dentre as suas diversas modalidades destacou-se a teleducação, pois seus recursos, direcionados primariamente para fomentar a educação permanente dos profissionais alocados no Sistema Único de Saúde (SUS), foram indispensáveis para manter processos formativo-acadêmicos, capacitar os profissionais de saúde e oportunizar informação à comunidade. Concebendo a relevância desta estratégia, o presente estudo objetivou conhecer o contexto da teleducação no Núcleo de Telemedicina e Telessaúde de Goiás (NUTTs-GO). Trata-se de uma pesquisa de campo, descritiva e exploratória com uma abordagem de escopo quanti-qualitativa. O desenvolvimento da pesquisa compreendeu três fases: a realização de uma revisão integrativa da literatura para contextualização da teleducação no Brasil; a análise do banco de dados de teleducação do NUTTs-GO e a realização de uma entrevista com profissionais da atenção básica, usuários da modalidade teleducação. Os resultados da revisão de literatura demonstraram que a teleducação como estratégia fortaleceu-se por suas inúmeras possibilidades e por sua incorporação na dinâmica da sociedade. Constatou-se que há uma contínua ampliação dos pontos de telessaúde para propiciar aos trabalhadores da saúde no SUS maior acessibilidade ou oportunidades a momentos para educação permanente. Entretanto, ainda há desafios a serem superados como a necessidade de melhorar a instrumentalização das unidades e mais apoio dos gestores para implementar a iniciativa. A análise do banco de dados das teleaulas do NUTTs-GO permitiu verificar a existência de diversidade temática, boa abrangência em sua xiv Resumo disponibilização e o envolvimento multidisciplinar em sua construção, critérios que fazem o Núcleo Telessaúde em Goiás estar alinhado aos pressupostos para fomentar a capacitação de profissionais lotados na Atenção Básica. A análise qualitativa das entrevistas, última etapa do estudo, identificou que os profissionais dos Estabelecimentos Assistenciais de Saúde validam positivamente o processo de educação permanente mediado pela modalidade teleducação. Os elementos identificados em suas percepções indicam que os recursos de teleducação têm colaborado para interação, troca de experiências e aprimoramento técnico-científico, o que contribui para agregar qualidade ao cuidado e para uma prática assistencial mais resolutiva e humanizada. Todavia, as falas dos participantes indicaram que, para promover o processo de aprendizado com significado, premissa da educação permanente em saúde, os recursos de teleducação devem ser elaborados a partir da abordagem de problemas ou situações vivenciadas na prática laboral, ou de demandas de saúde locorregionais. Este alinhamento pode estimular a melhor reflexão crítica e a busca por melhorias efetivas nos processos de trabalho. Conclui-se que a imersão, no contexto da modalidade de teleducação no NUTTs-GO, permitiu vislumbrar uma dimensão importante da telessaúde. Como estratégia educativa, a teleducação alia recursos tecnodigitais para estender aos profissionais na atenção primária, mais conhecimento, consultoria e interatividade com os grandes centros e Universidades. Considerou-se que o Núcleo de Telessaúde em Goiás tem colaborado de maneira assertiva e proativa na formação de vínculos para implementar o processo de educação permanente dos profissionais da Atenção Básica no estado, movimento que vem ao encontro da Política Nacional de Educação Permanente para adjuvar o fortalecimento do SUS.
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    Avaliação da instalação de implantes dentários em mandíbula por meio de navegação dinâmica utilizando um novo software de tomografia computadorizada de feixe cônico
    (Universidade Federal de Goiás, 2024-07-16) Garrote, Marcel da Silva; Estrela, Carlos; http://lattes.cnpq.br/3611967334176683; Alencar, Ana Helena Gonçalves de; http://lattes.cnpq.br/2039898015468283; Alencar, Ana Helena Gonçalves de; Estrela, Cynthia Rodrigues de Araújo; Serpa, Giulliano Caixeta; Silva, Julio Almeida; Decurcio, Daniel de Almeida
    Introduction: Contemporary dentistry has been gradually adjusting to the changing needs and technological e-Volution of this field of health, and the use of modern techniques, with more advanced appliances, is essential in treatments with dental implants in the mandible, as in the case of the use of new cone beam computed tomography software, capable of dynamically navigating. contributing to the greater success of this type of procedure. Objectives: Evaluate Jaw Dental Implant Placement Through Dynamic Navigation Using Novel Cone Beam CT Scan Software. Methods: The initial sample consisted of 2,872 cone beam computed tomography scans of patients of both sexes aged between 18 and 80 years. The criteria used to evaluate the installation of dental implants were: location of the implants in the mandible; implant length; anatomical relationship with the mandibular canal; presence or absence of damage to the teeth adjacent to the implant; presence or absence of implant fracture; presence or absence of bone support for the implant. Categorical variables were described as frequencies and percentages and evaluated using the chi-square test. The level of significance was set at p <0.05. Statistical analysis was performed using the Statistical Package for the Social Sciences, version 20. Results: From the initial sample of 2,872 CBCT exams, 214 images of patients of both sexes and with a mean age of 44.5 years were included in the present study. The most frequent positioning of implants was in the posterior region of the mandible (93.5%), with 54.0% having a length between 9 and 14mm. It was found that 92.0% were located above the mandibular canal, and there were no records of implants inside the mandibular canal. There was no statistically significant relationship between implant length and mandibular canal invasion (p=0.357). Three cases of damage to adjacent teeth were observed, with no correlation with implant positioning (p=0.999). No correlation was observed between age group and damage to adjacent teeth (p=0.999). In 100.0% of cases of anterior implants there was the presence of bone support, and in 91.6% of posterior implants, no statistically significant difference was observed between them (p=0.614). There was no statistically significant difference between age groups regarding the presence of bone support (p=0.254). Although fractures were observed (1.7%) in implants with lengths between 9mm and 14mm, there was no statistically significant relationship between implant length and fracture (p=0.702). Conclusion: Dynamic navigation using e-VolDX allowed us to conclude that the installation of implants in the mandible occurred more frequently in the posterior region, in the presence of bone support and with a low percentage of damage to adjacent teeth, anatomical structures and fractures
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    Autopercepção da saúde e da qualidade de vida, desempenho funcional e prática de atividade física entre idosos residentes em município rural no interior do Brasil
    (Universidade Federal de Goiás, 2021-07-16) Barbosa, Renata da Costa; Sousa, Ana Luiza Lima; http://lattes.cnpq.br/6578713509935374; Sousa, Ana Luiza Lima; Souza, Weimar Kunz Sebba Barroso de; Batista, Sandro Rogério Rodrigues; Zanini, Claudia Regina de Oliveira; Leite,  Márcia Andréa Gonçalves
    Aging can lead to greater dependence on the individual, compromising functional performance, self-perception of health and quality of life. A physically active lifestyle can provide the maintenance of functionality and improve the quality of life and health of the elderly. Behavior and lifestyle habits may be influenced by the location where the elderly person lives. Understanding how elderly people living in rural municipalities perceive their health and quality of life can provide subsidies to better help these populations. Objective: To analyze the associations between self-perceived health and quality of life with functional performance and the practice of physical activity among elderly people living in rural municipality in Brazil. Method: Analytical cross-sectional population-based study. Individuals aged 60 years or more, noninstitutionalized, living in a rural municipality in the interior of Goiás were included. Sociodemographic, anthropometric and lifestyle variables were evaluated. In addition, functional performance was assessed using the Timed Up and Go (TUG) test and physical activity practice using the International Physical Activity Questionnaire (IPAQ). As outcome variables, self-perceived health and quality of life were assessed using the Bref and Old World Health Organization Quality of Life Instruments questionnaires (WHOQOL BREF and WHOQOL OLD). Data were obtained during a home visit, by an interview. To assess the association of the variables of interest, Pearson's chi-square test, Fisher's exact test and the Wilcoxon sign were used. Results: The study included 142 elderly people with a mean age of 72.4 (±8.0) years. More than half were classified as sufficiently active (66.9%), among these, 55.8% performed leisure activities, the vast majority were independent in activities of daily living (87.3%), with regular/good quality of life (average overall score: 3.6±0.3) and, respectively, 57.7% and 64.1% had self-perceived health and quality of life. Elderly people with poor or very poor self-perceived health had regular self-perceived quality of life (63.6%), individuals aged 80 years and over had lower self-perception of quality of life compared to others. There was an association of self-rated health with the practice of physical activity and functional performance. However, no associations were found with the type of physical activity. It was found that 50.0% of the elderly who were insufficiently xvii Abstract 18 active and independent perceived their health positively. Of the insufficiently active and dependent elderly, 35.7% had poor/very bad and good/very good self-perceived health. Conclusions: Elderly people living in a rural municipality showed good or very good perception of health and quality of life, independent in their activities of daily living and sufficiently active. Self-perceived health was associated with quality of life, functional performance and physical activity practice, not being associated with the other study variables.
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    Pseudodemência depressiva: fenomenologia psicopatológica e disfunções cognitivas
    (Universidade Federal de Goiás, 2019-11-22) Reimer, Cláudio Henrique Ribeiro; Caixeta, Leonardo Ferreira; http://lattes.cnpq.br/9536747113677509; Caixeta, Leonardo Ferreira; Azevedo, Paulo Verlaine Borges e; Vieira, Renata Teles; Nascimento, Eberson da Silva Rodrigues; Taveira, Daniela Londe
    Depressed patients often present cognitive impairment, including the possibility of developing dementia - called Depressive Pseudodementia. Despite the seriousness of the disease, publications with case presentation and psychopathological discussion are scarce. Objectives: To describe demographic, clinical and cognitive aspects in a group of patients with depressive Pseudodementia, besides reporting possible associations between Pseudodementia and the observed clinical findings. To perform a review on the topic and discuss the relevance and validity of the diagnosis. Methods: This is a descriptive study composed of patients with Pseudodementia Depressiva treated in Goiás in the 2007-2017 period, presenting a discussion about the results and comparison with other studies through literature review. Multidimensional anamnesis was used for the collection of clinical history and pathological antecedents. The diagnosis of Depressive Pseudodementia was performed by Yousef pseudodementia scale (YPS); other psychiatric diagnoses were defined by the DSM-5 and the severity of depression by the Hamilton scale. The cognitive assessment was performed by the Mini-Mental State Examination, functional questionnaire of Pfeffer and Clinical Dementia Rating (CDR). Results: The sample consisted mainly of women (96.67%) with a history of cardiovascular disease (43.33%) and neurological signs (53.33%). Depression with melancholic features occurred in 56,66% of the cases and the diagnosis of Bipolar Mood Disorder occurred in 100% of the sample. The main cognitive dysfunctions found were inattention (100%) and short-term hypomnesia (93.33%) corroborating the findings of the literature related to cognitive impairment and depression. Conclusions: The demographic and clinical aspects associated with Depressive Pseudo-dementia were female, antecedent of cardiovascular disease and presence of neurological signs; the basic psychiatric diagnosis was Bipolar Mood Disorder and the dominant depressive phenotype was depression with melancholic characteristics; and the central cognitive impairment was attention and short-term memory.
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    Perfil clínico, epidemiológico e molecular de crianças hospitalizadas em Centros Hospitalares de Goiânia-GO com Infecções Respiratórias Agudas (IRA) causadas pelos vírus Influenza A e B e seus subtipos
    (Universidade Federal de Goiás, 2022-10-13) Silva, Paulo Alex Neves da; Avelino, Melissa Ameloti Gomes; http://lattes.cnpq.br/0519039948275501; Carneiro, Lilian Carla; http://lattes.cnpq.br/6506744224041777; Carneiro, Lilian Carla; Byk, Jonas; Wastowski, Isabela Jubé; Pires, Debora de Jesus; Costa, Paulo Sérgio Sucasas da
    Acute respiratory infections (ARI) are the largest group of diseases with prevalence in children and were included among the three main public health problems of childhood in the late 1960s. The high rate of morbidity makes ARI the main cause of use of health services, representing 20 to 40% of consultations in pediatric services worldwide and 12 to 35% of hospital admissions. Among the main causes of infections, bacterial, fungal and viral infections can be mentioned and according to the World Health Organization, approximately 90% of respiratory infections in children are of viral origin. Given the above, the objectives of the study were to evaluate the epidemiological and molecular profile of acute respiratory infections caused by influenza A and B viruses and their subtypes in children in Hospital Centers in Goiânia-GO. All children with acute respiratory symptoms who were treated in the Emergency Department and/or were admitted to Pediatric wards and/or ICUs were included. Our results corroborate the data that indicate that Rhinovirus, Adenovirus, Metapneumovirus and Influenza are among the most important AKI agents in pediatrics. As for influenza viruses, most patients were asymptomatic, however, some patients had symptoms such as fever and cough. Most of the infected were female. Knowing the epidemic period of respiratory infections observed in Goiânia can be useful to plan and implement prevention strategies.
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    Transmissão sexual do Trypanosoma cruzi em humanos: uma revisão de escopo associada a um estudo observacional
    (Universidade Federal de Goiás, 2024-08-26) Costa, Marillia Lima; Lacerda, Elisângela de Paula Silveira; Zapata, Marco Tulio Antonio Garcia; http://lattes.cnpq.br/3672512339058369; Zapata, Marco Tulio Antonio Garcia; Teixeira, Antônio Raimundo Lima Cruz; Silva, Hugo Delleon da; Anunciação, Carlos Eduardo; Cardoso, Clever Gomes
    Introduction: The possibility of sexual transmission of Trypanosoma cruzi was suggested by Carlos Chagas after the discovery of the disease. However, the infectivity of semen samples and sexual transmission of the parasite on animal models occurred recently with few studies evaluating this transmission mechanism in humans. Objectives: to investigate the possibility of sexual transmission of trypanosomatids and T. cruzi, both in experimental animals and human. Methods: a scopimg review associated with an observational study was conducted. The search for studies was performed in the databases PubMed, Lilacs, Global Health and Portal CAPES with the following terms: “Trypanosomids”, “Trypanosoma”, “Leishmania”, “Sexual Transmission”, “Sêmen”, “Vaginal Secretion”, “Male”, “Female”, in English, Spanish and Portuguese. An observational study was also conducted to investigate the sexual transmission of T. cruzi in a population of 171 individuals distributed across 10 families residing in the municipality of São Felipe, Bahia. Blood and semen samples obtained were analyzed by serological and molecular methods, combined with socio-epidemiological information obtained from a questionnaire, in order to confirm or exclude the sexual transmission of T. cruzi. Results: According to the eligibility criteria 27 articles were found. Literature reports showed the presence of protozoa of Leishmania and Trypanosoma genus in reproductive organs and sexual fluids, as well as the sexual transmission of these parasites to sexual partners and offspring. In the observational study, the presence of T. cruzi in blood samples was found in 24,56% through molecular testing. Epidemiological analysis indicated that the infected group consisted predominantly of women, aged 20 to 50 years, married, self-identified as black, rural workers, born in the rural areas of the municipality, with low socioeconomic status and educational level. Analysis of semen samples revealed the protozoan in only one semen samples, with the presence confirmed by sequencing technique. The association of molecular findings from blood and semen analyses and information extracted from the applied questionnaire identified at least three cases of women who acquired the infection through sexual transmission. Conclusion: based on the information obtained from the review, as well as the presence of T. cruzi in semen samples, it was possible to conclude that trypanosomatids, especially T. cruzi, can be sexually transmitted, with semen being an infective fluid
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    Qualidade de vida dos demandantes de medicamentos oncológicos nas vias administrativa e judicial em Goiás
    (Universidade Federal de Goiás, 2022-10-16) Salha , Leila Abou; Barbosa, Maria Alves; http://lattes.cnpq.br/5025797873585225; Barbosa, Maria Alves; Brasil, Virgínia Visconde; Mendonça, Reginaldo Teixeira; Ferreira, Pedro Lopes; Féres, Valéria Christina de Rezende
    Background: The significant increase in access to oncological medicines through court cases suggests that constitutional guarantees of integral and universal care in the Brazilian public health system are uncertain. Methods: A retrospective observational study was conducted to analyze data from lawsuits requesting oncological medicines from 2014 to 2020 in the State of Goiás, Brazil, in state and federal courts. Sociodemographic, medical, and legal variables were statistically examined using descriptive, association, and correlation methods. Results: Women brought more than half (54%) of the 301 processes analyzed. The most frequent age group was over 55 years, with income below 3x the minimum wage (total about USD$600/month), and their cases were promoted through the public minister and public defender’s offices. The most requested medications, not on official public health system lists, were indicated for multiple myeloma and brain cancer. Conclusions: Improved quality of life, frequently used as a justification, could be conceptually confused with an increase in survival. Finally, judicialization indicates that individual health needs arise even with properly defined and adequately implemented public policies. These needs should be considered for the adequate provisioning of services by the state to ensure the right to health.
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    Vaginose bacteriana e tricomoníase: prevalência, fatores associados e desempenho de testes diagnósticos em mulheres atendidas em ambulatório de ginecologia preventiva
    (Universidade Federal de Goiás, 2022-02-21) Camargo, Kélvia Cristina de; Saddi, Vera Aparecida; http://lattes.cnpq.br/7496804650895441; Alves, Rosane Ribeiro Figueiredo; http://lattes.cnpq.br/8335736301768972; Alves, Rosane Ribeiro Figueiredo; Santos, Silvia Helena Rabelo dos; Matos, Marcos André de; Barbosa, Maria Alves; Ribeiro, Andrea Alves
    INTRODUCTION. Bacterial vaginosis BV and genital infections have a great impact on women's health and are the main causes of demand for health services. GOALS. To investigate the prevalence, associated factors and performance of diagnostic methods for BV and Trichomonas vaginalis TV. METHODS. The thesis is presented in articles, in an original cross-sectional article and a systematic review. The Crosssectional study, conducted with women seen at a preventive gynecology clinic, in the public network of Goiânia, referred to a gynecological consultation. Gynecological examination with evaluation of the characteristics of the vaginal secretion, and the collection of cervicovaginal material for cytological study, fresh examination, vaginal pH, Whiff test, Gram-stained bacterioscopy and the polymerase chain reaction (PCR) for the detection of TV . The samples were analyzed at the Genetic Diversity Laboratory of the Pontifical Catholic University of Goiás (PUC GO) and at the Rômulo Rocha Clinical Analysis Center of the Faculty of Pharmacy of the Federal University of Goiás (FF/UFG). Sociodemographic and behavioral characteristics were analyzed using descriptive statistics. Logistic regression analysis was performed to identify factors associated with BV. The degree of agreement between the clinical characteristics of the vaginal secretion and the different diagnostic methods was evaluated by the Kappa index. The systematic review study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) and performed according to the methodological guidelines of the “Preferred Reporting Items for Systematic Reviews and Meta-Analyses” (PRISMA). The search was performed on PubMed and Scopus databases in September 2021, with no language restriction. Articles were considered eligible if they investigated the prevalence of BV in Brazil; used Amsel's clinical diagnostic criteria or Gram-stained bacterioscopy in women of reproductive age and without comorbidities. Studies were evaluated by two investigators to establish reliability. The risk of bias and the quality of the selected studies were assessed using the Joana Briggs Institute (JBI) tool. RESULTS. The cross-sectional study showed a prevalence of BV, according to the Nugent criteria, of 33.7% and of trichomoniasis by PCR, of 0.5%. The complaint of abnormal vaginal secretion was significantly associated with the diagnosis of BV (OR = 2.2; 95%CI: 1.0- 4.5); The diagnostic accuracy for BV, by the methods of Amsel, Ison & Hay and cytological examination, compared to the Nugent criteria was 35.6%, 97.0% and 84.2%, respectively. The sensitivity and degree of agreement for the diagnosis of TV, by the fresh test was 0.0% and 0.0% and by the cytological test, 100% and 1, respectively. Systematic review included ten articles. The mean prevalence of BV in the included studies was 25.4% (95%CI: 24.0-26.8), ranging from 15.3% (95%CI: 11.8- 19.4) to 51. 0% (95%CI: 43.1-58.7). In three population-based studies, the prevalence ranged from 15.3% (95%CI:11.8-19.4) to 20% (95%CI:16.9-23.6), with a mean of 18,1% (CI:16.0-20.5). In seven clinical-based studies, the prevalence ranged from 18.6% (95%CI: 13.6-25.0) to 51% (95%CI: 43.1-58.7), with an average of 27.2% (95%CI: 24.6-29.9). Factors associated with BV were use of sexual accessories (OR: 2.4; 95%CI: 1.1-4.9), single marital status (OR: 1.4; 95%CI: 1.1-1.8), partner infidelity (OR: 1.5; 95%CI: 1.2-1.9), abnormal vaginal discharge (OR: 1.5; 95%CI:1.2-2.0), presence of trichomoniasis (OR: : 4.1 (95% CI: 1.5-11.5).CONCLUSION. The crosssectional study showed a high prevalence of BV and a low prevalence of TV; The report of abnormal vaginal secretion as the only factor associated with BV; the methods with the best diagnostic performance for BV, compared to the Nugent method, were those Abstract xix of Ison and Hay and cytological examination and cytological examination considered to be easily accessible in the daily clinic. The systematic carried out in this study showed a high prevalence of BV and associated factors linked to sexual behavior, although it is not considered a sexually transmitted infection.
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    Fatores de risco relacionados ao estresse materno e indicadores neurocomportamentais de recém-nascidos pré-termo em unidade de terapia intensiva neonatal
    (Universidade Federal de Goiás, 2023-04-01) Ramos, Bruna Abreu; Formiga, Cibelle Kayenne Martins Roberto; http://lattes.cnpq.br/5231575956660644; Amaral, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579; Amaral, Waldemar Naves do; Oliveira, Nayara Rodrigues Gomes de; Sousa, Juarez Antonio de; Ferreira, Rui Gilberto; Vieira, Martina Estevam Brom
    Introduction: Prematurity is the main cause of hospitalization in the Neonatal Intensive Care Unit, being considered an important factor for adverse infant outcomes, in terms of quality of life. Objectives: To analyze maternal stress and its correlation with neonatal neurobehavioral indicators and to identify the main risk factors (maternal and neonatal) associated with preterm newborns in neonatal intensive care units. Methods: The total study sample consisted of 251 preterm, low birth weight newborns and their respective mothers, who were admitted to the Neonatal Intensive Care Unit and the Neonatal Intermediate Care Unit of a Public Maternity Hospital in the city of Goiania ( GO). An analysis of medical records was performed, the parental stress assessment scale (PSS: NICU) was applied, and finally, the neurobehavioral assessment instrument for preterm newborns (NAPI) was used. For the statistical analysis of the total sample, the Spearman correlation test was performed (p < 0.05) and for the logistic regression analysis, the sample n of 165 participants was used based on the exclusion criteria, in order to test the possible factors of risk for maternal stress. In all analyses, p < 0.05 was considered. Results: Considering the outcome on maternal stress, the level of stress was assessed as moderate among mothers. The subscale that presented the highest level of stress was "Change in the Role of Mother" and the one with the lowest level of stress was "Sounds and Images", with total scores ranging from "little stressful" to "very stressful". . The higher the stress level on the item “the other sick babies in the room” the lower the leg resistance performance (p <0.049). It was also observed that neonatal and maternal risk factors did not present an outcome with maternal stress. The respiratory rate variable of 49.8 bpm and the scarf signal of 60.11 at the time of the neonatal neurobehavioral assessment, was shown to be a protective factor for maternal stress (p <0.05) and adjusted OR <1. Conclusion: The mothers considered the experience of having a newborn hospitalized in the Neonatal Intensive Care Unit moderately stressful. Weak correlations were identified between maternal stress and neonatal neurobehavioral indicators. No relationship was found between neonatal and maternal risk factors for maternal stress, but muscle tone (scarf sign) and respiratory rate at the time of assessment behaved as protective factors for maternal stress.
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    Aspectos emocionais e concepções de maternidade de mulheres inférteis em programa de reprodução assistida
    (Universidade Federal de Goiás, 2022-03-05) Marciano, Rafaela Paula; Amaral, Waldemar Naves do; http://lattes.cnpq.br/4092560599116579; Amaral, Waldemar Naves do; Burgarelli, Cristóvão Giovani; Alves, Rosane Ribeiro Figueiredo; Lima, Priscilla Melo Ribeiro de; Ferreira, Rui Gilberto
    Introduction: According to the WHO, infertility affects around 48 million couples worldwide.  The reproductive technology provide a privileged field in possible harmonization between the feminine and the desire of having a child.  Consider social and psychological importance of motherhood and reproduction in our society, infertility can affect the emotional, sexual and marital relationship spheres. Objectives: To understand the conceptions of motherhood and to analyze the emotional aspects of infertile women of different socioeconomic levels who are undergoing assisted reproduction treatment. Methodology: Descriptive, quali-quantitative study carried out between January and December 2019, in a private clinic and in a public clinic for assisted reproduction, both located in the city of Goiânia, Goiás. The study included 48 women, over 35 years old, undergoing treatment for high-complexity assisted reproduction, half of the sample from each institution. Individual interviews were conducted, which were recorded and transcribed in full. Results: The average age of the participants was 38.9 years, 43.75% of the sample was nulliparous, 56.2% had a female cause of sterility. The variables which had significant statistic difference were the schooling (p=0,005) and family income (p=<0,001). The women from the private clinic have shown higher schooling anda familiar income than from the public one. The participants represented the family in positive way, as a support system, of foundation and origin of love, embracing the family as a social bond. On the other hand the family concepts based on inbreeding were also present representing the family by perpetuation of the specie and by the importance of biological bond. Infertile women reported feelings of inferiority, worthlessness, impotence, inadequacy towards society, which reinforces the stigma of infertility. The prevalent feelings and symptoms were anxiety, anguish, insomnia, binge eating, sadness, frustration, fear and anger.  Infertility was represented with negative feelings related to pain, surprise and bitterness, in addition to anger, revolt and indignation, experiencing this situation as injustice against them or as a divine punishment. Conclusions: The results found contribute to necessary reflections on the role of women and our culture, since motherhood is still used as a measure for female success or failure. The woman experiences a dilemma between her desires, her reality and the possibility of choosing motherhood, but the latter is veiledly imperative. In addition, it is possible to raise the discussion on the issue of desire and demand for a biological child, aspects often forgotten in assisted reproduction clinics. At the same time, the possibility of procreation through RT is recognized as something positive for women who have the legitimate desire for biological motherhood and who find in science a possible ally to overcome the mark that their own body imposes on them.
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    Relações anatomotopográficas entre raízes e lesões periapicais de dentes superiores posteriores com o seio maxilar
    (Universidade Federal de Goiás, 2014-10-02) Nunes, Carla Aparecida Bernardes da Costa Meneses; Guedes, Orlando Aguirre; http://lattes.cnpq.br/3219560690903434; Estrela, Carlos; http://lattes.cnpq.br/3611967334176683; Estrela, Carlos; Guedes, Orlando Aguirre; Pécora, Jesus Djalma; Silva, Brunno Santos de Freitas; Alencar, Ana Helena Gonçalves de
    Purpose: To analyze the topographical anatomic relationship between the maxillary posterior teeth and the maxillary sinus (MS) using cone beam computed tomography (CBCT). Methods: A sample of 202 CBCT examinations, consisting of 600 premolars and 600 molars were selected for the study images. The distance between the root apex and the floor of the MS as well as the thickness of the cortical bone of the floor of the MS in closer to root apex and furcation region was measured. The vertical and horizontal relationships of the MS floor with the roots of the molars were classified according to Kwak et al. (2004) with adaptation. The mean and standard deviation of distances and thicknesses were obtained. The difference between the distances, as well as between cortical thicknesses was evaluated by Kruskal-Wallis test. The difference between the types of the vertical relationship, as well as between the types of the horizontal relationship, of the molars was assessed by Chi-square test. Significant values were considered p < 0.05. Results: The shortest distance between the apex and the MS floor was observed in MB root of the second molar (0.36 ± 1.17 mm) and the longest distance in V root of the first premolar (5.47 ± 4.43 mm). In the group of single-rooted premolar, the closest distance between the apex and the MS floor was observed in the roots of the second premolar (1.71 ± 2.81 mm). The greater cortical thickness of the floor of the MS was observed in the first premolar area (1.28 ± 0. 42 mm) and the lower, in the second molar área (0.65± 0.41 mm). There was no statistically significant difference in the thickness of cortical bone in relation to proximity to the apex of the MB, DB and P roots of the molars. The vertical relationship most observed in the molars was Type 2 and the horizontal was type 2H. Conclusions: The roots of the upper molars showed greater proximity to SM when compared to premolar; the thickness of the cortical bone of the floor of the SM in the region closest to the apex and furcation area was found to be similar; the roots of the upper molars presented more frequently a vertical and horizontal relationship of proximity with the SM.
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    O acesso a medicamentos pela via administrativa no setor público de saúde no Brasil
    (Universidade Federal de Goiás, 2015-05-08) Soares, Amanda Queiroz; Provin, Mércia Pandolfo; http://lattes.cnpq.br/1809891256443044; Amaral, Rita Goreti; http://lattes.cnpq.br/3665611660713029; Amaral, Rita Goreti; Dâmaso, Andréa Homsi; Andrade, Eli Iola Gurgel; Medeiros, Marcelo; Contezini, Silvana Nair Leite
    Although the Brazilian public healthcare system is based on the principles of the universality and integrality of access to health services, severe problems remain with respect to guaranteeing access to pharmaceutical drugs. This situation has contributed to the creation of new institutional frameworks, including the administrative channel, institutionalized by the executive power with the aim of meeting the repressed demand for pharmaceutical drugs not obtained within the public health service. This study analyzed access to pharmaceutical drugs through the administrative channel within the Brazilian public health sector. As part of this larger study, various methodologies were applied, including a case-control study, a descriptive study and an interpretive case study in which the focal group technique was used. The study was developed in the town of Goiânia, in Brazil’s mid-western region. General users of primary healthcare units (or their accompanying persons), users specifically requesting pharmaceutical drugs through the administrative channel and users who had successfully obtained pharmaceutical drugs through this channel participated in the study. Results show that administrative demands for access to pharmaceutical drugs are inserted within a multifactorial context that involves users’ economic and sociodemographic characteristics, as well as the characteristics of healthcare, pharmaceutical care and healthcare conditions. Furthermore, users who had gained access to at least one pharmaceutical drug requested through the administrative channel were found to be predominantly those who were less socioeconomically vulnerable, those with a positive self-evaluation of their state of health, those requesting insulin analogs and individuals who in general did not consult or obtain medication within the public healthcare sector. The steps taken by most of the individuals who had their request approved reveal their fluidity between the public and private healthcare sectors, characterizing their efforts to guarantee healthcare. Therefore, the administrative channel was found not to be free from the barriers to achieving access to pharmaceutical drugs that exist within the public health sector in view of its interdependency on a system with shortcomings both within the health sector itself and at higher levels within the system.
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    A judicialização do fornecimento de medicamentos no Sistema Único de Saúde
    (Universidade Federal de Goiás, 2023-02-03) Rocha, Danilo Di Paiva Malheiros; Mrué, Fátima; http://lattes.cnpq.br/2424858504979076; Garcíazapata, Marco Túlio Antônio; http://lattes.cnpq.br/3672512339058369; Garcíazapata, Marco Túlio Antônio; Itria, Alexander; Soares, Carolina Chaves; Leão, Ana Lúcia de Melo; Souza Júnior, Edson Sidião de
    OBJECTIVE: To investigate the phenomenon of Judicialization of Health. METHODOLOGY: Mixed research involving a systematic literature review study and a quantitative and qualitative research. As for the systematic literature review, studies published between 2010 and 2021 were consulted. The quantitative research adopted a time frame between 2017 and 2019, contemplating a sample of 359 health lawsuits against the Municipality of Goiânia. The qualitative study adopted a bibliographical narrative review, with the following steps: selection of the topic and question of interest, definition of descriptors, definition of search sources, selection of relevant articles by reading the title and abstract, reading in full, extraction of the most important information from these articles and synthesis of the main findings. RESULTS: Most studies analyzed the legalization of drugs related to the official list of free distribution. A study from Colombia prioritized the increase in lawsuits. From Argentina, he found that the judges were not concerned about promoting equity. In Costa Rica, drugs were ranked according to their priorities. Of the lawsuits studied, more than half (53%) had a claim value between R$1,000.00 and R$50,000.00, aged between 18 and 59 years (49%), filed by the Goiás Public Defender's Office (78%) . Injunctions were granted in 92% and Nat-Jus heard in 22% of cases and final favorable judgment in 77%. Proposals point to the need for deep knowledge of Clinical Protocols and Therapeutic Guidelines (PCDTs); adoption of organization and management of drug stocks; implementation of support centers for the Judiciary (NATJUS) and; creation of specialized rods. Implemented experiences: “SUS C.O.M VC” in Jundiaí-SP; Technical Support Center added to the Municipal Ombudsman in Araguarina-TO; Drug Conciliation Nucleus in Lages-SC; Regionalized Management Program for the Judicialization of Health in Santa Catarina; REMUME update in Canguçu-RS. CONCLUSION: It is necessary to engage all the professionals involved, demanding institutional dialogue and adopting a multicentric solution for the maintenance of the Public Health System. Proposals and practices for health rationalization are essential measures and deserve to migrate from specific experiences to a national scope.
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    Níveis séricos e efeito da suplementação de vitamina D sobre a composição corporal e perfil metabólico de crianças
    (Universidade Federal de Goiás, 2020-12-21) Alves, Ana Gabriella Pereira; Silva, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496; Silva, Maria Sebastiana; Hadler, Maria Claret Costa Monteiro; Guillo, Lídia Andreu; Santos, Renata Carvalho dos; Martins, Karine Anusca
    Introduction: Vitamin D plays a role in several metabolic pathways, including cell diferentiation and proliferation, hormonal control, modulation of inflammation and immune system regulation. Since vitamin D receptors are presented in different tissues and organs, it is related to many diseases, such as obesity, hipertension and dyslipidemia. Objective: To evaluate the serum levels and the effect of cholecalciferol supplementation on body composition and metabolic profile in of children. Methods: A randomized, placebo-controlled, triple-blind, crossover study was conducted with 62 children, 4 to 11 years old, from a public educational institution, that met the selection criteria. Sociodemographic, economic and sunscreen use data were collected from a specific questionnaire; the body area daily exposed to the sun was evaluated by a questionnaire with a representative figure of the body percentage; a specific questionnaire was used to evaluate physical activity and sedentary behavior; anthropometry (body mass and height) and body composition (waist circumference, body fat percentage, fat-free mass, triceps and subscapular skinfolds) were obtained using a stadiometer, electronic scale, anthropometric tape, tetrapolar bioimpedance and adipometer; blood pressure was measured using an automatic digital monitor; 25-hydroxyvitamin D [25(OH)D], fasting glucose and lipid profile were analysed from blood collection; and food intake data was evaluated through the 24-hour recall. In the intervention study, the two groups, supplemented and placebo, received 5 drops of cholecalciferol (1000 IU/day) and 5 drops of sunflower oil (placebo), respectively, for 12 weeks, separated by 10-week washout period. Results: Among children with sufficient serum vitamin D (≥ 75 nmol/L), who participated in the baseline study, no difference was found in sex, self-reported race, physical activity, age, anthropometry, body composition, biochemical parameters and blood pressure between children with 25(OH)D 75-99 and ≥ 100 nmol/L, in addition to the non-association of 25(OH)D with body composition and metabolic profile. In the crossover study, conducted with hypertriglyceridemic children, cholecalciferol supplementation reduced serum total cholesterol (TC) (p < 0.001), LDL-c (p < 0.001), non HDL-c (p < 0.001), TC/HDL-c (p = 0.001) and LDL-c/HDL-c (p < 0.001) ratio, when compared to placebo group. Conclusions: Serum vitamin D was not associated with body composition and metabolic profile among children with 25(OH) ≥ 75 nmol/L, and 1000 IU/day of cholecalciferol supplementation, for 90 days, in hypertriglyceridemic children without 25(OH)D serum deficiency, was able to improve lipid profile.
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    Vínculo parental, saúde mental e catastrofização em mulheres com dor pélvica crônica
    (Universidade Federal de Goiás, 2022-10-26) Campos, Vânia Meira e Siqueira; Deus, José Miguel de; http://lattes.cnpq.br/8644071247922633; Conde, Délio Marques; http://lattes.cnpq.br/8628571386803692; Conde, Délio Marques; Alcântara, Keila Correia de; Ribeiro, Marília Oliveira; Finotti, Marta Curado Carvalho Franco; Silva, Nílzio Antonio da
    Introduction: The experience of pain and its coping strategies, mental disorders such as anxiety and depression, and maladaptive personality traits such as catastrophizing have been associated with parenting styles in childhood. In turn, catastrophizing has been considered an important predictor of outcomes for different types of pain, including chronic pelvic pain (CPP) in women, which is a common and difficult-to-treat health condition. Aims: To perform a narrative review of the available literature on CPP in women. To evaluate the association between parenting style and CPP in women, and to investigate the association between catastrophizing, pain intensity, anxiety, depression, and parenting style in women with CPP. Methods: A search was conducted of the Medline, Embase and SciELO (Scientific Electronic Library Online) databases up to the cut-off date of October 15, 2021. The following terms were used: chronic pelvic pain, central sensitization, hyperalgesia, chronic pain, neuromodulation, women, somatic pain, visceral pain, nociplastic pain and neuropathic pain. An observational case-control study was also conducted between May 2018 and August 2021 with 123 women with CPP and 123 pain-free controls. Sociodemographic, clinical, and behavioral data were investigated. Parental Bonding Instrument was used to assess parenting styles. Generalized Anxiety Disorder-7 e 9-item Patient Health Questionnaire were used to evaluate anxiety and depression, respectively. Pain intensity and catastrophizing were investigated in the CPP group using, respectively, a 10-cm numerical pain rating scale and the Pain Catastrophizing Scale. Yates’s chi-square test and the Mann-Whitney test were used to compare characteristics between the groups. Multiple logistic regression analyses were conducted to determine possible associations between each parenting style and CPP in women, and the odds ratios (OR) and their respective 95% confidence intervals (95%CI) were calculated. Spearman’s correlation coefficient (r) was used to verify possible correlations between catastrophizing, pain intensity, the duration of pain, anxiety, depression, and parental bonding style (maternal and paternal care and overprotection) in the group of women with CPP. Results: A higher frequency of low maternal care (60.7% versus 45.2%; p=0.026), anxiety (79.7% versus 56.9%; p<0.001), depression (73.2% versus 56.1%; p=0.008), physical violence (31.7% versus 14.6%; p=0.003), relationship difficulties (39.8% versus 19.5%; p=0.001), and abdominal/pelvic surgery (78.0% versus 63.4%; p=0.017) were found in the CPP group compared to the control group. The domains of parental bonding were not independently associated with CPP in women. Catastrophizing was identified in 77.2% of women in the CPP group. Catastrophizing women were found to use significantly more pain medication compared to non-catastrophizing women (94.7% vs 78.6%; p=0.024). A positive correlation was found between catastrophizing and pain intensity (r=0.342; p<0.001), anxiety (r=0.271; p=0.002), depression (r=0.272; p=0.002), and maternal overprotection (r=0.185; p=0.046). A negative correlation was found between anxiety and maternal (r=-0.184; p=0.047) and paternal (r=-0.286; p=0.006) care and between depression and maternal (r=-0.219; p=0.018) and paternal (r=-0.234; p=0.026) care in the CPP group. Conclusions: CPP is an challenger condition that may not be associated with an obvious cause. A timely scheme of investigation and treatment of associated comorbidities is recommended. The clinical identification of a central sensitization phenotype can guide the management of women with CPP, which must be interdisciplinary and involve biopsychosocial aspects. Low maternal care was more common in women with CPP compared to the pain-free controls, with no independent association between parental bonding and CPP. Catastrophizing was very common and positively, but weakly, correlated with the intensity of pain, anxiety, depression, and maternal overprotection in the CPP group. Maternal and paternal care was negatively and weakly correlated with anxiety and depression in women with CPP. Our findings suggest further studies on the role of families, particularly fathers and mothers, in the emotional development and pain coping strategies of women with CPP. They also indicate the need for a personalized approach to women with CPP, seeking better therapeutic outcomes.
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    Vaginose bacteriana, infecção cervical pelo Papilomavírus humano (HPV) e anormalidades citológicas cervicais em mulheres adultas
    (Universidade Federal de Goiás, 2022-02-18) Martins, Bruno César Teodoro; Saddi, Vera Aparecida; http://lattes.cnpq.br/7496804650895441; Saddi, Vera Aparecida; Santos, Sílvia Helena Rabelo dos; Alves, Rosane Ribeiro Figueiredo; Barbosa, Maria Alves; Matos, Marcos André de
    Resumo em língua estrangeira: Bacterial vaginosis (BV) is the most common cause of vaginal discharge and occurs when there is an imbalance in the vaginal microbiota, predominantly composed of Lactobacillus spp. Human Papillomavirus (HPV) is the most common sexually transmitted virus in the world. Persistent infection with high-risk HPV genotypes is the main cause of the development of cervical intraepithelial neoplasia and cervical cancer. The aim of this study was to investigate the association between BV, cervical HPV infection and cervical cytological abnormalities in adult women. A systematic review with meta-analysis and a cross-sectional study were performed. The systematic review and meta-analysis were based on the PRISMA methodological guidelines. PubMed and Web of Science were searched using the descriptors: “bacterial vaginosis and HPV”, in June 2019. Inclusion criteria were original studies that investigated an association between BV and cervical HPV infection; published in English, Spanish or Portuguese; performed in young and adult women, over 15 years of age, non-pregnant, declared to be HIV negative, who used the Nugent criteria for the diagnosis of BV and PCR for the detection of HPV. Odds ratios (OR) and respective 95% confidence intervals (95% CI) were calculated for the association between BV and cervical HPV infection using random effects models. A value of p<0.05 was considered statistically significant. Six studies published between 2012 and 2019 were selected for analysis and demonstrated a significant association between BV and cervical HPV infection (OR: 2.68; 95% CI: 1.64-4.40; p<0.001). The cross-sectional study was carried out in a gynecology outpatient clinic of the public health network in Goiânia, Goiás. A total of 202 women were included and underwent gynecological examination, with cervical specimen collection. Cervical cytopathological exams, bacterioscopy and Nugent's criteria were performed for the diagnosis of BV and PCR and reverse hybridization for HPV detection and genotyping. By using bivariate analysis the association between BV and cervical HPV infection and between BV and cervical cytological abnormalities were investigated. The odds ratio was calculated, with the respective 95% confidence intervals (95% CI) and 5% significance level (p <0.05). The prevalence of BV was 33.2% (67/202), of cervical HPV infection was 38.6% (78/202) and of cervical cytological abnormalities was 6.0% (12/202). Bivariate analysis did not identify a significant association between BV and cervical HPV infection (OR: 0.69; 95% CI: 0.37-1.27; p=0.23), nor between BV and cervical cytological abnormalities (OR: 0.65; 95% CI: 0.17-2.50; p=0.54). In the systematic review and meta-analysis, BV was considered a risk factor for cervical HPV infection, however, in the cross-sectional study, BV was not associated with cervical HPV infection nor with cervical cytological abnormalities in the group of adult women investigated.
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    Percepção discente do ambiente educacional de residência multiprofissional em hospital universitário
    (Universidade Federal de Goiás, 2020-03-04) Costa, Ana Carolina Arantes Coutinho; Pereira, Edna Regina Silva; http://lattes.cnpq.br/4503589425013098; Costa, Nilce Maria Silva Campos; http://lattes.cnpq.br/6977373149115047; Costa, Nilce Maria da Silva Campos; Marques, Flávio; Naghettini, Alessandra Vitorino; Mota, João Felipe; Batista, Sandro Rogério Rodrigues
    INTRODUCTION: The educational environment has a significant impact on students' behavior and learning, being strongly related to satisfaction and success. Students are important elements in the quality of the educational environment, one of these being the residents. OBJECTIVE: To analyze the perceptions of the educational environment of the multidisciplinary health residency in a university hospital from the students' perspective. METHODS: The DREEM questionnaire was applied to all students in the multiprofessional residency program in health for the first and second years, with data analysis using the T-student test, Mann-Whitney and Kruskall Wallis. RESULTS: The total score was 85.23 (95% CI), which shows a more negative than positive educational environment. None of the 50 questions had a score above 3.5. 71.4% of the questions were identified as problematic. The three highest points are confident that I will pass this year, I have good friends on this course and I live in a comfortable place, the lowest three were: the teaching adopted is often stimulating, there is a good support program for stressed students and I rarely I feel discouraged in this course. CONCLUSIONS: The poor analysis of the educational environment, especially in the learning and social domains, may signal the need to review the educational structure of the residence as well as the creation of support for students who feel overwhelmed, stressed or unable to deal with their own insecurities and expectations as well as supporting the coping with the patient's health-disease process. A longitudinal analysis, with a larger sample or with a qualitative evaluation can also help to face the limitations of the study. The difficulties are similar to those faced by other multiprofessional residency programs in health, suggesting, therefore, that there is a systemic action by the Ministry of Health and also Brazilian Education.
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    Retinol sérico, proteína ligante de retinol (RBP-4) e fatores de risco cardiometabólicos em crianças de 4 a 11 anos de idade
    (Universidade Federal de Goiás, 2020-02-06) Trindade, Neidiane Rosa; Silva, Maria Sebastiana; http://lattes.cnpq.br/1329422634395496; Silva, Maria Sebastiana; Silva, Gilberto Reis Agostinho; Santos, Renata Carvalho dos; Rebelo, Ana Cristina Silva; Guilho, Lidia Andreu
    Based on the hypothesis that children choose dyslipidemia, they present alterations in American retinol samples known as fat-soluble vitamins and antioxidants and that these variations can be used as cardiovascular risk. Therefore, the objectives of this study were to investigate the associations / influences of serum retinol and retinol binding protein (RBP-4) concentrations on risk factors and the cardiometabolic association. The study population included 212 children recruited from a public school in the city of Santo Antônio-Goiás for the study of serum retinol, and 36 were randomly selected for the RBP-4 study. The survey was conducted in 2018 and 2019. Height, body mass, waist circumference, blood pressure, lipoproteins and retinol serum were evaluated. Serum retinol concentrations were analyzed by high performance liquid chromatography. Regarding the correlation of retinol concentration with anthropometric variables, blood pressure and lipid profile, there was a positive association, cholesterol (r=0.25 p=0.001) and LDL (r=0.20 p=0.002). Logistic regression analysis with adjusted cholesterol found an association of retinol only in the group with hypercholesterolemia (β= -0.02) (p=0.015). In the comparative analysis it was observed that the 212 children with hypercholesterolemia had higher serum LDL-c concentrations (p< 0.001) total cholesterol (p< 0.001) retinol (p=0.020) e HDL-c (p=0.040). The results obtained from 36 children drawn showed similar dietary intake among those who had adequate cholesterol and hypercholesterolemia. In children with hypercholesterolemia, a positive association of RBP-4 with lipids was observed (p=0,049) and retinol (p= 0,013). Through multiple linear regression, it was found that for each 1g of lipid ingested, there was an increase of de 0.08 µmol/L de RBP-4 (β= 0.088 p=0.041) and for every 1 µmol / L retinol in the blood there is a 55.50 µmol / L increase in circulating RBP-4 (β= 55.50 p=0.0009). Conclusion: Children with hypercholesterolemia have cardiometabolic risk factors associated with serum retinol concentration and elevated RBP-4. Also, in children with hypercholesterolemia, RBP-4 was associated with retinol and dietary lipids.