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1.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 40: e2020302, 2022. tab, graf
Article in English | LILACS-Express | LILACS, SES-SP | ID: biblio-1143856

ABSTRACT

ABSTRACT Objective: To analyze literature data about unnecessary exposure of pediatric emergency patients to ionizing agents from imaging examinations, nowadays and during times of COVID-19. Data sources: Between April and July 2020, articles were selected using the databases: Virtual Health Library, PubMed and Scientific Electronic Library Online. The following descriptors were used: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] and [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Inclusion criteria were articles available in full, in Portuguese or English, published from 2016 to 2020 or from 2019 to 2020, and articles that covered the theme. Articles without adherence to the theme and duplicate texts in the databases were excluded. Data synthesis: 61 publications were identified, of which 17 were comprised in this review. Some imaging tests used in pediatric emergency departments increase the possibility of developing future malignancies in patients, since they emit ionizing radiation. There are clinical decision instruments that allow reducing unnecessary exam requests, avoiding over-medicalization, and hospital expenses. Moreover, with the COVID-19 pandemic, there was a growing concern about the overuse of imaging exams in the pediatric population, which highlights the problems pointed out by this review. Conclusions: It is necessary to improve hospital staff training, use clinical decision instruments and develop guidelines to reduce the number of exams required, allowing hospital cost savings; and reducing children's exposure to ionizing agents.


RESUMO Objetivo: Analisar dados da literatura sobre exposição desnecessária de pacientes da emergência pediátrica a agentes ionizantes dos exames de imagem, na atualidade e em tempos de COVID-19. Fontes de dados: Entre abril e julho de 2020 ocorreu a seleção dos artigos, utilizando-se as bases de dados: Biblioteca Virtual em Saúde, PubMed e Scientific Electronic Library Online. Utilizaram-se os descritores: [(pediatrics) AND (emergencies) AND (diagnostic imaging) AND (medical overuse)] e [(Coronavirus infections) OR (COVID-19) AND (pediatrics) AND (emergencies) AND (diagnostic imaging)]. Incluíram-se artigos disponíveis na íntegra, em português ou inglês, publicados no período de 2016 a 2020 ou de 2019 a 2020, e artigos que contemplassem o tema. Excluiu-se artigos sem aderência com a temática e textos duplicados. Síntese dos dados: Identificaram-se 61 publicações, sendo 17 utilizadas para a elaboração desta revisão. Alguns exames de imagem utilizados nos Setores de Urgência e Emergência (SUEs) pediátricos, por emitirem radiação ionizante, aumentam a possibilidade de desenvolver malignidades futuras nas crianças. Destarte, há instrumentos de decisão clínica que possibilitam diminuir requisições de exames desnecessários, evitando a sobremedicalização e os gastos hospitalares. Ademais, com a pandemia da COVID-19, cresceu a preocupação com o uso excessivo de exames de imagem na população pediátrica, o que reafirma a problematização deste estudo. Conclusões: Veem-se como necessárias a capacitação da equipe hospitalar, a utilização de instrumentos de decisão clínica e a confecção de protocolos que possam avaliar a singularidade da criança. Isso permitirá reduzir o número de exames requeridos, possibilitando economia de custos hospitalares e redução da exposição de crianças a agentes ionizantes.

3.
J. Health NPEPS ; 6(1)jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1147344

ABSTRACT

Objetivo: analisar a letalidade da COVID-19 por sexo e idade entre os profissionais de saúde do Estado Pará, Brasil. Método: estudo epidemiológico e observacional, com utilização de dados secundários públicos sobre casos e óbitos acumulados por COVID-19 e dados demográficos, entre março e outubro de 2020. O número de casos e óbitos por COVID-19 ocorridos entre profissionais de saúde foram comparados em relação à idade e ao sexo pelo teste qui-quadrado, seguido por regressão logística pelo método Backward Stepwise de Wald. Resultados: entre os 15.332 casos confirmados de COVID-19, 70,3% eram do sexo feminino e 61,3% com idade entre 30 a 49 anos (39,2±11,6 anos). Registraram-se 97 óbitos, com uma taxa de letalidade de 0,6%. A probabilidade de óbito foi 52,8 vezes (20,7-134,5) e 4,0 vezes (2,5-6,2) maior entre jovens e homens quando comparados às demais notificações. Conclusão: a taxa de letalidade entre os profissionais de saúde é alta, especialmente entre homens jovens. Este é um alerta sobre os impactos da doença entre os trabalhadores da saúde e suscita ao poder público, especificamente ao setor saúde melhores condições de trabalho e políticas de saúde do trabalhador.(AU)


Objective: to analyze the lethality of COVID-19 by sex and age among health professionals in the state of Pará, Brazil. Method: epidemiological and observational study, using public secondary data on cases and deaths accumulated by COVID-19 and demographic data, between March and October 2020. The number of cases and deaths by COVID-19 that occurred among health professionals were compared in relation to age and sex using the chi-square test, followed by logistic regression using Wald's Backward Stepwise method. Results: among the 15,332 confirmed cases of COVID-19, 70.3% were female and 61.3% aged between 30 and 49 years (39.2 ± 11.6 years). 97 deaths were recorded, with a fatality rate of 0.6%. The probability of death was 52.8 times (20.7-134.5) and 4.0 times (2.5-6.2) higher among young men and men when compared to other reports. Conclusion: the lethality rate among health professionals is high, especially among young men. This is an alert about the impacts of the disease among health workers and raises the public authorities, specifically the health sector, better working conditions and worker health policies.(AU)


Objetivo: analizar la letalidad de COVID-19 por sexo y edad en profesionales de la salud en el estado de Pará, Brasil. Método: estudio epidemiológico y observacional, utilizando datos secundarios públicos sobre casos y defunciones acumulados por COVID-19 y datos demográficos, entre marzo y octubre de 2020. Se comparó el número de casos y defunciones por COVID-19 ocurridos entre profesionales de la salud en relación con edad y sexo usando la prueba de chi-cuadrado, seguida de regresión logística usando el método de Wald Backward Stepwise. Resultados: entre los 15.332 casos confirmados de COVID-19, el 70,3% eran mujeres y el 61,3% tenían entre 30 y 49 años (39,2 ± 11,6 años). Se registraron 97 muertes, con una tasa de letalidad del 0,6%. La probabilidad de muerte fue 52,8 veces (20,7-134,5) y 4,0 veces (2,5-6,2) más grande entre hombres y jóvenes en comparación con otros informes. Conclusión: la tasa de letalidad entre los profesionales de la salud es alta, especialmente entre los hombres jóvenes. Se trata de una alerta sobre los impactos de la enfermedad entre los trabajadores de la salud y plantea a las autoridades públicas, específicamente al sector salud, mejores condiciones laborales y políticas de salud laboral.(AU)


Subject(s)
Humans , Occupational Health , Health Personnel/statistics & numerical data , Coronavirus Infections/mortality , Health Policy , Brazil , Epidemiologic Studies
4.
Revista Digital de Postgrado ; 10(1): 275, abr. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147596

ABSTRACT

El hígado graso del embarazo es una patología poco frecuente en la especialidad obstétrica, cuyo diagnóstico se realiza basado en los criterios de Swansea, muchas veces es un diagnóstico que se realiza por exclusión; usualmente se presenta entre las semanas 30 y 35 del embarazo, y la cura definitiva se realiza con la interrupción expedita del mismo; con una tasa de recuperación casi del 100% si se realiza la interrupción oportuna y una tasa de mortalidad materno fetal actual del 10%. Es importante estar atentos a la ganancia ponderal de la embarazada durante el control prenatal, la epigastralgia, y los signos clínicos asociados a hipoglicemia(AU)


Fatty liver of pregnancy is a rare pathology in obstetrics, whose diagnosis is made based on the Swansea criteria, many times it is a diagnosis that is made by exclusion; It usually occurs between weeks 30 and 35, and the definitive cure is carried out with the expeditious interruption of pregnancy; with a recovery rate of almost 100% if timely interruption is made and a current maternal-fetal mortality rate of 10%. It is important to be attentive to the weight gain of the pregnant woman during prenatal control, epigastric pain, and clinical signs associated with hypoglycemia


Subject(s)
Humans , Female , Pregnancy , HELLP Syndrome , Abortion , Fatty Liver/pathology , Hypoglycemia , Maternal Mortality , Fetal Mortality , Diagnostic Techniques, Obstetrical and Gynecological
5.
Revista Digital de Postgrado ; 10(1): 255, abr. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1147589

ABSTRACT

A principios del nuevo milenio surgió el concepto del "Trauma urbano moderno", sustentando en la experiencia de varios conflagraciones en zonas densamente pobladas. Fue definido como un conflicto violento, cerrado, con heridas destructivas y de difícil acceso para su evacuación. Su manejo incluyo el cuestionamiento de viejos dogmas y la incorporación de nuevas estrategias. El motín del reten "La Planta", el incremento en las detonaciones por granadas fragmentarias y los graves enfrentamientos entre bandas delictivas o contra cuerpos de seguridad, en diversas zonas de Caracas indican el establecimiento de una modalidad mas agresiva de violencia. Los cirujanos capitalinos se enfrentan con más frecuencia a lesiones severas y múltiples. El personal medico requiere la adecuada comprensión y preparación para afrontar este nuevo tipo de heridas. La reciente enfermedad Covid 19 representa un desafió agregado en el abordaje de los pacientes con traumatismos(AU)


The experience in many combats in densely populated urban areas, determined the new concept of "Modern urban warfare" in the beginning of the new millennium. This definition is a warfare violent, close-quarter, with destructive injuries and the delayed of evacuation. New innovations were incorporate. The revolt in the "La Planta" prison, the increase of grenades explosions and engagement between criminal organized, in many zones of Caracas, illustrated this new definition. The venezuelans surgeons attended many severe and multiple injuries. The surgical personal need understand this new kind of injuries. The new disease Covid 19 represents a challenge in the attention of these patients(AU)


Subject(s)
Humans , Male , Female , Urban Population , Violence , Wounds and Injuries , Mortality , Health Personnel , Gun Violence , Prisons , Adaptation, Psychological , Occupational Health , Coronavirus Infections
6.
Revista Digital de Postgrado ; 10(1): 280, abr. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147585

ABSTRACT

Se evaluó la composición proximal, el contenido de polifenoles totales y la capacidad antioxidante de un chocolate oscuro formulado a partir de granos de cacao orgánico, seco, y no sometido al proceso fermentativo. Este producto fue elaborado con insumos y procesos desarrollados en la Granja Experimental El Cairo, ubicada en la Universidad Nacional de Colombia (GEL-UN), departamento de Arauca, Colombia. El contenido de grasa se encontró entre los rangos conocidos (>50%), siendo una característica ligada al origen genético, y a las condiciones climáticas. El alto contenido de proteínas (16,21%), evidencia que se trata de granos de cacao secos no fermentados. Tal contenido juega un papel importante en la formación de los precursores del sabor y aroma, en chocolates finos y exquisitos. El pH determinado es un indicativo de un chocolate amargo, con bajo índice de fermentación y de baja acidez acética o láctica. El contenido de polifenoles totales se relaciona de manera directa con la alta actividad antioxidante de este chocolate. Se concluye que el tipo de material genético usado como insumo, así como los procesos implementados para la obtención del chocolate, en GEL-UN, contribuyeron para la obtención de un producto tipo comercial, con propiedades funcionales, entre ellas las relacionadas con la capacidad antioxidante(AU)


Thee proximal chemical composition, the content of total polyphenols, and the antioxidant capacity of a dark chocolate formulated from organic, dry cocoa beans and not subjected to the fermentation process were evaluated. This product was made with inputs and processes developed at the El Cairo Experimental Farm, located at the Universidad Nacional de Colombia (CEF-UN), Arauca, Colombia. The fat content was found between the known ranges (> 50%), being a characteristic linked to the genetic origin, and to the climatic conditions. The high protein content (16.21%) evidenced that it´s unfermented dry cocoa beans. Such content plays an important role in the formation of precursors of flavor and aroma, in fine and exquisite chocolates. The determined pH is indicative of a dark chocolate, with a low fermentation index and low acetic or lactic acidity. The content of total polyphenols is directly related to the high antioxidant activity of this chocolate. It is concluded that the type of genetic material used as input, as well as the processes implemented to obtain chocolate, in CEF-UN, contributed to obtaining a commercial type product, with functional properties, including those related to antioxidant capacity(AU)


Subject(s)
Polyphenols , Chocolate/analysis , Antioxidants , Cacao , Food, Organic , Food Handling
9.
Rev. Odontol. Araçatuba (Impr.) ; 42(1): 9-13, jan.-abr. 2021. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1148159

ABSTRACT

O objetivo do presente estudo foi mensurar o pH externo radicular de dentes bovinos que foram desinfetados em solução de cloramina por 7 dias. Neste estudo foram utilizadas soluções irrigadoras, hipoclorito de sódio 1%, clorexidina 0,12% e hipoclorito de sódio 2,5% associadas ao edta e as medicações intracanais, hidróxido de cálcio, hidróxido de cálcio com PMCC e clorexidina gel 2%. O preparo químico mecânico foi realizado com as limas easy logic e as soluções foram agitadas com ultrassom durante 3 minutos e após os dentes foram imersos em água deionizada em eppendorfs estéreis e mantidos em estufa a 37°C. O pH externo foi analisado utilizando as fitas medidoras de pH no período de 24 horas, 48 horas, 7 dias, 10 dias e 15 dias. A normalidade dos valores obtidos de cada ensaio foi testada através do teste Kolmogorof- Smirnov, e o teste estatístico foi ANOVA de uma via e comparações múltiplas de Tukey. Os resultados mostraram que houve diferença estatística nos valores de pH nos grupos avaliados dentro dos tempos (p< 0,05). Concluiu-se que mesmo com as variações de pH nos períodos avaliados, as medicações e as soluções irrigantes podem ser utilizadas de forma associadas na endodontia, com o intuito de eliminar o maior número de microrganismos dos canais radiculares(AU)


The objective of the present study was to measure the external root pH of bovine teeth that were disinfected in chloramine solution for 7 days. Irrigating solutions, 1% sodium hypochlorite, 0.12% chlorhexidine and 2.5% sodium hypochlorite associated with edta and intracanal medications, calcium hydroxide, calcium hydroxide with PMCC and chlorhexidine gel 2%. The mechanical chemical preparation was performed with the easy logic files and the solutions were shaken with ultrasound for 3 minutes and after the teeth were immersed in deionized water in eppendorfs and kept in an oven at 37 ° C. The external pH was analyzed using the pH measuring tapes in the period of 24 hours, 48 hours, 7 days, 10 days and 15 days. The normal values obtained from each test were tested using the Kolmogorof-Smirnov test, and the statistical test was one-way ANOVA and Tukey's multiple comparisons. The results showed that there was a statistical difference in pH values in the groups evaluated within the times (p< 0.05). It was concluded that even with pH variations in the evaluated periods, medications and irrigating solutions can be used in an associated way in endodontics, in order to eliminate the largest number of microorganisms in the root canals(AU)


Subject(s)
Root Canal Irrigants , Root Canal Preparation , Sodium Hypochlorite , Calcium Hydroxide , Chloramines , Chlorhexidine , Analysis of Variance , Edetic Acid , Endodontics
10.
Rev. Odontol. Araçatuba (Impr.) ; 42(1): 14-18, jan.-abr. 2021.
Article in Portuguese | LILACS, BBO | ID: biblio-1148160

ABSTRACT

Objetivo: Este trabalho tem como propósito relatar, a partir de um olhar acadêmico, as experiências vivenciadas no programa "Partiu Estágio" do governo da Bahia, direcionado à gestão da atenção básica e produção técnico-científica com o Telessaúde Redes Brasil. Metodologia: A vivência ocorreu no período de novembro de 2017 a julho de 2018, no município de Salvador, Bahia, e teve a participação de 07 estudantes de diferentes cursos de graduação. Ocorreram visitas, estudos de imersão teórica, rodas de conversas e dinâmicas, visando o entendimento da realidade do Sistema Único de Saúde e do programa Telessaúde. Resultados: O programa "Partiu Estágio" promoveu a aproximação entre universitários e Atenção Básica, enquanto o Telessaúde viabilizou a integração dos sistemas de informação em saúde. No período de experiência identificouse pontos positivos como a possibilidade de acompanhamento das ações de saúde do SUS e o funcionamento do Telessaúde, entretanto, existem fragilidades, especialmente, no que concerne à estrutura do Telessaúde e verbas para ampliação do programa. Conclusão: A relevância dos programas abordados é imprescindível, pois impacta na operacionalização da Atenção Básica. Ressalta-se a relevância de aproximar estudantes de cursos de graduação, voltados para saúde, a experimentarem os espaços de aprendizagem no SUS e na Atenção Primária(AU)


Objective: This study aimed to report, from an academic perspective, the experiences of the "Partiu Estágio" program of the Bahia government, aimed at the management of basic care and technical-scientific production with Telehealth Networks Brazil. Methodology: The experience occurred in the period from November 2017 to July 2018, in the city of Salvador, Bahia, and had the participation of 07 students from different undergraduate courses. Visits, theoretical immersion studies, conversation wheels and dynamics, aimed at understanding the reality of the Unified Health System and the Telehealth program. Results: The "Partiu Estágio" program promoted the rapprochement between university students and Primary Care, while Telehealth enabled the integration of health information systems. During the period of experience, positive points were identified such as the possibility of monitoring health actions of the SUS and the operation of Telehealth, as well as participation in the process of promoting the continuity of care of the population by the permeability of available resources, regardless of the place where assistance was generated. However, there are weaknesses, especially with regard to the structure of telehealth and funds to expand the program Conclusion: The relevance of the programs addressed is essential, as it impacts on the operationalization of Primary Care. It is important to highlight the relevance of bringing undergraduate, health-oriented students to experience the learning spaces in SUS and Primary Care(AU)


Subject(s)
Primary Health Care , Students, Medical , Telemedicine , Unified Health System , Problem-Based Learning
11.
Rev. Odontol. Araçatuba (Impr.) ; 42(1): 19-23, jan.-abr. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1148162

ABSTRACT

O tratamento periodontal consiste na remoção do biofilme patogênico, através da raspagem e alisamento radicular. O desbridamento ultrassônico de boca toda promove uma instrumentação mais conservadora, porém eficiente da superfície radicular, em sessão única. Evitando a translocação bacteriana de uma região tratada para outra que já foi. O objetivo do presente trabalho foi realizar uma comparação entre a eficácia da raspagem manual e a ultrassônica dentro do protocolo da FMD, através de um relato de caso clínico. Houve uma melhora nos parâmetros clínicos periodontais em todos os quadrantes, porém resultados superiores foram observados com o desbridamento com ultrassom e irrigação com clorexidina. A instrumentação com ultrassom associada a clorexidina no tratamento da periodontite estágio III grau C generalizada, reduz com eficácia o tempo de tratamento, otimizando o tempo do paciente e profissional(AU)


Periodontal treatment consists of removing the pathogenic biofilm, by scaling and root planing. Ultrasonic debridement of the entire mouth promotes more conservative, yet efficient instrumentation of the root surface, in a single session. Avoiding bacterial translocation from one treated region to another that has already been. The objective of the present study was to make a comparison between the effectiveness of manual and ultrasonic scraping within the FMD protocol, through a clinical case report. There was an improvement in periodontal clinical parameters in all quadrants, but superior results were observed with debridement with ultrasound and irrigation with chlorhexidine. Instrumentation with ultrasound associated with chlorhexidine in the treatment of generalized stage III grade C periodontitis, effectively reduces treatment time, optimizing patient and professional time(AU)


Subject(s)
Periodontitis , Dental Scaling , Periodontal Debridement , Ultrasonic Therapy , Chlorhexidine , Dental Plaque
12.
Rev. Odontol. Araçatuba (Impr.) ; 42(1): 24-32, jan.-abr. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1148164

ABSTRACT

O uso de próteses mal adaptadas pode ocasionar o surgimento de processos proliferativos não neoplásicos. A hiperplasia fibrosa inflamatória (HFI) é uma lesão benigna, proveniente de reação hiperplásica do tecido conjuntivo fibroso em resposta às injúrias crônicas de baixa intensidade. O objetivo do presente trabalho é relatar um caso clínico sobre remoção cirúrgica de HFI, seguida de reabilitação oral com próteses removíveis. Paciente de 75 anos do sexo masculino relatou que gostaria de fazer a troca da sua prótese, pois a mesma estava fraturada. Ao exame clínico intra-oral constatou-se que suas próteses possuíam higienização precária, e, a superior, possuía uma borda cortante que causou uma lesão hiperplásica na região de fundo de vestíbulo anterior. Quanto ao aspecto clínico, apresentava-se com consistência fibrosa e firme à palpação, de coloração semelhante a mucosa e assintomática. O plano de tratamento proposto foi reembasamento da prótese antiga com resina Soft Confort (Dencril, Brasil) eliminando as áreas que traumatizavam a mucosa, cirurgia pré-protética para a remoção da HFI, exame histopatológico e a confecção de novas próteses, sendo a superior prótese total convencional e a inferior prótese parcial removível. Observa-se a importância no cuidado do planejamento reabilitador protético dos pacientes, pois, como foi descrito neste caso, em algumas situações pode haver necessidade de lançarmos mão de diversas modalidades de tratamento prévias à reabilitação(AU)


The use of poorly adapted prostheses can lead to the emergence of non-neoplastic proliferative processes. Inflammatory fibrous hyperplasia (HFI) is a benign lesion, resulting from a hyperplastic reaction of fibrous connective tissue in response to low-intensity chronic injuries. The aim of the present study is to report a clinical case about surgical removal of HFI, followed by oral rehabilitation with removable prostheses. A 75-year-old male patient reported that he would like to change his prosthesis, because it was fractured. On intra-oral clinical examination, it was found that his prostheses had poor hygiene, and the upper one had a cutting edge that caused a hyperplastic lesion in the deep region of the anterior vestibule. As for the clinical aspect, it was fibrous and firm on palpation, mucosa-like and asymptomatic. The proposed treatment plan was to repurpose the old prosthesis with Soft Confort resin (Dencril, Brazil), eliminating the areas that traumatized the mucosa, pre-prosthetic surgery for the removal of HFI, histopathological examination and the making of new prostheses, the upper prosthesis being conventional total and the lower partial removable prosthesis. It is observed the importance in the care of the prosthetic rehabilitation planning of the patients, because, as it was described in this case, in some situations it may be necessary to resort to different treatment modalities prior to the rehabilitation(AU)


Subject(s)
Dental Prosthesis Design , Hyperplasia , Connective Tissue , Denture, Complete , Denture, Partial, Removable , Denture Rebasing
13.
Goiânia; SES-GO; 01 março 2021. 1-50 p. ilus, tab.
Non-conventional in Portuguese | LILACS, ColecionaSUS, CONASS, SES-GO | ID: biblio-1096093

ABSTRACT

O surto da doença respiratória causada pelo novo coronavírus (SARS-CoV-2) aconteceu na cidade de Wuhan, capital da província de Hubei, na China, em dezembro de 2019, a qual disseminou-se de forma acelerada e, logo, atingiu mais de uma centena de países dos cinco continentes. Em 12 de março de 2020, a situação foi caracterizada como pandemia pela Organização Mundial de Saúde (OMS, 2020). Em razão da disseminação o do Coronavírus pelo mundo, o Ministério da Saúde declarou Emergência de Saúde Pública de Importância Nacional (ESPIN) em decorrência da infecção pelo novo coronavírus (COVID-19) e estabeleceu o Centro de Operações de Emergência em Saúde Pública (COE-COVID-19) como mecanismo de gestão coordenada da resposta à ESPIN no país (BRASIL, 2020a). Seguindo a linha mundial, o Ministério da Saúde elaborou e publicou "Plano de Contingência Nacional para Infecção Humana pelo Novo Coronavírus COVID-19" para organizar a detecção, monitoramento e resposta dos serviços de saúde à doença (BRASIL, 2020b). O Estado de Goiás instituiu o Centro de Operações Estratégicas de Saúde Pública (COE) em 18 de fevereiro de 2020 (GOIÁS, 2020a). E, seguindo as orientações nacionais, propõe o presente PLANO ESTADUAL DE CONTINGÊNCIA PARA O ENFRENTAMENTO DA DOENÇA PELO CORONAVÍRUS (COVID-19), a fim de organizar e fortalecer as políticas públicas de saúde, visto que, para que atinjam eficácia e eficiência, é necessário atuação conjunta e ordenada dos entes federados, bem como dos setores públicos e privados.


The outbreak of respiratory disease caused by the new coronavirus (SARS-CoV-2) occurred in Wuhan city, capital of Hubei province, China, in December 2019, which spread rapidly and thus reached more than a hundred countries on five continents. On March 12, 2020, the situation was characterized as a pandemic by the World Health Organization (WHO, 2020). Due to the spread of Coronavirus around the world, the Ministry of Health declared a Public Health Emergency of National Importance (ESPIN) due to infection by the new coronavirus (COVID-19) and established the Center for Emergency Operations in Public Health (COE-COVID-19) as a mechanism for coordinated management of the response to ESPIN in the country (BRASIL, 2020a). Following the global line, the Ministry of Health elaborated and published "National Contingency Plan for Human Infection by the New Coronavirus COVID-19" to organize the detection, monitoring and response of health services to the disease (BRASIL, 2020b). The State of Goiás established the Center for Strategic Operations of Public Health (COE) on February 18, 2020 (GOIÁS, 2020a). And, following the national guidelines, it proposes this State CONTINGENCY PLAN FOR COPING WITH CORONAVIRUS DISEASE (COVID-19), in order to organize and strengthen public health policies, since, in order to achieve effectiveness and efficiency, joint and orderly action of federal entities, as well as public and private sectors, is necessary.


Subject(s)
Humans , Male , Female , Pregnancy , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Public Health , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/prevention & control , Coronavirus Infections/therapy , Coronavirus Infections/transmission , Pandemics
14.
Rev. venez. oncol ; 33(1): 2-10, mar. 2021. ilus, tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147430

ABSTRACT

Presentar nuestra experiencia de 18 años en el tratamiento con radioterapia y evaluar cifras de control tumoral local en pacientes con diagnóstico de tumor de células gigantes tenosinovial difuso sinovitis villonodular pigmentada difusa. 33 pacientes, tratados durante el período 2000-2018. En 19 (57,6 %) se practicó sinovectomía parcial, 10 (30,3 %) fueron tratados con artroplastia y sinovectomía, 4 (12,2 %) con sinovectomía total. 32 pacientes recibieron radioterapia posoperatoria, 1 paciente preoperatoria. Técnica más empleada fue planificación 2D 51,5 % seguida de conformada con planificación 3D (RTC3D) 48,5 %. La dosis total promedio administrada 44 Gy (rango 10,5 - 50). Tiempo promedio de tratamiento radiante 28 días (8-35). Tiempo de seguimiento entre 0,7 - 240,8 meses, mediana 12 meses, promedio 52,1 meses. 26 pacientes (79 %) presentaron mejoría de la sintomatología inicial y 6 (18 %) refirieron estabilidad de los síntomas. La respuesta clínica al tratamiento en relación al tiempo de seguimiento, 12 pacientes (36,4 %) estaban asintomáticos, 10 con un seguimiento mayor a 60 meses; 14 (42,4 %) refieren respuesta clínica satisfactoria, (2 con un seguimiento mayor a 60 meses) 6 pacientes presentaban enfermedad estable, para un control local del 97 %. El 87,9 % presentaron dermatitis grado I, 1 desarrolló dermatitis grado II, 3 no presentaron efectos adversos. La radioterapia es una modalidad de tratamiento muy efectiva como adyuvante a la sinovectomía, observándose altas tasas de control local de la enfermedad con una baja morbilidad(AU)


To report our eighteen-year experience with radiation therapy in the treatment of diffuse tenosinovial giant cell tumor / diffuse pigmented villonodular synovitis and to assess local control of the disease. A review of 33 patients with treated with radiation therapy during the period 2000-2018 was done. 19 (57.6 %) partial synovectomy was performed, 10 (30.3 %) underwent arthroplasty plus synovectomy, 4 (12.2 %) total synovectomy. 32 patients received radiotherapy postoperative and 1 pre-operative. Most common technique employed was conventional (2D) in 51.5 % and 3D conformal (3DCRT) in 48.5 %. The average total dose was 44 Gy (range 10.5-50), with a mean treatment time of 28 days (8-35). Follow-up time ranged from 0.7- 240.8 months, median time and mean time of 12 and 52.1 months respectively After RT 26 (79 %) of the patients obtained improvement of the initial symptoms and 6 (18 %) were stable. 12 patients (36.4 %) were asymptomatic with follow-up time longer than 36 months (10 of 12 had follow-up time >60 months), 14 (42.4 %) had significant clinical improvement (2 of 14 had follow-up time >60 months), and 6 had stable disease, local control of 97 %. Complications were few, acute skin toxicity was grade I in 29 (87.9%) and grade II in 1 patient. There was no significant chronic toxicity. Radiation therapy is an effective adjuvant treatment modality after synovectomy in patients with high local control rates and low morbidity(AU)


Subject(s)
Humans , Male , Female , Trisomy/genetics , Giant Cell Tumor of Tendon Sheath/etiology , Giant Cell Tumor of Tendon Sheath/radiotherapy , Arthroscopy , Musculoskeletal Physiological Phenomena , Neoplasm Metastasis
16.
Rev. venez. oncol ; 33(1): 46-59, mar. 2021. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1147479

ABSTRACT

El cáncer de mama Triple Negativo es un subtipo molecular que se caracteriza por ausencia de expresión de receptores de estrógeno, progesterona y proteína HER2. Representa el 10 % a 15 % de todos los subtipos de cáncer de mama con impacto en el pronóstico y en las líneas de tratamiento; siendo negativo para receptores hormonales y HER2, la terapéutica hormonal y anti-HER2 no cuentan para su manejo. Aún no se dispone de productos dirigidos a blancos específicos para esta categoría.(AU)


The Triple Negative breast cancer is a molecular subtype characterized by no expression of the estrogen, the progesterone and the HER2 protein receptors. They represents 10 % to 15 % of all the breast cancer subtypes with an impact on the prognosis and in the treatment lines; is negative for the hormone receptors and for the HER2, hormonal and the anti-HER2 therapeutics do not count for the management of them. The products targeting specific to this category are not yet available(AU)


Subject(s)
Humans , Female , Biomarkers, Tumor , Anthracyclines/therapeutic use , Taxoids/therapeutic use , Triple Negative Breast Neoplasms/pathology , Triple Negative Breast Neoplasms/epidemiology , Mammography , Drug Therapy , Medical Oncology
17.
Rev. venez. oncol ; 33(1): 40-45, mar. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1147477

ABSTRACT

El linfoma de Burkitt es una neoplasia altamente agresiva y es un tipo raro de linfoma no Hodgkin localizado. Aunque los niños son los más frecuentemente afectados, en adultos ocurren principalmente durante el embarazo o el puerperio. La mama rara vez constituye la localización primaria del linfoma no Hodgkin. Se presenta un caso de linfoma de Burkitt primario de mama durante el embarazo. Paciente de 37 años con embarazo de 24 semanas quien presentó aumento de volumen difuso de mama derecha. La mama estaba aumentada de tamaño, dolorosa y homogénea con tumoración elástica y firme. La ecografía demostró inflamación difusa con tumoración heterogénea e hipoecoica con contornos ligeramente irregulares, marcadores tumorales estaban normales las pruebas serológicas fueron negativas. La biopsia de la lesión mostró tejido mamario reemplazado por células linfoideas de tamaño mediano con citoplasma basófilo y múltiples vacuolas. Estudios inmunohistoquímicos fueron positivos para el antígeno leucocitario común, CD10, CD20, CD43, Bcl-6. El análisis cromosómico reveló que más del 90 % de las células neoplásicas exhibieron translocación t llevando al diagnóstico final de linfoma de Burkitt de mama. Luego de evaluar las posibilidades terapéuticas y del consentimiento de la paciente se inició tratamiento citostático sistémico. Los linfomas primarios de mama son extremadamente raros. El linfoma de Burkitt primario de la mama es mucho menos común que los otros linfomas. Los métodos de clasificación, detección y tratamiento de esta afección siguen siendo objeto de debates e investigaciones(AU)


The Burkitt's lymphoma is a highly aggressive neoplasm and is a rare type of localized non-Hodgkin lymphoma. Although children are the most frequently affected, in adults they occur mainly during the pregnancy or the puerperium. The breast rarely constitutes the primary location for non-Hodgkin lymphoma. The study of a case of primary Burkitt lymphoma of the breast during pregnancy is presented. This is a 37 year old patient with a 24 week pregnancy who presented a diffuse increase in the volume of the right breast. The breast was enlarged, painful and homogeneous with a firm, elastic mass. The ultrasonography showed diffuse inflammation with a heterogeneous and hypoechoic tumor with slightly irregular contours. The tumor marker values were normal and the serological tests were negative. The biopsy of the lesion showed breast tissue replaced by medium-sized lymphoid cells with basophilic cytoplasm and multiple vacuoles. Immunohistochemically studies were positive for the common leukocyte antigen, CD10, CD20, CD43, Bcl-6. The chromosomal analysis revealed that more than 90 % of neoplastic cells exhibited t translocation leading to the final diagnosis of Burkitt lymphoma of the breast. After evaluating the therapeutic possibilities and the patient's consent, systemic cytostatic treatment was started. Primary breast lymphomas are extremely rare. The primary Burkitt lymphoma of the breast is much less common than other lymphomas. The methods of classification, detection, and the treatment of this condition continue to be the subject of debate and research(AU)


Subject(s)
Humans , Female , Adult , Lymphoma, Non-Hodgkin , Breast Neoplasms , Burkitt Lymphoma/physiopathology , Precursor Cells, B-Lymphoid , Vincristine/therapeutic use , Prednisone/therapeutic use , Doxorubicin/therapeutic use , Tomography, X-Ray Computed , Cyclophosphamide/therapeutic use , Rituximab/therapeutic use
18.
Rev. venez. oncol ; 33(1): 33-39, mar. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1147475

ABSTRACT

La hemiagenesia tiroidea representa un trastorno congénito caracterizado por la ausencia de desarrollo de uno de los lóbulos tiroideos, asociado o no a ausencia del istmo. Es más frecuente en las mujeres y por lo general se presenta como falta del lóbulo izquierdo, con hipertrofia compensatoria del lóbulo contralateral. Su diagnóstico es generalmente incidental o por manifestaciones del lóbulo tiroideo presente. Se hizo una revisión bibliografía, en donde no se encontraron casos reportados en Venezuela de hemiagenesia o agenesia tiroidea, describiéndose el siguiente. Presentamos a una paciente de 50 años de edad, conocida con hipotiroidismo desde los 31 años, negando cualquier cirugía en el área de cabeza y cuello. Desde febrero 2019 presentó aumento progresivo de volumen en región anterior de cuello. Al examen físico se observó aumento de volumen en región anterior derecha del cuello, palpándose lóbulo tiroideo derecho aumentado de tamaño, de aspecto nodular, no doloroso. En ecosonograma tiroideo se concluyó como bocio tiroideo derecho de aspecto multinodular, con ausencia del lóbulo izquierdo. Perfil tiroideo dentro de límites normales. Se lleva a mesa operatoria corroborándose ausencia del lóbulo izquierdo y presentado en la biopsia definitiva hiperplasia nodular en el lóbulo derecho. Se discute su frecuencia, la forma de presentación y se hace revisión de la literatura(AU)


Thyroid hemiagenesis represents a congenital disorder characterized by the absence of development of one of thyroid lobes, associated or not with absence of isthmus. It is more frequent in women and generally presents as absence of the left lobe, with compensatory hypertrophy of the contralateral lobe. Its diagnosis is generally incidental or by manifestations of the present thyroid lobe. A bibliography review was made, where no cases reported in Venezuela of hemiagenesis or thyroid agenesis were found, describing the following. We present a 50-year-old patient, known with hypothyroidism since she was 31, denying any surgery in the head and neck area. Since February 2019, presented a progressive increase in volume in the anterior neck region. On physical examination, an increase in volume was observed in right anterior region of the neck, palpating an enlarged right thyroid lobe, with a nodular appearance and not painful. In a thyroid echo-sonogram, it was concluded as a right thyroid goiter with a multinodular appearance, with the absence of the left lobe. Thyroid profile within normal limits. It is taken to the operating table, confirming the absence of the left lobe and presented in the definitive biopsy nodular hyperplasia in the right lobe. Its frequency, form of presentation, and literature review are discussed(AU)


Subject(s)
Humans , Female , Middle Aged , Thyroid Gland/physiopathology , Goiter , Hypothyroidism/surgery , Thyroid Diseases , Triiodothyronine , Ultrasonography
19.
Rev. venez. oncol ; 33(1): 11-32, mar. 2021. ilus, tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1147464

ABSTRACT

Clasificar los carcinomas de pulmón según criterios establecidos por la OMS 2015 en biopsias de la sección de patología respiratoria del Instituto Anatomopatológico "Dr. José Antonio O`Daly" en el período enero 2006-diciembre 2016. Se realizó estudio descriptivo y retrospectivo, en el que se evaluaron todos los casos de carcinomas pulmonares recibidos entre enero 2006 diciembre 2016. La edad de presentación del carcinoma pulmonar fue 61 ± 11,45 años. Fue más frecuente en el sexo masculino 56,57 %. El tipo histológico más frecuente fue el adenocarcinoma 61,6 %. El adenocarcinoma el patrón predominantemente sólido fue el más constante 57,3 %, seguido de patrón predominantemente acinar 18,2 % y patrones mixtos. El carcinoma de células escamosas fue el segundo tipo más frecuente con 30,3 % de los casos representando el carcinoma de células escamosas poco diferenciado no queratinizante un 40 %. El carcinoma neuroendocrino fue el tercer tipo de carcinoma más común y el carcinoma de células pequeñas representó el 80 % de estos casos. Al menos 10,8 % de los casos fueron carcinomas no clasificables por necrosis o muestra escasa. Los casos previamente diagnosticados como adenocarcinoma poco diferenciado se corresponden con patrón sólido. Es importante el uso de inmunohistoquímica para el diagnóstico definitivo especialmente de adenocarcinoma patrón predominantemente sólido. El uso de la actual clasificación permite definir pronóstico y tratamiento personalizado(AU)


To classify the lung carcinomas according to criteria established by WHO 2015 in the biopsies of the section of respiratory pathology of the Anatomo Pathological Institute "Dr. José Antonio O`Daly" in the period January 2006 December 2016. A study will be carried out descriptive and retrospective, in which all cases of the pulmonary carcinomas received between January 2006 and December 2016 were evaluated. The age of presentation of the lung carcinoma was 61 ± 11.45 years old. It was more frequent in the male sex 56.57 %. The most frequent histological type was the adenocarcinoma 61.6 %. The predominantly solid adenocarcinoma pattern was the most constant 57.3 % followed by predominantly acinar pattern 18.2 % and the mixed patterns. The squamous cell carcinoma was the second most frequent type 30.3 %, and the poorly differentiated and non-keratinizing type was a 40 %. The neuroendocrine carcinoma was the third most common type of it the small cell carcinoma accounted an 80 %. At least 10.8 % of the cases were carcinomas unclassifiable due to necrosis or scarce sample. The cases previously diagnosed as poorly differentiated adenocarcinoma correspond to a solid pattern. The immunohistochemically use is important for the definitive diagnosis, especially for the adenocarcinoma predominantly solid pattern. The use of the current classification allowsdefining the prognosis and the personalized treatment(AU)


Subject(s)
Humans , Male , Female , Biopsy , Carcinoma, Bronchogenic/epidemiology , Lung Neoplasms/epidemiology , Public Health , Drug Therapy , Medical Oncology
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