RESUMO
Abstract Obesity affects several areas of the human body, leading to increased morbidity and mortality and the likelihood of other diseases, such as type 2 diabetes mellitus, cardiovascular diseases and musculoskeletal disorders. These conditions predispose to bone fractures and sarcopenic obesity, defined by the presence of an obesity-associated decrease in muscle mass and strength. Both bone fragility and sarcopenic obesity disease are consequences of several factors, such as a low degree of chronic inflammation, insulin resistance, hormonal changes, nutritional deficiencies, ectopic fat deposits and sedentary lifestyle. The diagnosis of obesity-related musculoskeletal disorders is limited by the lack of sarcopenia criteria and lower accuracy of bone mineral density measurement by dual-energy X-ray absorptiometry in overweight people. Reducing body weight provides undeniable benefits to this population, however treating cases of severe obesity with bariatric surgery can cause even greater damage to bone and muscle health, especially in the long term. The mechanisms involved in this process are not yet fully understood, but factors related to nutrient malabsorption and mechanical discharge as well as changes in gut hormones, adipokines and bone marrow adiposity should be taken into account. Depending on the surgical technique performed, greater musculoskeletal damage may occur, especially in cases of malabsorptive surgeries such as Roux-en-Y gastric bypass, when compared to restrictive techniques such as sleeve gastrectomy. This difference is probably due to greater weight loss, nutrient malabsorption and important hormonal changes that occur as a consequence of the diversion of intestinal transit and loss of greater absorptive surface. Thus, people undergoing bariatric procedures, especially malabsorptive ones, should have their musculoskeletal health supervised to allow early diagnosis and appropriate therapeutic interventions to prevent osteoporotic fractures and preserve the functionality of the skeletal muscles. Arch Endocrinol Metab. 2022;66(5):621-32
RESUMO
Objetivo: Relatar as experiências vivenciadas por acadêmicas do curso de medicina sobre o acolhimento na atenção primária à saúde. Métodos: Trata-se de um relato de experiência de ações vivenciadas na Unidade Básica de Saúde (UBS) de Parque dos Coqueiros, Natal/RN, a partir da prática de intervenção que aperfeiçoasse o acolhimento aos usuários. Foi realizada uma análise prévia das condições do acolhimento na UBS e capacitações de profissionais por meio de palestras interativas e atividades lúdicas. Foi elaborado um fluxograma identificando as rotas que devem ser seguidas pelos usuários de acordo com suas buscas, a ser utilizado durante o acolhimento. Resultados: Durante a visita técnica, foi encontrado um cenário carente de acolhimento e de profissionais que compreendessem esse processo. Uma média de 10 funcionários participou das intervenções. Os profissionais elaboraram questionamentos, sanaram dúvidas, questionaram sobre a importância e repercussões do ato de acolher. O fluxograma foi bem aceito pela UBS e foi fixado em sua estrutura física em formato de banner. Conclusão: As atividades foram bem aceitas pelos profissionais, que relataram satisfação e aprendizado. O acolhimento passou a ser implantado nesta unidade. (AU)
Objective: To report the experiences of academic course of medicine on the reception in primary health care. Methods: This is an account of the experience lived shares in Unit Basic Health (UBS) of Parque dos Coqueiros, Natal/RN, from the intervention of practice to perfect the reception users. A previous analysis of the reception conditions was held at UBS and professional skills through interactive lectures and recreational activities was held. A flow chart has been prepared identifying the routes to be followed by the users according to their searches, to be used during the reception. Results: During the technical visit found a needy scenario reception and professionals to understand. An average of 10 employees participated in the intervention and prepared questions, doubts remedied, questioned on the importance and implications of the act of receiving. The flowchart was well accepted by UBS and was set in its physical structure in banner format. Conclusion: The activities were well accepted by professionals who reported satisfaction and learning. The reception has to be implemented on this unit. (AU)