Gestante com Covid-19 submetida à cesariana por sofrimento fetal: primeiro relato de caso descrito no Brasil / Pregnant with Covid-19 submitted to cesarian for fetal suffering: first case report described in Brazil

A COVID-19 pode provocar um quadro respiratório agudo e sua sintomatologia varia de leve a crítica, culminando, às vezes, com à morte. Em relação às grávidas, existem poucas informações, relata-se, portanto o primeiro caso descrito no Brasil de uma gestante de 19 anos, que apresentava dispneia, hipóxia, tosse produtiva e febre, sendo diagnosticada com COVID-19. Após a evolução para a síndrome respiratória aguda grave foi submetida a cesárea de urgência devido a insuficiência respiratória materna e sofrimento fetal agudo. Após o parto, a parturiente foi encaminhada a unidade de terapia intensiva (UTI) e mantida sob ventilação pulmonar com parâmetros elevados. No décimo dia de internamento na UTI, houve progressão da insuficiência respiratória, coagulação vascular disseminada e hemorragia pulmonar que culminou com o óbito. Em função da gravidade, o recém-nascido (RN) foi entubado e encaminhado a unidade de terapia intensiva neonatal, onde apresentou melhora progressiva, sendo suspenso o oxigênio no vigésimo dia de vida. O RN recebeu alta hospitalar 29 dias após a internação, sem alteração no estado clínico geral. No presente estudo o parto cesariano mostrou-se seguro, ficando o RN isento de contaminação do SARS-CoV-2, ainda que, em sofrimento fetal os cuidados intensivos foram eficientes culminando com boa evolução e alta hospitalar.

COVID-19 can cause an acute respiratory condition and its symptoms vary from mild to critical, sometimes culminating in death. Regarding pregnant women, there is little information, therefore, the first case reported in Brazil of a 19-year-old pregnant woman, who had dyspnea, hypoxia, productive cough and fever, being diagnosed with COVID-19. After progressing to severe acute respiratory syndrome, she underwent an emergency cesarean section due to maternal respiratory failure and acute fetal distress. After delivery, the parturient was referred to the intensive care unit (ICU) and kept under pulmonary ventilation with high parameters. On the tenth day of admission to the ICU, there was a progression of respiratory failure, disseminated vascular coagulation and pulmonary hemorrhage that culminated in death. Depending on the severity, the newborn (NB) was intubated and sent to the neonatal intensive care unit, where he showed progressive improvement, with oxygen being suspended on the 20th day of life. The NB was discharged from the hospital 29 days after admission, with no changes in general clinical status. In the present study, cesarean delivery proved to be safe, leaving the newborn free from SARS-CoV-2 contamination, even though, in fetal distress, intensive care was efficient, culminating in a good evolution and hospital discharge.

Impact of primary hyperhidrosis on the life of physical education academics of a university in the Brazilian Northeast

Abstract Aim: To assess the prevalence, quality of life (QoL), and the damages caused by PH, in the professional and personal scope of Physical Education academics with Primary Hyperhidrosis (PH). Methods: A descriptive, exploratory, qualitative and quantitative cross-sectional study was carried out. Twenty-five students from the physical education course at Tiradentes University, Aracaju-SE, were interviewed from August to November 2017. Validated questionnaires were used on PH's influence in academic activities and QoL. absolute and relative frequencies in the case of categorical variables and measures of trend and central variability in the case of numerical variables. Results: The prevalence of PH in students of Physical Education was 11.11%, mainly in combined sites, such as palmoplantar, and with no difference between the sexes. The symptoms started mostly during childhood and adolescence. Most of the interviewees (92%) reported difficulties with activities such as sports, use of personal protective equipment, handling of work equipment and instruments, and exacerbation in stress situations. They reported significant harm to QoL in situations of greeting people with handshakes, writing, wearing socks and dancing socially. Conclusion: Although PH is a disease that negatively impacts the QoL, it is still little known in the academic world with little demand for medical help. Therefore, it is necessary greater dissemination of the disease for its early diagnosis, related to the intensity of the sweating for a better therapeutic approach.

Perfil Epidemiológico e Qualidade de Vida dos Estudantes de Medicina Portadores de Hiperidrose Primária / Epidemiological Profile and Quality of Life of Medicine Students with Primary Hyperhidrosis

RESUMO Hiperidrose é a produção excessiva de suor pelo corpo, podendo ser primária ou secundária e generalizada ou localizada. As regiões craniofacial, axilar, palmar, dorso, face interna das coxas, plantar são comumente afetadas. A hiperidrose primária (HP), embora seja uma doença benigna, apresenta um eminente impacto negativo na qualidade de vida do paciente. Essa doença é classificada quantitativamente de acordo com a Escala de Gravidade da Doença da Hiperidrose, com base em como ela pode afetar as atividades diárias, podendo ser de leve a grave intensidade. Os acadêmicos de medicina enfrentam situações desgastantes físicas e emocionais durante seus afazeres e, quando portadores de doenças crônicas como a HP, podem ser estigmatizados como inseguros na sua profissão. Objetivou-se definir a prevalência, os critérios diagnósticos, a gravidade e o impacto na qualidade de vida que a HP proporciona nos âmbitos profissional e extracurricular dos acadêmicos de medicina. Trata-se de um estudo transversal de abordagem quantitativa de caráter descritivo, que inclui 300 acadêmicos do curso de Medicina da Universidade Tiradentes, em Aracaju/SE, no período de agosto a novembro de 2017. Utilizaram-se frequências absolutas e relativas no caso de variáveis categóricas e medidas de tendência e variabilidade central no caso de variáveis numéricas. O valor de p < 0,05 foi considerado significativo. A prevalência de HP em estudantes de medicina foi de 18% sem diferença entre os sexos e com predomínios das cores branca e parda. A doença ocorreu principalmente em sítios combinados, como palmoplantar, sendo a região palmar a mais acometida. Os sintomas iniciaram-se, principalmente, durante a infância e adolescência, com prejuízo importante nas atividades diárias pessoais e laborativas, e exacerbação do suor com situações de estresse. A gravidade da HP mais encontrada foi a moderada, sendo o impacto negativo na qualidade de vida principalmente relatado nos graus mais avançados da doença, dificultando as atividades acadêmicas. É importante a inclusão do conhecimento da HP no currículo médico para uma maior divulgação da doença, de modo a permitir um diagnóstico precoce e relacionado à intensidade da sudorese na sua abordagem terapêutica.

ABSTRACT Hyperhidrosis is the excessive production of sweat by the body, which can be primary or secondary and generalized or localized. The craniofacial, axillary, palmar, dorsum, inner thigh, and plantar regions are commonly affected. Primary hyperhidrosis (HP), although a benign disease, has an imminent negative impact on the patient's quality of life. This disease is quantitatively classified according to the Hyperhidrosis Disease Severity Scale, based on how the disease affects daily activities, ranging from mild to severe intensity. Medical undergraduate students face physical and emotional stressful situations during their tasks, and when they have a chronic illness such as HP, they can be stigmatized as unsafe for their profession. The objective was to define HP prevalence, diagnostic criteria, severity and impact on the quality of life in the professional and extracurricular scenario of undergraduate medical students. This is a cross-sectional quantitative study of a descriptive nature, including 300 students from the Tiradentes University medical school, in Aracaju-SE, from August to November 2017. Absolute and relative frequencies were used in the case of categorical variables and measures of central tendency and variability were used for numerical variables; p value was considered significant when p <0.05. The prevalence of HP in medical students was 18%, with no difference between the genders and with the predominance of white and brown ethnicities. The disease occurred mainly in combined sites, such as palmar-plantar, with the palmar region being the most affected one. The symptoms began mainly during childhood and adolescence, with significant impairment in daily personal and work activities, with disease exacerbation under stress situations. The most common HP severity was moderate, with a negative impact on quality of life, mainly reported at the more advanced stages of the disease, hindering academic activities. It is important to include the knowledge of HP in the medical curriculum for a greater dissemination of information on the disease, allowing its early diagnosis and related to the intensity of sweating in its therapeutic approach.

Effect of aqueous extract of the leaves of Baccharis trimera on the proliferation of hepatocytes after partial hepatectomy in rats

Abstract Purpose: To evaluate the effect of aqueous extract of Baccharis trimera leaves on the proliferative capacity of the liver after partial hepatectomy (PH) in rats. Methods: Twenty Wistar rats weighing between 300 and 450g were divided into two groups: control (HP) and test (HP100-rats that received the aqueous extract of Baccharis trimera for four days at a dose of 100 mg / kg / day). On the fifth day, animals from both groups underwent resection of 70% of the liver. Twenty-four hours later, they were sacrificed and the remnant liver was removed and prepared for studied through PCNA immunohistochemistry. Data analysis for comparison between the two groups was made through the non-parametric statistical test Mann-Whitney test. Results: In all the animals studied was found most abundant nuclear immunostaining positive hepatocytes interlobular located in regions of the liver. Quantitative analysis of PCNA-positive cells revealed positivity rate significantly higher mean (p = 0.02) in HP100 group (77.1 ± 13.6) compared to the HP group (45.8 ± 12.9). Conclusion: DAdministration of aqueous extract of the leaves of Baccharis trimera 100 mg/kg of animal has a significant positive effect on liver regeneration in rats, 24 hours after hepatectomy (70%).