Diagnosis of metabolic syndrome in nursing professionals: An accuracy study.

Metabolic Syndrome (MetS) represents a group of cardiovascular risk factors. This article aims to evaluate the accuracy of the tools of MetS diagnosis in Nursing professionals from Primary Health Care (PHC) in Bahia, Brazil. A cross-sectional study with a random sample selected according to essential health information for the diagnostic of MetS. For MetS diagnostic, we used EGIR, NCEP-ATPIII, AACE, IDF, Barbosa et al. (2006), and IDF/AHA/NHLBI (defined as gold standard) definition. Sensitivity, specificity, predictive values, and likelihood ratio were estimated for each diagnostic tool and compared with the gold standard. Kappa statistic was used to determine the agreement between the diagnostic methods. One thousand one hundred and eleven nursing professionals were included in this study. Sensitivity varied from 15% to 95.1%, and specificity varied between 99.5% and 100%. IDF and Barbosa et al. (2006) definitions were more sensitive (95.1% and 92.8%, respectively), and EGIR, NCEP, ATP III, and IDF showed 100% specificity. IDF and Barbosa et al. (2006) use suitable metabolic syndrome identification and confirmation criteria. The highest agreement was found in the definition of the IDF, Barbosa et al. (2006) and the NCEP ATP III. Defining metabolic syndrome with a higher diagnostic accuracy could contribute to the screening and the early identification of nursing professionals with cardiovascular disease risk factors, which provide opportunities for appropriate prevention and treatment.

Conservative treatment of acute limb ischemia in a child - case report.

Acute limb ischemia is a rare event in the pediatric population, with an estimated incidence of 26 per 100,000 admissions, the majority of which are associated with trauma or iatrogeny. The ideal treatment for these cases is not well-established in the literature, although there is a tendency to choose noninvasive treatment. We report the case of an infant who suffered ischemia to all four limbs secondary to hemodynamic complications after complex heart surgery and in whom significant tissue preservation was achieved with conservative treatment.

Complications related to diabetic foot ulcer and associated social vulnerability factors at a referral centre in Brazil.

OBJECTIVE: To analyse the prevalence and associated social vulnerability factors of complications related to diabetic foot ulcer (DFU) among individuals followed up in a public care centre in Brazil. METHOD: This is a cross-sectional study carried out with individuals followed up at the diabetic foot service of the State Referral Center for Diabetes and Endocrinology Assistance (CEDEBA) between December 2019 and October 2020, during the COVID-19 pandemic. Descriptive analysis and comparison of the prevalence of complications related to DFU were carried out. The factors associated with the outcome variables were verified by hierarchical logistic regression analysis. RESULTS: Among the 253 participants in this study, 30.4% had an active ulcer, 57.1% had a previous ulcer and 45.1% had an amputation. Lower limb ulcers were positively associated with male sex (prevalence ratio (PR): 1.22 (1.04-1.43)) and negatively associated with age >60 years (PR: 0.71 (0.61-0.83)), screening for diabetic foot (PR: 0.79 (0.67-0.92)) and the use of public transport to access CEDEBA (PR: 0.82 (0.71-0.96)). On the other hand, amputations were positively associated with male sex (PR: 1.61 (1.23-2.11)) and not working (PR: 3.83 (1.48-9.95)) and negatively associated with age >60 years (PR: 0.57 (0.45-0.74)) and the use of public transport to access CEDEBA (PR: 0.63 (0.49-0.81)). CONCLUSION: The prevalence of complications was higher than in previous studies, and associated with sociodemographic and clinical characteristics. Further research should be encouraged to investigate the role that determinants of health play in the course of the disease, contributing to the construction of strategies that incorporate formulations developed in the social and economic spheres to broaden the impact of health actions on the prevention of major diabetic foot complications.

Prevalence and Factors Associated with Metabolic Syndrome in Patients at a Psychosocial Care Center: A Cross-Sectional Study.

BACKGROUND: Metabolic syndrome (MS) is associated with greater risk of morbimortality and it has high prevalence in people with mental illness. OBJECTIVE: Estimate the prevalence of Metabolic Syndrome (MS) and its associated factors in the patients of a Psychosocial Care Center (CAPS in Brazilian Portuguese) in the city of Salvador, state of Bahia, Brazil. METHOD: Cross-sectional study set at CAPS in the city of Salvador-Bahia between August 2019 and February 2020. MS was evaluated according to the National Cholesterol Education Program's Adult Treatment Panel III. In addition to descriptive statistics, gross and adjusted prevalence ratios were described. RESULTS: MS was found in 100 (35.2%) individuals, 116 (40.9%) were obese and 165 (58.1%) had increased waist circumference. Polypharmacy was identified in 63 (22.3%) patients and 243 (85.9%) used antipsychotics. Under gross evaluation, women (PR = 1.88; 95%CI: 1.35-2.63) and those who used antidepressants (PR = 1.41; 95%CI: 1.05-1.88) showed an association with MS. After logistic regression, depression (PR = 1.86; 95%CI: 1.38-2.51), acanthosis (PR = 1.50; 95%CI: 1.18-1.90), use of antipsychotics (PR = 1.88; 95%CI: 1.13-2.75), and hypertriglyceridemic waist (PR = 3.33; 95%CI: 2.48-4.46) were associated with MS. CONCLUSION: The prevalence of MS signals multimorbidity among individuals with mental disorders and suggests a need for clinical screening.

Tratamento conservador de isquemia aguda de extremidades em lactente - relato de caso / Conservative treatment of acute limb ischemia in a child - case report

Resumo A isquemia aguda de extremidades é um evento raro na população pediátrica, com incidência estimada em 26 a cada 100.000 internações, sendo a maioria associada a trauma ou iatrogenia. O tratamento ideal para esses quadros não está bem estabelecido pela literatura, havendo a tendência ao tratamento não invasivo. Relatamos o caso de uma lactente que apresentou isquemia dos quatro membros secundária a complicações hemodinâmicas após realização de cirurgia cardíaca complexa, apresentando preservação tecidual expressiva com o tratamento conservador.

Abstract Acute limb ischemia is a rare event in the pediatric population, with an estimated incidence of 26 per 100,000 admissions, the majority of which are associated with trauma or iatrogeny. The ideal treatment for these cases is not well-established in the literature, although there is a tendency to choose noninvasive treatment. We report the case of an infant who suffered ischemia to all four limbs secondary to hemodynamic complications after complex heart surgery and in whom significant tissue preservation was achieved with conservative treatment.

Demographic and professional profile of Brazilian women in vascular surgery: final results.

BACKGROUND: Gender diversity in health teams is associated with better productivity. As women's participation in surgery has been growing, it is important to improve knowledge about the elements that guide their professional development. OBJECTIVES: The aim of this study was to outline the demographic and professional features of female vascular surgeons in Brazil. METHODS: A cross-sectional study was designed, in which a questionnaire was made available online for 60 days. Invitations to participate were distributed by institutional e-mail sent from the Brazilian Society of Angiology and Vascular Surgery (SBACV) to associate women surgeons. Results are presented as numbers and percentages. Odds ratios and chi-square tests were used for analysis. RESULTS: From a total of 810 invitations sent out, 281 questionnaires were completed. The most prevalent age groups were 25-35 years (n = 115) and 36-45 years (n = 114). Among those who worked exclusively in the private sector, 79.8% had at least one board certification (OR: 0.76, 95% CI: 0.65-0.89; p = 0.001). Regarding workload distribution, 64.4% and 34.2% reported that they spend more time in the clinic and hospital, respectively. Respondents with more years of experience reported a predominance of office practice (p = 0.002). Although 67.3% (n = 189) had published scientific papers, 68% (n = 191) had never held leadership roles. CONCLUSIONS: The study respondents consisted of highly qualified women surgeons with respect to training, certification, and scientific engagement, but they remain underrepresented in professional management positions. Surgical societies and health institutions should act to promote inclusive and diverse leadership.

CONTEXTO: A diversidade de gênero em equipes médicas está associada a uma melhor produtividade. Com o aumento da participação feminina na cirurgia, é importante conhecer melhor os elementos que orientam o desenvolvimento dessas profissionais. OBJETIVOS: Delinear as características demográficas e profissionais das cirurgiãs vasculares no Brasil. MÉTODOS: Estudo de caráter transversal, em que foi disponibilizado um questionário on-line por 60 dias. O convite foi enviado pelo e-mail institucional da Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV) às cirurgiãs associadas. Os resultados são apresentados como números e porcentagens. Os testes de odds ratio (OR) e do qui-quadrado foram utilizados para a análise. RESULTADOS: De 810 convites enviados, 281 questionários foram respondidos. Os grupos etários predominantes foram 25-35 anos (n = 115) e 36-45 anos (n = 114). Entre as que trabalhavam exclusivamente no setor privado, 79,8% possuíam ao menos um Título de Especialista (OR: 0,76; intervalo de confiança de 95% 0,65-0,89; p = 0,001). Em relação à distribuição da carga horária, 64,4% e 34,2% relataram que passavam mais tempo no ambulatório e no hospital, respectivamente. Entre as com mais anos de experiência, houve predomínio da prática em consultório (p = 0,002). Embora 67,3% (n = 189) tenham publicado artigos científicos, 68% (n = 191) nunca ocuparam cargos de liderança. CONCLUSÕES: As participantes do estudo consistiram em cirurgiãs altamente qualificadas em relação a treinamento, certificação e engajamento científico. No entanto, permanecem pouco representadas em cargos de gestão profissional. As sociedades cirúrgicas e as instituições de saúde devem agir para promover uma liderança inclusiva e diversa.

The Prevalence of Abdominal Adiposity among Primary Health Care Physicians in Bahia, Brazil: An Epidemiological Study.

BACKGROUND: Labor activities are demanding for workers and can induce occupational stress. Primary health care (PHC) workers have faced problems that can lead to the development of stress and abdominal obesity. The aim of this study was to estimate the prevalence of abdominal adiposity among primary health care physicians in the metropolitan mesoregion of Salvador, Bahia. METHODS: This is a cross-sectional study conducted with physicians from the family health units (FHUs) of the metropolitan mesoregion of Salvador, Bahia, Brazil. The number of FHUs corresponded to 41 teams (52 physicians). Anamnesis was performed and a questionnaire was applied. The clinical examination consisted of measuring waist circumference (WC), blood pressure levels (BP), and body mass index (BMI), as well as examining for acanthosis nigricans. Blood samples were collected for biochemical dosages. The data obtained were analyzed by SPSS version 22.0. RESULTS: The sample included 41 physicians (response rate: 78.8%), of which 18 were women (44.0%). The percentage of overweight participants represented by BMI was 31.7%. The hypertriglyceridemia prevalence was 29.2%. HDL-c was low in 48.7% of the participants. The waist circumference measurement revealed a prevalence of abdominal adiposity of 38.8% (women) and 34.8% (men). CONCLUSIONS: Medical professionals in PHC are more susceptible to having higher abdominal adiposity, especially female physicians.

In-hospital mortality in patients with acute limb ischemia over a 12-year period in the Brazilian public health-care system.

BACKGROUND: Arterial diseases represent a severe public health problem in the 21st century. Although men have a higher overall prevalence, reports have suggested that women may exhibit atypical manifestations, be asymptomatic, and have hormonal peculiarities, resulting in worse outcomes and severe emergencies, such as acute limb ischemia (ALI). OBJECTIVES: To analyze the morbidity and mortality profile of ALI emergencies in Brazil between 2008 and 2019. METHODS: An ecological study was carried out with secondary data from SIH/SUS, using ICD-10 code I.74 The proportions of emergency hospital admissions and in-hospital mortality rates (HMR) by gender, ethnicity, and age were extracted from the overall figures. P<0.05 was considered significant. RESULTS: From 2008 to 2019, there were 195,567 urgent hospitalizations due to ALI in Brazil, 111,145 (56.8%) of which were of men. Women had a higher HMR (112:1,000 hospitalizations) than men (85:1,000 hospitalizations) (p<0.05), and a higher chance of death (OR=1.36; p<0.05). Furthermore, mean survival was significantly higher among men (8,483/year versus 6,254/year; p<0.05). Stratified by ethnicity, women who self-identified as white (OR=1.44; p<0.05), black (OR=1.33; p<0.05), and brown (RR=1.25; p <0.05) had greater chances of death than men in the same ethnicity categories. Moreover, women over the age of 50 years had a higher chance of death, with a progressive increment in risk as age increased. CONCLUSIONS: There was a trend to worse prognosis in ALI emergencies associated with women, especially in older groups. The literature shows that the reasons for these differences are still poorly investigated and more robust studies of this relevant disease in the area of vascular surgery are encouraged.

CONTEXTO: Doenças arteriais representam um grave problema de saúde pública no século XXI. Apesar de homens apresentarem maior prevalência geral, estudos sugerem que mulheres podem cursar com quadros assintomáticos, clínica atípica e particularidades hormonais, que resultam em desfechos desfavoráveis e urgências graves, como oclusões arteriais aguda (OAA). OBJETIVOS: Analisar o perfil de morbimortalidade das urgências em OAA no Brasil entre 2008 e 2019. MÉTODOS: Realizou-se estudo ecológico com dados secundários do Sistema de Informações Hospitalares/Sistema Único de Saúde, utilizando-se o código I.74 do Código Internacional de Doenças-10. Dos números absolutos, obteve-se proporções de internamentos de urgência e taxa de mortalidade intra-hospitalar (TMH) por gênero, etnia e idade. Considerou-se p < 0,05 significativo. RESULTADOS: Entre 2008 e 2019, houve 195.567 internamentos de urgência por OAA no Brasil, dos quais 111.145 (56,8%) eram homens. Mulheres tiveram maior TMH (112:1.000 hospitalizações) em comparação a homens (85:1.000 hospitalizações) (p < 0,05), assim como maior chance de morte (odds ratio [OR] = 1,36; p < 0,05). Ademais, a média de sobrevida anual foi maior entre homens do que entre mulheres (8.483/ano vs. 6.254/ano, respectivamente; p < 0,05). Estratificando por etnia, mulheres apresentaram maior chance de óbitos entre brancas (OR = 1,44; p < 0,05), pretas (OR = 1,33; p < 0,05) e pardas (razão de risco [RR] = 1,25; p < 0,05), comparadas a homens das mesmas etnias. Nas análises etárias, mulheres com mais de 50 anos apresentaram maior chance de óbito, com aumento progressivo do risco com o envelhecimento. CONCLUSÕES: Nossas análises comparativas evidenciaram tendência de pior prognóstico nas urgências em OAA associadas a mulheres, sobretudo em grupos de idade avançada. A literatura evidencia que as razões para essas diferenças ainda são pouco estudadas, estimulando investigações mais robustas sobre essa importante casuística da cirurgia vascular.

Demographic and professional profile of Brazilian women in vascular surgery: final results / Perfis demográfico e profissional de mulheres brasileiras na cirurgia vascular: resultados finais

Abstract Background Gender diversity in health teams is associated with better productivity. As women's participation in surgery has been growing, it is important to improve knowledge about the elements that guide their professional development. Objectives The aim of this study was to outline the demographic and professional features of female vascular surgeons in Brazil. Methods A cross-sectional study was designed, in which a questionnaire was made available online for 60 days. Invitations to participate were distributed by institutional e-mail sent from the Brazilian Society of Angiology and Vascular Surgery (SBACV) to associate women surgeons. Results are presented as numbers and percentages. Odds ratios and chi-square tests were used for analysis. Results From a total of 810 invitations sent out, 281 questionnaires were completed. The most prevalent age groups were 25-35 years (n = 115) and 36-45 years (n = 114). Among those who worked exclusively in the private sector, 79.8% had at least one board certification (OR: 0.76, 95% CI: 0.65-0.89; p = 0.001). Regarding workload distribution, 64.4% and 34.2% reported that they spend more time in the clinic and hospital, respectively. Respondents with more years of experience reported a predominance of office practice (p = 0.002). Although 67.3% (n = 189) had published scientific papers, 68% (n = 191) had never held leadership roles. Conclusions The study respondents consisted of highly qualified women surgeons with respect to training, certification, and scientific engagement, but they remain underrepresented in professional management positions. Surgical societies and health institutions should act to promote inclusive and diverse leadership.

Resumo Contexto A diversidade de gênero em equipes médicas está associada a uma melhor produtividade. Com o aumento da participação feminina na cirurgia, é importante conhecer melhor os elementos que orientam o desenvolvimento dessas profissionais. Objetivos Delinear as características demográficas e profissionais das cirurgiãs vasculares no Brasil. Métodos Estudo de caráter transversal, em que foi disponibilizado um questionário on-line por 60 dias. O convite foi enviado pelo e-mail institucional da Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV) às cirurgiãs associadas. Os resultados são apresentados como números e porcentagens. Os testes de odds ratio (OR) e do qui-quadrado foram utilizados para a análise. Resultados De 810 convites enviados, 281 questionários foram respondidos. Os grupos etários predominantes foram 25-35 anos (n = 115) e 36-45 anos (n = 114). Entre as que trabalhavam exclusivamente no setor privado, 79,8% possuíam ao menos um Título de Especialista (OR: 0,76; intervalo de confiança de 95% 0,65-0,89; p = 0,001). Em relação à distribuição da carga horária, 64,4% e 34,2% relataram que passavam mais tempo no ambulatório e no hospital, respectivamente. Entre as com mais anos de experiência, houve predomínio da prática em consultório (p = 0,002). Embora 67,3% (n = 189) tenham publicado artigos científicos, 68% (n = 191) nunca ocuparam cargos de liderança. Conclusões As participantes do estudo consistiram em cirurgiãs altamente qualificadas em relação a treinamento, certificação e engajamento científico. No entanto, permanecem pouco representadas em cargos de gestão profissional. As sociedades cirúrgicas e as instituições de saúde devem agir para promover uma liderança inclusiva e diversa.

In-hospital mortality in patients with acute limb ischemia over a 12-year period in the Brazilian public health-care system / Mortalidade hospitalar na saúde pública brasileira em pacientes com isquemia aguda dos membros em um período de 12 anos

Abstract Background Arterial diseases represent a severe public health problem in the 21st century. Although men have a higher overall prevalence, reports have suggested that women may exhibit atypical manifestations, be asymptomatic, and have hormonal peculiarities, resulting in worse outcomes and severe emergencies, such as acute limb ischemia (ALI). Objectives To analyze the morbidity and mortality profile of ALI emergencies in Brazil between 2008 and 2019. Methods An ecological study was carried out with secondary data from SIH/SUS, using ICD-10 code I.74 The proportions of emergency hospital admissions and in-hospital mortality rates (HMR) by gender, ethnicity, and age were extracted from the overall figures. P<0.05 was considered significant. Results From 2008 to 2019, there were 195,567 urgent hospitalizations due to ALI in Brazil, 111,145 (56.8%) of which were of men. Women had a higher HMR (112:1,000 hospitalizations) than men (85:1,000 hospitalizations) (p<0.05), and a higher chance of death (OR=1.36; p<0.05). Furthermore, mean survival was significantly higher among men (8,483/year versus 6,254/year; p<0.05). Stratified by ethnicity, women who self-identified as white (OR=1.44; p<0.05), black (OR=1.33; p<0.05), and brown (RR=1.25; p <0.05) had greater chances of death than men in the same ethnicity categories. Moreover, women over the age of 50 years had a higher chance of death, with a progressive increment in risk as age increased. Conclusions There was a trend to worse prognosis in ALI emergencies associated with women, especially in older groups. The literature shows that the reasons for these differences are still poorly investigated and more robust studies of this relevant disease in the area of vascular surgery are encouraged.

Resumo Contexto Doenças arteriais representam um grave problema de saúde pública no século XXI. Apesar de homens apresentarem maior prevalência geral, estudos sugerem que mulheres podem cursar com quadros assintomáticos, clínica atípica e particularidades hormonais, que resultam em desfechos desfavoráveis e urgências graves, como oclusões arteriais aguda (OAA). Objetivos Analisar o perfil de morbimortalidade das urgências em OAA no Brasil entre 2008 e 2019. Métodos Realizou-se estudo ecológico com dados secundários do Sistema de Informações Hospitalares/Sistema Único de Saúde, utilizando-se o código I.74 do Código Internacional de Doenças-10. Dos números absolutos, obteve-se proporções de internamentos de urgência e taxa de mortalidade intra-hospitalar (TMH) por gênero, etnia e idade. Considerou-se p < 0,05 significativo. Resultados Entre 2008 e 2019, houve 195.567 internamentos de urgência por OAA no Brasil, dos quais 111.145 (56,8%) eram homens. Mulheres tiveram maior TMH (112:1.000 hospitalizações) em comparação a homens (85:1.000 hospitalizações) (p < 0,05), assim como maior chance de morte (odds ratio [OR] = 1,36; p < 0,05). Ademais, a média de sobrevida anual foi maior entre homens do que entre mulheres (8.483/ano vs. 6.254/ano, respectivamente; p < 0,05). Estratificando por etnia, mulheres apresentaram maior chance de óbitos entre brancas (OR = 1,44; p < 0,05), pretas (OR = 1,33; p < 0,05) e pardas (razão de risco [RR] = 1,25; p < 0,05), comparadas a homens das mesmas etnias. Nas análises etárias, mulheres com mais de 50 anos apresentaram maior chance de óbito, com aumento progressivo do risco com o envelhecimento. Conclusões Nossas análises comparativas evidenciaram tendência de pior prognóstico nas urgências em OAA associadas a mulheres, sobretudo em grupos de idade avançada. A literatura evidencia que as razões para essas diferenças ainda são pouco estudadas, estimulando investigações mais robustas sobre essa importante casuística da cirurgia vascular.

Thromboprophylaxis during the Pregnancy-Puerperal Cycle - Literature Review.

OBJECTIVE: To identify current strategies and recommendations for venous thromboembolism prophylaxis associated with the pregnancy-puerperal cycle, a condition of high morbidity and mortality among women. METHODS: The literature search was performed between May and October 2019, using the PubMed database, including papers published in Portuguese, English and Spanish. The terms thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) were used as descriptors, including randomized controlled trials, meta-analyses, systematic reviews and guidelines published from 2009 to 2019, presenting strategies for prevention of thromboembolism during pregnancy and the postpartum. RESULTS: Eight articles met the inclusion criteria. Many studies evaluated were excluded because they did not address prevention strategies. We compiled the recommendations from the American Society of Hematologists, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada, the American College of Chest Physicians and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. CONCLUSION: There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period. Thus, the attention of the professionals involved in the care of pregnant and postpartum women is crucial, as it is a condition associated with high morbidity and mortality.

OBJETIVO: Identificar as estratégias e recomendações atuais para profilaxia de tromboembolismo venoso associado ao ciclo gravídico-puerperal, condição de alta morbimortalidade entre mulheres. MéTODOS: A busca na literatura ocorreu entre maio e outubro de 2019, com pesquisa na base de dados do PubMed, contemplando trabalhos publicados nos idiomas português, inglês e espanhol. Os termos thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) foram utilizados como descritores, incluindo ensaios clínicos randomizados, metanálises, revisões sistemáticas e diretrizes publicadas entre 2009 a 20019, apresentando estratégias de prevenção de tromboembolismo venoso durante a gravidez e o pós-parto. RESULTADOS: Oito artigos abordando estratégias de tromboprofilaxia primária e secundária durante a gestação, parto e puerpério foram selecionados para a presente revisão sistemática. Muitos estudos avaliados foram excluídos por não abordarem estratégias de prevenção. Foram compiladas as recomendações das seguintes sociedades: American Society of Hematologists, American College of Obstetricians and Gynecologists, Royal College of Obstetricians and Gynecologists, Society of Obstetricians and Gynaecologists of Canada, American College of Chest Physicians e Royal Australian and New Zealand College of Obstetricians and Gynaecologists. CONCLUSãO: Até o presente momento, há algumas lacunas e estudos clínicos com metodologia adequada se fazem necessários para respaldar a tomada de decisão frente ao risco de tromboembolismo venoso no período perigestacional. Torna-se fundamental a atenção dos profissionais envolvidos no atendimento às gestantes e puérperas, pois trata-se de uma condição associada a alta morbimortalidade.

Thromboprophylaxis during the pregnancy-puerperal cycle - literature review / Tromboprofilaxia no ciclo gravídico-puerperal - revisão da literatura

Abstract Objective To identify current strategies and recommendations for venous thromboembolism prophylaxis associated with the pregnancy-puerperal cycle, a condition of high morbidity and mortality among women. Methods The literature search was performed between May and October 2019, using the PubMed database, including papers published in Portuguese, English and Spanish. The terms thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) were used as descriptors, including randomized controlled trials, meta-analyses, systematic reviews and guidelines published from 2009 to 2019, presenting strategies for prevention of thromboembolism during pregnancy and the postpartum. Results Eight articles met the inclusion criteria. Many studies evaluated were excluded because they did not address prevention strategies. We compiled the recommendations from the American Society of Hematologists, the American College of Obstetricians and Gynecologists, the Royal College of Obstetricians and Gynecologists, the Society of Obstetricians and Gynaecologists of Canada, the American College of Chest Physicians and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Conclusion: There are some gaps in the research, and clinical studies with appropriate methodology are needed to support decisions made regarding the risk of thromboembolism in the perigestational period. Thus, the attention of the professionals involved in the care of pregnant and postpartum women is crucial, as it is a condition associated with high morbidity and mortality.

Resumo Objetivo Identificar as estratégias e recomendações atuais para profilaxia de tromboembolismo venoso associado ao ciclo gravídico-puerperal, condição de alta morbimortalidade entre mulheres. Métodos A busca na literatura ocorreu entre maio e outubro de 2019, com pesquisa na base de dados do PubMed, contemplando trabalhos publicados nos idiomas português, inglês e espanhol. Os termos thromboembolism (Mesh) AND pregnancy (Mesh) OR postpartum (Mesh) foram utilizados como descritores, incluindo ensaios clínicos randomizados, metanálises, revisões sistemáticas e diretrizes publicadas entre 2009 a 20019, apresentando estratégias de prevenção de tromboembolismo venoso durante a gravidez e o pós-parto. Resultados Oito artigos abordando estratégias de tromboprofilaxia primária e secundária durante a gestação, parto e puerpério foram selecionados para a presente revisão sistemática. Muitos estudos avaliados foram excluídos por não abordarem estratégias de prevenção. Foram compiladas as recomendações das seguintes sociedades: American Society of Hematologists, American College of Obstetricians and Gynecologists, Royal College of Obstetricians and Gynecologists, Society of Obstetricians and Gynaecologists of Canada, American College of Chest Physicians e Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Conclusão Até o presente momento, há algumas lacunas e estudos clínicos com metodologia adequada se fazem necessários para respaldar a tomada de decisão frente ao risco de tromboembolismo venoso no período perigestacional. Torna-se fundamental a atenção dos profissionais envolvidos no atendimento às gestantes e puérperas, pois trata-se de uma condição associada a alta morbimortalidade.

Women in vascular surgery: a brief analysis of the Brazilian profile.

BACKGROUND: There has been a striking increase in female participation in the Brazilian and worldwide medical contingent, but the number of female surgeons does not follow the same trend. In addition to quantitative analysis, there is a need for further study of the determinants of choice of surgical specialty and the characteristics of professional practice. OBJECTIVES: To outline the profile of female vascular surgeons in Brazil in terms of demographic characteristics, qualifications, scientific engagement, and labor market integration. METHODS: A survey was made available online for 30 days and its link was widely circulated among female vascular surgeons. At the end of data collection, 101 valid questionnaires had been returned and their data were tabulated in Microsoft Excel spreadsheets for simple descriptive analysis. RESULTS: The profile traced was of women aged up to 45 years who have been working in the area for up to 10 years. They were predominantly trained in medical residencies or internships recognized by the specialty board. Venous surgery, Esthetic Phlebology and Vascular Ultrasound were the major fields of activity for female vascular surgeons. Although they hold degrees and author scientific publications, the proportion of leadership positions held by women remains low. More than 64% of the participants reported feeling undervalued because they were women. CONCLUSIONS: Despite the limitations of the study population, this preliminary study confirms the idea that female vascular surgeons demonstrate continuous dedication to practicing their specialty and sets a precedent so that further studies can investigate the professional practice of female vascular surgeons in greater detail, stimulating discussion of gender inequalities in medical practice.

Mulheres na cirurgia vascular: uma breve análise do perfil brasileiro / Women in vascular surgery: a brief analysis of the Brazilian profile

O aumento da participação feminina no contingente médico brasileiro e mundial tem sido notório; entretanto, o número de mulheres cirurgiãs não acompanha a mesma tendência. Além da análise quantitativa, os fatores determinantes da escolha pela especialidade cirúrgica e as características da atuação profissional necessitam de mais estudos. Objetivos: Delinear o perfil das cirurgiãs vasculares brasileiras no que diz respeito às características demográficas, grau de qualificação, engajamento científico e integração ao mercado de trabalho. Métodos: Um questionário eletrônico foi disponibilizado on-line durante 30 dias e teve seu link amplamente divulgado entre cirurgiãs vasculares. Após coleta, retornaram 101 questionários válidos, cujos dados foram tabulados em planilhas do Microsoft Excel para análise descritiva simples. Resultados: O perfil encontrado foi de mulheres com até 45 anos de idade que atuam na área por no máximo 10 anos. A formação foi predominantemente por meio de residência médica ou estágio reconhecido pela sociedade da especialidade. Cirurgia venosa, flebologia estética e ecografia vascular mostraram-se como principais campos de atuação para cirurgiãs vasculares. Apesar de possuírem titulação e publicações científicas, a sua representatividade nos cargos de liderança permanece baixa. Mais de 64% das participantes referiram sentimento de desvalorização profissional devido ao fato de serem mulheres. Conclusões: Apesar das limitações da população estudada, este estudo preliminar corrobora com a ideia de que as cirurgiãs vasculares demonstram uma contínua dedicação à especialidade e abre um precedente para que novas pesquisas acessem os pormenores dessa atuação profissional, fomentando a discussão sobre as desigualdades entre os gêneros no exercício da medicina

There has been a striking increase in female participation in the Brazilian and worldwide medical contingent, but the number of female surgeons does not follow the same trend. In addition to quantitative analysis, there is a need for further study of the determinants of choice of surgical specialty and the characteristics of professional practice. Objectives: To outline the profile of female vascular surgeons in Brazil in terms of demographic characteristics, qualifications, scientific engagement, and labor market integration. Methods: A survey was made available online for 30 days and its link was widely circulated among female vascular surgeons. At the end of data collection, 101 valid questionnaires had been returned and their data were tabulated in Microsoft Excel spreadsheets for simple descriptive analysis. Results: The profile traced was of women aged up to 45 years who have been working in the area for up to 10 years. They were predominantly trained in medical residencies or internships recognized by the specialty board. Venous surgery, Esthetic Phlebology and Vascular Ultrasound were the major fields of activity for female vascular surgeons. Although they hold degrees and author scientific publications, the proportion of leadership positions held by women remains low. More than 64% of the participants reported feeling undervalued because they were women. Conclusions: Despite the limitations of the study population, this preliminary study confirms the idea that female vascular surgeons demonstrate continuous dedication to practicing their specialty and sets a precedent so that further studies can investigate the professional practice of female vascular surgeons in greater detail, stimulating discussion of gender inequalities in medical practice.