Grupo operativo para hipertensos e diabéticos: resultados da interrupção das atividades devido a pandemia de COVID-19 / Group process for hypertensive and diabetic patients: results of the interruption of activities due to the COVID-19 pandemic

A pandemia da COVID-19 provocada, pelo SARS-CoV-2, levou a humanidade ao estabelecimento do isolamento social. Tal contexto acarretou fragilidades na realização de ações coletivas nos denominados Grupos Operativos da Atenção Primária em Saúde (APS). Esta pesquisa teve como objetivo analisar a contribuição do processo grupal para hipertensos e diabéticos na APS frente a interrupção das atividades coletivas durante a pandemia da COVID-19. Para tal, utilizou-se o limite geopolítico do município Paraopeba/MG e, como amostra, todos os usuários pertencentes ao território da UBS Papa João Paulo II, com laudo médico de hipertensão arterial sistêmica e diabetes mellitus tipo, que participavam regularmente das atividades do grupo operativo para hipertensos/diabéticos, entre o período de 2018 a 2021. Para realização desta pesquisa optou-se pela abordagem quali-quantitativa. Para a abordagem qualitativa, realizou-se uma análise a partir de fontes documentais do município e dados do IBGE, para caracterizar o município de forma macro quanto aos seus aspectos sociais, ambientais, econômicos e de saúde. Já para caracterização da população hipertensa, diabética e das atividades desenvolvidas no Grupo Operativo, foi realizado uma análise descritiva de forma micro, dos participantes do Grupo Operativo da UBS Papa João Paulo II. Para tal análise, recorreu-se a fonte documental e relatórios disponíveis no município e na UBS que registravam a situação de saúde de hipertensos, diabéticos e a realização das atividades. O método quantitativo foi do tipo longitudinal retrospectivo, por meio da consulta e acompanhamento longitudinal de dados retrospectivos referentes à pressão arterial sistólica, diastólica e da glicemia capilar. Utilizou-se dados coletados do cartão municipal do hipertenso, cartão municipal do diabético e do prontuário físico e/ou eletrônico do cidadão (PEC), dos participantes do Grupo Operativo da UBS Papa João Paulo II de Paraopeba/MG. Assim sendo, a amostra foi composta por 36 indivíduos hipertensos, que tiveram acompanhamento referente aos níveis pressóricos, sendo que quatorze destes indivíduos também eram diabéticos que, além do acompanhamento dos níveis pressóricos, tiveram acompanhamento dos seus glicêmicos. Os resultados obtidos permitiram verificar que os níveis de pressão sistólica aumentaram significativamente no período pandêmico, enquanto o diastólico manteve-se estável. Apesar disso, os valores, tanto sistólicos quanto diastólicos, estiveram dentro da faixa considerada como pressão não elevada. Quanto aos níveis glicêmicos, não houve diferença significativa, mas estes se mantiveram altos nos dois períodos comparados. Sendo assim, a interrupção das atividades regulares do Grupo Operativo durante a pandemia parece ter tido efeito no controle da hipertensão arterial e diabetes mellitus, haja vista que não houve melhora significativa nos níveis pressóricos e glicêmicos. Com efeito, foi percebida a necessidade de normatização dos trabalhos do grupo operativo de hipertensão/diabetes, por meio de planejamento, acompanhamento e avaliação das ações educativas, com o propósito de orientar o processo de aprendizagem dos participantes para o manejo adequado dos seus problemas de saúde.

The COVID-19 pandemic, caused by SARS-CoV-2, has led to socialisolation. This context demanded the interruption of collective actions in the so- called Primary Health Care (PHC) operative groups. This research aimed to analyze the contribution of the operative group for hypertensive and diabetic PHC patients in view of the interruption of group activities during the COVID-19 pandemic. This study was restricted to the geopolitical boundary of the municipality of Paraopeba/MG and included all users belonging to the territory of the UBS Papa João Paulo II, with a medical report of systemic arterial hypertension and type 2 diabetes mellitus, whoregularly participated in the activities of an operative group for hypertensive/diabetic patients, between the period of 2018 to 2021. To carry out this research, a qualitative-quantitative approach was chosen. For the qualitative approach, an analysis was carried out based on documentary sources from the municipality and data from the IBGE, to characterize the municipality in terms of its social, environmental, economic and health aspects. To the characterization of the hypertensive and diabetic population participating to the Operative Group of UBS Papa João Paulo II and the activities carried out in the Operative Group, a descriptive analysis was carried out. To this analysis, we accessed documents and reports available in the city and in the UBS records, including the health status of hypertensive and diabetic patients and the performance of activities. The quantitative method was a retrospective longitudinal type, through the consultation and follow-up data on systolic and diastolic blood pressure, and capillary blood glucose. We accessed data from the municipal hypertensive patient's passbook, the diabetics passbook and the physical and/or electronic medical records of citizens (PEC). Therefore, the sample consisted of 36 hypertensive individuals, who had their blood pressure levels monitored. The results obtained allowed verifying that the levels of systolic pressure increased significantly in the pandemic period, while the diastolic pressure remained stable. Despite this, both systolic and diastolic values were within the range considered as non-elevated pressure. Concerning the glycemic levels, there was no significant difference, but these remained high in the two compared periods. Therefore, the interruption of the regular activities of the operative group during the pandemic seems to have had an effect on the control of arterial hypertension and diabetes mellitus, given that there was no significant improvement in blood pressure and glucose levels. Indeed, the need to standardize the work of the hypertension/diabetes operative group was perceived, through planning, monitoring and evaluation of educational actions, with the purpose of guiding the participants' learning process towards the adequate management of their health problems.

Metals in the soil of urban cemeteries in Carazinho (South Brazil) in view of the increase in deaths from COVID-19: projects for cemeteries to mitigate environmental impacts.

The increasing mortality of COVID-19 can aggravate soil contamination by metals, harmful to the health of the population, requiring new projects for future cemeteries capable of mitigating these impacts to the environment, justifying the importance of studying the concentrations of metals in the soil of urban cemeteries. The paper analyzed the levels of metals in the soil of urban cemeteries in the City of Carazinho, in the state of Rio Grande do Sul, located in southern Brazil, considering the increase in deaths by COVID-19, for the purpose of future projects for cemeteries aimed at mitigating the impacts generated on the environment. The soils of the three urban cemeteries in Carazinho were sampled, with 5 internal and external points, with 3 repetitions at depths of 0-20 and 20-40 cm, adding 180 samples to measure the concentrations of Fe, Mn, Cu, Zn, Cr and Pb (g kg-1), considering the analytical sequence: (1) analysis in triplicate with mean deviation (RDS); (2) R2 of the analytical curve; (3) traceability of the pattern of each metal; (4) quantification limit of each metal (QL), with the performance of nitroperchloric digestion of the samples and the determinations of metals by flame modality atomic absorption spectrometry. Quantitative data on deaths by COVID-19 were analyzed by univariate modeling of time series, in the integrated autoregressive moving averages model. The results of this study were made available to fifteen architects, who attributed future solutions for environmentally sustainable cemeteries. The results showed high levels of copper (Cu) and iron (Fe) in the soil of the cemeteries studied. Considering the increase in deaths and subsequent burials per COVID-19 revealed a prediction for the death toll of 6,082,306 for June 9, 2022, it is assumed that metal contamination can reach even higher levels. To mitigate these levels of contamination by metals, 80% of the architect respondents expressed their preference for a vertical cemetery, with treatment of gases and effluents to mitigate environmental impacts.

Hamartoma condromatoso de parede torácica: relato de caso / Chondromatous chest wall hamartoma: case report

"O hamartoma condromatoso (HC) é um tipo raro de tumor benigno de cartilagem que se origina nos primeiros anos de vida. Na maioria das vezes seu sítio primário é o gradil torácico e pode ou não ter sintomatologia. Suas características histológicas mostram proliferação do tecido conjuntivo cartilaginoso associado a cistos de células ósseas. É de difícil diagnóstico devido sua apresentação histológica. Neste trabalho é relatado um caso de HC e sua evolução"

"Chondromatous hamartoma (HC) is a rare type of benign cartilage tumor that originates in the first years of life. Most of the time its primary site is the thoracic bar and may or may not have symptoms. Its histological characteristics show proliferation of cartilaginous connective tissue associated with bone cell cysts. It is difficult to diagnose due to its histological presentation. This work reports a case of HC and its evolution"

How to Achieve Facial Balance by Mandibular Contouring Ostectomy in Hemimandibular Hyperplasia.

Hemimandibular hyperplasia is a rare type of condylar hyperplasia which leads to facial asymmetry. Its surgical correction may be challenging since it usually requires complex mandibular osteotomies. Mandibular inferior border ostectomy is poorly described in the literature. The aim of this report is to present a new surgical technique guided by a customized surgical splint manufactured using computer-aided design/computer-aided manufacturing technology. Very good aesthetic results are achieved as it is very precise.

Síndrome de Down: aspectos citogenéticos, clínicos epidemiológicos / Down syndrome: cytogenetic aspects, clinical and epidemiological

Objetivo: descrever os perfis citogenético, clínico e epidemiológico dos pacientes que possuemSíndrome de Down matriculados no Hospital Universitário Bettina Ferro de Souza, período de 2002 a2011. Método: estudo transversal de 156 prontuários. Foram analisadas variáveis de identificação,sócio-demográficas, de gestação, parto e nascimento, clínicas, citogenéticas, de comorbidades, deexames, de tratamento e de seguimento multiprofissional. Utilizou-se o programa BioEstat 5.0 parafazer a análise estatística. Resultados: a maioria dos pacientes pertencia ao sexo masculino (54,49%),entre 0 a 2 anos (57,05%), com média de idade de 4 anos e procedentes da Região Metropolitana deBelém (67,95%). As alterações fenotípicas mais vistas foram: pregas epicânticas (77,56%), alteraçãoauricular (69,87%), macroglossia (50,64%), alteração nasal (46,15%) e fendas palpebrais oblíquas(45,51%). O cariótipo mostrou 90,9% de trissomia livre, 6,07% de translocação e 3,03% demosaicismo. Destacaram-se como principais antecedentes pessoais: internação hospitalar (48,71%),IVAS (44,87%), cardiopatias congênitas (42,94%) e pneumonia (33,97%). Realizou-se reabilitaçãomultiprofissional em 69,87% dos casos. Constatou-se a evolução com o desfecho ao óbito em 1,28%dos casos. Conclusões: As informações obtidas neste estudo evidenciaram a diversidade que aSíndrome de Down possui e por isso a necessidade de aprimoramento e ampliação dos serviçosmultiprofissionais ofere

Objective: to describe the cytogenetic profile, and clinical-epidemiological study of patients who haveDown syndrome enrolled in the University Hospital Bettina Ferro de Souza, from 2002 to 2011.Method: cross-sectional study of 156 medical records. Were analyzed variables of identification,socio-demographics, pregnancy, labor and birth, clinical, cytogenetic, comorbidities; examinations;and multidisciplinary rehabilitation. We used the program BioEstat 5.0 to statistical analysis. Results:most patients belonged to males (54.49%), between 0-2 years (57.05%), with a mean age of 4 yearsand resident the Metropolitan Region of Belém (67.95%). The phenotypic changes most common:epicanthal folds (77.56%), ear alteration (69.87%), large tongue (50.64%), nasal alteration (46.15%)and oblique palpebral fissures (45.51%). The karyotype showed 90.9% of free trisomy, 6.07% oftranslocation and 3.03% of mosaicism. Stood out as major personal history of hospitalization(48.71%), upper respiratory infections (44.87%), congenital heart disease (42.94%) and pneumonia(33.97%). The multidisciplinary rehabilitation occurred in 69.87% of cases. It was found developmentswith the outcome to death in 1.28% of cases. Conclusions: the informations obtained in this studyshowed the diversity that has the Down syndrome and therefore the need for improvement andexpansion of multidisciplinary services offered.

Orthodontic-orthognathic surgical treatment in a patient with Class II subdivision malocclusion: occlusal plane alteration.

Despite the different orthodontic treatment options for patients with Class II subdivision malocclusions, the involvement of the skeletal structures is significant. It is desirable to combine orthodontic and surgical treatment to achieve a stable and better esthetic result, as illustrated in this case report. The occlusal plane was canted to the right as a part of the patient's facial asymmetry. Consequently, a 3-mm differential impaction of the maxilla on the left side allowed occlusal plane leveling. Mandibular rotation with advancement on the right side corrected the right Class II malocclusion. The successful attainment of the treatment goals was accomplished through teamwork and integration between the orthodontist and the maxillofacial surgeon.

Disostose cleidocraniana - relato de um caso clínico com abordagem multidisciplinar / Cleidocranial dysostosis - case report of a multidisciplinary approach

A disostose cleidocraniana é uma síndrome genética rara, autossómica dominante. Neste caso particular, os muitos desafios dos tratamentos foram resolvidos por uma equipe odontológica, cujo traccionamento ortodôntico de dentes inclusos associados com a cirurgia ortognática bimaxilar foi o principal foco. O objectivo deste tratamento ortodôntico-cirúrgico foi restaurar a oclusão funcional e melhorar a estética facial, aproveitando a vantagem de todos os dentes impactados que caracterizam esta síndrome.

Cleidocranial dysostosis (CCD) is a rare genetic syndrome, autosomal dominant. In this paper a patient with cleidocranial dysostosis was treated under a multidisciplinary basis. Many treatment challenges were solved by a dental team, in which the orthodontic traction of unerupted teeth associated with bimaxilar surgery had the main focus. The aim of this surgical-orthodontic treatment was to restore the functional occlusion and to improve the facial aesthetics, taking advantage of all the impacted teeth which characterize this syndrome.